Particular protrusion perception arising from plantar sensory input and task guidance enhances lower limb joint dynamics during gait

[Purpose] To assess the influence of plantar sensory input and task guidance produced by a protrusion on lower limb joint dynamics during gait by changes in muscle activity and two-dimensional motion analysis. The protrusion seals on the soles of the feet, named “Perceptual Stimulus Protrusion” were used in this study. [Participants and Methods] In this study, 40 and 42 healthy adults were recruited for muscle activity and two-dimensional analysis, respectively. In addition to walking without perceptual stimulus protrusion (“Control” condition), the testing conditions included attachment of the protrusion to the heel (“Heel Condition”) and the hallucal (“Hallucal Condition”). As task guidance, participants were orally instructed how to walk for each conditions. The muscle activities of the rectus femoris, vastus medialis, tibialis anterior, and medial head of the gastrocnemius were measured. The two-dimensional analysis was compared with the angle of ankle dorsiflexion and plantarflexion, the toe height during the swing phase between the test conditions, respectively. [Results] In the Heel Condition, the tibialis anterior and vastus medialis activity in the stance and swing phases, toe height, and angle of ankle dorsiflexion and plantarflexion increased. In the Hallucal Condition, tibialis anterior activity during the stance and swing phases, gastrocnemius activity during the stance phase, toe height, and angle of ankle plantarflexion increased. [Conclusion] Plantar sensory input and task guidance using perceptual stimulus protrusion influences active motion control. Therefore, the application of this procedure can be expected to support motion guidance, such as gait and load practice.

The effects of plantar perception training on balance and falls efficacy of the elderly with a history of falls: A single-blind, randomized controlled trial

PURPOSE

The purpose of this study was to identify the effects of plantar perception training using a hardness discrimination task on balance and falls efficacy of the elderly who have experienced a fall.

MATERIALS AND METHODS

Sixty-two elderly persons 65 years of age or older were randomly allocated to the experimental group (n = 31) or the control group (n = 31). The experimental group performed a hardness discrimination task using five different levels of hardness of sponge mats, while the control group performed the same task except that they were not asked to discriminate hardness levels of sponge mats. All subjects performed 10 sessions for two weeks. Outcome measures were conducted using center of pressure (CoP) sway in the standing position, the Timed Up and Go (TUG) test, and falls efficacy scale (FES) to measure balance and falls efficacy.

RESULTS

There were no significant differences in general characteristics between both groups (p > .05). After 10 sessions, plantar perception was significantly improved in the experimental group (F = 101.18, p < .001). Additionally, changes in CoP sway with eye closed and TUG test were significantly different (p < .05) between the experimental group (CoP sway with eye closed, -208.32 ± 74.89; TUG test, -1.91 ± 0.72) and the control group (CoP sway with eye closed, -14.55 ± 35.44; TUG test, -1.31 ± 0.75).

CONCLUSIONS

These results showed that plantar perception training might be beneficial to improve falls efficacy as well as balance of the elderly.

The impact of a vestibular-stimulating exercise regimen on postural stability in women over 60

Background/Objective

The aim of this study was to assess whether a program of exercise specifically designed to target the vestibular organ improved the postural stability of female participants over 60 years old.

Methods

Twenty-eight healthy female volunteers aged from 60 years to 76 years were assigned to a group (n = 15) engaging in vestibular-stimulating exercises, or to a control group (n = 13) engaging in traditional training exercises. Training sessions (∼45 minutes each) occurred twice a week over the course of 3 months. The following parameters were analyzed before and after training for both groups: stabilogram ellipse area and radii, total length of stabilogram, and visual-inspection indicator (eyes open).

Results

Results in terms of stabilogram ellipse area and radius without visual control (eyes closed) revealed statistically significant differences in the experimental group between the values before and after the training regimen (74.8 ± 51.6 - 54.5 ± 42.5 for area of ellipse, 6.6 ± 2.8 - 5.8 ± 2.8 for axis minor, 13.2 ± 4.3 - 11.1 ± 3.3 for axis major, respectively). No significant changes were observed in the control group.

Conclusion

Exercises stimulating the vestibular organ, such as those described herein, should be a part of efforts to improve balance in older people.

Effect of a plantar perceptual learning task on walking stability in the elderly: a randomized controlled trial

OBJECTIVE

To determine whether the plantar perceptual learning task, using a hardness discrimination training, efficiently improves walking stability in the elderly.

DESIGN

A randomized controlled trial.

SETTING

Elder day-care center.

PARTICIPANTS

Eighty-six elderly people (73.84 SD 5.98 years) who went to an elder day-care center were randomly assigned evenly to either an intervention or a control group.

INTERVENTION

The intervention group performed a task to discriminate hardness differences while standing on sponge mats of different levels of hardness. The control group underwent the same task except that they were not instructed to discriminate hardness levels of the mats. The tasks were carried out over a four-week period for 10 days for both groups.

OUTCOME MEASURES

Outcome was assessed by determining root mean squares of trunk acceleration during walking.

RESULTS

Plantar perception was significantly improved in the intervention group after training (F = 26.24, p < 0.01). In addition, changes in root mean square values of acceleration were significantly greater after training in the intervention group (medial-lateral, 0.36 SD 0.26; vertical, 0.32 SD 0.24; anterio-posterior, 0.26 SD 0.24) than in the control group (medial-lateral, 0.14 SD 0.28, vertical, 0.16 SD 0.35, anterio-posterior, 0.12 SD 0.29) (p < 0.05). Changes in walking speed were not significantly different (p = 0.13) between the intervention (0.06 SD 0.13) and control groups (0.02 SD 0.14).

CONCLUSION

The plantar perceptual learning task might efficiently stabilize postural control during walking in the elderly.

Effects of plantar perception training on standing posture balance in the old old and the very old living in nursing facilities: a randomized controlled trial

Objective: To determine whether plantar perception training using a hardness discrimination task efficiently improves stabilization of standing posture balance in the old old as well as the very old.

Design: A randomized two-group parallel controlled trial.

Setting: Nursing homes.

Participants: Forty-six elderly persons 75 years of age or older living in nursing facilities were randomly assigned evenly to either an intervention or a control group.

Intervention: The intervention group was given a task to discriminate hardness differences while standing on foam rubber of different levels of hardness, while the control group was given the task to simply remain standing on foam rubber. The tasks were imposed for 10 successive days.

Outcome measures: Outcome assessment was made by determinations of centre-of-gravity sway in the standing position and the Functional Reach Test.

Results: Planter perception was significantly improved and centre-of-gravity sway in the standing position was also significantly reduced in the intervention group after the intervention. In the control group, however, there were no significant changes in perception or in sway ( P < 0.01) There was a significant difference in the Functional Reach Test values between the two groups: an increment of 12.3 ± 10.1 cm in the intervention group vs. 2.3 ± 5.8 cm in the control group ( P < 0.001).

Conclusion: These results suggested that plantar perception exercises might efficiently stabilize standing postural balance in the old old as well as the very old.