Severity of injuries associated with falls in the community dwelling elderly are not affected by fall characteristics and physical function level

Many elderly people experience difficulty with independent living after injuries associated with falls. This study aimed to examine the influence of fall characteristics and physical function level on the severity of fall related injuries. The surveys were conducted in 1955 community dwelling elderly. The questions regarded the following: fall experience within the past year, fall direction, fall cause, injured parts and degree of injury, and an activity of daily living (ADL) questionnaire from the Ministry of Education, Culture, Sports, Science and Technology Japan. Data of 1850 subjects with available and complete responses were used for analysis. Three hundred and eighty-six (20.9%) elderly people experienced a fall within the past year and 257 (66.7%) were injured. ADL score was significantly higher in the elderly without fall experience than the elderly with fall experience. No significant difference was found in frequency of fall cause and fall direction between the elderly with and without injuries caused by falling. Significant correlations were found between fall direction and fall cause and injured parts (φ=. 0.49 and 0.32). ADL score of the elderly who fell by leg backlash was significantly lower than that of the elderly who fell by tripping, slipping and staggering. A decrease of ADL affects the rate of falls in the elderly, but not the degree of injury. Fall characteristics may not be related to the extent of fall injury. © 2011 Elsevier Ireland Ltd

Examination of validity of fall risk assessment items for screening high fall risk elderly among the healthy community-dwelling Japanese population

We aimed to examine the validity of fall risk assessment items for the healthy community-dwelling elderly Japanese population. Participants were 1122 healthy elderly individuals aged 60 years and over(380malesand742females). The percentage who had experienced a fall was 15.8%. This study used fall experience and 50 fall risk assessment items representing the five risk factors(symptoms of falling, physical function, disease and physical symptom, environment, and behavior andcharacter), as we described before. The accuracy of predicting fall experience from the total score or each risk factor score was examined by discriminant analysis. The percentage correctly distinguishing the faller from the total score was 14.4%, and that from the five risk factor scores was 39.7%. This percentage, when using each risk factor score as an independent variable, was 42.5%(symptom of falling),0.6%(physical function score), 0.6%(disease and physical symptoms score), 0.0%(environment score),and 1.1%(behavior and character score), respectively. The best predictor of fall experience of the community-dwelling elderly was the ‘‘symptomoffalling’’ score. For fall risk assessment of the community-dwelling elderly, both of screening of fall risk level and assessing risk profile comprehensively is important

Sex and age-level differences of walking time in preschool children on an obstacle frame

<p>Abstract</p> <p>Background</p> <p>Stepping over an obstacle is a kind of compound movement that makes walking more difficult, especially for preschool children. This study examines sex and age-level differences in walking time in preschool children on an obstacle frame.</p> <p>Methods</p> <p>The participants included 324 healthy preschool children: four-year-old boys (51) and girls (51), five-year-old boys (50) and girls (60), and six-year-old boys (62) and girls (50). A 5 cm- or 10 cm-high obstacle (depth 11.5 cm, width 23.5 cm) was set at the halfway point of a 200 cm × 10 cm walking course.</p> <p>Results</p> <p>The participants walked to the end of the course and back as fast as possible under three conditions: no obstacle, low obstacle and high obstacle. Walking time showed age-level differences in all conditions, but there were no differences in sex. Age levels were divided into two groups, with one group within the first six months of their birthday, and the second group within the last six months of that year. Walking time for children in the first half of their fourth year was longer than that of the five- and six-year-old children. In addition, for children in the last half of their fourth year, walking time was longer than both sexes in the last half of their fifth and sixth years. The children in the latter half of their fifth year had a longer walking time in the high obstacle condition than those in the last half of their sixth year. In the four-year-old participants, walking time was shorter with no obstacles than with a high obstacle frame.</p> <p>Conclusions</p> <p>In the above data, obstacle course walking time does not show a gender difference, except that the four-year-old participants needed longer than the five- and six-year-old children. Setting the obstacle 10 cm high also produced a different walking time in the five- and six-year-old participants. The high obstacle step test (10 cm) best evaluated the dynamic balance of preschool children.</p

Examination of validity of fall risk assessment items for screening high fall risk elderly among the healthy community-dwelling Japanese population

We aimed to examine the validity of fall risk assessment items for the healthy community-dwelling elderly Japanese population. Participants were 1122 healthy elderly individuals aged 60 years and over (380 males and 742 females). The percentage who had experienced a fall was 15.8%. This study used fall experience and 50 fall risk assessment items representing the five risk factors (symptoms of falling, physical function, disease and physical symptom, environment, and behavior and character), as we described before. The accuracy of predicting fall experience from the total score or each risk factor score was examined by discriminant analysis. The percentage correctly distinguishing the faller from the total score was 14.4%, and that from the five risk factor scores was 39.7%. This percentage, when using each risk factor score as an independent variable, was 42.5% (symptom of falling), 0.6% (physical function score), 0.6% (disease and physical symptoms score), 0.0% (environment score), and 1.1% (behavior and character score), respectively. The best predictor of fall experience of the community-dwelling elderly was the "symptom of falling" score. For fall risk assessment of the community-dwelling elderly, both of screening of fall risk level and assessing risk profile comprehensively is important. © 2010 Elsevier Ireland Ltd. All rights reserved

Determination of Persons at a High Risk of Falling in a Population of Healthy Community-Dwelling Elderly Japanese

Background: Falling is an important social issue for the elderly. This study\u27s aim is to determine useful risk factors that could be used to screen for the elderly at high risk of falling. Methods: Participants included 965 healthy elderly individuals ≥ 60 years of age (349 males and 616 females; men age: 70.1 ± 7.1 years). We assessed fall risk in these elderly using Demura et al\u27s fall-risk assessment scale (DFRA), which consists of previous experiences with falls and 50 other fall-risk assessment items representing the five risk factors related to the potential for falling, physical function, disease and physical symptoms, environment, and behavior and character (Demura et al., 2010). Receiver-operating characteristics analysis was conducted using previous experiences with falls (faller or non-faller) as the dependent variable and each fall-risk factor score in the DFRA as the independent variable. Results: The potential for falling was calculated as the highest area under the ROC curve (AUC) (AUC = 0.80; sensitivity = 0.87; specificity = 0.75). However, it was difficult to screen for the elderly as high risk of falling using other fall-risk factor scores. Conclusion: These results suggest that the potential for falling is a useful risk factor that can be used to screen for the elderly at high risk of falling. © 2012