Article

OBJECTIVE: To identify quantitative measurement variables that characterize
mobility in older adults, meet reliability and validity criteria, distinguish
fall risk, and predict future falls. DESIGN: Observational study with 1-year
weekly falls follow-up. SETTING: Mobility laboratory. PARTICIPANTS:
Community-dwelling volunteers (N=74; age, 65-94y) categorized at entry as 27
nonfallers or 47 fallers by using Medicare criteria (1 injury fall or >1
noninjury fall in the previous year). INTERVENTIONS: None. MAIN OUTCOME MEASURES:
Test-retest and within-subject reliability, criterion and concurrent validity;
predictive ability indicated by observed sensitivity and specificity to entry
fall-risk group (falls status), Tinetti Performance Oriented Mobility Assessment
(POMA), computerized dynamic posturography Sensory Organization Test (SOT), and
subsequent falls reported weekly. RESULTS: Measurement variables were selected
that met reliability (intraclass coefficient of correlation >.6) and/or
discrimination (P<.01) criteria (clinical variables: turn steps and time, gait
velocity, step-in-tub time, downstairs time; forceplate variables: quiet standing
Romberg ratio sway area, maximal lean anterior-posterior excursion, sit-to-stand
medial-lateral excursion, sway area). Sets were created (3 clinical, 2
forceplate) using combinations of variables appropriate for older adults with
different functional activity levels, and composite scores were calculated.
Scores identified entry falls status and concurred with POMA and SOT scores. The
full clinical set (5 measurement variables) produced sensitivity of 80% and
specificity of 74% to falls status. Composite scores were more sensitive and
specific overall in predicting subsequent injury falls and multiple falls
compared with falls status and POMA or SOT score. CONCLUSIONS: Sets of
quantitative measurement variables obtained with this mobility battery provided
sensitive prediction of future injury falls and screening for multiple subsequent
falls by using tasks that should be appropriate to diverse participants.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS