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; 65–94 years old) categorized at entry as 27 ‘Non-fallers’ or 47 ‘Fallers’ by Medicare criteria (1 injury fall or >1 non-injury falls in the previous year).
Interventions
None
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 (ICC > 0.6) and/or discrimination (p<.01) criteria (Clinical variables- Turn- steps, time, Gait- velocity, Step-in-tub-time, and Downstairs- time; Force plate variables- Quiet standing Romberg ratio sway-area, Maximal lean- anterior-posterior excursion, Sit-to-stand medial-lateral excursion and sway-area). Sets were created (3 clinical, 2 force plate) utilizing 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. The Full clinical set (5 measurement variables) produced sensitivity/specificity (.80/.74) to Falls-status. Composite scores were sensitive and specific in predicting subsequent injury falls and multiple falls compared to Falls-status, POMA or SOT.
Conclusions
Sets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls using tasks that should be appropriate to diverse participants.
OBJECTIVE
We attempted to determine whether multimedia fall prevention education using different instructional strategies increases older adults’ knowledge of fall threats and their fall prevention behaviors.
METHOD
Fifty-three community-dwelling older adults were randomized to two educational groups or a control group. Multimedia-based educational interventions to increase fall threats knowledge and encourage fall prevention behaviors had two tailoring strategies: (1) improve content realism for individual learners (authenticity group) and (2) highlight program goals and benefits while using participants’ content selections (motivation group). Knowledge was measured at baseline and 1-mo follow-up. Participants recorded prevention behaviors for 1 mo.
RESULTS
Intervention group participants showed greater knowledge gains and posttest knowledge than did control group participants. The motivation group engaged in more prevention behaviors over 1 mo than did the other groups.
CONCLUSION
Tailoring fall prevention education by addressing authenticity and motivation successfully improved fall threats knowledge. Combining motivational strategies with multimedia education increased the effectiveness of the intervention in encouraging fall prevention behaviors.
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