背景:跌倒风险较高的老年人可以转诊给物理治疗师。物理疗法的护理是为老年人从高跌倒风险过渡到中度到低跌倒风险而设计的。然而,这些护理事件在时间和持续时间上都是有限的。有令人信服的证据表明,基于小组的运动课程可以解决风险,将老年人从物理治疗过渡到基于小组的计划可能是通过连续护理来管理风险的有效方法。
目的:这项研究的目的是将研究结果转化为“现实世界”环境,并证明将基于证据的跌倒预防练习整合到高级生活设施的先前存在的练习课程中的有效性,作为未来计划的“概念证明”模型。
方法:24名年龄在65岁及以上的参与者生活在一个老年人社区和社区中,被分成基于小组的运动课程。来自功能结果测量的截止分数用于对参与者进行分层。奥塔哥运动计划的练习已实施到班级中。收集的功能结果测量包括10米步行测试,30秒坐着站着,和定时和去(TUG)。跌倒次数,住院治疗,和物理治疗的护理事件也被跟踪。将数据与不同的高级生活社区中的对照组进行比较,该社区提供类似的练习课程,旨在提高力量和流动性。这些课程由运动生理学家教授,持续时间和频率相等。
结果:参与者在所有功能结果测量中表现出显著改善。TUG平均值从13.5s提高到10.4s(p=0.034)。30秒的坐姿平均从10.5提高到13.4(p=0.002)。10米步行测试从0.81米/秒提高到0.98米/秒(p<0.0001)。参与者没有经历任何跌倒或住院,和两名参与者需要物理治疗发作的护理。
结论:在老年人生活计划中实施基于证据的跌倒减少计划对力量有积极影响,balance,跌倒风险,步态速度,下降率,住院治疗,以及物理治疗干预的数量。
BACKGROUND: Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care.
OBJECTIVE: The purpose of this study was to translate research findings into a \"real world\" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a \"proof of concept\" model for future programing.
METHODS: Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency.
RESULTS: Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s (p = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 (p = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s (p < 0.0001). Participants did not experience any falls or hospitalizations, and two participants required physical therapy episodes of care.
CONCLUSIONS: Implementing an evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention.