COMPARISON OF PLANTAR SENSITIVITY, POSTURAL SWAY AND FEAR OF FALL IN OLDERS WITH AND WITHOUT FALLING STORY

Year 2017, Volume: 28 Issue: 1, 19 - 26, 14.04.2017

Banu Ünver Nilgün Bek Aynur Çiçek

https://doi.org/10.21653/tfrd.330518

Cited By: 1

Abstract

Purpose: The aim of this study is to investigate differences between olders with and without falling story in terms of plantar sensitivity, postural sway and fear of fall.

Methods: Fourty subjects consisting of 21 women and 19 men, and over 65 years of age included in this study. Subjects were divided into two groups as with (n=14) and without falling story (n=26). Plantar light touch-tactile and static two point discrimination sensitivity were measured; anteroposterior and mediolateral deviation quantity and speed of the center of mass (COM) were recorded by WinTrack® Pedobarograph under eyes-open and eyes-closed conditions. Fear of fall were evaluated by Falls Efficacy Scale.

Results: There were no significant differences between olders with and without falling story in terms of plantar sensitivity and postural sway parameters (p>0.05); fear of fall was higher in olders with falling story according to those without falling story (p=0.007).

Discussion: More than 33% of individuals over 65 years fall more than once a year and fear of falling causes decreased quality of life by limiting outdoor activities. There are studies showing that tactile sensory loss in first toe and first metatarsophalangeal joint and increase in postural sway are related to falls. Our study found no difference between olders with and without falling story in terms of plantar sensitivity and postural sway, but higher fear of falling in those with falling story. Reducing fear of falling should take place among treatment targets for reducing the risk of falls in olders.

Keywords

Older, fall, plantar sensitivity, postural sway

Düşme Öyküsü Olan ve Olmayan Yaşlılarda Plantar Duyu, Postural Salınım ve Düşme Korkusunun Karşılaştırılması

Abstract

Amaç: Bu çalışmanın amacı, düşme öyküsü olan ve olmayan yaşlılar arasında plantar duyu, postural salınım, düşme korkusu açısından fark olup olmadığını araştırmaktır.

Yöntemler: Çalışmaya 21 kadın, 19 erkek olmak üzere 65 yaş üstü 40 birey dahil edildi. Bireyler düşme öyküsü olanlar (n=14) ve olmayanlar (n=26) olarak ikiye ayrıldı. Olguların plantar hafif dokunma-basınç ve statik iki nokta ayrımı duyuları ölçüldü; vücut kütle merkezinin (centre of mass-COM) anteroposterior ve mediolateral yönlerdeki salınım miktar ve hızları, WinTrack® Pedobarografi cihazı ile statik ayakta duruşta, gözler açık ve kapalı olarak kaydedildi. Düşme korkusu ise Düşme Etkinlik Ölçeği ile değerlendirildi.

Sonuçlar: Ölçülen plantar duyu ve postural salınım parametreleri açısından düşme öyküsü olan ve olmayan yaşlılar arasında anlamlı bir fark olmadığı (p>0,05), düşme korkusunun ise düşme öyküsü olan yaşlılarda olmayanlara göre yüksek olduğu (p=0,007) bulundu.

Tartışma: 65 yaş üstü bireylerin %33'ünden fazlasının yılda en az bir kez düştüğü ve düşme korkusunun ev dışı aktiviteleri limitleyerek yaşam kalitesinde azalmaya neden olduğu bilinmektedir. Literatürde, birinci parmak ve birinci metatarsofalangeal eklemdeki taktil duyu kaybının ve postural salınımdaki artışın düşmelerle ilişkili olduğunu gösteren çalışmalar bulunmaktadır. Bizim çalışmamız, düşme öyküsü olan ve olmayan yaşlılar arasında plantar duyu ve postural salınım açısından fark olmadığını ancak, düşme korkusunun düşme öyküsü olanlarda daha yüksek olduğunu ortaya çıkarmıştır. Yaşlı bireylerde düşme riskinin azaltılmasına dönük tedavi hedefleri arasında düşme korkusunun azaltılması da yer almalıdır.

