Dennison Andrew C, Noorigian Joseph V, Robinson Keith M, Fisman David N, Cianci Heather J, Moberg Paul, Bunting-Perry Lisette, Martine Rebecca, Duda John, Stern Matthew B
Baylor College of Medicine/University of Texas-Houston Medical School, Physical Medicine and Rehabilitation Alliance, Houston, Texas, USA.
Am J Phys Med Rehabil. 2007 Aug;86(8):621-32. doi: 10.1097/PHM.0b013e311611583.
To identify falling risk factors in a study population of recurrent fallers compared with nonfallers who have Parkinson disease, and to prioritize falling risk factors in this patient population to target them for modification.
Twenty-three recurrent fallers and 25 nonfallers who have Parkinson disease were recruited, and they participated in a comprehensive assessment probing for the presence of falling risk factors. To identify falling risk factors, a group comparative design was used to compare recurrent fallers and nonfallers across an array of variables. To prioritize those risk factors, modeling using recursive partitioning was performed, entering into the model falling, risk factors identified in this and other studies that were considered potentially modifiable.
A specific profile of variables distinguished recurrent fallers who have Parkinson disease in our study population: higher disease severity, higher level of motor impairment, higher level of disability, impaired leg agility or lower-limb coordination, impaired ability to arise from a chair or compromised proximal lower-limb motor control, impaired ambulation, impaired motor planning of the hands and feet, impaired dynamic balance as measured by ability to walk in tandem, and fear of falling. Recursive partitioning prioritized three risk factors: impaired ambulation, impaired lower-limb motor planning, and orthostasis.
In this study, an idiosyncratic falling risk factor profile was demonstrated among our subjects who have Parkinson disease. Three variables were prioritized for potential modification: impaired ambulation, impaired lower-limb motor planning, and orthostasis.
在帕金森病反复跌倒者的研究人群中识别跌倒风险因素，并对该患者群体中的跌倒风险因素进行优先级排序，以便针对这些因素进行调整。
招募了23名帕金森病反复跌倒者和25名未跌倒者，他们参与了一项全面评估，以探究跌倒风险因素的存在情况。为了识别跌倒风险因素，采用组间比较设计，在一系列变量上比较反复跌倒者和未跌倒者。为了对这些风险因素进行优先级排序，使用递归划分进行建模，将本研究及其他研究中确定的、被认为可能可调整的跌倒风险因素纳入模型。
在我们的研究人群中，一组特定的变量区分了帕金森病反复跌倒者：疾病严重程度更高、运动障碍水平更高、残疾程度更高、腿部敏捷性或下肢协调性受损、从椅子上起身能力受损或近端下肢运动控制受损、步行能力受损、手脚运动计划受损、通过串联行走能力测量的动态平衡受损以及害怕跌倒。递归划分将三个风险因素列为优先级：步行能力受损、下肢运动计划受损和直立性低血压。
在本研究中，我们的帕金森病受试者中表现出一种独特的跌倒风险因素特征。三个变量被列为潜在调整的优先级：步行能力受损、下肢运动计划受损和直立性低血压。
