Effectiveness of clinical and instrumental tools to predict falls In elderly patients neurological hospital

10.12737/7220 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Робинсон ◽  
K. Robinson ◽  
Ахмадуллин ◽  
F. Akhmadullin ◽  
Харисова ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Sagittal Plane ◽  
Center Of Pressure ◽  
Berg Balance Scale ◽  
Timed Up And Go ◽  
Balance Test ◽  
Eyes Closed ◽  
Medical University ◽  
Reactive Balance ◽  
Falls In Elderly

The purpose of this study was evaluation of the most effective clinical and paraclinical methods for prediction of falls in elderly patients of neurology ward. Мaterials and methods: the study included 251 patients (all retired by age) who admitted to neurology ward at the Hospital of Bashkir State Medical University (Ufa, Russia). The following tools were used: “Timed up and Go” (TUG), Berg Balance Scale (B), Duncan test (D), reactive balance test (T) and computerized stabilometric tests on force platform «STABILO-MBN» (Moscow). Results: Mean age of patients was 66.68 years (SD=8.79, median=64 года). The mean results of the clinical tests were the following: TUG=13.42 sec, SD=5.57 (normal reference time is less than 10 sec.), B= 45.90 (SD=7.70), which is interpreted as low risk for falling, D= 26.10 сm (SD=7.77), which is significantly less than normal results, T= 1.50 (SD=0.54), which is also worse than in healthy individuals. The best predictive power for prognosis of falls was calculated for reactive balance test values and root-mean-square deviation of center of pressure in frontal (CPF) or sagittal plane with the eyes closed. The authors present the predictive equations for prognosis of the number of falls. For instance, the predicted number of falls during 12 months =1.476 + 0.122TUG – 1.411T + 0.0161CPF. Conclusion: The tools evaluated in this study, have different effectiveness for prognosis of falls in patients and could be used in clinical practice as a part of predictive mathematical model.

scholarly journals Prevalence of falls among elderly participants of a health promotion group and comparison of balance tests to detect risk of falls

2017 ◽  
Vol 30 (3) ◽  
pp. 519-525
Author(s):  
Vanessa Lobo Carvalho ◽  
Analita Alves Clementino ◽  
Edel Quinn Ferreira Ferro de Magalhães ◽  
Edlanne Morais Belo da Silva ◽  
Jussara Almeida de Oliveira Baggio
Keyword(s):  
Health Promotion ◽  
Elderly Patients ◽  
Public Health Problem ◽  
Berg Balance Scale ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Timed Up And Go ◽  
Balance Test ◽  
Cross Sectional ◽  
Risk Of Falls

Abstract Introduction: Falls of elderly people are common, representing a serious public health problem. The use of appropriate instruments in the assessment of elderly patients supports the early detection of individuals under risk of falls and its prevention. Objective: To verify the incidence of falls in a group of elderly patients and detect which balance test is the most appropriate for the studied sample. Methods: Quantitative, cross-sectional study with an observational approach. A total of 30 elderly patients aged over 60 years old participating in a health promotion group were included in the sample. The participants were initially interviewed and subsequently assessed by means of the following instruments: Berg Balance Scale (BBS), Timed Up and Go test (TUG), and the Dynamic Gait Index (DGI). Results: The mean age of the participants was 69.30 ± 7.47 years; 90% were women and 46.7% of the individuals reported falls. The participants obtained a mean value of 10.2 ± 2.5 seconds in the TUG, 51.4 ± 2.6 in the BBS, and 18.6 ± 4.2 in the DGI. The sensitivity of the scales was 0.71 in the TUG, 0.50 in the DGI, and 0.42 in the BBS; specificity was 0.44 in the TUG, 0.32 in the DGI and 0.63 in the BBS. Conclusion: A high prevalence of falls was observed in the sample. In addition, the TUG was the most sensitive test to assess balance in the assessed sample. However, its use alone requires caution in this sample.

scholarly journals Minimal shoes improve stability and mobility in persons with a history of falls

