노인의 낙상 위험에 관한 TUG, BBS, FRT, OLST의 예측 타당도
The Predictive validity of the TUG, BBS, FRT, OLST of Falls Risk in Elderly Patient
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초록
본 연구의 지역사회에 거주하는 노인들을 대상으로 한 후향적 연구(1년 전 낙상 경험에대한 기록)로서 낙상 유무에 따라 4가지의 균형 평가인 Timed Up & Go test(TUG), Berg Balance Scale(BBS), Functional Reaching Test(FRT), One Leg Stance Test(OLST)에 차이가 있는지 알아보고 낙상 예측에 관한 선별 기준값과 예측 타당도 및 낙상과의 관련성을검증하고자 하였다. 낙상에 따른 일반의학적인 특성을 알아보기 위하여 카이제곱 검정(χ2 )과크기 효과(size effect)를 각 평가에 대한 측정자간 신뢰도(Intra-class Coefficient), 측정변수들의 낙상 예측에 관한 선별 기준값(cutoff value)과 교차비(Odds ratio)를 구하였다. 본 연구 결과 BBS의 선별 기준값은 < 42점, 민감도(82%)와 특이도(75%)가 가장 높고,OLST의 선별 기준값은 < 13.51초, BBS 다음으로 특이도(70%)가 높은 것으로 나타나 노인들의 낙상을 예측하는데 가장 유용한 평가 도구임을 확인할 수 있었다. 특히 BBS는 다양한자세조절에 관한 균형 평가가 가능하므로 낙상요소와 관련된 평가 항목에 대한 선택적인 평가가 가능하다는 점과 OLST는 단시간에 낙상을 예측할 수 있는 평가 도구로 활용이 가능하다. 따라서 BBS와 OLST는 신체적인 능력이 감소되어 있는 노인들을 대상으로 낙상을 예측하는데변별력이 있는지 재평가되어야 하며 그에 따른 전향적인 연구가 있어야 할 것이다.
Abstract
This study as a retrospective study of elderly living in the community, if it makes a difference to find out the Timed Up & Go test (TUG), Berg Balance Scale (BBS), Functional Reaching Test (FRT), One Leg Stance Test (OLST) in falls depending on whether or not the four balance assessment, was to validate the predictive validity and the relevance of the falls and falls on the prediction of selective reference. The chi-square test and Size effect to examine the characteristics of a general medical due to fall was calculated for each evaluation Intra-class Coefficient,cutoff value on the prediction of fall and the odds ratio. The results of this study,cutoff value of the BBS is < 42 points, the highest sensitivity(82%) and specificity (75%), cutoff value of the OLST is < 13.51 seconds, found that the most useful assessment tool for the prediction of fall of the elderly appears to be a high specificity(70%) of next the BBS. Especially, the BBS is possible to assess the balance on the control of various posture, so the choice of evaluation is possible assessment about the item associated with the element fall and OLST can be used as an assessment tool to predict fall in the short term. Therefore, BBS and OLST be reassessed if there is discriminatory to predict the fall of the elderly has been reduced physical abilities, subsequent will have to be prospective study.
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