Citation

Middleton A, Fulk GD, Herter TM, Beets MW, Donley J, Fritz SL. Am. J. Phys. Med. Rehabil. 2016; 95(7): 475-482.

Affiliation

From the Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas (AM); Department of Physical Therapy, Clarkson University, Potsdam, New York (GDF); Department of Exercise Science, Division of Rehabilitation Sciences, University of South Carolina, Columbia, South Carolina (TMH, SLF); Department of Exercise Science, Division of Health Aspects of Physical Activity, University of South Carolina, Columbia, South Carolina (MWB); and Palmetto Health, Research Physical Therapy Specialists, Columbia, South Carolina (JD).

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/PHM.0000000000000488

PMID

27003205

Abstract

OBJECTIVE: To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults.

DESIGN: WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) and ratio (WSRratio = MWS/SSWS).

RESULTS: SSWS (P < 0.001), MWS (P < 0.001), and WSRdiff (P < 0.01) were associated with fall status. The cutpoints identified were 0.76 m/s for SSWS (65.4% sensitivity, 70.9% specificity), 1.13 m/s for MWS (76.6% sensitivity, 60.0% specificity), and 0.24 m/s for WSRdiff (56.1% sensitivity, 70.9% specificity). SSWS and MWS better discriminated between fallers and non-fallers (SSWS: AUC = 0.69, MWS: AUC = 0.71) than WSRdiff (AUC = 0.64).

CONCLUSIONS: SSWS and MWS seem to be equally informative measures for assessing fall status in community-dwelling older adults. Older adults with SSWSs less than 0.76 m/s and those with MWSs less than 1.13 m/s may benefit from further fall risk assessment. Combining SSWS and MWS to calculate an individual's WSR does not provide additional insight into fall status in this population.

Language: en