Prediction of Falls Using a 3-m Zigzag Walk Test

Abstract

[Objective] This study investigated the applicability of a 3-m zigzag walk test for the prediction of falls and examined the relationships among fall history, the 3-m zigzag walk test, 10-m walk, and age. [Subjects] A total of 50 elderly individuals (23 males and 27 females) aged 65 and over, who were able to walk independently, were studied. [Methods] Four poles made of PET bottles were placed on a 3-m walkway in a straight line to create a zigzag course, and the time needed to walk it was measured. The best results on days 1 and 2 were adopted for the fall and no-fall groups, and intra-rater reproducibility was evaluated by calculating the intra-class correlation coefficient and performing the paired t-test. For comparison of the time needed to walk the zigzag between the 2 groups, the unpaired t-test was performed. The relationships between the times needed to walk the 3-m zigzag and 10 m and age were analyzed by calculating the correlation coefficient with fall history as the dependent variable, in multiple logistic regression analysis with the times needed to walk the 3-m zigzag and 10 m and age as independent variables. For the optimal classification of the fall and no-fall groups, cutoffs were calculated based on the ROC curve. [Results] The paired t-test results did not show differences between measurements, and the ICC was 0.97 in the fall, and 0.94 in the no-fall groups. The fall group needed significantly more time than the no-fall group to walk the 3-m zigzag. Further, the Pearson product-moment correlation coefficient revealed a significant correlation between the times needed to walk the 3-m zigzag and 10 m, while no correlation was observed between the time needed to walk the 3-m zigzag and age (r=0.225). The time needed to walk the 3-m zigzag was extracted as a factor associated with fall history in multiple logistic regression analysis, with an odds ratio of 0.377. Its significance as a variable was p<0.01. In the Hosmer-Lemeshow test of the study model, the rate of discrimination between the predicted and actual values was 82.0%. [Conclusion] The cutoff time to walk the 3-m zigzag was estimated to be 10.5 seconds, suggesting that this model may be a valid index for the prediction of falls.

Reliability of 3-m Backward Walk Test in Patients with Primary Total Knee Arthroplasty

“…Walking speed has been shown to be a key factor in determining rehabilitation needs and discharge location and has the potential to predict the future health status, functional decline, fear of falling, and fall risk. 15,16 In addition to these objectives, assessment of walking after TKA provides important information about the healing process. 17 Therefore, walking has to be assessed in patients with TKA.…”

Relationship between straight and curved walking abilities among inpatients in the subacute phase according to walking independence level

“…The 3ZW [5] is a test combining walking and turns, and has shown high inter-rater reliabilities (ICC=0.97 and 0.94) when involving community residents with and without a history of falls, respectively [5]. Following the original instruction, in the present study, testing was conducted on a 3 meter zigzag course, with marked starting and finishing points and 4 poles placed at intervals of 60 cm from the starting point to the finishing point.…”

“…Similarly, Masuda et al [4] developed the 10-meter zigzag walk test to simulate home environments and focus on the frequent turns associated with indoor falls. The 3-meter zigzag walk test (3ZW) based on this is also available [5]. Both tests facilitate more practical assessment of curved walking ability under simulated daily living environments.…”

“…Among primary-care patients, declines in straight walking ability and F8W results increase the risk of falls [7]. On the other hand, among community-dwelling older adults, the 3ZW has been shown to be associated with the walking velocity, and cut-off values for this test for predicting falls have also been calculated [5]. However, studies to examine inpatients using the F8W or 3ZW have not been conducted, and the relationship between straight and curved walking ability has remained unclear.…”

Kinematic analysis of tandem gait on a sine wave walkway

“…Therefore, it is excellent for comparison with a reference value. Some reports have described this method in evaluating the physical fitness of elderly people2, 3 ) and its association with myofunction4, 5 ) . However, the kinematics, specifically of knee joint rotation, during direction change have not been examined.…”