title: Force platform balance measures as predictors of indoor and outdoor falls in community-dwelling women aged 63-76 years.
abstract: BACKGROUND
  Inability to maintain balance while standing increases risk of falls in older people. The present study assessed whether center of pressure (COP) movement measured with force platform technology predicts risk for falls among older people with no manifest deficiency in standing balance.
  
  
  METHODS
  Participants were 434 community-dwelling women, aged 63-76 years. COP was measured in six stances on a force platform. Following balance tests, participants reported their falls with 12 monthly calendars. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were computed from negative binomial regression models. For the analysis, those with > or =1 fall indoors were coded "indoor fallers," those with > or =1 fall outdoors, but no indoor falls, were coded "outdoor fallers." Outcome in the models was number of falls. Analyses were repeated including only participants without fall history prior to follow-up.
  
  
  RESULTS
  Among 198 fallers, there were 57 indoor and 132 outdoor fallers. The participants in the highest COP movement tertile, irrespective of the balance test, had a two- to fourfold risk for indoor falls compared to participants in the lowest COP tertile of the test. Inability to complete the tandem stance was also a significant predictor of the fall risk. The trend for increased risk for indoor falls was found also for participants in the highest COP movement tertile and without fall history. The COP movement in balance tests was not associated with outdoor falls.
  
  
  CONCLUSIONS
  Force platform balance tests provide valid information of postural control that can be used to predict fall risk even among older people without apparent balance problems or fall history. When the force platform is not available, tandem stance provides a screening tool to show increased fall risk in community-dwelling older people.
authors.affiliation: Department of Health Sciences, The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, P.O. Box 35 (Viv), FIN-40014 University of Jyväskylä. pajalass@mail.nih.gov
authors.forename: Satu
authors.initials: S
authors.lastname: Pajala
authors.forename: Pertti
authors.initials: P
authors.lastname: Era
authors.forename: Markku
authors.initials: M
authors.lastname: Koskenvuo
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
authors.forename: Timo
authors.initials: T
authors.lastname: Törmäkangas
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D005387:Finland; D006801:Humans; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D011237:Predictive Value of Tests; D011312:Pressure; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors