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中风患者的跌倒恐惧:与既往跌倒及功能特征的关系

Fear of falling in stroke patients: relationship with previous falls and functional characteristics.

作者信息

Andersson Asa G, Kamwendo Kitty, Appelros Peter

机构信息

Department of Geriatrics, Orebro University Hospital, Orebro, Sweden.

出版信息

Int J Rehabil Res. 2008 Sep;31(3):261-4. doi: 10.1097/MRR.0b013e3282fba390.

Abstract

The objectives of this study were to determine the relationship between fear of falling and functional characteristics of patients after stroke as well as to determine what characterizes fallers who score high fall-related self-efficacy, and nonfallers who score low fall-related self-efficacy. Patients (n=140) treated in a stroke unit during a 12-month period were included. On follow-up, fallers were identified and patients answered the questions in the Falls Efficacy Scale, Swedish version (FES-S). Assessments of motor capacity, functional mobility and balance were also made. In univariate analysis, low fall-related self-efficacy was significantly associated with increased age, female sex, earlier falls, visual and cognitive impairment, low mood and impaired physical function. In multivariate analysis, only earlier falls and physical function remained significant. Twenty percent of the patients scored low fall-related self-efficacy without having experienced a fall, and 11% who experienced a fall scored high fall-related self-efficacy. Impaired physical function was significantly associated with scoring low fall-related self-efficacy, for both fallers and nonfallers. Fear of falling is significantly associated with poor physical function and earlier falls. Falls Efficacy Scale, Swedish version could add useful information to a fall risk analysis. Patients scoring low fall-related self-efficacy should be offered fall prevention measures whether they have fallen or not.

摘要

本研究的目的是确定卒中后患者的跌倒恐惧与功能特征之间的关系,以及确定跌倒相关自我效能得分高的跌倒者和得分低的未跌倒者的特征。纳入了在12个月期间在卒中单元接受治疗的140例患者。在随访中,确定跌倒者,并让患者回答瑞典语版跌倒效能量表(FES-S)中的问题。还对运动能力、功能活动能力和平衡进行了评估。单因素分析中,跌倒相关自我效能低与年龄增加、女性、既往跌倒史、视觉和认知障碍、情绪低落及身体功能受损显著相关。多因素分析中,仅既往跌倒史和身体功能仍具有显著性。20%的患者跌倒相关自我效能得分低但未发生过跌倒,11%发生过跌倒的患者跌倒相关自我效能得分高。身体功能受损与跌倒者和未跌倒者的跌倒相关自我效能得分低均显著相关。跌倒恐惧与身体功能差和既往跌倒史显著相关。瑞典语版跌倒效能量表可为跌倒风险分析提供有用信息。无论是否跌倒,跌倒相关自我效能得分低的患者均应采取预防跌倒措施。

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