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomasz Cudejko ◽  
James Gardiner ◽  
Asangaedem Akpan ◽  
Kristiaan D’Août
Keyword(s):  
Fall Prevention ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Stability Margin ◽  
Timed Up And Go ◽  
Balance Test ◽  
Margin Of Stability ◽  
Eyes Open ◽  
History Of ◽  
Falls In Older Adults

AbstractPostural and walking instabilities contribute to falls in older adults. Given that shoes affect human locomotor stability and that visual, cognitive and somatosensory systems deteriorate during aging, we aimed to: (1) compare the effects of footwear type on stability and mobility in persons with a history of falls, and (2) determine whether the effect of footwear type on stability is altered by the absence of visual input or by an additional cognitive load. Thirty participants performed standing and walking trials in three footwear conditions, i.e. conventional shoes, minimal shoes, and barefoot. The outcomes were: (1) postural stability (movement of the center of pressure during eyes open/closed), (2) walking stability (Margin of Stability during normal/dual-task walking), (3) mobility (the Timed Up and Go test and the Star Excursion Balance test), and (4) perceptions of the shoes (Monitor Orthopaedic Shoes questionnaire). Participants were more stable during standing and walking in minimal shoes than in conventional shoes, independent of visual or walking condition. Minimal shoes were more beneficial for mobility than conventional shoes and barefoot. This study supports the need for longitudinal studies investigating whether minimal footwear is more beneficial for fall prevention in older people than conventional footwear.

scholarly journals Assessment of the Effects of Rehabilitation on Balance Impairment in Patients After Ischemic Stroke According to Selected Tests and Scales

2015 ◽  
Vol 51 (2) ◽  
pp. 55-63 ◽  
Author(s):  
Magdalena Jaworska ◽  
Tomasz Tuzim ◽  
Małgorzata Starczyńska ◽  
Magdalena Wilk-Frańczuk ◽  
Agnieszka Pedrycz
Keyword(s):  
Test Group ◽  
Berg Balance Scale ◽  
Modern Medicine ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Balance Test ◽  
Raising Awareness ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Age Range

Abstract Cerebral stroke is one of the most important issues for modern medicine. Despite the fact that numerous activities have been undertaken for the purpose of raising awareness and significance of prevention, this condition still remains one of the main reasons behind disability. The objective of the work was to assess the effects of the type of therapy, age and period from the incident occurrence, on the progress of rehabilitation of imbalance and body stability observed in a group of researched patients, on the basis of results obtained according to the Berg Balance Scale, tandem balance test, Kwolek’s loading symmetry index and Timed Up and Go test. The test group comprised of 55 post-stroke patients. The group consisted of 29 women (52.73%) and 26 men (47.27%). The average age of the subjects was 61.02 years (age range between 33-85 years). A number of the patients were subjected to rehabilitation with the use of classic kinesitherapy, whereas the remaining group underwent rehabilitation based on the proprioceptive neuromuscular facilitation method (PNF).

scholarly journals Applying the Minimal Detectable Change of a Static and Dynamic Balance Test Using a Portable Stabilometric Platform to Individually Assess Patients with Balance Disorders

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 402 ◽  
Author(s):  
Juan De la Torre ◽  
Javier Marin ◽  
Marco Polo ◽  
José J. Marín
Keyword(s):  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Static Balance ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Balance Test ◽  
Balance Disorders ◽  
Eyes Closed ◽  
Specialist Physician

