Revisiting the Instrumented Romberg Test: Can Today’s Technology Offer a Risk-of-Fall Screening Device for Senior Citizens? An Experience-Based Approach

Abstract

Risk of fall (ROF) is a worldwide major concern for its prevalence and consequent dramatic outcomes in the elderly population. The growing age-related risk appears to be associated with increasing motor, sensory, and cognitive problems in the elderly population. There is a consensus on the need to screen for these balance dysfunctions, but the available methods are largely based on subjectively assessed performances. The instrumented Romberg test using a force plate represents a validated assessment process for the evaluation of balance performances. The purpose of this study is to propose an innovative instrumental method to identify balance deficits, assess their severity, and give an automated indication of the most likely etiology. The proposed new method was applied to the instrumented Romberg test, using force plate data recorded in a cohort of 551 females aged >65 participating in adapted physical activity courses. The method allowed us to identify 145 dysfunctional subjects and to determine the likely origin of their deficit: 21 central, 5 vestibular, 9 visual, 59 proprioceptive (musculoskeletal etiology), and 51 functional. Based on the preliminary findings of the study, this test could be an efficient and cost-effective mass screening tool for identifying subjects at risk of fall, since the procedure proves to be rapid, non-invasive, and apparently devoid of any contraindications.

Assessing the Impact of Fencing on Postural Parameters: Observational Study Findings on Elite Athletes

“…In particular, four athletes exhibit hypertonic postural behaviour, while the other four exhibit hypotonic behaviours. The value of SL/SA was out of the normative reference range, suggesting an anomalous relationship between the SL and SA of the COP displacement [15]. A hypertonic postural behaviour with an SL/SA ratio exceeding 1.5 leads to increased energy expenditure, which could negatively influence performance and fatigue, conversely, with participants showing a hypotonic behaviour.…”

“…The percentual distribution of the body weight on the 4 quadrants of the stabilometric platform was investigated to evaluate the possible presence of clinically significant postural alterations (i.e., repartition of the body weight between the left and right quadrants >10%) [14]. Concerning the postural parameters, the ratio sway length/sway area (SL/SA) for each participant was also assessed and compared with normative reference data to evaluate the possible presence of clinically significant postural alterations: this ratio is proportional to postural tone and a value under 1.5 can suggest a hypertonic postural tone, whilst a value over 3 can suggest a hypotonic postural tone [15].…”

Technological Evolution in the Instrumentation of Ataxia Severity Measurement

“…Fall screening and prediction: Falls are identified as a significant cause of injury in individuals with CA [192]. In an effort to provide a non-invasive screening platform, work by Gallamini and colleagues suggested employing a standing platform and Romberg's balance test to investigate the risk of falling [193]. Falls prediction employed the traditional approach to search for linkage between a signal's features and a fall.…”

Sway Spectral Analysis in the Instrumented Romberg Test: Is there a Correlation between the Most Evident Harmonics of Closed Eyes Sway and Musculoskeletal Dysfunction Foci? A Medical Hypothesis Based on Clinical Experience

“…The sample consisted of 195 healthy young volunteers, 119 of whom were elite athletes [16] and was subsequently extended to a total of 1212 normofunctional individuals. Since then we have collected several thousand test results during our routine clinical practice, investigations which included a specific test to explore the feasibility of using the Romberg test as a screening tool for balance deficits [17], and we noticed the as-yet unreported relationship between the harmonic analysis and the position of what could perhaps be described as an irritative focus. It was only during a recent discussion of the topic that the co-authors of this paper came to exchange experiences and comments which led to the definition of the present medical hypothesis.…”