Miyata Kazuhiro, Kaizu Yoichi, Usuda Shigeru
Department of Physical Therapy, Ibaraki Prefectural University of Health Science: 4669-2 Ami-Machi, Inashiki-gun, Ibaraki 300-0394, Japan.
Graduate School of Health Sciences, Gunma University, Japan.
J Phys Ther Sci. 2018 Apr;30(4):514-519. doi: 10.1589/jpts.30.514. Epub 2018 Apr 13.
[Purpose] The purpose of this study was to clarify the relationships between falls and sections of the Balance Evaluation Systems Test (BESTest) in patients with stroke or those with a history of fracture. [Subjects and Methods] This longitudinal study included 51 self-ambulatory inpatients. Balance was assessed 1 week prior to discharge using the BESTest, and the incidence of falls within 6 months after discharge was investigated. Relationships between falling and balance components were analyzed using the ttest or the Mann-Whitney U test and receiver operating characteristic (ROC) curve analysis. [Results] Five subjects were dropped out before follow-up at 6 months. Falls were reported by 10 of the remaining 46 participants. Scores for two sections (Anticipatory Postural Adjustments and Sensory Orientation) were significantly lower in fallers than in non-fallers with stroke. Four of the six sections (Biomechanical Constraints, Anticipatory Postural Adjustments, Sensory Orientation, and Stability in Gait) showed areas under the ROC curves >0.8 (0.82, 0.83, 0.84, and 0.81, respectively). In patients with a history of fractures, all sections were not significantly different between fallers and non-fallers. [Conclusion] Anticipatory Postural Adjustments and Sensory Orientation sections of the BESTest were related to future occurrence of fall after discharge in self-ambulatory stroke patients.
[目的] 本研究旨在阐明中风患者或有骨折病史患者的跌倒与平衡评估系统测试(BESTest)各部分之间的关系。[对象与方法] 这项纵向研究纳入了51名能够自主行走的住院患者。在出院前1周使用BESTest评估平衡能力,并调查出院后6个月内的跌倒发生率。采用t检验、曼-惠特尼U检验和受试者工作特征(ROC)曲线分析来分析跌倒与平衡组成部分之间的关系。[结果] 5名受试者在6个月随访前退出。其余46名参与者中有10人报告发生了跌倒。中风患者中,跌倒者的两个部分(预期姿势调整和感觉定向)得分显著低于未跌倒者。六个部分中的四个(生物力学限制、预期姿势调整、感觉定向和步态稳定性)的ROC曲线下面积>0.8(分别为0.82、0.83、0.84和0.81)。在有骨折病史的患者中,跌倒者和未跌倒者在所有部分上均无显著差异。[结论] BESTest的预期姿势调整和感觉定向部分与能够自主行走的中风患者出院后未来跌倒的发生有关。