재가 노인의 낙상공포 여부에 따른 건강상태, 신체기능상태 및 가정환경 위험 비교

임경춘(Kyung-Choon Lim),전경자(Kyung Ja June),윤종률(Jong-Lull Yoon) 한국노년학회 2009 한국노년학 Vol.29 No.4

본 연구는 재가노인을 대상으로 낙상공포 여부에 따른 건강상태, 신체기능상태 및 가정환경의 위험을 비교하고, 낙상공포에 영향 미치는 요인을 규명하는 것을 목적으로 하였다. 대상자는 A시 D구 노인보건센터에 방문보건사업 대상자로 등록된 65세 이상 노인으로 선정하였다. 2006년 1월부터 2007년 12월까지 사전에 교육받은 방문간호사가 직접 가정방문하여, 재가노인기능상태평가도구(Resident Assessment Instrument, RAI)를 이용해 자료를 수집하였다. 연구에 참여한 973명의 평균 연령은 76.8(±7.6)세였고, 여성이 74.8%였으며, 낙상공포를 가진 대상자는 20.7%였다. 낙상공포 여부에 따른 건강상태 비교에서 요실금, 통증, 이환질병 수, 지난 3일 간 우울/불안/슬픔의 징후에 있어서 유의한 차이를 보였다. 신체기능 상태는 낙상공포가 있는 집단에서 일상생활수행능력 의존도가 유의하게 높았고, 시력 문제가 많았으며, 불안정한 걸음걸이를 보이는 대상자가 현저히 많았다. 가정환경위험은 화장실, 방 출입 및 집 밖 출입 시 낙상공포가 없는 집단에 비해 유의하게 더 어려움이 많았다. 연령이 많을수록, 일상생활 의존도가 높을수록, 이환질병 수가 증가할수록, 걸음걸이가 불안정하거나 낙상경험이 있는 경우에 낙상공포가 증가하는 것으로 나타났다. 반면, 통증, 우울/불안/슬픔의 징후, 복용하는 약은 낙상공포와 유의하지 않았다. 이 연구는 지역사회의 노인을 사정할 때 낙상공포에 관련된 주요요인인 연령, 일상생활수행능력, 현재 앓고 있는 질환 및 걸음걸이 사정이 매우 중요하다는 것을 재확인시켜준다. 또한, 재가노인의 낙상예방 전략 수립을 위한 기초 자료로 활용될 수 있을 것이며, 불안정한 걸음걸이의 원인을 파악하고 이에 대한 중재방법을 모색하는 지속적인 연구의 필요성을 제시한다. 이 연구를 토대로 건강상태와 신체기능을 향상시키려는 포괄적인 간호중재를 통해 낙상공포를 감소시키고 낙상 발생률을 낮추면, 궁극적으로 노인의 삶의 질이 향상될 것이다. The purpose of this study was to compare the health status, functional status, and home environment hazards by the fear of falling and explore the factors that contribute to the fear of falling. This was a descriptive study. Data were collected for two years with 973 older adults who enrolled in a health center at A city. Trained nurses visited subjects' home and collected data using Resident Assessment Instrument MDS-HC. The average age of the subjects was 76.8 (±7.6) and female was 74.8%. 20.7% of subjects reported fear of falling. In terms of the fear of falling, two groups were compared. There were significant differences in vision, urinary incontinence, pain that interrupts daily activity, unstable gait, comorbidities, frequency of depressive or anxious sign. The greater the age, IADL and ADL dependency, comorbidities, unstabled gait, the more fear of falling. In conclusion, this study reassured the importance of assessing the major factors related to fear of falling such as age, IADL and ADL, comorbities, gait among older adults. This study will contribute to establish strategies for preventing fall. Reducing the fear of falling through the comprehensive nursing intervention will ultimately improve the quality of life in the elderly.

