{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:09:40Z","timestamp":1767773380844,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute on Minority Health and Health Disparities of the National Institutes of Health","award":["R01MD018025","3R01MD018025-02S1"],"award-info":[{"award-number":["R01MD018025","3R01MD018025-02S1"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01MD018025","3R01MD018025-02S1"],"award-info":[{"award-number":["R01MD018025","3R01MD018025-02S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The Fall Risk Appraisal Matrix (FRAM) is a simple fall risk assessment tool that categorizes older adults into four separate groups based on their fear of falling (FOF) and static balance performance. Static balance for the FRAM is evaluated solely by postural sway distance, which does not account for other static balance parameters, such as sway area, anterior\u2013posterior (AP) sway range, medial\u2013lateral (ML) sway range, and sway velocity. The objective of this study was to compare these additional metrics across the FRAM groups to assess their relevance and validity for inclusion in static balance performance assessment. Hence, these measures were compared among the four different fall risk groups within the FRAM (203 participants; mean age = 75.0 \u00b1 7.2 years) using Kruskal\u2013Wallis test, followed by Dunn\u2019s post hoc tests with Bonferroni correction. All balance metrics were significantly greater in the Incongruent (poor balance\/low FOF) and Congruent (poor balance\/high FOF) groups than the Rational (good balance\/low FOF) group, as well as in the Congruent group than the Irrational (good balance\/high FOF) group (p &lt; 0.001). Additionally, AP sway range and sway velocity significantly differed between the Irrational and Incongruent groups (p &lt; 0.001). The results suggest that the inclusion of these additional static balance measures, in addition to sway distance, reveals specific tendencies in static balance among different fall risk groups, which can serve as a reference for other researchers and future studies to develop more individually tailored intervention programs based on their static balance specificities.<\/jats:p>","DOI":"10.3390\/ijerph22071079","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T02:53:07Z","timestamp":1751856787000},"page":"1079","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of Static Balance Metrics in Community-Dwelling Older Adults Categorized Using the Fall Risk Appraisal Matrix"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6549-6297","authenticated-orcid":false,"given":"Jethro Raphael M.","family":"Suarez","sequence":"first","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA"},{"name":"College of Nursing, University of Central Florida, Orlando, FL 32826, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon-Hyuk","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA"},{"name":"Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology, 333 Techno Jungang Daero, Hyeonpung-eup, Dahseong-gun, Daegu 42988, Republic of Korea"},{"name":"Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8506-5812","authenticated-orcid":false,"given":"Ladda","family":"Thiamwong","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Central Florida, Orlando, FL 32826, USA"},{"name":"Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"430","DOI":"10.3390\/nursrep11020041","article-title":"Fall risk assessment scales: A systematic literature review","volume":"11","author":"Strini","year":"2021","journal-title":"Nurs. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1016\/j.jamda.2020.09.038","article-title":"The short physical performance battery (SPPB): A quick and useful tool for fall risk stratification among older primary care patients","volume":"22","author":"Welch","year":"2021","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Said, C.M., Churilov, L., and Shaw, K. (2017). Validation and inter-rater reliability of a three item falls risk screening tool. BMC Geriatr., 17.","DOI":"10.1186\/s12877-017-0669-z"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The Timed \u201cUp & Go\u201d: A Test of Basic Functional Mobility for Frail Elderly Persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1136\/jech-2017-209769","article-title":"Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample","volume":"71","author":"Lohman","year":"2017","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3928\/00989134-20200302-01","article-title":"Assessing fall risk appraisal through combined physiological and perceived fall risk measures using innovative technology","volume":"46","author":"Thiamwong","year":"2020","journal-title":"J. Gerontol. Nurs."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1123\/mc.2017-0074","article-title":"Effects of foot placement on postural sway in the anteroposterior and mediolateral directions","volume":"23","author":"Gibbons","year":"2019","journal-title":"Motor Control"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.gaitpost.2015.07.057","article-title":"Balance characteristics in patients with major depression after a two-month walking exercise program: A pilot study","volume":"42","author":"Deschamps","year":"2015","journal-title":"Gait Posture"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"614","DOI":"10.3109\/00207454.2011.602807","article-title":"Postural sway in patients with mild to moderate parkinson\u2019s disease","volume":"121","author":"Stylianou","year":"2011","journal-title":"Int. J. Neurosci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.exger.2018.04.004","article-title":"Do depressive symptoms affect balance in older adults with mild cognitive impairment? Results from the \u201cgait and brain study\u201d","volume":"108","year":"2018","journal-title":"Exp. Gerontol."},{"key":"ref_11","first-page":"35","article-title":"Characteristics of postural sway in older adults standing on a soft surface","volume":"34","author":"Tanaka","year":"2005","journal-title":"J. Hum. Ergol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lo, P.Y., Su, B.L., You, Y.L., Yen, C.W., Wang, S.T., and Guo, L.Y. (2022). Measuring the reliability of postural sway measurements for a static standing task: The effect of age. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.850707"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Oliveira, M.R., Vieira, E.R., Gil, A.W.O., Fernandes, K.B.P., Teixeira, D.C., Amorim, C.F., and da Silva, R.A. (2018). One-legged stance sway of older adults with and without falls. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0203887"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1177\/1533317515602547","article-title":"Postural stability of elderly people with cognitive impairments","volume":"31","year":"2016","journal-title":"Am. J. Alzheimer\u2019s Dis. Other Dement."