1
|
Kostro AM, Augustynik A, Kuryliszyn-Moskal A, Jamiołkowski J, Pocienè M, Dzięcioł-Anikiej Z. Significance of Selected Posturographic Methods in Diagnosis of Balance Disorders in Patients with Early-Stage Gonarthrosis. J Clin Med 2024; 13:3298. [PMID: 38893009 PMCID: PMC11172557 DOI: 10.3390/jcm13113298] [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: 04/23/2024] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Degenerative joint disease is a dynamic pathological process characterised by a destabilisation of the degradation and synthesis processes of articular cartilage and subchondral bone layer. Studies suggest that individuals with gonarthrosis experience deficits in proprioception, in addition to changes within their joints, which directly affects their ability to maintain posture and increases their risk of falling. Objectives: The aim of this study was to assess the functional status of patients with gonarthrosis through a posturographic examination conducted on a stabilometric platform (force plate) and a functional clinical examination. Methods: Participants were divided into two groups-a control group (n = 125) and a study group (n = 125). During the qualification process, subjective and objective examinations were conducted, including a functional assessment by means of such tests as the "Up and Go" Test, Functional Reach Test, Five Time Sit to Stand Test, and the Step Test. Subsequently, an assessment was conducted on the force plate by means of a posturographic test-the Romberg test performed with open and closed eyes in a standing position-and balance was evaluated using the Berg Balance Scale. The obtained data were analysed with the use of the IBM SPSS Statistics software version 27.0, by means of the Mann-Whitney test, and correlations were determined by means of Spearman's test. A significance level of p = 0.05 was adopted. Results: Statistically significant differences were observed among the assessed groups as a result of both functional and posturographic examinations, along with positive correlations for disease duration, age, and BMI index. Conclusions: Patients with gonarthrosis exhibited disturbances in balance, functionality, and posture compared to healthy individuals in the control group.
Collapse
Affiliation(s)
- Amanda Maria Kostro
- Rehabilitation Clinic, Medical University of Białystok, 15-089 Białystok, Poland (A.K.-M.)
| | - Artur Augustynik
- Rehabilitation Clinic, Medical University of Białystok, 15-089 Białystok, Poland (A.K.-M.)
| | - Anna Kuryliszyn-Moskal
- Rehabilitation Clinic, Medical University of Białystok, 15-089 Białystok, Poland (A.K.-M.)
| | - Jacek Jamiołkowski
- Population Medicine and Civilisation Disease Prevention Division, Medical University of Białystok, 15-089 Białystok, Poland
| | - Monika Pocienè
- Department of Physiotherapy and Beauty Therapy, Klaipèdos Valstybine Kolegia, 91274 Klaipėda, Lithuania
| | - Zofia Dzięcioł-Anikiej
- Rehabilitation Clinic, Medical University of Białystok, 15-089 Białystok, Poland (A.K.-M.)
| |
Collapse
|
2
|
Nowakowska-Lipiec K, Michnik R, Linek P, Myśliwiec A, Zadoń H, Gorwa J. Effect of strengthening and weakening of abdominal and dorsal muscles on lumbar spine loads in parents of disabled children. J Biomech 2023; 161:111864. [PMID: 37976939 DOI: 10.1016/j.jbiomech.2023.111864] [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: 04/27/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
Pain in the lower part of the back is one of the most common chronic illnesses globally. This work aimed to determine the impact of the reinforcement of particular groups of abdominal and dorsal muscles on the loads exerted on the lumbar section of the spine in 30 mothers of children with motor disabilities. An optical Ariel Performance Analysis System recorded and processed the kinematics data of everyday activities. Tests investigating the effects of the strengthening or weakening of abdominal and dorsal muscles on loading in the lumbar section of the spine utilized the AnyBody Modelling System. Input data for the simulations included mean values of body positions, while the effects of strengthening or weakening of muscles were simulated in the muscle forces model by introducing different values for muscle physiological cross-sectional area (PCSA). Simulations used decreasing or increasing PCSA values of abdominal muscles and the erector spinae. The analysis involved component and resultant force values on the lumbosacral joint (L5-S1) of the spine and intra-abdominal pressure values. The highest reduction of the resultant reaction value in L5-S1 was observed in the simulations that increased the PCSA of the transverse abdominal (TrA). Indeed, a double increase in the TrA cross-section caused a reduction of the resultant reaction in L5-S1 by 30% and the anterior-posterior and proximal-distal forces by approximately 20-30%. Increased PCSA of the erector spinae exerted higher loads on the spine. These results indicate that strengthening weakened abdominal muscles, particularly TrA, in parents of children with motor disabilities reduces lower spinal loads during daily activities.
Collapse
Affiliation(s)
- Katarzyna Nowakowska-Lipiec
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland.
| | - Robert Michnik
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Paweł Linek
- Institute of Physiotherapy and Health Sciences, Musculoskeletal Elastography and Ultrasonography Laboratory, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Andrzej Myśliwiec
- Institute of Physiotherapy and Health Sciences, Laboratory of Physiotherapy and Physioprevention, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Hanna Zadoń
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Joanna Gorwa
- Department of Biomechanics, Faculty of Sport Sciences, Poznan University of Physical Education, Poznań, Poland
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Jo SH, Choi HJ, Cho HS, Yoon JH, Lee WY. Effect of Core Balance Training on Muscle Tone and Balance Ability in Adult Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12190. [PMID: 36231489 PMCID: PMC9564429 DOI: 10.3390/ijerph191912190] [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: 08/02/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The amount of physical activity most adults perform is less than the recommended amount, and the resulting decrease in physical strength makes them vulnerable to various diseases. A decrease in muscle size and strength due to damage caused by disease or aging negatively affects functional strength. Muscle evaluation in adults can yield results that are predictive indicators of aging and unexpected disability. In addition, balance ability is essential to prevent falls and injuries in daily life and maintain functional activities. It is important to develop and strengthen balance in the lower extremities and core muscles to maintain and enhance overall body balance. This study aimed to analyze the effects of core balance training on muscle tone and balance ability in adults. (2) Methods: The participants of this study were 32 adult male and female university students (male: mean age = 21.3 ± 1.9 years, weight = 74.2 ± 12.6 kg, BMI = 23.4 + 2.5, n = 14; female: mean age = 21.0 ± 1.4 years, weight = 64.6 + 1.2 kg, BMI = 22.4 ± 2.4, n =18). Thirty-two adults (training group: 16, control group: 16; male: 16, female: 16) participated in the Myoton PRO (gastrocnemius lateral/medial, tibialis anterior), Pedalo balance system, and Y-balance test. (3) Results: The following results were obtained for muscle elasticity, stiffness, and dynamic/static balance ability after 10 weeks of core balance training. 1. There was no significant difference in muscle elasticity (gastrocnemius lateral/medial, tibialis anterior) (p < 0.05). 2. Muscle stiffness (gastrocnemius lateral/medial, tibialis anterior) significantly increased (p < 0.05). 3. Dynamic/static balance ability significantly increased (p < 0.05). (4) Conclusions: In future, data for the age and sex of various participants, should be accumulated by recruiting participants to study muscle characteristics, such as muscle elasticity and stiffness. Estimating the appropriate injury range and optimal exercise capacity is possible through follow-up studies. The findings can then be used as a basis for predicting injuries or determining and confirming the best time to resume exercise.
Collapse
Affiliation(s)
- Sun-Ha Jo
- Department of Advanced industry Convergence, Chosun University, Gwangju 61452, Korea
| | - Hyuk-Jae Choi
- Department of Medical Convergence Research & Development, Rehabilitation Engineering Research Institute, Korea Workers’ Compensation & Welfare Service, Incheon 21419, Korea
| | - Hyeon-Seok Cho
- Department of Medical Convergence Research & Development, Rehabilitation Engineering Research Institute, Korea Workers’ Compensation & Welfare Service, Incheon 21419, Korea
| | - Jin-Hwan Yoon
- Institute of Sports Medicine, Hannam University, Daejeon 34430, Korea
| | - Won-Young Lee
- Institute of Sports Medicine, Hannam University, Daejeon 34430, Korea
| |
Collapse
|
5
|
Losini AE, Grillet AC, Woloszyn M, Lavrik L, Moletti C, Dotelli G, Caruso M. Mechanical and Microstructural Characterization of Rammed Earth Stabilized with Five Biopolymers. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3136. [PMID: 35591470 PMCID: PMC9104653 DOI: 10.3390/ma15093136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023]
Abstract
This study aims to check the compatibility of a selection of waste and recycled biopolymers for rammed earth applications in order to replace the more common cement-based stabilization. Five formulations of stabilized rammed earth were prepared with different biopolymers: lignin sulfonate, tannin, sheep wool fibers, citrus pomace and grape-seed flour. The microstructure of the different formulations was characterized by investigating the interactions between earth and stabilizers through mercury intrusion porosimetry (MIP), nitrogen soprtion isotherm, powder X-ray diffraction (XRD) and scanning electron microscopy (SEM). The unconfined compressive strength (UCS) was also evaluated for all stabilized specimens. Three out of five biopolymers were considered suitable as rammed earth stabilizers. The use of wool increased the UCS by 6%, probably thanks to the combined effect of the length of the fibers and the roughness of their surfaces, which gives a contribution in binding clay particles higher than citrus and grape-seed flour. Lignin sulfonate and tannin increased the UCS by 38% and 13%, respectively, suggesting the additives' ability to fill pores, coat soil grains and form aggregates; this capability is confirmed by the reduction in the specific surface area and the pore volume in the nano- and micropore zones.
