传统物理疗法与奥塔哥运动方案预防老年 ALF 住院患者跌倒的疗效比较。
Efficacy of Traditional Physical Therapy Versus Otago-Based Exercise in Fall Prevention for ALF-Residing Older Adults.
机构信息
Doctor of Physical Therapy Program, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando.
Orlando Senior Health Network, Orlando, Florida.
出版信息
J Geriatr Phys Ther. 2021;44(4):210-218. doi: 10.1519/JPT.0000000000000285.
BACKGROUND AND PURPOSE
Falls are a leading cause of morbidity, mortality, loss of independence, and significant functional decline in aging populations. Effective interventions aimed at reducing the risk of falls, and preventing associated disability and functional decline, are needed to promote the health and wellness of older adults. Recent literature has found that an Otago-based exercise program (OBEP), which incorporates strengthening, balance, and walking, may not only decrease falls and fall risk among community-dwelling older adults but may also be effective among older adults residing in assisted living facilities (ALFs). The purpose of this study is to expand upon current research by comparing the outcomes of an OBEP and traditional physical therapy (TPT) in decreasing falls and the risk of falls among older adults living in an ALF. The authors hypothesized that traditional physical therapy would reduce fall risk and the number of falls in older adults residing in ALFs more than an OBEP.
METHODS
This study conducted a 2-group retrospective chart review of 59 older adults living in an ALF from January 2013 to October 2018 who received either TPT (n = 29) or the OBEP (n = 30). Participants were a mean of 87 years old and were classified at risk for falls by the Tinetti Performance-Oriented Mobility Assessment (POMA). Primary variables included the number of falls prior to intervention, during intervention, and 1 year following intervention, as well as pre- and posttreatment Tinetti POMA scores. Efficacy was examined using multiple linear regression analysis.
RESULTS AND DISCUSSION
Both groups achieved reduced falls and increased POMA scores. Group assignment did not significantly predict performance in key outcome measures, namely the number of falls (P = .199) and Tinetti POMA scores (P = .063) following treatment.
CONCLUSIONS
These findings indicated that both an OBEP and tpt may be effective interventions for reducing falls and fall risk in the ALF setting.
背景与目的
在老龄化人口中，跌倒已成为发病率、死亡率、丧失独立性和严重功能衰退的主要原因。需要采取有效的干预措施来降低跌倒风险，预防相关残疾和功能衰退，以促进老年人的健康和幸福。最近的文献发现，以奥塔戈为基础的锻炼计划（OBEP），结合了力量、平衡和行走，不仅可以降低社区居住的老年人跌倒和跌倒风险，而且对于居住在辅助生活设施（ALF）中的老年人也可能有效。本研究的目的是通过比较 OBEP 和传统物理疗法（TPT）在降低 ALF 中老年人跌倒和跌倒风险方面的效果，进一步扩展当前的研究。作者假设，与 OBEP 相比，传统物理疗法会降低 ALF 中老年人的跌倒风险和跌倒次数。
方法
本研究对 2013 年 1 月至 2018 年 10 月期间在 ALF 中接受 TPT（n = 29）或 OBEP（n = 30）治疗的 59 名年龄在 87 岁左右的 ALF 中老年人进行了回顾性 2 组图表回顾。参与者有跌倒风险，通过 Tinetti 表现为导向的移动评估（POMA）进行分类。主要变量包括干预前、干预期间和干预后 1 年的跌倒次数，以及治疗前后的 Tinetti POMA 评分。使用多元线性回归分析检查疗效。
结果与讨论
两组都减少了跌倒次数，提高了 POMA 评分。分组对关键结果测量的表现没有显著预测作用，即治疗后跌倒次数（P =.199）和 Tinetti POMA 评分（P =.063）。
结论
这些发现表明，OBEP 和 tpt 可能都是降低 ALF 中跌倒和跌倒风险的有效干预措施。
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