Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, 1230 Miyakoda-cho, Kita-ku, Hamamatsu, Shizuoka, 431-2102, Japan.
Arch Osteoporos. 2019 Aug 16;14(1):90. doi: 10.1007/s11657-019-0641-y.
We derived a clinical prediction rule (CPR) to determine fall risk. The probability of falls increased, with positive likelihood ratio being 17.8 and post-test probability (positive predictive value) being 88.2%, in cases where the CPR score was 2 points. Our CPR could be a useful screening test to detect fall risk probability.
We aimed to examine the risk factors for falls in individuals with knee osteoarthritis (OA) and derive a clinical prediction rule (CPR) to determine fall risk.
Eighty-one individuals with medial compartment knee OA were included. The outcome was whether the participants had a self-reported fall within the past 1 year of this study being conducted. The collected data included sex, age, body mass index, Kellgren-Lawrence grade, lesion type (bilateral or unilateral knee OA), pain (rated using the visual analog scale), muscle strength test of the quadriceps femoris, one-leg standing test (OLST), five times sit-to-stand test (FTSST), and 5-m walk test, which were used in binomial logistic regression analysis. The outcome measure of the analysis was whether the study participants belonged to a fall or non-fall group. Receiver operating characteristic (ROC) analysis was performed for the outcome measurements, and the factors were selected by binomial logistic regression analysis. Then, a CPR to determine fall risk was extracted, and its diagnostic characteristics were calculated.
Binomial logistic regression analysis showed that the OLST and FTSST were significant. ROC analysis showed that the cut-off values of the OLST and FTSST were 5.3 s and 7.9 s, respectively. The post-test probability (positive predictive value) increased to 88.2% (positive likelihood ratio = 17.8) when the OLST and FTSST were both positive (the CPR score was 2 points).
The CPR obtained from this study would be useful as a screening test to detect the fall risk probability in individuals with knee OA.
我们得出了一个临床预测规则（CPR）来确定跌倒风险。当 CPR 得分为 2 分时，跌倒的可能性增加，阳性似然比为 17.8，后验概率（阳性预测值）为 88.2%。我们的 CPR 可以作为一种有用的筛查试验来检测跌倒风险概率。
我们旨在研究膝关节骨关节炎（OA）患者跌倒的危险因素，并得出一个临床预测规则（CPR）来确定跌倒风险。
纳入 81 例内侧间室膝关节 OA 患者。结局为参与者在本研究进行的过去 1 年内是否有自我报告的跌倒。收集的数据包括性别、年龄、体重指数、Kellgren-Lawrence 分级、病变类型（双侧或单侧膝 OA）、疼痛（使用视觉模拟量表评估）、股四头肌肌力测试、单腿站立测试（OLST）、五次坐立测试（FTSST）和 5 米步行测试，这些测试都用于二项逻辑回归分析。分析的结局测量是研究参与者属于跌倒组还是非跌倒组。对结局测量进行受试者工作特征（ROC）分析，并通过二项逻辑回归分析选择因素。然后，提取一个用于确定跌倒风险的 CPR，并计算其诊断特征。
二项逻辑回归分析显示，OLST 和 FTSST 是显著的。ROC 分析显示，OLST 和 FTSST 的截断值分别为 5.3 秒和 7.9 秒。当 OLST 和 FTSST 均为阳性（CPR 得分为 2 分）时，后验概率（阳性预测值）增加至 88.2%（阳性似然比=17.8）。
本研究得出的 CPR 可作为一种有用的筛查试验，用于检测膝 OA 患者的跌倒风险概率。
