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AbstractAimsMethodsResultsConclusionsAging is an inevitable stage in which in addition to physiological and mental changes, perception and awareness decline, and memory functions gradually deteriorate. The aim of this study was to examine the effects of body awareness on fall-related behaviors and fall risk in geriatric individuals.This cross-sectional study was conducted with 176 individuals over 65 years of age who presented to family health centers. Body awareness (BAQ), fall-related behaviors (FaB) and fall risk (Morse) were examined. Statistical significance was accepted as p < 0.05 in the analyzes.There was a moderate, negative, and statistically significant relationship between the Morse and BAQ scores of the participants (r=-0.576) (p < 0.05). There was a moderate, positive, and statistically significant relationship between the BAQ and FaB scores of the participants (r = 0.235) (p < 0.05).The results showed a significant relationship between body awareness levels and fall-related behaviors and fall risk in geriatric individuals. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThe aim of the study was to discriminate the risk of falling in patients with Multiple Sclerosis with low to moderate impairment who do not use walking aid using the Timed Up and Go (TUG) Test.This study was planned as a prospective descriptive study with 204 patients. Falls were recorded in three-month prospective diaries, and the balance was evaluated using the TUG Test.By using three-month prospective diaries, the mean age of 109 faller patients and 95 non-faller patients was 35.87 ± 8.35 and 35.35 ± 9.39 years, respectively. The faller group’s mean TUG Test score was 9.46 ± 4.14, whereas the non-faller group’s was 7.74 ± 2.02 s. The TUG Test has an area under the receiver operating characteristic curve value of 0.666 in discriminating fallers from non-fallers (0.592–0.740, %95 Cl). To identify fallers, the TUG Test score of ≥7.85 s has a sensitivity of 0.65 and a specificity of 0.65.As a result of the present study, the TUG Test was found to have moderate sensitivity and specificity in predicting the risk of falling. It is not a sufficient stand-alone measure for fall risk prediction, so it is recommended that this test be included as part of a comprehensive falls screening programme.Assessment of fall risk in patients with Multiple Sclerosis (PwMS) using sensitive assessment methods is critical in planning rehabilitation approaches.The Timed Up and Go (TUG) Test, one of the most often used balance evaluations in PwMS, was found to have moderate sensitivity and specificity in measuring the risk of falling.The TUG Test can be used as part of comprehensive falls screening tools by healthcare professionals in PwMS. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResults and conclusions\nImplications for rehabilitationAccidental falls among adult cancer survivors are a health concern. Falls impose economic burdens and detrimental consequences to cancer survivors. This review aimed to synthesize findings from published research to explore the relationship between falls and cancer diagnosis and treatment among cancer survivors.A scoping review was conducted using four databases (Medline, EMBASE, CINAHL, and Scopus) for the years 2001–2021. A total of 425 abstracts were identified after removing duplicates. A second search for the years 2022–2023 was completed where 80 abstracts were identified. Abstract screening, full-text review, and data extraction were conducted. Study characteristics and key findings were extracted from full texts. Descriptive numerical summaries were presented, and narrative analyses were performed.A total of 42 articles were included in the scoping review which demonstrated (1) an increased prevalence of falls among cancer survivors, (2) the presence of cancer-specific fall risk factors, (3) a lack of cancer-specific fall prediction tools, and (4) few fall prevention interventions as part of usual care among cancer survivors. Younger cancer survivors were underrepresented. Cancer survivors should be aware of their risk of falls, and health professionals should ensure that fall prevention is part of usual care.Falls are associated with cancer survivorship and as there are more people living with and beyond cancer, falls are becoming more significant.There are cancer-specific fall risk factors relevant to cancer survivors which can contribute to increased fall risk.However, fall prevention may not be addressed in standard care for cancer survivors.This review suggests cancer-specific fall risk tools are needed, and that fall prevention should be part of oncologic care.Falls are associated with cancer survivorship and as there are more people living with and beyond cancer, falls are becoming more significant.There are cancer-specific fall risk factors relevant to cancer survivors which can contribute to increased fall risk.However, fall prevention may not be addressed in standard care for cancer survivors.This review suggests cancer-specific fall risk tools are needed, and that fall prevention should be part of oncologic care. [ABSTRACT FROM AUTHOR]

To verify the psychometric properties of the Brazilian-Portuguese version of the Falls Behavioral (FaB-Brazil) Scale in Parkinson's disease (PD). Participants (n = 96) were assessed by disease-specific, self-report and functional mobility measures. Internal consistency of the FaB-Brazil scale was evaluated using Cronbach's alpha and inter-rater and test–retest reliability using intraclass correlation coefficients (ICC). The standard error of measurement (SEM), minimal detectable change (MDC), ceiling and floor effects, and convergent and discriminative validity were evaluated. Internal consistency was moderate (α = 0.77). Excellent inter-rater (ICC = 0.90; p < 0.001) and test–retest (ICC = 0.91; p < 0.001) reliability were found. The SEM was 0.20 and MDC was 0.38. Ceiling and floor effects were not found. Convergent validity was established by the positive correlations between the FaB-Brazil scale and age, modified Hoehn and Yahr, PD duration, Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Motor Aspects of Experiences of Daily Living, Timed Up & Go and 8-item Parkinson's Disease Questionnaire, and negative correlations between the FaB-Brazil scale and community mobility, Schwab & England, and Activities-specific Balance Confidence scale. Females showed greater protective behaviors than males; recurrent fallers showed greater protective behaviors than non-recurrent fallers (p < 0.05). The FaB-Brazil scale is reliable and valid for assessing people with PD. Fall-related behaviors should be part of the fall risk assessment of community-dwelling people with Parkinson's disease. The Brazilian-Portuguese version of the Fall Behavioral (FaB-Brazil) Scale is reliable and valid for assessing everyday behaviors and actions related to falling in community-dwelling people with Parkinson's disease. The FaB-Brazil scale may be used to tailor individualized fall prevention programs. [ABSTRACT FROM AUTHOR]

Falls among older people are a major health concern. This study aims to develop a multifactorial fall risk assessment system for older people using a low-cost, markerless Microsoft Kinect. A Kinect-based test battery was designed to comprehensively assess major fall risk factors. A follow-up experiment was conducted with 102 older participants to assess their fall risks. Participants were divided into high and low fall risk groups based on their prospective falls over a 6-month period. Results showed that the high fall risk group performed significantly worse on the Kinect-based test battery. The developed random forest classification model achieved an average classification accuracy of 84.7%. In addition, the individual's performance was computed as the percentile value of a normative database to visualise deficiencies and targets for intervention. These findings indicate that the developed system can not only screen out 'at risk' older individuals with good accuracy, but also identify potential fall risk factors for effective fall intervention. Practitioner summary: Falls are the leading cause of injuries in older people. We newly developed a multifactorial fall risk assessment system for older people utilising a low-cost, markerless Kinect. Results showed that the developed system can screen out 'at risk' individuals and identify potential risk factors for effective fall intervention. [ABSTRACT FROM AUTHOR]

