卒中患者平衡能力状况与影响因素分析

Balance Ability and Its Influencing Factors in Stroke Patients

目的了解脑卒中患者的平衡能力,并通过比较不同健康状况脑卒中患者的平衡能力,为给卒中患者提供更有效的康复和更针对性的跌倒预防措施提供依据。方法采用随机抽样的方法选择居住在上海市长宁区的脑卒中患者,应用老人跌倒相关平衡能力测试量,表现场测试调查对象的平衡能力,并应用自行设计的调查表,对可能的影响因素进行入户调查。结果卒中患者平衡能力得分均数为(9.1±7.7),平衡能力良好、较好、差、很差等级的比例分别为17.1%(256人)、19.9%(298人)、40.6%(607人)和22.3%(334人)。不同卒中类型、不同累及部位和是否伴有后遗症的卒中患者间其平衡能力等级分布不同(P<0.05)。脑卒中主要的后遗症除是否伴有疼痛症状外,其余均显著降低患者的平衡能力。结论脑卒中患者平衡能力较差,后遗症对平衡能力的影响较大,增加了跌倒风险。因此有后遗症的卒中患者应该作为跌倒干预的优先人群。老年跌倒相关平衡能力测试可作为筛查卒中患者中跌倒高危人群的有效手段。

Objective To evaluate balance ability of stroke patients and provide a guide for prescribing a more efficient rehabilitation program and tailored fall prevention program for stroke patients by comparing stroke patients in differenthealth conditions.Methods A random sampling method was used to recruit stroke patients in Changning District,Shanghai.An elderly falls-related balance scale was applied to assess the balance ability of subjects while a home-designedquestionnaire was used to detect related risk factors.Results The mean score of balance ability of surveyed stroke patientswas9.1±7.7.The proportions of excellent,fair,poor and very poor were17.1%,19.9%,40.6%and22.3%,respectively.Thebalance ability of stroke patients was affected significantly by stroke types,affected parts and the residual disabilities(p<0.05).All the residual symptoms,except for pain,significantly decreased balance ability of stoke patients.ConclusionThe balance ability of stroke patients is impaired by the residual disabilities thus increase the risk of falling.Falls preventionpriority should be given to stroke patients with residual disabilities.Elderly falls-related balance scale would be an useful toolin screening stroke patients at high risk of falls.