Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan.
Department of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
Int J Environ Res Public Health. 2021 Sep 5;18(17):9374. doi: 10.3390/ijerph18179374.
Reablement services are approaches for maintaining and improving the functional independence of older adults. Previous reablement studies were conducted in a home environment. Due to the limited evidence on the effects of multicomponent interventions and reablement in a community-based context, this study aimed to develop and evaluate the effect of community-based physical-cognitive training, health education, and reablement (PCHER) among rural community-dwelling older adults with mobility deficits. The trial was conducted in rural areas of New Taipei City, Taiwan. Older adults with mild to moderate mobility deficits were recruited from six adult daycare centers, and a cluster assignment was applied in a counterbalanced order. The experimental group ( = 16) received a PCHER intervention, comprising 1.5 h of group courses and 1 h of individualized reablement training, while the control group ( = 12) underwent PCHE intervention, comprising 1.5 h of group courses and 1 h of placebo treatment. A 2.5-h training session was completed weekly for 10 weeks. The outcome measures contained the de Morton Mobility Index (DEMMI), the Saint Louis University Mental Status (SLUMS) Examination, the Barthel Index (BI), the Short Physical Performance Battery (SPPB), and the Canadian Occupational Performance Measure (COPM). The PCHER significantly improved the DEMMI, SLUMS, BI, SPPB, and COPM (all < 0.05), with medium-to-large effect sizes. PCHER also showed an advantage over PCHE in terms of the SPPB ( = 0.02). This study verified that combining individualized reablement with group-based multicomponent training was superior to group courses alone in enhancing the functional abilities of community-dwelling older adults with mobility deficits.
康复服务是维持和提高老年人功能独立性的方法。以前的康复研究是在家庭环境中进行的。由于在社区环境中多组分干预和康复的效果证据有限，本研究旨在为有行动障碍的农村社区居住老年人制定并评估基于社区的身体-认知训练、健康教育和康复（PCHER）。该试验在台湾新北市的农村地区进行。从六个成人日间护理中心招募有轻至中度行动障碍的老年人，并以平衡的顺序应用群组分配。实验组（n=16）接受 PCHER 干预，包括 1.5 小时的小组课程和 1 小时的个体化康复训练，而对照组（n=12）接受 PCHE 干预，包括 1.5 小时的小组课程和 1 小时的安慰剂治疗。每周完成一次 2.5 小时的培训课程，共进行 10 周。结果测量包括德莫顿行动能力指数（DEMMI）、圣路易斯大学精神状态（SLUMS）检查、巴氏量表（BI）、简短体能表现测试（SPPB）和加拿大职业表现测量（COPM）。PCHER 显著改善了 DEMMI、SLUMS、BI、SPPB 和 COPM（均<0.05），效果大小为中到大。与 PCHE 相比，PCHER 在 SPPB 方面也具有优势（=0.02）。本研究证实，将个体化康复与基于群体的多组分训练相结合，在提高有行动障碍的社区居住老年人的功能能力方面优于单纯的群体课程。
