Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 9 , Pages 1708-1713 , September 2008

Lateral Balance Factors Predict Future Falls in Community-Living Older Adults

  • Marjorie Johnson Hilliard, PT, MS

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
  • ,
  • Katherine M. Martinez, PT, MA

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
  • ,
  • Imke Janssen, PhD

      Affiliations

    • Department of Preventive Medicine, Rush University Medical School, Chicago, IL
  • ,
  • Beatrice Edwards, MD

      Affiliations

    • Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
  • ,
  • Marie-Laure Mille, PhD

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
  • ,
  • Yunhui Zhang, MS

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
  • ,
  • Mark W. Rogers, PhD, PT

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
    • Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
    • Corresponding Author InformationReprint requests to Mark W. Rogers, PhD, PT, Dept of Physical Therapy and Human Movement Sciences, Northwestern University Medical School, 645 N Michigan Ave, Ste 1100, Chicago, IL 60611

References 

  1. Lord SR, Rogers MW, Howland A, Fitzpatrick R. Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc. 1999;47:1077–1081
  2. Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol. 1994;49:M72–M84
  3. Stel VS, Smit JH, Pluijm SM, Lips P. Balance and mobility performance as treatable risk factors for recurrent falling in older persons. J Clin Epidemiol. 2003;56:659–668
  4. Brauer SG, Burns YR, Galley P. A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci. 2000;55:M469–M476
  5. Lord SR, Sherrington C, Menz HB. Falls in older people: risk factors and strategies for prevention. Cambridge: Cambridge Univ Pr; 2001;
  6. Maki BE, Edmondstone MA, McIlroy WE. Age-related differences in laterally directed compensatory stepping behavior. J Gerontol A Biol Sci Med Sci. 2000;55:M270–M277
  7. Mille ML, Johnson ME, Martinez KM, Rogers MW. Age-dependent differences in lateral balance recovery through protective stepping. Clin Biomech (Bristol, Avon). 2005;20:607–616
  8. Rogers MW, Mille ML. Lateral stability and falls in older people. Exerc Sport Sci Rev. 2003;31:182–187
  9. Johnson ME, Mille ML, Martinez KM, Crombie G, Rogers MW. Age-related changes in hip abductor and adductor joint torques. Arch Phys Med Rehabil. 2004;85:593–597
  10. Chang SH, Mercer VS, Giuliani CA, Sloane PD. Relationship between hip abductor rate of force development and mediolateral stability in older adults. Arch Phys Med Rehabil. 2005;86:1843–1850
  11. Pidcoe PE, Rogers MW. A closed-loop stepper motor waist-pull system for inducing protective stepping in humans. J Biomech. 1998;31:377–381
  12. Schenkman M, Hughes MA, Bowden MG, Studenski SA. A clinical tool for measuring functional axial rotation. Phys Ther. 1995;75:151–156
  13. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–1707
  14. Lord SR, Tiedemann A, Chapman K, Munro B, Murray SM, Sherrington C. The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial. J Am Geriatr Soc. 2005;53:1296–1304
  15. Harrell FE. Regression modeling strategies with applications to linear models, logistic regression and survival analysis. New York: Springer; 2001;
  16. Cumming RG, Klineberg RJ. Fall frequency and characteristics and the risk of hip fractures. J Am Geriatr Soc. 1994;42:774–778
  17. Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82:1050–1056
  18. Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int. 1993;52:192–198
  19. Greenspan SL, Myers ER, Maitland LA, Resnick NM, Hayes WC. Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA. 1994;271:128–133
  20. Luchies CW, Alexander NB, Schultz AB, Ashton-Miller JA. Stepping responses of young and old adults to postural disturbances: kinematics. J Am Geriatr Soc. 1994;42:506–512
  21. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332:556–561
  22. Kerrigan DC, Todd MK, Della Croce U, Lipsitz LA, Collins JJ. Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments. Arch Phys Med Rehabil. 1998;79:317–322
  23. Lewis C, Bottomley J. Musculoskeletal changes with age. In:  Lewis C editors. Aging: health care's challenge. 2nd ed.. Philadelphia: FA Davis; 1990;p. 145–146
  24. Henry SM, Fung J, Horak FB. Control of stance during lateral and anterior/posterior surface translations. IEEE Trans Rehabil Eng. 1998;6:32–42
  25. Rietdyk S, Patla AE, Winter DA, Ishac MG, Little CE. Balance recovery from medio-lateral perturbations of the upper body during standing. J Biomech. 1999;32:1149–1158
  26. Winter DA. A.B.C.: anatomy, biomechanics and control of balance during standing and walking. Waterloo: Waterloo Biomechanics; 1995;
  27. Rogers MW, Pai YC. Dynamic transitions in stance support accompanying leg flexion movements in man. Exp Brain Res. 1990;81:398–402
  28. MacKinnon CD, Winter DA. Control of whole body balance in the frontal plane during human walking. J Biomech. 1993;26:633–644
  29. Cho BL, Scarpace D, Alexander NB. Tests of stepping as indicators of mobility, balance, and fall risk in balance-impaired older adults. J Am Geriatr Soc. 2004;2:1168–1173
  30. Shumway-Cook A, Gruber W, Baldwin M, Liao S. The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. Phys Ther. 1997;77:46–57
  31. Tinetti ME. Clinical practice (Preventing falls in elderly persons). N Engl J Med. 2003;348:42–49
  32. Jobges M, Heuschkel G, Pretzel C, Illhardt C, Renner C, Hummelsheim H. Repetitive training of compensatory steps: a therapeutic approach for postural instability in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2004;75:1682–1687
  33. Protas EJ, Mitchell K, Williams A, Qureshy H, Caroline K, Lai EC. Gait and step training to reduce falls in Parkinson's disease. NeuroRehabilitation. 2005;20:183–190

 Supported by the National Institutes of Health (grant no. R01 AG16780).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)00395-X

doi: 10.1016/j.apmr.2008.01.023

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 9 , Pages 1708-1713 , September 2008