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Hung YJ, Couverette F, Hamon J, Willard D. Acute and Acclimated Effects of Wearing Compression Garments on Balance Control in Community-Dwelling Older Adults. Motor Control 2024; 28:326-340. [PMID: 38580304 DOI: 10.1123/mc.2023-0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/08/2024] [Accepted: 02/26/2024] [Indexed: 04/07/2024]
Abstract
Falls are very serious health concerns among older adults. Providing additional cutaneous and proprioceptive feedback to older adults may enhance their balance control and therefore reduce the incidents of falls. This study aimed to investigate the acute and acclimated effect of wearing waist-to-above-ankle compression garments (CGs) on balance control in community-dwelling older adults. Thirty-one older adults participated in the study. The Timed Up and Go, Berg Balance Scale, and the Fall Risk Test of the Biodex Balance System were used in a random order to examine balance control in three testing sessions 1 week apart. Results indicated wearing CGs had a significant impact on the Timed Up and Go test (p < .001), Berg Balance Scale (p = .001), and the Fall Risk Test (p = .001). For the Timed Up and Go test, participants exhibited significant improvement in both the acute (8.68 vs. 7.91 s) and acclimated effect (7.91 vs. 7.41 s) of wearing CGs. For the Berg Balance Scale, participants showed significant improvement after wearing CGs for 1 week in comparison to the no CGs condition (55.77 vs. 55.39 points). For the Fall Risk Test, participants showed a significant improvement in the acute effect of wearing CGs in comparison to the no CGs condition (1.55° vs. 1.31°). This exploratory study showed that wearing waist-to-above-ankle CGs provided a positive impact on balance control in healthy community-dwelling older adults. It lays the foundation for future studies with a larger sample size to investigate the potential benefits of wearing CGs in individuals with balance control deficits and/or other comorbidities.
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Affiliation(s)
- You-Jou Hung
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | | | - Jeffrey Hamon
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - Dustyn Willard
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
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Alshehri MA, Alzahrani H, van den Hoorn W, Klyne DM, Vette AH, Hendershot BD, Roberts BWR, Larivière C, Barbado D, Vera-Garcia FJ, van Dieen JH, Cholewicki J, Nussbaum MA, Madigan ML, Reeves NP, Silfies SP, Brown SHM, Hodges PW. Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis. PLoS One 2024; 19:e0296968. [PMID: 38265999 PMCID: PMC10807788 DOI: 10.1371/journal.pone.0296968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Sitting on an unstable surface is a common paradigm to investigate trunk postural control among individuals with low back pain (LBP), by minimizing the influence lower extremities on balance control. Outcomes of many small studies are inconsistent (e.g., some find differences between groups while others do not), potentially due to confounding factors such as age, sex, body mass index [BMI], or clinical presentations. We conducted a systematic review with an individual participant data (IPD) meta-analysis to investigate whether trunk postural control differs between those with and without LBP, and whether the difference between groups is impacted by vision and potential confounding factors. METHODS We completed this review according to PRISMA-IPD guidelines. The literature was screened (up to 7th September 2023) from five electronic databases: MEDLINE, CINAHL, Embase, Scopus, and Web of Science Core Collection. Outcome measures were extracted that describe unstable seat movements, specifically centre of pressure or seat angle. Our main analyses included: 1) a two-stage IPD meta-analysis to assess the difference between groups and their interaction with age, sex, BMI, and vision on trunk postural control; 2) and a two-stage IPD meta-regression to determine the effects of LBP clinical features (pain intensity, disability, pain catastrophizing, and fear-avoidance beliefs) on trunk postural control. RESULTS Forty studies (1,821 participants) were included for the descriptive analysis and 24 studies (1,050 participants) were included for the IPD analysis. IPD meta-analyses revealed three main findings: (a) trunk postural control was worse (higher root mean square displacement [RMSdispl], range, and long-term diffusion; lower mean power frequency) among individuals with than without LBP; (b) trunk postural control deteriorated more (higher RMSdispl, short- and long-term diffusion) among individuals with than without LBP when vision was removed; and (c) older age and higher BMI had greater adverse impacts on trunk postural control (higher short-term diffusion; longer time and distance coordinates of the critical point) among individuals with than without LBP. IPD meta-regressions indicated no associations between the limited LBP clinical features that could be considered and trunk postural control. CONCLUSION Trunk postural control appears to be inferior among individuals with LBP, which was indicated by increased seat movements and some evidence of trunk stiffening. These findings are likely explained by delayed or less accurate corrective responses. SYSTEMATIC REVIEW REGISTRATION This review has been registered in PROSPERO (registration number: CRD42021124658).
