Arai Tomoyuki, Fujita Hiroaki, Maruya Kohei, Morita Yasuhiro, Asahi Ryoma, Ishibashi Hideaki
Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan.
Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan.
J Orthop Sci. 2020 Jul;25(4):688-692. doi: 10.1016/j.jos.2019.06.014. Epub 2019 Jul 20.
Falls are a primary cause of physical disability in older adults, making them a major public health problem. Locomotive syndrome risk assessments have proven to be simple to administer, practical, and useful as screening tools in detecting decreased mobility in middle-aged and elderly adults. The current prospective study investigated whether these tests were associated with future falls among elderly Japanese.
This study was a two-year prospective observational study. A total of 1800 individuals (aged 65-79 years) who were without certification of long-term care or physical disability were initially invited through letters to participate in the study. Of these, 499 individuals (225 men, 274 women) agreed to participate and underwent baseline assessments. Demographic information, body function physical performance measurements, and locomotive syndrome risk tests [Stand-Up Test (SUT), Two-Step Test (TST), and the 25-question Geriatric Locomotive Function Scale (GLFS-25)] were assessed. Following baseline evaluation, we sent a follow-up questionnaire to assess fall history in the past two years. Participants were classified as either "non-fallers" or "fallers" (denoted by one or more falls). Multiple logistic regression was used to evaluate the association between falls and each factor by providing adjusted odds ratio estimates.
The follow-up questionnaire was returned by 399 participants, 54 of whom (13.5%) fell at least once during the two-year observation period. The multiple logistic regression analysis revealed that difficulty with standing on one leg from a 40-cm-high seat (a portion of the SUT) was a significant predictor of future falls (odds ratio = 2.20, 95%CI = 1.04-4.69, p = 0.04). A history of falling was also a risk factor of falls.
Our results suggest that standing on one leg from a 40-cm-high seat is predictive of falling in older adults, even after adjustment for previous falls and other confounding variables.
跌倒为老年人身体残疾的主要原因，使其成为一个重大的公共卫生问题。事实证明，运动机能综合征风险评估操作简便、切实可行，作为筛查工具，在检测中老年人群行动能力下降方面很有用。当前的这项前瞻性研究调查了这些测试是否与日本老年人未来的跌倒情况相关。
本研究为一项为期两年的前瞻性观察性研究。最初通过信函邀请了总共1800名（年龄在65 - 79岁之间）未获得长期护理或身体残疾认证的个体参与研究。其中，499名个体（225名男性，274名女性）同意参与并接受了基线评估。评估了人口统计学信息、身体功能体能测量以及运动机能综合征风险测试[起立测试（SUT）、两步测试（TST）以及包含25个问题的老年运动机能功能量表（GLFS - 25）]。在基线评估之后，我们发送了一份随访问卷以评估过去两年的跌倒史。参与者被分为“未跌倒者”或“跌倒者”（定义为发生过一次或多次跌倒）。通过提供调整后的比值比估计值，采用多因素逻辑回归来评估跌倒与各因素之间的关联。
399名参与者回复了随访问卷，其中54名（13.5%）在两年观察期内至少跌倒过一次。多因素逻辑回归分析显示，从40厘米高的座位单腿站立困难（SUT的一部分）是未来跌倒的一个显著预测因素（比值比 = 2.20，95%置信区间 = 1.04 - 4.69，p = 0.04）。跌倒史也是跌倒的一个风险因素。
我们的结果表明
