Development of a clinical multiple-lunge test to predict falls in older adults
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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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This document has been peer reviewed.