Evaluation of the risk of falling in institution-dwelling elderly: clinical tests versus biomechanical analysis of stepping-up

Abstract

Falls in the elderly constitute a major socio-economic problem for modern healthcare. The aim of the study was to extract biomechanical parameters to indicate balance level and the risk of falling in the elderly. It is a preliminary work as part of the development of a home-test based on force-plate technology. Seven faller and 12 non-faller elderly subjects performed stepped up onto a forceplate. Each subject was tested once per weekday for three weeks. Tinetti, Mini Mental Scale test (MMS) and the Geriatric Depression Scale (GDS) scores were measured before the experimentations. Temporal and ground reaction force parameters were measured. The Tinetti test was not correlated with falls in the following six-month period. In contrast, the biomechanical parameters related to the forces measured at foot-contact and to the durations of the phases of the stepping-up were correlated with fall, as well as with MMS and GDS. These results demonstrated that biomechanical parameters could be used as indicators of balance and risk of fall.

Comparison of balance assessment modalities in emergency department elders: a pilot cross-sectional observational study

“…Balance plates using limits of stability measurements have been used to predict fall risk in both institution-dwelling and community-dwelling elders [ 18 , 19 , 27 , 28 ]. In addition to the lack of correlation between balance plate and TUG testing, there was no relationship between the balance plate testing and patient provided history of falls in univariate logistic regression analysis.…”

Neuromuscular Changes in Older Adults during the Lateral Step Task

“…The increased time of step movement indicates a risk for fall or injury as was explained that older adults experience decreased speed in performing activities [88]. This supports accounts that there are age-related changes in motor function during daily activities [8,12,26,46,76,82,[86][87][88][89][90][91][92][93][94][95][96].…”

“…The ability to perform ADL has proven to be different among different categories such as age and gender. In order to assess age-related changes in motor function during daily activities, specific ADL have been studied, for example, gait (the act of walking) [86][87][88][89], sit to stand (the act of going from a seated position to a standing position) [90,91], stepping [8,12,46,82,[92][93][94][95] and posture [8,26,76,96].…”

“…Swing time and muscle burst duration averages in the MS Excel worksheet were imported into an SPSS (SPSS Inc, IL) worksheet and restricted so the average of all the interested variables were entered group wise (younger/older, 4inch/8inch). Subjects were categorized based on age, which is one of the most common risk factors for joint injury and falls[11,92,107]. Prior to analysis, data was reviewed to ensure whether data was normally distributed for all variables in each of the groups.…”