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助行器的使用会对老年康复期间的步态和活动能力评估产生不利影响。

Rollator use adversely impacts on assessment of gait and mobility during geriatric rehabilitation.

机构信息

Department of Geriatric Research, Agaplesion Bethanien-Hospital/Geriatric Centre at University of Heidelberg, Heidelberg, Germany.

出版信息

J Rehabil Med. 2011 Apr;43(5):424-9. doi: 10.2340/16501977-0791.

Abstract

OBJECTIVE

To investigate the influence of the use of a rollator walking aid on assessment of gait and mobility.

DESIGN

Prospective, longitudinal study.

SUBJECTS

Geriatric patients during inpatient rehabilitation (n=109; mean age 83.1 years).

METHODS

Assessment at the beginning and prior to discharge from rehabilitation using: gait-analysis (GAITRite®, speed, cadence, stride-time, stride-length, base-of-support, double-support), Performance-Oriented-Mobility-Assessment (POMA), and Timed-Up-and-Go (TUG). Differences between outcomes obtained without and with rollator use were calculated for baseline assessment and for changes over time for the total group and subgroups according to diagnosis (hip fracture vs. other). Responsiveness was calculated using standardized response means.

RESULTS

Baseline performances were significantly (p ≤ 0.05) higher when assessed with vs. without rollator in the total group and in hip fracture (except cadence) and other (except cadence, stride-time, TUG) patients. Changes over time were significantly greater when assessed without vs. with rollator in the total group and hip fracture (except cadence, POMA) and other patients (except base-of-support, double-support). Tests without rollator showed superior responsiveness (except TUG).

CONCLUSION

The use of rollator walking aids limits the detection of initial gait and mobility deficits, adversely affects the assessment of changes over time in gait and mobility performance, and reduces the responsiveness of tests. When full weight-bearing is permitted, assessment without a walking aid is recommended.

摘要

目的

研究助行器(rollator)的使用对步态和活动能力评估的影响。

设计

前瞻性、纵向研究。

研究对象

住院康复期间的老年患者(n=109;平均年龄 83.1 岁)。

方法

使用步态分析(GAITRite®,速度、步频、步时、步长、支撑基础、双支撑)、活动能力测试(POMA)和计时起立行走测试(TUG),在康复开始时和出院前进行评估。计算有和无助行器使用时基线评估以及总组和根据诊断(髋部骨折与其他)分组的随时间变化的结果之间的差异。使用标准化反应均值计算反应性。

结果

总组和髋部骨折(除步频外)和其他(除步频、步时、TUG 外)患者在有和无助行器使用时的基线表现有显著差异(p≤0.05)。在总组和髋部骨折(除步频、POMA 外)和其他患者(除支撑基础、双支撑外)无助行器评估的随时间变化更大。无助行器测试的反应性更好(除 TUG 外)。

结论

助行器的使用限制了初始步态和活动能力缺陷的发现,对步态和活动能力随时间变化的评估产生不利影响,并降低了测试的反应性。在允许完全负重的情况下,建议不使用助行器进行评估。

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