Postural balance and self-reported functional ability in 75-year-old men and women: a cross-national comparative study.
ABSTRACT To study postural balance in relation to self-reported functional ability (mobility and ADL) and general physical activity in elderly men and women living in three different Nordic environments.
A random sample of 448 men and 556 women from among the 75-year-old residents in Glostrup, Denmark, and Göteborg, Sweden, and all the residents of relevant age (127 men and 261 women) in Jyväskylä, Finland.
Assessment of postural balance with eyes open and closed using a piezoelectric force platform. A structured interview on self-reported functional ability and physical activity. An in-laboratory medical examination.
In spite of some differences in balance between the groups studied (better results in women compared with men and, to some extent, better results in the participants from Denmark and Finland than in those from Sweden), the performance in the balance tests was similarly associated with functional ability within all groups. The subjects reporting no need of help in performing the ADL and mobility functions performed significantly better in the balance tests. These differences were seen more clearly in the control of anteroposterior movement of center of forces than in the mediolateral direction. The performance in the balance tests was also significantly better among the subjects reporting a higher level of general physical activity than in their less active counterparts. Physical activity and than in their less active counterparts. Physical activity and certain long standing illnesses modified significantly the relationship between postural balance and ADL-performance. When these factors were analyzed simultaneously, the role of balance as a predictor of ADL-performance largely disappeared.
The results suggest that good balance is one of the prerequisites of performance without difficulty in mobility and ADL functions. Physical exercise may help to maintain balancing abilities in old age; good balance, in turn, may also enable a physically active way of life. The associations of balance with functional ability and physical activity were independent of sex and locality. The results also support the validity of static stabilometry as a tool for evaluating threats to functional limitations in older subjects.
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ABSTRACT: Background/PurposeThis study presents the results of structure validity tests of two measures of mobility for healthy older people. The aim of this article is to analyze whether the results of the validation study by Avlund et al (Scand J Soc Med 1993;21:233–46; Eur J Public Health 1996;6:35–41) can be reproduced in Germany and to explore whether fatigue as measured by one of the scales is predictive of the need for help and nursing costs at 3-year follow-up.Method Data were collected between 2004 and 2007 from 1197 75+-year-olds in southern Germany. Mobility was measured by questions in relation to fatigue and need of help. Structural validity and internal consistency was tested using the Rasch model for item analysis. The fit of the Rasch model was compared with latent class analysis (LCA) in order to explore whether the used scales produce quantitative or qualitative data. The predictive validity of the scales was analyzed in relation to need of help in mobility and costs to the nursing and health insurance systems in Germany at 3-year follow-up.ResultsTwo scales on mobility, one in relation to need of help (the Mob-H scale) and one regarding fatigue (the Mob-T scale), were derived. The classes in the latent class solution differed in their sum scores, so that the use of the sum score produced valid differences although the qualitative latent classes showed a better model fit than did the quantitative Rasch model. Furthermore, fatigue as measured by the Mob-T scale turned out to be related to the development of dependency in mobility and to nursing care costs at 3-year follow-up. Further, the strongest predictor of nursing care costs was need of help, measured by the quantitative Mob-H scale.Conclusion The Mob-T and Mob-H scales developed in Denmark were reproduced in a German population, using the Rasch model for item analysis. Further, fatigue in mobility activities (Mob-T) was predictive of need of help and nursing care costs at 3-year follow-up. These findings are substantial because they suggest that it is highly relevant to put attention to fatigue in mobility in health care programs with the aim of reducing health care and nursing costs.03/2012; 3(1):29–35. DOI:10.1016/j.jcgg.2011.11.007
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ABSTRACT: Purpose: The purpose of the study was to evaluate the effect of BodyBalance ® training on balance, functional task performance, fear of falling, and health-related quality of life in adults aged over 55 years. Participants and methods: A total of 28 healthy, active adults aged 66±5 years completed the randomized controlled trial. Balance, functional task performance, fear of falling, and self-reported quality of life were assessed at baseline and after 12 weeks. Participants either undertook two sessions of BodyBalance per week for 12 weeks (n=15) or continued with their normal activities (n=13). Results: Significant group-by-time interactions were found for the timed up and go (P=0.038), 30-second chair stand (P=0.037), and mediolateral center-of-pressure range in narrow stance with eyes closed (P=0.017). There were no significant effects on fear of falling or self-reported quality of life. Conclusion: Twelve weeks of BodyBalance training is effective at improving certain balance and functional based tasks in healthy older adults.Clinical Interventions in Aging 11/2014; 9. DOI:10.2147/CIA.S71769 · 1.82 Impact Factor
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ABSTRACT: Mobility is essentially based on successful balance control. The evaluation of functional strategies for postural stability is requisite for effective balance rehabilitation and fall prevention in elderly subjects. Our objective was to clarify control mechanisms of different standing positions reflecting challenges of typical everyday life situations. For this purpose, elderly subjects stood on different surfaces resulting in a change of the biomechanical constraints. Sway parameters out of time and frequency domain were calculated from center-of-pressure (COP) excursions. Besides the classic quantification of the amount of sway variability, we investigated the temporal organization of postural sway by means of nonlinear time series analysis. Limb load symmetry was quantified via foot pressure insoles. We found task dependent motor outputs: (1) asymmetrical loading in all conditions; (2) altered amount and structure of COP movements with dissimilar changes in medio-lateral and anterior-posterior direction; (3) changes of the motor output affect several time scales especially when standing on a balance board or with one foot on a step. Our results indicate that elderly subjects preferred forcefully one limb which supports a step-initiation strategy. Modifications of the postural sway structure refer to the interaction of multiple control mechanisms to cope with the altered demands. The identification of postural strategies employed in daily activities augments the ecological validity of postural control studies.Human movement science 09/2013; 32(6). DOI:10.1016/j.humov.2013.05.005 · 2.03 Impact Factor