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多组分职业疗法干预对机构养老老年人平衡能力、功能性移动能力和本体感觉的疗效:一项随机对照试验。

Efficacy of a Multicomponent Occupational Therapy Intervention on Balance, Functional Mobility, and Proprioception in Institutionalized Older Adults: A Randomized Controlled Pilot Trial.

作者信息

Caña-Pino Alejandro, Marín-Rubio Alba

机构信息

Surgical Medical-Therapy Department, Medicine Faculty and Health Sciences, University of Extremadura, 06006 Badajoz, Spain.

Research Group PhysioH (Fisioterapia e Hipoterapia), University of Extremadura, 06006 Badajoz, Spain.

出版信息

Healthcare (Basel). 2025 Sep 12;13(18):2287. doi: 10.3390/healthcare13182287.

Abstract

: With the progressive aging of the in institutionalized settings population, functional decline-manifested as reduced proprioception, joint stiffness, and muscle loss-poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. : These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements-such as proprioception and balance-did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability.

摘要

随着机构养老人群的逐渐老龄化,功能衰退(表现为本体感觉减退、关节僵硬和肌肉流失)对老年人的自主性和生活质量构成了越来越大的威胁。职业治疗通过有针对性的、基于证据的干预措施在应对这些挑战方面发挥着核心作用。 这项临床试验评估了一种多成分职业治疗干预措施的有效性,该措施将平衡和姿势稳定性练习、本体感觉刺激以及下肢强化与传统老年体操相结合。该项目旨在改善机构养老老年人的步态表现、降低跌倒风险并促进其独立性。 共有35名社区居住的老年人被随机分为三组:老年体操干预组(n = 13)、多成分干预组(n = 13)和对照组(n = 9)。参与者接受了为期6周的干预,每周包括两次45分钟的课程。干预前后的评估重点是姿势稳定性和与平衡相关的功能结果。 多成分组在平衡、本体感觉和功能移动性方面呈现出改善趋势,尽管这些未达到统计学意义。使用功能测量的最小临床重要差异(MCIDs)来定义具有临床意义的改善,如定时起立行走测试(TUG)(>1.3秒)和以性能为导向的移动性评估(POMA)(≥3分)。多成分组的本体感觉准确性提高了22.1%,移动性(TUG)提高了13.9%。此外,这种趋势可能表明对与年龄相关的功能衰退具有潜在的保护作用。 这些发现表明,多成分职业治疗干预可能有助于维持机构养老老年人的移动性并减少功能衰退。在下肢力量方面观察到了统计学上的显著增加,而其他改善,如本体感觉和平衡,虽未达到显著水平,但接近临床相关性。由于样本量小(n = 35)和干预持续时间短,限制了统计效力和普遍性,因此解释应保持谨慎。

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