A fall can change an older person’s life in a matter of seconds. Many falls result in fractures, hospital stays, reduced mobility, and loss of confidence.
Some older adults become afraid of walking independently after a fall and begin limiting their activities. This can weaken muscles, reduce balance, and increase the chance of future falls.
Because of these serious consequences, scientists have been searching for better ways to identify people who are likely to fall before an accident happens.
At the University of Michigan Health, Dr. James Richardson believed doctors were often intervening too late. In many cases, conversations about balance only happened after someone had already been injured.
Richardson wanted to develop a practical system that could identify people at risk much earlier and reveal the specific reasons behind their balance problems.
This effort led to the creation of the JEDII Fall Clinic, which focuses on the early detection of balance problems and the prevention of future injuries.
Doctors already use a simple test called unipedal stance time to evaluate balance. During this assessment, patients stand on one foot for as long as possible. Research has shown that people who cannot maintain this position for at least 15 seconds have a much higher chance of falling during the following seven to ten years.
While this test identifies people at risk, it does not explain why they struggle to balance.
To investigate this question, Richardson and his colleagues conducted a study involving 172 participants and published their findings in Aging Clinical and Experimental Research. The participants included older adults and people with conditions that commonly increase fall risk, including diabetic nerve damage and liver disease.
The researchers identified three key factors that strongly influenced a person’s ability to stand on one foot. These factors involved sensory function in the feet, the speed of brain processing, and the strength needed to stabilize the body.
The first test is remarkably simple. A vibrating tuning fork is placed on the big toe. Patients say when they can no longer feel the vibration. This assessment measures how effectively the nerves in the feet and ankles send information to the brain. Healthy sensation allows people to notice changes in position and respond rapidly if they begin to lose balance.
The second test uses a specially designed tool called the ReacStick. The patient sits with one arm ready while the device is suddenly dropped. The patient must quickly decide whether to catch it.
The test measures two abilities. First, it measures reaction speed by recording how rapidly the patient grabs the device. Second, it measures decision-making ability by requiring patients to catch the device only when green lights appear. This part of the assessment examines how efficiently the brain processes information under time pressure.
The final assessment evaluates core muscle strength. Patients lie on their side and perform a side plank. Strong core muscles help people stabilize their bodies and recover after slips or trips.
The researchers found that these three abilities together explained about two-thirds of the differences in people’s balance performance. In other words, many balance problems can be understood by looking at nerve function, thinking speed, and strength.
One important message from the study is that fall prevention can be personalized. If someone performs poorly on one test but does well on others, doctors can recommend exercises or strategies that target that person’s particular weakness.
Some people may benefit from balance training, others from strengthening exercises, and some may need programs that improve reaction speed and coordination.
The study also shows that balance involves much more than muscles alone. Preventing falls requires healthy nerves, fast information processing, and the ability to respond quickly to unexpected situations.
The findings highlight a shift from treating falls after they occur to preventing them before they happen. The assessments are relatively simple and address different aspects of human movement and balance.
Although larger studies are still needed, the approach appears promising because it helps explain why people are at risk rather than simply labeling them as high risk. This could eventually allow doctors to create individualized prevention plans and help older adults maintain independence and quality of life for longer.
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Source: University of Michigan.
