老年脑卒中患者活动情况及其影响因素

Physical activities in elderly stroke patients and its influencing factors

【摘要】目的 探讨老年脑卒中患者活动不足和久坐行为的状况,并分析活动不足的影响因素。方法 选取2022年1月至10月某三甲医院收治的302例老年脑卒中患者为研究对象,并对其一般资料与疾病状况展开调查。采用国际体力活动问卷、国际跌倒效能感量表、简版老年抑郁量表、起立-行走测试评估患者的活动和心理情况。根据患者是否活动不足,将患者分为两组,对比两组各指标差异。采用SPSS 26.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。采用二元logistic回归分析活动不足的影响因素。结果 302例老年脑卒中患者中,115例(38.1%)活动不足,225例(74.5%)有久坐行为,124例(41.10%)有跌倒恐惧,55例(18.21%)有抑郁情绪,212例(70.20%)活动能力减退。单因素分析显示,有无活动不足的患者在年龄、婚姻状态、多重用药、是否有高血压、糖尿病、抑郁情绪、是否有下肢感觉异常、使用助行器、跌倒恐惧、久坐行为、活动能力减退方面,差异有统计学意义(P＜0.05)。logistic分析显示,有跌倒恐惧(OR=4.66,95%CI 2.64~8.24)、久坐行为(OR=4.03,95%CI 1.67~9.74)、下肢感觉异常(OR=2.23,95%CI 1.15~4.33)、抑郁情绪(OR=2.21,95%CI 1.08~4.53)是老年脑卒中患者活动不足的影响因素(P<0.05)。结论 老年脑卒中患者普遍存在活动不足和久坐行为。在改善患者活动不足问题时,不仅要关注患者的躯体功能问题,改善患者下肢肌力,减少久坐时间,以间断轻度活动代替久坐,也要关注患者心理问题,制定多维度干预方案,改善患者活动情况,从而实现更有效的康复。

基金项目:国家重点研发计划(2018YFC2001400)

【Abstract】Objective To investigate physical activity insufficiency and sedentary behavior in the elderly stroke patients, and to analyze the influencing factors of insufficient activities. Methods From January to October 2022,302 elderly stroke patients in a tertiary hospital were selected and investigated using general information, disease status, International Physical Activity Questionnaire, International Fall Efficacy Scale, geriatric depression scale-15, timed up and go test. According to the physical activity level, the patients were divided into two groups, and they were compared for the differences in the indicators. SPSS 26.0 was used for data analysis. Comparison between the two groups was performed using t-test or χ²test depending on the data type. Binary logistic regression was used to analyze the independent influencing factors of physical activity insufficiency. Results Among the 302 elderly stroke patients, 115 (38.1%) had inactive physical activity , 225 (74.5%) had sedentary behavior, 124 (41.10%) had fear of falling, 55 (18.21%) had depression, and 212 (70.20%) had impaired mobility. Univariate analysis showed that there were statistically significant differences in age, marital status, polypharmacy, hypertension, diabetes, depression, lower extremities paresthesias, use of walkers, fear of falling, sedentary behavior, and impaired mobility (P＜0.05). Multivariate logistic regression analysis showed that fear of falling (OR=4.66, 95%CI 2.64-8.24), sedentary behavior (OR=4.03,95%CI 1.67-9.74), paresthesia of the lower extremities (OR=2.23,95%CI 1.15-4.33), and depression (OR=2.21,95%CI 1.08-4.53) were independent risk factors of insufficient activities in the elderly stroke patients (P<0.05). Conclusion The elderly stroke patients are mostly physically inactive and sedentary. To address their inactivity, it is not only necessary to improve their physical function, to strengthen lower limb muscles, and to avoid being sedentary by intermittent and mild physical activities, but also necessary to attend their psychological problems. A multi-dimensional intervention program should be formulated to enhance activity for more effective recovery.

This work was supported by National Key Research and Development Program of China (2018YFC2001400)