Effects of structured positive feedback intervention on standing reach ability among older adults admitted to a convalescent rehabilitation ward: a small-sample pilot randomized controlled trial.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

European Geriatric Medicine Pub Date : 2024-11-07 DOI:10.1007/s41999-024-01094-8

Hiroyuki Uchida, Akina Miki, Akane Ida, Takumi Igusa, Kazuki Hirao

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引用次数: 0

Abstract

Purpose: Interventions to improve the standing reach ability of older adults are essential for full functional independence, and structured positive feedback (PF) may be an effective intervention strategy. The purposes of this pilot randomized controlled trial (RCT) are to investigate the preliminary efficacy of structured PF for improving the standing reach ability of older patients admitted to a convalescent rehabilitation ward and evaluate the feasibility of a future full-scale RCT.

Methods: Thirty-two eligible older adults (83.3 ± 5.9 years, 23 women) out of 587 potential participants were randomly assigned 1:1 to structured PF (experimental) and conventional rehabilitation (control) groups. Only the experimental group received PF intervention for standing reach ability once every 3 days. Both groups engaged in conventional rehabilitation programs for 2-3 h every day. The primary outcome was change in Functional Reach Test (FRT) performance after 5 weeks of the indicated intervention compared to baseline. Secondary outcomes were change in Short Falls Efficacy Scale International (Short FES-I), a self-reported measure of fear of falling, and Functional Independence Measure (FIM) scores after the 5-week intervention.

Results: The estimated difference in mean FRT change (∆) between experimental and control groups was - 4.1 cm (P = 0.07) according to a linear mixed model, supporting the potential efficacy of PF for improving standing reach ability. Further, Hedge's g value was 0.71, consistent with a moderate effect size. However, the estimated mean change in Short FES-I between groups also indicated greater fear of falling in the experimental group (∆ = - 4.5, P = 0.009, g = 1.0). In contrast, the intervention effect on FIM was negligible (∆ = 2.0, P = 0.66, g = - 0.1).

Conclusions: These results support the preliminary effectiveness of structured PF for improving the standing reach ability of older adults. A larger-sample RCT is warranted for validation and optimization of the structured PF protocol.

Trial registration: The University Hospital Medical Information Network (UMIN) Registered 31 May 2022 (UMIN000047647).

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结构化积极反馈干预对入住疗养康复病房的老年人站立伸手能力的影响：小样本随机对照试验。

目的：改善老年人站立伸手能力的干预措施对于实现完全功能独立至关重要，而结构化正反馈（PF）可能是一种有效的干预策略。这项试点随机对照试验（RCT）旨在研究结构化正反馈疗法对改善疗养康复病房老年患者站立伸手能力的初步效果，并评估未来全面开展 RCT 的可行性：在 587 名潜在参与者中，32 名符合条件的老年人（83.3 ± 5.9 岁，23 名女性）被按 1:1 的比例随机分配到结构化腹肌锻炼组（实验组）和传统康复组（对照组）。只有实验组每 3 天接受一次针对站立伸展能力的体位法干预。两组均每天进行 2-3 小时的常规康复训练。主要结果是与基线相比，实验组在接受 5 周的干预后，其功能性前伸测试（FRT）成绩的变化。次要结果是5周干预后国际跌倒效能短量表（Short FES-I）和功能独立性量表（FIM）得分的变化：结果：根据线性混合模型，实验组和对照组的平均站立伸展能力变化（Δ）的估计差异为-4.1厘米（P = 0.07），这支持了PF对改善站立伸展能力的潜在疗效。此外，Hedge's g 值为 0.71，符合中等效应规模。然而，各组间短 FES-I 的估计平均变化也表明，实验组更害怕跌倒（∆ = - 4.5，P = 0.009，g = 1.0）。相比之下，干预对 FIM 的影响可以忽略不计（∆ = 2.0，P = 0.66，g = - 0.1）：这些结果支持了结构化 PF 对提高老年人站立伸手能力的初步有效性。试验注册：试验注册：大学医院医学信息网（UMIN）于 2022 年 5 月 31 日注册（UMIN000047647）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Geriatric Medicine GERIATRICS & GERONTOLOGY-

CiteScore

6.70

自引率

2.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.