Dynamic postural stability is not impaired by moderate-intensity physical activity in healthy or balance-impaired older people

A busy day has minimal effect on factors associated with falls in older people: An ecological randomised crossover trial

Fatigue is a common complaint in older people. Laboratory-induced muscle fatigue has been found to affect physical functions in older populations but these protocols are rigorous and are unlikely to accurately reflect daily activities. This study used an ecological approach to determine the effects of a busy day on self-reported fatigue and fall-related measures of physical and cognitive function in older people. Fifty community-dwelling adult volunteers, aged 60-88 (mean 73) years participated in this randomised crossover trial. Participants undertook assessments of balance, strength, gait, mobility, cognitive function and self-reported fatigue, before and after a planned rest day and a planned busy day (randomly allocated) at least one week apart. Participants wore an activity monitor on both the rest and busy days. On average, participants undertook twice as many steps and 2.5 times more minutes of activity on the busy, compared with the rest day. Participants had a significant increase in self-reported fatigue on the afternoon of the busy day and no change on the rest day. Repeated measures ANOVAs found no significant day (rest/busy) × time (am/pm) interaction effects, except for the timed up and go test of mobility, resulting from relatively improved mobility performance over the rest day, compared with the busy day. This study showed few effects of a busy day on physical and cognitive performance tests associated with falls in older people.

Age-Related Changes in Dynamic Postural Control and Attentional Demands are Minimally Affected by Local Muscle Fatigue

Normal aging results in alterations in the visual, vestibular and somtaosensory systems, which in turn modify the control of balance. Muscle fatigue may exacerbate these age-related changes in sensory and motor functions, and also increase the attentional demands associated with dynamic postural control. The purpose of this study was to investigate the effect of aging on dynamic postural control and posture-related attentional demands before and after a plantar flexor fatigue protocol. Participants (young adults: n = 15; healthy seniors: n = 13) performed a dynamic postural task along the antero-posterior (AP) and the medio-lateral (ML) axes, with and without the addition of a simple reaction time (RT) task. The dynamic postural task consisted in following a moving circle on a computer screen with the representation of the center of pressure (COP). This protocol was repeated before and after a fatigue task where ankle plantar flexor muscles were targeted. The mean COP-target distance and the mean COP velocity were calculated for each trial. Cross-correlation analyses between the COP and target displacements were also performed. RTs were recorded during dual-task trials. Results showed that while young adults adopted an anticipatory control mode to move their COP as close as possible to the target center, seniors adopted a reactive control mode, lagging behind the target center. This resulted in longer COP-target distance and higher COP velocity in the latter group. Concurrently, RT increased more in seniors when switching from static stance to dynamic postural conditions, suggesting potential alterations in the central nervous system (CNS) functions. Finally, plantar flexor muscle fatigue and dual-tasking had only minor effects on dynamic postural control of both young adults and seniors. Future studies should investigate why the fatigue-induced changes in quiet standing postural control do not seem to transfer to dynamic balance tasks.

Influence of repeated effort induced by a 6-min walk test on postural response in older sedentary women

According to the latest recommendations, adults should exercise regularly at moderate intensity to improve aerobic fitness and body composition. However, it is unknown whether aerobic exercise at submaximal intensity has detrimental effects on balance in older sedentary adults. We explored the effects of two 6-min walk tests (6MWTs) on the postural responses in 49 sedentary women between 60 and 76 years old. We assumed that an increase in the center of pressure (COP) fluctuations or a loss in the complexity of the COP time series would be a sign of a deleterious effect on balance. We used kinematic stabilometric parameters, recurrence quantification analysis (RQA) and the central tendency measure (CTM). We refer to the measures obtained through RQA and CTM methods by dynamical measures. Repeated-measures analysis of variance showed no significant differences between the three sets of postural kinematic measures (before vs. after the first vs. after the second 6MWT). However, we observed significant differences between the three sets for the CTM measure in the antero-posterior direction (p < 0.002), RQA determinism in the medio-lateral (ML) direction (p < 0.0001), and RQA entropy in the ML direction (F = 5.93; p < 0.004).Our results indicate that the effects of moderate-intensity walking exercise on posture are not revealed by classical postural kinematic measures but only by dynamical measures. The loss of complexity in the COP time series observed after both the first and second 6MWTs may indicate presymptomatic deterioration in the postural adaptive capabilities of sedentary older women.

Age effects on mediolateral balance control

BACKGROUND

Age-related balance impairments, particularly in mediolateral direction (ML) may cause falls. Sufficiently sensitive and reliable ML balance tests are, however, lacking. This study is aimed to determine (1) the effect of age on and (2) the reliability of ML balance performance using Center of Mass (CoM) tracking.

METHODS

Balance performance of 19 young (26±3 years) and 19 older (72±5 years) adults on ML-CoM tracking tasks was compared. Subjects tracked predictable and unpredictable target displacements at increasing frequencies with their CoM by shifting their weight sideward. Phase-shift (response delay) and gain (amplitude difference) between the CoM and target in the frequency domain were used to quantify performance. Thirteen older and all young adults were reassessed to determine reliability of balance performance measures. In addition, all older adults performed a series of clinical balance tests and conventional posturography was done in a sub-sample.

