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Prediction of balance perturbations and falls on stairs in older people using a biomechanical profiling approach: A 12-month longitudinal study.

Ackermans, TMA, Francksen, NC, Lees, C, Papatzika, F, Arampatzis, A, Baltzopoulos, V, Lisboa, P, Hollands, MA, O'Brien, TD and Maganaris, CN (2020) Prediction of balance perturbations and falls on stairs in older people using a biomechanical profiling approach: A 12-month longitudinal study. Journals of Gerontology Series A. ISSN 1758-535X

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Abstract

BACKGROUND: Stair falls are a major health problem for older people, but presently there are no specific screening tools for stair fall prediction. The purpose of the present study was to investigate whether stair fallers could be differentiated from non-fallers by biomechanical risk factors or physical/psychological parameters and to establish the biomechanical stepping profile posing the greatest risk for a stair fall. METHODS: Eighty-seven older adults (age: 72.1±5.2 y) negotiated an instrumented seven-step staircase and performed a range of physical/psychological tasks. K-means clustering was used to profile the overall stair negotiation behaviour with biomechanical parameters indicative of fall risk as input. Falls and events of balance perturbation (combined "hazardous events") were then monitored during a 12-month follow-up. Cox-regression analysis was performed to examine if physical/psychological parameters or biomechanical outcome measures could predict future hazardous events. Kaplan-Meier survival curves were obtained to identify the stepping strategy posing a risk for a hazardous event. RESULTS: Physical/psychological parameters did not predict hazardous events and the commonly used Fall Risk Assessment Tool (FRAT) classified only 1/17 stair fallers at risk for a fall. Single biomechanical risk factors could not predict hazardous events on stairs either. On the contrary, two particular clusters identified by the stepping profiling method in stair ascent were linked with hazardous events. CONCLUSION: This highlights the potential of the stepping profiling method to predict stair fall risk in older adults against the limited predictability of single parameter approaches currently used as screening tools.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in [insert journal title] following peer review. The version of record Thijs Ackermans, PhD, Natasha Francksen, MSc, Carolyn Lees, PhD, Fyllis Papatzika, MSc, Adamantios Arampatzis, PhD, Vasilios Baltzopoulos, PhD, Paulo Lisboa, PhD, Mark Hollands, PhD, Thomas O’Brien, PhD, Constantinos Maganaris, PhD, Prediction of balance perturbations and falls on stairs in older people using a biomechanical profiling approach: A 12-month longitudinal study, The Journals of Gerontology: Series A, , glaa130, https://doi.org/10.1093/gerona/glaa130 is available online at: http://dx.doi.org/10.1093/gerona/glaa130
Uncontrolled Keywords: 1103 Clinical Sciences
Subjects: Q Science > QM Human anatomy
Q Science > QP Physiology
R Medicine > R Medicine (General)
T Technology > T Technology (General)
Divisions: Education
Engineering & Technology Research Institute
Sports & Exercise Sciences
Publisher: Oxford University Press (OUP)
Related URLs:
Date Deposited: 01 Jun 2020 10:57
Last Modified: 01 Jun 2020 10:57
DOI or Identification number: 10.1093/gerona/glaa130
URI: http://researchonline.ljmu.ac.uk/id/eprint/13027

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