Improving balance in older people
Falls are a leading cause of injuries, hospitalisations and other complications among older men and women. Now, results of a small study show that vibrating gel-based insoles significantly improve balance control in elderly people, and may eventually help to prevent falls.
Significant improvement in balance control
The October 2004 issue of The Lancet published research results of James Collins, professor of biomedical engineering at Boston University, demonstrating that by introducing sub-sensory mechanical noise (in the form of very weak vibrations) to the soles of subjects' feet through vibrating insoles, balance in elderly people can be improved.
Collins' research reported that somatosensory function, which provides touch and position sense, declines with age. His research team studied 13 subjects with an average of 23 years and 12 subjects with an average of 73 years of age. During the trial, subjects remained standing with their eyes closed, while the investigators measured the degree of sway with and without vibration. Each group, when standing on vibrating insoles, showed a significant improvement in balance control. The 73-year-olds improved their balance more by comparison with the 20-year-old youths.
Ability of nervous system enhanced
Collins argues that vibration through the feet improves balance because the vibrations enhance the ability of the nervous system to detect weak somatosensory signals. The vibrations cause the neurons in the soles of the feet to be more sensitive to weak pressure change signals. This information is then used by the balance control mechanism to maintain a more stable stance.
A practical device
Several of the researchers, including Collins, are shareholders in the Afferent Corporation of Rhode Island , which is working to commercialise this technology using low-level electrical stimulation to treat sensory dysfunction that results from disease and injury. The prototype vibrating insoles are now available at a very affordable price. The hope is that vibrating insoles may turn out to be useful in enhancing balance control in older individuals and reduce their risk for falling.
However, commenting on this research, Mary Tenitti, professor of medicine at Yale University and a leading expert on falls among the elderly, comments that while Collins work is interesting and promising, one of the problems with the study is that balance tested during swaying does not correlate well with balance during walking. The clinically important question is whether this vibrating helps people's balance when they walk, she says. It is too early to say whether these vibrating insoles will be useful clinically.
More needs to be done to prevent fractures
According to Tinetti, “…a leveling off in the death rate seen over the past two decades may, in part, account for the increasing age of those who suffer from hip fractures. It is the frailer people who are dying. The healthy older people get through it very well. Therefore, more work needs to be done to prevent hip fractures and to find better ways of reducing mortality after fracture. ”
Thus, the question remains, have we reduced mortality from fractures as much as we can? We certainly have to increase our efforts in preventing hip fractures among the frail elderly. http://www.health24.com/news/Ageing/1-888,24880.asp
Measures of Australia 's progress
The Draft National Injury Prevention and Safety Promotion Plan: 2004 Onwards was released for public consultation in August 2004 with submissions closing in September 2004.
Thirty-seven submissions were received and summarised into an issues paper which was discussed at a national workshop in Canberra on 5 November 2004. A broad range of stakeholders (including government and non-government representatives from both within and outside the health sector) attended the national workshop.
A number of suggestions put forward at the workshop were incorporated into the Plan. The final version was submitted to the National Public Health Partnership for endorsement in January 2005, before going to the Australian Health Ministers Advisory Council, and the Australian Health Ministers Conference. It is anticipated that the plan, now known as The National Injury Prevention and Safety Promotion Plan: 2004-2014 , will be publicly released in July 2005.
Ref: Injury Issues Monitor http://www.nisu.flinders.edu.au/monitor/monitor32.php
