Force Platform Measurements as Predictors of Falls among Older People – A ReviewPiirtola M.a · Era P.b
aDepartment of Family Medicine, University of Turku, Turku, Satakunta Central Hospital, Pori; Härkätie Health Centre, Lieto; bMetitur Oy and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Article / Publication Details
Background: Poor postural balance is one of the major risk factors for falling. A great number of reports have analyzed the risk factors and predictors of falls but the results have for the most part been unclear and partly contradictory. Objective data on these matters are thus urgently needed. The force platform technique has widely been used as a tool to assess balance. However, the ability of force platform measures to predict falls remains unknown. Objective: The purpose of this systematic review was to extract and critically review the findings of prospective studies where force platform measurements have been used as predictors of falls among elderly populations. Methods: The study was done as a systematic literature review. PubMed, the Cochrane Central Register of Controlled Trials, and CINAHL databases from 1950 to April 2005 were used. The review includes prospective follow-up studies using the force platform as a tool to measure postural balance. Results: Nine original prospective studies were included in the final analyses. In five studies fall-related outcomes were associated with some force platform measures and in the remaining four studies associations were not found. For the various parameters derived on the basis of the force platform data, the mean speed of the mediolateral (ML) movement of the center of pressure (COP) during normal standing with the eyes open and closed, the mean amplitude of the ML movement of the COP with the eyes open and closed, and the root-mean-square value of the ML displacement of COP were the indicators that showed significant associations with future falls. Measures related to dynamic posturography (moving platforms) were not predictive of falls. Conclusion: Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various indicators of the lateral control of posture. However, the small number of studies available makes it difficult to draw definitive conclusions.
© 2006 S. Karger AG, Basel
- Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701–1707.
- Luukinen H, Koski K, Hiltunen L, Kivela SL: Incidence rate of falls in an aged population in northern Finland. J Clin Epidemiol 1994;47:843–850.
Nevitt MC, Cummings SR, Hudes ES: Risk factors for injurious falls: a prospective study. J Gerontol 1991;46:M164–M170.
- Alexander BH, Rivara FP, Wolf ME: The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health 1992;82:1020–1023.
- Sterling DA, O’Connor JA, Bonadies J: Geriatric falls: injury severity is high and disproportionate to mechanism. J Trauma 2001;50:116–119.
- Chrischilles E, Shireman T, Wallace R: Costs and health effects of osteoporotic fractures. Bone 1994;15:377–386.
- Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001;49:664–672.
- Baloh RW, Corona S, Jacobson KM, Enrietto JA, Bell T: A prospective study of posturography in normal older people. J Am Geriatr Soc 1998;46:438–443.
Lord SR, Sherrington C, Menz H: Falls in Older People. Risk Factors and Strategies for Prevention. Cambridge, University Press, 2001.
Thapa PB, Gideon P, Brockman KG, Fought RL, Ray WA: Clinical and biomechanical measures of balance as fall predictors in ambulatory nursing home residents. J Gerontol A Biol Sci Med Sci 1996;51:M239–M246.
Perell KL, Nelson A, Goldman RL, Luther SL, Prieto-Lewis N, Rubenstein LZ: Fall risk assessment measures: an analytic review. J Gerontol A Biol Sci Med Sci 2001;56:M761–M766.
- Rogers ME, Rogers NL, Takeshima N, Islam MM: Methods to assess and improve the physical parameters associated with fall risk in older adults. Prev Med 2003;36:255–264.
Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992;(suppl 2):S7–S11.
Berg KO, Wood-Dauphinee S, Williams JI, Gayton D: Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 1989;41:304–311.
- Raiche M, Hebert R, Prince F, Corriveau H: Screening older adults at risk of falling with the Tinetti balance scale. Lancet 2000;356:1001–1002.
- Tinetti ME: Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986;34:119–126.
- Tinetti ME, Williams TF, Mayewski R: Fall risk index for elderly patients based on number of chronic disabilities. Am J Med 1986;80:429–434.
- Shumway-Cook A, Brauer S, Woollacott M: Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896–903.
Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB: A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49:M85–M94.
- de Rekeneire N, Visser M, Peila R, Nevitt MC, Cauley JA, Tylavsky FA, Simonsick EM, Harris TB: Is a fall just a fall: correlates of falling in healthy older persons. The Health, Aging and Body Composition Study. J Am Geriatr Soc 2003;51:841–846.
- Era P, Heikkinen E: Postural sway during standing and unexpected disturbance of balance in random samples of men of different ages. J Gerontol 1985;40:287–295.
Era P, Heikkinen E, Gause-Nilsson I, Schroll M: Postural balance in elderly people: Changes over a five-year follow-up and its predictive value for survival. Aging Clin Exp Res 2002;14:37–46.
- Era P, Avlund K, Jokela J, Gause-Nilsson I, Heikkinen E, Steen B, Schroll M: Postural balance and self-reported functional ability in 75-year-old men and women: a cross-national comparative study. J Am Geriatr Soc 1997;45:21–29.
Maki BE, Holliday PJ, Topper AK: A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994;49:M72–M84.
- Maki BE: Biomechanical approach to quantifying anticipatory postural adjustments in the elderly. Med Biol Eng Comput 1993;31:355–362.
- Topper AK, Maki BE, Holliday PJ: Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall? J Am Geriatr Soc 1993;41:479–487.
- Bergland A, Jarnlo GB, Laake K: Predictors of falls in the elderly by location. Aging Clin Exp Res 2003;15:43–50.
- Kario K, Tobin JN, Wolfson LI, Whipple R, Derby CA, Singh D, Marantz PR, Wassertheil-Smoller S: Lower standing systolic blood pressure as a predictor of falls in the elderly: a community-based prospective study. J Am Coll Cardiol 2001;38:246–252.
- Stel VS, Smit JH, Pluijm SM, Lips P: Balance and mobility performance as treatable risk factors for recurrent falling in older persons. J Clin Epidemiol 2003;56:659–668.
- Boulgarides LK, McGinty SM, Willett JA, Barnes CW: Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther 2003;83:328–339.
- Hill K, Schwarz J, Flicker L, Carroll S: Falls among healthy, community-dwelling, older women: a prospective study of frequency, circumstances, consequences and prediction accuracy. Aust NZ J Public Health 1999;23:41–48.
Brauer SG, Burns YR, Galley P: A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci 2000;55:M469–M476.
- Bergland A, Wyller TB: Risk factors for serious fall related injury in elderly women living at home. Inj Prev 2004;10:308–313.
- Tinetti ME: Clinical practice. Preventing falls in elderly persons. N Engl J Med 2003;348:42–49.
- Lord SR, Clark RD, Webster IW: Physiological factors associated with falls in an elderly population. J Am Geriatr Soc 1991;39:1194–1200.
- Barnett A, Smith B, Lord SR, Williams M, Baumand A: Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age Aging 2003;32:407–414.
Campbell AJ, Borrie MJ, Spears GF: Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol 1989;44:M112–M117.
- Sihvonen SE, Sipila S, Era PA: Changes in postural balance in frail elderly women during a 4-week visual feedback training: a randomized controlled trial. Gerontology 2004;50:87–95.
- Sihvonen S, Sipila S, Taskinen S, Era P: Fall incidence in frail older women after individualized visual feedback-based balance training. Gerontology 2004;50:411–416.
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