Fredrick D. Pociask, Rosanne DiZazzo-Miller, Allon Goldberg, Diane E. Adamo; Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults. Am J Occup Ther 2015;70(1):7001270010. https://doi.org/10.5014/ajot.2016.015727
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Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance.
Addressing the contributions of postural sway to fall risk can add insight into the understanding of fall-related injuries and possibly inform interventions that may help prevent both fatal and nonfatal injuries among people age 60 yr and older.
Alterations in postural sway may reduce balance and stability required to perform ADLs and will likely impede a person’s ability to engage in meaningful and purposeful occupations and overall independence in daily living.
Clinical testing of balance provides an objective method for quantifying aspects of postural control under conditions frequently encountered during the performance of ADLs (e.g., altered surface and visual conditions, changes in head position) and a focus for allocating resources and directing clinical rehabilitation programming.
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