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護理之家住民下肢被動關節角度改變之危險因子探討一二個月前瞻性研究

Factors Related to Deteriorations of Lower Extremity Joints Passive Range of Motion in Nursing Home Residents-A Two-Month Prospective Study

摘要


Purpose: The aims of this study were to describe the changes of passive range of motion (PROM) over 2-month period for lower extremity joints and to identify potential risk factors in nursing home residents. Methods: Forty-eight nursing home residents who were able to participate in at least two evaluation sessions within 2 months were recruited (mean age=70.5 years old; 28 males, 20 females). The following data were collected from each resident: demographic characteristics; mobility status(Postural Assessment Scale for Stroke patients); physical examination(pain status, muscle tone, strength, timed up and go test, BarthelIndex, etc.); duration of physical therapy interventions (min); passive joint ranges (degree) of bilateral hip, knee and ankle flexion and extension. The passive ranges of motion were measured again two months later. Results: The PROMs of the hip flexion, hip extension, knee extension and ankle dorsiflexion decreased significantly over two months (p<0.05). The occurrence of hip flexion range deterioration is higher if it was the sound side (odds ratio=1.057;95%CI 1.012 to 1.104) and had a higher baseline PROM (odds ratio=2.678;95%CI 1.063 to 6.744). The occurrence of hip extension range deterioration is higher if the subject had higher scores in PASS (odds ratio=1.090;95%CI 1.021 to 1.163). The occurrence of knee extension range deterioration is higher if it had higher resistance to passive joint motion (odds ratio=1.357;95%CI 1.091 to 1.689) and the subject had length of disease onset less than one year (odds ratio=0.191;95%CI 0.049 to 0.740). The occurrence of ankle dorsiflexion range deterioration is higher if it had abnormal muscle tone over ankle plantarflexor (odds ratio=3.619; 95%CI 1.025 to 12.770). The occurrence of ankle plantarflexion range deterioration is higher if it had a higher baseline PROM (odds ratio=1.083; 95%CI 1.023 to 1.147). Conclusions: Nursing home residents demonstrated significant deteriorations in lower extremity joints PROM in as short as 2 months duration. Being the sound side, having a better baseline range of motion, having better bed mobility, having increased resistance to PROM, or onset of major diseases within 1 year are main risk factors for joint range deteriorations.

並列摘要


Purpose: The aims of this study were to describe the changes of passive range of motion (PROM) over 2-month period for lower extremity joints and to identify potential risk factors in nursing home residents. Methods: Forty-eight nursing home residents who were able to participate in at least two evaluation sessions within 2 months were recruited (mean age=70.5 years old; 28 males, 20 females). The following data were collected from each resident: demographic characteristics; mobility status(Postural Assessment Scale for Stroke patients); physical examination(pain status, muscle tone, strength, timed up and go test, BarthelIndex, etc.); duration of physical therapy interventions (min); passive joint ranges (degree) of bilateral hip, knee and ankle flexion and extension. The passive ranges of motion were measured again two months later. Results: The PROMs of the hip flexion, hip extension, knee extension and ankle dorsiflexion decreased significantly over two months (p<0.05). The occurrence of hip flexion range deterioration is higher if it was the sound side (odds ratio=1.057;95%CI 1.012 to 1.104) and had a higher baseline PROM (odds ratio=2.678;95%CI 1.063 to 6.744). The occurrence of hip extension range deterioration is higher if the subject had higher scores in PASS (odds ratio=1.090;95%CI 1.021 to 1.163). The occurrence of knee extension range deterioration is higher if it had higher resistance to passive joint motion (odds ratio=1.357;95%CI 1.091 to 1.689) and the subject had length of disease onset less than one year (odds ratio=0.191;95%CI 0.049 to 0.740). The occurrence of ankle dorsiflexion range deterioration is higher if it had abnormal muscle tone over ankle plantarflexor (odds ratio=3.619; 95%CI 1.025 to 12.770). The occurrence of ankle plantarflexion range deterioration is higher if it had a higher baseline PROM (odds ratio=1.083; 95%CI 1.023 to 1.147). Conclusions: Nursing home residents demonstrated significant deteriorations in lower extremity joints PROM in as short as 2 months duration. Being the sound side, having a better baseline range of motion, having better bed mobility, having increased resistance to PROM, or onset of major diseases within 1 year are main risk factors for joint range deteriorations.

被引用紀錄


賴佐君(2011)。社區腦中風患者復健照護情形之探討〔碩士論文,亞洲大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0118-1511201215462595
蔡沛穎(2016)。護理之家中高齡住民參與體能促進方案發展與成效研究〔碩士論文,國立中正大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0033-2110201614072404

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