Balance In Community-dwelling Older Adults Research Articles

The stepping test, and infrared depth sensor, provide reliable measures of balance in community-dwelling older adults.

[Purpose] The purpose was to examine relationships between variables characterizing the 20-second stepping test movement pattern, assessed with an infrared depth sensor (KinectTM), and measurements of dynamic and static balance. [Participants and Methods] A total of 27 independent-living, older adults (7 males and 20 females) participated in this study. For each participant, the stepping test total movement distance, movement displacement, knee movement distance, and step number were calculated from Kinect closed joint-point coordinate data. Dynamic and static balance were assessed using a NeuroCom Balance Master Platform system. [Results] The stepping test total movement distance had a moderate negative correlation with endpoint excursion (r=-0.469) and a moderate positive correlation with total movement distance, corrected for knee movement distance (r=0.557). Step numbers had a moderate negative correlation with stepping test total movement distance (r=-0.667) and total movement distance, corrected for knee movement distance (r=-0.531). Division into high and low-balance sub-groups (based on endpoint excursion or sway velocity scores) revealed that stepping test total movement distances and movement displacements were greater, and step numbers were fewer, in low balance groups. [Conclusion] The stepping test, combined with a KinectTM-assessed movement pattern provides a simple, objective, reliable means for assessing balance in community-dwelling, independent-living older adults.

Effects of exercise using a modified elastic band with a coconut shell on muscle strength and balance in community-dwelling older adults.

[Purpose] To investigate the effects of exercise using a modified elastic band with a coconut shell on leg muscle strength and balance in older adults. [Participants and Methods] The study consisted of 30 participants aged 60 years and older. The participants were randomly assigned to either the exercise (n=15) or control groups (n=15). The exercise group used a modified elastic band with a coconut shell three days a week for four weeks. Both groups received a single educational session on fall prevention after a baseline assessment. The Functional Reach Test (FRT) and Timed Up and Go Test (TUG) were used to assess balance, respectively. The 30-second chair stand test (30CST) was also used to measure leg strength. All outcome parameters were measured at the beginning of the study, immediately after a single exercise session, and after four weeks of exercise. [Results] The FRT and 30CST significantly increased in the exercise group after four weeks of exercise. The TUG significantly decreased in the exercise group after completing the program. [Conclusion] This study demonstrated that exercise using a modified elastic band with a coconut shell could effectively improve leg muscle strength and balance in older adults.

Design of a Sensor-Technology-Augmented Gait and Balance Monitoring System for Community-Dwelling Older Adults in Hong Kong: A Pilot Feasibility Study.

Routine assessments of gait and balance have been recognized as an effective approach for preventing falls by issuing early warnings and implementing appropriate interventions. However, current limited public healthcare resources cannot meet the demand for continuous monitoring of deteriorations in gait and balance. The objective of this study was to develop and evaluate the feasibility of a prototype surrogate system driven by sensor technology and multi-sourced heterogeneous data analytics, for gait and balance assessment and monitoring. The system was designed to analyze users' multi-mode data streams collected via inertial sensors and a depth camera while performing a 3-m timed up and go test, a five-times-sit-to-stand test, and a Romberg test, for predicting scores on clinical measurements by physiotherapists. Generalized regression of sensor data was conducted to build prediction models for gait and balance estimations. Demographic correlations with user acceptance behaviors were analyzed using ordinal logistic regression. Forty-four older adults (38 females) were recruited in this pilot study (mean age = 78.5 years, standard deviation [SD] = 6.2 years). The participants perceived that using the system for their gait and balance monitoring was a good idea (mean = 5.45, SD = 0.76) and easy (mean = 4.95, SD = 1.09), and that the system is useful in improving their health (mean = 5.32, SD = 0.83), is trustworthy (mean = 5.04, SD = 0.88), and has a good fit between task and technology (mean = 4.97, SD = 0.84). In general, the participants showed a positive intention to use the proposed system in their gait and balance management (mean = 5.22, SD = 1.10). Demographic correlations with user acceptance are discussed. This study provides preliminary evidence supporting the feasibility of using a sensor-technology-augmented system to manage the gait and balance of community-dwelling older adults. The intervention is validated as being acceptable, viable, and valuable.