Keywords

Yaşlı, düşme, plantar duyu, postural salınım

References

• 1. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.
• 2. Karlsson MK, Magnusson H, von Schewelov T, Rosengren BE. Prevention of falls in the elderly-a review. Osteoporos Int. 2013;24(3):747-62.
• 3. Howcroft J, Kofman J, Lemaire ED. Review of fall risk assessment in geriatric populations using inertial sensors. J Neuroeng Rehabil. 2013;10(1):91-103.
• 4. Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82(8):1050-56.
• 5. Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: A review of the literature. Maturitas. 2013;75(1):51-61.
• 6. Stevens JC, Patterson MQ. Dimensions of spatial acuity in the touch sense: Changes over the life span. Somatosens Mot Res. 1995;12:29–47.
• 7. Mold JW, Vesely SK, Keyl BA, Schenk JB, Roberts M. The prevalence, predictors, and consequences of peripheral sensory neuropathy in older patients. J Am Board Fam Pract. 2004;17(5):309–18.
• 8. Menz HB, Tiedemann A, Kwan MMS, Latt MD, Sherrington C, Lord SR. Reliability of clinical tests of foot and ankle characteristics in older people. J Am Podiatr Med Assoc. 2003;93(5):380-87.
• 9. Menz HB, Morris ME, Lord SR. Foot and ankle risk factors for falls in older people: A prospective study. J Gerontol A Biol Sci Med Sci. 2006;61(8), 866-70.
• 10. Menz HB, Morris ME, Lord SR. Foot and ankle characteristics associated with impaired balance and functional ability in older people. J Gerontol A Biol Sci Med Sci. 2005;60(12), 1546-52.
• 11. Cruz-Almeida Y, Black ML, Christou EA, Clark DJ. Site-specific differences in the association between plantar tactile perception and mobility function in older adults. Front Aging Neurosci. 2014;6(68):1-6.
• 12. Melzer I, Benjuya N, Kaplanski J. Postural stability in the elderly: A comparison between fallers and non-fallers. Age Ageing. 2004;33(6):602-07.
• 13. Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73;1073–80.
• 14. Wallmann HW. Comparison of elderly nonfallers and fallers on performance measures of functional reach, sensory organization, and limits of stability. J Gerontol A Biol Sci Med Sci. 2001;56(9):580-3.
• 15. Brauer SG, Burns YR, Galley P. A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci. 2000;55(8):469-76.
• 16. Liu-Ambrose T, Khan KM, Donaldson MG, Eng JJ, Lord SR, McKay HA. Falls-related self-efficacy is independently associated with balance and mobility in older women with low bone mass. J Gerontol A Biol Sci Med Sci. 2006;61(8):832-8.
• 17. Martin FC, Hart D, Spector T, Doyle DV, Harari D. Fear of falling limiting activity in young-old women is associated with reduced functional mobility rather than psychological factors. Age Ageing, 2005;34(3):281-7.
• 18. Masud T, Morris RO. (2001). Epidemiology of falls. Age Ageing. 2001;30(S4):3-7.
• 19. Lamb SE, Jørstad-Stein EC, Hauer K, Becker C. Development of a common outcome data set for fall injury prevention trials: The Prevention of Falls Network Europe consensus. J Am Geriatr Soc. 2005;53(9):1618–22.
• 20. Perry SD. Evaluation of age-related plantar-surface insensitivity and onset age of advanced insensitivity in older adults using vibratory and touch sensation tests. Neurosci Lett. 2006;392(1):62-7.
• 21. Franco PG, Bohrer RC, Rodacki AL. Intra-observer reproducibility of the feet soles two-point discrimination test in asymptomatic elderly and young individuals. Braz J Phys Ther. 2012;16(6):523-7.
• 22. Sadeghi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in able-bodied gait: A review. Gait Posture. 2000;12(1):34-45.
• 23. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45(6):239-43.
• 24. Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr. 2012;54(3):429-33.
• 25. Machado ÁS, da Silva CBP, da Rocha ES, Carpes FP. Effects of plantar foot sensitivity manipulation on postural control of young adult and elderly. Rev Bras Reumatol. 2016;57(1):30-6.
• 26. Pinheiro HA, Vilaça KHC, Carvalho GDA. Assessment of muscle mass, risk of falls and fear of falling in elderly people with diabetic neuropathy. Fisioter Mov. 2015;28(4):677-83.
• 27. Billot M, Handrigan GA, Simoneau M, Corbeil P, Teasdale N. Short term alteration of balance control after a reduction of plantar mechanoreceptor sensation through cooling. Neurosci Lett. 2013;535:40-4.
• 28. Brauer S, Burns Y, Galley P. Lateral reach: A clinical measure of mediolateral postural stability. Physiother Res Int. 1999;4(2):81-8.
• 29. Hewson DJ, Singh NK, Snoussi H, Duchene J. Classification of elderly as fallers and non-fallers using centre of pressure velocity. In Engineering in Medicine and Biology Society (EMBC), 32nd Annual International Conference of the IEEE; 2010 August 31 -September 4; Buenos Aires: IEEE; 2010. p. 3678-81.
• 30. Hughes CC, Kneebone II, Jones F, Brady B. A theoretical and empirical review of psychological factors associated with falls-related psychological concerns in community-dwelling older people. Int Psychogeriatr. 2015;27(7):1071-87.
• 31. Payette MC, Belanger C, Léveillé V, Grenier S. Fall-related psychological concerns and anxiety among community-dwelling older adults: Systematic review and meta-analysis. PLoS one. 2016;11(4):1-17.