对帕金森病患者进行深部脑刺激时，通过门诊姿势不稳评估预测跌倒风险的前瞻性评估。
A Prospective Evaluation of an Outpatient Assessment of Postural Instability to Predict Risk of Falls in Patients with Parkinson's Disease Presenting for Deep Brain Stimulation.
作者信息
Brandmeir Nicholas J, Brandmeir Cheryl L, Kuzma Kristine, McInerney James
机构信息
Department of Neurosurgery Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA.
Department of Therapy Services Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA.
出版信息
Mov Disord Clin Pract. 2015 Nov 27;3(2):151-155. doi: 10.1002/mdc3.12257. eCollection 2016 Mar-Apr.
BACKGROUND
Postural instability (PI) and falls, major causes of morbidity in patients with PD, are often overlooked. DBS is a mainstay therapy for Parkinson's disease (PD) and has been purported to both worsen and improve PI. An effective PI evaluation that can predict fall risk in patients with PD presenting for DBS is needed.
METHODS
Forty-nine consecutive patients with PD were enrolled. Self-reported falls were the gold standard. Tests evaluated were the Berg Balance Scale (BBS), Timed-Up-and-Go (TUG), Pull Test, and Biodex Balance System Sway Index on firm (SI-FIRM) and soft (SI-SOFT) surfaces.
RESULTS
The best single tests for fall risk were the BBS and SI-FIRM, each with sensitivities of 79% and specificities of 60% and 65%, respectively. When the evaluation was combined into a composite measure requiring four positive tests out of five, the sensitivity was 72% and specificity was 80%.
CONCLUSIONS
A simple, efficient outpatient physical therapy assessment is effective in diagnosing fall risk in patients with PD.
背景
姿势不稳（PI）和跌倒，是帕金森病（PD）患者发病的主要原因，却常常被忽视。脑深部电刺激术（DBS）是帕金森病（PD）的主要治疗方法，据称它既能加重也能改善姿势不稳。需要一种有效的姿势不稳评估方法，以预测接受DBS治疗的帕金森病患者的跌倒风险。
方法
连续纳入49例帕金森病患者。自我报告的跌倒情况为金标准。所评估的测试包括伯格平衡量表（BBS）、定时起立行走测试（TUG）、拉拽测试，以及在坚硬（SI-FIRM）和柔软（SI-SOFT）表面上的Biodex平衡系统摆动指数。
结果
预测跌倒风险的最佳单项测试是BBS和SI-FIRM，其敏感性分别为79%，特异性分别为60%和65%。当将各项评估组合成一个综合指标，即五项测试中需要四项呈阳性时，敏感性为72%，特异性为80%。
结论
一种简单、有效的门诊物理治疗评估方法，对于诊断帕金森病患者的跌倒风险是有效的。
Zotero 插件