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Klusek J, Newman-Norlund R, Fairchild AJ, Newman-Norlund S, Sayers S, Stewart JC, Berry-Kravis E, Fridriksson J. Low normal FMR1 genotype in older adult women: Psychological well-being and motor function. Arch Gerontol Geriatr 2022; 103:104789. [PMID: 35981426 PMCID: PMC9464716 DOI: 10.1016/j.archger.2022.104789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/28/2022]
Abstract
The FMR1 gene plays a key role in adult neurogenesis and neuroplasticity, and thus may contribute to age-related health in the population. The current study focused on the "low normal" FMR1 genotype, defined by lower-than-typical numbers of FMR1 CGG repeats (<26), as a potential genetic determinant of age-related health. We characterized the effect of the low normal FMR1 genotype on psychological well-being and motor function in a racially diverse non-clinical sample of older adult women. Women with low CGG repeats were distinguished from those with CGGs falling within the mid-high end of the normal range by reduced performance on multimodal assessments of motor function and psychological well-being, with large effect sizes. Robust continuous associations were also detected between lower CGG repeat length and reduced psychological well-being, balance, and dexterity. Findings suggest that FMR1 may represent an important mediator of individual differences in age-related health; larger epidemiological studies are needed. Given that approximately 23-35% of females carry the low normal genotype, efforts to understand its clinical effects have relevance a broad swath of the aging population.
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Affiliation(s)
- Jessica Klusek
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Close-Hipp Building, 1705 College Street, Columbia, SC 29208, USA.
| | - Roger Newman-Norlund
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Close-Hipp Building, 1705 College Street, Columbia, SC 29208, USA; Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA
| | - Amanda J Fairchild
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA
| | - Sarah Newman-Norlund
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Close-Hipp Building, 1705 College Street, Columbia, SC 29208, USA
| | - Sara Sayers
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Close-Hipp Building, 1705 College Street, Columbia, SC 29208, USA
| | - Jill C Stewart
- Physical Therapy Program, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Neurological Sciences and Anatomy and Cell Biology, Rush University Medical Center, 1725 West Harrison Street, Suite 718, Chicago, IL 60612, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Close-Hipp Building, 1705 College Street, Columbia, SC 29208, USA
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2
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Sozzi S, Ghai S, Schieppati M. Incongruity of Geometric and Spectral Markers in the Assessment of Body Sway. Front Neurol 2022; 13:929132. [PMID: 35923830 PMCID: PMC9339954 DOI: 10.3389/fneur.2022.929132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/21/2022] [Indexed: 01/15/2023] Open
Abstract
Different measurements of body oscillations in the time or frequency domain are being employed as markers of gait and balance abnormalities. This study investigates basic relationships within and between geometric and spectral measures in a population of young adult subjects. Twenty healthy subjects stood with parallel feet on a force platform with and without a foam pad. Adaptation effects to prolonged stance were assessed by comparing the first and last of a series of eight successive trials. Centre of Foot Pressure (CoP) excursions were recorded with Eyes Closed (EC) and Open (EO) for 90s. Geometric measures (Sway Area, Path Length), standard deviation (SD) of the excursions, and spectral measure (mean power Spectrum Level and Median Frequency), along the medio-lateral (ML) and antero-posterior (AP) direction were computed. Sway Area was more strongly associated than Path Length with CoP SD and, consequently, with mean Spectrum Level for both ML and AP, and both visual and surface conditions. The squared-SD directly specified the mean power Spectrum Level of CoP excursions (ML and AP) in all conditions. Median Frequency was hardly related to Spectrum Level. Adaptation had a confounding effect, whereby equal values of Sway Area, Path Length, and Spectrum Level corresponded to different Median Frequency values. Mean Spectrum Level and SDs of the time series of CoP ML and AP excursions convey the same meaning and bear an acceptable correspondence with Sway Area values. Shifts in Median Frequency values represent important indications of neuromuscular control of stance and of the effects of vision, support conditions, and adaptation. The Romberg Quotient EC/EO for a given variable is contingent on the compliance of the base of support and adaptation, and different between Sway Area and Path Length, but similar between Sway Area and Spectrum Level (AP and ML). These measures must be taken with caution in clinical studies, and considered together in order to get a reliable indication of overall body sway, of modifications by sensory and standing condition, and of changes with ageing, medical conditions and rehabilitation treatment. However, distinct measures shed light on the discrete mechanisms and complex processes underpinning the maintenance of stance.
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Affiliation(s)
- Stefania Sozzi
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
| | - Shashank Ghai
- Department of Physical Therapy, Rsgbiogen, New Delhi, India
| | - Marco Schieppati
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
- *Correspondence: Marco Schieppati
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Otomi Y, Irahara S, Inoue H, Shinya T, Otsuka H, Harada M. Increased 18F-FDG Uptake in the Axillary Lymph Nodes of the Vaccinated Side Associated with COVID-19 Vaccination. Mol Imaging Radionucl Ther 2022; 31:169-171. [PMID: 35771098 PMCID: PMC9246311 DOI: 10.4274/mirt.galenos.2021.22590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 50-year-old female patient underwent (18fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) following modified radical mastectomy for cancer of the left breast. Ten days before the PET/CT, the coronavirus disease-2019 (COVID-19) vaccine was injected intramuscularly into the right deltoid muscle. Increased (18F-FDG uptake of maximum standardized uptake value (11.0) was observed in the lymph nodes of the right axilla, which had not been observed in the previous PET/CT. The size of the oval-shaped lymph nodes was up to approximately 11×9 mm; however, it was larger than that observed on the previous PET/CT. We contemplate that the increased (18F-FDG uptake was a reactive change in the lymph nodes associated with the COVID-19 vaccine.
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Affiliation(s)
- Yoichi Otomi
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Saho Irahara
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Hiroaki Inoue
- Tokushima University, Department of Thoracic and Endocrine Surgery and Oncology, Tokushima, Japan
| | | | - Hideki Otsuka
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Masafumi Harada
- Tokushima University, Department of Radiology, Tokushima, Japan
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Shell CE, Christie BP, Marasco PD, Charkhkar H, Triolo RJ. Lower-Limb Amputees Adjust Quiet Stance in Response to Manipulations of Plantar Sensation. Front Neurosci 2021; 15:611926. [PMID: 33679300 PMCID: PMC7930749 DOI: 10.3389/fnins.2021.611926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/25/2021] [Indexed: 01/13/2023] Open
Abstract
Interfering with or temporarily eliminating foot-sole tactile sensations causes postural adjustments. Furthermore, individuals with impaired or missing foot-sole sensation, such as lower-limb amputees, exhibit greater postural instability than those with intact sensation. Our group has developed a method of providing tactile feedback sensations projected to the missing foot of lower-limb amputees via electrical peripheral nerve stimulation (PNS) using implanted nerve cuff electrodes. As a step toward effective implementation of the system in rehabilitation and everyday use, we compared postural adjustments made in response to tactile sensations on the missing foot elicited by our system, vibration on the intact foot-sole, and a control condition in which no additional sensory input was applied. Three transtibial amputees with at least a year of experience with tactile sensations provided by our PNS system participated in the study. Participants stood quietly with their eyes closed on their everyday prosthesis while electrically elicited, vibratory, or no additional sensory input was administered for 20 s. Early and steady-state postural adjustments were quantified by center of pressure location, path length, and average angle over the course of each trial. Electrically elicited tactile sensations and vibration both caused shifts in center of pressure location compared to the control condition. Initial (first 3 s) shifts in center of pressure location with electrically elicited or vibratory sensory inputs often differed from shifts measured over the full 20 s trial. Over the full trial, participants generally shifted toward the foot receiving additional sensory input, regardless of stimulation type. Similarities between responses to electrically elicited tactile sensations projected to the missing foot and responses to vibration in analogous regions on the intact foot suggest that the motor control system treats electrically elicited tactile inputs similarly to native tactile inputs. The ability of electrically elicited tactile inputs to cause postural adjustments suggests that these inputs are incorporated into sensorimotor control, despite arising from artificial nerve stimulation. These results are encouraging for application of neural stimulation in restoring missing sensory feedback after limb loss and suggest PNS could provide an alternate method to perturb foot-sole tactile information for investigating integration of tactile feedback with other sensory modalities.
