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2 - Postural stability and falls

Published online by Cambridge University Press:  03 May 2010

Stephen R. Lord
Affiliation:
Prince of Wales Medical Research Institute, Sydney
Catherine Sherrington
Affiliation:
University of Sydney
Hylton B. Menz
Affiliation:
Prince of Wales Medical Research Institute, Sydney and La Trobe University, Melbourne
Jacqueline C. T. Close
Affiliation:
Prince of Wales Medical Research Institute, Sydney and Prince of Wales Hospital, Sydney
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Summary

Postural stability can be defined as the ability of an individual to maintain the position of the body, or more specifically, its centre of mass, within specific boundaries of space, referred to as stability limits. Stability limits are boundaries in which the body can maintain its position without changing the base of support. This definition of postural stability is useful as it highlights the need to discuss stability in the context of a particular task or activity. For example, the stability limit of normal relaxed standing is the area bounded by the two feet on the ground, whereas the stability limit of unipedal stance is reduced to the area covered by the single foot in contact with the ground. Due to this reduction in the size of the stability limit, unipedal stance is an inherently more challenging task requiring greater postural control.

Regardless of the task being performed, maintaining postural stability requires the complex integration of sensory information regarding the position of the body relative to the surroundings and the ability to generate forces to control body movement. Thus, postural stability requires the interaction of musculo-skeletal and sensory systems. The musculo-skeletal component of postural stability encompasses the biomechanical properties of body segments, muscles and joints. The sensory components include vision, vestibular function and somatosensation, which act to inform the brain of the position and movement of the body in three-dimensional space.

Type
Chapter
Information
Falls in Older People
Risk Factors and Strategies for Prevention
, pp. 26 - 49
Publisher: Cambridge University Press
Print publication year: 2007

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References

Shumway-Cook, A. & Woollacott, M., Motor Control: Theory and Practical Applications (Baltimore: Williams and Wilkins, 1995).Google Scholar
Kokmen, E., Bossemeyer, R. W. Jr, Barney, J. & Williams, W. J., Neurological manifestations of aging. Journal of Gerontology, 32 (1977), 411–19.CrossRefGoogle Scholar
Thornbury, J. M. & Mistretta, C. M., Tactile sensitivity as a function of age. Journal of Gerontology, 36 (1981), 34–9.CrossRefGoogle ScholarPubMed
Kaplan, F. S., Nixon, J. E., Reitz, M., Rindfleish, L. & Tucker, J., Age-related changes in proprioception and sensation of joint position. Acta Orthopaedica Scandinavica, 56 (1985), 72–4.CrossRefGoogle ScholarPubMed
Lord, S. R. & Ward, J. A., Age-associated differences in sensori-motor function and balance in community dwelling women. Age and Ageing, 23 (1994), 452–60.CrossRefGoogle ScholarPubMed
Sheldon, J. H., The effect of age on the control of sway. Gerontology Clinics, 5 (1963), 129–38.CrossRefGoogle ScholarPubMed
Fitzpatrick, R., Rogers, D. K. & McClosky, D. I., Stable human standing with lower-limb muscle afferents providing the only sensory input. Journal of Physiology, 480 (1994), 395–403.CrossRefGoogle ScholarPubMed
Simoneau, G. G., Leibowitz, H. W., Ulbrecht, J. S., Tyrrell, R. A. & Cavanagh, P. R., The effects of visual factors and head orientation on postural steadiness in women 55 to 70 years of age. Journal of Gerontology, 47 (1992), M151–8.CrossRefGoogle ScholarPubMed
Fitzpatrick, R. & McCloskey, D., Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans. Journal of Physiology, 478 (1994), 173–86.CrossRefGoogle ScholarPubMed
Shumway-Cook, A. & Horak, F. B., Assessing the influence of sensory interaction on balance: suggestion from the field. Physical Therapy, 66 (1986), 1548–50.CrossRefGoogle ScholarPubMed
Lord, S. R., Clark, R. D. & Webster, I. W., Postural stability and associated physiological factors in a population of aged persons. Journal of Gerontology, 46A (1991), M69–76.CrossRefGoogle Scholar
