Topper A K, Maki B E, Holliday P J
Centre for Studies in Aging, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
J Am Geriatr Soc. 1993 May;41(5):479-87. doi: 10.1111/j.1532-5415.1993.tb01881.x.
To determine whether an activity-based test of balance and gait is predictive of the risk of: (1) falling in situations that are related to specific tasks evaluated as part of the test, (2) experiencing falls precipitated by different classes of biomechanical events, or (3) falling in general; and to compare the predictive ability of the activity-based test for the falls described in (2) and (3) to that of a posturography test that has been found previously to be predictive of falling risk.
Cohort study.
Baseline tests performed in balance laboratory; subsequent history of falling monitored prospectively for 1 year in two residential-care facilities.
Seventeen male and 83 female consecutive volunteers (mean age = 83, SD = 6) who were independent in activities of daily living and able to stand unaided.
Independent variables were derived from an activity-based balance-and-gait test and a posturography test. Dependent variables were the numbers of subjects with one or more: (1) falls in specific situations related to activity-based test items, (2) falls related to general classes of biomechanical precipitant, and (3) falls in general.
Subjects who were rated as "abnormal" in activity-based test items related to transfers, turning or reaching were more likely to experience one or more falls in related situations in everyday life. Activity-based scores were predictive of risk of experiencing falls with no obvious biomechanical precipitant and falls precipitated by center-of-mass perturbation, but not falls precipitated by base-of-support perturbation. In comparison, a posturographic measure of spontaneous medial-lateral postural sway (blindfolded conditions) failed to predict falls having no biomechanical precipitant, but provided the best predictions of both center-of-mass and base-of-support falls, as well as risk of falling in general.
Activity-based testing of certain tasks (transfer, turning, reaching) may be useful in indicating a specific need for intervention to reduce the risk of falling during related everyday activities. In terms of predicting falling risk, a static posturography test may provide better prediction overall of the different classes of falls and may be useful as a quick and simple screening tool to help identify high-risk individuals.
确定基于活动的平衡和步态测试是否能预测以下风险：（1）在与测试中评估的特定任务相关的情况下跌倒；（2）经历由不同类别的生物力学事件引发的跌倒；或（3）总体跌倒情况；并比较基于活动的测试对（2）和（3）中所述跌倒的预测能力与先前已发现可预测跌倒风险的姿势描记测试的预测能力。
队列研究。
在平衡实验室进行基线测试；随后在两个住宅护理机构对跌倒史进行为期1年的前瞻性监测。
17名男性和83名女性连续志愿者（平均年龄 = 83岁，标准差 = 6岁），他们在日常生活活动中具有独立性且能够独立站立。
自变量来自基于活动的平衡和步态测试以及姿势描记测试。因变量是出现以下一种或多种情况的受试者数量：（1）与基于活动的测试项目相关的特定情况下跌倒；（2）与一般类别的生物力学促发因素相关的跌倒；（3）总体跌倒情况。
在与转移、转身或伸手相关的基于活动的测试项目中被评定为“异常”的受试者在日常生活中更有可能在相关情况下经历一次或多次跌倒。基于活动的得分可预测无明显生物力学促发因素的跌倒风险以及由质心扰动引发的跌倒风险，但不能预测由支撑面扰动引发的跌倒风险。相比之下，姿势描记法对自发的内侧 - 外侧姿势摆动（蒙眼条件下）的测量未能预测无生物力学促发因素的跌倒，但对质心和支撑面跌倒以及总体跌倒风险提供了最佳预测。
对某些任务（转移、转身、伸手）进行基于活动的测试可能有助于表明在相关日常活动中降低跌倒风险的特定干预需求。就预测跌倒风险而言，静态姿势描记测试可能总体上对不同类别的跌倒提供更好的预测，并且可能作为一种快速简单的筛查工具，有助于识别高危个体。