Balance disorders have a high prevalence among elderly people in developed countries, and falls resulting from balance disorders involve high healthcare costs. Therefore, tools and indicators are necessary to assess the response to treatments. Therefore, the aim of this study is to detect relevant changes through minimal detectable change (MDC) values in patients with balance disorders, specifically with vertigo. A test-retest of a static and dynamic balance test was conducted on 34 healthy young volunteer subjects using a portable stabilometric platform. Afterwards, in order to show the MDC applicability, eight patients diagnosed with balance disorders characterized by vertigo of vestibular origin performed the balance test before and after a treatment, contrasting the results with the assessment by a specialist physician. The balance test consisted of four tasks from the Romberg test for static balance control, assessing dynamic postural balance through the limits of stability (LOS). The results obtained in the test-retest show the reproducibility of the system as being similar to or better than those found in the literature. Regarding the static balance variables with the lowest MDC value, we highlight the average velocity of the center of pressure (COP) in all tasks and the root mean square (RMS), the area, and the mediolateral displacement in soft surface, with eyes closed. In LOS, all COP limits and the average speed of the COP and RMS were highlighted. Of the eight patients assessed, an agreement between the specialist physician and the balance test results exists in six of them, and for two of the patients, the specialist physician reported no progression, whereas the balance test showed worsening. Patients showed changes that exceeded the MDC values, and these changes were correlated with the results reported by the specialist physician. We conclude that (at least for these eight patients) certain variables were sufficiently sensitive to detect changes linked to balance progression. This is intended to improve decision making and individualized patient monitoring.

scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling In Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. 70% of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. Objectives In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results FTR 1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = − 0.63, P < 0.001), Pull Test (r = − 0.65, P < 0.001), Timed Up and Go test (r = − 0.57, P < 0.001), and Berg Balance Scale (r = 0.62, P < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

scholarly journals The Relationship between Reactive Balance Control and Back and Hamstring Strength in Physiotherapists with Non-Specific Back Pain: Protocol for a Cross-Sectional Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5578
Author(s):  
Erika Zemková ◽  
Eva Ďurinová ◽  
Andrej Džubera ◽  
Henrieta Horníková ◽  
Juraj Chochol ◽  
...  
Keyword(s):  
Back Pain ◽  
Center Of Pressure ◽  
Balance Control ◽  
Balance Test ◽  
Cross Sectional ◽  
Maximum Voluntary Isometric Contraction ◽  
Postural Responses ◽  
Muscle Groups ◽  
The Relationship ◽  
Reactive Balance

Back pain is one of the most costly disorders among the worldwide working population. Within that population, healthcare workers are at a high risk of back pain. Though they often demonstrate awkward postures and impaired balance in comparison with healthy workers, there is no clear relationship between compensatory postural responses to unpredictable stimuli and the strength of related muscle groups, in particular in individuals with mild to moderate back pain. This paper presents a study protocol that aims to evaluate the relationship between peak anterior to peak posterior displacements of the center of pressure (CoP) and corresponding time from peak anterior to peak posterior displacements of the CoP after sudden external perturbations and peak force during a maximum voluntary isometric contraction of the back and hamstring muscles in physiotherapists with non-specific back pain in its early stages. Participants will complete the Oswestry Disability Questionnaire. Those that rate their back pain on the 0–10 Low Back Pain Scale in the ranges 1–3 (mild pain) and 4–6 (moderate pain) will be considered. They will undergo a perturbation-based balance test and a test of the maximal isometric strength of back muscles and hip extensors. We assume that by adding tests of reactive balance and strength of related muscle groups in the functional testing of physiotherapists, we would be able to identify back problems earlier and more efficiently and therefore address them well before chronic back disorders occur.

scholarly journals Effects of a health promotion and fall prevention program in elderly individuals participating in interaction groups

2014 ◽  
Vol 27 (1) ◽  
pp. 101-109 ◽  
Author(s):  
Lays Cavallero Pagliosa ◽  
Alexandra Renosto
Keyword(s):  
Health Promotion ◽  
Elderly People ◽  
Public Health Problem ◽  
The Elderly ◽  
Berg Balance Scale ◽  
Functional Abilities ◽  
Timed Up And Go ◽  
Group Activities ◽  
Risk Of Falls ◽  
Falls In Elderly

Introduction Falls in elderly people are an increasing public health problem resulting in high costs to health services. Thus, it is essential to invest in the development of actions and programs focused on decreasing such risks. Objective To verify the effects of a program of health promotion and prevention of falls in relation to balance and functional abilities in elderly people participating in interaction groups in Caxias do Sul City, RS State. Materials and methods For this purpose, 14 elderly people were selected for assessment and reassessment through the following instruments: the Barthel Index, Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and a questionnaire to characterize the sample. Over the course of 2 months, group activities were conducted in a multi-sensory and proprioceptive circuit with a frequency of 2 times per week, totaling 14 meetings. Results The average age of participants was about 72 years old, mostly women (78.6%); 64.3% of them had experienced falls, and 92.9% had already practiced physical activities. After the intervention, there was an average increase of 9.14 points in the BBS (p = 0.000) and an average reduction of 4.4 seconds in gait speed on the TUG test (p = 0.000). Conclusion The application of the proposed program resulted in increasing balance and gait performance of the elderly, reducing the risk of falls.

