Physiotherapy Course, Department of Biomechanics, Medicine and Rehabilitation of Locomotor System, and Rehabilitation and Functional Performance Program, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Department of Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
J Geriatr Phys Ther. 2019 Jul/Sep;42(3):176-182. doi: 10.1519/JPT.0000000000000147.
With the increase in the percentage of the population in older adulthood, issues such as frailty syndrome need to be considered. The aim of the present study was to evaluate the ability of the Balance Evaluation Systems Test (BESTest) and center of pressure (COP) in their ability to discriminate between nonfrail, prefrail, and frail older adults. The proposed hypothesis is that frail older adults would show poorer performance in BESTest tasks and higher oscillation of COP on a force platform.
Sixty older adults 65 years or older were divided into 3 groups of 20: group 1, nonfrail; group 2, prefrail; and group 3, frail. The prefrail and frail identifications were made by Fried's 5 frailty phenotype criteria. Balance was assessed using the BESTest and a force platform in 6 positions: (1) fixed platform with eyes open; (2) fixed platform with eyes closed; (3) unstable platform with foam, with eyes open; (4) unstable platform, with eyes closed; (5) semitandem with eyes open; and (6) semitandem with eyes closed.
Frail older adults had lower scores in all sections and in the total score of the BESTest, indicating worse performance in the tasks. However, on the force platform, the frail older adults did not show higher oscillations, having similar mean values when compared with the prefrail and nonfrail older adults, indicating similar behavior of COP.
The BESTest seems to be more appropriate than a force plate for assessing postural control impairment and discriminating balance performance among frail, prefrail, and nonfrail older adults, providing information about different components of postural control rather than the force plate, which evaluates sensory orientation.
随着成年后期人口比例的增加，需要考虑脆弱综合征等问题。本研究的目的是评估平衡评估系统测试（BESTest）和压力中心（COP）在区分非脆弱、虚弱前期和脆弱老年人方面的能力。提出的假设是，虚弱的老年人在 BESTest 任务中的表现会更差，在力台上的 COP 摆动更大。
60 名 65 岁或以上的老年人分为 3 组，每组 20 人：第 1 组为非脆弱组；第 2 组为虚弱前期组；第 3 组为虚弱组。采用 Fried 的 5 项脆弱表型标准对虚弱前期和虚弱进行识别。使用 BESTest 和力台在 6 个位置评估平衡：（1）睁眼固定平台；（2）闭眼固定平台；（3）睁眼不稳定平台（泡沫）；（4）闭眼不稳定平台；（5）睁眼半蹲位；（6）闭眼半蹲位。
虚弱的老年人在 BESTest 的所有部分和总分中得分较低，表明在任务中的表现更差。然而，在力台上，虚弱的老年人并没有表现出更高的摆动，与虚弱前期和非脆弱老年人的平均值相似，表明 COP 的行为相似。
与力台相比，BESTest 似乎更适合评估姿势控制障碍，并区分虚弱、虚弱前期和非脆弱老年人的平衡表现，提供有关姿势控制不同组成部分的信息，而不是力台，后者评估感觉定向。
