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The functional interaction of the brain default network with motor networks is modified by aging. Behav Brain Res 2019; 372:112048. [DOI: 10.1016/j.bbr.2019.112048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 12/27/2022]
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Huang C, Sun S, Wang W, Li Y, Feng W, Wu Y. Cognition Mediates the Relationship Between Sensory Function and Gait Speed in Older Adults: Evidence from the English Longitudinal Study of Ageing. J Alzheimers Dis 2019; 70:1153-1161. [PMID: 31306130 DOI: 10.3233/jad-190364] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Chuanying Huang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Shuqin Sun
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Yujie Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Wenjing Feng
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
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Porto C, Lemos T, Ferreira AS. Analysis of the postural stabilization in the upright stance using optimization properties. Biomed Signal Process Control 2019. [DOI: 10.1016/j.bspc.2019.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pieruccini-Faria F, Lord SR, Toson B, Kemmler W, Schoene D. Mental Flexibility Influences the Association Between Poor Balance and Falls in Older People - A Secondary Analysis. Front Aging Neurosci 2019; 11:133. [PMID: 31263408 PMCID: PMC6584815 DOI: 10.3389/fnagi.2019.00133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/20/2019] [Indexed: 12/15/2022] Open
Abstract
Impairments of balance predispose older people to falls. Some cognitive functions, especially executive functioning have been shown to affect balance and discriminate fallers from non-fallers. Mental flexibility is a component of the executive function and comprises multiple cognitive processes that work together to adjust the course of thoughts or actions according to the changing demands of a situation without the use of explicit instructions. However, the role of mental flexibility in balance in older people remains unclear. The study aim was to examine the relationship between mental flexibility and falls in a cohort of 212 older people (80.6 ± 4.9 years; 62% female). We hypothesized that: (i) participants with impaired balance would have worse mental flexibility compared to those with good balance; and (ii) poor mental flexibility would predict falls in the sub-group with impaired balance. Balance performance was assessed by measuring postural sway while standing on a medium density foam mat with eyes open for 30 s. Mental flexibility was assessed using a computerized short-form of the Wisconsin Card Sorting Test (WCST; 64 cards) with its sub-components comprising general performance, perseveration, failure-to-maintain set and conceptual ability. Falls were measured prospectively for 12-months using monthly calendars. MANCOVA revealed that WCST performance was associated with balance [Wilks' Lambda = 0.883, F = 2.168; p = 0.013, partial eta squared ( η p 2 ) = 0.061] due primarily to reduced concept formation ability [F (2,207) = 5.787, p = 0.004, η p 2 = 0.053]. Negative binomial regression analysis adjusting for age, education, contrast sensitivity, proprioception, inhibition, and inhibitory choice stepping reaction time (iCSRT) revealed that lower concept formation ability was predictive for falls [Incidence Rate Ratio 1.048 (95% confidence interval 1.016-1.081)]. Further, lower concept formation ability partly explained the association between balance and falls: i.e., fallers in the upper balance tertile had reduced concept formation performance whereas non-fallers had similar concept formation performance across the three balance tertiles. These findings suggest that poor mental flexibility affects the ability to maintain steady balance contributing to increased risk of falls in older people.
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Affiliation(s)
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
| | - Barbara Toson
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Daniel Schoene
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia.,Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Henry M, Baudry S. Age-related changes in leg proprioception: implications for postural control. J Neurophysiol 2019; 122:525-538. [PMID: 31166819 DOI: 10.1152/jn.00067.2019] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
In addition to being a prerequisite for many activities of daily living, the ability to maintain steady upright standing is a relevant model to study sensorimotor integrative function. Upright standing requires managing multimodal sensory inputs to produce finely tuned motor output that can be adjusted to accommodate changes in standing conditions and environment. The sensory information used for postural control mainly arises from the vestibular system of the inner ear, vision, and proprioception. Proprioception (sense of body position and movement) encompasses signals from mechanoreceptors (proprioceptors) located in muscles, tendons, and joint capsules. There is general agreement that proprioception signals from leg muscles provide the primary source of information for postural control. This is because of their exquisite sensitivity to detect body sway during unperturbed upright standing that mainly results from variations in leg muscle length induced by rotations around the ankle joint. However, aging is associated with alterations of muscle spindles and their neural pathways, which induce a decrease in the sensitivity, acuity, and integration of the proprioceptive signal. These alterations promote changes in postural control that reduce its efficiency and thereby may have deleterious consequences for the functional independence of an individual. This narrative review provides an overview of how aging alters the proprioceptive signal from the legs and presents compelling evidence that these changes modify the neural control of upright standing.
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Affiliation(s)
- Mélanie Henry
- Laboratory of Applied Biology and Research Unit in Applied Neurophysiology, ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Stéphane Baudry
- Laboratory of Applied Biology and Research Unit in Applied Neurophysiology, ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
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Maïano C, Hue O, Lepage G, Morin AJS, Tracey D, Moullec G. Do Exercise Interventions Improve Balance for Children and Adolescents With Down Syndrome? A Systematic Review. Phys Ther 2019; 99:507-518. [PMID: 31089706 DOI: 10.1093/ptj/pzz012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 09/18/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Youths with Down syndrome are characterized by deficits in balance/postural stability. One way to palliate balance deficits among this population is through exercise interventions. However, to the authors' knowledge, the effects of exercise interventions designed to improve the balance of youths with Down syndrome have never been systematically reviewed. PURPOSE The purpose of this review was to summarize the findings from studies examining the effects of exercise interventions designed to improve balance in youths with Down syndrome. DATA SOURCES A systematic literature search was performed in 10 databases (Academic Search Complete, CINAHL Plus With Full-Text, Education Source, ERIC, Medline With Full-Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, Scopus, SocINDEX, and SPORTDiscus With Full-Text) on June 12, 2017. STUDY SELECTION Randomized controlled trials and controlled trials examining the effects of exercise interventions designed to improve balance in youths with Down syndrome were included. DATA EXTRACTION Two authors selected the studies and extracted their characteristics and results. Three authors assessed the risk of bias in the studies using the Cochrane Collaboration tool. DATA SYNTHESIS Eleven studies, published between 2010 and 2017, met the inclusion criteria. The findings showed that exercise interventions were more effective than control conditions for improving the static balance of children with Down syndrome and the static-dynamic balance (ie, global balance score obtained with a scale measuring both static and dynamic balance) of children and adolescents with Down syndrome. Nevertheless, the findings on dynamic balance in children and static balance in adolescents were inconclusive. LIMITATIONS With a small number of studies and their high risk of bias, the present findings must be interpreted with caution. CONCLUSIONS The reviewed exercise interventions were successful in improving the static balance of children with Down syndrome and the static-dynamic balance of children and adolescents with Down syndrome.
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Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 5 Rue Saint-Joseph, Saint Jérôme, Quebec, Canada J7Z 0B7
| | - Olivier Hue
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Geneviève Lepage
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Danielle Tracey
- School of Education, Western Sydney University, Sydney, New South Wales, Australia
| | - Grégory Moullec
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais; Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Quebec, Canada; and Research Center, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Montréal, Quebec, Canada
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Purcell NL, Goldman JG, Ouyang B, Bernard B, O'Keefe JA. The Effects of Dual-Task Cognitive Interference and Environmental Challenges on Balance in Huntington's Disease. Mov Disord Clin Pract 2019; 6:202-212. [PMID: 30949551 PMCID: PMC6417749 DOI: 10.1002/mdc3.12720] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Huntington's disease (HD) is characterized by chorea, balance and gait impairments, and cognitive deficits, which increase fall risk. Dual task (DT) and environmentally challenging paradigms reflect balance related to everyday life. Furthermore, the impact of cognitive deficits on balance dysfunction and falls in HD is unknown. OBJECTIVE To determine the impact of DT interference, sensory feedback, and cognitive performance on balance and falls in HD. METHODS Seventeen participants with HD (55 ± 9.7 years) and 17 age-matched controls (56.5 ± 9.3 years) underwent quantitative balance testing with APDM inertial sensors. Postural sway was assessed during conditions of manipulated stance, vision, proprioception, and cognitive demand. The DT was a concurrent verbal fluency task. Neuropsychological assessments testing multiple cognitive domains were also administered. RESULTS HD participants exhibited significantly greater total sway area, jerk, and variability under single-task (ST) and DT conditions compared to controls (P = 0.0002 - < 0.0001). They also demonstrated greater DT interference with vision removed for total sway area (P = 0.01) and variability (P = 0.02). Significantly worse postural control was observed in HD with vision removed and reduced proprioception (P = 0.001 - 0.01). Decreased visuospatial performance correlated with greater total sway and jerk (P = 0.01; 0.009). No balance parameters correlated with retrospective falls in HD. CONCLUSIONS HD participants have worse postural control under DT, limited proprioception/vision, and greater DT interference with a narrowed base and no visual input. These findings may have implications for designing motor and cognitive strategies to improve balance in HD.
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Affiliation(s)
| | - Jennifer G. Goldman
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
| | - Bichun Ouyang
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
| | - Bryan Bernard
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
| | - Joan A. O'Keefe
- Department of Cell and Molecular MedicineRush University Medical CenterChicagoILUSA
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
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Craig CE, Doumas M. Slowed sensory reweighting and postural illusions in older adults: the moving platform illusion. J Neurophysiol 2019; 121:690-700. [PMID: 30540502 DOI: 10.1152/jn.00389.2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We investigated whether postural aftereffects witnessed during transitions from a moving to a stable support are accompanied by a delayed perception of platform stabilization in older adults, in two experiments. In experiment 1, postural sway and muscle cocontraction were assessed in 11 healthy young, 11 healthy older, and 11 fall-prone older adults during blindfolded stance on a fixed platform, followed by a sway-referenced platform and then by a fixed platform again. The sway-referenced platform was more compliant for young adults, to induce similar levels of postural sway in both age groups. Participants were asked to press a button whenever they perceived that the platform had stopped moving. Both older groups showed significantly larger and longer postural sway aftereffects during platform stabilization compared with young adults, which were pronounced in fall-prone older adults. In both older groups elevated muscle cocontraction aftereffect was also witnessed. Importantly, these aftereffects were accompanied by an illusory perception of prolonged platform movement. After this, experiment 2 examined whether this illusory perception was a robust age effect or an experimental confound due to greater surface compliance in young adults, which could create a larger perceptual discrepancy between moving and stable conditions. Despite exposure to the same surface compliance levels during sway-reference, the perceptual illusion was maintained in experiment 2 in a new group of 14 healthy older adults compared with 11 young adults. In both studies, older adults took five times longer than young adults to perceive platform stabilization. This supports that sensory reweighting is inefficient in older adults. NEW & NOTEWORTHY This is the first paper to show that postural sway aftereffects witnessed in older adults after platform stabilization may be due to a perceptual illusion of platform movement. Surprisingly, in both experiments presented it took older adults five times longer than young adults to perceive platform stabilization. This supports a hypothesis of less efficient sensory reintegration in this age group, which may delay the formation of an accurate postural percept.
