Background: The timely detection of fall risk or balance impairment in older adults is transcendental because, based on a reliable diagnosis, clinical actions can be taken to prevent accidents. This study presents a statistical model to estimate the fall risk from the center of pressure (CoP) data.Methods: This study is a cross-sectional analysis from a cohort of community-dwelling older adults aged 60 and over living in Mexico City. CoP balance assessments were conducted in 414 older adults (72.2% females) with a mean age of 70.23 ± 6.68, using a modified and previously validated Wii Balance Board (MWBB) platform. From this information, 78 CoP indexes were calculated and analyzed. Multiple logistic regression models were fitted in order to estimate the relationship between balance alteration and the CoP indexes and other covariables.Results: The CoP velocity index in the Antero-Posterior direction with open eyes (MVELAPOE) had the best value of area under the curve (AUC) to identify a balance alteration (0.714), and in the adjusted model, AUC was increased to 0.827. Older adults with their mean velocity higher than 14.24 mm/s had more risk of presenting a balance alteration than those below this value (OR(Odd Ratio) = 2.94,p<0.001, 95%C.I.(Confidence Interval) 1.68–5.15). Individuals with increased age and BMI were more likely to present a balance alteration (OR1.17,p<0.001, 95%C.I.1.12–1.23;OR1.17,p<0.001, 95%C.I.1.10–1.25). Contrary to what is reported in the literature, sex was not associated with presenting a balance alteration (p= 0.441, 95%C.I.0.70–2.27).Significance: The proposed model had a discriminatory capacity higher than those estimated by similar means and resources to this research and was implemented in an embedded standalone system which is low-cost, portable, and easy-to-use, ideal for non-laboratory environments. The authors recommend using this technology to support and complement the clinical tools to attend to the serious public health problem represented by falls in older adults.

This paper analyzes the reliability and usability of a portable electronic instrument that measures balance and balance impairment in older adults. The center of pressure (CoP) metrics are measured with a modified Wii Balance Board (mWBB) platform. In the intra- and inter-rater testing, 16 and 43 volunteers (mean 75.66 and standard deviation (SD) of 7.86 years and 72.61 (SD 7.86) years, respectively) collaborated. Five volunteer raters (5.1 (SD 3.69) years of experience) answered the System Usability Scale (SUS). The most reliable CoP index in the intra-examiner tests was the 95% power frequency in the medial-lateral displacement of the CoP with closed-eyes. It had excellent reliability with an intraclass correlation coefficient ICC = 0.948 (C.I. 0.862–0.982) and a Pearson’s correlation coefficient PCC = 0.966 (p < 0.001). The best index for the inter-rater reliability was the centroidal frequency in the anterior-posterior direction closed-eyes, which had an ICC (2,1) = 0.825. The mWBB also obtained a high usability score. These results support the mWBB as a reliable complementary tool for measuring balance in older adults. Additionally, it does not have the limitations of laboratory-grade systems and clinical screening instruments.

Objective: This paper presents the design and development of a new electronic portable device to assess the human balance of the human body during standing, using a minimal number of sensors and peripheral components. This device is aimed to evaluate human balance in environments outside of specialized laboratories, such as small clinics and therapy offices. Approach : The design is based on previous designs using three or more resistive force sensors attached to the feet, however in the present work, the sensors were attached on an adjustable platform, to fit several sizes of feet. Furthermore, all the signal acquisition, process, storage and display are executed by an embedded electronic system, thus avoiding the use of computers and external peripherals. A new method to compute the CoP using only two sensors per foot was developed and tested in a group of 50 university students, (17 women and 33 men), 26.04 ± 4.94 years. Main results : It was developed a portable electronic system to measure the trajectory of the CoP and to calculate the indexes values derived from it. The system is capable to discriminate between measuring situations (open and closed eyes), using only two sensors per foot (p < 0.0001). A comparison between the values obtained for young subjects using the proposed device, and the values reported in the literature showed a similar tendency. Significance : The results indicate that the proposed system is a good, low-cost, and easy-to-use alternative tool for researchers and clinicians interested in the evaluation of human balance, especially if the measurements must be done outside laboratories.

The aim of this study was to improve the diagnostic ability of fall risk classifiers using a Bayesian approach and the Simulated Annealing (SA) algorithm. A total of 47 features from 181 records (40 Center of Pressure (CoP) indices and 7 patient descriptive variables) were analyzed. The wrapper method of feature selection using the SA algorithm was applied to optimize the cost function based on the difference of the mean minus the standard deviation of the Area Under the Curve (AUC) of the fall risk classifiers across multiple dimensions. A stratified 60–20–20% hold-out method was used for train, test, and validation sets, respectively. The results showed that although the highest performance was observed with 31 features (0.815 ± 0.110), lower variability and higher explainability were achieved with only 15 features (0.780 ± 0.055). These findings suggest that the SA algorithm is a valuable tool for feature selection for acceptable fall risk diagnosis. This method offers an alternative or complementary resource in situations where clinical tools are difficult to apply.