Author(s): GUO, L., LIN, P., HSU, M., Institution: KAOHSIUNG MEDICAL UNIVERSITY, Country: TAIWAN, Abstract-ID: 627

INTRODUCTION:
Falls are a major public health concern in the aging population. Although fall research has largely emphasized lower-limb function and gait, the contribution of cervical function to postural control remains underexplored. Age-related declines in cervical mobility, posture, and proprioception may disrupt sensorimotor integration and postural regulation. This study investigated the relationships among cervical function, oculomotor mechanisms, and balance, and developed a cervical-centered model for fall risk classification.
METHODS:
Sixty community-dwelling older adults (65–85 years) were classified as fallers (n = 21) or non-fallers (n = 39) based on fall history in the previous three months. Fall-related concern was assessed using the Falls Efficacy Scale–International. Cervical kinematic and sensorimotor characteristics (range of motion, joint position error, deep neck flexor endurance, and forward head posture) and pain intensity were assessed.
postural stability was assessed using a force plate during quiet standing with and without a concurrent saccadic task, along with dynamic balance and lower-limb function. Group and task effects were analyzed using independent t-tests and two-way repeated-measures ANOVA. Variables significant in univariate analyses (p < 0.05) were entered into a logistic regression model to identify independent fall risk factors.
RESULTS:
Fallers reported significantly greater neck pain and higher FES-I scores than non-fallers (p < 0.001). They also demonstrated significantly larger neck flexion joint position error (p = 0.035). Although the saccadic task reduced COP sway in both groups, fallers showed a significantly greater reduction in mean velocity and total displacement, indicating a significant group-by-task interaction (p < 0.01). The remaining variables showed no statistically significant differences between the two groups. Multivariable logistic regression identified neck pain(OR = 1.584, 95% CI [1.09,2.30], p = 0.015) and neck flexion JPE(OR = 1.505, 95% CI [1.02,2.23], p = 0.040) as independent predictors of falls, explaining 50.3% of fall-risk variance (Nagelkerke R²).
CONCLUSION:
Cervical pain and impaired proprioception, particularly increased joint position error during flexion, were significantly associated with fall risk in community-dwelling older adults. Differences in postural responses under visual challenge suggest altered sensorimotor control strategies. Cervical sensorimotor integration may be considered a potential target for fall-risk assessment and intervention.