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- Fall risk assessment in elderly with and without history of falls: kinematic gait analysis: a comparative studyPublication . Coutinho, António; Fragata, C.; Maio, D.; Vivas, Inês; Gonçalves, M.Objectives: The objective of this research was to verify if there was a variation in the MFC (Minimum Foot Clearance) value among elderly with and without history of falls and, if there were any, verify which joint of the lower limb was responsible for that variation. It was also a main objective to verify if there was a correlation between the risk of falling, achieved through the Timed Up and Go Test (TUG), and the MFC variation. Material and Methods: The sample consisted of a total of 30 elderly who met the inclusion and exclusion criteria. These were divided into the group without history of falls (n=15) and into the group with history of falls (n=15). The MFC and the joint movement amplitudes of the hip, knee and ankle, of the dominant lower limb, were assessed using the Kinovea programme and for the risk of fall assessment it was used the TUG. Results: There were no statistically significant differences in the MFC and TUG values between the groups with and without history of falls. However, there is a decrease of the MFC value for the group with history of falls, being the ankle the joint that most contributed to the MFC variation in the group without history of falls, and the knee in the group with history of falls. About the relation between MFC and TUG, it was obtained a negative correlation (r=-0,269) but it was not significant (p=0,150). Conclusion: In our sample no significant differences in the MFC value were obtained between the group with history of falls and the group without history of falls. Besides the lack of significant differences in the MFC value it was determined the articulation of the lower limb responsible for its variation, and it has been found, although with a p>0,05, that for the group with no history of falls it was the ankle that more contributed to this variation and the knee to the group with history of falls. Concerning to the TUG and MFC value correlation it wasn’t significant. Thus, it was concluded that the TUG use is more effective and sensitive in predicting the risk of falling when compared with the kinematic analysis to obtain the MFC value and the joints amplitude.
- Fall risk assessment in elderly with and without history of falls: relationship between disorders of balance, fear of falling and gait changes: a comparative studyPublication . Coutinho, António; Fragata, C.; Maio, D.; Vivas, Inês; Gonçalves, M.Objectives: The aim of this study was to assess the changes that occur in the balance, fear of falling and kinematic parameters such as stride length, velocity and time support in elderly with and without a history of falling. Main objective was also to verify whether a relationship exists between changes in gait parameters evaluated, balance and fear of falling. Methods: The sample comprised 30 patients (15 with history of falls and 15 without a history of falls), which met the criteria for inclusion and exclusion. The kinematic evaluation was performed in the dominant leg, which was right in this sample. The stride length, speed and duration of support were assessed using the program Kinovea and for assessment of balance and fear of falling were assessed using the Berg Balance Scale and the Falls Efficacy Scale. Statistical analysis was performed with SPSS version 20. Results: There were no significant differences in the parameters analyzed, except for scores on the Berg Balance Scale (p=0.000) between groups with and without history of falls. However, there is a decrease in the length of the stride and duration of left leg support and the increased length of right leg support, the speed and the fear of falling. The relationship between the parameters obtained, there is only statistically significant result between speed and stride length (r=0.507, p=0.004) and between the score of the Berg Balance Scale and the stride length (r=0.393, p=0,032). Conclusion: Although not having obtained statistically significant results we can conclude that in elderly with a history of falls have changes in speed and stride length that can be related to balance disorders and the aging process itself. However, it is concluded that the use of the Berg Balance Scale is more responsive and effective in the detection of changes occurring in the individual after a fall, and subsequent evaluation of the risk of falling that performing a kinematic analysis.