Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.
Department of Rehabilitation Medicine, National Higashisaitama Hospital, Hasuda, Saitama, Japan.
J Neuromuscul Dis. 2022;9(2):303-310. doi: 10.3233/JND-210730.
Few studies have examined falls and their predictors in patients with amyotrophic lateral sclerosis (ALS).
The aim of this study was to survey fall incidence and to identify variables predicting the presence or absence of falls occurring within 3 months after discharge of patients with ALS from hospital.
The following variables were evaluated in 14 patients with ALS: timed up and go test (TUG), functional reach test, 10-m comfortable gait speed, single-leg stance time, manual muscle test (MMT) scores for the lower limb, total modified Ashworth scale score for the lower limbs, fear of falling, and pull test score. The primary outcome variable was the occurrence of a fall within 3 months after discharge. The fall rate was calculated based on fall record forms. The specific circumstances of each fall were also recorded. Univariate and multiple regression analyses were used to identify fall predictors.
Seven of the 14 ALS patients (50%) experienced a fall within 3 months. Five fallers reported experiencing a fall that had caused injury, and three reported experiencing a fall that had required a hospital visit. Univariate logistic regression analysis identified TUG time, gait speed and MMT of the ankle dorsiflexors as factors associated with falls (p = 0.02-0.04). Multiple linear regression analysis of fall numbers identified age and TUG time as predictor models (p = 0.03).
TUG time and MMT of ankle dorsiflexors may help predict falls in ALS patients. Validation studies in larger cohorts are needed.
鲜有研究调查肌萎缩侧索硬化症（ALS）患者的跌倒及其预测因素。
本研究旨在调查跌倒发生率，并确定可预测 ALS 患者出院后 3 个月内是否发生跌倒的变量。
评估了 14 名 ALS 患者的以下变量：计时起立行走测试（TUG）、功能性伸展测试、10 米舒适步行速度、单腿站立时间、下肢徒手肌力测试（MMT）评分、下肢改良 Ashworth 量表总分、对跌倒的恐惧以及拉力测试评分。主要结局变量是出院后 3 个月内发生跌倒。根据跌倒记录表格计算跌倒率。还记录了每次跌倒的具体情况。使用单变量和多变量回归分析来确定跌倒的预测因素。
14 名 ALS 患者中有 7 名（50%）在 3 个月内发生了跌倒。5 名跌倒者报告跌倒后受伤，3 名跌倒者报告需要住院治疗。单变量逻辑回归分析确定 TUG 时间、步行速度和踝关节背屈肌的 MMT 是与跌倒相关的因素（p=0.02-0.04）。对跌倒次数的多元线性回归分析确定年龄和 TUG 时间为预测模型（p=0.03）。
TUG 时间和踝关节背屈肌的 MMT 可能有助于预测 ALS 患者的跌倒。需要在更大的队列中进行验证研究。
