Article

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. TO
CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at
http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this
article, the reader should be able to: (1) Describe the different methods for
calculating walking speed reserve and discuss the potential of the metric as an
outcome measure; (2) Explain the degree to which self-selected walking speed,
maximal walking speed, and walking speed reserve are associated with fall status
among community-dwelling older adults; and (3) Discuss potential limitations to
using walking speed reserve to identify fall status in populations without
mobility restrictions. LEVEL: Advanced ACCREDITATION: : The Association of
Academic Physiatrists is accredited by the Accreditation Council for Continuing
Medical Education to provide continuing medical education for physicians. The
Association of Academic Physiatrists designates this activity for a maximum of
1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit
commensurate with the extent of their participation in the activity.

Langue : ANGLAIS