Elderly patients with recurrent falls.: Role of posturographic studies

BACKGROUND AND OBJECTIVE: our purpose was to provide information about static and dynamic balance posturographic disorders in elderly people with recurrent falls, and to compare the results with a healthy elderly group. PATIENTS AND METHOD: We included 95 subjects: 57 patients who fell (86% women; age, 78.1 years) and 38 controls. Posturography by Balance Master (Neurocom). Tests performed included: a) weight bearing squat (WBS); b) modified clinical test for the sensory interaction on balance (MGT); c) sit to stand (SS); d) walk across (WA), and e) step and over (SO). RESULTS: No differences in the WBS test between both groups. MCT test: The speed of the movement of the gravity center standing on a firm surface was faster in the fallers group, both with open (p = 0.034) and closed eyes (p = 0.003). The same was seen when we assessed the balance on a foam surface (p < 0.005). 45% of subjects with falls showed instability and fell when they tried to stand if we altered propioceptive conditions and nullified visual afference, as compared to only 18.4% of the control group (p = 0.009). SS test: The elapsed time (in seconds) in order to stand was greater in the study group. d) WA test: Walking velocity was faster in the fallers group. SO test: Non-falters made more body pressure when they went down a step, without interaction with age or gender. CONCLUSIONS: There was an increase in the number of individuals in the fallers group who fell after nullifying visual and propioceptive afferences. It seems necessary to identify these patients in order to establish early intervention programs. The abnormal results in tests which assess daily life activities could be associated with an after-fall anxiety syndrome. Posturography could be a good way to detect the after-fall anxiety syndrome and to develop effective strategies for prevention and treatment.