Assessments of Balance Control Using Tetra-ataxiametric Posturography

네 개의 독립 힘판 균형 측정기를 이용한 균형 조절 능력의 평가

Kim, Chung-Reen;Chun, Min-Ho;Lee, Gin-A
김충린;전민호;이진아

  • Published : 20090000

Abstract

Objective: To assess and to compare the balance control between healthy old and young adults using clinical tests and tetra-ataxiametric posturography. Method: Eighteen healthy elderly adults over 60 years old and twenty one young individuals under 60 years old were recruited. All subjects had no neurological, cognitive and musculoskeletal problems, and were capable of standing and walking independently. The postural control capabilities of the subjects were assessed using the timed up and go test, Berg balance scale and a Tetrax$^{\circledR}$ tetra-ataxiametric posturography (Tetrax, Ramat Gan, and Sunlight Medical, Tel-Aviv, Israel), which utilized two paired force plates measuring vertical pressure fluctuations over both heels and forefeet. Stability index, weight distribution index, synchronization index, and Fourier index were measured at six different head positions and at two positions with standing on pillows, and analyzed by independent t-test. Results: The stability index was higher in the elderly subjects (p<0.05) than in young subjects, which indicated that the ability of balance control in the elderly subjects was poor. The abnormality of peripheral vestibular system, central nervous system and musculoskeletal system all affected the balance control in the elderly subjects, when standing on pillows or turning head to the up, down, right and left sides. However, the weight distribution index and synchronization of both heels and forefeet were not significantly different between the elderly and young subjects. Conclusion: These findings suggest that elderly adults have more deficits in postural control than young subjects. Therefore changing environment around elderly adults and educating for prevention of falls were needed.

Keywords

References

  1. Cohen H, Blatchly CA, Gombash LL. A study of clinical test of sensory interaction and balance. Phys Ther 1993; 76: 576-585
  2. Ishizaki H, Pyykko I, Aalto H, Starck J. Repeatability and effects of instruction of body sway. Acta Otolaryngol (Stockh) 1991; 481: 589-592
  3. Prado JM, StoVregen TA, Duarte M. Postural sway during dual tasks in young and elderly adults. Gerontology 2007; 53: 274-281 https://doi.org/10.1159/000102938
  4. Daubney ME, Culham EG. Lower-extremity muscle force and balance performance in adults aged 65 years and older. Phys Ther 1999; 79: 1177-1185
  5. Woo YK, Hwang JH, An J, Park H, Kim YH, Lee KW, Kim NG. Effect of characteristics of joint motion of lower extremity according to aging on balance in elderly. J Korean Acad Rehab Med 2005; 29: 109-118
  6. Lacour M, Bernard-Demanze L, Dumitrescu M. Posture control, aging, and attention resources: models and posture-analysis methods. Neurophysiol Clin 2008; 38: 411-421 https://doi.org/10.1016/j.neucli.2008.09.005
  7. Campbell AJ, Reinken J, Allan BC, Martinez GS. Falls in old age: a study of frequency and related clinical factors. Age Ageing 1981; 10: 264-270 https://doi.org/10.1093/ageing/10.4.264
  8. Stel VS, Smit JH, Pluijm SMF, Lips P. Consequences of falling in older men and women and risk factors for health service use and functional decline. Age Ageing 2004; 33: 58-65 https://doi.org/10.1093/ageing/afh028
  9. Hatch J, Gill-Body KM, Portney LG. Determinants of balance confidence in community-dwelling elderly people. Phys Ther 2003; 83: 1072-1079
  10. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health 1992; 82: 1020-1023 https://doi.org/10.2105/AJPH.82.7.1020
  11. Yelnik A, Bonan I. Clinical tools for assessing balance disorders. Neurophysiol Clin 2008; 38: 439-445 https://doi.org/10.1016/j.neucli.2008.09.008
  12. Kohen-Raz R. Application of tetra-ataxiametric posturography in clinical and developmental diagnosis. Percept Mot Skills 1991; 73: 635-656 https://doi.org/10.2466/PMS.73.5.635-656
  13. Podsiadlo D, Richardson S. The timed 'up & go': a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-148
  14. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community dwelling older adults using the Timed Up & Go test. Phys Ther 2000; 80: 896-903
  15. Berg K, Wood-Dauphinee S, Williams JI. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995; 27: 27-36
  16. Jung HY, Park JH, Shim JJ, Kim MJ, Hwang MR, Kim SH. Reliability test of Korean version of berg balance scale. J Korean Acad Rehab Med 2006; 30: 611-618
  17. Kohen-Ratz R, Kohen-Ratz A, Erel J, Davidson B, Caine Y, Froom P. Postural control in pilots and candidates for flight training. Aviat Space Environ Med 1994; 54: 323-326
  18. de Wit G. Optic versus vestibular and proprioceptive impulses, measured by posturometry. Agressologie 1972; 13: 75-79
  19. Di Fabio RP, Badke MB. Relationship of sensory organization to balance function in patients with hemiplegia. Phys Ther 1990; 70: 542-548
  20. Lord SR, Clark RD, Webster IW. Postural stability and associated physiological factor in a population of aged persons. J Gerontol 1991; 12: 635-658
  21. Gardner MM, Robertson MC, Campbell AJ. Exercise in preventing falls and fall related injuries in older people: a review of randomized controlled trials. Br J Sports Med 2000; 34: 7-17 https://doi.org/10.1136/bjsm.34.1.7
  22. Barnett A, Smith B, Lord SR, Williams M, Baumand A. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomized controlled trial. Age Ageing 2003; 32: 407-414 https://doi.org/10.1093/ageing/32.4.407
  23. Park HD, Hwang JH, Lee KW, Kim NG. Sensitive balance parameters in detecting age-related changes of balance control in elderly. J Korean Acad Rehab Med 2006; 30: 595-603
  24. Baloh RW, Corona S, Jacobson KM, Enrietto JA, Bell T. A prospective study of in older people. J Am Ceriatr Soc 1988; 46: 438-443
  25. Lord SR, Rogers MW, Howland A, Fizpatrick R. Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc 1999; 47: 1077-1081
  26. Asakawa Y, Ikezoe T, Hazaki K, Kuroki Y, Kawano I, Kanzaki H. Relationship between falls and knee extention strength in the eldery. J Phys Ther Sci 1996; 8: 45-48 https://doi.org/10.1589/jpts.8.45
  27. Hageman PA, Leibowitz JM, Blanke D. Age and gender effects on posturol measures. Arch Phys Med Rehabil 1995; 76: 961-965 https://doi.org/10.1016/S0003-9993(95)80075-1