Article

[Evaluation of postural control systems in elderly patients with repeated falls].

Unidad de Caídas, Servicio de Geriatría, Hospital Clínico San Carlos, Madrid, España.
Revista Española de Geriatría y Gerontología 43(2):71-5. pp.71-5
Source: PubMed

ABSTRACT a) to describe postural control disorders in elderly patients with recurrent falls; b) to analyze the influence of sensory deficits on centre of gravity control mechanisms; and c) to assess the functional consequences of balance disorders and falls in this group of patients.
patients aged more than 65 years old referred to a falls unit with two or more falls in the previous 6 months were included in this study. The protocol included posturographic studies with a Neurocom Balance Master. To evaluate motor control, Rhythmic Weight Shift (RWS test) was performed. To assess sensorial control, Modified Clinical Test of Sensory Interaction on Balance (MCT test) was used. Other tests performed were the Sit to Stand (SS test), Walk across (WA test) and Step up over (SO test).
a total of 109 patients (85.3% women) were studied. Mean age was 78.01 years (SD: 5.38). Disorders in one or more afferent sensorial systems were found in 51.7% of the patients (27.5% visual deficiencies, 17.6% vestibular alterations, and 6.6% somatosensorial deficits). Two afferent systems were compromised in 25.3%, and all three were compromised in 11.1% of the patients. No significant differences were found in directional control (RWS) when compared with the number of altered systems.
posturographic studies provide sensitive information on static and dynamic centre of gravity control systems, eventual sensory deficits, and patients' ability to carry out basic activities of daily living. In our sample, the most frequent deficit was visual impairment. This information is essential to establish a correct management programme.

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    Article: Reliabilitätsprüfung des Biodex Balance Systems
    Johannes Strobel
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    ABSTRACT: Context: In order for balance to be maintained, the postural control system must process above all visual, vestibular and proprioceptive information and translate this input into appropriate motor responses. It is still unclear which factores affect the computerized dynamic posturography (CDP). Objective: To investigate the realiability of the CDP by use of the Biodex Balance Systems, with a special attention of age, body height, body mass index (BMI), gender, one leg stance, visual and auditory input, stability level, regular sporting activity and acute maximal exercise on balance. Setting: Military tertiary care teaching hospital. Subjects and methods: 110 subjects completed a standardized questionnaire on their age, gender height, BMI and sporting activity. We then assessed the postural stability of the subjects. Additionally seventeen further subjects performed a maximal exercise test on a bicycle ergometer. We used CDP and a predefined protocol to assess balance at rest, at maximal exercise and then at 5-minute intervals until recovery. Results: Body height, gender, one leg stance, auditory inputs and regular physical activity did not influence balance ability. By contrast, age, stability level, visual feed back, BMI and acute physical exercise had a strong effect. Conclusions: A high BMI value, age, stability level and acute maximal exercise lead to a considerable decrease in postural stability. Our results can thus explain the increasing risk of injury after strenuous physical activity, especially in sporting activities with changing requirements of balance, e.g. skiing. Furthermore we can say that the CDP is a highly reliable method to examine postural stability, if attention is payed to several influencing factors, especially BMI and age.
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Keywords

17.6% vestibular alterations
 
27.5% visual deficiencies
 
6.6% somatosensorial deficits
 
afferent sensorial systems
 
afferent systems
 
correct management programme
 
directional control
 
dynamic centre
 
elderly patients
 
eventual sensory deficits
 
functional consequences
 
gravity control mechanisms
 
gravity control systems
 
Modified Clinical Test
 
motor control
 
Neurocom Balance Master
 
postural control disorders
 
Rhythmic Weight Shift
 
sensitive information
 
sensorial control