Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology.
Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology.
复制标题
作者：
Mohler MJ;Wendel CS;Taylor-Piliae RE;Toosizadeh N;Najafi B
很少有关于预期跌倒与基于传感器的运动表现和体力活动测量之间的关联的研究单独评估脆弱状态的亚组。评估基于可穿戴传感器的步态、平衡和体力活动(PA)测量，这些测量可以预测社区老年人未来跌倒的情况。亚利桑那州图森市的亚利桑那州脆弱队列研究跟踪调查了65岁及以上社区居住的成年人(没有基线认知缺陷、严重运动障碍或最近中风)六个月的跌倒情况。基线测量包括Fred脆弱标准；使用经过验证的可穿戴技术测量的在家和基于传感器的步态(正常和快速行走)、平衡(两足动物睁开眼睛和闭上眼睛)，以及48小时内自发的每日PA。在119名参与者(36%非虚弱，48%虚弱，16%虚弱)中，48人报告了一次或多次跌倒(47%非虚弱，33%虚弱，47%虚弱)。虽然平衡缺陷和PA是衰弱前期和衰弱组中独立的跌倒预测因子，但在非衰弱组中，它们对预测未来跌倒并不敏感。尽管步态表现随着虚弱程度的增加而恶化，但当参与者根据虚弱状态进行分层时，步态并不能预测未来的跌倒。在体弱前组中，重心摆动(OR=5.9，95%CI 2.6~13.7)、PA平均步行时间(OR=1.1，95%CI 1.0~1.2)、PA平均站立比赛时间(OR=.94，95%CI.91~.99)、前6个月跌倒(OR=7.3，95%CI 1.5~36.4)是跌倒的独立预测因素(AUC：0.882)。这项研究表明，跌倒的独立预测因素取决于虚弱的状态。在传感器提取的参数中，平衡缺陷、较长的典型行走发作和较短的典型站立发作是在合并的虚弱和虚弱样本中对预期跌倒最敏感的预测因子。在虚弱的状态下，步态缺陷不是一个敏感的跌倒预测指标。
Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity have evaluated subgroups of frailty status separately. To evaluate wearable sensor-based measures of gait, balance, and physical activity (PA) that are predictive of future falls in community-dwelling older adults. The Arizona Frailty Cohort Study in Tucson, Arizona followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over six months. Baseline measures included Fried frailty criteria; in-home, and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 hours, measured using validated wearable technologies. Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway (OR= 5.9, 95% CI 2.6 – 13.7), PA mean walking bout duration (OR = 1.1, 95% CI 1.0 – 1.2), PA mean standing bout duration (OR = .94, 95% CI .91 - .99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5 – 36.4) were independent predictors for prospective falls (AUC: 0.882). This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail sample. Gait deficit was not a sensitive fall predictor in the context of frailty status.
登录
查看更多内容
DOI：
10.1093/gerona/61.3.262
发表时间：
2006-03-01
影响因子：
5.1
作者：
Bandeen-Roche, K;Xue, QL;Fried, LP
通讯作者：
Fried, LP
DOI：
10.1111/j.1532-5415.2005.53455.x
发表时间：
2005-09-01
影响因子：
6.3
作者：
Lamb, SE;Jorstad-Stein, EC;Becker, C
通讯作者：
Becker, C
影响因子：
6.7
作者：
Horan, MA;Clague, JE
通讯作者：
Clague, JE
影响因子：
3.5
作者：
Greene, Barry R.;Doheny, Emer P.;Kenny, Rose A.
通讯作者：
Kenny, Rose A.
DOI：
10.1111/j.1532-5415.1991.tb01616.x
发表时间：
1991-02-01
影响因子：
6.3
作者：
PODSIADLO, D;RICHARDSON, S
通讯作者：
RICHARDSON, S