New findings about balance and fear of falling

Published: 28 September 2018

Researchers at Luleå University of Technology have developed a new model to better investigate the cause of impaired balance among older adults with fall-related concern. Balance consists of many sensory and motor systems that will work together. Previously, only individual systems have been investigated. In the new model, researchers have been able to look at the integration of all balance-related systems.

– We have been able to see that impaired balance in older adults who have fall-related concern, involves multiple systems and is more complex than, for example, only due to reduced muscle strength, Mascha Pauelsen, says, a researcher in Physiotherapy.

It is in the Motion-Lab at Luleå University of Technology that the new analysis method has been tested. Here, 45 people over 70 years have been included in a test where researchers have investigated what it is in the physical ability of the elderly that actually correlates to fear of falling. The researchers measured many different subsystems that together affect a person's balance, such as vision, muscle strength, reaction time, touch sensation, proprioception (one's ability to, for example, determine how the legs and feet are positioned in relation to the substrate) but also balance and fall-related concern.

All systems are examined

So far, in this area, researchers have investigated one or two of these subsystems and related them to either balance or fall-related concerns.

– However, that gives an incomplete picture, as we know that the two factors are affected by a whole host of other factors that also mediate each other. Now, we have been able to look at the relationships between all factors, while mediating each other in every direction, Mascha Pauelsen, says.

In order to measure balance, the researchers have used a force plate. The plate records which corrections a person needs to do and how fast these happen, in order for the person to maintain balance and actually stand upright. The use of a force plate gives a more accurate way of looking at balance by measuring the small movements a person makes to correct the body to maintain balance under different conditions. The small movements are called sway and are registered as center of pressure (CoP) on the force plate. Now the researchers have managed to investigate the integration between all measured balance-related systems.

– Thanks to analytical methods that are new to the field, we have been able to build models where all subsystems and balance as a whole are included to see how it explains increased fall-related concerns, Mascha Pauelsen, says.

New tools to reduce fall-related concern

This has now resulted in models that show that in addition to reduced strength, also reduced proprioception impaired vision and slower reaction times play their parts in increased fall-related concerns among oldr adults. This knowledge provides new tools for preventive work in case of fall-related concerns  amongst older adults.

– Fall-related concern causes a dramatic decline in physical activity, therefore, it is important for the individual and for the society to reduce those concerns. This new knowledge can lead us forward in developing measures that reduce fall-related concerns and maintain activity levels and good health, Mascha Pauelsen, says.

The study has been carried out as part of the BAHRT (Balancing Human and Robot) project The project is a collaboration between the Department of Health Sciences at Luleå University of Technology (HLV) and the Department of Systems and Space Technology (SRT) at Luleå University of Technology and funded by the Swedish Research Council.

The new results and the new model are published as a scientific article in Elsevier's journal, see link below.

Mascha Pauelsen

Mascha Pauelsen, PhD Student position

Phone: +46 (0)920 491732
Organization: Physiotherapy, Health and Rehabilitation, Department of Health Sciences