scholarly journals The underlying mechanisms of improved balance after short- and long-term training in older adults

2020 ◽  
Author(s):  
Leila Alizadehsaravi ◽  
Ruud Koster ◽  
Wouter Muijres ◽  
Huub Maas ◽  
Sjoerd M. Bruijn ◽  
...  
Keyword(s):  
Older Adults ◽  
Time Course ◽  
Balance Control ◽  
H Reflex ◽  
Balance Performance ◽  
Unipedal Standing ◽  
Ankle Muscles ◽  
Reflex Gain ◽  
And Performance

AbstractWith training older adults can improve balance control, but the time course and neural mechanisms underlying these improvements are unclear. We studied changes in balance (robustness and performance), as well as in H-reflex gains, paired reflex depression (PRD) and co-contraction duration (CCI) in ankle muscles after short-term (1 session; STT) and long-term (3 weeks; LTT) balance training in 22 older adults. Mediolateral balance robustness during unipedal stance (time to balance loss in unipedal standing on a robotic platform with decreasing rotational stiffness) improved (33%) after STT, with no further improvement after LTT. Balance performance (mean absolute mediolateral center of mass velocity) improved (18.75%) after STT in perturbed unipedal standing and after LTT (18.18%) in unperturbed unipedal standing. CCI of soleus/tibialis anterior did not change after STT but increased (16%) after LTT. H-reflex gain and PRD excitability did not change with training. Cross-correlations showed that H-reflex gains in unipedal stance were lower and CCI was higher in participants with a more robust balance at the last time-point measurement and, CCI was higher in participants with better balance performance at several time-points. However, changes in robustness and performance were uncorrelated with changes in CCI, H-reflex gain, or PRD. Our results indicate that balance robustness improves over a single session, while balance performance improves more gradually over multiple sessions. Changes in co-contraction and motor neuron excitability of ankle muscles are not exclusive causes of improved balance performance and robustness.

Balance performance when responding to visual stimuli in patients with Benign Paroxysmal Positional Vertigo (BPPV)

2020 ◽  
Vol 30 (4) ◽  
pp. 267-274
Author(s):  
Sang-I Lin ◽  
Yi-Ju Tsai ◽  
Pei-Yun Lee
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Benign Paroxysmal Positional Vertigo ◽  
Balance Control ◽  
Visual Stimuli ◽  
Balance Performance ◽  
Positional Vertigo ◽  
Vestibular Information ◽  
Eyes Open ◽  
Paroxysmal Positional Vertigo

BACKGROUND: Patients with Benign Paroxysmal Positional Vertigo (BPPV) often report a sensation of disequilibrium before treatment with the canalith repositioning maneuvers. Apart from vestibular information, visual input also contributes to balance control. How visual stimuli influence balance control in BPPV patients is unclear. OBJECTIVE: To investigate the influence of visual stimuli on balance performance in BPPV patients. METHODS: Three groups of participants, patients with BPPV, and healthy young and older adults, were instructed to stand under three conditions: 1) eyes open (EO); 2) while watching a static picture via a video display; and 3) while watching a rotating visual scene. Antero-posterior (AP), lateral (ML), and total sway path during standing were analyzed. RESULTS: In all conditions, patients with BPPV showed significantly larger AP, ML and total sway path than young, whereas older adults only showed significantly larger AP and total sway path than young adults. During the visual stimuli, all participants exhibited significantly increased AP and total sway while watching a static image and a moving scene as compared with the EO condition. CONCLUSIONS: Patients with BPPV have similar balance control to older adults, but poorer balance control than young adults. The reduced lack of standing balance control in the coronal plane of patients with BPPV, might affect balance strategy after external perturbations.

scholarly journals The effects of the Otago Exercise Programme on actual and perceived balance in older adults: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255780
Author(s):  
Huei-Ling Chiu ◽  
Ting-Ting Yeh ◽  
Yun-Ting Lo ◽  
Pei-Jung Liang ◽  
Shu-Chun Lee
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Balance Control ◽  
Meta Analysis ◽  
Exercise Programme ◽  
Control Group ◽  
Balance Performance ◽  
Group Setting ◽  
Balance Confidence ◽  
Balance Ability

