足病治疗对老年人跌倒预防干预效果的Meta分析  

Effectiveness of podiatry treatment on falls prevention among older people:a Meta-analysis

作　　者：石佳卉 周俊丽 李春[1] 丁美祝[2] Shi Jiahui;Zhou Junli;Li Chun;Ding Meizhu(School of Nursing,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]广州中医药大学护理学院,广东广州510006 [2]广东省中医院

出　　处：《护理学杂志》2020年第20期87-91,101,共6页Journal of Nursing Science

基　　金：广东省研究生教育创新计划项目(2019JGXM26)。

摘　　要：目的评价足病治疗对预防老年人跌倒的效果。方法从PubMed、Cochrane library和中国知网等中英文献数据库中检索有关老年人足病治疗的随机对照试验研究(RCTs)文献,根据纳入和排除标准独立筛选文献、提取数据,进行文献质量评价,运用RevMan5.3软件对数据进行Meta分析。结果共纳入12个RCTs文献,Meta分析结果显示,足病治疗组在跌倒率[OR=0.77,95%CI(0.62~0.95),P=0.01]、平衡功能评分(BBS)[WMD=5.56,95%CI(2.81~8.31),P<0.01]方面优于对照组,但在动态平衡能力评分(TUG)[WMD=-1.97,95%CI(-3.91^-0.02),P=0.05]、足部疼痛与残疾指数评分、抑郁心理、跌倒自我效能、生活质量、日常活动能力方面的效果尚不确切。结论多层面足病治疗(足踝矫形器及鞋类建议、足踝功能锻炼、防跌倒宣传册)可提高老年人姿势平衡能力,降低老年人跌倒率,但在老年人抑郁心理、跌倒自我效能、动态平衡能力、日常生活活动能力等方面未见显著效果。Objective To evaluate the effect of podiatry treatment on falls prevention in the elderly.Methods We searched a number of databases such as PubMed,Cochrane library and CNKI,etc.,to retrieve publications regarding RCTs on podiatry intervention among older people.RCTs that met the inclusion and exclusion criteria were included,critically appraised and pooled for Meta-analysis using RevMan 5.3 software.Results A total of 12 RCTs were included.The results of Meta-analysis showed that the podiatry treatment group had lower fall rate[OR=0.77,95%CI(0.62-0.95),P=0.01],better balance function(BBS scores)[WMD=5.56,95%CI(2.81-8.31),P<0.01],than the control group,while the effect of podiatry treatment on the dynamic balance ability(TUG scores)[WMD=-1.97,95%CI(-3.91--0.02),P=0.05],Manchester Foot Pain and Disability Index scores,depression,falls self-efficacy,quality of life,and activities of daily life between the 2 groups were not clear.Conclusion Multi-faceted podiatry treatment(foot and ankle orthosis and footwear recommendations,foot and ankle functional exercises,and fall prevention brochures)can reduce fall rate and improve postural balance ability of the elderly.However,its effect on depression,falls self-efficacy,dynamic balance ability,activities of daily living,etc.,has not been significant.

关 键 词：老年人 足病治疗 足部护理 跌倒预防 足踝矫形器 功能鞋垫 动态平衡能力 META分析 

分 类 号：R47[医药卫生—护理学] R212.7[医药卫生—临床医学]