Balance, gait performance and muscular strength in the elderly

Abstract: Fracture incidence is higher in urban than in rural inhabitants. Background factors such as physical activity and workload may have an influence on the tendency to fall, leading to fractures. We found that elderly women with a recent fracture of the distal radius appear to have impaired balance, an impairment that seems to normalise with time after fracture. The aim of this study was also to get normative data for healthy subjects of functional performance, such as balance, gait performance and muscular strength. Different populations were investigated. Men and women 50, 60, 70 and 80 years of age and women of 40 years from an urban and a rural area were investigated. Background factors such as age, gender, housing, medical status, workload and sparetime activities were collected. Urban subjects had significantly inferior balance compared with rural subjects and this difference increased with increasing age. The urban subjects walked faster but the rural subjects took longer steps. Sparetime activities correlated with balance and step length and workload with walking speed. Muscular strength of knee extension was significantly lower in the urban men and women in almost all age groups. This difference was not pronounced in knee flexion except for the oldest subjects. To investigate whether any of the clinical balance and gait performance tests could be related to computerised balance and muscular strength tests, 230 women, of 75 years of age were examined. The computerised balance platform test, could not be related to any of the clinical balance tests, gait performance tests or muscular strength tests. The clinical balance test was correlated with walking speed and step length. Extension and flexion strength of the knee and ankle dorsiflexion were also related to walking speed and step length. The heavier an individual was, the slower she walked and the shorter her steps, despite having stronger knee muscles. Women over the age of 65, who had participated for more than 20 years in physical exercise groups, had significantly better balance, gait performance and muscular strength of the knee and were less in need of home aid compared to urban women of the same age. When the active women were compared with age-matched rural women this difference was less pronounced. The results of this study emphasise the necessity of using correct normative data as regards balance, gait performance and muscular strength when different populations are compared.