gms | German Medical Science

Researches have shown self-assessed balance and walking correlate highly with performance-based balance measures. Typical examples are the performance-based tests one-legged-stance [1], stair climbing [2], functional reach [3] and the Timed Up & Go [4]. Forceplate balance measurements offer a higher precision. They may be useful for detecting / diagnosing subtle balance problem [5] and are to some extent used clinically. However, the information collected during the history-taking seems to be of use. The aim of this study was to examined concurrent and prospective validity of self-reported and performed walking and balance performance in elderly women.

In a random sample of 307 women aged 75 years and over (mean 80.8 years), base-line registrations of function, walking and balance were recorded. Fall and serious fall injuries, which occurred during one year, were recorded prospectively.

In all, 51.5% fell one or more times and 51% of the 308 falls resulted in an injury. Seventy-four women (24%) experienced serious fall injury. Forty falls (13%) resulted in fractures. A self-reported walking (RW) index was identified by factor analysis. It consists of five items concerning various aspects of self-reported walking. The sum score on this RW-index correlated moderately (r = .32 - .62) with a number of clinical tests of balance. With forceplate measures of balance the highest correlations were with the length of the path of centre of pressure (COP) in the frontal (r = .26, 95% CI = .19 - .33) and in the sagittal plane (r = .24, 95% CI = .14 - .34). The COP measures, which were taken under dual task conditions, also had rather low correlations with the clinical tests of balance and walking, the highest one being 0.27,between tandem stance and the length of the COP path in the frontal plane. To have a poorer score on the RW-index predicted more falls (OR = 1.83, p = 0.03), and fall-related fractures (OR = 1.83, p = 0.03) during a one-year follow-up.

The results show that easily collected clinical information provided by older people regarding walking and balance contributes in identifying subjects at increased risk of falling and fall-related fractures.