COMPARISON OF MOBILITY AND STRENGTH IN FALLERS AND NON-FALLERS IN GERIATRIC POPULATION: AN OBSERVATIONAL STUDY

N. Patel¹, M. Sheth²

¹Mahatma Gandhi College of Physiotherapy, Gujarat University, Assistant Professor, Ahmedabad, India, ²SBB College of Physiotherapy, Gujarat University, Lecturer, Ahmedabad, India

Background: Falls among older adults are a serious social concern, mainly because falls are strongly associated with loss of independence, institutionalization, and mortality. Changes in balance, mobility, and muscle strength are associated with aging and interfere with performance of activities of daily living and functional capacity.

Purpose: Documentation of the fall event, cause, and consequences are few in literature. The mobility and strength of muscles of upper and lower limbs may be different in fallers and non-fallers in geriatrics. Studies comparing fallers and non-fallers are less. Therefore, this study was conducted to compare the mobility and strength in fallers and non-fallers in geriatric population and to find association between the history of falls and history of medical condition with mobility and strength variables in geriatric population.

Methods: This observational analytical study included 80 (40 in each group) older adults who lived independently in the community using purposive sampling. People with acute musculoskeletal, neurological and cardiopulmonary conditions were excluded. Participants were divided into two groups. Geriatrics individuals with a history of fall in the last one year (fallers) and non-fallers. Each geriatric individual performed Timed up and go test (TUG test), TUG (manual) test and TUG (cognitive) test to assess the mobility, 30 sec chair stand test (CST) to assess lower limb strength and 30 sec arm curl test (ACT) to assess upper limb strength. Each subject was given an appropriate rest period between all tests. Level of significance was kept at 5%.

Results: A significant difference was found between fallers and non-fallers for TUG test (U=495.50,p=0.003), TUG (manual) test (U=456,p=0.001) and TUG (cognitive) test (U=438,p=0.000). A significant difference was found between fallers and non-fallers for CST (U=458,p=0.001) whereas difference in ACT was not found to be statistically significant (U=-0.533,p=010). Association of history of falls is eight times more in people with hypertension (B=8.043,p=021), four times more in persons with diabetes (B=4.487,p=023), six times more in people with more than one medical condition (B=6.965,p=0.11). Weak association was found between falls and mobility with manual (B=1.13,p=0.48) and cognitive (B=1.32,p=0.11) tasking. No association was seen between history of fall and mobility (B=0.79,p=0.32) [single task], upper limb (B=0.85,p=0.29) and lower limb (B=1.02,p=0.83) strength.

Conclusions: Longer time to complete mobility, mobility with manual and cognitive tasking along tests with reduced lower limb strength is seen in fallers compared to age matched non-fallers. Upper limb strength in both the groups was not different. Falling is seen to increase with the presence of medical conditions especially hypertension and diabetes.

Implications: There is a need to increase awareness for prevention of falls in people with comorbidities like hypertension and diabetes. Also studies to improve mobility, balance and lower limb strength can be conducted in the geriatrics with comorbidities. Prior to any geriatric rehabilitation, history of falls must be considered. Detailed assessment about medical conditions can be taken. Subjective assessment of fear of fall, and cause of fall can be studied in geriatric population. Further studies can assess balance, cognition level and physical activity in fallers and non-fallers.

Funding acknowledgements: None

Keywords:
Fall
Mobility
Strength

Topics:
Older people
Community based rehabilitation
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: SBB College of Physiotherapy, VSGH, Ahmedabad, GujaratT, India

Committee: SBB College of Physiotherapy, VSGH, Ahmedabad, GujaratT, India

Ethics number: PTC/IEC 30/2020-21