老年人因严重后凸畸形伴低体力活动导致的体力下降的运动干预后的体力变化的二次分析。
Secondary analysis of change in physical function after exercise intervention in older adults with hyperkyphosis and low physical function.
机构信息
Chronic Pain Management, San Francisco Kaiser Permanente Medical Center, 4141 Geary Blvd, Suite 212, San Francisco, CA, 94118, USA.
Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, 1500 Owens Street, Suite 400, San Francisco, CA, 94143, USA.
出版信息
BMC Geriatr. 2021 Feb 22;21(1):133. doi: 10.1186/s12877-021-02062-8.
BACKGROUND
Hyperkyphosis is common in older adults and associated with low physical function and reduced health related quality of life (HrQol). Improved kyphosis has been previously established in kyphosis-targeted interventions in randomized controlled trials in older adults with hyperkyphosis; however, evidence for improved physical function is conflicting. Few studies have investigated change in physical function after a targeted kyphosis intervention in older adults with low physical function. The primary aim in this descriptive study was to explore change in physical function after a progressive high-intensity 3-month targeted kyphosis exercise and posture training intervention in older adults with low physical function and hyperkyphosis. Secondary aims were to explore change in HrQol, spinal strength and spinal curvature, and adherence and safety of the intervention.
METHODS
In this secondary analysis of the Specialized Center of Research (SCOR) Kyphosis randomized trial, 101 community dwelling older men and women with hyperkyphosis who completed the intervention were divided into a low function group (LFG) and high function group (HFG). Baseline characteristics were compared between LFG and HFG. Physical function, HrQol, spinal strength and spinal curvature (kyphosis and lordosis) pre/post intervention change scores were explored within and between groups. Adherence and adverse events were examined in the LFG and HFG.
RESULTS
Twenty-six (26%) older adults were LFG, mean Short Phyiscal Performance Battery (SPPB) 9.62 (SD = 1.17) points. At baseline, the LFG was older than HFG (p = 0.005), experienced more pain, (p = 0.060), had worse physical function and HrQol (p ≤ 0.001), and comparable kyphosis (p = 0.640). SPPB changed 0.62 (95% CI: - 0.20 to 1.44) points in the LFG and - 0.04 (95%CI: - 0.28 to 0.19) points in the HFG, p = 0.020. Gait speed changed 0.04 (95% CI: - 0.02 to 0.10) m/s in the LFG. Kyphosis improved equally in both groups. Adherence to the intervention was 83% in the LFG and 79% in the HFG. There were no adverse events in either group.
CONCLUSIONS
Older adults with low physical function and hyperkyphosis may improve physical function after a kyphosis targeted intervention. Older adults with low physical function may safely participate in targeted high-intensity kyphosis exercise and posture training. This observation needs to be confirmed in larger adequately powered studies.
TRIAL REGISTRATION
Clinicaltrials.gov identifier: NCT01766674 .
背景
脊柱后凸在老年人中很常见，与身体机能降低和健康相关生活质量（HrQol）下降有关。在针对老年人脊柱后凸的随机对照试验中，脊柱后凸靶向干预措施已证实可改善脊柱后凸；然而，关于身体机能改善的证据存在矛盾。很少有研究调查针对身体机能降低的老年人进行脊柱后凸靶向干预后身体机能的变化。本描述性研究的主要目的是探讨身体机能降低且患有脊柱后凸的老年人接受为期 3 个月的渐进高强度脊柱后凸靶向运动和姿势训练干预后的身体机能变化。次要目的是探讨干预后 HrQol、脊柱力量和脊柱曲度以及依从性和安全性的变化。
方法
在专门研究中心（SCOR）脊柱后凸随机试验的二次分析中，101 名患有脊柱后凸且身体机能降低的社区居住的老年男性和女性完成了干预，他们被分为低功能组（LFG）和高功能组（HFG）。比较 LFG 和 HFG 之间的基线特征。在组内和组间探讨了干预前后物理功能、HrQol、脊柱力量和脊柱曲度（后凸和前凸）的变化得分。在 LFG 和 HFG 中检查了依从性和不良事件。
结果
26 名（26%）老年人为 LFG，平均短体生理表现测试（SPPB）为 9.62（SD=1.17）分。基线时，LFG 比 HFG 年龄更大（p=0.005），疼痛更严重（p=0.060），身体机能和 HrQol 更差（p≤0.001），脊柱后凸相当（p=0.640）。LFG 的 SPPB 变化 0.62（95%CI：-0.20 至 1.44）分，HFG 变化-0.04（95%CI：-0.28 至 0.19）分，p=0.020。LFG 的步态速度变化 0.04（95%CI：-0.02 至 0.10）m/s。两组的脊柱后凸都得到了同等程度的改善。LFG 的依从率为 83%，HFG 的依从率为 79%。两组均无不良事件。
结论
身体机能降低且患有脊柱后凸的老年人可能会在脊柱后凸靶向干预后改善身体机能。身体机能降低的老年人可以安全地参与靶向高强度脊柱后凸运动和姿势训练。这一观察结果需要在更大的、充分有力的研究中得到证实。
试验注册
Clinicaltrials.gov 标识符：NCT01766674。
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