Kulmala Jenni, Sihvonen Sanna, Kallinen Mauri, Alen Markku, Kiviranta Ilkka, Sipilä Sarianna
University of Jyväskylä, Department of Health Sciences.
J Geriatr Phys Ther. 2007;30(3):114-20. doi: 10.1519/00139143-200712000-00006.
To investigate whether self-assessed balance confidence and functional balance are associated with falls in older persons with hip fracture history.
This study is a part of a larger study on functional capacity and exercise rehabilitation in hip fracture patients. Seventy-nine patients, operated at the local hospital for collum or trochanter fracture within one-half to 7 years, participated in the laboratory measurements. Balance confidence was assessed with Activities-specific Balance Confidence scale (ABC) and functional balance using the Berg Balance Scale (BBS). According to self-reported number of falls during the previous 6 months participants were classified as those with falls vs. no falls; recurrent falls (3 or more falls) vs. occasional/no falls (< 3 falls); indoor falls vs. no indoor falls; outdoor falls vs. no outdoor falls. The relationships between ABC, BBS, and fall status were tested by logistic regression.
Lower BBS score was associated with all falls during previous 6 months (OR 0.929, 95% CI 0.875-0.987). Lower ABC score was associated with recurrent falling (OR 0.974, 0.952-0.998), as well as lower BBS score (OR 0.876, 0.797- 0.962). Additionally, lower ABC and lower BBS scores were related to indoor falls (ABC OR 0.975, 0.957-0.993; BBS OR 0.913, 0.852-0.978). Participants with outdoor falls did not differ from those with no outdoor falls in ABC scores or BBS.
Self-assessed balance confidence and functional balance are related to prevalence of recurrent and indoor falls in older hip fracture patients. Therefore use of Activities-specific Balance Confidence scale and Berg Balance Scale might be reasoned to expand in evaluating the probability for falls among at-risk elders.
探讨自我评估的平衡信心和功能平衡与有髋部骨折病史的老年人跌倒之间是否存在关联。
本研究是一项关于髋部骨折患者功能能力和运动康复的大型研究的一部分。79名在当地医院接受股骨颈或转子骨折手术半年至7年的患者参与了实验室测量。使用特定活动平衡信心量表(ABC)评估平衡信心,使用伯格平衡量表(BBS)评估功能平衡。根据参与者自我报告的前6个月跌倒次数,将其分为跌倒组与未跌倒组;反复跌倒(3次或更多次跌倒)组与偶尔/未跌倒(<3次跌倒)组;室内跌倒组与未发生室内跌倒组;室外跌倒组与未发生室外跌倒组。通过逻辑回归检验ABC、BBS与跌倒状态之间的关系。
较低的BBS评分与前6个月的所有跌倒相关(比值比0.929,95%置信区间0.875 - 0.987)。较低的ABC评分与反复跌倒相关(比值比0.974,0.952 - 0.998),以及较低的BBS评分(比值比0.876,0.797 - 0.962)。此外,较低的ABC和较低的BBS评分与室内跌倒相关(ABC比值比0.975,0.957 - 0.993;BBS比值比0.913,0.852 - 0.978)。发生室外跌倒的参与者在ABC评分或BBS评分方面与未发生室外跌倒的参与者没有差异。
自我评估的平衡信心和功能平衡与老年髋部骨折患者反复跌倒和室内跌倒的发生率相关。因此,在评估高危老年人跌倒概率时,使用特定活动平衡信心量表和伯格平衡量表可能是合理的。