Collapse
Affiliation(s)
| | - Anne-Cecile Grillet
- LOCIE, CNRS, Universite Savoie Mont Blanc, 73000 Chambery, France; (A.-C.G.); (M.W.)
| | - Monika Woloszyn
- LOCIE, CNRS, Universite Savoie Mont Blanc, 73000 Chambery, France; (A.-C.G.); (M.W.)
| | - Liudmila Lavrik
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy; (L.L.); (C.M.); (G.D.)
| | - Chiara Moletti
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy; (L.L.); (C.M.); (G.D.)
| | - Giovanni Dotelli
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy; (L.L.); (C.M.); (G.D.)
| | - Marco Caruso
- Material Testing Laboratory, Politecnico di Milano, 20133 Milano, Italy;
| |
Collapse
|
6
|
Szturm T, Parmar ST, Mehta K, Shetty DR, Kanitkar A, Eskicioglu R, Gaonkar N. Game-Based Dual-Task Exercise Program for Children with Cerebral Palsy: Blending Balance, Visuomotor and Cognitive Training: Feasibility Randomized Control Trial. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22030761. [PMID: 35161508 PMCID: PMC8838424 DOI: 10.3390/s22030761] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 05/16/2023]
Abstract
The objective of this exploratory randomized controlled trial (RCT) was to provide evidence for the feasibility and therapeutic value of a novel game-based dual-task balance exercise program in children with cerebral palsy (CP). Twenty children with CP were recruited and randomized into two groups: (a) the conventional balance training group (CG) and (b) the experimental group (XG), which received a game-based dual-task (DT) balance exercise program. Both groups received their respective therapy programs for 12 weeks at a frequency of three sessions per week. Semi-structured interviews with the parents and children and qualitative analysis were conducted to evaluate the children's experiences with the game-based exercise program. The quantitative analysis included (a) the Pediatric Balance Scale (PBS), (b) Gross Motor Function Measure-88 (GMFM-88), and (c) computerized measures of standing balance performance during various dual-task conditions. Compliance was 100% for all 20 participants. Four themes captured the range of each participant's experiences and opinions: (a) reasons for participation, (b) likes and dislikes with the technologies, (c) positive effects of the program, and (d) future expectations. Children in the XG demonstrated greater improvements in PBS, GMFM, and DT balance measures as compared to children in the CG. The findings demonstrate feasible trial procedures and acceptable DT-oriented training with a high compliance rate and positive outcomes. These findings support further research and development and progression to the next phase of a full-scale RCT to evaluate the clinical effectiveness of the game-based DT balance exercise program for children with CP.
Collapse
Affiliation(s)
- Tony Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E0T6, Canada;
- Correspondence: (T.S.); (S.T.P.)
| | - Sanjay Tejraj Parmar
- SDM College of Physiotherapy, Dharwad 580009, India;
- Correspondence: (T.S.); (S.T.P.)
| | - Kavisha Mehta
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E0T6, Canada;
| | | | - Anuprita Kanitkar
- Department of Applied Health Sciences, University of Manitoba, Winnipeg, MB R3E0T6, Canada;
| | - Rasit Eskicioglu
- Computer Sciences, University of Manitoba, Winnipeg, MB R3E0T6, Canada;
| | | |
Collapse
|
7
|
Computational epidemiology study of homeostatic compensation during sensorimotor aging. Neural Netw 2021; 146:316-333. [PMID: 34923219 DOI: 10.1016/j.neunet.2021.11.024] [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] [Received: 04/16/2021] [Revised: 10/26/2021] [Accepted: 11/24/2021] [Indexed: 11/20/2022]
Abstract
The vestibulo-ocular reflex (VOR) stabilizes vision during head motion. Age-related changes of vestibular neuroanatomical properties predict a linear decay of VOR function. Nonetheless, human epidemiological data show a stable VOR function across the life span. In this study, we model cerebellum-dependent VOR adaptation to relate structural and functional changes throughout aging. We consider three neurosynaptic factors that may codetermine VOR adaptation during aging: the electrical coupling of inferior olive neurons, the long-term spike timing-dependent plasticity at parallel fiber - Purkinje cell synapses and mossy fiber - medial vestibular nuclei synapses, and the intrinsic plasticity of Purkinje cell synapses Our cross-sectional aging analyses suggest that long-term plasticity acts as a global homeostatic mechanism that underpins the stable temporal profile of VOR function. The results also suggest that the intrinsic plasticity of Purkinje cell synapses operates as a local homeostatic mechanism that further sustains the VOR at older ages. Importantly, the computational epidemiology approach presented in this study allows discrepancies among human cross-sectional studies to be understood in terms of interindividual variability in older individuals. Finally, our longitudinal aging simulations show that the amount of residual fibers coding for the peak and trough of the VOR cycle constitutes a predictive hallmark of VOR trajectories over a lifetime.
Collapse
|
8
|
A Velostat-Based Pressure-Sensitive Mat for Center-of-Pressure Measurements: A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115958. [PMID: 34199360 PMCID: PMC8199542 DOI: 10.3390/ijerph18115958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 11/17/2022]
Abstract
Center-of-pressure (CoP) displacements play a key role in studies assessing postural stability. The accepted instrument to measure CoP trajectories is the force platform, but pressure-sensitive mats (PSMs) are an alternative composed of a matrix of sensitive cells. A typical cell comprises two electrodes with piezoresistive material in between, while a force platform has a force sensor at each of its corners. In this paper, we compare a homemade Velostat-based PSM and an affordable commercial mat with a commercial force platform in a test series with 42 healthy volunteers in single-legged trials (29 males, 13 females; height 1.74 (0.09) m, weight 74.3 (16.34) kg, age 31.21 (12.66) years). The aim of the research was to perform a preliminary study of the performance of our prototype to measure CoP, and more specifically, the standard deviation of the CoP path on both axes, the medial-lateral and anterior-posterior. We could thus discover several improvements for future clinical applications. The intraclass correlation coefficient (ICC) for agreement in the base experiment showed a moderate value for the prototype (0.38 to 0.63) and lower values for the commercial mat (0.11 to 0.12). However, we identified several factors that were relevant to improve ICC and reduce error by considering several processing options: (i) the known crosstalk problem between cells that appears in this kind of mats must be eliminated; (ii) the response time of the sensor has to be taken into account; and (iii) increasing the mat resolution also improves agreement. Therefore, as future work, we plan to test the improved version of the prototype in a clinical environment.
Collapse
|
9
|
Nayak A, Alhasani R, Kanitkar A, Szturm T. Dual-Task Training Program for Older Adults: Blending Gait, Visuomotor and Cognitive Training. FRONTIERS IN NETWORK PHYSIOLOGY 2021; 1:736232. [PMID: 36925571 PMCID: PMC10013153 DOI: 10.3389/fnetp.2021.736232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022]
Abstract
Objective: Physical and cognitive impairments are common with aging and often coexist. Changes in the level of physical and mental activity are prognostic for adverse health events and falls. Dual-task (DT) training programs that can improve mobility and cognition simultaneously can bring significant improvements in rehabilitation. The objective of this mixed methods exploratory RCT was to provide evidence for the feasibility and therapeutic value of a novel game-assisted DT exercise program in older adults. Methods: Twenty-two community dwelling participants, between the ages of 70-85 were randomized to either dual-task treadmill walking (DT-TR) or dual-task recumbent bicycle (DT-RC). Both groups viewed a standard LED computer monitor and performed a range of cognitive game tasks while walking or cycling; made possible with the use of a "hands-free", miniature, inertial-based computer mouse. Participants performed their respective 1-h DT exercise program twice a week, for 12 weeks at a community fitness centre. Semi-structured interviews and qualitative analysis was conducted to evaluate the participant's experiences with the exercise program. Quantitative analysis included measures of standing balance, gait function (spatiotemporal gait variable), visuomotor and executive cognitive function, tested under single and DT walking conditions. Results: Compliance was 100% for all 22 participants. Four themes captured the range of participant's experiences and opinions: 1) reasons for participation, 2) difficulties with using the technologies, 3) engagement with the computer games, and 4) positive effects of the program. Both groups showed significant improvements in standing balance performance, visuomotor and visuospatial executive function. However, significant improvement in dual task gait function was observed only in the DT-TR group. Medium to large effect sizes were observed for most balance, spatiotemporal gait variables, and cognitive performance measure. Conclusion: With only minor difficulties with the technology being reported, the findings demonstrate feasible trial procedures and acceptable DT oriented training with a high compliance rate and positive outcomes. These findings support further research and development, and will direct the next phase of a full-scale RCT.
Collapse
Affiliation(s)
- Akshata Nayak
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Rehab Alhasani
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Anuprita Kanitkar
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
10
|
Efficacy of an 8-Week Resistance Training Program in Older Adults: A Randomized Controlled Trial. J Aging Phys Act 2020; 29:121-129. [PMID: 32788412 DOI: 10.1123/japa.2020-0078] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 11/18/2022]
Abstract
Older adults are challenged with aging-related declines in skeletal muscle mass and function. Although exercise interventions of longer duration typically yield larger changes, shorter-term interventions may kick-start positive effects, allowing participants to begin engaging in more activity. This study aimed to determine whether 8 weeks of a resistance training program (Stay Strong, Stay Healthy [SSSH]) improved dynamic muscle strength, balance, flexibility, and sleep. Inactive adults aged ≥60 years were randomized into SSSH (n = 15), walking (WALK; n = 17), or control (CON; n = 14) groups. The SSSH and WALK groups met 2 times per week for 60 min. The participants completed pre/post general health, activity, and sleep questionnaires; DXA scans; and functional tasks. One-way repeated-measures multivariate analysis of variance was used to determine interactions and decomposed using repeated-measures analysis of variance. SSSH improved sit-to-stand performance, back scratch distance, and sleep quality and reported more auxiliary physical activity than WALK or CON (p < .05). Resistance training interventions in sedentary older adults can improve physical function and encourage additional activity in 8 weeks.