To develop and cross-culturally adapt a Brazilian-Portuguese version of the Falls Behavioral Scale (FaB-Brazil) and to verify its psychometric properties. The translation and cross-cultural adaptation process of the scale followed standard guidelines. The FaB-Brazil scale was applied to 93 community-dwelling older people. Cronbach's alpha was calculated to evaluate internal consistency and the intraclass correlation coefficient (ICC) to evaluate interrater and test–retest reliability. The standard error of measurement (SEM), minimal detectable change (MDC), ceiling and floor effects, convergent and discriminative validity were evaluated. A significance level of.05 was set for statistical analyses. Internal consistency was moderate (α = 0.73). An excellent inter-rater (ICC = 0.93; p < 0.001) and a good test–retest (ICC = 0.79; p < 0.001) reliability were found. The SEM was 0.27 and MDC was 0.53. Neither ceiling nor floor effects were found. Convergent validity was established by the positive correlations between the FaB-Brazil scale, age, and functional mobility, and by the negative correlations between the FaB-Brazil scale and balance confidence, community mobility and EuroQol-5D (p < 0.05). No significant differences were found between males and females and between non-fallers and fallers. Our results offer evidence for the reliability and validity of the FaB-Brazil scale for community-dwelling older people. Fall-related behaviors should be part of the fall risk assessment of community-dwelling older people. The Brazilian-Portuguese version of the Falls Behavioral Scale (FaB-Brazil) is reliable and valid for assessing fall-related behaviors in community-dwelling older people. The FaB-Brazil scale may be used to raise awareness about potential fall hazards and to guide fall prevention programs. [ABSTRACT FROM AUTHOR]

This study investigated the accuracy of an accelerometer-based smartphone application for predicting the risk of falls in older adults. Eighty community-dwelling older adults (70.05 ± 4.5 years) were assessed using an accelerometer-based smartphone application for balance assessment at baseline, which included 1) the Modified Clinical Test of Sensory Interaction in Balance (MCTSIB), 2) a single-leg stance (SLST), and 3) limit of stability (LOS) test. The fall incidence during a 6-month follow-up was recorded. The area under the receiver operating characteristic curve (AUC) was used to determine accuracy. The accuracy in predicting falls of all assessments was high (AUC = 0.78–0.99). The MCTSIB had the highest AUC (0.99) compared with the SLST (0.86) and the LOS test (0.78). The MCTSIB had a cutoff score of 8.04, sensitivity of 100%, and specificity of 98%. The accelerometer-based smartphone application could predict falls in older adults with excellent accuracy. [ABSTRACT FROM AUTHOR]

The single-leg stance test is included in the FUNfitness (FF) screening for Special Olympic athletes to determine if balance education and/or referrals are needed. There are limited data regarding the use of the single-leg stance test for people with intellectual disabilities. Data were collected for this prospective study as part of the FF screens during the 2018 Special Olympics summer games. Each athlete completed the SLS test on the right (R) and left (L) lower extremity (LE), with eyes opened (SLS-EO) and closed (SLS-EC), and asked if they had fallen in the past year. A total of 178 athletes completed the test. Data analysis revealed a weak relationship between falls and SLS-EO (R LE rs = −0.170 and L LE rs = −0.185) and SLS-EC (R LE rs = −0.169 and L LE rs = −0.187), all of which were significant (p<.05). Sensitivity and specificity of the SLS-EO were low for both the R LE (74.5% and 42.2%, respectively) and L LE (74.5% and 42.7%, respectively). Sensitivity rose slightly with SLS-EC (R LE = 80.9% and L LE = 89.1%), while specificity decreased (R LE = 22.9% and L LE = 25.2%). The positive predictive values for SLS-EO and SLS-EC ranged from 27.3% to 31.8%. The SLS test demonstrated poor accuracy in identifying fallers in SO athletes with area under the curve values ranging from 0.610 to 0.623. These results indicate that the SLS test, or cutoff scores used, may not be the most appropriate for this population. [ABSTRACT FROM AUTHOR]

Purpose: Postural instability can increase the risk of a fall in older adults. In this study, the impact of mental fatigue on postural stability among healthy older adults was investigated. Method: Participants were randomly divided into two groups: experimental and control groups. Postural stability of all participants was tested using the Biodex Balance System (BBS) before and immediately after watching a 30-min documentary program (control group) or completing a 30-min Stroop task (experimental group). Subjective ratings of mental fatigue were measured before and after the Stroop task or watching documentary program. Results: The results indicated that experimental group revealed higher stability scores in the posttest compared to pretest (P ≤ 0.001). However, there were no significant differences for BBS scores between pre and posttest in control group (P =.688). In addition, posttest of subjective ratings of mental fatigue was significantly different between experimental and control groups. Finally, there was also evidence of an association between Visual analog scale and BBS scores in the experimental group (rs = 0.712, P =.002). Conclusions: Mental fatigue caused by Stroop task had a negative impact on postural stability in older adults. This may be due to reduction in attentional resources that was caused by mental fatigue. Thus, mental fatigue could be considered as a risk factor for increased risk of falls in older adults [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a complex disorder marked with non-motor and motor impairments, including gait abnormalities and postural instability. As a result of balance dysfunction and postural instability, falls and injuries are common composite impairments of PD. The modified Four Square Step Test (mFSST) replaces the canes utilized in the traditional Four Square Step Test (FSST) with tape to evaluate dynamic standing balance while stepping in multiple directions. Determine the reliability and validity of the mFSST in individuals with PD. Twenty-seven participants diagnosed with PD on medication H&Y I–III, mean age 73.07 ± 6.4, completed the FSST and mFSST. Participants performed both assessments two times using the fastest time for interrater reliability and concurrent validity. To determine the test–retest reliability, participants performed the mFSST again 20–60 min following initial assessment. The interrater and test–retest reliability was excellent (r = 0.916–0.999, ICC2,2 = 0.96–0.99). The mFSST and FSST were highly correlated for concurrent validity (r = 0.823, p <.01). The mFSST demonstrates excellent reliability and validity while assessing dynamic standing balance in individuals with PD. The mFSST can be completed while requiring little equipment, space, and time in multiple rehabilitation settings. [ABSTRACT FROM AUTHOR]

Aim: Describe the 3- and 6-month outcomes and perceptions of older adults who participated in a HOP-UP-PT clinical trial. Methods: A questionnaire was administered to HOP-UP-PT participants to garner frequency of self-reported falls, healthcare utilization, perceptions of interventions, and fiscal considerations 3- and 6- months after program completion. Results: 76 total respondents, mean age 77 (SD = 7) years and 75% female. A fall was reported by 12% and 16%, additional therapy needs by 16% and 17%, and hospitalization by 3% and 6% at the 3- and 6-month encounters, respectively. Respondents agreed or strongly agreed to positive benefits of the HOP-UP-PT interventions as follows: exercise (71%, 69%), wearable activity monitor (59%, 59%), automated blood pressure monitor (78%, 87%), and improved nutrition (48%, 41%). Respondents were willing to contribute 10% of program cost and 93% supported insurers covering the cost gap. Conclusion: HOP-UP-PT participants had positive outcomes and perceptions in after program participation. [ABSTRACT FROM AUTHOR]

