老年髋部骨折合并肌少症病人修订版奥塔戈运动方案的初步构建

Preliminary construction of modified Otago exercise programme for elderly patients with hip fracture combined with sarcopenia

目的初步构建修订版奥塔戈运动方案,为预防老年髋部骨折合并肌少症病人术后康复期跌倒提供借鉴。方法通过文献研究法形成奥塔戈运动方案初稿,经两轮专家函询,结合专家意见修改相应条目,形成终版方案。结果共纳入6篇随机对照试验,15名专家共进行了两轮德尔菲函询。专家权威系数为0.943;专家积极性第一轮为100%,第二轮为93.3%;保留重要性评分>4.0和变异系数<0.2的条目,两轮函询Kendall’s W分别为0.244、0.334,差异均有统计学意义(P<0.001)。最终运动方案包括热身运动、肌力训练、平衡训练等3个一级项目、23个二级项目及4个术后运动时间节点。结论本研究初步构建的运动方案针对性较强,专家权威程度高,专家意见协调程度较好,可为预防老年髋部骨折合并肌少症病人术后康复期跌倒提供借鉴。

Objective To construct modified Otago exercise programme for the prevention of falls during rehabilitation period in the elderly patients with hip fracture combined with sarcopenia.Methods A project team was set up to form the first draft of the scheme on the basis of literature research.After two rounds of Delphi method,various items were modified to form the final version of the programme.Results A total of 6 randomized controlled trials were included,and 15 experts conducted two rounds of Delphi method.The experts authority coefficient was 0.943.The enthusiasm of experts was 100%in the first round and 93.3%in the second round.Items with importance scores>4.0 and coefficient of variation<0.2 were retained,and Kendall’s W for two rounds of inquiry were 0.244 and 0.334,respectively,with statistically significant differences(P<0.001).The final exercise plan included 3 primary items such as warm-up exercise,muscle strength training and balance training,23 secondary items and 4 postoperative exercise time nodes.Conclusions The preliminary exercise programme has a strong pertinency,high degree of experts authority,and good coordination of experts’opinions,which can provide a reference for the prevention of falls in the elderly patients with hip fracture and sarcopenia during postoperative rehabilitation.