Fried A V, Cwikel J, Ring H, Galinsky D
Department of Geriatric Medicine, Soroka Medical Center, Faculty of Medical Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel.
Int Disabil Stud. 1990 Oct-Dec;12(4):161-4. doi: 10.3109/03790799009166609.
Gait and balance disturbances are recognized risk factors for falls among elderly persons. The prevention of falls and their adverse complications is one of the challenges in geriatric care, requiring the early detection of risk factors. Heretofore, gait assessment procedures have required considerable investment in equipment for sophisticated biomechanical testing. This has limited the use of gait-testing procedures to the laboratory or clinic. We describe a simple and effective method for at-home or community gait testing, ELGAM (extra-laboratory gait assessment method). ELGAM was field-tested as part of a study of 36 community-dwelling elderly in Beer Sheba, Israel. The ELGAM parameters studied included step length, walking speed, initial starting style of walking, ability to turn head while walking, and static balance. Slow walking speed (less than 0.5 m/s), small steps, difficulty in turning the head, and impaired balance were significantly associated (chi-square analyses, p less than 0.01) with unstable gait. The parameters were also positively associated one with another, except for head turning. The ELGAM parameters were significantly related to self-assessed fall frequency, and reported 'near falls' among women only. In addition, among women only, slow walking speed was associated with depressive symptoms as detected by a validated screening test, the Short Geriatric Depression Scale, and with poor subjective health rating. Among 58% of this independently living elderly sample, ELGAM detected one or more risk factors. ELGAM is a 'low-tech', functionally based, effective method for direct recording of gait parameters that is applicable for community studies of the early detection of risk factors for falls and mobility problems.
步态和平衡障碍是老年人跌倒的公认风险因素。预防跌倒及其不良并发症是老年护理中的挑战之一，需要早期发现风险因素。迄今为止，步态评估程序需要大量投资用于复杂的生物力学测试设备。这限制了步态测试程序仅在实验室或诊所使用。我们描述了一种用于家庭或社区步态测试的简单有效方法，即ELGAM（实验室外步态评估方法）。作为对以色列贝尔谢巴36名社区居住老年人的研究的一部分，对ELGAM进行了实地测试。研究的ELGAM参数包括步长、步行速度、初始步行起始方式、行走时转头能力和静态平衡。慢步行速度（小于0.5米/秒）、小步幅、转头困难和平衡受损与不稳定步态显著相关（卡方分析，p小于0.01）。除转头外，这些参数之间也呈正相关。ELGAM参数与自我评估的跌倒频率显著相关，且仅在女性中报告有“险些跌倒”情况。此外，仅在女性中，慢步行速度与经有效筛查测试（简短老年抑郁量表）检测出的抑郁症状以及主观健康评分差相关。在这个独立生活的老年样本中，58%的人ELGAM检测出一种或多种风险因素。ELGAM是一种“低技术”、基于功能的有效方法，可直接记录步态参数，适用于社区研究中早期发现跌倒和行动问题的风险因素。
