Evaluating the fall risk among elderly population by choice step reaction test

Abstract

Falls during daily activities are often associated with injuries and physical disabilities, thereby affecting quality of life among elder adults. Balance control, which is crucial in avoiding falls, is composed of two elements: muscle strength and central nervous system (CNS) control. A number of studies have reported that reduced muscle strength raises the risk of falling. However, to date there has been only limited research focused on the relationship between fall risk and the CNS. This study aimed to investigate the relationship between CNS and risk of falling among the elderly. A total of 140 elderly people (92 females and 48 males) were divided into faller and nonfaller groups based on questionnaire responses concerning falls in their daily life. Participants undertook a choice step reaction test in which they were required to respond to random visual stimuli using foot movements as fast as possible in the left or right directions. Response time was quantified as premotor time (PMT) and motor time (MT). In addition, the participants’ electro-myography data were recorded during the choice step reaction test. A maximal isokinetic torque test was also performed. PMT was greater in the fallers than in the nonfallers group. There was a significant difference between fall status and direction on PMT. PMT of the left limb in nonfallers was faster than the right, but in fallers there was no difference between left and right limbs. A similar phenomenon was also observed for MT. There were significant differences between fallers and nonfallers in maximum isokinetic torque at knee and ankle joints. The correct rate of PMT was higher than other variables, such as MT and maximal isokinetic torque, in evaluating elderly fall risk by using logistic regression analyses. The results suggest that PMT in the choice step reaction test could be a useful parameter to assess risk of fall among elder adults. In addition, decreased maximal isokinetic torque was related to greater PMT and disappearance of asymmetry in older adults who were at higher risk of fall, especially in the lower limb.

Choice reaction time and subsequent mobility decline: Prospective observational findings from The Irish Longitudinal Study on Ageing (TILDA)

“…For instance, postural control has been shown to be affected by access to attentional resources, as illustrated by the fact that response times to auditory tasks were increased when healthy older individuals were asked to concurrently achieve postural stability in the absence of visual and somatosensory cues [2] . This is supported by the finding that premotor time in the choice step reaction time task is longitudinally associated with falls risk in older adults [3] .…”

Influence of knee osteoarthritis and aging on isokinetic muscle strength of the lower limbs in women

“…Our previous study has shown that decreased maximal isokinetic torque (muscle strength) was related to greater PMT and disappearance of asymmetry in older adults who were at higher risk of fall, especially in the lower limb. Therefore, the fall risk could be significantly higher for OA patients [11]. Table 2.…”

What are the Acute Effects of Aerobic Exercise on Fractionated Response Time: A Systematic Review and Meta-analysis

“…Using FRT instead of RT provides a more precise estimate of the location of the effect of aerobic exercise on cognitive or motor components of the response. In addition, FRT may led to a better understanding of the presence of cognitive or motor deficits in different pathological conditions [18,59,60]. For example, in a recent study on Parkinson's disease patients, the authors found the disease mainly affected the speed of mental processing (PMT) without any significant change in motor execution of the task (MT) [59].…”