The association between task-specific lumbopelvic motor-control performance assessed using pressure biofeedback and postural control in older adults considering physical, psychological, and behavioral factors: a cross-sectional study

The trunk is a central body segment links the upper and lower extremities and may be relevant to postural control. However, the potential association between clinically assessed task-specific lumbopelvic motor-control performance assessed using pressure biofeedback unit (PBU) and postural control remains unclear, particularly when relevant physical, psychological, and behavioral are considered. The study aimed to determine this association in older adults while accounting for emotional state, physical activity, fear of falling, and general health status. This cross-sectional study included 76 participants aged ≥ 65 years. Lumbopelvic motor-control performance was measured using a PBU during posterior pelvic tilt (PPT), abdominal drawing-in maneuver (ADIM), and trunk extension maneuver (TEM). The Berg Balance Scale (BBS), Functional Reach Test (FRT), and Timed Up and Go test (TUG) were used to assess balance. Individual factors were evaluated using the Tinetti Fall Efficacy Scale (FES), the International Physical Activity Questionnaire (IPAQ), the Hospital Anxiety and Depression Scale (HADS), and the Short Form-12 (SF-12). Participants were classified as being at low and high risk according to the BBS, FRT and TUG cutoff values. Correlation and exploratory linear regression analyses were performed to assess the associations between motor-control and balance performance. 30.2%, 23.6%, and 53.9% of participants were classified as being at high risk according to the TUG, BBS, and FRT cutoffs, respectively. TEM performance was consistently lower in all high-risk groups ( p = 0.001 to p < 0.001), and PPT performance was reduced in the TUG and BBS high-risk groups ( p = 0.03–0.002). Both TEM and PPT performance were significantly correlated with all balance measures ( p = 0.004 to p = 0.015), whereas ADIM performance showed no significant associations. In multivariable analyses, TEM and PPT performance remained significantly associated with balance outcomes ( p = 0.01 to p < 0.001). High-risk groups also had lower IPAQ and FES scores, while HADS-D was higher only in the TUG high-risk group. IPAQ was independently associated with FRT scores (β = 0.40, p < 0.001). Participants classified as being at high risk according to fall-risk screening instrument cutoffs demonstrated poorer TEM and PPT performance, lower physical activity levels, and greater fear of falling. This pattern of findings highlights the potential relevance of lumbopelvic motor control performance and physical, psychological, and behavioral factors in fall risk assessment.