Development of a Model and Review of Clinical Methods of Balance Function in the Elderly Using Structural Equation Modeling

Abstract

Background and Objective: Balance disorder is one of the most common problems in the elderly, leading to falls and serious injuries. One of the most important issues in the health of the elderly is balance and its related components. Therefore, the present study aimed to assess balance function tests, the relationship between age and anthropometric index, and perform equilibrium tests using structural equation modeling. Materials and Methods: A total of 136 elderly men and women living in a retirement home in Hamadan were included in this cross-sectional study. Balance function tests included finger-to-nose test, maintaining balance on one foot, standing up and walking tests, and heel-toe walking tests. Data were analyzed using an independent t-test, Pearson correlation coefficient, and structural equation model with 95% confidence using SPSS (version 23) and EQS (version 6.1) software. Results: The mean (standard deviation) age of the participants in this study was 66.05±2.83 and out of 136 patients, 77 (56.62%) cases were female. There was a significant difference between the mean scores of men and women in balance performance tests. In the Finger-to-nose test, women with the dominant and non-dominant hand performed the test in less time, and in other tests, the men performed faster. The intra-class correlation (ICC) coefficient obtained in all tests showed high repeatability of these tests. The coefficients obtained from the structural equation model showed that for every one year increase in age, the motor index and the anthropometric index increased and decreased significantly by 0.68 and 0.60 units, respectively. There was a decrease of 0.06 units in the mean of equilibrium performance tests. The model of fitted structural equations was confirmed based on the fitted goodness index (χ2 was not significant total, (0.095-0.077) 0.089: RMSEA, 0.918CFI: and GFI: 0.908). Conclusion: Age and gender were effective on balance function tests and anthropometric indices. The mean motor index and anthropometric index increased and decreased significantly for every one year increase in age. Furthermore, among the balance performance tests, the most difficult test was related to standing on one leg.