The Postural Stability Measures Most Related to Aging, Physical Performance, and Cognitive Function in Healthy Adults

Non-surgical reduction in thoracolumbar kyphosis and sagittal vertical axis corresponding with improved sensorimotor control in an older adult with spinal deformity: a Chiropractic Biophysics® case report

[Purpose] We document the significant improvement in posturography and spinal deformity by Chiropractic BioPhysics® (CBP®) technique methods. [Participant and Methods] A 78-year-old male presented with 20 years of chronic hip and lower back pain and stiffness. The pain was 5/10 and disability was 38%. The patient also complained of walking difficulty and balance problems. Radiographic assessment demonstrated a significant thoracolumbar kyphosis and anterior C7-S1 sagittal vertical axis (SVA). Force plate posturography showed high centre of pressure (COP) parameter values including the total path length, particularly for the vestibular condition of the modified clinical test of sensory integration and balance (mCTSIB). [Results] The patient was treated with 36 sessions of CBP corrective exercises and spinal traction as well as PowerPlate balance and gait exercises. Assessment after 4-months showed improvements in sleep, pain, disability, and mobility. There was a 79 mm reduction in SVA and improved postural control in many parameters including a 49 cm and 22 cm reduction in COP total path length for the vestibular and visual trials on the mCTSIB, respectively. The pain and disability were reduced to 0/10 and 22%. [Conclusion] This case demonstrates the significant improvement in postural control as quantified by the mCTSIB with the reduction of excessive SVA as demonstrated on post-treatment x-rays.

Stimulated cervical afferent input increases postural instability in older people with chronic neck pain: a cross-sectional study

BACKGROUND

Several potential causes can impair balance in older people. The neck torsion maneuver may be useful in demonstrating impaired balance caused by the stimulation of cervical proprioceptive input. Whereas evidence suggests impaired standing balance in older people with chronic neck pain, balance impairment during the neck torsion position and its relationship with clinical characteristics have not yet been investigated in this population. The aims of this study were to investigate whether the neck torsion position could significantly influence balance responses in older people with chronic non-specific neck pain and to determine the relationships between the balance responses and characteristics of neck pain.

METHODS

Sixty-eight older people (34 with chronic non-specific neck pain and 34 controls) participated in the study. Balance was tested using a force plate during comfortable stance with eyes open under four conditions: neutral head on a firm surface, neutral head on a soft surface, neck torsion to left and right on a firm surface and neck torsion to left and right on a soft surface. Balance outcomes were anterior-posterior (AP) and medial-lateral (ML) displacements, sway area and velocity. Characteristics of neck pain were intensity, duration and disability.

RESULTS

Overall, the neck pain group exhibited greater AP and ML displacements, sway area and velocity in the neck torsion position on firm and soft surfaces compared to controls (partial eta squared (η²p) = 0.06-0.15, p < 0.05). The neck pain group also had greater AP displacement, sway area and velocity in the neutral position on a soft surface compared to controls (η²p = 0.09-0.16, p < 0.05). For both groups, the neck torsion position displayed overall greater postural sway compared to the neutral position (η²p = 0.16-0.69, p < 0.05). There were no relationships between the postural sway outcomes and characteristics of neck pain (p > 0.05).

CONCLUSION

The neck torsion maneuver, stimulating the receptors resulted in increased postural sway in older people, with a more pronounced effect in those with neck pain. The study provides evidence supporting the use of neck torsion for assessing impaired balance related to abnormal cervical input in older people with chronic non-specific neck pain.

Graceful gait: virtual ballet classes improve mobility and reduce falls more than wellness classes for older women

Introduction

Dance is an effective and motivating form of exercise for older women, but few studies have quantified the benefits of virtual dance classes nor, specifically, ballet. This study tested the effectiveness of virtual ballet compared to virtual wellness classes, with the goal of reaching underserved populations. It is among the first to explore the effects of virtual classical ballet on functional gait mobility, balance, and quality of life measures in older women.

