Article

Falls and fear of falling (FOF) are common in persons with late
effects of polio, but there is limited knowledge of associated factors.
OBJECTIVE: To determine how knee muscle strength, dynamic balance, and gait
performance (adjusted for gender, age, and body mass index) are associated with
falls and FOF in persons with late effects of polio.
DESIGN: A cross-sectional
study. SETTING: A university hospital outpatient clinic. PARTICIPANTS: Eighty-one
ambulatory persons with verified late effects of polio (43 men; mean age 67 years). MAIN OUTCOME MEASUREMENTS: Number of falls the past year, Falls Efficacy
Scale-International to assess FOF, a Biodex dynamometer to measure knee muscle
strength, the Timed Up & Go test to assess dynamic balance, and the 6-Minute Walk
test to assess gait performance. Univariate and multivariate logistic regression
analyses were used for falls (categorical data) and linear regression analyses
for FOF (continuous data) as dependent variables. RESULTS: Fifty-nine percent
reported at least 1 fall during the past year, and 79% experienced FOF. Reduced
knee muscle strength in the more affected limb and gait performance were
determinants of falls. An increase of 10 Nm in knee flexor and knee extensor
strength reduced the odds ratio between 0.70 and 0.83 (P = .01), and an increase
of 100 m in 6-Minute Walk test reduced the odds ratio to 0.41 (P = .001). All
factors were determinants of FOF; reduced knee muscle strength in the more and
less affected limbs explained 17%-25% of the variance in FOF, dynamic balance
30%, and gait performance 41%. Gender, age, and body mass index only marginally
influenced the results. CONCLUSIONS: Reduced gait performance, knee muscle
strength, and dynamic balance are to a varying degree determinants of falls and
FOF in ambulatory persons with late effects of polio. Future studies need to
evaluate whether rehabilitation programs targeting these factors can reduce falls
and FOF in this population. LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS