Reider Nadia, Gaul Catherine
University of Victoria, Schoolof Exercise Science, Physical & Health Education, Canada.
Arch Gerontol Geriatr. 2016 Jul-Aug;65:133-9. doi: 10.1016/j.archger.2016.03.004. Epub 2016 Mar 15.
Successfully identifying older adults with a high risk of falling can be complicated, time consuming and not feasible in daily medical practice. This study compared the effectiveness of the Minimal Chair Height Standing Ability Test (MCHSAT) and 5-repetition sit-to-stand tst (5R-STS) as fall risk-screening instruments for the elderly.
167 community-dwelling older adults (mean age=83.6±7.3years) were interviewed for demographics, fall history, cognition, and mobility status. MCHSAT performance was assessed using a chair whose seat height was modifiable by increments of 5cm, starting at 47cm and lowering after each successful attempt. 5R-STS performance was assessed by recording the time it took to rise and sit back down five consecutive times from a chair of 47cm high. Operating Receiving Characteristic (ROC) curves and Area under the Curve (AUC) were calculated for each test as well as for sub-groups of participants classified based on medical comorbidities (e.g. cardiac disease/stroke, lower limb arthritis).
The MCHSAT and 5R-STS were equally effective fall-risk screening instruments for the overall population (AUC (95% CI)=0.72 (0.63-0.82) and 0.73(0.64-0.81) respectively). The 5R-STS was more effective than the MCHSAT for participants suffering from lower limb arthritis (AUC (95% CI)=0.81(0.70-0.92) and 0.71(0.58-0.85) respectively) while the opposite was true for participants with a history of cardiac disease or stroke (AUC (95% CI)=0.59 (0.44-0.80) and 0.65 (0.47-0.84) respectively).
Due to their simplicity and quick administration time, the MCHSAT and 5R-STS are equally suitable for implementation in clinical settings.
在日常医疗实践中,成功识别出跌倒风险高的老年人可能很复杂、耗时且不可行。本研究比较了最低椅高站立能力测试(MCHSAT)和5次坐立试验(5R-STS)作为老年人跌倒风险筛查工具的有效性。
对167名社区居住的老年人(平均年龄=83.6±7.3岁)进行了人口统计学、跌倒史、认知和活动能力状况的访谈。使用一把座位高度可按5厘米增量调节的椅子评估MCHSAT表现,起始高度为47厘米,每次成功尝试后降低高度。通过记录从47厘米高的椅子上连续五次起身和坐下所需的时间来评估5R-STS表现。计算每个测试以及根据合并症(如心脏病/中风、下肢关节炎)分类的参与者亚组的操作特征曲线(ROC)和曲线下面积(AUC)。
MCHSAT和5R-STS作为总体人群跌倒风险筛查工具同样有效(AUC(95%CI)分别为0.72(0.63-0.82)和0.73(0.64-0.81))。对于患有下肢关节炎的参与者,5R-STS比MCHSAT更有效(AUC(95%CI)分别为0.81(0.70-0.92)和0.71(0.58-0.85)),而对于有心脏病或中风病史的参与者则相反(AUC(95%CI)分别为0.59(0.44-0.80)和0.65(0.47-0.84))。
由于其简单性和快速的实施时间,MCHSAT和5R-STS同样适用于临床环境。