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两种 24 周多模式运动方案对有跌倒风险的社区居住老年人反应时、移动能力和双重任务表现的影响:一项随机对照试验。

Effects of two 24-week multimodal exercise programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling: a randomized controlled trial.

机构信息

Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.

Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.

出版信息

BMC Public Health. 2021 Nov 10;21(Suppl 2):408. doi: 10.1186/s12889-021-10448-x.

Abstract

BACKGROUND

Falls in older adults are considered a major public health problem. Declines in cognitive and physical functions, as measured by parameters including reaction time, mobility, and dual-task performance, have been reported to be important risk factors for falls. The aim of this study was to investigate the effects of two multimodal programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling.

METHODS

In this randomized controlled trial, fifty-one participants (75.4 ± 5.6 years) were allocated into two experimental groups (EGs) (with sessions 3 times per week for 24 weeks), and a control group: EG1 was enrolled in a psychomotor intervention program, EG2 was enrolled in a combined exercise program (psychomotor intervention program + whole-body vibration program), and the control group maintained their usual daily activities. The participants were assessed at baseline, after the intervention, and after a 12-week no-intervention follow-up period.

RESULTS

The comparisons revealed significant improvements in mobility and dual-task performance after the intervention in EG1, while there were improvements in reaction time, mobility, and dual-task performance in EG2 (p ≤ 0.05). The size of the interventions' clinical effect was medium in EG1 and ranged from medium to large in EG2. The comparisons also showed a reduction in the fall rate in both EGs (EG1: -44.2%; EG2: - 63.0%, p ≤ 0.05) from baseline to post-intervention. The interventions' effects on reaction time, mobility, and dual-task performance were no longer evident after the 12-week no-intervention follow-up period.

CONCLUSIONS

The results suggest that multimodal psychomotor programs were well tolerated by community-dwelling older adults and were effective for fall prevention, as well as for the prevention of cognitive and physical functional decline, particularly if the programs are combined with whole-body vibration exercise. The discontinuation of these programs could lead to the fast reversal of the positive outcomes achieved.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03446352. Date of registration: February 07, 2018.

摘要

背景

老年人跌倒被认为是一个重大的公共卫生问题。据报道,认知和身体功能下降,包括反应时间、移动能力和双重任务表现等参数的下降,是跌倒的重要危险因素。本研究旨在探讨两种多模式方案对有跌倒风险的社区居住老年人的反应时间、移动能力和双重任务表现的影响。

方法

在这项随机对照试验中,51 名参与者(75.4±5.6 岁)被分配到两个实验组(EG)(每周 3 次,共 24 周)和对照组:EG1 参加了心理运动干预计划,EG2 参加了综合运动计划(心理运动干预计划+全身振动计划),对照组保持日常活动。参与者在基线、干预后和 12 周无干预随访期间进行评估。

结果

比较显示,干预后 EG1 的移动能力和双重任务表现有显著改善,而 EG2 的反应时间、移动能力和双重任务表现也有改善(p≤0.05)。干预的临床效果大小在 EG1 中为中等,在 EG2 中为中等到较大。比较还显示,两组的跌倒率均有所下降(EG1:-44.2%;EG2:-63.0%,p≤0.05),从基线到干预后。干预后 12 周无干预随访期间,反应时间、移动能力和双重任务表现的干预效果不再明显。

结论

结果表明,多模式心理运动方案被社区居住的老年人很好地耐受,并能有效预防跌倒,以及预防认知和身体功能下降,特别是如果方案与全身振动运动相结合。这些方案的停止可能导致取得的积极成果迅速逆转。

试验注册

ClinicalTrials.gov 标识符:NCT03446352。注册日期:2018 年 2 月 7 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9295/8582089/bdacd2b6146e/12889_2021_10448_Fig1_HTML.jpg

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