基于虚拟现实的八段锦对养老机构老年骨质疏松症患者跌倒风险及生活质量的影响

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摘要目的探讨基于虚拟现实（VR）的八段锦对养老机构老年骨质疏松症（OP）患者跌倒风险及生活质量的影响。方法选择2016年7月～2017年12月南京江宁沐春园护理院老年OP患者64例进行研究，按随机数字表法将其分为对照组和观察组，每组32例。两组均接受常规抗骨质疏松治疗，观察组在此基础上采用基于VR的八段锦训练，每周训练3次，每次50 min，共训练12个月。观察两组患者的躯体功能、跌倒效能、疼痛程度、骨密度（BMD）、跌倒次数和生活质量。结果研究过程中，每组各有2例脱落。最终，对照组和观察组各30例。治疗前，两组患者简易躯体执行能力测试量表（SPPB）评分、修订版跌倒效能量表（MFES）评分、视觉模拟评分法（VAS）评分、简明健康调查简表（SF-36）评分比较，差异均无统计学意义（P ＞ 0.05）；治疗12个月后，两组患者SPPB、MFES、SF-36评分均较治疗前显著增加（P ＜ 0.05），VAS评分较治疗前显著降低（P ＜ 0.05），且观察组的SPPB、MFES和SF-36评分均显著高于对照组（P ＜ 0.05），VAS评分显著低于对照组（P ＜ 0.05）。治疗前，两组患者腰椎（L2-4）、股骨颈和全髋的BMD值比较，差异均无统计学意义（P ＞ 0.05）；治疗12个月后，两组患者各项BMD值均较治疗前显著增加（P ＜ 0.05），且观察组的各项BMD值显著高于对照组。治疗前12个月内，两组患者跌倒次数比较，差异无统计学意义（P ＞ 0.05）；治疗12个月内，两组患者跌倒次数均较治疗前显著下降（P ＜ 0.05），且观察组的跌倒次数显著低于对照组（P ＜ 0.05）。结论基于VR的八段锦可有效改善养老机构老年OP患者的躯体功能、跌倒效能、腰背部疼痛程度及BMD，降低跌倒风险和跌倒次数，提高其生活质量，易于在养老机构内推广应用。

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	孙志成1
	2 顾晓美1 欧阳钢1 奚旸1 张娜2 陈秀荣2 潘丽君2

关键词 ：老年骨质疏松症, 虚拟现实, 八段锦, 养老机构, 跌倒风险, 生活质量

Abstract：Objective To explore the effects of baduanjin based on virtual reality (VR) on the risk of falls and quality of life of elderly patients with osteoporosis (OP) in nursing institution for the aged. Methods From July 2016 to December 2017, 64 elderly OP patients in Nanjing Jiangning Muchunyuan Nursing Home were selected for the study. They were divided into the control group and the observation group according to the random number table method, with 32 cases in each group. Both groups received conventional anti-osteoporosis treatment. On this basis, the observation group adopted baduanjin based on VR training three times a week for a total of 12 months, each time 50 min. Physical function, fall effectiveness, pain level, bone mineral density (BMD), the number of falls and quality of life were observed in both groups of patients. Results During the study, 2 cases fell out in each group. In the end, there were 30 cases each in the control group and the observation group. Before treatment, there was no statistically significant differences in the short physical performance battery (SPPB) score, the modified falls efficacy scale (MFES) score, the visual analogue scale (VAS) score and the short-form 36 item health survey questionnaire (SF-36) score between the two groups of patients (P ＞ 0.05). After 12 months of treatment, SPPB, MFES and SF-36 scores in both groups of patients were significantly higher than those before treatment (P ＜ 0.05), and VAS scores were significantly lower than those before treatment (P ＜ 0.05). SPPB, MFES and SF-36 scores in the observation group were significantly higher than those in the control group (P ＜ 0.05), and VAS scores were significantly lower than those in the control group (P ＜ 0.05). Before treatment, BMD values of lumbar spine (L2-4), femoral neck and total hip of the two groups of patients were not significantly different (P ＞ 0.05). After 12 months of treatment, BMD values in both groups of patients were significantly higher than those before treatment (P ＜ 0.05), and BMD values in the observation group were significantly higher than those in the control group. Within 12 months before treatment, there was no significant difference in the number of falls between the two groups of patients (P ＞ 0.05). Within 12 months after treatment, the number of falls of patients in both groups was significantly lower than that before treatment (P ＜ 0.05), and the number of falls in the observation group was significantly lower than that in the control group (P ＜ 0.05). Conclusion Based on VR, baduanjin can effectively improve the physical function, fall efficiency, lower back pain and BMD of elderly OP patients in nursing institution for the aged, reduce the risk and number of falls, improve their quality of life, and facilitate the promotion and application in nursing institution for the aged.

