Usefulness of the tri-axial accelerometer for assessing balance function in children

Relationship between static and dynamic balance in 4-to-5-year-old preschoolers: a cross-sectional study

BACKGROUND

Balance is crucial for physical development in preschool children. Exploring the relationship between different types of balance can help understand early physical development in children. Currently, research is mostly focused on the relationship between different types of balance in the adult population and lacks exploration of the preschool population. The aim of this study explored the relationship between static and dynamic balance in preschool children aged 4 to 5 years.

METHODS

A total of 128 preschool children between the ages of 4 to 5 years were selected. The following tests were conducted as they wore inertial sensors detecting their centers of mass (COM): T1, standing with eyes open; T2, standing with eyes closed; T3, standing with eyes open on foam; T4, standing with eyes closed on foam; and T5, walking on the balance beam. Static balance was measured by the angular velocity modulus (ω-T1-ω-T4) of the shaking COM, as well as the pitch angle (θ-T1-θ-T4) and roll angle (φ-T1-φ-T4) indicators in T1-T4 testing. Dynamic balance was measured by the time (t) and angular velocity modulus (ω-T5), as well as the pitch angle (θ-T5) and roll angle (φ-T5) indicators in the T5 test. The Pearson product-moment correlation coefficient was used to test the correlation between static and dynamic balance indicators.

RESULTS

There is no correlation between ω-T1-ω-T4 and t (P > 0.05), while ω-T1-ω-T4 and ω-T5 (r = 0.19-0.27, P < 0.05) and ω-T1-ω-T4 and θ-T5, φ-T5 (r = 0.18-0.33, P < 0.05) were weakly correlated. There is no correlation between θ-T1-θ-T4, φ-T1-φ-T4 and t (P > 0.05), while θ-T1-θ-T4, φ-T1-φ-T4, and θ-T5, φ-T5 were weakly correlated (r = 0.01-0.28, P < 0.05).

CONCLUSIONS

The relationship between static and dynamic balance in preschool children aged 4-5 years is weak. Static and dynamic balance in children needs to be intervened separately for the development of children.

Assessment of Physical Tests in 6-11 Years Old Children: Findings from the Play Lifestyle and Activity in Youth (PLAY) Study

The purpose was to evaluate selected physical tests in children and to compare the outcomes by sex. A cross-sectional study design was used to evaluate children 6-11 years who completed five physical tests: hand grip, vertical jump, sit and reach, Y-balance, and obstacle course (time and score). The outcome measures including test results were descriptively examined and compared by sex. The study participants consisted of 133 children (62 males and 71 females, with a median age of 7.8 years). Girls showed superior sit and reach performance (p = 0.002) compared with boys. Boys demonstrated better Y-balance scores (p = 0.007) and faster obstacle time (p = 0.042) than girls. Sex comparison within three age groups (6-<8 years, 8-<10 years, and 10-<12 years) showed that girls performed better on the sit and reach compared with boys in the in 6-<8 years (p = 0.009). Boys demonstrated higher Y-balance scores (p = 0.017) and faster obstacle time (p = 0.007) compared with girls in the 8-<10-year age group. These data will serve to guide future efforts to evaluate normative measures of physical literacy and guide targeted training interventions to promote sustained physical activity in children with deficits relative to their age and sex norms.

Reliability analysis of inertial sensors for testing static balance of 4-to-5-year-old preschoolers

BACKGROUND

Balance ability is important for preschoolers' motor and physical development. Portable accelerometers can provide resolution tests and identification of preschoolers with balance defects.

RESEARCH QUESTION

Despite previous studies on the balance measures of accelerometer tests, there is a lack of complete analyses for preschoolers aged 4-5 years. In this study, we aim to verify the reliability of measuring the static balance of preschoolers in this age range based on inertia sensors for the acceleration and angular velocity moduli.

