居家脊柱专项运动在胸椎后凸老年人中应用的可行性研究

A feasibility study on home-based kyphosis-specific exercises on reducing thoracic hyperkyphosis in older adults

目的 评估不同运动习惯的中国老年人进行居家脊柱后凸专项运动的可行性,探讨该运动计划对减少胸椎后凸角度和改善活动能力的效果.方法 本研究采用单组前后对照研究设计.在中国武汉市4个社区选取20名年龄≥60岁,患有胸椎过度后凸畸形且有康复潜力的老年人为研究对象.老年人接受为期6周的居家脊柱后凸专项运动干预,包括热身、肌肉加强、脊柱直立、脊柱灵活性和放松5个部分(22个动作),共有7次1 h的小组课程和35次的居家练习.在干预前后对老年人两种站立姿势下胸椎后凸角度、静态平衡、动态平衡、心肺功能、功能步态、疼痛及自我形象等指标进行评估并比较.采用老年人小组课程的出勤率、居家练习依从性及参与评价等指标来分析干预的可行性.结果 所有老年人均完成了小组课程和>75%的居家练习内容.干预后老年人在放松和最佳站立姿势下胸椎后凸角度较干预前均减少,中位数及四分位数间距分别 为-12.0°(-15.5°,-4.0°)(Z=-3.98,P<0.001)和-10.0°(-14.0°,-5.3°)(Z=-3.79,P<0.001).此外,干预后老年人疼痛程度明显减轻(P<0.001),自我形象认知得分提高(P<0.001),5项活动能力水平也有所提高(P<0.01).干预前后凸严重程度和日常体力活动强度不影响干预效果.大多数老年人认为干预强度适中且令人满意.结论 居家脊柱后凸专项运动在老年人胸椎过度后凸干预中具有可行性,并且可减少胸椎后凸角度,提升活动能力.

Objectives This study aimed to assess the feasibility of the home-based kyphosis-specific exercises among Chinese older adults with different exercise habits and explore its potential effects on reducing the kyphosis angle and improving physical performance.Methods A single-group,pre-and post-test design was conducted according to CONSORT 2010 statement:extension for pilot and feasibility trials.A total of 20 participants aged≥60 with thoracic hyperkyphosis and rehabilitation potential were recruited from four local communities in Wuhan,China.Participants underwent a six-week home-based kyphosis-specific exercises intervention that included warm-up,muscle strengthens,spinal alignment,spinal mobility and flexibility,and cool down five sections(22 exercises).The intervention involved seven 1-h group classes and 35 times daily home practice with identical content.At pre-and post-intervention,the participants'kyphosis angle in two standing postures,static balance,dynamic balance,cardiopulmonary function,dynamic gait assessment,pain,and self-image were assessed and compared.Feasibility was assessed by group class attendance,home practice adherence,and participant evaluations.Results All participants completed group classes and>75%home practice.Post-intervention,the participant’s kyphosis angle in relaxed and best-standing postures was changed by−12.0°(−15.5°,−4.0°)(Z=−3.98,P<0.001)and−10.0°(−14.0°,−5.3°)(Z=−3.79,P<0.001),respectively.In addition,participants had significantly less pain(P<0.001),better self-image(P<0.001),and improved performance in five physical assessments(P<0.01).Different pre-intervention hyperkyphosis angle and daily physical activity did not affect intervention effects.Most participants considered the interventional exercise as moderate intensity and satisfactory.Conclusions Home-based kyphosis-specific exercises showed the possibility of being a feasible intervention.And it was advantageous to reducing the kyphosis angle and improving physical performance.