TY - JOUR
T1 - Eye-head coordination during postural perturbation as a predictor of falls in community-dwelling elderly women
AU - Di Fabio, Richard P.
AU - Greany, John F.
AU - Emasithi, Alongkot
AU - Wyman, Jean F
PY - 2002
Y1 - 2002
N2 - Objectives: To assess the functional significance of eye-head coordination during postural perturbations and to determine the contribution of angular vestibulo-ocular reflex (AVOR) suppression to the prediction of 1-year fall history in community-dwelling elderly women. Design: Descriptive analysis of factors correlated with falls. Setting: Community-based independent and senior assisted living facilities. Participants: Volunteer sample of 38 older women (mean age ± standard deviation, 81.6±3.9y; range, 74-92y). Interventions: Not applicable. Main Outcome Measures: Multiple and logistic regression variables (slope coefficients, partial R2, percent-correct fall history classifications) and fall prediction equations generated by using minimal sets of predictor variables. Results: Instantaneous AVOR gain and sedative use were predictors of 1-year history of falls in all minimal sets of predictor variables. R2 for the prediction models varied from.47 to.62 and indicated substantial shared variance with the 1-year history of falling. Elderly women who failed to suppress the AVOR gain were 18 times more likely to have experienced a fall in the past year compared with elderly women who showed AVOR suppression (odds ratio = 18; 95% confidence interval, 1.63-198.42). Conclusions: When controlling for all other variables in the model, instantaneous AVOR gain accounted for nearly 30% of the variance of fall history. The strong association between 1-year fall history, the use of sedatives, and changes in the AVOR gain supports a functional link between AVOR suppression and effective balance in elderly women.
AB - Objectives: To assess the functional significance of eye-head coordination during postural perturbations and to determine the contribution of angular vestibulo-ocular reflex (AVOR) suppression to the prediction of 1-year fall history in community-dwelling elderly women. Design: Descriptive analysis of factors correlated with falls. Setting: Community-based independent and senior assisted living facilities. Participants: Volunteer sample of 38 older women (mean age ± standard deviation, 81.6±3.9y; range, 74-92y). Interventions: Not applicable. Main Outcome Measures: Multiple and logistic regression variables (slope coefficients, partial R2, percent-correct fall history classifications) and fall prediction equations generated by using minimal sets of predictor variables. Results: Instantaneous AVOR gain and sedative use were predictors of 1-year history of falls in all minimal sets of predictor variables. R2 for the prediction models varied from.47 to.62 and indicated substantial shared variance with the 1-year history of falling. Elderly women who failed to suppress the AVOR gain were 18 times more likely to have experienced a fall in the past year compared with elderly women who showed AVOR suppression (odds ratio = 18; 95% confidence interval, 1.63-198.42). Conclusions: When controlling for all other variables in the model, instantaneous AVOR gain accounted for nearly 30% of the variance of fall history. The strong association between 1-year fall history, the use of sedatives, and changes in the AVOR gain supports a functional link between AVOR suppression and effective balance in elderly women.
KW - Accidental falls
KW - Aging
KW - Coordination impairment
KW - Eye
KW - Hand
KW - Projections and predictions
KW - Reflex, vestibulo-ocular
KW - Rehabilitation
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U2 - 10.1053/apmr.2002.32640
DO - 10.1053/apmr.2002.32640
M3 - Article
C2 - 12098154
AN - SCOPUS:0036304419
SN - 0003-9993
VL - 83
SP - 942
EP - 951
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 7
ER -