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Affiliation(s)
- Chesney E Craig
- School of Psychology, Queen's University Belfast , Belfast , United Kingdom.,Research Centre for Musculoskeletal Science and Sports Medicine, Department of Exercise and Sport Science, Manchester Metropolitan University, Crewe, United Kingdom
| | - Michail Doumas
- School of Psychology, Queen's University Belfast , Belfast , United Kingdom
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Laatar R, Baccouch R, Borji R, Kachouri H, Rebai H, Sahli S. Ramadan Fasting Effects on Postural Control in the Elderly: A Comparison Between Fallers and Non-fallers. JOURNAL OF RELIGION AND HEALTH 2019; 58:28-40. [PMID: 27804006 DOI: 10.1007/s10943-016-0323-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Our purpose was to compare the effects of Ramadan fasting on postural control in elderly fallers and non-fallers. The protocol involved twenty-four healthy old volunteer males divided into two groups: fallers (mean age = 75.43 ± 5.26 years, weight = 67.25 ± 5.30 kg and height = 1.65 ± 0.02 m) and non-fallers (mean age = 72.3 ± 6.42 years, weight = 65.5 ± 6.15 kg and height = 1.64 ± 0.03 m). Participants performed a simple reaction time test (SRT) and a postural control protocol on four different occasions: one week before Ramadan (BR), during the second (SWR) and the fourth week (FWR) of Ramadan and three weeks after Ramadan (AR). Center of pressure (CoP) parameters [the CoP medial-lateral length (CoPX), and the CoP antero-posterior length (CoPY)] were assessed using a force platform under two surface conditions: Firm surface and Foam surface. The results showed that Ramadan fasting influences similarly fallers and non-fallers. In fact, for both groups, the CoPX and the CoPY values increased significantly during the SWR and the FWR compared to BR. These CoP parameters decreased significantly in the Firm surface conditions in the FWR. Moreover, the CoP parameters were significantly higher during the FWR and AR in comparison with BR in the Foam surface conditions. However, the amplitude of increase of the CoP[X] % and the CoP[Y] % (ΔCoP[X] % and ΔCoP[Y] %) between BR and the SWR was significantly higher in the fallers than non-fallers. The SRT of elderly fallers and non-fallers was significantly higher in the SWR and in the FWR compared to BR. In conclusion, Ramadan fasting alters similarly postural control of elderly fallers and non-fallers, but the amplitude (ΔCoP[X] % and ΔCoP[Y] %) of this alteration seems to be more pronounced in fallers than non-fallers. A probable beginning of adaptation occurs at the FWR. However, three weeks seems to be insufficient to recover postural control alterations due to Ramadan fasting in difficult sensory conditions in elderly fallers and non-fallers.
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Affiliation(s)
- Rabeb Laatar
- Research Unit Education, Motricité, Sport et Santé, UR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Route de l'Aérodrôme, Km 3.5, BP 1068, 3000, Sfax, Tunisia.
| | - Rym Baccouch
- Faculty of Sciences of Bizerte, University of Carthage, Tunis, Tunisia
| | - Rihab Borji
- Research Unit Education, Motricité, Sport et Santé, UR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Route de l'Aérodrôme, Km 3.5, BP 1068, 3000, Sfax, Tunisia
| | - Hiba Kachouri
- Research Unit Education, Motricité, Sport et Santé, UR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Route de l'Aérodrôme, Km 3.5, BP 1068, 3000, Sfax, Tunisia
| | - Haithem Rebai
- Research Unit Education, Motricité, Sport et Santé, UR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Route de l'Aérodrôme, Km 3.5, BP 1068, 3000, Sfax, Tunisia
| | - Sonia Sahli
- Research Unit Education, Motricité, Sport et Santé, UR15JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Route de l'Aérodrôme, Km 3.5, BP 1068, 3000, Sfax, Tunisia
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The Effect of Cognitive Resource Competition Due to Dual-Tasking on the Irregularity and Control of Postural Movement Components. ENTROPY 2019; 21:e21010070. [PMID: 33266786 PMCID: PMC7514179 DOI: 10.3390/e21010070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 01/04/2023]
Abstract
Postural control research suggests a non-linear, n-shaped relationship between dual-tasking and postural stability. Nevertheless, the extent of this relationship remains unclear. Since kinematic principal component analysis has offered novel approaches to study the control of movement components (PM) and n-shapes have been found in measures of sway irregularity, we hypothesized (H1) that the irregularity of PMs and their respective control, and the control tightness will display the n-shape. Furthermore, according to the minimal intervention principle (H2) different PMs should be affected differently. Finally, (H3) we expected stronger dual-tasking effects in the older population, due to limited cognitive resources. We measured the kinematics of forty-one healthy volunteers (23 aged 26 ± 3; 18 aged 59 ± 4) performing 80 s tandem stances in five conditions (single-task and auditory n-back task; n = 1–4), and computed sample entropies on PM time-series and two novel measures of control tightness. In the PM most critical for stability, the control tightness decreased steadily, and in contrast to H3, decreased further for the younger group. Nevertheless, we found n-shapes in most variables with differing magnitudes, supporting H1 and H2. These results suggest that the control tightness might deteriorate steadily with increased cognitive load in critical movements despite the otherwise eminent n-shaped relationship.
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Akınoğlu B, Kocahan T. Comparison of muscular strength and balance in athletes with visual impairment and hearing impairment. J Exerc Rehabil 2018; 14:765-770. [PMID: 30443521 PMCID: PMC6222145 DOI: 10.12965/jer.1836304.152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/10/2018] [Indexed: 11/22/2022] Open
Abstract
This study was conducted to compare muscular strength and balance of athletes with visual and hearing impairment. The study was carried out with 20 athletes of national Olympic level sports goalball team and 20 athletes of national Olympic level sports hearing-impaired karate team. Isokinetic muscular strength was assessed by IsoMed 2000 device as concentric-concentric at 60°/sec and 240°/sec. Balance assessment was carried out with the Human Body Equilibrium 360 device. There was no significant difference between groups regarding age, height, weight and body mass index (P>0.05). There were no differences between the dominant and nondominant knee flexion and extension peak torque (PT), % of flexion/extension PT ratio, % of dominant/nondominant PT differences at 60°/sec and 240°/sec velocities (P>0.05). There was no difference between the groups regarding of both leg static balance (P>0.05). However, single leg standing balance was significantly different between groups in favor of athletes with hearing impairment (P<0.001). As a result of our study it was determined that muscular strength and static balance of athletes with visual and hearing impairment were similar, but athletes with visual problems are likely to have lower levels of single leg balance. Strategies to promote single leg balance in athletes with visual impairments are warranted.
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Affiliation(s)
- Bihter Akınoğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Tuğba Kocahan
- Department of Health Services, Sports General Directorship, The Ministry of Youth and Sports, Center of Athlete Training and Health Research, Ankara, Turkey
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Falls in Geriatric Populations and Hydrotherapy as an Intervention: A Brief Review. Geriatrics (Basel) 2018; 3:geriatrics3040071. [PMID: 31011106 PMCID: PMC6371164 DOI: 10.3390/geriatrics3040071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/08/2018] [Accepted: 10/16/2018] [Indexed: 11/16/2022] Open
Abstract
Falls and fall-related injuries are a serious health concern in geriatric populations, especially with age-related deficits in postural control and during postural control challenging dual-task situations. Balance training has been reported to be beneficial in reducing falls. However, some of these exercises have their inherent physical challenges that prevent the elderly population from performing them effectively. Other concomitant age-related illness in the elderly pose further challenges in performing these exercises. Hence, the topic of finding alternative types of balance training that are effective and are performed in a safer environment is constantly researched. One such alternative is hydrotherapy that focuses on balance and postural perturbation-based exercises in water-based environments such as aquatic swimming pools or in dedicated hydrotherapy pools. Hydrotherapy for geriatric populations has been reported to be beneficial in improving balance, motor and cognitive tasks with improved motivation and positive attitude towards exercises. Additionally, hydrotherapy also has properties of buoyancy, resistance and temperature, which benefit biomechanical and physiological wellness and offers a safe environment to perform balance training. Hydrotherapy balance training need to be scaled and prescribed according to individual needs and can serve as an effective training and rehabilitation protocol in reducing falls in geriatric population.
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63
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Hand movement illusions show changes in sensory reliance and preservation of multisensory integration with age for kinaesthesia. Neuropsychologia 2018; 119:45-58. [DOI: 10.1016/j.neuropsychologia.2018.07.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 07/18/2018] [Accepted: 07/25/2018] [Indexed: 11/20/2022]
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Arora T, Oates A, Lynd K, Musselman KE. Current state of balance assessment during transferring, sitting, standing and walking activities for the spinal cord injured population: A systematic review. J Spinal Cord Med 2018; 43:10-23. [PMID: 29869951 PMCID: PMC7006707 DOI: 10.1080/10790268.2018.1481692] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
CONTEXT Comprehensive balance measures with high clinical utility and sound psychometric properties are needed to inform the rehabilitation of individuals with spinal cord injury (SCI). OBJECTIVE To identify the balance measures used in the SCI population, and to evaluate their clinical utility, psychometric properties and comprehensiveness. METHODS Medline, PubMed, Embase, Scopus, Web of Science, and the Allied and Complementary Medicine Database were searched from the earliest record to October 19/16. Two researchers independently screened abstracts for articles including a balance measure and adults with SCI. Extracted data included participant characteristics and descriptions of balance measures. Quality was evaluated by considering study design, sampling method and adequacy of description of research participants. Clinical utility of all balance measures was evaluated. Comprehensiveness was evaluated using the modified Systems Framework for Postural Control. RESULTS 2820 abstracts were returned and 127 articles included. Thirty-one balance measures were identified; 11 evaluated a biomechanical construct and 20 were balance scales. All balance scales had high clinical utility. The Berg Balance Scale and Functional Reach Test were valid and reliable, while the mini-BESTest was the most comprehensive. CONCLUSION No single measure had high clinical utility, strong psychometric properties and comprehensiveness. The mini-BESTest and/or Activity-based Balance Level Evaluation may fill this gap with further testing of their psychometric properties.
