任务导向性运动训练对老年衰弱住院患者的临床效果  

Clinical effects of task-oriented exercise in hospitalized elderly patients with frailty

作　　者：刘若琳[1] 顾新[1] 刘庆梅 邢进[1] 赵亮宇[1] 叶娜 丁钥 Liu Ruolin;Gu Xin;Liu Qingmei;Xing Jin;Zhao Liangyu;Ye Na;Ding Yue(Department of Rehabilitation,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院康复医学科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2024年第7期863-868,共6页Chinese Journal of Geriatrics

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2019TX320003)。

摘　　要：目的制订适合老年衰弱住院患者的任务导向性运动训练(TOE)方案,评价其对患者上下肢运动能力和日常生活活动能力的影响。方法采用便利抽样法,选取北京医院2019年8—12月收治的老年衰弱患者60例,随机分为任务导向性运动组(TOE组)和常规组各30例。在常规治疗和护理的基础上,TOE组进行翻身取物和多向移步,常规组进行有氧训练和抗阻训练,两组均完成10次训练。两组患者干预前评估基线资料,干预后评估患者的握力(作为上肢运动功能的评价指标)、世界卫生组织残疾评定量表(WHODAS)2.0的运动部分(作为下肢运动功能的评价指标)和改良Barthel指数(作为日常生活活动能力的评价指标)。结果干预前TOE组和常规组握力分别为(20.21±6.39)kg、(17.61±10.59)kg,WHODAS 2.0运动部分评分分别为(16.07±6.64)分、(20.23±1.18)分;干预后TOE组握力和WHODAS 2.0运动部分评分分别为(22.13±5.97)kg、(12.86±5.17)分,与常规组(19.05±9.16)kg、(15.67±1.11)分比较差异均有统计学意义(t=2.005、-18.210,P=0.049、<0.001);干预后TOE组握力和WHODAS 2.0运动部分结果均较干预前提高(t=5.005、-5.291,均P<0.001),但常规组干预前后握力和WHODAS 2.0运动部分结果比较差异均无统计学意义(t=0.247、1.614,P=0.806、0.112)。干预后TOE组和常规组改良Barthel指数总分分别为(55.27±37.12)分、(57.27±33.39)分,较干预前(42.27±29.92)分、(40.54±20.55)分均有提高(均P<0.05),干预后两组Barthel指数总分比较差异无统计学意义(t=1.042,P=0.303)。结论对老年衰弱住院患者,TOE方案简便易行、安全有效,不仅能够与常规运动方案达到同样的改善日常生活活动能力的目的,还能更快地提高上下肢运动功能表现。Objective To develop a task-oriented exercise(TOE)program suitable for hospitalized elderly frailty patients,and to evaluate its effects on patients'upper and lower limb mobility and activities of daily living.Methods Using the convenience sampling method,60 elderly frailty patients admitted to Beijing Hospital between August and December 2019 were selected and randomly divided into a TOE group and a conventional care group,with 30 in each group.In addition to conventional treatment and care,the TOE group performed task-oriented training(turning to fetch objects and multidirectional stepping),while the conventional care group performed aerobic training and resistance training.Both groups completed 10 training sessions.Baseline data of patients in both groups were assessed before intervention.Grip strength(as a measure of upper limb motor function),the motor component of the World Health Organization disability assessment schedule(WHODAS)2.0(as a measure of lower limb motor function),and the modified Barthel index(as measure of the ability to perform activities of daily living)were assessed after intervention.Results Before intervention,the grip strength values of the TOE group and the conventional care group were(20.21±6.39)kg and(17.61±10.59)kg,and the scores of the motor component of WHODAS 2.0 were(16.07±6.64)and(20.23±1.18),respectively.After intervention,the grip strength value and the score of the motor component of WHODAS 2.0 of the TOE group were(22.13±5.97)kg and(12.86±5.17)kg,respectively,with statistically significant differences compared with those of the conventional care group,which were(19.05±9.16)kg for grip strength and(15.67±1.11)for the motor component of WHODAS 2.0(t=2.005,P=0.049;t=-18.210,P<0.001).The value of grip strength and the score of the motor component of WHODAS 2.0 were higher post-intervention than pre-intervention in the TOE group(t=5.005、-5.291,P<0.001 for both),but they showed no statistical differences in the conventional care group(t=0.247、1.614,P=0.806,0.112).Afte

关 键 词：衰弱 行为康复训练 握力 日常生活活动 

分 类 号：R473.5[医药卫生—护理学]