Walking adaptability for targeted fall-risk assessments

Gait Posture. 2019 May;70:203-210. doi: 10.1016/j.gaitpost.2019.02.013. Epub 2019 Feb 20.

Abstract

Background: Most falls occur during walking and are due to trips, slips or misplaced steps, which suggests a reduced walking adaptability. The objective of this study was to evaluate the potential merit of a walking-adaptability assessment for identifying prospective fallers and risk factors for future falls in a cohort of stroke patients, Parkinson's disease patients, and controls (n = 30 for each group).

Research question: Does an assessment of walking-adaptability improve the identification of fallers compared to generic fall-risk factors alone?

Methods: This study comprised an evaluation of subject characteristics, clinical gait and balance tests, a quantitative gait assessment and a walking-adaptability assessment with the Interactive Walkway. Subjects' falls were registered prospectively with falls calendars during a 6-month follow-up period. Generic and walking-related fall-risk factors were compared between prospective fallers and non-fallers. Binary logistic regression and Chi-square Automatic Interaction Detector analyses were performed to identify fallers and predictor variables for future falls.

Results: In addition to fall history, obstacle-avoidance success rate and normalized walking speed during goal-directed stepping correctly classified prospective fallers and were predictors of future falls. Compared to the use of generic fall-risk factors only, the inclusion of walking-related fall-risk factors improved the identification of prospective fallers.

Significance: If cross-validated in future studies with larger samples, these fall-risk factors may serve as quick entry tests for falls prevention programs. In addition, the identification of these walking-related fall-risk factors may help in developing falls prevention strategies.

Keywords: Control; Fall-risk assessment; Parkinson’s disease; Stroke; Walking adaptability.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Adaptation, Physiological*
  • Aged
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Gait
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Parkinson Disease / physiopathology*
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / physiopathology*
  • Walking / physiology*
  • Walking Speed