Department of Geriatrics, Carl von Ossietzky Universität Oldenburg Faculty VI Medicine and Health Sciences, Department of Health Services Research, Ammerländer Heerstraße 140, Oldenburg, 26129, Germany.
Institute for Biomedicine of Ageing Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nuremberg, Germany.
BMC Geriatr. 2024 Apr 10;24(1):326. doi: 10.1186/s12877-024-04932-3.
Preservation of mobility and fall prevention have a high priority in geriatric rehabilitation. Square-Stepping Exercise (SSE) as an evaluated and standardized program has been proven to be an effective training for older people in the community setting to reduce falls and improve subjectively perceived health status. This randomized controlled trial (RCT), for the first time, examines SSE in the context of inpatient early geriatric rehabilitation compared to conventional physiotherapy (cPT).
Data were collected in a general hospital in the department of acute geriatric care at admission and discharge. Fifty-eight inpatients were randomized to control (CG, n = 29) or intervention groups (IG, n = 29). CG received usual care with cPT five days per week during their hospital stay. For the IG SSE replaced cPT for at least six sessions, alternating with cPT. Physical function was measured with the Short Physical Performance Battery (SPPB) and Timed "Up & Go" (TUG). Gait speed was measured over a distance of 10 m. In a subgroup (n = 17) spatiotemporal gait parameters were analyzed via a GAITRite® system.
Both the SPPB total score improved significantly (p = < 0.001) from baseline to discharge in both groups, as did the TUG (p < 0.001). In the SPPB Chair Rise both groups improved with a significant group difference in favor of the IG (p = 0.031). For both groups gait characteristics improved: Gait speed (p = < 0.001), walk ratio (p = 0.011), step length (p = < 0.001), stride length (p = < 0.001) and double support (p = 0.009). For step length at maximum gait speed (p = 0.054) and stride length at maximum gait speed (p = 0.060) a trend in favor of the IG was visible.
SSE in combination with a reduced number of sessions of cPT is as effective as cPT for inpatients in early geriatric rehabilitation to increase physical function and gait characteristics. In the Chair Rise test SSE appears to be superior. These results highlight that SSE is effective, and may serve as an additional component for cPT for older adults requiring geriatric acute care.
DRKS00026191.
在老年康复中，保持活动能力和预防跌倒具有很高的优先级。作为一种经过评估和标准化的方案，方步走训练（SSE）已被证明是一种在社区环境中对老年人进行有效训练的方法，可降低跌倒风险并改善主观感知的健康状况。本随机对照试验（RCT）首次将 SSE 应用于住院早期老年康复治疗中，与常规物理治疗（cPT）进行比较。
数据是在急性老年护理部门的一家综合医院中入院时和出院时收集的。将 58 名住院患者随机分为对照组（CG，n=29）和干预组（IG，n=29）。CG 在住院期间每周接受 5 天的常规护理和 cPT。对于 IG，SSE 至少替代 cPT 进行 6 次，然后与 cPT 交替进行。使用简短的身体表现测试（SPPB）和计时“站起和行走”（TUG）来测量身体功能。步态速度通过 10 米的距离进行测量。在亚组（n=17）中，通过 GAITRite®系统分析时空步态参数。
两组的 SPPB 总分均从基线显著提高（p < 0.001），TUG 也显著提高（p < 0.001）。在 SPPB 坐起测试中，两组都有改善，IG 组的改善具有显著的组间差异（p=0.031）。对于两组，步态特征都有所改善：步态速度（p < 0.001）、行走比例（p=0.011）、步长（p < 0.001）、步幅长度（p < 0.001）和双支撑（p=0.009）。对于最大步行速度下的步长（p=0.054）和最大步行速度下的步幅长度（p=0.060），IG 组的趋势更为明显。
SSE 联合减少 cPT 的次数与 cPT 对早期老年康复住院患者一样有效，可提高身体功能和步态特征。在坐起测试中，SSE 似乎更具优势。这些结果强调了 SSE 的有效性，并可能成为需要老年急性护理的老年人接受 cPT 的附加组成部分。
DRKS00026191。
