Concern about Falling and Complexity of Free-Living Physical Activity Patterns in Well-Functioning Older Adults

Abstract

Background: Fall-related psychological concerns are common among older adults, potentially contributing to functional decline as well as to restriction of activities and social participation. To effectively prevent such negative consequences, it is important to understand how even very low concern about falling could affect physical activity behavior in everyday life. We hypothesized that concern about falling is associated with a reduction in diversity, dynamics, and performance of daily activities, and that these features can be comprehensively quantified in terms of complexity of physical activity patterns. Methods: A sample of 40 community-dwelling older adults were assessed for concern about falling using the Falls Efficacy Scale-International (FES-I). Free-living physical activity was assessed using a set of metrics derived from data recorded with a chest-worn tri-axial accelerometer. The devised metrics characterized physical activity behavior in terms of endurance (total locomotion time, longest locomotion period, usual walking cadence), performance (cadence of longest locomotion period, locomotion periods with at least 30 steps and 100 steps/min), and complexity of physical activity patterns. Complexity was quantified according to variations in type, intensity, and duration of activities, and was considered as an adaptive response to environmental exigencies over the course of the day. Results: Based on FES-I score, participants were classified into two groups: not concerned at all/fully confident (n = 25) and concerned/less confident (n = 15). Demographic and health-related variables did not differ significantly between groups. Comparison of physical activity behavior indicated no significant differences for endurance-related metrics. In contrast, performance and complexity metrics were significantly lower in the less confident group compared to the fully confident group. Among all metrics, complexity of physical activity patterns appeared as the most discriminative feature between fully confident and less confident participants (p = 0.001, non-parametric Cliff’s delta effect size = 0.63). Conclusions: These results extend our understanding of the interplay between low concern about falling and physical activity behavior of community-dwelling older persons in their everyday life context. This information could serve to better design and evaluate personalized intervention programs in future prospective studies.

Effect of 24‐week strength training on unstable surfaces on mobility, balance, and concern about falling in older adults

“…It is possible that the imbalance disruption imposed by unstable surfaces improved not only the balance but also increased the confidence of the UST group older adults to perform greater complexity tasks in their everyday life context. This hypothesis can be supported by Paraschiv‐Lonescu et al, who concluded that older adults capable of performing more complex tasks have less concern about falling. Future studies should confirm the preventive role of this exercise mode in both healthy and clinical populations at risk of falling (ie, multimorbidity and frailty individuals).…”

Multidimensional Measures of Physical Activity and Their Association with Gross Motor Capacity in Children and Adolescents with Cerebral Palsy

“…Our approach of looking at PA pattern complexity of the barcodes, as previously proposed for other populations [ 28 , 29 ], is completely new in children with CP. We believe that this approach outreaches simple activity count, as it takes into consideration other aspects such as variety and temporal dynamics of barcode states.…”

“…In a future study, this approach could be transferred into real-life with the same population, and compared to our five-sensor set-up for validation. Methods to use single-sensor data for PA barcoding have been described and used in well-functioning older adults [ 29 ]. Providing these metrics with a single-sensor measurement could offer a simplified alternative to the comprehensive five-sensor set-up we used.…”

“…Additional dimensions such as the context (e.g., school/home) and pattern (e.g., changes between different activities) of PA provide further insight into an individual’s physical behavior. Paraschiv-Ionescu et al reported the value of using a multi-sensor-setup in order to barcode human PA by integrating these diverse aspects of PA [ 28 ], and of its subsequent complexity analyses [ 29 ]. Validity of such barcoding and complexity analyses has been shown for patients with chronic pain [ 28 ] and well-functioning older adults [ 29 ].…”

“…The aims of our study were to (1) objectively measure PA of children and adolescents with CP using multidimensional measures (i.e., PA states (PAS) based on the barcoding method by Paraschiv-Ionescu et al [ 28 ] and PA pattern complexity [ 29 ]), (2) to investigate the relationship between PA and gross motor capacity, and (3) to use gross motor capacity to determine cut-off levels needed to achieve a certain level of motor performance.…”