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Affiliation(s)
- Mansour Abdullah Alshehri
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Wolbert van den Hoorn
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Albert H. Vette
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Canada
| | - Brad D. Hendershot
- Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, United States of America
| | - Brad W. R. Roberts
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada
| | - David Barbado
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Francisco J. Vera-Garcia
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Jaap H. van Dieen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jacek Cholewicki
- Center for Neuromusculoskeletal Clinical Research, Michigan State University, Lansing, Michigan, United States of America
- Department of Osteopathic Manipulative Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Maury A. Nussbaum
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | - Michael L. Madigan
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | | | - Sheri P. Silfies
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States of America
| | - Stephen H. M. Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Tang Y, Liang P, Pan J, Zhang C, Ren H, Cheng S, Kong PW. Effects of Ankle Orthoses, Taping, and Insoles on Postural Stability of Individuals with Chronic Ankle Instability: A Systematic Review. Healthcare (Basel) 2023; 11:2570. [PMID: 37761767 PMCID: PMC10530830 DOI: 10.3390/healthcare11182570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Chronic ankle instability (CAI) is a prevalent condition characterized by recurring instances of the ankle giving way and persistent symptoms, including pain and diminished function. Foot and ankle external supports are commonly used in clinical practice and research for treating CAI. This systematic review aimed to assess the effects of foot and ankle external supports on the postural stability of individuals with CAI to guide clinical practice and inform future research. A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Google Scholar databases from 1 January 2012 to 1 November 2022. Eighteen studies involving individuals with CAI were chosen in this systematic review. The quality of the included studies and risk of bias were assessed using Cochrane Collaboration's tool for randomized controlled trials, the Newcastle-Ottawa Scale for case-control studies, and the DELPHl-list for crossover trial studies. The external supports included in this review were ankle orthoses (elastic, semi-rigid, and active orthoses), taping (kinesiotaping and fibular reposition taping), and insoles (textured and supportive insoles). The outcome measures included static and dynamic postural stability tests, such as the single-leg stance test, star excursion balance test, Y-balance test, single-leg landing test, lateral jump test, walking test, and running test. The results showed that elastic orthoses, Kinesiotaping, and textured insoles demonstrated potential benefits in improving postural stability in individuals with CAI. Elastic orthoses decreased ankle joint motion variability, kinesiotaping facilitated cutaneous receptors and proprioceptive feedback, while textured insoles increased tactile stimulation and foot position awareness. However, the effects of semi-rigid orthoses, fibular reposition taping, and arch support insoles were inconsistent across studies. Future research should explore the long-term effects of these external supports, analyze the effects of different characteristics and combinations of supports, and employ standardized outcome measures and testing protocols for assessing postural stability.
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Affiliation(s)
- Yunqi Tang
- College of Art and Design, Shaanxi University of Science and Technology, Xi’an 710021, China; (Y.T.); (P.L.); (H.R.); (S.C.)
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore;
| | - Peiyao Liang
- College of Art and Design, Shaanxi University of Science and Technology, Xi’an 710021, China; (Y.T.); (P.L.); (H.R.); (S.C.)
| | - Jingwen Pan
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore;
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore 308232, Singapore
| | - Cui Zhang
- Sport Biomechanics Laboratory, Shandong Institute of Sports Science, Jinan 250014, China;
- Graduate School, Shandong Physical Education University, Jinan 250014, China
| | - Hui Ren
- College of Art and Design, Shaanxi University of Science and Technology, Xi’an 710021, China; (Y.T.); (P.L.); (H.R.); (S.C.)
| | - Shizhe Cheng
- College of Art and Design, Shaanxi University of Science and Technology, Xi’an 710021, China; (Y.T.); (P.L.); (H.R.); (S.C.)
