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不同跌倒风险认知的老年人中与跌倒相关的主要身体功能因素有哪些?

What are the Main Physical Functioning Factors Associated With Falls Among Older People With Different Perceived Fall Risk?

作者信息

Moreira Mirian N, Bilton Tereza L, Dias Rosangela C, Ferriolli Eduardo, Perracini Monica R

机构信息

Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo - UNICID, São Paulo, Brazil.

Human Science and Health College, Pontificia Universidade Catolica - PUCSP, São Paulo, Brazil.

出版信息

Physiother Res Int. 2017 Jul;22(3). doi: 10.1002/pri.1664. Epub 2016 Mar 7.

Abstract

BACKGROUND AND PURPOSE

Fall risk perceptions may influence the judgement over physical and functional competencies to avoid falls. However, few studies have explored the physical functioning characteristics associated with falls among older people with low perceived fall risk. This study aimed to identify the prevalence of falls and physical functioning factors associated with falling among community-dwelling older adults with low and high perceived fall risk.

METHODS

We conducted a cross-sectional population based study with 773 community-dwelling elders. Perceived fall risk was investigated using Falls Efficacy Scale International. We considered fallers those who reported at least one fall in the previous 12 months. Physical functioning measures used were grip strength, usual gait speed, sit-to-stand test, five step test, timed up and go test, one-legged stance test, anterior and lateral functional reach test.

RESULTS

At least one fall was reported by 103 (30%) participants with low perceived fall risk and by 196 (46%) participants with high perceived fall risk. The odds of falling were lower among those with greater grip strength and with a greater stance time in one-legged test, and the odds of falling among elders with high perceived fall risk were higher among those who took more time in performing the five step test.

DISCUSSION

We believe that our results highlight the need of not neglecting the risk of falls among active older adults with low perceived fall risk, particularly in those elders that show reduced stability in a small base of support and a lower leg strength. In addition, we suggest that elders with high perceived fall risk should be assessed using anticipatory postural adjustment tests. Particularly, our results may help physiotherapists to identify eligible elders with different perceptions of fall risk for tailored interventions aimed at reducing falls. Copyright © 2016 John Wiley & Sons, Ltd.

摘要

背景与目的

对跌倒风险的认知可能会影响对避免跌倒所需身体和功能能力的判断。然而,很少有研究探讨低跌倒风险认知的老年人中与跌倒相关的身体功能特征。本研究旨在确定社区居住的、低跌倒风险认知和高跌倒风险认知的老年人中跌倒的发生率以及与跌倒相关的身体功能因素。

方法

我们对773名社区居住的老年人进行了一项基于人群的横断面研究。使用国际跌倒效能量表调查跌倒风险认知。我们将那些报告在过去12个月中至少跌倒过一次的人视为跌倒者。所使用的身体功能测量指标包括握力、平常步态速度、坐立试验、五步试验、计时起立行走试验、单腿站立试验、前向和侧向功能性伸展试验。

结果

103名(30%)低跌倒风险认知的参与者和196名(46%)高跌倒风险认知的参与者报告至少跌倒过一次。握力越大和单腿试验中站立时间越长的人跌倒几率越低,而在五步试验中花费时间越多的高跌倒风险认知的老年人跌倒几率越高。

讨论

我们认为,我们的结果凸显了不应忽视低跌倒风险认知的活跃老年人跌倒风险的必要性,特别是那些在小支撑面时稳定性降低且腿部力量较弱的老年人。此外,我们建议应使用预期姿势调整测试对高跌倒风险认知的老年人进行评估。特别是,我们的结果可能有助于物理治疗师识别具有不同跌倒风险认知的符合条件的老年人,以便进行旨在减少跌倒的针对性干预。版权所有© 2016约翰威立父子有限公司。

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