title: Clinical measures are feasible and sensitive to assess balance and gait capacities in older persons with mild to moderate Intellectual Disabilities.
abstract: Mobility limitations are common in persons with Intellectual Disabilities (ID). Differences in balance and gait capacities between persons with ID and controls have mainly been demonstrated by instrumented assessments (e.g. posturography and gait analysis), which require sophisticated and expensive equipment such as force plates or a 3D motion analysis system. Most physicians and allied healthcare professionals working with persons with ID do not have such equipment at their disposal, so they must rely on clinical tests to determine whether balance and gait are affected. The aim of this study was to investigate whether existing clinical balance and gait tests are feasible in older persons with mild to moderate ID and to examine whether these tests are able to show limitations in balance and gait capacities in the ID population compared to age-matched peers in the general population. Furthermore, it was aimed to identify the most important determinants of balance and gait disability in persons with the ID. A total of 76 older persons with mild to moderate ID (43 male, mean age 63.1 ± 7.6 years) and 20 healthy controls (14 male, mean age 62.2 ± 5.6 years) participated. Balance and gait abilities were assessed with the Berg Balance Scale (BBS), the Functional Reach test (FR), the Timed Up and Go Test (TUGT), the timed Single Leg Stance (SLS) and the Ten Metre Walking Test (TMWT). Our study showed that it is feasible to conduct standard clinical balance and gait tests in older persons with mild to moderate ID. Balance and gait performance of persons with ID is substantially worse compared to older persons of the general population. Age, number of co-morbidities, Body Mass Index (BMI), body sway and fear of falling are associated with balance and gait performance in persons with ID. These factors might help in the selection of subjects to be monitored on their balance and gait capacities.
authors.affiliation: Department of Rehabilitation, Radboud University Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, The Netherlands. l.enkelaar@reval.umcn.nl
authors.forename: Lotte
authors.initials: L
authors.lastname: Enkelaar
authors.forename: Ellen
authors.initials: E
authors.lastname: Smulders
authors.forename: Henny
authors.initials: H
authors.lastname: van Schrojenstein Lantman-de Valk
authors.forename: Vivian
authors.initials: V
authors.lastname: Weerdesteyn
authors.forename: Alexander C H
authors.initials: AC
authors.lastname: Geurts
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D019957:Motor Skills Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index