Ashburn A, Hyndman D, Pickering R, Yardley L, Harris S
School of Health Professions and Rehabilitation Science, University of Southampton, UK.
Age Ageing. 2008 May;37(3):270-6. doi: 10.1093/ageing/afn066.
falls are common following a stroke, but knowledge about predicting future fallers is lacking.
to identify, at discharge from hospital, those who are most at risk of repeated falls.
consecutively hospitalised people with stroke (independently mobile prior to stroke and with intact gross cognitive function) were recruited. Subjects completed a battery of tests (balance, function, mood and attention) within 2 weeks of leaving hospital and at 12 months post hospital discharge.
122 participants (mean age 70.2 years) were recruited. Fall status at 12 months was available for 115 participants and of those, 63 [55%; 95% confidence interval (CI) 46-64] experienced one or more falls, 48 (42%; 95% CI 33-51) experienced repeated falls, and 62 (54%) experienced near-falls. All variables available at discharge were screened as potential predictors of falling. Six variables emerged [near-falling in hospital, Rivermead leg and trunk score, Rivermead upper limb score, Berg Balance score, mean functional reach, and the Nottingham extended activities of daily living (NEADL) score]. A score of near-falls in hospital and upper limb function was the best predictor with 70% specificity and 60% sensitivity.
participants who were unstable (near-falls) in hospital with poor upper limb function (unable to save themselves) were most at risk of falls.
中风后跌倒很常见，但缺乏预测未来跌倒者的相关知识。
在出院时识别出那些再次跌倒风险最高的患者。
招募连续住院的中风患者（中风前可独立活动且总体认知功能完好）。受试者在出院后2周内及出院后12个月完成一系列测试（平衡、功能、情绪和注意力）。
招募了122名参与者（平均年龄70.2岁）。115名参与者有12个月时的跌倒状态数据，其中63名（55%；95%置信区间[CI] 46 - 64）经历了一次或多次跌倒，48名（42%；95% CI 33 - 51）经历了反复跌倒，62名（54%）经历了险些跌倒。对出院时所有可用变量进行筛选，作为跌倒的潜在预测因素。出现了六个变量[住院时险些跌倒、Rivermead下肢和躯干评分、Rivermead上肢评分、Berg平衡评分、平均功能性伸展距离以及诺丁汉扩展日常生活活动（NEADL）评分]。住院时险些跌倒和上肢功能评分是最佳预测因素，特异性为70%，敏感性为60%。
住院时不稳定（险些跌倒）且上肢功能差（无法自我保护）的参与者跌倒风险最高。
