Step length appears to be a strong discriminant gait parameter for elderly females highly concerned about falls: a cross-sectional observational study

Objective

To determine if gait parameters and the Timed Up and Go test can discriminate between elderly females with high and low concern about falls. Knowledge of these parameters could help in the development of rehabilitation programmes focused on the prevention of falls, fear of falling and functional decline.

Design

Cross-sectional, observational study.

Setting

Human motion laboratory.

Participants

One hundred and fifty-four elderly females (aged 64 to 83 years), divided into two groups based on their Falls Efficacy Scale International score: high concern (n = 81) and low concern (n = 73) about falls.

Main outcome measures

Eight gait parameters recorded with the GAITRite system and the Timed Up and Go test score.

Results

Factor 2 (composed of step length, gait velocity and Timed Up and Go mobility test) explained 20% of the variability of the data and was the only factor to discriminate between the groups, with 63% correct classifications. Step length proved to be the variable with the greatest discriminant ability, with a much higher discriminant coefficient (0.889) than the Timed Up and Go test (−0.369) and gait velocity (−0.268).

Conclusions

High concern about falls is primarily associated with decreased step length. Step length could be used as a screening tool to identify elderly women with low and high concern about falls in order to target these groups in a rehabilitation programme aimed to slow reduction in gait velocity and mobility.     

预防患者坠床的风险管理方法及效果

目的 探讨在医院实施风险预警管理,预防患者坠床的方法与效果.方法 成立防坠床预警管理小组,制订防坠床预警管理制度及应急预案,实施风险预警管理,采取现场质量控制的管理模式.结果 提高了护士对患者危险评估准确率和护理措施落实率,降低了患者坠床发生率(P<0.01或P＜0.05).结论 早期采取有效的干预措施,可以减少患者坠...     

老年单、双膝痛骨关节炎患者的平衡功能及其跌倒风险对比分析

目的比较单膝痛和双膝痛骨关节炎老年患者的平衡功能特点及其跌倒风险。方法对30例老年无膝痛骨关节炎患者、30例老年单膝痛骨关节炎患者和32例老年双膝痛骨关节炎患者进行计时起立-行走测试(TUG)、静态姿势稳定性测试(PS)、动态姿势稳定极限性测试(LOS)以及动态跌倒风险测试(DFI)。结果单膝痛组TUG时间长于无膝痛组(P<0.05),双膝痛组明显长于无膝痛组(P<0.01),单、双膝痛组之间无显著性差异(P>0.05)。双膝痛组PS得分高于无膝痛组与单膝痛组(P<0.05),无膝痛组与单膝痛组之间无显著性差异(P>0.05)。双膝痛组的LOS完成时间明显长于无膝痛组和单膝痛组(P<0.01),无膝痛组与单膝痛组之间无显著性差异(P>0.05)。单、双膝痛组的DFI得分高于无膝痛组(P<0.05),双膝痛组高于单膝痛组(P<0.05)。结论老年单膝痛骨关节炎患者动态平衡功能的下降,存在高跌倒风险;老年双膝痛骨关节炎患者静态和动态平衡功能均下降,跌倒风险更高。     

2006-2010年江苏省监测地区儿童跌倒/坠落伤特征分析

目的:了解2006~2010年江苏省监测地区儿童跌倒/坠落伤发生特征,为制定干预措施提供依据?方法:收集5年来医院监测点儿童跌倒/坠落伤病例资料进行分析?结果:跌倒/坠落伤位居各类儿童伤害就诊的首位,占40.4%;男性多于女性,男女比例为2.1∶1;各年龄段均有发生,比例近似?跌倒/坠落伤发生的前3位地点为家中(32.9%)?学校与公共场所(32.0%)和公共居住场所(18.1%);伤害发生时从事最多的活动为休闲活动,占66.5%;受伤性质以扭伤/擦伤最为多见,占55.3%;受伤最多的3个部位为头部(39.9%)?上肢(28.9%)和下肢(24.6%);80.3%的病例为轻伤,重度伤害仅占0.4%;意外伤害占99.3%?比较城乡间跌倒/坠落伤特征,发现两地就诊者性别?伤害意图?发生季节?发生旬段4个特征分布差异无显著性,在年龄?文化程度?发生地点?发生时活动?发生时段?伤害性质?部位?严重程度?结局等特征分布差异有显著性(P < 0.05)?结论:跌倒/坠落伤是江苏省监测地区就诊比例最高的儿童伤害,应根据不同分布特征选择优先干预的方向并开展干预活动?     