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Affiliation(s)
- Courtney E Shell
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.,Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States
| | - Breanne P Christie
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States.,Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States
| | - Paul D Marasco
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.,Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States
| | - Hamid Charkhkar
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Ronald J Triolo
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
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Hauer K, Dutzi I, Gordt K, Schwenk M. Specific Motor and Cognitive Performances Predict Falls during Ward-Based Geriatric Rehabilitation in Patients with Dementia. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5385. [PMID: 32962248 PMCID: PMC7570858 DOI: 10.3390/s20185385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
The aim of this study was to identify in-hospital fall risk factors specific for multimorbid hospitalized geriatric patients with dementia (PwD) during hospitalization. Geriatric inpatients during ward-based rehabilitation (n = 102; 79.4% females; 82.82 (6.19) years of age; 20.26 (5.53) days of stay) were included in a comprehensive fall risk assessment combining established clinical measures, comprehensive cognitive testing including detailed cognitive sub-performances, and various instrumented motor capacity measures as well as prospective fall registration. A combination of unpaired t-tests, Mann-Whitney-U tests, and Chi-square tests between patients with ("in-hospital fallers") and without an in-hospital fall ("in-hospital non-fallers"), univariate and multivariate regression analysis were used to explore the best set of independent correlates and to evaluate their predictive power. In-hospital fallers (n = 19; 18.63%) showed significantly lower verbal fluency and higher postural sway (p < 0.01 to 0.05). While established clinical measures failed in discriminative as well as predictive validity, specific cognitive sub-performances (verbal fluency, constructional praxis, p = 0.01 to 0.05) as well as specific instrumented balance parameters (sway area, sway path, and medio-lateral displacement, p < 0.01 to 0.03) significantly discriminated between fallers and non-fallers. Medio-lateral displacement and visuospatial ability were identified in multivariate regression as predictors of in-hospital falls and an index combining both variables yielded an accuracy of 85.1% for fall prediction. Results suggest that specific cognitive sub-performances and instrumented balance parameters show good discriminative validity and were specifically sensitive to predict falls during hospitalization in a multimorbid patient group with dementia and an overall high risk of falling. A sensitive clinical fall risk assessment strategy developed for this specific target group should include an index of selected balance parameters and specific variables of cognitive sub-performances.
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Affiliation(s)
- Klaus Hauer
- Department of Geriatric Research, AGAPLESION Bethanien-Hospital/Geriatric Centre at the Heidelberg University, 69126 Heidelberg, Germany; (K.H.); (I.D.)
| | - Ilona Dutzi
- Department of Geriatric Research, AGAPLESION Bethanien-Hospital/Geriatric Centre at the Heidelberg University, 69126 Heidelberg, Germany; (K.H.); (I.D.)
| | - Katharina Gordt
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany;
| | - Michael Schwenk
- Network Aging Research (NAR), Heidelberg University, 69115 Heidelberg, Germany
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6
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Surkar SM, Harbourne R, Corr B, Arpin D, J Kurz M. Exploration of a novel physical therapy protocol that uses a sensory substitution device to improve the standing postural balance of children with balance disorders. Physiother Theory Pract 2020; 38:637-647. [PMID: 32615828 DOI: 10.1080/09593985.2020.1786869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore if an intensive balance training protocol that incorporated the BrainPort sensory substitution device improves the standing postural balance of children with balance disorders. METHODS Eight children with balance disorders received 8-weeks of balance training while using the BrainPort device. Pre- and post-intervention changes in the Bruininks-Oseretsky Test of Motor Proficiency balance subtest (BOT-2) scores, standing duration on an unstable surface, and center of pressure (COP) sway were assessed. RESULTS Post-intervention, the BOT-2 balance subtest scores increased by 29.6% and demonstrated clinically meaningful improvements. Overall, the standing duration with vision increased. The standing duration on the unstable surface without vision increased significantly from pre- to post-intervention. However, anterior-posterior (AP) and medial-lateral (ML) sway did not change post-intervention. The children also reported new functional activities (i.e. riding a bike, standing on unsteady or narrow surfaces). CONCLUSION Balance training with the BrainPort sensory substitution device has the potential to result in clinically relevant improvements in the standing postural balance of children with balance disorders.
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Affiliation(s)
- Swati M Surkar
- Department of Physical Therapy, College of Allied Health Sciences, Greenville, NC, USA.,Department of Physical Therapy, Munroe Meyer Institute of Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
| | - Regina Harbourne
- Department of Physical Therapy, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Brad Corr
- Department of Physical Therapy, Munroe Meyer Institute of Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
| | - David Arpin
- Department of Physical Therapy, Munroe Meyer Institute of Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
| | - Max J Kurz
- Department of Physical Therapy, Munroe Meyer Institute of Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
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7
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Cheng CH, Lai DM, Lau PY, Wang SF, Chien A, Wang JL, Hsu WL. Upright Balance Control in Individuals with Cervical Myelopathy Following Cervical Decompression Surgery: A Prospective Cohort Study. Sci Rep 2020; 10:10357. [PMID: 32587272 PMCID: PMC7316780 DOI: 10.1038/s41598-020-66057-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/30/2020] [Indexed: 11/12/2022] Open
Abstract
Patients with cervical myelopathy may manifest impairments in functional activities and balance control caused by compression of the spinal cord. The objective of the current study was to determine long-term changes in the upright balance control of patients with cervical myelopathy who had undergone cervical decompression surgery. This is a prospective cohort study from the preoperative phase to 3 months, 6 months, and 1 year postsurgery. Fifty-three patients with cervical myelopathy were recruited for the cervical myelopathy group and 22 age-matched healthy controls were recruited for the control group. Functional assessments including Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire-Lower Extremity Function (JOACMEQ-LEF) and 10-second step test; as well as balance assessments including postural sway (center-of-pressure: COP) were performed for both groups. The JOACMEQ-LEF (p = 0.036) scores of the myelopathy group improved postoperatively, and a significant decrease in COP variables of postural sway was observed. The upright posture was less stable in the myelopathy group than in the control group (p < 0.05) both before and after surgery. The effect size and standard response mean of the COP variables ranged from −0.49 to 0.03 at 3 months, 6 months, and 1 year postsurgery. The upright balance control had improved significantly 6 months after decompression surgery. However, the balance control of the patients who had undergone decompression surgery remained less stable than that of the age-matched healthy controls. Balance training should be initiated before 6 months postsurgery to accelerate balance control recovery in patients with cervical myelopathy.
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Affiliation(s)
- Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Dar-Ming Lai
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Phooi Yee Lau
- School & Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shwu-Fen Wang
- School & Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Andy Chien
- Department of Physical Therapy & Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Jaw-Lin Wang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Wei-Li Hsu
- School & Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan. .,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan.
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8
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Objective evaluation of Nintendo Wii Fit Plus balance program training on postural stability in Multiple Sclerosis patients: a pilot study. Int J Rehabil Res 2020; 43:199-205. [DOI: 10.1097/mrr.0000000000000408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Alghadir AH, Alotaibi AZ, Iqbal ZA. Postural stability in people with visual impairment. Brain Behav 2019; 9:e01436. [PMID: 31578824 PMCID: PMC6851802 DOI: 10.1002/brb3.1436] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 09/04/2019] [Accepted: 09/14/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The visual system enables the brain to assess information regarding the position of the body in space. Congenital or acquired blindness leads to the development of abnormal sensory-motor interactions that results in development of typical musculoskeletal deformities and gait patterns that cause disability. Diabetes and related complications are expected to increase exponentially in the next 10 years; thus, the number of people with visual impairment is expected to increase. However, there have been few studies regarding etio-pathogenesis of postural alteration and balance impairment in people with visual impairment; moreover, no previous study has investigated postural stability in this population. This study aimed to assess the center of gravity (COG) velocity in subjects with visual impairment and compared with that in sighted subjects. METHODS Seventy male subjects, 20-40 years of age, participated in this study; they were divided into sighted (control) and visually impaired groups. COG velocity while standing on an unstable surface was measured using the NeuroCom® Balance Master Version 8.5.0. For the sighted group, data were recorded with eyes open and then with eyes closed. For the visually impaired group, no instructions were given with respect to eyes during data collection. RESULTS Mean COG velocity was significantly higher in the visually impaired group than in the sighted group with eyes open. However, there was no difference in mean COG velocity between the visually impaired group and the sighted group with eyes closed. The difference in mean COG velocity between sighted subjects with eyes open and eyes closed was also significant. Mean COG velocity while standing on a foam surface varied among visually impaired subjects and sighted subjects with eyes open and closed. CONCLUSION This study showed that subjects with visual impairment, regardless of eye opening or closure, behave in the same manner as sighted subjects with eyes closed.
