“起立-行走”计时测试在脑卒中患者跌倒风险评估中的应用价值

Application value of timed up and go test in the evaluation of fall risk for stroke patients

目的探讨“起立-行走”计时测试在脑卒中患者跌倒风险评估中的应用价值。方法纳入357名脑卒中患者进行问卷调查,采用“起立-行走”计时测试(timed up and go test,TUGT)评估患者的移动能力。随访1年,统计随访期间的跌倒次数。采用ROC曲线分析TUGT测试对脑卒中患者跌倒风险评估的价值。结果随访1年间,357名脑卒中患者中146名发生跌倒事件,其中1次跌倒92名,频繁跌倒54名。频繁跌倒组、1次跌倒组以及未跌倒组患者年龄、性别、TUGT测试结果,以及独居、辅助用具使用、跌倒史、贫血、痛风比例,差异均有统计意义(P<0.05)。TUGT测试对跌倒的AUC为0.589(95%CI:0.524~0.627);调整年龄、性别因素后,TUGT测试对跌倒的AUC为0.613(95%CI:0.582~0.698)。TUGT测试对频繁跌倒的AUC为0.697(95%CI:0.614~0.781);调整年龄、性别因素后,TUGT测试对频繁跌倒的AUC为0.784(95%CI:0.657~0.864)。结论调整年龄和性别因素后,作为简单、有效、方便的测试工具,“起立-行走”计时测试(TUGT)对脑卒中患者频繁跌倒具有一定的预测价值。

Objective To explore the application value of timed up and go test(TUGT)in the evaluation of fall risk for stroke patients.Methods A total of 357 stroke patients were selected for questionnaire survey,and TUGT was used to evaluate the mobility.The patients were followed up for one year,and the number of falls during the follow-up period was counted.ROC curve was used to analyze the value of TUGT in fall risk assessment of stroke patients.Results During one year of follow-up,146 of 357 stroke patients had falls,including 92 once and 54 frequently.There were significant differences in the age,gender,living alone,assistive devices,falls,anemia,gout,and TUGT results among the frequent fall group,one-fall group and non-fall group(P<0.05).The AUC of TUGT for falls was 0.589(95%CI:0.524-0.627).After adjusting for age and gender factors,the AUC of TUGT for falls was 0.613(95%CI:0.582-0.698).The AUC of TUGT for frequent falls was 0.697(95%CI:0.614-0.781).After adjusting for age and gender factors,the AUC of TUGT for frequent falls was 0.784(95%CI:0.657-0.864).Conclusions After adjusting for age and gender factors,as a simple,effective and convenient test tool,TUGT has a certain predictive value for frequent falls in stroke patients.