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

Addie Middleton, George D. Fulk, Troy M. Herter, Michael W. Beets, Jonathan Donley, Stacy L. Fritz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVE: 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. DESIGN: 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). RESULTS: 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). CONCLUSIONS: 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.

Original languageEnglish (US)
JournalAmerican Journal of Physical Medicine and Rehabilitation
DOIs
StateAccepted/In press - Mar 21 2016

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Independent Living
Walking Speed
Area Under Curve
Sensitivity and Specificity
Senior Centers

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults. / Middleton, Addie; Fulk, George D.; Herter, Troy M.; Beets, Michael W.; Donley, Jonathan; Fritz, Stacy L.

In: American Journal of Physical Medicine and Rehabilitation, 21.03.2016.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: 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. DESIGN: 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). RESULTS: 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). CONCLUSIONS: 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.",
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AU - Donley, Jonathan

AU - Fritz, Stacy L.

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N2 - OBJECTIVE: 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. DESIGN: 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). RESULTS: 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). CONCLUSIONS: 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.

AB - OBJECTIVE: 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. DESIGN: 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). RESULTS: 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). CONCLUSIONS: 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.

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