Methods

Older women were recruited in two waves and randomized to two groups: a ballet class modified for older adults and a wellness-based control class. Both groups received 12 weeks of online classes, meeting twice per week for 45-min sessions. Classes were taught by a local company that offers community-based ballet classes. The same instructor led both the ballet and the wellness classes. Pre- and post-intervention assessments include gait and balance testing using wearable inertial sensors and self-report outcomes including quality of life and mood questionnaires.

Results

Forty-four older women completed the study: Ballet group (n = 21, 67.81 ± 7.3 years); Wellness group (n = 23, 69.96 ± 6.7 years). Pre- to post-intervention, both groups increased velocity on the two-minute walk test (F1,42 = 25.36, p < 0.001) and improved their time on the Timed Up and Go (F1,42 = 4.744, p = 0.035). Both groups improved balance on the Mini-BESTest (F1,42 = 38.154, p < 0.001), increased their scores on the Activities-Specific Balance Confidence Scale (F1,42 = 10.688, p < 0.001), and increased quality of life via the Short Form Health Survey (F1,42 = 7.663, p = 0.008). The ballet group improved gait variability in the backward direction (F1,42 = 14.577, p < 0.001) and reduced fall rates more than the wellness group [χ2(1) = 5.096, p = 0.024].

Discussion

Both virtual ballet and wellness classes improve select measures of gait, balance, and quality of life. The benefits seen in both groups highlight the importance of considering social interaction as a key component when developing future interventions to target mobility in older women.

Rating of perceived difficulty scale for measuring intensity of standing balance exercises in individuals with vestibular disorders

BACKGROUND

A method for prescribing the difficulty or intensity of standing balance exercises has been validated in a healthy population, but requires additional validation in individuals with vestibular disorders.

OBJECTIVE

This study validated the use of ratings of perceived difficulty for estimation of balance exercise intensity in individuals with vestibular disorders.

METHODS

Eight participants with a confirmed diagnosis of a vestibular disorder and 16 healthy participants performed two sets of 16 randomized static standing exercises across varying levels of difficulty. Root Mean Square (RMS) of trunk angular velocity was recorded using an inertial measurement unit. In addition, participants rated the perceived difficulty of each exercise using a numerical scale ranging from 0 (very easy) to 10 (very difficult). To explore the concurrent validity of rating of perceived difficulty scale, the relationship between ratings of perceived difficulty and sway velocity was assessed using multiple linear regression for each group.

RESULTS

The rating of perceived difficulty scale demonstrated moderate positive correlations RMS of trunk velocity in the pitch (r = 0.51, p < 0.001) and roll (r = 0.73, p < 0.001) directions in participants with vestibular disorders demonstrating acceptable concurrent validity.

CONCLUSIONS

Ratings of perceived difficulty can be used to estimate the intensity of standing balance exercises in individuals with vestibular disorders.

Effects of Jaques-Dalcroze eurhythmics program on postural stability in elderly women

Decreased postural stability is observed in older adults. There is an increased risk of falls, which may lead to serious complications and death. Elderly people can maintain and even improve their postural stability through properly selected exercises. This study investigated the effect of exercise using the Emil Jaques–Dalcroze’s Eurhythmics (JDE) method on the postural stability of women over 65 years of age. The study model was based on a randomized controlled trial—parallel group design. Fifty-nine women (69.85 ± 3.29) were divided into two groups: intervention (IG, n = 26) and control (CG, n = 33). The IG subjects participated in a JDE exercise programme for 12 weeks, twice a week for 45 min each. Postural stability was determined using a test on the AMTI AccuSway Plus posturography platform, recording centre of pressure (COP) point displacement. A biofeedback model was used. Accuracy, speed and reaction time of movements were assessed. Two measurement sessions were conducted in both groups: 1 week before starting the exercise programme and immediately afterwards. After 12 weeks of exercise, subjects from IG scored significantly better in the test of accuracy (p < 0.05) and speed (p < 0.05) of movements. Additionally, for parameters determining accuracy of movements, an interaction between allocation to a group and a measurement session was shown (group × time). A 12-week exercise program using the JDE method improves the postural stability of women over 65 years of age by improving the parameters of speed and accuracy of torso movements.