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Prediction of future falls in a community dwelling older adult population using instrumented balance and gait analysis

Prädiktion von Sturzereignissen in einem Kollektiv selbständig lebender Älterer mittels instrumenteller Gang- und Gleichgewichtsanalyse

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Abstract

Background

The role of instrumented balance and gait assessment when screening for prospective fallers is currently a topic of controversial discussion.

Objectives

This study analyzed the association between variables derived from static posturography, instrumented gait analysis and clinical assessments with the occurrence of prospective falls in a sample of community dwelling older people.

Methods

In this study 84 older people were analyzed. Based on a prospective occurrence of falls, participants were categorized into fallers and non-fallers. Variables derived from clinical assessments, static posturography and instrumented gait analysis were evaluated with respect to the association with the occurrence of prospective falls using a forward stepwise, binary, logistic regression procedure.

Results

Fallers displayed a significantly shorter single support time during walking while counting backwards, increased mediolateral to anteroposterior sway amplitude ratio, increased fast mediolateral oscillations and a larger coefficient (Coeff) of sway direction during various static posturography tests. Previous falls were insignificantly associated with the occurrence of prospective falls.

Conclusion

Variables derived from posturography and instrumented gait analysis showed significant associations with the occurrence of prospective falls in a sample of community dwelling older adults.

Zusammenfassung

Hintergrund

Der Nutzen instrumenteller Gang- und Gleichgewichtsanalyse, zur Früherkennung von Stürzereignissen, wird aktuell kontrovers diskutiert.

Fragestellung

Untersucht wurde der Zusammenhang zwischen Variablen der statischen Posturographie, der instrumentellen Ganganalyse und klinischer Assessments mit dem Auftreten von Stürzereignissen, bei selbstständig lebenden älteren Personen.

Methoden

Basierend auf einem prospektiv aufgetretenen Sturz wurden 84 ältere Personen in „Stürzer“ und „Nichtstürzer“ klassifiziert. Variablen aus klinischen Assessments, der statischen Posturographie und der instrumentellen Ganganalyse wurden in Hinblick auf eine Assoziation mit prospektiven Stürzen evaluiert, dazu diente ein vorwärts schrittweises, binärer, logistisches Regressionsverfahren.

Ergebnisse

Stürzer zeigten eine signifikant kürzere monopedale Standphase bein Gehen und Rückwärtszählen, im Vergleich mit anterior-posterioren Schwankungen höheremedio-laterale Schwankungen, verstärkte schnelle mediolaterale Oszillationen und einen vergrößerten Koeffizient der Schwankungsrichtung während verschiedener statische posturographischer Tests. Frühere Stürzereignisse waren nicht signifikant assoziiert mit prospektiv erfassten Stürzen.

Diskussion

Variablen der statischen Posturographie und instrumenteller Ganganalyse zeigten bei selbstständig lebenden älteren Personen signifikante Assoziationen mit prospektiv erfassten Stürzen.

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References

  1. Berry SD, Miller RR (2008) Falls: epidemiology, pathophysiology, and relationship to fracture. Curr Osteoporos Rep 6:149–154

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hill KD, Moore KJ, Dorevitch MI et al (2008) Effectiveness of falls clinics: an evaluation of outcomes and client adherence to recommended interventions. J Am Geriatr Soc 56:600–608

    Article  PubMed  Google Scholar 

  3. Gillespie LD, Robertson MC, Gillespie WJ et al (2012) Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 9:CD007146

    PubMed  Google Scholar 

  4. Kenny RAM, Rubenstein LZ, Tinetti ME et al (2011) Summary of the updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for prevention of falls in older persons. J Am Geriatr Soc 59:148–157

    Article  Google Scholar 

  5. Kannus P, Sievanen H, Palvanen M et al (2005) Prevention of falls and consequent injuries in elderly people. Lancet 366:1885–1893

    Article  PubMed  Google Scholar 

  6. Berg K, Wood-Dauphinee S, Williams JI (1995) The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 27:27–36

    CAS  PubMed  Google Scholar 

  7. Duncan PW, Weiner DK, Chandler J et al (1990) Functional reach: a new clinical measure of balance. J Gerontol 45:M192–M197

    Article  CAS  PubMed  Google Scholar 

  8. Applegate WB, Blass JP, Williams TF (1990). Instruments for the functional assessment of older patients. N Engl J Med 322:1207–1214

    Article  CAS  PubMed  Google Scholar 

  9. Kressig RW, Beauchet O, European GAITRite Network Group (2006) Guidelines for clinical applications of spatio-temporal gait analysis in older adults. Aging Clin Exp Res 18:174–176

    Article  PubMed  Google Scholar 

  10. Kressig RW, Herrmann FR, Grandjean R et al (2008) Gait variability while dual-tasking: fall predictor in older inpatients? Aging Clin Exp Res 20:123–130

    Article  PubMed  Google Scholar 

  11. Ruhe A, Fejer R, Walker B (2010) The test-retest reliability of centre of pressure measures in bipedal static task conditions—a systematic review of the literature. Gait Posture 32:436–445

