Exploring Training Methodologies Towards the Improvement of Elderly Balance

The purpose of this study was to investigate the effects of utilizing sensory (i.e., vision and touch), as well as static and dynamic base of support training on the balance of senior participants aged 60–80 years old. For each participant, there were several weeks of training, two sessions per week and assessments every two weeks. Training included walking and standing exercises on a hard surface, compliant and stiffer foam walking and standing balance training, and navigating obstacles. Within each session, to modify vision, all training included eyes-open and closed. Further, there were increases in training difficulty as the sessions progressed. It was observed that training over several weeks resulted in increases in stability, as observed by the decreases in Balance Error Scoring System (BESS) assessment results. However, increases in balance confidence, as observed by the Activities-Specific Balance Confidence (ABC) scale were less certain in this healthy elderly (or senior) population. It is an interesting and positive finding that, in doing relatively simple, but targeted exercises and training, senior individuals can have moderate improvements in their balance and, perhaps ultimately, reduce their fall-risk.

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The measurable parameters of balance trainings in case of young healthy adults: Improved balance confidence or better postural stability? A pilot study

Developments in Health Sciences ◽

10.1556/2066.2021.00037 ◽

2021 ◽

Author(s):

G. Posa ◽

D. Farkasinszky ◽

T. Margithazi ◽

E. Nagy

Keyword(s):

Pilot Study ◽

Postural Sway ◽

Force Plate ◽

Balance Training ◽

Balance Confidence ◽

Eyes Closed ◽

Healthy Female ◽

Eyes Open ◽

Support Surfaces ◽

Base Of Support

AbstractPurposeThe objective of this pilot study was to compare the effects of two parallel balance trainings on postural sway and balance confidence. The study was performed in different contexts with stable vs. unstable base of support and balance confidence was measured with a scale modified for young adults with higher functional level.Materials/methodsTwenty healthy female physiotherapist students volunteered for the study and took part in a six-week balance training intervention. They were randomly assigned to two groups training on different support surfaces. Postural sway was recorded under various conditions: on different surfaces (firm, foam) and with different visual conditions (eyes open (EO), eyes closed (EC)). Modified Activities-specific Balance Confidence (mABC) scale was self-evaluated.ResultsBoth types of training caused a significant improvement in the mABC scores. The sway path increased after the training in the less challenging balance situations. We found a tendency of decreasing sway path only in the more challenging balance situations, that is standing on foam mounted on force plate with EC.ConclusionsConsidering the improved balance confidence in the case of both groups, we suggest that an increase in sway path after balance training may be the behavioural sign of the higher confidence in the less challenging balance situations.

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Sensory-Specific Balance Training in Older Adults: Effect on Proprioceptive Reintegration and Cognitive Demands

Physical Therapy ◽

10.2522/ptj.20060263 ◽

2007 ◽

Vol 87 (10) ◽

pp. 1274-1283 ◽

Cited By ~ 34

Author(s):

Kelly P Westlake ◽

Elsie G Culham

Keyword(s):

Balance Training ◽

Exercise Group ◽

Falls Prevention ◽

Prevention Education ◽

Balance Confidence ◽

Education Group ◽

Balance Exercise ◽

Scale Scores ◽

Abc Scale

Background and Purpose Age-related changes in the ability to adjust to alterations in sensory information contribute to impaired postural stability. The purpose of this randomized controlled trial was to investigate the effect of sensory-specific balance training on proprioceptive reintegration. Subjects The subjects of this study were 36 older participants who were healthy. Methods Participants were randomly assigned to a balance exercise group (n=17) or a falls prevention education group (n=19). The primary outcome measure was the center-of-pressure (COP) velocity change score. This score represented the difference between COP velocity over 45 seconds of quiet standing and each of six 5-second intervals following proprioceptive perturbation through vibration with or without a secondary cognitive task. Clinical outcome measures included the Fullerton Advanced Balance (FAB) Scale and the Activities-specific Balance Confidence (ABC) Scale. Assessments were conducted at baseline, postintervention, and at an 8-week follow-up. Results Following the exercise intervention, there was less destabilization within the first 5 seconds following vibration with or without a secondary task than there was at baseline or in the falls prevention education group. These training effects were not maintained at the 8-week follow-up. Postintervention improvements also were seen on the FAB Scale and were maintained at follow-up. No changes in ABC Scale scores were identified in the balance exercise group, but ABC Scale scores indicated reduced balance confidence in the falls prevention education group postintervention. Discussion and Conclusion The results of this study support short-term enhanced postural responses to proprioceptive reintegration following a sensory-specific balance exercise program.