scholarly journals Effect of ultrasound-guided percutaneous neuromodulation in ankle instability: a case study

2019 ◽  
Vol 02 (02) ◽  
pp. 100-101
Author(s):  
Rodríguez Rosal M. ◽  
Sánchez Sixto A. ◽  
Álvarez Barbosa F. ◽  
Yáñez Álvarez A.
Keyword(s):  
Effect Size ◽  
Center Of Pressure ◽  
Tibial Nerve ◽  
Ankle Instability ◽  
Center Of Mass ◽  
Force Plate ◽  
Chronic Ankle Instability ◽  
Balance Test ◽  
Eyes Closed ◽  
Eyes Open

Abstract Background and Aims Ankle proprioception can be tested in many ways. Some studies have found improvements in individuals with chronic ankle instability after receiving treatment and training proprioceptive acuity and speed. Currently, there is a scarcity of evidence concerning percutaneous neuromodulation. The first findings were reported in the post-surgical stage after total knee arthroplasty and in neural improvements and symptoms in patients with hyperactive bladder. Aim To evaluate the effectiveness of percutaneous neuromodulation on the tibial nerve for the improvement of various proprioception parameters in patients with chronic ankle instability. Material and Methods Five men (age: 24.8 ± 4.9 years; height: 1.78 ± 0.08 m; weight: 86 ± 9.8 kg) with chronic ankle instability, who regularly practiced sports activities participated in the present study. People who had undergone an injury in the previous three months were excluded from the speed. Currently, there is a scarcity of evidence concerning test before and immediately after percutaneous neuromodulation. A single leg balance test was performed with eyes open and closed, maintaining the single-legged position on a force plate during 30 seconds (Accupower; AMTI, Watertown, MA) registering 1000 Hz. The displacement of the center of pressure (DOT) was determined based on the distances of its antero-posterior axes (DOT_AP) and medio-lateral (DOT_ML). Furthermore, the amplitudes of anteroposterior and mediolateral displacement were evaluated (ACPap and ACPml). The posterior tibial nerve was stimulated under ultrasound guidance using a 100 Vpp current, with a pulse width of 250 μs and a repetition frequency of 2 to 10 Hz. The process was performed on three occasions during 30 seconds, with an intensity that was acknowledged by the patient but which did not go beyond a score of 3 in the visual analog scale (VAS). The means and standard deviations were calculated for all variables. The effect size was calculated establishing the confidence interval at 90% and the probability of the change being significant was qualitatively calculated. Results A decrease was found in the ACPap (Pre-test eyes open: 5.42 ± 0.62 and eyes closed: 15.99 ± 0.60; Post-test eyes open 4.05 ± 0.36 and eyes closed 10.33 ± 0.49) after the neuromodulation intervention on the tibial nerve. This was a significant change and a “possible” effect size was found in the closed eyes condition (-0.54; ± 0.72), according to Hopkins. For the remaining variables, no significant differences were observed. Conclusions A decreased displacement of the center of mass was found in the antero-posterior axis after performing the neuromodulation technique on the tibial nerve in patients with chronic ankle instability.

scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling in Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali Shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background: Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error.Objectives: In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods: Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results: FTR1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = −0.63, P < 0.001), Pull Test (r = −0.65, P < 0.001), Timed Up and Go test (r = −0.57, P < 0.001), and Berg Balance Scale (r = 0.62, P < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions: Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling in Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali Shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background: Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error.Objectives: In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods: Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results: FTR1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = −0.63, P < 0.001), Pull Test (r = −0.65, p < 0.001), Timed Up and Go test (r = −0.57, p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions: Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

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