Using postural sway data for falls risk mitigation

Three distinct clusters have now emerged from Balance Mat testing: low, medium and high.

I moved into my new workspace at Hastings Medical Centre in October 2024. Since then the practice nurses like Sarah King (pictured with a patient – image used by permission) and yours truly – Ian Bergman – have used the Balance Mat to measure the postural sway of 110 of the Centre’s patients.

Postural sway measurements are important because a high degree of postural sway can indicate reduced balance and an increased risk of falls (see Postural sway: Symptoms, what affects it, and how to improve it, MedicalNewsToday.com).

Every year, approximately 30% of Australians older than 65 years fall, with 10% of these falls leading to injury (see Preventing Harm from Falls in Older People, Australian Commission on Safety and Quality in Health Care).

The good news is that falls risk can now be mitigated with a simple sequence of two 20-second tests on the Balance Mat, combined with medical or allied health intervention as appropriate – what we at Balance Metrix describe as “nuanced healthcare.”

Balance Mat tests only take a minute!

Twenty seconds to enter patient biodata, 20 seconds in the normal stance and 20 seconds in the semi-tandem stance, then save and upload data (or “use test”). Only 60 seconds and your test is done. It’s as simple, quick and easy as that!

The Multimetric Balance Mat measures postural sway in two stances: normal and semi-tandem. During my testing at Wauchope I have found the results from these two tests are sufficient to identify people at low, medium and high falls risk, based on their postural sway readings.

Most people in good health of all ages have low postural sway in the normal and semi-tandem stances. For example, one 81-year-old woman who scored zero in both stances told me she’d always been fit and healthy.

People who are unsteady in the semi-tandem test can be said to have a balance problem. It is simply a matter of degree – do they have medium or high postural sway? There are different healthcare strategies in each case.

In the case of diabetes it is most common to have high postural sway in the normal stance and low postural sway in the semi-tandem – i.e. the opposite of most people. Time will tell whether this type of reading can be predictive of diabetes.

The variations demonstrate why we need to do at least two tests. The other tests available are the tandem, left foot and right foot. Many frail or unwell people are not able to stand in these positions.

We have found in more than 1,000 balance tests that the normal and semi-tandem tests provide enough information to arrive at an aggregate assessment of a person’s postural sway or falls risk.

Normal stance results

The normal stance results in the chart above show the Balance Mat ratings (from lowest to highest) of 110 people at Hastings Medical Centre Wauchope, tested from October 2024 to January 2025. The traffic-light colours show the low, medium and high postural sway (and therefore falls risk) groupings. Every blue dot represents a person.

The Balance Mat test results scale is as follows: Low: Zero to 0.30; Medium: 0.31 to 1.00; and High: 1.01 or above.

Individual patient records – especially those in the medium and high categories – can be sent to the allied health or medical professional for follow-up as well as to the patient.

Semi-tandem stance results

The semi-tandem results in this second chart show a similar pattern of Balance Mat ratings (once again from lowest to highest) of the 110 people at Wauchope. However, you will notice that the scores are higher for people in the medium (amber) and high (red) categories than in the normal stance. For example, the highest score in the normal stance is 1.7 and the highest score in the semi-tandem stance is 3.0. That is because the semi-tandem stance narrows the base of support, causing greater postural sway.

Data that is recordable, repeatable and reportable at your fingertips!

Postural sway can be invisible to the eye. The Balance Mat records all the patient’s movements on the mat, including those tiny gravity-defying ones a person makes to remain standing. The technology is vastly more sensitive than observation alone, or observation combined with a stop watch. As mentioned above, it actually measures postural sway in a 20-second test for each of two stances, giving you a graph and score for each patient that together help you arrive at an aggregate falls risk analysis.

The beauty of the Balance Mat is that these postural sway tests are recordable, repeatable and reportable. You can easily and quickly use Balance Mat technology to:

• See if the patient has a balance problem
• Use the data to help you decide on an appropriate treatment
• Repeat the test to see if the treatment is working.

For those people with low postural sway (or low falls risk) you can repeat the test annually as part of a regular health checkup.

For those who have medium postural sway (or medium falls risk) we know they’re at risk of slipping into the high falls risk category. To mitigate their current risk you can prescribe some exercise therapy with your own allied health partner if you have one or a Balance Metrix allied health partner.

For those people with high postural sway (or high falls risk) you can refer them to a specialist or allied health practitioner if it’s a neurological condition. For example, if it’s a sarcopenia-related condition (i.e. weakened muscles due to ageing) you can refer the patient to an allied health practitioner.

Finally, if it’s a condition like diabetes where you have prescribed medicine you can check their postural sway against their baseline measurement as the treatment progresses to see if there’s an improvement. Alternatively, you can prescribe a course of exercise therapy with an exercise physiologist or physiotherapist who focuses on exercise. Once again, we can help you with that.

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