A Standing Low-frequency Vibration Exercise Device for Improving Balance in Community-dwelling Older Adults: A Single-blind Randomized Controlled Trial.

This study aimed to compare the effects of the standing low-frequency vibration exercise device (SLVED) and walking training on balance ability on an unstable surface in community-dwelling elderly people. Thirty-eight older adults were randomly allocated to the SLVED sessions: the intervention group (n = 19), and the walking sessions: the control group (n = 19). Each group session lasted 20 min and was performed twice a week for 12 weeks. Standing balance was assessed by the change in center-of-gravity sway of the participant standing on foam rubber with eyes open (EO) and eyes closed (EC). The primary outcome measures were the root mean square (RMS) values of the center of foot pressure in the mediolateral and anteroposterior directions and the RMS area. Secondary outcome measures were the results of the 10-m walking time test (10 MWT), five-times sit-to-stand (5T-STS) test, and timed up-and-go (TUG) test. Analysis of variance showed a significant group × time interaction for the TUG test. Significant improvements were observed in Y-RMS for EO condition; RMS, X-RMS, Y-RMS, and RMS area for EC condition; and 10 MWT, 5T-STS test, and TUG test for the main effect of the time factor. SLVED for intervention in community-dwelling older adults showed a greater improvement than walking training in the TUG test. In addition, SLVED improved the Y-RMS for the EO condition on foam rubber; RMS, X-RMS, Y-RMS, and RMS area for the EC condition on foam rubber in standing balance; and the 10 MWT and 5T-STS test, suggesting that it has similar effects to walking training.

Balance and Fall Risk Assessment in Community-Dwelling Older Adults after Recovery from COVID-19: A Cross-Sectional Study.

SARS-CoV-2 atypical symptoms in older persons include falls, confusion, dizziness, and unusual weariness. Falls and their consequences are among the most prevalent causes of disability among older adults, significantly lowering quality of life and resulting in the loss of independence as well as impaired psychosocial functioning. The study purpose was to examine the impact of the SARS-CoV-2 infectious disease on balance in community-dwelling older adults. Sixty-four older adults aged ≥ 60 years from both sexes, 31 treated for SARS-CoV-2 infection and 33 matched normal controls participated in the study. The Biodex Stability System (BSS) and Berg Balance Scale (BBS) were used for evaluation of balance and fall risk. The correlation between the Biodex overall stability index and the Berg Balance Scale score was investigated. When compared to controls, the SARS-CoV-2 group had significantly higher values of the Biodex overall stability index (OSI) (p = 0.011), anterior-posterior stability index (APSI) (p = 0.013), mediolateral stability index (MLSI) (p = 0.018), and fall risk index (FRI) (p = 0.008), as well as statistically lower scores on the Berg balance scale (p = 0.003). A moderate negative correlation was found between the two assessment tools in the SARS-CoV-2 group. Balance impairment and an increased risk of falling are among the outcomes of SARS-CoV-2 in community-dwelling older adults.

Association Between Typologies of Sedentary Behavior and Muscle Strength, Gait Speed, and Balance in Community-Dwelling Older Adults.

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3-4, and ≥5hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3-4 and ≥5hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled.

Effects of Mat Exergame-Based Multicomponent Training on the Standing Balance of Community-Dwelling Older Adults With and Without Fall Risk

Objective: Exergames may enhance postural stability and prevent falls. This study investigated the effects of mat exergame-based multicomponent training on the static and dynamic standing balance capacities of community-dwelling older adults. Materials and Methods: Study participants comprised 34 community-dwelling older adults who were assigned into the high-risk group (yes to at least one question) or low-risk group (no to all three questions) based on the 3-item subset of a fall risk questionnaire. A 2-hour Stampede mat exergaming, including resistance, aerobics, flexibility, and balance training, was completed weekly for 3 months. The postural stability test, fall risk test, limits of stability (LOS) test, and the modified clinical test of sensory interaction and balance were conducted using the Biodex Balance System SD before and after the intervention. Intervention effects within and between groups were compared. Results: After the intervention, significant improvements in the fall risk index (FRI, P = 0.007) and overall stability index (OSI, P = 0.008) were observed in the high-risk group (n = 18; mean age, 71.0 ± 4.7 years). Medium effect sizes (ESs) were noted in the low-risk group (n = 16; mean age, 70.8 ± 4.4 years) for the FRI (ES = 0.35), OSI (ES = 0.43), and LOS (ES = 0.40–0.45). The change scores were not different between groups. Conclusion: Mat exergame-based multicomponent training is effective in enhancing the standing balance. Exergame-based intervention is recommended for balance training among older adults.

