Understanding the impact of age, gender, height and body mass index on children's balance

Short- and Long-Term Changes in Balance After Active Video Game Training in Children With and Without Developmental Coordination Disorder: A Randomized Controlled Trial

Active video games (AVG) have been used as training tools and are known to ameliorate balance performance in children with Developmental Coordination Disorder (DCD). Our aim was to evaluate balance using clinical tests and by measuring body sway using a force plate with a mixed design of vision (eyes open/eyes closed), surface (rigid/soft), and support (stance/semitandem) before, and after, training and 4 months later (follow-up). Thirty-six DCD children and 40 typically developing children participated in the study, of which 50 children (26 DCD; 24 typically developing) were retested after 4 months. Balance improved on the clinical measures after the training, which was independent of type of AVG (Wii-Fit and Xbox Kinect) used, and this effect was still present after 4 months. The AVG training did not influence general sway behavior, but only sway in the eyes-open condition, corresponding with task demands of the training and indicating a training-specific effect. Overall, DCD children and typically developing children responded comparably to the AVG training, thereby maintaining the gap in performance between the two groups. The changes in postural sway are interpreted as a sign of more confidence and less freezing of the joints, enabling greater flexibility of movements and balance strategies as supported by the improved performance on balance tests in the DCD children. This is the first study that showed long-term effects of AVG training on balance performance. However, these follow-up results should be interpreted with caution given that 35% of the children were lost in follow-up.

An initial set of reference values for the Balance Tracking System (BTrackS) Limits of Stability protocol

BACKGROUND

The Balance Tracking System (BTrackS) Limits of Stability (LOS) protocol is a relatively new means of evaluating unconstrained dynamic postural control ability. While the reliability of this protocol has previously been established, reference data is currently unavailable to assist in the interpretation of results.

RESEARCH QUESTION

What are typical reference values for the BTrackS LOS protocol with respect to sex, height, and BMI?

METHODS

A cross= -section of 800 healthy, young adults (aged 18-29 years; 368 men, 432 women) were administered the BTrackS LOS protocol. Sex, height and weight variables were also captured for the participants.

RESULTS

Results of a stepwise linear regression showed that the outcome measure for BTrackS LOS testing (i.e. LOS Area) was larger in taller individuals and in men. Based on these findings, four percentile ranking categories were established and associated look-up tables created.

SIGNIFICANCE

The reference values provided by this study offer much needed guidance to clinicians and researchers for the determination of dynamic balance abnormalities based on BTrackS LOS testing.

Factors associated with balance ability in Duchenne and Becker muscular dystrophies

BACKGROUND

Problems such as progressive muscle function loss, postural deteriorations, and contractures seen in patients with Duchenne and Becker muscular dystrophies (D/BMD) may affect children's balance ability, and impaired balance ability may lead to limitations in children's functional level.

RESEARCH QUESTION

What factors are associated with balance ability in children with D/BMD?

METHODS

Twenty participants with D/BMD were included in the study. Participants' ages were asked; height, body weight, and body mass index (BMI) were recorded. Children's functional level was assessed with the Motor Function Measurement-32 (MFM-32), Brooke and Vignos Scales. Muscle strength of hip flexion and extension, knee flexion and extension, and ankle dorsiflexion was measured with a handheld dynamometer. Balance measurements were performed using the Balance Master System. The relationship between balance and continuous independent variables was determined using Spearman's test.

RESULTS

The mean age of the participants was 8.57 ± 3.27 years. The balance abilities of children with BMD were better than those of children with DMD (p < 0.05). The balance diminished with age (p < 0.05), while there was a positive correlation between balance and weight, height, BMI (p < 0.05). There was a positive correlation between the balance and the MFM-32 total and subsection scores. Muscle strength was positively related to balance (p < 0.05).

SIGNIFICANCE

The results showed the balance ability in children with D/BMD was affected by age, height, weight, BMI, functional level, and muscle strength. Based on the results of this study, balance and strength training should be an integral part of the rehabilitation of children with D/BMD.

Is There Influence of Gender and the Specificity of Sports Activities on the Performance of Body Balance in Young Athletes?

Sports training can significantly influence specific motor skills. The aim of this study was to investigate the influence of gender and the specificity of sports activities on body balance, symmetry of lower extremity loads (SI) as well as body mass index (BMI) in young athletes aged 14 to 17. There were 240 participants (145 boys and 95 girls) divided into five groups: swimmers, dancers, soccer players, archery and control group. The average age was 16. Participants had 3 years of training experience (training three times a week or training that lasted between 4.5 and 6 h weekly). To assess balance, the stabilized Zebris platform was used in the study. The SI was calculated based on the percentage load on the lower extremities, dividing the greater value by the lower. Body mass index was calculated on the basis of height and weight. Women had a significantly lower BMI and balance in some analyzed parameters, while men had better SI. Archers obtained the best results of the balance parameters and the worst results of SI. Only swimmers and soccer players had a normal SI. Sports specialization generates significant differences in the manifestation of balance compared to the gender variable and sport discipline.

Age and gender differences in static and dynamic balance of Chinese preschool children

Objectives: Balance is a crucial ability of early age, but there is conflicting evidence with regard to age and gender differences in preschool children's balance ability. Additionally, there are several tools available to measure balance, yet, wide variation in their use has restricted the capacity to synthesize the reference values. Therefore, the primary purpose of this study was to investigate the balance ability of preschool-aged children and determine how it is moderated by age and gender. The analysis pertained to determining whether different testing methods affect the results of static or dynamic balancing ability to provide a basis for normative balance ability data for healthy boys and girls between 3 and 6 years of age. Method: Six hundred and nineteen preschool children (296 boys and 323 girls) aged 3-6 years participated in the study. The static balance (SB) was assessed with children standing on one leg (OST) and in a tandem stance (TS) with respect to time. The balance beam test (BBT) and functional reach test (FRT) were used to evaluate dynamic balance (DB) by measuring the time spent and the distance reached, respectively. Result: The results revealed significant differences in OST with respect to gender (η2 = 0.037, p < 0.001), TS (η2 = 0.026, p < 0.001) and FRT (η2 = 0.016, p = 0.002); the girls performed better than boys on most balance tests except on BBT (η2 = 0.000, p = 0.596). Age had positive effects on the static and dynamic balance performance on the OST (η2 = 0.336, p < 0.001), TS (η2 = 0.205, p < 0.001), BBT (η2 = 0.367, p < 0.001) and FRT (η2 = 0.392, p < 0.001). Older children performed better than their younger counterparts. No significant interactions between age groups and sex were found. Conclusion: This study revealed that static and dynamic balance stability in preschool-aged children was affected by gender and age. Gender dimorphism is present in preschool children, older girls displayed better postural stability than boys, and balance performance improved with age. In addition, the study provides age- and gender-specific balance performance reference values for preschool children across multiple methods, which can be used to monitor static and dynamic balance development.

Investigations Concerning the Influence of Sleep Disorders on Postural Stability in Young Men

Lack of sleep is a factor that disrupts the receptors’ reception of information from the environment and contributes to the emergence of problems with maintaining balance. The main aim of the study was to determine whether sleep disorders affect postural stability in young men. The study participants were 76 male students who were divided into groups with good and poor sleep quality. The division was made based on the results obtained from the questionnaire of the Pittsburgh Sleep Quality Index (PSQI). In each group, postural stability had been tested using three main tests: Sensory Organization Test (SOT); Motor Control Test (MCT); and Adaptation Test (ADT). The results of the analysis show that the obtained results differ in the examined groups under the SOT test. Different values of the tested parameters were noted among people with poor sleep quality and compared with the values of those who sleep well, which translates into a difference in the ability to maintain balance. The greatest impact is observed when using visual and a vestibular system to maintain a stable posture. It was confirmed that the lack of sleep significantly disturbs postural stability.

