IDENTIFICATION OF FALL RISK IN OLDER ADULTS LIVING IN A NURSING HOME USING THE MARBES BALANCE SYSTEM: A PILOT STUDY BASED ON ROC ANALYSIS

Yıl 2025, Cilt: 8 Sayı: 2, 123 - 137

Canan Günay Yazici , Tuğba Kuru Çolak , Zubeyir Sarı

https://doi.org/10.52538/iduhes.1740021

Öz

This pilot study aimed to assess the effectiveness of center of pressure (COP) sway distance, measured with the MarBES (Marmara Balance and Education System), in predicting fall risk among older adults living in a nursing home. A total of 72 participants were evaluated and classified into two groups based on the Timed Up and Go test, Berg Balance Scale, and gait speed: High Fall Risk Group (HFRG; n=36, with falls in the past 12 months) and Low Fall Risk Group (LFRG; n=36, no falls or balance issues). COP sway measurements were performed using the MarBES under double-leg and single-leg stance conditions, with both eyes open and eyes closed. Sway distances in the mediolateral (X) and anteroposterior (Y) directions were analyzed using Receiver Operating Characteristic (ROC) analysis. The highest discriminative power was observed in the eyes-closed, left single-leg stance for COP Y sway distance (AUC=0.853, p<0.001). Overall, more challenging postural tasks yielded stronger discrimination between fallers and non-fallers, while simpler tasks showed lower AUC values (e.g., AUC = 0.663 in the double-leg, eyes-open stance). This pilot study suggests that COP sway distance may serve as an effective tool for identifying fall risk, particularly under challenging balance conditions. Measurements obtained with portable and cost-effective systems, such as the MarBES balance platform, may provide practical and objective data for the early identification of fall risk and the implementation of preventive strategies in long-term care environments, like nursing homes.

Anahtar Kelimeler

balance , elderly , fall , nursing home , technology assessment

MARBES DENGE CİHAZI İLE HUZUREVİNDE YAŞAYAN YAŞLI BİREYLERDE DÜŞME RİSKİNİN BELİRLENMESİ: ROC ANALİZİNE DAYALI BİR PİLOT ÇALIŞMA

Öz

Bu pilot çalışmanın amacı, huzurevinde yaşayan yaşlı bireylerde MarBES (Marmara Balance and Education System) denge cihazı kullanılarak ölçülen merkez basınç (Center of Pressure, COP) salınım mesafesinin düşme riskini öngörmedeki etkinliğini değerlendirmek ve ROC analizi aracılığıyla bu parametrelerin duyarlılık, özgüllük ve ayırt edicilik düzeylerini incelemektir. Çalışmaya huzurevinde yaşayan toplam 72 yaşlı birey katıldı. Katılımcıların düşme risk düzeyleri; Zamanlı Kalk Yürü Testi (TUG), Berg Denge Ölçeği ve yürüyüş hızı değerlendirmeleri temel alınarak belirlenmiş ve bireyler, son 12 ay içinde düşme öyküsü olanlar Yüksek Riskli Düşme Grubu (YRDG; n=36), düşme öyküsü olmayan ve belirgin denge bozukluğu bulunmayanlar ise Düşük Riskli Düşme Grubu (DRDG; n=36) olarak sınıflandırıldı. COP salınımları MarBES denge cihazı ile çift ayak ve tek ayak duruş pozisyonlarında, gözler açık ve kapalı koşullar altında ölçüldü. COP X ve COP Y yönündeki salınım mesafeleri analiz edilerek ROC eğrileri üzerinden sınıflandırma başarıları değerlendirildi. En yüksek ayırt edicilik gücü, sol tek ayak duruş ve gözler kapalı koşulunda COP Y salınım mesafesi ile elde edildi (AUC = 0.853, p<0.001). Genel olarak, zorlu postüral koşullarda (örneğin gözler kapalı ve tek ayak duruş) COP parametrelerinin ayırt edicilik düzeyleri anlamlı şekilde artarken, daha basit duruş pozisyonlarında (örneğin gözler açık ve çift ayak duruş) bu değerlerin daha düşük olduğu bulundu (AUC = 0.663). Bu pilot çalışma, COP salınım mesafesinin özellikle zorlu denge koşullarında düşme riskini ayırt etmede etkili olabileceğini göstermektedir. MarBES denge cihazı gibi taşınabilir ve düşük maliyetli sistemlerle yapılan bu tür ölçümler, huzurevi gibi uzun süreli bakım ortamlarında düşme riskine yönelik erken tanı ve müdahale stratejilerinde önemli katkı sağlayabilir.

Anahtar Kelimeler

denge , düşme , huzurevi , teknoloji değerlendirmesi , yaşlı

Etik Beyan

Çalışma, Marmara Üniversitesi Tıp Fakültesi Etik Kurulu tarafından onaylandı (Onay Numarası: 09.2023.797) ve Helsinki Prensipleri Deklarasyonu’na uygun olarak yürütüldü.

Destekleyen Kurum

Çalışmayı maddi yönden destekleyen herhangi bir kişi/kuruluş yoktur.

Kaynakça

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