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BMJ:有计划地体育活动可以减少男性老年人严重跌倒相关的住院和骨折

2016-02-04 MedSci译 MedSci原创

该研究的目的是测试与健康教育相比,长期的,结构化的体力活动计划是否会降低久坐有功能限制的的老年人严重跌倒受伤的风险。 原始出处:Thomas M Gill,Marco Pahor,Jack M Guralnik,et al.Effect of structured physical activity on prevention of serious fall injuries in ad

该研究的目的是测试与健康教育相比,长期的,结构化的体力活动计划是否会降低久坐有功能限制的的老年人严重跌倒受伤的风险。

该多中心,单盲试验在2010年2月和2011年12月美国的8个中心进行。该研究纳入了1635名久坐的,功能限制的成年人年龄在70-89岁,功能限制被定义为短的物理性能电池得分≤9,但能够步行400米。

一个置换块算法通过现场中心和性别分层用于分配干预。受试者随机接受结构化,中等强度的身体活动程序(n=818)在一个中心进行(每周两次)以及在家完成(每周3-4次),包括有氧,强度,柔韧性和平衡训练活动,或接受一个健康教育计划(n=817),以和老年人上肢伸展运动有关的讲座形式组成。

主要检测指标为严重的跌倒受伤,定义为跌倒导致的在临床性,非脊椎骨折或另一种严重受伤跌倒导致住院,是LIFE研究事先规定的次要结果。结果是每半年一次评估,长达42个月,工作人员均不知道干预分配。所有的受试者都纳入分析。

在平均2.6年随访过程中,严重的跌倒损伤体力活动组中的发生75例患者(9.2%),健康教育组有84例患者(10.3%)(危险比0.90,95%可信区间为0.66〜经历1.23; P=0.52)。这些结果是在几个亚组中是一致的,包括性别。然而,在没有预先设定的分析中,所有观察到的严重跌倒损伤率(男性率比0.54,95%置信区间0.31至0.95;女性为1.07,0.75至1.53; 相互作用P=0.043),跌倒骨折(男性0.47,0.25至0.86;女性1.12,0.77至1.64;相互作用P=0.017),与跌倒相关的住院(男性0.41,0.19到0.89;女性0.41,0.77至1.64,相互作用p=0.039)有性别特异性差异。

在这项试验中,不足以检测到小的但很严重的跌倒损伤,但其在严重跌倒损伤种可能有重要的减少,结构化的体力活动计划与健康教育项目相比并没有减少久坐有功能限制的老年人严重跌倒损伤的风险。这些结果,伴随着暗示的证据表明,体力活动程序可能会减少男性跌倒相关的骨折和住院率。

小知识:

体力活动指任何由运动系统产生并消耗能量、能够加快心率的身体活动,其中包括结构化(structured)与非结构化(unstructured)体力活动。结构化体力活动即我们常说的体育锻炼,指有计划、可重复的体力活动。非结构化体力活动即其他随意的自由玩耍。

原始出处:

Thomas M Gill,Marco Pahor,Jack M Guralnik,et al.Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89,BMJ,2016.2.3

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    2016-11-27 gaoxiaoe
  2. [GetPortalCommentsPageByObjectIdResponse(id=1847895, encodeId=6145184e895a6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Nov 27 09:14:00 CST 2016, time=2016-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64079, encodeId=fc76640e9d5, content=多锻炼, beContent=null, objectType=article, channel=null, level=null, likeNumber=177, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4371683642, createdName=文医生, createdTime=Fri Feb 12 17:46:00 CST 2016, time=2016-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63538, encodeId=33ef6353847, content=?, beContent=null, objectType=article, channel=null, level=null, likeNumber=169, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150714/IMG55A4BC357ED6E1444.jpg, createdBy=9f231612624, createdName=liushui8012, createdTime=Sun Feb 07 08:13:00 CST 2016, time=2016-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63383, encodeId=bdf4633834d, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4a6b1686125, createdName=1de47ca2m12(暂无匿称), createdTime=Fri Feb 05 14:29:00 CST 2016, time=2016-02-05, status=1, ipAttribution=)]
    2016-02-12 文医生

    多锻炼

    0

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    2016-02-07 liushui8012

    ?

    0

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