个体化多元运动干预对住院老年患者衰弱状态和躯体功能的影响

Effect of multi-component individualized exercise intervention on frailty and physical function in elderly inpatients

目的探讨个体化运动干预对住院老年患者衰弱状态和躯体功能的改善效果。方法收集2018年8月至2019年2月武汉大学中南医院老年医学科收治的老年患者(FRAIL量表得分≥1)58例,随机数表法分为试验组和照组,各组29例。对照组患者在住院期仅接受常规护理照护及常规宣教。试验组患者在对照组基础上实施个体化、多元运动干预,包括肌力训练、有氧训练及平衡训练。干预12周后,记录并比较2组患者衰弱状态、步速及起立行走计时试验(TUGT)结果。采用SPSS18.0统计软件对数据进行分析。结果干预前,2组患者衰弱构成比(实验组:衰弱前期16例,衰弱13例;对照组:衰弱前期12例,衰弱17例)差异无统计学意义(P=0.293),但干预12周后,2组患者衰弱构成比(实验组:衰弱前期20例,衰弱9例;对照组:衰弱前期8例,衰弱21例)差异有统计学意义(P=0.002)。干预前后,实验组衰弱构成比差异有统计学意义(P=0.019),但对照组患者干预前后差异不显著(P=0.269)。干预前,实验组与对照组患者在步速[(0.61±0.16)和(0.59±0.14)m/s]、TUGT[(17.82±3.48)和(18.25±3.32)s]方面比较差异无统计学意义(P>0.05);干预12周后,试验组步速[(0.66±0.12)和(0.57±0.11)m/s]、TUGT[(16.19±2.74)和(19.84±2.35)s]较对照组均得到明显改善(P<0.05)。且试验组患者的步速、TUGT及对照组患者TUGT在干预前后比较,差异亦有统计学意义(P<0.05)。结论个体化运动干预能够改善住院老年患者的衰弱状态和躯体功能,值得临床推广。

Objective To investigate the impact of individualized exercise intervention on the improvement of frailty and physical function in elderly inpatients.Methods Fifty-eight elderly patients (FRAIL score ≥1) admitted in the Zhongnan Hospital from August 2018 to February 2019 were recruited in this study.They were randomly divided into control and experimental group,with 29 cases in each.The control group received only routine nursing care and routine education during hospitalization.On the basis of these,the experimental group was given multi-component individualized exercise,including muscle strength training,aerobic training and balance training.After 12 weeks′ intervention,the frailty status,walking speed,and result of time up and go test (TUGT) were recorded and compared between the 2 groups.SPSS statistics 18.0 were used for data analysis.Results Before intervention,there was no significant difference in the composition ratio of frailty severity between the 2 groups (experimental group: 16 cases in pre- frailty,13 in frailty;control group: 12 in pre-frailty and 17 in frailty;P =0.293),but after 12 weeks of intervention,obvious difference was seen in the composition ratio (experimental group: 20 in the pre-frailty,9 in frailty;control group: 8 in pre-frailty and 21 frailty;P =0.002 ).There was notable difference in the composition ratio in the experimental group before and after the intervention ( P =0.019),but no such difference was seen in control group ( P =0.269).Before intervention,there were no significant differences in walking speed [(0.61±0.16) vs (0.59±0.14)m/s] and TUGT [(17.82±3.48) vs (18.25±3.32)s] between the 2 groups ( P >0.05 ).After 12 weeks of intervention,the experimental group had remarkably better walking speed [(0.66±0.12) vs ( 0.57±0.11 )m/s] and improved TUGT [(16.19±2.74) vs (19.84±2.35)s] than the control group ( P <0.05).There were also significant differences in walking speed and TUGT in experimental group before and after treatment,so were the TUGT in control group ( P <0.05).Conclusion Multi-component individualized exercise intervention can improve the frailty status and physical function in frail elderly inpatients,and is worthy of clinical promotion.