Collapse
|
11
|
Robotic balance assessment in community-dwelling older people with different grades of impairment of physical performance. Aging Clin Exp Res 2020; 32:491-503. [PMID: 31691151 DOI: 10.1007/s40520-019-01395-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/19/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Impaired physical performance is common in older adults and has been identified as a major risk factor for falls. To date, there are no conclusive data on the impairment of balance parameters in older subjects with different levels of physical performance. AIMS The aim of this study was to investigate the relationship between different grades of physical performance, as assessed by the Short Physical Performance Battery (SPPB), and the multidimensional balance control parameters, as measured by means of a robotic system, in community-dwelling older adults. METHODS This study enrolled subjects aged ≥ 65 years. Balance parameters were assessed by the hunova robot in static and dynamic (unstable and perturbating) conditions, in both standing and seated positions and with the eyes open/closed. RESULTS The study population consisted of 96 subjects (62 females, mean age 77.2 ± 6.5 years). According to their SPPB scores, subjects were separated into poor performers (SPPB < 8, n = 29), intermediate performers (SPPB = 8-9, n = 29) and good performers (SPPB > 9, n = 38). Poor performers displayed significantly worse balance control, showing impaired trunk control in most of the standing and sitting balance tests, especially in dynamic (both with unstable and perturbating platform/seat) conditions. CONCLUSIONS For the first time, multidimensional balance parameters, as detected by the hunova robotic system, were significantly correlated with SPPB functional performances in community-dwelling older subjects. In addition, balance parameters in dynamic conditions proved to be more sensitive in detecting balance impairments than static tests.
Collapse
|
12
|
Christopher A, Kraft E, Olenick H, Kiesling R, Doty A. The reliability and validity of the Timed Up and Go as a clinical tool in individuals with and without disabilities across a lifespan: a systematic review. Disabil Rehabil 2019; 43:1799-1813. [PMID: 31656104 DOI: 10.1080/09638288.2019.1682066] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE To summarize the available literature related to reliability and validity of the Timed Up and Go in typical adults and children, and individuals diagnosed with the following pathologies: Huntington's disease, stroke, multiple sclerosis, Parkinson's disease, spinal cord injury, Down syndrome, or cerebral palsy. MATERIALS AND METHODS A search was conducted using MeSH terms and keywords through a variety of databases. Data regarding reliability and validity were synthesized. RESULTS This review included 77 articles. Results were variable depending on the studied population. The Timed Up and Go showed excellent reliability in typical adults, in individuals with cerebral palsy, in individuals with multiple sclerosis, in individuals with Huntington's disease, individuals with a stroke, and individuals with a spinal cord injury. The TUG demonstrated strong concurrent validity for individuals with stroke and spinal cord injury. Predictive validity data was limited. CONCLUSIONS Based on the literature assessed, the Timed Up and Go is clinically applicable and reliable across multiple populations. The Timed Up and Go has a wide variety of clinical use making it a diverse measure that should be considered when choosing an outcome an activity based outcome measure. However, there are some limitations in the validity of the utilization of the Timed Up and Go to some populations due to a lack of data and/or poor choice of comparison outcome measures when assessing validity. Additional research is needed for young to middle aged adults.IMPLICATIONS FOR REHABILITATIONOutcome measures are a vital component of clinical practice across all populations.The Timed Up and Go is a highly studied outcome measure in the geriatric population, but lacks research of its applicability to other populations.This study was able to highlight the clinical utility of the Timed Up and Go in populations that under utilize this outcome measure.
Collapse
Affiliation(s)
| | - Emily Kraft
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| | - Hannah Olenick
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| | - Riley Kiesling
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| | - Antonette Doty
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| |
Collapse
|
13
|
Meseguer-Henarejos AB, Rubio-Aparicio M, López-Pina JA, Carles-Hernández R, Gómez-Conesa A. Characteristics that affect score reliability in the Berg Balance Scale: a meta-analytic reliability generalization study. Eur J Phys Rehabil Med 2019; 55:570-584. [DOI: 10.23736/s1973-9087.19.05363-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
14
|
Ferraro R, Garman S, Taylor R, Parrott JS, Kadlowec J. The effectiveness of transverse abdominis training on balance, postural sway and core muscle recruitment patterns: a pilot study comparison across age groups. J Phys Ther Sci 2019; 31:729-737. [PMID: 31631946 PMCID: PMC6751050 DOI: 10.1589/jpts.31.729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/17/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This pilot study aims to determine whether improvements in postural sway, particularly among older adults, can be augmented immediately after training participants to activate and isolate the transverse abdominis (TrA) muscle. [Participants and Methods] Fifty six participants (in three age groups) took part in a single session TrA training intervention. Aspects of postural sway, balance and muscle activation patterns were measured before and after training and compared. [Results] There was significant improvement across four of six postural sway variables for the combined sample of all age groups. Older adults improved more than younger and middle-age participants in two important postural sway variables. No marked differences were evident in static reach distance across all age groups. There were no differences between groups with regard to surface electromyography (sEMG) amplitudes despite the emergence of different activation patterns among age groups. [Conclusion] Immediate effects were induced in postural sway measures after the single session training intervention. By improving neuromuscular control of the TrA and maximizing the efficiency of related proximal core muscles center of pressure (COP) sway velocities decreased during single limb standing (SLS).
Collapse
Affiliation(s)
- Richard Ferraro
- School of Health Professions, Rutgers, The State University of New Jersey: 200 College Drive, Jefferson Hall, Blackwood, New Jersey 08012, USA
| | - Sarah Garman
- School of Health Professions, Rutgers, The State University of New Jersey: 200 College Drive, Jefferson Hall, Blackwood, New Jersey 08012, USA
| | - Rebecca Taylor
- School of Health Professions, Rutgers, The State University of New Jersey: 200 College Drive, Jefferson Hall, Blackwood, New Jersey 08012, USA
| | - J Scott Parrott
- Departments of Interdisciplinary Studies and Epidemiology, Rutgers, The State University of New Jersey, USA
| | | |
Collapse
|
15
|
Sant'Anna P, Silva FDO, Rodrigues ACDMA, Plácido J, Ferreira JV, Meereis ECW, Praxedes J, Marinho V, Laks J, Sobral R, Deslandes AC. Posturographic analysis of older adults without dementia and patients with Alzheimer's disease: A cross-sectional study. Dement Neuropsychol 2019; 13:196-202. [PMID: 31285794 PMCID: PMC6601301 DOI: 10.1590/1980-57642018dn13-020008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Additional clinical tools should be investigated to facilitate and aid the early
diagnosis of cognitive decline. Postural control worsens with aging and this may
be related to pathological cognitive impairment.
Collapse
Affiliation(s)
- Paula Sant'Anna
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | | | | | - Jéssica Plácido
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | | | | | | | - Valeska Marinho
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Jerson Laks
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Renato Sobral
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,Post-graduate Program of Health Sciences, Universidade Estadual de Montes Claros, MG, Brazil
| | | |
Collapse
|
16
|
Lusardi MM, Fritz S, Middleton A, Allison L, Wingood M, Phillips E, Criss M, Verma S, Osborne J, Chui KK. Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability. J Geriatr Phys Ther 2018; 40:1-36. [PMID: 27537070 PMCID: PMC5158094 DOI: 10.1519/jpt.0000000000000099] [Citation(s) in RCA: 302] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
BACKGROUND Falls and their consequences are significant concerns for older adults, caregivers, and health care providers. Identification of fall risk is crucial for appropriate referral to preventive interventions. Falls are multifactorial; no single measure is an accurate diagnostic tool. There is limited information on which history question, self-report measure, or performance-based measure, or combination of measures, best predicts future falls. PURPOSE First, to evaluate the predictive ability of history questions, self-report measures, and performance-based measures for assessing fall risk of community-dwelling older adults by calculating and comparing posttest probability (PoTP) values for individual test/measures. Second, to evaluate usefulness of cumulative PoTP for measures in combination. DATA SOURCES To be included, a study must have used fall status as an outcome or classification variable, have a sample size of at least 30 ambulatory community-living older adults (≥65 years), and track falls occurrence for a minimum of 6 months. Studies in acute or long-term care settings, as well as those including participants with significant cognitive or neuromuscular conditions related to increased fall risk, were excluded. Searches of Medline/PubMED and Cumulative Index of Nursing and Allied Health (CINAHL) from January 1990 through September 2013 identified 2294 abstracts concerned with fall risk assessment in community-dwelling older adults. STUDY SELECTION Because the number of prospective studies of fall risk assessment was limited, retrospective studies that classified participants (faller/nonfallers) were also included. Ninety-five full-text articles met inclusion criteria; 59 contained necessary data for calculation of PoTP. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) was used to assess each study's methodological quality. DATA EXTRACTION Study design and QUADAS score determined the level of evidence. Data for calculation of sensitivity (Sn), specificity (Sp), likelihood ratios (LR), and PoTP values were available for 21 of 46 measures used as search terms. An additional 73 history questions, self-report measures, and performance-based measures were used in included articles; PoTP values could be calculated for 35. DATA SYNTHESIS Evidence tables including PoTP values were constructed for 15 history questions, 15 self-report measures, and 26 performance-based measures. Recommendations for clinical practice were based on consensus. LIMITATIONS Variations in study quality, procedures, and statistical analyses challenged data extraction, interpretation, and synthesis. There was insufficient data for calculation of PoTP values for 63 of 119 tests. CONCLUSIONS No single test/measure demonstrated strong PoTP values. Five history questions, 2 self-report measures, and 5 performance-based measures may have clinical usefulness in assessing risk of falling on the basis of cumulative PoTP. Berg Balance Scale score (≤50 points), Timed Up and Go times (≥12 seconds), and 5 times sit-to-stand times (≥12) seconds are currently the most evidence-supported functional measures to determine individual risk of future falls. Shortfalls identified during review will direct researchers to address knowledge gaps.
