Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, Hamamatsu and.
Department of Physical Therapy, Faculty of Health and Medical Science, Teikyo Heisei University, Toshima, Japan.
Int J Rehabil Res. 2022 Dec 1;45(4):336-342. doi: 10.1097/MRR.0000000000000547. Epub 2022 Sep 12.
The aim of this study was to derive a screening tool for predicting the risk of falls in community-dwelling older adults with knee osteoarthritis. This prospective cohort study was conducted in four orthopedic clinics. The main outcome measure was falls or nonfalls for 5 months, and the predictors were sex, age, BMI, Kellgren-Lawrence grade, laterality, number of comorbidities, pharmacotherapy, physical therapy period, use of a cane, household, previous history of falls, visual analog scale for pain, one-leg standing test (OLST), five times sit-to-stand test (FTSST), and Frenchay activities index. Ninety outpatients (74 females and 16 males) with a mean (SD) age of 73.1 (9.3) years completed a 5-month follow-up. According to the binomial logistic regression analysis, previous history of falls [odds ratio (OR), 6.85; P = 0.019], OLST (OR, 5.97; P = 0.048), and FTSST (OR, 12.93; P = 0.034) were identified as risk factors for falls, and the clinical prediction rule was derived from these variables. The pretest probability of fallers in this study was 21.1% (19 of 90 participants). When the total screening tool score was three points (the participant scored one point for each item: previous history of falls, yes; OLST, ≤6.84 s; FTSST, ≥8.77 s), the positive likelihood ratio was 16:19, and the posttest probability increased to 81.3%. Therefore, this simple screening tool possesses potential clinical utility for identifying patients with knee osteoarthritis at high risk of falls in the future because it demonstrated sufficient diagnostic test accuracy.
本研究旨在为社区中膝骨关节炎的老年患者设计一种预测跌倒风险的筛查工具。这是一项前瞻性队列研究，在四个骨科诊所进行。主要结局指标是 5 个月内的跌倒或非跌倒情况，预测指标包括性别、年龄、BMI、Kellgren-Lawrence 分级、侧别、合并症数量、药物治疗、物理治疗期、使用手杖、家庭状况、既往跌倒史、疼痛视觉模拟评分、单腿站立试验（OLST）、五次坐站试验（FTSST）和 Frenchay 活动指数。90 名门诊患者（74 名女性和 16 名男性）完成了 5 个月的随访，平均（SD）年龄为 73.1（9.3）岁。根据二项逻辑回归分析，既往跌倒史（比值比 [OR]，6.85；P = 0.019）、OLST（OR，5.97；P = 0.048）和 FTSST（OR，12.93；P = 0.034）被确定为跌倒的危险因素，并从这些变量中推导出临床预测规则。本研究中跌倒者的术前概率为 21.1%（90 名参与者中有 19 名）。当总筛查工具得分为 3 分时（参与者在每个项目中得 1 分：既往跌倒史，是；OLST，≤6.84 s；FTSST，≥8.77 s），阳性似然比为 16:19，术后概率增加至 81.3%。因此，这种简单的筛查工具具有潜在的临床应用价值，可以识别未来患有膝骨关节炎且有高跌倒风险的患者，因为它具有足够的诊断测试准确性。
