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Evaluating a clinical tool to assess...

University of Manitoba (Canada).

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Evaluating a clinical tool to assess balance disorders in community-dwelling seniors.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Evaluating a clinical tool to assess balance disorders in community-dwelling seniors./
Author:	Desai, Ankur.
Description:	125 p.
Notes:	Source: Masters Abstracts International, Volume: 46-04, page: 2106.
Contained By:	Masters Abstracts International46-04.
Subject:	Biology, Physiology. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=MR35816
ISBN:	9780494358160

Evaluating a clinical tool to assess balance disorders in community-dwelling seniors.
Desai, Ankur.

Evaluating a clinical tool to assess balance disorders in community-dwelling seniors. - 125 p.

Source: Masters Abstracts International, Volume: 46-04, page: 2106.

Thesis (M.Sc.)--University of Manitoba (Canada), 2007.

Purpose. The aim of the study was to determine the ability of a new dynamic standing balance assessment test to identify falters in community-dwelling seniors (older adults). Relevance. Poor balance, mobility restrictions, fear of falling and fall injuries are serious problems for many people over 65 who reside in community-dwellings. Routine clinical balance assessments incorporate a range of static and dynamic tasks. However, most of these tests are self-paced and performed in a predictable environment. Laboratory-based instruments can identify balance impairment but require expensive setup and special training. There is a critical need for a clinical tool which can assess both predictive and unpredictive balance control. Examining community-dwelling older adults in both control (normal surface) and unpredictable (compliant surface) environment can provide valuable insight and help in designing appropriate interventions to reduce fall risk in this population. Participants. Seventy-two community-dwelling older adults who were being treated for balance and mobility impairment in a day hospital setup. Methods. Based on the concept of the modified Clinical Test of Sensory Interaction and Balance (mCTSIB), a Dynamic Balance Assessment (DBA) test was developed. The DBA test consists of six graded balance tasks performed first on a normal surface then on a compliant sponge surface. The DBA test evaluates contribution of sensory interactions to balance control by eliminating or distorting sensory information. Each task was performed for 20 seconds and if the participant failed to complete the task, it was recorded as a loss of balance (LOB). Balance performance was quantified by a flexible pressure mapping mat - FSA (Verg Inc., Winnipeg, Canada), which measured centre of fool pressure (COP). The participant's balance performance was also evaluated by routine clinical balance assessment tools, in particular, the Berg Balance Scale (BBS), the Time up and Go test (TUG), gait velocity (GV) and the 6-minute walk test (SMWT). Analysis. For each completed task, peak excursion and pathlength for COP signals were computed. Frequency of LOB and a "Composite" score was calculated to index balance performance in the DBA test. The Mann-Whitney U test was used for the non-normally distributed variables and independent t-test was used for the normally distributed variables to determine difference between fallers and non-fallers based on history of falls in the last one year. The Spearman correlation was computed to determine the relationship between experimental and clinical variables. Results. No significant difference was noted between the two groups for age, gender, use of assistive device for walking, home care (assistance), medication and walking half a mile. The falters in this study showed higher (low composite score) COP excursions and swaypathlength than non-fallers. All COP experimental variables for composite scores and compliant surface scores (p≤0.02) and LOB (p = 0.04) in the DBA test were able to distinguish fallers from non-fallers. However, on the normal surface, only the COP ML excursion scores showed a significant difference between fallers and non-fallers (p = 0.02). Only the TUG was able to differentiate people who fell once from those who had not fallen (p = 0.03). The clinical balance assessment tools showed poor correlation with the experimental variables of the DBA test. Conclusion. The findings of this study indicate that measuring COP is an appropriate method to assess dynamic standing balance control in older adults. Further, the DBA test can be used in community-dwelling older adults to distinguish fallers from non falters.

ISBN: 9780494358160Subjects--Topical Terms:

1017816
Biology, Physiology.

Evaluating a clinical tool to assess balance disorders in community-dwelling seniors.
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035 $a (UMI)AAIMR35816
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100 1 $a Desai, Ankur. $3 1043266
245 1 0 $a Evaluating a clinical tool to assess balance disorders in community-dwelling seniors.
300 $a 125 p.
500 $a Source: Masters Abstracts International, Volume: 46-04, page: 2106.
502 $a Thesis (M.Sc.)--University of Manitoba (Canada), 2007.
520 $a Purpose. The aim of the study was to determine the ability of a new dynamic standing balance assessment test to identify falters in community-dwelling seniors (older adults). Relevance. Poor balance, mobility restrictions, fear of falling and fall injuries are serious problems for many people over 65 who reside in community-dwellings. Routine clinical balance assessments incorporate a range of static and dynamic tasks. However, most of these tests are self-paced and performed in a predictable environment. Laboratory-based instruments can identify balance impairment but require expensive setup and special training. There is a critical need for a clinical tool which can assess both predictive and unpredictive balance control. Examining community-dwelling older adults in both control (normal surface) and unpredictable (compliant surface) environment can provide valuable insight and help in designing appropriate interventions to reduce fall risk in this population. Participants. Seventy-two community-dwelling older adults who were being treated for balance and mobility impairment in a day hospital setup. Methods. Based on the concept of the modified Clinical Test of Sensory Interaction and Balance (mCTSIB), a Dynamic Balance Assessment (DBA) test was developed. The DBA test consists of six graded balance tasks performed first on a normal surface then on a compliant sponge surface. The DBA test evaluates contribution of sensory interactions to balance control by eliminating or distorting sensory information. Each task was performed for 20 seconds and if the participant failed to complete the task, it was recorded as a loss of balance (LOB). Balance performance was quantified by a flexible pressure mapping mat - FSA (Verg Inc., Winnipeg, Canada), which measured centre of fool pressure (COP). The participant's balance performance was also evaluated by routine clinical balance assessment tools, in particular, the Berg Balance Scale (BBS), the Time up and Go test (TUG), gait velocity (GV) and the 6-minute walk test (SMWT). Analysis. For each completed task, peak excursion and pathlength for COP signals were computed. Frequency of LOB and a "Composite" score was calculated to index balance performance in the DBA test. The Mann-Whitney U test was used for the non-normally distributed variables and independent t-test was used for the normally distributed variables to determine difference between fallers and non-fallers based on history of falls in the last one year. The Spearman correlation was computed to determine the relationship between experimental and clinical variables. Results. No significant difference was noted between the two groups for age, gender, use of assistive device for walking, home care (assistance), medication and walking half a mile. The falters in this study showed higher (low composite score) COP excursions and swaypathlength than non-fallers. All COP experimental variables for composite scores and compliant surface scores (p≤0.02) and LOB (p = 0.04) in the DBA test were able to distinguish fallers from non-fallers. However, on the normal surface, only the COP ML excursion scores showed a significant difference between fallers and non-fallers (p = 0.02). Only the TUG was able to differentiate people who fell once from those who had not fallen (p = 0.03). The clinical balance assessment tools showed poor correlation with the experimental variables of the DBA test. Conclusion. The findings of this study indicate that measuring COP is an appropriate method to assess dynamic standing balance control in older adults. Further, the DBA test can be used in community-dwelling older adults to distinguish fallers from non falters.
590 $a School code: 0303.
650 4 $a Biology, Physiology. $3 1017816
650 4 $a Gerontology. $3 533633
650 4 $a Health Sciences, Rehabilitation and Therapy. $3 1017926
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710 2 $a University of Manitoba (Canada). $3 1018707
773 0 $t Masters Abstracts International $g 46-04.
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791 $a M.Sc.
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856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=MR35816