Understanding Approaches to Balance Assessment in Physical Therapy Practice for Elderly Inpatients of a Rehabilitation Hospital

Abstract

Purpose: Balance is a critical modifiable risk factor for falls in older adults. The purpose of this study was to identify the physiotherapy assessment tools used to evaluate balance in clinical practice and to determine the components of balance assessed through the use of standardized and/or other measures. Methods: A retrospective chart review was performed on 250 patients aged 65 and older undergoing in-patient rehabilitation with a clinical diagnosis associated with a balance impairment (stroke, musculoskeletal conditions, lower limb amputation, deconditioning, or cardiac surgery) at a rehabilitation hospital in Ontario. Results: All patients received at least one assessment that incorporated a balance component. Standardized balance measures were performed for 73% of patients; the timed up-and-go test (48%) and Berg Balance Scale (36%) were most commonly used for this assessment. Reactive movement strategies and cognitive processing were the least commonly assessed components of balance. Balance was assessed least often among people with cardiac surgery. Conclusions: Considerable variation exists in the assessment of balance, and the data suggest that not all relevant components are equally considered. Future research should be conducted in other clinical settings and should include other health care practitioners' assessments to develop a more complete understanding of current balance assessment procedures.Key Words: aged; outcome assessment (health care); postural balance. RÉ SUMÉObjectif : L'é quilibre constitue un facteur modifiable critique de risque de chutes chez les adultes â gé s. Cette é tude visait à dé terminer les outils utilisé s en physiothé rapie pour é valuer l'é quilibre en pratique clinique et les é lé ments constituants de l'é quilibre é valué s au moyen de mesures normalisé es ou autres. Mé thodes : On a procé dé à un examen ré trospectif des dossiers de 250 patients â gé s de 65 ans et plus qui ont suivi une ré adaptation en service interne aprè s avoir reç u un diagnostic clinique associé à une dé ficience de l'é quilibre (accident vasculaire cé ré bral, problè mes de l'appareil locomoteur, amputation d'un membre infé rieur, dé conditionnement et chirurgie cardiaque) à un hô pital de ré adaptation de l'Ontario. Ré sultats : Tous les patients ont fait l'objet d'au moins une é valuation comportant un volet é quilibre. On a pris des mesures normalisé es de l'é quilibre chez 73 % des patients : le test chronomé tré lever-marcher (48 %) et le test d'é quilibre de Berg (36 %) ont servi le plus souvent pour cette é valuation. Les straté gies de mouvement ré actifs et le traitement cognitif ont é té les é lé ments de l'é quilibre é valué s le moins souvent. L'é quilibre a é té é valué le moins souvent chez les personnes qui avaient subi une chirurgie cardiaque. Conclusions : Il existe une variation importante au niveau de l'é valuation de l'é quilibre et les donné es indiquent qu'il n'est pas tenu compte é galement de tous les é lé ments pertinents. Les recherches à venir dans d'autr...

Influência da preocupação com quedas na mobilidade e na força de reação do solo em idosas durante descida de escada

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“…Esse fato pode ter contribuído para que aqueles autores encontrassem sujeitos desempenhando o teste de forma mais lenta. 9,20 A baixa autoeficácia encontrada em idosos ao subir e descer escadas, em estudos que os comparam a jovens, tem sido relacionada com frequência à falta de confiança sobre as capacidades motoras, além da presença de déficits motores e mecânicos. 1,[25][26][27] A hipótese do presente estudo foi que idosas com preocupação em cair teriam o primeiro pico da Fz menor com relação a idosas sem preocupação.…”

A theory-based multi-component intervention to increase reactive balance measurement by physiotherapists in three rehabilitation hospitals: an uncontrolled single group study

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The comparison of postural balance in elderly active, sedentary and with vestibulopathy

“…(4) Furthermore, to be sedentary or have the presence of any disease related to vestibular system also can compromise the performance of the postural control and thus, increases the risk of falls. Some studies have investigated postural control in elderly people with different health conditions, (5,6) but few reported difference between those with vestibular disorder related to two different groups (active and sedentary elderly) based on balance parameters from a force platform measurement.…”