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Specific Joint Pain Patterns and Muscle Strengthening Activity Predict Four-year Risk for Multiple Falls in Older Adults

Heather K. Vincent, PhD, MS (University of Florida, Gainesville, Florida); Kevin R. Vincent, MD, PhD; Michael Sein, MD

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: Heather K. Vincent, PhD, MS: No financial relationships or conflicts of interest

Objective: This study determined: 1) Specific patient subgroups at greatest risk for multiple falls over a four-year period based on pain site location and pain site combinations, and 2) Whether participation in muscle strengthening-endurance activity contributed to the number of falls over time.

Design: Secondary analysis from the Osteoarthritis Initiative (OAI).Setting : Academic research setting.Participants : Participants (N&#3f3373; 61.2±9.1 years; 58.1% female) were stratified into 30 different groups by single joint pain (ankle, knee, hip, back, neck), all five sites of pain, and the possible combinations of two-to-four of these five pain sites. Falls were calculated over a four-year period.

Interventions: Not applicable.

Main Outcome Measures: Main outcome measure was annual number of falls; total falls four years were categorized into one or multiple (>2 falls). Secondary outcomes included patient-reported weekly hours of participation in muscle strengthening-endurance activity (Physical Activity Scale for the Elderly score). Covariates included pain medication use, four-year change in body weight, smoking status, sociodemographic-socioeconomic variables, body weight change and Charlson Index. First, binary logistic regression models were generated to predict multiple falls (yes/no). After controlling for covariates, joint pain group was entered into the model. Second, a linear regression model was generated to predict total falls; after entering covariates and joint pain group, hours of muscle strengthening-endurance activity were entered last.

Results: Joint pain groups at highest risk for multiple falls were ankle-back-neck (OR 3.86), ankle-knee-hip (OR 7.0) and all sites (OR 5.39). Single pain sites had ORs ranging from 0.9-2.3. Every hour of strengthening-endurance activity reduced the number of falls over four years for the whole cohort (coefficient -0.50; pConclusions: Multisite pain was a stronger predictor of repeat fall risk than single joint pain. Habitual participation in activities that promote skeletal muscle strength-endurance can help offset this fall risk.

Level of Evidence: Level II

To cite this abstract in AMA style:

Vincent HK, Vincent KR, Sein M. Specific Joint Pain Patterns and Muscle Strengthening Activity Predict Four-year Risk for Multiple Falls in Older Adults [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/specific-joint-pain-patterns-and-muscle-strengthening-activity-predict-four-year-risk-for-multiple-falls-in-older-adults/. Accessed May 20, 2025.
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