| Objective To investigate the fear of falling status and The gait features under dual task walking in elderly patients with type 2 diabetes.To explore the relationship between fear of falling and gait features under dual task walking in elderly patients with type 2 diabetes,so as to provide reference for implementing effective prevention strategies and reducing adverse events.Methods From July 2016 to October 2017,By convenience sampling,a total of 192 elderly patients with type 2 diabetes who were hospitalized in Department of Endocrinology,a top three hospital in Hefei,were enrolled in this study.Patients were asked to complete the general information questionnaire,mini-mental state examination,single item fear of falling assessment and Modified Falls Efficacy Scale.The gait parameters under normal and dual task walking were mearsured objectively and quantitatively by IDEEA,and the relationship between fear of falling and the gait parameters under dual task walking were explored.Results(1)Among 192 elderly patients with type 2 diabetes,103 patients(53.65%)reported fear of falling.The fall efficiency scores of elderly diabetic patients who are fear of falling is significantly lower than those who are not fear of falling[(7.87±0.98)VS(8.99±0.91),P< 0.001].(2)Multivariate Logistic regression analysis showed that age(OR=1.063),education level(OR=0.652),and fall history in the past year(OR=2.086)were the risk factors involved in the fear of falling in elderly patients with type 2 diabetes.(3)In normal walking test,the stride time was(1.05(0.99~1.14))s,the velocity was(64.66 ±14.32)m/min,the cadence was(112.85±10.31)steps/min,the step length was(0.57±0.10)m and the stride time variability was(3.19(2.29~4.68))% among elderly patients with type 2 diabetes.And the stride time was(1.20(1.08~1.32))s,the velocity was(53.93±14.75)m/min,the cadence was(100.41±14.40)steps/min,the step length was(0.54±0.10)m and the stride time variability was(5.52(3.72~8.07))% in dual task walking.Compared with normal walking,the gait performance in dual task walking decreased significantly in elderly patients with type 2 diabetes,such as longer stride time,lower velocity,cadence and and step length,higher stride time variability(all P<0.05).(4)Compared with those who are not fear of falling,the gait performance in dual task walking decreased significantly in the patients with fear of falling,such as longer stride time,lower velocity and step length,higher stride time variability(all P<0.05).(5)Spearman correlation analysis showed that the stride time and stride time variability were positively correlated with the single item fear of falling assessment(r=0.171,P=0.0 17;r=0.258,P<0.001,respectively),the velocity,cadence and step length were negatively correlated with the single item fear of falling assessment(r=-0.235,P=0.001;r=-0.157,P =0.030;r=-0.208,P=0.004,respectively)(6)Spearman correlation analysis showed that the stride time and stride time variability were negatively correlated with MFES scores(r=-0.262,P<0.001;r=-0.214,P=0.003,respectively).Pearson correlation analysis showed that the velocity,cadence and step length were positively correlated with MFES scores(r=-0.333,P<0.001;r=0.249,P<0.001;r=0.2 52,P<0.001,respectively).Conclusion(1)53.7% of elderly patients with type 2 diabetes have fear of falling.Higher education level was the protective factor for fear of falling.Older age and fall history of the past year were the risk factor for fear of falling.(2)Elderly patients with type 2 diabetes were more prone to gait disorders in dual tasking than normal walking.Normal walking test may overestimate the actual walking ability of patients,In contrast,dual task walking tests can better reflect the challenges of daily life,but also closer to the patient walking patterns in real life,may be better suited for assessing the actual mobility of patients.(3)elderly patients with type 2 diabetes who are fear of falling are more prone to gait abnormalities in dual tasking walking. |
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