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Affiliation(s)
- Tarun Arora
- Health Sciences, College of Medicine, University of Saskatchewan, Saskatoon, Canada,School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Alison Oates
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Kaylea Lynd
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada,Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | - Kristin E. Musselman
- Health Sciences, College of Medicine, University of Saskatchewan, Saskatoon, Canada,School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada,Toronto Rehabilitation Institute-University Health Network, Toronto, Canada,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Canada,Correspondence to: Kristin E. Musselman PT, PhD, SCI Mobility Lab, Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, 520 Sutherland Drive, Toronto, ON, Canada, M4G 3V9; Ph: (416) 597-3422 x6190.
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Cheng S, Ma J, Sun J, Wang J, Xiao X, Wang Y, Hu W. Differences in sensory reweighting due to loss of visual and proprioceptive cues in postural stability support among sleep-deprived cadet pilots. Gait Posture 2018; 63:97-103. [PMID: 29727778 DOI: 10.1016/j.gaitpost.2018.04.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 04/10/2018] [Accepted: 04/24/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sleep deprivation is known to diminish postural control. RESEARCH QUESTION We investigated whether sleep deprivation affects sensory reweighting for postural control due to loss of visual and proprioceptive cues. METHODS Two cohorts of cadet pilots were deprived of sleep for 40 h. Variabilty in force-platform center of pressure was analyzed based on the whole path length (WPL); circumference area (CA); mean of displacement along x and y axes and corresponding standard deviations (SDx, SDy); and frequency of body-sway intensity, all of which were recorded while the cadets stood with eyes open (NEO), eyes closed (NEC), and eyes closed on a foam platform base (FEC) A sleepiness index (SUBI) based on principal component analysis of selected Cohort 1 data (n = 37) was used to compare Cohort 2 data (n = 29) with scores for the Stanford Sleepiness Scale (SSS) and Pittsburg Sleep Quality Index (PSQI). RESULTS Balance began to deteriorate at 16 h for NEO and at 28 h for NEC and FEC (p < 0.05). At 40 h, WPL, CA, and SDy of COP for NEO indicated balance deteriorated further while WPL and SDy for NEC and WPL, CA, SDx, and SDy for FEC indicated balance incrementally improved. Frequency bias of body-sway differed between NEO, NEC, and FEC. In Cohort 2, the SUBI correlated significantly with SSS (p < 0.05), but not with PSQI. SIGNIFICANCE Effects of sleep deprivation were mitigated over time, suggesting that compensatory mechanisms influenced sensory reweighting for NEC and FEC between 28 and 40 h of sleep deprivation, but not for NEO. Frequency bias of body-sway suggested that sensory reweighting in the absence of visual cues differed from that in the absence of both visual and proprioceptive cues.
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Affiliation(s)
- Shan Cheng
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Jin Ma
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Jicheng Sun
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Jian Wang
- Bureau of Health, Air Force Logistics Command, Beijing, 100009, PR China
| | - Xiao Xiao
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Yihan Wang
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China
| | - Wendong Hu
- Department of Aerospace Medical Equipment, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China.
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66
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Maïano C, Hue O, Tracey D, Lepage G, Morin AJS, Moullec G. Static postural control among school-aged youth with Down syndrome: A systematic review. Gait Posture 2018; 62:426-433. [PMID: 29653404 DOI: 10.1016/j.gaitpost.2018.03.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/11/2018] [Accepted: 03/15/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Youth with Down syndrome are characterized by motor delays when compared to typically developing (TD) youth, which may be explained by a lower postural control or reduced postural tone. OBJECTIVE In the present article, we summarize research comparing the static postural control, assessed by posturography, between youth with Down syndrome and TD youth. METHODS A systematic literature search was performed in 10 databases and seven studies, published between 2001 and 2017, met our inclusion criteria. RESULTS Based on the present reviewed findings, it is impossible to conclude that children with Down syndrome present significantly lower static postural control compared to TD children. In contrast, findings showed that adolescents with Down syndrome tended to present significantly lower static postural control compared to TD adolescents when visual and plantar cutaneous inputs were disturbed separately or simultaneously. CONCLUSION The present findings should be interpreted with caution given the limitations of the small number of reviewed studies. Therefore, the static postural control among youth with Down syndrome should be further investigated in future rigorous studies examining the contribution of a range of sensory information.
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Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada; Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada.
| | - Olivier Hue
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Danielle Tracey
- School of Education, Western Sydney University, Sydney, Australia
| | - Geneviève Lepage
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Grégory Moullec
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada; Research Center, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Montréal, Canada
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67
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Shanbehzadeh S, Salavati M, Talebian S, Khademi-Kalantari K, Tavahomi M. Attention demands of postural control in non-specific chronic low back pain subjects with low and high pain-related anxiety. Exp Brain Res 2018; 236:1927-1938. [PMID: 29696316 DOI: 10.1007/s00221-018-5267-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/17/2018] [Indexed: 12/17/2022]
Abstract
Impaired postural control in chronic low back pain (CLBP) has been attributed to deficits in sensory and motor functions. However, it is not known if pain-related anxiety affects motor and cognitive function of postural control. The aim of this study was to compare the interactive effects of postural and cognitive function in CLBP patients with high and low pain-related anxiety and healthy subjects. Thirty-eight patients with nonspecific CLBP (19 with low and 19 with high pain-related anxiety levels) and 20 asymptomatic subjects participated. Postural control was assessed by center of pressure (COP) parameters including mean total sway velocity, area, anterior-posterior (A-P), and medial-lateral (Med-Lat) range. Postural task was assessed during four conditions (eyes open with and without ankle vibration-eyes closed with and without ankle vibrations). Participants performed the postural task with or without auditory Stroop task. Average reaction time and error ratio of auditory Stroop test were calculated as measures of the cognitive task performance. Significantly reduced sway area was observed in CLBP patients with high pain-related anxiety and control subjects during the dual-task condition as compared with the single task. In addition, A-P range was significantly reduced in CLBP patients with high pain-related anxiety during dual tasking when eyes were closed with ankle vibration. In addition, only the CLBP subjects with high pain-related anxiety showed significantly longer reaction times by increasing the difficulty of standing postural task. Pain-related anxiety may influence the postural cognitive interactions in CLBP patients. Furthermore, it may be considered as a contributing factor for postural strategies adopted by CLBP patients.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahyar Salavati
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Khademi-Kalantari
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahnaz Tavahomi
- Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Iran
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68
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Impact of age and obstacle negotiation on timing measures of gait initiation. J Bodyw Mov Ther 2018; 22:361-365. [DOI: 10.1016/j.jbmt.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/04/2017] [Accepted: 05/15/2017] [Indexed: 01/08/2023]
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69
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van den Hoorn W, Kerr GK, van Dieën JH, Hodges PW. Center of Pressure Motion After Calf Vibration Is More Random in Fallers Than Non-fallers: Prospective Study of Older Individuals. Front Physiol 2018; 9:273. [PMID: 29632494 PMCID: PMC5879095 DOI: 10.3389/fphys.2018.00273] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/08/2018] [Indexed: 11/25/2022] Open
Abstract
Aging is associated with changes in balance control and elderly take longer to adapt to changing sensory conditions, which may increase falls risk. Low amplitude calf muscle vibration stimulates local sensory afferents/receptors and affects sense of upright when applied in stance. It has been used to assess the extent the nervous system relies on calf muscle somatosensory information and to rapidly change/perturb part of the somatosensory information causing balance unsteadiness by addition and removal of the vibratory stimulus. This study assessed the effect of addition and removal of calf vibration on balance control (in the absence of vision) in elderly individuals (>65 years, n = 99) who did (n = 41) or did not prospectively report falls (n = 58), and in a group of young individuals (18-25 years, n = 23). Participants stood barefoot and blindfolded on a force plate for 135 s. Vibrators (60 Hz, 1 mm) attached bilaterally over the triceps surae muscles were activated twice for 15 s; after 15 and 75 s (45 s for recovery). Balance measures were applied in a windowed (15 s epoch) manner to compare center-of-pressure (CoP) motion before, during and after removal of calf vibration between groups. In each epoch, CoP motion was quantified using linear measures, and non-linear measures to assess temporal structure of CoP motion [using recurrence quantification analysis (RQA) and detrended fluctuation analysis]. Mean CoP displacement during and after vibration did not differ between groups, which suggests that calf proprioception and/or weighting assigned by the nervous system to calf proprioception was similar for the young and both groups of older individuals. Overall, compared to the elderly, CoP motion of young was more predictable and persistent. Balance measures were not different between fallers and non-fallers before and during vibration. However, non-linear aspects of CoP motion of fallers and non-fallers differed after removal of vibration, when dynamic re-weighting is required. During this period fallers exhibited more random CoP motion, which could result from a reduced ability to control balance and/or a reduced ability to dynamically reweight proprioceptive information. These results show that non-linear measures of balance provide evidence for deficits in balance control in people who go on to fall in the following 12 months.
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Affiliation(s)
- Wolbert van den Hoorn
- Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Graham K. Kerr
- Movement Neuroscience Program, Institute of Health and Biomechanical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jaap H. van Dieën
- Amsterdam Movement Sciences, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Paul W. Hodges
- Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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70
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Bryanton MA, Bilodeau M. The Effect of Vision and Surface Compliance on Balance in Untrained and Strength Athletes. J Mot Behav 2018; 51:75-82. [PMID: 29377776 DOI: 10.1080/00222895.2017.1423019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this investigation was to evaluate the effect of the removal of vision and/or surface compliance on postural stability in strength athletes who habitually use free-weights and compound movements in their training (i.e., powerlifters, Olympic weightlifters), and untrained individuals. Static and dynamic balance testing was performed with eyes open or closed on stable and memory foam surfaces. Both groups had similar increases in postural sway area and velocity during quiet standing testing; whereas group main effects and interactions for dynamic testing revealed that untrained participants experienced greater relative declines in postural performance when voluntary limits of stability are stressed, especially when both vision and surface compliance were deterred. These results demonstrate that in comparison to untrained young adults, postural control variables may be reduced to a lesser extent in strength athletes when sensory constraints are altered; however this appears to be specific to the type of postural task performed.
