Stephen R Lord

Stephen R Lord
Neuroscience Research Australia · Falls and Balance Research Group

PhD, DSc

About

692
Publications
257,922
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50,407
Citations
Citations since 2016
204 Research Items
25385 Citations
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201620172018201920202021202201,0002,0003,0004,000

Publications

Publications (692)
Article
Profiling performance in the physiological domains underpinning upper limb function (such as strength, sensation, coordination) provides insight into an individual's specific impairments. This compliments the traditional medical "diagnosis" model that is currently used in contemporary medicine. From an initial battery of 13 tests in which data were...
Article
Full-text available
Digital gait biomarkers (including walking speed) indicate functional decline and predict hospitalization and mortality. However, waist or lower-limb devices often used are not designed for continuous life-long use. While wrist devices are ubiquitous and many large research repositories include wrist-sensor data, widely accepted and validated digit...
Article
Ladder falls from overreaching are a problem in older adults. Evidence suggests ladder use behavior to be dependent on interfacing user and environmental circumstances (i.e. situational factors). This study investigates the effects of situational factors (remaining debris, ladder position, time into task, hand dominant reach, reaching disposition)...
Article
Full-text available
Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding pert...
Article
Full-text available
Background our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. Methods Design systematic review and meta-analysis. Data sources Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. Eligibility criteria randomised controlled trials of older partici...
Article
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Background: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives: to create a set of evi...
Article
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Background Core outcome sets are advocated as a means to standardize outcome reporting across randomized controlled trials (RCTs) and reduce selective outcome reporting. In 2005, the Prevention of Falls Network Europe (ProFaNE) published a core outcome set identifying five domains that should be measured and reported, at a minimum, in RCTs or meta-...
Preprint
Background Exergaming is promising method to deliver evidence-based fall prevention exercise for improved adherence and has potential to incorporate the training of both cognitive and motor risk factors for falls. This study examined the effectiveness of two home based exergame interventions (smart±step) of step (cognitive and step training) and se...
Preprint
Full-text available
Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding pert...
Article
Full-text available
Background Total knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectively quantify these balance parameters in a clinical setting....
Article
Background: globally, falls and fall-related injuries are the leading cause of injury-related morbidity and mortality in older people. In our ageing society healthcare costs are increasing, therefore programmes that reduce falls and are considered value for money are needed. Objective: to complete an economic evaluation of an e-Health balance ex...
Article
Over the past 50 years we have transitioned from accepting falls as an inevitable consequence of ageing to something that can and should be prevented. Numerous studies have elucidated the contributors to falls and how to assess a person’s risk of falling. There are many effective approaches to preventing falls in older people including those with c...
Article
Full-text available
Objective Mild cognitive impairment (MCI) is considered an intermediate stage between normal cognitive function and dementia. Fall risk is increased in this group, but there is limited literature exploring specific fall risk factors that may be addressed in fall prevention strategies. The aim of this study was to examine risk factors for falls in o...
Article
Background Falls are frequent among older adults and have significant health and economic consequences. There have been few studies on the epidemiology of falls in residential aged care facilities (RACFs). This study aimed to determine the incidence of falls in RACFs using longitudinal routinely collected incident data over five years (Jul 2014-Dec...
Article
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Background The Peninsula Health Falls Risk Assessment Tool (PH-FRAT) is a validated and widely applied tool in residential aged care facilities (RACFs) in Australia. However, research regarding its use and predictive performance is limited. This study aimed to determine the use and performance of PH-FRAT in predicting falls in RACF residents. Meth...
Article
Background Pathological conditions can impair responses to postural perturbations and increase risk of falls. Research question To what extent are postural reflexes impaired in people with pathological conditions and can exercise interventions shorten postural reflexes? Methods MEDLINE, EMBASE, Scopus, SportDiscus and Web of Science were systemati...
Article
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Background Falls in older adults remain a pressing health concern. With advancements in data analytics and increasing uptake of electronic health records, developing comprehensive predictive models for fall risk is now possible. We aimed to systematically identify studies involving the development and implementation of predictive falls models which...
