Unipedal stance testing as an indicator of fall risk among older outpatients

Abstract

Hurvitz EA, Richardson JK, Werner RA, Ruhl AM, Dixon MR. Unipedal stance testing as an indicator of fall risk among older outpatients. Arch Phys Med Rehabil 2000;81:587-91. Objective: To test the hypothesis that a decreased unipedal stance time (UST) is associated with a history of falling among older persons. Design: Fifty-three subjects underwent a standardized history and physical examination and three trials of timed unipedal stance. Setting: The electroneuromyography laboratories of tertiary care Veterans Administration and university hospitals. Subjects: Ambulatory outpatients 50 years and older referred for electrodiagnostic studies. Outcome Measures: UST and fall histories during the previous year. Results: Twenty subjects (38%) reported falling. Compared with the subjects who had not fallen, those who fell had a significantly shorter UST (9.6 [SD 11.6] vs 31.3 [SD 16.3] seconds, using the longest of the three trials, p <.00001). An abnormal UST (<30sec) was associated with an increased risk of having fallen on univariate analysis and in a regression model (odds ratio 108; 95% confidence interval 3.8, >100; p <.007). The sensitivity of an abnormal UST in the regression model was 91% and the specificity 75%. When UST was considered age was not a predictor of a history of falls. Conclusions: UST of <30sec in an older ambulatory outpatient population is associated with a history of falling, while a UST of ≥30sec is associated with a low risk of falling. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation