Articles
Unipedal stance testing as an indicator of fall risk among older outpatients,☆☆

https://doi.org/10.1016/S0003-9993(00)90039-XGet rights and content

Abstract

Hurvitz EA, Richardson JK, Werner RA, Ruhl AM, Dixon MR. Unipedal stance testing as an indicator of fall risk among older outpatients. Arch Phys Med Rehabil 2000;81:587-91. Objective: To test the hypothesis that a decreased unipedal stance time (UST) is associated with a history of falling among older persons. Design: Fifty-three subjects underwent a standardized history and physical examination and three trials of timed unipedal stance. Setting: The electroneuromyography laboratories of tertiary care Veterans Administration and university hospitals. Subjects: Ambulatory outpatients 50 years and older referred for electrodiagnostic studies. Outcome Measures: UST and fall histories during the previous year. Results: Twenty subjects (38%) reported falling. Compared with the subjects who had not fallen, those who fell had a significantly shorter UST (9.6 [SD 11.6] vs 31.3 [SD 16.3] seconds, using the longest of the three trials, p <.00001). An abnormal UST (<30sec) was associated with an increased risk of having fallen on univariate analysis and in a regression model (odds ratio 108; 95% confidence interval 3.8, >100; p <.007). The sensitivity of an abnormal UST in the regression model was 91% and the specificity 75%. When UST was considered age was not a predictor of a history of falls. Conclusions: UST of <30sec in an older ambulatory outpatient population is associated with a history of falling, while a UST of ≥30sec is associated with a low risk of falling. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Patients

The protocol for this study was approved by the review boards of both institutions involved. All patients referred to the electroneuromyography laboratory were assessed for eligibility for the study. Patients were included if they were: referred for a study of the lower extremities, or for a generalized problem such as peripheral neuropathy or weakness; at least 50 years old; able to ambulate in the community without assistive device; and able and willing to complete the protocol. Patients were

Background information

Fifty-three patients met the criteria for the study. Forty-seven (88.6%) were male. The mean age was 65.7 years (SD = 8.5). Fifty-one percent were referred for electrodiagnostic study on suspicion of a radiculopathy, 43% on suspicion of peripheral neuropathy, and the remainder for other causes.

Twenty subjects (38%) reported a fall in the previous year. Fifteen (28% of all subjects, and 75% of those who reported any fall) had a history of multiple falls in the previous year. Patients who

Discussion

The major finding is that our primary hypothesis, which proposed that a decreased UST would be associated with falls, was strongly supported. Subjects with a history of falls demonstrated a significantly decreased maximal UST over three trials compared with the subjects without a history of falls (9.6 [11.6] and 31.3 [16.3] seconds, respectively, p <.00001). Using 30 seconds as a cutoff between “normal” and “abnormal” UST appears useful in that all subjects (but one) who were classified as

References (31)

  • TM Cutson

    Falls in the elderly

    Am Fam Phys

    (1994)
  • JK Richardson et al.

    Peripheral neuropathy: a true risk factor for falls

    J Gerontology: Med Sci

    (1995)
  • S Studenski et al.

    Postural responses and effector factors in persons with unexplained falls: results and methodologic issues

    J Am Geriatr Soc

    (1991)
  • JK Richardson et al.

    The relationship between electromyographically documented peripheral neuropathy and falls

    J Am Geriatr Soc

    (1992)
  • EL Feldman et al.

    A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy

    Diabetes Care

    (1994)
  • Cited by (204)

    • Tai Chi exercise to improve balance and prevent falls among older people with dementia

      2022, Exercise to Prevent and Manage Chronic Disease Across the Lifespan
    View all citing articles on Scopus

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

    ☆☆

    Reprint requests to James K. Richardson, MD, University of Michigan Medical Center, Department of Physical Medicine and Rehabilitation, 1500 East Medical Center Drive, Room 1D204, Ann Arbor, MI 48109-0042.

    View full text