Article
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Background Falls among older people are a major global health concern. This process evaluation investigates the experience of participants aged 60+ in a yoga program aimed at preventing falls which transitioned from studio-based classes to online classes in response to COVID-19 restrictions. We sought to understand how the Successful AGEing (SAGE)...
Article
Objective: To understand health-care burden from fall-related injury, we investigated patterns of health service use in participants of the Australian statewide Stepping On fall prevention program. Methods: Routinely collected ambulance, emergency, hospital and mortality data for 9163 participants across NSW Local Health Districts between 2009 a...
Article
Aim: Identification of modifiable intrinsic factors for occupational falls is required for initiating effective fall prevention strategies for older workers. This study aimed to identify modifiable intrinsic factors related to falls during occupational activities among older workers. Methods: This retrospective study involved 1164 older workers...
Article
Objectives This study aimed to assess whether the amount and quality of daily-life walking obtained using wearable technology can predict depression onset over a 2-year period, independently of self-reported health status. Design Longitudinal cohort study. Setting and Participants Three-hundred twenty-two community-dwelling older people recruited...
Article
Background: A randomised controlled trial implemented and evaluated a new model of care for non-transported older fallers to prevent future falls and unplanned health service use. This current study uses linked data to evaluate the effects of the intervention beyond the initial 12-month study period. Method: Study data from an established cohort...
Article
Background: . Upper-limb sensory and motor impairments are common in people with multiple sclerosis (MS), yet the current gold standard criteria for documenting functional impairment largely focuses on mobility, balance and postural stability. Objective: . We aimed to determine the validity of the upper-limb Physiological Profile Assessment (PPA...
Article
Introduction: Dementia and depression often coexist. Understanding how concomitant comorbidities affect function can improve assessment and management strategies. We examined the relationship between cognitive, psychological, and physical function and depressive symptoms in people with cognitive impairment. Methods: Cross-sectional study using b...
Chapter
This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...
Chapter
This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...
Chapter
This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...
Chapter
This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...
Chapter
This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...
Chapter
This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...
Article
Background This statistical analysis plan details the Coaching for Healthy AGEing (CHAnGE) trial analysis methodology. Objective To investigate the effect of a combined physical activity and fall prevention program on physical activity and falls compared to a healthy eating among people aged 60 years and over. Methods The CHAnGE trial is a pragma...
Article
Background To examine reactive balance responses to a realistic trip and slip during gait in people with multiple sclerosis (MS). Methods This cross-sectional laboratory study involved 29 participants with MS (50.6 ± 13.4 years) and 29 gender-and-aged-matched healthy controls (50.9 ± 19.2 years). Falls following an induced trip and slip along a 10...
Article
Background People with Parkinson’s disease (PD) have difficulties adapting their gait. While underlying neural mechanisms involving the prefrontal cortex (PFC) have been studied across various complex walking tasks, less is know about the premotor cortex (PMC) and supplementary motor area (SMA), key cortical regions for motor planning. This study c...
Article
Objectives Understanding the relationship between white matter hyperintensities (WMHs) and cognitive and physical decline in people with dementia will assist in determining potential treatment strategies. Currently there is conflicting evidence describing the association between WMHs and cognitive decline and, WMHs association with declines in obje...
Article
Full-text available
Ladder fall and injury risk increases with age. People who present to a hospital after an injurious ladder fall have been surveyed, but little is known about ladder use in the community. The purpose of this study was to: (1) document salient factors related to ladder safety, and (2) determine physical, executive function, psychological and frequenc...
Article
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Background: Walkway and treadmill induced trips have contrasting advantages, for instance walkway trips have high-ecological validity whereas belt accelerations on a treadmill have high-clinical feasibility for perturbation-based balance training (PBT). This study aimed to (i) compare adaptations to repeated overground trips with repeated treadmill...
Article
Purpose This systematic review aimed to identify risk factors for prospectively ascertained falls, focusing on those that are potentially modifiable (physical and neuropsychological factors), in older people with cognitive impairment living in the community. Results A comprehensive search of five databases identified 16 high quality (Newcastle-Ott...