Comparing the Effects of Single-Task versus Dual-Task Balance Training on Gait Smoothness and Functional Balance in Community-Dwelling Older Adults: A Randomized Controlled Trial.

To compare the effects of single- versus dual-task balance training on the gait smoothness and balance of community-dwelling older adults, 69 volunteers were randomized to single-, dual-task training, and control (no intervention) groups. Exercises were received in 18 sessions through 6 weeks. The gait smoothness was measured by the harmonic ratio of trunk accelerations using a triaxial accelerometer. Balance performance was assessed through the Fullerton Advanced Balance scale, Timed Up and Go test, Activities-specific Balance Confidence, and gait speed. After the trial, all variables improved significantly in the training groups. Moreover, differences in the mean change of all variables, except the Timed Up and Go test, were statistically significant between the interventional groups and the control group, but no significant difference was reported between the two training groups. This study suggests that balance training can improve gait smoothness as well as balance status in healthy older adults.

Longitudinal Association of Executive Function and Balance in Community-Dwelling Older Adults

Declines in Executive Function (EF) are associated with balance in community-dwelling older adults with Mild Cognitive Impairment (MCI). While this has been examined in cross-sectional studies, no longitudinal studies describe change over time. The purpose of this study was to examine how performance on the components of the Short Physical Performance Battery (SPPB) are associated with EF in community-dwelling older adults who transition into MCI. This secondary data analysis employed eight years of data from the National Health and Aging Trends Study dataset (2011 – 2018) with 1,225 participants in all eight waves (balanced). EF was measured with the Clock Drawing Test and SPPB balance tests included side-by-side, semi-tandem, full tandem, and single leg stance with eyes open or closed. Longitudinal ordered logistic regression was used to examine associations between each balance measure and EF while controlling for comorbidity, function, depression, gender, age, and ethnicity. EF was significantly associated with tandem, semi-tandem, and single leg stance after controlling for covariates. One point increase in SPPB can reduce the risk of EF impairment by 8.2% (Odds Ratio (OR)=0.918, p<0.001). Among SPPB components, semi-tandem (OR=0.468) and side-by-side (OR=0.472) were the strongest predictors of EF impairment. Declines in both EF and balance performance occurred over an eight-year period in adults. This may reflect common neural processes shared between the cognitive and motor areas of the central nervous system. Best practice suggests screening both balance (tandem, semi-tandem, or single leg stance) and EF in the clinical assessment of community-dwelling older adults.

Longitudinal Association of Executive Function and Balance in Community-Dwelling Older Adults

Cognitive impairment increases an individual’s risk of falls due to the role cognition plays in gait control. Older adults with dementia fall 2-3 times more than cognitively healthy older adults and there is a lack of evidence for effective fall prevention interventions for community-dwelling cognitively impaired adults. We conducted a systematic review and meta-analysis to investigate the effectiveness of fall prevention interventions in improving falls, perceived risk of falls, gait, balance, and functional mobility. We searched 7 databases for interventions involving community-dwelling adults ≥50 years with mild to moderate cognitive impairment. Reviewers screened citations, extracted data, assessed risk of bias and certainty of evidence (GRADE). We performed a meta-analysis of 509 community-dwelling adults (mean age 67.5 to 84.0 years) with mild to moderate cognitive impairment from 12 randomized controlled trails (8 exercise interventions, 3 multifactorial, and 1 providing medication). Interventions had medium significant effects on perceived risk of falls (SMD -0.73 [-1.10, -0.36]), balance (SMD 0.66 [0.19, 1.12]), and timed up and go test (SMD -0.56 [-0.94, -0.17]) and small significant effects on gait speed and control (SMD 0.26 [0.08, 0.43]) with moderate certainty of evidence. There were no significant effects for falls. Sub-analysis showed that exercise and studies at low risk of bias remained significant for balance and perceived risk of falls. The effect of fall prevention interventions on falls remains unclear; exercise interventions are effective at addressing fall risk factors. However, high quality and longer studies with adequate sample sizes are needed to determine their effectiveness on falls.