METHODS

Thirty children wore an inertial sensor in the 5th lumbar vertebra and completed four tests, i.e., standing on a firm surface and on a foam surface with open and closed eyes. The standard deviation of the acceleration modulus and root mean square of the angular velocity modulus were calculated. The analysis was based on the intraclass correlation coefficient (ICC) to determine the internal consistency and feasibility.

RESULTS

The ICC of the acceleration modulus was between 0.597 and 0.683 (P < 0.01), and the test-retest reliability was medium. The ICC of the angular velocity modulus was between 0.683 and 0.812 (P < 0.01, P < 0.001), and the test-retest reliability was medium to good. The standard error of measurement (SEM) of the acceleration modulus was between 0.001591 and 0.007248 (g), and the SEM% was between 21.24% and 34.12%. The angular velocity modulus SEM values ranged from 1.296 to 3.441 (deg/s), and the SEM% ranged from 25.17% to 33.26%. The difference between the two tests was evenly distributed on both sides of the mean value, and the difference between the test results was within the consistency limit.

SIGNIFICANCE

Inertial sensors can be used to evaluate the static balance ability of preschoolers aged 4-5 years. Further, the angular velocity modulus is more reliable than the acceleration modulus.

Interrelationship Between Age, Gender, and Weight Status on Motor Coordination in Italian Children and Early Adolescents Aged 6-13 Years Old

Although numerous evidences reported a negative correlation between motor coordination (MC) and overweight/obesity in children and adolescents, the interrelationship between age, gender, and weight status is still debatable. Hence, the aim of this cross-sectional study was to examine the association between MC and weight status according to age and gender across childhood and early adolescence in a large sample of Italian elementary and middle school students. A number of 1961 Italian school students (1,026 boys, 935 girls) was stratified in three consecutive age groups (6-7, 8-10, and 11-13 years) and four weight status categories (underweight, normal weight, overweight, and obese) according to Cole's body mass index (BMI) cut-off points for children. MC performance was assessed measuring motor quotient (MQ) with the Körperkoordinationstest für Kinder (KTK). Results showed significantly lower MQ levels in children in overweight (OW) and with obesity (OB) in both sexes for all age groups than peers in normal weight (NW), except in 6-7-year-old boys. Girls in OW and with OB had similar MQ levels across all age groups, while younger boys in OW and with OB showed higher MQ levels than older ones (p < 0.05). The 6-7-year-old boys showed better MQ levels than girls peers in NW, OW, and with OB, while 8-10-year-old boys in underweight (UW), NW, and OW; and 11-13-year-old boys only in NW (p < 0.05). No interaction effect was found between age, gender, and weight status on MQ levels. These outcomes showed the negative impact of higher weight status on MC performance according to age and gender, pointing out the importance of planning targeted motor programs that consider these variables to improve MC performance.

Intraday reliability, sensitivity, and minimum detectable change of national physical fitness measurement for preschool children in China

China General Administration of Sport has published and adopted the National Physical Fitness Measurement (NPFM-preschool children version) since 2000. However, studies on intraday reliability, sensitivity, and minimum detectable change (MDC) are lacking. This study aimed to investigate and compare the reliability, sensitivity, and MDC values of NPFM in preschool children between the ages of 3.5 to 6 years. Six items of NPFM including 10-m shuttle run, standing long jump, balance beam walking, sit-and-reach, tennis throwing, and double-leg timed hop, were tested for 209 Chinese kindergarten children in Beijing in the morning. Intraday relative reliability was tested using intraclass correlation coefficient (ICC3,1) with a 95% confidence interval while absolute reliability was expressed in standard error of measurement (SEM) and percentage of coefficient of variation (CV%). Test sensitivity was assessed by comparing the smallest worthwhile change (SWC) with SEM, while MDC values with 95% confidence interval (MDC95) were established. Measurements in most groups, except 10-m shuttle run test (ICC3,1: 0.56 to 0.74 [moderate]) in the 3.5 to 5.5-year-old groups, balance beam test in 4- and 5-year-old (ICC3,1: 0.33 to 0.35 [poor]) and 5.5-year-old (ICC3,1 = 0.68 [moderate]) groups, and double-leg timed hop test (ICC3,1 = 0.67 [moderate]) in the 4.5-year-old group, demonstrated good to excellent relative reliability (ICC3,1: 0.77 to 0.97). The balance beam walking test showed poor absolute reliability in all the groups (SEM%: 11.76 to 22.28 and CV%: 15.40 to 24.78). Both standing long jump and sit-and-reach tests demonstrated good sensitivity (SWC > SEM) in all subjects group, boys, and girls. Pairwise comparison revealed systematic bias with significantly better performance in the second trial (p<0.01) of all the tests with moderate to large effect size.

