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| 題 名 | 震動治療對骨質疏鬆症成效之先驅性研究 : 以照護機構內之中老年人為例=A Pilot Study of Vibration Therapy on Osteoporosis : Example of Institutionalized Middle-aged and Old People |
|---|---|
| 作 者 | 陳正一; 鍾瑞容; 張家銘; 官大紳; 謝裕弘; 陳家成; 吳至行; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
| 卷 期 | 4:3 2009.08[民98.08] |
| 頁 次 | 頁169-178 |
| 分類號 | 415.596 |
| 關鍵詞 | 非藥物治療; 低骨量; 骨密度; 雙能量 X光吸收儀; Non-pharmacological therapy; Low bone mass; Osteoporosis; DXA; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 的:瞭解機構中老年住民之骨質疏鬆症盛行率和震動治療的成效。方法:於 2008年 7月至 2009年 1月,選取台灣南部某長期照護機構可自行活動住民共 25人 (女 /男 = 13/12) 為研究對象 (年齡:71.96±16.08歲,身體質量指數:24.34 ± 2.93 kg/m2),所有個案以 2:1雙盲隨機方式分為實驗組與對照組進行研究。於六個月試驗期間,實驗組 (女/男 = 7/10) 每天 20分鐘站立於震動治療儀上,每星期最少五天的震動治療計劃,對照組 (女/男 = 6/2) 則站立於僅有聲響沒有震動之假性震動治療儀上。於 0及 6個月以移動式雙能量 X光吸收儀進行全髖骨與股骨頸骨密度檢測。 結果:依世界衛生組織定義之骨質疏鬆與低骨量個案分別為 7位 (28.0%)及 8位 (32.0%),其中男性 (n = 12) 有 41.7%為低骨量,16.7%為骨質疏鬆;女性 (n = 13) 有 15.4%為低骨量, 46.2%為骨質疏鬆。介入前之實驗組與對照組全髖骨 BMD分別為 0.76 ± 0.157及 0.797 ± 0.112 (p = 0.562);股骨頸 BMD分別為 0.621 ± 0.123及 0.675 ± 0.138 (p = 331)。震動治療平均遵醫囑率為 55%,六個月後實驗組與對照組全髖骨 BMD分別為 ± 0.136 (與介入前比較 p = 0.68) 及 0.794 ± 0.123 (與介入前比較 p = 0.819);股骨頸 BMD為 0.609 ± 0.125 (與介入前比較 p = 0.018) 及 0.686 ± 0.13 (與介入前比較 p = 0.381)。以共變數分析 (ANCOVA) 調整住民的年齡、性別、遵醫囑率及身體質量指數,發現有無接受震動治療兩組在股骨頸骨密度的改變略有差異(p = 0.045),但是全髖骨則無差異 (p = 0.638)。 結論:長照機構中老年住民有骨質疏鬆症或低骨量的盛行率將近 60%。持續六個月震動治療對於髖骨骨密度值尚未能達到顯著改善成效,可能需要更多個案及更久期間的治療研究才能確認震動治療對骨質疏鬆症的成效。 |
| 英文摘要 | Objective: To realize the prevalence of osteoporosis and effect of vibration therapy in the institutionalized middle-aged and old people. Methods: Subjects were collected from a long-term care facility in southern Taiwan during July 2008 to Jan. 2009. Twenty-five ambulatory middle-aged and old subjects (F/M = 13/12, Age:72.0 ± 16.1, body mass index:24.3 ± 2.9 kg/m2) were randomized (2:1 double-blinded) into study and placebo group. Study group (F/M = 7/10) received a 6-month vibration therapy (Juvent 1000, 0.3G, 32-37 Hz) with 20 min daily and 5 days a week at least, the placebo group received the same course but with placebo machine (Juvent 1000 placebo). Total hip and neck bone mineral density (BMD, g/cm2) were obtained at 0-month and 6-month by mobile dual-energy X-ray absorptiometry (mobile DXA, Hologic Explorer QDR) for each subject. Result: According to the WHO diagnostic criteria, subjects with the low bone mass and osteoporosis were 7 (28%) and 8 (32%) in total group, 41.7% and 16.7% in males, 15.4% and 46.2% in females, respectively. At 0-month, the total hip BMD were 0.76 ± 0.16 for study group and 0.8 ± 0.11 for placebo group (p = 0.56), neck BMD were 0.62 ± 0.12 and 0.68 ± 0.14 (p = 0.33) accordingly. The compliance rate was 55.0%. At 6-month, the total hip BMD were 0.76 ± 0.14 (compared with 0-month, p = 0.68) for study group and 0.79 ± 0.12 (compared with 0-month, p = 0.82) for placebo group (p = 0.56), neck BMD were 0.61 ± 0.13 (compared with 0-month, p = 0.018) and 0.686 ± 0.13 (compared with 0-month, p = 0.381) accordingly. The ANCOVA, adjusted for age, sex, compliance and body mass index, found a significant difference of the neck BMD change between study and placebo group (p = 0.045), but no statistical significance in total hip BMD(p = 0.638). Discussion: The prevalence of osteoporosis was around 60% in institutionalized middle-aged and aged people. The 6-month course of vibration therapy did not reveal a significant change of BMD. More subjects and longer study duration to evaluate the vibration therapy for the osteoporosis are warranted. |
本系統中英文摘要資訊取自各篇刊載內容。