Collapse
Affiliation(s)
- Michelle M Lusardi
- 1Department of Physical Therapy and Human Movement Science, College of Health Professions, Sacred Heart University, Fairfield, Connecticut 2Department of Physical Therapy, Arnold School of Public Health, University of South Carolina, Columbia 3Division of Rehabilitation Sciences and Center for Recovery, Physical Activity and Nutrition, University of Texas Medical Branch, Galveston 4Department of Physical Therapy, Winston Salem State University, Winston Salem, North Carolina 5University of Vermont Medical Center, Colchester 6University of North Carolina Memorial Hospitals, Chapel Hill 7Physical Therapy Program, Chatham University, Pittsburgh, Pennsylvania 8Care One at the Highlands, Edison, New Jersey 9Geriatric Residency Program, Brooks Rehabilitation Institute of Higher Learning, Jacksonville, Florida 10School of Physical Therapy, Pacific University, Hillsboro, Oregon
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Inukai Y, Masaki M, Otsuru N, Saito K, Miyaguchi S, Kojima S, Onishi H. Effect of noisy galvanic vestibular stimulation in community-dwelling elderly people: a randomised controlled trial. J Neuroeng Rehabil 2018; 15:63. [PMID: 29970144 PMCID: PMC6029379 DOI: 10.1186/s12984-018-0407-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/19/2018] [Indexed: 11/29/2022] Open
Abstract
Background Balance disorders are a risk factor for falls in the elderly. Although noisy galvanic vestibular stimulation (nGVS) has been reported to improve balance in young people, randomised control trials targeting community-dwelling elderly people have not been conducted to date. We aimed to assess the influence of nGVS on COP sway in the open-eye standing posture among community-dwelling elderly people in a randomised controlled trial. Methods A randomised controlled trial of 32 community-dwelling elderly people randomly assigned to control (sham stimulation) and an nGVS groups. All participants underwent centre of pressure (COP) sway measurements while standing with open eyes at baseline and during stimulation. The control group underwent sham stimulation and the nGVS group underwent noise stimulation (0.4 mA; 0.1–640 Hz). Results In the nGVS group, sway path length, mediolateral mean velocity and anteroposterior mean velocity decreased during stimulation compared with baseline (P < 0.01). The effect of nGVS was large in participants with a high COP sway path length at baseline, but there was no significant difference in COP sway in the control group. Conclusions We conclude that nGVS decreases the COP sway path length and mean velocity of community-dwelling elderly people when standing with open eyes. This suggests that nGVS could be effective for treating balance dysfunction in the elderly.
Collapse
Affiliation(s)
- Yasuto Inukai
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan. .,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan.
| | - Mitsuhiro Masaki
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan
| | - Naofumi Otsuru
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan
| | - Kei Saito
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan
| | - Shota Miyaguchi
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan
| | - Sho Kojima
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan
| | - Hideaki Onishi
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata, Japan
| |
Collapse
|
18
|
Baldacchino FV, Pedrinolla A, Venturelli M. Exercise-induced adaptations in patients with Alzheimer’s disease: the role of circadian scheduling. SPORT SCIENCES FOR HEALTH 2018. [DOI: 10.1007/s11332-018-0479-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
19
|
Lee K, Lee YW. Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial. J Phys Ther Sci 2017; 29:1590-1595. [PMID: 28931994 PMCID: PMC5599827 DOI: 10.1589/jpts.29.1590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/08/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults.
Collapse
Affiliation(s)
- Kyeongjin Lee
- Department of Physical Therapy, Kyungdong University, Republic of Korea
| | - Yong Woo Lee
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung2-dong, Nowon-gu, Seoul 139-742, Republic of Korea
| |
Collapse
|
20
|
Balance Performance Is Task Specific in Older Adults. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6987017. [PMID: 29018817 PMCID: PMC5605868 DOI: 10.1155/2017/6987017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 08/03/2017] [Indexed: 12/21/2022]
Abstract
Balance ability among the elderly is a key component in the activities of daily living and is divided into two types: static and dynamic. For clinicians who wish to assess the risk of falling among their elderly patients, it is unclear if more than one type of balance test can be used to measure their balance impairment. In this study, we examined the association between static balance measures and two dynamic balance field tests. One hundred and twelve community-dwelling older adults (mean age 74.6) participated in the study. They underwent the Tetrax static postural assessment and then performed the Timed Up and Go (TUG) and the Functional Reach (FR) Test as dynamic balance tests. In general, low-moderate correlations were found between the two types of balance tests. For women, age and static balance parameters explained 28.1–40.4% of the variance of TUG scores and 14.6–24% of the variance of FR scores. For men, age and static balance parameters explained 9.5–31.2% of the variance of TUG scores and 23.9–41.7% of the variance of FR scores. Based on our findings, it is suggested that a combination of both static and dynamic tests be used for assessing postural balance ability.
Collapse
|
21
|
Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults. Am J Phys Med Rehabil 2017; 95:475-82. [PMID: 27003205 DOI: 10.1097/phm.0000000000000488] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults. DESIGN WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) and ratio (WSRratio = MWS/SSWS). RESULTS SSWS (P < 0.001), MWS (P < 0.001), and WSRdiff (P < 0.01) were associated with fall status. The cutpoints identified were 0.76 m/s for SSWS (65.4% sensitivity, 70.9% specificity), 1.13 m/s for MWS (76.6% sensitivity, 60.0% specificity), and 0.24 m/s for WSRdiff (56.1% sensitivity, 70.9% specificity). SSWS and MWS better discriminated between fallers and non-fallers (SSWS: AUC = 0.69, MWS: AUC = 0.71) than WSRdiff (AUC = 0.64). CONCLUSIONS SSWS and MWS seem to be equally informative measures for assessing fall status in community-dwelling older adults. Older adults with SSWSs less than 0.76 m/s and those with MWSs less than 1.13 m/s may benefit from further fall risk assessment. Combining SSWS and MWS to calculate an individual's WSR does not provide additional insight into fall status in this population. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Describe the different methods for calculating walking speed reserve and discuss the potential of the metric as an outcome measure; (2) Explain the degree to which self-selected walking speed, maximal walking speed, and walking speed reserve are associated with fall status among community-dwelling older adults; and (3) Discuss potential limitations to using walking speed reserve to identify fall status in populations without mobility restrictions. LEVEL Advanced ACCREDITATION : The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.
Collapse
|
22
|
Beauchet O, Barden J, Liu-Ambrose T, Chester VL, Szturm T, Allali G. The relationship between hippocampal volume and static postural sway: results from the GAIT study. AGE (DORDRECHT, NETHERLANDS) 2016; 38:19. [PMID: 26833034 PMCID: PMC5005866 DOI: 10.1007/s11357-016-9883-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/26/2016] [Indexed: 05/24/2023]
Abstract
The role of the hippocampus in postural control, in particular in maintaining upright stance, has not been fully examined in normal aging. This study aims to examine the association of postural sway with hippocampal volume while maintaining upright stance in healthy older individuals. Seventy healthy individuals (mean age 69.7 ± 3.4 years; 41.4 % women) were recruited in this study based on cross-sectional design. Hippocampal volume (quantified from a three-dimensional T1-weighted MRI using semi-automated software), three center of pressure (COP) motion parameters (sway area, path length of anterior-posterior (AP) and medial-lateral (ML) displacement) while maintaining upright stance (eyes open and closed), and the relative difference between open and closed eye conditions were used as outcome measures. Age, sex, body mass index, lower limb proprioception, distance vision, 15-item geriatric depression scale score, total cranial volume, and white matter abnormalities were used as covariates. The sway area decreased from open to closed eye condition but this variation was non-significant (P = 0.244), whereas path length of AP and ML displacement increased significantly (P < 0.003). Increase in sway area from open to closed eyes was associated with greater hippocampal volume (β -18.21; P = 0.044), and a trend for an association of increase in path length of AP displacement (P = 0.075 for open eyes and P = 0.071 for closed eyes) with greater hippocampal volume was reported. The hippocampus is involved in upright postural control in normal aging, such that an increase in sway area of COP motion from open to closed eyes is associated with greater hippocampal volume in healthy older adults.
Collapse
Affiliation(s)
- Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada.
- Centre of Excellence on Aging and Chronic Diseases of McGill integrated University Health Network, Quebec, Canada.
| | - John Barden
- Neuromechanical Research Centre, Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, BC, Canada
| | - Victoria L Chester
- Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland
| |
Collapse
|
23
|
Paillard T, Noé F, Bru N, Couderc M, Debove L. The impact of time of day on the gait and balance control of Alzheimer's patients. Chronobiol Int 2016; 33:161-8. [PMID: 26785632 DOI: 10.3109/07420528.2015.1124885] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Alzheimer's patients suffer from circadian dysregulation. The aim of this study was to examine the evolution of balance control and gait at different times of the day (11:00, 14:00, 18:00) in order to identify whether Alzheimer's patients were more likely to fall at certain periods of the day. Spatio-temporal parameters of centre of foot pressure displacements were measured with a force platform and spatio-temporal parameters of walking were evaluated with a gait analysis device. The results highlighted that balance control was worse in the evening and the afternoon than in the morning. Furthermore, the walking speed was faster and support duration, swing duration and cycle duration were shorter in the evening than in the morning and afternoon. The combined analysis of balance control and gait parameters revealed that balance control and walking are concomitantly altered in the evening which increases the fall risk in the evening, in comparison with the morning, for Alzheimer's patients.
