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改良定时起立行走测试用于评估步态不稳老年患者的跌倒倾向和平衡能力

Modified Timed Up and Go Test for Tendency to Fall and Balance Assessment in Elderly Patients With Gait Instability.

作者信息

Soto-Varela Andrés, Rossi-Izquierdo Marcos, Del-Río-Valeiras María, Faraldo-García Ana, Vaamonde-Sánchez-Andrade Isabel, Lirola-Delgado Antonio, Santos-Pérez Sofía

机构信息

Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.

Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain.

出版信息

Front Neurol. 2020 Jun 12;11:543. doi: 10.3389/fneur.2020.00543. eCollection 2020.

Abstract

To compare the results from the modified Timed Up and Go Test (TUG) with posturographic variables, the subjective perception of disability due to gait instability, and the number of falls in a sample of the elderly population with imbalance, to confirm that the TUG Test is a useful clinical instrument to assess the tendency to fall in individuals of this age group. Cross-sectional study conducted in a tertiary university hospital, in 174 people aged 65 years or older with gait instability. Modified TUG Test was performed; time, step count and the need for support during the test were the analyzed variables. They were compared with the number of falls, Computerized Dynamic Posturography scores, and questionnaires scores (Dizziness Handicap Inventory and a shortened version of the Falls Efficacy Scale-International). The average time to complete the TUG Test was 21.24 ± 8.18 s, and the average step count was 27.36 ± 7.93. One hundred two patients (58.6%) required no support to complete the test, whereas the other 72 (41.4%) used supports. The time taken to complete the Test was significantly related with having or not having fallen in the previous year, with the scores of the questionnaires, and with various parameters of dynamic posturography. A higher percentage of patients who took more than 15 s had fallen in the previous year than those who took up to 15 s to complete the test [ = 0.012; = 2.378; 95% CI (1.183, 4.780)]. No significant correlation was found between the step count and the number of falls in the previous year, with falling during the test or not, or with being a single or a frequent faller. No relation was found between the need for supports and the number of falls, with having or not having fallen in the previous year, or with being a single or frequent faller. The modified TUG Test is in relation with the presence or absence of falls. Time is the essential parameter for analyzing the risk of falling and the 15-s threshold is a good value to differentiate elderly patients at high risk of falling. NCT03034655, www.clinicaltrials.gov.

摘要

为了比较改良的计时起立行走测试(TUG)结果与姿势描记变量、步态不稳导致的残疾主观感受以及老年失衡人群样本中的跌倒次数,以证实TUG测试是评估该年龄组个体跌倒倾向的有用临床工具。在一所三级大学医院对174名65岁及以上步态不稳的患者进行了横断面研究。进行了改良的TUG测试;分析的变量为时间、步数以及测试期间是否需要支撑。将这些变量与跌倒次数、计算机化动态姿势描记评分以及问卷评分(头晕残障量表和国际跌倒效能量表简版)进行比较。完成TUG测试的平均时间为21.24±8.18秒,平均步数为27.36±7.93步。102名患者(58.6%)完成测试时无需支撑,而其他72名患者(41.4%)使用了支撑。完成测试所需的时间与上一年是否跌倒、问卷评分以及动态姿势描记的各种参数显著相关。完成测试用时超过15秒的患者中,上一年跌倒的比例高于用时15秒及以内完成测试的患者[ = 0.012; = 2.378;95%置信区间(1.183,4.780)]。未发现步数与上一年跌倒次数、测试期间是否跌倒或是否为单次或频繁跌倒者之间存在显著相关性。未发现支撑需求与跌倒次数、上一年是否跌倒或是否为单次或频繁跌倒者之间存在关联。改良的TUG测试与跌倒的发生与否相关。时间是分析跌倒风险的关键参数,15秒阈值是区分跌倒高风险老年患者的良好数值。NCT03034655,www.clinicaltrials.gov。

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