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Liang SGS, Fan ESL, Lam PK, Kwok WT, Ma CZH, Lam FMH. The effect of adding real-time postural feedback in balance and mobility training in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 123:105439. [PMID: 38643641 DOI: 10.1016/j.archger.2024.105439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES This study aimed to systematically review the additional value of providing real-time postural feedback during balance and mobility training in older people. METHODS PubMed, Embase, CINAHL, and Web-of-Science were searched from inception to August 2023. Studies comparing the effectiveness of feedback-based versus non-feedback-based postural balance or mobility training on balance or mobility outcomes were selected. Similar outcomes were pooled in meta-analyses using a random-effect model. The quality of evidence for available outcomes was rated by Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Eight studies were identified with 203 subjects. Two studies showed that providing postural feedback immediately improved stability in static balance and gait. For the post-training effect, however, no significant change was found in trunk movement during single-leg standing (i.e., pitch angle, MD=0.65, 95 %CI=-0.77 to 2.07, low-quality; roll angle, MD=0.96, 95 %CI=-0.87 to 2.80, moderate-quality), in the Mini-BESTest (MD=1.88, 95 %CI=-0.05 to 3.80, moderate-quality), and in balance confidence (MD=0.29, 95 %CI=-3.43 to 4.2, moderate-quality). A worsened functional reach distance was associated with providing feedback during balance training (MD=-3.26, 95 %CI=-6.31 to -0.21, high-quality). Meta-analyses on mobility outcomes were mostly insignificant, except for the trunk-roll angle of walking (MD=0.87, 95 %CI=0.05 to 1.70, low-quality) and trunk-pitch angle of walking with head-turning (MD=1.87, 95 %CI=0.95 to 2.79, moderate-quality). CONCLUSION Adding real-time postural feedback to balance and mobility training might immediately improve stability in balance and mobility in older people. However, mixed results were reported for its post-training effect.
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Affiliation(s)
- Sam Guo-Shi Liang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Eva Si-Long Fan
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Pik Kwan Lam
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Wing Tung Kwok
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Freddy Man-Hin Lam
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
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Alshahrani MS, Reddy RS. Quadriceps Strength, Postural Stability, and Pain Mediation in Bilateral Knee Osteoarthritis: A Comparative Analysis with Healthy Controls. Diagnostics (Basel) 2023; 13:3110. [PMID: 37835853 PMCID: PMC10573007 DOI: 10.3390/diagnostics13193110] [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: 08/18/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Bilateral knee osteoarthritis (OA) poses significant challenges to individuals' functional abilities, including quadriceps strength, postural stability, and pain perception. Understanding the complex relationships among these factors is crucial for enhancing knee OA management strategies. The primary objective of this research is to evaluate and draw comparisons between the strength of the quadriceps and the level of postural stability in two distinct groups: individuals afflicted with bilateral knee OA and those who are healthy. Furthermore, the study seeks to examine the potential correlation between the strength of the quadriceps and the level of postural stability in individuals with knee OA. In addition to this, an investigation into the potential mediating effect of pain on the relationship between these physiological factors will also be conducted. A total of 95 participants with bilateral knee OA and 95 healthy controls were recruited. Quadriceps strength was assessed using dynamometry and postural stability was evaluated through anterior-posterior and medial-lateral sway measurements along with the ellipse area using a force plate. Pain levels were measured using the Visual Analog Scale (VAS). Mediation analysis was employed to explore the role of pain in mediating the relationship between quadriceps strength and postural stability. Statistical analyses included t-tests, Pearson correlation coefficients, and mediation analysis. Knee OA participants exhibited significantly lower quadriceps strength (1.08 Nm/kg ± 0.54) compared to controls (1.54 Nm/kg ± 0.57, p < 0.001). They also demonstrated compromised postural stability with increased anterior-posterior sway (9.86 mm ± 3.017 vs. 2.98 mm ± 1.12, p < 0.001), medial-lateral sway (7.87 mm ± 2.23 vs. 3.12 mm ± 1.34, p < 0.001), and larger ellipse area (935.75 mm2 ± 172.56 vs. 436.19 mm2 ± 135.48, p < 0.001). Negative correlations were observed between quadriceps strength and postural stability variables (r = from -0.43 to -0.51, p < 0.001). Pain significantly mediated the relationship between quadriceps strength and postural stability variables (p < 0.05). This study highlights the associations between quadriceps strength, postural stability, and pain mediation in individuals with bilateral knee OA. Our findings emphasize the need for targeted interventions addressing quadriceps weakness and compromised postural stability. Additionally, the mediation effect of pain underscores the complexity of these relationships, offering insights for more effective management strategies.
