Dynamic gait stability, clinical correlates, and prognosis of falls among community-dwelling older adults.
Identifieur interne : 000C70 ( Main/Exploration ); précédent : 000C69; suivant : 000C71Dynamic gait stability, clinical correlates, and prognosis of falls among community-dwelling older adults.
Auteurs : Tanvi Bhatt [États-Unis] ; Debbie Espy ; Feng Yang ; Yi-Chung PaiSource :
- Archives of physical medicine and rehabilitation [ 1532-821X ] ; 2011.
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Abstract
OBJECTIVE
To establish an accurate measure for prognostic assessment of fall risk in community-dwelling older adults, this study examined the prediction accuracy of a dynamic gait stability measure and common clinical tests for slip-related falls among these adults.
DESIGN
Participants were tested for their fall-risk likelihood on a slip-test.
SETTING
Biomechanics research laboratory.
PARTICIPANTS
Community-dwelling older adults (N=119; ≥65y).
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Participants performed a battery of clinical tests, including Berg Balance Scale, Timed Up & Go (TUG) test, static posturography, isometric muscle strength, and bone density. They were then exposed to an unannounced slip during gait. The dynamic stability during unperturbed gait was measured based on the center of mass position and velocity relative to the limits of stability against backward falling. Accuracy of each measure was examined for prediction of slip outcome (fall or recovery).
RESULTS
On the slip, 59 participants fell, 56 recovered their balance, and 4 were harness-assisted. Dynamic stability predicted fall outcome with 69% accuracy. Except for TUG and bone density, no other measure could differentiate fallers from nonfallers; TUG predicted 56% of fall outcomes.
CONCLUSIONS
Reproduction of actual falls provides a new benchmark for evaluating the prognostic power of different performance-based assessment tools. The TUG was able to better predict fall outcome than other clinical measures; however, the new dynamic gait stability measure was more sensitive than TUG in its prediction of falls. Ultrasound bone scan could be used to screen older adults for fall risk.
DOI: 10.1016/j.apmr.2010.12.032
PubMed: 21530728
Affiliations:
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Espy</name></author><author><name sortKey="Yang, Feng" sort="Yang, Feng" uniqKey="Yang F" first="Feng" last="Yang">Feng Yang</name></author><author><name sortKey="Pai, Yi Chung" sort="Pai, Yi Chung" uniqKey="Pai Y" first="Yi-Chung" last="Pai">Yi-Chung Pai</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="RBID">pubmed:21530728</idno><idno type="pmid">21530728</idno><idno type="doi">10.1016/j.apmr.2010.12.032</idno><idno type="wicri:Area/Main/Corpus">000C45</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000C45</idno><idno type="wicri:Area/Main/Curation">000C45</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000C45</idno><idno type="wicri:Area/Main/Exploration">000C45</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Dynamic gait stability, clinical correlates, and prognosis of falls among community-dwelling older adults.</title><author><name sortKey="Bhatt, Tanvi" sort="Bhatt, Tanvi" uniqKey="Bhatt T" first="Tanvi" last="Bhatt">Tanvi Bhatt</name><affiliation wicri:level="4"><nlm:affiliation>Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL 60612, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL 60612</wicri:regionArea><placeName><region type="state">Illinois</region><settlement type="city">Chicago</settlement></placeName><orgName type="university">Université de l'Illinois à Chicago</orgName></affiliation></author><author><name sortKey="Espy, Debbie" sort="Espy, Debbie" uniqKey="Espy D" first="Debbie" last="Espy">Debbie Espy</name></author><author><name sortKey="Yang, Feng" sort="Yang, Feng" uniqKey="Yang F" first="Feng" last="Yang">Feng Yang</name></author><author><name sortKey="Pai, Yi Chung" sort="Pai, Yi Chung" uniqKey="Pai Y" first="Yi-Chung" last="Pai">Yi-Chung Pai</name></author></analytic><series><title level="j">Archives of physical medicine and rehabilitation</title><idno type="eISSN">1532-821X</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Female (MeSH)</term><term>Gait (MeSH)</term><term>Geriatric Assessment (methods)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Postural Balance (MeSH)</term><term>Residence Characteristics (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Caractéristiques de l'habitat (MeSH)</term><term>Chutes accidentelles (MeSH)</term><term>Démarche (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Équilibre postural (MeSH)</term><term>Évaluation gériatrique (méthodes)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Geriatric Assessment</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Évaluation gériatrique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Accidental Falls</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Gait</term><term>Humans</term><term>Male</term><term>Postural Balance</term><term>Residence Characteristics</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Caractéristiques de l'habitat</term><term>Chutes accidentelles</term><term>Démarche</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Équilibre postural</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To establish an accurate measure for prognostic assessment of fall risk in community-dwelling older adults, this study examined the prediction accuracy of a dynamic gait stability measure and common clinical tests for slip-related falls among these adults.</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>Participants were tested for their fall-risk likelihood on a slip-test.</p></div><div type="abstract" xml:lang="en"><p><b>SETTING</b></p><p>Biomechanics research laboratory.</p></div><div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b></p><p>Community-dwelling older adults (N=119; ≥65y).</p></div><div type="abstract" xml:lang="en"><p><b>INTERVENTIONS</b></p><p>Not applicable.</p></div><div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASURES</b></p><p>Participants performed a battery of clinical tests, including Berg Balance Scale, Timed Up & Go (TUG) test, static posturography, isometric muscle strength, and bone density. They were then exposed to an unannounced slip during gait. The dynamic stability during unperturbed gait was measured based on the center of mass position and velocity relative to the limits of stability against backward falling. Accuracy of each measure was examined for prediction of slip outcome (fall or recovery).