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步速和计时起立行走测试对体弱老年患者的活动能力变化较为敏感。

Gait velocity and the Timed-Up-and-Go test were sensitive to changes in mobility in frail elderly patients.

作者信息

van Iersel Marianne B, Munneke Marten, Esselink Rianne A J, Benraad Carolien E M, Olde Rikkert Marcel G M

机构信息

Department of Geriatrics, Radboud University Nijmegen Medical Centre, Internal code 925, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

出版信息

J Clin Epidemiol. 2008 Feb;61(2):186-91. doi: 10.1016/j.jclinepi.2007.04.016. Epub 2007 Oct 15.

DOI:10.1016/j.jclinepi.2007.04.016
PMID:18177792
Abstract

OBJECTIVE

To estimate clinically relevant changes in functional mobility tests and quantitative gait measures at group and individual level in frail elderly patients.

STUDY DESIGN AND SETTING

This study was a cohort study of consecutively admitted frail elderly patients. Gait velocity, Timed-Up-and-Go test (TUG), and other mobility tests were measured on admission and 2 weeks later. In between, patients received multidisciplinary treatment. Three experts decided from video recordings if patients had a clinically relevant change in gait, defined as change in the expected risk of falling.

RESULTS

A total of 85 patients (mean age 75.8 years, 46 female) participated. Of whom, 45% had dementia; 59 patients were stable and 26 showed a clinically relevant change in gait. Gait velocity and TUG were most sensitive to change at group level. In individual patients, a 5% change from baseline in gait velocity and 9% change in TUG had a sensitivity of 92% and 93% for detection of clinically relevant change, but specificity of 27% and 34%, respectively.

CONCLUSION

At group level, gait velocity and TUG were, from all investigated tests, most sensitive to change and in this perspective the best outcome variables. In individual patients, the high intraindividual variability makes these measures unsuitable as independent screening instruments for clinically relevant changes in gait.

摘要

目的

评估体弱老年患者在群体和个体水平上功能移动测试及定量步态测量的临床相关变化。

研究设计与设置

本研究是一项对连续入院的体弱老年患者进行的队列研究。在入院时和2周后测量步态速度、计时起立行走测试(TUG)及其他移动测试。在此期间,患者接受多学科治疗。三位专家根据视频记录判断患者步态是否有临床相关变化,定义为跌倒预期风险的变化。

结果

共有85名患者(平均年龄75.8岁,46名女性)参与。其中,45%患有痴呆症;59名患者病情稳定,26名患者步态出现临床相关变化。在群体水平上,步态速度和TUG对变化最为敏感。在个体患者中,步态速度较基线变化5%以及TUG变化9%时,检测临床相关变化的敏感度分别为92%和93%,但特异度分别为27%和34%。

结论

在群体水平上,从所有调查测试来看,步态速度和TUG对变化最为敏感,从这个角度而言是最佳的结局变量。在个体患者中,个体内的高变异性使得这些测量方法不适用于作为步态临床相关变化的独立筛查工具。

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