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社区居住的慢性卒中患者的平衡能力和跌倒自我效能与跌倒史的关联。

The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke.

作者信息

Belgen Beliz, Beninato Marianne, Sullivan Patricia E, Narielwalla Khushnum

机构信息

Cyprus Turkish Orthopaedic Disability Association Physical Therapy Rehabilitation Center, Nicosia, North Cyprus.

出版信息

Arch Phys Med Rehabil. 2006 Apr;87(4):554-61. doi: 10.1016/j.apmr.2005.12.027.

Abstract

OBJECTIVES

To describe the frequency of falls; to relate capacity-based and self-efficacy measures to fall history; and to determine to what extent capacity-based and self-efficacy measures are explained by subject characteristics and stroke impairments.

DESIGN

Cross-sectional.

SETTING

Community.

PARTICIPANTS

Convenience sample of 50 people with chronic stroke.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Fall history, Falls Efficacy Scale-Swedish Version, fear of falling, and the mood subscore of the Stroke Impact Scale. Balance, strength, and functional mobility were measured using the Berg Balance Scale, timed sit to stand, and Timed Up & Go, respectively.

RESULTS

Falls were reported by 40% (n=20) of subjects; 22% (n=11) reported multiple falls. Subjects with fall history had more fear of falling (relative risk [RR], 2.4; 95% confidence interval [CI], 1.1-4.9), had less falls-related self-efficacy (P=.04), and more depressive symptoms (P=.02) than nonfallers. Subjects with multiple fall history had poorer balance (P=.02), more fear of falling (RR=5.6; 95% CI, 1.3-23), and used a greater number of medications (P=.04) than non- and 1-time fallers. Strength partially explained balance, mobility, and falls-related self-efficacy.

CONCLUSIONS

Balance and falls-related self-efficacy are associated with fall history and should be addressed in people with chronic stroke.

摘要

目的

描述跌倒的频率;将基于能力和自我效能的测量指标与跌倒史相关联;并确定基于能力和自我效能的测量指标在多大程度上可由受试者特征和中风损伤来解释。

设计

横断面研究。

地点

社区。

参与者

50例慢性中风患者的便利样本。

干预措施

不适用。

主要观察指标

跌倒史、瑞典版跌倒效能量表、跌倒恐惧以及中风影响量表的情绪子量表。分别使用伯格平衡量表、定时起立试验和计时起立行走试验测量平衡、力量和功能活动能力。

结果

40%(n = 20)的受试者报告有跌倒;22%(n = 11)报告有多次跌倒。有跌倒史的受试者比未跌倒者更害怕跌倒(相对危险度[RR],2.4;95%置信区间[CI],1.1 - 4.9),与跌倒相关的自我效能较低(P = 0.04),且抑郁症状更多(P = 0.02)。有多次跌倒史的受试者比未跌倒者和仅有一次跌倒史者平衡能力更差(P = 0.02),更害怕跌倒(RR = 5.6;95% CI,1.3 - 23),且使用的药物数量更多(P = 0.04)。力量部分解释了平衡、活动能力以及与跌倒相关的自我效能。

结论

平衡和与跌倒相关的自我效能与跌倒史相关,慢性中风患者应予以关注。

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