Straight and Curved Path Walking Among Older Adults in Primary Care: Associations With Fall‐Related Outcomes. Issue 8 (28th December 2015) - Welch, Sarah A.
Abstract: Background: Most falls among community‐dwelling older adults occur while walking. Simple walking tests that require little resources and can be interpreted quickly are advocated as useful screening tools for fall prone patients. Objective: To investigate 2 clinically feasible walking tests consisting of straight‐ and curved‐path walking and examine their associations with history of previous falls and fall‐related outcomes among community‐living older adults. Design: A cross‐sectional analysis was performed on baseline data from a longitudinal cohort study. Setting: Participants were recruited through primary care practices. Participants: Participants included 428 primary care patients ≥65 years of age at risk for mobility decline. Participants had a median age of 76.5 years, 67.8% were women, and 82.5% were white. Methods: Straight‐path walking performance was measured as the time needed to walk a 4‐meter straight path at usual pace from standstill using a stopwatch (timed to 0.1 second). Curved‐path walking performance was timed while participants walked from standstill in a figure‐of‐8 pattern around two cones placed 5 feet apart. Main Outcome Measurements: Multivariable negative binomial regression analyses were performed to assess the relationship between straight‐path walking or curved‐path walking and self‐reported history of number of falls. For fall‐related injuries, and fall‐related hospitalizations, logistic regression models were used. Results: In the fully adjusted model, an increase of 1 second in straight path walking time was associated with 26% greater rate of falls (rate ratio 1.26, 95% confidence interval 1.10‐1.45). An increase in curved‐path walking time was associated with 8% greater rate of falls (rate ratio 1.08, 95% confidence interval = 1.03‐1.14). Neither walk test was associated with history of fall‐related injuries or hospitalizations. Conclusions: Poor performance on straight‐ and curved‐path walking performance was associated with a history of greater fall rates in the previous year but not with a history of fall‐related injuries or hospitalizations. This information helps inform how previous fall history is related to performance on walking tests in the primary care setting.