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Affiliation(s)
- Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Z Alotaibi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zaheen A Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Long-Term Effects of Balance Training on Habitual Physical Activity in Older Adults with Parkinson's Disease. PARKINSONS DISEASE 2019; 2019:8769141. [PMID: 31485305 PMCID: PMC6702829 DOI: 10.1155/2019/8769141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/29/2019] [Accepted: 07/10/2019] [Indexed: 11/18/2022]
Abstract
The HiBalance program is a progressive and highly challenging balance training intervention incorporating Parkinson's disease (PD) specific balance components. The program improves balance and gait and increases the amount of ambulation in short-term, in older adults with PD. Yet, potential short- and long-term effects on habitual physical activity and sedentary behavior are currently unidentified. The aim of this study was to conduct preplanned secondary analyses of short- and long-term effects of the HiBalance program on objectively measured amount and bouts of brisk walking, sedentary behavior, and total physical activity in older adults with PD. Further, our aim was to investigate demographic, intervention-related, disease-related, and function-related factors potentially related to a difference in activity after intervention. A total of 100 older adults with mild-moderate PD were recruited. The intervention group participated in the HiBalance program, and the control received care as usual and was offered the HiBalance program after study termination. Physical activity data were collected using accelerometers at baseline, after intervention and after 6 and 12 months. A multilevel model was utilized to investigate the postintervention and long-term (6 and 12 months) effects on total physical activity, amount and bouts of brisk walking (i.e., moderate intensity physical activity), and sedentary behavior. Between-group difference for the main outcome brisk walking was at postintervention: Δ -10, CI -23.78 to 3.69 min/day (p < 0.05); 6 months: Δ -10, CI -23.89 to 3.89 min/day (p < 0.05); and 12 months: Δ -4, CI -16.81 to 8.81 min/day (p=0.43). Being part of the intervention group as well as finishing training during spring/summer showed an independent association to increased brisk walking after the intervention period. In conclusion, the HiBalance program increases the physical activity on moderate intensity after intervention and at 6 months but not at 12 months, independently of improved balance. Season seems to influence the effect on the physical activity.
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Wong WJ, Lai DM, Wang SF, Wang JL, Hsu WL. Changes of balance control in individuals with lumbar degenerative spine disease after lumbar surgery: a longitudinal study. Spine J 2019; 19:1210-1220. [PMID: 30844510 DOI: 10.1016/j.spinee.2019.02.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/24/2019] [Accepted: 02/27/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Lumbar degenerative spine disease (DSD) with neurological symptoms is the most common indication requiring lumbar surgery when nonoperative treatment is not effective. Individuals with lumbar DSD have sensory, proprioception, and musculoskeletal system alterations, which may result in balance impairment. However, evidence regarding balance recovery in individuals with lumbar DSD after lumbar surgery is limited. PURPOSE To evaluate balance control, pain, and functional activities in individuals with lumbar DSD after lumbar surgery. STUDY DESIGN/SETTING A prospective study with a cross-sectional control group. PATIENT SAMPLE Seventy individuals with lumbar DSD (DSD group) and 30 age-matched healthy adults (control group) were recruited. Participants in the DSD group were diagnosed by a neurological surgeon and received lumbar surgery according to relevant imaging findings and neurological symptoms. OUTCOME MEASURES Clinical assessments, including a visual analogue scale (VAS), the Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RMDQ), were performed in the DSD group only. Balance control was assessed in all participants using the root mean square (RMS) distance of the center of pressure (COP) in anteroposterior and mediolateral directions. METHODS All participants were instructed to stand in natural stance and Romberg stance with eyes open and eyes closed on a force platform for 35 seconds, respectively. The assessments were performed in the DSD group at four time points: preoperative phase (baseline), 3 months, 6 months, and 12 months postoperatively. In the age-matched healthy control group, only one assessment on the recruitment day was performed. RESULTS The VAS, ODI, and RMDQ scores of the DSD group significantly improved after lumbar surgery (p<.001). The RMS distance of COP in the DSD group significantly decreased after lumbar surgery (p<.017) compared with baseline in most of the testing conditions. However, the RMS distance of the COP in the DSD group after surgery was significantly greater than in the healthy control group (p<.05), especially 6 months and 12 months postoperatively. CONCLUSIONS Balance control, pain, and functional activities of individuals with lumbar DSD showed improvement after lumbar surgery. However, balance control in individuals with lumbar DSD was still less stable than in age-matched healthy adults from 6 to 12 months after surgery. Therefore, individuals with lumbar DSD require fall prevention programs after lumbar surgery, including balance assessments and postoperative balance training.
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Affiliation(s)
- Wei-Jin Wong
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Dar-Ming Lai
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Shwu-Fen Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Jaw-Lin Wang
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan.
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12
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Ghamkhar L, Kahlaee AH. The effect of trunk muscle fatigue on postural control of upright stance: A systematic review. Gait Posture 2019; 72:167-174. [PMID: 31207565 DOI: 10.1016/j.gaitpost.2019.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 06/08/2019] [Accepted: 06/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Fatigability and postural control deficits are both serious concerns in a variety of chronic musculoskeletal conditions. Research has shown that muscle fatigue may adversely affect postural control. This is while the evidence on the relevance of fatigue to postural control has never been summarized nor critically appraised. RESEARCH QUESTION Is there sufficient and strong enough evidence to accept trunk muscle fatigue as a contributing factor to postural control alterations during upright standing posture?. METHODS EMBASE, Scopus, ELSEVIER, PubMed, ProQuest, Google scholar and reference lists of the relevant articles were searched through April 2018. Studies having investigated the trunk muscle fatigue effect on postural control in asymptomatic individuals were included in the study. Only those studies having assessed postural control in terms of center of pressure driven variables were included. RESULTS Twelve studies (218 asymptomatic participants) matched the inclusion criteria of this systematic review. Their results supported the hypothesis that fatigue has a significant effect on postural control in terms of the time domain variables. Sway velocity was consistently found to be affected by fatigue. The results were inconsistent in the frequency domain. The only study on the structural dynamics of center of pressure displacements also confirmed such a relationship. SIGNIFICANCE The present review indicates that postural control is altered in asymptomatic individuals following trunk muscle fatigue. This may suggest that trunk muscle endurance training is crucial to address postural impairment in chronic spine musculoskeletal conditions.
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Affiliation(s)
- Leila Ghamkhar
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir Hossein Kahlaee
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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da Silva RA, Vieira ER, Léonard G, Beaulieu LD, Ngomo S, Nowotny AH, Amorim CF. Age- and low back pain-related differences in trunk muscle activation during one-legged stance balance task. Gait Posture 2019; 69:25-30. [PMID: 30658312 DOI: 10.1016/j.gaitpost.2019.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Postural control declines with age and can be affected by low back pain. Poor balance has been reported in people with chronic low back pain (CLBP), which in turn could be explained by the changes in trunk muscle activation. RESEARCH QUESTION Are there differences between younger and older adults with and without chronic low back pain (CLBP) on trunk muscle activity during one-legged stance task? METHODS Twenty (20) with, and 20 subjects without nonspecific CLBP participated in the study. Each group was comprised of 10 younger (50% males; mean age: 31 years) and 10 older adults (50% males; mean age: 71 years). Subjects performed 3 × 30-second trials of one-legged stance, with eyes open, on a force platform, while surface electromyography (EMG) measurements were obtained bilaterally on the multifidus at L5, iliocostalis lumborum at L3, rectus abdominis and biceps femoris muscles.EMG amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance tasks, to determine the muscular activity of each muscle. RESULTS Participants with CLBP presented 15% lower lumbar muscle activation (p < 0.05), and 23% higher co-activation (ratio between rectus adominis by multifidus) than participants without CLBP, regardless of age. Significant differences (p < 0.05) between older and young groups were observed only for lower lumbar muscles (mean 24% lower in older than younger adults) and rectus adominis muscles (mean 17% lower in older than younger adults). SIGNIFICANCE CLBP individuals have different trunk muscle activity than those without CLBP, and older adults exhibit lower trunk activation during one-legged stance balance task. The use of the EMG in evaluation of trunk neuromuscular function during one-legged stance may thus be a valuable tool when assessing balance in CLBP and older people.
