Physical Aspects of Healthy Aging: Assessments of Three Measures of Balance for Studies in Middle-Aged and Older Adults

Clementina D Ceria-Ulep,Kamal H Masaki,J David Curb,Randi Chen,Jack Guralnik,Tim A Donlon,John Grove,D Craig Willcox,Claudio Nigg,Beatriz L Rodriguez,Bradley J Willcox

doi:10.1155/2010/849761

Abstract

Objectives. To investigate the reliability and correlations with age of the balance components of the EPESE, NHANES, and the Good Balance Platform System (GBPS) in a normal population of adults. Design. Cross-sectional. Setting. Urban Medical Center in the Pacific. Participants. A random sample of 203 healthy offspring of Honolulu Heart Program participants, ages 38–71. Measurements. Subjects were examined twice at visits one week apart using the balance components of the EPESE, NHANES, and the good balance system tests. Results. The EPESE and NHANES batteries of tests were not sufficiently challenging to allow successful discrimination among subjects in good health, even older subjects. The GBPS allowed objective quantitative measurements, but the test-retest correlations generally were not high. The GBPS variables correlated with age only when subjects stood on a foam pad; they also were correlated with anthropometric variables. Conclusion. Both EPESE and NHANES balance tests were too easy for healthy subjects. The GBPS had generally low reliability coefficients except for the most difficult testing condition (foam pad, eyes closed). Both height and body fat were associated with GBPS scores, necessitating adjusting for these variables if using balance as a predictor of future health.

Highlights

Assessment of balance is important, especially in the elderly, since balance affects the ability of the individual to be mobile and functionally independent [1]
The Good Balance Platform System (GBPS) variables correlated with age only when subjects stood on a foam pad; they were correlated with anthropometric variables
46% were on medication for hypertension, 11% were being treated for diabetes, and 43% and 14% met body max index (BMI) World Health Organization (WHO) [33] criteria for overweight and obese, respectively

Summary

Introduction

Assessment of balance is important, especially in the elderly, since balance affects the ability of the individual to be mobile and functionally independent [1]. Psychometric properties have been established for various balance measures utilizing older adults including but are not limited to Berg Balance Scale and Multidirectional Reach Test [21]; side-step test [22]; Fullerton Advanced Balance Scale [23]; Late-Life Function and Disability Instrument [24]; Dynamic Gait Index [25], and Activities-specific Balance Confidence Scale and the Survey of Activities and Fear of Falling in the Elderly [26] These studies have helped define and improve the geriatric definition and utility of balance but have not addressed its potential utility as a predictor of future functional capacity in healthy adults. This is rather different from using physical performance to detect current disease, since we hope to distinguish among people at the upper end of performance; at present, tools to assess balance are geared towards those with balance weakness or deficit

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Discussion

Conclusion