Orma, E. J., The effects of cooling the feet and closing the eyes on standing equilibrium: different patterns of standing equilibrium in young men and women. Acta Physiologica Scandinavica, 38 (1957), 288–97.CrossRefGoogle ScholarPubMed
Magnusson, M., Enbom, H., Johansson, R. & Wiklund, J., Significance of pressor input from the human feet in lateral postural control. Acta Otolaryngologica, 110 (1990), 321–7.CrossRefGoogle ScholarPubMed
Magnusson, M., Enbom, H., Johansson, R. & Pyykko, I., Significance of pressor input from the human feet in anterior-posterior postural control. Acta Otolaryngologica, 110 (1990), 182–8.CrossRefGoogle ScholarPubMed
Romberg, M., A manual of the nervous diseases of man. Sydenham Transactions, 2 (1853), 396.Google Scholar
Hellbrandt, F. A. & Braun, G. L., The influence of sex and age on the postural sway of man. American Journal of Physical Anthropology, XXIV (1939), 347–60.CrossRefGoogle Scholar
Boman, K. & Jalavisto, E., Standing steadiness in old and young persons. Annales Medicinae Eperimentalis et Biologiae Fenniae, 31 (1953), 447–55.Google ScholarPubMed
Fregly, A. R. & Graybiel, A., An ataxia test battery not requiring rails. Aerospace Medicine, 39 (1968), 277–82.Google Scholar
Murray, M. P., Seireg, A. A. & Sepic, S. B., Normal postural stability and steadiness: quantitative assessment. Journal of Bone and Joint Surgery, 57A (1975), 510–16.CrossRefGoogle Scholar
Hasselkus, B. R. & Shambes, E. M., Aging and postural sway in women. Journal of Gerontology, 30 (1975), 661–7.CrossRefGoogle ScholarPubMed
Overstall, P. W., Exton-Smith, A. N., Imms, F. J. & Johnson, A. L., Falls in the elderly related to postural imbalance. British Medical Journal, 1 (1977), 261–4.CrossRefGoogle ScholarPubMed
Brocklehurst, J. C., Robertson, D. & James-Groom, P., Clinical correlates of sway in old age – sensory modalities. Age and Ageing, 11 (1982), 1–10.CrossRefGoogle ScholarPubMed
Era, P. & Heikkinen, E., Postural sway during standing and unexpected disturbance of balance in random samples of men of different ages. Journal of Gerontology, 40 (1985), 287–95.CrossRefGoogle ScholarPubMed
Ekdahl, C., Jarnlo, E. B. & Andersson, S. I., Standing balance in healthy subjects. Scandinavian Journal of Rehabilitative Medicine, 21 (1989), 187–95.Google ScholarPubMed
Ring, C., Nayak, U. S. & Isaacs, B., The effect of visual deprivation and proprioceptive change on postural sway in healthy adults. Journal of the American Geriatrics Society, 37 (1989), 745–9.CrossRefGoogle ScholarPubMed
Maki, B. E., Holliday, P. J. & Fernie, G. R., Aging and postural control. A comparison of spontaneous- and induced-sway balance tests. Journal of the American Geriatrics Society, 38 (1990), 1–9.CrossRefGoogle ScholarPubMed
Pyykko, I., Jantti, P. & Aalto, H., Postural control in elderly subjects. Age and Ageing, 19 (1990), 215–21.CrossRefGoogle ScholarPubMed
Peterka, R. J. & Black, F. O., Age-related changes in human posture control: sensory organization tests. Journal of Vestibular Research, 1 (1990), 73–85.Google ScholarPubMed
Colledge, N. R., Cantley, P., Peaston, I.et al., Ageing and balance: the measurement of spontaneous sway by posturography. Gerontology, 40 (1994), 273–8.CrossRefGoogle ScholarPubMed
Baloh, R. W., Fife, T. D., Zwerling, L.et al., Comparison of static and dynamic posturography in young and older normal people. Journal of the American Geriatrics Society, 42 (1994), 405–12.CrossRefGoogle Scholar
Okuzumi, H., Tanaka, A., Haishi, K.et al., Age-related changes in postural control and locomotion. Perceptual and Motor Skills, 81 (1995), 991–4.CrossRefGoogle ScholarPubMed
Collins, J. J., Luca, C. J., Burrows, A. & Lipsitz, L. A., Age-related changes in open-loop and closed-loop postural control mechanisms. Experimental Brain Research, 104 (1995), 480–492.CrossRefGoogle ScholarPubMed
McClenaghan, B., Williams, H., Dickerson, J.et al., Spectral characteristics of ageing postural control. Gait and Posture, 3 (1995), 123–31.CrossRefGoogle Scholar
Hageman, P. A., Leibowitz, J. M. & Blanke, D., Age and gender effects on postural control measures. Archives of Physical Medicine and Rehabilitation, 76 (1995), 961–5.CrossRefGoogle ScholarPubMed
