Head and Trunk Control While Walking in Older Adults with Diabetes: Effects of Balance Confidence

2017 ◽  
Vol 50 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Patricia Hewston ◽  
Nandini Deshpande
Robotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 101
Author(s):  
Lara A. Thompson ◽  
Mehdi Badache ◽  
Joao Augusto Renno Brusamolin ◽  
Marzieh Savadkoohi ◽  
Jelani Guise ◽  
...  

For the rapidly growing aging demographic worldwide, robotic training methods could be impactful towards improving balance critical for everyday life. Here, we investigated the hypothesis that non-bodyweight supportive (nBWS) overground robotic balance training would lead to improvements in balance performance and balance confidence in older adults. Sixteen healthy older participants (69.7 ± 6.7 years old) were trained while donning a harness from a distinctive NaviGAITor robotic system. A control group of 11 healthy participants (68.7 ± 5.0 years old) underwent the same training but without the robotic system. Training included 6 weeks of standing and walking tasks while modifying: (1) sensory information (i.e., with and without vision (eyes-open/closed), with more and fewer support surface cues (hard or foam surfaces)) and (2) base-of-support (wide, tandem and single-leg standing exercises). Prior to and post-training, balance ability and balance confidence were assessed via the balance error scoring system (BESS) and the Activities specific Balance Confidence (ABC) scale, respectively. Encouragingly, results showed that balance ability improved (i.e., BESS errors significantly decreased), particularly in the nBWS group, across nearly all test conditions. This result serves as an indication that robotic training has an impact on improving balance for healthy aging individuals.


2021 ◽  
Vol 17 (4) ◽  
pp. 247-255
Author(s):  
Rahim Nor ◽  
Maria Justine ◽  
Angelbeth Joanny ◽  
Azrul Anuar Zolkafli

This study determined the effectiveness of a 3-month group-based multicomponent exercise program in the mobility, balance confidence, and muscle performance of older adults. A total of 40 participants (mean age=70.60±6.25 years completed pre- and posttest clinical intervention measures of mobility using the Timed Up and Go (TUG) test, balance confidence using the Activities-specific Balance Confidence scale, upper limb strength (handgrip dynamometer), and lower limb function (30-sec chair rise test). Data were analyzed using paired t-test and based on TUG criteria for risk of fall (low- and high-risk groups). Significant improvements were found in all measures (All P<0.05) following the 3-month program. Measures according to the risk of fall categories were also significantly improved (P<0.01), except the left handgrip strength (P>0.05). The low-risk group showed a higher improvement in mobility (14.87% vs. 11.74%), balance confidence (34.21% vs. 26.08%), and lower limb function (96.87% vs. 21.20%) but was not significantly different from the high-risk group (P>0.05). A group-based multicomponent exercise program benefited the physical functions of older adults at low- or high risk of falls.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27 ◽  
Author(s):  
Shawn Leng-Hsien Soh ◽  
Chee-Wee Tan ◽  
Lane Judith ◽  
Nigel Gleeson ◽  
Tim Xu

Abstract Background Falls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. Empirical evidence is needed to justify the selection of a specific instrument to measure the intended construct. Objectives To summarize evidence on the development, content validity and structural validity of instruments measuring falls efficacy in community-dwelling older adults using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Study Design and Setting MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology guided the review of eligible studies and methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesized. A modified GRADE approach was applied to evidence synthesis. Results 35 studies on 18 instruments were included in the review. High quality evidence showed that modified Falls-Efficacy Scale (FES)–13 items (mFES-13) is relevant but not comprehensive for measuring falls efficacy. Moderate quality evidence supported the FES-10 had sufficient relevance and the mFES-14 had sufficient comprehensibility. Only the Activities-specific Balance Confidence (ABC) Scale–Simplified (ABC-15) had sufficient relevance of moderate quality evidence to measure balance confidence. Low to very low quality evidence underpinned content validity of other instruments. High quality evidence supported sufficient unidimensionality for eight instruments (FES-10, mFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES–International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)). Conclusion Content validity of the instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate the broader continuum of falls efficacy.


2019 ◽  
Vol 126 (3) ◽  
pp. 389-409 ◽  
Author(s):  
Ada W. W. Ma ◽  
Hsing-Kuo Wang ◽  
Duan-Rung Chen ◽  
Ya-Mei Chen ◽  
Yvonne T. C. Chak ◽  
...  

