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全身振动(WBV)运动干预对机构养老老年人的影响:一项随机、多中心、平行对照临床试验。

Effects of a whole body vibration (WBV) exercise intervention for institutionalized older people: a randomized, multicentre, parallel, clinical trial.

作者信息

Sitjà-Rabert Mercè, Martínez-Zapata Ma José, Fort Vanmeerhaeghe Azahara, Rey Abella Ferran, Romero-Rodríguez Daniel, Bonfill Xavier

机构信息

Blanquerna School of Health Sciences (Universitat Ramon Llull), Barcelona, Spain.

Iberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), CIBERESP (CIBER Epidemiología y Salud Pública), Barcelona, Spain.

出版信息

J Am Med Dir Assoc. 2015 Feb;16(2):125-31. doi: 10.1016/j.jamda.2014.07.018. Epub 2014 Oct 3.

Abstract

OBJECTIVES

To assess the efficacy of an exercise program on a whole-body vibration platform (WBV) in improving body balance and muscle performance and preventing falls in institutionalized elderly people.

DESIGN/SETTING/PARTICIPANTS: A multicentre randomized parallel assessor-blinded clinical trial was conducted in elderly persons living in nursing homes.

INTERVENTIONS

Participants were randomized to an exercise program performed either on a whole body vibratory platform (WBV plus exercise group) or on a stationary surface (exercise group). The exercise program for both groups consisted of static and dynamic exercises (balance and strength training over a 6-week training period of 3 sessions per week). The frequency applied on the vibratory platform was 30 to 35 Hz and amplitude was 2 to 4 mm.

MEASUREMENTS

The primary outcome measurement was static/dynamic body balance. Secondary outcomes were muscle strength and number of falls. Efficacy was analyzed on an intention-to-treat basis and per protocol. The effects of the intervention were evaluated using the t test, Mann-Whitney test, or chi-square test, depending on the type of outcome. Follow-up measurements were collected 6 weeks and 6 months after randomization.

RESULTS

A total of 159 participants from 10 centers were included: 81 in the WBV plus exercise group and 78 in the control group. Mean age was 82 years, and 67.29% were women. The Tinetti test score showed a significant overall improvement in both groups (P < .001). No significant differences were found between groups at week 6 (P = .890) or month 6 (P = .718). The Timed Up and Go test did not improve (P = .599) in either group over time, and no significant differences were found between groups at week 6 (P = .757) or month 6 (P = .959). Muscle performance results from the 5 Sit-To-Stand tests improved significantly across time (P = .001), but no statistically significant differences were found between groups at week 6 (P = .709) or month 6 (P = .841). A total of 57 falls (35.8%) were recorded during the follow-up period, with no differences between groups (P = .406).

CONCLUSION

Exercise program on a vibratory platform provides benefits similar to those with exercise program on a stationary surface in relation to body balance, gait, functional mobility, and muscle strength in institutionalized elderly people. Longer studies in larger samples are needed to assess falls.

摘要

目的

评估在全身振动平台(WBV)上进行的锻炼计划对改善机构养老老年人身体平衡和肌肉性能以及预防跌倒的效果。

设计/地点/参与者:在养老院居住的老年人中进行了一项多中心随机平行评估者盲法临床试验。

干预措施

参与者被随机分配到在全身振动平台上进行的锻炼计划(WBV加锻炼组)或在固定表面上进行的锻炼计划(锻炼组)。两组的锻炼计划均包括静态和动态锻炼(在为期6周、每周3次的训练期间进行平衡和力量训练)。振动平台上施加的频率为30至35赫兹,振幅为2至4毫米。

测量指标

主要结局指标是静态/动态身体平衡。次要结局指标是肌肉力量和跌倒次数。在意向性分析和符合方案分析的基础上分析疗效。根据结局类型,使用t检验、曼-惠特尼检验或卡方检验评估干预效果。在随机分组后6周和6个月收集随访测量数据。

结果

来自10个中心的159名参与者被纳入研究:WBV加锻炼组81名,对照组78名。平均年龄为82岁,女性占67.29%。Tinetti测试评分显示两组总体均有显著改善(P <.001)。在第6周(P =.890)或第6个月(P =.718)时,两组之间未发现显著差异。两组的定时起立行走测试随时间均未改善(P =.599),在第6周(P =.757)或第6个月(P =.959)时,两组之间也未发现显著差异。5次坐立试验的肌肉性能结果随时间有显著改善(P =.001),但在第6周(P =.709)或第6个月(P =.841)时,两组之间未发现统计学上的显著差异。随访期间共记录到57次跌倒(35.8%),两组之间无差异(P =.406)。

结论

对于机构养老的老年人,在振动平台上进行的锻炼计划在身体平衡、步态、功能活动能力和肌肉力量方面提供的益处与在固定表面上进行的锻炼计划相似。需要在更大样本中进行更长时间的研究来评估跌倒情况。

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