Effects on Physical Functioning and Fear of Falling of a 3-Week Balneotherapy Program Alone or Associated with a Physical Activity and Educational Program in Older Adult Fallers: A Randomized-Controlled Trial.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY Clinical Interventions in Aging Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S472816

Pierre Louis Bernard, Xavier de la Tribonniere, Alessandra Pellecchia, Lucie Gamon, Fanchon Herman, Marie-Christine Picot, Nathalie J Raffort, Thierry Paillard, Jean-Baptiste Robiaud, Gregory Ninot, Jean Bousquet, Hubert Blain

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Abstract

Background: The effects on gait and posture of balneotherapy in fallers are unknown. We assessed the effects on physical functioning and fear of falling of a balneotherapy program alone or combined with a physical activity and educational program in older adult fallers.

Methods: A multicenter randomized controlled trial enrolled patients aged 65 or older referred to a 3-week balneotherapy program, and screened for risk of falling (a history of falls in the last year and a timed up and go test or a five chair rising test >12 sec or a 4-meter walk test >4 sec). In addition to balneotherapy, patients had either no intervention (controls) or twelve 60-minute sessions of physical activity including 15 minutes of health education and three 90-minute sessions of an educational program (intervention).

Results: There were 118 control and 105 intervention patients. The balneotherapy program alone had a clinically significant effect on (i) the grip strength, (ii) the five chair rising test, (iii) the 4-meter walk test, and (iv) the short physical performance battery (Cohen's d 0.29-0.46). It had no effect on (i) the maximum time stood on one foot, and (ii) the timed up and go test. Furthermore, it worsened the falls efficacy scale (d = 0.27). Adding a physical activity and educational program significantly improved (i) the time stood on one foot (Cohen's d =-0.34), and (ii) the timed up and go test (d=- 0.44), (iii) and reduced the concern about falling (Falls Efficacy scale, d=-0.25), and (iv) the fear of falling (d=-0.34).

Conclusion: Older patients referred to a balneotherapy program and at high risk of falling when screened at the entrance of the center should be offered an additional physical and educational program to further improve the functional effects of balneotherapy on the timed up and go test, balance, and the fear of falling.

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单独或与体育活动和教育计划相结合的为期 3 周的 Balneotherapy 计划对跌倒老人的身体功能和跌倒恐惧的影响：随机对照试验。

背景：目前尚不清楚浴疗法对跌倒者步态和姿势的影响。我们评估了单独或结合体育锻炼和教育计划的浴疗法对老年人跌倒者的身体机能和跌倒恐惧的影响：一项多中心随机对照试验招募了 65 岁或以上的患者，让他们参加为期 3 周的浴疗项目，并对他们进行跌倒风险筛查（过去一年中有过跌倒史、定时起立测试或五把椅子起立测试 >12 秒或四米步行测试 >4 秒）。除了浴疗法外，患者还接受了无干预（对照组）或 12 次 60 分钟的体育锻炼（包括 15 分钟的健康教育）以及 3 次 90 分钟的教育计划（干预组）：结果：共有 118 名对照组和 105 名干预组患者。单独的浴疗法对(i)握力、(ii)五人起立测试、(iii)四米步行测试和(iv)短期体能测试有显著的临床效果（Cohen's d 0.29-0.46）。它对(i) 单脚站立的最长时间和(ii) 定时起立行走测试没有影响。此外，跌倒效能量表（d = 0.27）也有所下降。加入体育锻炼和教育计划后，(i) 单脚站立时间（Cohen's d =-0.34）和(ii) 定时站立行走测试（d=- 0.44）、(iii) 对跌倒的担忧程度（跌倒效能量表，d=-0.25）和(iv) 对跌倒的恐惧程度（d=-0.34）均有明显改善：结论：在中心入口处进行筛查时，转诊至浴疗项目的高跌倒风险老年患者应接受额外的物理和教育项目，以进一步改善浴疗在定时起立和走动测试、平衡和跌倒恐惧方面的功能效果。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.80

自引率

2.80%

发文量

193

审稿时长

6-12 weeks

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.