The Effect of Balance Confidence and Context on Functional Reach Ability in Healthy Older Adults

ObjectiveTo assess functional reach (FR) ability in 4 contexts in older adults (≥ 60 years) with high balance confidence (HBC) and low balance confidence (LBC).DesignA repeated-measures design was used to compare 2 groups in 4 reaching contexts.SettingCommunity setting.SubjectsTwenty-four healthy older adults with HBC and 27 healthy older adults with LBC.MethodsFR distance was assessed in 4 contexts presented in random order: (1) traditional FR (TFR); (2) functional reach on foam (FRF); (3) object present functional reach (OPFR); and (4) object present functional reach on foam (OPFRF). For TFR and FRF, 3 trials were performed for each task, and the average reach distance across 3 trials was calculated. During the OPFR and OPFRF contexts, the object was moved toward or away from the participant in 1.3-cm increments until maximal reach distance to the object was obtained.Main Outcome MeasureMaximal reach distance in each of the 4 FR contexts.ResultsParticipants in the HBC group scored significantly higher than did participants in the LBC group regardless of reaching contexts (P =.004). For both balance confidence groups, reaching distance increased significantly from FRF to TFR to OPFRF to OPFR (P < .001).ConclusionThe results of this study highlight the beneficial effect of an external target on balance performance, even with the added challenge of an unstable surface. These findings suggest that although balance performance is greater for persons with HBC, the same pattern of reaching ability in differing FR contexts is found regardless of whether balance confidence is high or low. The clinical utility of these findings pertain to the importance of the use of task objects during FR balance assessment to determine an individual's balance capacity. Future research is needed to assess the effectiveness of context-oriented reaching tasks in balance training programs.