Journal des nouvelles physiothérapies

Abstrait

Instrumental Assessment of Balance Functional Performance. A Numerical Score to Discriminate Defective Subjects: A Retrospective Study

Michele Gallamini, Giorgio Piastra, Debora Porzio, Matteo Ronchi, Fabio Scoppa and Franco Bertora

Balance keeping is a key functional performance that becomes of crucial importance with increasing age when frailty makes falling a traumatic event. This functionality can be measured through several tests such as the Instrumented Romberg Test on a Force Platform. Many parameters and indicators obtained through this test have been proposed to quantify performance deficit and to point to possible aetiological causes. However, in spite of many studies, no final definition has been agreed upon. Rather, it seems that different combinations of strategies – probably in connection with anthropometrics, personal attitudes and lifestyle – can effectively solve the biomechanical problem of balance keeping. Such variability, in turn, entails a wide range of variability of all the individual parameters used to describe the path followed by the Center of Pressure over the force platform surface during the test. Ultimately, such a wide range makes the classical parameters rather undependable, when considered one by one, for clinical diagnostics. The diagnostic process in any case requires both a functionality assessment and, hopefully, reliable clues to achieve a deeper understanding of the dysfunction aetiology. A new heuristic approach has been proposed to develop a Score of Postural Functionality based on a reference population of healthy individuals. In this retrospective study, we applied this criterion in the analysis of the balance testing of 1626 compensated senior citizens. The Score has been compared to the most widely used balance indicators. The results do confirm the capability of this approach to quickly spot dysfunctional individuals with a high degree of sensitivity and specificity. The Score obtained seems potentially to show a correlation with the Risk-of-fall.