Feasibility of repeated self-measurements of maximum step length and gait speed by community-dwelling older persons

Abstract

ObjectivesSelf-management of mobility and fall risk can be important in fall prevention; however, it remains unstudied. Therefore, the current study assessed whether community-dwelling older persons were able to repeatedly self-assess maximum step length (MSL) and gait speed (GS) in their own home for a 6-month period, how these tests changed during this period and if these changes were related to falling.DesignThis is a prospective study.SettingThis study was conducted at home.ParticipantsA total of 56 community-dwelling older adults (24 women (43%), mean age 76.2 (SD 3.9) years) entered the study; of which, 45 completed the study.MethodsParticipants performed MSL and GS once a week in their own home during a 6-month period.Primary and secondary outcomesRepeated MSL and GS measurements were the primary outcomes. Falls, self-management and mobility were the secondary outcomes.ResultsSelf-assessment of MSL and GS by older persons is feasible. Compliance of repeatedly self-measuring MSL and GS was good; the median number of weekly measurements was 23.0 (88%) and 21.0 (81%) for MSL and GS, respectively. Drop-outs showed less self-management abilities compared to the participants who completed the study (p=0.049). Linear mixed models showed a small significant improvement in MSL and GS over time (p<0.001), without an influence on falling.ConclusionsMost community-dwelling older persons are able and willing to repeatedly assess their MSL and GS. Self-managing mobility and fall risk did not increase fall occurrence. The fact that older persons can be actively involved in their own healthcare is clinically relevant. Further studies are needed to examine the (cost-)effectiveness of self-management in fall prevention interventions.

Feasibility study by a single-blind randomized controlled trial of self-management of mobility with a gait-speed feedback device by older persons at risk for falling

“…Therefore, technological acceptance needs to be studied in future research. Compliance amounted to more than 80% for participants who completed the study and was comparable to our previous study based on self-management (Bongers et al, 2016). The current research method is safe because participants in the intervention group did not fall more, and they were not more fearful of falling.…”

“…Not speaking and understanding Dutch, not being able to answer the falls telephone (FT), and not having an informal caregiver who could answer the FT for them were exclusion criteria. The FT system (ASK Community Systems, Rotterdam, The Netherlands) is a computerized system that automatically contacts participants by telephone and was found to be feasible, reliable, and valid for assessing falls and fall related injuries in older people (Bongers, Schoon & Olde Rikkert, 2016;Marck vd, Overeem, Klok, Bloem, & Munneke, 2011;Reelick, Faes, Lenferink, Esselink, & Olde Rikkert, 2011).…”

“…The ability of older persons to quickly identify changes in their mobility could give them a tool to take responsibility for their own mobility-related well-being. Previous results of the Senior Step Study showed that gait speed as a single-item tool has the potential to be a self-management tool for mobility and fall risk and showed that older people are willing to engage in their own healthcare using this tool (Bongers, Schoon, Graauwmans, Hoogsteen-Ossewaarde, & Olde Rikkert, 2015;Bongers, Schoon, & Olde Rikkert, 2016). Furthermore, Robinson et al studied the views of older people on self-management and adherence with exercise-based programs and found that older people are open to this (Robinson, Newton, Jones, & Dawson, 2014).…”

Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults

“…In addition to questionnaires, physical tests can be performed repeatedly. This could also be done at home, as community‐dwelling older adults appeared able and willing to self‐assess maximum step length and gait speed weekly for a 6‐month period . Furthermore, step counters could be used to monitor patients at home and allow healthcare professionals to intervene early .…”

“…This could also be done at home, as community-dwelling older adults appeared able and willing to self-assess maximum step length and gait speed weekly for a 6-month period. 26 Furthermore, step counters could be used to monitor patients at home and allow healthcare professionals to intervene early. 27 Also, nonwearable technology is increasingly available, such as infrared sensors placed in older adults' homes that measure walking speed, total daily activity, and time out of home.…”