| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 107 === Introduction: Taiwan has become an aged society in 2018. Falling is a common accident among the community-dwelling older people. Approximately 28-35% of the elderly fall annually. Health promotion in fall presentation for elderly is a major concern due to the increased society costs and mortality in older age. However, the past studies of fall prevention training in reducing fall risks are not dependent on the performance for each person. Single interventions may be insufficient to training the elderly people with multiple risk factors. There are still few studies on the individualized intervention in elderly people currently.
Purposes: The purpose of this study is to develop individualized interventions to reduce fall risks for fall prevention in elderly people and to investigate effects on the individualized interventions to reduce fall risk.
Methods: This was an exploratory, randomized controlled trial and participant-blinded, within-subject repeated-measures design. The participants were recruited from community dwelling people aged 65 and older. The participants were allocated to one of the two groups, the individualized intervention group for 30 minutes (IEP-30) and intervention group for 60 minutes (IEP-60). Participants in the individualized intervention group and multiple exercise group received the training comprising strengthening, balance training and gait twice a week for 12 weeks. The training time of three exercise in the individualized intervention group is depend on their performance score. The multiple exercise group is training in same proportion of time in three exercise. The outcomes measure include the lower extremity strength, functional balance tests [Functional Reach(FR), Berg Balance Scale (BBS), time up and go test(TUG)], laboratory assessment [single leg standing, static balance, dynamic balance], walking ability [normal gait speed, fast gait speed], and questionnaires [Falls Efficacy Scale International (FES-I), and 12-Item Short Form Survey (SF-12)]. The baseline data of all subjects were described as descriptive statistics. Outcomes were analyzing by two-way repeated measures ANOVA for examining the effect of two groups. The dependent variables between-group were analyzed by Kruskal-Wallis test with intention-to-treat analysis. Dunn's test was used for post hoc analysis. Statistical significance was set at level of 0.05.
Results: This study enrolled 29 subjects, excluding 2 subjects for cardiopulmonary and neurological disease, and 27 subjects were eligible for the study. 25 people completed the pre-test. 10 people completed 6 weeks of training and secondary testing; 8 completed the last 12 weeks of training and Third tests. After 6 weeks training, participants in both groups improved FR & BBS, and reached statistical significance (P=0.033). IEP-30 is better than IEP-60 in Static posture sway area in normal stance(HAS)(p= 0.025).Both groups in Static posture anterior-posterior sway range in narrow stance(NSAP) declined(p= 0.016).The 12th week compared with the 6th week: IEP-60 is better than IEP-30 in Static posture sway area in narrow stance(NAS)(p= 0.048), Right knee flexion strength(RKF)(p=0.013), Left knee flexion strength(LKF) (p=0.007))and Right ankle plantar flexion strength(RAPF)(p=0.042). After 12 weeks training, both groups improved(p=0.02). Training at the same total time, IEP-30 trained in the 12th week is better than IEP-60 in the 6th week of training (p=0.014).
Conclusions: The Individualized 60 mins exercise program in this study is the best plan of fall prevention exercise, and it is recommended to maintain 12 weeks of training to achieve the best results. According to the established Individualized exercise program, the strength is the first priority, balance training is second and walking training is third. Those who with better abilities of muscle strength and balance should focus on walking training.
|
|---|
