title: Reconceptualizing balance: attributes associated with balance performance.
abstract: Balance tests are commonly used to screen for impairments that put older adults at risk for falls. The purpose of this study was to determine the attributes that were associated with balance performance as measured by the Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) balance test. This study was a cross-sectional secondary analysis of baseline data from a longitudinal cohort study, the Boston Rehabilitative Impairment Study of the Elderly (Boston RISE). Boston RISE was performed in an outpatient rehabilitation research center and evaluated Boston area primary care patients aged 65 to 96 (N=364) with self-reported difficulty or task-modification climbing a flight of stairs or walking 1/2 of a mile. The outcome measure was standing balance as measured by the FICSIT-4 balance assessment. Other measures included: self-efficacy, pain, depression, executive function, vision, sensory loss, reaction time, kyphosis, leg range of motion, trunk extensor muscle endurance, leg strength and leg velocity at peak power. Participants were 67% female, had an average age of 76.5 (±7.0) years, an average of 4.1 (±2.0) chronic conditions, and an average FICSIT-4 score of 6.7 (±2.2) out of 9. After adjusting for age and gender, attributes significantly associated with balance performance were falls self-efficacy, trunk extensor muscle endurance, sensory loss, and leg velocity at peak power. FICSIT-4 balance performance is associated with a number of behavioral and physiologic attributes, many of which are amenable to rehabilitative treatment. Our findings support a consideration of balance as multidimensional activity as proposed by the current International Classification of Functioning, Disability, and Health (ICF) model.
authors: Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States. Electronic address: juthomas@wakehealth.edu.
authors: Julia C
authors: JC
authors: Thomas
authors: Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States. Electronic address: charles.odonkor@yale.edu.
authors: Charles
authors: C
authors: Odonkor
authors: Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138, United States. Electronic address: lagriffith@partners.org.
authors: Laura
authors: L
authors: Griffith
authors: Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138, United States. Electronic address: nholt1@partners.org.
authors: Nicole
authors: N
authors: Holt
authors: Department of Medicine - General Medicine Division, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States. Electronic address: spercaclima@partners.org.
authors: Sanja
authors: S
authors: Percac-Lima
authors: College of Nursing and Health Sciences, UMass Boston, 100 Morrissey Blvd., Boston, MA 02125, United States. Electronic address: suzanne.leveille@umb.edu.
authors: Suzanne
authors: S
authors: Leveille
authors: Health and Disability Research Institute, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States. Electronic address: psni@bu.edu.
authors: Pensheng
authors: P
authors: Ni
authors: Health and Disability Research Institute, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States. Electronic address: nlatham@bu.edu.
authors: Nancy K
authors: NK
authors: Latham
authors: Health and Disability Research Institute, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States. Electronic address: ajette@bu.edu.
authors: Alan M
authors: AM
authors: Jette
authors: Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138, United States; Department of PM&R, Harvard Medical School, 300 First Avenue, Boston, MA 02129, United States. Electronic address: jfbean@partners.org.
authors: Jonathan F
authors: JF
authors: Bean
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D008297:Male; D008606:Mental Processes; D010807:Physical Endurance; D004856:Postural Balance; D020377:Self Efficacy
keywords: Activity; Balance; Body systems; Boston Rehabilitative Impairment Study of the Elderly; FICSIT