Determination and clinical significance of 4 m-walking speed test threshold for stroke patients
10.3760/cma.j.issn.1674-2907.2018.31.010
- VernacularTitle:脑卒中患者预测跌倒的4m-步行速度测试临界值确定及临床意义
- Author:
Zheyan TAO
1
;
Feifei WANG
;
Dongmei MU
Author Information
1. 温州医科大学附属第二医院神经外科
- Keywords:
Stroke;
Fall;
4 m-walking speed;
Threshold
- From:
Chinese Journal of Modern Nursing
2018;24(31):3765-3768
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the threshold of 4 m-walking speed for predicting falls in patients with stroke and to evaluate its clinical significance. Methods A total of 1 079 cases of stroke patients in Neurology Surgery Department and Neurology Medicine Department of the Second Affiliated Hospital of Wenzhou Medical University from July 2015 to May 2017 were selected as the research subjects by convenience sampling method. Data of physical examination, body composition measurement, blood biochemistry, muscle strength and 4 m-walking speed were collected by questionnaire. According to the results of 4 m-walking speed test, the receiver operating characteristic curve (ROC) of subjects was drawn to determine the critical value of 4 m-walking speed for stroke patients, and the predictive value of the critical value of 4 m-walking speed for the risk of falling was analyzed by logistic regression. Results The incidence of falls was 37.5% in stroke patients. The 4 m-walking speed for male and female with stroke was (0.75±0.02) m/s and (0.82±0.06) m/s respectively. ROC curve showed that, in male patients, the critical value of 4 m-walking speed was 0.84 m/s, the area under curve (AUC) was 0.71 (0.65, 0.75), the sensitivity was 87.5%, and the specificity was 65.9%. In female, the critical value of 4 m-walking speed was 0.79 m/s, the AUC was 0.68 (0.62, 0.73), the sensitivity was 75.3%, and the specificity was 78.6%. Logistic regression analysis showed that after adjusting for age, BMI, smoking, alcohol consumption, exercise and disease history, compared with the elderly population below 4 m-walking speed threshold, the OR values of falls in male and female stroke patients above the 4 m-walking speed threshold were 2.97 (1.94, 4.56) and 2.25 (1.40, 3.60) respectively. Conclusions The incidence of fall is high in stroke patients. The threshold of 4 m-walking speed to predict the fall risk of male and female patients with stroke was 0.84 m/s and 0.79 m/s respectively. The determination of the threshold of 4 m-walking speed can provide reference for the prevention of falls in stroke patients and is worthy of clinical popularization and application.