Article
Background and purpose: Falls can result in bone fractures and disability, presenting a serious threat to quality of life and independence in older adults. The majority of falls in community-living older adults occur while walking and are often caused by trips and slips. The study aimed to identify the specific sensorimotor and psychological facto...
Article
Full-text available
Background and purpose: With an aging population, falls have become an increasing public health concern. While face-to-face exercise programs have demonstrated efficacy in reducing falls, their effectiveness is hampered by low participation and adherence. Digital technologies are a novel and potentially effective method for delivering tailored fal...
Article
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Background: Choice stepping reaction time tasks are underpinned by neuropsychological, sensorimotor, and balance systems and therefore offer good indices of fall risk and physical and cognitive frailty. However, little is known of the neural mechanisms for impaired stepping and associated fall risk in older people. We investigated cognitive and mot...
Article
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Introduction One in three people aged 65 years and over fall each year. The health, economic and personal impact of falls will grow substantially in the coming years due to population ageing. Developing and implementing cost-effective strategies to prevent falls and mobility problems among older people is therefore an urgent public health challenge...
Article
Full-text available
People aged over 50 are the most likely to present to a physician for dizziness. It is important to identify the main cause of dizziness in order to develop the best treatment approach. Our goal was to determine the prevalence of benign paroxysmal positional vertigo (BPPV), and peripheral and central vestibular function in people that had experienc...
Article
Background : Understanding the relationship between white matter hyperintensities (WMH) and gait may assist in understanding the central control of gait and determining treatment modalities. These relationships are yet to be realized in older people with dementia. Objective : To examine the association between WMH volume and gait under single-task...
Article
Full-text available
Aim: The aim of this prospective cohort study was to identify the predictors of the development and persistence of musculoskeletal pain (MSKP) in older people. Methods: Participants comprised 431 community-dwelling older people aged 70+ years. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical a...
Article
Full-text available
Objective To test whether StandingTall, a home based, e-health balance exercise programme delivered through an app, could provide an effective, self-managed fall prevention programme for community dwelling older people. Design Assessor blinded, randomised controlled trial. Setting Older people living independently in the community in Sydney, Aust...
Article
Background: In older people with cognitive impairment (CI), executive function (EF) has been associated with motor performance including balance and gait. The literature examining and supporting a relationship between balance performance and other cognitive domains is limited. Objective: To investigate the relationship between global cognition a...
Article
Ladder falls are a common cause of injury in the domestic setting, particularly among older adults. There is a need, therefore, to understand contributing factors of safe and effective ladder use in this group. This study investigated associations between individual human factors (vision, lower and upper limb sensation, upper limb control, strength...
Article
Full-text available
Introduction Falls have a multifactorial aetiology, which may limit the effectiveness of the common approach of exercise as the sole intervention strategy. Multifactorial interventions could be more effective in people at high risk of falling; however, the focus of such interventions has traditionally been quite narrow. This paper describes the des...
Article
Full-text available
Background The rate of falls in patients after total knee arthroplasty (TKA) is high and related to lower limb muscle weakness and poor balance control. However, since routine post-TKA rehabilitation is uncommon, it is paramount to explore alternative strategies to enhance balance and physical functioning in post-TKA patients. As Tai Chi is a prove...
Article
Full-text available
Background Upper limb motor impairments, such as slowness of movement and difficulties executing sequential tasks, are common in people with Parkinson’s disease (PD). Objective To evaluate the validity of the upper limb Physiological Profile Assessment (PPA) as a standard clinical assessment battery in people with PD, by determining whether the te...
Chapter
Falls pose a major threat to the well-being and quality of life of older people. Over 90% of hip fractures result from a fall, and falls are the leading cause of injury-related hospitalization and death in people aged over 65 years. There is now robust evidence on fall risk factors and effective targeted intervention strategies to prevent falls in...