Can two multimodal psychomotor exercise programs improve attention, affordance perception, and balance in community dwellings at risk of falling? A randomized controlled trial

BackgroundFalls are associated with cognitive and physical function deterioration. Attention decline, inaccurate affordance perception, and balance impairment are considered to be risk factors for falls. Furthermore, few studies have reported psychomotor intervention as a fall prevention program. This study aimed to investigate the effects of two multimodal programs on attention, perceptual and stepping-forward boundaries, and balance in community-dwelling older adults at risk of falling.MethodsFifty-one community-dwelling older adults were recruited to participate in a 24-week randomized controlled trial. Participants (75.4 ± 5.6 years) were randomly assigned to one of three groups: the 1) multimodal psychomotor program [EG1], 2) combined program (multimodal psychomotor program + whole-body vibration program) [EG2], and 3) control group. Participants were assessed at baseline, at post-intervention, and after a 12-week no-intervention follow-up period.ResultsThe within-group comparisons showed significant improvements in attention and balance in EG1 and EG2 after the intervention (p <  0.05). The magnitudes of the treatment effects were similar in both EGs, ranging from medium to large. Decreases in the fall rate were also observed in EG1 (− 44.2%) and EG2 (− 63.0%) (p <  0.05). During the follow-up period, these improvements in attention were maintained, while those in balance were reversed in both EGs. No significant differences between groups were found.ConclusionsThese study results suggest that both multimodal exercise programs were effective for fall prevention and were well tolerated by the participants. Specifically, EG1 and EG2 showed identical improvements in attention, and EG2 presented a slightly larger enhancement in balance and a larger decrease in the fall rate. Our findings demonstrate the benefits of maintaining the psychomotor intervention program by itself or in combination with the whole-body vibration program to prevent cognitive and physical function deterioration.Trial registrationClinicalTrials.gov Identifier:NCT03446352. Date of registration: February 26, 2018.

Association ankle function and balance in community-dwelling older adults.

Ankle function declines with age. The objective of this study was to investigate the association between ankle function and balance in older adults, with a focus on range of motion (ROM) and strength. This was a cross-sectional study that included 88 healthy community-dwelling older adults. Ankle mobility was measured while bearing weight (lunge test) and not bearing weight. The plantar-flexor muscle strength was assessed using a hand-held dynamometer. Balance was measured in terms of dynamic balance and mobility (timed up and go test), monopodal and bipodal static balance with open and closed eyes (single-leg stand test and platform measures), and margins of stability (functional reach test). Linear correlation and multiple regression analyses were conducted with a 95% CI. Most participants had limited ankle mobility (n = 75, 86%). Weight-bearing ankle dorsiflexion ROM was the strongest predictor of dynamic balance and included general mobility and stability ([Formula: see text] = [0.34]; β = [-0.50]). In contrast, plantar-flexor muscle strength was a significant predictor of static standing balance with open eyes ([Formula: see text] = [0.16-0.2]; β = [0.29-0.34]). Overall, weight-bearing ankle dorsiflexion ROM was a more representative measure of balance and functional performance; however, a non-weight-bearing mobility assessment provides complementary information. Therefore, both measures can be used in clinical practice. This study supports the concept that ankle mobility contributes to the performance of dynamic tasks, while the plantar-flexor muscle strength helps to develop a standing static balance. Identification of alterations in ankle function is warranted and may assist in the design of tailored interventions. These interventions can be used in isolation or to augment conventional balance training in order to improve balance performance in community-dwelling older adults.

