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Gait and balance assessments as early indicators of frailty in patients with known peripheral artery disease.
Clin Biomech (Bristol, Avon). 2016 Feb; 32:1-7.CB

Abstract

BACKGROUND

Peripheral artery disease is associated with increased morbidity and mortality, and frailty syndrome may mediate the risk of these adverse health outcomes to predict intervention results. The aim of this study was to determine the association between motor performance impairments based on in-clinic gait and balance measurements with frailty at intermediate stages (pre-frailty) in peripheral artery disease patients.

METHODS

Seventeen participants with peripheral artery disease (≥ 55 years) were recruited and frailty assessed using Fried criteria. Gait and balance were quantified using wearable sensor technologies in the clinical setting. Between-group differences in frailty were assessed using analysis of variance, and independent associations between gait and balance parameters with frailty were determined using logistic regression models.

FINDINGS

Based on Fried index nine (53%), participants were pre-frail and eight (47%) were non-frail. Although no between-group differences in demographics or clinical parameters was observed, gait parameters were worse among pre-frail compared to non-frail participants. The highest effect sizes for between-group differences were observed in double support during habitual normal walking (effect size=1.86, p<0.01), speed variability during dual-task (effect size=1.26, p=0.03), and trunk sway during fast walking (effect size=1.43, p=0.02). No significant difference was observed in balance parameters (p>0.07). The regression model using gait parameters demonstrated a high sensitivity and specificity in predicting pre-frailty.

INTERPRETATION

A short 25-step sensor-based in-clinic overground gait test objectively identified pre-frailty independent of age. Double support was the most sensitive parameter in identifying pre-frail aging adults.

Authors+Show Affiliations

Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA; Arizona Center on Aging, University of Arizona, Tucson, AZ, USA.Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA; Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA; Arizona Center on Aging, University of Arizona, Tucson, AZ, USA.Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA; Arizona Center on Aging, University of Arizona, Tucson, AZ, USA; Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA. Electronic address: najafi.bijan@gmail.com.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26775227

Citation

Thiede, Rebecca, et al. "Gait and Balance Assessments as Early Indicators of Frailty in Patients With Known Peripheral Artery Disease." Clinical Biomechanics (Bristol, Avon), vol. 32, 2016, pp. 1-7.
Thiede R, Toosizadeh N, Mills JL, et al. Gait and balance assessments as early indicators of frailty in patients with known peripheral artery disease. Clin Biomech (Bristol, Avon). 2016;32:1-7.
Thiede, R., Toosizadeh, N., Mills, J. L., Zaky, M., Mohler, J., & Najafi, B. (2016). Gait and balance assessments as early indicators of frailty in patients with known peripheral artery disease. Clinical Biomechanics (Bristol, Avon), 32, 1-7. https://doi.org/10.1016/j.clinbiomech.2015.12.002
Thiede R, et al. Gait and Balance Assessments as Early Indicators of Frailty in Patients With Known Peripheral Artery Disease. Clin Biomech (Bristol, Avon). 2016;32:1-7. PubMed PMID: 26775227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gait and balance assessments as early indicators of frailty in patients with known peripheral artery disease. AU - Thiede,Rebecca, AU - Toosizadeh,Nima, AU - Mills,Joseph L, AU - Zaky,Mahmoud, AU - Mohler,Jane, AU - Najafi,Bijan, Y1 - 2015/12/22/ PY - 2015/07/12/received PY - 2015/12/11/revised PY - 2015/12/14/accepted PY - 2016/1/18/entrez PY - 2016/1/18/pubmed PY - 2016/11/1/medline KW - Balance postural control KW - Dual task KW - Frailty KW - Locomotion KW - Peripheral artery disease KW - Wearable sensor technology SP - 1 EP - 7 JF - Clinical biomechanics (Bristol, Avon) JO - Clin Biomech (Bristol, Avon) VL - 32 N2 - BACKGROUND: Peripheral artery disease is associated with increased morbidity and mortality, and frailty syndrome may mediate the risk of these adverse health outcomes to predict intervention results. The aim of this study was to determine the association between motor performance impairments based on in-clinic gait and balance measurements with frailty at intermediate stages (pre-frailty) in peripheral artery disease patients. METHODS: Seventeen participants with peripheral artery disease (≥ 55 years) were recruited and frailty assessed using Fried criteria. Gait and balance were quantified using wearable sensor technologies in the clinical setting. Between-group differences in frailty were assessed using analysis of variance, and independent associations between gait and balance parameters with frailty were determined using logistic regression models. FINDINGS: Based on Fried index nine (53%), participants were pre-frail and eight (47%) were non-frail. Although no between-group differences in demographics or clinical parameters was observed, gait parameters were worse among pre-frail compared to non-frail participants. The highest effect sizes for between-group differences were observed in double support during habitual normal walking (effect size=1.86, p<0.01), speed variability during dual-task (effect size=1.26, p=0.03), and trunk sway during fast walking (effect size=1.43, p=0.02). No significant difference was observed in balance parameters (p>0.07). The regression model using gait parameters demonstrated a high sensitivity and specificity in predicting pre-frailty. INTERPRETATION: A short 25-step sensor-based in-clinic overground gait test objectively identified pre-frailty independent of age. Double support was the most sensitive parameter in identifying pre-frail aging adults. SN - 1879-1271 UR - https://www.unboundmedicine.com/medline/citation/26775227/Gait_and_balance_assessments_as_early_indicators_of_frailty_in_patients_with_known_peripheral_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0268-0033(15)00326-5 DB - PRIME DP - Unbound Medicine ER -