LAM-Laboratorio Analisi Movimento, AUSL Reggio Emilia, SOC Neuroriabilitazione, Ospedale di Correggio, Reggio Emilia, Italy.
Gait Posture. 2012 Sep;36(4):662-6. doi: 10.1016/j.gaitpost.2012.06.016. Epub 2012 Jul 24.
Falls are common events in the elderly and represent the main risk factor for fractures and other injuries. Strategies for fall prevention rely on the multifactorial assessment of the risk of falling. The contribution of instrumented balance assessment to the prediction of falls remains unclear in the literature. In this study, we analyzed the association between the fall-history of a wide sample of older people without dementia and the values of a set of posturographic parameters acquired in different visual, proprioceptive and mental conditions. A consecutive sample of 130 cognitively able elderly subjects, age≥70 years, was analyzed. Based on their fall-history in the last year, subjects were categorized into non-fallers (NF), fallers (F) and recurrent fallers (RF>2 falls). Each subject was assessed by measurements of cognition and functional ability. Static posturography tests were performed in five conditions: with eyes open/close (EO/EC) on a firm/compliant (FS/CS) surface and while performing a cognitive task. The center of pressure (COP) mean position referred to the mid-point of the heels, area of the 95% confidence ellipse, sway mean velocities and RMS displacements in the antero-posterior (AP) and medio-lateral (ML) directions were computed and their association with the fall-history was assessed. The mean position of the COP in the AP direction and the confidence ellipse area were associated with the fall-history in the EOFS, ECFS and EOCS conditions (P<0.05). RMS displacements were also associated with the fall-history in the EOCS condition (P<0.05). Significant group differences (P<0.05) were found in the EOCS conditions, which greatly enhanced the differences among NF, F and RF. The ability to control balance while standing with eyes open on a compliant surface showed a high degree of association with the fall-history of older people with no or mild cognitive impairment.
跌倒在老年人中很常见，是骨折和其他损伤的主要危险因素。预防跌倒的策略依赖于对跌倒风险的多因素评估。仪器平衡评估对跌倒预测的贡献在文献中仍不清楚。在这项研究中，我们分析了无痴呆症的老年人广泛样本的跌倒史与一组在不同视觉、本体感觉和心理条件下获得的平衡参数值之间的关联。分析了 130 名认知能力正常的年龄≥70 岁的老年人连续样本。根据他们在过去一年中的跌倒史，将受试者分为非跌倒者（NF）、跌倒者（F）和复发性跌倒者（RF>2 次跌倒）。每位受试者都进行了认知和功能能力的评估。在五种条件下进行静态平衡测试：睁眼/闭眼（EO/EC）在硬/软（FS/CS）表面上，同时进行认知任务。中心压力（COP）的平均位置是脚跟的中点，95%置信椭圆的面积，前后（AP）和内外（ML）方向的摆动平均速度和 RMS 位移，并评估它们与跌倒史的关联。COP 在 AP 方向的平均位置和置信椭圆面积与 EOFS、ECFS 和 EOCS 条件下的跌倒史相关（P<0.05）。RMS 位移也与 EOCS 条件下的跌倒史相关（P<0.05）。在 EOCS 条件下，组间差异显著（P<0.05），这极大地增强了 NF、F 和 RF 之间的差异。睁眼在软表面上站立时控制平衡的能力与无或轻度认知障碍的老年人的跌倒史高度相关。