낙상공포와 인지적 과제 수행이 고령자의 장애물 보행에 미치는 영향

유연주,이기광,김석범 대한운동학회 2014 아시아 운동학 학술지 Vol.16 No.4

[PURPOSE] The purpose of this study was to investigate characteristics of the concurrent performance of a secondary cognitive task influences on obstacle gait in older adults with Fear Of Falling(FOF). [METHODS] Six elders with FOF(Age: 74.3±5.9yr, Height: 150±10cm, Weight: 57.7±9.8kg)and nine elders with Non FOF(Age: 72.4±3.7yr, Height: 150±10cm, Weight: 52.0±4.7kg)participated in the study. Ten cameras, marker sets, Visual 3D program, and two force platforms were used to analyze the performance of an obstacle gait. In the dual task, each subject stepped over an obstacle in accordance with performing a cognitive task(1-back task). Two way ANOVA was used to compare kinematic and obstacle gait parameters. [RESULTS] FOF significantly affected the flexion of the hip, knee, and ankle joint, foot clearance, and maximum vertical ground reaction force of the leading foot. Variables which we investigated were not affected by the addition of a secondary cognitive task. [CONCLUSIONS] Elders with FOF showed the stiff walking with less flexion of the lower extremity and stepping over the obstacle with conservative strategy. The relative importance of the secondary task to the subjects in real life may apply to the future study. [목적] 본 연구의 목적은 낙상공포를 느끼는 노인들과 느끼지 않는 노인들을 대상으로 청각을 통해 제시한 인지과제를 동시에 수행하는 장애물 보행과 일반 장애물 보행 간 움직임 특성의 차이를 비교·분석하는데 있다. [방법] 낙상공포를 느끼는 노인 6명(연령: 74.3±5.9세, 키: 150±10cm, 체중: 57.7±9.8kg)과 낙상공포를 느끼지 않는 노인 9명(연령: 72.4±3.7세, 키: 150±10cm, 체중: 52.0±4.7kg)이 참여하였다. 장애물 보행 시 인체의 움직임을 분석하기 위해 카메라 10대, 마커, Visual 3D 프로그램이 사용되었고, 장애물을 건너며 지면을 내딛는 하지의 힘과 압력중심의 변화를 살펴보기 위해 지면반력기가 사용되었으며, 인지과제로 1-back 과제가 사용되었다. 낙상공포 집단과 비낙상공포 집단의 단일과제(장애물 보행)와 이중과제(인지과제+장애물 보행)의 특성을 비교 분석하기 위해 반복측정 이원분산분석이 사용되었다. [결과] 낙상공포는 엉덩이, 무릎과 발목의 굴곡력, 발의 수직거리, 장애물을 먼저 건넌 후 지면을 딛는 발의 최대수직지면반력에 유의한 영향을 주었으며, 인지과제는 분석된 변인에 통계적으로 유의한 영향을 미치지 않았다. [결론] 낙상공포를 느끼는 노인들은 장애물 보행 시 엉덩이, 무릎과 발목을 적게 굴곡하여 걸었으며, 장애물의 중심을 지날 때 발의 가장 낮은 부분과 장애물의 가장 윗부분 사이의 최소 수직 거리가 짧게 나타났고, 장애물을 건넌 후 조심스럽게 지면을 딛는 것으로 나타났다. 향후 이중과제 연구 시 본 연구에 사용된 1-back 과제 외에 일상생활에서 자주 사용되는 실질적인 인지과제의 적용이 필요하다.

지역사회에 거주하는 파킨슨병환자의 낙상공포 영향 요인

선순희(Sun Hee Seon),김정선(Jeong Sun Kim) 한국콘텐츠학회 2016 한국콘텐츠학회논문지 Vol.16 No.1

본 연구는 지역사회에 거주하는 파킨슨병환자의 운동기능, 우울, 낙상공포의 관계를 파악하고 낙상공포에 미치는 영향요인을 규명하기 위한 것이다. 대상자는 편의표집에 의해 선정된 파킨슨병환자 180명이다. 수집된 자료는 IBM SPSS Statistics 20.0을 이용하여 기술통계, t-test, ANOVA, Pearson correlation coefficient와 multiple linear regression으로 분석하였다. 그 결과, 파킨슨병환자는 여성, 직업이 없는 경우. 보행보조기구 사용자, 2회 이상 낙상 경험자, 파킨슨병 4단계 환자, 유병기간이 9년을 초과한 경우, 항고혈압제 복용 환자, 독립적 운동수행력 하위군, 우울이 있는 경우 낙상공포가 더 높게 나타났다. 낙상공포는 운동기능 및 우울과 유의한 순상관관계를 나타냈다. 파킨슨병환자의 낙상공포의 영향요인은 우울, 낙상횟수, 파킨슨병 단계, 성별, 항고혈압제, 운동기능으로 변량의 36.0%의 설명력을 나타냈으며 영향요인 중 우울이 가장 강력한 요인으로 나타났다. 따라서 지역사회 거주하는 파킨슨병환자의 낙상공포를 예방하기 위해서는 영향요인에 대한 체계적 간호사정과 함께 우울을 완화할 수 있는 중재전략이 필요함을 제시해 주었다. The purpose of this study was to examine the relation of motor function, depression, and fear of falling, and to identify factors influencing fear of falling in patients with Parkinson’s disease in the community. The participants were 180 patients with Parkinson’s disease who were selected by convenience sampling. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and multiple linear regression. There was a significant difference in fear of falling according to gender, occupation, walking assistance device, number of falls, Parkinson’s disease stage, duration of illness, antihypertensive drug, motor function, and depression. Fear of falling showed significant positive correlations with motor function, and depression. Depression, number of falls, Parkinson’s disease stage, gender, antihypertensive drug, and motor function were significant predictors influencing fear of falling in patients with Parkinson’s disease, and these variables accounted for 36.0% of the variance. Depression of the influencing factors was the strongest factor. The results of this study suggest that a variety of intervention strategies for preventing or mitigating depression with systematic nursing assessment of the influencing factors on fear of falling are needed to prevent fear of falling in patients with Parkinson’s disease.

