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. 2008 Mar;102(5):585-92.
doi: 10.1007/s00421-007-0613-6. Epub 2007 Dec 11.

Identification of elderly fallers by muscle strength measures

Mirjam Pijnappels  1 , Petra J C E van der Burg, Neil D Reeves, Jaap H van Dieën
Affiliations

Identification of elderly fallers by muscle strength measures

Mirjam Pijnappels et al. Eur J Appl Physiol. 2008 Mar.

Abstract

For efficient prevention of falls among older adults, individuals at a high risk of falling need to be identified. In this study, we searched for muscle strength measures that best identified those individuals who would fall after a gait perturbation and those who recovered their balance. Seventeen healthy older adults performed a range of muscle strength tests. We measured maximum and rate of development of ankle plantar flexion moment, knee extension moment and whole leg push-off force, as well as maximum jump height and hand grip strength. Subsequently, their capacity to regain balance after tripping over an obstacle was determined experimentally. Seven of the participants were classified as fallers based on the tripping outcome. Maximum isometric push-off force in a leg press apparatus was the best measure to identify the fallers, as cross-validation of a discriminant model with this variable resulted in the best classification (86% sensitivity and 90% specificity). Jump height and hand grip strength were strongly correlated to leg press force (r = 0.82 and 0.59, respectively) and can also be used to identify fallers, although with slightly lower specificity. These results indicate that whole leg extension strength is associated with the ability to prevent a fall after a gait perturbation and might be used to identify the elderly at risk of falling.

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Figures

Fig. 1
Fig. 1
Pictures of the experimental settings for a right plantar flexion moment measurements, b left knee extension moment measurements, c leg press push-off force measurements, d jumping measurements, and e tripping experiments
Fig. 2
Fig. 2
Averaged group differences in capacity measures between fallers and non-fallers. Maximum (max) and rate of moment development (RTD) of plantar flexion moment (anklemax and anklertd) and knee extension moment (kneemax and kneertd), maximum and rate of force development (RFD) of leg press push-off force (legpressmax and legpressrfd), jump height (jumph), and hand grip strength (handf). Significant differences between groups are indicated with p-values
Fig. 3
Fig. 3
Distribution of the individual values of maximum leg press push-off force (legpressmax) with jump height (jumph) and hand grip strength (handf) for fallers and non-fallers. Crosses indicate the incorrect classified cases (x for legpressmax, + for jumph and handf)
See this image and copyright information in PMC

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