Objective Falls are serious issues in older populations. Balance problems are a major cause of falls and may lead to fear of falling and decreased balance confidence. The Otago Exercise Programme (OEP) is an effective fall prevention program that benefits balance function and fear of falling. The primary aim of the meta-analysis was to investigate the effectiveness of the OEP intervention on actual balance performance (i.e., static, dynamic, proactive or reactive balance) and perceived balance ability (i.e., balance confidence or fear of falling) for older adults; the secondary aim was to examine which OEP protocol most improves balance in older adults. Methods A systematic electronic review search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines to identify randomized controlled trials (RCTs) investigating the effects of the OEP on actual balance performance and perceived balance ability in healthy older adults, and examining which OEP training protocol and intervention format most improves balance. Results A total of 12 RCTs were included in the analyses. The OEP exerted significant effects on static balance (Hedges’s g = 0.388; 95% confidence interval [CI] = 0.131 to 0.645), dynamic balance (g = -0.228; 95% CI = -0.352 to -0.1.4), proactive balance (g = 0.239; 95% CI = 0.061 to 0.416) and perceived balance (g = -0.184; 95% CI = -0.320 to -0.048) in older adults. Subgroup analysis indicated that the group format for the OEP was more effective for improving static (p = 0.008), dynamic (p = 0.004) and perceived balance (p = 0.004) than was the individual format. Sessions of >30 minutes were more effective in improving static (p = 0.007) and perceived balance (p = 0.014) than were sessions of ≤30 minutes. However, the effects of the OEP on balance were unrelated to the types of control group, training frequency and training period. Discussion The OEP is helpful for improving actual balance including static, dynamic, and proactive balance; enhancing confidence in balance control; and reducing fear of falling in older adults. In particular, administrating the OEP in a group setting in >30-minute sessions may be the most appropriate and effective exercise protocol for improving balance.

scholarly journals Balance training improves feedback control of perturbed balance in older adults

2021 ◽  
Author(s):  
Leila Alizadehsaravi ◽  
Sjoerd M. Bruijn ◽  
Jaap H. van Dieen
Keyword(s):  
Older Adults ◽  
Angular Momentum ◽  
Feedback Control ◽  
Center Of Mass ◽  
Balance Training ◽  
Rate Of Change ◽  
The Body ◽  
Balance Performance ◽  
Short Term

Recovering balance after perturbations becomes challenging with aging, but an effective balance training could reduce such challenges. In this study, we examined the effect of balance training on feedback control after unpredictable perturbations by investigating balance performance, recovery strategy, and muscle synergies. We assessed the effect of balance training on unipedal perturbed balance in twenty older adults (>65 years) after short-term (one session) and long-term (3-weeks) training. Participants were exposed to random medial and lateral perturbations consisting of 8-degree rotations of a robot-controlled balance platform. We measured full-body 3D kinematics and activation of 9 muscles (8 stance leg muscles, one trunk muscle) during 2.5 s after the onset of perturbation. The perturbation was divided into 3 phases: phase1 from the onset to maximum rotation of the platform, phase 2 from the maximum rotation angle to the 0-degree angle and phase 3 after platform movement. Balance performance improved after long-term training as evidenced by decreased amplitudes of center of mass acceleration and rate of change of body angular momentum. The rate of change of angular momentum did not directly contribute to return of the center of mass within the base of support, but it reoriented the body to an aligned and vertical position. The improved performance coincided with altered activation of synergies depending on the direction and phase of the perturbation. We concluded that balance training improves control of perturbed balance, and reorganizes feedback responses, by changing temporal patterns of muscle activation. These effects were more pronounced after long-term than short-term training.

scholarly journals Physical Activity and Performance Impact Long-term Quality of Life in Older Adults at Risk for Major Mobility Disability

2019 ◽  
Vol 56 (1) ◽  
pp. 141-146 ◽  
Author(s):  
Erik J. Groessl ◽  
Robert M. Kaplan ◽  
W. Jack Rejeski ◽  
Jeffrey A. Katula ◽  
Nancy W. Glynn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Older Adults ◽  
At Risk ◽  
Mobility Disability ◽  
Performance Impact ◽  
And Performance

scholarly journals Self-perceived functional ability and performance-based testing of physical function in older women with or without long-term back pain – results of the H70 study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hilda Kristin Svensson ◽  
Jon Karlsson ◽  
Therese Rydberg Sterner ◽  
Felicia Ahlner ◽  
Ingmar Skoog ◽  
...  
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Activities Of Daily Living ◽  
Physical Function ◽  
Older Women ◽  
Birth Cohort ◽  
Functional Ability ◽  
Daily Living ◽  
And Performance