Kamen, G., Patten, C., Du, C. D., Sison, S., An accelerometry-based system for the assessment of balance and postural sway. Gerontology, 44 (1995), 40–5.CrossRefGoogle Scholar
Hay, L., Bard, C., Fleury, M. & Teasdale, N., Availability of visual and proprioceptive afferent messages and postural control in elderly adults. Experimental Brain Research, 108 (1996), 129–39.CrossRefGoogle ScholarPubMed
Perrin, P. P., Jeandel, C., Perrin, C. A. & Bene, M. C., Influence of visual control, conduction, and central integration on static and dynamic balance in healthy older adults. Gerontology, 43 (1997), 223–31.CrossRefGoogle ScholarPubMed
Slobounov, S. M., Moss, S. A., Slobounova, E. S. & Newell, K. M., Aging and time to instability in posture. Journal of Gerontology, 53A (1998), B71–8.Google Scholar
Baloh, R. W., Corona, S., Jacobson, K. M., Enrietto, J. A. & Bell, T., A prospective study of posturography in normal older people. Journal of the American Geriatrics Society, 46 (1998), 438–43.CrossRefGoogle ScholarPubMed
Choy, N. L., Brauer, S. & Nitz, J., Changes in postural stability in women aged 20 to 80 years. Journal of Gerontology, 58A (2003), 525–30.Google Scholar
Fernie, G. R., Gryfe, C. I., Holliday, P. J. & Llewellyn, A., The relationship of postural sway in standing to the incidence of falls in geriatric subjects. Age and Ageing, 11 (1982), 11–16.CrossRefGoogle ScholarPubMed
Judge, J. O., King, M. B., Whipple, R., Clive, J. & Wolfson, L. I., Dynamic balance in older persons: effects of reduced visual and proprioceptive input. Journal of Gerontology, 50A (1995), M263–70.Google Scholar
Era, P., Schroll, M., Ytting, H.et al., Postural balance and its sensory-motor correlates in 75-year-old men and women: a cross-national comparative study. Journal of Gerontology, 51A (1996), M53–63.Google Scholar
Satariano, W. A., DeLorenze, G. N., Reed, D. & Schneider, E. L., Imbalance in an older population: an epidemiological analysis. Journal of Aging and Health, 8 (1996), 334–58.CrossRefGoogle Scholar
Carter, N. D., Khan, K. M., Mallinson, A. & Janssen, P. A., Knee strength is a significant determinant of static and dynamic balance as well as quality of life in older community-dwelling women with osteoporosis. Gerontology, 48 (2002), 360–8.CrossRefGoogle ScholarPubMed
MacLennan, W. J., Timothy, J. I. & Hall, M. R. P., Vibration sense, proprioception and ankle reflexes in old age. Journal of Clinical and Experimental Gerontology, 2 (1980), 159–71.Google Scholar
Duncan, G., Wilson, J. A., MacLennan, W. J. & Lewis, S., Clinical correlates of sway in elderly people living at home. Gerontology, 38 (1992), 160–6.CrossRefGoogle ScholarPubMed
Anacker, S. L. & Fabio, R. P.Di, Influence of sensory inputs on standing balance in community-dwelling elders with a recent history of falling. Physical Therapy, 72 (1992), 575–81.CrossRefGoogle ScholarPubMed
Kristinsdottir, E. K., Jarnlo, G. B. & Magnusson, M., Aberrations in postural control, vibration sensation and some vestibular findings in healthy 64–92-year-old subjects. Scandinavian Journal of Rehabilitation Medicine, 29 (1997), 257–65.Google ScholarPubMed
Lichtenstein, M. J., Shields, S. L., Shiavi, R. G. & Burger, M. C., Clinical determinants of biomechanics platform measures of balance in aged women. Journal of the American Geriatrics Society, 36 (1988), 996–1002.CrossRefGoogle ScholarPubMed
Stelmach, G. E., Phillips, J., DiFabio, R. P. & Teasdale, N., Age, functional postural reflexes, and voluntary sway. Journal of Gerontology, 44 (1989), B100–6.CrossRefGoogle ScholarPubMed
Cohen, H., Heaton, L. G., Congdon, S. L. & Jenkins, H. A., Changes in sensory organization test scores with age. Age and Ageing, 25 (1996), 39–44.CrossRefGoogle ScholarPubMed
Danis, C. G., Krebs, D. E., Gill-Body, K. M. & Sahrmann, S., Relationship between standing posture and stability. Physical Therapy, 78 (1998), 502–517.CrossRefGoogle ScholarPubMed
Kejonen, P., Kauranen, K. & Vanharanta, H., The relationship between anthropometric factors and body-balancing movement in postural balance. Archives of Physical Medicine and Rehabilitation, 84 (2003), 17–22.CrossRefGoogle ScholarPubMed
Woolley, S. M., Czaja, S. J. & Drury, C. G., An assessment of falls in elderly men and women. Journal of Gerontology, 52A (1997), M80–7.Google Scholar
