中文版21项跌倒风险指数对社区老年脑卒中患者的心理测量特征。

IF 3.4 3区 医学 Q1 REHABILITATION
Peiming Chen, Shamay S Ng, K Cheng, Y Hui, C Law, H Leung, T Cheung, Billy C So, Richard H Xu, Chun L Hsu, Kim J Li, Cynthia Y Lai, Mimi M Tse
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引用次数: 0

摘要

背景:制定了21项跌倒风险指数问卷(FRI-21)来筛查老年人的跌倒风险。它显示了在评估中风人群跌倒风险方面的巨大潜力。然而,尚无研究对香港中风患者进行信度和效度调查。目的:研究脑卒中患者与健康老年人之间的FRI-21水平;2)脑卒中患者复测信度;3) FRI-21与Berg平衡量表(BBS)相关的收敛效度;4)随访2年,FRI-21对跌倒发生的预测能力;5) 2年随访中区分脑卒中患者跌倒与非跌倒的最佳fr -21分值;6)中国版fr -21的天花板效应和地板效应。设计:横断面研究。设置:校本康复实验室。人群:共有57名中风患者和31名健康老年人。方法:在卒中患者第1天和第2天(第1天后7天)评估fr -21测试,并仅在第1天对健康老年人进行评估。BBS也在第1天进行评估。结果:脑卒中患者的平均FRI-21评分为7.37分。在脑卒中患者中,ri -21表现出良好的评分间信度(类内相关[ICC] 0.74)和良好的重测信度(ICC=0.798)。ri -21评分与BBS呈显著负相关(r=-0.308)。研究发现,在2年的随访中,ri -21评分是跌倒的重要预测因子(OR 1.40 [95% CI 1.06-1.85], P=0.018)。受试者工作特征曲线分析发现,最佳的ri -21截断值为7.5分,在区分脑卒中患者的降压者和非降压者方面具有可接受的诊断能力(曲线下面积= 0.723,P=0.002),具有中等的敏感性(80.0%)和特异性(60.5%)。天花板和地板的影响可以忽略不计。结论:本研究反映了FRI-21作为评估50岁及以上无认知障碍的中风患者跌倒风险的自我管理工具的可靠性和有效性。7.5分被确定为区分中风患者的跌倒和非跌倒的分值。ri -21评分是中风患者跌倒的重要预测指标。它能有效区分中风患者和健康老年人的跌倒风险。未来的研究应增加样本量,以提高研究结果的普遍性。临床康复影响:临床医生可以使用该工具有效地识别中风幸存者中的高危个体,并实施有针对性的早期干预。这种早期跌倒风险筛查工具使医疗保健提供者能够针对风险最高的患者启动预防措施和强化康复方案,从而潜在地减少继发性并发症,改善功能结局,并降低再入院率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Psychometric properties of the Chinese version of 21-item Fall Risk Index for community-dwelling older adults with stroke.

Psychometric properties of the Chinese version of 21-item Fall Risk Index for community-dwelling older adults with stroke.

Psychometric properties of the Chinese version of 21-item Fall Risk Index for community-dwelling older adults with stroke.

Psychometric properties of the Chinese version of 21-item Fall Risk Index for community-dwelling older adults with stroke.

Background: The 21-item Fall Risk Index questionnaire (FRI-21) was developed to screen for fall risk in older adults. It showed great potential in assessing the fall risk in stroke population. However, no previous study investigated its reliability and validity in people with stroke in Hong Kong.

Aim: This study aimed to translate FRI-21 to Chinese and investigate: 1) the FRI-21 scores between people with stroke and healthy older adults; 2) the test-retest reliability of the FRI-21 in people with stroke; 3) the convergent validity by correlated of the FRI-21 with Berg Balance Scale (BBS); 4) the predictive ability of FRI-21 on the fall occurrence in the 2 years follow-up; 5) the optimal FRI-21 cut-off score that distinguishes faller and non-faller among people with stroke in the 2 years follow-up; and 6) the ceiling and floor effects of the Chinese version of the FRI-21.

Design: Cross-sectional study.

Setting: University-based rehabilitation laboratory.

Population: In total, 57 people with stroke and 31 healthy older adults.

Methods: The FRI-21 test was assessed in people with stroke on Day1 and Day 2 (7 days after Day 1), and assessed in healthy older adults on Day 1 only. The BBS was also assessed in Day 1.

Results: The mean FRI-21 scores in subjects with stroke was 7.37. The FRI-21 demonstrated good inter-rater reliability (intraclass correlation [ICC] 0.74) and good test-retest reliability (ICC=0.798) in people with stroke. The FRI-21 scores demonstrated significant negative correlations with the BBS (r=-0.308). The FRI-21 score was found to be a significant predictor (OR 1.40 [95% CI 1.06-1.85], P=0.018) of fall in the 2 years of follow-up. The receiver operating characteristic curve analysis identified an optimal FRI-21 cutoff score of 7.5, showing an acceptable diagnostic power in distinguishing faller and non-faller among people with stroke (area under curve = 0.723, P=0.002), with moderate sensitivity (80.0%) and specificity (60.5%). Ceiling and floor effects are negligible.

Conclusions: This study reflects the reliability and validity of the FRI-21 as self-administered tool for assessing fall risk in individuals aged 50 and over with stroke, and without cognitive impairments. A cut-off score of 7.5 was identified to distinguish faller and non-faller in people with stroke. The FRI-21 score was a significant predictor of fall in people with stroke. It effectively differentiates fall risk between people with stroke and healthy older adults. Future research should increase the sample size to enhance the generalizability of the findings.

Clinical rehabilitation impact: Clinicians can use this tool to efficiently identify high-risk individuals among stroke survivors and implement targeted early interventions. This early fall risk screening tool allows healthcare providers to initiate preventive measures and intensive rehabilitation protocols for those at greatest risk, potentially reducing secondary complications, improving functional outcomes, and decreasing hospital readmission rates.

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来源期刊
CiteScore
8.50
自引率
4.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: The European Journal of Physical and Rehabilitation Medicine publishes papers of clinical interest in physical and rehabilitation medicine.
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