Proprioception: The strongest predictor to falls in older females – A cross-sectional study

Abstract

Background

Falls are a leading cause of injury, loss of independence, and premature mortality among older adults, and they place a substantial burden on individuals, caregivers, and healthcare systems.

Objective

This cross-sectional study aimed to determine the contribution of vibration and proprioception sense, isometric muscle strength, static balance, reaction time and postural stability to falls in females aged 65 and over.

Methods

In this cross-sectional study, 92 females (aged ≥65 years) were evaluated for vibration sense, proprioception, isometric muscle strength, static balance, reaction time, and postural stability. The number of falls within the past year was recorded. Statistical analyses were performed using IBM SPSS v27.0, with non-normally distributed variables compared using the Mann–Whitney U test and independent contributors to falls identified by multiple linear regression with backward stepwise elimination.

Results

Fallers demonstrated reduced vibration sense, larger ankle joint reposition errors, weaker dorsiflexor and plantarflexor strength, and slower dorsiflexion and plantarflexion reaction times (all p < 0.001); no group differences were seen for invertor/evertor strength, static balance duration, or postural sway (p > 0.05). In multivariable regression, greater plantarflexion joint reposition error (β = 0.454, p < 0.001), poorer vibration sense (β = −0.214, p = 0.005), reduced plantarflexor strength (β = -0.149, p = 0.040) and longer plantarflexion reaction time (β = 0.232, p = 0.003) independently predicted number of falls (VIF < 2.2).

Conclusion

Impaired vibration sense, greater plantar flexion proprioceptive error, reduced plantar flexor strength, and slower plantarflexion reaction time were independently associated with more falls. Targeted interventions to enhance proprioceptive function, muscle strength, and neuromuscular response may be essential for fall prevention and promoting safer, more independent aging.