Tests of Stepping as Indicators of Mobility, Balance, and Fall Risk in Balance-Impaired Older Adults
Objectives: To determine the relationships between two tests of stepping ability (the maximal step length (MSL) and rapid step test (RST)) and standard tests of standing balance, gait, mobility, and functional impairment in a group of at‐risk older adults. Design: Cross‐sectional study. Setting: Uni...
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| Published in: | Journal of the American Geriatrics Society (JAGS) Vol. 52; no. 7; pp. 1168 - 1173 |
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| Main Authors: | , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Oxford, UK
Blackwell Science Inc
01-07-2004
Blackwell Wiley Subscription Services, Inc |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Objectives: To determine the relationships between two tests of stepping ability (the maximal step length (MSL) and rapid step test (RST)) and standard tests of standing balance, gait, mobility, and functional impairment in a group of at‐risk older adults.
Design: Cross‐sectional study.
Setting: University‐based laboratory.
Participants: One hundred sixty‐seven mildly balance‐impaired older adults recruited for a balance‐training and fall‐reduction program (mean age 78, range 65–90).
Measurements: Measures of stepping maximally (MSL, the ability to maximally step out and return to the initial position) and rapidly (RST, the time taken to step out and return in multiple directions as fast as possible); standard measures of balance, gait, and mobility including timed tandem stance (TS), tandem walk (TW, both timing and errors), timed unipedal stance (US), timed up and go (TUG), performance oriented mobility assessment (POMA), and 6‐minute walk (SMW); measures of leg strength (peak knee and ankle torque and power at slow and fast speeds); self‐report measures of frequent falls (>2 per 12 months), disability (Established Population for Epidemiologic Studies of the Elderly (EPESE) physical function), and confidence to avoid falls (Activity‐specific Balance Confidence (ABC) Scale). Spearman and Pearson correlation, intraclass correlation coefficient, logistic regression, and linear regression were used for data analysis.
Results: MSL consistently predicted a number of self‐report and performance measures at least as well as other standard balance measures. MSL correlations with EPESE physical function, ABC, TUG, and POMA scores; SMW; and peak maximum knee and ankle torque and power were at least as high as those correlations seen with TS, TW, or US. MSL score was associated with the risk of being a frequent faller. In addition, the six MSL directions were highly correlated (up to 0.96), and any one of the leg directions yielded similar relationships with functional measures and a history of falls. Relationships between RST and these measures were relatively modest.
Conclusion: MSL is as good a predictor of mobility performance, frequent falls, self‐reported function, and balance confidence as standard stance tests such as US. MSL simplified to one direction may be a useful clinical indicator of mobility, balance, and fall risk in older adults. |
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| Bibliography: | ark:/67375/WNG-8KJ5M052-8 ArticleID:JGS52317 istex:110A5BE0DEE919748627EBEA12C839A254730E3B Funding received from National Institute on Aging (NIA) Claude Pepper Older Adults Independence Center Grant AG08808, NIA Grant AG10542, and Department of Veterans Affairs Research and Development. Dr. Alexander is a recipient of the K24 Mid‐Career Investigator Award in Patient‐Oriented Research AG109675 from NIA. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
| ISSN: | 0002-8614 1532-5415 |
| DOI: | 10.1111/j.1532-5415.2004.52317.x |