Determine whether race predicts fear of falling (FOF) in older adults with a history of previous fall(s) while controlling for mobility performance, activity of daily living (ADL) independence, age, gender, and education. We examined predictors of FOF among community-dwelling older adults using data from two longitudinal randomized controlled trials that implemented fall prevention programs for community-dwelling older adults. Two hundred fifty-nine participants were included in the analysis; 145 reported low FOF, while 59 reported high FOF. After controlling for mobility performance, ADL independence, and sociodemographic factors, Black older adults were more likely to report FOF (OR = 2.17) compared to White older adults. Overall, older adults with lower mobility performance/functioning scores were more likely to have FOF (OR = 0.08). Older adults (aged ≥65 years) who are at higher risk, based on a prior history of fall(s), are more susceptible to developing FOF, as evidenced by the older adults within this study, due to limited mobility performance and functioning. Black older adults may be at greater risk of FOF than their White counterparts based on previous fall history and level of functional mobility. Incorporating measures of objective performance-based function along with measures of psychological factors are viable methods to identify and address FOF within Black older adult populations. [ABSTRACT FROM AUTHOR]

To investigate the gender difference effect on postural balance, functional mobility, and fall risk after performing a fatiguing task in adults with multiple sclerosis (MS). Eleven women (30.91 ± 8.19 years) and seven men (30.29 ± 7.99 years) with relapsing-remitting MS performed a fatiguing task: three sets of the Five-repetition Sit-To-Stand Test (5-STST) were performed before and after the six-minute WalkTest (6MWT). Bipedal postural balance in eyes open and eyes closed conditions were assessed prefatigue (T0) and postfatigue (T3) using a force platform. Unipedal balance, functional mobility (Timed Up and Go Test), fall risk (Four Square Step Test) and fatigue [Visual Analogue Scale of Fatigue (VASF)] were assessed at T0 and T3. Heart rate (HR) and Rating of Perceived Exertion (RPE) were recorded before (only for HR), during and after the fatiguing task. Compared to women, men showed an impairment of posturographic parameters [mean center of pressure (CoP) velocity (CoPVm) in both conditions (p < 0.05); CoP sway area (CoPAr) in both conditions (p < 0.01)], unipedal balance on the dominant leg (p <0.001), mobility (p<0.001) and an increased fall risk (p < 0.05). No gender differences were observed in 6MWT, 5-STST, HR, RPE, and VASF. This preliminary study showed that fatiguing task negatively affected postural control, mobility and fall risk only in men. These gender differences were inconclusive but could be taken into account in postural balance rehabilitation programs for MS persons. [ABSTRACT FROM AUTHOR]

While physical therapy may help improve function and quality of life in patients with neurofibromatosis (NF), a standard of care remains to be established. This case report describes the physical therapy management of an individual with NF who was at high fall risk. A 61-year-old male with NF and multiple comorbidities was determined to be at high fall risk by the Dynamic Gait Index, Berg Balance Scale, and Modified Falls Efficacy Scale. Deficits included coordination and strength which limited his ability to ascend and descend stairs or walk on uneven terrain. This reduced his independence at home and in his rural community. Interventions incorporated components of hip and trunk coordination, and addressed balance, strength, and functional mobility. The patient scored above the cutoff for high fall risk on all outcome assessments. This case report describes physical therapy management to reduce fall risk for an individual with NF. Due to the limited research on NF, the treatment plan was developed using evidence-based practice for fall-risk reduction in other neurological disorders. [ABSTRACT FROM AUTHOR]

Slowed gait is one of the strongest predictors of fall risk in older adults. The present study investigated whether gait speed mediated the relationship between depression and fall history in 147 older adults presenting to a memory clinic for cognitive complaints. Depression, cognitive status, gait speed, and number of falls within the last year were the primary measures. Results revealed fallers, relative to non-fallers, had slower gait speed and higher depression scores. As hypothesized, analyses using the PROCESS macro found that gait mediated the relationship between depression and fall history. Additionally, the combination of depression and mild cognitive impairments (MCI) associated with a significantly greater likelihood of falling. Our findings indicate that combined depression and MCI have additive effects on fall risk, likely through the destabilizing effect of slowed gait on balance. Better understanding the underlying pathophysiology involved in MCI and depression-related gait disturbances may lead to improved intervention targets for fall risk prevention. [ABSTRACT FROM AUTHOR]

This study aims to examine group differences in performance and self-report measures distinguishing non-, single, and recurrent fallers. Fifty-seven community-dwelling older adults completed cognitive and functional assessments and reported number of falls over 12 months. A one-way analysis of variance (ANOVA) examined differences between non-, single, and recurrent fallers. Significant group differences were found on fast and comfortable gait speed (p <.01 and p <.01, respectively), Falls Efficacy Scale-International (FES-I) (p =.04), 30-Second Chair Stand (30-SCS) (p <.01), and Mini Mental State Examination (MMSE) (p <.01). An analysis of covariance (ANCOVA) was used to control for MMSE after which the previous outcome measures no longer displayed significance. Group differences exist between fallers; further, single fallers may experience a fall differently than other fallers. This sample consisted of healthy older adults yet cognition still played a role, demonstrating that the link between cognition and fall risk is yet to be fully understood. [ABSTRACT FROM AUTHOR]

Falls and related injuries are known to be the major health problem leading to disability and mortality among older adults. Identification and management of fall risks aimed to prevent falling is considered to be essential. The aim of this study was to develop a mobile application for screening and management of fall risks based for older adults. First, we determined product features based on literature reviews. Then we asked 10 experts to assess the importance of capabilities. The application was designed in Android environment based on the STEADI toolkit. Finally, the usability and satisfaction of the application were assessed among 30 older adults by means of a usability questionnaire, and the final version was modified. The experts rated the majority of feasibility features to be important. The application consisted of falls risk self-assessment, and the Timed Up and Go (TUG) test to measure individual fall risks, fall prevention education, and suggestions for training based on the individuals' level of fall risk among older adults. The results of the usability assessment showed that the users were satisfied with the application, 8.83 out of 10. The mobile application can be used to screen and manage fall risks in older adults. It may help health providers to identify older adults at low, moderate, and high risks of falls provide education and training to minimise falls and fall-related injuries. Falls are a major health problem in older people. A great proportion of falls and falls related injuries are preventable. Given the availability and accessibility of various mobile health application and the increasing mobile device usage among older adults, mobile application can be used as a platform for delivering fall prevention programmes such as education and exercise training. The mobile application may be a valuable tool in the fall prevention and their consequences either in old adult. [ABSTRACT FROM AUTHOR]

