Physical factors underlying the association between lower walking performance and falls in older people: A structural equation model

Shimada, Hiroyuki; Tiedemann, Anne; Lord, Stephen R.; Suzukawa, Megumi; Makizako, Hyuma; Kobayashi, Kumiko; Suzuki, Takao

doi:10.1016/j.archger.2010.11.003

Cited by 42 publications

(36 citation statements)

References 33 publications

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“…A gait speed of less than 1 meter/sec had already been associated with an increased risk of falls. 38 For women, but not for men, a slower gait speed seems to be the strongest indicator of those who are more likely to fall, even if their global SPPB scores are in the medium to high range. Women probably have a higher incidence of arthritis and foot disorders, such as hammer toe, that affect gait and balance, predisposing them to falls.…”

Section: Discussionmentioning

confidence: 99%

Association Between Short Physical Performance Battery and Falls in Older People: The Progetto Veneto Anziani Study

Veronese

Bolzetta

Toffanello

et al. 2014

Rejuvenation Research

156

113

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It is known that weakness in the lower limbs is associated with recurrent falls in old people. Among the tests routinely used to assess lower extremity strength, the Short Physical Performance Battery (SPPB) is one of those used most often, but its relationship with recurrent falls is poorly investigated. We aimed to determine if SPPB scores are related to recurrent falling in a sample of 2710 older-aged people, and to ascertain which test in the SPPB is most strongly associated with a higher rate of falls. In this cross-sectional study, we demonstrated that participants scoring 0-6 in the SPPB were more likely to be recurrent fallers than those scoring 10-12 (odds ratio [OR] = 3.46, 95% confidence interval [CI] 2.04-5.88 in women; OR = 3.82, 95% CI 1.77-8.52, in men). SPPB scores of 7-9 were only associated with women being more likely to be recurrent fallers (OR = 2.03, 95% CI 1.28-3.22). When the SPPB items were analyzed separately, even a lower score in gait speed for women was significantly associated with the presence of recurrent falls (OR = 2.11; 95% CI 1.04-4.30), whereas in men only a significant increase in the time taken to complete the five timed chair stands test was associated with a higher rate of falls (OR = 2.75; 95% CI 1.21-6.23). In conclusion, our study demonstrated that SPPB scores £ 6 are associated with a higher fall rate in old people of both genders; in females, even an SPPB score between 7 and 9 identifies subjects at a higher likelihood of being recurrent fallers. Among the single items of the SPPB, the most strongly associated with falls were gait speed in women and the five timed chair stands test in men.

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Section: Discussionmentioning

confidence: 99%

Association Between Short Physical Performance Battery and Falls in Older People: The Progetto Veneto Anziani Study

Veronese

Bolzetta

Toffanello

et al. 2014

Rejuvenation Research

156

113

View full text Add to dashboard Cite

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“…The above-cited studies [3,7,8] together with additional studies [9,10,11,12,13,14,15,16,17] already extend the knowledge regarding the relationship between strength, power and balance performance. However, in these studies balance abilities were tested nonconclusively.…”

Section: Introductionmentioning

confidence: 99%

“…bipedal stance, alternate step test, 6-meter walking test) in older adults (mean age: 74 ± 6 years) and observed correlations ranging from r = –0.01 to –0.41. Lastly, Shimada et al [8] established correlations (r = –0.18 to +0.34) between steady-state (i.e. one-leg standing test, tandem walk test, 6-meter walking time) and proactive balance, i.e.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Strength, Power and Balance Performance in Seniors

Besemer²,

et al. 2012

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Background: Deficits in strength, power and balance represent important intrinsic risk factors for falls in seniors. Objective: The purpose of this study was to investigate the relationship between variables of lower extremity muscle strength/power and balance, assessed under various task conditions. Methods: Twenty-four healthy and physically active older adults (mean age: 70 ± 5 years) were tested for their isometric strength (i.e. maximal isometric force of the leg extensors) and muscle power (i.e. countermovement jump height and power) as well as for their steady-state (i.e. unperturbed standing, 10-meter walk), proactive (i.e. Timed Up & Go test, Functional Reach Test) and reactive (i.e. perturbed standing) balance. Balance tests were conducted under single (i.e. standing or walking alone) and dual task conditions (i.e. standing or walking plus cognitive and motor interference task). Results: Significant positive correlations were found between measures of isometric strength and muscle power of the lower extremities (r values ranged between 0.608 and 0.720, p < 0.01). Hardly any significant associations were found between variables of strength, power and balance (i.e. no significant association in 20 out of 21 cases). Additionally, no significant correlations were found between measures of steady-state, proactive and reactive balance or balance tests performed under single and dual task conditions (all p > 0.05). Conclusion: The predominately nonsignificant correlations between different types of balance imply that balance performance is task specific in healthy and physically active seniors. Further, strength, power and balance as well as balance under single and dual task conditions seem to be independent of each other and may have to be tested and trained complementarily.

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“…This is due to the incremental nature of ISWT, which demands agility to execute the changes of direction, as well the association already established between performance on tests of walking and balance (3,11). Individuals with a history of falls have lower performance, compared to people who did not fall (11).…”

Section: Introductionmentioning

confidence: 99%

Test timed up and go and its correlation with age and functional exercise capacity in asymptomatic women

et al. 2017

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Introduction:The Timed Up and Go test (TUG) is widely used and valid in chronic patients, but rarely addressed in asymptomatic individuals. Objective: To assess the reliability, the age-related changes and the correlation between TUG and the Functional Exercise Capacity (FEC) adjusted for non-institutionalized middle-aged and elderly women. Methods: Ninety-eight women (57 ± 10 years) were selected and stratified into age groups. We have performed the tests TUG, Berg Balance Scale (BBS) and evaluation of usual gait speed (UGS). Fifty-eight participants (57 ± 10 years) also performed incremental shuttle walk test (ISWT). Results: Worse performance in TUG (p < 0,05) for participants aged ≥ 70 years for age groups 40-49 and 50-59 years. The reliability of TUG was excellent between the first and second TUG (intraclass correlation coefficient, 0.933; confidence interval of 95%, from 0.901 to 0.955) and between the second and third TUG (0.958, 0.938 to 0.972). The group of 58 participants who underwent further the ISWT, TUG correlated significantly (p <0.05) with ISWT (r = -0.72), VUM (r = -0.54) and BBS (r= 0.58). A multiple linear regression analysis selected TUG (R 2 = 0.517) and VUM (R 2 = 0.083) as determinants of FEC. Conclusion: TUG adapted

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Physical factors underlying the association between lower walking performance and falls in older people: A structural equation model

Cited by 42 publications

References 33 publications

Association Between Short Physical Performance Battery and Falls in Older People: The Progetto Veneto Anziani Study

Association Between Short Physical Performance Battery and Falls in Older People: The Progetto Veneto Anziani Study

Relationship between Strength, Power and Balance Performance in Seniors

Test timed up and go and its correlation with age and functional exercise capacity in asymptomatic women

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