A Ten-Week Motor Skills Training Program Increases Motor Competence in Children with Developmental Coordination Disorder

The present study aimed to investigate the effect of a motor skills training program in children with DCD considering their gender. The Movement Assessment Battery for Children (MABC-2) classified the children and assessed their skill changes over time. The study was implemented at four kindergartens in the Khorezm region of Uzbekistan. In the study, all the children suffered from DCD (5.17 ± 0.70 years; 10 girls), and all the indicators of MABC-2 were less than 16%. The participants were divided into an experimental group (n = 17), receiving ten weeks of motor skills training program for 45 min twice per week; and a control group (n = 7), which proceeded with exercises of everyday living. The ANCOVA showed differences between the groups in the post-test concerning each domain: manual dexterity (F _(1, 20) = 18.703, p < 0.001; η² = 0.471); aiming and catching (F _(1, 20) = 9.734, p = 0.005; η² = 0.317); balance (F _(1, 20) = 35.140, p = 0.000; η² = 0.626); and total MABC-2 test score (F _(1, 20) = 66.093, p < 0.001; η² = 0.759), with all the children in the EG exhibiting better results. The Wilcoxon test revealed statistically significant differences for the EG between moments for all the variables (p < 0.001) but not for the CG (p > 0.050). The effectiveness of the intervention program was similar across both genders. The study suggests that a 10 week motor skills training program can increase the quality of children’s motor competence and represent a valuable procedure for physical education specialists to enhance motor competence for children with DCD.

Reference values for the Modified Timed Up and Go Test in Saudi children aged 4-12 years old in Riyadh city: cross-sectional study

PURPOSE

The study aimed to report within-session reliability, estimate the reference values for the Modified Timed Up and Go (mTUG) test in typically developing (TD) Saudi children aged 4-12 years old, develop a reference equation for the estimated mTUG, and compare the measured mTUG in the present study with the predicted mTUG obtained from the previous regression equation.

METHODS

In this cross-sectional observational study, anthropometric measurements and mTUG test were investigated in 805 child. The association between the mTUG test and predictive variables was studied.

RESULTS

Average mTUG speed was 4.63 ± 0.68 s. Within-session reliability was excellent with intraclass correlation coefficient of 0.90. The test was significantly and negatively correlated with age, height, and weight (r = -0.66, p = .00), (r = -0.54, p = .01), and (r = -0.33, p = .01) respectively. According to the stepwise regression analysis, age and weight were the predictors and explained 47% of total variance of mTUG scores.

CONCLUSION

This study provided the mTUG reference values that can be used clinically to evaluate functional mobility and dynamic balance in TD Saudi children aged 4-12 years. The mTUG scores can be predicted as a function of age and weight.KEY MESSAGESModified Timed Up and Go test used to assess the functional mobility and dynamic balance for children with or without developmental abnormalities.Availability of reference values according to age is helpful to compare the performance of children at same ages.

Hip Abductor and Adductor Rate of Torque Development and Muscle Activation, but Not Muscle Size, Are Associated With Functional Performance