To compare the immediate effects of voluntary-induced stepping response training (VSR) and DynSTABLE perturbation training (DST) on protective stepping in patients with stroke. A randomized controlled trial (registration number: TCTR20170827001) was conducted in 34 patients with chronic stroke who were randomly allocated to the VSR (n = 17) or DST (n = 17) group. The VSR group was instructed to lean forward to induce protective stepping, while the DST group experienced support surface translation. All participants received one session of training (3 set, 10 min for each set with 10-minute rest in between). Step length, step width, number of steps and center of mass (CoM) position during protective stepping were assessed using a computer-assisted rehabilitation environment (CAREN) system prior to and immediately after training. Two-way ANOVA was used to compare between groups and times. Both types of training resulted in an increase in step width, but step length increased and there was a more positive COM position exhibited following DST (p <.05) than following VSR. Single-step incidence increased, whereas multiple-step incidence decreased significantly in both groups. Only participants in the VSR group generated protective stepping with the affected leg in a larger percentage of trials (27%) after training than before training. Both DST and VSR led to changes in protective stepping parameters after a single session of training. VSR may be a feasible alternative to equipment-based training but requires further study. VSR and DST trainings improved protective stepping in stroke. Step length and CoM control at foot touchdown increased after DST training. VSR training for 50 minutes led to increase affected stepping and reduce grasping. Step width, affected step length, and single step increased after both trainings. Without instrument, VSR increased steps execution and performance similar to DST. [ABSTRACT FROM AUTHOR]

Mastery learning is a form of competency-based education in which learning time varies but outcomes are uniform. Trainees must meet a minimum passing standard (MPS) before completing a mastery learning curriculum. The objective of this study was to establish a curriculum for fall risk and gait assessment for medical students, determine an MPS for a fall risk and gait assessment clinical skills examination (CSE), and apply the MPS to a sample of medical students completing a fall risk and gait assessment CSE. Medical students completed an interactive session about fall risk and gait assessment including the Timed Up and Go (TUG) test and completed deliberate practice with 3 patients. Skills were evaluated using an 18-item skills checklist. A panel of clinical experts set the MPS at 82%. Eighty-seven medical students participated. The average score on the checklist was 14.7 of 18 (81.4%.) Although almost all performed the TUG correctly, only 61% met the MPS for the checklist. Our results suggest that a mastery learning approach may better prepare the 39% of students that did not meet MPS to complete a fall risk and gait assessment. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the effect of two types of physical activity, dance, and general exercises, on balance in older women. Study participants comprised two groups of women. The participants attended 45-min DMT (n = 20) or GRE sessions (n = 19) three times per week for 12 weeks. Before and after the training, the participants underwent the Postural Stability Test, the Limits of Stability Test, and the Fall Risk Test. Improvement of the balance was confirmed for only one test both for the dance group and the general exercises group. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine a cutoff value of the calf-raise senior test and dual-calf-raise senior test according to fall history. 150 elderly individuals participated in descriptive study. Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Functional Reach Test (FRT), Calf-Raise Senior Test (CRST) and Calf-Raise Senior Test with additional cognitive task (dual- CRST) were applied. It was found to be high correlation between CRST and the BBS ,medium with TUG, and high with FRT. It was found to be high correlation dual-CRST and the BBS,medium with the TUG and high with FRT. According to the fall history, the cutoff value for the CRST was found 18.3 repetitions and 11.5 repetitions for the dual-CRST. The present study has contributed significantly to the literature in terms of determining the cutoff value for fall risk in the CRST and dual-CRS. [ABSTRACT FROM AUTHOR]

Accurate prediction of fall likelihood is advantageous for instituting fall prevention program in rehabilitation facilities. This study was designed to determine the clinical measures, which can predict the risk of fall events in a rehabilitation hospital. Medical records of 166 patients (114 males and 52 females) who were hospitalized in an adult inpatient unit of a rehabilitation hospital were retrospectively analyzed for this study. As predictor variables for assessing fall risk, demographic data and the following measurements were selectively collected from patient's medical records: Tinetti Performance-Oriented Mobility Assessment-Ambulation (POMA-G), Timed Up and Go test (TUG), 10 m walk test, 2 min walk test, Korean version Mini-Mental State Examination (K-MMSE), Korean version of the Modified Barthel Index (KMBI), Berg Balance Scale (BBS), Global Deterioration Scale (GDS), and Morse Fall Scale (Morse FS). The Morse FS, TUG, and age were found to be risk factors for the classification of faller and non-faller groups. This study suggests Morse FS, TUG, and age in the routine initial assessment upon admission in a rehabilitation setting, as key variables for screening the risk of fall. Additionally, the cutoff scores of Morse FS and TUG were observed to be more rigid than other clinical settings. [ABSTRACT FROM AUTHOR]

This study sought to compare the biomechanical parameters of the lower extremities during a countermovement jump in elderly people who are engaged in frequent practice of tai chi chuan (TCG) and in the general population of healthy elderly people (HG). Each group included 12 participants. Ten Vicon Motion System infrared cameras and two Kistler force plates were employed for measurement. The jump height, duration, centre of mass (COM) displacement, joint ROM, and upward velocity were analysed in this study. Motion analysis and force platform data were combined to calculate joint moments and powers during the takeoff phase. The data were analysed using independent sample t-tests. The results showed that the tai chi chuan practitioner group (0.13 m) achieved 44% higher jump heights (p < 0.05). The COM displacement during squatting was lower in the TCG (0.25 m) than in the HG (0.19 m) (p < 0.05). The knee and ankle ROMs of the TCG were higher than those of the HG (p < 0.05). Peak knee moment 23% and peak knee power 32% higher in TCG compared to the HG (p < 0.05), suggesting that frequent practice of tai chi chuan may slow the rate of knee degeneration. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess feasibility and changes in outcome measures following the Merging Yoga and Occupational Therapy for Parkinson's Disease (MY-OT for PD) program: a 14-session program which combined community-based yoga for PD, and fall-risk focused group occupational therapy sessions. Seventeen participants completed an 8-week control period consisting of their normal participation, and an 8-week intervention period (14 MY-OT for PD sessions). There were fewer self-reported falls in the intervention (6) vs. control periods (10). One fall risk factor management scale (the Fall Prevention and Management Questionnaire, p=.02), and balance (p<.01) showed significant improvement between the control and intervention. The MY-OT for PD program is an encouraging occupational therapist-led program, which may improve balance and reduce self-reported falls. [ABSTRACT FROM AUTHOR]