| | - Pui Wah Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore;
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Zhang G, Chen TLW, Wang Y, Tan Q, Hong TTH, Peng Y, Chen SF, Zhang M. Effects of prolonged brisk walking induced lower limb muscle fatigue on the changes of gait parameters in older adults. Gait Posture 2023; 101:145-153. [PMID: 36841121 DOI: 10.1016/j.gaitpost.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 01/20/2023] [Accepted: 02/14/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Lower extremity muscle fatigue affects gait stability and increases the probability of injuries in the elderly. RESEARCH QUESTION How does prolonged walking-induced fatigue affect lower limb muscle activity, plantar pressure distribution, and tripping risk? METHODS Eighteen elderly adults walked fast on a treadmill for 60 minutes at a fixed speed. The plantar pressure was measured with an in-shoe monitoring system, eight lower limb muscles were monitored using surface electromyography, and foot movements were tracked by a motion capture analysis system. The above data and participants' subjective fatigue level feedback were collected every 5 minutes. Statistical analysis used the Friedman one-way repeated measures analysis of variance by ranks test followed by Wilcoxon signed-ranks test with Benjamini-Hochberg stepwise correction. RESULTS The subjective reported fatigue on the Borg scale increased gradually from 1 to 6 (p = 0.001) during the 60 minutes, while the EMG amplitude of vastus medialis significant decreased (p = 0.013). The results of plantar pressure demonstrated that the distribution of load and impulse shifted medially in both the heel and arch regions while shifted laterally in both the toes and metatarsal regions. The significantly increased contact area supports this shift at the medial arch (p = 0.036, increased by 6.94%, the 60th minute vs. the baseline). The symmetry of medial-lateral plantar force increased at the toes, metatarsal, and arch regions. The significantly increased parameters also include the swing time and contact time. The minimum foot clearance was reduced, increasing tripping probability, not significantly, though. SIGNIFICANCE This study facilitates a better understanding of changes in lower limb muscle activity and gait parameters during prolonged fast walking. Besides, this study has good guiding significance for developing smart devices based on plantar force, inertial measurement units, and EMG sensors to monitor changes in muscle activation in real-time and prevent tripping.
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Affiliation(s)
- Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region; Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region
| | - Tommy Tung-Ho Hong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region
| | - Shane Fei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region; Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China.
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Xuan C, Zhang B, Jia X. The Effect of Human Settlement Pedestrian Environment on Gait of Older People: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1567. [PMID: 36674319 PMCID: PMC9865741 DOI: 10.3390/ijerph20021567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Older people are limited by the pedestrian environment in human settlements and are prone to travel difficulties, falls, and stumbles. Furthermore, we still lack systematic knowledge of the pedestrian environment affecting the gait of older people. The purpose of this review is to synthesize current evidence of effective human settlement pedestrian environments interfering with gait in older people. The systematic effects of the human settlement pedestrian environment on gait in older people are discussed. Databases such as Web of Science, Medline (via PubMed), Scopus, and Embase were searched for relevant studies up to June 2022. The literature was screened to extract relevant evidence from the included literature, assess the quality of the evidence, and analyze the systematic effects of the pedestrian environment on gait in older people. From the 4297 studies identified in the initial search, 11 systematic reviews or meta-analysis studies were screened, from which 18 environmental factors and 60 gait changes were extracted. After removing duplicate elements and merging synonymous features, a total of 53 relationships between environmental factors and gait change in older people were extracted: the main human settlement pedestrian environmental factors affecting gait change in older people in existing studies were indoor and outdoor stairs/steps, uneven and irregular ground, obstacles, walking path turns, vibration interventions, mechanical perturbation during gait, and auditory sound cues. Under the influence of these factors, older people may experience changes in the degree of cautiousness and conservatism of gait and stability, and their body posture performance and control, and muscle activation may also be affected. Factors such as ground texture or material, mechanical perturbations during gait, and vibration interventions stimulate older people's understanding and perception of their environment, but there is controversy over the results of specific gait parameters. The results support that human settlements' pedestrian environment affects the gait changes of older people in a positive or negative way. This review may likely contribute evidence-based information to aid communication among practitioners in public health, healthcare, and environmental construction. The above findings are expected to provide useful preference for associated interdisciplinary researchers to understand the interactions among pedestrian environments, human behavior, and physiological characteristics.
