Assessing Fall Risk in Older Adults: The Role of Reaction Time and Inhibitory Control Testing With ReacStick

IF 4 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2026-10-01 Epub Date: 2026-06-04 DOI:10.1016/j.apmr.2026.06.001

Pawarut Palakawong Na Ayudhya MD, Chatkaew Pongmala PhD, James K. Richardson MD, Chernkhuan Stonsaovapak MD, Krisna Piravej MD

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引用次数: 0

Abstract

Objectives

To determine whether ReacStick parameters can differentiate recurrent fallers from nonfallers and to compare their diagnostic precision with that of functional tests.

Design

Cross-sectional study.

Setting

Outpatient Rehabilitation Clinic in a Tertiary Hospital.

Participants

Community-dwelling older adults were recruited using convenience sampling. Ninety participants were enrolled, with those having recurrent falls (>1 time) in the prior year, age- and sex-matched with nonfallers.

Interventions

Not applicable.

Main Outcome Measures

Sensorimotor functions (visual acuity, vibratory sensation, and knee extensor strength), cognition, timed Up and Go, and Berg Balance Scale were evaluated. ReacStick parameters, which assessed simple reaction time (SRT) using the ruler-drop method and reaction accuracy by requiring participants to grasp or release the device within 390 ms based on a light cue, were collected. The percentage of correctly caught light on trials (ON Accuracy), correctly released light off trials (OFF Accuracy), and the combination (All Accuracy) was recorded. Group comparisons and receiver operating characteristic curves were used to assess the ability of the parameters to discriminate between fallers and nonfallers. Multivariate logistic regression identified independent variables for faller status.

Results

Recurrent fallers showed significantly worse SRT, OFF Accuracy, All Accuracy, and OFF Accuracy/SRT. The highest area under the curves was observed for All Accuracy (0.80), OFF Accuracy/SRT (0.79), and OFF Accuracy (0.76). OFF Accuracy/SRT best predicted faller status (adjusted odds ratio, 12.18; 95% confidence interval, 3.75-39.53). Timed Up and Go and Berg Balance Scale showed nonsignificant trends, while knee extensor strength was protective (adjusted odds ratio, 0.53; 95% confidence interval, 0.29-0.97).

Conclusions

Diminished short-latency inhibitory control was the most accurate means to identify faller status, whereas good knee extensor strength showed a protective effect. ReacStick may offer potential as a sensitive tool for assessing short-latency inhibitory control and processing speed related to faller status in older adults. When combined with strength assessment, incorporating ReacStick in clinical practice may improve the accuracy of fall-status classification.

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评估老年人跌倒风险：反应时间和ReacStick抑制控制测试的作用。

目的：探讨ReacStick参数对复发性跌倒者和非跌倒者的鉴别价值，并与功能试验的诊断精度进行比较。设计：横断面研究设置：某三级医院门诊康复诊所参与者：采用方便抽样方法招募社区居住的老年人。90名参与者被纳入研究，其中年龄和性别与未跌倒者相匹配，这些人在前一年有过反复跌倒（10次）。干预措施：不适用。主要观察指标：感觉运动功能（视觉灵敏度、振动感觉、膝关节伸肌强度）、认知、计时起走（TUG）和伯格平衡量表（BBS）进行评估。ReacStick参数，评估简单反应时间（SRT）和反应精度（要求参与者根据灯光提示在390毫秒内抓住或释放设备）。记录正确捕获光照试验的百分比（on Accuracy），正确释放光照试验的百分比（off Accuracy）以及组合（All Accuracy）。采用分组比较和受试者工作特征（ROC）曲线来评估参数区分患者和非患者的能力。多变量逻辑回归确定了跌倒状态的自变量。结果：复发性跌倒者的SRT、OFF准确率、All准确率和OFF准确率/SRT明显较差。所有准确度（0.80）、OFF准确度/SRT（0.79）和OFF准确度（0.76）的曲线下面积最高。OFF准确度/SRT最能预测跌倒状态[aOR=12.18, 95% CI: 3.75-39.53]。TUG和BBS无明显趋势，而膝关节伸肌力量具有保护作用（aOR=0.53, 95% CI: 0.29-0.97）。结论：短潜伏期抑制控制减弱是识别跌倒状态的最准确手段，而良好的膝关节伸肌力量具有保护作用。ReacStick可能作为评估与老年人跌倒状态相关的短潜伏期抑制控制和处理速度的敏感工具提供潜力。当与强度评估相结合时，在临床实践中采用ReacStick可以提高跌倒状态分类的准确性。泰国临床试验注册号：TCTR20240828002。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.