Obstacle course performance and risk of falling in community-dwelling elderly persons

Objective: To determine the efficacy of obstacle course performance scores in predicting persons at risk for falls, after adjusting for age, sociodemographic, health-status, and physiologic variables. Design: Correlational descriptive study design utilizing a logistic regression model. Setting: Community setting. Patients or Participants: A convenience sample of 352 community-dwelling elderly individuals at sites in a metropolitan area. Main Criterion Measure: Number of falls reported prospectively during a 2-year follow-up period. Results: Obstacle course performance, fall history, symptoms of balance dysfunction, and activity level distinguished those who fell and those who did not 12 and 18 months later. At 24 months, range of motion and number of medications also were significant. In multivariate logistic regression, only history of a fall was a significant predictor of future falling at 12 and 18 months; at 24 months, the presence of balance dysfunction symptoms was the significant predictor of those who fell. Conclusions: The obstacle course, as a predictor of future falls, is not superior to the question of whether or not an individual has fallen in the previous year, and is not recommended to predict future falls. The obstacle course may be better as a short-term indicator of response to a rehabilitation program for balance and mobility. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.