Factors associated with falls in Japanese polio survivors

Daisuke Imoto, Koshiro Sawada, Motoyuki Horii, Kazuya Hayashi, Motomi Yokota, Fumi Toda, Eiichi Saito, Yasuo Mikami, Toshikazu Kubo

Research output: Contribution to journalArticle

Abstract

Purpose: To identify factors associated with falls in Japanese polio survivors and assess the extent of their impact. Materials and methods: Subjects were 128 polio survivors. Fall history and fear of falling, lower limb muscle strength, gait ability (determined by walking speed and number of steps per day), post-polio syndrome incidence, and orthosis or walking aid use were assessed, and factors associated with falls were identified using logistic regression analysis. Results: The fall rate was 64%. Fallers (subjects with one or more falls in the preceding 12 months) had low lower limb muscle strength, slow walking speed, high total scores on the Fall Efficacy Scale-International, which assesses fear of falling, and a high orthosis use rate. Knee extension muscle strength on the weaker side was identified as a main factor influencing risk of falls (odds ratio: 0.72, 95% confidence interval: 0.56–0.96). Receiver operating characteristic curve analysis gave a cutoff value for knee extension muscle strength on the weaker side of 0.42 N/kg or lower. Conclusion: Low knee extension muscle strength on the weaker side was associated with falls, but predictive ability using a single internal factor might be poor. It appears that a comprehensive examination, including other factors, is required.Implications for rehabilitation As polio survivors age, their risk of falling increases. To identify polio survivors who are at risk of falls, it is important to determine the factors associated with falls and their influence on fall risk. The results of this study showed that reduced knee extension muscle strength on the weaker side was a risk factor for falls in polio survivors. To precisely predict the risk of falls in polio survivors, a comprehensive evaluation of both internal and external factors is required.

Original languageEnglish
JournalDisability and Rehabilitation
DOIs
Publication statusAccepted/In press - 01-01-2018

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Muscle Strength
Poliomyelitis
Survivors
Accidental Falls
Knee
Orthotic Devices
Aptitude
Fear
Lower Extremity
Postpoliomyelitis Syndrome
Gait
ROC Curve
Walking
Rehabilitation
Logistic Models
History
Odds Ratio
Regression Analysis
Confidence Intervals
Incidence

All Science Journal Classification (ASJC) codes

  • Rehabilitation

Cite this

Imoto, D., Sawada, K., Horii, M., Hayashi, K., Yokota, M., Toda, F., ... Kubo, T. (Accepted/In press). Factors associated with falls in Japanese polio survivors. Disability and Rehabilitation. https://doi.org/10.1080/09638288.2018.1537381
Imoto, Daisuke ; Sawada, Koshiro ; Horii, Motoyuki ; Hayashi, Kazuya ; Yokota, Motomi ; Toda, Fumi ; Saito, Eiichi ; Mikami, Yasuo ; Kubo, Toshikazu. / Factors associated with falls in Japanese polio survivors. In: Disability and Rehabilitation. 2018.
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abstract = "Purpose: To identify factors associated with falls in Japanese polio survivors and assess the extent of their impact. Materials and methods: Subjects were 128 polio survivors. Fall history and fear of falling, lower limb muscle strength, gait ability (determined by walking speed and number of steps per day), post-polio syndrome incidence, and orthosis or walking aid use were assessed, and factors associated with falls were identified using logistic regression analysis. Results: The fall rate was 64{\%}. Fallers (subjects with one or more falls in the preceding 12 months) had low lower limb muscle strength, slow walking speed, high total scores on the Fall Efficacy Scale-International, which assesses fear of falling, and a high orthosis use rate. Knee extension muscle strength on the weaker side was identified as a main factor influencing risk of falls (odds ratio: 0.72, 95{\%} confidence interval: 0.56–0.96). Receiver operating characteristic curve analysis gave a cutoff value for knee extension muscle strength on the weaker side of 0.42 N/kg or lower. Conclusion: Low knee extension muscle strength on the weaker side was associated with falls, but predictive ability using a single internal factor might be poor. It appears that a comprehensive examination, including other factors, is required.Implications for rehabilitation As polio survivors age, their risk of falling increases. To identify polio survivors who are at risk of falls, it is important to determine the factors associated with falls and their influence on fall risk. The results of this study showed that reduced knee extension muscle strength on the weaker side was a risk factor for falls in polio survivors. To precisely predict the risk of falls in polio survivors, a comprehensive evaluation of both internal and external factors is required.",
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Imoto, D, Sawada, K, Horii, M, Hayashi, K, Yokota, M, Toda, F, Saito, E, Mikami, Y & Kubo, T 2018, 'Factors associated with falls in Japanese polio survivors', Disability and Rehabilitation. https://doi.org/10.1080/09638288.2018.1537381

