[Backward disequilibrium in the elderly: review of symptoms and proposition of a tool for quantitative assessment].

Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France.
La Revue de Médecine Interne (Impact Factor: 0.9). 05/2007; 28(4):242-9. DOI: 10.1016/j.revmed.2006.12.002
Source: PubMed

ABSTRACT PURPOSE: Although there is currently no epidemiological data on backward disequilibrium, this disturbance of posture does not seem to be rare in frail elderly. ACTUALITIES AND STRONG POINTS: Backward disequilibrium is characterized by the following criteria: the location of buttocks on the anterior side of the seat while the trunk rested at the back of the armchair in the sitting position; an inadequate forward of the trunk and a backward projection of the trunk outside the base of support during sit-to-stand; and a posterior projection of the center of mass outside the base of support in the standing position. Several pathological situations either somatic (degenerative, ischemic and traumatic brain lesions), psycho-somatic (psychomotor disadaptation syndrome, extended bed confining, non-use) or psychological (depression) affections can entail backward disequilibrium. Falls, loss of autonomy and the risk of the vicious circle with its causes are the main consequences of backward disequilibrium. PROSPECTS AND PROJECTS: Although the geriatrician is familiarized with backward disequilibrium, there is no scale to quantify it. In this paper we review causes, consequences and management of backward disequilibrium, and in order to assess it, we propose a semi-quantitative scale, based on some activities of everyday living which are sitting position, sit-to-stand, back-to-sit and standing position. So, a backward disequilibrium score could be determined.

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