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Affiliation(s)
- Changzheng Xuan
- Architecture College, Inner Mongolia University of Technology (IMUT), Hohhot 010051, China
- Inner Mongolia Key Laboratory of Green Building, Hohhot 010051, China
| | - Bo Zhang
- Architecture College, Inner Mongolia University of Technology (IMUT), Hohhot 010051, China
- Inner Mongolia Key Laboratory of Green Building, Hohhot 010051, China
| | - Xiaohu Jia
- Architecture College, Inner Mongolia University of Technology (IMUT), Hohhot 010051, China
- Inner Mongolia Key Laboratory of Green Building, Hohhot 010051, China
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Van Andel S, Mohr M, Schmidt A, Werner I, Federolf P. Whole-body movement analysis using principal component analysis: What is the internal consistency between outcomes originating from the same movement simultaneously recorded with different measurement devices? Front Bioeng Biotechnol 2022; 10:1006670. [DOI: 10.3389/fbioe.2022.1006670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
A growing number of studies apply Principal Component Analysis (PCA) on whole-body kinematic data to facilitate an analysis of posture changes in human movement. An unanswered question is, how much the PCA outcomes depend on the chosen measurement device. This study aimed to assess the internal consistency of PCA outcomes from treadmill walking motion capture data simultaneously collected through laboratory-grade optical motion capture and field-suitable inertial-based motion tracking. Data was simultaneously collected using VICON (whole-body plug-in gait marker positions) and Xsens (body segment positions) from 20 participants during 2-min treadmill walking. Using PCA, Principal Movements (PMs) were determined using two commonly used practices: on an individual and a grouped basis. For both, correlation matrices were used to determine internal consistency between outcomes from either measurement system for each PM. Both individual and grouped approach showed excellent internal consistency between outcomes from the two systems among the lower order PMs. For the individual analysis, high correlations were only found along the diagonal of the correlation matrix while the grouped analysis also showed high off-diagonal correlations. These results have important implications for future application of PCA in terms of the independence of the resulting PM data, the way group-differences are expressed in higher-order PMs and the interpretation of movement complexity. Concluding, while PCA-outcomes from the two systems start to deviate in the higher order PMs, excellent internal consistency was found in the lower order PMs which already represent about 98% of the variance in the dataset.
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Detecting differences in gait initiation between older adult fallers and non-fallers through multivariate functional principal component analysis. J Biomech 2022; 144:111342. [DOI: 10.1016/j.jbiomech.2022.111342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/15/2022] [Accepted: 10/03/2022] [Indexed: 11/20/2022]
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Anzai E, Ren D, Cazenille L, Aubert-Kato N, Tripette J, Ohta Y. Random forest algorithms to classify frailty and falling history in seniors using plantar pressure measurement insoles: a large-scale feasibility study. BMC Geriatr 2022; 22:746. [PMID: 36096722 PMCID: PMC9469527 DOI: 10.1186/s12877-022-03425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/30/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Frailty and falls are two adverse characteristics of aging that impair the quality of life of senior people and increase the burden on the healthcare system. Various methods exist to evaluate frailty, but none of them are considered the gold standard. Technological methods have also been proposed to assess the risk of falling in seniors. This study aims to propose an objective method for complementing existing methods used to identify the frail state and risk of falling in older adults. METHOD A total of 712 subjects (age: 71.3 ± 8.2 years, including 505 women and 207 men) were recruited from two Japanese cities. Two hundred and three people were classified as frail according to the Kihon Checklist. One hundred and forty-two people presented with a history of falling during the previous 12 months. The subjects performed a 45 s standing balance test and a 20 m round walking trial. The plantar pressure data were collected using a 7-sensor insole. One hundred and eighty-four data features were extracted. Automatic learning random forest algorithms were used to build the frailty and faller classifiers. The discrimination capabilities of the features in the classification models were explored. RESULTS The overall balanced accuracy for the recognition of frail subjects was 0.75 ± 0.04 (F1-score: 0.77 ± 0.03). One sub-analysis using data collected for men aged > 65 years only revealed accuracies as high as 0.78 ± 0.07 (F1-score: 0.79 ± 0.05). The overall balanced accuracy for classifying subjects with a recent history of falling was 0.57 ± 0.05 (F1-score: 0.62 ± 0.04). The classification of subjects relative to their frailty state primarily relied on features extracted from the plantar pressure series collected during the walking test. CONCLUSION In the future, plantar pressures measured with smart insoles inserted in the shoes of senior people may be used to evaluate aspects of frailty related to the physical dimension (e.g., gait and balance alterations), thus allowing assisting clinicians in the early identification of frail individuals.
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Affiliation(s)
- Emi Anzai
- Faculty of Engineering, Nara Women's University, Nara, Japan
| | - Dian Ren
- Department of Cooperative Major in Human Centered Engineering, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Leo Cazenille
- Department of Information Sciences, Ochanomizu University, Tokyo, Japan
| | - Nathanael Aubert-Kato
- Department of Information Sciences, Ochanomizu University, Tokyo, Japan
- Center for Interdisciplinary AI and Data Science, Ochanomizu University, Tokyo, Japan
| | - Julien Tripette
- Center for Interdisciplinary AI and Data Science, Ochanomizu University, Tokyo, Japan.
