老 人 跌倒 的評估篩 檢與實作

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老 人 跌倒 的評估篩 檢與實作. Lec 10 2012.11.20 林清 維. 定義. 跌倒是指突發、不自主、非故意的體位改變,倒在地面或比初始位置更低的平面上;如果患者失去平衡在摔倒的過程中由他人輔助倒在地板上,這也被稱作為跌倒。 按照國際疾病分類( ICD-10 )對跌倒的分類,包括以下兩類 ︰ 從一個平面至另一個平面的跌落; 同一平面的跌落。 老年跌倒是多原素導致的一種老年綜合征。. How serious is the problem of falls?. 流行病學數據 -1. - PowerPoint PPT Presentation

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Lec 102012.11.201ICD-10

2How serious is the problem of falls?

33-135-40%10%30%10-15%50%25%620-55%

44620-25%50% 30% (Kenny and Richardson 2001)1/10 $ 14,300 $1,200 (Cotter et al 2006)

5-2 20001902020320200360-6430/I/75-79150/1/2001864020211.8166-31.3 2000250050160-1801996WHO,6041.2318.0%209

772005466520.5%1258,99

10

> (>80) > 1

11

1

8084 6064 100

122/13Alzheimer

1450%1516Pressure sores/Bone resorptionPostural hypotensionPneumoniaThrombophlebitis and thromboembolismUrinary incontinenceConstipation and fecal impactionContractures171718 19

20-21

22

23-11.the dynamic gait indexDGI Shumway Cook80340241824-12.functional reach testFRT Duncan9075 min30%3625-2 3.multi-directional reach test, MDRTBerg 4.Bergberg balance scaleBBS1520 min145040456BBS45BBS

26-35.one-leg balance test5 s3676316.balance self-perceptions test, BSPT12060

27-47.modified gait abnormality rating scale ,GARS-M7,40302162878.Tinettitinetti gait and balance test916712281015 min192419705328

1.physical performance testPPT

9504367179Tinetti292.time up and go testTUGPodsiadlo,12 min20 s30 s2029 s87BBS

301.the falls efficacy scaleFES Tinetti10110100FES2.survey of activities and fear of falling in the elderlySAFFESAFFE11FES3.modified falls efficacy scaleMFESFES14411010311.activties specific balance confidence scaleABCPowell160100FESABC2.SPPB10DEFMorse

32 3.BarthelMBILondonLHS4.(MMSE)33(Berg balance scale BBS)34(Berg balance scale BBS): 56 5,12,25 10-1535(Berg balance scale BBS)BBS , , : , 36: ;,: 37BBS 5 (0- 4 ) , 0, 1-3 , , 4, 0-5638,BBSInterpretation: 41-56 = low fall risk 21-40 = medium fall risk 0 20 = high fall risk 391. sitting to standing ( ) 4 ( ) 3 ( ) 2 ( ) 1 ( ) 0

402. (standing unsupported) ( ) 4 ( ) 3 ( ) 2 ( ) 1 ( ) 0

413. (sitting unsupported) ( ) 4 ( ) 3 ( ) 2 ( ) 1 ( ) 0 2434424. (standing to sitting) ( ) 4 () ( ) 3 ( ) 2 ( ) 1 ( ) 0 435. (transfers) ( ) 4 ( ) 3 ( ) 2 ( ) 1 ( ) 0 446. (standing with eyes closed) 10 ( ) 4 10 ( ) 3 10 ( ) 2 3 ( ) 1 3 ( ) 0 457. (standing with feet together) ( ) 4 ( ) 3 ( ) 2 30 ( ) 1 15 ( ) 0 15 468. (reaching forward with outstretched arm) 90( 90) ( ) 4 25 ( ) 3 12 ( ) 2 5 ( ) 1 ( ) 0 479. (retrieving object from floor) ( ) 4 ( ) 3 ( ) 2 (2-5cm ) ( ) 1 ( ) 0 4810. (turning to look behind) ( ) 4 ( ) 3 ( ) 2 ( ) 1 ( ) 0 4911.360 (turning 360 degrees) 360360 ( ) 4 4360 ( ) 3 4360 ( ) 2 360 ( ) 1 ( ) 0 5012. (placing alternate foot on stool) ( ) 4 20 ( ) 3 20 ( ) 2 ( ) 1 ( ) 0 5113. ( )( 3)( ) 4 30 ( ) 3 30 ( ) 2 30 ( ) 1 15 ( ) 0 5214. (standing on one foot) ( ) 4 10( ) 3 5-10( ) 2 33( ) 1 3( ) 0 5354

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