Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall?

J Am Geriatr Soc. 1993 May;41(5):479-87. doi: 10.1111/j.1532-5415.1993.tb01881.x.


Objective: To determine whether an activity-based test of balance and gait is predictive of the risk of: (1) falling in situations that are related to specific tasks evaluated as part of the test, (2) experiencing falls precipitated by different classes of biomechanical events, or (3) falling in general; and to compare the predictive ability of the activity-based test for the falls described in (2) and (3) to that of a posturography test that has been found previously to be predictive of falling risk.

Design: Cohort study.

Setting: Baseline tests performed in balance laboratory; subsequent history of falling monitored prospectively for 1 year in two residential-care facilities.

Participants: Seventeen male and 83 female consecutive volunteers (mean age = 83, SD = 6) who were independent in activities of daily living and able to stand unaided.

Measurements: Independent variables were derived from an activity-based balance-and-gait test and a posturography test. Dependent variables were the numbers of subjects with one or more: (1) falls in specific situations related to activity-based test items, (2) falls related to general classes of biomechanical precipitant, and (3) falls in general.

Main results: Subjects who were rated as "abnormal" in activity-based test items related to transfers, turning or reaching were more likely to experience one or more falls in related situations in everyday life. Activity-based scores were predictive of risk of experiencing falls with no obvious biomechanical precipitant and falls precipitated by center-of-mass perturbation, but not falls precipitated by base-of-support perturbation. In comparison, a posturographic measure of spontaneous medial-lateral postural sway (blindfolded conditions) failed to predict falls having no biomechanical precipitant, but provided the best predictions of both center-of-mass and base-of-support falls, as well as risk of falling in general.

Conclusions: Activity-based testing of certain tasks (transfer, turning, reaching) may be useful in indicating a specific need for intervention to reduce the risk of falling during related everyday activities. In terms of predicting falling risk, a static posturography test may provide better prediction overall of the different classes of falls and may be useful as a quick and simple screening tool to help identify high-risk individuals.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Biomechanical Phenomena
  • Cohort Studies
  • Female
  • Gait*
  • Geriatric Assessment*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Observer Variation
  • Postural Balance*
  • Posture*
  • Predictive Value of Tests
  • Prospective Studies
  • Residential Facilities
  • Risk Factors
  • Surveys and Questionnaires