Development of an objective balance assessment method for purposes of telemonitoring and telerehabilitation in elderly population

Abstract

Purpose. Reliable assessment of balance abilities and determination of the likelihood of falling in the elderly requires a skilled clinician to guide and assist the individual throughout the scoring of a suitable balance assessment method. The most widely used clinical instrument is the Berg Balance Scale (BBS). The aim of this study was to develop an objective balance assessment measure that would correlate well with BBS and could thus be used to test balancing abilities remotely.

Methods. Twenty elderly individuals were divided into two groups: fallers and non-fallers based on their falling records. Balance abilities were assessed by means of BBS as well as through analysis of peak amplitude of center-of-pressure (COP) responses that followed induced-sway, provoked by a moveable standing frame in the medio-lateral plane. An independent t-test was used to compare BBS scores and COP based measures between both groups. Additionally, correlation between both tests was determined by use of the Pearson correlation coefficient.

Results. Fallers exhibited significantly lower BBS scores as well as significantly lower peak values of COP responses. The coefficient of correlation between both tests was relatively high (0.68) and statistically significant.

Conclusion. The high degree of correlation between both tests implies that the proposed objective balance testing apparatus and methods could be used for remote assessment of balance abilities in the elderly, which has implications for the development of home-based mobility training programs.

Keywords:

• Elderly
• balance
• telerehabilitiation

Acknowledgements

The authors are grateful to David Sok, PT who managed the assessment of BBS and Miroljub Jakovljević, PT, MSc for discussion on the study protocol. Financial support by the Agency for Research, Republic of Slovenia is gratefully acknowledged.