Revisiting the Instrumented Romberg Test: Can Today’s Technology Offer a Risk-of-Fall Screening Device for Senior Citizens? An Experience-Based Approach

Risk of fall (ROF) is a worldwide major concern for its prevalence and consequent dramatic
outcomes in the elderly population. The growing age-related risk appears to be associated
with increasing motor, sensory, and cognitive problems in the elderly population. There is a consensus
on the need to screen for these balance dysfunctions, but the available methods are largely
based on subjectively assessed performances. The instrumented Romberg test using a force plate
represents a validated assessment process for the evaluation of balance performances. The purpose
of this study is to propose an innovative instrumental method to identify balance deficits, assess
their severity, and give an automated indication of the most likely etiology. The proposed new
method was applied to the instrumented Romberg test, using force plate data recorded in a cohort
of 551 females aged >65 participating in adapted physical activity courses. The method allowed us
to identify 145 dysfunctional subjects and to determine the likely origin of their deficit: 21 central, 5
vestibular, 9 visual, 59 proprioceptive (musculoskeletal etiology), and 51 functional. Based on the
preliminary findings of the study, this test could be an efficient and cost-effective mass screening
tool for identifying subjects at risk of fall, since the procedure proves to be rapid, non-invasive, and
apparently devoid of any contraindications.