The high number of patient falls occurring within acute care hospitals throughout the United States has led to increased patient impairment and contributed to rising healthcare costs. The Morse Fall Risk Scale is a commonly used assessment tool for prediction of a patient's potential for experiencing a fall while in a healthcare facility. This retrospective study reviewed the use of the Morse Fall Risk Scale in a 300+ bed acute care hospital setting to determine adequacy for patient fall predictions over a four-month period. Use of multivariate regressions and Chi-Square test statistics revealed the Morse Fall Risk Scale was a predictor of patients' fall risk in this setting with other significant predictors of fall risk potential including male gender and diagnosis (neurologic, cardiac, general medical/surgical conditions). Patients experiencing a fall had a statistically significant longer hospital stay. Occupational therapy practitioners play an important role on the interdisciplinary team by providing a comprehensive fall assessment, developing fall prevention programs, and providing discharge recommendations. [ABSTRACT FROM AUTHOR]

Background: In self-ankle mobilization with movement (S-MWM) therapy, a strap can be utilized to stabilize the posterior glide of the talus during ankle dorsiflexion movements. Objectives: Our objective was to compare the effects of 4-week self-mobilization with movement (S-MWM) with those of calf muscle stretching (CMS) on ankle dorsiflexion passive range of motion (DF-PROM), gait parameters, and fall risk in patients with chronic stroke with limited ankle dorsiflexion. Methods: Participants were randomized into the S-MWM (n = 19) and CMS groups (n = 19). Both groups received conventional physiotherapy for 30 minutes per session. In addition, S-MWM and CMS techniques were performed 3 times per week for 4 weeks and were performed by the participants themselves. Ankle DF-PROM, gait parameters, and fall risk were measured after 4 weeks of training. Results: After 4 weeks of training, both groups showed significant improvement in all outcome measures (p <.05). Furthermore, ankle DF-PROM, gait parameters (gait speed, cadence, and stride lengths on both sides), and fall risk showed greater improvement in the S-MWM group than in the CMS group (p <.05). Conclusions: This study shows that S-MWM training combined with conventional physiotherapy improved ankle DF-PROM, gait parameters, and fall risk in patients with chronic stroke. [ABSTRACT FROM AUTHOR]

Background and Purpose: Persons with stroke have increased risk for recurrent stroke. Group exercise programs like cardiac rehabilitation might reduce this risk. These programs commonly use the six-minute walk test to measure aerobic capacity. However, failure to assess fall risk may compromise safety for persons with stroke. The study aim was to determine the association between the six-minute walk test and fall risk in persons with stroke. Methods: Cross-sectional analysis measured the association between the six-minute walk test and fall risk in 66 persons with stroke with a mean age of 66 years (SD 12) and median stroke chronicity of 60.9 months (range 6.0–272.1). The six-minute walk test was evaluated using logistic regression. The best fit model was used in Receiver Operating Characteristic analysis. Likelihood ratios and post-test probabilities were calculated. Results: Lower six-minute walk test distance was associated with increased fall risk in logistic regression (p =.002). The area under the curve for the univariate six-minute walk test model (best fit) was 0.701 (p =.006). The cutoff for increased fall risk was six-minute walk test <331.65 m. The post-test probability of fall risk increased to 74.3% from a pre-test probability of 59.1%. Discussion: The moderate association between fall risk and six-minute walk test suggests that in addition to assessing capacity, the six-minute walk test provides insight into fall risk/balance confidence. Conclusion: Using the six-minute walk test cutoff to screen fall risk in community exercise programs may enhance safety for persons with stroke without additional testing required. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to observe the effects of eccentric endurance training (ET) on physical function in community-dwelling older adults. Methods: Participants were randomly assigned to control (n = 15; 67.5 ± 2.6 yrs) and ET (n = 15; 69.0 ± 4.4 yrs) groups. The ET group completed 1 week of familiarization and 8 weeks of training on an eccentric step machine. Participants completed two, 5–15 minute sessions per week, with RPE-based intensity. Pre-, mid-, and post-training assessments were conducted for the 30-second sit-to-stand (30CST), Berg Balance Scale (BBS), single leg stance with eyes closed (SLS-EC), Functional Gait Assessment (FGA), Timed Up-and-Go (TUG), and maximal eccentric strength (MES). Results: Significant improvements in 30CST, BBS, FGA, and TUG performance were observed for the ET group only (p <.05). Conclusions: This study provides evidence that 8-weeks of progressive ET improves muscular fitness, gait characteristics, and overall physical function. [ABSTRACT FROM AUTHOR]

Purpose: To adapt the Merging Yoga and Occupational Therapy program and develop the Merging Yoga and Occupational Therapy for Parkinson's disease (MY-OT for PD) program, designed to target fall risk management. Creating a new program involved the targeted development of Stage 1 manuals. Methods: Researchers employed a pragmatic qualitative design to focus on meeting the purpose of the study. Stage 1 manuals were created following a literature review, a focus group of participants with PD, and individual interviews with experts in practice or research. Visual familiarization with data, generation of conclusions, and results verification were used to translate participant feedback into manual revisions. Results: Themes included revisions to model, content, and delivery. Revisions were incorporated into Stage 1 manuals to create a PD-specific program to improve fall risk management. Conclusion: A structured process is necessary to create Stage 1 manuals in a novel population prior to feasibility and pilot testing. [ABSTRACT FROM AUTHOR]

The aim of this study was to characterize daily fluctuations in postural control, gait and plantar cutaneous sensitivity in institutionalized older adults. Twenty-five older adults (>85 years old) living in a nursing home were recruited. Postural, gait and plantar cutaneous sensitivity parameters were collected at the following times: 8:00, 11:00, 14:00 and 17:00. Statistics were first calculated with the data from the whole group of the participants. A hierarchical cluster analysis was performed as a second step in order to determine if there was more than one pattern in the daily fluctuations of gait, postural control and plantar cutaneous sensitivity. When considering data from the whole group, results showed that postural control deteriorated from morning to the early afternoon and that gait improved from early to late morning. Daily fluctuations of plantar cutaneous sensitivity showed a decrease in tactile acuity in the afternoon. For most gait, postural control and plantar cutaneous sensitivity parameters, the hierarchical cluster analysis showed that there were three subgroups within the whole group of participants who had similar fluctuation patterns. Participants with the best tactile acuity, postural control and gait displayed relatively constant patterns without a period of increased risk of falling. By contrast, participants who presented a poor tactile acuity with a less efficient postural control and gait had greater daily fluctuations of plantar cutaneous sensitivity, with a marked decline of postural control and gait in the afternoon. In spite of a strong relationship between plantar cutaneous sensitivity and gait/postural control, the decline in postural control and gait observed in the afternoon could not be related to plantar sensation. It might rather relate to a cognitive function which is known to peak early in human circadian rhythms and to have a greater contribution in postural control regulation in the elderly than in young healthy subjects. [ABSTRACT FROM AUTHOR]

Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention. [ABSTRACT FROM AUTHOR]

