老年人活力再现计划

Click here to load reader

  • date post

    30-Dec-2015
  • Category

    Documents

  • view

    149
  • download

    1

Embed Size (px)

description

--- 老年人活力再现计划. 老年化社会日本 的运动器官康复医学. 徐守宇 浙江中医药大学康复医学教研室 日本顺天堂大学医学部医学博士. 今天的话题. 1. 日本社会的老龄化和老年性疾病的急增 2. 老年人的运动器官疾病:运动器官不安 定症 3. 针对运动器官不安定症的运动疗法 4. 老年人运动器官疾患的预防:   ロコモティブ症候群( JOA 原创造语 = locomotive syndrome ). 进行中的日本国老年化社会. 推进中的老年化. 现今: 低出生率老年化社会 - PowerPoint PPT Presentation

Transcript of 老年人活力再现计划

  • ---

  • JOA= locomotive syndrome

  • 23.1%4540.5%

  • (UN, World population Prospects: The 2006 Revision)

  • 20062009

  • 2007

  • 2009.7044.0%

  • 50%

  • 29.114.923.18.910.912.517.511.831.622.21610.56.5%

  • 2030%

  • KOA

  • ADL

  • 365JA+121215Timed up & go test 20

  • KOA

  • KOAXKOA25308601679KOA800 2009, Yoshimura N et al. ROAD study

  • KOA(Yoshimura N, et al.: JBMM 2009)

  • 65,000(0.65%)(2007)9,935,00099.35%)10,000,000ROAD Study)

    KOA

  • KOANSAID

  • KOAKOA

  • KOA

    evidence

    II.

  • KOA,1/2~3m,JKOM,X-ray)HA

  • KOA RCT1991 vs (n=79, 12w)2000 vs (n=119, 12w)2003 vs (n=59,12w). 2006n=142, 18m

    2005n=257, ~8y2007 vs n=98, 6m)2008n=57, 8w

  • 1SLRSLRnSLRHome Exercise vs NSAID 12JOA ScoreCybexstraight leg raising

  • Home ExerciseSLRstraight leg raising

  • 1SLR199110090807077.085.587.9****85.388.3**76.680.084.7**78.30

  • SLRJOARCT..(Doi T, et al.: Am J Phys Med Rehabil 87:258-269, 2008)

  • JOA RCTMaterials; Flow chartRandomizedIntention to treat (ITT) analysisdrop-out 9drop-out 12Quad.Ex. 63NSAID 58Quad.Ex. 72NSAID 70Participants 142

    ITT analysis121

  • Comparing : Quad. Ex.- NSAID Box-plots (improvement ratio)JKOM * WOMAC SF-36 VASp
  • KOARCT1992,Kover,P.A.,:8 weeks, walking, 92pts1997,Ettinger,W.H.,:18 months, aerobic ex. or resistance ex., 365 pts1999,OReilly,S.C.,:6 months, resistance ex.,191 pts2000,Deyle,G.D.,: 4 weeks, manual therapy & ex., 83 pts2000,Messier,S.P.,: 6 months, ex & diet or ex alone, 21 pts2000, Hopman-Rock,M.,: 6 months, ex or education, 105 pts2000,Petrella,R.J.,: 8weeks,ex or conventional treatment,177 pts2001, Pennix,B.W.,: 18 months, aerobic ex, resistance ex or control, 250 pts2002, Thomas,K.S.,: 24 months, HEx, HEx+phone or phone only, 786 pts2004, Messier,S.P.,: 18 months, diet(D), Ex or D+Ex, 316 pts2004,8SLREx or NSAID1212005,Thomas,K.S.,: 24 months, Hex, Hex+phone or phone only, 759 pts2006, Karatosun,V.,: 18 months, Hex vs HA inject., 105 pts2007, Messier, S.P.,: 12 months, Glcn/Chrn vs Ex, 89 pts2007, Hurley, M.V.,: 6 months, usual therapy vs Ex, 418 pts2008, Lund, H.,: 8 weeks, aerobic vs m. strength, aqua vs land Ex, 79 pts2008, Lim, B-W.,: 12 weeks, Hex, varus moment measuring, 107 pts IV.

  • Home Exercise89: 933- 41, 200647

  • XXVV3
  • Home Exercisen=31445.815.7m

  • 90.576.05060708090100( n=107)( n=55),( n=24) JOA 66.277.773.765.8XJOA Score *: p
  • KOAKOANSAIDHA

  • JOARCTShirado O, et al: Spine 35:E811-9,2010[][]201EXNSAID12StretchJLEQ(Japan Low back pain Evaluation Questionaire)[]EXNSAID

  • locomotive syndrome:RiskLocomotive organJOA

  • 40

  • locomotive syndromemetabolic syndrome

  • locomotive syndrome

  • 2005 Li F, et al., 2009 Wang C, et al.

  • 6523%40%2030%

  • *****************************