脑卒中患者跌倒风险的相关因素研究

doi:10.3969/j.issn.1006-9771.2024.07.009

Abstract

Abstract:

Objective To explore the factors affecting the fall risks in stroke patients, and predict the level of fall risk.
Methods A retrospective analysis was conducted. A total of 64 stroke patients in Huadong Hospital from July, 2022 to January, 2024 were enrolled. The patient's demographic data, functional indicators and walking indicator, including gender, age, height, weight, stroke type, course of disease, WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), simplified Fugl-Meyer Assessment (FMA), Functional Reaching Test (FRT), Multi-Directional Reach Test (MDRT), Montreal Cognitive Assessment (MoCA) and Timed Up and Go Test were recorded. Using the risk level of falls in stroke patients as the dependent variable, first, a univariate analysis was conducted, and then discriminant analysis was followed to observe the risk factors for falls in stroke patients.
Results All the included stroke patients had an average age of approximately 66 years old, more males than females, and more cerebral infarction patients than cerebral hemorrhage patients. The average course of the disease was (4.50±6.02) months. There were 19, 26 and 19 stroke patients with mild, moderate and severe fall risk levels, respectively. One-way analysis of variance showed that the scores of WHODAS 2.0, FMA, FMA-Upper Extremities (FMA-UE), FMA-Lower Extremities (FMA-LE), FRT, MDRT-Forward (MDRT-F), MDRT-Right (MDRT-R) and MoCA were significantly differenct among stroke patients with different fall risk levels (F > 2.277, P < 0.05). Discriminant analysis showed that patients with different fall risk levels had different functional parameter equations, using the retrospective method, the accuracy rates of Fisher discriminant function and Bayes discriminant function were 75% and 78.1%, and the misjudgment rates were 25% and 21.9%, respectively.
Conclusion Activity and participation ability, upper and lower extremity motor function, stability limits of the forward and right direction and cognitive function are related factors to the risk level of falls. It could predicte the risk level of falls by establishing a discriminant function through functional indicators.

Key words: stroke, fall, International Classification of Functioning, Disability and Health, World Health Organization Disability Assessment Schedule, activity and participation, motor function, discriminant analysis

CLC Number:

R743.3

DUAN Linru, ZHENG Jiejiao, CHEN Xi, LI Yan. Analysis of relevant factors for fall risk in stroke patients[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 811-817.

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References 34

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风险等级	n	性别/n		年龄/岁	卒中类型/n		身高/cm	体质量/(kg•m^-2)	病程/月
风险等级	n	男	女	年龄/岁	脑梗死	脑出血	身高/cm	体质量/(kg•m^-2)	病程/月
轻度异常	19	17	2	68.11±9.03	14	5	170.79±4.66	72.26±7.40	3.16±2.52
中度异常	26	14	12	64.04±8.48	23	3	166.46±6.51	68.04±6.99	4.35±4.37
重度异常	19	17	2	68.21±8.69	17	2	167.00±4.50	72.00±10.97	6.05±9.46
总体	64	48	16	66.48±8.81	54	10	167.91±5.70	70.47±8.58	4.50±6.02

风险因素	风险等级			F值	P值
风险因素	轻度异常	中度异常	重度异常	F值	P值
WHODAS2.0	36.32±6.00	70.73±5.69	83.84±6.38	15.182	< 0.001
FMA	76.74±5.04	69.50±3.18	55.84±4.76	5.709	0.005
FMA-UE	47.68±15.61	44.81±11.38	37.79±17.83	2.277	0.011
FMA-LE	29.16±6.61	24.69±5.75	18.05±3.94	19.171	< 0.001
FRT	25.91±4.07	24.10±5.03	20.55±5.67	5.750	0.005
MDRT-F	25.67±4.18	23.85±5.04	20.16±5.64	6.048	0.004
MDRT-B	15.26±4.42	12.58±3.68	12.64±4.27	2.816	0.068
MDRT-L	20.07±4.21	17.43±4.72	16.56±4.89	3.008	0.057
MDRT-R	21.51±5.09	17.67±3.69	16.91±5.13	5.669	0.006
MoCA	24.05±2.78	21.92±2.08	22.00±3.15	4.223	0.019

Fisher判别函数预测结果	跌倒风险程度			合计
Fisher判别函数预测结果	轻度异常	中度异常	重度异常	合计
轻度异常	15	1	3	19
中度异常	2	19	5	26
重度异常	1	4	14	19
合计	18	24	22	64

Bayes判别函数预测结果	跌倒风险程度			合计
Bayes判别函数预测结果	轻度异常	中度异常	重度异常	合计
轻度异常	15	1	3	19
中度异常	3	19	4	26
重度异常	1	2	16	19
合计	19	22	23	64

Analysis of relevant factors for fall risk in stroke patients

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