转弯方向对老年脑卒中患者360°转弯测试评估转弯能力及跌倒风险的影响

Effects of turn direction on the 360°turn test on turning ability and fall risk in elderly stroke patients

目的:通过对不同运动功能分组的老年脑卒中患者进行不同转向单、双任务360°转弯测试,探讨每组受试者健、患侧转向测试间数据差异变化规律,并分析其对评估转弯能力及跌倒风险的影响。方法:选取老年脑卒中患者70例,进行单、双任务向健、患侧转身的360°转弯测试,分别记录3种条件下向两侧转身测试的时间与步数。按Brunnstrom分期将受试者分为Ⅲ—Ⅳ期组(有联带运动)和Ⅴ期组(无联带运动),2组数据分别按患侧下肢单腿支撑时间进行排序,观察排序之后360°转弯测试的数据,观察指标为健侧转弯与患侧转弯之间的数据差异,根据观察结果进行数据分析,并统计其有效性。结果:BrunnstromⅢ—Ⅳ期组,单腿支撑时间≥9s时,3种条件下测试结果均为向健侧360°转弯时间>向患侧360°转弯时间,差异有显著性意义(P<0.05),步数差异无显著性意义(P>0.05);BrunnstromⅤ期组,单腿支撑时间≤7s时,3种条件下测试结果均为向健侧360°转弯时间<向患侧360°转弯时间,差异有显著性意义(P<0.05),向健侧360°转弯步数<向患侧360°转弯步数,差异有显著性意义(P<0.05)。结论:应用360°转弯测试评估转弯能力及预测跌倒风险时,应考虑转弯方向。

Objective:By testing the time and steps of the single and dual-task 360°turn test in elderly stroke patients with different motor function groups,the data changes between the healthy and affected side turn tests of each group were investigated and analyzed.Method:Seventy elderly stroke patients were selected and completed the single task or dual task 360°turn test when turning to the unaffected side or the affected side.We recorded the time and the number of steps under three conditions.According to the Brunnstrom stage,the patients were divided into the stageⅢ—Ⅳgroup(with Synkinesis)and the stage V group(without Synkinesis).The data of each group was sorted according to the single leg support time.The observation index was the data difference between the healthy side turn and the affected side turn,then the data analysis and validity were counted based on the observations.Result:In the BrunnstromⅢ—Ⅳstage group,when the single-leg support time≥9s,the data showed that the 360°turn time when turning to the unaffected side was greater than the 360°turn time when turning to the affected side under all three conditions,and the difference was significant(P<0.05).However,the number of steps had no significant difference(P>0.05).In the Brunnstrom V stage group,when the single-leg support time≤7s,the time and steps under all conditions exhibited the greater turn time when turning to the unaffected side compared with when turning to the affected side,and the difference was significant(P<0.05).Conclusion:Turning direction should be considered when evaluating turning ability and predicting fall risk by 360°turning test.