Article

Gait variables may constitute surrogate outcomes for fall risk. Their
reliability in a specific population of older fallers has not been fully
established, which limits their research and clinical applications. This study
aimed to determine test-retest reliability and minimal detectable change (MDC)
values for selected fall-related gait variables in older adults with a recent
fall history. METHODS: Community-dwelling (n=30) and hospitalized (n=30) fallers
aged>/=65 years were assessed twice using an instrumented pressure-sensitive
walkway, under single- and dual-task gait conditions. Intraclass correlation
coefficient (ICC(2,1)), standard error of measurement (SEM; SEM%) and MDC at 95%
confidence level (MDC95; MDC95%), were used as reliability estimates. RESULTS:
The ICC(2,1) for gait velocity was greater than 0.84 across all gait conditions
and groups; SEM% and MDC95% did not exceed 6.5% and 18.1%, respectively. Gait
variability measures returned lower ICC(2,1) (range 0.18-0.79), and markedly
higher SEM% (16.3-31.9%) and MDC95% (45.3-88.3%). Overall, hospitalized fallers
exhibited larger SEM and MDC95 values for variability measures compared to
community-dwellers in all gait conditions, while larger values were found for all
variables while dual-tasking compared to single-tasking in both groups.
CONCLUSIONS: Gait velocity was found to be highly reliable and likely to be
sensitive to change over repeated sessions in community-dwelling and hospitalized
older fallers, both under single- and dual-task conditions. Gait variability
measures showed lower reliability, irrespective of gait condition or group,
displaying consistently larger measurement error, particularly under dual-task
conditions. Clinicians should consider MDC95 values before using gait variability
variables as evaluative outcome measures at patient level.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS