Walking adaptability for targeted fall-risk assessments

Publication date: Available online 20 February 2019

Source: Gait & Posture

Author(s): Daphne J. Geerse, Melvyn Roerdink, Johan Marinus, Jacobus J. van Hilten

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.

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