Impaired standing balance in elderly: a new engineering method helps to unravel causes and effects

J Am Med Dir Assoc. 2014 Mar;15(3):227.e1-227.e6. doi: 10.1016/j.jamda.2013.09.009. Epub 2013 Nov 9.

Abstract

Deteriorated balance control is the most frequent cause of falls and injuries in the elderly. Balance control comprises a complex interplay of several underlying systems (ie, the sensory systems, the motor system, and the nervous system). Available clinical balance tests determine the patient's ability to maintain standing balance under defined test conditions and aim to describe the current state of this ability. However, these tests do not reveal which of the underlying systems is deteriorated and to what extent, so that the relation between cause and effect often remains unclear. Especially detection of early-stage balance control deterioration is difficult, because the balance control system is redundant and elderly may use compensation strategies. This article describes a new method that is able to identify causal relationships in deteriorated balance control, called CLSIT (Closed Loop System Identification Technique). Identification of impaired balance with CLSIT is a base for development of tailored interventions and compensation strategies to reduce the often serious consequences of deteriorated balance control in the elderly.

Keywords: Elderly; clinical balance tests; closed loop system identification technique; impaired standing balance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control
  • Aged / physiology*
  • Geriatric Assessment / methods*
  • Humans
  • Postural Balance / physiology*
  • Psychomotor Performance / physiology*