基于社区的、多方面的、为期 18 个月的运动方案对骨折风险老年人患者报告结局的影响：一项随机对照试验的二次分析。
Effects of an 18-month community-based, multifaceted, exercise program on patient-reported outcomes in older adults at risk of fracture: secondary analysis of a randomised controlled trial.
机构信息
Institute for Physical Activity and Nutrition Research (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia.
出版信息
Osteoporos Int. 2023 May;34(5):891-900. doi: 10.1007/s00198-023-06693-y. Epub 2023 Mar 2.
UNLABELLED
This study identified that an 18-month community-based, multifaceted, exercise program consisting of resistance, weight-bearing impact, and balance/mobility training combined with osteoporosis education and behavioural support can improve health-related quality of life (HRQoL) and osteoporosis knowledge in older adults at risk of fracture, but only for those adherent to the exercise regime.
PURPOSE
To evaluate the effects of an 18-month community-based exercise, osteoporosis education and behaviour change program (Osteo-cise: Strong Bones for Life) on HRQoL, osteoporosis knowledge and osteoporosis health beliefs.
METHODS
This was a secondary analysis of an 18-month randomised controlled trial in which 162 older adults aged ≥ 60 years with osteopenia or increased falls/fracture risk were randomized to the Osteo-cise program (n = 81) or control group (n = 81). The program consisted of progressive resistance, weight-bearing impact and balance training (3 days/week); osteoporosis education to facilitate self-management of musculoskeletal health and behavioural support to enhance adherence to exercise. HRQoL, osteoporosis knowledge and osteoporosis health beliefs were assessed using the EuroQoL questionnaire (EQ-5D-3L), Osteoporosis Knowledge Assessment Tool and Osteoporosis Health Belief Scale, respectively.
RESULTS
Overall, 148 participants (91%) completed the trial. Mean exercise adherence was 55% and mean attendance for the three osteoporosis educational sessions ranged from 63-82%. After 12 and 18 months, there were no significant effects of the Osteo-cise program on HRQoL, osteoporosis knowledge or health beliefs relative to controls. Per protocol analyses (≥ 66% exercise adherence; n = 41) revealed a significant net benefit in EQ-5D-3L utility for the Osteo-cise group relative to controls after 12 months (P = 0.024) and 18 months (P = 0.029) and a significant net improvement in osteoporosis knowledge scores at 18 months (P = 0.014).
CONCLUSION
This study supports the importance of adherence to exercise regimes, as adherence to the Osteo-cise: Strong Bones for Life program was associated with improvements in HRQoL and osteoporosis knowledge in older adults at increased risk for falls and fractures.
TRIAL REGISTRATION NUMBER
ACTRN12609000100291.
目的
评估一项为期 18 个月的基于社区的运动、骨质疏松症教育和行为改变计划（Osteo-cise：Strong Bones for Life）对健康相关生活质量（HRQoL）、骨质疏松症知识和骨质疏松症健康信念的影响。
方法
这是一项为期 18 个月的随机对照试验的二次分析，其中 162 名年龄在 60 岁及以上、有骨量减少或增加跌倒/骨折风险的老年人被随机分为 Osteo-cise 组（n=81）或对照组（n=81）。该计划包括渐进式抗阻、负重冲击和平衡训练（每周 3 天）；骨质疏松症教育以促进肌肉骨骼健康的自我管理，以及行为支持以增强对运动的依从性。使用欧洲五维健康量表（EQ-5D-3L）、骨质疏松症知识评估工具和骨质疏松症健康信念量表分别评估 HRQoL、骨质疏松症知识和骨质疏松症健康信念。
结果
总体而言，148 名参与者（91%）完成了试验。平均运动依从率为 55%，三次骨质疏松教育课程的平均出勤率为 63-82%。在 12 个月和 18 个月时，与对照组相比，Osteo-cise 计划对 HRQoL、骨质疏松症知识或健康信念均无显著影响。方案分析（≥66%的运动依从率；n=41）显示，与对照组相比，Osteo-cise 组在 12 个月（P=0.024）和 18 个月（P=0.029）时 EQ-5D-3L 效用有显著的净获益，在 18 个月时骨质疏松症知识评分有显著的净改善（P=0.014）。
结论
本研究支持了坚持运动方案的重要性，因为坚持 Osteo-cise：Strong Bones for Life 计划与增加跌倒和骨折风险的老年人的 HRQoL 和骨质疏松症知识的改善相关。
试验注册号
ACTRN12609000100291。
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