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基于扰动的老年人平衡训练及其对生理、认知和社会心理因素的影响:一项为期12个月随访的随机对照试验的二次分析

Perturbation-based balance training of older adults and effects on physiological, cognitive and sociopsychological factors: a secondary analysis from a randomised controlled trial with 12-month follow-up.

作者信息

Nørgaard Jens Eg, Andersen Stig, Ryg Jesper, Andreasen Jane, Oliveira Anderson de Souza Castelo, Stevenson Andrew James Thomas, Danielsen Mathias Brix Brix, Jorgensen Martin Gronbech

机构信息

Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark.

Department of Clinical Medicine, Aalborg Universitet, Aalborg, Denmark.

出版信息

BMJ Open. 2024 Aug 7;14(8):e080550. doi: 10.1136/bmjopen-2023-080550.

Abstract

BACKGROUND

Perturbation-based balance training (PBT) has shown promising, although diverging, fall-preventive effects; however, the effects on important physical, cognitive and sociopsychological factors are currently unknown. The study aimed to evaluate these effects on PBT at three different time points (post-training, 6-months and 12-months) in community-dwelling older adults compared with regular treadmill walking.

METHODS

This was a preplanned secondary analysis from a randomised, controlled trial performed in Aalborg, Denmark, between March 2021 and November 2022. Community-dwelling older adults aged ≥65 were randomly assigned to participate in four sessions (lasting 20 min each) of either PBT (intervention) or regular treadmill walking (control). All participants were assigned to four testing sessions: pretraining, post-training, 6-month follow-up and 12-month follow-up. At these sessions, physical, cognitive and sociopsychological measures were assessed.

RESULTS

In total, 140 participants were randomly allocated to either the PBT or control group. Short-term (pretraining to post-training) between-group differences were seen for choice stepping reaction time (-49 ms, 95% CI -80 to -18), dual-task gait speed (0.05 m/s, 95% CI 0.01 to 0.09) favouring the PBT group. However, these improvements were not sustained at the 6-month and 12-month follow-up. No significant between-group differences were found in other physical, cognitive or sociopsychological factors.

CONCLUSIONS

This study showed that PBT, in the short term, improved choice stepping reaction time and dual-task gait speed among community-dwelling older adults. Yet, these improvements were not retained for 6- or 12-months. The healthy state of the study's population may have imposed a ceiling effect limiting the ability to show any clinically relevant effects of PBT.

TRIAL REGISTRATION NUMBER

NCT04733222.

摘要

背景

基于扰动的平衡训练(PBT)已显示出有前景的、尽管存在差异的预防跌倒效果;然而,其对重要的身体、认知和社会心理因素的影响目前尚不清楚。本研究旨在评估在社区居住的老年人中,PBT在三个不同时间点(训练后、6个月和12个月)与常规跑步机行走相比的这些影响。

方法

这是一项对2021年3月至2022年11月在丹麦奥尔堡进行的随机对照试验的预先计划的二次分析。年龄≥65岁的社区居住老年人被随机分配参加四节(每节持续20分钟)PBT(干预)或常规跑步机行走(对照)。所有参与者被分配到四个测试阶段:训练前、训练后、6个月随访和12个月随访。在这些阶段,评估身体、认知和社会心理指标。

结果

总共140名参与者被随机分配到PBT组或对照组。短期(训练前到训练后)组间差异在选择步幅反应时间(-49毫秒,95%CI -80至-18)、双任务步态速度(0.05米/秒,95%CI 0.01至0.09)方面有利于PBT组。然而,这些改善在6个月和12个月随访时未持续。在其他身体、认知或社会心理因素方面未发现显著的组间差异。

结论

本研究表明,PBT在短期内改善了社区居住老年人的选择步幅反应时间和双任务步态速度。然而,这些改善在6个月或12个月时未保留。研究人群的健康状态可能产生了天花板效应,限制了显示PBT任何临床相关效果的能力。

试验注册号

NCT04733222。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad86/11404139/3d7f363dddea/bmjopen-14-8-g001.jpg

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