The objective of this study was to evaluate the potential merit of a walking-adaptability assessment with the Interactive Walkway for identifying prospective fallers and risk factors for future falls in a cohort of stroke patients, Parkinson’s disease patients, and controls.
This study comprised an evaluation of subject characteristics, clinical gait and balance tests, and a quantitative gait assessment and walking-adaptability assessment on the Interactive Walkway. Subjects’ falls were registered with monthly falls calendars during a 6-month follow-up period to identify subjects as prospective fallers (i.e., experiencing at least one walking-related fall during the follow-up period) or non-fallers.
Prospective fallers experienced more fear of falling and more fear-of-falling-related activity avoidance at baseline than non-fallers. In addition, prospective fallers walked slower and with smaller steps, and had a poorer performance on clinical gait and balance tests.
As anticipated, prospective fallers also performed worse on various walking-adaptability tasks. In addition to fall history, obstacle-avoidance success rate and normalized walking speed during goal directed stepping were identified as predictor variables for falls and these fall-risk factors improved the identification of fallers. It appears that subjects who performed worse on the obstacle-avoidance task without substantially lowering their walking speed during goal-directed stepping are most at risk of falling.
Identification of these task-specific fall-risk factors may lead to more targeted, personalised and, possibly, more effective falls prevention programmes. If validated in larger samples in future studies these measures hold promise as future entry tests for falls prevention programmes.
> From: Geerse et al., Gait Posture 70 (2019) 203-210 . All rights reserved to Elsevier B.V. Click here for the online summary.
