Kerschan K, Alacamlioglu Y, Kollmitzer J, Wöber C, Kaider A, Hartard M, Ghanem A H, Preisinger E
Department of Physical Medicine and Rehabilitation, University of Vienna, Austria.
Am J Phys Med Rehabil. 1998 Jul-Aug;77(4):326-32. doi: 10.1097/00002060-199807000-00013.
Low bone mass, functional impairment, low muscle strength, and postural instability are predictors of the risk of fracture in an elderly person. The purpose of this study was to investigate the functional impact of an unvarying long-term exercise program to be carried out at home. The exercises had been shown to delay bone loss in an elderly population. At the Department of Physical Medicine and Rehabilitation, University of Vienna, postmenopausal women who had been stratified into exercise or control groups 5 to 10 yr ago were called in for a follow-up examination. Frequency of training, habits, and pain causing disability in activities of daily living were recorded. Walking velocity, muscle strength, and postural stability were measured. Functional assessment, blood analysis, and x-rays of the spine were performed additionally. One hundred twenty-four women aged 68.3 +/- 6.8 yr (mean +/- SD) underwent a follow-up investigation at the outpatient clinic. After 7.7 +/- 1.1 yr the compliance of the training group was still 36%. Self-chosen gait velocity was slightly higher in the regular exercisers than in the controls. No intergroup differences were found for pain induced disability, muscle strength, body sway, and fracture rate. The pain disability index was significantly associated with corrected self-chosen gait velocity. The results suggest that an unvarying home-based exercise program may support general agility but does not yield enough force to improve muscle strength and postural stability in healthy, nondisabled, postmenopausal women who start exercising at the age of 60 yr. Further studies are needed to define more appropriate exercise programs for a comprehensive improvement of functional outcome in a population at high risk for osteoporosis.
低骨量、功能障碍、肌肉力量低下和姿势不稳是老年人骨折风险的预测因素。本研究的目的是调查一项在家中进行的长期不变的锻炼计划的功能影响。这些锻炼已被证明可延缓老年人群的骨质流失。在维也纳大学物理医学与康复系，5至10年前被分层到锻炼组或对照组的绝经后女性被召回进行随访检查。记录训练频率、习惯以及日常生活活动中导致残疾的疼痛情况。测量步行速度、肌肉力量和姿势稳定性。另外还进行了功能评估、血液分析和脊柱X光检查。124名年龄为68.3±6.8岁（均值±标准差）的女性在门诊接受了随访调查。7.7±1.1年后，训练组的依从率仍为36%。经常锻炼者自我选择的步态速度略高于对照组。在疼痛导致的残疾、肌肉力量、身体摇摆和骨折率方面未发现组间差异。疼痛残疾指数与校正后的自我选择步态速度显著相关。结果表明，对于60岁开始锻炼的健康、无残疾的绝经后女性，一项不变的家庭锻炼计划可能有助于提高总体敏捷性，但不足以产生足够的力量来改善肌肉力量和姿势稳定性。需要进一步研究来确定更合适的锻炼计划，以全面改善骨质疏松高危人群的功能结局。
