The Semmes-Weinstein Monofilament Examination for predicting physical performance and the risk of falls in older people: results from the Pro.V.A. longitudinal study

Publication date: Available online 20 September 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Pamela Carrer, Caterina Trevisan, Chiara Curreri, Valter Giantin, Stefania Maggi, Gaetano Crepaldi, Enzo Manzato, Giuseppe Sergi
Objectivesto investigate whether Semmes Weinstein Monofilament Examination (SWME) was associated with, and could predict measures of physical performance and the risk of fall in elderly subjects.Designprospective study (mean follow-up 4.4-years).Settingcommunity.Subjects2826 older subjects enrolled in the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study. For longitudinal analyses, we considered a subsample of 1885 persons who did not report falls at baseline.Interventionsnot applicable.Main outcome measuresfalls reported in the year preceding the assessment and Short Physical Performance Battery (SPPB) were recorded at baseline and again after 4.4 years.ResultsAt baseline, 830 (29.4%) subjects had experienced falls in the previous year, with a higher prevalence of falls in those positive at SWME (SWME+) than in those negative at SWME (SWME-) (35.8% vs 28.0%, p=0.001). Using logistic regression, SWME+ subjects had a significant 66% higher risk of presenting worse SPPB score (95%CI: 1.51-1.83), and between 25% and 32% higher risks of having experienced at least one or recurrent falls, than those SWME-. The incidence of falls at follow-up was higher in the SWME+ compared with the SWME- group (42.2% vs 30.7%, p=0.001), and multinomial logistic regression showed that the former had a 13% higher risk of decline in SPPB scores (95%CI: 1.03-1.25), particularly for gait and balance, 48% higher risk of having had at least one fall and 77% higher risk of recurrent falls. At both baseline and follow-up, the larger the extension of neuropathy (SWME- vs unilateral vs bilateral SWME+), the greater its negative impact on falls and physical performance.ConclusionSMWE was associated with, and could predict lower-extremity physical performance and falls in older people.



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