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中年及老年多发性硬化症患者跌倒后初始恢复延迟及长期卧床情况。

Delayed initial recovery and long lie after a fall among middle-aged and older people with multiple sclerosis.

作者信息

Bisson Etienne J, Peterson Elizabeth W, Finlayson Marcia

机构信息

School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.

Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL.

出版信息

Arch Phys Med Rehabil. 2015 Aug;96(8):1499-505. doi: 10.1016/j.apmr.2015.04.012. Epub 2015 Apr 28.

Abstract

OBJECTIVES

To determine (1) the prevalence of lying on the floor or ground for ≥10 minutes (delayed initial recovery [IR]) and for >1 hour (long lie) after a fall; and (2) the factors associated with delayed IR among people with multiple sclerosis (PwMS).

DESIGN

A secondary analysis of data available from a national, cross-sectional descriptive study of PwMS. Information regarding postfall experiences was extracted from open-ended questions about participants' most recent fall.

SETTING

Community.

PARTICIPANTS

PwMS (N=700) aged ≥55 years were recruited from the North America Committee on Multiple Sclerosis Registry; 354 of them completed the interview, and 322 provided a fall story that included information regarding postfall experiences.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

Participants' self-reports regarding time lying on the floor or ground after their most recent fall were used to determine delayed IR and long lie.

RESULTS

A total of 89 (27.6%) of 322 fallers reported delayed IR; 15 (4.7%) of them reported a long lie. Logistic regression analysis revealed 5 factors associated with delayed IR: longer disease duration (odds ratio [OR]=1.03; 95% confidence interval [CI], 1.00-1.05), fall leading to a fracture (OR=2.73; 95% CI, 1.11-6.72), received help to get up (OR=3.94; 95% CI, 2.07-7.50), depression (OR=1.96; 95% CI, 1.10-3.49), and leg weakness (OR=2.14; 95% CI, 1.13-4.03). No significant differences were found between fallers who reported a long lie and those who reported a delayed IR.

CONCLUSIONS

The findings suggest that while delayed IR is common, long lies are not prevalent among PwMS. The high prevalence of delayed IR highlights the importance of including fall management strategies in fall prevention programs for PwMS.

摘要

目的

确定(1)跌倒后躺在地板或地面上≥10分钟(初始恢复延迟[IR])以及>1小时(长时间躺卧)的发生率;(2)多发性硬化症患者(PwMS)中与初始恢复延迟相关的因素。

设计

对一项全国性的PwMS横断面描述性研究中的可用数据进行二次分析。关于跌倒后经历的信息从关于参与者最近一次跌倒的开放式问题中提取。

设置

社区。

参与者

从北美多发性硬化症登记委员会招募年龄≥55岁的PwMS(N = 700);其中354人完成了访谈,322人提供了包含跌倒后经历信息的跌倒事件描述。

干预

不适用。

主要观察指标

参与者关于最近一次跌倒后躺在地板或地面上的时间的自我报告,用于确定初始恢复延迟和长时间躺卧情况。

结果

在322名跌倒者中,共有89人(27.6%)报告了初始恢复延迟;其中15人(4.7%)报告了长时间躺卧。逻辑回归分析显示与初始恢复延迟相关的5个因素:疾病持续时间较长(比值比[OR]=1.03;95%置信区间[CI],1.00 - 1.05)、跌倒导致骨折(OR = 2.73;95%CI,1.11 - 6.72)、起身时得到帮助(OR = 3.94;95%CI,2.07 - 7.50)、抑郁(OR = 1.96;95%CI,1.10 - 3.49)和腿部无力(OR = 2.14;95%CI,1.13 - 4.03)。报告长时间躺卧的跌倒者与报告初始恢复延迟的跌倒者之间未发现显著差异。

结论

研究结果表明,虽然初始恢复延迟很常见,但长时间躺卧在PwMS中并不普遍。初始恢复延迟的高发生率凸显了在PwMS的跌倒预防计划中纳入跌倒管理策略的重要性。

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