The influence of the forward head posture on balance, fall self-efficacy, and physical activity level in community-dwelling women age 60 and older; and the relationship of these variables to self-reported fall history

Scope and method of study. This research assessed: (a) the relationships among risk factors for falling in a healthy population of women 60 years and older, and (b) the predictive potential of these risk factors for falling in this population. Subjects were recruited from a variety of women's groups, and public and private organizations. Recruitment efforts yielded 112 women volunteers ranging in age from 60 to 95 years. Individual subject ages were well-distributed throughout the age variable of the study. The subjects completed two surveys, a balance stability test, and a fall history interview. The forward head position was assessed via analysis of a profile photograph taken during the balance test. Data analysis included descriptive indices, multi-factor ANOVA, and hierarchical multiple regression analysis.; Findings and conclusions. The forward head posture was significantly inversely correlated to the balance score; i.e., a more severe forward head posture was associated with diminished balance stability. This relationship statistically supported the underlying premise of the present study which postulated that the forward head posture places the head near or outside the limits of the balance stability envelope, and would adversely influence an elderly individual's balance capability. This inverse correlation was also found between the forward head posture and the variables of balance confidence and activity level. Only balance confidence and physical activity levels were related to fall history. Subjects' high activity levels may have contributed to high balance scores, subsequently influencing the relationship between balance and positive fall history. The conclusions were: (a) this study provided a first tier of evidence to support the incorporation of postural exercises for head position in balance training programs, (b) the findings also supported the potential protective effect of high activity levels on balance stability and fall self-efficacy, and (c) the findings provided further justification for health care professionals to conduct ongoing assessments of the needs and characteristics of the elder populations they serve.