訪問指導による運動介入の違いが在宅高齢者の身体機能・生活の質・自己効力感に及ぼす継続的効果：簡易運動と多種目運動の比較

抄録

We examined the effects of two home-based exercise programs (simple-exercise and multiple-exercise) conducted for three months on physical functioning, quality of life and self-efficiency of older Japanese adults. Simple-exercise consisted of squatting and standing on one leg, whereas multiple-exercise composed of squatting, calf raises, leg extensions, step exercises, isometric training of the upper and lower arms among others. Participants were randomly divided into simple-exercise (3 men and 12 women, aged 71.2 ± 2.6 years) and multiple-exercise groups (3 men and 12 women, aged 72.1 ± 2.2 years). Participants were also given biweekly home visit instructions. Participants worked out daily during the home-based exercise program without supervision of the instructor. The 30-second Chair Stand Test (CS-30), maximum step length, Timed up & Go (TUG), standing on one leg with eyes open were assessed as physical functioning. Health-Related Quality of Life (HRQOL), and Fall Efficacy Scale (FES) were assessed. After the home visiting intervention, we conducted a 6-month follow-up study of physical functioning and exercise adherence that was reinforced prompting by telephone. An analysis of variance indicated that both groups significantly increased scores in the standing on one leg with eyes open, maximum step length, TUG, CS-30, HRQOL (role physical and emotional), and FES following the interventions. The results of the follow-up investigations indicated that both groups maintained their CS-30, maximum step length, standing on one leg with eyes open, and HRQOL (role physical and emotional) scores until 6-months after the intervention. However, TUG and FES scores decreased significantly at the 3- and 6-month follow-up assessment. These results indicated that the effects of simple-exercise and multiple-exercise conducted by visiting homes did not have a differential effect on functioning, HRQOL or FES. The frequency of exercise decreased significantly in both groups 1-5 weeks into the follow-up period. However, the exercise frequencies of both groups were maintained at over three times a week in 5-24 weeks. It is suggested that both types of home-based exercise programs including follow-up phone calls were equally effective for maintaining exercise adherence over a 6-month period.