Gender Differences in Postural Stability among 13-Year-Old Alpine Skiers

This experiment examined changes in body sway after Wingate test (WAnT) in 19 adolescents practicing alpine skiing, subjected to the same type of training load for 4–5 years (10 girls and nine boys). The postural examinations were performed with eyes open (EO), eyes closed (EC), and sway reverenced vision (SRV) in the medial-lateral (ML) and anterior-posterior (AP) planes. The displacement of center of foot pressure (CoP), range of sway (RS), mean sway velocity (MV), way length, and surface area were measured in bipedal upright stance before and after the WAnT to assess the influence of fatigue on postural balance. There were no significant differences in WAnT parameters between girls and boys. Relative peak power (RPP), relative total work (RWtot) were (girls vs. boys) 8.89 ± 0.70 vs. 9.57 ± 1.22 W/kg, p < 0.05 and 227.91 ± 14.98 vs. 243.22 ± 30.24 W/kg, p < 0.05 respectively. The fatigue index (FI) was also on similar level in both genders; however, blood lactate concentration (BLa) was significantly higher in boys (10.35 ± 1.16 mM) than in girls (8.67 ± 1.35 mM) p = 0.007. In the EO examination, statistically significant differences between resting and fatigue conditions in the whole group and after the division into girls and boys were found. In fatigue conditions, significant gender differences were noted for measurements in the ML plane (sway path and RS) and RS in the AP plane. Comparison of the three conditions shows differences between EO vs. EC and SRV in AP plane measured parameters, and for RS in ML plane in rest condition in girls. The strong correlations between FI and CoP parameters mainly in ML plane in the whole group for all examination conditions were noted. By genders, mainly RS in ML plane strongly correlates with FI (r > 0.7). No correlation was found between BLa and CoP parameters (p > 0.06). The presented results indicate that subjecting adolescents of both genders to the same training may reduce gender differences in the postural balance ability at rest but not in fatigue conditions and that girls are significantly superior in postural balance in the ML plane than boys. It was also shown that too little or too much information may be destructive to postural balance in young adolescents.

Age and sex differences in human balance performance from 6-18 years of age: A systematic review and meta-analysis

Background

The process of growing leads to inter-individual differences in the timing of growth, maturational, and developmental processes during childhood and adolescence, also affecting balance performance in youth. However, differences in balance performance by age and sex in youth have not been systematically investigated yet.

Objective

The objective of the present study was to characterize and quantify age- and sex-related differences in balance performance in healthy youth.

Methods

A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus. To be applicable for analysis, studies had to report at least one measure of static steady-state, dynamic steady-state, proactive or reactive balance in healthy children (6–12 years) and/or adolescents (13–18 years). Coding of the studies was done according to the following criteria: age, sex, and balance outcome. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies. Weighted standardized mean differences were calculated and classified according to their magnitude.

Results

Twenty-one studies examined age-related differences in balance performance. A large effect for measures of static steady-state balance (SMD_ba = 1.20) and small effects for proxies of dynamic steady-state (SMD_ba = 0.26) and proactive balance (SMD_ba = 0.28) were found; all in favor of adolescents. Twenty-five studies investigated sex-related differences in balance performance. A small-sized effect was observed for static steady-state balance (SMD_bs = 0.33) in favor of girls and for dynamic steady-state (SMD_bs -0.02) and proactive balance (SMD_bs = -0.15) in favor of boys. Due to a lack of studies, no analysis for measures of reactive balance was performed.

