Assessing Static Balance, Balance Confidence, and Fall Rate in Patients with Heart Failure and Preserved Ejection...

Area of Science:

• Gerontology
• Cardiology
• Biomechanics

Background:

• Chronic heart failure (CHF) is linked to frailty, falls, and hospitalizations.
• Heart failure with preserved ejection fraction (HFpEF) increases with age and is associated with non-cardiovascular mortality.
• HFpEF patients often experience impaired balance and increased fall risk.

Purpose of the Study:

• To evaluate static balance in patients with HFpEF compared to healthy controls.
• To assess the impact of task difficulty on balance control discrimination.
• To investigate associations between static balance, balance confidence, falls, muscle mass, and strength.

Main Methods:

• Seventy-two HFpEF patients and 72 matched controls performed static balance tests (Bilateral Stance, Tandem-Romberg Stance) on a force platform.
• Balance confidence was measured using the Activities-Specific Balance Confidence (ABC) Scale; fall history was recorded.
• Lower limb strength and lean muscle mass were assessed using dynamometry and bioelectrical impedance analysis.

Main Results:

• HFpEF patients showed significantly lower static balance in both stance tests (p < 0.05).
• Patients with HFpEF reported 21.5% lower balance confidence and 72.9% more falls (p < 0.05).
• Static balance in lab settings showed minimal correlation with falls, strength, or muscle mass.

Conclusions:

• Patients with HFpEF have impaired static balance and reduced balance confidence, leading to increased falls.
• The Bilateral Stance test was more effective in differentiating HFpEF patients from controls.
• While lab-based static balance is reduced in HFpEF, it poorly predicts real-world falls, which are linked to confidence, age, and strength.