Prediction of Functional Limitations in Balance after Tests of Tandem Walking and Standing Balance in Older Adults.

objectiveOlder adults who may not complain of balance problems may nevertheless be developing subtle balance problems that may affect future functioning. This study sought to determine whether subtle problems could be predicted by standard balance testing.

methodsAt the geriatric medicine clinic at an academic tertiary-care center, geriatricians referred 27 people who were ambulatory without gait aids and had no apparent neurologic or musculoskeletal impairments affecting their balance or gait performance. Initially, subjects were screened with some questions about vertigo, tests of standing balance on foam with eyes closed (Romberg tests) with head still, and head nodding (pitch) and shaking (yaw) at 0.3 Hz, and tandem walking with eyes closed (TW). Approximately 2 years later, 22 subjects were available to be rescreened.

resultsAt the second test date subjects' scores declined slightly but significantly on all three variations of the Romberg tests: with head still, head pitch, and head yaw,

conclusionsThe data suggest that some older adults may have subtle musculoskeletal impairments that may be indicated by simple balance tests. A finding on these tests may indicate the need for further workup for balance-related problems. These quick, inexpensive tests can be administered by ancillary staff and may add important information to the initial visit and annual follow-up visits.