How do physiological components of balance affect mobility in elderly men?

The purpose of this study was to assess the relationship between physiological components of balance and mobility in elderly men without significant disease. Our a priori hypothesis was that physical function is influenced more by accumulated modest impairments than by a single deficit. We examined 39 ambulatory men (> 69 years). Subjects were classified functionally as high, intermediate, or low. Assessment included mobility functions (6-minute walk, mobility skills, reach, 10ft walk time) and physiological components of balance: sensory (vibration, proprioception, vision, vestibular), effector (ankle, knee, hip strength, range of motion), and central processing (response time to perturbations). All mobility functions were significantly (p < .05) different between groups. Impairments in components of postural control were rarely different between groups: the major differences were in ankle strength and visual fields. The number of impaired domains differed across the three groups. Nineteen percent of the low group had at least three domains impaired; none of the intermediate or high groups were impaired in three domains. Fifty-six percent of the low, 20% of the intermediate, and 7% of the high were impaired in two or more domains. Variability in specific mobility measures was also predicted by the number of impaired domains. The decline in physical function may be better explained by the accumulation of deficits across multiple domains than by any single specific impairment.