Abstract Background The proportion of older adults is increasing rapidly, and the majority are female. In 2050, the number of persons aged 60 years and over is estimated to reach 2.1 billion worldwide, constituting one-third of the total population of Europe. Long-term back pain is a disabling and common condition, primarily affecting older women. Although standardized functional evaluations are essential in the screening of older adults, self-rated activities of daily living capture a different aspect of the person’s ability in the context of his or her environment and social support system. This study aimed to describe how older women with or without long-term back pain self-rate their activities of daily living (ADL) and instrumental activities of daily living (IADL) in relation to their performance-based testing of physical function, including walking test, leg muscle strength, balance, and endurance. Method This study is part of the Gothenburg H70 Birth Cohort Studies in Sweden (H70 studies) and uses data from the 1944 birth cohort examined in 2015–16 at age 70. In the present study, only female participants were included in the analysis, and all cases of dementia (n = 17) and cases of acute and sub-acute back pain excluded (n = 181), leaving an effective sample of 446 female participants. Results Women with long-term back pain self-perceived their ADL and IADL as being as good as those without back pain, although they performed poorer in all performance-based tests and perceived themselves as less physically fit. Conclusion The discrepancy between self-perceived functional ability (ADL/IADL) and performance-based testing of functioning based on clinical tests calls for further investigation to incentivize person-centered care in older women with long-term back pain in municipal or emergency health-care settings.

scholarly journals Are Static and Dynamic Postural Balance Assessments Two Sides of the Same Coin? A Cross-Sectional Study in the Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Alex Rizzato ◽  
Antonio Paoli ◽  
Marta Andretta ◽  
Francesca Vidorin ◽  
Giuseppe Marcolin
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Postural Balance ◽  
Balance Control ◽  
Handgrip Strength ◽  
Dynamic Balance ◽  
Task Condition ◽  
Balance Performance ◽  
Dual Task Condition ◽  
Healthy Older Adults

The aim of this study was to investigate if the combination of static and dynamic postural balance assessments gives more accurate indications on balance performance among healthy older adults. We also aimed at studying the effect of a dual-task condition on static and dynamic postural balance control. Fifty-seven healthy older adults (age = 73.2 ± 5.0 year, height = 1.66 ± 0.08 m, and body mass = 72.8 ± 13.8 kg) completed the study. Static and dynamic balance were assessed both in single-task and dual-task conditions through a force plate and an oscillating platform. The dominant handgrip strength was also measured with a dynamometer. Pearson’s correlation revealed non-statistically significant correlations between static and dynamic balance performance. The dual-task worsened the balance performance more in the dynamic (+147.8%) than in the static (+25.10%, +43.45%, and +72.93% for ellipse area, sway path, and AP oscillations, respectively) condition (p < 0.001). A weak correlation was found between dynamic balance performance and handgrip strength both in the single (p < 0.05; r = −0.264) and dual (p < 0.05; r = −0.302) task condition. The absence of correlations between static and dynamic balance performance suggests including both static and dynamic balance tests in the assessment of postural balance alterations among older adults. Since cognitive-interference tasks exacerbated the degradation of the postural control performance, dual-task condition should also be considered in the postural balance assessment.

scholarly journals Determining the optimal dose of reactive balance training after stroke: study protocol for a pilot randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038073
Author(s):  
Avril Mansfield ◽  
Elizabeth L Inness ◽  
Cynthia J Danells ◽  
David Jagroop ◽  
Tanvi Bhatt ◽  
...  
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Controlled Trial ◽  
Balance Training ◽  
Optimal Dose ◽  
Pilot Randomised Controlled Trial ◽  
Healthy Older Adults ◽  
Randomised Controlled ◽  
Reactive Balance

IntroductionFalls risk poststroke is highest soon after discharge from rehabilitation. Reactive balance training (RBT) aims to improve control of reactions to prevent falling after a loss of balance. In healthy older adults, a single RBT session can lead to lasting improvements in reactive balance control and prevent falls in daily life. While increasing the dose of RBT does not appear to lead to additional benefit for healthy older adults, stroke survivors, who have more severely impaired balance control, may benefit from a higher RBT dose. Our long-term goal is to determine the optimal dose of RBT in people with subacute stroke. This assessor-blinded pilot randomised controlled trial aims to inform the design of a larger trial to address this long-term goal.Methods and analysisParticipants (n=36) will be attending out-patient stroke rehabilitation, and will be randomly allocated to one of three groups: one, three or six RBT sessions. RBT will replace a portion of participants’ regular physiotherapy so that the total physical rehabilitation time will be the same for the three groups. Balance and balance confidence will be assessed at: (1) study enrolment; (2) out-patient rehabilitation discharge; and (3) 6 months postdischarge. Participants will report falls and physical activity for 6 months postdischarge. Pilot data will be used to plan the larger trial (ie, sample size estimate using fall rates, and which groups should be included based on between-group trends in pre-to-post training effect sizes for reactive balance control measures). Pilot data will also be used to assess the feasibility of the larger trial (ie, based on the accrual rate, outcome completion rate and feasibility of prescribing specific training doses).Ethics and disseminationInstitutional research ethics approval has been received. Study participants will receive a lay summary of results. We will also publish our findings in a peer-reviewed journal.Trial registration numberNCT04219696; Pre results.

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