Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

R H A Weijer; M J M Hoozemans; J H van Dieën; M Pijnappels

doi:10.1016/j.gaitpost.2018.04.002

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

R H A Weijer, M J M Hoozemans, J H van Dieën, M Pijnappels^*

^*Corresponding author for this work

Biomechanics

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Abstract

BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.

RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.

METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.

RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.

SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.

Original language	English
Pages (from-to)	475-479
Number of pages	5
Journal	Gait and Posture
Volume	62
Early online date	4 Apr 2018
DOIs	https://doi.org/10.1016/j.gaitpost.2018.04.002
Publication status	Published - 1 May 2018

Funding

This research was funded by a VIDI grant (no. 91714344 ) from the Dutch Organization for Scientific Research (NWO) .

Funders	Funder number
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	91714344

Keywords

Accelerometry
Accidental falls
Elderly
Entropy
Self efficacy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.gaitpost.2018.04.002

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adultsFinal published version, 275 KBLicence: Article 25fa Dutch Copyright Act

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title = "Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults",

abstract = "BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.",

keywords = "Accelerometry, Accidental falls, Elderly, Entropy, Self efficacy",

author = "Weijer, {R H A} and Hoozemans, {M J M} and {van Die{\"e}n}, {J H} and M Pijnappels",

year = "2018",

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doi = "10.1016/j.gaitpost.2018.04.002",

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T1 - Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

AU - Weijer, R H A

AU - Hoozemans, M J M

AU - van Dieën, J H

AU - Pijnappels, M

PY - 2018/5/1

Y1 - 2018/5/1

N2 - BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.

AB - BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.

KW - Accelerometry

KW - Accidental falls

KW - Elderly

KW - Entropy

KW - Self efficacy

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DO - 10.1016/j.gaitpost.2018.04.002

M3 - Article

C2 - 29674287

SN - 0966-6362

VL - 62

SP - 475

EP - 479

JO - Gait and Posture

JF - Gait and Posture

ER -

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

Abstract

Funding

Keywords

UN SDGs

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