Article

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

University of Burgundy, Dijon, Bourgogne, France
La Revue de Médecine Interne (Impact Factor: 1.32). 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.

Download full-text

Full-text

Available from: Dominic Pérennou, Dec 09, 2014
2 Followers
 · 
571 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: IntroductionGait and balance often change with age. Few studies are available on gait analysis in the elderly. In our work, we have focused on slow walking and variation in pace. Since first introduced by Lundlin, the dual-task paradigm has been largely used to test for the risk of falls and to better understand the link between mild cognitive decline and variation in gait. To our knowledge, very few clinical data are available on the gait changes observed in the elderly in the dual-task situation. In this study, we compared changes in gait and balance between the simple task and the dual-task situation in a 10-m walk test conducted in community-dwelling old people.
    Revue Neurologique 03/2010; 166(3):321-327. DOI:10.1016/j.neurol.2009.07.009 · 0.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In clinical practice of geriatric rehabilitation, balance assessment is often time-consuming and is difficult to achieve, but it is a very precious means to identify treatment priorities or to assess care efficiency. The main difficulty is the choice of the tests, that are often non-adapted to the population fatigability. Therefore it is important to rationalize this choice and to better adapt balance assessment to patient’s capacities. To this aim, we analysed several papers referenced in PubMed, in the field of balance assessment in geriatrics. We propose a two steps graduated assessment. The first one, entirely quantitative, could enable a distinction between two levels of functional capacities and the second one, quantitative and qualitative, could help to better guide the system identification involved in the deficiency. These last years, new data from theoretical neurosciences have highlighted some age-related changes in the central processing of information and the preparation of motor action. These modifications could induce a posture-motor failure leading to a balance disorder in the elderly. An assessment of this central component of motricity during check-up seems justified. We will present some ways to realise this assessment. The aim of this work is to suggest a judicious assessment of balance function, which would represent a compromise between the assessment needs and the practical constraints, intended in priority for the physiotherapists working in geriatric rehabilitation. Level of evidence: not applicable
    Kinésithérapie la Revue 02/2012; 12(122):40–48. DOI:10.1016/S1779-0123(12)75273-7