Gait Speed Modifies Efficacy of Home-Based Exercise for Falls in Older Adults with a Previous Fall: Secondary Analysis of a Randomized Controlled Trial.

IF 3.5 4区医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2025-01-29 DOI:10.1093/ptj/pzaf008

Jordyn Rice, Ryan S Falck, Jennifer C Davis, Chun Liang Hsu, Larry Dian, Kenneth Madden, Naaz Parmar, Wendy L Cook, Karim M Khan, Teresa Liu-Ambrose

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引用次数: 0

Abstract

Objective: Exercise is an evidence-based strategy for preventing falls. However, its efficacy may vary based on individual characteristics, like gait speed. The study examined whether baseline gait speed modified the effects of home-based exercise on subsequent falls among older adults.

Methods: This is a secondary analysis of a 12-month, randomized controlled trial in community-dwelling adults who were ≥ 70 years old and who had fallen within the previous 12 months. Participants were randomized to either 12 months of home-based exercise (n = 172) or standard of care (n = 172). This study examined intervention effects on fall rates at 6 and 12 months stratified by baseline gait speed (slow [<0.80 m/s] or normal [≥0.80 m/s]) using negative binomial regressions. Baseline gait speed was investigated as a potential modifier of the intervention effects on mobility and cognitive function using linear mixed modeling.

Results: At baseline, 134 participants had slow (exercise = 70; standard of care = 64) and 210 had normal (exercise = 102; standard of care = 108) gait speeds. For participants with slow gait speed, exercise reduced fall rates by 44% at 6 months (incidence rate ratio = 0.56; 95% CI = 0.33 to 0.95) but not at 12 months (incidence rate ratio = 0.63; 95% CI = 0.38 to 1.03) compared with standard of care; for participants with normal gait speed, there was no significant effect of exercise on fall rates at 6 or 12 months. Gait speed modified intervention effects; in the exercise group, participants with slow gait showed significant improvements in the Timed "Up & Go" Test at 6 months (estimated mean difference = -4.05; 95% CI = -6.82 to -1.27) and the Digit Symbol Substitution Test at 12 months (estimated mean difference = 2.51; 95% CI = 0.81 to 4.21).

Conclusion: Older adults with slow gait speed had a reduction in subsequent falls in response to exercise at 6 months. Gait speed modified the effects of exercise on mobility and cognition.

Impact: Older adults with slow gait speed may be a target population for exercise-based fall prevention.

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来源期刊

Physical Therapy Multiple-

CiteScore

7.10

自引率

0.00%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.