Semmes-Weinstein Monofilament Examination for Predicting Physical Performance and the Risk of Falls in Older People: Results of the Pro.V.A. Longitudinal Study

Abstract

Objective: To investigate whether the Semmes-Weinstein monofilament examination (SWME) was associated with, and could predict, measures of physical performance and the risk of fall in older people.

Design: Prospective study.

Setting: Community.

Participants: Older participants (N=2826) enrolled in the Progetto Veneto Anziani (Pro.V.A.) study and a subsample of persons (n=1885) who did not report falls at baseline for longitudinal analyses.

Interventions: Not applicable.

Main outcome measures: Falls reported in the year preceding the assessment and Short Physical Performance Battery (SPPB) were recorded at baseline and again after 4.4 years.

Results: At baseline, 830 participants (29.4%) had experienced falls in the previous year, with a higher prevalence of falls in those positive at SWME than in those negative at SWME (35.8% vs 28.0%; P=.001). Using logistic regression, participants positive at SWME had a (significant) 66% higher risk of presenting worse SPPB score (95% confidence interval, 1.51-1.83) and between 25% and 32% higher risks of having experienced ≥1 fall or recurrent falls than did those negative at SWME. The incidence of falls at follow-up was higher in the positive SWME group than in the negative SWME group (42.2% vs 30.7%; P=.001), and multinomial logistic regression showed that the former had a 13% higher risk of decline in SPPB scores (95% confidence interval, 1.03-1.25), particularly for gait and balance; 48% higher risk of having had 1 fall; and 77% higher risk of recurrent falls. At both baseline and follow-up, the larger the extension of neuropathy (negative SWME vs unilateral impairment in positive SWME vs bilateral impairment in positive SWME), the greater its negative effect on falls and physical performance.

Conclusions: SMWE was associated with, and could predict, lower extremity physical performance and falls in older people.

Keywords: Aged; Lower extremity; Peripheral nervous system diseases; Rehabilitation.