Collapse
Affiliation(s)
- Thierry Paillard
- a Département STAPS, Laboratoire Activité Physique, Performance et Santé , Université de Pau et des Pays de l'Adour , Tarbes , France
| | - Frederic Noé
- a Département STAPS, Laboratoire Activité Physique, Performance et Santé , Université de Pau et des Pays de l'Adour , Tarbes , France
| | - Noëlle Bru
- b Laboratoire de Mathématique et leurs Applications, UMR CNRS 5142 , Université de Pau et des Pays de l'Adour , Pau , France
| | - Martine Couderc
- c Centre Hospitalier de Lourdes, Service gériatrique , Lourdes , France
| | - Lola Debove
- a Département STAPS, Laboratoire Activité Physique, Performance et Santé , Université de Pau et des Pays de l'Adour , Tarbes , France.,c Centre Hospitalier de Lourdes, Service gériatrique , Lourdes , France
| |
Collapse
|
24
|
Campbell C, Kress J, Schroeder J, Donlin A, Rozenek R. The Relationship Between Pedometer-Determined Ambulatory Activity and Balance Variables Within an Older Adult Population. Gerontol Geriatr Med 2016; 2:2333721416681919. [PMID: 28138503 PMCID: PMC5153022 DOI: 10.1177/2333721416681919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/06/2016] [Accepted: 10/28/2016] [Indexed: 12/04/2022] Open
Abstract
The purpose of this investigation was to determine the differences between gender, physical activity level, and balance in an older adult population. A secondary purpose was to examine the relationship between pedometer-determined ambulatory activity and balance. Forty-six older adults aged 73.7 ± 6.2 years participated in the study. Participants completed the Fullerton Advanced Balance (FAB) Scale and completed a 2-week daily step recording to determine average steps taken per day. Low-level activity participants (<5,000 steps/day) were significantly different from the high-level activity participants (>7,500 steps/day) in weight, age, and the number of medications reported. Males performed better than females on the two-footed jump test and reactive postural test FAB assessments. High-level activity participants performed significantly better than low-level activity participants on all FAB assessments except stand with feet together and eyes closed, reach forward to object, and walk with head turns.
Collapse
Affiliation(s)
| | - Jeff Kress
- California State University, Long Beach, USA
| | | | - Ayla Donlin
- California State University, Long Beach, USA
| | | |
Collapse
|
25
|
Kannenberg A, Zacharias B, Pröbsting E. Benefits of microprocessor-controlled prosthetic knees to limited community ambulators: systematic review. ACTA ACUST UNITED AC 2015; 51:1469-96. [PMID: 25856664 DOI: 10.1682/jrrd.2014.05.0118] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 09/30/2014] [Indexed: 11/05/2022]
Abstract
The benefits of microprocessor-controlled prosthetic knees (MPKs) have been well established in community ambulators (Medicare Functional Classification Level [MFCL]-3) with a transfemoral amputation (TFA). A systematic review of the literature was performed to analyze whether limited community ambulators (MFCL-2) may also benefit from using an MPK in safety, performance-based function and mobility, and perceived function and satisfaction. We searched 10 scientific databases for clinical trials with MPKs and identified six publications with 57 subjects with TFA and MFCL-2 mobility grade. Using the criteria of a Cochrane Review on prosthetic components, we rated methodological quality moderate in four publications and low in two publications. MPK use may significantly reduce uncontrolled falls by up to 80% as well as significantly improve indicators of fall risk. Performance-based outcome measures suggest that persons with MFCL-2 mobility grade may be able to walk about 14% to 25% faster on level ground, be around 20% quicker on uneven surfaces, and descend a slope almost 30% faster when using an MPK. The results of this systematic review suggest that trial fittings may be used to determine whether or not individuals with TFA and MFCL-2 mobility grade benefit from MPK use. Criteria for patient selection and assessment of trial fitting success or failure are proposed.
Collapse
|
26
|
Szturm T, Hochman J, Wu C, Lisa L, Reimer K, Wonneck B, Giacobbo A. Games and Telerehabilitation for Balance Impairments and Gaze Dysfunction: Protocol of a Randomized Controlled Trial. JMIR Res Protoc 2015; 4:e118. [PMID: 26490109 PMCID: PMC4704916 DOI: 10.2196/resprot.4743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 08/15/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Digital media and gaming have received considerable interest from researchers and clinicians as a model for learning a broad range of complex tasks and facilitating the transfer of skills to daily life. These emerging rehabilitation technologies have the potential to improve clinical outcomes and patient participation because they are engaging, motivating, and accessible. Our research goal is to develop preventative and therapeutic point-of-care eHealth applications that will lead to equivalent or better long-term health outcomes and health care costs than existing programs. We have produced a novel computer-aided tele-rehabilitation platform that combines computer game-based exercises with tele-monitoring. OBJECTIVE Compare the therapeutic effectiveness of an in-home, game-based rehabilitation program (GRP) to standard care delivered in an outpatient physical therapy clinic on measures of balance, gaze control, dizziness, and health-related quality of life. METHODS A randomized, controlled, single-blind pilot trial will be conducted. Fifty-six participants with a diagnosis of peripheral vestibular disorder will be randomly assigned to either usual physical therapy (comparator group) or to a game-based intervention (experimental group). Measures to be assessed will include gaze control, dynamic balance, and self-reported measures of dizziness. RESULTS The project was funded and enrollment was started in August 2014. To date, 36 participants have been enrolled. There have been 6 drop-outs. It is expected that the study will be completed January 2016 and the first results are expected to be submitted for publication in Spring of 2016. CONCLUSIONS A successful application of this rehabilitation program would help streamline rehabilitation services, leverage therapist time spent with clients, and permit regular practice times at the client's convenience. TRIAL REGISTRATION Clinicaltrials.gov: NCT02134444; https://clinicaltrials.gov/ct2/show/NCT02134444 (Archived by WebCite at http://www.webcitation.org/6cE18bqqY).
Collapse
Affiliation(s)
- Tony Szturm
- College of Rehabilitation Sciences, Department of Physical Therapy, University of Manitoba, Winnipeg, MB, Canada.
| | | | | | | | | | | | | |
Collapse
|
27
|
Kuznetsov NA, Riley MA. The role of task constraints in relating laboratory and clinical measures of balance. Gait Posture 2015; 42:275-9. [PMID: 26112778 DOI: 10.1016/j.gaitpost.2015.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/09/2015] [Accepted: 05/28/2015] [Indexed: 02/02/2023]
Abstract
This study tested the hypothesis that age-related postural control deficits are more clearly detected from force plate recordings when using postural control tasks with an explicitly defined goal as opposed to the frequently used quiet stance task. Eighteen older adults (over 65) and seventeen younger adults (under 30) stood on a force plate with visual feedback (VFB) of the center of pressure (COP) and without such visual feedback with eyes open (NVFB). In the VFB condition, online visual feedback about the COP was provided and participants maintained that feedback on a stationary visual target for 80s. We hypothesized that age-related difference in COP variability (standard deviation of COP position and average absolute maximum COP velocity; AAMV) would be more pronounced in the VFB than in the NVFB condition. In addition, we hypothesized that Berg balance scale (BBS) scores for older adults would correlate more strongly with the COP measures in the VFB condition than in the NVFB condition. Results showed that VFB enhanced age-related differences only for AAMV in anterior-posterior direction. Both age groups decreased postural sway when using VFB. Older adults increased AAMV with VFB while young adults did not, indicating that the task modified their postural control strategy stronger than in younger adults. BBS scores were correlated with the AAMV in both feedback conditions, while COP position variability was more clearly correlated with BBS in the VFB condition. These results suggest that the quiet stance task is sufficient to index balance function if velocity-based COP variables are utilized in the analysis.
Collapse
Affiliation(s)
| | - Michael A Riley
- Department of Psychology, University of Cincinnati, Cincinnati, OH USA; Center for Cognition, Action, & Perception, University of Cincinnati, Cincinnati, OH USA
| |
Collapse
|
28
|
Szturm T, Reimer KM, Hochman J. Home-Based Computer Gaming in Vestibular Rehabilitation of Gaze and Balance Impairment. Games Health J 2015; 4:211-20. [DOI: 10.1089/g4h.2014.0093] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Karen M. Reimer
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jordan Hochman
- Department of Otolaryngology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
29
|
Clark RA, Vernon S, Mentiplay BF, Miller KJ, McGinley JL, Pua YH, Paterson K, Bower KJ. Instrumenting gait assessment using the Kinect in people living with stroke: reliability and association with balance tests. J Neuroeng Rehabil 2015; 12:15. [PMID: 25884838 PMCID: PMC4333881 DOI: 10.1186/s12984-015-0006-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/28/2015] [Indexed: 11/15/2022] Open
Abstract
Background The Microsoft Kinect has been used previously to assess spatiotemporal aspects of gait; however the reliability of this system for the assessment of people following stroke has not been established. This study examined the reliability and additional information that the Kinect provides when instrumenting a gait assessment in people living with stroke. Methods The spatiotemporal variables of step length, step length asymmetry, foot swing velocity, foot swing velocity asymmetry, peak and mean gait speed and the percentage difference between the peak and mean gait speed were assessed during gait trials in 30 outpatients more than three months post-stroke and able to stand unsupported. Additional clinical assessments of functional reach (FR), step test (ST), 10 m walk test (10MWT) and the timed up and go (TUG) were performed, along with force platform instrumented assessments of center of pressure path length velocity during double-legged standing balance with eyes closed (DLEC), weight bearing asymmetry (WBA) and dynamic medial-lateral weight-shifting ability (MLWS). These tests were performed on two separate occasions, seven days apart for reliability assessment. Separate adjusted multiple regressions models for predicting scores on the clinical and force platform assessments were created using 1) the easily assessed clinically-derived gait variables 10MWT time and total number of steps; and 2) the Kinect-derived variables which were found to be reliable (ICC > 0.75) and not strongly correlated (Spearman’s ρ < 0.80) with each other (i.e. non-redundant). Results Kinect-derived variables were found to be highly reliable (all ICCs > 0.80), but many were redundant. The final regression model using Kinect-derived variables consisted of the asymmetry scores, mean gait velocity, affected limb foot swing velocity and the difference between peak and mean gait velocity. In comparison with the clinically-derived regression model, the Kinect-derived model accounted for >15% more variance on the MLWS, ST and FR tests and scored similarly on all other measures. Conclusions In conclusion, instrumenting gait using the Kinect is reliable and provides insight into the dynamic balance capacity of people living with stroke. This system provides a minimally intrusive method of examining potentially important gait characteristics in people living with stroke.
