Development of an objective balance assessment method for purposes of telemonitoring and telerehabilitation in elderly population

Purpose. Reliable assessment of balance abilities and determination of the likelihood of falling in the elderly requires a skilled clinician to guide and assist the individual throughout the scoring of a suitable balance assessment method. The most widely used clinical instrument is the Berg Balance Scale (BBS). The aim of this study was to develop an objective balance assessment measure that would correlate well with BBS and could thus be used to test balancing abilities remotely. Methods. Twenty elderly individuals were divided into two groups: fallers and non-fallers based on their falling records. Balance abilities were assessed by means of BBS as well as through analysis of peak amplitude of center-of-pressure (COP) responses that followed induced-sway, provoked by a moveable standing frame in the medio-lateral plane. An independent t-test was used to compare BBS scores and COP based measures between both groups. Additionally, correlation between both tests was determined by use of the Pearson correlation coefficient. Results. Fallers exhibited significantly lower BBS scores as well as significantly lower peak values of COP responses. The coefficient of correlation between both tests was relatively high (0.68) and statistically significant. Conclusion. The high degree of correlation between both tests implies that the proposed objective balance testing apparatus and methods could be used for remote assessment of balance abilities in the elderly, which has implications for the development of home-based mobility training programs.

[1]  B. E. Maki,et al.  Measuring balance in the elderly: validation of an instrument. , 1992, Canadian journal of public health = Revue canadienne de sante publique.

[2]  Vivian Weerdesteyn,et al.  A Five-Week Exercise Program Can Reduce Falls and Improve Obstacle Avoidance in the Elderly , 2006, Gerontology.

[3]  Y. Lajoie,et al.  Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Confidence (ABC) scale for comparing fallers and non-fallers. , 2004, Archives of gerontology and geriatrics.

[4]  A. Zupan,et al.  Effects of dynamic balance training during standing and stepping in patients with hereditary sensory motor neuropathy , 2006, Disability and rehabilitation.

[5]  I. Cikajlo,et al.  A novel approach in objective assessment of functional postural responses during fall-free perturbed standing in clinical environment. , 2007, Technology and health care : official journal of the European Society for Engineering and Medicine.

[6]  L. Kurlowicz,et al.  The Mini Mental State Examination (MMSE). , 1999, Director.

[7]  A. Olenšek,et al.  Methods for dynamic balance training during standing and stepping. , 2005, Artificial organs.

[8]  R. Fitzpatrick,et al.  Lateral Stability, Sensorimotor Function and Falls in Older People , 1999, Journal of the American Geriatrics Society.

[9]  David A. Winter,et al.  Human balance and posture control during standing and walking , 1995 .

[10]  F. Horak,et al.  Central programming of postural movements: adaptation to altered support-surface configurations. , 1986, Journal of neurophysiology.

[11]  Bastiaan R. Bloem,et al.  An update on falls , 2003, Current opinion in neurology.

[12]  T E Howe,et al.  Exercise for improving balance in older people. , 2007, The Cochrane database of systematic reviews.

[13]  B. Maki,et al.  Aging and Postural Control , 1990, Journal of the American Geriatrics Society.

[14]  T. Sinkjaer,et al.  Functional postural responses after perturbations in multiple directions in a standing man: a principle of decoupled control. , 2001, Journal of biomechanics.

[15]  A. Shumway-cook,et al.  Predicting the probability for falls in community-dwelling older adults. , 1997, Physical therapy.