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Affiliation
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Laboratory of Physiology and Biomechanics of Locomotion, Institute of Neuroscience (IoNS), Université catholique de Louvain (UCL), Louvain-la-Neuve, Belgium. |
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Abstract
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More than 25% of elderly adults fall each year [1] and these falls are often associated with serious injuries and hospitalizations [2]. Knowing that the percentage of worldwide population over 60 year-old will continue to rise, the prevention of falls is a major issue for our society.
The most commonly fall prediction factor, as well as the best single predictor, is the history of falling [3, 4]. However, despite its high predictive power, it is irrelevant to identify the first-fall risk [5]. Nevertheless, this detection is essential: the first-fall increases the risk of falling by three [5] and can result in a fear of further falling leading to self-restriction of physical and social activities [6]. Other usual fall indicators are screening tools based on an evaluation of daily movements (e.g. gait, changing position, turning reaching, standing, etc). But according to Gates et al. [7], there is no strong evidence that those screening tools are valid to identify fallers. For example, the large number of variants and cut-offs of the Tinetti Test [8] complicates its validation for falls prediction [9]. Moreover, these screening tools are based on subjective analysis requiring the presence of a trained, self-reliant expert [10] and are limited by ceiling effect [11].
In contrast, measuring instruments during standing tasks allow an objective and sensitive evaluation of the subject’s postural stability. For example, the measure of the center of pressure excursion of the subject using a force platform can objectify the postural control. Using this measure, Melzer et al. [12] have shown that balance testing in narrow stance is able to distinguish elderly adults who experience recurrent falls from non-falling elderly adults.
Beside balance tests, gait analysis is now recognized as a powerful tool to identify markers of early pathology and maximize healthy ageing. Gait may seem like a simple task ...
Language: en |