{"title":"多成分职业治疗干预对老年人平衡、功能活动和本体感觉的影响:一项随机对照试验。","authors":"Alejandro Caña-Pino, Alba Marín-Rubio","doi":"10.3390/healthcare13182287","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background</b>: With the progressive aging of the in institutionalized settings population, functional decline-manifested as reduced proprioception, joint stiffness, and muscle loss-poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. <b>Objectives:</b> This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. <b>Methods:</b> A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. <b>Results:</b> The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. <b>Conclusions</b>: These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements-such as proprioception and balance-did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470052/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of a Multicomponent Occupational Therapy Intervention on Balance, Functional Mobility, and Proprioception in Institutionalized Older Adults: A Randomized Controlled Pilot Trial.\",\"authors\":\"Alejandro Caña-Pino, Alba Marín-Rubio\",\"doi\":\"10.3390/healthcare13182287\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background</b>: With the progressive aging of the in institutionalized settings population, functional decline-manifested as reduced proprioception, joint stiffness, and muscle loss-poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. <b>Objectives:</b> This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. <b>Methods:</b> A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. <b>Results:</b> The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. <b>Conclusions</b>: These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements-such as proprioception and balance-did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability.</p>\",\"PeriodicalId\":12977,\"journal\":{\"name\":\"Healthcare\",\"volume\":\"13 18\",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470052/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Healthcare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/healthcare13182287\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/healthcare13182287","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
背景:随着在机构设置的人口的逐渐老龄化,功能下降-表现为本体感觉下降,关节僵硬和肌肉损失-对老年人的自主性和生活质量构成越来越大的威胁。通过有针对性的、基于证据的干预措施,职业治疗在应对这些挑战方面发挥着核心作用。目的:本临床试验评估了将平衡和姿势稳定性练习、本体感觉刺激和下肢强化与传统老年体操相结合的多组分职业治疗干预的有效性。该项目旨在改善老年人的步态表现,降低跌倒风险,并促进老年人的独立性。方法:将35名社区老年人随机分为老年体操干预组(n = 13)、多成分干预组(n = 13)和对照组(n = 9)。参与者接受了为期6周的干预,包括每周两次45分钟的疗程。干预前和干预后评估的重点是姿势稳定性和与平衡相关的功能结果。结果:多组分组表现出平衡、本体感觉和功能活动能力改善的趋势,尽管这些没有达到统计学意义。临床上有意义的改善是通过功能测量的最小临床重要差异(MCIDs)来定义的,如Timed UP and Go (TUG) (>1.3 s)和performance oriented Mobility Assessment (POMA)(≥3分)。多组分组本体感觉准确度提高22.1%,活动能力(TUG)提高13.9%。此外,这种趋势可能表明对与年龄相关的功能衰退有潜在的保护作用。结论:这些研究结果表明,多成分的职业治疗干预可能有助于维持老年人的活动能力,减少老年人的功能下降。在下肢力量方面观察到统计学上显著的增加,而其他方面的改善,如本体感觉和平衡,虽然没有达到显著性,但接近临床相关性。这些初步结果支持在职业治疗中进一步研究平衡训练,以促进独立性和降低跌倒风险。由于样本量小(n = 35)和干预时间短,解释应保持谨慎,这限制了统计能力和概括性。
Efficacy of a Multicomponent Occupational Therapy Intervention on Balance, Functional Mobility, and Proprioception in Institutionalized Older Adults: A Randomized Controlled Pilot Trial.
Background: With the progressive aging of the in institutionalized settings population, functional decline-manifested as reduced proprioception, joint stiffness, and muscle loss-poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. Objectives: This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. Methods: A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. Results: The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. Conclusions: These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements-such as proprioception and balance-did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability.
期刊介绍:
Healthcare (ISSN 2227-9032) is an international, peer-reviewed, open access journal (free for readers), which publishes original theoretical and empirical work in the interdisciplinary area of all aspects of medicine and health care research. Healthcare publishes Original Research Articles, Reviews, Case Reports, Research Notes and Short Communications. We encourage researchers to publish their experimental and theoretical results in as much detail as possible. For theoretical papers, full details of proofs must be provided so that the results can be checked; for experimental papers, full experimental details must be provided so that the results can be reproduced. Additionally, electronic files or software regarding the full details of the calculations, experimental procedure, etc., can be deposited along with the publication as “Supplementary Material”.