Original articleA Pilot Study to Explore the Predictive Validity of 4 Measures of Falls Risk in Frail Elderly Patients
Section snippets
Participant Selection
A convenience sample of 30 subjects was recruited from day hospital patients between December 2002 and February 2003. The inclusion criteria were: ability to rise from a chair and walk 6m; no severe cognitive impairment or blindness; and age 65 years or older. Subjects had been referred for a variety of reasons, and none had commenced rehabilitation prior to entry to the study. Ethics approval was obtained from the local research ethics committee and written informed consent was obtained from
Intrarater Reliability
ICCs were in the range of fair to excellent35 (TUG test=.75; FRT=.87; OLST=.69; B-POMA=.84).
Demographics
Thirty subjects consented to take part in the study, of whom 18 were fallers and 12 were nonfallers. Demographics are described in table 1. There was a significant difference in the body mass index (BMI) between the 2 groups (t=-3.011, P=.005, effect size [ES]=1.07). We found no significant difference in the proportion of fallers using a walking aid (Fisher exact test=.066) or in sex of fallers (Fisher
Discussion
The B-POMA and OLST differentiated between fallers and nonfallers and predicted fallers in a day hospital setting, whereas TUG and FRT did not differentiate between fallers and nonfallers, although a TUG time above 32.6 seconds was associated with a significant OR of being a faller.
Several versions of the B-POMA are in use, and the version we used was taken from Tinetti et al.17 The results showed good sensitivity and specificity, although neither was as high as those reported by Chiu et al,11
Conclusions
The B-POMA, OLST, and TUG can be recommended as measures to identify patients at risk of falling because of physical factors in a day hospital setting, although this finding must be confirmed in a larger scale prospective study. The OLST and TUG may be more useful as a quick screening tool or objective marker. The B-POMA examines several different aspects of balance and so may be seen as the measure of choice during a full physical assessment. After rehabilitation, the measures can be used to
Acknowledgment
We thank Alasdair MacSween, PhD, for his helpful comments in the preparation of this manuscript.
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