Clinical use of the gaze stabilization test for screening falling risk in community-dwelling older adults

摘要

Objective: This study examined the clinical use of the computerized gaze stabilization test (GST) as a screener for falls. Design: Cross-sectional, descriptive. Setting: Tertiary medical center. Subjects: Fifteen older community-dwelling adults with a history of falls and 15 controls without a history of falls were recruited for participation in the study. Main Outcome Measures: Participants performed GST with yaw plane head movements. The GST velocity was measured and compared with the dynamic gait index (DGI). Receiver operating characteristic (ROC) curves and area under the ROC curve (AUC) identified GST velocity cut points for identification of fallers based on history of falls and as compared with DGI score. Results: Our results suggested that GST can discriminate between individuals at risk for falls versus those not at risk. ROC analysis identified an AUC of 0.92 (≤100.5 degrees per second criterion value) for GST based on history of falls and an AUC of 0.85 (≤100.5 degrees per second criterion value) based on DGI for classifying falling risk. When GST and DGI scores were combined, the protocol identified an AUC of 1.0 (100% sensitivity, 100% specificity) for identifying falling risk. Conclusion: There were significant head movement velocity differences from participants classified by history of falls and the DGI. Therefore, GST may serve as a potential falling risk assessment measure for older individuals with a history of falls. It is recommended that GST be used in a combined protocol with DGI to accurately identify individuals with falling risk rather than used in isolation.