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平衡和行动能力表现作为老年人反复跌倒的可治疗风险因素。

Balance and mobility performance as treatable risk factors for recurrent falling in older persons.

作者信息

Stel Vianda S, Smit Jan H, Pluijm Saskia M F, Lips Paul

机构信息

Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, P.O. Box 7057, Amsterdam, The Netherlands.

出版信息

J Clin Epidemiol. 2003 Jul;56(7):659-68. doi: 10.1016/s0895-4356(03)00082-9.

Abstract

BACKGROUND AND OBJECTIVES

The purpose of this study was to examine whether easily measurable measures for balance and muscle strength predicted recurrent falling as well as sophisticated measurements, and to examine which of the modifiable risk factors were strongest associated with recurrent falling.

METHODS

The study was performed in a subsample (n=439, aged 69-92 years) of the Longitudinal Aging Study Amsterdam (LASA). Balance, muscle strength, physical activity, and performance tests were assessed. Falls were recorded during 1 year. The outcome measure was recurrent falls (>/=2 falls within 1 year).

RESULTS

The area under the curve (AUC) of mediolateral sway (AUC=0.67; 95% CI:0.57-0.77), tandem stand (AUC=0.61; 95% CI:0.49-0.73), leg extension strength (AUC=0.58; 95% CI:0.51-0.64), and handgrip strength (AUC=0.57; 95% CI:0.51-0.64) for recurrent falling were not significantly different. In a multivariate model, mediolateral sway (OR=2.8; 95% CI:1.1-6.9), tandem stand (OR=2.1; 95% CI:1.1-3.8), and walking test (OR=2.2; 95% CI:1.1-4.1) were significantly associated with recurrent falling.

CONCLUSIONS

The easily measurable tandem stand and handgrip strength predicted recurrent falling as well as the sophisticated measures. Mediolateral sway was strongest associated with recurrent falling.

摘要

背景与目的

本研究旨在探讨易于测量的平衡和肌肉力量指标是否能像复杂测量指标一样预测反复跌倒,以及哪些可改变的风险因素与反复跌倒关联最为密切。

方法

本研究在阿姆斯特丹纵向衰老研究(LASA)的一个子样本(n = 439,年龄69 - 92岁)中进行。评估了平衡、肌肉力量、身体活动及功能测试。记录了1年内的跌倒情况。结局指标为反复跌倒(1年内跌倒≥2次)。

结果

用于预测反复跌倒的外侧摆动(曲线下面积[AUC]=0.67;95%置信区间[CI]:0.57 - 0.77)、前后站立(AUC = 0.61;95% CI:0.49 - 0.73)、腿部伸展力量(AUC = 0.58;95% CI:0.51 - 0.64)和握力(AUC = 0.57;95% CI:0.51 - 0.64)之间无显著差异。在多变量模型中,外侧摆动(比值比[OR]=2.8;95% CI:1.1 - 6.9)、前后站立(OR = 2.1;95% CI:1.1 - 3.8)和步行测试(OR = 2.2;95% CI:1.1 - 4.1)与反复跌倒显著相关。

结论

易于测量的前后站立和握力与复杂测量指标一样能预测反复跌倒。外侧摆动与反复跌倒的关联最为密切。

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