Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan.
Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan.
Geriatr Gerontol Int. 2019 Mar;19(3):240-244. doi: 10.1111/ggi.13594. Epub 2019 Jan 8.
To elucidate the incidences and circumstances of falls and fall-related injuries, and to explore the physical characteristics of community-dwelling ambulatory stroke survivors who experienced falls.
A total of 144 community-dwelling ambulatory survivors of hemiparetic stroke (mean age 68.0 years [SD 10.4 years]) who were undergoing rehabilitation in an adult daycare center participated in this prospective study. The mean duration from stroke onset was 5.21 years (SD 3.15 years). The occurrence of falls was collected for 1 year with a fall diary. The incidence rates of falls and fall-related injuries, and the detailed circumstances of falls were descriptively analyzed. The characteristics of fallers were explored by comparing background information, motor impairments and results of physical function tests, including the 10-m walk test, Timed Up and Go test and five-times-sit-to-stand test, between fallers and non-fallers.
The incidence rates of falls and fall-related fractures were 0.88 per person-year and 2.8 per 100 person-years, respectively. Falls occurred more frequently during daytime and in winter. Falls were caused most often by losing balance while walking indoors, especially on the way to the toilet. After falling, 34.1% of individuals who fell could not stand up by themselves. The time of the five-times-sit-to-stand test was significantly longer in fallers than in non-fallers (P < 0.05).
The incidence rate of falls was high among community-dwelling ambulatory survivors of hemiparetic stroke. Appropriate approaches, including mastering the skills to cope with falling, are required, especially for individuals with reduced lower limb muscle strength. Geriatr Gerontol Int 2019; 19: 240-244.
阐明跌倒和与跌倒相关伤害的发生率和情况，并探讨社区居住的偏瘫脑卒中幸存者跌倒的身体特征。
本前瞻性研究共纳入 144 名在成人日托中心接受康复治疗的社区居住的偏瘫脑卒中幸存者（平均年龄 68.0 岁[标准差 10.4 岁]）。从脑卒中发病到研究开始的平均时间为 5.21 年（标准差 3.15 年）。使用跌倒日记收集了 1 年的跌倒发生情况。对跌倒和与跌倒相关伤害的发生率以及跌倒的详细情况进行描述性分析。通过比较跌倒者和非跌倒者的背景信息、运动障碍以及 10 米步行测试、计时起立行走测试和五次坐站测试的身体功能测试结果，探讨了跌倒者的特征。
跌倒和与跌倒相关骨折的发生率分别为 0.88 人/年和 2.8 人/100 人年。白天和冬季跌倒更为频繁。跌倒最常发生在室内行走时失去平衡，尤其是在去厕所的路上。跌倒后，34.1%的跌倒者无法自行站立。五次坐站测试的时间在跌倒者中明显长于非跌倒者（P < 0.05）。
偏瘫脑卒中幸存者在社区居住时跌倒的发生率较高。需要采取适当的方法，包括掌握应对跌倒的技能，特别是对于下肢肌肉力量减弱的个体。
