Impaired standing balance : unraveling the underlying cause in elderly

Abstract

Impaired balance is often seen in elderly and can result in impaired mobility and finally in falling. Failure of compensation strategies or deterioration of underlying systems involved in standing balance could result in impaired balance. To apply targeted interventions to improve balance, it is important to know the underlying cause of impaired balance. In this thesis, it is shown that the underlying systems involved in balance, represented by muscle characteristics, blood pressure and cognition, are all associated with the ability to maintain standing balance in elderly outpatients. However, the quality of standing balance, determined using force plates measuring ground reaction forces, is not associated with the underlying systems involved in standing balance. Therefore, it is not possible to detect the underlying cause of impaired balance in elderly outpatients using aforementioned measures. System identification techniques are introduced to identify the contribution of the underlying systems in standing balance. In this thesis, the method is validated and it is shown that it is possible to identify the underlying systems involved in standing balance in elderly. This gives the opportunity to use this method to unravel the underlying cause of impaired balance in elderly and therefore to apply targeted interventions and reduce falling.