单独进行为期 3 周的水疗方案或与身体活动和教育方案联合进行对老年跌倒者的身体机能和跌倒恐惧的影响：一项随机对照试验。
Effects on Physical Functioning and Fear of Falling of a 3-Week Balneotherapy Program Alone or Associated with a Physical Activity and Educational Program in Older Adult Fallers: A Randomized-Controlled Trial.
机构信息
Euromov Digital Health in Motion, Université de Montpellier, IMT Mines d'Ales, France.
Transversal Patient Education Unit (UTEP), University Hospital of Montpellier, Montpellier, France.
出版信息
Clin Interv Aging. 2024 Oct 30;19:1753-1763. doi: 10.2147/CIA.S472816. eCollection 2024.
BACKGROUND
The effects on gait and posture of balneotherapy in fallers are unknown. We assessed the effects on physical functioning and fear of falling of a balneotherapy program alone or combined with a physical activity and educational program in older adult fallers.
METHODS
A multicenter randomized controlled trial enrolled patients aged 65 or older referred to a 3-week balneotherapy program, and screened for risk of falling (a history of falls in the last year and a timed up and go test or a five chair rising test >12 sec or a 4-meter walk test >4 sec). In addition to balneotherapy, patients had either no intervention (controls) or twelve 60-minute sessions of physical activity including 15 minutes of health education and three 90-minute sessions of an educational program (intervention).
RESULTS
There were 118 control and 105 intervention patients. The balneotherapy program alone had a clinically significant effect on (i) the grip strength, (ii) the five chair rising test, (iii) the 4-meter walk test, and (iv) the short physical performance battery (Cohen's d 0.29-0.46). It had no effect on (i) the maximum time stood on one foot, and (ii) the timed up and go test. Furthermore, it worsened the falls efficacy scale (d = 0.27). Adding a physical activity and educational program significantly improved (i) the time stood on one foot (Cohen's d =-0.34), and (ii) the timed up and go test (d=- 0.44), (iii) and reduced the concern about falling (Falls Efficacy scale, d=-0.25), and (iv) the fear of falling (d=-0.34).
CONCLUSION
Older patients referred to a balneotherapy program and at high risk of falling when screened at the entrance of the center should be offered an additional physical and educational program to further improve the functional effects of balneotherapy on the timed up and go test, balance, and the fear of falling.
背景
温泉疗法对跌倒者步态和姿势的影响尚不清楚。我们评估了温泉疗法单独或与身体活动和教育计划联合应用于老年跌倒者对身体功能和跌倒恐惧的影响。
方法
一项多中心随机对照试验纳入了被转诊至为期 3 周温泉治疗项目的年龄在 65 岁或以上的患者，并对其跌倒风险进行了筛查（过去 1 年内有跌倒史，计时起立行走测试或 5 次椅子站立测试>12 秒或 4 米步行测试>4 秒）。除了温泉疗法，患者还接受了无干预（对照组）或 12 次 60 分钟的身体活动，包括 15 分钟的健康教育和 3 次 90 分钟的教育计划（干预组）。
结果
对照组有 118 例患者，干预组有 105 例患者。单独的温泉疗法对（i）握力、（ii）5 次椅子站立测试、（iii）4 米步行测试和（iv）简短体能测试电池（Cohen's d 0.29-0.46）具有临床显著效果。它对（i）单脚站立的最大时间和（ii）计时起立行走测试没有影响。此外，它还降低了跌倒效能量表（d=0.27）。添加身体活动和教育计划显著改善了（i）单脚站立的时间（Cohen's d=-0.34），和（ii）计时起立行走测试（d=-0.44），（iii）降低了对跌倒的担忧（跌倒效能量表，d=-0.25），和（iv）对跌倒的恐惧（d=-0.34）。
结论
当在中心入口处筛查时，被转诊至温泉治疗计划且跌倒风险较高的老年患者应接受额外的身体活动和教育计划，以进一步提高温泉疗法对计时起立行走测试、平衡和跌倒恐惧的功能效果。
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