Abstract: Background　Falls have become the leading cause of death among elderly people over the age of 65 in China，which are associated with over 50% of the injuries requiring hospital treatment in this group.Plantar perception training can improve balance ability and may be of value in reducing falls.Objective　To explore the effect of plantar perception training on the balance ability and risk of falls in the elderly with a history of falls，with a view to providing a basis for reducing falls in the elderly.Methods　From May 2017 to May 2018，62 out of the elderly patients over the age of 60 with an experience of at least one fall within 6 months before 2018-06-01 were recruited from Geriatrics Center，Hainan General Hospital，and were randomly divided into the experimental group and control group with 31 in each.All of them received the same plantar perception training of the same duration from rehabilitation department except that the controls were not required to distinguish the hardness levels of five sponge pads.General information，balance test results〔pre- and post-intervention eye opening，center-of-pressure（COP）total trajectory length with eyes closed，timed up and go（TUG）test〕，and fall risk assessment（FES）results were collected and compared between the groups.Results　In the experimental group，the scores of plantar perception training on the 7th，8th，9th，and 10th days of training were all lower than those on the 1st day（P<0.05）.In eyes-open conditions，there was no interaction between the training method and time on the COP total trajectory length（P>0.05）.Training duration produced significant main effect on the COP total trajectory length（P<0.05），while training duration did not（P>0.05）.There was an interaction between training method and time on COP total trajectory length and TUG results（P<0.05）.Both training method and time exerted significant main effects on COP total trajectory length and TUG results（P<0.05）.The COP total trajectory length decreased in both groups after training（P<0.05）.In eyes-closed conditions，the COP total trajectory length decreased in both groups after training（P<0.05）.Compared with the control group，the mean COP total trajectory length was longer before training but it was shorter after training in the experimental group（P<0.05）.The time used to complete the TUG test decreased in both groups after training（P<0.05）.The experimental group used shorter mean time to complete the TUG test either before or after training（P<0.05）.There was an interaction between the training method and time on the FES score（P<0.05）.Both the training method and time had significant main effects on the FES score（P<0.05）.The mean FES score increased in both groups after training（P<0.05）.Although the mean FES score was lower before training in the experimental group in comparison with the control group，it became higher after training（P<0.05）.Conclusion　Plantar perception training helps to improve the balance ability in elderly people，thus the risk of falls may be reduced.

Key words: Accidental falls, Aged, Plantar perception training, Balance ability, Treatment outcome

摘要： 背景　跌倒已经成为我国65岁以上老年人因伤致死的首位原因。因受伤到医疗机构就诊的老年人中，一半以上是因为跌倒。足底感知训练能够改善平衡功能，可能会对减少跌倒有一定价值。目的　探讨足底感知训练对有跌倒史老年人平衡能力和跌倒风险的影响，以期为减少老年人群跌倒提供依据。方法　2017年5月—2018年5月，从海南省人民医院老年医学中心招募在2018-06-01前6个月中至少经历过1次跌倒的60岁以上老年人。最终选择62名老年人为研究对象，依据随机数字表法将其分为试验组和对照组，各31例。收集患者一般资料，试验组在康复医学科进行足底感知训练，对照组以与试验组相同的方式和时间进行训练，但是不要求区分5个海绵垫的硬度水平。比较两组平衡检测〔干预前后睁眼、闭眼时压力中心（COP）移动路径长度，起立行走计时测试（TUG）结果〕、跌倒风险评估〔跌倒效能量表（FES）得分〕结果。结果　试验组第7、8、9、10天足底感知训练得分均低于第1天（P<0.05）。干预方法与时间在睁眼时COP移动路径长度上不存在交互作用（P>0.05）；干预方法在睁眼时COP移动路径长度上主效应不显著（P>0.05）；时间在睁眼时COP移动路径长度上主效应显著（P<0.05）。干预方法与时间在闭眼时COP移动路径长度、TUG结果上存在交互作用（P<0.05）；干预方法、时间在睁眼时COP移动路径长度、TUG结果上主效应显著（P<0.05）。对照组、试验组干预后睁眼时COP移动路径长度分别短于本组干预前（P<0.05）。试验组干预前闭眼时COP移动路径长度长于对照组，干预后闭眼时COP移动路径长度短于对照组（P<0.05）；对照组、试验组干预后前闭眼时COP移动路径长度分别短于本组干预前（P<0.05）。试验组干预前、干预后TUG结果均短于对照组（P<0.05）；对照组、试验组干预后TUG结果分别短于本组干预前（P<0.05）。干预方法与时间在FES得分上存在交互作用（P<0.05）；干预方法、时间在FES得分上主效应显著（P<0.05）。试验组干预前FES得分低于对照组，干预后FES得分高于对照组（P<0.05）；对照组、试验组干预后FES得分分别高于本组干预前（P<0.05）。结论　足底感知训练有利于提高老年人的平衡能力，从而减少跌倒。

关键词: 意外跌倒, 老年人, 足底感知训练, 平衡能力, 治疗结果