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Affiliation(s)
- Megan A Bryanton
- a School of Human Kinetics, University of Ottawa , Ottawa , Ontario , Canada.,b Aging and Movement Laboratory, Bruyere Research Institute , Ottawa , Ontario , Canada
| | - Martin Bilodeau
- b Aging and Movement Laboratory, Bruyere Research Institute , Ottawa , Ontario , Canada.,c School of Rehabilitation Sciences, University of Ottawa , Ottawa , Ontario , Canada
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71
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An Overview of the Physiology and Pathophysiology of Postural Control. BIOSYSTEMS & BIOROBOTICS 2018. [DOI: 10.1007/978-3-319-72736-3_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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72
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O’Callaghan G, O’Dowd A, Stapleton J, Merriman NA, Roudaia E, Newell FN. Changes in Regional Brain Grey-Matter Volume Following Successful Completion of a Sensori-Motor Intervention Targeted at Healthy and Fall-Prone Older Adults. Multisens Res 2018; 31:317-344. [DOI: 10.1163/22134808-00002604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 08/08/2017] [Indexed: 02/03/2023]
Abstract
Previous studies have suggested that discrete cross-sensory events could be incorrectly combined in the brain of older adults with a history of falls, possibly undermining motor and balance control. Based on previous findings that multisensory integration is modifiable with practice, even in an ageing population, we designed a serious game, named CityQuest, to train typical, everyday multisensory processes including sensori-motor control, spatial navigation, obstacle avoidance and balance control. Played over several sessions, this game was shown to improve these functions in older adults with and without a history of falls, depending on the specific condition of the game on which they were trained. Here, using voxel-based morphometry analysis of anatomical magnetic resonance imaging (MRI) data, we investigated structural changes in the brain of a smaller group of older adults from those who successfully completed this five-week intervention. A grey-matter (GM) volume increase in the precentral gyrus, and GM volume reduction in the inferior temporal and orbitofrontal gyri, was found for all participants. Changes in GM volume within regions of the cerebellum were differentially associated with fall-prone and healthy older adults. Furthermore, a greater GM volume increase in the precentral gyrus was observed in participants who performed the full CityQuest intervention relative to those required to avoid obstacles only. Our results support previous evidence that multisensory training can affect structural changes in the older brain and have implications for programmes designed for the successful rehabilitation of perceptual and cognitive functions.
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Affiliation(s)
- Georgia O’Callaghan
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Alan O’Dowd
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
| | - John Stapleton
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Niamh A. Merriman
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Eugenie Roudaia
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Fiona N. Newell
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
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73
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Suzuki T, Ogahara K, Higashi T, Sugawara K. The Effect of Cane Use on Attentional Demands During Walking. J Mot Behav 2017; 51:19-24. [PMID: 29236578 DOI: 10.1080/00222895.2017.1408560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We investigated the effects of cane use, lateral walking stability, and cane use practice on attentional demands during walking. Attentional demands were assessed using dual-task methodology with a reaction time (RT) task. Sixteen healthy young subjects performed the RT task during walking, before and after cane use practice under four conditions: with/without cane use while wearing normal/unstable shoes. Among normal shoe conditions, cane use resulted in longer RTs. In contrast, RTs were similar regardless of cane use in the unstable shoe conditions. Among conditions without cane use, unstable shoes resulted in longer RTs. In contrast, RTs were similar regardless of shoe type in the cane use conditions. This study suggests that using a cane during walking requires additional attention; however, the resulting attentional demands depend on walking stability.
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Affiliation(s)
- Tomotaka Suzuki
- a School of Rehabilitation, Kanagawa University of Human Services , Yokosuka , Japan
| | - Kakuya Ogahara
- a School of Rehabilitation, Kanagawa University of Human Services , Yokosuka , Japan.,b Unit of Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Toshio Higashi
- b Unit of Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Kenichi Sugawara
- a School of Rehabilitation, Kanagawa University of Human Services , Yokosuka , Japan
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74
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Mehdizadeh H, Khalaf K, Ghomashchi H, Taghizadeh G, Ebrahimi I, Taghavi Azar Sharabiani P, Mousavi SJ, Parnianpour M. Effects of cognitive load on the amount and temporal structure of postural sway variability in stroke survivors. Exp Brain Res 2017; 236:285-296. [PMID: 29138873 DOI: 10.1007/s00221-017-5126-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
Abstract
This study aimed to investigate the variability in postural sway patterns during quiet standing in stroke survivors. The postural sway was measured in 19 stroke survivors, as well as 19 healthy demographically matched participants, at 3 levels of postural difficulty (rigid surface with closed and open eyes, and foam surface with closed eyes), and 3 levels of cognitive difficulty (without a cognitive task, easy and difficult cognitive tasks). Both linear analyses (the amount of postural sway variability, including the standard deviation of the COP velocity in both the anteroposterior (AP) and mediolateral (ML) directions), as well as non-linear analyses [the temporal structure of the COP variability, including % Recurrence, % Determinism, Shannon Entropy, Trend and the maximum diagonal line (D max)] were employed. The results revealed that the amount of variability of the postural sway of stroke survivors was significantly greater than that of healthy participants, along both the ML and AP directions, with the highest obtained during standing on foam with closed eyes. All measures of the temporal structure of the COP variability were significantly greater in stroke survivors, as compared to the control group, along the ML direction, but not along the AP direction. The cognitive error was significantly higher during difficult cognitive tasks, although it was neither affected by postural difficulty nor by group. The different results obtained for the amount and temporal structure of the COP variability in the AP and ML directions shed light on the intricate mechanisms employed by the CNS in post-stroke balance control, and suggest that effective rehabilitative and therapeutic strategies should be patient-specific, taking both the environment/surface as well as the specific protocols into consideration.
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Affiliation(s)
- Hajar Mehdizadeh
- Department of Neurosciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kinda Khalaf
- Department of Biomedical Engineering, Khalifa University of Science, Technology and Research, Abu Dhabi, UAE
| | - Hamed Ghomashchi
- Faculty of Mechanical and Industrial Engineering, Islamic Azad University, Qazvin Branch, Qazvin, Iran
| | - Ghorban Taghizadeh
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Shahnazari Street, Mirdamad Boulevard, Tehran, Iran. .,Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Ismaeil Ebrahimi
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | | | | | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
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75
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Lee KH, Baksh A, Bryant A, McGowan M, McMillan R, Chong RK. Two Mechanisms of Sensorimotor Set Adaptation to Inclined Stance. Front Hum Neurosci 2017; 11:480. [PMID: 29109683 PMCID: PMC5660095 DOI: 10.3389/fnhum.2017.00480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 09/19/2017] [Indexed: 12/05/2022] Open
Abstract
Orientation of posture relative to the environment depends on the contributions from the somatosensory, vestibular, and visual systems mixed in varying proportions to produce a sensorimotor set. Here, we probed the sensorimotor set composition using a postural adaptation task in which healthy adults stood on an inclined surface for 3 min. Upon returning to a horizontal surface, participants displayed a range of postural orientations – from an aftereffect that consisted of a large forward postural lean to an upright stance with little or no aftereffect. It has been hypothesized that the post-incline postural change depends on each individual’s sensorimotor set: whether the set was dominated by the somatosensory or vestibular system: Somatosensory dominance would cause the lean aftereffect whereas vestibular dominance should steer stance posture toward upright orientation. We investigated the individuals who displayed somatosensory dominance by manipulating their attention to spatial orientation. We introduced a distraction condition in which subjects concurrently performed a difficult arithmetic subtraction task. This manipulation altered the time course of their post-incline aftereffect. When not distracted, participants returned to upright stance within the 3-min period. However, they continued leaning forward when distracted. These results suggest that the mechanism of sensorimotor set adaptation to inclined stance comprises at least two components. The first component reflects the dominant contribution from the somatosensory system. Since the postural lean was observed among these subjects even when they were not distracted, it suggests that the aftereffect is difficult to overcome. The second component includes a covert attentional component which manifests as the dissipation of the aftereffect and the return of posture to upright orientation.
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Affiliation(s)
- Kyoung-Hyun Lee
- Center for Sport Science in Gwangju, Gwangju Sports Council, Gwangju, South Korea
| | - Asheeba Baksh
- Department of Physical Therapy, Augusta University, Augusta, GA, United States
| | - Alyssa Bryant
- Department of Physical Therapy, Augusta University, Augusta, GA, United States
| | - Mollie McGowan
- Department of Physical Therapy, Augusta University, Augusta, GA, United States
| | - Ryan McMillan
- Department of Physical Therapy, Augusta University, Augusta, GA, United States
| | - Raymond K Chong
- Department of Physical Therapy, Augusta University, Augusta, GA, United States
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76
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Effects of dual task difficulty in motor and cognitive performance: Differences between adults and adolescents. Hum Mov Sci 2017; 55:8-17. [DOI: 10.1016/j.humov.2017.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/15/2017] [Accepted: 07/16/2017] [Indexed: 11/20/2022]
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77
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Wiesmeier IK, Dalin D, Wehrle A, Granacher U, Muehlbauer T, Dietterle J, Weiller C, Gollhofer A, Maurer C. Balance Training Enhances Vestibular Function and Reduces Overactive Proprioceptive Feedback in Elderly. Front Aging Neurosci 2017; 9:273. [PMID: 28848430 PMCID: PMC5554492 DOI: 10.3389/fnagi.2017.00273] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/28/2017] [Indexed: 01/01/2023] Open
Abstract
Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training program on these postural control impairments using a brain network model based on system identification techniques. Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model. Results: With balance training, the elderly subjects significantly reduced their overly large postural reactions and approximated those of younger subjects. Less significant differences between elderly and young subjects' postural control, namely larger spontaneous sway amplitudes, velocities, and frequencies, larger overall time delays and a weaker motor feedback compared to young subjects were not significantly affected by the balance training. Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits.
