Concomitant changes in clinical and posturographic data in elderly fallers during the course of an in-home anti-falling multimodal program--a preliminary investigation

Aim of the study: The objective of this preliminary study was to evaluate the effectiveness, in terms of fall reduction, of an in-home strategy that we have developed for elderly fallers. We also aimed at finding links between the expected changes in the data obtained in static posturography and in clinical balance tests through our program.

Patients and methods: Twelve elderly patients living at home who were diagnosed as fallers (5 males and 7 females; 77.9±4.1 years) participated in the study. Our multimodal intervention lasted 6 months. Before this period, and one year later, an evaluation was conducted using cognitive (MMSE), clinical balance tests (i.e. Berg Balance Scale, Balance One leg, Timed Up and Go, and Functional Reach tests) and static posturography (where the area of body sway, velocity and medio-lateral and antero-posterior amplitudes were recorded twice, first with eyes open and then with eyes closed).

Results: Among the 12 patients who were diagnosed as fallers, eight became non-fallers. When comparing data obtained after the intervention with those obtained beforehand, we found significant changes in all of the clinical balance tests and in the posturographic-derived variables indicating improvements in the balance control in our group of subjects. We also found significant correlations between the changes in the Berg Balance Scale scores and the changes in the area of body sway data, in antero-posterior amplitude both with eyes open and with eyes closed, and also in the medio-lateral amplitude in the eyes closed condition.

Conclusions: We prospectively demonstrated the relevance of our anti-falling intervention at home and of the use of posturography for clinical follow-up.