Association of polypharmacy with postural instability and impaired balance in community-dwelling older adults in Turkey

Objective: Polypharmacy, an important geriatric syndrome, has been shown to be an independent risk factor for falling. However, the data about effects of polypharmacy on balance is lacking. We aimed to evaluate the effects of polypharmacy and inappropriate drug use on balance in older adults. Patients and Methods: Fifty-one patients using ≥ 5 drugs and 50 patients using &amp;lt; 5 drugs were included in the study. Inappropriate drug usage of the patients was evaluated by Beers criteria. Postural stability and risk of falling was investigated by using Biosway Portable Balance System (BPBS). Activities and functional status of the patients were assessed by using Short Physical Performance Battery (SPPB) and Activities Specific Balance Confidence Scale (ABC). All patients underwent comprehensive geriatric assessment. Results: Age, gender, hand grip strength, SPPB scores of the patients were similar between polypharmacy and control groups (all had p&amp;gt;0.05). ABC score was higher in polypharmacy group than control (p&amp;lt;0.01). Overall, anterior-posterior, medial-lateral stability index and eyes closed firm surface scores detected in BPBS were higher, indicating worse stability in the polypharmacy group than control (p&amp;lt;0.05). Limit of stability score was lower in the polypharmacy group than control (p=0.03). Rates of polypharmacy and inappropriate drug usage were higher in patients with a history of falling than without (p&amp;lt;0.01, p&amp;lt;0.01, respectively). In multivariate analysis model, polypharmacy was found to be an independently correlated parameter for impaired balance (OR 24.31; 95%CI 3.05- 193.91; p&amp;lt;0.01). Conclusion: This study has demonstrated that polypharmacy might be a related factor for impaired balance. Struggling with polypharmacy should be one of the most important part of comprehensive geriatric assessment.

The Impact of Ankle-foot Orthoses on Balance in Older Adults: a Scoping Review.

Balance impairment is a contributing factor to falls. Falls are a leading cause of injury and death in older adults. An ankle-foot orthosis (AFO) is a device that can be prescribed as an intervention to help individuals with compromised balance to ambulate safely. The purpose of this review was to investigate the role ankle-foot orthoses have in affecting balance in community-dwelling older adults. A scoping review was conducted searching MEDLINE, CINAHL, EMBASE, and REHABDATA databases to obtain the appropriate literature to meet the following criteria: 1) quantitative research design; 2) studies with participants over age 65; 3) studies with participants with drop-foot or sensory deficits in the lower extremity; 4) the treatment intervention was unilateral or bilateral AFOs; 5) the outcome measure was balance or stability. The retrieved articles were assessed based on the internal validity, external validity, objectivity, and reliability of the study design and the interpretation of results. 11 articles were identified that met the inclusion criteria. Four major themes emerged in the analysis about the impact that ankle-foot orthoses have on balance in older adults: (1) AFOs improved lateral stability, (2) AFOs improved balance under static conditions, (3) AFOs provided a reduction in postural sway and (4) AFOs increased walking speed in community-dwelling older adults. The evidence from the findings of the review indicate that ankle-foot orthoses have a generally positive affect on balance in older adults. Clinicians can consider the ankle-foot orthosis an effective intervention that can improve balance in some older adult patient populations.

A Comparative Study on the Effects of Matter of Balance and Tai Chi on Measures of Balance in Community-Dwelling Older Adults

A Comparative Study on the Effects of Matter of Balance and Tai Chi on Measures of Balance in Community-Dwelling Older Adults

Can Insoles Be Used to Improve Static and Dynamic Balance of Community-Dwelling Older Adults? A Systematic Review on Recent Advances and Future Perspectives.

This systematic review investigated the effects of orthopedic, vibrating, and textured insoles on the postural balance of community-dwelling older adults. Articles published in English from 1999 to 2019 investigating the effects of (a)orthopedic, (b)vibrating, and (c)textured insoles on static and dynamic balance in community-dwelling older adults were considered. Twenty-four trials with a total of 634 older adults were identified. The information gathered generally supported the balance-improving effects of orthopedic, vibrating, and textured insoles in both static and dynamic conditions among community-dwelling older adults. Further examination found that rigidity, texture patterns, vibration thresholds, and components like arch supports and heel cups are important factors in determining whether insoles can improve balance. This review highlights the potential of insoles for improving the static and dynamic balance of community-dwelling older adults. Good knowledge in insole designs and an understanding of medical conditions of older adults are required when attempts are made to improve postural balance using insoles.