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Affiliation(s)
- Rubens A da Silva
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada; Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), UNOPAR University, Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR, Londrina, PR, Brazil.
| | - Edgar R Vieira
- Florida International University (FIU), Physical Therapy & Neuroscience Departments, Wertheim Colleges of Nursing and Health Sciences & Medicine, 11200 SW 8th St., AHC3-430, Miami, FL, USA
| | - Guillaume Léonard
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis-David Beaulieu
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada
| | - Suzy Ngomo
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada
| | - Alexandre H Nowotny
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), UNOPAR University, Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR, Londrina, PR, Brazil
| | - César F Amorim
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada; Florida International University (FIU), Physical Therapy & Neuroscience Departments, Wertheim Colleges of Nursing and Health Sciences & Medicine, 11200 SW 8th St., AHC3-430, Miami, FL, USA; Doctoral and Masters Program in Physical Therapy, UNICID, São Paulo, SP, Brazil
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Oliveira LC, Oliveira RG, Pires-Oliveira DADA. Pilates increases the isokinetic muscular strength of the knee extensors and flexors in elderly women. J Bodyw Mov Ther 2017; 21:815-822. [DOI: 10.1016/j.jbmt.2017.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 01/17/2023]
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Gil AWDO, Silva RAD, Oliveira MRD, Carvalho CE, Oliveira DADAP. Comparação do controle postural em cinco tarefas de equílibrio e a relação dos riscos de quedas entre idosas e adultas jovens. FISIOTERAPIA E PESQUISA 2017. [DOI: 10.1590/1809-2950/15804424022017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O envelhecimento é um processo natural que acarreta mudanças intrínsecas e extrínsecas ao organismo. O objetivo é analisar cinco tarefas de equilíbrio postural em idosas através da Plataforma de força, correlacionando com o risco de quedas avaliado pelo teste Timed Up and Go (TUG). Participaram do estudo 43 idosos e 40 adultos jovens, todos do sexo feminino, que foram avaliadas em uma plataforma de força com um protocolo padrão: descalças, com os braços ao longo do corpo nas tarefas bipodal e semitandem, ambos olhos abertos e fechados, apoio unipodal utilizando o centro de oscilação postural (COP) e as velocidades nos eixos anteroposterior (Vel AP) e médio-lateral (Vel ML). Após 5 minutos de descanso, realizou-se o TUG. Os resultados mostraram que as idosas tiveram maior instabilidade postural (p<0.05) em relação às adultas jovens, e a tarefa que mais desafiou o equilíbrio foi o apoio unipodal COP 10,02 (cm2) Vel AP 3,00 (cm/s) e Vel ML 3,32 (cm/s), e as idosas tiveram um tempo médio no TUG de 9,01 segundos considerando um baixo risco de quedas. Conclusão: Idosas apresentam um maior déficit no equilíbrio em relação às jovens, sendo a tarefa de apoio UNP a que mais apresentou desafios no controle postural das duas populações. Idosas saudáveis apresentaram um baixo risco para as quedas, nenhuma correlação foi encontrada entre o equilíbrio postural através da plataforma de força e risco de quedas do TUG.
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Shigaki L, Vieira ER, de Oliveira Gil AW, Araújo CGA, Carmargo MZ, Sturion LA, de Oliveira MR, da Silva RA. Effects of Holding an External Load on the Standing Balance of Older and Younger Adults With and Without Chronic Low Back Pain. J Manipulative Physiol Ther 2017; 40:284-292. [PMID: 28395983 DOI: 10.1016/j.jmpt.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 01/26/2017] [Accepted: 01/26/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the effect of holding an external load on the standing balance of younger and older adults with and without chronic low back pain (CLBP). METHODS Twenty participants with and 20 without CLBP participated in the study. Each group contained 10 younger (50% men) and 10 older adults (50% men). Participants were instructed to look straight ahead while standing on a force platform during two 120-second trials with and without holding an external load (10% of body mass). The center of pressure area, mean velocity, and mean frequency in the anteroposterior and mediolateral directions were measured. RESULTS Older adults had worse standing balance than younger adults did (P < .001, d = 0.20). There were no significant balance differences between participants with and without CLBP within age groups during standing balance condition. However, holding the external load significantly increased postural instability for both age groups and CLBP status, with mean effect size across center of pressure variables of d = 0.82 for older participants without CLBP and d = 2.65 for younger participants without CLBP. These effects for people with CLBP were d = 1.65 for subgroup of older and d = 1.60 for subgroup of younger participants. CONCLUSION Holding an external load of 10% of body mass increased postural instability of both younger and older adults with and without CLBP.
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Affiliation(s)
- Leonardo Shigaki
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Londrina, Brazil
| | - Edgar Ramos Vieira
- Physical Therapy & Neuroscience Departments, Wertheims' Colleges of Nursing and Health Sciences & Medicine, Florida International University, Miami, FL
| | - André Wilson de Oliveira Gil
- Universidade Norte do Paraná, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Londrina, Brazil
| | | | - Mariana Zingari Carmargo
- Universidade Norte do Paraná, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Londrina, Brazil
| | - Leandro Amaral Sturion
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Londrina, Brazil
| | - Marcio Roǵerio de Oliveira
- Universidade Norte do Paraná, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Londrina, Brazil
| | - Rubens A da Silva
- Universidade Norte do Paraná, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Londrina, Brazil.
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Yamagata M, Ikezoe T, Kamiya M, Masaki M, Ichihashi N. Correlation between movement complexity during static standing and balance function in institutionalized older adults. Clin Interv Aging 2017; 12:499-503. [PMID: 28331301 PMCID: PMC5352153 DOI: 10.2147/cia.s132425] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Sample entropy (SampEn) is an analysis to evaluate movement complexity of the center of pressure (COP). A lower value of SampEn indicates lower complexity of COP variability, that is, rigidity, and lower degrees of freedom. Previous studies reported the association of increased SampEn with improved standing balance ability in young subjects. However, no studies have examined these relationships among older adults. Thus, we aimed to investigate the relationship between SampEn and standing balance ability in older adults. Subjects and methods The subjects were 33 institutionalized older adults (aged 82.2±6.5 years). COP during static standing was measured. The standard deviation (SD) values of COP and SampEn in the sagittal and frontal planes were calculated using time series data. One-leg standing test (OLST), functional reach (FR) test, and lateral reach (LR) test were also measured to evaluate standing balance ability. Results OLST, FR, and LR were 6.5±8.3 s, 19.8±5.9 cm, and 18.2±6.4 cm, respectively. Pearson correlation analysis revealed that SampEn in the sagittal plane significantly correlated with OLST (r=−0.35) and FR (r=−0.36). However, SampEn in the frontal plane and SD of COP in both sagittal and frontal planes had no relationship with any of the clinical balance tests. Conclusion Lower SampEn implies rigidity for postural control. In the present study, it was found that lower SampEn in the sagittal plane was related to a higher balance function, which suggests that older adults utilized body rigidity to maintain postural stability as a compensative strategy.
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Affiliation(s)
- Momoko Yamagata
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto
| | - Tome Ikezoe
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto
| | - Midori Kamiya
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto
| | - Mitsuhiro Masaki
- Department of Physical Therapy; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto
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Leme GLM, Carvalho IFD, Scheicher ME. Melhora do equilíbrio postural em mulheres idosas com o uso de informação sensorial adicional. FISIOTERAPIA E PESQUISA 2017. [DOI: 10.1590/1809-2950/16753224012017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O processo natural do envelhecimento humano apresenta alterações morfológicas e fisiológicas, como alterações de equilíbrio e da marcha, aumentando o risco de cair. Alguns estudos investigaram a utilização da informação sensorial na melhora do equilíbrio corporal utilizando o toque suave em uma superfície rígida e estacionária, verificando uma redução significativa da oscilação corporal. Avaliou-se os efeitos da informação sensorial adicional durante a marcha em mulheres idosas. Foram avaliadas 30 mulheres com 60 anos ou mais. A adição da informação sensorial foi feita por uma bandagem infrapatelar. As participantes realizaram os testes propostos pelo Dynamic Gait Index (DGI), pelo Timed Up and Go (TUG) e pelo Teste de Caminhada de 10 Metros (TC10m), com e sem a bandagem infrapatelar. As comparações dos dados foram realizadas com o teste t pareado e o teste de Wilcoxon, com p≤0,05. Houve diferença significativa na comparação do TUG (sem bandagem: 10,13±2,1; com bandagem: 9,71±2,1, p=0,0007) e no DGI (sem bandagem: 20,65±2,1; com bandagem: 22,1±2,1, p=0,002). Não houve diferença significativa no uso da bandagem no TC10m. Os resultados mostraram que o uso da informação sensorial adicional gerada pela bandagem infrapatelar promoveu melhora da mobilidade funcional e do desempenho físico em mulheres idosas.
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Aylar MF, Firouzi F, Araghi MR. Influence of time restriction, 20 minutes and 94.6 months, of visual information on angular displacement during the sit-to-stand (STS) task in three planes. J Phys Ther Sci 2017; 28:3330-3336. [PMID: 28174446 PMCID: PMC5276755 DOI: 10.1589/jpts.28.3330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 08/09/2016] [Indexed: 11/29/2022] Open
Abstract
[Purpose] The purpose of this investigation was to assess whether or not restriction of
visual information influences the kinematics of sit-to-stand (STS) performance in
children. [Subjects and Methods] Five girls with congenital blindness (CB) and ten healthy
girls with no visual impairments were randomly selected. The girls with congenital
blindness were placed in one group and the ten girls with no visual impairments were
divided into two groups of five, control and treatment groups. The participants in the
treatment group were asked to close their eyes (EC) for 20 minutes before the STS test,
whereas those in the control group kept their eyes open (EO). The performance of the
participants in all three groups was measured using a motion capture system and two force
plates. [Results] The results show that the constraint duration of visual sensory
information affected the range of motion (ROM), the excursion of the dominant side ankle,
and the ROM of the dominant side knee in the EC group. However, only ankle excursion on
the non-dominant side was affected in the CB group, and this was only observed in the
sagittal plane. [Conclusion] These results indicate that visual memory does not affect the
joint angles in the frontal and transverse planes. Moreover, all of the participants could
perform the STS transition without falling, indicating; the participants performed the STS
maneuver correctly in all planes except the sagittal one.
