Usefulness of the Subjective Risk Rating of Specific Tasks for Falls in Frail Elderly People

Abstract

Abstract.[Purpose] The purpose of this study was to examine the reliability and clinical usefulness of a subjective risk rating of specifi c tasks (SRRST) for assessing risks of falls in frail elderly people. The participants were 30 elderly individuals who utilized day-care services. [Subjects and Methods] Participants were investigated the SRRST, grip strength, one repetition maximum of leg-press machine (1RM), one-leg standing time (OLS), functional reach, timed up and go test (TUG), and 10 m-walking speed, Barthel index, Tokyo Metropolitan Institute of Gerontology index, and history of falls in the previous year. The SRRST is comprised of 7 dichotomous questions screening of fall risk during activities of daily living such as walking, transferring, and wandering, and was scored twice a week by four raters.[Results] Intra-rater reliabilities of the SRRST were high (ICC (1,1) = 0.727 to 0.914, ICC (1,2) = 0.842 to 0.955), and inter-rater reliabilities of the SRRST were moderate to high (ICC (2,1) = 0.513, ICC (2,4) = 0.808). In comparison to the non-faller group, the faller group showed signifi cantly lower 1RM and higher the SRRST. The SRRST showed moderate correlations with the OLS and TUG.[Conclusion] The SRRST showed moderate to high reliability and concurrent validity for assessing the fall risks in frail elderly people.

Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability

“…A single Level III study70 with small sample (n = 29) suggests that the Medical Outcome Short Form Health Survey (SF-36) Physical Activity Subscale score of less than 72.5 may be useful (PoTP = 54% if positive, PoTP = 20% if negative). Measures of caregiver concern71 and of overall health status41 were cited in single studies with small to moderate sample sizes. Neither demonstrated ability to identify fall risk.…”

A systematic review of one-legged balance performance and falls risk in community-dwelling adults

“…Our database searches identified a total of 4,310 unique records. After the two-stage screening and additional papers identified via the reference list search, a total of 55 papers are included in the review (Andresen et al, 2006;Ansai et al, 2016;Arai et al, 2020;Beauchet et al, 2010;Bergland and Wyller, 2004;Blain et al, 2021;Bongue et al, 2011;Briggs et al, 1989;Buatois et al, 2006;Buatois et al, 2010;Cho and Kamen, 1998;Choy et al, 2008;Choy et al, 2007;Crenshaw et al, 2020;de Rekeneire et al, 2003;Delbaere et al, 2010;Depasquale and Toscano, 2009;Ek et al, 2019a;Ek et al, 2019b;El-Sobkey, 2011;Eto and Miyauchi, 2018;Gerdhem et al, 2005;Hasegawa et al, 2019;Hashidate et al, 2011;Heitmann et al, 1989;Ikegami et al, 2019;Jalali et al, 2015;Kwan et al, 2011;Lim et al, 2016;Lin et al, 2004b;MacRae et al, 1992;Mahoney et al, 2019;Moreira et al, 2017;Muir et al, 2010;Mulasso et al, 2017;Nevitt et al, 1989;Niam and Wee, 1999;Park et al, 2020;Porto et al, 2020;Rossat et al, 2010;…”

“…Estimated heterogeneity in study outcomes in these meta-analyses was low for both cross-sectional (I 2 =14% (0,50%)) and longitudinal (I 2 =0% (0,60%)) analyses. Visual inspection of the funnel plot and Egger test (p=0.05) suggested that there may be minimal publication bias (see Appendix F); however, this was primarily driven by Cho and Kamen(1998;n= 16) and Hashidate et al(2011;n=30)(p=0.16 when removed), although there was no impact on the cross-sectional SMD when Cho and Kamen(1998) and Hashidate et al (2011) were removed from the meta-analysis (-0.28 (95% CI: -0.37,-0.19)).…”

“…As upper body movement can counteract postural instability despite an unstable centre of gravity, leniency in movement of the arms or stance leg could reduce the reliability and comparability of balance times. Some studies explicitly permitted movement of the legs or arms (Bergland and Wyller, 2004;Heitmann et al, 1989;Sampaio et al, 2013), others ended the trial if there was any movement (Briggs et al, 1989;Choy et al, 2008;Choy et al, 2007;Depasquale and Toscano, 2009;El-Sobkey, 2011;Eto and Miyauchi, 2018;Hasegawa et al, 2019;Hashidate et al, 2011;MacRae et al, 1992;Mulasso et al, 2017;Niam and Wee, 1999), while most studies did not provide details. Similarly, several studies instructed participants to focus their eyes on a headlevel target (Ansai et al, 2016;El-Sobkey, 2011;Niam and Wee, 1999); this is hypothesised to improve balance performance as visual concentration can improve proprioceptive input (Wulf and Lewthwaite, 2016;Wulf et al, 2001).…”

Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

“…The information of the SRRST and history of falls was obtained at the same time. Prior to the commencement of the study, three raters completed the SRRST twice at weekly intervals (n = 4 × 2 × 30), and test-retest and inter-rater (one physical therapist, one nurse, and two caregivers) reliability comparisons of total scores revealed intraclass correlation coefficients (ICCs) of 0.84 to 0.96 and 0.81, respectively [ 20 ].…”