Aging Clinical and Experimental Research

, Volume 29, Issue 5, pp 1021–1030 | Cite as

Standing balance and strength measurements in older adults living in residential care communities

  • Bader A. Alqahtani
  • Mary Ann Ferchak
  • Theodore J. Huppert
  • Ervin Sejdic
  • Subashan Perera
  • Susan L. Greenspan
  • Patrick J. Sparto
Original Article


Research on balance and mobility in older adults has been conducted primarily in lab-based settings in individuals who live in the community. Although they are at greater risk of falls, residents of long-term care facilities, specifically residential care communities (RCCs), have been investigated much less frequently. We sought to determine the feasibility of using portable technology-based measures of balance and muscle strength (i.e., an accelerometer and a load cell) that can be used in any RCC facility. Twenty-nine subjects (age 87 ± 6 years) living in RCCs participated. An accelerometer placed on the back of the subjects measured body sway during different standing conditions. Sway in antero-posterior and mediolateral directions was calculated. Lower extremity strength was measured with a portable load cell and the within-visit reliability was determined. Assessments of grip strength, gait speed, frailty, and comorbidity were also examined. A significant increase in postural sway in both the AP and ML directions occurred as the balance conditions became more difficult due to alteration of sensory feedback (p < 0.001) or reducing the base of support (p < 0.001). There was an association between increased sway and increased frailty, more comorbidities and slower gait speed. All strength measurements were highly reliable (ICC = 0.93–0.99). An increase in lower extremity strength was associated with increased grip strength and gait speed. The portable instruments provide inexpensive ways for measuring balance and strength in the understudied RCC population, but additional studies are needed to examine their relationship with functional outcomes.


Long-term care Residential care communities Accelerometer Standing balance Muscle strength 



This study was supported by funds from the National Institutes of Health, National Institute on Aging (NIH R01AG028086), and by University of Pittsburgh Older Americans Independence Center (NIH P30 AG024827). We thank staff and participants of the following sites from which data has been collected: Asbury Heights site, Seneca Hills Village, and Cumberland Woods Village.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board (IRB) of the University of Pittsburgh.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Bader A. Alqahtani
    • 1
  • Mary Ann Ferchak
    • 2
  • Theodore J. Huppert
    • 3
  • Ervin Sejdic
    • 4
  • Subashan Perera
    • 2
  • Susan L. Greenspan
    • 2
  • Patrick J. Sparto
    • 1
  1. 1.Department of Physical Therapy, 433 Eye and Ear InstituteUniversity of PittsburghPittsburghUSA
  2. 2.Department of MedicineUniversity of PittsburghPittsburghUSA
  3. 3.Department of RadiologyUniversity of PittsburghPittsburghUSA
  4. 4.Department of Electrical and Computer EngineeringUniversity of PittsburghPittsburghUSA

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