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为期 10 周的全身振动训练对老年人跌倒和身体表现的影响:一项为期 1 年随访的盲法、随机、对照临床试验。

Effect of 10-Week Whole-Body Vibration Training on Falls and Physical Performance in Older Adults: A Blinded, Randomized, Controlled Clinical Trial with 1-Year Follow-Up.

机构信息

The UKK Institute for Health Promotion Research, FI-33500 Tampere, Finland.

Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, FI-33520 Tampere, Finland.

出版信息

Int J Environ Res Public Health. 2024 Jul 2;21(7):866. doi: 10.3390/ijerph21070866.

DOI:10.3390/ijerph21070866
PMID:39063443
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11276669/
Abstract

Whole-body vibration training (WBV) training has shown positive effects on bone strength, muscle strength, and balance, but the evidence on fall prevention is not yet persuasive. This study aimed to evaluate the effectiveness of WBV training in preventing falls and improving physical performance among older adults at fall risk. The study was an assessor- and participant-blinded, randomized, and controlled 10-week training trial with a 10-month follow-up. One hundred and thirty older adults (mean age 78.5 years, 75% women) were randomly allocated into the WBV group ( = 68) and the low-intensity wellness group ( = 62). Falls were prospectively collected using monthly returned and verified diaries. Physical performance was evaluated at baseline before randomization, after the intervention, and follow-up with established methods. The data were analyzed on an intention-to-treat basis. Negative binomial regression was used to estimate the incidence rate ratios for falls, and Cox regression models were used to calculate the hazard ratios for fallers. Between-group differences in physical performance were estimated by generalized linear mixed models. The retention rate was 93%, and the mean adherence to the WBV training was 88% and 86% to the wellness training. Sixty-eight participants fell at least once, and there were 156 falls in total. In the WBV group, the incidence rate of falls was 1.5 (95% confidence interval 0.9 to 2.5) compared to the wellness group ( = 0.11). The hazard ratio for fallers in the WBV group was 1.29 (0.78 to 2.15) ( = 0.32). There was no between-group difference in physical performance after the training period, but by the end of the follow-up, WBV-related benefits appeared. The chair-rising capacity was maintained in the WBV group, while the benefit disappeared in the wellness group ( = 0.004). Also, the 0.5-point difference in short physical performance battery (SPPB) score favored WBV training ( = 0.009). In conclusion, progressive side-alternating WBV training was feasible and well-tolerated among fall-prone older adults. During the one-year follow-up, WBV training was associated with improved physical performance but did not prevent falls compared to chair-based group exercises.

摘要

全身振动训练(WBV)已显示出对骨强度、肌肉力量和平衡的积极影响,但关于预防跌倒的证据尚不足够有说服力。本研究旨在评估 WBV 训练对预防跌倒和改善有跌倒风险的老年人身体机能的有效性。这是一项为期 10 周的评估员和参与者双盲、随机、对照训练试验,随访 10 个月。130 名老年人(平均年龄 78.5 岁,75%为女性)被随机分配到 WBV 组(n=68)和低强度健康组(n=62)。使用每月返还并经核实的日记来前瞻性收集跌倒情况。使用既定方法在基线(随机分组前)、干预后和随访时评估身体机能。数据基于意向治疗进行分析。使用负二项回归估计跌倒的发生率比,使用 Cox 回归模型计算跌倒者的风险比。使用广义线性混合模型估计身体机能的组间差异。保留率为 93%,WBV 训练的平均依从率为 88%,健康训练的平均依从率为 86%。68 名参与者至少跌倒一次,共发生 156 次跌倒。在 WBV 组,跌倒发生率为 1.5(95%置信区间 0.9 至 2.5),而健康组为 0.11。WBV 组跌倒者的风险比为 1.29(0.78 至 2.15)(=0.32)。在训练期间,两组间的身体机能没有差异,但在随访结束时,WBV 相关的益处出现了。在 WBV 组,坐起能力得以维持,而健康组的益处消失(=0.004)。此外,短程体能测试电池(SPPB)评分的 0.5 分差异有利于 WBV 训练(=0.009)。总之,渐进式交替侧方 WBV 训练在易跌倒的老年人中是可行且耐受良好的。在一年的随访期间,与基于椅子的团体运动相比,WBV 训练与身体机能的改善相关,但与跌倒的预防无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15fc/11276669/61b5cfd207e2/ijerph-21-00866-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15fc/11276669/d1372de2ece9/ijerph-21-00866-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15fc/11276669/61b5cfd207e2/ijerph-21-00866-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15fc/11276669/d1372de2ece9/ijerph-21-00866-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15fc/11276669/61b5cfd207e2/ijerph-21-00866-g002.jpg

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