Dataset Information

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

ABSTRACT: To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults.WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) and ratio (WSRratio = MWS/SSWS).SSWS (P < 0.001), MWS (P < 0.001), and WSRdiff (P < 0.01) were associated with fall status. The cutpoints identified were 0.76 m/s for SSWS (65.4% sensitivity, 70.9% specificity), 1.13 m/s for MWS (76.6% sensitivity, 60.0% specificity), and 0.24 m/s for WSRdiff (56.1% sensitivity, 70.9% specificity). SSWS and MWS better discriminated between fallers and non-fallers (SSWS: AUC = 0.69, MWS: AUC = 0.71) than WSRdiff (AUC = 0.64).SSWS and MWS seem to be equally informative measures for assessing fall status in community-dwelling older adults. Older adults with SSWSs less than 0.76 m/s and those with MWSs less than 1.13 m/s may benefit from further fall risk assessment. Combining SSWS and MWS to calculate an individual's WSR does not provide additional insight into fall status in this population.Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Describe the different methods for calculating walking speed reserve and discuss the potential of the metric as an outcome measure; (2) Explain the degree to which self-selected walking speed, maximal walking speed, and walking speed reserve are associated with fall status among community-dwelling older adults; and (3) Discuss potential limitations to using walking speed reserve to identify fall status in populations without mobility restrictions.Advanced: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

SUBMITTER: Middleton A

PROVIDER: S-EPMC4912425 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

Middleton Addie A Fulk George D GD Herter Troy M TM Beets Michael W MW Donley Jonathan J Fritz Stacy L SL

American journal of physical medicine & rehabilitation 20160701 7

<h4>Objective</h4>To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults.<h4>Design</h4>WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) ...[more]

PMID: 27003205

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Project description:This study aimed to provide multiple regression equations taking into account differences in running speed, leg length, and step characteristics to predict kinematics of maximal speed sprinting. Seventy-nine male sprinters performed a maximal effort 60-m sprint, during which they were videoed through the section from the 40- to 50-m mark. From the video images, leg kinematic variables were obtained and used as dependent variables for multiple linear regression equation with predictors of running speed, leg length, step frequency, and swing/support ratio. Multiple regression equations to predict leg kinematics of maximal speed sprinting were successfully obtained. For swing leg kinematics, a significant regression model was obtained to predict thigh angle at the contralateral foot strike, maximal knee flexion and thigh lift angular velocities, and maximal leg backward swing velocity (adjusted R 2 = 0.194-0.378, medium to large effect). For support leg kinematics, a significant regression model was obtained to predict knee flexion and extension angular displacements, maximal knee extension velocity, maximal leg backward swing angular velocity, and the other 13 kinematic variables (adjusted R 2 = 0.134-0.757, medium to large effect). Based on the results, at a given leg length, faster maximal speed sprinting will be accompanied with greater thigh angle at the contralateral foot strike, greater maximal leg backward swing velocity during the swing phase, and smaller knee extension range during the support phase. Longer-legged sprinters will accomplish the same running speed with a greater thigh angle at contralateral foot strike, greater knee flexion range, and smaller maximal leg backward swing velocity during the support phase. At a given running speed and leg length, higher step frequencies will be achieved with a greater thigh angle at contralateral foot strike and smaller knee flexion and extension ranges during the support phase. At a given running speed, leg length and step frequency, a greater swing/support ratio will be accompanied with a greater thigh angle at contralateral foot strike and smaller knee extension angular displacement and velocity during the support phase. The regression equations obtained in this study will be useful for sprinters when trying to improve their maximal speed sprinting motion.

Dataset Information

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

Publications

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

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