Original Article Published on 22 Aug, 2019

A Comparative Study Between Self-Perception of Walking Ability, Balance and Risk of Fall with Actual Clinical Assessment

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Vol. 13 No. 2 : 2018 (133-144)

NURULAINI A NURULAINI A
SYAHNAZ MH SYAHNAZ MH
Shamsul AS Shamsul AS
TEH ROHAILA J TEH ROHAILA J

Abstract
Gait and balance disorder are among the most common causes of falls in elderly and often lead to injury, disability and loss of independence. However, there might be a discrepancy between elderly’s perception of their own walking ability, balance, risk of fall with doctor’s evaluation. The aim of this study was to compare perception of the elderly’s walking ability, balance and risk of fall with clinical assessment. This cross sectional study was done in a Primary Care Clinic which involved elderly > 60 years using systematic random sampling. Participants completed a self-administered questionnaire comprising of sociodemographic data and question assessing their perception of ability of walking, balance and risk of fall. Actual clinical assessment was done using Tinetti Performance Oriented Mobility Assessment. Most of the participants perceived they had good walking (84.4%) and balance ability (77%). A small proportion (11.5%) agreed that they are at risk of fall. There was a good agreement in walking ability (k: 0.702, p: <0.001), moderate agreement in balance (k: 0.546, p: <0.001) but poor agreement in the risk of fall (k: 0.300, p: <0.001). Multiple logistic regression demonstrated that factors associated with participant’s perception of risk of fall are age, having stroke and taking psychotropic drugs. A discrepancy is observed between self-perception of balance and risk of fall with actual assessment. Advancing age, history of stroke and psychotropic drugs were significantly associated with increased perception of fall risk. The future intervention programme need to focus on creating awareness particularly among those who have these factors.
Keywords : agreement, balance, clinical assessment, elderly, gait, perception, primary care,
Abstrak
Masalah gaya jalan dan keseimbangan adalah diantara sebab utama kejatuhan dikalangan warga tua dan sering menyebabkan kecederaan, ketidakupayaan dan kebergantungan. Walau bagaimanapun, mungkin terdapat percanggahan di antara persepsi warga tua sendiri dengan penilaian doktor mengenai keupayaan diri untuk berjalan, keseimbangan dan risiko kejatuhan. Objektif kajian ini adalah untuk membandingkan diantara persepsi diri warga tua mengenai keupayaan berjalan, keseimbangan dan risiko kejatuhan dengan penilaian klinikal. Kajian ini merupakan kajian keratan lintang yang telah dijalankan di Klinik Kesihatan Primer dan melibatkan warga tua berumur > 60 tahun yang direkrut menggunakan persampelan rawak sistematik. Peserta telah mengisi sendiri borang yang mengandungi maklumat mengenai butir-butir diri dan soalan yang menilai persepsi diri mengenai keupayaan berjalan, keseimbangan dan risiko kejatuhan. Penilaian klinikal dijalankan menggunakan ‘Tinetti Performance Oriented Mobility Assessment’. Kebanyakan peserta menganggap diri mereka mempunyai keupayaan yang baik untuk berjalan (84.4%) dan daya keseimbangan baik (77%). Segelintir (11.5%) mengakui terdapat risiko untuk kejatuhan. Terdapat persetujuan/persamaan baik dari segi keupayaan berjalan (k:0.702, p:<0.001), persetujuan/persamaan sederhana mengenai keseimbangan (k:0.546, p:<0.001) dan persetujuan/persamaan lemah mengenai risiko kejatuhan (k:0.300, p<0.001). Regresi logistik berganda menunjukkan faktor-faktor yang mempengaruhi persepsi risiko kejatuhan adalah umur, mengalami strok dan pengambilan ubat psikotropik. Percanggahan telah didapati diantara persepsi diri dengan penilaian klinikal mengenai keseimbangan dan risiko kejatuhan. Peningkatan umur, sejarah mengalami strok dan ubat psikotropik didapati berkaitan dengan peningkatan persepsi risiko kejatuhan. Program intervensi dicadangkan perlu fokus terhadap meningkatkan kesedaran terutamanya dikalangan mereka yang mempunyai faktor-faktor tersebut.
Kata Kunci : gaya berjalan, kesimbangan, penilaian klinikal, penjagaan primer, persepsi, persetujuan, warga tua,

Correspondance Address
Dr. Syahnaz Mohd Hashim. Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +603-91456117 Email: syahnaz74@gmail.com/ syahnaz@ppukm.ukm.edu.my


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