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门诊步态分析中的“跌倒风险评分”:适用于养老院居民的新跌倒风险评估的验证。

"Fall Risk Scoring" in Outpatient Gait Analysis: Validation of a New Fall Risk Assessment for Nursing Home Residents.

机构信息

Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg, Deutschland.

Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen, Tübingen, Deutschland.

出版信息

Z Orthop Unfall. 2024 Oct;162(5):474-478. doi: 10.1055/a-2151-4709. Epub 2023 Oct 9.

Abstract

Falls in senior home residents are common. Individual preventive training can lower the fall risk. To detect the need for training, a systematic assessment of the individual fall risk is needed. The aim of this study was thus to assess whether a fall risk score based on free field insole measurements can distinguish between an at-risk group of senior home residents and a healthy young control group. A published fall risk score was used in senior home residents over the age of 75 and a young (< 40 years) control group to determine the individual fall risk. In addition, the fall events over 12 months were assessed. Statistical analysis including ROC analysis was performed to determine the ability of the score to detect participants at heightened fall risk. In total, 18 nursing home residents and 9 young control participants were included. Of the nursing home residents, 15 had at least one fall, with a total of 37 falls recorded over 12 months. In the control group, no falls were recorded. The fall risk score was significantly different between nursing home residents and the control group (9.2 + 3.2 vs. 5.7 ± 2.2). Furthermore, the score significantly differentiated fallers from non-fallers (10.3 ± 1.8 vs. 5.2 ± 2.5), with a cut-off > 7.5 (AUC: 0.95) and a sensitivity of 86.7% (specificity 83.3%). The fall risk score is able to detect the difference between senior nursing home residents and young, healthy controls, as well as between fallers and non-fallers. Its main proof of concept is demonstrated, as based on movement data outside special gait labs, and it can simplify the risk of fall determination in geriatric nursing home residents and can now be used in further, prospective studies.

摘要

老年人在养老院中经常跌倒。个体预防训练可以降低跌倒风险。为了检测培训需求,需要对个体跌倒风险进行系统评估。因此,本研究旨在评估基于自由场鞋垫测量的跌倒风险评分是否可以区分高危组养老院居民和健康的年轻对照组。在 75 岁以上的养老院居民和年轻(<40 岁)对照组中使用已发表的跌倒风险评分来确定个体跌倒风险。此外,还评估了 12 个月内的跌倒事件。进行了包括 ROC 分析在内的统计分析,以确定该评分识别高跌倒风险参与者的能力。共纳入 18 名养老院居民和 9 名年轻对照组参与者。在养老院居民中,有 15 人至少跌倒一次,12 个月内共记录了 37 次跌倒。在对照组中,没有记录到跌倒。养老院居民和对照组之间的跌倒风险评分差异显著(9.2 ± 3.2 对 5.7 ± 2.2)。此外,该评分还显著区分了跌倒者和非跌倒者(10.3 ± 1.8 对 5.2 ± 2.5),截断值>7.5(AUC:0.95),灵敏度为 86.7%(特异性为 83.3%)。跌倒风险评分能够检测到养老院老年人和年轻、健康对照组之间的差异,以及跌倒者和非跌倒者之间的差异。它的主要概念验证是基于特殊步态实验室外的运动数据,它可以简化老年养老院居民跌倒风险的确定,并可用于进一步的前瞻性研究。

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