Dynamic balance and instrumented gait variables are independent predictors of falls following stroke.
Kelly Bower, Shamala Thilarajah, Yong-Hao Pua and 5 others
PMID 30612584WHAT IT FOUND
After stroke discharge, people who fell had less side-to-side pelvic movement during fast walking, measured by a motion camera.
The step test and Timed Up and Go also flagged falls risk; static balance and gait speed did not. This is not yet routine.
Key findings
01A lower mediolateral pelvic displacement (5.38 cm versus 7.22 cm) was associated with 6.75 times greater odds of falling.
02The standard Timed Up and Go and the step test predicted falls even after stopwatch gait speed was included in the model.
03Static standing balance measured with the Wii Balance Board was not associated with falls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was an observational falls-prediction study, not a treatment trial, so it cannot show that changing gait or balance reduces falls. The analysed sample was 81 people, and the effective sample size for the falls model was 51, so some findings may be unstable. Participants had to be able to walk 10 m independently or with minimal assistance, so results may not apply to people with more severe walking impairment. The Kinect's accuracy for mediolateral pelvic displacement has been questioned in healthy adults, and measurement error could affect the odds ratios. Several gait and balance variables were tested, and some analyses excluded people using walkers or assistance, so different models gave different results. Falls were recorded by participants on calendars, with telephone follow-up for missing data, and some fall details were missing.
Declared interests
The supplied text does not include a funding or conflict-of-interest statement; the article metadata lists non-U.S. government research support.
The easy way to misread this
Do not treat a smaller mediolateral pelvic displacement as a proven cause of falls or as a ready-to-use clinical test. The study was observational, and the Kinect measurement of this variable has previously shown low reliability and accuracy.