Short-term effects of additional sensory information in mobility and gait speed in older fallers

Background: Postural balance consists of information emanating from the interaction of visual, somatosensory and vestibular systens. This information is impaired in aging, leading to postural control changes in the elderly, increasing the risk of falls in this population. The postural balance may be improved with the addition of sensory information, such as a subpatelar bandage. Objective: To investigate the effect of using additional sensory information in gait speed and functional mobility of older fallers. Methods: 28 elderly women were evaluated, all were considered fallers. The test Timed Up and Go (TUG) was used to assess functional mobility and 10m Test to evaluate the gait speed. The tests were performed with and without the addition of additional sensory information (subpatelar strip). The normality was verified by the Shapiro-Wilk test and the results were compared using paired Student t test and Wilcoxon test. Results: There was significant difference in the TUG (p = 0.0006) and in the gait speed (p = 0.004) with and without subpatelar strip. Conclusion: The use of additional sensory information increased the gait speed and functional mobility of older fallers. Key-words: Older Fallers, Postural Balance, Proprioception, Mobility Limitation. Corresponding author: Marcos Eduardo Scheicher Av. Hygino Muzzi Filho, 737, Bairro: Mirante, 17.525-000 Marília, SP, Brasil Phone: 0055 14 3414 9430 email: mscheicher@marilia.unesp. br 2 Professor of the Department of Physical Therapy and Occupational Therapy, Universidade Estadual Paulista “Júlio de Mesquita Filho” UNESP, Marília, SP, professor of the Postgraduate Program in Human Development and Technologies, Universidade Estadual Paulista “Júlio de Mesquita Filho” UNESP, Rio Claro (SP), Brazil. Full list of author information is available at the end of the article. Financial support: The authors declare no financial support. Submission date 08 March 2017; Acceptance date 24 October 2017; Publication date 14 February 2018 http://dx.doi. org/10.17784/mtprehabjournal.2017. 15.474 INTRODUCTION Fall is defined as an unintended episode, which results in a lower position which the individual failed to correct in a timely manner(1-3). Fall down is one of the issues related to the geriatric health of the population(4), considering that 30% of the older faller at least once a year and 50% will fall on a recurring basis(5). In addition, it is the 6th leading cause of death in people over 65 and is considered the main cause of morbidity, loss of autonomy and quality of life in aging(6,7). Postural balance is the result of the harmonic interaction between the vestibular, visual and somatosensory systems, and changes in these systems or in the interaction between them increases the risk of falls(8-10). One of the forces that maintain postural control is sensory information, interfering with motor action related to postural control, and it is influenced by motor actions(9-11). Some studies have indicated that sensory information can be used continuously in individuals with proprioceptive deficit with good results in reducing body oscillation and improving mobility(8-14). The first studies by Bonfim and Barela(11), showed the body oscillation reduction in a situation of contact with a touch bar in individuals who had lesions of anterior cruciate ligament (ACL). Felicio et al.(12) in his study evaluated the use of sensory addition in individuals with Patellofemoral Syndrome, while Carvalho et al.(13) showed an improvement in functional mobility in older ladies fallers and older fallers who do not fall with the use of the subpatellar. The additional sensory information is also the great importance for healthy individuals, as long as it provides useful information for carrying out the proposed task(8-10). The first studies using the addition of sensory information proved their efficacy in healthy individuals, but it is of greater relevance in subjects with proprioceptive deficit(9,11,15,16). Therefore, the geriatric population can benefit from the effect of additional sensory information, which is a low-cost tool which may help maintain postural balance and reduce the risk of falls(13). Although the number of studies with the addition of sensory information has increased in recent years, however there is still discordance results related to the geriatric population with a history of falls. The aim of this study was to investigate the short-term effect of additional subpatellar strip sensory information use on functional mobility and average gait velocity in elderly women with a history of falls.