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Activity Limitations After a Fall Injury

Armando S. Miciano, Jr., MD (Nevada Rehabilitation Institute, Las Vegas, Nevada); Chad L. Cross

Meeting: AAPM&R Annual Assembly 2021

Categories: General Rehabilitation (2021)

Session Information

Session Title: Research Spotlight: General Rehabilitation

Session Time: None. Available on demand.

Disclosures: Armando S. Miciano, Jr., MD: No financial relationships or conflicts of interest

Objective: 1. Quantify the activity limitations (AL) of individuals after a fall injury (IFI). 2. Investigate the inter-relationship of AL status with the muscle performance (MP) of IFI. 3. Establish the association between AL and IFI body function changes (‘BF’: anxiety, depression, fatigue, sleep disturbance, pain intensity)

Design: Retrospective cross-sectionalSetting : PMR clinicParticipants : 23 total (11 males [SD] age: females/males 51.9[12.8]/54.91[9.4])

Interventions: n/a

Main Outcome Measures: WHO-ICF measures quantified AL: 1) capacity qualifiers – 6-Minute-Walk Test-gait-speed (6MWT-speed), 30-s-chair-rise-test (30CRT), and Dynamic Gait Index (DGI); and, 2) performance qualifiers – PROMIS-29v2.0-Physical-Function (PROMIS-PF) and the Pain Disability Questionnaire-Functional Status (PDQ-FS) sub-scales. MP measures explored: strength, by dynamometer testing; lower extremity (LE) power/endurance, by Timed-Up-&-Go (TUG) and 6MWT-distance; and balance, by Berg Balance Scale (BBS). Body function (BF) measures included: PROMIS-29v2.0 anxiety, depression, fatigue, sleep disturbance, and pain intensity sub-scales.

Results: Mean scores (SD) F/M include: PROMIS-PF 36.5[8.5]/35.1[7.0]; PDQ-FS 47.6[18.5]/43.5[19.2]; 6MWT-speed 1.68[0.66]/1.98[0.65] mph; 30CRT 7.7[3.4]/8.0[2.6]; and, Dynamic Gait Index 18.0[5.3]/17.3[6.2]. For TUG, Mann-Whitney test showed no sex differences (p = 0.882). Correlations for dynamometer, which differed by sex (t = 13.7, p = 0.024), had no significant associations with AL. Significant Pearson correlations between AL and MP included: PROMIS-PF with BBS [r=0,657;p=0.002]; PDQ-FS with distance [r=-0.569;p=0.007], BBS [r=-0.587;p=0.004]; 6MWT-speed with distance [r=0.995;p=0.00], BBS [r=0.854;p=0.00]; 30CRT with distance [r=0.513;p=0.025], BBS [r=0.547;p=0.013]; and, DGI with distance [r=0.842;p=0.00] and BBS [r=0.893;p=0.00]. Significant correlations of AL with BF included: fatigue with 6MWT-speed [r=-0.539;p=0.017], PDQ-FS [r=0.56;p=0.008], PROMIS-PF [r=-0.48;p=0.028]; and, pain intensity with PDQ-FS [r=0.49;p=0.018].Conclusions: IFI tend to have severe AL, be clinically slow, and have moderately decreased LE strength, balance, and power/endurance. AL significantly correlated with IFI’s MP (balance, LE strength, LE power/endurance) and body function changes (fatigue, pain severity), supporting the target of said MP and BF markers in interventions for IFI. Further research needed on inter-relationships of AL, MP, and BF in other post-trauma syndromes,

Level of Evidence: Level II

To cite this abstract in AMA style:

Miciano AS, Cross CL. Activity Limitations After a Fall Injury [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/activity-limitations-after-a-fall-injury/. Accessed May 21, 2025.
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