老年脑卒中患者活动情况影响因素分析

目的 探讨老年脑卒中患者活动不足和久坐行为的状况,并分析活动不足的影响因素。方法 选取2022年1月～2022年10月某三甲医院302名老年脑卒中患者,采用一般资料与疾病状况调查、国际体力活动问卷、国际跌倒效能感量表、简版老年抑郁量表、起立-行走测试对患者进行调查。根据患者是否活动不足,将患者分为2组,对比2组各指标差异。采用SPSS26.0软件进行数据分析,采用二元Logistic回归分析活动不足的独立影响因素。结果 302名老年脑卒中患者中,115例（38.1%）活动不足,225例（74.5%）有久坐行为,124例（41.10%）有跌倒恐惧,55例（18.21%）有抑郁情绪,212例（70.20%）活动能力减退。Logistic分析显示,有跌倒恐惧（OR=4.66）、久坐行为（OR=4.03）、下肢感觉异常（OR=2.23）、抑郁情绪（OR=2.21）是老年脑卒中患者活动不足的独立风险因素。结论 老年脑卒中患者普遍存在活动不足和久坐行为。在改善患者活动不足问题时,不仅要关注患者的躯体功能问题,改善患者下肢肌力,减少久坐时间,以间断轻度活动代替久坐,也要关注患者心理问题,制定多维度干预方案,改善患者活动情况,从而实现更有效的康复。

Prevalence and Associated Risk Factors of Insufficient Activities in Older Stroke Patients

Objective To explore the status of insufficient activity and sedentary behavior in older stroke patients, and analyze the influencing factors of insufficient activity. Methods From January to October 2022, 302 older stroke patients in a tertiary hospital were investigated; the information included general information, disease status, International Physical Activity Questionnaire, International Fall Efficacy Scale, Simplified Geriatric Depression Scale, Time-Up and Go Test. According to the physically activity level, the patients were divided into two groups, the differences in the indicators of the two groups were compared. SPSS 26.0 software was used for data analysis, and binary logistic regression was used to analyze the independent influencing factors of insufficient activity. Results Among 302 older stroke patients, 115 patients（38.1%）were inactivity, 225（74.5%）had sedentary behavior, 124 (41.10%) had fear of falling, 55 (18.21%) were depressed, and 212 (70.20%) had impaired mobility. Multivariate analysis showed that fear of falling (OR=4.66), sedentary behavior (OR=4.03), paresthesia of the lower extremities (OR=2.23), and depression (OR=2.21) were independent risk factors for insufficient activity in older stroke patients. Conclusion Insufficient activity and sedentary behavior prevail among older stroke patients. When improving physical activity of patients, it is necessary to improve their physical function and lower limb muscle strength, and avoid sedentary behavior, doing intermittent and mild physical activity instead. It is also necessary to solve their psychological problems. A multi-dimensional intervention program should be formulated to improve activity and achieve more effective recovery.