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Investigating Relationships between Balance Confidence and Balance Ability in Older Adults

Journal of Aging Research ◽

10.1155/2021/3214366 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Lara A. Thompson ◽

Mehdi Badache ◽

Joao Augusto Renno Brusamolin ◽

Marzieh Savadkoohi ◽

Jelani Guise ◽

...

Keyword(s):

Older Adults ◽

Balance Training ◽

Older Individuals ◽

Balance Performance ◽

Balance Confidence ◽

Stroke Group ◽

Balance Ability ◽

Performance Ability ◽

Abc Scale ◽

Healthy Participants

Increasing balance confidence in older individuals is important towards improving their quality of life and reducing activity avoidance. Here, we investigated if balance confidence (perceived ability) and balance performance (ability) in older adults were related to one another and would improve after balance training. The relationship of balance confidence in conjunction with balance performance for varied conditions (such as limiting vision, modifying somatosensory cues, and also base of support) was explored. We sought to determine if balance confidence and ability, as well as their relationship, could change after several weeks of training. Twenty-seven healthy participants were trained for several weeks during standing and walking exercises. In addition, seven participants with a higher risk of imbalance leading to falls (survivors of stroke) were also trained. Prior to and after training, balance ability and confidence were assessed via the Balance Error Scoring System (BESS) and Activities Specific Balance Confidence (ABC) Scale, respectively. Both groups showed improvements in balance abilities (i.e., BESS errors significantly decreased after training). Balance confidence was significantly higher in the healthy group than in the stroke group; however, ABC results reflected that balance confidence did not significantly increase after training for each. The correlations between balance ability and balance confidence were explored. Encouragingly, healthy participants displayed a negative correlation between BESS errors and ABC (i.e., enhancements in balance confidence (increases in ABC Scale results) were related to improvements in balance ability (decreases in BESS errors)). For the stroke participants, despite improvements in balance ability, our results showed that there was no relation to balance confidence (i.e., no correlation between BESS errors and ABC) in this group.

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Does the Fatigue Index Induced in Athlete’s Affect Static Balance?

Journal of Education and Learning ◽

10.5539/jel.v8n5p81 ◽

2019 ◽

Vol 8 (5) ◽

pp. 81

Author(s):

Recep Soslu

Keyword(s):

Anaerobic Power ◽

Balance Training ◽

The Body ◽

Static Balance ◽

Fatigue Index ◽

Eyes Closed ◽

Post Test ◽

Eyes Open ◽

Continuous Feedback ◽

Base Of Support

Balance is the process of maintaining the body center of gravity vertically over the base of support and relies on rapid, continuous feedback and integration of afferent information coming from three sensory components, that is somatosensory, visual, and vestibular systems, resulting in smooth and coordinated neuromuscular actions. To investigate the effects of fatigue index on the static balance of sportsmen. A total of 51 male elite sportsmen from 4 different sports branches (Football players: 19, Volleyball players: 13, Skiers: 10 and Athletes: 9) participated in the study. The Wingate anaerobic power and capacity test was applied to induce fatigue. The Technobody isokinetic balance meter (Pro-Kin. CSMI) was used to measure pre- and post-fatigue static balance. There was a significant interaction between dependent (pre and post test balance) and independent (test statue and sport branches) variables were observed (F(63,1031.14) = 1.59, η2 = .07, p ˂ .05). Main effect results showed that pre-fatigue balance values were significantly different than post-fatigue balance values in all groups (F(1.14, 213.91) = 177.99, η2 = .49, p ˂ .05).Moreover, significant differences were identified between pre- and post-fatigue test results in sport branches (F(3.188) = 4.12, ƞ2 = .06, p < .05) and test statue (eyes open and closed) (F(3.188) = 3.32, ƞ2 = .05, p < .05). Bonferonni follow-up test indicated that there was a significant increase from footballers’ average static balance to the athletes’ average static balance (p ˂ .05). In test statue, pre fatigue eyes closed values were significantly different than post fatigue eyes opened values (p ˂ .05). Static balance training should be included in the training to be performed, fatigue static balance training should be performed in team and individual sports and the content of the training should be reorganized in line with the results obtained.

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Effects of Perturbation-Based Balance Training in Subacute Persons With Stroke: A Randomized Controlled Trial

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319829453 ◽

2019 ◽

Vol 33 (3) ◽

pp. 213-224 ◽

Cited By ~ 9

Author(s):

Shirley Handelzalts ◽

Michal Kenner-Furman ◽

Ganit Gray ◽

Nachum Soroker ◽

Guy Shani ◽

...