Cho, C. Y. & Kamen, G., Detecting balance deficits in frequent fallers using clinical and quantitative evaluation tools. Journal of the American Geriatrics Society, 46 (1998), 426–30.CrossRefGoogle ScholarPubMed
Lord, S. R., Clark, R. D. & Webster, I. W., Physiological factors associated with falls in an elderly population. Journal of the American Geriatrics Society, 39 (1991), 1194–2000.CrossRefGoogle Scholar
Maki, B. E., Holliday, P. J. & Topper, A. K., A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. Journal of Gerontology, 49 (1994), M72–84.CrossRefGoogle Scholar
Lord, S. R., Lloyd, D. G. & Li, S. K., Sensori-motor function, gait patterns and falls in community-dwelling women. Age and Ageing, 25 (1996), 292–9.CrossRefGoogle ScholarPubMed
Lord, S. R. & Clark, R. D., Simple physiological and clinical tests for the accurate prediction of falling in older people. Gerontology, 42 (1996), 199–203.CrossRefGoogle ScholarPubMed
Thapa, P. B., Gideon, P., Brockman, K. G., Fought, R. L. & Ray, W. A., Clinical and biomechanical measures of balance as fall predictors in ambulatory nursing home residents. Journal of Gerontology, 51A (1996), M239–46.Google Scholar
Stel, V. S., Smit, J. H., Pluijm, S. M. F. & Lips, P., Balance and mobility performance as treatable risk factors for recurrent falling in older persons. Journal of Clinical Epidemiology, 56 (2003), 659–68.CrossRefGoogle ScholarPubMed
Lord, S. R., Sambrook, P. N., Gilbert, C.et al., Postural stability, falls and fractures in the elderly: results from the Dubbo Osteoporosis Epidemiology Study. Medical Journal of Australia, 160 (1994), 684–5, 688–91.Google ScholarPubMed
Lord, S. R., McLean, D. & Stathers, G., Physiological factors associated with injurious falls in older people living in the community. Gerontology, 38 (1992), 338–46.CrossRefGoogle ScholarPubMed
Lord, S. R., Ward, J. A., Williams, P. & Anstey, K. J., Physiological factors associated with falls in older community-dwelling women. Journal of the American Geriatrics Society, 42 (1994), 1110–17.CrossRefGoogle ScholarPubMed
Kirby, R. L., Price, N. A. & MacLeod, D. A., Influence of foot position on standing balance. Journal of Biomechanics, 20 (1987), 423–7.CrossRefGoogle ScholarPubMed
Goldie, P. A., Bach, T. M. & Evans, O. M., Force platform measures for evaluating postural control: reliability and validity. Archives of Physical Medicine and Rehabilitation, 70 (1989), 510–17.Google ScholarPubMed
Kollegger, H., Wober, C., Baumgartner, C. & Deecke, L., Stabilizing and destabilizing effects of vision and foot position on body sway of healthy young subjects: a posturographic study. European Neurology, 29 (1989), 241–5.CrossRefGoogle ScholarPubMed
Day, B. L., Steiger, M. J., Thompson, P. D. & Marsden, C. D., Effect of vision and stance width on human body motion when standing: implications for afferent control of lateral sway. Journal of Physiology, 469 (1993), 479–99.CrossRefGoogle ScholarPubMed
Fregly, A. R., Smith, M. J. & Graybiel, A., Revised normative standards of performance of men on a quantitative ataxia test battery. Acta Otolaryngologica, 75 (1973), 10–16.CrossRefGoogle ScholarPubMed
Bohannon, R. W., Larkin, P. A., Cook, A. C., Gear, J. & Singer, J., Decrease in timed balance test scores with aging. Physical Therapy, 64 (1984), 1067–70.CrossRefGoogle ScholarPubMed
Heitmann, D. K., Gossman, M. R., Shaddeau, S. A. & Jackson, J. R., Balance performance and step width in noninstitutionalized, elderly, female fallers and nonfallers. Physical Therapy, 69 (1989), 923–31.CrossRefGoogle ScholarPubMed
Iverson, B. D., Gossman, M. R., Shaddeau, S. A. & Turner, M. E. Jr., Balance performance, force production, and activity levels in noninstitutionalized men 60 to 90 years of age. Physical Therapy, 70 (1990), 348–55.CrossRefGoogle ScholarPubMed
Speers, R. A., Ashton-Miller, J. A., Schultz, A. B. & Alexander, N. B., Age differences in abilities to perform tandem stand and walk tasks of graded difficulty. Gait and Posture, 7 (1998), 207–13.CrossRefGoogle ScholarPubMed
Crosbie, W. J., Nimmo, M. A., Banks, M. A., Brownlee, M. G. & Meldrum, F., Standing balance responses in two populations of elderly women: a pilot study. Archives of Physical Medicine and Rehabilitation, 70 (1989), 751–4.Google ScholarPubMed
Briggs, R. C., Gossman, M. R., Birch, R., Drews, J. E. & Shaddeau, S. A., Balance performance among noninstitutionalized elderly women. Physical Therapy, 69 (1989), 748–56.CrossRefGoogle ScholarPubMed
Maki, B. E., Holliday, P. J. & Topper, A. K., Fear of falling and postural performance in the elderly. Journal of Gerontology, 46 (1991), M123–31.CrossRefGoogle ScholarPubMed
Balogun, J. A., Akindele, K. A., Nihinlola, J. O. & Marzouk, D. K., Age-related changes in balance performance. Disability and Rehabilitation, 16 (1994), 58–62.CrossRefGoogle ScholarPubMed
Vellas, B. J., Wayne, S. J., Romero, L.et al., One-leg balance is an important predictor of injurious falls in older persons. Journal of the American Geriatrics Society, 45 (1997), 735–738.CrossRefGoogle ScholarPubMed
Lord, S. R., Rogers, M. W., Howland, A. & Fitzpatrick, R., Lateral stability, sensorimotor function and falls in older people. Journal of the American Geriatrics Society, 47 (1999), 1077–81.CrossRefGoogle ScholarPubMed
Studenski, S., Duncan, P. W. & Chandler, J., Postural responses and effector factors in persons with unexplained falls: results and methodologic issues. Journal of the American Geriatrics Society, 39 (1991), 229–34.CrossRefGoogle ScholarPubMed
Hurvitz, E., Richardson, J., Werner, R., Ruhl, A. & Dixon, M., Unipedal stance testing as an indicator of fall risk among older outpatients. Archives of Physical Medicine and Rehabilitation, 81 (2000), 587–91.CrossRefGoogle ScholarPubMed
King, M. B., Judge, J. O. & Wolfson, L., Functional base of support decreases with age. Journal of Gerontology, 49 (1994), M258–63.CrossRefGoogle ScholarPubMed
Duncan, P. W., Weiner, D. K., Chandler, J. & Studenski, S., Functional reach: a new clinical measure of balance. Journal of Gerontology, 45 (1990), M192–7.CrossRefGoogle Scholar
Weiner, D. K., Duncan, P. W., Chandler, J. & Studenski, S. A., Functional reach: a marker of physical frailty. Journal of the American Geriatrics Society, 40 (1992), 203–7.CrossRefGoogle ScholarPubMed
Duncan, P. W., Studenski, S., Chandler, J. & Prescott, B., Functional reach: predictive validity in a sample of elderly male veterans. Journal of Gerontology, 47 (1992), M93–8.CrossRefGoogle Scholar
Weiner, D. K., Bongiorni, D. R., Studenski, S. A., Duncan, P. W. & Kochersberger, G. G., Does functional reach improve with rehabilitation?Archives of Physical Medicine and Rehabilitation, 74 (1993), 796–800.CrossRefGoogle ScholarPubMed
Wernick-Robinson, M., Krebs, D. E. & Giorgetti, M. M., Functional reach: does it really measure dynamic balance?Archives of Physical Medicine and Rehabilitation, 80 (1999), 262–9.CrossRefGoogle ScholarPubMed
Brauer, S., Burns, Y., Galley, P., Lateral reach: a clinical measure of medio-lateral postural stability. Physiotherapy Research International, 4 (1999), 81–8.CrossRefGoogle ScholarPubMed
Newton, R., Validity of the multi-directional reach test: a practical measure for limits of stability in older adults. Journal of Gerontology, 56A (2001), M248–52.Google Scholar
Brauer, S., Burns, Y. & Galley, P., A prospective study of laboratory and clinical measures of postural stability to predict community dwelling fallers. Journal of Gerontology, 55A (2000), M469–76.Google Scholar
Lord, S. R., Ward, J. A. & Williams, P., Exercise effect on dynamic stability in older women: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 77 (1996), 232–6.CrossRefGoogle ScholarPubMed
Lord, S. R. & Menz, H. B., Physiologic, psychologic and health predictors of 6-minute walk performance in older people. Archives of Physical Medicine and Rehabilitation, 83, (2002), 907–11.CrossRefGoogle ScholarPubMed
Menz, H. B. & Lord, S. R., The contribution of foot problems to mobility impairment and falls in older people. Journal of the American Geriatrics Society, 49 (2001), 1651–6.CrossRefGoogle ScholarPubMed
Sturnieks, D. L., Lord, S. R., Tiedemann, A.et al., Physiological risk factors for falls in older people with lower limb arthritis. Journal of Rheumatology, 31 (2004), 2272–9.Google ScholarPubMed
Day, L., Fildes, B., Gordon, I., A randomized factorial trial of falls prevention among older people living in their own homes. British Medical Journal, 325 (2002), 128–33.CrossRefGoogle ScholarPubMed