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Affiliation(s)
- Mozhgan Faraji Aylar
- Faculty of Engineering, Electrical Engineering Department, Imam Reza International University, Iran
| | - Faramarz Firouzi
- Faculty of Engineering, Department of Biomedical Engineering, Mashhad Branch, Islamic Azad University, Iran
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Comparison between static stretching and the Pilates method on the flexibility of older women. J Bodyw Mov Ther 2016; 20:800-806. [DOI: 10.1016/j.jbmt.2016.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 12/24/2015] [Accepted: 01/23/2016] [Indexed: 11/16/2022]
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Back muscle fatigue of younger and older adults with and without chronic low back pain using two protocols: A case-control study. J Electromyogr Kinesiol 2015; 25:928-36. [DOI: 10.1016/j.jelekin.2015.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/24/2015] [Accepted: 10/07/2015] [Indexed: 12/18/2022] Open
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Age-related differences on low back pain and postural control during one-leg stance: a case–control study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:1251-7. [DOI: 10.1007/s00586-015-4255-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 12/19/2022]
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Oliveira MR, Vidotto LS, Gil AW, Merli MF, Probst VS, Silva RAD. Can functional exercise capacity discriminate older individuals with poor postural control? MOTRIZ: REVISTA DE EDUCACAO FISICA 2015. [DOI: 10.1590/s1980-65742015000300005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractPostural instability can be related to functional limitations as a result of the aging process. This study aimed to compare functional exercise capacity and postural control in older adults. Participants were allocated into three groups according to their functional exercise capacity based on the six minute walking test (6MWT): 1) Low performance group (LP: distance walked ≤ 80% of the predicted value n = 19), 2) Normal performance group (NP: distance walked 81-100% of the predicted value n = 21) and, 3) High performance group (HP: distance walked >100% of the predicted value n = 23). All groups performed three trials of a one-leg stance for 30s on a force platform. LP showed worse postural control in comparison to NP and HP, and significant differences (p < .05) were found between groups for area, velocity antero-posterior of center of pressure and time limit variables during the one-leg stance task. These results have implications for rehabilitation management with regard to exercise, balance assessment and intervention in older adults.
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Kuznetsov NA, Riley MA. The role of task constraints in relating laboratory and clinical measures of balance. Gait Posture 2015; 42:275-9. [PMID: 26112778 DOI: 10.1016/j.gaitpost.2015.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/09/2015] [Accepted: 05/28/2015] [Indexed: 02/02/2023]
Abstract
This study tested the hypothesis that age-related postural control deficits are more clearly detected from force plate recordings when using postural control tasks with an explicitly defined goal as opposed to the frequently used quiet stance task. Eighteen older adults (over 65) and seventeen younger adults (under 30) stood on a force plate with visual feedback (VFB) of the center of pressure (COP) and without such visual feedback with eyes open (NVFB). In the VFB condition, online visual feedback about the COP was provided and participants maintained that feedback on a stationary visual target for 80s. We hypothesized that age-related difference in COP variability (standard deviation of COP position and average absolute maximum COP velocity; AAMV) would be more pronounced in the VFB than in the NVFB condition. In addition, we hypothesized that Berg balance scale (BBS) scores for older adults would correlate more strongly with the COP measures in the VFB condition than in the NVFB condition. Results showed that VFB enhanced age-related differences only for AAMV in anterior-posterior direction. Both age groups decreased postural sway when using VFB. Older adults increased AAMV with VFB while young adults did not, indicating that the task modified their postural control strategy stronger than in younger adults. BBS scores were correlated with the AAMV in both feedback conditions, while COP position variability was more clearly correlated with BBS in the VFB condition. These results suggest that the quiet stance task is sufficient to index balance function if velocity-based COP variables are utilized in the analysis.
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Affiliation(s)
| | - Michael A Riley
- Department of Psychology, University of Cincinnati, Cincinnati, OH USA; Center for Cognition, Action, & Perception, University of Cincinnati, Cincinnati, OH USA
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Jeter PE, Haaz Moonaz S, Bittner AK, Dagnelie G. Ashtanga-Based Yoga Therapy Increases the Sensory Contribution to Postural Stability in Visually-Impaired Persons at Risk for Falls as Measured by the Wii Balance Board: A Pilot Randomized Controlled Trial. PLoS One 2015; 10:e0129646. [PMID: 26107256 PMCID: PMC4479589 DOI: 10.1371/journal.pone.0129646] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 05/09/2015] [Indexed: 11/23/2022] Open
Abstract
Objective Persons with visual impairment (VI) are at greater risk for falls due to irreparable damage to visual sensory input contributing to balance. Targeted training may significantly improve postural stability by strengthening the remaining sensory systems. Here, we evaluate the Ashtanga-based Yoga Therapy (AYT) program as a multi-sensory behavioral intervention to develop postural stability in VI. Design A randomized, waitlist-controlled, single-blind clinical trial Methods The trial was conducted between October 2012 and December 2013. Twenty-one legally blind participants were randomized to an 8-week AYT program (n = 11, mean (SD) age = 55(17)) or waitlist control (n=10, mean (SD) age = 55(10)). AYT subjects convened for one group session at a local yoga studio with an instructor and two individual home-based practice sessions per week for a total of 8 weeks. Subjects completed outcome measures at baseline and post-8 weeks of AYT. The primary outcome, absolute Center of Pressure (COP), was derived from the Wii Balance Board (WBB), a standalone posturography device, in 4 sensory conditions: firm surface, eyes open (EO); firm surface, eyes closed (EC); foam surface, EO; and foam surface, EC. Stabilization Indices (SI) were computed from COP measures to determine the relative visual (SIfirm, SIfoam), somatosensory (SIEO, SIEC) and vestibular (SIV, i.e., FoamEC vs. FirmEO) contributions to balance. This study was not powered to detect between group differences, so significance of pre-post changes was assessed by paired samples t-tests within each group. Results Groups were equivalent at baseline (all p > 0.05). In the AYT group, absolute COP significantly increased in the FoamEO (t(8) = -3.66, p = 0.01) and FoamEC (t(8) = -3.90, p = 0.01) conditions. Relative somatosensory SIEO (t(8) = -2.42, p = 0.04) and SIEC (t(8) = -3.96, p = 0.01), and vestibular SIV (t(8) = -2.47, p = 0.04) contributions to balance increased significantly. As expected, no significant changes from EO to EC conditions were found indicating an absence of visual dependency in VI. No significant pre-post changes were observed in the control group (all p > 0.05). Conclusions These preliminary results establish the potential for AYT training to develop the remaining somatosensory and vestibular responses used to optimize postural stability in a VI population. Trial Registration www.ClinicalTrials.govNCT01366677
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Affiliation(s)
- Pamela E. Jeter
- Department of Ophthalmology, Lions Vision Research Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Integrative Health Sciences, Maryland University of Integrative Health, Laurel, Maryland, United States of America
- * E-mail:
| | - Steffany Haaz Moonaz
- Department of Integrative Health Sciences, Maryland University of Integrative Health, Laurel, Maryland, United States of America
| | - Ava K. Bittner
- College of Optometry, Nova Southeastern University, Ft. Lauderdale, Florida, United States of America
| | - Gislin Dagnelie
- Department of Ophthalmology, Lions Vision Research Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America
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Oliveira MRD, Inokuti TT, Bispo NNDC, Oliveira DADAP, Oliveira RFD, Silva Jr. RAD. Elderly individuals with increased risk of falls show postural balance impairment. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.002.ao07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Falls are a serious public health problem. Objective The aim of this study was to evaluate whether elderly individuals with increased risk of falls have a postural balance deficit, evaluated using a force platform during a one-leg stance. Materials and methods The sample consisted of 94 physically independent elderly individuals from the EELO project. The instruments used were the Downton scale, in order to assess the risk as well as the history of falls, and the force platform to measure postural balance through parameters from the center of pressure (COP). Results Elderly individuals were split into two groups according to the score observed with the Downton scale: G1 — low fall risk (score ≤ 2) — and G2 — high fall risk (score > 2). No differences were observed between the groups concerning gender (P > 0.05, Chi Square test). On the other hand, individuals from G2 showed postural instability when compared to individuals from G1, and individuals from G2 showed higher values in all COP parameters analysed (Mann-Whitney test, P < 0.05). Conclusion It can be concluded that the Downton scale has sensitivity for identifying individuals with balance impairment as well as a risk of falls. Therefore, it may be suggested that this scale may be useful in primary health care for detecting falls in the elderly.
