| 總結: | <p><strong>Background:</strong> Neurogenic claudication (NC) is a debilitating spinal condition affecting older adults’ mobility and quality of life.</p>
<p><strong>Methods:</strong> A randomised controlled trial of 438 participants evaluated the effectiveness of a physical and psychological group intervention (BOOST programme) compared to physiotherapy assessment and tailored advice (best practice advice [BPA]) for older adults
with NC. Participants were identified from spinal clinics (community and secondary care)
and general practice records and randomised 2:1 to the BOOST programme or BPA. The
primary outcome was the Oswestry Disability Index (ODI) at 12 months. Data was also
collected at 6 months. Other outcomes included ODI walking item, 6-minute walk test
(6MWT) and falls. The primary analysis was intention-to-treat.</p>
<p><strong>Results:</strong> The average age of participants was 74.9 years (SD 6.0) and 57% (246/435) were female. There was no significant difference in ODI scores between treatment groups at 12 months (adjusted mean difference (MD): -1.4 [95% Confidence Intervals (CI) -4.03, 1.17]), but, at 6 months, ODI scores favoured the BOOST programme (adjusted MD: -3.7 [95% CI -6.27, -1.06]). At 12 months, the BOOST programme resulted in greater improvements in
walking capacity (6MWT MD 21.7m [95% CI 5.96, 37.38]) and ODI walking item (MD -0.2
[95% CI -0.45, -0.01]) and reduced falls risk (odds ratio 0.6 [95% CI 0.40, 0.98]) compared
to BPA. No serious adverse events were related to either treatment.</p>
<p><strong>Conclusions:</strong> The BOOST programme substantially improved mobility for older adults with NC. Future iterations of the programme will consider ways to improve long-term pain related disability.</p>
|
|---|