A comparison of different balance tests in the prediction of falls in older women with vertebral fractures: a cohort study

Abstract

Background: people with vertebral fractures are at high risk of developing hip fractures. Falls risk is important in the pathogenesis of hip fractures. Aim: to investigate if balance tests, in conjunction with a falls history, can predict falls in older women with vertebral fractures. Methods: a cohort study of community-dwelling women aged over 60 years, with vertebral fractures. Balance tests investigated were: 5 m-timed-up-and-go-test (5 m-TUG), timed 10 m walk, TURN180 test (number of steps to turn 180°), tandem walk, ability to stand from chair with arms folded. Leg extensor power was also measured. Outcome measure: fallers (at least one fall in a 12 month follow-up period) versus non-fallers. Results: one hundred and four women aged 63-91 years [mean = 78 ± 7], were recruited. Eighty-six (83%) completed the study. Four variables were significantly associated with fallers: previous recurrent faller (2+ falls) [OR = 6.52; 95% CI = 1.69–25.22], 5 m-TUG test [OR = 1.03; 1.00–1.06], timed 10 m walk [OR = 1.07; 1.01–1.13] and the TURN180 test [OR = 1.22; 1.00–1.49] [P Conclusions: a previous history of recurrent falls and the inability to perform the 5 m-TUG test within 30 s predicted falls in older women with vertebral fractures. Combining these two measures can predict fallers with a high degree of specificity (although a low sensitivity), allowing the identification of a group of patients suitable for fall and fracture prevention measures.