title: Standing balance and strength measurements in older adults living in residential care communities.
abstract: Research on balance and mobility in older adults has been conducted primarily in lab-based settings in individuals who live in the community. Although they are at greater risk of falls, residents of long-term care facilities, specifically residential care communities (RCCs), have been investigated much less frequently. We sought to determine the feasibility of using portable technology-based measures of balance and muscle strength (i.e., an accelerometer and a load cell) that can be used in any RCC facility. Twenty-nine subjects (age 87 ± 6 years) living in RCCs participated. An accelerometer placed on the back of the subjects measured body sway during different standing conditions. Sway in antero-posterior and mediolateral directions was calculated. Lower extremity strength was measured with a portable load cell and the within-visit reliability was determined. Assessments of grip strength, gait speed, frailty, and comorbidity were also examined. A significant increase in postural sway in both the AP and ML directions occurred as the balance conditions became more difficult due to alteration of sensory feedback (p < 0.001) or reducing the base of support (p < 0.001). There was an association between increased sway and increased frailty, more comorbidities and slower gait speed. All strength measurements were highly reliable (ICC = 0.93-0.99). An increase in lower extremity strength was associated with increased grip strength and gait speed. The portable instruments provide inexpensive ways for measuring balance and strength in the understudied RCC population, but additional studies are needed to examine their relationship with functional outcomes.
authors.affiliation: Department of Physical Therapy, 433 Eye and Ear Institute, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA. Baa60@pitt.edu.
authors.forename: Bader A
authors.initials: BA
authors.lastname: Alqahtani
authors.affiliation: Department of Medicine, University of Pittsburgh, 3471 Fifth Avenue Kaufmann Medical Building, Suite 500, Pittsburgh, PA, 15213, USA.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Ferchak
authors.affiliation: Department of Radiology, University of Pittsburgh, PUH Suite E204, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.
authors.forename: Theodore J
authors.initials: TJ
authors.lastname: Huppert
authors.affiliation: Department of Electrical and Computer Engineering, University of Pittsburgh, 1203 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA.
authors.forename: Ervin
authors.initials: E
authors.lastname: Sejdic
authors.affiliation: Department of Medicine, University of Pittsburgh, 3471 Fifth Avenue Kaufmann Medical Building, Suite 500, Pittsburgh, PA, 15213, USA.
authors.forename: Subashan
authors.initials: S
authors.lastname: Perera
authors.affiliation: Department of Medicine, University of Pittsburgh, 3471 Fifth Avenue Kaufmann Medical Building, Suite 500, Pittsburgh, PA, 15213, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Greenspan
authors.affiliation: Department of Physical Therapy, 433 Eye and Ear Institute, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Sparto
mesh_terms: D061725:Accelerometry / Q000379:methods*; D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D000073496:Frailty / Q000175:diagnosis; D006801:Humans; D008134:Long-Term Care; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology*; D015203:Reproducibility of Results; D057566:Self Report; D000072797:Walking Speed / Q000502:physiology
keywords: Accelerometer; Long-term care; Muscle strength; Residential care communities; Standing balance