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Low efficacy using the 256-Hz tuning fork when evaluating the influence of somatosensation in balance control for relatively healthy elderly

Abstract Background: Diminished foot somatosensation contributes to balance deficits and increased fall risk. However, it remains unclear if the 256-Hz tuning fork is adequate to measure, in the outpatient clinical setting, somatosensation in relatively healthy elderly. Aims/Objectives: To evaluate the performance of the 256-Hz tuning fork compared to other measures of somatosensation and balance. Material and methods: Thirty-six subjects (mean 69.4 ± 5.3 years) were allocated into four 256-Hz tuning fork sensation groups (TFSG) based on their ability to detect vibration at the first metatarsal, malleolus, tibia or no sites. A biothesiometer measured vibration perception thresholds (VPTs) and 20 monofilaments tactile pressure sensation thresholds (TPSTs). Balance was evaluated with posturography, functional balance tests and questionnaires. Results: There were no significant differences in age, VPTs or TPSTs between the four TFSGs, nor in outcome of functional balance tests, posturography and questionnaires. Very few significant associations were found between TFSGs and VPTs, TPSTs, functional balance tests, posturography and questionnaires. Conclusions and significance: Somatosensation measured with a 256-Hz tuning fork seems to be a minor determinant for balance and thus superfluous when evaluating the importance of vibration perception for balance control in relatively healthy elderly.