Collapse
Affiliation(s)
- Ross A Clark
- School of Exercise Science, Australian Catholic University, Melbourne, Australia.
| | - Stephanie Vernon
- School of Exercise Science, Australian Catholic University, Melbourne, Australia.
| | - Benjamin F Mentiplay
- School of Exercise Science, Australian Catholic University, Melbourne, Australia.
| | - Kimberly J Miller
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
| | | | - Yong Hao Pua
- Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.
| | - Kade Paterson
- School of Physiotherapy, University of Melbourne, Melbourne, Australia.
| | - Kelly J Bower
- School of Exercise Science, Australian Catholic University, Melbourne, Australia. .,Department of Physiotherapy, Royal Melbourne Hospital, Melbourne, Australia.
| |
Collapse
|
30
|
Alhasani R, Nayak A, Szturm T, Nankar M, Boreskie S, Brousseau G. The Feasibility of a Novel Dual-Task Exercise Program Which Integrates Balance, Gaze, Mobility and Cognition in Community Dwelling Older Adults: Protocol for a Randomized Clinical Pilot Trial. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/aar.2015.43012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
31
|
Szturm T, Sakhalkar V, Boreskie S, Marotta JJ, Wu C, Kanitkar A. Integrated testing of standing balance and cognition: test-retest reliability and construct validity. Gait Posture 2015; 41:146-52. [PMID: 25455701 DOI: 10.1016/j.gaitpost.2014.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 02/02/2023]
Abstract
Balance and cognitive impairments which are common with aging often coexist, are prognostic of future adverse health events, including fall injuries. Consequently, dual-task assessment programs that simultaneously address both stability and cognition are important to consider in rehabilitation and benefit healthy aging. The objective of this study was to establish test-retest reliability and construct validity of a dual-task computer game-based platform (TGP) that integrates head tracking and cognitive tasks with balance activities. Thirty healthy, community-dwelling individuals median age 64 (range 60-67) were recruited from a certified Medical Fitness Facility. Participants performed a series of computerized head tracking and cognitive game tasks while standing on fixed and sponge surfaces. Testing was conducted on two occasions, one week apart. Moderate to high test retest reliability (ICC values of 0.55-0.75) was observed for all outcome measures representing balance, gaze performance, cognition, and dual-task performance. A significant increase in center of foot pressure (COP) excursion was observed during both head tracking and cognitive dual-task conditions. The results demonstrate the system's ability to reliably detect changes related to specific and integrated aspects of balance, gaze, and cognitive performance.
Collapse
Affiliation(s)
- Tony Szturm
- School of Medical Rehabilitation, University of Manitoba, Canada.
| | - Vedant Sakhalkar
- School of Medical Rehabilitation, University of Manitoba, Canada.
| | | | | | - Christine Wu
- Department of Mechanical Engineering, University of Manitoba, Canada; Department of Manufacturing Engineering, University of Manitoba, Canada.
| | | |
Collapse
|
32
|
Sibley KM, Beauchamp MK, Van Ooteghem K, Straus SE, Jaglal SB. Using the systems framework for postural control to analyze the components of balance evaluated in standardized balance measures: a scoping review. Arch Phys Med Rehabil 2014; 96:122-132.e29. [PMID: 25073007 DOI: 10.1016/j.apmr.2014.06.021] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/30/2014] [Accepted: 06/23/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To identify components of postural control included in standardized balance measures for adult populations. DATA SOURCES Electronic searches of MEDLINE, EMBASE, and CINAHL databases using keyword combinations of postural balance/equilibrium, psychometrics/reproducibility of results/predictive value of tests/validation studies, instrument construction/instrument validation, geriatric assessment/disability evaluation, gray literature, and hand searches. STUDY SELECTION Inclusion criteria were measures with a stated objective to assess balance, adult populations (18y and older), at least 1 psychometric evaluation, 1 standing task, a standardized protocol and evaluation criteria, and published in English. Two reviewers independently identified studies for inclusion. Sixty-six measures were included. DATA EXTRACTION A research assistant extracted descriptive characteristics and 2 reviewers independently coded components of balance in each measure using the Systems Framework for Postural Control, a widely recognized model of balance. DATA SYNTHESIS Components of balance evaluated in these measures were underlying motor systems (100% of measures), anticipatory postural control (71%), dynamic stability (67%), static stability (64%), sensory integration (48%), functional stability limits (27%), reactive postural control (23%), cognitive influences (17%), and verticality (8%). Thirty-four measures evaluated 3 or fewer components of balance, and 1 measure-the Balance Evaluation Systems Test-evaluated all components of balance. CONCLUSIONS Several standardized balance measures provide only partial information on postural control and omit important components of balance related to avoiding falls. As such, the choice of measure(s) may limit the overall interpretation of an individual's balance ability. Continued work is necessary to increase the implementation of comprehensive balance assessment in research and practice.
Collapse
Affiliation(s)
- Kathryn M Sibley
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Marla K Beauchamp
- Department of Physical Medicine and Rehabilitation, Spaulding Outpatient Center, Harvard Medical School, Boston, MA
| | - Karen Van Ooteghem
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Sharon E Straus
- Li-Ka-Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan B Jaglal
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
33
|
de Melo LL, Menec VH, Ready AE. Relationship of Functional Fitness With Daily Steps in Community-Dwelling Older Adults. J Geriatr Phys Ther 2014; 37:116-20. [DOI: 10.1519/jpt.0b013e3182abe75f] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
34
|
Kobayashi T, Leung AKL, Akazawa Y, Hutchins SW. Correlations between Berg balance scale and gait speed in individuals with stroke wearing ankle-foot orthoses - a pilot study. Disabil Rehabil Assist Technol 2014; 11:219-22. [PMID: 24954715 DOI: 10.3109/17483107.2014.932019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The Berg balance scale (BBS) is commonly used to assess balancing ability in patients with stroke. The BBS may be a good candidate for clinical assessment prior to orthotic intervention, if it correlates well with outcome measures such as gait speed. The purpose of this study was to investigate the correlation between the BBS measured prior to walking with an ankle-foot orthosis (AFO) and specific temporal-spatial parameters of gait when walking with an AFO donned. METHODS Eight individuals with chronic stroke participated in this study. Balancing ability was assessed using the BBS, while temporal-spatial parameters of gait (gait speed, bilateral step length, stride length and step width) were measured using a three-dimensional motion analysis system. The correlations between the BBS and gait parameters were investigated using a non-parametric Kendall's Tau (τ) correlation analysis. RESULTS The BBS showed correlations with gait speed (τ = 0.64, p < 0.05), the step length of the affected side (τ = 0.74, p < 0.05), and the stride length (τ = 0.64, p < 0.05). CONCLUSIONS Assessment of the BBS prior to AFO prescription may potentially help clinicians to estimate the gait speed achievable following orthotic intervention in patients with stroke. Implications for Rehabilitation Assessment of the BBS prior to AFO prescription may help orthotists to estimate the gait speed following an orthotic intervention in patients with stroke. Assessment of the BBS prior to AFO prescription may help orthotists to understand overall balance and postural control abilities in patients with stroke. A larger scale multifactorial analysis is warranted to confirm the results of this pilot study.
Collapse
Affiliation(s)
| | - Aaron K L Leung
- b Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering , The Hong Kong Polytechnic University , Hong Kong , People's Republic of China
| | - Yasushi Akazawa
- c The Hyogo Institute of Assistive Technology , Kobe , Japan , and
| | - Stephen W Hutchins
- d Centre for Health, Sport and Rehabilitation Sciences Research, University of Salford , Manchester , UK
| |
Collapse
|
35
|
Thomas JC, Odonkor C, Griffith L, Holt N, Percac-Lima S, Leveille S, Ni P, Latham NK, Jette AM, Bean JF. Reconceptualizing balance: attributes associated with balance performance. Exp Gerontol 2014; 57:218-23. [PMID: 24952097 DOI: 10.1016/j.exger.2014.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 06/04/2014] [Accepted: 06/17/2014] [Indexed: 11/18/2022]
Abstract
Balance tests are commonly used to screen for impairments that put older adults at risk for falls. The purpose of this study was to determine the attributes that were associated with balance performance as measured by the Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) balance test. This study was a cross-sectional secondary analysis of baseline data from a longitudinal cohort study, the Boston Rehabilitative Impairment Study of the Elderly (Boston RISE). Boston RISE was performed in an outpatient rehabilitation research center and evaluated Boston area primary care patients aged 65 to 96 (N=364) with self-reported difficulty or task-modification climbing a flight of stairs or walking 1/2 of a mile. The outcome measure was standing balance as measured by the FICSIT-4 balance assessment. Other measures included: self-efficacy, pain, depression, executive function, vision, sensory loss, reaction time, kyphosis, leg range of motion, trunk extensor muscle endurance, leg strength and leg velocity at peak power. Participants were 67% female, had an average age of 76.5 (±7.0) years, an average of 4.1 (±2.0) chronic conditions, and an average FICSIT-4 score of 6.7 (±2.2) out of 9. After adjusting for age and gender, attributes significantly associated with balance performance were falls self-efficacy, trunk extensor muscle endurance, sensory loss, and leg velocity at peak power. FICSIT-4 balance performance is associated with a number of behavioral and physiologic attributes, many of which are amenable to rehabilitative treatment. Our findings support a consideration of balance as multidimensional activity as proposed by the current International Classification of Functioning, Disability, and Health (ICF) model.
