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Fear of Falling Correlates with Subtle Neuromuscular Balance and Strength Deficits of Fragility Fracture Patients

View Article: PubMed Central - PubMed

ABSTRACT

Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures. Forty-one subjects (20 fragility fracture patients, 21 controls without history of fragility fractures) over the age of 50 were recruited from three outpatient orthopaedic clinics. All subjects were administered a FES-I Fear of Falling Survey, a portion of an SF-36 survey, and tested using three different portable CATs: the Wii Balance Board, iPod Level Belt and Saehan Squeeze Hand Grip Dynamometer. There were several measured variables that showed a moderate correlation with Fear of Falling scores. Of note, correlations between FES-I scores and maximum hand grip strength for both the dominant hand (R= -0.302, p=0.069) and non-dominant hand (R= -0.309, p=0.059), as well as maximum anterior-posterior sway measured by the iPod Level Belt (R=0.320, p=0.056) were found to be marginally significant. In addition, the correlation between FES-I and average anterior-posterior sway was found to be significant (R=0.416, p=0.012). The Nintendo Wii and iPod Level Belt are relatively inexpensive, portable tools that can assess patients for subtle deficits during dynamic functional tasks. The results indicate that these tools can provide a more objective measure of a patient’s limitations during daily activities such as walking by assigning them a numerical value and correlating this value to physical deficits that impact balance and coordination. In the future, CATs may also have a role in predicting outcomes and in individualizing care, therapy, and at-home preventive measures.

No MeSH data available.


Wii Balance Board setup. The television is positioned away from the patient and the Balance Board is placed safely.
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F1-ad-7-5-585: Wii Balance Board setup. The television is positioned away from the patient and the Balance Board is placed safely.

Mentions: This study used three different technologies: the Wii Balance Board, iPod Level Belt Pro application, and Saehan hand grip dynamometer. The Wii Balance Board was placed an adequate distance away from any sharp objects and the research assistant, so that both the participant and research assistant could rotate with their arms at a 90 degree angle from their bodies while avoiding contact with any obstacles (Fig. 1). The television screen was only made visible to the research assistant to eliminate confusion, as some tasks selected by the research team were not consistent with the demonstrations provided by the Wii program. Standard folding walkers without wheels were placed on the right and left sides of the board to ensure patient safety, and patients were instructed to stabilize themselves using the walker whenever they felt unstable. Foldable walkers were selected to maintain portability and affordability.


Fear of Falling Correlates with Subtle Neuromuscular Balance and Strength Deficits of Fragility Fracture Patients
Wii Balance Board setup. The television is positioned away from the patient and the Balance Board is placed safely.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036953&req=5

F1-ad-7-5-585: Wii Balance Board setup. The television is positioned away from the patient and the Balance Board is placed safely.
Mentions: This study used three different technologies: the Wii Balance Board, iPod Level Belt Pro application, and Saehan hand grip dynamometer. The Wii Balance Board was placed an adequate distance away from any sharp objects and the research assistant, so that both the participant and research assistant could rotate with their arms at a 90 degree angle from their bodies while avoiding contact with any obstacles (Fig. 1). The television screen was only made visible to the research assistant to eliminate confusion, as some tasks selected by the research team were not consistent with the demonstrations provided by the Wii program. Standard folding walkers without wheels were placed on the right and left sides of the board to ensure patient safety, and patients were instructed to stabilize themselves using the walker whenever they felt unstable. Foldable walkers were selected to maintain portability and affordability.

View Article: PubMed Central - PubMed

ABSTRACT

Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures. Forty-one subjects (20 fragility fracture patients, 21 controls without history of fragility fractures) over the age of 50 were recruited from three outpatient orthopaedic clinics. All subjects were administered a FES-I Fear of Falling Survey, a portion of an SF-36 survey, and tested using three different portable CATs: the Wii Balance Board, iPod Level Belt and Saehan Squeeze Hand Grip Dynamometer. There were several measured variables that showed a moderate correlation with Fear of Falling scores. Of note, correlations between FES-I scores and maximum hand grip strength for both the dominant hand (R= -0.302, p=0.069) and non-dominant hand (R= -0.309, p=0.059), as well as maximum anterior-posterior sway measured by the iPod Level Belt (R=0.320, p=0.056) were found to be marginally significant. In addition, the correlation between FES-I and average anterior-posterior sway was found to be significant (R=0.416, p=0.012). The Nintendo Wii and iPod Level Belt are relatively inexpensive, portable tools that can assess patients for subtle deficits during dynamic functional tasks. The results indicate that these tools can provide a more objective measure of a patient’s limitations during daily activities such as walking by assigning them a numerical value and correlating this value to physical deficits that impact balance and coordination. In the future, CATs may also have a role in predicting outcomes and in individualizing care, therapy, and at-home preventive measures.

No MeSH data available.