The contribution of foot problems to mobility impairment and falls in community-dwelling older people
The contribution of foot problems to mobility impairment and falls in community-dwelling older people
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DOI：
10.1111/j.1532-5415.2001.49275.x
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发表时间：
2001-12-01
影响因子：
6.3
通讯作者：
Lord, SR
中科院分区：
文献类型：
--
作者：
Menz, HB;Lord, SR
目的：调查社区居住老年人的足部问题、平衡能力和功能能力之间的关系，并确定有多次跌倒史的老年人是否比没有跌倒或只跌倒过一次的老年人表现出更严重的足部损伤。设计：一项横断面回顾性研究。地点：澳大利亚悉尼皇家北岸医院跌倒与平衡实验室。参与者：135 岁的社区居住男性和女性 75 至 93（平均年龄标准差，79.8 +/- 4.1）。测量：足部问题评分；姿势摇摆；协调稳定；楼梯的上升和下降；交替步进测试；定时6米步行；以及视觉、感觉、力量和反应时间测试。结果：百分之八十七的样本至少有一只脚有问题。女性的足部问题得分明显高于男性。足部问题得分与协调稳定性测试、上下楼梯、交替踏步测试和定时 6 米步行的表现显着相关。多元回归分析表明，足部问题评分是协调稳定性测试、上下楼梯以及交替踏步测试中表现的重要独立预测因素。有多次跌倒史的受试者的足部问题评分显着高于那些没有跌倒或仅跌倒过一次的受试者，但这些组之间个体足部状况或足部疼痛的发生率没有差异。结论：足部问题在老年人中很常见，并且与功能测试中的平衡和表现受损有关。此外，有多次跌倒史的老年人比没有跌倒或仅跌倒过一次的人有更严重的足部损伤。这些发现进一步证明足部问题是跌倒风险因素，并表明多种足部问题的累积效应在增加跌倒风险方面比存在或不存在个别足部疾病更为重要。
OBJECTIVES: To investigate the relationship between foot problems, balance, and functional ability in community-dwelling older people and to determine whether older people with a history of multiple falls exhibit greater foot impairment than those who have not fallen or who have fallen once only.DESIGN: A cross-sectional, retrospective study.SETTING: Falls and Balance Laboratory, Royal North Shore Hospital, Sydney, Australia.PARTICIPANTS: One hundred thirty-five community-dwelling men and women age 75 to 93 (mean age standard deviation, 79.8 +/- 4.1).MEASURES: Foot problem score; postural sway; coordinated stability; stair ascent and descent; an alternate stepping test; timed 6-meter walk; and tests of vision, sensation, strength, and reaction time.RESULTS: Eighty-seven percent of the sample had at least one foot problem. Women had a significantly higher foot problem score than did men. The foot problem score was significantly associated with performance on the coordinated stability test, stair ascent and descent, alternate stepping test, and timed 6-meter walk. Multiple regression analyses revealed that the foot problem score was a significant independent predictor of performance in the coordinated stability test, stair ascent and descent, and the alternate stepping test. Subjects with a history of multiple falls had a significantly higher foot problem score than did those who had not fallen or who had fallen once only, but the prevalence of individual foot conditions or the presence of foot pain did not differ between these groups.CONCLUSIONS: Foot problems are common in older people and are associated with impaired balance and performance in functional tests. Furthermore, older people with a history of multiple falls have greater foot impairment than non- or once-only fallers. These findings pro-vide further evidence that foot problems are a falls risk factor and suggest that the cumulative effect of multiple foot problems is more important in increasing falls risk than the presence or absence of individual foot conditions.