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使用助行器的虚弱老年人跌倒的发生率:一项比较研究。

Prevalence of falls in frail elderly users of ambulatory assistive devices: a comparative study.

机构信息

Department of Physiotherapy, Federal University of Bahia, Salvador, Brazil.

Estadual Reference Centre for Care Elderly Health.

出版信息

Disabil Rehabil Assist Technol. 2020 Jul;15(5):510-514. doi: 10.1080/17483107.2019.1587016. Epub 2019 Mar 25.

Abstract

The aim of this study was to verify the prevalence of falls in frail users of ambulatory assistive devices (AAD) and compare with controls. Nineteen frail elderly users of AAD (G1) and 31 non-users (G2) participated in the study. The occurrence of falls, at the last 6 months, was collected by an interview with the patient and the caregiver. Cognitive status was assessed by the Mini Mental State Examination, functional capacity by the Pfeffer's Questionnaire and Modified Barthel's Index, the frail level by a functional stratification and the risk of falls by the Timed Up and Go (TUG) test. T-Student test was used to compare independent variables. The significance level was set at 5%. Both groups G1 and G2 were homogeneous in relation to the functional and sociodemographic variables. G1 reported more falls in the last 6 months, but most of the participants did not use AAD at the time of the fall. Transferences were the main reason for falls in G1 and stumble in the street in G2. Elderly users of AAD fall out when they are not using the walk device.IMPLICATIONS FOR REHABILITATIONFalling is the second leading cause of death from unintentional injuries in the world. Fall prevention programmes prescribe ambulatory assistive devices, such as walking sticks, crutches and walkers device and walking training with a physiotherapist to provide independence, safety, satisfaction, adherence and psychosocial benefits. However, studies have showed a higher prevalence of falls in frail elderly users of ambulatory-assistive devices.In our study, we verified if users of the ambulatory-assistive devices were using it at the moment of the fall. We found that frail elderly fall down when they are not using the walk device during their activities of day living. Thus, education strategies should be developed to encourage the use of ambulatory-assistive devices by the frail elderly previously evaluated by physiotherapists. Prevalence of falls in this population could reduce if frail elderly users of ambulatory assistive devices really use it during the activities of daily living.

摘要

本研究旨在验证使用助步器的虚弱使用者(G1)和未使用者(G2)中跌倒的发生率,并进行比较。19 名使用助步器的虚弱老年人(G1)和 31 名未使用者(G2)参加了研究。通过对患者和护理人员进行访谈,收集了过去 6 个月内跌倒的发生情况。认知状态通过简易精神状态检查(Mini Mental State Examination)评估,功能能力通过 Pfeffer 问卷和改良巴氏指数(Modified Barthel's Index)评估,虚弱程度通过功能分层评估,跌倒风险通过计时起立行走测试(Timed Up and Go test,TUG)评估。采用 t 检验比较两组间的独立变量。显著性水平设为 5%。G1 和 G2 在功能和社会人口学变量方面均具有同质性。G1 在过去 6 个月内报告的跌倒次数更多,但大多数参与者在跌倒时并未使用助步器。转移是 G1 跌倒的主要原因,而 G2 则是在街上绊倒。使用助步器的老年人在不使用行走装置时会跌倒。

康复意义

跌倒已成为全球意外伤害导致死亡的第二大原因。预防跌倒的方案规定了助步器的使用,如步行杖、拐杖和助行器,以及由物理治疗师进行的步行训练,以提供独立性、安全性、满意度、依从性和社会心理益处。然而,研究表明,虚弱的助步器使用者跌倒的发生率更高。

在我们的研究中,我们验证了助步器使用者在跌倒时是否正在使用该装置。我们发现,虚弱的老年人在日常生活活动中不使用步行器时会摔倒。因此,应制定教育策略,鼓励经过物理治疗师评估的虚弱老年人使用助步器。如果真正使用助步器,使用助步器的虚弱老年人的跌倒发生率可能会降低。

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