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Campos de Oliveira L, Gonçalves de Oliveira R, Pires-Oliveira DADA. Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial. J Phys Ther Sci 2015; 27:871-6. [PMID: 25931749 PMCID: PMC4395733 DOI: 10.1589/jpts.27.871] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 11/07/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the present study was to determine the effects of Pilates on lower
leg strength, postural balance and the health-related quality of life (HRQoL) of older
adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to
the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two
sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age,
64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks.
The following evaluations were performed before and after the interventions: isokinetic
torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg
Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group
analysis, the EG demonstrated significant improvement in all variables. In the inter-group
analysis, the EG demonstrated significant improvement in most variables. [Conclusion]
Pilates exercises led to significant improvement in isokinetic torque of the knee
extensors and flexors, postural balance and aspects of the health-related quality of life
of older adults.
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Carvalho CE, da Silva RA, Gil AW, Oliveira MR, Nascimento JA, Pires-Oliveira DAA. Relationship between foot posture measurements and force platform parameters during two balance tasks in older and younger subjects. J Phys Ther Sci 2015; 27:705-10. [PMID: 25931713 PMCID: PMC4395697 DOI: 10.1589/jpts.27.705] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/21/2014] [Indexed: 11/29/2022] Open
Abstract
[Purpose] The aim of this study was to compare age-related differences in balance and anthropometric posture measurements of the foot and to determine any relationship between them. [Subjects and Methods] Sixty-eight older and 42 younger adults participated in this study. Foot posture was tested for four domains: 1) hallux flexion and extension range of motion using a goniometer, 2) navicular height and 3) length of the foot using a pachymeter, and 4) footprint (width of forefoot, arch index and hallux valgus). Balance was tested under two conditions on a force platform: bipodal in 60-s trials and unipodal in 30-s trials. The sway area of the center of pressure and velocity in the anteroposterior and mediolateral directions were computed. [Results] Older individuals showed significantly poorer balance compared with younger adults under in the unipodal condition (center of pressure area 9.97 vs. 7.72 cm(2)). Older people presented a significantly lower hallux mobility and higher values for width of the forefoot and transverse arch index than younger adults. The correlations between all foot posture and center of pressure parameters varied across groups, from weak to moderate (r -0.01 to -0.46). Low hallux mobility was significantly related to higher center of pressure values in older people. [Conclusion] These results have clinical implications for balance and foot posture assessments.
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Affiliation(s)
- Carlos E. Carvalho
- Physical Exercise Master program in Health Promtion; Master
and Doctoral Rehabilitation program, Universidade Norte do Paraná (UNOPAR), Brazil
| | - Rubens A. da Silva
- Physical Exercise Master program in Health Promtion; Master
and Doctoral Rehabilitation program, Universidade Norte do Paraná (UNOPAR), Brazil
| | - André W. Gil
- Physical Exercise Master program in Health Promtion; Master
and Doctoral Rehabilitation program, Universidade Norte do Paraná (UNOPAR), Brazil
| | - Márcio R. Oliveira
- Physical Exercise Master program in Health Promtion; Master
and Doctoral Rehabilitation program, Universidade Norte do Paraná (UNOPAR), Brazil
| | - Juliana A. Nascimento
- Physical Exercise Master program in Health Promtion; Master
and Doctoral Rehabilitation program, Universidade Norte do Paraná (UNOPAR), Brazil
| | - Deise A. A. Pires-Oliveira
- Physical Exercise Master program in Health Promtion; Master
and Doctoral Rehabilitation program, Universidade Norte do Paraná (UNOPAR), Brazil
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Siriphorn A, Chamonchant D, Boonyong S. The effects of vision on sit-to-stand movement. J Phys Ther Sci 2015; 27:83-6. [PMID: 25642044 PMCID: PMC4305605 DOI: 10.1589/jpts.27.83] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/18/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] It is well known that vision is an important factor contributing to postural control. However, there has been little discussion about the effect of vision on sit-to-stand movement. The purpose of this study was to evaluate the effect of constrained vision on sit-to-stand movement. [Subjects and Methods] Twenty-three healthy subjects (11 males, 12 females) aged 18-23 years with normal body mass indices were recruited for this study. Each participant was asked to stand as quickly as possible from a height-adjustable chair 3 times under 2 conditions: with eyes closed (EC) and eyes open (EO). The weight transfer time, rising index, and center of gravity sway velocity were measured using a NeuroCom Balance Master. [Results] The results show there were significant differences between the EC and EO conditions in the weight transfer time and the centre of gravity sway velocity. No significant difference was found between the EC and EO conditions in the rising index. These findings suggest that visual perception may play a role in balance control while performing sit-to-stand movement.
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Affiliation(s)
- Akkradate Siriphorn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| | - Dannaovarat Chamonchant
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| | - Sujitra Boonyong
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
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de Oliveira MR, da Silva RA, Dascal JB, Teixeira DC. Effect of different types of exercise on postural balance in elderly women: A randomized controlled trial. Arch Gerontol Geriatr 2014; 59:506-14. [DOI: 10.1016/j.archger.2014.08.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 08/13/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022]
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Placidi G, Avola D, Ferrari M, Iacoviello D, Petracca A, Quaresima V, Spezialetti M. A low-cost real time virtual system for postural stability assessment at home. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2014; 117:322-333. [PMID: 25070756 DOI: 10.1016/j.cmpb.2014.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 06/25/2014] [Accepted: 06/30/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The degeneration of the balance control system in the elderly and in many pathologies requires measuring the equilibrium conditions very often. In clinical practice, equilibrium control is commonly evaluated by using a force platform (stabilometric platform) in a clinical environment. In this paper, we demonstrate how a simple movement analysis system, based on a 3D video camera and a 3D real time model reconstruction of the human body, can be used to collect information usually recorded by a physical stabilometric platform. METHODS The algorithm used to reconstruct the human body model as a set of spheres is described and discussed. Moreover, experimental measurements and comparisons with data collected by a physical stabilometric platform are also reported. The measurements were collected on a set of 6 healthy subjects to whom a change in equilibrium condition was stimulated by performing an equilibrium task. RESULTS The experimental results showed that more than 95% of data collected by the proposed method were not significantly different from those collected by the classic platform, thus confirming the usefulness of the proposed system. CONCLUSIONS The proposed virtual balance assessment system can be implemented at low cost (about 500$) and, for this reason, can be considered a home use medical device. On the contrary, astabilometric platform has a cost of about 10,000$ and requires periodical calibration. The proposed system does not require periodical calibration, as is necessary for stabilometric force platforms, and it is easy to use. In future, the proposed system with little integration can be used, besides being an emulator of a stabilometric platform, also to recognize and track, in real time, head, legs, arms and trunk, that is to collect information actually obtained by sophisticated optoelectronic systems.
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Affiliation(s)
- Giuseppe Placidi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100 L'Aquila, Italy.
| | - Danilo Avola
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100 L'Aquila, Italy
| | - Marco Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100 L'Aquila, Italy
| | - Daniela Iacoviello
- Department of Computer, Control and Management Engineering Antonio Ruberti, Sapienza University of Rome, Via Ariosto 25, 00185 Rome, Italy
| | - Andrea Petracca
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100 L'Aquila, Italy
| | - Valentina Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100 L'Aquila, Italy
| | - Matteo Spezialetti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100 L'Aquila, Italy
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Tantisuwat A, Chamonchant D, Boonyong S. Multi-directional Reach Test: An Investigation of the Limits of Stability of People Aged between 20-79 Years. J Phys Ther Sci 2014; 26:877-80. [PMID: 25013287 PMCID: PMC4085212 DOI: 10.1589/jpts.26.877] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The multi-directional reach test (MDRT) is a simple, inexpensive, reliable and
valid screening tool for assessing the limits of stability in the anterorposterior and
mediolateral directions. The aim of this study was to quantify the limits of stability of
people aged between 20 and 79 years using the MDRT. [Subjects] One hundred and eighty
subjects were divided into the following 6 age groups: 20–29, 30–39, 40–49, 50–59, 60–69
and 70–79 years (n=30 per group). [Methods] The MDRT was used to measure the limits of
stability in four directions: forward, backward, leftward and rightward. Subjects
performed maximal outstretched arm reach in each direction with their feet flat on the
floor. [Results] All age groups performed the greatest values of the limit of stability in
the forward direction. The 60–79 year group demonstrated significantly lower limits of
stability in the forward, leftward and rightward directions compared to the 20–39 year
group. [Conclusion] The limits of stability declined with age mainly in the forward,
leftward and rightward directions. The MDRT appears to be a useful assessment tool for
postural control and balance of those aged 60 years and over.
