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Do voluntary step reactions in dual task conditions have an added value over single task for fall prediction? A prospective study

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Abstract

Background and aims: Stepping reactions play a critical role in responding to balance perturbations, whether they are a consequence of external perturbation or self-induced in nature. The aim of the present study was to determine prospectively the capacity of voluntary stepping performance in singleand dual-task conditions, to predict future falls among older community-dwelling persons. We also aimed to assess whether dual task conditions have an added value over single tasks for fall prediction. Methods: A total of 100 healthy old volunteers (mean age 78.4±5.7 yrs), from two self-care protected retirement homes for older adults, performed the Voluntary Step Execution Test in single- and dual-task conditions as a reaction time task while standing on a single force platform. Step initiation, preparatory and swing phases, and foot-contact time were extracted from data on center of pressure and ground reaction force. One-year fall incidences were monitored. Results: Ninety-eight subjects completed the one-year follow-up, 49 non-fallers, 32 one-time fallers, and 17 recurrent fallers (two or more falls). Recurrent fallers had significantly slower voluntary step execution times in both single- and dual-task conditions, especially due to a slower preparation phase. Two stepwise (backward) logistic regression models showed that longer step execution times have strong predictive value for falls in both single- and dual-task conditions (odds ratio (OR) 8.7 and 5.4, respectively, p<0.05). Conclusions: Voluntary Step Execution Test in both single- and dual-task conditions is a simple and safe examination which can potentially and effectively predict future falls, with no added value to dual- over single-task condition.

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Authors and Affiliations

  1. Schwartz Movement Analysis and Rehabilitation Laboratory, Physical Therapy Department, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, 84105, Israel

    Itshak Melzer PhD, PT & Ilan Kurz

  2. The S. Daniel Abraham International Center for Health and Nutrition, Faculty of Health Sciences, Ben-Gurion University, Israel

    Danit Shahar

  3. Sister Kenny Rehabilitation Institute, Research Center, Minneapolis, MN, USA

    Lars I. E. Oddsson

Authors
  1. Itshak Melzer PhD, PT
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  2. Ilan Kurz
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  3. Danit Shahar
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  4. Lars I. E. Oddsson
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Correspondence to Itshak Melzer PhD, PT.

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Melzer, I., Kurz, I., Shahar, D. et al. Do voluntary step reactions in dual task conditions have an added value over single task for fall prediction? A prospective study. Aging Clin Exp Res 22, 360–366 (2010). https://doi.org/10.1007/BF03324940

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