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Pauelsen M1, Vikman I1, Johansson Strandkvist V1, Larsson A1, Röijezon U1
1Luleå University of Technology, Health Sciences, Luleå, Sweden
Background: Physical performance including balance tasks is one of the main factors explaining the variance in falls self-efficacy in older adults. However, balance performance is, in a clinical setting, often measured by use of gross assessment scales, which assess the result of the integration of all systems involved in postural control. This makes it difficult to identify which of the sensory and motor systems are correlated with the variation of falls self-efficacy.
Purpose: We aimed to investigate which measurements of postural control correlate to falls self-efficacy scores as measured by the FES-I instrument, and which sensory and motor systems best explain them.
Methods: A cross sectional study was designed, in which 45 older adults (aged 75.2 ± 4.5) performed quiet stance with eyes open and closed on stable and unstable surface and limits of stability tests during which their center of pressure (CoP) excursion was recorded. We measured falls self-efficacy using the Falls Efficacy Scale - International. Eyesight, vestibular function, proprioception, touch sensation, reaction time and strength were also assessed. We then used a hierarchical orthogonal projection of latent structures (O-PLS) multivariate regression to model FES-I with the CoP trials and subsequently with the sensory and muscle function data.
Results: The base model, which included the CoP-variables, explained Fes-I to 39%, with the eyes open trials and the limits of stability trial loading the heaviest. That base model could then be explained to 40% using the sensory and muscle function data, with lower limb strength, leg proprioception, neck proprioception, touch sensation, reaction time and eyesight loading the heaviest.
Conclusion(s): As expected, lower limb strength plays an important role in postural control changes correlated to falls self-efficacy, but reaction time, sight, touch sensation, and proprioception are also involved and should not be overlooked. Aspects within sensory input, central integration, and motor output all are correlated with changes in falls self-efficacy.
Implications: As aspects within sensory input, central integration, and motor output all are correlated to changes in FES-I, it is of the utmost importance that physiotherapists assess and treat a decline in all three areas of integrated balance performance. Future research should focus on identifying the system declines with the largest impact on falls self-efficacy for the individual, so that specific treatments can be initialized.
Keywords: Self efficacy, Postural balance, Aging
Funding acknowledgements: This work was supported by the Swedish Research Council (grant number 521-2014-3381).
Purpose: We aimed to investigate which measurements of postural control correlate to falls self-efficacy scores as measured by the FES-I instrument, and which sensory and motor systems best explain them.
Methods: A cross sectional study was designed, in which 45 older adults (aged 75.2 ± 4.5) performed quiet stance with eyes open and closed on stable and unstable surface and limits of stability tests during which their center of pressure (CoP) excursion was recorded. We measured falls self-efficacy using the Falls Efficacy Scale - International. Eyesight, vestibular function, proprioception, touch sensation, reaction time and strength were also assessed. We then used a hierarchical orthogonal projection of latent structures (O-PLS) multivariate regression to model FES-I with the CoP trials and subsequently with the sensory and muscle function data.
Results: The base model, which included the CoP-variables, explained Fes-I to 39%, with the eyes open trials and the limits of stability trial loading the heaviest. That base model could then be explained to 40% using the sensory and muscle function data, with lower limb strength, leg proprioception, neck proprioception, touch sensation, reaction time and eyesight loading the heaviest.
Conclusion(s): As expected, lower limb strength plays an important role in postural control changes correlated to falls self-efficacy, but reaction time, sight, touch sensation, and proprioception are also involved and should not be overlooked. Aspects within sensory input, central integration, and motor output all are correlated with changes in falls self-efficacy.
Implications: As aspects within sensory input, central integration, and motor output all are correlated to changes in FES-I, it is of the utmost importance that physiotherapists assess and treat a decline in all three areas of integrated balance performance. Future research should focus on identifying the system declines with the largest impact on falls self-efficacy for the individual, so that specific treatments can be initialized.
Keywords: Self efficacy, Postural balance, Aging
Funding acknowledgements: This work was supported by the Swedish Research Council (grant number 521-2014-3381).
Topic: Older people; Health promotion & wellbeing/healthy ageing; Human movement analysis
Ethics approval required: Yes
Institution: Regional Ethical Review Board Umeå
Ethics committee: Regional Ethical Review Board Umeå
Ethics number: 2015-182-31
All authors, affiliations and abstracts have been published as submitted.
