Abstract
Many older adults suffer injuries due to falls as the ability to safely move between sitting and standing degrades. Unfortunately, while existing measures describe sit-to-stand (STS) performance, they do not directly measure the conditions for balance. To gain insight into the effect of age on STS balance, we analyzed how far 8 older and 10 young adults strayed from a state of static balance and how well each group maintained dynamic balance. Static balance was evaluated using the position of the center-of-mass (COM) and center-of-pressure (COP), relative to the functional base-of-support (BOS). As the name suggests, static balance applies when the linear and angular velocity of the body is small in magnitude, in the range of that observed during still standing. Dynamic balance control was evaluated using a model-based balance metric, the foot-placement-estimator (FPE), relative to the COP and BOS. We found that the older adults stay closer to being statically balanced than the younger participants. The dynamic balance metrics show that both groups keep the FPE safely within the BOS, though the older adults maintain a larger dynamic balance margin. Both groups exhibit similar levels of variability in these metrics. Thus, the conservative STS performance in older adults is likely to compensate for reduced physical ability or reduced confidence, as their dynamic balance control does not seem affected. The presented analysis of both static and dynamic balance allows us to distinguish between STS performance and balance, and as such can contribute to the identification of those older adults prone to falling, thus ultimately reducing the number of falls during STS transfers.
Highlights
The ability to get up from a chair is a fundamental prerequisite to perform daily activities and function independently
The four static balance measures all indicated that the older adults stay closer to being statically balanced than the younger participants between seat-off and standing (Figure 5)
There was no detectable difference in within-subject variability between the older and younger adults in the duration of the movement nor in any of the four static balance measures (p = 0.12–0.95 see Supplementary Table 2)
Summary
The ability to get up from a chair is a fundamental prerequisite to perform daily activities and function independently. Difficulty moving from a sit to a stand (STS) is common among older adults, and affects the lives of over 6% of those living independently as well as over 60% of long-term care residents (Jeyasurya et al, 2013). Poor STS performance can make ambulatory older adults prisoners in their chairs and can result in falling. STS is considered the most mechanically demanding task of common daily activities, requiring leg muscle strength, coordination, and balance control (Riley et al, 1997; Millor et al, 2014). Metrics to analyze balance during STS have yet to be found to identify those at risk of falling
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