Aim: To determine if an instrumented Timed Up and Go (iTUG) can accurately classify older adult recurrent fallers and non-fallers who are age and sex-matched. Methods: iTUG data from older adult recurrent fallers (n = 25) and age and sex-matched non-fallers (n = 25) were selected for comparison from a pool of participants (n = 148) that were involved in a larger age and mobility related study. Results: All of the iTUG measures demonstrated a low level of accuracy in classifying recurrent fallers from non-fallers (AUC = 0.49-0.56) and there were no significant differences in any of the iTUG performance measures between groups. Conclusion: The iTUG was unable to appropriately classify or differentiate older adult recurrent fallers from non-fallers who were both age and sex-matched. The role and usefulness of body-worn sensors for assessing mobility and fall risk require further investigation. [ABSTRACT FROM AUTHOR]

Walking is one of the preferred exercises among elderly, but could a prolonged walking increase gait variability, a risk factor for a fall in the elderly? Here we determine whether 30 min of treadmill walking increases coefficient of variation of gait in elderly. Because gait responses to exercise depend on fitness level, we included 15 sedentary and 15 active elderly. Sedentary participants preferred a lower gait speed and made smaller steps than the actives. Step length coefficient of variation decreased ~16.9% by the end of the exercise in both the groups. Stride length coefficient of variation decreased ~9% after 10 minutes of walking, and sedentary elderly showed a slightly larger step width coefficient of variation (~2%) at 10 min than active elderly. Active elderly showed higher walk ratio (step length/cadence) than sedentary in all times of walking, but the times did not differ in both the groups. In conclusion, treadmill gait kinematics differ between sedentary and active elderly, but changes over time are similar in sedentary and active elderly. As a practical implication, 30 min of walking might be a good strategy of exercise for elderly, independently of the fitness level, because it did not increase variability in step and stride kinematics, which is considered a risk of fall in this population. [ABSTRACT FROM AUTHOR]

Objective: Falls represent a major concern for older adults and may serve as clinically salient index events for those presenting in the prodromal stages of mild cognitive impairment. Declines in executive function performance and in gait consistency have shown promise in predicting fall risk; however, associated neurophysiological underpinnings have received less attention. In this study, we used a multimodal approach to assess fall risk in a group of older adults with and without a previous fall history. Method: Processing speed, inductive reasoning, verbal fluency, crystallized ability, episodic memory, and executive functioning were assessed using standardized neuropsychological tests. Cognitive interference was assessed using the Multi-Source Interference Task. Spatiotemporal gait parameters were assessed with and without cognitive load using a 6.4-m instrumented walkway. Hemodynamic responses were measured using functional near-infrared spectroscopy. Results: Whereas no group differences were observed in cognitive behavioral performance, during a cognitive interference task fallers displayed more oxygenated hemoglobin across the prefrontal cortex than nonfallers, suggesting that engaging in the cognitive task was more effortful for them overall, therefore eliciting greater cortical activation. Between-group differences in spatial as well as temporal gait parameters were also observed. Conclusions: These results are in keeping with assertions that diminished executive control is related to fall risk. Notably, the group differences observed in prefrontal cortical activation and in gait parameters may ultimately precede those observed in cognitive behavioral performance, with implications for measurement sensitivity and early identification. [ABSTRACT FROM PUBLISHER]

Objective:The aim of the study was to explore how home-dwelling elderly who use fall-risk-increasing drugs (FRIDs) perceive their fall risk and how they relate this to their drug use. Design, setting and subjects:A qualitative study with 14 home-dwelling elderly FRID users between 65 and 97 years in Central Norway participating in semi-structured individual interviews. The data were analyzed thematically by using systematic text condensation. Results:The main finding was that the informants did not necessarily perceive the use of FRIDs to be a prominent risk factor for falls. Some informants said they did not reflect upon drug use whatsoever and said they fully trusted their physician’s choices. When either experiencing dizziness, fall episodes or by reading the patient information leaflet the informants said to either adjust their drug use or to contact their physician. Some felt rejected due to not getting their point across or their wish to alter the drug was not granted by the physician. Conclusions:Elderly FRID users did not necessarily relate their drug use to fall risk or struggled to present their perceived drug-related problems. Physicians need to regularly inform, monitor and assess the drug treatment when treating elderly with FRIDs. [ABSTRACT FROM PUBLISHER]

Objective: To compare fall statistics (e.g. incidence, prevalence), fall risks, and characteristics of patients who seek hearing healthcare from an audiologist to individuals who have not sought such services.Design: Case-control study.Study sample: Two groups of community-dwelling older adult patients: 25 audiology patients aged 60 years or older (Mage: 69.2 years,SD: 4.5, range: 61–77) and a control group (gender- and age-matched ±2 years) of 25 non-audiology patients (Mage: 69.6,SD: 4.7, range: 60–77).Results: Annual incidence of falls (most recent 12 months) was higher in audiology patients (68.0%) than non-audiology patients (28.0%;p = .005). Audiology patients reported a higher incidence of multiple recent falls (p =.025) and more chronic health conditions (p = .028) than non-audiology patients.Conclusions: Significantly more audiology patients fall on an annual basis than non-audiology patients, suggesting that falls are a pervasive issue in general hearing clinics. Further action on the part of healthcare professionals providing audiologic services may be necessary to identify individuals at risk for falling. [ABSTRACT FROM PUBLISHER]

We evaluated the hypothesis that greater lean mass promotes better overnight hydration, improved postural blood pressure and greater strength. Thirty women, aged 71 ± 0.9 years (mean ± SE), completed one measurement in a euhydrated state and another the following morning after an overnight fast. Measurements included hydration, lean mass, orthostatic blood pressure and strength. Participants were grouped by fat-free mass index (FFMI), with cut-points defined as low (< 15.0 kg/m2) and normal (≥ 15.0 kg/m2). Women with normal FFMI had significantly greater hydration (p < 0.01), lean mass (p < 0.001) and upper body strength (p < 0.05), while those with low FFMI had more unstable blood pressure. On day 1, women with low FFMI experienced significant postural systolic blood pressure changes from sitting to standing (–11.3 ± 4.0 mmHg,p < 0.05). On day 2, they experienced significant systolic changes from lying to sitting (–8.0 ± 2.2 mmHg,p < 0.01) and sitting to standing (–14.9 ± 5.5 mmHg,p < 0.05), and diastolic changes from lying to sitting (–8.9 ± 2.8 mmHg,p < 0.05). In conclusion, overnight fluid shifts in older women with low lean mass result in unstable postural blood pressure and loss of strength that increases the risk for early morning falls. [ABSTRACT FROM AUTHOR]

