title: Development of a clinical Multiple-Lunge Test to predict falls in older adults.
abstract: OBJECTIVE
  To develop a new Multiple-Lunge Test to distinguish between fallers and nonfallers in community-dwelling older adults.
  
  
  METHODS
  A cross-sectional design was used to establish the sensitivity and specificity of the test to predict faller status based on retrospective self-reported fall history.
  
  
  METHODS
  Local retirement villages.
  
  
  METHODS
  Community-dwelling older adults (N=130; mean age ± SD, 77±7y) with (n=40) and without (n=90) a history of falls.
  
  
  METHODS
  The Multiple-Lunge Test required individuals to lunge forward to a step length determined as 60% of their leg length, and return to start, for 5 consecutive repetitions. Interday and intraday test-retest reliability of the Multiple-Lunge Test was established across 2 testing occasions.
  
  
  METHODS
  Number of steps performed correctly, total time to complete 5 steps.
  
  
  RESULTS
  The Multiple-Lunge Test was found to be reliable across trials (Intraday: intraclass correlation coefficient [ICC]=.79-.81 for steps, ICC=.86-.88 for time; Interday: ICC=.77 for steps; ICC=.84 for time). Sensitivity and specificity values were calculated as 73% and 63%, respectively, for predicting multiple fallers using the measure of all 5 steps done correctly.
  
  
  CONCLUSIONS
  The test is easily administered and because of its challenging nature, it may be well suited to detect subtle differences in abilities of higher functioning, community-dwelling older adults. A practitioner can be confident in 7 of 10 cases that an older adult who cannot complete all 5 steps of the Multiple-Lunge Test is at high risk of falls. The results suggest that there is potential for the Multiple-Lunge Test to be used in clinical practice; however, additional research on how to further increase its validity appears warranted.
authors.affiliation: Centre for Physical Activity and Nutrition Research, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand. ruth.wagenaar@aut.ac.nz
authors.forename: Ruth
authors.initials: R
authors.lastname: Wagenaar
authors.forename: Justin W
authors.initials: JW
authors.lastname: Keogh
authors.forename: Denise
authors.initials: D
authors.lastname: Taylor
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D056808:Biostatistics; D001837:Body Weights and Measures; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D004856:Postural Balance; D015995:Prevalence; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012189:Retrospective Studies; D018570:Risk Assessment; D016138:Walking