Fitness, Balance Efficacy, and Postural Control in Community-Dwelling Older Adults

Abstract

Age-related declines in postural control and physical fitness are strong risk factors for falls in older adults. Balance efficacy has been utilized to identify poor postural control, reduced physical function, and fall risk. However, it is not clear as to whether balance efficacy is truly a better predictor of functional fitness outcomes or postural control. Distinguishing these associations is an important step in the future derivation of physiotherapeutic programming to remediate acute and chronic decline. Therefore, the purpose of this cross-sectional study was to partition which measures are more associated with balance efficacy, fitness, or postural control. One hundred eleven community-dwelling older adults participated and were asked to complete the Balance Efficacy Scale (BES), a functional fitness measure (the Senior Fitness Test [SFT]), and a measure of postural control (the Sensory Organization Test [SOT]).We found that the SFT was more significantly associated with balance efficacy (R 2 = .37) than the SOT (R 2 = .08) in older adults. Overall, aerobic endurance, functional mobility in the SFT, and the vestibular score on the SOT were significantly associated with balance efficacy.We concluded that clinicians utilizing the BES as a preliminary screen should recommend physiotherapy follow-up activities that build endurance (walking), lower extremity functional mobility (sit-to-stand), and vestibular function (head movement while walking). Understanding the links between a preliminary screening tool and the physiological needs of the patient will allow for targeted activities to be prescribed. Keywords aging, fall risk, balance efficacy, postural control, physical fitness 2 SAGE Open measure of fitness in older adults (Rikli & Jones, 2013). It includes measurements of strength (i.e., chair stand, arm curl), flexibility (i.e., chair sit-and-reach, shoulder stretch), endurance (i.e., 6-min walk, 2-min step test), and functional mobility (i.e., 8-foot up-and-go). Moreover, the Sensory Organization Test (SOT) has been regarded as an important measurement tool used to examine and understand postural control through the integration of visual, somatosensory, and vestibular components (Jacobson, Newman, & Kartush, 1993).Previous studies have found that balance efficacy is related to functional fitness (Klima, Newton, Keshner, & Davey, 2012;Woollacott & Shumway-Cook, 2002) and postural control (Arnold & Faulkner, 2009). For example, Klima et al. (2012) found that balance efficacy is significantly correlated with balance ability and functional mobility in community-dwelling older men. Other researchers have found aerobic endurance is strongly related to balance efficacy in older adults (Julius, Brach, Wert, & VanSwearingen, 2012). Moreover, it has been found that balance efficacy is an independent predictor of balance performance in challenging sensory conditions (Arnold & Faulkner, 2009;Liu-Ambrose et al., 2006). However, according to Lane et al. (2014), balance performance scores from the SOT did not sh...

Examining the relationship between falls self-efficacy and postural sway in community-dwelling older adults

“…Conversely, if a person reports low falls self-efficacy, their eyes open balance will be lower. This finding is in line with previous research (Kamide et al, 2019;Lee et al, 2016;Pua et al, 2017;Schepens et al, 2012) indicating that psychological states strongly affect physiological outcomes. Additionally, in line with research done by Tinetti et al (1994) and Vellas et al (1997), after a person falls, their fear of falling grows, which can cause them to live more cautiously, more sedentarily.…”

The validity and reliability of the “My Jump App” for measuring jump height of the elderly

“…Specifically, for the elderly, the vertical jump has been shown to be a good predictor of functional capacity ( Pijnappels et al, 2008 ), and risk of falling ( Lee, Biggan & Ray, 2016 ). It has been previously shown that loss of functional capacity interferes with the performance of activities of daily living (ADL) ( Foldvari et al, 2000 ; Macaluso & De Vito, 2004 ; Farias et al, 2013 ), decreasing the independence in ADL, and also increasing the prevalence of falls ( Lee, Biggan & Ray, 2016 ; Vieira et al, 2013 ). Therefore, it is reasonable to highlight that the vertical jump can be one of the most appropriate, useful, and suitable tests to evaluate the functional capacity of elderly people.…”

The Phasic Influence of Vestibular Neural Inputs During Sit-to-Stand: A Case Report

“…Therefore, we believe that our results are clinically significant as it adds further and deeper understanding of the vestibular influence on a commonly performed daily function like sitto-stand could make test like timed up-and-go test and 30-second sitto-stand test more potentially useful in clinical decision making. Clinicians could benefit from an in-depth and feasible analysis of the role of vestibular inputs during sit-to-stand and what they expect from their patients as elderly or patients with balance disorders [2,15] which could help researchers and clinicians determine the root cause of functional limitations to develop more effective assessment and interventions.…”