Walking adaptability for targeted fall-risk assessments

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

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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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

Keywords

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

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