Date of this Version

3-1-2012

Document Type

Journal Article

Publication Details

Accepted version

Wagenaar, R., Keogh, J. W., & Taylor, D. (2012). Development of a clinical multiple-lunge test to predict falls in older adults. Archives of Physical Medicine and Rehabilitation, 93(3), 458-465

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NOTICE: this is the author’s version of a work that was accepted for publication in Archives of Physical Medicine and Rehabilitation. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Archives of Physical Medicine and Rehabilitation, 93(3), 458-465.

© Copyright by the American Congress of Rehabilitation Medicine, 2012

ISSN

0003-9993

Abstract

Objective: To develop a new Multiple-Lunge Test to distinguish between fallers and nonfallers in community-dwelling older adults.

Design: A cross-sectional design was used to establish the sensitivity and specificity of the test to predict faller status based on retrospective self-reported fall history.

Setting: Local retirement villages.

Participants: Community-dwelling older adults (N 130; mean age SD, 77 7y) with (n 40) and without (n 90) a history of falls.

Interventions: The Multiple-Lunge Test required individuals to lunge forward to a step length determined as 60% of their leg length, and return to start, for 5 consecutive repetitions. Interday and intraday test-retest reliability of the Multiple-Lunge Test was established across 2 testing occasions.

Main Outcome Measures: Number of steps performed correctly, total time to complete 5 steps.

Results: The Multiple-Lunge Test was found to be reliable across trials (Intraday: intraclass correlation coefficient [ICC] .79 –.81 for steps, ICC .86 –.88 for time; Interday: ICC .77 for steps; ICC .84 for time). Sensitivity and specificity values were calculated as 73% and 63%, respectively, for predicting multiple fallers using the measure of all 5 steps done correctly.

Conclusions: The test is easily administered and because of its challenging nature, it may be well suited to detect subtle differences in abilities of higher functioning, communitydwelling older adults. A practitioner can be confident in 7 of 10 cases that an older adult who cannot complete all 5 steps of the Multiple-Lunge Test is at high risk of falls. The results suggest that there is potential for the Multiple-Lunge Test to be used in clinical practice; however, additional research on how to further increase its validity appears warranted.

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