Increased Prevalence of Fall Risk Factors in Older People following Hip Fracture
Increased Prevalence of Fall Risk Factors in Older People following Hip Fracture
复制标题
髋部骨折后老年人跌倒危险因素的患病率增加
作者：
C. Sherrington;S. Lord
背景：许多髋部骨折患者并没有达到完全的功能恢复。简单的身体功能测试，如股四头肌力量和姿势摆动，可能会深入了解为什么这一人群经历进一步跌倒和骨折的风险增加，并有助于制定预防跌倒的康复策略。目的：确定与跌倒相关的髋部骨折患者是否比没有跌倒病史的社区居民的配对样本更容易受到生理指标和特定医疗条件的损害。方法：对88例老年人进行病例对照研究。髋部骨折组包括44名年龄为-94岁的人，平均在跌倒导致髋部骨折后7个月进行评估。从社区样本中随机抽取年龄和性别匹配的对照组(招募前12个月内未跌倒的老年人)。结果：与对照组相比，髋部骨折组在坚固和顺应性(泡沫橡胶)表面进行测试时，股四头肌力量显著降低，身体摇摆增加。与对照组相比，髋部骨折组患者视力低下、关节炎和中风的患病率也更高，服用的药物更多，体力活动更少，摔倒的风险更大。两组之间在心血管状况、主观健康状况和精神活性药物使用方面没有明显差异。多变量分析确定股四头肌力量和柔韧性表面上的身体摆动是区分髋部骨折组和非髋部骨折组的最重要的变量。这两个变量对92%的病例进行了正确分类，具有同等的敏感性和特异性。结论：研究结果表明，在髋部骨折的老年人中，某些身体跌倒危险因素的患病率增加。股四头肌力量的减弱和姿势摆动的增加可能是可以改变的。旨在改善这些变量在这一人群中的表现的干预计划需要调查。
Background: Many people who suffer a hip fracture do not achieve full functional recovery. Simple tests of physical function such as quadriceps strength and postural sway may provide insight into why this population is at increased risk of experiencing further falls and fractures and assist in developing rehabilitation strategies for preventing falls. Objective: To determine whether impairments in a range of physiological measures and specific medical conditions are more prevalent in people who have suffered a fall-related hip fracture than in a matched sample of community-dwelling people without a history of falls. Methods: This case-control study involved 88 older people. The hip fracture group comprised 44 persons aged 64–94 years, assessed on average 7 months following a fall-related hip fracture. An age- and sex-matched control group (older persons who had not fallen in a 12-month period before recruitment) was drawn randomly from community samples. Results: Compared with the control group, the hip fracture group had markedly reduced quadriceps strength and increased body sway when tested on firm and compliant (foam rubber) surfaces. Patients in the hip fracture group also had higher prevalence rates of poor vision, arthritis and stroke, were taking more medications, were less physically active and perceived themselves to be at greater risk of falling than the control group. No significant differences were apparent for cardiovascular conditions, subjective health status and psychoactive medication use between the groups. Multivariate analyses identified quadriceps strength and body sway on the compliant surface as the most important variables for distinguishing between the hip fracture and no hip fracture groups. These two variables correctly classified 92% of the cases, with equal sensitivity and specificity. Conclusion: The findings identify an increased prevalence of certain physical fall risk factors among older persons who have suffered a hip fracture. Decreased quadriceps strength and increased postural sway are potentially modifiable. Intervention programs designed to improve performance on these variables among this population require investigation.
老年人随后发生髋部骨折。
影响因子：
12.7
作者：
Wolinsky,FD;Fitzgerald,JF
通讯作者：
Fitzgerald,JF