中国全科医学 ›› 2025, Vol. 28 ›› Issue (02): 193-199.DOI: 10.12114/j.issn.1007-9572.2024.0215

• 论著 • 上一篇    下一篇

平衡强化训练对住院老年精神分裂症患者平衡能力的影响:一项随机对照试验

秦伟1,2, 涂刚英3, 万小梅3, 王芳1,2,*()   

  1. 1.330029 江西省南昌市,江西省精神卫生中心护理部
    2.330029 江西省南昌市,南昌大学附属精神病医院护理部
    3.330029 江西省南昌市,江西省精神卫生中心老年科
  • 收稿日期:2024-04-10 修回日期:2024-08-01 出版日期:2025-01-15 发布日期:2024-10-28
  • 通讯作者: 王芳

  • 作者贡献:

    秦伟提出主要研究思路,制订具体研究方案,撰写论文;涂刚英、万小梅负责研究的实施,进行数据的收集与整理,统计学分析,绘制图表;秦伟、王芳负责文章的质量控制与审查,对论文负责。

  • 基金资助:
    江西省精神心理疾病临床医学研究中心资助项目(202311003)

Effects of Balance-strengthening Training on Balance Ability in Elderly Inpatients with Schizophrenia: a Randomized Controlled Trial

QIN Wei1,2, TU Gangying3, WAN Xiaomei3, WANG Fang1,2,*()   

  1. 1. Department of Nursing, Jiangxi Mental Health Center, Nanchang 330029, China
    2. Department of Nursing, Mental Hospital of Nanchang University, Nanchang 330029, China
    3. Department of Geriatrics, Jiangxi Mental Health Center, Nanchang 330029, China
  • Received:2024-04-10 Revised:2024-08-01 Published:2025-01-15 Online:2024-10-28
  • Contact: WANG Fang

摘要: 背景 住院老年精神疾病患者跌倒发生率呈上升趋势,而运动不足和久坐不动的生活方式成为住院老年患者的现状,平衡训练可以有效减少跌倒已被证实,但在精神科运用甚少。 目的 探讨平衡强化训练对住院老年精神分裂症患者平衡能力的影响。 方法 选取2023年江西省某三级甲等精神专科医院老年科住院精神分裂症患者72例作为研究对象,采用随机数字表法分为试验组(36例)和对照组(36例)。对照组采用常规康复训练,试验组在对照组基础上采用平衡强化训练方案进行干预,在干预前及干预4、12周后,使用Berg平衡量表(BBS)和中文版Barthel指数(BI)以及国际版跌倒效能量表(FES-I)对两组患者进行评估。 结果 共62例患者完成训练,其中试验组30例,对照组32例。两因素重复测量方差分析显示,组别与时间对BBS、BI评分存在交互作用(P<0.05),组别对BBS评分主效应显著(P<0.05),对BI评分主效应不显著(P>0.05),时间对BBS、BI评分主效应均显著(P<0.05)。干预12周,试验组BBS、BI评分高于对照组(P<0.05)。组内比较显示,试验组干预4周BBS、BI评分高于干预前,干预12周后BBS、BI评分高于干预前、干预4周(P<0.05)。组别与时间对FES-I总分与室内、室外活动评分均存在交互作用(P<0.05);组别对FES-I室内活动评分主效应显著(P<0.05),对FES-I总分及室外活动评分主效应不显著(P>0.05);时间对FES-I总分及室内、室外活动评分主效应均显著(P<0.05)。干预12周,试验组FES-I总分及室内、室外活动评分高于对照组(P<0.05)。组内比较显示,试验组干预4周FES-I总分及室内、室外活动评分均高于干预前(P<0.05);试验组干预12周FES-I总分及室内、室外活动评分均高于干预前、干预4周(P<0.05)。 结论 平衡强化训练方案可有效提高住院老年精神分裂症患者平衡能力、生活自理能力及跌倒自我效能,降低跌倒风险。

关键词: 精神分裂症, 老年人, 平衡强化训练, 平衡能力, 跌倒, 随机对照试验

Abstract:

Background

The incidence of falls among elderly inpatients with psychiatric disorders is on the rise. A lack of adequate physical activity and a sedentary lifestyle have become prevalent among hospitalized elderly patients. Balance training has been demonstrated to be efficacious in reducing the occurrence of falls, yet its application within psychiatric care remains limited.

Objective

To explore the effect of balance intensive training on balance ability of hospitalized elderly patients with schizophrenia.

Methods

Seventy-two elderly patients with schizophrenia from a tertiary psychiatric hospital in Jiangxi Province were selected as objects for this research in 2023. Participants were randomly assigned into experimental group (n=36) and control group (n=36). The control group received standard rehabilitation training, whereas the experimental group was provided with a balance-strengthening training program in addition to the standard regimen. The Berg Balance Scale (BBS), the Chinese version of the Barthel Index (BI), and the International Falls Effectiveness Scale (FES-I) were utilized to assess patients at baseline and after 4 and 12 weeks of intervention.

Results

A total of 62 patients completed the study, with 30 in the experimental group and 32 in the control group. Two-factor repeated measurement ANOVA showed that there was interaction between group and time on BBS and BI scores (P<0.05), group had significant main effect on BBS scores (P<0.05), but had no significant effect on BI scores (P>0.05), and time had significant effect on BBS and BI scores (P<0.05). After 12 weeks of intervention, the BBS and BI scores of experimental group were higher than those of control group (P<0.05). Intra-group comparison showed that the BBS and BI scores of the experimental group were higher at 4 weeks of intervention than before intervention, and the BBS and BI scores after 12 weeks of intervention were higher than before intervention and 4 weeks of intervention, with statistical significance (P<0.05). Group and time had interaction effects on the total score of FES-I and indoor and outdoor activity scores (P<0.05). The main effect on FES-I indoor activity score was significant (P<0.05), but the main effect on FES-I total score and outdoor activity score was not significant (P>0.05). The main effects of time on the total score of FES-I and indoor and outdoor activity scores were significant (P<0.05). After 12 weeks of intervention, the total score of FES-I and indoor and outdoor activity scores of experimental groups were higher than those of control group (P<0.05). Intra-group comparison showed that the total score of FES-I and indoor and outdoor activity scores of experimental groups were higher than before intervention at 4 weeks (P<0.05) ; the total score of FES-I and indoor and outdoor activity scores at 12 weeks of intervention were higher than those before and after 4 weeks of intervention (P<0.05) .

Conclusion

Implementing a balance-strengthening training program among elderly inpatients with schizophrenia can lead to significant improvements in balance, self-care, and fall self-efficacy, thereby potentially reducing the risk of falls.

Key words: Schizophrenia, Elderly, Balance-strengthening training, Balance ability, Falls, Randomized controlled trial

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