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Reduced gait and postural stability under challenging conditions in fallers with upper limb fracture.

Abstract：

BACKGROUND:While most fractures are caused by falls, not all falls result in fractures. Risk factors for falls are well established, but only weak associations have been demonstrated for risk factors for fractures. Conflicting results on the implication of bone mineral density (BMD) suggest that other risk factors should be studied, such as gait and balance disorders. AIMS:Gait and postural stability in challenging conditions were, therefore, compared between fallers with and without fracture. METHODS:We enrolled 80 adults aged 55 and older who fell in the previous year. We compared gait and posture after obstacle crossing between fallers with an upper-limb fracture (n = 38), and fallers without fracture (n = 42). Data on BMD, body mass index, handgrip strength, fear of falling, number of comorbidities, number of falls, global cognition, executive functioning and education level were collected. RESULTS:Compared to fallers without fracture, fallers with fracture had significant lower gait velocity (Likelihood-Ratio = 4.93; P = 0.03) and lower postural stability during stabilization after obstacle crossing (Likelihood-Ratio = 10.99; P < 0.001). In addition, fallers with fracture had lower handgrip strength (Likelihood-Ratio = 9.92; P = 0.002), lower education level (Likelihood-Ratio = 8.32; P = 0.004), poorer executive functions (Likelihood-Ratio = 5.81; P = 0.02, higher fear of falling (Likelihood-Ratio = 5.55; P = 0.02) and were more likely women (Likelihood-Ratio = 17.55; P < 0.001), compared to fallers without fracture. DISCUSSION:This study demonstrated that the main difference between fallers with upper-limb fracture and fallers without fracture is mobility in dynamic condition. Poor executive function and low muscular strength could also be involved. CONCLUSIONS:These factors should be taken into account when assessing risk factors for fracture and implementing preventive programs. CLINICAL TRIAL REGISTRATION:clinicaltrials.gov. NCT02292316.

journal_name

Aging Clin Exp Res

journal_title

Aging clinical and experimental research

authors

Langeard A,Pothier K,Chastan N,Marcelli C,Chavoix C,Bessot N

doi

10.1007/s40520-018-0992-z

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

483-489

issue

eissn

1594-0667

issn

1720-8319

pii

10.1007/s40520-018-0992-z

journal_volume

pub_type

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Reduced gait and postural stability under challenging conditions in fallers with upper limb fracture.