Carrer Pamela, Trevisan Caterina, Curreri Chiara, Giantin Valter, Maggi Stefania, Crepaldi Gaetano, Manzato Enzo, Sergi Giuseppe
Department of Medicine, Geriatrics Division, University of Padua, Padua, Italy.
Department of Medicine, Geriatrics Division, University of Padua, Padua, Italy.
Arch Phys Med Rehabil. 2018 Jan;99(1):137-143.e1. doi: 10.1016/j.apmr.2017.08.480. Epub 2017 Sep 20.
To investigate whether the Semmes-Weinstein monofilament examination (SWME) was associated with, and could predict, measures of physical performance and the risk of fall in older people.
Prospective study.
Community.
Older participants (N=2826) enrolled in the Progetto Veneto Anziani (Pro.V.A.) study and a subsample of persons (n=1885) who did not report falls at baseline for longitudinal analyses.
Not applicable.
Falls reported in the year preceding the assessment and Short Physical Performance Battery (SPPB) were recorded at baseline and again after 4.4 years.
At baseline, 830 participants (29.4%) had experienced falls in the previous year, with a higher prevalence of falls in those positive at SWME than in those negative at SWME (35.8% vs 28.0%; P=.001). Using logistic regression, participants positive at SWME had a (significant) 66% higher risk of presenting worse SPPB score (95% confidence interval, 1.51-1.83) and between 25% and 32% higher risks of having experienced ≥1 fall or recurrent falls than did those negative at SWME. The incidence of falls at follow-up was higher in the positive SWME group than in the negative SWME group (42.2% vs 30.7%; P=.001), and multinomial logistic regression showed that the former had a 13% higher risk of decline in SPPB scores (95% confidence interval, 1.03-1.25), particularly for gait and balance; 48% higher risk of having had 1 fall; and 77% higher risk of recurrent falls. At both baseline and follow-up, the larger the extension of neuropathy (negative SWME vs unilateral impairment in positive SWME vs bilateral impairment in positive SWME), the greater its negative effect on falls and physical performance.
SMWE was associated with, and could predict, lower extremity physical performance and falls in older people.
探讨Semmes-Weinstein单丝检查（SWME）是否与老年人的身体机能指标及跌倒风险相关，以及能否对其进行预测。
前瞻性研究。
社区。
参与威尼托老年人项目（Pro.V.A.）研究的老年参与者（N = 2826），以及纵向分析中基线时未报告跌倒的子样本（n = 1885）。
不适用。
在基线时以及4.4年后再次记录评估前一年报告的跌倒情况和简短身体机能量表（SPPB）。
在基线时，830名参与者（29.4%）在前一年经历过跌倒，SWME结果为阳性者的跌倒患病率高于SWME结果为阴性者（35.8%对28.0%；P = 0.001）。使用逻辑回归分析，SWME结果为阳性的参与者出现较差SPPB评分的风险（显著）高出66%（95%置信区间，1.51 - 1.83），经历≥1次跌倒或反复跌倒的风险比SWME结果为阴性的参与者高出25%至32%。随访时，SWME结果为阳性组的跌倒发生率高于SWME结果为阴性组（42.2%对30.7%；P = 0.001），多项逻辑回归显示，前者SPPB评分下降的风险高出13%（95%置信区间，1.03 - 1.25），尤其是在步态和平衡方面；跌倒1次的风险高出48%；反复跌倒的风险高出77%。在基线和随访时，神经病变范围越大（SWME结果为阴性与SWME结果为阳性的单侧损伤相比，以及SWME结果为阳性的双侧损伤相比），对跌倒和身体机能的负面影响就越大。
SWME与老年人的下肢身体机能及跌倒相关，且能够对其进行预测。
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