Barnett, A., Smith, B., Lord, S. R., Williams, M. & Bauman, A., Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age and Ageing, 32 (2003), 407–14.CrossRefGoogle ScholarPubMed
Lord, S. R., Castell, S., Corcoran, J.et al., The effect of group exercise on physical functioning and falls in frail older people living in retirement villages: a randomised controlled trial. Journal of the American Geriatrics Society, 51 (2003), 1685–92.CrossRefGoogle Scholar
Stelmach, G. E. & Worringham, C. J., Sensorimotor deficits related to postural stability. Implications for falling in the elderly. Clinics in Geriatric Medicine, 1 (1985), 679–94.Google ScholarPubMed
Grabiner, M. D. & Jahnigen, D. W., Modeling recovery from stumbles: preliminary data on variable selection and classification efficacy. Journal of the American Geriatrics Society, 40 (1992), 910–13.CrossRefGoogle ScholarPubMed
Lord, S. R. & Fitzpatrick, R. C., Choice stepping reaction time: a composite measure of falls risk in older people. Journal of Gerontology, 56A (2001), M627–32.Google Scholar
Lord, S. R., Menz, H. B. & Tiedemann, A., A physiological profile approach to falls risk assessment and prevention. Physical Therapy, 83 (2003), 237–52.Google ScholarPubMed
Medell, J. L. & Alexander, N. B., A clinical measure of maximal and rapid stepping in older women. Journal of Gerontology, 55A (2000), M424–8.Google Scholar
Luchies, C., Schiffman, J., Richards, L.et al., Effects of age, step direction, and reaction condition on the ability to step quickly. Journal of Gerontology, 57A (2002), M246–9.Google Scholar
Dite, W. & Temple, V., A clinical test of stepping and change of direction to identify multiple falling older adults. Archives of Physical Medicine and Rehabilitation, 83 (2002), 1566–71.CrossRefGoogle ScholarPubMed
Davis, J. W., Ross, P. D., Nevitt, M. C. & Wasnich, R. D., Risk factors for falls and for serious injuries on falling among older Japanese women in Hawaii. Journal of the American Geriatrics Society, 47 (1999), 792–8.CrossRefGoogle ScholarPubMed
Campbell, A. J., Borrie, M. J. & Spears, G. F., Risk factors for falls in a community-based prospective study of people 70 years and older. Journal of Gerontology, 44 (1989), M112–17.CrossRefGoogle Scholar
Nevitt, M., Cummings, S., Kidd, S. & Black, D., Risk factors for recurrent non-syncopal falls. Journal of the American Medical Association, 261 (1989), 2663–8.CrossRefGoogle Scholar
Lipsitz, L. A., Jonsson, P. V., Kelley, M. M. & Koestner, J. S., Causes and correlates of recurrent falls in ambulatory frail elderly. Journal of Gerontology, 46 (1991), M114–22.CrossRefGoogle ScholarPubMed
Schwartz, A. V., Villa, M. L., Prill, M.et al., Falls in older Mexican American women. Journal of the American Geriatrics Society, 47 (1999), 1371–8.Google ScholarPubMed
O'Loughlin, J. L., Robitaille, Y., Boivin, J. F. & Suissa, S., Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. American Journal of Epidemiology, 137 (1993), 342–54.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Williams, T. F. & Mayewski, R., Fall risk index for elderly patients based on number of chronic disabilities. American Journal of Medicine, 80 (1986), 429–34.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Speechley, M. & Ginter, S. F., Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319 (1988), 1701–7.CrossRefGoogle ScholarPubMed
Faber, M. J., Bosscher, R. J. & Wieringen, P. C., Clinimetric properties of the performance-oriented mobility assessment. Physical Therapy, 86 (2006), 944–54.Google ScholarPubMed
Tinetti, M. E., Performance-oriented assessment of mobility problems in elderly patients. Journal of the American Geriatrics Society, 34 (1986), 119–26.CrossRefGoogle ScholarPubMed
Berg, K. O., Maki, B. E., Williams, J. I., Holliday, P. J. & Wood-Dauphinee, S. L., Clinical and laboratory measures of postural balance in an elderly population. Archives of Physical Medicine and Rehabilitation, 73 (1992), 1073–80.Google Scholar
Lichtenstein, M. J., Burger, M. C., Shields, S. L. & Shiavi, R. G., Comparison of biomechanics platform measures of balance and videotaped measures of gait with a clinical mobility scale in elderly women. Journal of Gerontology, 45 (1990), M49–54.CrossRefGoogle ScholarPubMed
