深脑刺激核下区治疗的帕金森病患者的跌倒恐惧和跌倒。

Fear of falling and falls in people with Parkinson's disease treated with deep brain stimulation in the subthalamic nuclei.

机构信息

Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.

出版信息

Acta Neurol Scand. 2011 Jun;123(6):424-9. doi: 10.1111/j.1600-0404.2010.01418.x. Epub 2010 Sep 29.

DOI:10.1111/j.1600-0404.2010.01418.x

PMID:21492098

Abstract

BACKGROUND

No previous study prospectively investigated the effects of subthalamic deep brain stimulation on fear of falling (FOF) and falls.

AIM

The aim was to prospectively explore whether FOF and fall rate were affected after STN stimulation in people with Parkinson's disease (PD).

METHODS

Twenty participants (mean age: 65, SD 6.4) were included. Falls and near falls were recorded (fall diary) during 3 months before and 1 year after surgery. FOF was evaluated using the Falls-Efficacy Scale, Swedish version, FES(S), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE).

RESULTS

After surgery, the FES(S) scores of complex activities improved (P=0.026), i.e. median 34 (q1-q3, 26-50) vs 43 (32-55). SAFFE scores also improved (P=0.007): median 25 (22-30) versus 22 (18-27). The rate of near falls decreased (P=0.014). Nine participants reported no near falls. For the remaining ten participants, the median near fall rate decreased from 6 (3-17) to 2 (1-8). The rate of falls showed no significant (P>0.3) difference.

CONCLUSIONS

After surgery, fewer activities were avoided owing to the risk of falling, and fall-related self-efficacy had improved during complex activities. The rate of near falls decreased. The results cannot support any change in fall rate.

摘要

背景

以前没有研究前瞻性地调查丘脑底核深部脑刺激对跌倒恐惧（FOF）和跌倒的影响。

目的

旨在前瞻性探讨帕金森病（PD）患者 STN 刺激后 FOF 和跌倒率是否受到影响。

方法

纳入 20 名参与者（平均年龄：65 岁，SD 6.4）。在手术前 3 个月和手术后 1 年内，使用跌倒日记记录跌倒和接近跌倒的情况。使用瑞典版跌倒效能量表（FES(S)）和改良老年人活动恐惧与跌倒调查（SAFFE）评估 FOF。

结果

手术后，复杂活动的 FES(S)评分改善（P=0.026），即中位数 34（q1-q3，26-50）vs 43（32-55）。SAFFE 评分也改善（P=0.007）：中位数 25（22-30）vs 22（18-27）。接近跌倒的发生率降低（P=0.014）。9 名参与者报告无接近跌倒。对于其余 10 名参与者，接近跌倒的中位数发生率从 6（3-17）降至 2（1-8）。跌倒率无显著差异（P>0.3）。