Callisaya Michele L, Blizzard Leigh, Martin Kara, Srikanth Velandai K
Menzies Institute for Medical Research Tasmania, University of Tasmania, Hobart, Tasmania, Australia; Southern Clinical School, Monash Medical Centre, Monash University, Clayton, Victoria, Australia.
Menzies Institute for Medical Research Tasmania, University of Tasmania, Hobart, Tasmania, Australia.
Gait Posture. 2016 Sep;49:19-24. doi: 10.1016/j.gaitpost.2016.06.006. Epub 2016 Jun 16.
In a population-based study of older people to examine whether 1) overall gait initiation (GI) time or its components are associated with falls and 2) GI under dual-task is a stronger predictor of falls risk than under single-task.
Participants aged 60-85 years were randomly selected from the electoral roll. GI was obtained with a force platform under both single and dual-task conditions. Falls were ascertained prospectively over a 12-month period. Log multinomial regression was used to examine the association between GI time (total and its components) and risk of single and multiple falls. Age, sex and physiological and cognitive falls risk factors were considered as confounders.
The mean age of the sample (n=124) was 71.0 (SD 6.8) years and 58.9% (n=73) were male. Over 12 months 21.8% (n=27) of participants reported a single fall and 16.1% (n=20) reported multiple falls. Slower overall GI time under both single (RR all per 100ms 1.28, 95%CI 1.03, 1.58) and dual-task (RR 1.14, 95%CI 1.02, 1.27) was associated with increased risk of multiple, but not single falls (p<0.05). Multiple falls were also associated with slower time to first lateral movement under single-task (RR 1.90 95%CI 0.59, 1.51) and swing time under dual-task condition (RR 1.44 95%CI 1.08, 1.94).
Slower GI time is associated with the risk of multiple falls independent of other risk factors, suggesting it could be used as part of a comprehensive falls assessment. Time to the first lateral movement under single-task may be the best measures of this risk.
在一项针对老年人的基于人群的研究中，检验1）整体步态起始（GI）时间或其组成部分是否与跌倒有关，以及2）双任务条件下的GI是否比单任务条件下更能预测跌倒风险。
从选民名单中随机选取60 - 85岁的参与者。在单任务和双任务条件下，使用测力平台获取GI。前瞻性地确定12个月内的跌倒情况。采用对数多项回归分析来检验GI时间（总和其组成部分）与单次和多次跌倒风险之间的关联。将年龄、性别以及生理和认知跌倒风险因素视为混杂因素。
样本（n = 124）的平均年龄为71.0（标准差6.8）岁，男性占58.9%（n = 73）。在12个月期间，21.8%（n = 27）的参与者报告了单次跌倒，16.1%（n = 20）报告了多次跌倒。单任务（每100毫秒RR为1.28，95%置信区间1.03, 1.58）和双任务（RR为1.14，95%置信区间1.02, 1.27）条件下较慢的整体GI时间与多次跌倒风险增加相关，但与单次跌倒无关（p < 0.05）。多次跌倒还与单任务下首次侧向移动时间较慢（RR为1.90，95%置信区间0.59, 1.51）和双任务条件下摆动时间较慢（RR为1.44，95%置信区间1.08, 1.94）有关。
较慢的GI时间与多次跌倒风险相关，独立于其他风险因素，表明它可作为综合跌倒评估的一部分。单任务下首次侧向移动时间可能是该风险的最佳测量指标。
