Re: 'falls definition validation'.
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Biomedical subjects
Publications and source records attributed to Dawn A Skelton.
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The purpose of the study was to identify physical activity questionnaires for older adults that might be suitable outcome measures in clinical trials of fall-injury-prevention intervention and to undertake a systematic quality assessment of their measurement properties. PubMed, CINAHL, and PsycINFO were systematically searched to identify measurements and articles reporting the methodological quality of relevant measures. Quality extraction relating to content, population, reliability, validity, responsiveness, acceptability, practicality, and feasibility was undertaken. Twelve outcome measures met the inclusion criteria. There is limited evidence about the measures' properties. None of the measures is entirely satisfactory for use in a large-scale trial at present. There is a need to develop suitable measures. The Stanford 7-day Physical Activity Recall Questionnaire and the Community Health Activities Model Program for Seniors questionnaire might be appropriate for further development. The results have implications for the designs of large-scale trials investigating many different geriatric syndromes.
BACKGROUND: although low strength is a risk factor for falls, lower limb explosive power is more predictive of functional difficulties than strength. Power may be more predictive of a future fall than strength per se. OBJECTIVE: to compare leg muscle strength and explosive power and asymmetry of leg strength and power of women aged 65 or over living at home, with and without a history of falls. DESIGN: a case controlled study of self-reported 'fallers' versus 'non-fallers'. SUBJECTS: twenty women, aged 65 or over, with a history of at least three falls in the previous year were age matched with 15 women with no history of falls in the previous year. METHODS: lower limb explosive power, isometric strength of the quadriceps and hamstrings, isokinetic concentric strength (100 degrees/sec) of the quadriceps, hamstrings, ankle plantar- and dorsi-flexors and quadriceps eccentric strength (100 degrees/sec). Habitual physical activity was assessed using the self-completed Habitual Activity Profile Questionnaire. RESULTS: the women with a history of falls were less active but were not significantly weaker in any of the strength measurements, apart from ankle dorsiflexion adjusted for body weight. Both groups had significant asymmetry in all the leg muscles for both strength and power. Although both groups were asymmetrical in their lower limb power, the fallers demonstrated a significantly greater asymmetry. When the least powerful legs were compared, the women with a history of falls were 24% less powerful for their weight than those who did not fall (P=0.04). CONCLUSIONS: weakness and asymmetry is prevalent in women aged 65 and over, with and without a history of falls. Poor lower limb explosive power combined with asymmetry between limbs may be more predictive of future falls than more traditional measurements of strength in older women who live independently.