TY - JOUR PY - 2016// TI - Self-selected and maximal walking speeds provide greater insight into fall status than walking speed reserve among community-dwelling older adults JO - American journal of physical medicine and rehabilitation A1 - Middleton, Addie A1 - Fulk, George D. A1 - Herter, Troy M. A1 - Beets, Michael W. A1 - Donley, Jonathan A1 - Fritz, Stacy L. SP - 475 EP - 482 VL - 95 IS - 7 N2 - 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

LA - en SN - 0894-9115 UR - http://dx.doi.org/10.1097/PHM.0000000000000488 ID - ref1 ER -