The relationship between movement reinvestment, balance confidence, and clinical balance performance in older adults

Abstract

Movement reinvestment is a personality trait that may confound clinical balance performance. It is assessed using the Movement Specific Reinvestment Scale (MSRS) which has a conscious motor processing (CMP) subscale (tendency to consciously attend to and control movement) and a movement self-consciousness (MSC) subscale (tendency to be self-conscious about movement). The thesis objectives were to 1) explore relationships between movement reinvestment, balance confidence, and clinical balance outcomes, and 2) determine whether movement reinvestment explained variation in clinical balance performance over and above that of other established predictors of balance like age and balance confidence. Two hundred and forty-three older adults living independently in the community (173 females, mean (SD) age = 66.79 (7.31) years) completed the MSRS, Activities-Specific Balance Confidence (ABC) scale, and three trials (best trial taken) of a single leg stance (SLS) test (duration), timed-up-and-go (TUG) test (duration), functional reach (FR) test (distance), and obstacle course (OC) test (duration + error). First, bivariate correlations were conducted among all measures. Next, four separate hierarchical linear regressions were performed to predict clinical balance outcomes. In all regressions, age, sex, fall status, health status, and balance confidence were entered simultaneously on the first step, followed by CMP and MSC together on the second step. The results showed that higher CMP and MSC were associated with lower balance confidence. Higher MSC was associated with poorer clinical balance performance including shorter SLS durations, longer TUG durations, and higher OC scores. CMP was unrelated to clinical balance outcomes. Age and balance confidence were significant predictors of clinical balance outcomes. However, only the final regression model predicting OC score showed significant change from the initial model (R2 change of .018). MSC and not CMP was significantly positively related to OC score on the final step, after controlling for demographic variables and balance confidence. The results provide novel evidence of a relationship between greater self consciousness concerning movement style and poorer clinical balance outcomes in community-living adults over the age of 55 years of age. MSC can provide added insight into performance on a challenging obstacle course over and above that of other commonly used predictors including age, sex, fall status, health status and balance confidence. The results suggest that trait movement reinvestment and specifically MSC may be important to consider in clinical balance assessment protocols especially for complex adaptive gait tasks.