Article

Near falls (NFs) are more frequent than falls, and may occur before falls,
potentially predicting fall risk. As such, identification of a NF is important.
We aimed to assess intra and inter-rater reliability of the traditional
definition of a NF and to demonstrate the potential utility of a new definition.
To this end, 10 older adults, 10 idiopathic elderly fallers, and 10 patients with
Parkinson's disease (PD) walked in an obstacle course while wearing a safety
harness. All walks were videotaped. Forty-nine video segments were extracted to
create 2 clips each of 8.48 min. Four raters scored each event using the
traditional definition and, two weeks later, using the new definition. A fifth
rater used only the new definition. Intra-rater reliability was determined using
Kappa (K) statistics and inter-rater reliability was determined using ICC. Using
the traditional definition, three raters had poor intra-rater reliability
(K<0.054, p>0.137) and one rater had moderate intra-rater reliability (K=0.624,
p<0.001). With the traditional definition, inter-rater reliability between the
four raters was moderate (ICC=0.667, p<0.001). In contrast, the new NF definition
showed high intra-rater (K>0.601, p<0.001) and excellent inter-rater reliability
(ICC=0.815, p<0.001). A priori, it is easy to distinguish falls from usual
walking and NFs, but it is more challenging to distinguish NFs from obstacle
negotiation and usual walking. Therefore, a more precise definition of NF is
required. The results of the present study suggest that the proposed new
definition increases intra and inter-rater reliability, a critical step for using
NFs to quantify fall risk.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS