N. L. Low Choy

Medial-lateral postural stability in community-dwelling women over 40 years of age.

Objective: To document the change in medial–lateral balance in women aged between 40 and 80 years. Design: A cross-sectional study of six measures of medial–lateral balance was undertaken. Setting: The Betty Byrne Henderson Centre for Women and Ageing, Royal Womens Hospital, Australia. Subjects: Five hundred and three community-dwelling women between 40 and 80 years of age were randomly recruited from a large metropolitan region with 366 subjects admitted after applying exclusion criteria. Measurements: The clinical measurements included the lateral reach and step tests while laboratory measurements were gathered from the Balance Master software programs for unilateral stance and limits of stability. Results: A significant decline in all measures (p < 0.02) was evident between the forties and sixties age decade cohorts. The clinical step test showed a significant (p < 0.001) decline between the forties and fifties groups. A significant correlation was shown between step test and unilateral stance (p < 0.001) and movement velocity, reaction time and end-point excursion centre of gravity (COG) on the limits of stability test (p < 0.001). Conclusions: This new evidence demonstrates that there is a significant decline in medial–lateral balance in women that occurs between their forties and sixties. Suggestions for further study were made.

Falling is not just for older women: support for pre-emptive prevention intervention before 60

Objective This study aimed to report falls and identify factors that might predict a fall in women aged between 40 and 80 years and thus provide evidence of earlier falls and need for morbidity preventive intervention. Design and participants A prospective cohort study design over 5 years. Personal demographic data of age, co-morbidities, number of prescribed medications, falls, activity level and living situation were obtained at face-to-face interview. Height, weight, body mass index and postural stability were measured in participating women living independently in the community. Results Women were categorized into age decade cohorts, with 463 remaining at the year 5 assessment. At baseline, 8% of the women in their forties, 14% in their fifties, 25% in their sixties and 40% in their seventies had fallen in the previous 12 months. Over the 5-year study period, 21% of women in their forties and fifties, 31% of women in their sixties and 47% in their seventies had fallen. Multiple fallers mostly comprised women in their sixties and seventies. Parametric modeling and the classification tree approach revealed age and number of co-morbidities to be most predictive of a fall. Women < 60 years old had an increased risk of a fall by 8% and women > 60 years an increased risk of a fall by 35% with every additional co-morbidity. Stability and other demographics were not predictive of falling. Conclusions For women over 40 years old, the number of co-morbidities increased the risk of a fall. The falls risk escalated with additional co-morbidities if they were over 60 years. Preventive program participation to maintain good health beginning by the forties appears vital to prevent falls.

Controlling balance decline across the menopause using a balance-strategy training program: a randomized, controlled trial

Objective To evaluate effectiveness and long-term benefits of a specific balance-strategy training program in sedentary women aged 40–60 years and whether participation leads to adoption of a more active lifestyle. Method Fifty healthy women were admitted to the randomized, controlled trial on the basis of their activity level. Subjects were randomly assigned to an intervention or control group, with the former attending twice-weekly for 12 weeks. Assessments made pre- and post-intervention and at 9 months follow-up included: personal demographics, hormone replacement therapy medication, activity level, balance measures, somatosensory function, ankle flexibility and leg muscle strength. Results The intervention group showed improvement in balance measures (p < 0.030), right ankle tactile sensation (p = 0.027), ankle flexibility (p < 0.000) and muscle strength (p < 0.018) of quadriceps, hip abductors and external rotators, compared with the control group immediately after intervention. At 9 months follow-up, the intervention effect was maintained for all measures and a latent improvement of somatosensory measures (tactile acuity of foot (p < 0.05), joint repositioning sense (p < 0.010), and vibration threshold of the left knee (p < 0.016)) revealed. The intervention group also adopted a more active lifestyle (p = 0.000). Conclusion These results provide evidence that this physiotherapist-designed program preserves/reverses the balance decline associated with age and leads to adoption of a more active lifestyle.

Changes in activity level in women aged 40–80 years

Objectives The purpose of this study was to report habitual physical activity levels in women and document the change in level of activity and factors affecting this change over a 5-year period. Methods A 5-year prospective cohort design was used. Women aged 40–80 years, living independently in the community, were recruited via the electoral role. The effects were investigated, first, of age, activity level, history of falls, number of co-morbidities and medications, body mass index and stability at baseline on change in activity level and, second, change in these demographics on activity level over the study period. Results Data from 459 women who completed our study are reported. Only activity level and body mass index at baseline significantly affected change in activity level (p < 0.000). Change in activity level was not influenced by change in demographics over the study period. The forties and fifties cohorts accounted for the baseline body mass index effect on activity change (p < 0.04). In the forties cohort, number of medical conditions at base line (p < 0.03) and, in the sixties cohort, increase in number of medical conditions (p = 0.011) affected activity level change. Conclusions Activity level at baseline and body mass index in younger women were most likely to affect change over time. Being unsteady or having already fallen did not stimulate change.