由坐至站之動態分析與中風病人跌倒之關係

The Kinetic Assessment of Sit-to-Stand in Stroke Patients and Its Relationship to Fall

鄭寶釵(Pao-Tsai Cheng) ； 吳淑霞(Shu-Hsia Wu) ； 廖美雲(Mei-Yun Liaw) ； 林佩欣(Pay-Shin Lin) ； 黃美涓(May-Kuen Wong) ； 陳協慶(Hsieh-Ching Chen) ； 鄧復旦(Fuk-Tan Tang)

《中華民國復健醫學會雜誌》 25卷2期 (1997/12) Pp. 119-127

摘要

Fall has been reported as a major cause of morbidity, hospitalization and mortality of older people. Stroke patients are more prone to fall than non-stroke subjects, because of the pathological conditions inposing upon the physiological aging process. Since fall is so frequent, fall prevention strategies should therefore be developed and included in rehabilitation programs.
Falls are associated with many physical and environmental factors. Excluding tripping, many of the falls in stroke patients occurred during the patients changing their positions, such as standing up, sitting down or initiation of steps. Therefore, the purpose of this study is focus on the kinetic analysis of rising / sitting down activities and to find its relationship to the fall in stroke patients.
Totally 25 normal subjects, and 33 stroke patients (18 faller , 15 non-faller ) were included in this study. There was a significant difference between stroke patients and normal controls in the tested motor tasks--the stroke patients favoured their non-affected leg. The body weight distribution was asymmetric while patients rising/sitting down spontaneously. The vertical floor reaction force difference between affected and non-affected leg was 53% of body weight in stroke patients with fall, 42% of body weight in stroke without fall (p＜0.05), while only 17% in the normal control (p＜0.005). The rate of change in force (dF/dT) for rising from the chair was calculated from the data collected by computer. Stroke patients with fall had significantly lower dF/dT than non-fallers,(23.78±17.38 Kg/sec vs 55.23±31.24 Kg/sec, p＜0.05).As compared to the normal control dF/dT (85.96±42.4 Kg/sec),stroke patients had significant low dF/dT (p＜0.005). The hemiplegic patients have also shown significantly increased postural sway, especially in medio-lateral direction while rising/sitting down, p＜0.05. The centers of pressure (COP) sway were greater in medio-lateral direction than antero-posterior direction in stroke patients during rising/sitting down. In contrast, the COP sway were greater in antero-posterior direction in normal controls. With feet parallel, the stroke patient was deficient in shifting weight toward the hemiplegic leg (p＜0.05).

關鍵字

由坐至站 ； 動力學分析 ； 中風 ； 跌倒

並列摘要

Fall has been reported as a major cause of morbidity, hospitalization and mortality of older people. Stroke patients are more prone to fall than non-stroke subjects, because of the pathological conditions inposing upon the physiological aging process. Since fall is so frequent, fall prevention strategies should therefore be developed and included in rehabilitation programs.
Falls are associated with many physical and environmental factors. Excluding tripping, many of the falls in stroke patients occurred during the patients changing their positions, such as standing up, sitting down or initiation of steps. Therefore, the purpose of this study is focus on the kinetic analysis of rising / sitting down activities and to find its relationship to the fall in stroke patients.
Totally 25 normal subjects, and 33 stroke patients (18 faller , 15 non-faller ) were included in this study. There was a significant difference between stroke patients and normal controls in the tested motor tasks--the stroke patients favoured their non-affected leg. The body weight distribution was asymmetric while patients rising/sitting down spontaneously. The vertical floor reaction force difference between affected and non-affected leg was 53% of body weight in stroke patients with fall, 42% of body weight in stroke without fall (p＜0.05), while only 17% in the normal control (p＜0.005). The rate of change in force (dF/dT) for rising from the chair was calculated from the data collected by computer. Stroke patients with fall had significantly lower dF/dT than non-fallers,(23.78±17.38 Kg/sec vs 55.23±31.24 Kg/sec, p＜0.05).As compared to the normal control dF/dT (85.96±42.4 Kg/sec),stroke patients had significant low dF/dT (p＜0.005). The hemiplegic patients have also shown significantly increased postural sway, especially in medio-lateral direction while rising/sitting down, p＜0.05. The centers of pressure (COP) sway were greater in medio-lateral direction than antero-posterior direction in stroke patients during rising/sitting down. In contrast, the COP sway were greater in antero-posterior direction in normal controls. With feet parallel, the stroke patient was deficient in shifting weight toward the hemiplegic leg (p＜0.05).

並列關鍵字

sit to stand ； stroke ； fall ； kinetic analysis