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Affiliation(s)
- Isabella K Wiesmeier
- Department of Neurology and Neurophysiology, University Hospital FreiburgFreiburg, Germany
| | - Daniela Dalin
- Department of Neurology and Neurophysiology, University Hospital FreiburgFreiburg, Germany
| | - Anja Wehrle
- Institute for Sports and Sport Science, University of FreiburgFreiburg, Germany.,Department of Internal Medicine, Institute for Exercise and Occupational Medicine, University Hospital FreiburgFreiburg, Germany
| | - Urs Granacher
- Division of Training and Movement Science, University of PotsdamPotsdam, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences, Biomechanics of Sport, Institute of Sport and Movement Sciences, University Duisburg-EssenEssen, Germany
| | - Joerg Dietterle
- Department of Neurology and Neurophysiology, University Hospital FreiburgFreiburg, Germany
| | - Cornelius Weiller
- Department of Neurology and Neurophysiology, University Hospital FreiburgFreiburg, Germany
| | - Albert Gollhofer
- Institute for Sports and Sport Science, University of FreiburgFreiburg, Germany
| | - Christoph Maurer
- Department of Neurology and Neurophysiology, University Hospital FreiburgFreiburg, Germany
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78
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Sheikh M, Azarpazhooh MR, Hosseini HA. The effect of immediate decreasing of weight bearing asymmetry on quiet standing postural control in individuals with chronic stroke. Physiother Theory Pract 2017; 33:751-757. [PMID: 28786742 DOI: 10.1080/09593985.2017.1357154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The main patterns characterizing standing posture of hemiparetic patients include: weight-bearing asymmetry (WBA), larger postural sway, asymmetrical contribution of lower limbs to balance control, and increased visual dependency to balance control. The aim of this study was to evaluate the effect of decreasing WBA with the use of a shoe lift, on quiet standing postural control in patients with chronic stroke. Twenty-seven patients participated in this study. Patients completed two tests: 1) quiet standing; and 2) quiet standing while a lift was placed under the non-paretic limb. The following tests were completed on force plates for evaluation: asymmetry of the balance measures (weight bearing, root mean square (RMS) of anterior-posterior (AP) and medial-lateral (ML) center of pressure (COP) velocity), RMS of total AP and ML COP velocity, and AP and ML Romberg quotients. Paired t-tests were used to analyze the data. The mean value of WBA index decreased significantly after using a lift (p < 0.05). However, the changes of the mean value of other postural control parameters were not significant (p > 0.05). The results indicate that there may not be an association between decreased WBA and improved postural control during quiet standing in patients with stroke.
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Affiliation(s)
- Mania Sheikh
- a Department of Physical Therapy, School of Paramedical Sciences , Campus of Mashhad University of Medical Sciences , Mashhad , Iran
| | | | - Hossein Asghar Hosseini
- a Department of Physical Therapy, School of Paramedical Sciences , Campus of Mashhad University of Medical Sciences , Mashhad , Iran
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79
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Cha JH, Kim JJ, Ye JG, Lee SJ, Hong JM, Choi HK, Choi HS, Shin WS. Static balance according to hip joint angle of unsupported leg during one-leg standing. J Phys Ther Sci 2017; 29:931-935. [PMID: 28603375 PMCID: PMC5462702 DOI: 10.1589/jpts.29.931] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/20/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine static balance according to hip joint angle of
the unsupported leg during one-leg standing. [Subjects and Methods] Subjects included 45
healthy adult males and females in their 20s. During one-leg standing on the non-dominant
leg, the position of the unsupported leg was classified according to hip joint angles of
point angle was class. Static balance was then measured using a force plate with eyes open
and closed. The total length, sway velocity, maximum deviation, and velocity on the
mediolateral and anteroposterior axes of center of pressure were measured. [Results] In
balance assessment with eyes open, there were significant differences between groups
according to hip joint angle, except for maximum deviation on the anteroposterior axis. In
balance assessment with eyes closed, there were significant differences between total
length measurements at 0° and 30°, 60° and between 30° and 90°. There were significant
differences between sway velocity measurements at 0° and 30° and between 30° and 90°.
[Conclusion] Thus, there were differences in static balance according to hip joint angle.
It is necessary to clearly identify the hip joint angle during one-leg standing
testing.
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Affiliation(s)
- Ju-Hyung Cha
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
| | - Jang-Joon Kim
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
| | - Jae-Gwan Ye
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
| | - Seul-Ji Lee
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
| | - Jeong-Mi Hong
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
| | - Hyun-Kyu Choi
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Ho-Suk Choi
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
| | - Won-Seob Shin
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
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80
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Ghai S, Ghai I, Effenberg AO. Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis. Clin Interv Aging 2017; 12:557-577. [PMID: 28356727 PMCID: PMC5367902 DOI: 10.2147/cia.s125201] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The use of dual-task training paradigm to enhance postural stability in patients with balance impairments is an emerging area of interest. The differential effects of dual tasks and dual-task training on postural stability still remain unclear. A systematic review and meta-analysis were conducted to analyze the effects of dual task and training application on static and dynamic postural stability among various population groups. Systematic identification of published literature was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, from inception until June 2016, on the online databases Scopus, PEDro, MEDLINE, EMBASE, and SportDiscus. Experimental studies analyzing the effects of dual task and dual-task training on postural stability were extracted, critically appraised using PEDro scale, and then summarized according to modified PEDro level of evidence. Of 1,284 records, 42 studies involving 1,480 participants met the review’s inclusion criteria. Of the studies evaluating the effects of dual-task training on postural stability, 87.5% of the studies reported significant enhancements, whereas 30% of the studies evaluating acute effects of dual tasks on posture reported significant enhancements, 50% reported significant decrements, and 20% reported no effects. Meta-analysis of the pooled studies revealed moderate but significant enhancements of dual-task training in elderly participants (95% CI: 1.16–2.10) and in patients suffering from chronic stroke (−0.22 to 0.86). The adverse effects of complexity of dual tasks on postural stability were also revealed among patients with multiple sclerosis (−0.74 to 0.05). The review also discusses the significance of verbalization in a dual-task setting for increasing cognitive–motor interference. Clinical implications are discussed with respect to practical applications in rehabilitation settings.
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Affiliation(s)
- Shashank Ghai
- Institute of Sports Science, Leibniz University, Hannover, Germany; Department of Sports Science, University of Waikato, Hamilton, New Zealand
| | - Ishan Ghai
- School of Engineering & Life Sciences, Jacobs University, Bremen, Germany
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81
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Mochizuki G, Boe SG, Marlin A, McIlroy WE. Performance of a concurrent cognitive task modifies pre- and post-perturbation-evoked cortical activity. Neuroscience 2017; 348:143-152. [PMID: 28215746 DOI: 10.1016/j.neuroscience.2017.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 02/03/2017] [Accepted: 02/08/2017] [Indexed: 11/17/2022]
Abstract
Preparation for postural instability engages cortical resources that serve to optimize compensatory balance responses. Engagement of these cortical resources in cognitive dual-task activities may impact the ability to appropriately prepare and optimize responses to instability. The purpose of this study was to determine whether cognitive dual-task activities influenced cortical activity preceding and following postural instability. Postural instability was induced using a lean-and-release paradigm in 10 healthy participants. Perturbations were either temporally predictable (PRED) or unpredictable (UNPRED) and presented with (COG) or without a cognitive dual-task, presented in blocks of trials. The electroencephalogram was recorded from multiple frontal electrode sites. EEG data were averaged over 25-35 trials across conditions. Area under the curve of pre-perturbation cortical activity and peak latency and amplitude of post-perturbation cortical activity were quantified at the Cz site and compared across conditions. Performance of the concurrent cognitive task reduced the mean (SE) magnitude of pre-perturbation cortical activity in advance of predictable bouts of postural instability (PRED: 18.7(3.0)mVms; PRED-COG; 14.0(2.3)mVms). While the level of cognitive load influenced the amplitude of the post-perturbation N1 potential in the predictable conditions, there were no changes in N1 with a cognitive dual task during unpredictable conditions (PRED: -32.1(3.2)µV; PRED-COG: -50.8(8.4)µV; UNPRED: -65.0(12.2)µV; UNPRED-COG: -64.2(12.7)µV). Performance of the cognitive task delayed and reduced the magnitude of the initial gastrocnemius response. The findings indicate that pre- and post-perturbation cortical activity is affected by a cognitive distractor when postural instability is temporally predictable. Distraction also influences associated muscle responses.
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Affiliation(s)
- George Mochizuki
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada; Mobility Research Team, Toronto Rehabilitation Institute, Toronto, ON, Canada.
| | - Shaun G Boe
- Laboratory for Brain Recovery and Function, School of Physiotherapy, Dalhousie University, Halifax, NS, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Amanda Marlin
- Mobility Research Team, Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - William E McIlroy
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada; Mobility Research Team, Toronto Rehabilitation Institute, Toronto, ON, Canada; Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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82
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Honeine JL, Crisafulli O, Schieppati M. Body sway adaptation to addition but not withdrawal of stabilizing visual information is delayed by a concurrent cognitive task. J Neurophysiol 2017; 117:777-785. [PMID: 27903641 DOI: 10.1152/jn.00725.2016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/26/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to test the effects of a concurrent cognitive task on the promptness of the sensorimotor integration and reweighting processes following addition and withdrawal of vision. Fourteen subjects stood in tandem while vision was passively added and removed. Subjects performed a cognitive task, consisting of counting backward in steps of three, or were "mentally idle." We estimated the time intervals following addition and withdrawal of vision at which body sway began to change. We also estimated the time constant of the exponential change in body oscillation until the new level of sway was reached, consistent with the current visual state. Under the mentally idle condition, mean latency was 0.67 and 0.46 s and the mean time constant was 1.27 and 0.59 s for vision addition and withdrawal, respectively. Following addition of vision, counting backward delayed the latency by about 300 ms, without affecting the time constant. Following withdrawal, counting backward had no significant effect on either latency or time constant. The extension by counting backward of the time interval to stabilization onset on addition of vision suggests a competition for allocation of cortical resources. Conversely, the absence of cognitive task effect on the rapid onset of destabilization on vision withdrawal, and on the relevant reweighting time course, advocates the intervention of a subcortical process. Diverting attention from a challenging standing task discloses a cortical supervision on the process of sensorimotor integration of new balance-stabilizing information. A subcortical process would instead organize the response to removal of the stabilizing sensory input.NEW & NOTEWORTHY This study is the first to test the effect of an arithmetic task on the time course of balance readjustment following visual withdrawal or addition. Performing such a cognitive task increases the time delay following addition of vision but has no effect on withdrawal dynamics. This suggests that sensorimotor integration following addition of a stabilizing signal is performed at a cortical level, whereas the response to its withdrawal is "automatic" and accomplished at a subcortical level.
