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Age and Ageing Advance Access published online on June 1, 2007
Age and Ageing, doi:10.1093/ageing/afm068
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Copyright © The Author 2007. Published by Oxford University Press on behalf of the British Geriatrics Society.

Application of the voluntary step execution test to identify elderly fallers

I. Melzer1,, I. Kurz1, D. Shahar2, M. Levi2 and Lie Oddsson3

1 Rehabilitation and Movement Analysis Laboratory in the Leon and Matilda Recanati School for Community Health Professions, Physical Therapy Department, Faculty of Health Sciences at Ben-Gurion University, Israel
2 The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University, Israel
33 Neuromuscular Research Center, Boston University, Boston, MA, USA

Address correspondence to: I. Melzer. Tel: +972 (0) 8 647 7727; Fax: +972 (0) 8 647 7683. Email: itzikm{at}bgumail.bgu.ac.il

Objectives: to assess the use of the Voluntary Step Execution Test to identify fallers.

Design: cross-sectional retrospective.

Setting: two self-care, residential facilities.

Participants: a total of 100 healthy old volunteers (mean age = 78.4 ± 5.7).

Measurements: the study investigated the use of the Voluntary Step Execution Test to identify fallers under single and dual-task conditions. Berg Balance Test (BBS) and Timed Get Up and Go (TUG) were used to assess balance and gait function.

Results: there were no significant differences found between fallers and non-fallers in BBS and TUG (50.5 ± 4.6 versus 52.5 ± 3.4 and 9.4 ± 3.4 versus 7.98 ± 2.3 respectively). There were no statistically significant differences between non-fallers and fallers across all step execution parameters under the single-task condition. However, adding cognitive load to the Voluntary Step Execution Test revealed statistically significant increases in duration of the preparatory phase, swing time and the time to foot-contact (P = 0.035;P = 0.033 and P = 0.037, respectively). Based on the coefficients of the logistic regression model participants with dual-task step execution times of ≥1,100 ms had five times the risk of falling than participants with execution times of <1,100 ms.

Conclusions: the study provides evidence that a simple, safe measure ofstep executon under dual-task conditions can identify elderly individuals at risk for falls.

Keywords: ageing, balance, falls, postural control, step reaction times, elderly

Received 17 September 2006; accepted in revised form 27 March 2007.


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