This randomized controlled trial explored the effects of a Ving Tsun (VT) Chinese martial art training program on reactive standing balance performance, postural muscle reflex contraction latency, leg muscle performance, balance confidence and falls in community-dwelling older adults. We randomly assigned 33 healthy older adults to either a VT group (mean age = 67.5 years) or a control group (mean age = 72.1 years). The VT group received two 1-hour VT training sessions per week for three months (24 sessions). Primary outcome measures collected before and after the intervention period were electromyographic muscle activation onset latencies of the hamstring and gastrocnemius and the center of pressure path, length and movement velocity in standing (reactive balance performance). Secondary outcome measures included isometric peak force and time to isometric peak force of the knee extensors and flexors, the Activities-Specific Balance Confidence Scale score, and fall history. Results revealed that the mean gastrocnemius muscle activation onset latency was significantly longer (22.53 ms) in the VT group after the intervention. The peak force of the knee flexors significantly increased (by 1.58 kg) in the control group over time but not in the VT group. The time to reach peak force in the knee flexors was significantly longer (by 0.51 s) in the control group (but not the VT group) at posttest compared with the pretest value. No other significant group, time, or group-by-time interaction effects were noted. We discussed possible reasons for the failure of three months of martial art training to benefit fall risks among these older adults.


2001 ◽  
Vol 24 (1) ◽  
pp. 17
Author(s):  
K L McCulloch ◽  
J K Freburger ◽  
C A Giuliani ◽  
J Busby-White-head

2019 ◽  
Vol 48 (6) ◽  
pp. 811-816 ◽  
Author(s):  
Toby C T Mak ◽  
William R Young ◽  
Wing-Kai Lam ◽  
Andy C Y Tse ◽  
Thomson W L Wong

Abstract Background This study evaluated the effect of attentional focus instructions on movement efficiency during a level-ground walking task in older adults with and without a history of falls. Methods One hundred and thirty-four community-dwelling older adults were categorised into older fallers (OF) (n = 37) and older non-fallers (ONF) (n = 97). Each participant was instructed to walk at a self-selected pace along a 6 m walkway under three attentional focus conditions (i.e. internal, goal-directed and control) for a total of nine trials. Average muscle activity indices of lower limb co-contractions were measured using surface electromyography. Results Both shank and thigh muscle co-contractions were higher in OF than in ONF in all three conditions. OF also demonstrated higher shank muscle co-contraction under the internal relative to the goal-directed condition, with no such change observed in ONF. Conclusion Despite no significant between-group differences in functional balance and balance confidence, relative walking inefficiencies were observed in OF compared with ONF. This finding demonstrates the debilitating consequences of falling that can occur with relative independence from various physiological or psychological factors that are commonly associated with falling and used to rationalise behavioural change. We also provide evidence that OF are more susceptible to conditions that provoke them to allocate attention internally. Therefore, in clinical contexts (e.g. gait rehabilitation), verbal instructions that refer to body movements (internal focus) might serve to compromise movement efficiency in older adults with a history of falls. Such changes will, theoretically, lessen the ability to react efficiently to changing environments experienced in daily life.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 790-790
Author(s):  
Chad Tiernan ◽  
Allon Goldberg

Abstract Balance confidence assessment in older adults has implications for falls and quality of life. It remains unclear whether the original Activities-specific Balance Confidence (ABC-16) scale or the shortened 6-item (ABC-6) scale is recommended. To further inform the decision-making process of balance confidence tool selection, a secondary analysis of an existing dataset consisting of 77 community-dwelling older adults was performed. ABC-16 and ABC-6 association and agreement, internal consistencies, and relationships with self-rated health (SRH) were assessed. Participants were primarily female (80.5%) between the ages of 60 and 87 years. Results indicated a strong association between the scales [r = .97, p&lt;.001); ICC(2,1) = .80] but limited agreement (95% Limits of Agreement range = 22.1; mean difference of 7.2 points in the direction of the ABC-16). Cronbach’s alphas were .95 (ABC-16) and .89 (ABC-6), suggesting high internal consistency for both scales but possible item redundancy with the ABC-16. Regression model 1 (ABC-6 = primary predictor) explained more of the variance (R2=.36) in SRH compared to model 2 (ABC-16 = primary predictor; R2=.29). Hotelling’s t-test [t(74)=2.4, p=.008] indicated that the correlation coefficient (Multiple R) from the ABC-6 model was significantly higher than the correlation coefficient from the ABC-16 model. In conclusion, despite a high correlation, the two scales did not agree strongly and should not be considered interchangeable. Given that the ABC-16 takes longer to administer, does not relate to SRH as strongly, and could have redundant items, the ABC-6 should be considered for balance confidence assessment in older adults.


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