The Short Physical Performance Battery (SPPB): A Quick and Useful Tool for Fall Risk Stratification Among Older Primary Care Patients.
Sarah A Welch, Rachel E Ward, Marla K Beauchamp and 3 others
PMID 33191134WHAT IT FOUND
Older primary care patients with low SPPB scores had higher one-year fall rates, especially slow walkers.
Over four years, total SPPB and walking speed still flagged higher fall rates.
Key findings
01Low total SPPB and low performance on gait, chair stand, and balance each had higher adjusted one-year fall rates than high performers.
02Over four years, only low total SPPB and low gait time remained significantly associated with higher adjusted fall rates; chair stand and balance did not.
03Among participants with a positive adapted STEADI screen, worse SPPB performance added fall risk; among those with a negative screen, SPPB groups did not show increased risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
Only 417 of 430 enrolled participants were analyzed because baseline data were missing. All participants already reported difficulty or task modification with walking one-half mile or climbing stairs, and people with SPPB below 4 or Mini Mental State Exam below 18 were excluded, so findings do not apply to those groups. Falls were captured by quarterly phone calls rather than monthly fall calendars, and some participants could not be reached every quarter, so fall counts may be underestimated. The adapted STEADI screen omitted the worry-about-falls question and used balance self-efficacy instead, and all participants received SPPB testing, so it does not exactly follow the STEADI algorithm. Groups within the STEADI analysis were small, limiting statistical power. This was an observational cohort; it did not test whether using the SPPB changes care or reduces falls.
Declared interests
The supplied text tags the article as Research Support, N.I.H., Extramural; no further funding or conflict statements are given.
The easy way to misread this
Do not read the SPPB as a proven way to reduce falls. It was tested as a marker of future fall rates, not as an intervention, and it did not add risk prediction among participants who screened negative on the adapted STEADI criteria.