- Department of Human-Environmental Science, Faculty of Human Life and Environmental Sciences, Ochanomizu University, Tokyo, Japan.
| | - Yuji Ohta
- Department of Human-Environmental Science, Faculty of Human Life and Environmental Sciences, Ochanomizu University, Tokyo, Japan
- Faculty of Core Research Natural Science Division, Ochanomizu University, Tokyo, Japan
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Bazanova OM, Kovaleva AV. Stabilometric Biofeedback Training in Cognitive and Affective Function Improvement. Contribution of the Russian Scientific School. Part II. HUMAN PHYSIOLOGY 2022; 48:271-284. [PMID: 35677212 PMCID: PMC9163904 DOI: 10.1134/s0362119722030021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
This review is the second part of the critical analysis of recent papers of Russian and other authors devoted to the study of the stabilometric parameters in postural control biofeedback training and rehabilitation, associated with psychological functions. The review presents the studies of postural control features in chronic pain syndrome, chronic fatigue syndrome, Parkinson's disease, multiple sclerosis, and depression. The leading role of Russian researchers in the development and application of stabilometric biofeedback in the training of optimal functioning, rehabilitation, and correction of neurological disorders is noted. The paradigm of stabilometric biofeedback training of the cognitive and affective functions is offered.
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Affiliation(s)
- O. M. Bazanova
- Scientific Research Institute of Neuroscience & Medicine, Novosibirsk, Russia
| | - A. V. Kovaleva
- Anokhin Research Institute of Normal Physiology, Moscow, Russia
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Two-dimensional dynamic walking stability of elderly females with a history of falls. Med Biol Eng Comput 2021; 59:1575-1583. [PMID: 34264481 DOI: 10.1007/s11517-021-02410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Injuries related with falls are a major health risk for the elderly. Accurate evaluation of the dynamic walking stability of elderly people is the key to fall prevention. A two-dimensional (2-D) model is proposed in this study given that the custom method is mainly focused on the dynamic walking stability along the antero-posterior axis. An inverted pendulum model was utilised to calculate the region of stability at toe-off, and stability conditions were evaluated first along the antero-posterior and medio-lateral axes. The analysis was then extended to the 2-D plane. In the 2-D case, the region of stability was determined based on the use of the information of the envelope of the foot. Twenty-four female participants, categorised as healthy young, healthy elderly, and elderly with a history of falls, were examined. Significant differences among the three groups were demonstrated with the 2-D analysis method, but not in the antero-posterior or medio-lateral analyses. The centre-of-masses of elderly fallers were significantly closer to the foot-supporting boundary compared with that of healthy young and elderly adults at toe-off. A 2-D analysis method using the envelope-of-foot could evaluate the dynamic stability of elderly females based on a more accurate scale.
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Khanmohammadi R, Olyaei G, Talebian S, Hadian MR, Hossein B, Aliabadi S. The effect of video game-based training on postural control during gait initiation in community-dwelling older adults: a randomized controlled trial. Disabil Rehabil 2021; 44:5109-5116. [PMID: 34027754 DOI: 10.1080/09638288.2021.1925360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim was to investigate the effect of video game training as compared to dual-task training on gait initiation (GI) which is a sensitive indicator of balance deficiency in older adults. METHOD Sixty-six older adults were allocated to the video game-based training (intervention group) or the motor-cognitive dual-task training (active control group). The outcome measures were the mediolateral (ML)/anteroposterior (AP) displacement and velocity of COP during the phases of GI (anticipatory, weight transition, and locomotor). RESULTS The results indicated in the anticipatory phase, the ML & AP COP displacement were significantly increased at post-training relative to pre-training across both groups (p < 0.041). In the weight transition phase, the AP COP displacement & ML COP velocity were significantly increased at post-training than pre-training (p < 0.032). However, in the locomotor phase, within the intervention group, the ML COP displacement & ML COP velocity were significantly increased at follow-up as compared to pre-training (p < 0.05), while no such differences were observed within the control group. CONCLUSION Both treatments were effective in improving COP trajectory during the phases of anticipatory and weight transition, while the intervention group was more effective during the phase of locomotor. So, these treatments can be recommended for clinical settings.Implications for rehabilitationThe video game and dual task training were effective in improving COP trajectory during the phases of anticipatory and weight transition.The video game-based training was more effective during the phase of locomotor.The study findings could have useful implications to further introduce cognition-based rehabilitation programs such as video games for older adults.Rehabilitation professionals could use the video game to improve the postural control of older adults.
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Affiliation(s)
- Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Olyaei
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Talebian
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Hadian
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagheri Hossein
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Saina Aliabadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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