Can the Control of Bodily Orientation Be Significantly Improved in a Group of Older Adults with a History of Falls?

Abstract

OBJECTIVE : To determine the short‐term effectiveness of a biofeedback‐based, computerized intervention that applied the principles of the ecological theory of perception and control of bodily orientation to the rehabilitation of older adults with a history of falling. PARTICIPANTS : Forty‐five older adults (X = 78.5 years) with a history of falls were assigned to either a control (n = 21) or intervention group (n = 24). DESIGN : A 2 × 2 (Group × Time) mixed factorial design with repeated measures on the second factor. MEASUREMENT : Impairments in multiple dimensions of balance (i.e., dynamic postural control and sensory organization) were measured before and after an 8‐week balance intervention using the 100% Limits of Stability Test® and Sensory Organization Test®. More functional limitations in balance and/or mobility were measured using two clinical tests: Berg Balance Scale and Timed Up and Go test. MAIN RESULTS : Repeated measures multivariate analyses and follow‐up testing indicated significant improvements in the dynamic balance and sensory integration capabilities in the case of the intervention group only ( P < .03). Significant improvements were also observed in the two clinical measures of balance and mobility evaluated before and after the intervention for the intervention group only. CONCLUSIONS : Theory‐driven rehabilitation programs that focus on manipulating individual, task, and environmental constraints concurrently can significantly improve the control of bodily orientation of older adults with a previous history of falls in both static and dynamic action environments. Moreover, the significant improvements in functional performance observed for the intervention group suggest that interventions emphasizing task‐specific practice are not the only means by which an older adult's ability to perform daily activities requiring postural control can be improved. J Am Geriatr Soc 48: 275–282, 2000 .