CONCEPTS AND METHODS FOR ASSESSING POSTURAL INSTABILITY

Current research suggests that there are complex interactions between intrinsic factors related to the individual and extrinsic environmenta l factors, all of which contribute to falls in the older adult. A new approach to balance assessment, the task-oriented conceptual framework for clinical intervention, takes into account many of these intrinsic and extrinsic variables in assessing balance function. It contains th ree levels of assessment of balance and gait function: performance-bas ed functional assessment, strategy assessment, and impairment assessme nt. This approach quantifies performance on functional tests of balanc e, determines the strategies used by the individual to carry out funct ional tasks, and evaluates the relative contribution of specific neura l and musculoskeletal variables to normal postural control. Results of recent experiments suggest that older adults who are given a sensory training propram that is designed to improve the organization of senso ry inputs contributing to balance control (strategy level) are able to significantly improve sway and that this training effect transfers to other balance conditions.