Department of Physical Therapy, University of Florida, PO Box 100154, Gainesville, FL 32610-0154, USA.
Phys Ther. 2010 Nov;90(11):1598-606. doi: 10.2522/ptj.20090284. Epub 2010 Aug 12.
Low fall-related efficacy is associated with the number and severity of future falls in older adults with balance disorders.
The purpose of this study was to examine whether improvements in clinical measures of balance after an intervention program were associated with changes in efficacy.
A prospective, nonexperimental, pretest-posttest design was used.
Sixty-three people (43 men, 20 women; mean [±SD] age=76.6±4.9 years) with a history of at least 2 falls in the previous 12 months were enrolled between 2004 and 2008 to participate in a 12-week home exercise program. Balance deficits were identified using the Berg Balance Scale (BBS) and the Dynamic Gait Index (DGI), and participants were evaluated monthly. Hierarchical linear regression was used to assess the relationship between measures of balance (BBS and DGI) and efficacy (Falls Efficacy Scale) before intervention. A second model examined the relationship between changes in balance and changes in efficacy after participation in the program.
Preintervention scores of efficacy were significantly associated with age, depression, and BBS and DGI scores. After controlling for age, depression, and strength (force-generating capacity), BBS and DGI scores together accounted for 34% of the variance in preintervention efficacy. Significant improvements were noted in efficacy, BBS and DGI scores, and depression after intervention. When controlling for preintervention efficacy and changes in depression, the changes in DGI and BBS scores together explained 11% of the variance in the change in fall-related efficacy; however, only DGI scores contributed uniquely. Limitations These results are tempered by the absence of a control group to examine the role of time on changes in efficacy.
The results suggest that increased emphasis on mobility during rehabilitation leads to improved confidence to perform activities of daily living without falling.
在患有平衡障碍的老年人中，较低的跌倒效果与未来跌倒的次数和严重程度有关。
本研究旨在检验干预计划后平衡临床测量的改善是否与疗效的变化相关。
采用前瞻性、非实验性、前后测试设计。
2004 年至 2008 年间，共招募了 63 名（43 名男性，20 名女性；平均[±标准差]年龄=76.6±4.9 岁）在过去 12 个月内至少发生过 2 次跌倒的人参加为期 12 周的家庭运动计划。使用 Berg 平衡量表（BBS）和动态步态指数（DGI）来识别平衡缺陷，每月评估一次。分层线性回归用于评估干预前平衡测量（BBS 和 DGI）与疗效（跌倒效能量表）之间的关系。第二个模型检查了参与计划后平衡变化与疗效变化之间的关系。
干预前的疗效评分与年龄、抑郁以及 BBS 和 DGI 评分显著相关。在控制年龄、抑郁和力量（产生力量的能力）后，BBS 和 DGI 评分共同解释了干预前疗效的 34%。干预后，疗效、BBS 和 DGI 评分以及抑郁显著改善。当控制干预前的疗效和抑郁变化时，DGI 和 BBS 评分的变化共同解释了与跌倒相关的疗效变化的 11%；然而，只有 DGI 评分有独特的贡献。局限性：由于缺乏对照组来研究时间对疗效变化的作用，这些结果受到限制。
结果表明，在康复期间更加重视移动能力会提高对执行日常活动而不跌倒的信心。
