Postural stability in the elderly: a comparison between fallers and non-fallers

I Melzer, N Benjuya, J Kaplanski
Age and Ageing 2004, 33 (6): 602-7

BACKGROUND: the identification of specific risk factors for falls in community-dwelling elderly persons is required to identify older people at risk of falling.

OBJECTIVE: the aim of the study was to determine the ability of various biomechanical measures of postural stability to identify fallers in the elderly population.

METHOD: 19 subjects (78.4 +/- 1.3 years old) who reported having fallen unexpectedly at least twice in the last 6 months, and 124 non-fallers (77.8 +/- 0.53 years old) participated in the study. Balance measurements were made in the upright position in six different conditions using a force platform, and the Limits of Stability Test was carried out. Static two-point discrimination (TPD) testing to the underside of the first toe was made to evaluate the innervation density of the slowly adapting receptors. Finally, maximal isometric lower limb strength was measured in major muscle groups. Repeated measures analysis of variance tests were performed to assess the mean differences between the two groups (fallers and non-fallers). The level of significance was set to 0.05.

RESULTS AND DISCUSSION: results suggest that control of balance in narrow base stance may be an important tool in identifying elderly fallers. The findings show an increase in mediolateral sway in narrow base stance in older people who experienced recurrent falls. Also, TPD appears to be impaired in elderly fallers (14.93 +/- 1.1 mm versus 12.98 +/- 0.3 mm).

CONCLUSIONS: simple and safe laboratory quantitative tests were able to differentiate between elderly fallers and elderly individuals who did not fall, suggesting a possible clinical application as a preliminary screening tool for predicting future risk of falling.

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