STRENGTH IS A MAJOR FACTOR IN BALANCE, GAIT, AND THE OCCURRENCE OF FALLS

We studied the effects of lower extremity strength as well as gait and balance on the occurrence of falls in nursing home residents, Nursing home residents with a history of falls had less than half of the knee and ankle strength of nonfalling subjects residing in the same home. The differences were more prominent at the ankle than the knee, and we re most pronounced in the ankle dorsiflexors, where they were one-tent h that of controls. Also of note was the fact that this same group of fallers had slowed gait velocity (58% of control) as well as an impair ed response to postural perturbation as determined on the Postural Str ess Test (55% of control). In a recently completed study we measured s trength as balance (EquiTest balance platform) of community-dwelling s ubjects. The occurrence of loss of balance during the sensory organiza tion test was correlated with diminished lower extremity (Pearson R = -.36, p = .001) as well as ankle dorsi and plantar flexion moments (Pe arson R = -.37, p = .001). Using a logistic regression model, we demon strated an independent effect of strength on the odds ratio of an SOT- LOB; for each newtonmeter per kg increase in strength there was a 20% decrease (95% CI,.74-87) in the odds ratio. The data from both nursing home and community-dwelling subjects indicate a strong relationship o f lower extremity strength to balance and gait. The nursing home studi es demonstrated an association between these functions and the occurre nce of falls. The quantitative nature of these relationships is still to be determined although there is likely a strength threshold under w hich gait and balance are compromised.