FALL PREVENTION PROGRAMS FOR RURAL COMMUNITY DWELLING OLDER ADULTS RESULTS IN IMPROVED BALANCE

More than one in four older adults (OA) in the US fall each year and 20 to 30% suffer moderate to severe injuries such as head trauma or hip fractures. Falls are both a medical and financial burden that can be significantly reduced by lifestyle interventions. One of the main strategies to help reduce these statistics is evidence-based fall prevention classes which help to build muscle, improve balance, and increase participants’ confidence in fall control. A goal of the Arkansas Geriatric Workforce Enhancement Program (HRSA grant U1QHP28723) is to deliver community-based programs that improve health outcomes and quality of life. Evidence-based preventive health training is a major way to meet this goal. Two of these evidence-based trainings are Tai Chi (TC) and A Matter of Balance (AMOB), multi-week classes that help to improve balance and reduce fall risk. This study took place at scheduled community-based classes, where demographic and balance data were obtained. The aim was to determine the difference in the balance of community-dwelling OA as measured by Balance Tracking System® before and after AMOB and TC courses. Both groups showed positive changes in their mean balance percentage with the AMOB class having a higher Mean ± SD (24.3 ± 21.0) vs. the TC participants (4.0 ± 29.7). The One-Way Analysis of Variance showed statistically significant difference in the AMOB class over those in the TC class, F (1, 32) = 5.280, p < 0.05. The Cohen’s d = 0.789 indicates a large effect between the two groups.

Reconstruction of body motion during self-reported losses of balance in community-dwelling older adults

Older adults experience slips, trips, stumbles, and other losses of balance (LOBs). LOBs are more common than falls and are closely linked to falls and fall-injuries. Data about real-world LOBs is limited, particularly information quantifying the prevalence, frequency, and intrinsic and extrinsic circumstances in which they occur. This paper describes a new method to identify and analyze LOBs through long-term recording of community-dwelling older adults. The approach uses wearable inertial measurement units (IMUs) on the feet, trunk and one wrist, together with a voice recorder for immediate, time-stamped self-reporting of the type, context and description of LOBs. Following identification of an LOB in the voice recording, concurrent IMU data is used to estimate foot paths and body motions, and to create body animations to analyze the event. In this pilot study, three older adults performed a long-term monitoring study, with four weeks recording LOBs by voice and two concurrent weeks wearing IMUs. This report presents a series of LOB cases to illustrate the proposed method, and how it can contribute to interpretation of the causes and contexts of the LOBs. The context and timing information from the voice records was critical to the process of finding and analyzing LOB events within the voluminous sensor data record, and included much greater detail, specificity, and nuance than past diary or smartphone reporting.

Contribution of hip abductor-adductor muscles on static and dynamic balance of community-dwelling older adults.

The previous studies have investigated causes of and risk factors for falls and impairment of functional capability in older adults. However, the biomechanical factors involved in functional performance and postural control, and the contribution of hip muscles, are still unknown. The aim of the present study was to verify the association between the muscle function of hip abductors and adductors and static and dynamic balance, in a narrow base of support, in community-dwelling older adults. Eighty-one older adults, including both women and men, were evaluated. Tandem gait and single-leg stance were used to assess static and dynamic balance, and an isokinetic dynamometer was used to analyze muscle function (peak torque and rate of torque development according to body weight). Data were analyzed by a multivariate linear regression test without adjustment and with adjustment using two models: adjustment I (sex) and adjustment II (age). There was a statistically significant association between peak torque of abductor in single-leg stance and tandem gait speed. The PT of hip adductors contributed to static balance performance, in a narrow base of support from the unadjusted data and from the adjusted data by sex. The findings of the present study are relevant, because if deficits in balance and functionality in older adults can be linked to a decline in maximum muscle strength of hip abductors, this parameter can be treated to maintain independence in older adults for as long as possible.

Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults †.

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.