Journal of Rehabilitation Medicine 51-1CompleteIssue | Page 74
J Rehabil Med 2019: 51: 71–76
ORIGINAL REPORT
USEFULNESS OF AN UNSTABLE BOARD BALANCE TEST TO ACCURATELY
IDENTIFY COMMUNITY-DWELLING ELDERLY INDIVIDUALS WITH A HISTORY OF
FALLS
Kazunori AKIZUKI, PhD, PT 1 , Yuki ECHIZENYA, MS, PT 2 , Tatsuya KANENO, MS, OT 3 and Yukari OHASHI, PhD, PT 4
From the 1 Department of Physical Therapy, Mejiro University; present address: Department of Physical Therapy, Kobe International
University, Kobe, 2 Saitama Rehabilitation Center, 3 Department of Occupational Therapy, Mejiro University, and 4 Department of Physical
Therapy, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Objective: To determine the usefulness of an un
stable board balance test in identifying a fall history
among high-functioning community-dwelling elderly
individuals.
Design: Case-control study.
Subjects: Sixty-one community-dwelling elderly
aged ≥ 65 years and having the capacity to walk in-
dependently without an assistive device.
Methods: Subjects completed 3 balance performance
tests: the Unstable Board Balance Test, Functional
Reach Test, and Timed Up and Go. For analysis, sub-
jects were classified as fallers or non-fallers based
on the history of falls over the previous year, and
performance outcomes were compared between the
2 groups. Subjects classified as fallers were then
matched 1:1 with non-fallers (for sex, age, body
weight and height), and the optimal cut-off score
and area under the receiver operating characteristic
curve (AUC) for each test were calculated.
Results: Functional reach test and Timed Up and Go
did not reliably discriminate between fallers and
non-fallers. In contrast, the score on the unstable
board balance test was significantly different bet-
ween the 2 groups (p = 0.040). Among all 3 tests,
AUC was largest for the unstable board balance test
(0.78), with superior sensitivity (0.67) and specifi-
city (0.87).
Conclusion: For high-functioning elderly subjects,
the unstable board balance test was useful in discri-
minating between fallers and non-fallers.
Key words: dynamic balance; assessment of falls; history of
falls; elderly people.
Accepted Oct 8, 2018; Epub ahead of print Nov 8, 2018
J Rehabil Med 2019: 51: 71–76
Correspondence address: Kazunori Akizuki, Department of Physical
Therapy, Kobe International University, 9-1-6 Koyouchou, Higasinada-
ku, Kobe-shi, Hyogo 658-0032, Japan. E-mail: [email protected]
I
t is estimated that one out of every 3 elderly indivi-
duals over the age of 65 years will experience one or
more falls per year (1), resulting in health impairment
of varying degrees of severity (2). In Japan, fall-related
injuries are the fourth leading cause for elderly indi-
viduals requiring nursing care (3). As we consider the
ageing of the general population globally (4), preven-
LAY ABSTRACT
The aim of this study was to determine the ability of an
Unstable Board Balance Test to discriminate fall history
in high-functioning community-dwelling elderly people.
Subjects underwent an Unstable Board Balance Test, a
Functional Reach Test (FRT), Timed Up and Go (TUG)
measurement, and body height and body weight mea-
surement. The age of subjects was determined and they
were asked whether they had fallen within the past year.
FRT and TUG did not differ significantly between fallers
and non-fallers, but the Unstable Board Balance Test did
show a significant difference between groups. We found
that, in high-functioning elderly subjects, the Unstable
Board Balance Test was able to detect elderly people
with a fall history more accurately than either FRT or
TUG.
tion of falls and fall-related injuries among the elderly
population has become increasingly important.
Early identification of individuals at high risk of falls
has been shown to be an effective strategy to reduce
the occurrence of falls (5). Various clinical tools have
been developed to identify individuals at high risk of
falling (6). Of these, the Berg Balance Scale (BBS),
the Timed Up and Go (TUG) and the Functional Reach
Test (FRT) are widely used for their convenience and
availability of cut-off values to identify those at risk
of falling (7–10). The cut-off values (to differentiate
fallers from non-fallers) for these tests, however, vary
depending on individuals’ characteristics and the length
of follow-up (11, 12). Moreover, the use of these tests
in healthy, active, elderly individuals is limited due
to a ceiling effect. In fact, both the BBS and TUG
lack the specificity to identify a decrease in balance
capacity predictive of a risk of falls among healthy,
high-functioning, elderly individuals (13, 14). There-
fore, there is a need for an assessment tool to detect
changes in balance capacity that are predictive of falls
in healthy, active elderly individuals.
Previous studies have shown that dynamic balance
tests could be more appropriate than the BBS and TUG
to differentiate the risk of falls among healthy, active,
elderly individuals (15, 16). Thus, we developed the
Unstable Board Balance Test for this purpose, antici-
pating that it would not be limited by the same ceiling
This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm
Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977
doi: 10.2340/16501977-2504