Relationship between dynamic balance measures and functional performance in community-dwelling elderly people

Ankur Desai, Valerie Goodman, Naaz Kapadia, Barbara L Shay, Tony Szturm
Physical Therapy 2010, 90 (5): 748-60

BACKGROUND: Poor balance control, mobility restrictions, and fall injuries are serious problems for many older adults.

OBJECTIVE: The purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults.

DESIGN: This was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital.

METHOD: A Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed "Up & Go" Test, gait speed, and the Six-Minute Walk Test. Participants were classified as "fallers" or "nonfallers" based on a self-report.

RESULTS: No significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed "Up & Go" Test was able to differentiate between the faller and nonfaller groups. Limitations A prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample.

CONCLUSIONS: The findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.

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