Bewertung des Sturzrisikos bei älteren Menschen: Divergenzen zwischen der subjektiven sturzassoziierten Selbstwirksamkeit und objektiven Sturzrisiken

Zusammenfassung

Hintergrund: Mit zunehmendem Alter stellen Stürze ein enormes Problem dar. Die Folgen von Fehleinschätzungen des eigenen Sturzrisikos sind bislang wenig untersucht.

Ziel: Die Studie verfolgte die Frage, ob Physiotherapeuten eine inadäquate Selbsteinschätzung des Sturzrisikos bei älteren Menschen mithilfe von ausschließlich funktionellen Untersuchungen identifizieren können.

Methode: Bei der Sekundäranalyse einer Validierungsstudie mit 99 älteren Teilnehmern wurden die Ergebnisse von Activities-specific Balance Confidence Scale, Berg-Balance-Skala, Timed-up-and-go-Test und selbstgewählter Gehgeschwindigkeit miteinander verglichen, um eine adäquate oder nicht adäquate Selbsteinschätzung der Sturzgefahr und mögliche Erklärungen für das Auftreten solcher Divergenzen zu ermitteln. Hierzu erfolgte eine multiple lineare Regressionsanalyse und anschließendem Mann-Whitney-U-Test.

Ergebnisse: Eine schlechte sturzassoziierte Selbstwirksamkeitserwartung erklärt sich durch höheres Alter, schlechtere Balancefähigkeit und geringere Gehgeschwindigkeit. Im Gegensatz zu den sturzgefährdeten Teilnehmern ergaben sich bei den nicht sturzgefährdeten Unterschiede zwischen den Gruppen der adäquaten und nicht adäquaten Selbsteinschätzungen.

Schlussfolgerung: Die Identifizierung einer nicht adäquaten sturzassoziierten Selbstwirksamkeitserwartung bei älteren Patienten ist mit ausschließlich funktionellen Messungen nicht möglich. Für die Wahl geeigneter Therapien sollten Physiotherapeuten deshalb neben der objektiven Sturzgefahr auch immer die sturzassoziierte Selbstwirksamkeitserwartung ermitteln.

Abstract

Background: Falls are considered to be an enormous problem with increasing age. The consequences of inadequate self-assessment of fall risk are poorly investigated to date.

Objective: This study examined the question whether physiotherapists are able to identify an inadequate self-assessment of fall risk in older people using functional tests alone.

Method: A secondary analysis of a validation study with 99 older participants compared the results of the Activities-specific Balance Confidence (ABC) Scale, Berg Balance Scale, Timed-up-and-go Test and voluntary gait speed in order to identify an adequate or inadequate self-assessment of fall risk as well as a possible explanation for such divergences. For this purpose a multiple-linear regression analysis and subsequently the Mann-Whitney-U-Test were performed.

Results: A poor anticipation of falls-related self-efficacy may be explained by higher age, poorer balance and low gait speed. In comparison to participants with fall risk those with no fall risk showed differences between adequate and inadequate self-assessment of fall risk.

Conclusions: Functional tests alone cannot identify an inadequate anticipation of self-assessment of fall risk in older patients. Physiotherapists should therefore always assess the objective anticipation of falls-related self-efficacy along with the objective fall risk.

Schlüsselwörter

Selbstwirksamkeitserwartung - unfallbedingte Stürze - physiotherapeutisches Handeln - Selbstbewertung

Key words

anticipation of self-efficacy - accident-related falls - physiotherapeutic modalities - self-assessment

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