Abstract
Although turning has been reported as one of the leading activities performed during a fall, and falls during turning result in 8-times more hip fractures than falls during linear gait, the quantity and quality of turns resulting in falls remain unknown since turns are rarely assessed during activities of daily living. 160 community-dwelling older adults were monitored for one week using smartphone technology. Turn measures and activity rates were quantified. Fall incidence within 12 months from continuous monitoring defined fall status, with 7/153 prospective fallers/non-fallers. Based on the analysis of 718,582 turns, prospective fallers turned less frequently, took longer to turn, and were less consistent in turn angle (p = 0.007, 0.025, and 0.038, respectively). Prospective fallers also walked slower and spent less time walking and turning and more time engaged in sedentary behavior (p = 0.043, 0.012, and 0.015, respectively). Individuals experiencing decline in the control of gait and/or turning may attempt to reduce their risk of falling by limiting their exposure and implementing cautionary movement strategies while turning. Since there was no difference in the overall active rate between prospective fallers and non-fallers, impaired gait and turning ability, specifically, may attribute to elevated fall risk within this cohort.
Highlights
Lower turn quality during smaller turns and more day-to-day variability in the duration of larger turns were associated with future recurrent falls
These findings suggest that continuous monitoring methods may be essential when working to predict future falls since information on turn quantity, quality, and variability across time is only obtainable by use of continuous monitoring via a body-worn sensor
Turning strategy could not be fully characterized via our continuous monitoring methods since body segment kinematic analysis requires the use of more than one sensor, the turn quality measures obtained in this study can be used to characterize certain features of turning strategy, as detailed in our Methods
Summary
The purpose of this study was to assess the relationships between natural turns and fall history/risk in community-dwelling older adults
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