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亚急性康复出院时,步态速度的限制依然存在。

Limitations in gait speed persist at discharge from subacute rehabilitation.

作者信息

Barthuly April M, Bohannon Richard W, Gorack Walter

机构信息

AllStar Therapy.

出版信息

J Phys Ther Sci. 2013 Jul;25(7):891-3. doi: 10.1589/jpts.25.891. Epub 2013 Aug 20.

Abstract

[Purpose] Walking speed is related to important outcomes such as mortality and is fundamental to independent and safe ambulation in the community. The objectives of this study were to determine if the discharge gait speed of patients completing subacute rehabilitation was slow relative to normative and street crossing reference values, and whether such speed was associated with age, gender, or diagnosis. [Subjects and Methods] Consecutive patients admitted to a subacute rehabilitation facility were screened based on inclusion and exclusion criteria. Participants were 109 patients (56 women) 60 to 98 (mean=78.2) years old who were divided into 10 diagnostic categories. Gait speed was measured over a distance of 5.2 meters as patients walked at their most comfortable speed beyond a designated finish line. Timing with a digital stopwatch began after an acceleration distance of 1 meter and ceased as patients crossed the finish line. [Results] The patients' comfortable gait speed (mean=0.58; SD=0.19; range=0.09-1.10 m/s) was significantly less than 1.0m/s (normal reference value) (1.11±0.15 m/s) but significantly greater than that required for crossing the street (0.49 m/s). Nevertheless, 27.5% of patients did not achieve a walking speed of 0.49 m/s. Speed was inversely related to age and was lower among women, but it was not affected by diagnostic category. [Conclusion] Gait speed remains limited when patients are discharged home from subacute rehabilitation and was slowest among older women patients. Further therapy may be warranted for such patients after discharge.

摘要

[目的] 步行速度与死亡率等重要预后相关,是社区中独立安全行走的基础。本研究的目的是确定完成亚急性康复的患者出院时的步态速度相对于正常参考值和过马路参考值是否较慢,以及这种速度是否与年龄、性别或诊断相关。[对象与方法] 根据纳入和排除标准对连续入住亚急性康复机构的患者进行筛选。参与者为109例患者(56名女性),年龄在60至98岁(平均 = 78.2岁)之间,分为10个诊断类别。当患者以最舒适的速度走过指定终点线时,在5.2米的距离内测量步态速度。在加速1米的距离后,用数字秒表计时,当患者越过终点线时停止计时。[结果] 患者的舒适步态速度(平均 = 0.58;标准差 = 0.19;范围 = 0.09 - 1.10米/秒)显著低于1.0米/秒(正常参考值)(1.11±0.15米/秒),但显著高于过马路所需速度(0.49米/秒)。然而,27.5%的患者未达到0.49米/秒的步行速度。速度与年龄呈负相关,女性速度较低,但不受诊断类别的影响。[结论] 患者从亚急性康复出院回家时,步态速度仍然受限,老年女性患者的步态速度最慢。此类患者出院后可能需要进一步治疗。

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