Hill Keith D, Stinson Amber T
National Ageing Research Institute, Parkville, Victoria, Australia.
Aging Clin Exp Res. 2004 Apr;16(2):126-31. doi: 10.1007/BF03324541.
BACKGROUND AND AIMS: Polio survivors are ageing, and reporting new complications including falls. The aims of this study were: 1) to determine the frequency of falls, circumstances surrounding them, and the consequences of falls in older people who have polio; and 2) to investigate the range of fall prevention interventions undertaken to reduce the individual's risk of falling. METHODS: A survey was conducted of members of the Eastern Polio Support Group of Victoria. Twenty-eight respondents (70%; 7 male, 21 female) had a mean age of 66 years and an average duration of 57 years since the onset of polio. The survey addressed demographic data, mobility, frequency and description of falls over the last 12 months, their consequences, and community services utilized. The Modified Falls Efficacy Scale (MFES) and Human Activity Profile (HAP) were also completed. Comparative data on the MFES and HAP were obtained from age- and gender-matched healthy community-dwelling older people. RESULTS: Fourteen respondents (50%) reported one or more falls over the past 12 months, half reporting multiple falls. Two-thirds of falls occurred while walking. Of those who fell, 67% did not require medical attention. The highest percentage of injuries were bruises or grazes (44%), with one fracture reported. Sixty-one percent reported being fearful of falling, with an average MFES of 7.4 (+/-2.0), compared with the average of 9.7 (+/-0.5) for the age- and gender-matched controls (p<0.05). Only 5 of the respondents reported changing their level of activity as the result of a fall. A significant difference was identified on the Adjusted Activity Score (AAS) of the HAP between polio non-fallers (mean 56.3+/-19.1), polio fallers (mean 40.1+/-15.6) and age- and gender-matched controls (mean 73.5+/-10.3) (F2,46=25.5, p=0.000). The median number of fall prevention activities undertaken in the previous 12 months was one, 11 of the 28 respondents undertaking two or more. The most common interventions implemented were vision checks (42%) and review of medications by a doctor (25%). CONCLUSIONS: A high rate of falling, fear of falling and low activity levels exist in older people with polio. There is a need for further research and clinical programs to reduce falls and injuries in this group.
背景与目的：脊髓灰质炎幸存者正逐渐老龄化，并出现包括跌倒在内的新并发症。本研究的目的是：1）确定脊髓灰质炎老年患者的跌倒频率、跌倒时的情况以及跌倒后果；2）调查为降低个体跌倒风险而采取的一系列预防跌倒干预措施。 方法：对维多利亚州东部脊髓灰质炎支持小组的成员进行了一项调查。28名受访者（70%；7名男性，21名女性）的平均年龄为66岁，自脊髓灰质炎发病以来平均病程为57年。该调查涉及人口统计学数据、活动能力、过去12个月内跌倒的频率和描述、跌倒后果以及所使用的社区服务。还完成了改良跌倒效能量表（MFES）和人类活动概况（HAP）。从年龄和性别匹配的健康社区居住老年人中获取了关于MFES和HAP的比较数据。 结果：14名受访者（50%）报告在过去12个月内发生了一次或多次跌倒，其中一半报告有多次跌倒。三分之二的跌倒发生在行走时。跌倒者中，67%不需要医疗护理。受伤比例最高的是擦伤或划伤（44%），报告有一例骨折。61%的人报告害怕跌倒，MFES平均分为7.4（±2.0），而年龄和性别匹配的对照组平均分为9.7（±0.5）（p<0.05）。只有5名受访者报告因跌倒而改变了活动水平。在HAP的调整活动得分（AAS）方面，未跌倒的脊髓灰质炎患者（平均56.3±19.1）、跌倒的脊髓灰质炎患者（平均40.1±15.6）与年龄和性别匹配的对照组（平均73.5±10.3）之间存在显著差异（F2,46=25.5，p=0.000）。在过去12个月内采取的预防跌倒活动的中位数为1项，28名受访者中有11人采取了两项或更多措施。最常见的干预措施是视力检查（42%）和医生对药物的复查（25%）。 结论：脊髓灰质炎老年患者跌倒发生率高、害怕跌倒且活动水平低。需要进一步开展研究和临床项目以减少该群体的跌倒和损伤。
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