Impaired standing balance in elderly: a new engineering method helps to unravel causes and effects.
Deteriorated balance control is the most frequent cause of falls and injuries in the elderly. Balance control comprises a complex interplay of several underlying systems (ie, the sensory systems, the motor system, and the nervous system). Available clinical balance tests determine the patient's ability to maintain standing balance under defined test conditions and aim to describe the current state of this ability. However, these tests do not reveal which of the underlying systems is deteriorated and to what extent, so that the relation between cause and effect often remains unclear. Especially detection of early-stage balance control deterioration is difficult, because the balance control system is redundant and elderly may use compensation strategies. This article describes a new method that is able to identify causal relationships in deteriorated balance control, called CLSIT (Closed Loop System Identification Technique). Identification of impaired balance with CLSIT is a base for development of tailored interventions and compensation strategies to reduce the often serious consequences of deteriorated balance control in the elderly.
Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands. Electronic address: d.engelhart@utwente.nl.
Denise
D
Engelhart
Department of Rehabilitation Medicine, Leiden University Medical Centre, Leiden, The Netherlands.
Jantsje H
JH
Pasma
Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands; Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.
Alfred C
AC
Schouten
Department of Rehabilitation Medicine, Leiden University Medical Centre, Leiden, The Netherlands.
Carel G M
CGM
Meskers
Section of Geriatrics and Gerontology, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
Andrea B
AB
Maier
Neurology, University of Freiburg, Freiburg, Germany.
Thomas
T
Mergner
Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands; Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.
Herman
H
van der Kooij
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged / Q000502:physiology*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D004856:Postural Balance / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology*
Elderly; clinical balance tests; closed loop system identification technique; impaired standing balance