Development of a Clinical Multiple-Lunge Test to Predict Falls in Older Adults

作者：Wagenaar Ruth^*; Keogh Justin W; Taylor Denise

来源：Archives of Physical Medicine and Rehabilitation, 2012, 93(3): 458-465.

DOI：10.1016/j.apmr.2011.08.044

• Accidental falls
• Aging
• Rehabilitation

Waaenaar R, Keogh JW, Taylor D. Development of a clinical Multiple-Lunge Test to predict falls in older adults. Arch Phys Med Rehabil 2012:93:458-65. %26lt;br%26gt;Objective: To develop a new Multiple-Lunge Test to distinguish between fallers and nonfallers in community-dwelling older adults. %26lt;br%26gt;Design: A cross-sectional design was used to establish the sensitivity and specificity of the test to predict faller status based on retrospective self-reported fall history. %26lt;br%26gt;Setting: Local retirement villages. %26lt;br%26gt;Participants: Community-dwelling older adults (N=130; mean age +/- SD, 77 +/- 7y) with (n=40) and without (n=90) a history of falls. %26lt;br%26gt;Interventions: The Multiple-Lunge Test required individuals to lunge forward to a step length determined as 60% of their leg length, and return to start, for 5 consecutive repetitions. Interday and intraday test-retest reliability of the Multiple-Lunge Test was established across 2 testing occasions. %26lt;br%26gt;Main Outcome Measures: Number of steps performed correctly, total time to complete 5 steps. %26lt;br%26gt;Results: The Multiple-Lunge Test was found to be reliable across trials (Intraday: intraclass correlation coefficient [ICC]=.79-81 for steps, ICC=.86.88 for time; Interday: ICC=.77 for steps; ICC=.84 for time). Sensitivity and specificity values were calculated as 73% and 63%, respectively, for predicting multiple fallers using the measure of all 5 steps done correctly. %26lt;br%26gt;Conclusions: The test is easily administered and because of its challenging nature, it may be well suited to detect subtle differences in abilities of higher functioning, community-dwelling older adults. A practitioner can be confident in 7 of 10 cases that an older adult who cannot complete all 5 steps of the Multiple-Lunge Test is at high risk of falls. The results suggest that there is potential for the Multiple-Lunge Test to be used in clinical practice; however, additional research on how to further increase its validity appears warranted.

• 出版日期2012-3