CHANGES IN INSTABILITY AND IRREGULARITY OF THE ELDERLY DUE TO DIFFERENT BALANCE ABILITY
Abstract
Older adults with a balance-related neurological disease or who have experienced previous falling incidents tend to show increase in instability and changes in irregularity of postural control. This study analyzed the impact of differences in balance ability on the instability and irregularity of postural control in older adults without neurological disease and previous fall experiences. The 49 subjects were older adults aged 65 years and above who did not have neurological disease and prior falling incidents during the previous year. The subjects were classified into two groups of 27 healthy (Berg score ) and 22 balance-impaired older adults (Berg score ) according to the Berg balance scale. Each subject was asked to hold in the standing position with eyes closed and with eyes open for one minute. Postural sway was measured along with acceleration using an inertial sensor attached to the subject’s waist. The measured postural sway was calculated using linear measures (95% confidence ellipse area, root mean square) that represented instability and nonlinear measures (sample, multi-scale and composite multi-scale entropy) that represented irregularity. All linear measures showed an increase in the average value in the balance-impaired older adult group’ as well as significant differences between the two groups, whereas the nonlinear measures did not show any differences. These findings indicated that differences in instability were not necessarily accompanied by irregularity changes, and the similarities in irregularity were assumed to be the result of the postural control mechanisms of the subjects without neurological diseases and prior fall incidents being similar to those of subjects with physical injuries.
References
- 1. , Trunk sway measures of postural stability during clinical balance tests: Effects of a unilateral vestibular deficit, Gait Posture 14 :227–237, 2001. Crossref, Web of Science, Google Scholar
- 2. , Degradation of postural control with aging, Proc Inst Mech Eng H 229 :638–644, 2015. Crossref, Web of Science, Google Scholar
- 3. , Postural stability in young adults with Down syndrome in challenging conditions, PLoS One 9 :e94247, 2014. Crossref, Web of Science, Google Scholar
- 4. , Entropy of balance: Some recent results, J Neuroeng Rehabil 7 :38, 2010. Crossref, Web of Science, Google Scholar
- 5. , Assessment of standing balance deficits in people who have undergone anterior cruciate ligament reconstruction using traditional and modern analysis methods, J Biomech 47 :1134–1137, 2014. Crossref, Web of Science, Google Scholar
- 6. , Multiscale entropy analysis of complex physiologic time series, Phys Rev Lett 89 :068102, 2002. Crossref, Web of Science, Google Scholar
- 7. , Regularity of center-of pressure trajectories depends on the amount of attention invested in postural control, Exp Brain Res 181 :1–11, 2007. Crossref, Web of Science, Google Scholar
- 8. , Trunk sway in mildly disabled multiple sclerosis patients with and without balance impairment, Exp Brain Res 213 :363–370, 2011. Crossref, Web of Science, Google Scholar
- 9. , Comparing postural stability entropy analyses to differentiate fallers and non-fallers, Ann Biomed Eng 44 :1636–1645, 2016. Crossref, Web of Science, Google Scholar
- 10. , Fractal dynamics in physiology: Alterations with disease and aging, Proc Natl Acad Sci 99 :2466–2472, 2002. Crossref, Web of Science, Google Scholar
- 11. , Evaluation of falls risk in community-dwelling older adults using body-worn sensors, Gerontology 58 :472–480, 2012. Crossref, Web of Science, Google Scholar
- 12. , Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls? Age Ageing 35 :ii7–ii11, 2006. Crossref, Web of Science, Google Scholar
- 13. , Frailty and the degradation of complex balance dynamics during a dual-task protocol, J Gerontol A Biol Sci Med Sci 64 :1304–1311, 2009. Crossref, Web of Science, Google Scholar
- 14. , Analysis of agreement of assessment tools of body balance in the elderly, Rev Bras Fisioter 15 :460–466, 2011. Crossref, Google Scholar
- 15. , Athletic skill level is reflected in body sway: A test case for accelometry in combination with stochastic dynamics, Gait Posture 29 :546–551, 2009. Crossref, Web of Science, Google Scholar
- 16. , Characterization of postural control deficit in whiplash patients by means of linear and nonlinear analyses — a pilot study, J Electromyogr Kinesiol 21 :291–297, 2011. Crossref, Web of Science, Google Scholar
- 17. , Dangers of geometric filtering, Physica D 68 :427–36, 1993. Crossref, Web of Science, Google Scholar
- 18. , Trunk accelerometry as a measure of balance control during quiet standing, Gait Posture 16 :60–68, 2002. Crossref, Web of Science, Google Scholar
- 19. , New insights into neck-pain-related postural control using measures of signal frequency and complexity in older adults, Gait Posture 39 :1069–1073, 2014. Crossref, Web of Science, Google Scholar
- 20. , Physiological time-series analysis using approximate entropy and sample entropy, Am J Physiol Heart Circ Physiol 278 :H2039–H2049, 2000. Crossref, Web of Science, Google Scholar
- 21. , Dynamical structure of center-of-pressure trajectories in patients recovering from stroke, Exp Brain Res 174 :256–269, 2006. Crossref, Web of Science, Google Scholar
- 22. , Postural control and freezing of gait in Parkinson’s disease, Parkinsonism Relat Disord 24 :107–112, 2016. Crossref, Web of Science, Google Scholar
- 23. , Predicting the probability for falls in community-dwelling older adults, Phys Ther 77 :812–819, 1997. Crossref, Web of Science, Google Scholar
- 24. , Detection of postural sway abnormalities by wireless inertial sensors in minimally disabled patients with multiple sclerosis: A case-control study, J Neuroeng Rehabil 12 :74, 2015. Crossref, Web of Science, Google Scholar
- 25. , Falls prediction in elderly people: A 1-year prospective study, Gait Posture 31 :317–321, 2010. Crossref, Web of Science, Google Scholar
- 26. , Pattern of age-associated decline of static and dynamic balance in community-dwelling older women, Geriatr Gerontol Int 14 :556–560, 2014. Crossref, Web of Science, Google Scholar
- 27. , Time series analysis using composite multi-scale entropy, Entropy 15 :1069–1084, 2013. Crossref, Web of Science, Google Scholar
