Quantifying Reactive Dynamic Balance in Older Adults: An Exploratory Lag-Plot-Based Approach toward Fall Risk...

Area of Science:

• Biomechanics
• Gerontology
• Rehabilitation Engineering

Background:

• Reactive dynamic balance is crucial for fall prevention in older adults.
• Current measures like Margin of Stability (MoS) have limitations for practical fall risk assessment.
• A need exists for accurate and reliable measures of reactive dynamic balance.

Purpose of the Study:

• To propose and evaluate novel perturbation-based reactive balance measures using acceleration data.
• To assess the predictive value of these exploratory measures for future falls in older adults.
• To explore the utility of lag plot analysis of trunk acceleration for balance assessment.

Main Methods:

• Sixty-four older adults (>60 years) with recent falls participated.
• A treadmill-based perturbation protocol assessed reactive balance responses.
• Exploratory parameters derived from lag plot analysis of trunk acceleration (ML and AP) were calculated.
• Stepwise logistic regressions evaluated predictive value for prospective falls.

Main Results:

• The Short Physical Performance Battery (SPPB) showed predictive relevance (OR=0.65).
• Exploratory perturbation-based parameters, particularly LMS_SD2^norm (OR=0.39), significantly predicted falls.
• Higher short-term trunk acceleration variability during right-leg acceleration perturbations correlated with lower fall risk.
• Proportion of Excursion (POE) also showed predictive value (OR=1.13).

Conclusions:

• Proposed exploratory perturbation-based acceleration parameters, especially LMS_SD2^norm, effectively quantify reactive dynamic balance relevant to fall risk.
• These novel measures show promise for integration into wearable technologies for real-world fall risk assessment.
• This approach offers a potential advancement in monitoring and preventing falls in older adults.