Bisson Etienne J, Peterson Elizabeth W, Finlayson Marcia
Int J MS Care. 2017 Mar-Apr;19(2):59-65. doi: 10.7224/1537-2073.2015-053.
Critical falls, defined in the literature as involving an inability to get up after the fall, have been associated with morbidity and mortality in older adults but have not been examined in people with multiple sclerosis (MS). To highlight the importance of the critical fall concept in MS, this exploratory study sought to identify the frequency of and factors associated with a proxy for critical falls in people with MS.
Of 354 adults with MS 55 years and older interviewed, 327 reported a story about their most recent fall that included information about fall-related experiences, including whether they received help to get up after a fall. We used this information as a proxy for critical falls in a logistic regression analysis.
A total of 177 individuals (54.1%) received help to get up after their most recent fall. Logistic regression analysis revealed six factors associated with this proxy for critical falls: fall leading to a fracture (OR = 4.21), leg weakness (OR = 3.12), living with others (OR = 2.48), female sex (OR = 1.96), balance or mobility problems (OR = 1.90), and longer disease duration (OR = 1.04).
Receiving help after a fall is common for people aging with MS, suggesting that critical falls need to be further studied. Findings support the need for fall management education that includes action planning for proper assistance and balance and strength training to increase the ability to get up safely after a fall.
文献中定义的严重跌倒,是指跌倒后无法自行起身,这与老年人的发病率和死亡率相关,但尚未在多发性硬化症(MS)患者中进行研究。为了强调严重跌倒概念在MS中的重要性,这项探索性研究旨在确定MS患者中严重跌倒替代指标的发生频率及相关因素。
在接受访谈的354名55岁及以上的MS成年患者中,327人讲述了他们最近一次跌倒的经历,包括与跌倒相关的情况,如跌倒后是否得到帮助起身。我们在逻辑回归分析中使用这些信息作为严重跌倒的替代指标。
共有177人(54.1%)在最近一次跌倒后得到帮助起身。逻辑回归分析显示与该严重跌倒替代指标相关的六个因素:跌倒导致骨折(比值比[OR]=4.21)、腿部无力(OR=3.12)、与他人同住(OR=2.48)、女性(OR=1.96)、平衡或行动问题(OR=1.90)以及病程较长(OR=1.04)。
MS老年患者跌倒后获得帮助的情况很常见,这表明严重跌倒需要进一步研究。研究结果支持开展跌倒管理教育的必要性,包括制定适当援助的行动计划以及进行平衡和力量训练,以提高跌倒后安全起身的能力。