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Oscar Herrero Guitarra Flamenca Paso A Paso Pdf

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Therefore, the normalized stride length may be clinically useful as a first screening test or in combination with other risk markers for falls and functional loss. It should be taken into account that stride length is an easily measurable parameter in the clinical practice though for research purposes we used a complex method here, stride length can be easily obtained by counting the steps given to walk a known distance.

Finally, considering that we have found that normalized stride length is predictive with falls, mortality and dependence, it is possible that the normalized stride length is also a good marker of fragility; this possibility should be pursued in further studies including other frailty markers and more frailty syndrome-related health events.

Step width Step width is relatively hard to record and requires laborious techniques such as footprints methods here used or expensive systems such as computerized walkways, which are also impractical to study gait at home. Although this parameter is an indicator of future disability and mortality, it is not independent of parameters such as age or baseline functional situation, which are more strongly associated with the appearance of adverse health outcomes.

Although some studies exist analyzing step width variability as a predictor of falls 32 , we only have found a previous prospective study on step width itself.

In this study step width showed weak association with falls, but they did not adjust the analysis by a number of other relevant parameters No other prospective studies studying the relationship between the step width and functional decline or mortality on general population were found.

Therefore, although the associations we found were not independent of other risk factors, our results are novel and may provide new insight in the field. As far as we know, no other authors have studied the relationship between step width and normalized stride length.

This interesting parameter which merges normalized stride length and width, it is not affected by sex, it is independently associated to incident falls, and a risk marker of functional loss.

However, it does not look a better predictor than normalized stride length alone, and it is much difficult to be measured, so it seems impractical its clinical application to us.

Limitations We did not measure gait speed, which has been clearly associated with functional decline, and also with falls, although with conflicting results.

Therefore, we cannot establish direct comparisons with the normalized stride length associations found here. However, comparing with previous published results, it does not seem that the predictive capacity of the normalized stride length is inferior to that of the gait speed.

Also, the predictive capacity of the gait speed for falls has been recently reported to be lower than believed, and lower than that found by us for the normalized stride length AUC: 0. Another limitation of this study was the reduction in the sample size, which was due to two main causes: on the one hand, not all the initially recruited elders could walk without the help of a third person; on the other hand, as a result of the quality-control of the gait test, part of the sample had to be excluded due to unnatural gait, as judged by any of two evaluators.

Such a sample reduction may impair the generalization of results although, statistically, the final sample size was enough to evaluate the studied associations. Even so, the final sample size may be considered large, when compared with those of other published studies, where difficult-to-measure gait parameters, such as the step width, were evaluated.

Global Cognitive function was introduced in the adjusted analysis because it has been consistently associated with falls, functional decline and mortality 35 , 36 , However, it would have been of interest to use a cognitive test which includes frontal lobe function, as it has been more directly related with gait changes 38 , Lastly, the quarterly telephone calls, used to follow-up the incidence of falls, were separated enough for memory bias to occur Such a bias consists in the fact that elders tend to forget some falls, especially inconsequential ones.

However, in our opinion, such a bias was not very important in our study, given that the global incidence of falls in our cohort published elsewhere 41 was very similar to those reported in many other studies of falls, some of them using more thorough recording methods. Conclusions In conclusion, normalized stride length of the elderly, which is easy to measure in the clinical practice, shows a strong association with functional decline and falls, which is not accounted for by other known risk factors for these outcomes.

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No independent relationship has been observed between the absolute value of the step width and adverse health outcomes studied, though the proportion of the step width to the normalized stride length is related to the risk of falling. References 1. Snijders, A. Neurological gait disorders in elderly people: clinical approach and classification.

Google Scholar 2.

Bloem, B.Oscar Herrero has always been associated with the guitar. More From fretworks. Z Capi A"peS'ios ,Aco.. Please click on the link in the confirmation email we just sent you to submit your question.

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