From the Departments of Otolaryngology - Head and Neck Surgery, Obstetrics and Gynecology, and Medicine, Baylor College of Medicine, Houston, Texas.
South Med J. 2020 Sep;113(9):423-426. doi: 10.14423/SMJ.0000000000001138.
Older adults who may not complain of balance problems may nevertheless be developing subtle balance problems that may affect future functioning. This study sought to determine whether subtle problems could be predicted by standard balance testing.
At the geriatric medicine clinic at an academic tertiary-care center, geriatricians referred 27 people who were ambulatory without gait aids and had no apparent neurologic or musculoskeletal impairments affecting their balance or gait performance. Initially, subjects were screened with some questions about vertigo, tests of standing balance on foam with eyes closed (Romberg tests) with head still, and head nodding (pitch) and shaking (yaw) at 0.3 Hz, and tandem walking with eyes closed (TW). Approximately 2 years later, 22 subjects were available to be rescreened.
At the second test date subjects' scores declined slightly but significantly on all three variations of the Romberg tests: with head still, head pitch, and head yaw, ≥ 0.02, but TW did not change significantly. TW was the best predictor of balance performance; the lowest-scoring subjects at the second test used a cane, had undergone hip surgery, or were scheduled for hip surgery: sensitivity 1.0, specificity 0.84. The second-best predictor was Romberg on foam with eyes closed and head still.
The data suggest that some older adults may have subtle musculoskeletal impairments that may be indicated by simple balance tests. A finding on these tests may indicate the need for further workup for balance-related problems. These quick, inexpensive tests can be administered by ancillary staff and may add important information to the initial visit and annual follow-up visits.
即使老年人可能没有抱怨平衡问题，但他们可能正在出现微妙的平衡问题，这些问题可能会影响他们未来的功能。本研究旨在确定标准平衡测试是否可以预测这些微妙的问题。
在学术三级保健中心的老年医学诊所，老年病医生转诊了 27 名无需助行器即可行走且没有明显影响平衡或步态表现的神经或肌肉骨骼损伤的老年人。最初，通过一些关于眩晕的问题对受试者进行了筛选，测试了闭眼时在泡沫上的站立平衡（Romberg 测试），头部保持静止，头部点头（俯仰）和摇头（偏航）频率为 0.3Hz，以及闭眼的双脚并拢行走（TW）。大约 2 年后，有 22 名受试者可以重新接受筛查。
在第二次测试时，所有三种 Romberg 测试（头部静止，头部俯仰和头部偏航）的得分均略有但明显下降，≥0.02，但 TW 没有明显变化。TW 是平衡表现的最佳预测指标；第二次测试得分最低的受试者使用手杖，接受过髋关节手术或计划进行髋关节手术：灵敏度 1.0，特异性 0.84。第二佳预测指标是闭眼泡沫上的 Romberg 测试和头部静止。
这些数据表明，一些老年人可能有微妙的肌肉骨骼损伤，这些损伤可能通过简单的平衡测试来指示。这些测试的结果可能表明需要进一步进行与平衡相关的问题检查。这些快速，廉价的测试可以由辅助人员进行，并可以为初始就诊和年度随访提供重要信息。
