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The aim of this prospective study was to assess whether accelerometry-based gait analysis is associated with the incidence of falls among individuals who are ambulatory and recently had a fracture, and to compare the ability to discriminate body function and structure and activity measures. A total of 100 patients who fulfilled our inclusion criteria were enrolled. At hospital discharge, the following outcomes were assessed: timed-up-and-go test, five-times-sit-to-stand test, one-leg standing test, 5-m gait test, and gait analysis using a wireless three-axis accelerometer. Root mean square (RMS) and autocorrelation (AC) values were analyzed on the basis of the acceleration waveform. Follow-up assessment of falls and subsequent fractures was performed 12 months after the fracture. Eighty-five percent of the participants completed the follow-up at 12 months. During the 12 months of follow-up, 61 falls were reported by 34 patients (31 women, three men), for a fall rate of 40.0% (34/85). The fall group had significantly poorer body function and structure and activity measures compared with the no-fall group. In accelerometry-based gait analysis, RMS and AC in the vertical axis and RMS in the anteroposterior axis were significantly lower in the fall group compared with the no-fall group. Multivariate logistic regression analysis showed that only AC in the vertical axis was a significant predictor of falls. This finding suggests that trunk acceleration AC in the vertical axis showed good discriminative ability for predicting the incidence of falls among patients who are ambulatory and recently had a fracture.

The purpose of this study was to determine the influence of standing posture on the physical function and incidence of multiple falls in community-dwelling older adults. [Participants and Methods] This study included 219 older adults (mean age 71.6 ± 9.1 years) who were living in a community setting. The study population was divided into those who had sustained multiple falls and those who had sustained only a single fall and those who had never fallen. The history and number of falls, locomotive syndrome, gait speed, skeletal muscle mass index, grip strength, and bone mass were evaluated. Standing posture was assessed using the kyphotic index, trunk tilt angle, and spinal kyphosis angle (upper and lower tilt). [Results] A higher kyphosis upper tilt angle correlated significantly with aging, locomotive syndrome, slower walking speed, and lower bone mass. The kyphosis upper tilt angle in the standing position was significantly greater in the multiple-fall group than in the single-fall group. [Conclusion] The spinal kyphosis angle (upper tilt) was associated with poorer physical performance and greater incidence of multiple falls.