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老年下肢关节炎患者跌倒的危险因素:当前知识及未来方向的概念框架

Risk factors for falls in older adults with lower extremity arthritis: a conceptual framework of current knowledge and future directions.

作者信息

Arnold Cathy M, Gyurcsik Nancy C

机构信息

School of Physical Therapy, College of Medicine.

出版信息

Physiother Can. 2012 Summer;64(3):302-14. doi: 10.3138/ptc.2011-12BH.

Abstract

PURPOSE

As the numbers of Canadians aged 65 years and over increases over the next 20 years, the prevalence of chronic conditions, including arthritis, will rise as will the number of falls. Although known fall-risk factors are associated with hip and knee osteoarthritis (OA), minimal research has evaluated fall and fracture risk and/or rates in this population. Thus, the purpose was to summarize research on fall and fracture risk in older adults with hip or knee OA and to develop a conceptual framework of fall-risk screening and assessment.

METHOD

The International Classification of Functioning, Disability and Health, clinical practice guidelines for fall-risk screening, and a selected literature review were used.

RESULTS

Gaps exist in our knowledge of fall and fracture risk for this population. Muscle performance, balance, and mobility impairments have been identified, but little is known about whether personal and environmental contextual factors impact fall and fracture risk. Physical activity may help to prevent falls, but non-adherence is a problem.

CONCLUSION

A need exists to assess fall risk in older adults with hip and knee OA. Promoting regular physical activity by focusing on disease- and activity-specific personal contextual factors may help direct treatment planning.

摘要

目的

在未来20年里,65岁及以上加拿大老年人的数量将会增加,包括关节炎在内的慢性病患病率将会上升,跌倒的人数也会增加。尽管已知的跌倒风险因素与髋部和膝部骨关节炎(OA)相关,但针对该人群跌倒和骨折风险及/或发生率的研究极少。因此,本研究旨在总结有关髋部或膝部OA老年患者跌倒和骨折风险的研究,并建立一个跌倒风险筛查与评估的概念框架。

方法

采用《国际功能、残疾和健康分类》、跌倒风险筛查临床实践指南以及选定的文献综述。

结果

我们对该人群跌倒和骨折风险的认识存在差距。已确定存在肌肉功能、平衡和活动能力受损的情况,但对于个人和环境背景因素是否会影响跌倒和骨折风险知之甚少。体育活动可能有助于预防跌倒,但依从性不佳是个问题。

结论

有必要对髋部和膝部OA老年患者进行跌倒风险评估。通过关注特定疾病和活动的个人背景因素来促进规律的体育活动,可能有助于指导治疗计划。

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