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Analysis of the Influence of Hospital Bed Height on Kinematic Parameters Associated with Patient Falls During Egress

机译：医院病床高度对出院期间与患者跌倒相关的运动学参数的影响分析

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Despite the fact that falls comprise a large percentage of hospital injuries, little is known quantitatively about what induces patient falls. Our study quantified kinematic and temporal parameters at key events of the sit-to-walk movement during hospital bed egress. Sixty five older adults (67.6 +/-14.1 years) with a history of falls (Morse Fall Scale score 53.3 +/- 21.4) comprised the study population. Full-body biomechanics during unconstrained sit-to-walk movements were captured as participants exited an adjustable, instrumented hospital bed at three bed heights classified as high, medium, and low. Trunk momentum during peak vertical velocity (i.e. rising) was significantly smaller during high bed exits than the other two bed heights. Change in center of mass velocity between seat-off and first toe-off was significantly faster during medium bed exits vs low bed exits. Temporal variables in low bed conditions revealed delays in rising and gait initiation. These temporal delays indicate lack of confidence and prioritization of postural stability. Since sit-to-walk momentum values were not significantly different between bed heights, this suggests individuals are using similar strategies to generate motion but executing the motion differently in each condition. Therefore lower bed heights may be inappropriate for fall-prone individuals due to increased postural demands. If an optimal setting for hospital bed height exists, our data indicate it may lie in the range of knee height or slightly higher.
机译：尽管跌倒在医院中占很大比例的伤害，但是对于导致病人跌倒的原因却鲜为人知。我们的研究量化了医院病床出院期间从步行到步行运动的关键事件的运动学和时间参数。研究对象为有跌倒史（莫尔斯跌倒量表得分为53.3 +/- 21.4）的65位老年人（67.6 +/- 14.1岁）。当参与者以三种床高（高，中，低）退出可调节的，仪器化的病床时，捕获了在不受约束的步行运动中的全身生物力学。在高床出口时，垂直垂直速度（即上升）时的树干动量明显小于其他两个床高度。在中床出口时与低床出口相比，就座和首次脚趾离开之间质心速度的变化明显更快。低床条件下的时间变量显示出上升和步态启动的延迟。这些时间上的延迟表明缺乏信心和姿势稳定性的优先次序。由于从坐到走的动量值在床高之间没有显着差异，因此这表明人们使用相似的策略来产生运动，但在每种情况下执行运动的方式都不同。因此，由于姿势需求增加，较低的床高度可能不适合于容易跌倒的人。如果存在最佳的医院病床高度设置，我们的数据表明它可能在膝盖高度范围内或稍高一些。

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