Construction And Application Of Lower Limb Passive Exercise Program In Senile Patients With Severe Asthenia

【Purpose】1.Construct passive exercise program suitable for lower limb exercise of elderly patients with severe frailty;2.To explore the influence of passive lower limb exercise on the degree of weakness,body function,muscle circumference and nutritional metabolism of elderly patients with severe asthenia,and provide reference for passive exercise treatment of elderly patients with severe asthenia.【Methods】1.Reviewed the literature and discussed with the research group about the construction of the lower limb passive exercise program,and invited 5 experts to conduct two rounds of demonstration and revision of the exercise program;Pretest was carried out according to the standard,and the lower limb passive exercise program was further modified and improved according to the results of the pretest.2.This study was a similar experimental study.A convenient sampling method was adopted to divide 66 patients with severe frailty from the Department of geriatrics of a third-class A hospital in Yunnan Province into an intervention group(33 cases)and a control group(33 cases).The control group was given the frailty routine management program,and the intervention group was given the constructed lower limb passive exercise program based on the frailty routine management program.Experimental data such as EFS scale score,BI index,calf circumference,SGA scale rating,ALB and HB were collected before intervention,4 weeks,8 weeks and 12 weeks after intervention,respectively.Relevant experimental data were statistically analyzed by SPSS26.0 to comprehensively evaluate the effect of passive lower limb exercise program on elderly patients with severe asthenia.【Results】1.Scheme construction(1)Through literature analysis and discussion by the research group,this research program has referred to 7 literatures,and extracted and summarized 1 first-level index,8second-level index and 15 third-level index.(2)Two rounds of expert letter consultation were conducted,and the coordination coefficient(W)was 0.406 and 0.426,respectively,and the average authority coefficient(Cr)was 0.9,indicating a high authority of experts..Delete 2 items,add 9 items,and modify 8indicators in the first round of correspondence,and modify 1 indicator in the second round of correspondence.The initial plan involves 24 indexes from 8 aspects,including motion position,content,intensity and cycle,including 1 first-level index,8 second-level indexes and 15 third-level indexes.(3)The scheme was modified according to the pre-test results and evaluation,and the final draft of the lower limb passive motion scheme was formed after improvement.2.Clinical applicationAfter 12 weeks of intervention,2 cases(1 case in the intervention group and 1 case in the control group)were shed,and 66 patients finished the study(33 cases in the intervention group and 33 cases in the control group).The index results of the two groups of patients are as follows:(1)Baseline data: Before intervention,the general demographic data,scores of each scale and laboratory observation indicators were comparable between the two groups,with no statistical significance(P>0.05).(2)Degree of weakness: After 12 weeks of intervention,EFS scale scores of two groups were significantly different in terms of time,group and interaction effect(P<0.05).In addition,the intervention group was better than the control group in each time period,and the difference was statistically significant(P<0.05).(3)Physical function: After 12 weeks of intervention,BI index of intervention group was higher than control group 45(45,50)VS 40(35,40),and the difference was statistically significant(P<0.05).(4)Lower limb muscle circumference: After 12 weeks of intervention,there were statistically significant differences in calf circumference between the two groups in terms of time,group and interaction effect(P<0.05);After 4 weeks of intervention,there was no statistically significant difference between the intervention group and the control group(P>0.05).After 8 weeks and 12 weeks of intervention,the intervention group was better than the control group,the difference was statistically significant(P<0.05).(5)Nutritional indexes: After 12 weeks of intervention,there were statistically significant differences in ALB and HB in time,group and interaction effect between the two groups(P<0.05);After 4 weeks of intervention,there was no statistical significance in ALB between the intervention group and the control group(P>0.05).After 8 weeks and12 weeks of intervention,ALB and HB in the intervention group were better than those in the control group,with statistical significance(P<0.05).After 12 weeks of intervention,the improvement of nutritional status in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05).【Conclusions】1.Through literature review,research group discussion and expert demonstration,this study established Passive Lower limb Exercise Program for Elderly patients with severe frailty.The two rounds of correspondence were well coordinated and authoritative,indicating that this research program has good feasibility and scientificity,and is suitable for lower limb exercise training for elderly patients with severe frailty.2.Clinical trials have proved that the lower limb passive exercise program built in this study on the basis of conventional frailty management can more effectively reduce the degree of frailty of patients,and has achieved certain results in improving the physical function of patients,correcting malnutrition and increasing muscle circumference.It shows that this study has clinical significance in the field of exercise therapy for senile patients with severe asthenia and is worthy of clinical application.