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Effect of a Single Dose of Diazepam on Balance Measures in Older People
Author(s) -
Cutson Toni M.,
Gray Shelly L.,
Hughes Michael A.,
Carson Stanley W.,
Hanlon Joseph T.
Publication year - 1997
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1997.tb05167.x
Subject(s) - medicine , diazepam , physical medicine and rehabilitation , placebo , electromyography , balance (ability) , posturography , anesthesia , physical therapy , alternative medicine , pathology
OBJECTIVE: This study examines the effect of a single dose of diazepam on a spectrum of balance measures in healthy older subjects. The measures include static (postural sway), dynamic (anterior tibialis muscle activation latency), and a complex self‐initiated task of balance (functional reach) in addition to neuropsychological tests of attention. DESIGN: A double‐blind, two‐period, cross‐over trial. SETTING: The community surrounding a university hospital. PARTICIPANTS: Community‐dwelling, nonsmoking volunteers 65 years of age and older MEASUREMENTS: Measures included response to unexpected perturbation (platform/EMG muscle latency), self‐initiated perturbation (functional reach), and a static measure of balance (postural sway). Neurocognitive tests (digital symbol substitution test, card sorting) were included to document the cognitive effect. RESULTS: Twelve nonsmoking healthy subjects (average age = 70.4 years (66–76 years)) participated. The anterior tibialis muscle latency increased in response to a sudden perturbation with diazepam compared with placebo (TA latency 149 ms vs 142 ms, P < .001). Neurocognitive tests were adversely affected for 90 minutes after diazepam administration compared with placebo ( P < .05). Other measures did not demonstrate significant effect of diazepam. CONCLUSIONS: This is among the first reports showing that benzodiazepines affect neuromuscular processing related to balance control. Increased muscle latency to sudden perturbations may represent an effect of diazepam upon the oligosynaptic spinal reflex distinct from the sedation. Surface electromyography may be a valuable noninvasive tool for future studies of drug effect on balance and falls risk among older people.