Abou Libak, Rice Laura A
Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Physiother Theory Pract. 2024 Nov;40(11):2530-2539. doi: 10.1080/09593985.2023.2266741. Epub 2023 Oct 6.
Functional assessments easy to administer within the clinic to identify non-ambulatory individuals with spinal cord injury at risk of recurrent falls are needed.
To examine the ability of functional balance and transfer quality to predict recurrent falls.
This 6-month prospective study examined remote assessments of transfer quality using the Transfer Assessment Instrument and functional sitting balance with the Function in Sitting Test and the Trunk Control Test. Then, participants prospectively monitored their falls for 6-month using fall diaries. Frequency of falls was categorized as infrequent fallers (≤2 falls) and recurrent fallers (>2 falls). A multivariable logistic regression analysis was conducted. A Receiver Operating Characteristic curve was performed to determine the area under the curve, the sensitivity, and the specificity of the model.
Eighteen non-ambulatory individuals (mean age = 44 ± 16 years, mean time since injury = 7.8 ± 32.6 years) participated in the study. Poor balance (lower Function in Sitting Test score) was associated with higher odds of future recurrent falls (Odds Ratio = 0.70, 95% CI, 0.48 to 1.00, = 0.05), area under the receiving operating curve = 0.87, sensitivity = 88%, and specificity = 70%.
A comprehensive sitting balance assessment that includes the static, proactive, and reactive components of balance with the integration of sensorial functions as evaluated within the Function in Sitting Test may be useful for predicting recurrent falls among non-ambulatory individuals with spinal cord injury. Replication of the findings in a larger sample is warranted.
需要在诊所内易于实施的功能评估，以识别有反复跌倒风险的非步行脊髓损伤患者。
研究功能平衡和转移质量预测反复跌倒的能力。
这项为期6个月的前瞻性研究使用转移评估工具对转移质量进行远程评估，并通过坐姿功能测试和躯干控制测试评估功能性坐姿平衡。然后，参与者使用跌倒日记对其跌倒情况进行为期6个月的前瞻性监测。跌倒频率分为偶尔跌倒者（≤2次跌倒）和反复跌倒者（>2次跌倒）。进行多变量逻辑回归分析。绘制受试者工作特征曲线以确定曲线下面积、模型的敏感性和特异性。
18名非步行个体（平均年龄=44±16岁，平均受伤时间=7.8±32.6年）参与了该研究。平衡能力差（坐姿功能测试得分较低）与未来反复跌倒的较高几率相关（优势比=0.70，95%置信区间，0.48至1.00，P=0.05），受试者工作曲线下面积=0.87，敏感性=88%，特异性=70%。
一项全面的坐姿平衡评估，包括平衡的静态、主动和反应成分，并结合坐姿功能测试中评估的感觉功能，可能有助于预测非步行脊髓损伤个体的反复跌倒。有必要在更大的样本中重复这些发现。
