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康复医院中,亚急性卒中患者与物理治疗师对跌倒风险认知的差异:一项回顾性队列研究。

Discrepancies in perception of fall risk between patients with subacute stroke and physical therapists in a rehabilitation hospital: a retrospective cohort study.

作者信息

Inoue Seigo, Otaka Yohei, Horimoto Yukari, Shirooka Hidehiko, Sugasawa Masafumi, Kondo Kunitsugu

机构信息

Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan.

Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.

出版信息

Front Aging. 2023 Jun 5;4:1204488. doi: 10.3389/fragi.2023.1204488. eCollection 2023.

DOI:10.3389/fragi.2023.1204488
PMID:37342863
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10277567/
Abstract

Falls are one of the most common complications of a stroke. This study aimed to clarify the discrepancy between the perceived fall risk of hospitalized patients with stroke and the clinical judgment of physical therapists and to examine the changes in discrepancy during hospitalization. Retrospective cohort study. This study included 426 patients with stroke admitted to a Japanese convalescent rehabilitation hospital between January 2019 and December 2020. The Falls Efficacy Scale-International was used to assess both patients' and physical therapists' perception of fall risk. The difference in Falls Efficacy Scale-International scores assessed by patients and physical therapists was defined as the discrepancy in fall risk, and its association with the incidence of falls during hospitalization was investigated. Patients had a lower perception of fall risk than physical therapists at admission ( < 0.001), and this trend continued at discharge ( < 0.001). The discrepancy in fall risk perception was reduced at discharge for non-fallers and single fallers ( < 0.001), whereas the difference remained in multiple fallers. Unlike physical therapists, patients underestimated their fall risk, especially patients who experienced multiple falls. These results may be useful for planning measures to prevent falls during hospitalization.

摘要

跌倒 是 中风 最 常见 的 并发症 之一。本 研究 旨在 明确 中风 住院 患者 感知 到 的 跌倒 风险 与 物理 治疗师 的 临床 判断 之间 的 差异,并 研究 住院 期间 差异 的 变化。回顾性 队列 研究。本 研究 纳入 了 2019 年 1 月 至 2020 年 12 月 期间 入住 一家 日本 康复 医院 的 426 例 中风 患者。采用 国际 跌倒 效能量表 评估 患者 和 物理 治疗师 对 跌倒 风险 的 感知。将 患者 和 物理 治疗师 评估 的 国际 跌倒 效能量表 得分 差异 定义 为 跌倒 风险 差异,并 研究 其 与 住院 期间 跌倒 发生率 的 关联。入院 时 患者 对 跌倒 风险 的 感知 低于 物理 治疗师(<0.001),出院 时 这 一 趋势 仍 存在(<0.001)。非 跌倒 者 和 单次 跌倒 者 在 出院 时 跌倒 风险 感知 差异 减小(<0.001),而 多次 跌倒 者 差异 仍 存在。与 物理 治疗师 不同,患者 低估 了 自己 的 跌倒 风险,尤其是 多次 跌倒 的 患者。这些 结果 可能 有助于 制定 住院 期间 预防 跌倒 的 措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fcd/10277567/aff80c273ce1/fragi-04-1204488-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fcd/10277567/b4e10c13f19d/fragi-04-1204488-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fcd/10277567/93e19e65b836/fragi-04-1204488-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fcd/10277567/aff80c273ce1/fragi-04-1204488-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fcd/10277567/b4e10c13f19d/fragi-04-1204488-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fcd/10277567/93e19e65b836/fragi-04-1204488-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fcd/10277567/aff80c273ce1/fragi-04-1204488-g003.jpg

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3
Fall Efficacy Scale-International cut-off score discriminates fallers and non-fallers individuals who have had stroke.
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J Bodyw Mov Ther. 2021 Apr;26:167-173. doi: 10.1016/j.jbmt.2020.12.002. Epub 2021 Feb 6.
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