Purpose:To evaluate effectiveness of fall-risk-assessment-based fall prevention for stroke rehabilitation inpatients. Method:A consecutive series of 232 patients admitted for the first time to a subacute stroke-rehabilitation ward during 2010–2011 was studied in detail. The Assessment Sheet for Fall Prediction in Stroke Inpatients (ASFPSI by Nakagawa et al.) was used to assess fall-risk upon admission. Association of ASFPSI score and patient characteristics with actual falls was statistically tested. Yearly incidence of falls per 1000 hospital days (HD) was retrospectively audited for the 2006–2014 period to evaluate effectiveness of fall-risk reduction measures. Results:The observed incidence of falls over the detailed-study-period was 3.0/1000 HD; 39% of the fallers fell during the first week after admission. ASFPSI score was not significantly associated with falls. Longer hospital stay, left body-side affected and non-extreme FIM score (55–101) were associated with higher odds of fall. Introduction of fall-risk reduction measures followed by compulsory fall-risk assessment lead to incidence of falls dropping from 7.1/1000 HD in 2006 to 2.8/1000 HD in 2011 and remaining at that level until 2014. Conclusions:The fall-risk-assessment-based measures appear to have led to decreasing falls risk among post-stroke rehabilitation inpatients classified as being at high risk of falls. The fall prevention programme as a whole was successful. Patients with non-extreme level of functional independence should receive enhanced fall prevention.Implications for RehabilitationRecognising the fall risk upon the patient's admission is essential for preventing falls in rehabilitation wards.Assessing the fall risk is a team tasks and combines information from various sources.Assessing fall risk in stroke patients using the assessment sheet by Nakagawa et al. immediately upon admission systematically draws attention to the risk of falls in each individual patient. [ABSTRACT FROM AUTHOR]

Alzheimer’s patients suffer from circadian dysregulation. The aim of this study was to examine the evolution of balance control and gait at different times of the day (11:00, 14:00, 18:00) in order to identify whether Alzheimer’s patients were more likely to fall at certain periods of the day. Spatio-temporal parameters of centre of foot pressure displacements were measured with a force platform and spatio-temporal parameters of walking were evaluated with a gait analysis device. The results highlighted that balance control was worse in the evening and the afternoon than in the morning. Furthermore, the walking speed was faster and support duration, swing duration and cycle duration were shorter in the evening than in the morning and afternoon. The combined analysis of balance control and gait parameters revealed that balance control and walking are concomitantly altered in the evening which increases the fall risk in the evening, in comparison with the morning, for Alzheimer’s patients. [ABSTRACT FROM AUTHOR]

Aims: To determine if a two-visit, personalized falls prevention educational intervention affected awareness of fall risk in community-dwelling older adults in Belize. Secondary aim: to assess new learning in a cross-cultural context and willingness to make lifestyle changes to reduce fall risk. Methods: A US-based team completed fall risk assessments (Short FES-I, mCTSIB, TUG, and 30-s Chair Stand Test), pre- and postintervention questionnaires, and an original postintervention semi-structured interview with eighteen participants. Investigators employed the Fall Risk Awareness Questionnaire (FRAQ) to assess awareness of fall risk. Intervention consisted of an educational class regarding fall risks that took place in a day centre, and a home visit. Questionnaire results were analyzed for statistical significance. Investigators completed thematic analysis of interviews. Results: Mean scores of the FRAQ rose slightly at posttest, but results were not statistically significant. Qualitative analyses revealed themes regarding specific fall risk awareness, barriers to change, and willingness to change. Conclusions: Participants in this sample demonstrated an increase in falls risk awareness after a brief falls prevention program. The sample size and prepost design limited generalizability of the results. Therapists should be aware of cultural competence, health literacy, and personal narrative of participants. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of high heeled shoes (HHS) wearing experience and heel height on human standing balance and functional mobility. Thirty young and healthy females (ten experienced and twenty inexperienced HHS wearers) participated in a series of balance tests when they wore shoes of four different heel heights: 1 cm (flat), 4 cm (low), 7 cm (medium) and 10 cm (high). Experimental results show that regardless of the wearing experience, the heel elevation induces more effort from lower limb muscles (particularly calf muscles) and results in worse functional mobility starting at 7 cm heel height. While the heel height increased to 10 cm, the standing balance also becomes worse. Experienced HHS wearers do not show significantly better overall performance on standing balance and functional mobility than inexperienced controls, even though they have better directional control (76.8% vs. 74.4%) and larger maximum excursion (93.3% vs. 89.7%). To maintain standing balance, experienced wearers exert less effort on tibialis anterior, vastus lateralis and erector spinae muscles at the cost of more intensive effort from gastrocnemius medialis muscle. Practitioner summary: Many women wear high heeled shoes (HHS) to increase female attractiveness. This study shows that HHS induce more muscular effort and worse human standing balance and functional mobility, especially when heel height reaches 10 cm. HHS wearing experience only provides certain advantages to wearers on limits of stability in terms of larger maximum excursion and better directional control. [ABSTRACT FROM PUBLISHER]

The purpose of this classic grounded theory study was to understand how seniors who are living independently resolve issues influenced by visual impairment and high fall risk. We interviewed and observed 13 seniors with visual impairment in their homes. We also interviewed six visual instructors with experience from many hundreds of relevant incidents from the same group of seniors. We found that the seniors are resolving their main concern of "remaining themselves as who they used to be" by self-preservation. Within this category, the strategies maintaining the established self and defying deterioration emerged as the most prominent in our data. The theme maintaining the established self is mostly guided by change inertia and includes living the past (retaining past activities, reminiscing, and keeping the home intact) and facading (hiding impairment, leading to avoidance of becoming a burden and to risk juggling). Defying deterioration is a proactive scheme and involves moving (by exercising, adapting activities, using walking aids, driving), adapting (by finding new ways), and networking by sustaining old support networks or finding new networks. Self-preservation is generic human behavior and modifying this theory to other fields may therefore be worthwhile. In addition, health care providers may have use for the theory in fall preventive planning. [ABSTRACT FROM AUTHOR]

Objectives:This study aims to examine the relationship between middle-aged and older adults’ depressive symptomology and anti-depressant use and the frequency of falls within the previous 12 months, controlling for sociodemographic variables, health indicators, and health behaviors. Method:From the 2010 National Social Life, Health, and Aging Project, 2338 cases were examined. Falls were categorized into a binary variable, comparing zero falls with one or more falls. An unadjusted model was run to examine the relationship between independent and dependent variables. Potential covariates were added into the model, and backward elimination was used among independent variables with a univariateP< 0.05 to identify the covariates with the strongest association with falls. This final adjusted binary logistic regression model was then used to examine the relationship between falls and the independent variables. Results:In the adjusted model, anti-depressant use was positively associated with falls (P= 0.001), as was being female (P< 0.001), having diabetes (P= 0.018), and having increased limitations in daily activities (P< 0.001). The relationship between depressive symptomology and anti-depressant prescription was also significantly associated with falls (P= 0.006). Conclusion:While findings confirm that a relationship between depressive symptomology and anti-depressant use are associated with falls among middle-aged and older adults, additional studies are needed that simultaneously examine the influence of these two risk factors. [ABSTRACT FROM PUBLISHER]

