运动疗法联合药物干预对老年护理医院骨质疏松患者跌倒风险的影响

摘要

目的 观察运动疗法联合药物治疗对老年护理院骨质疏松患者跌倒风险的影响.方法 选取2015年11月一2016年6月上海市金山区众仁老年护理医院老年病房骨质疏松住院患者201例,年龄65 ～98岁,平均(78.7±11.5)岁.随机分为对照组(n=98)和干预组(n=103),对照组予常规抗骨质疏松治疗,干预组在对照组的基础上联合运动疗法干预.记录2组治疗前后的跟骨定量超声传导速度(speed of sound,SOS)、简易躯体能力测试(short physical performance battery,SPPB)评分、日常生活能力(activity of daily living,ADL)量表评分、随访期间的跌倒和骨折发生率.结果 治疗后对照组SOS及步态速度测试优于治疗前(P＜0.05),干预组SOS、步态速度测试、椅子坐立测试及ADL评分优于治疗前(P＜0.05).治疗后干预组SOS、步态速度测试、椅子坐立测试及ADL评分均优于对照组治疗后(P＜0.05).随访期间,干预组跌倒和骨折的发生率低于对照组(P＜0.05).结论 老年护理医院骨质疏松患者在药物治疗的基础上联合运动疗法,能有效改善骨密度,提高肢体运动能力,促进平衡功能恢复,从而降低跌倒风险,减少骨折发生率.%Objective To observe the influence of exercise therapy combined with drug intervention on the risk of fall in the elderly with osteoporosis in aged care hospitals.Methods 201 elderly with osteoporosis in Department of Geriatric,Zhongren Aged Nursing Hospital during the period from Nov.,2015 to June,2016 were selected,aged from 65 to 98 with the average of (78.7±11.5) years,and randomly divided into 2 groups:intervention group (n=103) and control group (n=98);routine anti-osteoporosis treatment was performed in both groups while exercise therapy was added to the elderly in intervention group;the scores of speed of sound (SOS),short physical performance battery (SPPB) and activity of daily living (ADL) of all the elderly in the 2 groups before and after treatment were recorded as well as the occurrence of falls and fractures during the follow-up.Results After treatment,the scores of SOS and gait velocity test of the elderly in control group were better than those before treatment (P＜ 0.05);the scores of SOS,gait velocity test,SPPB (excluding equilibrium test) and ADL of the elderly in intervention group were improved much more than those before treatment (P＜0.05) and were superior to those of the elderly in control group (P＜0.05);the occurrence of falls and fractures in intervention group during the follow-up was lower than that in control group (P＜0.05).Conclusions Exercise therapy combined with drug intervention can effectively improve the bone mineral density of the elderly with osteoporosis in aged care hospital,raise the motor ability of limbs and promote the balance function rehabilitation,and thus decrease the risk of falls and the occurrence of fractures.