Gazibara Tatjana, Pekmezovic Tatjana, Tepavcevic Darija Kisic, Tomic Aleksandra, Stankovic Iva, Kostic Vladimir S, Svetel Marina
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia.
Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade 11000, Serbia.
Geriatr Nurs. 2014 Sep-Oct;35(5):364-9. doi: 10.1016/j.gerinurse.2014.05.001. Epub 2014 Jun 7.
Falls represent continuing, disabling and costly problem in Parkinson's disease (PD). The study was carried out at the Neurology Clinic in Belgrade from August 2011 to December 2012. As many as 180 community dwelling persons with PD aged 22-83 years who sustained a fall in past 6 months were included. Characteristics of the most recent fall were obtained through detailed interviews. Inclusion criteria were: Mini Mental State Examination (MMSE)≥24, ability to walk independently for at least 10 m and ability to statically stand for at least 90 s. Exclusion criteria were: presence of other neurologic as well as psychiatric, visual, audio-vestibular and orthopedic impairments. Falls more frequently took place outside (57.2%) and in the morning (53.9%). As much as 38.9% of persons with PD sustained an injury. Soft-tissue contusion was the most common injury (71.8%) both after indoor and outdoor falls. Fractures accounted for 5% of all fall-related injuries. All the fractures were either arm, clavicle or rib fractures. Tripping was identified as risk factor for outdoor falls (OR=7.90; 95% confidence interval [95% CI] 3.21-19.39; p=0.001). In contrast, lower extremity weakness (OR=0.20; 95% CI 0.05-0.72; p=0.015) and internal sense of sudden loss of balance (OR=0.19; 95% CI 0.05-0.73; p=0.015) were risk factors for indoor falls. To accomplish long-term results, development of particular prevention programs for persons with PD who fall at home vs. outdoors is recommended.
跌倒在帕金森病（PD）中是一个持续存在、导致残疾且代价高昂的问题。该研究于2011年8月至2012年12月在贝尔格莱德的神经科诊所进行。纳入了180名年龄在22 - 83岁之间、过去6个月内有过跌倒经历的社区居住帕金森病患者。通过详细访谈获取了最近一次跌倒的特征。纳入标准为：简易精神状态检查表（MMSE）≥24、能够独立行走至少10米以及能够静态站立至少90秒。排除标准为：存在其他神经以及精神、视觉、听觉 - 前庭和骨科损伤。跌倒更频繁地发生在户外（57.2%）和早晨（53.9%）。多达38.9%的帕金森病患者受到了损伤。软组织挫伤是室内和室外跌倒后最常见的损伤（71.8%）。骨折占所有跌倒相关损伤的5%。所有骨折均为手臂、锁骨或肋骨骨折。绊倒被确定为户外跌倒的危险因素（比值比[OR]=7.90；95%置信区间[95%CI]3.21 - 19.39；p = 0.001）。相比之下，下肢无力（OR = 0.20；95%CI 0.05 - 0.72；p = 0.015）和突然失去平衡的内在感觉（OR = 0.19；95%CI 0.05 - 0.73；p = 0.015）是室内跌倒的危险因素。为取得长期效果，建议针对在家中跌倒与在户外跌倒的帕金森病患者制定特定的预防方案。
