Low efficacy using the 256-Hz tuning fork when evaluating the influence of somatosensation in balance control for relatively healthy elderly

Abstract

Background: Diminished foot somatosensation contributes to balance deficits and increased fall risk. However, it remains unclear if the 256-Hz tuning fork is adequate to measure, in the outpatient clinical setting, somatosensation in relatively healthy elderly.

Aims/Objectives: To evaluate the performance of the 256-Hz tuning fork compared to other measures of somatosensation and balance.

Material and methods: Thirty-six subjects (mean 69.4 ± 5.3 years) were allocated into four 256-Hz tuning fork sensation groups (TFSG) based on their ability to detect vibration at the first metatarsal, malleolus, tibia or no sites. A biothesiometer measured vibration perception thresholds (VPTs) and 20 monofilaments tactile pressure sensation thresholds (TPSTs). Balance was evaluated with posturography, functional balance tests and questionnaires.

Results: There were no significant differences in age, VPTs or TPSTs between the four TFSGs, nor in outcome of functional balance tests, posturography and questionnaires. Very few significant associations were found between TFSGs and VPTs, TPSTs, functional balance tests, posturography and questionnaires.

Conclusions and significance: Somatosensation measured with a 256-Hz tuning fork seems to be a minor determinant for balance and thus superfluous when evaluating the importance of vibration perception for balance control in relatively healthy elderly.

Chinese abstract

背景：脚部体感的削弱会导致平衡缺陷和更易跌倒。然而, 256-Hz音叉是否适用于在门诊临床中测量相对健康老年人的体感, 这还不是很明确。

目的：通过与其他测量体感和平衡感的方法进行比较, 评估256-Hz音叉的性能。

材料和方法：根据36名受试者（平均69.4±5.3岁）感测到第一跖骨、踝、胫骨或无部位的振动的能力, 将他们分成4个256-Hz音叉感觉组（TFSG）。一台生物震感阈测量仪测量振动感知阈值（VPT）和20个单丝触觉压力感觉阈值（TPST）。通过姿势描记法、功能平衡测试和问卷来评估平衡。

结果：四个TFSG组之间的年龄、VPT或TPST没有显着差异, 功能平衡测试、姿势描记法和问卷调查的结果也没有显着差异。在TFSG和VPT、TPST、功能平衡测试、姿势描记法和问卷之间发现很少有显著关联。

结论和意义：使用256-Hz音叉测量的体感似乎是平衡的一个次要决定因素, 因此在评估振动感知对于相对健康的老年人的平衡控制的重要性时, 没有必要考虑它。

Keywords:

• Elderly
• balance
• postural control
• tactile sensation
• vibration sensation
• tuning fork test
• posturography
• one leg standing time
• functional balance

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was in part funded by a grant from the Acta Oto-Laryngologica Foundation [STIFTELSEN ACTA OTO-LARYNGOLOGICA, STEN HELLSTRÖM, KAROLINSKA UNIVERS.SJUKH., Stockholm (registration: 857500-9694)].