Article
Full-text available
IMPORTANCE With the global population aging, falls and fall-related injuries are ubiquitous, and several clinical practice guidelines for falls prevention and management for individuals 60 years or older have been developed. A systematic evaluation of the recommendations and agreement level is lacking. OBJECTIVES To perform a systematic review of c...
Conference Paper
Full-text available
Falls are one of the most common causes of injury and disability in people with Parkinson’s disease (PD). This study developed an augmented machine learning framework for screening the risk of falling in people with PD using multiple domain assessments. A sample of 109 people with PD (50 fallers and 59 non-fallers) undertook four domains of assessm...
Article
Introduction Falls in older adults are associated with increased healthcare costs. Falls may be prevented or minimised with multifactorial interventions including exercise and behavioural modification. Objectives and Approach To describe the reach of the scale-up of Stepping On, a fall prevention program targeting community-dwellers aged 65 years...
Article
Background Executive dysfunction and risk of falling are hallmarks of Parkinson’s disease (PD). However, it is unclear how executive dysfunction predisposes people with PD to falling. Objectives To: (i) identify sensorimotor, balance, and cardiovascular risk factors for falls that discriminate between those with normal executive function and those...
Article
Older adults have the highest incidence of domestic ladder falls, but little investigation has been given to this important injury issue. There is therefore a need to understand the influence of individual factors like physical and cognitive ability and psychological status on safe and effective ladder use in this population. This study investigate...
Article
Full-text available
Objective To systematically examine stepping performance as a risk factor for falls. More specifically, we examined (i) if step tests can distinguish fallers from non-fallers and (ii) the type of step test (e.g. volitional vs reactive stepping) that is required to distinguish fallers from non-fallers. Data source PubMed, EMBASE, CINAHL, Cochrane D...
Article
Full-text available
Governments around the globe have introduced quarantine, lockdown, and mandatory isolation to slow the transmission of COVID-19. These public health and policy measures aim to protect the public and vulnerable people. This perspective paper argues that the impacts of lockdown (such as social disconnection, reduced exercise, and fewer physiotherapy...
Article
Background. People with Parkinson’s disease (PD) have difficulties generating quick and accurate steps in anticipation of and/or in response to environmental hazards. However, neural mechanisms underlying performance in cognitively demanding stepping tasks are unclear. Objective. This study compared activation patterns in cognitive and motor cortic...
Article
Objective To determine whether impairments across cognitive and affective domains provide additional information to sensorimotor deficits for fall prediction among various populations. Design We pooled data from 5 studies for this observational analysis of prospective falls. Setting Community or low-level care facility. Participants Older people...
Article
Background This study aimed to develop cut-points for the 30-item and 10-item Iconographical Falls Efficacy Scale (IconFES) in community-dwelling older people and evaluate the psychometric properties, including construct and predictive validity with respect to falls and reduced physical activity over 1 year. Methods Eight hundred and one participa...
Article
Full-text available
Introduction: Falls significantly reduce independence and quality of life in older age. Balance-specific exercise prevents falls in people aged 60+ years. Yoga is growing in popularity and can provide a high challenge to balance; however, the effect of yoga on falls has not been evaluated. This trial aims to establish the effect on falls of a yoga...
Article
Background: The evidence to support effective fall prevention strategies in older people with cognitive impairment (CI) is limited. The aim of this randomized controlled trial (RCT) was to determine the efficacy of a fall prevention intervention in older people with CI. Methods: RCT involving 309 community-dwelling older people with CI. The inte...
Article
Full-text available
Background: The population prevalence of many diseases is known. However, little is known of the population prevalence of motor impairments. Methods: The aim of this study was to determine the point prevalence of specific motor impairments (weakness, fatigue, contracture, impaired balance and impaired coordination) in the population aged 55 year...
Article
Issue addressed We describe the reach of the scale‐up of Stepping On, a fall prevention program targeting community‐dwellers aged ≥65 years in NSW, along with fall‐related ambulance service use and fall‐related hospitalisations after scale‐up. Methods Data on program provision were received from Local Health Districts. Routinely‐collected fall‐rel...