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Affiliation(s)
- Jean-Louis Honeine
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; and
| | - Oscar Crisafulli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; and
| | - Marco Schieppati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; and.,Centro Studi Attività Motorie (CSAM), Fondazione Salvatore Maugeri (IRCSS), Scientific Institute of Pavia, Pavia, Italy
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83
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Kraan CM, Tan AHJ, Cornish KM. The developmental dynamics of gait maturation with a focus on spatiotemporal measures. Gait Posture 2017; 51:208-217. [PMID: 27816899 DOI: 10.1016/j.gaitpost.2016.10.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 02/02/2023]
Abstract
Gait analysis is recognised as a powerful clinical tool for studying relationships between motor control and brain function. By drawing on the literature investigating gait in individuals with neurological disorders, this review provides insight into the neural processes that contribute to and regulate specific spatiotemporal sub-components of gait and how they may mature across early to late childhood. This review also discusses the roles of changing anthropomorphic characteristics, and maturing sensory and higher-order cognitive processes in differentiating the developmental trajectories of the sub-components of gait. Importantly, although studies have shown that cognitive-gait interference is larger in children compared to adults, the contributing neurocognitive mechanisms may vary across age groups who have different types of attentional or cognitive vulnerabilities. These findings have implications for current models of gait maturation by highlighting the need for a dynamic model that focuses on the integration of various factors that contribute to gait though experience and practice. This is essential to elucidating why gait and other motor deficits are often contiguous with cognitive neurodevelopmental disorders.
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Affiliation(s)
- C M Kraan
- School of Psychological Sciences and The Monash Institute of Cognitive and Clinical and Neurosciences, Monash University, Clayton, Victoria, 3800, Australia
| | - A H J Tan
- School of Psychological Sciences and The Monash Institute of Cognitive and Clinical and Neurosciences, Monash University, Clayton, Victoria, 3800, Australia
| | - K M Cornish
- School of Psychological Sciences and The Monash Institute of Cognitive and Clinical and Neurosciences, Monash University, Clayton, Victoria, 3800, Australia.
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84
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Tyagi S, Perera S, Brach JS. Balance and Mobility in Community-Dwelling Older Adults: Effect of Daytime Sleepiness. J Am Geriatr Soc 2016; 65:1019-1025. [PMID: 27991662 DOI: 10.1111/jgs.14735] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To examine the effect of self-reported daytime sleepiness on performance-based balance measures and self-reported balance confidence in community-dwelling older adults. DESIGN Cross-sectional secondary analysis of an observational cohort study designed to develop and refine measures of balance and mobility in community-dwelling older adults. SETTING Community. PARTICIPANTS Older adults (aged 78.2 ± 5.9) (n = 120). MEASUREMENTS The performance-based gait and balance measures included gait speed, double support time, and step width. Narrow walk, obstacle walk, and timed standing balance were also assessed. The Activities-Specific Balance Confidence Scale was included as a self-reported measure. Daytime sleepiness was defined as an Epworth Sleepiness Scale score of 9 or greater. Body mass index, fall-related comorbidities, and use of central nervous system (CNS) medications were considered as covariates. RESULTS Forty-five percent of participants reported daytime sleepiness. Participants reporting daytime sleepiness differed significantly from those without in gait speed (adjusted difference (standard error (SE)) -0.09 (0.04) m/s, P = .03), step width (adjusted difference (SE) 0.02 (0.01), P = .03), and self-reported balance confidence (adjusted difference (SE) -1.02 (0.38), P = .01) even after adjusting for covariates. Two-way analysis of variance of CNS medication use and daytime sleepiness showed no significant interaction effects. CONCLUSION Self-reported daytime sleepiness is associated with slower gait speed and poor balance confidence in community-dwelling older adults. Subjective sleep assessment should be considered when assessing balance and implementing interventions for improving balance in older adults. Further study is needed to examine the role of CNS medication use.
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Affiliation(s)
- Shachi Tyagi
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Subashan Perera
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer S Brach
- Department of Physical Therapy, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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85
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Ku PX, Abu Osman NA, Wan Abas WAB. The limits of stability and muscle activity in middle-aged adults during static and dynamic stance. J Biomech 2016; 49:3943-3948. [PMID: 27865478 DOI: 10.1016/j.jbiomech.2016.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 11/04/2016] [Accepted: 11/05/2016] [Indexed: 11/26/2022]
Abstract
Balance control plays an important role in maintaining daily activity. However, studies on postural control among middle-aged adults are scarce. This study aims (i) to examine directional control (DCL) and electromyography activity (EMG) for different stability levels, and (ii) to determine left-right asymmetry for DCL and muscle activity among sedentary middle-aged adults. Twenty healthy, middle-aged adults (10 males, 10 females; age=50.0±7.5yrs; body height: 1.61±0.10m; body mass: 70.0±14.5kg) participated in the study. EMG for left and right side of rectus femoris (RF), biceps femoris (BF), and medial gastrocnemius (MG) were recorded. Two-way repeated measures analysis of variance was used to assess the effect of dynamic level on DCL and EMG, whereas independent sample t-test was conducted to analyse the asymmetries of DCL and EMG for the left and right leg. When the dynamic tilt surface increased, DCL scores significantly decreased (except forward, forward-rightward, and backward-leftward direction) and only RF muscle indicated significant differences. Left-right asymmetry was found in BF and MG muscles. No significant gender difference was observed in DCL and EMG. These data demonstrated that increased dynamic tilt surface may increase the displacement of center of pressure of certain directions, and stimulate RF activity in dynamic stance among sedentary middle-aged adults. Further studies should be conducted to examine the dynamic stance and muscle activity of the lower limb in age-matched patient groups with balance abnormalities.
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Affiliation(s)
- P X Ku
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Malaysia.
| | - N A Abu Osman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Malaysia.
| | - W A B Wan Abas
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Malaysia.
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86
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Tsang WWN, Chan VWL, Wong HH, Yip TWC, Lu X. The effect of performing a dual-task on postural control and selective attention of older adults when stepping backward. J Phys Ther Sci 2016; 28:2806-2811. [PMID: 27821940 PMCID: PMC5088131 DOI: 10.1589/jpts.28.2806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 06/16/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the study was to investigate the postural control and cognitive
performance of older adults when stepping backward with and without a concurrent cognitive
task. [Subjects and Methods] Thirty young adults and twenty-eight older adults (mean
age=21.3 ± 1.2 and 72.2 ± 5.7 years, respectively) were recruited. Participants were asked
to step backward and then maintain a single-leg stance for 10 seconds with and without a
concurrent auditory response task. The reaction time and error rate while performing the
cognitive task were recorded. Postural stability after stepping back was measured in terms
of total sway path and total sway area. [Results] The older subjects had significantly
longer reaction times and higher error rates in both single- and dual-tasking. When
dual-tasking, both groups had significantly longer reaction times than when
single-tasking. Only the older adults showed significantly higher error rates. The older
adults also had significantly longer total sway paths and larger total sway areas of
single-leg stance after stepping back. Neither group showed a significant difference in
total sway path and sway area between single- and dual-tasking. [Conclusion] Older adults
have poorer cognitive performance and postural stability during both single- and
dual-tasking. They tend to prioritize postural control over cognition in dual-tasking.
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Affiliation(s)
| | - Vito Wai-Lok Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China
| | - Henry Hei Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China
| | - Tony Wai-Cheong Yip
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China
| | - Xi Lu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China; Department of Rehabilitation Medicine, China-Japan Friendship Hospital, China
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87
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Relationship between changes in vestibular sensory reweighting and postural control complexity. Exp Brain Res 2016; 235:547-554. [PMID: 27812748 DOI: 10.1007/s00221-016-4814-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
Complexity measures have become increasingly prominent in the postural control literature. Several studies have found associations between clinical balance improvements and complexity, but the relationship between sensory reweighting and complexity changes has remained unobserved. The purpose of this study was to determine the relationship between sensory reweighting via Wii Fit balance training and complexity. Twenty healthy adults completed 6 weeks of training. Participants completed the sensory organization test (SOT) before and after the sessions. Complexity of postural control was analyzed through sample entropy of the center-of-pressure velocity time series in the resultant, anterior-posterior (AP), and medial-lateral directions, and compared to SOT summary score changes. Significant differences were found between pre- and post-training for the condition five (p < .001, d = .525) and vestibular summary scores (p < .001, d = .611). Similarly, changes in complexity were observed from pre- to post-training in the resultant (p = .040, d = .427) direction. While the AP velocity was not significant (p = .07, d = .355), its effect size was moderate. A moderate correlation was revealed in the posttest between AP complexity and condition 5 (r = .442, p = .05), as well as between AP complexity and the vestibular summary score (r = .351, p = .13). The results of this study show that a moderate relationship exists between postural control complexity and the vestibular system, suggesting that complexity may reflect the neurosensory organization used to maintain upright stance.
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88
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Kilby MC, Molenaar PCM, Slobounov SM, Newell KM. Real-time visual feedback of COM and COP motion properties differentially modifies postural control structures. Exp Brain Res 2016; 235:109-120. [PMID: 27644409 DOI: 10.1007/s00221-016-4769-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 08/30/2016] [Indexed: 11/26/2022]
Abstract
The experiment was setup to investigate the control of human quiet standing through the manipulation of augmented visual information feedback of selective properties of the motion of two primary variables in postural control: center of pressure (COP) and center of mass (COM). Five properties of feedback information were contrasted to a no feedback dual-task (watching a movie) control condition to determine the impact of visual real-time feedback on the coordination of the joint motions in postural control in both static and dynamic one-leg standing postures. The feedback information included 2D COP or COM position and macro variables derived from the COP and COM motions, namely virtual time-to-contact (VTC) and the COP-COM coupling. The findings in the static condition showed that the VTC and COP-COM coupling feedback conditions decreased postural motion more than the 2D COP or COM positional information. These variables also induced larger sway amplitudes in the dynamic condition showing a more progressive search strategy in exploring the stability limits. Canonical correlation analysis (CCA) found that COP-COM coupling contributed less than the other feedback variables to the redundancy of the system reflected in the common variance between joint motions and properties of sway motion. The COP-COM coupling had the lowest weighting of the motion properties to redundancy under the feedback conditions but overall the qualitative pattern of the joint motion structures was preserved within the respective static and dynamic balance conditions.