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Affiliation(s)
- Anong Tantisuwat
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| | - Dannaovarat Chamonchant
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| | - Sujitra Boonyong
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
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Neuropsychological, Balance, and Mobility Risk Factors for Falls in People With Multiple Sclerosis: A Prospective Cohort Study. Arch Phys Med Rehabil 2014; 95:480-6. [DOI: 10.1016/j.apmr.2013.09.017] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 09/20/2013] [Accepted: 09/23/2013] [Indexed: 11/15/2022]
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Tyson S, Desouza L. The Measurement of Balance Post-Stroke. Part 3: Instrumented Measurement Tools. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331902235001994] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Age-related changes in physical fall risk factors: results from a 3 year follow-up of community dwelling older adults in Tasmania, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5989-97. [PMID: 24284357 PMCID: PMC3863882 DOI: 10.3390/ijerph10115989] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/05/2013] [Accepted: 11/07/2013] [Indexed: 01/10/2023]
Abstract
As the population ages, fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, and placing an escalating burden on health care systems. Sixty-nine independent community-dwelling adults (60-85 years, 18 males) had their leg strength, physical activity levels and their annual fall rate assessed at two timepoints over three years, (summer 2010 and summer 2013) monitoring balance. Force platform measures of medio-lateral sway range increased significantly under conditions of eyes open (mean difference MD 2.5 cm; 95% CI 2.2 to 2.8 cm) and eyes closed (MD 3.2 cm; 95% CI 2.8 to 3.6 cm), respectively (all p < 0.001) indicating worsening static balance control. Dynamic balance showed similar changes (p < 0.036). Leg strength was not significantly different between visits (p > 0.26). Physical activity reduced significantly (MD -909 Cal/week; 95% CI -347 to -1,470 Cal/week; p = 0.002) during the course of the study. Participants maintained aerobic activities, however resistance and balance exercise levels decreased non-significantly. The likelihood of falling was higher at the end of the study compared to the first timepoint (odds ratio 1.93, 95% CI 0.94 to 3.94; p = 0.07). Results of this study indicate that despite maintenance of leg strength there was an increase in medio-lateral sway over a relatively short time frame, with higher than expected increases in fall rates.
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Lacherez P, Wood JM, Anstey KJ, Lord SR. Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population. J Gerontol A Biol Sci Med Sci 2013; 69:240-4. [PMID: 24170672 DOI: 10.1093/gerona/glt173] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults. METHODS The performance of 270 community-living adults aged 70-88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance. RESULTS Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%. CONCLUSIONS A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this sample. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.
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Affiliation(s)
- Philippe Lacherez
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane QLD 4059, Australia.
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Taylor ME, Delbaere K, Lord SR, Mikolaizak AS, Brodaty H, Close JCT. Neuropsychological, Physical, and Functional Mobility Measures Associated With Falls in Cognitively Impaired Older Adults. J Gerontol A Biol Sci Med Sci 2013; 69:987-95. [DOI: 10.1093/gerona/glt166] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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The Association between Seasonal Variation in Vitamin D, Postural Sway, and Falls Risk: An Observational Cohort Study. J Aging Res 2013; 2013:751310. [PMID: 24223307 PMCID: PMC3816055 DOI: 10.1155/2013/751310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/12/2013] [Accepted: 08/27/2013] [Indexed: 11/22/2022] Open
Abstract
Introduction. Low serum vitamin D levels are associated with increased postural sway. Vitamin D varies seasonally. This study investigates whether postural sway varies seasonally and is associated with serum vitamin D and falls. Methods. In a longitudinal observational study, eighty-eight independently mobile community-dwelling older adults (69.7 ± 7.6 years) were evaluated on five occasions over one year, measuring postural sway (force platform), vitamin D levels, fall incidence, and causes and adverse outcomes. Mixed-methods Poisson regression was used to determine associations between measures. Results. Postural sway did not vary over the year. Vitamin D levels varied seasonally (P < 0.001), peaking in summer. Incidence of falls (P = 0.01) and injurious falls (P = 0.02) were lower in spring, with the highest fall rate at the end of autumn. Postural sway was not related to vitamin D (P = 0.87) or fall rates, but it was associated with fall injuries (IRR 1.59 (CI 1.14 to 2.24, P = 0.007). Conclusions. Postural sway remained stable across the year while vitamin D varied seasonally. Participants with high values for postural sway demonstrated higher rates of injurious falls. This study provides important evidence for clinicians and researchers providing interventions measuring balance outcomes across seasons.
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da Costa CSN, Batistão MV, Rocha NACF. Quality and structure of variability in children during motor development: a systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:2810-2830. [PMID: 23792377 DOI: 10.1016/j.ridd.2013.05.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 06/02/2023]
Abstract
Variability has been perceived to be beneficial to movement organization and execution, being essential to selection of movement patterns during motor development, to obtain flexible patterns and adaptability to different task demands. Human movement variability can be measured by linear and nonlinear tools. Recently, nonlinear techniques have been used successfully to give insight into motor skills control in children, and be able to discriminate pathologic and non-pathologic children. For that, this paper is the first to review systematically studies that used nonlinear measures in children. We intend to describe which mathematical tools are utilized to analyze quality and structure of variability, the factors that influence this variability and methodological procedures which are considered for its analysis, and how they are interpreted in child motor development field. A search was performed by one reviewer in relevant databases and the quality appraisal was conducted independently by two reviewers. In all, 27 articles were identified and 20 were selected for the present review. It was detected a large variation in sample characteristics and methodological issues among studies. In fact, the main importance of this review was due to the attempt to define some parameters and standardize some values for typical children and children with disabilities. It is noted that the results from nonlinear techniques depend on the task being analyzed, the age and the type of mathematical technique chosen. The presence of disability is associated to decreases in complexity and nonlinear tools were considered sensible to investigate the effectiveness of practice and intervention in typical children and children with cerebral palsy. Furthermore, future studies should be more careful in standardizing selection, recruitment and explaining missing data. Future reports also should present details of their results and limitations to favor comparisons and helping in formulating new research questions.
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Age-Related Differences in Center of Pressure Measures During One-Leg Stance Are Time Dependent. J Appl Biomech 2013; 29:312-6. [DOI: 10.1123/jab.29.3.312] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to evaluate the changes in center of pressure (COP) movement in four time intervals (5, 10, 15 and 30 s) during a one-leg stance test performed by young and elderly adults. Twelve young adults (mean 20 years) and 12 elderly subjects (mean 68 years) participated in this study. The subjects performed three 30 s trials of an eyes open one-leg stance test on a force platform, in which the COP parameter was computed at four points in time from same original COP signal. Significant differences were found between the young and elderly adults (P< .007) only at the 10, 15 and 30 s intervals. For both groups, COP changes were significantly different between the 5 s time interval and other intervals (10, 15 and 30 s). In conclusion, these results pointed out that age-related difference in COP changes were time dependent. This suggests that the use of longer durations increases the possibility of distinguishing more subtle differences in postural strategy among different groups of subjects.
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Effect of trunk extensor fatigue on the postural balance of elderly and young adults during unipodal task. Eur J Appl Physiol 2013; 113:1989-96. [DOI: 10.1007/s00421-013-2627-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 03/11/2013] [Indexed: 10/27/2022]
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da Silva RA, Bilodeau M, Parreira RB, Teixeira DC, Amorim CF. Age-related differences in time-limit performance and force platform-based balance measures during one-leg stance. J Electromyogr Kinesiol 2013; 23:634-9. [PMID: 23403137 DOI: 10.1016/j.jelekin.2013.01.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 01/09/2013] [Accepted: 01/09/2013] [Indexed: 10/27/2022] Open
Abstract
Poor posture control has been associated with an increased risk of falls and mobility disability among older adults. This study was conducted to assess the test-retest reliability and sensitivity to group differences regarding the time-limit (TLimit) of one-leg standing and selected balance parameters obtained with a force platform in older and young adults. A secondary purpose was to assess the relationship between TLimit and these balance parameters. Twenty-eight healthy older adults (age: 69±5years) and thirty young adults (age: 21±4years) participated in this study. Two one-leg stance tasks were performed: (1) three trials of 30s maximum and (2) one TLimit trial. The following balance parameters were computed: center of pressure area, RMS sway amplitude, and mean velocity and mean frequency in both the anterio-posterior and medio-lateral directions. All balance parameters obtained with the force platform as well as the TLimit variable were sensitive to differences in balance performance between older and young adults. The test-retest reliability of these measures was found to be acceptable (ICC: 0.40-0.85), with better ICC scores observed for mean velocity and mean frequency in the older group. Pearson correlations coefficients (r) between balance parameters and TLimit ranged from -0.16 to -0.54. These results add to the current literature that can be used in the development of measurement tools for evaluating balance in older and young adults.
