Buchner D M, Cress M E, de Lateur B J, Esselman P C, Margherita A J, Price R, Wagner E H
Department of Health Services, University of Washington, Seattle, USA.
J Gerontol A Biol Sci Med Sci. 1997 Jul;52(4):M218-24. doi: 10.1093/gerona/52a.4.m218.
The study tested the effect of strength and endurance training on gait, balance, physical health status, fall risk, and health services use in older adults.
The study was a single-blinded, randomized controlled trial with intention-to-treat analysis. Adults (n = 105) age 68-85 with at least mild deficits in strength and balance were selected from a random sample of enrollees in a health maintenance organization. The intervention was supervised exercise (1-h sessions, three per week, for 24-26 weeks), followed by self-supervised exercise. Exercise groups included strength training using weight machines (n = 25), endurance training using bicycles (n = 25), and strength and endurance training (n = 25). Study outcomes included gait tests, balance tests, physical health status measures, self-reported falls (up to 25 months of follow-up), and inpatient and outpatient use and costs.
There were no effects of exercise on gait, balance, or physical health status. Exercise had a protective effect on risk of falling (relative hazard = .53, 95% CI = .30-.91). Between 7 and 18 months after randomization, control subjects had more outpatient clinic visits (p < .06) and were more likely to sustain hospital costs over $5000 (p < .05).
Exercise may have beneficial effects on fall rates and health care use in some subgroups of older adults. In community-living adults with mainly mild impairments in gait, balance, and physical health status, short-term exercise may not have a restorative effect on these impairments.
本研究测试了力量和耐力训练对老年人步态、平衡能力、身体健康状况、跌倒风险及医疗服务使用情况的影响。
本研究为单盲随机对照试验，并采用意向性分析。从一家健康维护组织的随机登记样本中选取了105名年龄在68至85岁之间、力量和平衡能力至少有轻度缺陷的成年人。干预措施为监督下的锻炼（每周三次，每次1小时，共24至26周），随后是自我监督的锻炼。锻炼组包括使用重量器械的力量训练（25人）、使用自行车的耐力训练（25人）以及力量和耐力训练（25人）。研究结果包括步态测试、平衡测试、身体健康状况测量、自我报告的跌倒情况（长达25个月的随访）以及住院和门诊使用情况及费用。
锻炼对步态、平衡能力或身体健康状况没有影响。锻炼对跌倒风险有保护作用（相对风险 = 0.53，95%置信区间 = 0.30 - 0.91）。在随机分组后的7至18个月期间，对照组受试者的门诊就诊次数更多（p < 0.06），并且更有可能产生超过5000美元的住院费用（p < 0.05）。
锻炼可能对某些老年亚组的跌倒率和医疗保健使用有有益影响。在步态、平衡能力和身体健康状况主要存在轻度损害的社区居住成年人中，短期锻炼可能对这些损害没有恢复作用。