Farmworkers endure many job-related hazards, including fall-related work injuries. Gait analysis may be useful in identifying potential fallers. The goal of this pilot study was to explore differences in gait between farmworkers and non-farmworkers. The sample included 16 farmworkers and 24 non-farmworkers. Gait variables were collected using the portable GAITRite system, a 16-foot computerized walkway. Generalized linear regression models were used to examine group differences. All models were adjusted for two established confounders, age and body mass index. There were no significant differences in stride length, step length, double support time, and base of support; but farmworkers had greater irregularity of stride length (P =.01) and step length (P =.08). Farmworkers performed significantly worse on gait velocity (P =.003) and cadence (P <.001) relative to non-farmworkers. We found differences in gait function between farmworkers and non-farmworkers. These findings suggest that measuring gait with a portable walkway system is feasible and informative in farmworkers and may possibly be of use in assessing fall risk. [ABSTRACT FROM AUTHOR]

A recent systematic review supported the use of strength and balance training for older adults at risk for falls, and provided preliminary evidence for those with peripheral neuropathy (PN). However, the role of gaming systems in fall risk reduction was not explored. The purpose of this case report was to describe the use of the Nintendo® Wii™ Fit gaming system to train standing balance in a community-dwelling older adult with PN and a history of recurrent near falls. A 76-year-old patient with bilateral PN participated in 1 h of Nintendo® Wii™ Fit balance training, two times a week for 6 weeks. Examination was conducted using a Computerized Dynamic Posturography system (i.e. Sensory Organization Test (SOT), Limits of Stability (LOS), Adaptation Test (ADT) and Motor Control Test (MCT) and clinical testing with the Berg Balance Scale (BBS), Timed Up and Go (TUG), Activities-specific Balance Confidence (ABC) scale and 30-s Chair Stand. Following training, sensory integration scores on the SOT were unchanged. Maximum excursion abilities improved by a range of 37-86% on the LOS test. MCT scores improved for amplitude with forward translations and ADT scores improved for downward platform rotations. Clinical scores improved on the BBS (28/56-34/56), ABC (57.5-70.6%) and TUG (14.9-10.9 s) which indicated reduced fall risk. Balance training with a gaming system showed promise as a feasible, objective and enjoyable method to improve physical performance and reduce fall risk in an individual with PN. [ABSTRACT FROM AUTHOR]

Objective: Aim of this study was to make a fall prognosis in a cohort of older people with dementia in short-term (2 month), mid-term (4 month) and long-term (8 month) intervals using accelerometry during the subjects' everyday life. Methods: The study was designed as a longitudinal cohort study. The subjects were recruited from a nursing home and geriatric assessment tests were conducted at baseline. Each subject underwent four visits and was measured at each visit for one week. Gait episodes were detected and gait parameters were extracted from these episodes. These gait parameters were combined with the falls occurred during the study. A decision tree induction method was used to analyze the data. Results: Forty subjects participated in the study, whereby 12 drop-outs were registered. The geriatric assessment tests were unable to distinguish between the groups (AUC < 0.6). The evaluation of the models induced with the decision tree classification showed a rate of correctly classified gait episodes of 88.4% for short-term, 74.8% for mid-term, and 88.5 % for long-term monitoring. Discussion and conclusions: We concluded that it is possible to classify gait episodes of fallers and non-fallers in people with dementia during everyday life using accelerometry. [ABSTRACT FROM AUTHOR]

Background and Objective: The Dynamic Gait Index (DGI) is a valid and reliable measure of gait, balance, and fall risk. The purpose of this study was to translate the DGI into Arabic and evaluate the reliability and validity of the Arabic version of the DGI (A-DGI) in patients with stroke. Methods: The DGI was translated into Arabic according to the World Health Organization forward/backward translation protocol for translating assessment tools. It was then administered to a convenience sample of patients with stroke. The inter-and intrarater reliability as well as convergent and discriminant validity of the A-DGI were examined. Results: Fifty-one patients with stroke (mean [SD] age, 64 [12] years; 33 male) were enrolled in the study. The A-DGI score reflected high agreement for both interrater (intraclass correlation coefficient [ICC]3,1 = .98; 95% confidence interval [CI], .97-.99) and intrarater (ICC1,1 = .97; 95% CI, .95-.98) reliability and correlated moderately but significantly with the Glasgow Coma Scale (rho = .39, P = .01), Beck Depression Inventory (rho = -.50, P < .01), and Stroke Impact Scale-16 version 3.0 domains. The A-DGI discriminated between subjects who were at risk of fall and those who were not (U = .00, P < .01), younger and older adults (U = 195, P = .03), side of hemiplegia (U = 218, P = .04), and mild and moderate (U = 105.5, P = .02) as well as mild and severe stroke severity (U = 30, P < .01). Conclusions: The A-DGI reflected high reliability and validity in the stroke population. The availability of a reliable and valid A-DGI facilitates its use among therapists from Arabic origins, which will enrich the rehabilitation process in their clinical practice. [ABSTRACT FROM AUTHOR]

Gait characteristics serve as indicators of fall risk. Exercise interventions have been shown to improve gait. However, the use of interactive video games with biofeedback to reduce fall risk has not been well explored. Eighty-two older adults were randomly assigned to either a traditional fitness or Wii group. Both 10-week interventions involved 45-minute exercise sessions (3 days per week). Pre- and post-testing gait measurements were taken. Both groups significantly improved velocity, stride length, cadence, swing time, and decreased double support time (p< .05). Interactive video games offer a promising alternative to traditional group exercise for older adults. [ABSTRACT FROM AUTHOR]

The risk of accidental falls and fall-related injuries increases with age. Regular physical exercises can delay the age-related changes affecting postural balance and reduce the risk of falls. Although Tai Chi (TC) has become a popular exercise among the elderly, does regular TC exercise lead to fewer falls and fall-related injuries? Who would receive the most benefit from TC exercise? What style of TC is best for fall risk reductions? What is the minimum amount of TC exercise needed before its positive effect is observed? How does the effect of TC exercise compare to other physical exercises? The goal of this study is to conduct a systematic review of recent literature on TC's effectiveness for reducing fall risks in elders. A summary and analysis is provided for the following variables: targeted subject population, TC curriculum, comparative effect, and outcome measures. [ABSTRACT FROM PUBLISHER]

Objective: The aim of this systematic review was to assess the ability of the Activities-specific Balance Confidence (ABC) scale to predict the fall risk in older community-living adults. Methods: A systematic literature review was conducted from February 1, 2010, to October 8, 2010, through Pubmed, CINAHL and MEDLINE. Appraisal of full-text English articles, which were published from January 1996 to October 2010, provided the framework for this analysis. Results: On the basis of our inclusion/exclusion criteria, three studies qualified for inclusion in this review. Two of the three selected studies indicated a significant association between ABC scores and falls. The third study concluded that the ABC scale was unable to distinguish fallers from nonfallers. Conclusion: Despite the abundance of studies, which include the ABC scale, there is insufficient research that specifically examines the relationship between balance confidence scores with actual falls in community-dwelling older adults. In this population of adults, who live in the community and are aged at least 60 years, there is limited support for the hypothesis that the ABC scale can predict the fall risk. [ABSTRACT FROM AUTHOR]