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Affiliation(s)
- Melissa C Kilby
- Department of Kinesiology, The University of Georgia, 330 River Rd, Athens, GA, 30602, USA.
| | - Peter C M Molenaar
- Department of Human Development and Family Studies, The Pennsylvania State University, 315 Health and Human Development East, University Park, PA, 16802, USA
| | - Semyon M Slobounov
- Department of Kinesiology, The Pennsylvania State University, 276 Recreation Building, University Park, PA, 16802, USA
| | - Karl M Newell
- Department of Kinesiology, The University of Georgia, 330 River Rd, Athens, GA, 30602, USA
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89
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Ruffieux J, Keller M, Lauber B, Taube W. Changes in Standing and Walking Performance Under Dual-Task Conditions Across the Lifespan. Sports Med 2016; 45:1739-58. [PMID: 26253187 PMCID: PMC4656695 DOI: 10.1007/s40279-015-0369-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Simultaneous performance of a postural and a concurrent task is rather unproblematic as long as the postural task is executed in an automatic way. However, in situations where postural control requires more central processing, cognitive resources may be exceeded by the addition of an attentionally demanding task. This may lead to interference between the two tasks, manifested in a decreased performance in one or both tasks (dual-task costs). Owing to changes in attentional demands of postural tasks as well as processing capacities across the lifespan, it might be assumed that dual-task costs are particularly pronounced in children and older adults probably leading to a U-shaped pattern for dual-task costs as a function of age. However, these changes in the ability of dual-tasking posture from childhood to old age have not yet been systematically reviewed. Therefore, Web of Science and PubMed databases were searched for studies comparing dual-task performance with one task being standing or walking in healthy groups of young adults and either children or older adults. Seventy-nine studies met inclusion criteria. For older adults, the expected increase in dual-task costs could be confirmed. In contrast, in children there was only feeble evidence for a trend towards enlarged dual-task costs. More good-quality studies comparing dual-task ability in children, young, and, ideally, also older adults within the same paradigm are needed to draw unambiguous conclusions about lifespan development of dual-task performance in postural tasks. There is evidence that, in older adults, dual-task performance can be improved by training. For the other age groups, these effects have yet to be investigated.
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Affiliation(s)
- Jan Ruffieux
- Department of Medicine, Movement and Sport Sciences, University of Fribourg, Bd de Pérolles 95, 1700, Fribourg, Switzerland.
| | - Martin Keller
- Department of Medicine, Movement and Sport Sciences, University of Fribourg, Bd de Pérolles 95, 1700, Fribourg, Switzerland
| | - Benedikt Lauber
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstr. 175, 79117, Freiburg, Germany
| | - Wolfgang Taube
- Department of Medicine, Movement and Sport Sciences, University of Fribourg, Bd de Pérolles 95, 1700, Fribourg, Switzerland
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90
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Cortical activity modulations underlying age-related performance differences during posture–cognition dual tasking. Exp Brain Res 2016; 234:3321-3334. [DOI: 10.1007/s00221-016-4730-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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91
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Martin T, Moussay S, Bulla I, Bulla J, Toupet M, Etard O, Denise P, Davenne D, Coquerel A, Quarck G. Exploration of Circadian Rhythms in Patients with Bilateral Vestibular Loss. PLoS One 2016; 11:e0155067. [PMID: 27341473 PMCID: PMC4920359 DOI: 10.1371/journal.pone.0155067] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/24/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND New insights have expanded the influence of the vestibular system to the regulation of circadian rhythmicity. Indeed, hypergravity or bilateral vestibular loss (BVL) in rodents causes a disruption in their daily rhythmicity for several days. The vestibular system thus influences hypothalamic regulation of circadian rhythms on Earth, which raises the question of whether daily rhythms might be altered due to vestibular pathology in humans. The aim of this study was to evaluate human circadian rhythmicity in people presenting a total bilateral vestibular loss (BVL) in comparison with control participants. METHODOLOGY AND PRINCIPAL FINDINGS Nine patients presenting a total idiopathic BVL and 8 healthy participants were compared. Their rest-activity cycle was recorded by actigraphy at home over 2 weeks. The daily rhythm of temperature was continuously recorded using a telemetric device and salivary cortisol was recorded every 3 hours from 6:00AM to 9:00PM over 24 hours. BVL patients displayed a similar rest activity cycle during the day to control participants but had higher nocturnal actigraphy, mainly during weekdays. Sleep efficiency was reduced in patients compared to control participants. Patients had a marked temperature rhythm but with a significant phase advance (73 min) and a higher variability of the acrophase (from 2:24 PM to 9:25 PM) with no correlation to rest-activity cycle, contrary to healthy participants. Salivary cortisol levels were higher in patients compared to healthy people at any time of day. CONCLUSION We observed a marked circadian rhythmicity of temperature in patients with BVL, probably due to the influence of the light dark cycle. However, the lack of synchronization between the temperature and rest-activity cycle supports the hypothesis that the vestibular inputs are salient input to the circadian clock that enhance the stabilization and precision of both external and internal entrainment.
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Affiliation(s)
- Tristan Martin
- UNICAEN, COMETE, 14032 Caen, France
- INSERM, U1075, 14032 Caen, France
- Normandie Universite, Caen, France
| | - Sébastien Moussay
- UNICAEN, COMETE, 14032 Caen, France
- INSERM, U1075, 14032 Caen, France
- Normandie Universite, Caen, France
| | - Ingo Bulla
- Theoretical Biology and Biophysics, Group T-6, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
- Institut für Mathematik und Informatik, Universität Greifswald, Walther-Rathenau-Straße 47, 17487 Greifswald, Germany
| | - Jan Bulla
- Department of Mathematics, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway
| | - Michel Toupet
- Centre d’explorations fonctionnelles oto-neurologiques, 10 rue Falguière, 75 015 Paris, France
| | - Olivier Etard
- Normandie Universite, Caen, France
- CHU de Caen, Service des Explorations Fonctionnelles, 14000 Caen, France
| | - Pierre Denise
- UNICAEN, COMETE, 14032 Caen, France
- INSERM, U1075, 14032 Caen, France
- Normandie Universite, Caen, France
- CHU de Caen, Service des Explorations Fonctionnelles, 14000 Caen, France
| | - Damien Davenne
- UNICAEN, COMETE, 14032 Caen, France
- INSERM, U1075, 14032 Caen, France
- Normandie Universite, Caen, France
| | - Antoine Coquerel
- UNICAEN, COMETE, 14032 Caen, France
- INSERM, U1075, 14032 Caen, France
- Normandie Universite, Caen, France
- CHU de Caen, Laboratoire de pharmacologie-toxicologie, 14000 Caen, France
| | - Gaëlle Quarck
- UNICAEN, COMETE, 14032 Caen, France
- INSERM, U1075, 14032 Caen, France
- Normandie Universite, Caen, France
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92
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Holt KR, Haavik H, Lee ACL, Murphy B, Elley CR. Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk in Older People: A Randomized Controlled Trial. J Manipulative Physiol Ther 2016; 39:267-78. [DOI: 10.1016/j.jmpt.2016.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/23/2015] [Accepted: 10/13/2015] [Indexed: 01/22/2023]
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93
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Blouin J, Bresciani JP, Guillaud E, Simoneau M. Prediction in the Vestibular Control of Arm Movements. Multisens Res 2016; 28:487-505. [PMID: 26595953 DOI: 10.1163/22134808-00002501] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The contribution of vestibular signals to motor control has been evidenced in postural, locomotor, and oculomotor studies. Here, we review studies showing that vestibular information also contributes to the control of arm movements during whole-body motion. The data reviewed suggest that vestibular information is used by the arm motor system to maintain the initial hand position or the planned hand trajectory unaltered during body motion. This requires integration of vestibular and cervical inputs to determine the trunk motion dynamics. These studies further suggest that the vestibular control of arm movement relies on rapid and efficient vestibulomotor transformations that cannot be considered automatic. We also reviewed evidence suggesting that the vestibular afferents can be used by the brain to predict and counteract body-rotation-induced torques (e.g., Coriolis) acting on the arm when reaching for a target while turning the trunk.
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94
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Associations between Tactile Sensory Threshold and Postural Performance and Effects of Healthy Aging and Subthreshold Vibrotactile Stimulation on Postural Outcomes in a Simple Dual Task. Curr Gerontol Geriatr Res 2016; 2016:9797369. [PMID: 27143967 PMCID: PMC4842039 DOI: 10.1155/2016/9797369] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/22/2016] [Indexed: 11/17/2022] Open
Abstract
Specific activities that require concurrent processing of postural and cognitive tasks may increase the risk for falls in older adults. We investigated whether peripheral receptor sensitivity was associated with postural performance in a dual-task and whether an intervention in form of subthreshold vibration could affect performance. Ten younger (age: 20–35 years) and ten older adults (70–85 years) performed repeated auditory-verbal 1-back tasks while standing quietly on a force platform. Foot sole vibration was randomly added during several trials. Several postural control and performance measures were assessed and statistically analyzed (significance set to α-levels of .05). There were moderate correlations between peripheral sensitivity and several postural performance and control measures (r = .45 to .59). Several postural performance measures differed significantly between older and younger adults (p < 0.05); addition of vibration did not affect outcome measures. Aging affects healthy older adults' performance in dual-tasks, and peripheral sensitivity may be a contributor to the observed differences. A vibration intervention may only be useful when there are more severe impairments of the sensorimotor system. Hence, future research regarding the efficacy of sensorimotor interventions in the form of vibrotactile stimulation should focus on older adults whose balance is significantly affected.
