Prediction of Balance Perturbations and Falls on Stairs in Older People Using a Biomechanical Profiling Approach: A 12-Month Longitudinal Study.
Accidental Falls
/ prevention & control
Aged
Biomechanical Phenomena
/ physiology
Female
Humans
Male
Mass Screening
/ methods
Outcome Assessment, Health Care
/ methods
Postural Balance
Predictive Value of Tests
Psychological Tests
Risk Assessment
/ methods
Risk Factors
Risk Reduction Behavior
Stair Climbing
/ physiology
Task Performance and Analysis
Clustering
Fall risk
Stair negotiation
Stepping behavior
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
31 03 2021
31 03 2021
Historique:
received:
04
11
2019
pubmed:
27
5
2020
medline:
5
8
2021
entrez:
27
5
2020
Statut:
ppublish
Résumé
Stair falls are a major health problem for older people, but presently, there are no specific screening tools for stair fall prediction. The purpose of the present study was to investigate whether stair fallers could be differentiated from nonfallers by biomechanical risk factors or physical/psychological parameters and to establish the biomechanical stepping profile posing the greatest risk for a stair fall. Eighty-seven older adults (age: 72.1 ± 5.2 years) negotiated an instrumented seven-step staircase and performed a range of physical/psychological tasks. k-Means clustering was used to profile the overall stair negotiation behavior with biomechanical parameters indicative of fall risk as input. Falls and events of balance perturbation (combined "hazardous events") were then monitored during a 12-month follow-up. Cox-regression analysis was performed to examine whether physical/psychological parameters or biomechanical outcome measures could predict future hazardous events. Kaplan-Meier survival curves were obtained to identify the stepping strategy posing a risk for a hazardous event. Physical/psychological parameters did not predict hazardous events and the commonly used Fall Risk Assessment Tool classified only 1/17 stair fallers at risk for a fall. Single biomechanical risk factors could not predict hazardous events on stairs either. On the contrary, two particular clusters identified by the stepping profiling method in stair ascent were linked with hazardous events. This highlights the potential of the stepping profiling method to predict stair fall risk in older adults against the limited predictability of single-parameter approaches currently used as screening tools.
Sections du résumé
BACKGROUND
Stair falls are a major health problem for older people, but presently, there are no specific screening tools for stair fall prediction. The purpose of the present study was to investigate whether stair fallers could be differentiated from nonfallers by biomechanical risk factors or physical/psychological parameters and to establish the biomechanical stepping profile posing the greatest risk for a stair fall.
METHODS
Eighty-seven older adults (age: 72.1 ± 5.2 years) negotiated an instrumented seven-step staircase and performed a range of physical/psychological tasks. k-Means clustering was used to profile the overall stair negotiation behavior with biomechanical parameters indicative of fall risk as input. Falls and events of balance perturbation (combined "hazardous events") were then monitored during a 12-month follow-up. Cox-regression analysis was performed to examine whether physical/psychological parameters or biomechanical outcome measures could predict future hazardous events. Kaplan-Meier survival curves were obtained to identify the stepping strategy posing a risk for a hazardous event.
RESULTS
Physical/psychological parameters did not predict hazardous events and the commonly used Fall Risk Assessment Tool classified only 1/17 stair fallers at risk for a fall. Single biomechanical risk factors could not predict hazardous events on stairs either. On the contrary, two particular clusters identified by the stepping profiling method in stair ascent were linked with hazardous events.
CONCLUSION
This highlights the potential of the stepping profiling method to predict stair fall risk in older adults against the limited predictability of single-parameter approaches currently used as screening tools.
Identifiants
pubmed: 32453832
pii: 5846125
doi: 10.1093/gerona/glaa130
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
638-646Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.