TY  - JOUR
PY  - 2015//
TI  - Straight and curved path walking among older adults in primary care: associations with fall-related outcomes
JO  - PM & R : the journal of injury, function, and rehabilitation
A1  - Welch, Sarah A.
A1  - Ward, Rachel E.
A1  - Kurlinski, Laura A.
A1  - Kiely, Dan K.
A1  - Goldstein, Richard
A1  - VanSwearingen, Jessie
A1  - Brach, Jennifer Sokol
A1  - Bean, Jonathan F.
SP  - 754
EP  - 760
VL  - 8
IS  - 8
N2  - BACKGROUND: 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. <br><br>OBJECTIVE: To investigate two clinically feasible walking tests, consisting of straight- and curved-path walking and examine their associations with history of prior falls and fall-related outcomes among community-living older adults. <br><br>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. <br><br>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. <br><br>RESULTS: In the fully adjusted model, an increase of 1 second in straight path walking time was associated with 26% greater rate of falls (RR=1.26, 95% CI: 1.10-1.45). An increase in curved-path walking time was associated with 8% greater rate of falls (RR=1.08, CI: 1.03-1.14). Neither walk test was associated with history of fall-related injuries or hospitalizations. <br><br>CONCLUSIONS: Poor performance on straight- and curved-path walking performance was associated with a history of greater fall rates in the prior year, but not with a history of fall-related injuries or hospitalizations. This information helps inform how prior fall history is related to performance on walking tests in the primary care setting.<p />  <p>Language: en</p>
LA  - en
SN  - 1934-1482
UR  - http://dx.doi.org/10.1016/j.pmrj.2015.12.004
ID  - ref1
ER  -