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1159\/000102938","article-title":"Postural sway during dual tasks in young and elderly adults","volume":"53","author":"Prado","year":"2007","journal-title":"Gerontology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"431","DOI":"10.3233\/JAD-132657","article-title":"Postural sway, falls, and cognitive status: A cross-sectional study among older adults","volume":"41","author":"Mignardot","year":"2014","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_17","first-page":"213","article-title":"Postural sway area of elderly subjects","volume":"3","author":"Rugelj","year":"2007","journal-title":"WSEAS Trans. Signal Process."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000089820","article-title":"Force platform measurements as predictors of falls among older people\u2014A review","volume":"52","author":"Piirtola","year":"2006","journal-title":"Gerontology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1080\/07317115.2021.1950254","article-title":"Maladaptive fall risk appraisal and falling in community-dwelling adults aged 60 and Older: Implications for screening","volume":"44","author":"Thiamwong","year":"2021","journal-title":"Clin. Gerontol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3928\/00989134-20230512-06","article-title":"Levels of accelerometer-based physical activity in older adults with a mismatch between physiological fall risk and fear of falling","volume":"49","author":"Thiamwong","year":"2023","journal-title":"J. Gerontol. Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"111250","DOI":"10.1016\/j.exger.2021.111250","article-title":"The effect of fear of falling on balance and dual task performance in the elderly","volume":"147","author":"Sapmaz","year":"2021","journal-title":"Exp. Gerontol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e51899","DOI":"10.2196\/51899","article-title":"Optimizing a technology-based body and mind intervention to prevent falls and reduce health disparities in low-income populations: Protocol for a clustered randomized controlled trial","volume":"12","author":"Thiamwong","year":"2023","journal-title":"JMIR Res. Protoc."},{"key":"ref_23","unstructured":"(2025, January 12). Historical Poverty Thresholds, Available online: https:\/\/www.census.gov\/data\/tables\/time-series\/demo\/income-poverty\/historical-poverty-thresholds.html."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_25","unstructured":"(2025, January 18). BTrackS Assess Balance: Some Common Applications and Use. Available online: https:\/\/balancetrackingsystems.com\/assess-balance."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"351","DOI":"10.2147\/CIA.S131047","article-title":"Combination of BTrackS and Geri-Fit as a targeted approach for assessing and reducing the postural sway of older adults with high fall risk","volume":"12","author":"Goble","year":"2017","journal-title":"Clin. Interv. Aging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1519\/JPT.0000000000000111","article-title":"Validity and reliability of a portable Balance Tracking System, BTrackS, in older adults","volume":"41","author":"Levy","year":"2018","journal-title":"J. Geriatr. Phys. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/ageing\/afm157","article-title":"The Short FES-I: A shortened version of the falls efficacy scale-international to assess fear of falling","volume":"37","author":"Kempen","year":"2008","journal-title":"Age Ageing"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"ooae088","DOI":"10.1093\/jamiaopen\/ooae088","article-title":"Recreating Fall Risk Appraisal matrix using R to support fall prevention programs","volume":"7","author":"Suarez","year":"2024","journal-title":"JAMIA Open"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1007\/s00198-021-06047-6","article-title":"\u201cFear of falling serves as protection and signifies potential danger\u201d: A qualitative study to conceptualise the phrase \u201cfear of falling\u201d in women with osteoporosis","volume":"32","author":"Hamed","year":"2021","journal-title":"Osteoporos. Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1017\/S0959259803001023","article-title":"Fear of falling: Links between imbalance and anxiety","volume":"13","author":"Yardley","year":"2004","journal-title":"Rev. Clin. Gerontol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/j.1471-6712.2011.00901.x","article-title":"Fear of falling from a daily life perspective; Narratives from later life","volume":"26","author":"Mahler","year":"2012","journal-title":"Scand. J. Caring Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"afac067","DOI":"10.1093\/ageing\/afac067","article-title":"Protective or harmful? A qualitative exploration of older people\u2019s perceptions of worries about falling","volume":"51","author":"Ellmers","year":"2022","journal-title":"Age Ageing"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/j.1469-8986.2005.00287.x","article-title":"A freezing-like posture to pictures of mutilation","volume":"42","author":"Azevedo","year":"2005","journal-title":"Psychophysiology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1007\/s002210100681","article-title":"The influence of postural threat on the control of upright stance","volume":"138","author":"Carpenter","year":"2001","journal-title":"Exp. Brain Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1007\/s00221-001-0974-8","article-title":"Fear of falling modifies anticipatory postural control","volume":"143","author":"Adkin","year":"2002","journal-title":"Exp. Brain Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1080\/03610730303711","article-title":"Balance, muscle strength, and fear of falling in older adults","volume":"29","author":"Binda","year":"2003","journal-title":"Exp. Aging Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.gaitpost.2008.09.006","article-title":"The relationship between fear of falling and human postural control","volume":"29","author":"Davis","year":"2009","journal-title":"Gait Posture"},{"key":"ref_39","first-page":"566","article-title":"Clinical assessment of postural stability","volume":"14","author":"Weber","year":"1993","journal-title":"Am. J. Otol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/7\/1079\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:05:22Z","timestamp":1760033122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/7\/1079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,6]]},"references-count":39,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["ijerph22071079"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22071079","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2025,7,6]]}}}