Boulgarides Lois K, McGinty Susan M, Willett Jayne A, Barnes Carole W
Kinesiology and Health Science Department, California State University, Sacramento, 6000 J St, Sacramento, CA 95819-6073, USA.
Phys Ther. 2003 Apr;83(4):328-39.
Few tests have been found to be strongly predictive of falls in community-dwelling older adults. The purpose of this study was to determine whether data from 5 balance tests-combined with data regarding fall history, number of medications, dizziness, visual problems, use of an assistive device, physical activity level, sex, and age-could predict falls in community-dwelling older adults who were independent.
Ninety-nine community-dwelling older adults aged 65 to 90 years (X =74.02, SD=5.64) were tested.
Subjects were tracked for falls over a 1-year period following testing. Impairment-based tests, which are tests that attempt to specifically identify which sensory systems are impaired or how motor control is impaired (eg, speed, accuracy of movement), were the Modified Clinical Tests of Sensory Interaction for Balance (Modified CTSIB) and the 100% Limits of Stability Test, both of which were done on the Balance Master 6.1. Performance-based tests, which are functional tests that identify functional limitations without necessarily identifying their causes, were the Berg Balance Scale, the Timed "Up Go" Test, and the Dynamic Gait Index. Demographic and health data included age, sex, number of medications, physical activity level, presence of dizziness, vision problems, and history of falls over the previous year. Logistic regression was used to determine which combinations of data from balance tests, demographics, and health factors were predictive of falls.
Two models-(1) the "standing on a firm surface with eyes closed" (FEC) condition of the Modified CTSIB and (2) the FEC combined with age and sex-were predictive of falls, but predicted only 1 and 2 subjects who were at risk for falling, respectively, out of 20 people who were at risk for falling.
Five balance tests combined with health and demographic factors did not predict falls in a sample of community-dwelling older adults who were active and independent.
很少有测试被发现能有力地预测社区居住的老年人跌倒情况。本研究的目的是确定来自5项平衡测试的数据——结合跌倒史、用药数量、头晕、视觉问题、辅助设备使用情况、身体活动水平、性别和年龄的数据——是否能预测独立生活的社区居住老年人的跌倒情况。
对99名年龄在65至90岁（X = 74.02，标准差 = 5.64）的社区居住老年人进行了测试。
测试后对受试者进行为期1年的跌倒跟踪。基于损伤的测试，即试图具体识别哪些感觉系统受损或运动控制如何受损（如速度、动作准确性）的测试，是改良的感觉交互平衡临床测试（改良CTSIB）和100%稳定极限测试，这两项测试均在平衡大师6.1上进行。基于表现的测试，即识别功能限制但不一定确定其原因的功能测试，是伯格平衡量表、定时“起立行走”测试和动态步态指数。人口统计学和健康数据包括年龄、性别、用药数量、身体活动水平、头晕情况、视觉问题以及上一年的跌倒史。使用逻辑回归来确定平衡测试、人口统计学和健康因素的数据哪些组合能预测跌倒。
两个模型——（1）改良CTSIB的“闭眼站在坚实表面上”（FEC）条件和（2）FEC结合年龄和性别——能预测跌倒，但在20名有跌倒风险的人中，分别仅预测出1名和2名有跌倒风险的受试者。
在一个活跃且独立生活的社区居住老年人群样本中，5项平衡测试结合健康和人口统计学因素并不能预测跌倒情况。
