WORK PACKAGE 3 - ASSESSMENT OF BALANCE FUNCTION AND PREDICTION OF FALLS

Abstract

Objectives: The development of effective fall prevention programs requires understanding of underlying causes of falls. Measurement tools are needed that predict the risk of falling and give objective assessment of balance function needed for daily life performance. The ultimate goal of the activities within this work package is to combine the expertise of different disciplines for the development of balance assessment tools that meet the requirements for large-scale intervention studies and routine-use in clinical settings. The knowledge needed to develop these instruments and measures is scattered over a wide range of disciplines (ranging from physiology to electrical engineering). The objectives of this work package are to combine expertise from different disciplines to transfer knowledge between disciplines, to co-operate in designing research and provide an intellectual environment for interdisciplinary projects and dissemination of knowledge into disciplines working in the clinical field.

Description of work: Recent technological developments allow for the measurement of human movement under real-life conditions by means of lightweight ambulatory equipment. This novel approach to the analysis of human movement can potentially fill the need for objective field instruments. However, suitable methods for balance assessment need to be developed. Activities of this work package are aimed at co-ordinating the development of methods that can be used in the clinical field for assessment of posture and gait. The work encompasses the organization of workshops, the co-ordination of research, and dissemination of knowledge through publications, teaching and training. Members co-ordinate their individual research efforts in such a way that the different research lines support and reinforce each other. The coordination of research will involve joint experiments and the definition of assessment protocols that can be used in the individual studies of all participating groups. The work focuses on the analysis of kinematic patterns during walking and standing in a natural environment by means of ambulatory equipment. Appropriate methods for signal acquisition and analysis are being developed. Protocols are being designed which specifically address different aspects of balance control (i.e. mental load, sensory dependence, and effects of mechanical manipulations). Laboratory tasks, which have proven to be sensitive for balance dysfunction, will be translated into valid, reliable and easy-to-use procedures for field use. These field instruments are based upon a sound theoretical framework against which the results can be understood and interpreted. In order to address the validity and predictive value of field instruments, longitudinal studies need to be performed that are in accordance with the work in other work packages. Apart from balance assessment procedures, activity levels, history of falls, and future falls need to be assessed. We expect this novel approach to give insight in the relation between objective measures of balance function, activity level and number of falls. Thus, the occurrence of falls can be related to (changes in) activity level.