Age-related differences in time-limit performance and force platform-based balance measures during one-leg stance.

Poor posture control has been associated with an increased risk of falls and mobility disability among older adults. This study was conducted to assess the test-retest reliability and sensitivity to group differences regarding the time-limit (TLimit) of one-leg standing and selected balance parameters obtained with a force platform in older and young adults. A secondary purpose was to assess the relationship between TLimit and these balance parameters. Twenty-eight healthy older adults (age: 69±5years) and thirty young adults (age: 21±4years) participated in this study. Two one-leg stance tasks were performed: (1) three trials of 30s maximum and (2) one TLimit trial. The following balance parameters were computed: center of pressure area, RMS sway amplitude, and mean velocity and mean frequency in both the anterio-posterior and medio-lateral directions. All balance parameters obtained with the force platform as well as the TLimit variable were sensitive to differences in balance performance between older and young adults. The test-retest reliability of these measures was found to be acceptable (ICC: 0.40-0.85), with better ICC scores observed for mean velocity and mean frequency in the older group. Pearson correlations coefficients (r) between balance parameters and TLimit ranged from -0.16 to -0.54. These results add to the current literature that can be used in the development of measurement tools for evaluating balance in older and young adults.

[1]  F. Horak,et al.  The relevance of clinical balance assessment tools to differentiate balance deficits. , 2010, European journal of physical and rehabilitation medicine.

[2]  A. Clifford,et al.  Postural control in healthy individuals. , 2010, Clinical biomechanics.

[3]  P J Holliday,et al.  Clinical and laboratory measures of postural balance in an elderly population. , 1992, Archives of physical medicine and rehabilitation.

[4]  M. Tinetti,et al.  Risk factors for falls among elderly persons living in the community. , 1988, The New England journal of medicine.

[5]  P. Goldie,et al.  Force platform measures for evaluating postural control: reliability and validity. , 1989, Archives of physical medicine and rehabilitation.

[6]  Mary Ann Holbein-Jenny,et al.  Validity of functional stability limits as a measure of balance in adults aged 23–73 years , 2007, Ergonomics.

[7]  C. Persad,et al.  Assessing falls in the elderly: should we use simple screening tests or a comprehensive fall risk evaluation? , 2010, European journal of physical and rehabilitation medicine.

[8]  Anna Maria Turcato,et al.  Comparison of Reliability, Validity, and Responsiveness of the Mini-BESTest and Berg Balance Scale in Patients With Balance Disorders , 2012, Physical Therapy.

[9]  H. Larsen,et al.  Performance in functional balance tests during menopausal hormone replacement: a double-blind placebo-controlled study. , 1999, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[10]  J. P. Paul,et al.  What is balance? , 2000, Clinical rehabilitation.

[11]  F. Prince,et al.  Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people. , 2004, Archives of physical medicine and rehabilitation.

[12]  L. Levy.  Falls in Older People: Risk Factors and Strategies for Prevention , 2002 .

[13]  D. Kiel,et al.  Correlations of clinical and laboratory measures of balance in older men and women , 2012, Arthritis care & research.

[14]  Christoph Bauer,et al.  Intrasession reliability of force platform parameters in community-dwelling older adults. , 2008, Archives of physical medicine and rehabilitation.

[15]  Jay Hertel,et al.  Effect of hip and ankle muscle fatigue on unipedal postural control. , 2004, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[16]  M A Hughes,et al.  The relationship of postural sway to sensorimotor function, functional performance, and disability in the elderly. , 1996, Archives of physical medicine and rehabilitation.

[17]  M. Ouaknine,et al.  Sensory strategies in human postural control before and after unilateral vestibular neurotomy , 1997, Experimental Brain Research.

[18]  I. Melzer,et al.  Postural stability in the elderly: a comparison between fallers and non-fallers. , 2004, Age and ageing.

[19]  M. Woollacott,et al.  Correlation between two clinical balance measures in older adults: functional mobility and sensory organization test. , 1998, The journals of gerontology. Series A, Biological sciences and medical sciences.

[20]  L. Rubenstein.  Falls in older people: epidemiology, risk factors and strategies for prevention. , 2006, Age and ageing.

[21]  André W O Gil,et al.  Relationship between force platform and two functional tests for measuring balance in the elderly. , 2011, Revista brasileira de fisioterapia (Sao Carlos (Sao Paulo, Brazil)).

[22]  Takehiro Michikawa,et al.  One-leg standing test for elderly populations , 2009, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[23]  Pertti Era,et al.  Force Platform Measurements as Predictors of Falls among Older People – A Review , 2006, Gerontology.

[24]  A Graybiel,et al.  Revised normative standards of performance of men on a quantitative ataxia test battery. , 1973, Acta oto-laryngologica.

[25]  R. Werner,et al.  Unipedal stance testing as an indicator of fall risk among older outpatients. , 2000, Archives of physical medicine and rehabilitation.

[26]  M Schieppati,et al.  The role of instrumental assessment of balance in clinical decision making. , 2010, European journal of physical and rehabilitation medicine.

[27]  C. Riach,et al.  Postural stability measures: what to measure and for how long. , 1996, Clinical biomechanics.

[28]  Daniel Imbeau,et al.  Reliability of centre of pressure summary measures of postural steadiness in healthy young adults. , 2008, Gait & posture.

[29]  J. Fleiss.  The design and analysis of clinical experiments , 1987 .

[30]  Maury A Nussbaum,et al.  Reliability of COP-based postural sway measures and age-related differences. , 2008, Gait & posture.

[31]  N. Vuillerme,et al.  Test-retest reliability of centre of foot pressure measures to assess postural control during unperturbed stance. , 2009, Medical engineering & physics.

[32]  L. Portney,et al.  Foundations of Clinical Research , 1993 .

[33]  F Prince,et al.  Intrasession reliability of the "center of pressure minus center of mass" variable of postural control in the healthy elderly. , 2000, Archives of physical medicine and rehabilitation.

[34]  R. Orr.  Contribution of muscle weakness to postural instability in the elderly. A systematic review. , 2010, European journal of physical and rehabilitation medicine.

[35]  L. Portney,et al.  Foundations of Clinical Research: Applications to Practice , 2015 .

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

[37]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[38]  Claire Ballinger,et al.  Exercise for improving balance in older people. , 2011, The Cochrane database of systematic reviews.