Collapse
Affiliation(s)
- Julia C Thomas
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States.
| | - Charles Odonkor
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
| | - Laura Griffith
- Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138, United States.
| | - Nicole Holt
- Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138, United States.
| | - Sanja Percac-Lima
- Department of Medicine - General Medicine Division, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
| | - Suzanne Leveille
- College of Nursing and Health Sciences, UMass Boston, 100 Morrissey Blvd., Boston, MA 02125, United States.
| | - Pensheng Ni
- Health and Disability Research Institute, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States.
| | - Nancy K Latham
- Health and Disability Research Institute, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States.
| | - Alan M Jette
- Health and Disability Research Institute, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States.
| | - Jonathan F Bean
- Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138, United States; Department of PM&R, Harvard Medical School, 300 First Avenue, Boston, MA 02129, United States.
| |
Collapse
|
36
|
Postural stability characteristics of transtibial amputees wearing different prosthetic foot types when standing on various support surfaces. ScientificWorldJournal 2014; 2014:856279. [PMID: 25003155 PMCID: PMC4070493 DOI: 10.1155/2014/856279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 05/16/2014] [Accepted: 05/29/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study aimed to evaluate the effects of prosthetic foot types on the postural stability among transtibial amputees when standing on different support surfaces. MATERIALS AND METHODS The postural stability of 10 transtibial amputees wearing solid ankle cushion heel (SACH) foot, single-axis (SA) foot, and energy-saving and return (ESAR) foot was assessed. Results were compared with able-bodied participants. Anterior-posterior stability index (APSI), mediolateral stability index (MLSI), and overall stability index (OSI) were measured by computed posturography in an upright stance on firm, foam, and unstable support surfaces. RESULTS The mean OSI score of SACH foot was significantly lower than that of an ESAR foot when the participants were standing on a compliant surface. When compared to able-bodied group, MLSI score was significantly higher for each of the prosthetic foot groups while OSI score was significantly higher for ESAR foot only in foam condition. CONCLUSIONS Differences between prosthetic foot types and groups (amputees versus able-bodied) can only be distinguished when individuals were standing on a compliant surface. Amputees exhibited an increased postural instability in the mediolateral direction than able-bodied individuals. Hence, the restoration of stability in the frontal plane and the enhancement of proprioception at the residual limb should be the basis of rehabilitation programs.
Collapse
|
37
|
Relevance of balance measurement tools and balance training for fall prevention in older adults. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.jcgg.2013.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
38
|
Park JW, Jung M, Kweon M. The Mediolateral CoP Parameters can Differentiate the Fallers among the Community-dwelling Elderly Population. J Phys Ther Sci 2014; 26:381-4. [PMID: 24707088 PMCID: PMC3976007 DOI: 10.1589/jpts.26.381] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/02/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Age-related mediolateral (ML) instability of static postural control in the
elderly has been well studied. Recent studies have provided evidence that ML center of
pressure (CoP) parameters during dynamic postural control are more sensitive for
differentiation of the fallers in the elderly. However, very limited studies have been
done in which ML stability differences between fallers and non-fallers were investigated.
The purpose of this study was to investigate the differences in ML CoP parameters between
elderly fallers and elderly non-fallers during dynamic postural control. [Subjects and
Methods] Twenty-nine community-dwelling older adults were divided into either fallers or
non-fallers according to a self-report related to falling history within a year. Every
participant performed 4 different tasks (static postural control tasks comprising quiet
stance with eyes open and eyes closed and dynamic postural control tasks comprising stance
with arm lifting and with trunk flexion) on force plates. [Results] The fallers
demonstrated decreased AP and ML CoP parameters, and ML CoP distance was significantly
smaller than in the non-fallers during both dynamic postural control tasks. [Conclusions]
ML CoP parameters were able to differentiate the fallers from the non-fallers in a
community-dwelling elderly population.
Collapse
Affiliation(s)
- Ji Won Park
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Republic of Korea
| | - Misook Jung
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Republic of Korea
| | - Migyoung Kweon
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Republic of Korea
| |
Collapse
|
39
|
Burton E, Lewin G, Clemson L, Boldy D. Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial. Clin Interv Aging 2013; 8:1591-601. [PMID: 24324331 PMCID: PMC3854921 DOI: 10.2147/cia.s44614] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults. Methods A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention) or the structured exercise program currently being used in the service (control). Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability. Results There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program. Conclusion Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes.
Collapse
Affiliation(s)
- Elissa Burton
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia ; Research Department, Silver Chain, Perth, WA, Australia
| | | | | | | |
Collapse
|
40
|
James A, Hunter M, Straker L, Beilby J, Bucks R, Davis T, Eikelboom RH, Hillman D, Hui J, Hung J, Knuiman M, Mackey DA, Newton RU, Palmer LJ, Musk AWB. Rationale, design and methods for a community-based study of clustering and cumulative effects of chronic disease processes and their effects on ageing: the Busselton healthy ageing study. BMC Public Health 2013; 13:936. [PMID: 24099269 PMCID: PMC3852572 DOI: 10.1186/1471-2458-13-936] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 09/13/2013] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The global trend of increased life expectancy and increased prevalence of chronic and degenerative diseases will impact on health systems. To identify effective intervention and prevention strategies, greater understanding of the risk factors for and cumulative effects of chronic disease processes and their effects on function and quality of life is needed.The Busselton Healthy Ageing Study aims to enhance understanding of ageing by relating the clustering and interactions of common chronic conditions in adults to function. Longitudinal (3-5 yearly) follow-up is planned. METHODS/DESIGN Phase I (recruitment) is a cross-sectional community-based prospective cohort study involving up to 4,000 'Baby Boomers' (born from 1946 to 1964) living in the Busselton Shire, Western Australia. The study protocol involves a detailed, self-administered health and risk factor questionnaire and a range of physical assessments including body composition and bone density measurements, cardiovascular profiling (blood pressure, ECG and brachial pulse wave velocity), retinal photography, tonometry, auto-refraction, spirometry and bronchodilator responsiveness, skin allergy prick tests, sleep apnoea screening, tympanometry and audiometry, grip strength, mobility, balance and leg extensor strength. Cognitive function and reserve, semantic memory, and pre-morbid intelligence are assessed. Participants provide a fasting blood sample for assessment of lipids, blood glucose, C-reactive protein and renal and liver function, and RNA, DNA and serum are stored. Clinically relevant results are provided to all participants. The prevalence of risk factors, symptoms and diagnosed illness will be calculated and the burden of illness will be estimated based on the observed relationships and clustering of symptoms and illness within individuals. Risk factors for combinations of illness will be compared with those for single illnesses and the relation of combinations of illness and symptoms to cognitive and physical function will be estimated. DISCUSSION This study will enable a thorough characterization of multiple disease processes and their risk factors within a community-based sample of individuals to determine their singular, interactive and cumulative effects on ageing. The project will provide novel cross-sectional data and establish a cohort that will be used for longitudinal analyses of the genetic, lifestyle and environmental factors that determine whether an individual ages well or with impairment.
Collapse
Affiliation(s)
- Alan James
- Department of Pulmonary Physiology and Sleep Medicine/West Australian Sleep Disorders Institute, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, Perth, WA, Australia
| | - Michael Hunter
- School of Population Health, The University of Western Australia, Crawley, Perth, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia
| | - Leon Straker
- School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, Perth, Australia
| | - John Beilby
- Pathwest, The University of Western Australia, Crawley, Perth, Australia
- School of Pathology and Laboratory, The University of Western Australia, Crawley, Perth, WA, Australia
| | - Romola Bucks
- School of Psychology, The University of Western Australia, Crawley, Perth, Australia
| | - Tim Davis
- Fremantle Hospital; School of Medicine and Health, The University of Western Australia, Crawley, Perth, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Ear Sciences Centre; School of Surgery, The University of Western Australia, Crawley, Perth, Australia
| | - David Hillman
- Department of Pulmonary Physiology and Sleep Medicine/West Australian Sleep Disorders Institute, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia
- School of Anatomy and Surgery, The University of Western Australia, Crawley, Perth, Australia
| | - Jennie Hui
- Pathwest, The University of Western Australia, Crawley, Perth, Australia
- School of Population Health, The University of Western Australia, Crawley, Perth, Australia
- School of Pathology and Laboratory, The University of Western Australia, Crawley, Perth, WA, Australia
| | - Joe Hung
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, Perth, WA, Australia
| | - Matthew Knuiman
- School of Population Health, The University of Western Australia, Crawley, Perth, Australia
| | - David A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Perth, Australia
| | - Robert U Newton
- Health and Wellness Institute, Edith Cowan University, Joondalup, Perth, Australia
| | - Lyle J Palmer
- Ontario Institute for Cancer Research and Samuel Lunenfeld Research Institute, University of Toronto, Toronto, Canada
| | - AW Bill Musk
- School of Population Health, The University of Western Australia, Crawley, Perth, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, Perth, WA, Australia
| |
Collapse
|
41
|
Abstract
BACKGROUND Psychometric limitations of balance measures for community-dwelling elderly may be related to gaps in task and environmental representation. OBJECTIVE The purposes of this study were: (1) to conduct item-level content analysis of balance measures for community-dwelling elderly people based on task and environmental factors and (2) to develop profiles of individual measures summarizing their task and environment representation. DESIGN A systematic content analysis was conducted. METHODS A literature search was conducted to identify balance measures. Item-level content analysis was based on 7 criteria related to task and environment: (1) task role, (2) environmental variation, (3) object interaction, (4) obstacle negotiation, (5) external forces, (6) dual-tasking, and (7) moving people or objects in the environment. RESULTS Twenty-six measures, containing 167 items, were identified. Task role was fairly evenly distributed, with the majority of items examining gait tasks (32.3%), followed by dynamic body stability (29.9%) and static body stability (25.1%). The majority of items involved no environmental variation (58.1%), followed by variation of support surfaces (20.4%), visual conditions (13.2%), and both support and visual conditions (8.4%). Limited task role variability was seen within measures, with 73.1% of measures examining only one task role. Environmental variation was present in 65.3% of measures, primarily during static body stability tasks. Few measures involved object interaction (23.1%), obstacle negotiation (38.5%), external forces (11.5%), dual-tasking (7.7%), or moving people or objects (0%). LIMITATIONS The classification framework was not externally validated. CONCLUSIONS Existing measures focus on single-task assessment in static environments, underrepresenting postural control demands in daily-life situations involving dynamic changing environments, person-environment interactions, and multitasking. New items better reflecting postural control demands in daily-life situations are needed for more ecologically valid balance assessment. Individual balance measure profiles provided can help identify the most appropriate measure for a given purpose.
