Gait Speed Modifies Efficacy of Home-Based Exercise for Falls in Older Adults With a Previous Fall: Secondary Analysis of a Randomized Controlled Trial.

IF 3.5 4区医学 Q1 ORTHOPEDICS

Physical Therapy Pub Date : 2025-03-03 DOI:10.1093/ptj/pzaf008

Jordyn Rice, Ryan S Falck, Jennifer C Davis, Chun L Hsu, Larry Dian, Kenneth Madden, Naaz Parmar, Wendy L Cook, Karim M Khan, Teresa Liu-Ambrose

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引用次数: 0

Abstract

Objective: Exercise is an evidence-based strategy for preventing falls. However, its efficacy may vary based on individual characteristics, like gait speed. This study examined whether baseline gait speed modified the effects of home-based exercise on subsequent falls among older adults.

Methods: This is a secondary analysis of a 12-month, randomized controlled trial in community-dwelling adults who were ≥70 years old and who had fallen within the previous 12 months. Participants were randomized to either 12 months of home-based exercise (n = 172) or standard of care (n = 172). This study examined intervention effects on fall rates at 6 and 12 months stratified by baseline gait speed (slow [<0.80 m/s] or normal [≥0.80 m/s]) using negative binomial regressions. Baseline gait speed was investigated as a potential modifier of the intervention effects on mobility and cognitive function using linear mixed modeling.

Results: At baseline, 134 participants had slow (exercise = 70; standard of care = 64) and 210 had normal (exercise = 102; standard of care = 108) gait speeds. For participants with slow gait speed, exercise reduced fall rates by 44% at 6 months (incidence rate ratio = 0.56; 95% CI [confidence interval] = 0.33-0.95) but not at 12 months (incidence rate ratio = 0.63; 95% CI = 0.38-1.03) compared with standard of care; for participants with normal gait speed, there was no significant effect of exercise on fall rates at 6 or 12 months. Gait speed modified intervention effects; in the exercise group, participants with slow gait showed significant improvements in the Timed "Up & Go" Test at 6 months (estimated mean difference = -4.05; 95% CI = -6.82 to -1.27) and the Digit Symbol Substitution Test at 12 months (estimated mean difference = 2.51; 95% CI = 0.81-4.21).

Conclusion: Older adults with slow gait speed had a reduction in subsequent falls in response to exercise at 6 months. Gait speed modified the effects of exercise on mobility and cognition.

Impact: Older adults with slow gait speed may be a target population for exercise-based fall prevention.

查看原文本刊更多论文

步态速度改变先前跌倒的老年人家庭运动对跌倒的疗效：一项随机对照试验的二次分析。

目的：运动是预防跌倒的循证策略。然而，它的功效可能因个人特征而异，比如步态速度。该研究调查了基线步态速度是否会改变老年人在家锻炼对随后跌倒的影响。方法：这是一项为期12个月的随机对照试验的二次分析，研究对象为≥70岁且在过去12个月内跌倒的社区居住成年人。参与者被随机分为12个月的家庭运动组（n = 172）和标准护理组（n = 172）。本研究考察了干预对6个月和12个月时跌倒率的影响，并按基线步态速度（慢）分层。结果：在基线时，134名参与者的慢(运动= 70；标准护理= 64)，210例正常(运动= 102；护理标准= 108)步速。对于步态缓慢的参与者，运动在6个月时减少了44%的跌倒率(发病率比= 0.56；95% CI = 0.33 ~ 0.95)，但12个月时没有(发病率比= 0.63；95% CI = 0.38 ~ 1.03)；对于走路速度正常的参与者，在6个月或12个月时，运动对跌倒率没有显著影响。步态速度调节干预效果；在运动组中，步态缓慢的参与者在6个月时的定时“Up & Go”测试中表现出显着改善(估计平均差异= -4.05；95% CI = -6.82至-1.27)和数字符号替代测试在12个月(估计平均差= 2.51；95% CI = 0.81 ~ 4.21)。结论：步态缓慢的老年人在6个月时进行运动后跌倒的次数减少。步态速度改变了运动对运动能力和认知能力的影响。影响：步态缓慢的老年人可能是运动预防跌倒的目标人群。

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

Physical Therapy Multiple-

CiteScore

7.10

自引率

0.00%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.