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痉挛、感觉及助行器对慢性卒中患者跌倒的影响

The effect of spasticity, sense and walking aids in falls of people after chronic stroke.

作者信息

Soyuer Ferhan, Oztürk Ahmet

机构信息

Halil Bayraktar Health Services Vocational College, Erciyes Universitesi, Kayseri, Turkey.

出版信息

Disabil Rehabil. 2007 May 15;29(9):679-87. doi: 10.1080/09638280600925860.

Abstract

OBJECTIVE

To study the effects of spasticity, sensory impairment, and type of walking aid on falls in community dwellers with chronic stroke.

METHODS

Functional Independence Measure (FIM) Instrument, Joint Position Sense Evaluation (JPS), the Rivermead motor assessment scale (RMA), Ashworth Scale, Tinetti Assessment Tool were used to assess 100 cases.

RESULTS

Fifty-three of the cases were grouped as nonfallers, 36 as one-time fallers and 11 as repeat fallers. These 3 groups were found to be different from each other in respect to FIM, Tinetti test and RMA (p < 0.001). In respect to knee JPS, nonfallers and one-time faller groups were found to be different from repeat fallers (p = 0.001). There is a difference among the groups in respect to Ashworth assessment (p < 0.001), use of walking aid (p = 0.01) and type of walking aid (p = 0.01). Some 43% of the cases use a walking aid (58.1% cane, 41.9% high cane). According to Ordinal logistic regression analysis, it was found that the possibility of fall increased (p < 0.01), as the value of spasticity increased while the possibility of the fall of the individuals with stroke decreased (p < 0.00 - 0.01) as Tinetti, RMA and FIM variables increased.

CONCLUSIONS

In respect to falls, spasticity is also an indicator for chronic stroke patients, as is motor impairment, functional situation, impairment of balance and walking. Sensory impairment, using a walking aid and the type were found to be ineffective.

摘要

目的

研究痉挛、感觉障碍和助行器类型对社区慢性卒中患者跌倒的影响。

方法

采用功能独立性评定量表(FIM)、关节位置觉评估(JPS)、Rivermead运动评估量表(RMA)、Ashworth量表、Tinetti评估工具对100例患者进行评估。

结果

53例患者被归为无跌倒者,36例为单次跌倒者,11例为反复跌倒者。发现这三组在FIM、Tinetti测试和RMA方面存在差异(p<0.001)。在膝关节JPS方面,无跌倒者和单次跌倒者组与反复跌倒者不同(p = 0.001)。在Ashworth评定(p<0.001)、助行器使用(p = 0.01)和助行器类型(p = 0.01)方面,各组之间存在差异。约43%的患者使用助行器(58.1%为手杖,41.9%为高把手手杖)。根据有序逻辑回归分析,发现随着痉挛值的增加,跌倒的可能性增加(p<0.01),而随着Tinetti、RMA和FIM变量的增加,卒中患者跌倒的可能性降低(p<0.00 - 0.01)。

结论

对于跌倒而言,痉挛与运动障碍、功能状况、平衡和行走障碍一样,也是慢性卒中患者的一个指标。感觉障碍、使用助行器及其类型被发现并无影响。

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