title: Dynamic gait stability, clinical correlates, and prognosis of falls among community-dwelling older adults.
abstract: OBJECTIVE
  To establish an accurate measure for prognostic assessment of fall risk in community-dwelling older adults, this study examined the prediction accuracy of a dynamic gait stability measure and common clinical tests for slip-related falls among these adults.
  
  
  METHODS
  Participants were tested for their fall-risk likelihood on a slip-test.
  
  
  METHODS
  Biomechanics research laboratory.
  
  
  METHODS
  Community-dwelling older adults (N=119; ≥65y).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participants performed a battery of clinical tests, including Berg Balance Scale, Timed Up & Go (TUG) test, static posturography, isometric muscle strength, and bone density. They were then exposed to an unannounced slip during gait. The dynamic stability during unperturbed gait was measured based on the center of mass position and velocity relative to the limits of stability against backward falling. Accuracy of each measure was examined for prediction of slip outcome (fall or recovery).
  
  
  RESULTS
  On the slip, 59 participants fell, 56 recovered their balance, and 4 were harness-assisted. Dynamic stability predicted fall outcome with 69% accuracy. Except for TUG and bone density, no other measure could differentiate fallers from nonfallers; TUG predicted 56% of fall outcomes.
  
  
  CONCLUSIONS
  Reproduction of actual falls provides a new benchmark for evaluating the prognostic power of different performance-based assessment tools. The TUG was able to better predict fall outcome than other clinical measures; however, the new dynamic gait stability measure was more sensitive than TUG in its prediction of falls. Ultrasound bone scan could be used to screen older adults for fall risk.
authors.affiliation: Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL 60612, USA.
authors.forename: Tanvi
authors.initials: T
authors.lastname: Bhatt
authors.forename: Debbie
authors.initials: D
authors.lastname: Espy
authors.forename: Feng
authors.initials: F
authors.lastname: Yang
authors.forename: Yi-Chung
authors.initials: YC
authors.lastname: Pai
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005684:Gait; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D004856:Postural Balance; D012111:Residence Characteristics