The association between fear of falling and smoothness of lower trunk oscillation in gait varies according to gait speed in community-dwelling older adults.
Tsuyoshi Asai, Shogo Misu, Ryuichi Sawa and 2 others
PMID 28103907WHAT IT FOUND
Older adults afraid of falling had less smooth lower trunk motion side-to-side at normal pace, and less smooth motion front-to-back when walking fast.
Fear of falling was linked to gait changes after fall history was considered.
Key findings
01Fear of falling was associated with less smooth side-to-side lower trunk motion at normal walking speed and less smooth front-to-back motion at fast walking speed, after adjustment.
02Older adults with fear of falling walked slower than those without fear of falling in both normal and fast walking conditions.
03Associations between fear of falling and gait smoothness or variability were not removed when fall history was added to the models.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study did not randomise treatment, so it cannot show that fear of falling caused the gait differences. All participants could walk independently without an assistive device and the study excluded older adults with decreased physical function, so the results may not apply to frailer patients. Fear of falling was measured with a yes/no question rather than a scale such as the Fall Efficacy Scale, so it did not capture how severe the fear was. The regression models explained only a small share of gait smoothness variability, so fear of falling alone is a weak marker of trunk control. The study did not test whether changing where staff stand during walking exercises improves safety.
Declared interests
The article reports funding from a Grant-in-Aid for Young Scientists (B) from KAKENHI in Japan.
The easy way to misread this
Do not conclude that fear of falling causes falls or that standing in a different position will reduce them. This was an observational association study, the effect was weak, and no intervention was tested.