伴有运动过度障碍患者的意外跌倒：系统综述。
Accidental Falls in Patients with Hyperkinetic Movement Disorders: A Systematic Review.
机构信息
Department of Neurology, Medical University Graz, Graz, Austria.
St. Elizabeth University of Health and Social Work, Bratislava, Slovakia.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2022 Oct 7;12:30. doi: 10.5334/tohm.709. eCollection 2022.
BACKGROUND
The significance of falls and their repercussions in Parkinson's disease has been extensively researched. However, despite potentially serious effects on health and quality of life and negative impact on the healthcare system, there is not a sufficient understanding of the role of falls in hyperkinetic movement disorders (HKMDs). This review aims to provide an overview of the prevalence of falls, injuries, and preventive measures in the most common HKMDs.
METHODS
Studies up to May 1, 2022 were searched in PubMed using Medical Subjects Headings of relatively prevalent HKMDs associated with the terms "accidental falls", "injuries", "fractures", and "accident prevention".
RESULTS
In our review of 37 studies out of 155, we found evidence that for several HKMDs, such as spinocerebellar ataxia, essential tremor, Huntington's disease, and dystonia, fall risk is increased. Falls were reported in up to 84% of spinocerebellar ataxia patients, 59% of essential tremor patients, and 79% of Huntington's patients, with 65% of the latter falling frequently. Injuries occurred in up to 73% in Huntington and 74% in ataxia patients. Most of the common diseases characterized by HKMDs were investigated for both fall causes and consequences, but prevention studies were limited to spinocerebellar ataxia and Huntington's disease.
DISCUSSION
The limited available data suggest that patients with several HKMDs can be considered to be at increased risk of falling and that the consequences can be serious. As a result, physicians should be advised to include fall exploration in their routine workup and provide advice for safer mobility. In general, more research into fall-related concerns in HKMDs is necessary.
HIGHLIGHTS
In contrast to Parkinson's disease, the prevalence of accidental falls, their repercussions, and preventive strategies are under-investigated in hyperkinetic movement disorders (HKMDs). Several HKMDs such as essential tremor, ataxia, and Huntington's disease have reported fall rates of up to 84% and fall-related injury rates of up to 74%. Therefore, routine examinations of HKMD patients should include a fall exploration and provide advice on safe mobility.
背景
跌倒及其对帕金森病的影响已得到广泛研究。然而，尽管跌倒可能对健康和生活质量产生严重影响，并对医疗保健系统造成负面影响，但人们对其在多动性运动障碍（HKMD）中的作用还没有足够的了解。本综述旨在概述最常见的 HKMD 中跌倒的发生率、伤害和预防措施。
方法
截至 2022 年 5 月 1 日，我们在 PubMed 中使用与以下术语相关的相对常见的 HKMD 的医学主题词搜索了研究：“意外跌倒”、“伤害”、“骨折”和“事故预防”。
结果
在对 155 项研究中的 37 项研究进行综述后，我们发现有证据表明，对于几种 HKMD，如脊髓小脑共济失调、特发性震颤、亨廷顿病和肌张力障碍，跌倒风险增加。高达 84%的脊髓小脑共济失调患者、59%的特发性震颤患者和 79%的亨廷顿病患者报告跌倒，后者中有 65%的患者经常跌倒。高达 73%的亨廷顿病患者和 74%的共济失调患者发生伤害。大多数以 HKMD 为特征的常见疾病都进行了跌倒原因和后果的研究，但预防研究仅限于脊髓小脑共济失调和亨廷顿病。
讨论
有限的现有数据表明，几种 HKMD 患者可能被认为跌倒风险增加，其后果可能很严重。因此，医生应被建议在常规评估中纳入跌倒评估，并提供更安全的活动建议。一般来说，需要对 HKMD 中的跌倒相关问题进行更多研究。
重点
与帕金森病不同，多动性运动障碍（HKMD）中意外跌倒的发生率、后果和预防策略的研究不足。特发性震颤、共济失调和亨廷顿病等几种 HKMD 的报告跌倒率高达 84%，跌倒相关伤害率高达 74%。因此，HKMD 患者的常规检查应包括跌倒评估，并提供安全活动建议。
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