Key words： Elderly osteoporosis Virtual reality Baduanjin Nursing institution for the aged Fall risk Quality of life

基金资助:江苏省老年医学研究所科研面上项目（L201503）；
2018年江苏卫生健康职业学院院级科研项目暨江苏高校品牌专业建设工程资助项目（JKPY1810）。

引用本文:

孙志成1,2 顾晓美1 欧阳钢1 奚旸1 张娜2 陈秀荣2 潘丽君2. 基于虚拟现实的八段锦对养老机构老年骨质疏松症患者跌倒风险及生活质量的影响[J]. 中国医药导报, 2020, 17(1): 90-93,97.
SUN Zhicheng1,2 GU Xiaomei1 OUYANG Gang1 XI Yang1 ZHANG Na2 CHEN Xiurong2 PAN Lijun2. Effects of baduanjin based on virtual reality on fall risk and quality of life of elderly osteoporosis patients in nursing institution for the aged. 中国医药导报, 2020, 17(1): 90-93,97.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I1/90

[1] 朱艳辉，李小霞，赵义，等.养老机构老年人骨质疏松与日常生活活动能力相关性分析[J].中国社会医学杂志，2016，33（6）：525-527.
[2] 欧阳晓俊.老年骨质疏松症——《原发性骨质疏松症诊疗指南（2017）》解读[J].实用老年医学，2018，32（1）：95-97.
[3] Moncada LVV，Mire LG. Preventing Falls in Older Persons [J]. Am Fam Physician，2017，96（4）：240-247.
[4] 杨亚男，史丽伟，倪青.骨质疏松症的康复技术与方法[J].北京中医药，2018，37（8）：735-739.
[5] 孙志成，王彤，王青，等.虚拟现实训练对养老院老年人跌倒相关危险因素的影响[J].中国康复医学杂志，2018， 33（6）：687-692.
[6] Prevention and management of osteoporosis [J]. World Health Organ Tech Rep Ser，2003，921：1-164.
[7] Mijnarends DM，Meijers JM，Halfens RJ，et al. Validity and reliability of tools to measure muscle mass，stability，and physical performance in community-dwelling older people：a systematic review [J]. J Am Med Dir Assoc，2013， 14（3）：170-178.
[8] 赫燕萍，刘雪琴.修订版跌倒效能量表在我国老年人群中的测试研究[J].中华护理杂志，2007，42（1）：19-21.
[9] 严广斌.视觉模拟评分法[J].中华关节外科杂志：电子版，2014，8（2）：34-34.
[10] Dong A，Chen S，Zhu L，et al. The reliability and validity of Chinese version of SF36 v2 in aging patients with chronic heart failure [J]. Aging Clin Exp Res，2017，29（4）：685-693.
[11] 张瑞鹏，尹英超，李石伦，等.髋部骨折指南解读与诊疗现状分析[J].河北医科大学学报，2018，39（6）：621-627.
[12] 史章娣，邓辉胜.衰弱与骨质疏松症的联系及治疗进展[J].医学综述，2018，24（18）：3673-3677.
[13] 袁忠.降钙素治疗老年性骨质疏松症疼痛临床疗效研究[J].当代医学，2018，24（3）：6-8.
[14] 杨华，郭勇.北京城镇中老年人25-羟维生素D3、甲状旁腺素、骨钙素与骨密度的相关性分析[J].中国现代医生，2018，56（2）：4-7.
[15] 李春亮，罗成林，朱海勇，等.骨质疏松合并压缩性骨折患者Th17细胞功能测定及其与骨代谢的相关性分析[J].疑难病杂志，2018，17（10）：1145-1148.
[16] 冯飞，陈浩，张湛金，等.维生素D干预对老年骨质疏松症患者躯体功能、肌力和跌倒风险的影响[J].中华骨质疏松和骨矿盐杂志，2017，10（4）：313-319.
[17] 陈国平，裴飞，王艳.八段锦结合平衡垫训练对于老年人平衡功能及跌倒风险的研究[J].中国康复，2017，32（2）：141-142.
[18] In T，Lee K，Song C. Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke：Randomized Controlled Trials [J]. Med Sci Monit，2016，22：4046-4053.
[19] 金星，许光旭，孟兆祥，等.基于虚拟现实技术的康复训练对脑外伤恢复期患者平衡功能的影响[J].中华物理医学与康复杂志，2016，38（6）：406-408.
[20] Smith AA，Silva AO，Rodrigues RA，et al. Assessment of risk of falls in elderly living at home [J]. Rev Lat Am Enfermagem，2017，25：e2754.
[21] Gillespie SM，Friedman SM. Fear of falling in new long-term care enrollees [J]. J Am Med Dir Assoc，2007，8（5）：307-313.
[22] 苏建华，邓强.八段锦联合抗骨质疏松药物治疗绝经后骨质疏松症的临床研究[J].中医药学报，2018，46（3）：84-88.
[23] 徐辉煌，张海宇，林勇，等.基于多粒度级联森林的骨质疏松性骨折预测研究[J].北京生物医学工程，2019，38（4）：384-391.
[24] 苟静，岳建彪，李霞，等.伊班膦酸钠联合唑来膦酸治疗绝经后骨质疏松症患者的临床效果及对生活质量的影响[J].疑难病杂志，2019，18（4）：383-387.
[25] 郑扬康，刘海全，侯蕾，等.原发性骨质疏松疼痛症的中医药治疗新进展[J].中国骨质疏松杂志，2018，24（8）：1080-1087.
[26] 陈鑫林.运动对原发性骨质疏松症的干预与机制[J].中国组织工程研究，2018，22（8）：1294-1299.