轻度认知功能障碍老年患者预防跌倒的干预研究

Prevention of tumble in elderly people with mild cognitive impairment

目的探讨步态与平衡功能干预对减少轻度认知障碍老年患者跌倒发生率的效果。方法使用区组随机化的方法,将2017年10月至2018年6月江苏省人民医院老年医学科门诊及老年医学科住院患者中共136例发生过跌倒的轻度认知功能障碍老年患者分成步态训练组、健康教育组、联合干预组及无处理对照组。健康教育组患者仅接受步态及预防跌倒的健康教育;步态训练组患者仅接受步态与平衡功能干预;联合干预组患者接受健康教育联合步态与平衡功能干预;无处理对照组患者不接受任何干预措施。比较研究开始前、开始第3个月、第6个月及研究结束后3个月4组患者的认知功能、步态及平衡功能,比较4组患者跌倒发生情况。结果联合干预组患者在开始第3个月、第6个月及结束后3个月时的认知功能、步态及平衡功能均高于其他3组(P<0.01);在研究开始第3个月、第6个月及研究结束后3个月,联合干预组患者跌倒发生率均低于其他3组患者。结论健康教育联合步态与平衡功能干预能够显著减少轻度认知障碍老年患者跌倒的发生率。

Objective To investigate the effect of gait and balance function intervention on reducing the incidence of tumble in elderly people with mild cognitive impairment(MCI). Methods One hundred and thirty-six elderly people with MCI who tumbled in the past were randomly divided into gait training group,health education group,combined intervention group and normal group.The patients in health education group received health education for gait and prevention of tumble merely.The patients in gait training group only received gait and balance function intervention.The patients in combined intervention group received health education combined with gait and balance function intervention.And the patients in normal group made no processing.The cognitive function,gait and balance function of the four groups were measured and compared before and at the third,sixth month after intervention. Results The cognitive function,gait and balance function of the patients in the combined intervention group were higher than those of any other groups at the third,sixth month after the end of the study ( P <0.01).The incidence of tumble in the combined intervention group was lower than any other group. Conclusions Health education combined with gait and balance function intervention can significantly reduce the incidence of tumble in elderly people with MCI.