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居住在社区中的中风患者:注意力缺陷、平衡能力、日常生活活动能力及跌倒情况。

People with stroke living in the community: Attention deficits, balance, ADL ability and falls.

作者信息

Hyndman D, Ashburn A

机构信息

Health and Rehabilitation Research Unit, University of Southampton, Southampton, UK.

出版信息

Disabil Rehabil. 2003 Aug 5;25(15):817-22. doi: 10.1080/0963828031000122221.

Abstract

PURPOSE

To describe levels of attention deficits among people with stroke living in the community and explore relationships between attention, balance, function and falls.

METHOD

Forty-eight mobile community-dwelling people with stroke (30 men, 18 women, mean age 68.4 +/- 11.2) were recruited to this cross-sectional investigation through General Practitioners. Twenty-six participants had a right, 21 a left hemisphere infarction and one had a brain stem lesion; mean time since stroke was 46 months (range five to 204). Participants' were interviewed about fall-events; attention, balance and function were assessed using standardised tests.

RESULTS

Visual inattention was identified in five participants (10%), deficits of sustained attention in 15 (31%), auditory selective attention in nine (19%), visual selective attention in 17 (35%) and divided attention deficits in 21 participants (43%). Sustained and divided attention scores correlated with balance, ADL ability and fall-status (p < 0.01). The balance and function of subjects with normal attention were better than those with abnormal scores (p < 0.01). Analysis of variance revealed differences between repeat-fallers and non-fallers with no near-falls for divided attention, balance and ADL ability (p < 0.01).

CONCLUSIONS

Attention deficits were common among this sample; sustained and divided attention deficits correlated with functional impairments and falls, highlighting that attention deficits might contribute to accident prone behaviour and falling.

摘要

目的

描述社区中中风患者的注意力缺陷水平,并探讨注意力、平衡能力、功能与跌倒之间的关系。

方法

通过全科医生招募了48名居住在社区且行动自如的中风患者(30名男性,18名女性,平均年龄68.4±11.2岁)。26名参与者为右侧半球梗死,21名为左侧半球梗死,1名患有脑干病变;中风后的平均时间为46个月(范围为5至204个月)。对参与者进行了跌倒事件的访谈;使用标准化测试评估注意力、平衡能力和功能。

结果

5名参与者(10%)存在视觉注意力不集中,15名(31%)存在持续性注意力缺陷,9名(19%)存在听觉选择性注意力缺陷,17名(35%)存在视觉选择性注意力缺陷,21名参与者(43%)存在分散注意力缺陷。持续性和分散注意力得分与平衡能力、日常生活活动能力及跌倒状况相关(p<0.01)。注意力正常的受试者的平衡能力和功能优于得分异常者(p<0.01)。方差分析显示,在分散注意力、平衡能力和日常生活活动能力方面,多次跌倒者与无近期跌倒者之间存在差异(p<0.01)。

结论

在该样本中注意力缺陷很常见;持续性和分散注意力缺陷与功能障碍及跌倒相关,这突出表明注意力缺陷可能导致易发生事故行为和跌倒。

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