서울·경기지역 재가 노인의 활동능력과 낙상공포

송경애,문정순 지역사회간호학회 2003 지역사회간호학회지 Vol.14 No.4

Purpose: To investigate the abilities to act and fear of falling in home-dwelling elderly. Methods: This study interviewed 351 home-dwelling elders residing in Seoul and Gyonggi-do using a Survey of Activities and Fear of Falling in the Elderly. Results: Of the 351 subjects, 203 (57,8%) had activity restrictions. The main three activities that the subjects could not perform were going out when it is slippy, reaching something overhead and walking crowded places outside. According to general characteristics, performable activities were significantly fewer in subjects perceiving that their health status was low that those perceiving that their health status was high. On a scale of 3 points for fear of falling, the average score of the subjects was 1.46. The highest score of fear of falling was 2.62 for the activity of going out when it is slippery, next 1.87 for the activity of reaching something overhead. There was a significant inverse relationship between subjects' abilities to act and fear of falling. Conclusions: The significant variables associated with fear of falling were gender (female), educational background, economic status (low-income), and experience of falls during the last one year. Thus further study is necessary, focused on the vulnerable population in order to prevent falls and to reduce fear of falling.

낙상공포와 인지적 과제 수행이 고령자의 장애물 보행에 미치는 영향

유연주,이기광,김석범 대한운동사협회 2014 대한운동사협회 워크숍자료집 Vol.41 No.-

낙상공포와 보행방향의 변화가 보행시작 동안 자세적응에 미치는 영향

유연주,이기광,김석범 대한운동학회 2017 아시아 운동학 학술지 Vol.19 No.3

[PURPOSE] The purpose of the study was to investigate postural adjustments on effects of fear of falling and directional change during Gait Initiation(GI). [METHODS] Three groups are formed with fear of falling and the senior fitness test results, and they performed with gait in a forward direction and to the right direction(90°). In order to get the data, ten cameras, makers, and EMG were used. Two way ANOVA was used to compare kinematic, spatio·temporal parameters and EMG data. [RESULTS] The HO-TO duration in a GI to the right direction was shorter than in a straight ahead GI at left foot swing. The step width of left foot in TO-HS was significantly larger in the GI to the right direction. The medial·lateral of center of mass velocity in the GI to the right direction was slower than in a straight ahead GI. [CONCLUSIONS] There were significant differences of kinematic parameters in the straight ahead GI and the GI to the right direction, but fear of falling did not affect in the walking type. Further research would be suggested investigating the change of weight load and center of mass for elders with fear of falling during GI.

골관절염 여성에게 적용한 타이치 운동과 자조관리 프로그램의 관절염증상 및 낙상공포감에 대한 효과비교

송라윤(Song Rhayun),엄애용(Eom Aeyong),이은옥(Eom Aeyong),Lam Paul,배상철(Bae Sang-Cheol) 대한근관절건강학회 2009 근관절건강학회지 Vol.16 No.1

Purpose: The purpose of the study was to compare the effects of the Tai Chi self-help program with a self-help program on pain, stiffness, physical functioning, and fear of falling in women with osteoarthritis. Method: Total of 82 women with Osteoarthritis recruited from outpatient clinics or community health centers were randomly assigned either to a Tai Chi self-help group or a self-help group. Thirty subjects in the Tai Chi self-help group and 39 in the self-help group completed posttest measures (pain, stiffness, physical functioning, and fear of falling) at 6 months. Results: After the 6 month study period, the subjects in the Tai Chi self-help group reported significantly less difficulties in performing daily activities (mean difference = -0.16 vs. 6.19 for the selfhelp), and less fear of falling (mean difference = -3.20 vs. 0.27 for the self-help) than those in the self-help group. There were no significantly differences in pain and stiffness between the groups. Conclusion: The Tai Chi combined with self-help program was more effective than the self-help only program in reducing difficulties in performing daily activities and fear of falling in women with Osteoarthritis. Whether these changes prevent fall episodes requires further study.

Convergence Study on the Relationship between Kinesiophobia and Fear of Falling in Patients with Stroke

조성배,최원재,정지혜,박지유,이승원 한국융합학회 2019 한국융합학회논문지 Vol.10 No.10

This study aimed to investigate the convergence relationship between kinesiophobia and fear of falling in patients with stroke. A total of 113 patients with stroke participated in this study. Participants underwent inpatient rehabilitation and completed surveys with three different questionnaires including the fall efficacy scale (FES), translated Tampa Scale for Kinesiophobia 13 (TSK-13), and activity-specific balance confidence scale (ABC). TSK-13 and FES showed weak negative correlation (r=-0.226), and TSK-13 and ABC showed moderate negative correlation (r=-0.300). FES had a very strong positive relationship compared with ABC (r=0.838). Faller showed significantly low FES and ABC scores compared with non-faller (p<0.05). These results present that patients with stroke had mild kinesiophobia, and kinesiophobia is related to fear of falling. It is necessary to evaluate kinesiophobia in stroke rehabilitation.