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Affiliation(s)
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
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Nouraeinejad A. Postural stability in strabismus and amblyopia. Strabismus 2023; 31:202-209. [PMID: 37489251 DOI: 10.1080/09273972.2023.2236138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
BACKGROUND Postural control is a complex skill based on the collaboration of dynamic sensory mechanisms, namely the visual, vestibular, and somatosensory systems. METHODS A literature survey regarding postural stability in strabismus and amblyopia was conducted using databases in order to collect data for a narrative review of published reports and available literature. RESULTS The results of the literature survey were analyzed to provide an overview of the current knowledge of postural stability in strabismus and amblyopia. The results revealed that although postural control depends on the fundamental integration of three essential components (the visual, vestibular, and somatosensory systems), the role of vision is critical in postural stability. Once normal binocular vision is undesirably disrupted in childhood by some reason, especially in strabismus and/or amblyopia, balance is also affected. Abnormal balance affects coordination in gross and fine motor controls in school-age children and results in weakened academic performance and delayed social progress. It also impacts a child's general health, self-esteem, and safety. CONCLUSIONS Binocular vision is imperative for the maturation and preservation of balance control in children, as balance performance is reduced in strabismus and/or amblyopia.
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Affiliation(s)
- Ali Nouraeinejad
- Department of Clinical Ophthalmology, University College London (UCL), London
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Ghamari N, Ghaderpanah R, Sadrian SH, Fallah N. Effect of a visual dual task on postural stability-A comparative study using linear and nonlinear methods. Health Sci Rep 2023; 6:e1437. [PMID: 37520463 PMCID: PMC10375842 DOI: 10.1002/hsr2.1437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
Background and Aims The dual-task experimental paradigm is used to study the attentional demands of postural control. Postural control is impaired in poststroke patients, and dual-task balance studies address the visual needs of postural control in stroke patients. A nonlinear approach can help us understand the overall behavior of the dynamic system. Methods A total of 20 chronic stroke patients and 20 healthy subjects with similar age, height, and weight participated in this study. The stability and complexity of postural control were assessed using linear and nonlinear methods. All data and parameters (center of pressure [COP] velocity, anteroposterior and mediolateral directions displacement, length of COP path, and phase plane) were analyzed using the Kolmogorov-Smirnov test. Results When postural control was examined based on linear analysis, the results showed that the main effect of the group was not significant, but the main impact of position was significant for all parameters of the COP variation (p < 0.05). Examination of postural control based on nonlinear analysis also showed that the main effect of the group was not significant, and the main effect of status was significant only for the parameters of approximate entropy in both directions and short-term Lyapunov view in the anterior-posterior direction (p < 0.05). Conclusion According to the results of this study, the assessment of postural control and gait performance in poststroke patients, as well as the dual tasks they have to perform in daily life, is crucial for their independence in activities of daily living.
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Affiliation(s)
- Narges Ghamari
- Bone and Joint Diseases Research CenterShiraz University of Medical SciencesShirazIran
| | - Rezvan Ghaderpanah
- Department of Physical Medicine and Rehabilitation, Students Research Committee, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Seyed Hassan Sadrian
- Department of Physical Medicine and Rehabilitation, Students Research Committee, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Nahid Fallah
- Department of Health, Sports Physiotherapy Research CommitteeUniversity of Bath, Claverton DownBathUK
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Nouraeinejad A. Effect of Strabismus and Amblyopia on Postural Stability. Ochsner J 2023; 23:5-6. [PMID: 36936491 PMCID: PMC10016211 DOI: 10.31486/toj.22.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Affiliation(s)
- Ali Nouraeinejad
- Department of Clinical Ophthalmology, University College London, London, United Kingdom
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Patti A, Fischetti F, Sahin FN, Bianco A. Editorial: Postural control, exercise physiology and the balance training-type of exercises, mechanisms and insights. Front Physiol 2023; 14:1149733. [PMID: 36875019 PMCID: PMC9982145 DOI: 10.3389/fphys.2023.1149733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Francesco Fischetti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, Bari, Italy
| | - Fatma Nese Sahin
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara, Türkiye
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Furtado GE, Letieri RV, Carballeira E. Exercise Evaluation and Prescription in Older Adults. Healthcare (Basel) 2022; 11:healthcare11010042. [PMID: 36611502 PMCID: PMC9819181 DOI: 10.3390/healthcare11010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
The over-65 age group is growing faster than other age groups worldwide [...].