Understanding the physiological variables that contribute to a functional task provides important information for trainers and clinicians to improve functional performance. The hip abductors and adductors muscles appear to be important in determining the performance of some functional tasks; however, little is known about the relationship of the hip abductor/adductors muscle strength, activation, and size with functional performance. This study aimed to investigate the relationship of maximum torque, rate of torque development (RTD), rate of activation (RoA), and muscle thickness of the hip abductors [tensor fascia latae (TFL) and gluteus medius (GM)] and adductor magnus muscle with the Four Square Step Test (FSST) and the two-leg hop test in healthy young adults. Twenty participants (five males) attended one testing session that involved ultrasound image acquisition, maximal isometric voluntary contractions (hip abduction and hip adduction) while surface electromyography (EMG) was recorded, and two functional tests (FSST and two-leg side hop test). Bivariate correlations were performed between maximum voluntary torque (MVT), RTD at 50, 100, 200, and 300ms, RoA at 0-50, 0-100, 0-200, and 0-300, and muscle thickness with the dynamic stability tests. For the hip abduction, MVT (r=-0.455, p=0.044) and RTD₃₀₀ (r=-0.494, p=0.027) was correlated with the FSST. GM RoA₅₀ (r=-0.481, p=0.032) and RoA₁₀₀ (r=-0.459, p=0.042) were significantly correlated with the two-leg side hop test. For the hip adduction, there was a significant correlation between the FSST and RTD₃₀₀ (r=-0.500, p=0.025), while the two-leg side hop test was correlated with RTD₂₀₀ (r=0.446, p=0.049) and RTD₃₀₀ (r=0.594, p=0.006). Overall, the ability of the hip abductor and adductor muscles to produce torque quickly, GM rapid activation, and hip abductor MVT is important for better performance on the FSST and two-leg hop tests. However, muscle size appears not to influence the same tests.

Is There a Link between Balance and Body Mass Composition in Children and Adolescents?

School-age children are particularly prone to disturbances in body composition, because this is a period of intensive growth and a period in which correct habits are shaped, especially in relation to diet. This is why it is so important to diagnose emerging disorders early so as to implement therapeutic or educational activities. The aim of this study was to assess the relationship between the factors of body mass composition and body mass index (BMI), as well as the balance parameters in children and adolescents. The study group consisted of 1137 children aged 7 to 15. There were 559 girls and 578 boys among the subjects. The study used the Tanita 780 body mass composition analyser and the Zebris stabilometric platform. It was found that girls were characterized by a significantly higher content of adipose tissue (24.37% vs. 20.45%), while boys were characterized by a higher content of lean tissue (32.99% vs. 30.43%), muscle tissue (31.23% vs. 28.86%) and water (24.15% vs. 22.28%). Interestingly, the girls had better balance than their peers in all analyzed parameters (COF TTL.-616.72 vs. 661.50; CEArea-73.63 vs. 112.24; COF HD-3.44 vs. 4.23; COF VD-4.52 vs. 5.12). It turned out that among children in adolescence, a higher adipose tissue content and a higher BMI correlated with a smaller surface area (p < 0.05) defined by the center of gravity and smaller deviations of the center of gravity in the horizontal plane (p < 0.05). Sex and adolescence play an important role in differentiating both body composition and body balance. The results of this study allow us to conclude that children with higher BMI values have better balance. Due to the fact that these conclusions are inconsistent with those of other researchers, it will be worth continuing the research (e.g., on a different population group) in order to confirm the results and to draw far-reaching conclusions.

Normative database of postural sway measures using inertial sensors in typically developing children and young adults

OBJECTIVE

Reference values utilizing the APDM MobilityLab® inertial sensor system have not been established in children and young adults ages 5-30. These values are necessary for clinicians and researchers to compare to children with balance impairments.

METHODS

A group of 144 typically developing children and young adults from age 5-30 years completed the instrumented SWAY test during 6 test conditions: normal stance, firm surface, eyes open (EO) and closed (EC); normal stance, foam surface, EO and EC; and tandem stance, firm surface, EO and EC. Selected variables for normative outcomes included total sway area, and the mean, sagittal and coronal values for RMS sway, jerk, sway velocity and path length. Sex differences were examined within age groups via t tests. The effect of age on postural sway variables was analyzed using a one-way ANOVA for the mean values of total sway area, RMS sway, velocity and jerk, followed by post-hoc pairwise comparisons.

RESULTS

All sway parameters decreased significantly with age (p < 0.0001). Adult-like total sway area and jerk were achieved by ages 9-10 except for jerk during EC on foam. RMS sway and sway velocity reached adult levels by ages 11-13 during all EO and tandem stance conditions, and 14-21 with EC during normal stance on firm and foam surfaces for RMS sway and EC on firm surfaces for velocity. Females ages 5-6 performed more poorly during EO firm and EC foam for certain variables, but better during EO tandem and females ages 7-13 outperformed males when sex differences were found.