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Affiliation(s)
- Rubens A da Silva
- Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance, Universidade Norte do Paraná (UNOPAR), 675 Paris Ave., CEP 86041-120, Londrina-PR, Brazil.
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A Perspective on Human Movement Variability With Applications in Infancy Motor Development. ACTA ACUST UNITED AC 2013. [DOI: 10.1123/krj.2.1.93] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Movement variability is considered essential to typical motor development. However, multiple theoretical perspectives and measurement tools have limited interpretation of the importance of movement variability in biological systems. The complementary use of linear and nonlinear measures have recently allowed for the evaluation of not only the magnitude of variability but also the temporal structure of variability. As a result, the theoretical model of optimal movement variability was introduced. The model suggests that the development of healthy and highly adaptable systems relies on the achievement of an optimal state of variability. Alternatively, abnormal development may be characterized by a narrow range of behaviors, some of which may be rigid, inflexible, and highly predictable or, on the contrary, random, unfocused, and unpredictable. In the present review, this theoretical model is described as it relates to motor development in infancy and specifically the development of sitting posture.
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Nguyen USDT, Kiel DP, Li W, Galica AM, Kang HG, Casey VA, Hannan MT. Correlations of clinical and laboratory measures of balance in older men and women. Arthritis Care Res (Hoboken) 2013; 64:1895-902. [PMID: 22745045 DOI: 10.1002/acr.21783] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 06/16/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE It is known that impaired balance is associated with falls in older adults; however, there is no accepted gold standard on how balance should be measured. Few studies have examined measures of postural sway and clinical balance concurrently in large samples of community-dwelling older adults. We examined the associations among 4 types of measures of laboratory- and clinic-based balance in a large population-based cohort of older adults. METHODS We evaluated balance measures in the Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly Boston Study (276 men and 489 women ages 64-97 years). The measures included laboratory-based anteroposterior (AP) path length and mean sway speed, mediolateral (ML) mean sway and root mean square, and area of ellipse postural sway; the Short Physical Performance Battery (SPPB); the Berg Balance Scale; and the one-leg stand test. Spearman's rank correlation coefficients were assessed among the balance measures. RESULTS The area of ellipse sway was highly correlated with the ML sway measures (r = >0.91, P < 0.0001) and sway speed was highly correlated with AP sway (r = 0.97, P < 0.0001). The Berg Balance Scale was highly correlated with the SPPB (r = 0.74, P < 0.001) and the one-leg stand test (r = 0.82, P < 0.001). Correlations between the laboratory- and clinic-based balance measures were low but statistically significant (-0.29 ≤ r ≤ -0.16, P < 0.0001). CONCLUSION Clinic-based balance measures, and laboratory-based measures comparing area of ellipse with ML sways or sway speed with AP sway, are highly correlated. There is less correlation between the clinic- and laboratory-based measures. Since both laboratory- and clinic-based measures inform balance in older adults, but are not highly correlated with each other, future work should investigate the differences.
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Sanjivani N D, Prema A K. Intra-rater reliability of timed ‘up and go’ test for children diagnosed with cerebral palsy. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2012. [DOI: 10.12968/ijtr.2012.19.10.575] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Khatri Prema A
- Ravi Nair College of Physiotherapy, Sawangi M Wardha, India
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Postural balance and physical activity in daily life (PADL) in physically independent older adults with different levels of aerobic exercise capacity. Arch Gerontol Geriatr 2012; 55:480-5. [DOI: 10.1016/j.archger.2012.04.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 04/12/2012] [Accepted: 04/17/2012] [Indexed: 11/21/2022]
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Nakao S, Takata S, Komatsu K, Tanaka T, Tamura E, Kashihara M, Osawa T, Masuda Y, Nishikawa K, Yamada M, Ogata Y, Nakamura Y, Yasui N. Three dimensional motion analyses for rehabilitation version of Awa Odori exercise and the expectancy of physical effects. THE JOURNAL OF MEDICAL INVESTIGATION 2011; 58:259-63. [PMID: 21921429 DOI: 10.2152/jmi.58.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
'Awa Odori Exercise--Rehabilitation version--was developed in 2006 for the new trial of physical exercise for the aging and the impaired person with lower balance performance in Tokushima prefecture, Japan. Public relations of this exercise had been spreading over Tokushima since then. The characteristics of the exercise were highly familiar with most of people in Tokushima because of popularity in original 'Awa Odori'. This study proposed the efficacies of Awa Odori Exercise as a rehabilitation exercise. This exercise expected the flexible balance reinforcements and the substitution for walking training with prevention of fall, bedridden and participating restriction for the old people, also promoting the health in Tokushima.
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Affiliation(s)
- Shigetaka Nakao
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
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Hasselgren L, Olsson LL, Nyberg L. Is leg muscle strength correlated with functional balance and mobility among inpatients in geriatric rehabilitation? Arch Gerontol Geriatr 2010; 52:e220-5. [PMID: 21156325 DOI: 10.1016/j.archger.2010.11.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 11/11/2010] [Accepted: 11/12/2010] [Indexed: 11/29/2022]
Abstract
Determinants of functional balance and mobility have rarely been investigated in geriatric wards. This study examined if leg muscle strength correlates to functional balance and mobility among geriatric inpatients. Fifty inpatients, 29 women and 21 men (mean age 79.6 years) were included. Functional balance was assessed with the Berg Balance Scale (BBS) and mobility was assessed with the Physiotherapy Clinical Outcome Variable Scale (COVS). Strength in the leg extension muscles was measured as 1 Repetition Maximum (1RM) in a leg press and strength in the ankle muscles was measured with Medical Research Council grades (MRC, 0-5). The sum scores, and most of the single items, of the BBS and the COVS significantly correlated to 1RM/body weight, ankle dorsiflexion, and plantar flexion. In a stepwise multiple regression, ankle dorsiflexion and 1RM/body weight together accounted for 39% of the variance of the BBS and 41% of the variance of the COVS. Estimated values of the BBS and the COVS can be calculated from the equation. In clinical work, the knowledge about how leg muscle strength associates with balance and mobility may be useful in analyzing underlying causes of reduced balance and mobility function, and in planning rehabilitation programs.
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Affiliation(s)
- Låtta Hasselgren
- Geriatric Centre, Umeå University Hospital, SE-901 85 Umeå, Sweden.
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Kyvelidou A, Harbourne RT, Shostrom VK, Stergiou N. Reliability of center of pressure measures for assessing the development of sitting postural control in infants with or at risk of cerebral palsy. Arch Phys Med Rehabil 2010; 91:1593-601. [PMID: 20875520 DOI: 10.1016/j.apmr.2010.06.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 05/31/2010] [Accepted: 06/02/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To establish the test-retest reliability of linear and nonlinear measures, including intra- and intersession reliability, when used to analyze the center of pressure (COP) time series during the development of infant sitting postural control in infants with or at risk for cerebral palsy (CP). DESIGN Longitudinal study. SETTING University hospital laboratory. PARTICIPANTS Infants with or at risk for CP (N=18; mean age ± SD at entry into the study, 13.7±3.6mo). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Infant sitting COP data were recorded for 3 trials at each session (2 sessions for each month within 1 week) for 4 consecutive months. The linear COP parameters of the root mean square, the range of sway for both the anterior-posterior and the medial-lateral directions, and the sway path were calculated. In addition, the nonlinear parameters of approximate entropy, Lyapunov exponent (LyE), and the correlation dimension for both directions were also calculated. Intra- and intersession reliability was computed by the intraclass correlation coefficient (ICC). RESULTS Regarding nonlinear measures, LyE showed high intra- and intersession ICC values in comparison with all other parameters evaluated. Intrasession and intersession reliability increased overall in the last 2 months of data collection and as sitting posture improved. CONCLUSIONS Our results suggested that the methodology presented is a reliable way of examining the development of sitting postural control in infants with or at risk for CP, and the reliability results generally parallel values found in sitting postural behavior in typical infants. Therefore, this methodology may be helpful in examining efficacy of therapy protocols directed at advancing sitting postural control in infants with motor developmental delays.
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Relationship between dynamic balance measures and functional performance in community-dwelling elderly people. Phys Ther 2010; 90:748-60. [PMID: 20223944 DOI: 10.2522/ptj.20090100] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Poor balance control, mobility restrictions, and fall injuries are serious problems for many older adults. OBJECTIVE The purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults. DESIGN This was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital. METHOD A Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed "Up & Go" Test, gait speed, and the Six-Minute Walk Test. Participants were classified as "fallers" or "nonfallers" based on a self-report. RESULTS No significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed "Up & Go" Test was able to differentiate between the faller and nonfaller groups. Limitations A prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample. CONCLUSIONS The findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.
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