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急性卒中患者对跌倒的恐惧:哥德堡跌倒研究(FallsGOT)

Fear of falling in acute stroke: The Fall Study of Gothenburg (FallsGOT).

作者信息

Larén Amanda, Odqvist Amanda, Hansson Per-Olof, Persson Carina U

机构信息

a Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden.

b Department of Molecular and Clinical Medicine, Institute of Medicine , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden.

出版信息

Top Stroke Rehabil. 2018 May;25(4):256-260. doi: 10.1080/10749357.2018.1443876. Epub 2018 Mar 1.

Abstract

Objective Little is known about which factors are associated with a patient's fear of falling (FoF) after acute stroke. The aim of this study was to investigate baseline variables and their association with FoF during rehabilitation in acute stroke. Patients and methods The study population consisted of the 462 patients with acute stroke who were admitted to a stroke unit, included in the observational study "The Fall Study in Gothenburg (FallsGOT)" and were able to answer a single question: "Are you afraid of falling?" (Yes/No). To analyze any association between FoF and clinical variables, univariable and multivariable stepwise multiple logistic regression analyses were performed. Results In the stepwise multivariable regression analysis, only female sex (OR = 2.25 [95% confidence interval (CI) 1.46-3.46, p = 0.0002]), the use of a walking aid (OR 3.40, [95% CI 2.12-5.43, p < 0.0001]), and postural control as assessed with the SwePASS total score were statistically significant associated with FoF. Among patients with a SwePASS score of 24 or less, the OR was 9.41 [95% CI 5.13-17.25, p < 0.0001] for FoF compared to patients with a SwePASS score of 31 or above; among the patients with a SwePASS score of 25-30, the OR was 2.29 [95% CI = 1.36-3.83, p = 0.0017]. Conclusions Our findings provide valuable insight for those involved in stroke rehabilitation during the acute phase after stroke. FoF is associated with poor postural control, female sex and the use of a walking aid.

摘要

目的 关于哪些因素与急性中风患者的跌倒恐惧(FoF)相关,目前所知甚少。本研究的目的是调查急性中风康复期间的基线变量及其与跌倒恐惧的关联。 患者与方法 研究人群包括462名入住中风单元的急性中风患者,这些患者被纳入观察性研究“哥德堡跌倒研究(FallsGOT)”,并且能够回答一个简单问题:“你害怕跌倒吗?”(是/否)。为了分析跌倒恐惧与临床变量之间的任何关联,进行了单变量和多变量逐步多元逻辑回归分析。 结果 在逐步多变量回归分析中,只有女性性别(比值比[OR]=2.25[95%置信区间(CI)1.46 - 3.46,p = 0.0002])、使用助行器(OR 3.40,[95% CI 2.12 - 5.43,p < 0.0001])以及用SwePASS总分评估的姿势控制与跌倒恐惧有统计学显著关联。在SwePASS评分为24分及以下的患者中,与SwePASS评分为31分及以上的患者相比,跌倒恐惧的OR为9.41[95% CI 5.13 - 17.25,p < 0.0001];在SwePASS评分为25 - 30分的患者中,OR为2.29[95% CI = 1.36 - 3.83,p = 0.00

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