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Affiliation(s)
- Guilherme Eustáquio Furtado
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar dos Cortiços-S. Martinho do Bispo, 3045-093 Coimbra, Portugal
- Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), Pavilhão 3, 3040-248 Coimbra, Portugal
| | - Rubens Vinícius Letieri
- Physical Education Department, Multidisciplinary Research Nucleus in Physical Education (NIMEF), Federal University of Northern of Tocantins (UFNT), Avenida Nossa Senhora de Fátima, 1558, Centro, Tocantinópolis 77900-000, Brazil
| | - Eduardo Carballeira
- Department of Physical Education and Sport, Faculty of Sports Science and Physical Education, University of A Coruña, 15001 A Coruña, Spain
- Correspondence:
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Akkus G, Sert M. Diabetic foot ulcers: A devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities. World J Diabetes 2022; 13:1106-1121. [PMID: 36578865 PMCID: PMC9791571 DOI: 10.4239/wjd.v13.i12.1106] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/21/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022] Open
Abstract
Diabetic foot ulcer is a devastating complication of diabetes mellitus and significant cause of mortality and morbidity all over the world and can be complex and costly. The development of foot ulcer in a diabetic patient has been estimated to be 19%-34% through their lifetime. The pathophysiology of diabetic foot ulcer consist of neuropathy, trauma and, in many patients, additional peripheral arterial disease. In particular, diabetic neuropathy leads to foot deformity, callus formation, and insensitivity to trauma or pressure. The standard algorithms in diabetic foot ulcer management include assessing the ulcer grade classification, surgical debridement, dressing to facilitate wound healing, off-loading, vascular assessment (status and presence of a chance for interventional vascular correction), and infection and glycemic control. Although especially surgical procedures are sometimes inevitable, they are poor predictive factors for the prognosis of diabetic foot ulcer. Different novel treatment modalities such as nonsurgical debridement agents, oxygen therapies, and negative pressure wound therapy, topical drugs, cellular bioproducts, human growth factors, energy-based therapies, and systematic therapies have been available for patients with diabetic foot ulcer. However, it is uncertain whether they are effective in terms of promoting wound healing related with a limited number of randomized controlled trials. This review aims at evaluating diabetic foot ulcer with regard to all aspects. We will also focus on conventional and novel adjunctive therapy in diabetic foot management.
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Affiliation(s)
- Gamze Akkus
- Department of Endocrinology, Cukurova University, Adana 33170, Turkey
| | - Murat Sert
- Department of Internal Medicine, Cukurova University Medical Faculty, Adana 33170, Turkey
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Does 8 Weeks of Integrated Functional Core and Plyometric Training Improve Postural Control Performance in Young Rhythmic Gymnasts? Motor Control 2022; 26:568-590. [PMID: 35894881 DOI: 10.1123/mc.2022-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 11/18/2022]
Abstract
It has been suggested that core stability and plyometric training (CPT) can enhance athletes' postural control. Nevertheless, the effects of an integrated core and plyometric training program on rhythmic gymnastics (RG) performance are unclear. This study aimed to evaluate the effects of an integrated functional CPT program on young rhythmics gymnasts' postural performance. A sample of 44 young female rhythmic gymnasts from a competitive team (age = 10.5 ± 1.8 years) participated in the study. The subjects were randomly divided into a control group and an experimental group. Pre- and posttest design was used. Postural control was assessed using single-leg stance tests and RG-specific balances over a force platform and evaluated by expert RG judges. The experimental group (n = 23) completed an 8-week functional CPT program based on RG technical requirements. Meanwhile, the control group (n = 21) received their usual training sessions. A mixed model of analysis of variance was applied to evaluate the effects of an intrasubject factor and an intersubject factor on each of the dependent variables. After 8 weeks, the experimental group obtained significant better results in some variables of the right support leg with eyes open and left support leg with eyes open single-leg support (p < .01), improvements were also found in some specific RG balances: Arabesque measured on the force platform (p < .01) and the side leg with help balance scored by the judges (p < .01). In conclusion, an integrated functional CPT program improved postural control in young rhythmic gymnasts. Coaches should consider using this CPT to improve RG performance.
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