RESULTS

Phase-shift and gain dropped below pre-determined thresholds (-90 degrees and 0.5) at lower frequencies in the older adults and were even lower below these frequencies than in young adults. Performance measures showed good to excellent reliability in both groups. All clinical scores were close to the maximum and no age effect was found using posturography. ML balance performance measures exhibited small but systematic between-session differences indicative of learning.

CONCLUSIONS

The ability to accurately perform ML-CoM tracking deteriorates with age. ML-CoM tracking tasks form a reliable tool to assess ML balance in young and older adults and are more sensitive to age-related impairment than posturography and clinical tests.

The effects of exertion on the postural stability in young soccer players

OBJECTIVE

: Analyze the effects of physical exertion during a soccer match on the functional capacity and stability of the lower limbs of young soccer players.

METHODS

: We analyzed 10 soccer players who underwent functional capacity assessment of the lower limbs by a Hop Test protocol and evaluation of the level of postural stability in the Biodex Stability System (Biodex, Inc., Shirley, NY) before and immediately after a friendly game lasting 45 minutes.

RESULTS

: After the match, there was a decrease in overall stability index (F_(1,23) = 7.29 P = .024) and anterior posterior index (APSI) (F_(1,23) = 5.53 P = .043). Fatigue in the dominant limb was responsible for the significant deficit in OSI (F_(1,23) = 3.16, P = .047) and APSI (F_(1,23) = 3:49, P = .029), while the non-dominant limb did not cause any change in the pre and post-game.

CONCLUSION

: A football match can cause decreased stability and functional capacity of the lower limbs in young players. Level of Evidence III, Pre-test and Post-test Study (Case-control).

The effects of one-half of a soccer match on the postural stability and functional capacity of the lower limbs in young soccer players

OBJECTIVE

Most injuries occur during the final 15 minutes of each half of a soccer match, suggesting that physical exertion may influence changes in neuromuscular control and the body's ability to stabilize the joints of the lower extremities. The aim of this study was to analyze the effects of one-half of a soccer match on the functional capacity and stability of the lower limbs in young soccer players.

METHODS

We analyzed 27 soccer players by evaluating the functional capacity of their lower limbs using the hop test protocol and their level of postural stability using the Biodex Stability System. The evaluations were performed before and after 45 minutes of game time.

RESULTS

After the match, there was a decrease in the overall stability index (OSI) (F(1,23) = 5.64, p = 0.026) and the anterior-posterior stability index (APSI) (F(1,23) = 5.24,p = 0.032). In the single and triple hop tests, there was a higher functional capacity in the dominant limb compared to the non dominant limb in the pre- and post-game comparisons.

CONCLUSION

The results of this study show that there is a decrease in the stability of the lower limbs in young soccer players after a 45 minutes soccer match, but the same result was not found for the functional capacity.

Ground reaction forces during gait in pregnant fallers and non-fallers

Pregnant women are at a high risk of experiencing a fall. To our knowledge, ground reaction forces (GRFs) in pregnant fallers and non-fallers have not been reported.

PURPOSE

The purpose of this study was to examine the effects of pregnancy and fall history on GRFs during walking.

METHODS

Forty one pregnant subjects in the mid 2nd and 3rd trimesters (pregnant fallers: n=15, pregnant non-fallers: n=14), and 40 control women walked at a freely chosen walking speed along an 8m walkway. A force plate, hidden in the walkway, was used to collect GRFs (1080Hz). Kinematic data (120Hz) were collected from a marker placed on the lumbar spine to estimate walking velocity. GRF variables included mediolateral Center of Pressure (COP) excursion, and GRFs normalized to body mass. A two factor ANOVA (trimester x fall group) was used to compare subject demographics, and walking velocity (α=0.05). A two factor ANCOVA (trimester×fall group, covariate: velocity) was performed to examine other GRF variables (Bonferroni corrected α=0.006) and the mediolateral COP excursion (α=0.05).

RESULTS

Walking velocity was greater in the control group (p<0.05). No differences were seen in the GRFs or COP movement between trimesters or between pregnant fallers and non-fallers.

CONCLUSIONS

When walking velocity was considered in the statistical model, ground reaction forces are essentially unchanged by pregnancy.

A single bout of resistance exercise does not affect nonlinear dynamics of lower extremity kinematics during treadmill walking

Peripheral fatigue has been known to result in altered force output and muscle recruitment patterns by the CNS. These changes may affect lower extremity movement during gait, and such behavior may present implications for the interpretation of nonlinear analysis of gait in situations where a subject might become fatigued. The purpose of this study was to examine the effects of a single bout of resistance training on lower extremity movement during treadmill walking in healthy subjects. Fifteen recreationally active subjects performed two 10min trials of treadmill walking at their preferred speed while knee and ankle kinematics of their right limb were recorded via optical motion capture. Between walking trials, subjects performed a series of lower extremity resistance exercises designed to induce moderate muscular fatigue. Detrended fluctuation analysis of stride length and stride time revealed that statistical persistence was unaffected by moderate muscle fatigue. Estimates of finite-time maximal Lyapunov exponents for ankle angle, knee angle, and vertical ankle movement over the short (0-1 stride) and long (4-10 strides) term were also unaffected by a single bout of resistance training. These results suggest that control of locomotion in healthy individuals, as measured by the nonlinear dynamics of lower extremity movement used here, is relatively robust to moderate muscle fatigue. Additional work with greater levels of fatigue will be necessary to fully characterize the effects of muscular fatigue on gait.