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The relation of balance performance and balance confidence with physical activity in elderly fallers and non-fallers

Balance is an important issue in aging research since it is undoubtedly linked with motor performance affecting, thus, activities of daily living and consecutively the quality of life in the elderly. Maintenance of good balance ability reduces the chance of a fall which, especially in the elderly, is not only an important predictor of mortality but also a major problem with important negative health and socio-economic consequences. The fear of falling, on the other hand, results in restrictions of physical activity, functional ability, and consequently may lead to reduced quality of life and adverse health consequences [5]. Another psychological variable linked to the fear of falling is balance confidence or falls self-efficacy, which refers to personal beliefs in one’s ability to engage in certain activities of daily living without falling or losing balance [8]. Increased balance confidence, which is determined to a great extent by balance performance [2], is associated with lower fear of falling and better functional ability [6]. Physical activity seems to have a positive relation with balance confidence but the outcomes of this relation are not well understood. Some findings suggest that the improvement in balance confidence through an exercise intervention program is only weakly correlated with improved general physical function and not associated with improvements in postural stability [7]. Other findings, however, suggest that balance confidence plays a mediatory role in the effects of fear of falling on functional outcomes [6], and if the exercise program is aimed at the enhancement of balance confidence then the fear of falling is likely to be reduced [4]. Balance confidence and balance performance have been found to be significant predictors of fall status [3]. It is not, known however, if the relationship between balance confidence, balance performance and habitual physical activity, is different in fallers than in nonfallers. This study aimed to examine the relationship between balance performance, balance confidence and physical activity, which is reflected in the number of steps performed in everyday life, taking into account the fall history of elderly persons.