SIGNIFICANCE

These reference values can now be used by clinicians and researchers to evaluate abnormal postural sway and response to interventions in children and young adults.

Static one-leg standing balance test as a screening tool for low muscle mass in healthy elderly women

Background

Identification of simple screening tools for detecting lower skeletal muscle mass may be beneficial for planning effective interventions in the elderly.

Aims

We aimed to (1) establish a threshold for one-leg standing balance test (OLST) time for low muscle mass, and (2) test the ability of that threshold to assess muscular impairments in a poor balance group.

Methods

Eyes-open OLST (maximum duration 30 s) was performed with right and left legs in 291 women (age 71 ± 6 years). OLST time was calculated as the sum of the OLST time of right and left legs. Fat-free mass (FFM), skeletal muscle mass (SMM), fat mass, biceps brachii and vastus lateralis sizes; handgrip strength (HGS), elbow flexion maximum torque (MVC_EF) and knee extension maximum torque (MVC_KE) were measured. Muscle quality was calculated as MVC_KE/FFM and physical activity was assessed by questionnaire. Low muscle mass was defined as SMM_relative of 22.1%, a previously established threshold for pre-sarcopenia.

Results

The OLST threshold time to detect low muscle mass was 55 s (sensitivity: 0.63; specificity: 0.60). The poor balance group (OLST < 55 s) had higher fat mass (3.0%, p < 0.001), larger VL thickness (5.1%, p = 0.016), and lower HGS (− 10.2%, p < 0.001), MVC_EF (− 8.2%, p = 0.003), MVC_KE (− 9.5%, p = 0.012), MVC_KE/FFM (− 11.0%, p = 0.004) and physical activity (− 8.0%, p = 0.024) compared to the normal balance group. While after adjusting age, the differences exist for HGS, fat mass and VL thickness only.

Discussion

An OLST threshold of 55 s calculated as the summed score from both legs discriminated pre-sarcopenic characteristics among active, community-dwelling older women with limited potential (sensitivity 0.63, specificity 0.60).

Conclusion

OLST, which can be performed easily in community settings without the need for more complex muscle mass measurement, may help identify women at risk of developing sarcopenia.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40520-021-01818-x.

DEVELOPMENT OF BALANCE IN CHILDREN PARTICIPATING IN DIFFERENT RECREATIONAL PHYSICAL ACTIVITIES

Balance, an important motor coordination ability, underlies the performance of variousmotor skills and allows for participation in common childhood activities. Research indicatesthat sport participation could support balance development in children. To confirm the aboveeffect, this study investigated whether participation in different recreational physicalactivities could induce differences in children’s balance ability. Specifically, 138 children, 5-11 years old (Mage=8.4±1.3), classified into four groups according to the activity they tookpart in (basketball, track and field, rhythmic gymnastics, contemporary dance), were assessedby the balance subset of the KörperKoordinationstest für Kinder. Pearson correlations wereapplied to detect associations of balance scores with age, height, body mass index (BMI) andshowed significant correlations for BMI (p< .001). The analyses of covariance (covariate:BMI) that were computed on children’s balance scores showed statistically significant effectsof group (p< .001). Sidak post hoc tests indicated that children participating in rhythmicgymnastics surpassed all three other groups; whereas those taking part in basketball had thelowest scores in almost every balance item. It seems that the type of physical activity a childparticipates in could be a significant contributor to the development of his/her balance.Physical activities encompassing the execution of various balance tasks, such as rhythmicgymnastics, seem to offer children greater opportunities to make improvements in this areacompared to children engaging in activities of low balancing requirements. This findinghighlights the potential that is available to coaches: they can contribute to children’s balancedevelopment by implementing sport-specific programs that target this human ability.