Article

OBJECTIVE: To investigate whether the Semmes-Weinstein monofilament examination
(SWME) was associated with, and could predict, measures of physical performance
and the risk of fall in older people. DESIGN: Prospective study. SETTING:
Community. PARTICIPANTS: Older participants (N=2826) enrolled in the Progetto
Veneto Anziani (Pro.V.A.) study and a subsample of persons (n=1885) who did not
report falls at baseline for longitudinal analyses. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Falls reported in the year preceding the
assessment and Short Physical Performance Battery (SPPB) were recorded at
baseline and again after 4.4 years. RESULTS: At baseline, 830 participants
(29.4%) had experienced falls in the previous year, with a higher prevalence of
falls in those positive at SWME than in those negative at SWME (35.8% vs 28.0%;
P=.001). Using logistic regression, participants positive at SWME had a
(significant) 66% higher risk of presenting worse SPPB score (95% confidence
interval, 1.51-1.83) and between 25% and 32% higher risks of having experienced
>/=1 fall or recurrent falls than did those negative at SWME. The incidence of
falls at follow-up was higher in the positive SWME group than in the negative
SWME group (42.2% vs 30.7%; P=.001), and multinomial logistic regression showed
that the former had a 13% higher risk of decline in SPPB scores (95% confidence
interval, 1.03-1.25), particularly for gait and balance; 48% higher risk of
having had 1 fall; and 77% higher risk of recurrent falls. At both baseline and
follow-up, the larger the extension of neuropathy (negative SWME vs unilateral
impairment in positive SWME vs bilateral impairment in positive SWME), the
greater its negative effect on falls and physical performance. CONCLUSIONS: SMWE
was associated with, and could predict, lower extremity physical performance and
falls in older people.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS