4种平衡功能测试方法在慢性阻塞性肺疾病患者中应用的比较

doi:10.3761/j.issn.0254-1769.2022.01.003

摘要/Abstract

摘要：

目的比较计时起立行走测试 (Time Up and Go Test,TUG) 、Berg平衡量表 (Berg Balance Scale,BBS) 、单腿站立测试 (Single Leg Stance,SLS) 、简化版平衡评价系统测试 (Brief-Balance Evaluation Systems Test,Brief-BESTest) 4种平衡功能测试方法对慢性阻塞性肺疾病 (chronic obstructive pulmonary disease,COPD) 患者跌倒的筛查能力,为临床选择合适的平衡功能测试方法提供参考。方法采用便利抽样法,选取2020年2月—2021年2月入住广东省某三级甲等医院呼吸与危重症医学科的86例COPD患者作为研究对象,采用TUG、BBS、SLS、Brief-BESTest对其平衡功能进行评估,以入院前3个月内有无跌倒史作为判定标准,通过Bayes判别分析和受试者操作特征曲线下面积 (areas under the curve,AUC) 比较4种平衡功能测试方法对COPD患者跌倒的筛查能力。结果 TUG、BBS、SLS、Brief-BESTest对患者跌倒筛查的交叉验证准确率分别为60.47%、68.60%、51.16%、72.09%。Brief-BESTest的AUC最大 (0.818),其次是BBS (0.758),TUG、SLS的AUC分别为0.686、0.568。Brief-BESTest最佳临界值为14分,阳性预测值为0.786,灵敏度为0.739,特异度为0.825。结论在4种平衡功能测试方法中,Brief-BES-Test对COPD患者跌倒的筛查能力最强。建议医护人员采用Brief-BESTest评估COPD患者的平衡功能、预测跌倒风险。

关键词: 肺疾病,慢性阻塞性, 平衡功能, 跌倒, 评估, 护理

Abstract:

Objective To compare the screening ability of the Timed Up and Go Test (TUG),Berg Balance Scale (BBS),Single Leg Stance (SLS) and Brief-Balance Evaluation Systems Test (Brief-BESTest) for fall risk in people with chronic obstructive pulmonary disease (COPD),and to provide references for clinical selection of appropriate screening tools for balance function. Methods From February 2020 to February 2021,a total of 86 COPD patients hospitalized in the department of respiratory and critical care medicine of a tertiary hospital in Guangdong were selected by convenience sampling method. Their balance abilities were assessed using the TUG,BBS,SLS and Brief-BESTest. Taking 3-month history of falls as the diagnostic standard,the identification ability of the 4 scales for falls was compared by Bayes discriminant analysis and the area under the receiver operating characteristic curve (AUC). Results The cross-validation accuracy of TUG,BBS,SLS and Brief-BESTest were 60.47%,68.60%,51.16% and 72.09%. The Brief-BESTest showed the biggest area under ROC curve (0.818),compared with BBS (0.758),TUG (0.686) and SLS (0.568). At the cutoff score of 14,the Brief-BESTest demonstrated a positive test accuracy of 0.786 with the sensitivity of 0.739,the specificity of 0.825. Conclusion Among the 4 balance function tests,brief-BESTest was the best at screening a history of falls in COPD patients. Brief-BESTest was recommended for clinical staff to assess balance and predict fall risk in patients with COPD.

Key words: Pulmonary Disease,Chronic Obstructive, Balance Function, Fall, Assessment, Nursing Care

柳蕊, 周春兰, 刘宇霞, 章明阳, 张银英, 聂芳. 4种平衡功能测试方法在慢性阻塞性肺疾病患者中应用的比较[J]. 中华护理杂志, 2022, 57(1): 23-28.

LIU Rui, ZHOU Chunlan, LIU Yuxia, ZHANG Mingyang, ZHANG Yinying, NIE Fang. Comparison of 4 balance function assessments in patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2022, 57(1): 23-28.

图/表 5

表1 两组一般资料比较

Table 1 Baseline characteristics of two groups

表2 采用4种平衡功能测试方法筛查慢性阻塞性肺疾病患者跌倒的交叉验证结果

Table 2 Cross-validation of falls in chronic obstructive pulmonary disease with four balance function assessments

表3 两组平衡功能测试结果的比较

Table 3 Comparison of four balance function assessments results between two groups

图1 4种平衡功能测试方法对慢性阻塞性肺疾病患者跌倒筛查的受试者操作特征曲线注：TUG为计时起立行走测试;BBS为Berg平衡量表;SLS为单腿站立测试;Brief-BESTest为简化版平衡评价系统测试。

Figure 1 Receiver operating characteristic curve of four balance function assessments in screening fall risk of chronic obstructive pulmonary disease

表4 4种平衡功能测试方法对慢性阻塞性肺疾病患者跌倒筛查的受试者操作特征曲线分析

Table 4 Receiver operating characteristic curve analysis of four balance function assessments in screening fall risk of chronic obstructive pulmonary disease

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