    Article  PubMed  Google Scholar 

  12. Merlo A, Zemp D, Zanda E et al (2012) Postural stability and history of falls in cognitively able older adults: the Canton Ticino study Gait Posture 36:662–666

    Article  PubMed  Google Scholar 

  13. Nardone A, Schieppati M (2010) The role of instrumental assessment of balance in clinical decision making. Eur J Phys Rehabil Med 46:221–237

    CAS  PubMed  Google Scholar 

  14. Bongue B, Dupré C, Beauchet O et al (2011) A screening tool with five risk factors was developed for fall-risk prediction in community-dwelling elderly. J Clin Epidemiol 64:1152–1160

    Article  PubMed  Google Scholar 

  15. Piirtola M, Era P (2006) Force platform measurements as predictors of falls among older people—a review. Gerontology 52:1–16

    Article  PubMed  Google Scholar 

  16. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  17. Sheikh JI, Yeswage JA (1986) Geriatrci depression scale (GDS): recent evidence and development of a shorter version. Clin Gerontol 5:165–173

    Article  Google Scholar 

  18. Podsiadlo D, Richardson S (1991) The timed “Up and Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148

    Article  CAS  PubMed  Google Scholar 

  19. Tinetti ME (1986) Performance oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34:119–128

    Article  CAS  PubMed  Google Scholar 

  20. McCarthy EK, Horvat MA, Holtsberg PA et al (2004) Repeated chair stands as a measure of lower limb strength in sexagenarian women. J Gerontol Ser A-Biol Sci Med Sci 59:1207–1212

    Article  Google Scholar 

  21. Davidson D, Eskridge J (1977) Reliability of visual acuity measures of amblyopic eyes. Am J Optom Physiol Opt 54:756–766

    Article  CAS  PubMed  Google Scholar 

  22. Lunetta M, Le Moli R, Grasso G et al (1998) A simplified diagnostic test for ambulatory screening of peripheral diabetic neuropathy. Diabetes Res Clin Pract 39:165–172

    Article  CAS  PubMed  Google Scholar 

  23. Lamb SE, Jørstad-Stein EC, Hauer K et al (2005) Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc 53:1618–1622

    Article  PubMed  Google Scholar 

  24. van Uden C, Besser M (2004) Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system (GAITRite(R)). BMC Musculoskelet Disord 5:13

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bauer C, Groeger I, Glabasnia A et al (2010) First results of the evaluation of a falls clinic. Int J Gerontol 4:130–136

    Article  Google Scholar 

  26. Bauer C, Groeger I, Rupprecht R et al (2008) Intrasession reliability of force platform parameters in community-dwelling older adults. Arch Phy Med Rehabil 89:1977–1982

    Article  Google Scholar 

  27. Murphy MA, Olson SL, Protas EJ et al (2003) Screening for falls in community-dwelling elderly. J Aging Phys Act 11:66–80

    Google Scholar 

  28. Paterson K, Hill K, Lythgo N (2011) Stride dynamics, gait variability and prospective falls risk in active community dwelling older women. Gait Posture 33:251–255

    Article  PubMed  Google Scholar 

  29. Liu H, McGee M, Wang W et al (2009) Comparison of gait characteristics between older rolling walker users and older potential walker users. Arch Gerontol Geriatr 48:276–280

    Article  PubMed  Google Scholar 

  30. Bridenbaugh SA, Kressig RW (2015) Motor cognitive dual tasking: early detection of gait impairment, fall risk and cognitive decline. Z Gerontol Geriatr 48:15–21

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Geriatrics Centre Erlangen, Medicine III, Waldkrankenhaus St Marien, Rathsberger Str. 57, 91054, Erlangen, Germany

    C.M. Bauer MSc, I. Gröger MD &  K.G. Gaßmann MD

  2. School of Health Professions, Institute of Physiotherapy, Research and Development, Zurich University of Applied Sciences, Technikumstr. 71, P.O. Box, 8401, Winterthur, Switzerland

    C.M. Bauer MSc & V.L. Marcar PhD

  3. Institute of Psychogerontology, Friedrich-Alexander University of Erlangen- Nuremberg, Kobergerstr. 62, 90408, Nuremburg, Germany

    R. Rupprecht PhD

Authors
  1. C.M. Bauer MSc
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  2. I. Gröger MD
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  3. R. Rupprecht PhD
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  4. V.L. Marcar PhD
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  5. K.G. Gaßmann MD
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Correspondence to C.M. Bauer MSc.

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Conflict of interest

C.M. Bauer, I. Gröger, R. Ruprecht, V.L. Marcar and K.G. Gaßmann declare that there no conflicts of interest.

The study was approved by the local ethics committee and was carried out in accordance with national law and the Helsinki Declaration of 1975 (in its current revised form). All participants signed informed consent prior to the study.

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Bauer, C., Gröger, I., Rupprecht, R. et al. Prediction of future falls in a community dwelling older adult population using instrumented balance and gait analysis. Z Gerontol Geriat 49, 232–236 (2016). https://doi.org/10.1007/s00391-015-0885-0

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  • DOI: https://doi.org/10.1007/s00391-015-0885-0

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