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Finding a Balance

Kim Bigelow, Wellness and Safety Lab director, helped develop a test to predict fall risks that can be taken in a doctor's office in two minutes.

National Falls Prevention Awareness Day is approaching Sept. 23 — the first day of fall — and the one-third of adults 65 and older who fall each year may find help to avoid falls with a quick, easy test.

Kim Bigelow, an assistant professor of mechanical engineering and director of the University of Dayton Engineering Wellness and Safety Lab, and Necip Berme, professor emeritus in The Ohio State University department of mechanical and aerospace engineering, have developed a test to predict a patient's fall risk that can be taken in the privacy of a doctor's office in less than two minutes.

The research, published in the Journal of Gerontology, evaluated patients performing four quiet-standing tasks — eyes open and eyes closed in both comfortable and narrow stances — while standing on a force-measuring platform or balance plate similar to Wii Fit video game system technology.

The researchers found the test using a comfortable stance with eyes closed was the best way to determine a fall risk.

"The majority of clinical tests to assess balance have limitations, including time and space requirements and subjective scoring," the study reported. "Posturography, though not commonly used clinically, is a quick-to-administer and quantitative test that could serve as a possible alternative to overcome these limitations."

The Centers for Disease Control and Prevention estimates more than a third of adults 65 and older fall each year in the United States.

"The eyes closed condition likely amplifies the differences between groups as it has been suggested that individuals with postural instability can often compensate for their differences by becoming more visually reliant," the authors wrote. "The eyes closed narrow stance condition was too challenging, even for non-recurrent fallers, making it inappropriate for the regular screening of older adults."

The study involved 150 adults 65-years-old and older. It was partially funded by a National Science Foundation ADVANCE grant.

"For this to be a feasible screening tool, physicians must know how to best test patients and must be able to interpret patients' results quickly and easily," the researchers said. "This study aimed to determine which conditions best differentiated recurrent fallers from non-recurrent fallers and which postural sway measure, or group of measures, should be used. To translate these findings to maximize their clinical potential, this study created an equation to weight each of the identified measures, calculating an overall probability of an older adult's likelihood of falling."

In an effort to continue to make posturography a useful clinical tool, Bigelow and her lab have recently concentrated on standardizing the testing methodology. Bigelow, who serves as the co-chair for the International Society of Posture and Gait Research's Committee for the International Standardization of Posturography, recently presented her lab's work at the American Society of Biomechanics Conference in Long Beach, Calif. Variations in posturography testing methods: Effect of talking, visual fixation, and time on plate on sway measurements indicated slight differences in clinical environments, such as artwork hung near the test, may alter measured postural sway.

The University of Dayton Engineering Wellness and Safety Lab combines engineering, medicine and physical therapy to understand balance, gait and mobility.

The students in the lab will present a workshop on fall prevention 3 to 5 p.m. Friday, Sept. 23, at St. Leonard in Centerville to observe National Falls Prevention Awareness Day. The free, public event features demonstrations on easy fixes around the house to prevent falls like installing grab bars in showers and tread tape to prevent slippage. There also will be a balance screening demonstration.


News and Communications Staff