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Inability to Perform the Repeated Chair Stand Task Predicts Fall-Related Injury in Older Primary Care Patients

Shea, Cristina A. BS; Ward, Rachel E. PhD, MPH; Welch, Sarah A. DO; Kiely, Dan K. MPH, MA; Goldstein, Richard PhD; Bean, Jonathan F. MD, MS, MPH

American Journal of Physical Medicine & Rehabilitation: June 2018 - Volume 97 - Issue 6 - p 426–432
doi: 10.1097/PHM.0000000000000889
Original Research Articles

Objective The aim of the study was to examine whether the chair stand component of the Short Physical Performance Battery predicts fall-related injury among older adult primary care patients.

Design A 2-yr longitudinal cohort study of 430 Boston-area primary care patients aged ≥65 yrs screened to be at risk for mobility decline was conducted. The three components of the Short Physical Performance Battery (balance time, gait speed, and chair stand time) were measured at baseline. Participants reported incidence of fall-related injuries quarterly for 2 yrs. Complementary log-log discrete time hazard models were constructed to examine the hazard of fall-related injury across Short Physical Performance Battery scores, adjusting for age, sex, race, Digit Symbol Substitution Test score, and fall history.

Results Participants were 68% female and 83% white, with a mean (SD) age of 76.6 (7.0). A total of 137 (32%) reported a fall-related injury during the follow-up period. Overall, inability to perform the chair stand task was a significant predictor of fall-related injury (hazard ratio = 2.11, 95% confidence interval = 1.23–3.62, P = 0.01). Total Short Physical Performance Battery score, gait component score, and balance component score were not predictive of fall-related injury.

Conclusions Inability to perform the repeated chair stand task was associated with increased hazard of an injurious fall for 2 yrs among a cohort of older adult primary care patients.

From the Harvard Medical School, Boston, Massachusetts (CAS, REW, RG, JFB); Spaulding Rehabilitation Hospital, Cambridge, Massachusetts (CAS, REW, DKK, RG, JFB); New England GRECC, Boston VA Healthcare System, Boston, Massachusetts (REW, JFB); and Vanderbilt University Medical Center, Nashville, Tennessee (SAW).

All correspondence should be addressed to: Jonathan F. Bean, MD, MS, MPH, New England GRECC, VA Boston Healthcare System, 150 S, Huntington St., Boston, MA 02130.

This work was supported by the National Institute on Aging (R01 AG032052-03), Eunice Kennedy Shriver National Institute of Child Health and Human Development (1K24HD070966-01), and the National Center for Research Resources in a grant to the Harvard Clinical and Translational Science Center (1 UL1 RR025758-01).

The main results of this study have been presented as a poster presentation at the 2017 American Congress of Rehabilitation Medicine conference. This study has not been previously submitted to any journal.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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