Assessment of balance control in the elderly: major issues

Abstract

One of the major concerns among the elderly is the high frequency of falls. As an initial step toward reducing falls, it is imperative to characterize those changes in the balance control system that are only "age-related." One approach is to identify the response characteristics to experimentally simulated conditions that can cause falls or near falls. The simulations used and the measures currently taken are varied. The tests include assessment of: (a) static unperturbed balance; (b) maintenance of upright posture under perturbation; (c) normal walking characteristics; and (d) maintenance of balance under perturbations introduced while the subjects are walking. The measurements range from simple time measures, centre of pressure, estimates of centre of gravity, and muscle activity levels. A number of important issues related to each of these paradigms are discussed, including the subject selection procedures. The advantages and limitations of the tests and measures used are discussed along with their potential predictive capabilities.