Factors associated with falls in Japanese polio survivors. / Imoto, Daisuke; Sawada, Koshiro; Horii, Motoyuki; Hayashi, Kazuya; Yokota, Motomi; Toda, Fumi; Saito, Eiichi; Mikami, Yasuo; Kubo, Toshikazu.

In: Disability and Rehabilitation, 01.01.2018.

Research output: Contribution to journalArticle

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T1 - Factors associated with falls in Japanese polio survivors

AU - Imoto, Daisuke

AU - Sawada, Koshiro

AU - Horii, Motoyuki

AU - Hayashi, Kazuya

AU - Yokota, Motomi

AU - Toda, Fumi

AU - Saito, Eiichi

AU - Mikami, Yasuo

AU - Kubo, Toshikazu

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: To identify factors associated with falls in Japanese polio survivors and assess the extent of their impact. Materials and methods: Subjects were 128 polio survivors. Fall history and fear of falling, lower limb muscle strength, gait ability (determined by walking speed and number of steps per day), post-polio syndrome incidence, and orthosis or walking aid use were assessed, and factors associated with falls were identified using logistic regression analysis. Results: The fall rate was 64%. Fallers (subjects with one or more falls in the preceding 12 months) had low lower limb muscle strength, slow walking speed, high total scores on the Fall Efficacy Scale-International, which assesses fear of falling, and a high orthosis use rate. Knee extension muscle strength on the weaker side was identified as a main factor influencing risk of falls (odds ratio: 0.72, 95% confidence interval: 0.56–0.96). Receiver operating characteristic curve analysis gave a cutoff value for knee extension muscle strength on the weaker side of 0.42 N/kg or lower. Conclusion: Low knee extension muscle strength on the weaker side was associated with falls, but predictive ability using a single internal factor might be poor. It appears that a comprehensive examination, including other factors, is required.Implications for rehabilitation As polio survivors age, their risk of falling increases. To identify polio survivors who are at risk of falls, it is important to determine the factors associated with falls and their influence on fall risk. The results of this study showed that reduced knee extension muscle strength on the weaker side was a risk factor for falls in polio survivors. To precisely predict the risk of falls in polio survivors, a comprehensive evaluation of both internal and external factors is required.

AB - Purpose: To identify factors associated with falls in Japanese polio survivors and assess the extent of their impact. Materials and methods: Subjects were 128 polio survivors. Fall history and fear of falling, lower limb muscle strength, gait ability (determined by walking speed and number of steps per day), post-polio syndrome incidence, and orthosis or walking aid use were assessed, and factors associated with falls were identified using logistic regression analysis. Results: The fall rate was 64%. Fallers (subjects with one or more falls in the preceding 12 months) had low lower limb muscle strength, slow walking speed, high total scores on the Fall Efficacy Scale-International, which assesses fear of falling, and a high orthosis use rate. Knee extension muscle strength on the weaker side was identified as a main factor influencing risk of falls (odds ratio: 0.72, 95% confidence interval: 0.56–0.96). Receiver operating characteristic curve analysis gave a cutoff value for knee extension muscle strength on the weaker side of 0.42 N/kg or lower. Conclusion: Low knee extension muscle strength on the weaker side was associated with falls, but predictive ability using a single internal factor might be poor. It appears that a comprehensive examination, including other factors, is required.Implications for rehabilitation As polio survivors age, their risk of falling increases. To identify polio survivors who are at risk of falls, it is important to determine the factors associated with falls and their influence on fall risk. The results of this study showed that reduced knee extension muscle strength on the weaker side was a risk factor for falls in polio survivors. To precisely predict the risk of falls in polio survivors, a comprehensive evaluation of both internal and external factors is required.

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