Walking adaptability for targeted fall-risk assessments

Daphne J. Geerse, Melvyn Roerdink, Johan Marinus, Jacobus J. van Hilten

Research output: Contribution to JournalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)203-210
Number of pages8
JournalGait and Posture
Volume70
Early online date20 Feb 2019
DOIs
Publication statusPublished - May 2019

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Walking
Gait
Prothrombin Time
Parkinson Disease
Logistic Models
History
Stroke
Research

Keywords

  • Control
  • Fall-risk assessment
  • Parkinson's disease
  • Stroke
  • Walking adaptability

Cite this

Geerse, Daphne J. ; Roerdink, Melvyn ; Marinus, Johan ; van Hilten, Jacobus J. / Walking adaptability for targeted fall-risk assessments. In: Gait and Posture. 2019 ; Vol. 70. pp. 203-210.
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Walking adaptability for targeted fall-risk assessments. / Geerse, Daphne J.; Roerdink, Melvyn; Marinus, Johan; van Hilten, Jacobus J.

In: Gait and Posture, Vol. 70, 05.2019, p. 203-210.

Research output: Contribution to JournalArticleAcademicpeer-review

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N2 - 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.

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