Balance training reduces fear of falling and improves dynamic balance and isometric strength in institutionalised older people: a randomised trial.
J Physiother. 2012 ;58(2):97-104. PMID: 22613239
Narcis Gusi, Jose Carmelo Adsuar, Hector Corzo, Borja Del Pozo-Cruz, Pedro R Olivares, Jose A Parraca
Faculty of Sport Sciences, University of Extremadura, Spain.
QUESTION: What is the effect of a balance training protocol with the Biodex Balance System in institutionalised older people with fear of falling?
DESIGN: Randomised controlled trial with concealed allocation and assessor blinding.
PARTICIPANTS: Forty older people who lived in a nursing home and had fear of falling.
INTERVENTION: The experimental group completed a 12-week balance training protocol based on balancing/rebalancing training with the Biodex Balance System, with two sessions per week. During the training period, participants in both groups received the same multidisciplinary care (such as physiotherapy, occupational therapy and nursing) that they usually received in the nursing home.
OUTCOME MEASURES: The primary outcome was fear of falling (Falls Efficacy Scale International questionnaire). Secondary outcomes were dynamic balance (Fall Risk Test) and isometric strength (torque of knee flexor and extensor isometric strength measured with an isokinetic dynamometer). Outcome measures were taken before and after the training program protocol.
RESULTS: Compared to the control group, the exercise group had significantly greater improvements at 12 weeks in fear of falling (by 8 points, 95% CI 4 to 12), in dynamic balance (by 2 degrees, 95% CI 1 to 3), and in isometric strength of the knee flexors (by 7Nm, 95% CI 3 to 11) and knee extensors (by 7Nm, 95% CI 1 to 13).
CONCLUSION: The training program was feasible and effective in reducing fear of falling and improving dynamic balance and isometric strength in institutionalised older people with fear of falling.
TRIAL REGISTRATION: ISRCTN21695765.
Article Published Date : Dec 31, 2011
Examining the reliability, correlation, and validity of commonly used assessment tools to measure balance.
Health Sci Rep. 2018 Dec;1(12):e98
Authors: Dawson N, Dzurino D, Karleskint M, Tucker J
Objectives: The Biodex SD Stability System has been shown to be a reliable assessment tool for postural stability. However, its ability to provide an accurate representation of balance has not been compared with functional performance measures such as the four-square step test (FSST) and timed-up-and-go test (TUG). The purpose of this study was to investigate reliability, internal consistency, and construct validity of FSST, TUG, and Biodex SD (limits of stability [LOS] and modified Clinical Test of Sensory Organization and Balance [m-CTSIB]).
Methods: An observational reliability and validity study was conducted. A convenience sample of 105 healthy adults, 77 females and 28 males, mean age 24.5 years old (± 4.66 SD) performed balance assessments including the FSST, TUG, Biodex SD LOS, and m-CTSIB. For LOS, the overall percentage and test duration were recorded. For m-CTSIB, the overall Sway Index was recorded. Condition 1 of the m-CTSIB represented simple postural stability.
Results: The Biodex SD LOS overall percentage, TUG, and FSST showed strong to excellent test-retest reliability (ICC [3, 1] = .83 [mean 1: 58.14, mean 2: 60.54], .88 [mean 1: 6.98 seconds, mean 2: 6.91 seconds], .92 [mean 1: 6.29 seconds, mean 2: 6.14 seconds], respectively), while the Biodex SD m-CTSIB overall percentage demonstrated strong test-retest reliability (ICC [3, 1] = .75 [mean 1: 1.18, mean 2: 1.18]). The LOS test duration showed moderate test-retest reliability (ICC [3, 1] = .58 [mean 1: 38.55 seconds, mean 2: 37.10 seconds]), while the m-CTSIB condition 1 showed poor test-retest reliability (ICC [3, 1] = .24 [mean 1: 0.63, mean 2: 0.66]). Weak construct validity was found between TUG, FSST, and Biodex SD measures of LOS and m-CTSIB (r values = -0.15-0.22).
Conclusion: It is suggested that clinicians use more than one measure to assess different aspects of a patient's balance deficits to better guide treatment and intervention.
PMID: 30623052 [PubMed]