电力隧道防坠落措施探讨与应用

高处坠落事故是电力工作中常见恶性事故之一。本文对电力隧道作业防坠落措施制定的必要性进行了探讨,并结合北京电力隧道工作实际,通过对比分析,制订了一套符合现场需要、具有可操作性的防坠落安全措施。     

芦荟膏敷贴联合穴位按摩护理在老年住院卧床便秘患者中的应用效果观察

目的 探讨芦荟膏敷贴联合穴位按摩对老年卧床便秘患者进行护理的临床应用效果.方法 将54例老年住院卧床便秘患者随机分为对照组和实验组各27例.对照组采用穴位按摩与常规护理,实验组在对照组的基础上采用芦荟膏敷贴进行护理干预,观察比较两组患者排便时间、大便形状的变化以及治疗效果与再次发生便秘的情况.结果 干预后实验组总有效率为92.59％,对照组为66.66％,两组比较差异有统计学意义(x2=5.59,P＜0.05);实验组复发率为4％,对照组复发率为50％,两组比较差异有统计学意义(x2 =10.85,P＜0.01);实验组患者排便时间及大便形状均优于对照组,差异均有统计学意义(u分别为-2.329,-2.728;P＜0.05).结论 芦荟膏敷贴疗法治疗便秘效果肯定,作用维持时间长,能够提高患者的生活质量.     

浅谈中药升降浮沉

升降浮沉理论是中药药性理论的基本内容之一,是升降学说在中药学领域中的具体体现。了解中药升降浮沉之性,对临床用药具有一定的指导意义。     

Falls and catastrophic thoughts about falls predict mobility restriction in community-dwelling older people: A structural equation modelling approach

Objectives: How and when concerns about falls emerge is not yet completely known, because these concerns are present in both people with and without a falls history. The aim of this study was to investigate the role of catastrophic beliefs about falls and previous falls in the development of concerns about falls and resulting mobility restrictions (MR).

Method: Within a cross-sectional design, 896 older people (mean age 76.2 ± 4.7) living independently in the community completed a battery of questionnaires. Self-report data was gathered on previous falls, catastrophic beliefs about consequences of a fall (Catastrophizing About Falls Scale), concerns about falls (modified Falls Efficacy Scale) and mobility restrictions during daily life (Sickness Impact Profile 68).

Results: Using structural equation modelling, we found that the number of falls in the previous year was not directly related to mobility restrictions in daily life, but via an increase of concerns about falls. Also catastrophic beliefs about the consequences of falls were related to concerns about falls and to mobility restrictions. Goodness-of-fit indices revealed that the presented model had an acceptable fit. Alternative models resulted in lesser-fit indices.

Conclusion: Both previous falls and catastrophic beliefs about falls are unique and independent predictors of concerns about falls and, subsequently, of mobility restrictions. A cognitive-behavioural perspective upon mobility restrictions may provide important additional components for treatment and prevention of excessive concerns about falls in older people.     

Fear of falling and activities of daily living function: mediation effect of dual-task ability

Objective: The aim of the study was to explore the association between fear of falling (FOF), dual-task ability during a mobility task, and the activities of daily living (ADL) in a sample of older adults.

Methods: Seventy-six older adults (mean age M = 70.87 ± 5.16 years) participated in the study. Data on FOF (using the Falls Self-Efficacy Scale-International), walking ability during both single- and dual-task performances and ADL were collected.

Results: Mediation analysis demonstrated the mediation effect of dual-task ability (β = 0.238, p = 0.011) between FOF and ADL level (β = 0.559, p < 0.001). Moreover, significantly lower performances were observed during dual-task condition [F (2, 73) = 7.386, p < 0.001], and lower ADL levels were also found in older adults with FOF [F (2, 73) = 13.734, p < 0.001].

Conclusion: The study underlines the relationship between FOF, dual-task ability and ADL level. These results could be used to develop specific intervention programmes for successful ageing.