Quantitative Assessment of Balance in Elderly Fallers and Nonfallers

Abstract

Falls are the most common problem in the elderly population because, at such ages, falls create major risks of morbidity and mortality. Balance disorders in the elderly are common causes of falls. To improve the quality of life of the elderly and reduce medical care expenditure, investigating the issues surrounding falls and their causes is very important. The purposes of this study were to quantitatively evaluate the postural sway of the elderly and to compare differences in postural sway between the fallers and the nonfallers. There were 78 elderly subjects (mean age=76.0±4.5 years; 44 females, 34 males), all selected from a senior center. Each subject underwent quantitative balance evaluation with 10 Motor Coordination Tests (MCTs) consisting of a combination of different platform manipulations and visual conditions. The results were as follows: (1) the right heel and left heel were the areas which most frequently supported body weight; (2) sway index, left/right (L/R) sway distance and anterior/posterior (A/F) sway distance with the eyes closed were higher than with the eyes opened on all MCTs except during the forward/backward (F/B) linear movement of the platform; (3) sway index, left/right (L/R) sway distance and anterior/posterior sway distance with the eyes closed were significantly higher than with the eyes opened on F/B and L/R tilting movement; (4) For the sway index, L/R sway distance, A/P sway distance, there were no significant differences between falter and nonfaller groups during 10 MCTs; (5) In older adults who had fair stereopsis and fair vestibular function, the sway index, L/R sway distance of the non falter group were lower than those of the faller group when the platform was manipulated by left/right tilting movement and the subjects' eyes were closed. Thus, among the various MCTs, postural sway during platform F/B and L/R tilting movement with the subjects' eyes closed was the most sensitive measure in reflecting the perturbation reaction of the elderly, while L/R tilting movement with eyes closed was helpful in detecting the falling history of the elderly with fair vestibular, proprioceptive and stereopsis functions.