Balance performance in community-dwelling female elderly fallers and non-fallers in Hong Kong

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Balance performance in community-dwelling female elderly fallers and non-fallers in Hong Kong

 

Author: Ho, Sau-tat
Title: Balance performance in community-dwelling female elderly fallers and non-fallers in Hong Kong
Degree: M.Sc.
Year: 1997
Subject: Falls (Accidents) in old age -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Pages: xii, 133 p. : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1410555
URI: http://theses.lib.polyu.edu.hk/handle/200/1750
Abstract: Falls in the elderly has been identified as one of the major problems because the yearly cost to the health care system for acute care associated with fall-related fractures is estimated to be in the billions of US dollars. This could imply that postural control of the fallers may be worse than that of the non-fallers and screening tools to detect early fall-related changes among those living in the community are essential so that more specific and effective rehabilitation interventions could be implemented. This study attempted to compare the postural control between community-dwelling elderly fallers and non-fallers under conditions with different combinations of sensory inputs as well as the ability to control the center of gravity to their limit of stability in performing required balance activities. The difference between these two groups of elderly in respect of the self-perceived balance confidence was also addressed. Thirty community-dwelling female older adults with a mean age of 68 years were recruited for the study. They were equally divided into faller and non-faller group. A computerized force platform assessment system and a self-perceived balance confidence test were used in the study. They were two objective balance assessment tests, the sensory organization test (SOT) and the limit of stability (LOS) test, and one self-perceived balance confidence test. For the SOT, all subjects were instructed to stand on the force platform and maintain a standing posture under the six testing conditions: (1) normal vision, normal support surface; (2) eyes closed, normal support surface; (3) visual enclosure, normal support surface; (4) normal vision, support surface servoed; (5) eyes closed, support surface servoed; and (6) visual enclosure and support surface both servoed. The maximum stability score was recorded in each condition and the average stability score was also calculated. For the LOS test, all subjects were instructed to bring their center of gravity to the eight target directions at their 60% theoretical limit of stability. Movement time and path sway were recorded for each target direction. For the self-perceived Activities-specific Balance Confidence (ABC) Scale, subjects were asked to rate their confidence level verbally from zero (no confidence at all) to ten (completely confident) for each of the sixteen items of common activities of daily living. The total score of the ABC Scale was recorded. Results indicated that the fallers had significantly lower maximum stability scores during the sensory conditions 4 to 6 and lower average stability score in the sensory organization test when compared with those of the non-faller group. The fallers also took a significantly longer movement time than the non-fallers to reach the targets in the limit of stability test. However, no significant difference in the path sway in reaching the peripheral targets was found between the fallers and non-fallers. Although no significant difference existed in the total score of the ABC Scale between the fallers and non-fallers in this study, the correlation of the ABC scale with the absence or disruption of either or both visual, somatosensory inputs, the elderly fallers were found to have more difficulty to maintain their postural control. This suggested that the ability to organize various sensory inputs for the postural control in this group of community-dwelling fallers might have been affected. The longer response times in the limit of stability test suggested that the postural adjustment prior or during the movement might be impaired in the fallers. Therefore, early screening of potential fallers and effective rehabilitation intervention would be beneficial to prevent further falls.

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