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动态平衡受损与脑卒中后患者跌倒有关。

Impaired dynamic balance is associated with falling in post-stroke patients.

机构信息

Department of Physical Therapy, Seoul Bukbu Hospital, Seoul, Republic of Korea.

出版信息

Tohoku J Exp Med. 2013 Aug;230(4):233-9. doi: 10.1620/tjem.230.233.

Abstract

Falling is one of the most common complications of stroke. The purpose of this study was to investigate the impact of falling on cognitive and physical function in post-stroke patients. Further, the predictive factors associated with independence of activity of daily living (ADL) in stroke patients with falls experience were investigated. Sixty-six participants were divided into 2 groups according to history of falling: faller (n = 34) and non-faller (n = 32). All participants were examined for cognitive and physical function. Static balance was measured by postural sway using a force platform. Dynamic balance was measured using the Berg Balance Scale (BBS) and the Modified Rivermead Mobility Index (MRMI), which shows the degree of performance for balance tasks. ADL was measured using the Modified Barthel Index (MBI), which shows the degree of independence. The fallers showed lower cognitive and physical function than the non-fallers (p < 0.05). This finding indicates that falling is associated with reduced physical function, as well as reduced cognitive function. In the fallers, the ADL (MBI) was moderately correlated with each of cognition [MMSE (r = 0.388, p = 0.023)], dynamic balance [MRMI (r = 0.514, p = 0.002) and BBS (r = 0.572, p < 0.000)]. In addition, regression analysis showed that BBS was a primary predictor for ADL performance (R(2) = 0.327, β = 0.572, p < 0.000). Our findings indicate that enhancement of dynamic balance is needed to improve in activities necessary for normal self-care of stroke patients with falls experience.

摘要

跌倒 是中风最常见的并发症之一。本研究旨在探讨中风后患者跌倒对认知和身体功能的影响。此外,还研究了伴有跌倒经历的中风患者日常生活活动(ADL)独立的相关预测因素。根据跌倒史,将 66 名参与者分为 2 组:跌倒组(n = 34)和非跌倒组(n = 32)。所有参与者均接受认知和身体功能检查。使用力平台测量姿势摆动来评估静态平衡。使用 Berg 平衡量表(BBS)和改良 Rivermead 移动指数(MRMI)测量动态平衡,这两个指标都可以反映平衡任务的表现程度。使用改良 Barthel 指数(MBI)评估 ADL,该指标可以反映独立程度。跌倒组的认知和身体功能均低于非跌倒组(p < 0.05)。这一发现表明,跌倒与身体功能下降以及认知功能下降有关。在跌倒组中,ADL(MBI)与认知[简易精神状态检查表(MMSE)(r = 0.388,p = 0.023)]、动态平衡[MRMI(r = 0.514,p = 0.002)和 BBS(r = 0.572,p < 0.000)]均呈中度相关。此外,回归分析表明 BBS 是 ADL 表现的主要预测因素(R² = 0.327,β = 0.572,p < 0.000)。我们的研究结果表明,需要增强动态平衡能力,以改善有跌倒经历的中风患者进行正常自理活动的能力。

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