Laughton, C. A., Slavin, M., Katdare, K.et al., Aging, muscle activity, and balance control: physiologic changes associated with balance impairment. Gait and Posture, 18 (2003), 101–8.CrossRefGoogle ScholarPubMed
Raiche, M., Hebert, R., Prince, F. & Corriveau, H., Screening older adults at risk of falling with the Tinetti balance scale. The Lancet, 356 (2000), 1001–2.CrossRefGoogle ScholarPubMed
Berg, K. O., Wood-Dauphinee, S. L., Williams, J. I. & Maki, B., Measuring balance in the elderly: validation of an instrument. Revue Canadienne de Sante Publique, 83 (1992), S7–11.Google ScholarPubMed
Thorbahn, L. D. & Newton, R. A., Use of the Berg Balance Test to predict falls in elderly persons. Physical Therapy, 76 (1996), 576–83.CrossRefGoogle Scholar
Shumway-Cook, A., Baldwin, M., Polissar, N. L. & Gruber, W., Predicting the probability for falls in community-dwelling older adults. Physical Therapy, 77 (1997), 812–19.CrossRefGoogle ScholarPubMed
O'Brien, K., Culham, E. & Pickles, B., Balance and skeletal alignment in a group of elderly female fallers and nonfallers. Journal of Gerontology, 52A (1997), B221–6.Google Scholar
Chiu, A. Y., Au-Yeung, S. S. & Lo, S. K., A comparison of four functional tests in discriminating fallers from non-fallers in older people. Disability and Rehabilitation, 25 (2003), 45–50.CrossRefGoogle ScholarPubMed
Daubney, M. E. & Culham, E. G., Lower-extremity muscle force and balance performance in adults aged 65 years and older. Physical Therapy, 79 (1999), 1177–85.Google ScholarPubMed
Riddle, D. L. & Stratford, P. W., Interpreting validity indexes for diagnostic tests: an illustration using the Berg balance test. Physical Therapy, 79 (1999), 939–48.Google ScholarPubMed
Shumway-Cook, A., Woollacott, M., Kerns, K. A. & Baldwin, M., The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls. Journal of Gerontology, 52A (1997), M232–40.Google Scholar
Mathias, S., Nayak, U. S. L. & Isaacs, B., Balance in elderly patients: the “Get-up and Go” test. Archives of Physical Medicine and Rehabilitation, 67 (1986), 387–9.Google ScholarPubMed
Podsiadlo, D. & Richardson, S., The timed “Up and Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39 (1991), 142–8.CrossRefGoogle ScholarPubMed
Shumway-Cook, A., Brauer, S. & Woollacott, M., Predicting the probability for falls in community-dwelling older adults using the Timed Up and Go Test. Physical Therapy, 80 (2000), 896–903.Google Scholar
Rose, D. J., Jones, C. J. & Lucchese, N., Predicting the probability of falls in community-residing older adults using the 8-foot up-and-go: a new measure of functional mobility. Journal of Aging and Physical Activity, 10 (2002), 466–75.CrossRefGoogle Scholar
Gunter, K., White, K., Hayes, W. C. & Snow, C. M., Functional mobility discriminates nonfallers from one-time and frequent fallers. Journal of Gerontology, 55 (2000), M672–6.Google ScholarPubMed
Rockwood, K., Awalt, E., Carver, D. & MacKnight, C., Feasibility and measurement properties of the Functional Reach and the Timed Up and Go tests in the Canadian Study of Health and Aging. Journal of Gerontology, 55A (2000), M70–3.Google Scholar
Siggeirsdottir, K., Jonsson, B., Jonsson, H. & Iwarsson, S., The timed Up and Go is dependent on chair type. Clinical Rehabilitation, 16 (2002), 609–16.CrossRefGoogle ScholarPubMed
Wolfson, L. I., Whipple, R., Amerman, P. & Kleinberg, A., Stressing the postural response. A quantitative method for testing balance. Journal of the American Geriatrics Society, 34 (1986), 845–50.CrossRefGoogle ScholarPubMed
Chandler, J. M., Duncan, P. W. & Studenski, S. A., Balance performance on the postural stress test: comparison of young adults, healthy elderly, and fallers. Physical Therapy, 70 (1990), 410–15.CrossRefGoogle ScholarPubMed
Clark, R. D., Lord, S. R. & Webster, I. W., Clinical parameters associated with falls in an elderly population. Gerontology, 39 (1993), 117–23.CrossRefGoogle Scholar
Nashner, L. M., Adaptation of movement to altered environments. Trends in Neuroscience, 5 (1982), 358–61.CrossRefGoogle Scholar
Woollacott, M. H., Shumway-Cook, A. & Nashner, L. M., Aging and posture control: changes in sensory organization and muscular coordination. International Journal of Aging and Human Development, 23 (1986), 97–114.CrossRefGoogle ScholarPubMed
