Comparison of Functional Balance and Probability of Falling in the Elderly with and Without a History of Falling Living in Care Centers

* Corresponding Author: Parisa Sedaghati, PhD. Address: Department of Sport Injuries and Corrective Exercise, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran. Tel: +98 (912) 2768326 E-mail: sedaghati@guilan.ac.ir 1. Department of Sport Injuries and Corrective Exercise, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran. Seyyed Mojtaba Tabatabaiasl1 , *Parisa Sedaghati1 , Fariba Javazi1


Introduction
ging affects all major body systems, including anatomical and functional designs, so the efficiency of postural and motor sys-A tems, which are responsible for postural stability, gradually decreases with age [4]. In most cases, low balance is the leading cause of falls [5]. Balance is the ability to maintain body position within the level of reliance. During static and dynamic balance, body position is controlled by shifting the center of gravity and initiating appropriate responses to return the body to a stable position, a complex process in which the visual senses, somatosensory, vestibular, and musculoskeletal systems play an important role [6]. The low balance in the elderly is accompanied by an increase in the rate of falls; every year, one-third of the elderly with 65 years and older experience falls.
Falling in the elderly causes severe complications such as severe fractures, especially in the bones of the neck, wrist, pelvis, and soft tissue injuries [7]. Research has also shown that half of the elderly with a history of falls have limited mobility [8]. Although physical and mental deficiencies caused by old age can be partially eliminated with drug therapy methods, it seems that to deal with this significant and growing problem of human societies, safer and more appropriate solutions should be found [9].

Methods
The present study was a causal-comparative study that was conducted in the field. The study subjects included 30 elderly men and women over 60 years of age from two nursing homes in Rasht and were selected by convenience sampling. Individuals who had no history of falls during the last six months were in the group without a history of falls. Individuals who had fallen once or more during the previous six months [14] were in the group with a history of falls. Balance and probability of falls in the elderly were assessed by Berg test and TUG test [15]. The code of ethics was also received from the Research Institute of Medical Sciences Technology of Guilan University. SPSS statistical software was used for data analysis. The Shapiro-Wilk test was used for normal distribution of data; descriptive statistics tests were used in statistics such as Mean±SD, median, and amplitude of changes and describe the inferential data statistics section to the comparison of variables, independent T-test was used.

Results
The demographic information of the elderly is given in Table 1. According to the results of the independent t-test, there was a significant difference between functional balance index in the elderly with a history of falls and no history of falls; the balance scores of the elderly without a history of falls were significantly higher than the elderly with a history of falls (P˂0.007).
The elderly had a history of falls (P˂0.007). According to the results of the independent t-test, there was a significant difference between the index of probability of fall in the elderly with a history of fall and without a history of fall, that is, the elderly without a history of falls performed the test in less time than the elderly with a history of falls (P˂0.001).

Discussion and Conclusion
This study aimed to evaluate and compare functional balance and the probability of falls in the elderly with a history of falls and no history of falls. The results showed a significant difference between functional balance and the probability of falling in the elderly with a history of falls and without a history of falls. In the elderly with a history of falls, compared to the elderly without a history of falls, there is a more significant balance problem and the possibility of re-falls. Impairment of functional capacity has significant consequences for the family, society, health system, and life of the elderly [23].
The results of this study and other studies show that the elderly with a history of falls have a lower balance score than the elderly without a history of falls; they are also more likely to fall again. As a result, people with a history of falls are more likely to be affected by fear of complexity and are more limited in their daily activities. Given the high prevalence of falls among the elderly, even among independent ones, balance problems must be diagnosed soon; balance problems make older people more susceptible to subsequent falls and possible complications, which may cause limitations and disability. To this end, balance criteria with sufficient sensitivity to elucidate emerging balance disorders seem necessary.

Compliance with ethical guidelines
All ethical principles are considered in this article. The participants were informed of the purpose of the research and its implementation stages. A written consent was obtained from subjects. This study was approved by the Ethics Committee of Guilan University of Medical Sciences (Code: 399.252IR.GUMS.REC).

Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.

Authors' contributions
Data collection and writing -original draft: Seyed Mojtaba Tabatabaiasl and Parisa Sedaghati; Conceptualization, implementation and data analysis: All authors.

Conflicts of interest
The authors declared no conflict of interest.