Do Muscle Strength And Functional Mobility Underpin Balance Confidence In Older Adults?

PURPOSE: Physiological, psychological and social factors are the three major determinants of falls in older adults. Psychological factors, especially balance confidence, have been suggested to be strongly associated with falls. However, it is unclear whether strength and mobility are associated with balance confidence. The purpose of the current study was to explore whether muscle strength and functional mobility reflect balance confidence in the elderly. METHODS: A group of 27 healthy community-dwelling adults (8M, 19F, 70.22±4.9yrs old) were recruited. Balance confidence was evaluated by using the Falls Efficacy Scale International (FES-I); functional mobility was measured by single-task Timed Up and Go test (TUG) , motor dual-task TUG and cognitive dual-task TUG tests; upper limb muscle strength was measured by grip strength with a hand dynamometer; lower limb muscle strength was measured by the 30-second Sit to Stand test (30STS). SPSS was used to analyze data, with Pearson’s correlation and independent samples t-test employed to examine the relationships among the measures. RESULTS: Pearson’s correlation showed that FES-I scores for the group were moderately correlated with single TUG (r=0.569,p=0.002), cognitive TUG (r=0.463,p=0.015) and motor TUG scores (r=0.562,p=0.002). However there was no significant correlation between FES-I scores and upper or lower limbs strength (both p>0.05). According to the FES-I cut-point score of 23 for low balance confidence, participants were divided into “high balance confidence” subgroup (n=12) and “low balance confidence” subgroup (n=15). Independent samples t-tests showed significantly worse scores for the low balance confidence subgroup in single task TUG (p=0.035) and motor dual task TUG (p=0.025). CONCLUSIONS: The findings from this preliminary study suggest that balance confidence is associated with functional mobility, but not with muscle strength. Thus, in order to improve balance confidence, interventions based on improving functional mobility, rather than strength, should be particularly targeted involved in physiotherapy programs.