Conclusions

Our systematic review and meta-analysis revealed better balance performances in adolescents compared to children, irrespective of the measure considered. Sex-related differences were inconsistent. These findings may have implications for example in terms of trainability of balance in youth that should be investigated in future studies.

Correlation of the functional difficulties questionnaire (FDQ-9) with dynamic balance using the SMART instrumented wobbleboard

OBJECTIVES

To investigate concurrent validity of the Functional Difficulties Questionnaire (FDQ-9) using balance tasks on the SMARTwobbleboard. Poor balance is associated with reduced physical activity which may impact on quality of life. There is a requirement to use simple tests to assess balance so that suitable interventions can be employed to ameliorate poor balance and enhance uptake of physical activity.

DESIGN

Observational study employing 30 healthy volunteers who completed the FDQ-9 and undertook three balance tasks on the SMARTwobbleboard: double leg stance eyes open (DLSEO); double leg stance eyes closed (DLSEC) and single leg stance eyes open (SLSEO).

RESULTS

There were moderate significant correlations between the FDQ-9 and DLSEO and SLSEO. There were significant between group differences in dynamic balance for participants with FDQ-9 ≤ 18 (indicative of no functional difficulties) and FDQ-9 ≥ 19 (indicative of one or more functional difficulties) for DLSEO and SLSEO.

CONCLUSIONS

Significant moderate correlations were recorded between the FDQ-9 and the SMARTwobbleboard in healthy adults indicating a relationship between dynamic balance and questionnaire scores (DLSEO and SLSEO). Initial findings contribute to the concurrent validity of the FDQ-9 which could also be used as a simple tool for assessing balance.

A novel accelerometry-based algorithm for the detection of step durations over short episodes of gait in healthy elderly

Background

The assessment of short episodes of gait is clinically relevant and easily implemented, especially given limited space and time requirements. BFS (body-fixed-sensors) are small, lightweight and easy to wear sensors, which allow the assessment of gait at relative low cost and with low interference. Thus, the assessment with BFS of short episodes of gait, extracted from dailylife physical activity or measured in a standardised and supervised setting, may add value in the study of gait quality of the elderly. The aim of this study was to evaluate the accuracy of a novel algorithm based on acceleration signals recorded at different human locations (lower back and heels) for the detection of step durations over short episodes of gait in healthy elderly subjects.

Methods

Twenty healthy elderly subjects (73.7 ± 7.9 years old) walked twice a distance of 5 m, wearing a BFS on the lower back, and on the outside of each heel. Moreover, an optoelectronic three-dimensional (3D) motion tracking system was used to detect step durations. A novel algorithm is presented for the detection of step durations from low-back and heel acceleration signals separately. The accuracy of the algorithm was assessed by comparing absolute differences in step duration between the three methods: step detection from the optoelectronic 3D motion tracking system, step detection from the application of the novel algorithm to low-back accelerations, and step detection from the application of the novel algorithm to heel accelerations.

Results

The proposed algorithm successfully detected all the steps, without false positives and without false negatives. Absolute average differences in step duration within trials and across subjects were calculated for each comparison, between low-back accelerations and the optoelectronic system were on average 22.4 ± 7.6 ms (4.0 ± 1.3 % of average step duration), between heel accelerations and the optoelectronic system were on average 20.7 ± 11.8 ms (3.7 ± 1.9 %), and between low-back accelerations and heel accelerations were on average 27.8 ± 15.1 ms (4.9 ± 2.5 % of average step duration).

Conclusions

This study showed that the presented novel algorithm detects step durations over short episodes of gait in healthy elderly subjects with acceptable accuracy from low-back and heel accelerations, which provides opportunities to extract a range of gait parameters from short episodes of gait.