Citation

Geerse DJ, Roerdink M, Marinus J, van Hilten JJ. Gait Posture 2019; 70: 203-210.

Affiliation

Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.gaitpost.2019.02.013

PMID

30901621

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.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

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