Reliability and fall experience discrimination of cross step moving on four spots test in the elderly

Objectives: To examine the reliability and fall experience discrimination of the Cross Step Moving on Four Spots Test (CSFT) and the relationship between CSFT and fall-related physical function. Design: The reliability of the CSFT was examined in a test-retest format with the same tester. Fall history, fall risk, fear of falling, activities of daily living (ADL), and various physical parameters were measured for all participants. Setting: A community center and university medical school. Participants: Elderly community-dwelling subjects (N=533; 62 men, 471 women) aged 65 to 94 years living independently. Interventions: Not applicable. Main Outcome Measures: Time to complete all the CSFT steps required, fall risk score, ADL score, and fall-related physical function (isometric muscle strength: toe grip, plantar flexion, knee extension, hip flexion, hand grip; balance: 1-leg standing time with eyes open, functional reach test using an elastic stick; and gait: 10-m maximal walking speed). Results: The trial-to-trial reliability test indicated good reliability of the CSFT in both sexes (intraclass correlation coefficient =.833 in men,.825 in women). However, trial-to-trial errors increased with an increase in the CSFT values in both sexes. Significant correlations were observed between the CSFT values and scores for most fall-related physical function tests in both sexes. However, the correlation coefficient for all significant correlations was <0.5. Two-way analysis of variance (sex × fall experience) revealed that the fall experience is a significant factor affecting CSFT values; values in fallers were significantly lower than those in nonfallers. The odds ratios in logistic regression analysis were significant in both sexes (men, 1.35; women, 1.48). As determined by the Youden index, the optimal cutoff value for identifying fall experience was 7.32 seconds, with an area under the curve of.676. Conclusions: The CSFT can detect fall experience and is useful in the evaluation of different fall-related physical functions including muscle strength, balance, and mobility. © 2013 by the American Congress of Rehabilitation Medicine

The prevalence of falling and status of physical function among elderly individuals with locomotive and visual/hearing disorders

In a super-aged society, the need for prevention of locomotor dysfunction is growing, and evidence for feasible preventive measures is thus required. This study aimed to examine the relationship between these disorders and the prevalence rates for falling and physical function status. Participants included 1182 community-dwelling elderly Japanese individuals aged 60 and older. Subjects were classified into four groups on the basis of the presence or absence of locomotive and visual/hearing disorders. Locomotive and visual/hearing organs disorders and physical function were assessed using a self-rated questionnaire. Competence level with activities of daily living (ADL) was used to assess physical function. Locomotive disorder was more prevalent in females than in males, and the presence of such disorders tended to have more influence on the risk of falling and decline in ADL function in females than in males. Locomotive disorders may have a greater effect on the lives of elderly females compared with elderly males. Although there was no significant odds ratio in the presence of multiple disorders, the prevalence rate of the multiple disorders increased with age and this increased the risk of falling also increases with age. © 2013 Elsevier Ireland Ltd