Introduction
There are indications that older adults who suffer from poor balance have an increased risk for adverse health outcomes, such as falls, mobility-related disability, and disability in daily activities [1-4]. Monitoring the development of balance over time enables early detection of balance decline. Providing interventions aimed at improving balance and preventing falls or disability could be beneficial to older adults with decreased balance because it can reduce their risk of these adverse outcomes [5-8]. Possibilities for monitoring the development of balance over time in older adults are clinical balance tests that are conducted by care professionals [9-11], (expensive) force plate equipment that is available in clinical/laboratory settings [12], and innovative telemonitoring devices [13-16]. The latter can be used by older adults in their own homes without the presence of a care professional. This can facilitate regular monitoring and early detection of change over time. Furthermore, such telemonitoring devices can provide direct information regarding balance changes to the user, which can support self-management. A telemonitoring device appropriate for home-based self-monitoring of balance is a modified bathroom scale [13]. This device uses an algorithm to calculate balance parameters and is equipped with Bluetooth, which enables the transfer of balance and weight data to a mobile phone-based app. Via the app, older adults can receive information about their own balance scores, or changes in these scores. Furthermore, the data could be forwarded to a database that can be accessed by care professionals, which enables them to monitor the development of balance in their patients over time from a distance [17,18]. Older adults are able to use the modified bathroom scale for home-based self-monitoring of balance because it does not differ from a normal bathroom scale [13,19]. Previous research that compared balance scores of the modified bathroom scale to clinical balance tests, such as the Performance-Oriented Mobility Assessment or Timed Up and Go, suggests good construct validity, especially in older adults with slightly diminished balance [20]. Besides that, the modified bathroom scale provides estimates of balance-related parameters similar to a force plate [21]. Since the bathroom scale seems to be able to provide valid balance measurements, it can be used to identify balance decline in older adults. However, no studies have been conducted yet in which the predictive validity of balance scores of the modified bathroom scale on adverse outcomes has been studied. Information regarding predictive validity can help older adults and care professionals to interpret the balance scores. Furthermore, it is important to know whether lower balance scores are associated with adverse outcomes in order to decide whether, or which, preventive interventions would be justified
when balance decline is detected. Therefore, the aim of this study is to explore the relationship between balance scores of the modified bathroom scale and falls and disability in older adults.
แนะนำ There are indications that older adults who suffer from poor balance have an increased risk for adverse health outcomes, such as falls, mobility-related disability, and disability in daily activities [1-4]. Monitoring the development of balance over time enables early detection of balance decline. Providing interventions aimed at improving balance and preventing falls or disability could be beneficial to older adults with decreased balance because it can reduce their risk of these adverse outcomes [5-8]. Possibilities for monitoring the development of balance over time in older adults are clinical balance tests that are conducted by care professionals [9-11], (expensive) force plate equipment that is available in clinical/laboratory settings [12], and innovative telemonitoring devices [13-16]. The latter can be used by older adults in their own homes without the presence of a care professional. This can facilitate regular monitoring and early detection of change over time. Furthermore, such telemonitoring devices can provide direct information regarding balance changes to the user, which can support self-management. A telemonitoring device appropriate for home-based self-monitoring of balance is a modified bathroom scale [13]. This device uses an algorithm to calculate balance parameters and is equipped with Bluetooth, which enables the transfer of balance and weight data to a mobile phone-based app. Via the app, older adults can receive information about their own balance scores, or changes in these scores. Furthermore, the data could be forwarded to a database that can be accessed by care professionals, which enables them to monitor the development of balance in their patients over time from a distance [17,18]. Older adults are able to use the modified bathroom scale for home-based self-monitoring of balance because it does not differ from a normal bathroom scale [13,19]. Previous research that compared balance scores of the modified bathroom scale to clinical balance tests, such as the Performance-Oriented Mobility Assessment or Timed Up and Go, suggests good construct validity, especially in older adults with slightly diminished balance [20]. Besides that, the modified bathroom scale provides estimates of balance-related parameters similar to a force plate [21]. Since the bathroom scale seems to be able to provide valid balance measurements, it can be used to identify balance decline in older adults. However, no studies have been conducted yet in which the predictive validity of balance scores of the modified bathroom scale on adverse outcomes has been studied. Information regarding predictive validity can help older adults and care professionals to interpret the balance scores. Furthermore, it is important to know whether lower balance scores are associated with adverse outcomes in order to decide whether, or which, preventive interventions would be justifiedเมื่อได้พบยอดดุลลดลง ดังนั้น จุดมุ่งหมายของการศึกษานี้คือการ สำรวจความสัมพันธ์ระหว่างคะแนนสมดุลปรับเปลี่ยนน้ำ และน้ำตกและพิการในผู้ใหญ่รุ่นเก่า
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