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95
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Laing JM, Tokuno CD. The effects of dual-tasking on arm muscle responses in young and older adults. Hum Mov Sci 2016; 46:159-66. [DOI: 10.1016/j.humov.2016.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 01/03/2016] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
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96
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Avelar BP, Costa JNDA, Safons MP, Dutra MT, Bottaro M, Gobbi S, Tiedemann A, de David AC, Lima RM. Balance Exercises Circuit improves muscle strength, balance, and functional performance in older women. AGE (DORDRECHT, NETHERLANDS) 2016; 38:14. [PMID: 26802006 PMCID: PMC5005874 DOI: 10.1007/s11357-016-9872-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 01/07/2016] [Indexed: 06/05/2023]
Abstract
This study introduces the Balance Exercises Circuit (BEC) and examines its effects on muscle strength and power, balance, and functional performance in older women. Thirty-five women aged 60+ (mean age = 69.31, SD = 7.35) were assigned to either a balance exercises group (BG, n = 14) that underwent 50-min sessions twice weekly, of a 12-week BEC program, or a wait-list control group (CG, n = 21). Outcome measures were knee extensor peak torque (PT), rate of force development (RFD), balance, Timed Up & Go (TUG), 30-s chair stand, and 6-min walk tests, assessed at baseline and 12 weeks. Twenty-three participants completed follow-up assessments. Mixed analysis of variance models examined differences in outcomes. The BG displayed improvements in all measures at follow-up and significantly improved compared with CG on, isokinetic PT60, PT180 (p = 0.02), RFD (p < 0.05), balance with eyes closed (p values range .02 to <.01) and TUG (p = 0.03), all with medium effect sizes. No changes in outcome measures were observed in the CG. BEC improved strength, power, balance, and functionality in older women. The BEC warrants further investigation as a fall prevention intervention.
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Affiliation(s)
| | | | | | | | - Martim Bottaro
- Faculdade de Educação Física, Universidade of Brasilia, Brasilia, Brazil
| | - Sebastião Gobbi
- Instituto de Biociências, Universidade Estadual Paulista - Rio Claro, Rio Claro, Brazil
| | - Anne Tiedemann
- Musculoskeletal Division, The George Institute for Global Health, University of Sydney, Sydney, Australia
- Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia
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97
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Meng H, O'Connor DP, Lee BC, Layne CS, Gorniak SL. Effects of adiposity on postural control and cognition. Gait Posture 2016; 43:31-7. [PMID: 26669948 DOI: 10.1016/j.gaitpost.2015.10.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 09/03/2015] [Accepted: 10/09/2015] [Indexed: 02/07/2023]
Abstract
In the U.S., it is estimated that over one-third of adults are obese (Body Mass Index (BMI)>30kg/m(2)). Previous studies suggest that obesity may be associated with deficits in cognitive performance and postural control. Increased BMI may challenge cognitive and postural performance in a variety of populations; however, most relevant studies have classified participants based on BMI values, which cannot be used to accurately assess the effects of adiposity on cognitive performance and postural control. The objective of the current study was to examine motor and cognitive responses for overweight and obese adults compared to normal weight individuals by using both BMI and adiposity measures. Ten normal weight (BMI=18-24.9kg/m(2)), ten overweight (BMI=25-29.9kg/m(2)), and ten obese (BMI=30-40kg/m(2)) adults were evaluated (age: 24±4 years). Participants were classified into three groups based on BMI values at the onset of the study, prior to body composition analysis. Participants performed (1) working memory task while maintaining upright stance, and (2) a battery of sensorimotor evaluations. Working memory reaction times, response accuracy, center-of-pressure (COP) path length, velocity, migration area, time to boundary values in anterior-posterior direction, and ankle-hip strategy-scores were calculated to evaluate cognitive-motor performance. No significant deficits in working memory performance were observed. Overall, measures of motor function deteriorated as BMI and body fat percentage increased. The relationship between deteriorating postural performance indices and body fat percentage were greater than those found between BMI and postural performance indices.
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Affiliation(s)
- Hao Meng
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States; Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204, United States
| | - Daniel P O'Connor
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States; Texas Obesity Research Center, University of Houston, Houston, TX 77204, United States
| | - Beom-Chan Lee
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States; Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204, United States
| | - Charles S Layne
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States; Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204, United States; Texas Obesity Research Center, University of Houston, Houston, TX 77204, United States
| | - Stacey L Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States; Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204, United States; Texas Obesity Research Center, University of Houston, Houston, TX 77204, United States.
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98
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Engelhart D, Pasma JH, Schouten AC, Aarts RGKM, Meskers CGM, Maier AB, van der Kooij H. Adaptation of multijoint coordination during standing balance in healthy young and healthy old individuals. J Neurophysiol 2015; 115:1422-35. [PMID: 26719084 DOI: 10.1152/jn.00030.2015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 12/23/2015] [Indexed: 11/22/2022] Open
Abstract
Standing balance requires multijoint coordination between the ankles and hips. We investigated how humans adapt their multijoint coordination to adjust to various conditions and whether the adaptation differed between healthy young participants and healthy elderly. Balance was disturbed by push/pull rods, applying two continuous and independent force disturbances at the level of the hip and between the shoulder blades. In addition, external force fields were applied, represented by an external stiffness at the hip, either stabilizing or destabilizing the participants' balance. Multivariate closed-loop system-identification techniques were used to describe the neuromuscular control mechanisms by quantifying the corrective joint torques as a response to body sway, represented by frequency response functions (FRFs). Model fits on the FRFs resulted in an estimation of time delays, intrinsic stiffness, reflexive stiffness, and reflexive damping of both the ankle and hip joint. The elderly generated similar corrective joint torques but had reduced body sway compared with the young participants, corresponding to the increased FRF magnitude with age. When a stabilizing or destabilizing external force field was applied at the hip, both young and elderly participants adapted their multijoint coordination by lowering or respectively increasing their neuromuscular control actions around the ankles, expressed in a change of FRF magnitude. However, the elderly adapted less compared with the young participants. Model fits on the FRFs showed that elderly had higher intrinsic and reflexive stiffness of the ankle, together with higher time delays of the hip. Furthermore, the elderly adapted their reflexive stiffness around the ankle joint less compared with young participants. These results imply that elderly were stiffer and were less able to adapt to external force fields.
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Affiliation(s)
- D Engelhart
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands;
| | - J H Pasma
- Department of Rehabilitation Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - A C Schouten
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - R G K M Aarts
- Department of Mechanical Automation, University of Twente, Enschede, The Netherlands
| | - C G M Meskers
- Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, The Netherlands; and
| | - A B Maier
- Section of Geriatrics and Gerontology, Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - H van der Kooij
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
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99
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Yang DJ, Park SK, Kim JH, Heo JW, Lee YS, Uhm YH. Effect of changes in postural alignment on foot pressure and walking ability of stroke patients. J Phys Ther Sci 2015; 27:2943-5. [PMID: 26504330 PMCID: PMC4616131 DOI: 10.1589/jpts.27.2943] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 06/18/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aims of this study were to determine (1) the significance of walking and
foot pressure in stroke patients, and (2) the association between changes in postural
alignment of stroke patients. [Subjects and Methods] Foot pressure and walking ability
based on postural alignment were measured in 50 stroke patients. Trunk imbalance, trunk
rotation, pelvic tilt, kyphosis, lordosis were measured using DIERS formetric4D (DIERS
International GmbH, Schlangenbad, Germany), which anlalyzes 3-dimensional spinal structure
in order to measure postural alignment. To determine foot pressure, the support rate of
weight and, average foot pressure were measured using DIERS pedoscan (DIERS International
GmbH, Schlangenbad, Germany) apparatus as a pressure platform. [Results] DIERS formetric
4D, DIERS pedoscan, and a 10 m walking test were utilized to measure foot pressure and
walking ability relative to changes in postural alignment in participating stroke
patients. [Conclusion] This study confirmed the significance of foot pressure and walking
ability as related postural alignment, indicating that postural alignment education and a
recovery therapy program for functional improvement of stroke patients should be provided
together.
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Affiliation(s)
- Dae Jung Yang
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Seung Kyu Park
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Je Ho Kim
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Jae Won Heo
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Yong Seon Lee
- Department of Physical Therapy, Graduate School of Physical Therapy, Sehan University, Republic of Korea
| | - Yo Han Uhm
- Department of Physical Therapy, Sehan University Mokpo Rehabilitation Hospital, Republic of Korea
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100
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Pasma JH, Engelhart D, Maier AB, Schouten AC, van der Kooij H, Meskers CGM. Changes in sensory reweighting of proprioceptive information during standing balance with age and disease. J Neurophysiol 2015; 114:3220-33. [PMID: 26424578 DOI: 10.1152/jn.00414.2015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/24/2015] [Indexed: 11/22/2022] Open
Abstract
With sensory reweighting, reliable sensory information is selected over unreliable information during balance by dynamically combining this information. We used system identification techniques to show the weight and the adaptive process of weight change of proprioceptive information during standing balance with age and specific diseases. Ten healthy young subjects (aged between 20 and 30 yr) and 44 elderly subjects (aged above 65 yr) encompassing 10 healthy elderly, 10 with cataract, 10 with polyneuropathy, and 14 with impaired balance, participated in the study. During stance, proprioceptive information of the ankles was disturbed by rotation of the support surface with specific frequency content where disturbance amplitude increased over trials. Body sway and reactive ankle torque were measured to determine sensitivity functions of these responses to the disturbance amplitude. Model fits resulted in a proprioceptive weight (changing over trials), time delay, force feedback, reflexive stiffness, and damping. The proprioceptive weight was higher in healthy elderly compared with young subjects and higher in elderly subjects with cataract and with impaired balance compared with healthy elderly subjects. Proprioceptive weight decreased with increasing disturbance amplitude; decrease was similar in all groups. In all groups, the time delay was higher and the reflexive stiffness was lower compared with young or healthy elderly subjects. In conclusion, proprioceptive information is weighted more with age and in patients with cataract and impaired balance. With age and specific diseases the time delay was higher and reflexive stiffness was lower. These results illustrate the opportunity to detect the underlying cause of impaired balance in the elderly with system identification.
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Affiliation(s)
- J H Pasma
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, The Netherlands;
| | - D Engelhart
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands
| | - A B Maier
- Section of Gerontology and Geriatrics, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - A C Schouten
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands; and
| | - H van der Kooij
- Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands; and
| | - C G M Meskers
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
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