Article

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.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS