Citation

Brogårdh C, Flansbjer UB, Lexell J. PM R 2016; 9(5): 455-463.

Affiliation

Department of Health Sciences, Lund University, Lund, Sweden; Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden; Department of Health Science, Luleå University of Technology, Luleå, Sweden.

Copyright

(Copyright © 2016, American Academy of Physical Medicine and Rehabilitation, Publisher Elsevier Publishing)

DOI

10.1016/j.pmrj.2016.08.006

PMID

27546494

Abstract

BACKGROUND: Falls and fear of falling (FOF) are common in persons with late effects of polio but there is limited knowledge of associated factors.

OBJECTIVE: To determine how knee muscle strength, dynamic balance and gait performance (adjusted for gender, age and BMI) are associated with falls and FOF in persons with late effects of polio.

DESIGN: A cross-sectional study. SETTING: A university hospital outpatient clinic. PARTICIPANTS: Eighty-one ambulatory persons with verified late effects of polio (43 men; mean age 67 years). MAIN OUTCOME MEASUREMENTS: Number of falls the past year, Falls Efficacy Scale -International (FES-I) to assess FOF, a Biodex dynamometer to measure knee muscle strength, the Timed Up and Go (TUG) test to assess dynamic balance and the Six Minute Walk test (6MWT) to assess gait performance. Univariate and multivariate logistic regression analyses were used for falls (categorical data) and linear regression analyses for FOF (continuous data) as dependent variables.

RESULTS: Fifty-nine % reported at least one fall during the past year and 79% experienced FOF. Reduced knee muscle strength in the more affected limb and gait performance were determinants of falls. An increase of 10 Nm in knee flexor and knee extensor strength reduced the OR between 0.70 and 0.83 (P=.01), and an increase of 100 meter in 6MWT reduced the OR to 0.41 (P=.001). All factors were determinants of FOF; reduced knee muscle strength in the more and less affected limbs explained 17% to 25% of the variance in FOF, dynamic balance 30% and gait performance 41%. Gender, age and BMI only marginally influenced the results.

CONCLUSIONS: Reduced gait performance, knee muscle strength and dynamic balance are to a varying degree determinants of falls and FOF in ambulatory persons with late effects of polio. Future studies need to evaluate if rehabilitation programs targeting these factors can reduce falls and FOF in this population.

Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Language: en