Wolfson, L., Whipple, R., Derby, C. A.et al., A dynamic posturography study of balance in healthy elderly. Neurology, 42 (1992), 2069–75.CrossRefGoogle ScholarPubMed
Whipple, R., Wolfson, L., Derby, C., Singh, D. & Tobin, J., Altered sensory function and balance in older persons. Journal of Gerontology, 48 (1993), 71–6.CrossRefGoogle ScholarPubMed
Keshner, E. A., Allum, J. H. & Honegger, F., Predictors of less stable postural responses to support surface rotations in healthy human elderly. Journal of Vestibular Research, 3 (1993), 419–29.Google ScholarPubMed
Nardone, A., Siliotto, R., Grasso, M. & Schieppati, M., Influence of aging on leg muscle reflex responses to stance perturbation. Archives of Physical Medicine and Rehabilitation, 76 (1995), 158–65.CrossRefGoogle ScholarPubMed
Nashner, L. M., Fixed patterns of rapid postural responses among leg muscles during stance. Experimental Brain Research, 30 (1977), 13–24.CrossRefGoogle ScholarPubMed
Nashner, L. M., Woollacott, M. & Tuma, G., Organization of rapid responses to postural and locomotor-like perturbations of standing man. Experimental Brain Research, 36 (1979), 463–76.CrossRefGoogle ScholarPubMed
Horak, F. B., Shupert, C. L. & Mirka, A., Components of postural dyscontrol in the elderly: a review. Neurobiology of Aging, 10 (1989), 727–38.CrossRefGoogle ScholarPubMed
Maki, B. E., Holliday, P. J. & Fernie, G. R., A posture control model and balance test for the prediction of relative postural stability. Transactions on Biomedical Engineering, 34 (1987), 797–810.CrossRefGoogle ScholarPubMed
Manchester, D., Woollacott, M., Zederbauer-Hylton, N. & Marin, O., Visual, vestibular and somatosensory contributions to balance control in the older adult. Journal of Gerontology, 44 (1989), M118–27.CrossRefGoogle ScholarPubMed
Camicioli, R., Panzer, V. P. & Kaye, J., Balance in the healthy elderly: posturography and clinical assessment. Archives of Neurology, 54 (1997), 976–81.CrossRefGoogle ScholarPubMed
Peterka, R. J. & Black, F. O., Age-related changes in human posture control: motor coordination tests. Journal of Vestibular Research, 1 (1990), 87–96.Google ScholarPubMed
Gu, M. J., Schultz, A. B., Shepard, N. T. & Alexander, N. B., Postural control in young and elderly adults when stance is perturbed: dynamics. Journal of Biomechanics, 29 (1996), 319–29.CrossRefGoogle Scholar
Maki, B. E., McIlroy, W. E., The role of limb movements in maintaining upright stance: the “change-in-support” strategy. Physical Therapy, 77 (1997), 488–507.CrossRefGoogle ScholarPubMed
Luchies, C. W., Alexander, N. B., Schultz, A. B. & Ashton-Miller, J., Stepping responses of young and old adults to postural disturbances: kinematics. Journal of the American Geriatrics Society, 42 (1994), 506–12.CrossRefGoogle Scholar
McIlroy, W. E. & Maki, B. E., Age-related changes in compensatory stepping in response to unpredictable perturbations. Journal of Gerontology, 51A (1996), M289–96.Google Scholar
Maki, B. E., Edmonstone, M. A. & McIlroy, W. E., Age-related differences in laterally directed compensatory stepping behavior. Journal of Gerontology, 55A (2000), M270–7.Google Scholar
Rogers, M., Hedman, L., Johnson, M., Cain, T. & Hanke, T., Lateral stability during forward-induced stepping for dynamic balance recovery in young and older adults. Journal of Gerontology, 56A (2001), M589–94.Google Scholar
Williams, H. G., McClenaghan, B. A. & Dickerson, J., Spectral characteristics of postural control in elderly individuals. Archives of Physical Medicine and Rehabilitation, 78 (1997), 737–44.CrossRefGoogle ScholarPubMed
Lord, S. R., Rogers, M. W., Howland, A. & Fitzpatrick, R., Lateral stability, sensorimotor function and falls in older people. Journal of the American Geriatrics Society, 47 (1999), 1077–81.CrossRefGoogle ScholarPubMed
Schulz, B. W., Ashton-Miller, J. A. & Alexander, N. B., Compensatory stepping in response to waist pulls in balance-impaired and unimpaired women. Gait and Posture, 22 (2005), 198–209.CrossRefGoogle ScholarPubMed
Owings, T. M., Pavol, M. J. & Grabiner, M. D., Mechanisms of failed recovery following postural perturbations on a motorised treadmill mimic those associated with an actual forward trip. Clinical Biomechanics, 16 (2001), 813–19.CrossRefGoogle Scholar
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