背景與目的：台灣已面臨人口老化的衝撃與威脅。跌倒是老人常見的意外。國內目前並無有關原 住民社區跌倒與非跌倒老人在下肢肌力、身體功能、平衡及走路能力探討之相關文獻。本研究目 的為(1)瞭解原住民社區部落女性老人跌倒現況，並比較跌倒與無跌倒老人在下肢肌力、身體功 能、平衡及走路能力之差異；（2)進一步選出最適切之跌倒篩選工具並得其最適切點。方法：參與 者為花蓮縣某偏鄉原住民社區部落之女性老人。紀錄其基本資料及過去一年內跌倒發生與否，評 估包括下肢肌力，老人活動量表、簡短身體功能量表、功能性前伸、單腳站、計時起走測試和10 公尺走路測試。符合常態分佈以t檢定而不符合常態分佈以Mann-Whitney U檢定檢測跌倒組與非跌 倒組之差異，複邏輯式迴歸分析影響跌倒發生之顯著因子，取其Receiver operating curve (ROC)及 最適切點，進一步探討其勝算比。結果：55位老人（平均年齡76.2±5.9歲），過去一年有發生跌倒 17位，佔31%。兩組老人在膝伸直及踝背屈表現，老人活動量表、簡短身體功能量表、計時起走 測試和10公尺走路測試達顯著差異(p<0.05 )。複邏輯式迴歸顯示簡短身體功能量表和膝伸直是影 響跌倒與否的顯著因子，其最適切點分別為10.5分與26.3%。以最適切點探討兩組老人之勝算比， 簡短身體功能量表為6.3倍，膝伸直為4.6倍。結論與臨床意義：本研究的原住民社區部落女性老 人跌倒率較國內一般社區老人偏高•而簡短身體功能量表與膝伸直為影響其跌倒發生之重要顯著 因子，其中簡短身體功能量表有最佳ROC曲線下面積，切線值10.5分，建議可用於原住民社區女 性老人的跌倒篩檢或活動設計之參考。然而本研究樣本數偏少，結果解釋仍需更謹慎。

Background and purpose: Aging has severely impacted Taiwan society. Falls are common among the elderly. There has, so far, been no investigation into the difference and relationship between lower-extremity strength, physical function, balance and walk ability between fallers and nonfallers in elderly aboriginal women. The aim of the study was to investigate the falls among elderly aboriginal women, and compare their differences in lower extremity strength, physical and balance functions, and walk ability. Secondly, we attempted to identify the best screening tool and the cut-point from these measures. Method: Participants were recruited from a remote aboriginal community in Hualien, and their falling or nonfalling over the previous years was recorded. The lower extremity strength, the elderly mobility scale (EMS), the short physical performance battery (SPPB), functional reach (FR), one-leg stand, the time up and go test (TUG) and 10-meter walk test were evaluated by an experienced physical therapist. The differences in evaluations with parametric data were compared by independent t and nonparametric data by Mann-Whitney U test, and the most significant factors for a fall identified by multivariate logistic regression. Receiver operating curve (ROC) and the cutoff point were obtained then the odds ratio was analyzed. Results: Fifty-five aboriginal elderly women (76.2+5.9), including seventeen subjects who experienced a fall in previous years (31%), participated in the study. The knee extension and ankle dorsiflexion, EMS, SPPB, TUG, 10~meter walk test present significant differences between the falling and nonfalling elderly (p<0.05). Among these evaluations, the SPPB and knee extension with cutoff values of 10.5-point and 26.3% respectively are the most significant factors in falls of the elderly aboriginal women. The odds ratios are 6.3 for the SPPB and 4.6 for knee extension. Conclusion: The episodes of falls among elderly aboriginal women are higher than those of populations in other communities. The SPPB and knee extension were the most significant factors on falls among elderly aboriginal women. We also found the SPPB has the best area under the ROC curve among these assessment tools, with the cutoff point of 10.5, From our findings, the SPPB might be used to screen for fall or as a reference for exercise programs designed for elderly aboriginal women. However, we need to interpret the results with caution due to the small sample size.