School of Psychology and Psychiatry, Monash University, Melbourne, VIC, Australia ; MonashHealth, Melbourne, VIC, Australia.
Neuropsychiatr Dis Treat. 2013;9:805-12. doi: 10.2147/NDT.S42628. Epub 2013 Jun 5.
Electroconvulsive therapy (ECT) is commonly used to treat depression in older adults. Despite its efficacy in this regard, an associated increase in the risk of falls in this population is a downside of treatment. ECT research has focused on the incidence of falls, but its effect on balance and gait - intrinsic factors in instability and falls - has not been studied. Our aim was to examine changes in balance and gait among older adults before and after a single ECT session and explore the effect of patient-related and treatment factors on any changes found.
Participants were 21 older adults requiring ECT for depression in public psychiatric services. Patients with clinically overt mobility problems (impairing test participation or increasing the risk of falls) were excluded. Balance and gait testing 1 hour pre-ECT and 1, 2 and 3 hours post-ECT included: (1) steady standing test; (2) perturbation of standing balance by self-initiated movements; (3) perturbation of standing balance by an external perturbation; and (4) timed up and go test.
No deterioration in test performance was found, using one-way repeated measures analysis of variance.
Balance and gait did not deteriorate immediately after ECT. Exclusion of participants with clinically overt mobility problems and falls being better attributable to factors unrelated to balance and gait (such as post-ECT confusion) may account for our findings. This research does not repudiate the occurrence of ECT-related falls but calls into question the utility of introducing routine balance and gait assessment among older ECT recipients without pre-existing mobility problems as a means of preventing them.
电抽搐疗法（ECT）常用于治疗老年抑郁症。尽管其在这方面有效，但该疗法会增加该人群跌倒的风险。ECT 研究集中在跌倒的发生率上，但它对平衡和步态的影响——不稳定和跌倒的内在因素——尚未研究。我们的目的是检查单次 ECT 治疗前后老年人平衡和步态的变化，并探讨患者相关和治疗因素对任何发现的变化的影响。
参与者为 21 名在公共精神卫生服务机构因抑郁症接受 ECT 的老年人。排除有明显临床移动问题的患者（妨碍测试参与或增加跌倒风险）。ECT 前 1 小时、ECT 后 1、2 和 3 小时进行平衡和步态测试，包括：（1）稳定站立测试；（2）自我发起运动对站立平衡的干扰；（3）外部干扰对站立平衡的干扰；和（4）计时起立和行走测试。
使用单向重复测量方差分析，未发现测试表现恶化。
ECT 后平衡和步态没有立即恶化。排除有明显移动问题和跌倒的参与者，并且跌倒更可能归因于与平衡和步态无关的因素（例如 ECT 后意识混乱），这可能解释了我们的发现。这项研究并不否认 ECT 相关跌倒的发生，但质疑在没有预先存在的移动问题的情况下，对老年 ECT 接受者常规进行平衡和步态评估以预防跌倒的有效性。