Collapse
|
42
|
The interacting effect of cognitive and motor task demands on performance of gait, balance and cognition in young adults. Gait Posture 2013; 38:596-602. [PMID: 23477841 DOI: 10.1016/j.gaitpost.2013.02.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 01/29/2013] [Accepted: 02/01/2013] [Indexed: 02/02/2023]
Abstract
Mobility limitations and cognitive impairments, each common with aging, reduce levels of physical and mental activity, are prognostic of future adverse health events, and are associated with an increased fall risk. The purpose of this study was to examine whether divided attention during walking at a constant speed would decrease locomotor rhythm, stability, and cognitive performance. Young healthy participants (n=20) performed a visuo-spatial cognitive task in sitting and while treadmill walking at 2 speeds (0.7 and 1.0 m/s).Treadmill speed had a significant effect on temporal gait variables and ML-COP excursion. Cognitive load did not have a significant effect on average temporal gait variables or COP excursion, but variation of gait variables increased during dual-task walking. ML and AP trunk motion was found to decrease during dual-task walking. There was a significant decrease in cognitive performance (success rate, response time and movement time) while walking, but no effect due to treadmill speed. In conclusion walking speed is an important variable to be controlled in studies that are designed to examine effects of concurrent cognitive tasks on locomotor rhythm, pacing and stability. Divided attention during walking at a constant speed did result in decreased performance of a visuo-spatial cognitive task and an increased variability in locomotor rhythm.
Collapse
|
43
|
Yamaji S, Demura S. Reliability and Fall Experience Discrimination of Cross Step Moving on Four Spots Test in the Elderly. Arch Phys Med Rehabil 2013; 94:1312-9. [DOI: 10.1016/j.apmr.2012.12.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/24/2012] [Accepted: 12/26/2012] [Indexed: 11/28/2022]
|
44
|
Nguyen USD, Kiel DP, Li W, Galica AM, Kang HG, Casey VA, Hannan MT. Correlations of clinical and laboratory measures of balance in older men and women. Arthritis Care Res (Hoboken) 2012; 64:1895-902. [PMID: 22745045 PMCID: PMC3467339 DOI: 10.1002/acr.21783] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 06/16/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE It is known that impaired balance is associated with falls in older adults; however, there is no accepted gold standard on how balance should be measured. Few studies have examined measures of postural sway and clinical balance concurrently in large samples of community-dwelling older adults. We examined the associations among 4 types of measures of laboratory- and clinic-based balance in a large population-based cohort of older adults. METHODS We evaluated balance measures in the Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly Boston Study (276 men and 489 women ages 64-97 years). The measures included laboratory-based anteroposterior (AP) path length and mean sway speed, mediolateral (ML) mean sway and root mean square, and area of ellipse postural sway; the Short Physical Performance Battery (SPPB); the Berg Balance Scale; and the one-leg stand test. Spearman's rank correlation coefficients were assessed among the balance measures. RESULTS The area of ellipse sway was highly correlated with the ML sway measures (r = >0.91, P < 0.0001) and sway speed was highly correlated with AP sway (r = 0.97, P < 0.0001). The Berg Balance Scale was highly correlated with the SPPB (r = 0.74, P < 0.001) and the one-leg stand test (r = 0.82, P < 0.001). Correlations between the laboratory- and clinic-based balance measures were low but statistically significant (-0.29 ≤ r ≤ -0.16, P < 0.0001). CONCLUSION Clinic-based balance measures, and laboratory-based measures comparing area of ellipse with ML sways or sway speed with AP sway, are highly correlated. There is less correlation between the clinic- and laboratory-based measures. Since both laboratory- and clinic-based measures inform balance in older adults, but are not highly correlated with each other, future work should investigate the differences.
Collapse
Affiliation(s)
| | - Douglas P. Kiel
- Hebrew SeniorLife Institute for Aging Research, Boston, MA
- Harvard Medical School, Boston, MA
| | - Wenjun Li
- University of Massachusetts Medical School, Worcester, MA
| | | | - Hyun Gu Kang
- California State Polytechnic University, Pomona, CA
| | | | - Marian T. Hannan
- Hebrew SeniorLife Institute for Aging Research, Boston, MA
- Harvard Medical School, Boston, MA
| |
Collapse
|
45
|
Wallmann HW, Player KR, Bugnet M. Acute Effects of Static Stretching on Balance in Young Versus Elderly Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2012. [DOI: 10.3109/02703181.2012.719076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Harvey W Wallmann
- 1Department of Physical Therapy, Western Kentucky University,
Bowling Green, Kentucky, USA
| | | | - Matthew Bugnet
- 3Rehab and Industrial Services of Nevada,
Winnemucca, Nevada, USA
| |
Collapse
|
46
|
Tseng KC, Wong AMK, Hsu CL, Tsai TH, Han CM, Lee MR. The iFit: an integrated physical fitness testing system to evaluate the degree of physical fitness of the elderly. IEEE Trans Biomed Eng 2012; 60:184-8. [PMID: 22899570 DOI: 10.1109/tbme.2012.2211357] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper presents an integrated physical fitness testing system (iFit) that evaluates the physical fitness of older adults. The intent of the test is to help them manage and promote their health and mitigate the effects of aging. National protocols of physical fitness were implemented to support the assessment. The proposed system encompasses four modules of physical fitness assessment for both users and medical professionals. The test information will be recorded and managed through a wireless sensor network that will enable a better understanding of users' fitness states. Furthermore, the iFit has been validated by a test session attended by elderly participants. The results show that there is a significant correlation between iFit use in the test of flexibility, grip strength, and balance, compared to conventional methods.
Collapse
Affiliation(s)
- Kevin C Tseng
- Product Design and Development Lab, Department of Industrial Design, Chang Gung University, Yuan 333, Taiwan.
| | | | | | | | | | | |
Collapse
|
47
|
Buchecker M, Pfusterschmied J, Moser S, Müller E. The effect of different Masai Barefoot Technology (MBT) shoe models on postural balance, lower limb muscle activity and instability assessment. FOOTWEAR SCIENCE 2012. [DOI: 10.1080/19424280.2012.674560] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
48
|
Souza ACDS, Santos GM. Sensibilidade da Escala de Equilíbrio de Berg em indivíduos com osteoartrite. MOTRIZ: REVISTA DE EDUCACAO FISICA 2012. [DOI: 10.1590/s1980-65742012000200011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo teve objetivo de analisar a sensibilidade e especificidade da Escala de Equilíbrio de Berg (EEB) em detectar o risco de queda em indivíduos com osteoartrite de joelho (OAJ). Verificar a associação entre a capacidade funcional, grau de OAJ, quadro álgico, índice de medo de cair e histórico de queda com o escore da EEB. Participaram 69 indivíduos com OAJ. Foram analisados os pontos de corte 45, 47, 49, 51 e 53 pontos da EEB, quanto à sensibilidade e especificidade do teste. Utilizou-se a escala analógica visual e os questionários WOMAC e Índice de preocupação em cair (FES-I). Os resultados evidenciaram diferença significativa (p=0,001) no escore da EEB entre os indivíduos com OAJ com e sem história de queda. A EEB apresentou correlação com Womac, FES-I, histórico de queda e grau de OAJ. A EEB não apresentou um ponto de corte ideal para indivíduos com OAJ. Contudo, a escala é sensível às diferenças individuais nesta população.
Collapse
|
49
|
|
50
|
Resnick B, Galik E, Gruber-Baldini AL, Zimmerman S. Falls and Fall-Related Injuries Associated With Function-Focused Care. Clin Nurs Res 2012; 21:43-63. [DOI: 10.1177/1054773811420060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to describe falls and injuries within assisted living (AL) communities and determine whether a function-focused care (FFC) intervention increased the risk of falls and/or injuries. This was a secondary data analysis using data from a 12-month cluster-randomized controlled trial in which four AL communities were matched based on ownership and randomly assigned to treatment (FFC-AL) or attention control (FFC—education only). Demographic information and information on comorbidities, falls, and consequences postfall, ability to ambulate 50 yards, gait and balance, cognition, person–environment fit, and medication use were collected. Logistic regression was used to test the hypotheses. Exposure to FFC-AL did not result in an increased likelihood of falling (Wald = 0.01, p = .96) or sustaining an injury ( B = 0.42, Wald = 0.88, p = .35). The study findings supported prior research findings supporting the safety of interventions that optimize function and encourage physical activity among older adults.
Collapse
|