A novel model to quantify balance alterations in older adults based on the center of pressure (CoP) measurements with a cross-sectional study

PLoS One. 2021 Aug 16;16(8):e0256129. doi: 10.1371/journal.pone.0256129. eCollection 2021.

Abstract

Background: The timely detection of fall risk or balance impairment in older adults is transcendental because, based on a reliable diagnosis, clinical actions can be taken to prevent accidents. This study presents a statistical model to estimate the fall risk from the center of pressure (CoP) data.

Methods: This study is a cross-sectional analysis from a cohort of community-dwelling older adults aged 60 and over living in Mexico City. CoP balance assessments were conducted in 414 older adults (72.2% females) with a mean age of 70.23 ± 6.68, using a modified and previously validated Wii Balance Board (MWBB) platform. From this information, 78 CoP indexes were calculated and analyzed. Multiple logistic regression models were fitted in order to estimate the relationship between balance alteration and the CoP indexes and other covariables.

Results: The CoP velocity index in the Antero-Posterior direction with open eyes (MVELAPOE) had the best value of area under the curve (AUC) to identify a balance alteration (0.714), and in the adjusted model, AUC was increased to 0.827. Older adults with their mean velocity higher than 14.24 mm/s had more risk of presenting a balance alteration than those below this value (OR (Odd Ratio) = 2.94, p<0.001, 95% C.I.(Confidence Interval) 1.68-5.15). Individuals with increased age and BMI were more likely to present a balance alteration (OR 1.17, p<0.001, 95% C.I. 1.12-1.23; OR 1.17, p<0.001, 95% C.I. 1.10-1.25). Contrary to what is reported in the literature, sex was not associated with presenting a balance alteration (p = 0.441, 95% C.I. 0.70-2.27).

Significance: The proposed model had a discriminatory capacity higher than those estimated by similar means and resources to this research and was implemented in an embedded standalone system which is low-cost, portable, and easy-to-use, ideal for non-laboratory environments. The authors recommend using this technology to support and complement the clinical tools to attend to the serious public health problem represented by falls in older adults.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Area Under Curve
  • Cross-Sectional Studies
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Independent Living
  • Male
  • Mexico
  • Physical Fitness / physiology*
  • Postural Balance / physiology*
  • Pressure
  • Video Games*

Grants and funding

Dr. Ángel Gabriel Estévez-Pedraza gratefully acknowledges the scholarship (Number 702002) from the Consejo Nacional de Ciencia y Tecnología (CONACyT) to pursue his doctoral studies. Dr. Lorena Parra-Rodríguez was supported by a grant from the Secretaría de Educación, Ciencia, Tecnología e Innovación de la Ciudad de México SECITI/042/2018 - INGER-DI-CRECITES-003-2018 “Red Colaborativa de Investigación Traslacional para el Envejecimiento Saludable de la Ciudad de México” (RECITES). The publication of this paper was supported by a grant from the Secretaría de Educación, Ciencia, Tecnología e Innovación de la Ciudad de México CM-SECTEI/200/2020 "Red Colaborativa de Investigación Traslacional para el Envejecimiento Saludable de la Ciudad de México" (RECITES). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.