</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>On the slip, 59 participants fell, 56 recovered their balance, and 4 were harness-assisted. Dynamic stability predicted fall outcome with 69% accuracy. Except for TUG and bone density, no other measure could differentiate fallers from nonfallers; TUG predicted 56% of fall outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Reproduction of actual falls provides a new benchmark for evaluating the prognostic power of different performance-based assessment tools. The TUG was able to better predict fall outcome than other clinical measures; however, the new dynamic gait stability measure was more sensitive than TUG in its prediction of falls. Ultrasound bone scan could be used to screen older adults for fall risk.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21530728</PMID><DateCompleted><Year>2011</Year><Month>07</Month><Day>11</Day></DateCompleted><DateRevised><Year>2011</Year><Month>05</Month><Day>02</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1532-821X</ISSN><JournalIssue CitedMedium="Internet"><Volume>92</Volume><Issue>5</Issue><PubDate><Year>2011</Year><Month>May</Month></PubDate></JournalIssue><Title>Archives of physical medicine and rehabilitation</Title><ISOAbbreviation>Arch Phys Med Rehabil</ISOAbbreviation></Journal><ArticleTitle>Dynamic gait stability, clinical correlates, and prognosis of falls among community-dwelling older adults.</ArticleTitle><Pagination><MedlinePgn>799-805</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.apmr.2010.12.032</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To establish an accurate measure for prognostic assessment of fall risk in community-dwelling older adults, this study examined the prediction accuracy of a dynamic gait stability measure and common clinical tests for slip-related falls among these adults.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">Participants were tested for their fall-risk likelihood on a slip-test.</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">Biomechanics research laboratory.</AbstractText><AbstractText Label="PARTICIPANTS" NlmCategory="METHODS">Community-dwelling older adults (N=119; ≥65y).</AbstractText><AbstractText Label="INTERVENTIONS" NlmCategory="METHODS">Not applicable.</AbstractText><AbstractText Label="MAIN OUTCOME MEASURES" NlmCategory="METHODS">Participants performed a battery of clinical tests, including Berg Balance Scale, Timed Up & Go (TUG) test, static posturography, isometric muscle strength, and bone density. They were then exposed to an unannounced slip during gait. The dynamic stability during unperturbed gait was measured based on the center of mass position and velocity relative to the limits of stability against backward falling. Accuracy of each measure was examined for prediction of slip outcome (fall or recovery).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">On the slip, 59 participants fell, 56 recovered their balance, and 4 were harness-assisted. Dynamic stability predicted fall outcome with 69% accuracy. Except for TUG and bone density, no other measure could differentiate fallers from nonfallers; TUG predicted 56% of fall outcomes.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Reproduction of actual falls provides a new benchmark for evaluating the prognostic power of different performance-based assessment tools. The TUG was able to better predict fall outcome than other clinical measures; however, the new dynamic gait stability measure was more sensitive than TUG in its prediction of falls. Ultrasound bone scan could be used to screen older adults for fall risk.</AbstractText><CopyrightInformation>Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bhatt</LastName><ForeName>Tanvi</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL 60612, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Espy</LastName><ForeName>Debbie</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Yang</LastName><ForeName>Feng</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Pai</LastName><ForeName>Yi-Chung</ForeName><Initials>YC</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>2R01-AG16727</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01-AG029616</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Arch Phys Med Rehabil</MedlineTA><NlmUniqueID>2985158R</NlmUniqueID><ISSNLinking>0003-9993</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000058" MajorTopicYN="Y">Accidental Falls</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005684" MajorTopicYN="Y">Gait</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015577" MajorTopicYN="N">Geriatric Assessment</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004856" MajorTopicYN="N">Postural Balance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012111" MajorTopicYN="N">Residence Characteristics</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2010</Year><Month>09</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2010</Year><Month>12</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2010</Year><Month>12</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>5</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>5</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2011</Year><Month>7</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">21530728</ArticleId><ArticleId IdType="pii">S0003-9993(11)00002-5</ArticleId><ArticleId IdType="doi">10.1016/j.apmr.2010.12.032</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li></region><settlement><li>Chicago</li></settlement><orgName><li>Université de l'Illinois à Chicago</li></orgName></list><tree><noCountry><name sortKey="Espy, Debbie" sort="Espy, Debbie" uniqKey="Espy D" first="Debbie" last="Espy">Debbie Espy</name><name sortKey="Pai, Yi Chung" sort="Pai, Yi Chung" uniqKey="Pai Y" first="Yi-Chung" last="Pai">Yi-Chung Pai</name><name sortKey="Yang, Feng" sort="Yang, Feng" uniqKey="Yang F" first="Feng" last="Yang">Feng Yang</name></noCountry><country name="États-Unis"><region name="Illinois"><name sortKey="Bhatt, Tanvi" sort="Bhatt, Tanvi" uniqKey="Bhatt T" first="Tanvi" last="Bhatt">Tanvi Bhatt</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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