title: Identification of functional parameters for the classification of older female fallers and prediction of 'first-time' fallers.
abstract: Falls remain a challenge for ageing societies. Strong evidence indicates that a previous fall is the strongest single screening indicator for a subsequent fall and the need for assessing fall risk without accounting for fall history is therefore imperative. Testing in three functional domains (using a total 92 measures) were completed in 84 older women (60-85 years of age), including muscular control, standing balance, and mean and variability of gait. Participants were retrospectively classified as fallers (n = 38) or non-fallers (n = 42) and additionally in a prospective manner to identify first-time fallers (FTFs) (n = 6) within a 12-month follow-up period. Principal component analysis revealed that seven components derived from the 92 functional measures are sufficient to depict the spectrum of functional performance. Inclusion of only three components, related to mean and temporal variability of walking, allowed classification of fallers and non-fallers with a sensitivity and specificity of 74% and 76%, respectively. Furthermore, the results indicate that FTFs show a tendency towards the performance of fallers, even before their first fall occurs. This study suggests that temporal variability and mean spatial parameters of gait are the only functional components among the 92 measures tested that differentiate fallers from non-fallers, and could therefore show efficacy in clinical screening programmes for assessing risk of first-time falling.
authors.affiliation: Institute for Biomechanics, ETH, Zürich, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: König
authors.affiliation: Institute for Biomechanics, ETH, Zürich, Switzerland taylorb@ethz.ch.
authors.forename: W R
authors.initials: WR
authors.lastname: Taylor
authors.affiliation: Centre for Muscle and Bone Research, Charité-Universitätsmedizin, Berlin, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Armbrecht
authors.affiliation: Centre for Muscle and Bone Research, Charité-Universitätsmedizin, Berlin, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Dietzel
authors.affiliation: Institute for Biomechanics, ETH, Zürich, Switzerland.
authors.forename: N B
authors.initials: NB
authors.lastname: Singh
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003627:Data Interpretation, Statistical; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods*; D004856:Postural Balance / Q000502:physiology*; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D016138:Walking / Q000502:physiology; D016387:Women's Health / Q000706:statistics & numerical data*
keywords: balance; falls; force control; functional assessment; gait; principal component analysis