Use of the walking and turning test to accurately discriminate between independently ambulatory community-dwelling older Thai adults with and without a history of falls: a retrospective diagnostic study

利用步行和转身测试准确区分有跌倒史和无跌倒史的独立行走、居住在社区的泰国老年人:一项回顾性诊断研究

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Abstract

OBJECTIVES: This study developed and investigated the possibility of using the walking and turning test (WTT) to indicate fall risk in community-dwelling older adults. DESIGN: Retrospective diagnostic study. SETTING: The study was carried out in a community setting. PARTICIPANTS: The study focused on community-dwelling older Thai adults. PRIMARY AND SECONDARY OUTCOME MEASURES: The participants were assessed based on demographics, fear of falls using a 'yes/no' question and the Short Falls Efficacy Scale International, as well as fall data in the previous 6 months. The participants then performed the WTT, timed up and go test, five times sit-to-stand test and handgrip strength test (HG) in random order. RESULTS: There were a total of 86 participants with an average age of 69.95±6.10 years (range from 60 to 88 years), most of whom were female (67.44%). 40 participants (46.51%) reported that they had fallen at least once in the previous 6 months. A comparison of various physical ability tests revealed significant differences between faller and non-faller participants (p<0.001). The outcomes of the WTT showed significant correlations with fall variables, balance and muscle strength (0.394 to 0.853, p<0.001). Based on sensitivity, specificity and area under the curve, the cut-off score of 6.40 s showed the highest level of ability to indicate falls among community-dwelling older adults, with a sensitivity of 92.50% and a specificity of 78.26%. CONCLUSIONS: The study suggests the clinical usefulness of the WTT in determining falls in older individuals. WTT is a physical ability measurement that indicates balance ability and muscle strength. The test is practical, requires little space and equipment and can be used in large populations.

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