Article

Most falls among community-dwelling older adults occur while walking.
Simple walking tests that require little resources and can be interpreted quickly
are advocated as useful screening tools for fall prone patients. OBJECTIVE: To
investigate 2 clinically feasible walking tests consisting of straight- and
curved-path walking and examine their associations with history of previous falls
and fall-related outcomes among community-living older adults. DESIGN: A cross-sectional analysis was performed on baseline data from a longitudinal
cohort study. SETTING: Participants were recruited through primary care
practices. PARTICIPANTS: Participants included 428 primary care patients >/=65
years of age at risk for mobility decline. Participants had a median age of 76.5
years, 67.8% were women, and 82.5% were white. METHODS: Straight-path walking
performance was measured as the time needed to walk a 4-meter straight path at
usual pace from standstill using a stopwatch (timed to 0.1 second). Curved-path
walking performance was timed while participants walked from standstill in a
figure-of-8 pattern around two cones placed 5 feet apart. MAIN OUTCOME
MEASUREMENTS: Multivariable negative binomial regression analyses were performed
to assess the relationship between straight-path walking or curved-path walking
and self-reported history of number of falls. For fall-related injuries, and
fall-related hospitalizations, logistic regression models were used. RESULTS: In
the fully adjusted model, an increase of 1 second in straight path walking time
was associated with 26% greater rate of falls (rate ratio 1.26, 95% confidence
interval 1.10-1.45). An increase in curved-path walking time was associated with
8% greater rate of falls (rate ratio 1.08, 95% confidence interval = 1.03-1.14).
Neither walk test was associated with history of fall-related injuries or
hospitalizations. CONCLUSIONS: Poor performance on straight- and curved-path
walking performance was associated with a history of greater fall rates in the
previous year but not with a history of fall-related injuries or
hospitalizations. This information helps inform how previous fall history is
related to performance on walking tests in the primary care setting.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS