Can a Portable Balance System Predict Fall Risk in Community-Dwelling Older Women?

PURPOSE: Increased fall risk has been linked to age, being female, and age-related changes in the postural control system. The purpose of this study was to determine if a portable balance system could predict fall risk by determining the relationship among the modified Clinical Test for Sensory Interaction on Balance (mCTSIB) scores, age, the Activities-specific Balance Confidence Scale (ABC) score, and the Berg Balance Scale (BBS) score in community-dwelling older women. Insight into these relationships may facilitate early intervention and decrease fall risk in older women. METHODS: This study was a non-experimental, prospective, cross-sectional, exploratory analysis to determine the relationship among the mCTSIB, age, ABC, and BBS. Women aged 65 years and over were selected from two independent living facilities using a sample of convenience (n=42). RESULTS: The mCTSIB firm surface, eyes open and the ABC predicted fall risk (BBS) scores, F(2, 36)=35.72, p<0.001, R2=0.67, but adding age did not significantly improve the model, b= -0.17, t(36)= -1.71, p=0.10. CONCLUSION: A portable balance system may be an effective screening tool to predict fall risk in community-dwelling older women and may be used by a variety of allied health professionals. Postural sway, and perceived balance, predicted fall risk scores (BBS). More specifically, data obtained from the mCTSIB firm surface, eyes open test condition when combined with ABC scores could lead to identification of increased fall risk, allowing clinicians to recommend early treatment intervention to prevent future falls.

Does Hands-on Guarding Influence Performance on the Functional Gait Assessment?

BACKGROUND AND PURPOSE: An accurate fall risk assessment is an important component of fall prevention, though a fall could occur during testing. To minimize this risk, different guarding methods are used, though there is disagreement regarding the optimal method. The purpose of this study was to compare the effect of 2 guarding methods, contact guarding (CG) and standby guarding (SG), on performance during the Functional Gait Assessment (FGA). We hypothesized that (1) there would not be a significant difference in FGA scores when comparing CG with SG, and (2) participants would not perceive a difference between the 2 guarding methods. METHODS: Twenty-three community-dwelling older adults, mean age 73.6 (SD = 6.2) years, participated in this study. Each participant completed 2 trials of the FGA, one with CG and another with SG. Guarding for all trials was provided by the same experienced physical therapist (PT) for this within-subjects design. All trials were video recorded for review by 2 PT raters who were blinded to the purpose of the study. RESULTS AND DISCUSSION: Functional Gait Assessment scores for the 2 PT raters indicated high internal agreement for both CG and SG conditions (CG: intraclass correlation coefficient [ICC] = 0.949; SG: ICC = 0.935), and CG FGA scores did not significantly differ from SG FGA scores (t22 = 0.15, P = .882). Furthermore, none of the participants perceived a difference in guarding methods. CONCLUSIONS: The results of this study indicate that hands-on guarding does not significantly influence performance on the FGA when the guarding is provided by an experienced PT and the participant is a community-dwelling older adult.

Examination of the use of a dual-channel functional electrical stimulation system on gait, balance and balance confidence of an adult with spastic diplegic cerebral palsy.

The purpose of this case report is to determine the effects of a dual-channel functional electrical stimulation (FES) system on gait and balance of a 57-year-old male diagnosed with spastic diplegic cerebral palsy (CP). Outcome measures included the: Activities-specific Balance Confidence Scale (ABC); Dynamic Gait Index (DGI); Observational Gait Scale (OGS) and Tinetti Performance Oriented Mobility Assessment (POMA). Assessments were completed with and without use of FES during the initial examination and after two, four and six weeks of intervention with FES. ABC Scale scores improved from 32.8 to 48.1% during the 6-week intervention. Scores on the DGI improved from 6/24 to 9/24 without FES and from 9/24 to 14/24 with FES. OGS scores improved on both legs with and without FES. Tinetti POMA scores improved from 12/28 to 15/28 without FES and decreased from 16/28 to 15/28 with FES. The patient demonstrated improvement in both objective and subjective measures. The use of FES facilitated improved gait and balance; however, the patient was still at increased risk for falls after the 6-week intervention despite improved scores on the ABC Scale, DGI, OGS and Tinetti POMA.

Efficacy of percutaneous vertebral augmentation and use of physical therapy intervention following vertebral compression fractures in older adults: a systematic review.

PURPOSE: The purpose of this systematic literature review was to summarize information on the efficacy of percutaneous vertebral augmentation (PVA) and the incorporation of physical therapy intervention following PVA for vertebral compression fractures (VCF). METHODS: Literature searches were completed using the Cochrane Library: Cochrane Database of Systematic Reviews (Cochrane Reviews); Agency for Healthcare Research and Quality (AHRQ): National Guideline Clearinghouse; Physiotherapy Evidence Database (PEDro); Medline; and Cumulative Index of Nursing and Allied Health Literature (CINAHL) through August 2005. RESULTS: Seventeen relevant studies were identified. They reported favorable outcomes (eg, earlier mobility, decreased pain, and improved spinal posture) after PVA. No study addressed physical therapy intervention after PVA. CONCLUSION: PVA appears to be an effective treatment option for individuals with VCF. However, research dealing with physical therapy after PVA is needed.