Natural turn measures predict recurrent falls in community-dwelling older adults: a longitudinal cohort study
Natural turn measures predict recurrent falls in community-dwelling older adults: a longitudinal cohort study
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DOI：
10.1038/s41598-018-22492-6
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发表时间：
2018-03-12
影响因子：
4.6
通讯作者：
Chiari, Lorenzo
中科院分区：
文献类型：
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作者：
Leach, Julia M.;Mellone, Sabato;Chiari, Lorenzo
虽然据报道，转弯是跌倒时的主要活动之一，转弯时的福尔斯跌倒导致的髋部骨折是直线步态时福尔斯跌倒的8倍，但由于在日常生活活动中很少评估转弯，因此导致福尔斯跌倒的转弯数量和质量仍然未知。160名居住在社区的老年人使用智能手机技术进行了为期一周的监测。量化了转弯措施和活动率。连续监测12个月内的跌倒发生率定义了跌倒状态，7/153例前瞻性跌倒者/非跌倒者。基于对718，582次转弯的分析，预期跌倒者的转弯频率较低，转弯时间较长，转弯角度不太一致（分别为p = 0.007，0.025和0.038）。预期的跌倒者也走得更慢，花更少的时间走路和转身，更多的时间从事久坐行为（p = 0.043，0.012和0.015，分别）。经历步态和/或转向控制下降的个体可能会尝试通过限制其暴露并在转向时实施谨慎运动策略来降低其跌倒风险。由于预期跌倒者和非跌倒者之间的总体活动率没有差异，因此步态和转向能力受损可能是该队列中跌倒风险升高的原因。
Although turning has been reported as one of the leading activities performed during a fall, and falls during turning result in 8-times more hip fractures than falls during linear gait, the quantity and quality of turns resulting in falls remain unknown since turns are rarely assessed during activities of daily living. 160 community-dwelling older adults were monitored for one week using smartphone technology. Turn measures and activity rates were quantified. Fall incidence within 12 months from continuous monitoring defined fall status, with 7/153 prospective fallers/non-fallers. Based on the analysis of 718,582 turns, prospective fallers turned less frequently, took longer to turn, and were less consistent in turn angle (p = 0.007, 0.025, and 0.038, respectively). Prospective fallers also walked slower and spent less time walking and turning and more time engaged in sedentary behavior (p = 0.043, 0.012, and 0.015, respectively). Individuals experiencing decline in the control of gait and/or turning may attempt to reduce their risk of falling by limiting their exposure and implementing cautionary movement strategies while turning. Since there was no difference in the overall active rate between prospective fallers and non-fallers, impaired gait and turning ability, specifically, may attribute to elevated fall risk within this cohort.