NDLI: Stiffness control of balance during dual task and prospective falls in older adults: the MOBILIZE Boston Study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kang, Hyun Gu Quach, Lien Li, Wenjun Lipsitz, Lewis A.
Description	Author Affiliation: Kang HG ( Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, United States. Electronic address: hgkang@csupomona.edu.)
Abstract	Outdoor fallers differ from indoor fallers substantially in demographics, lifestyle, health condition and physical function. Biomechanical predictors of outdoor falls have not been well characterized. Current validated measures of postural deficits, which describe only the overall postural behavior, are predictive of indoor falls but not outdoor falls. We hypothesized that a model-based description of postural muscle tone and reflexes, particularly during dual tasking, would predict outdoor falls. We tested whether postural stiffness and damping from an inverted pendulum model were predictive of future indoor and outdoor falls among older adults from the MOBILIZE Boston Study. The center of pressure data during standing were obtained from 717 participants aged 77.9±5.3 years. Participants stood barefoot with eyes open for 30s per trial, in two sets of five standing trials. One set included a serial subtractions task. Postural stiffness and damping values were determined from the postural sway data. After the postural measurements, falls were monitored prospectively using a monthly mail-in calendar over 6-36 months. Associations of postural measures with fall rates were determined using negative binomial regressions. After covariate adjustments, postural stiffness (p=0.02-0.05) and damping (p=0.007-0.1) were associated with lower outdoor falls risk, but not with indoor falls. Results were invariant by direction (anteroposterior versus mediolateral) or by condition (quiet standing versus dual task). Outdoor fall risk may be tied to postural control more so than indoor falls. Dual tasking is likely related to fall risk among older and sicker older adults, but not those relatively healthy.
File Format	HTM / HTML
ISSN	09666362
e-ISSN	18792219
DOI	10.1016/j.gaitpost.2013.03.022
Journal	Gait & Posture
Issue Number	4
Volume Number	38
Language	English
Publisher	Elsevier
Publisher Date	2013-09-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Psychomotor Performance Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Discipline Orthopedics Prospective Studies Risk Assessment Attention Models, Statistical Muscle Tonus Statistics & Numerical Data Physiology Accidental Falls Postural Balance
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rehabilitation Biophysics Sports Science

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