Keyword(s):

Outcome Measures ◽

Balance Training ◽

Treadmill Walking ◽

Secondary Outcome ◽

Walk Test ◽

Balance Confidence ◽

Abc Scale ◽

Reactive Balance ◽

Weight Shifting ◽

Multiple Step

Background: Reactive balance responses are critical for fall prevention. Perturbation-based balance training (PBBT) has shown a positive effect in reducing the risk of falls among older adults and persons with Parkinson’s disease. Objective: To explore the effect of a short-term PBBT on reactive balance responses, performance-based measures of balance and gait and balance confidence. Methods: Thirty-four moderate-high functioning, subacute persons with stroke (PwS) (lower extremity Fugl-Meyer score 29.2 ± 4.3; Berg Balance Scale [BBS] score 43.8 ± 9.5, 42.0 ± 18.7 days after stroke onset) hospitalized in a rehabilitation setting were randomly allocated to PBBT (n = 18) and weight shifting and gait training (WS&GT) (n = 16). Both groups received 12 training sessions, 30 minutes each, for a period of 2.5 weeks. PBBT included unexpected balance perturbations during standing and treadmill walking, WS&GT included weight shifting in standing and treadmill walking without perturbations. The main outcome measures, that is, multiple step-threshold and fall-threshold were examined at baseline, immediately postintervention, and about 5 weeks postintervention. The secondary outcome measures, that is, BBS, 6-minute walk test (6MWT), 10-meter walk test (10MWT), and Activity-specific Balance Confidence (ABC) scale were examined at baseline and immediately postintervention. Results: Compared with the WS&GT group, immediately postintervention participants in the PBBT group showed higher multiple-step thresholds in response to forward and backward surface translations (effect size [ES] = 1.07 and ES = 1.10, respectively) and moderate ES in the ABC scale (ES = 0.74). No significant differences were found in fall-threshold, BBS, 6MWT, and 10MWT between the groups. Conclusions: Inclusion of perturbation training during rehabilitation of PwS improved reactive balance and balance confidence.

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Multidirectional Overground Robotic Training Leads to Improvements in Balance in Older Adults

Robotics ◽

10.3390/robotics10030101 ◽

2021 ◽

Vol 10 (3) ◽

pp. 101

Author(s):

Lara A. Thompson ◽

Mehdi Badache ◽

Joao Augusto Renno Brusamolin ◽

Marzieh Savadkoohi ◽

Jelani Guise ◽

...

Keyword(s):

Older Adults ◽

Healthy Aging ◽

Robotic System ◽

Control Group ◽

Support Surface ◽

Training Methods ◽

Robotic Training ◽

Balance Confidence ◽

Balance Ability ◽

Abc Scale

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.

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Validation of a Laser Ranged Scanner-Based Detection of Spatio-Temporal Gait Parameters Using the aTUG Chair

Sensors ◽

10.3390/s21041343 ◽

2021 ◽

Vol 21 (4) ◽

pp. 1343

Author(s):

Sebastian Fudickar ◽

Jörn Kiselev ◽

Christian Stolle ◽

Thomas Frenken ◽

Elisabeth Steinhagen-Thiessen ◽

...

Keyword(s):

Correlation Coefficient ◽

Measurement Accuracy ◽

Dynamic Balance ◽

Step Length ◽

Berg Balance Scale ◽

Walking Ability ◽

Functional Requirements ◽

Balance Confidence ◽

Gait Parameters ◽

Abc Scale

This article covers the suitability to measure gait-parameters via a Laser Range Scanner (LRS) that was placed below a chair during the walking phase of the Timed Up&Go Test in a cohort of 92 older adults (mean age 73.5). The results of our study demonstrated a high concordance of gait measurements using a LRS in comparison to the reference GAITRite walkway. Most of aTUG’s gait parameters demonstrate a strong correlation coefficient with the GAITRite, indicating high measurement accuracy for the spatial gait parameters. Measurements of velocity had a correlation coefficient of 99%, which can be interpreted as an excellent measurement accuracy. Cadence showed a slightly lower correlation coefficient of 96%, which is still an exceptionally good result, while step length demonstrated a correlation coefficient of 98% per leg and stride length with an accuracy of 99% per leg. In addition to confirming the technical validation of the aTUG regarding its ability to measure gait parameters, we compared results from the GAITRite and the aTUG for several parameters (cadence, velocity, and step length) with results from the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence-(ABC)-Scale assessments. With confidence coefficients for BBS and velocity, cadence and step length ranging from 0.595 to 0.798 and for ABC ranging from 0.395 to 0.541, both scales demonstrated only a medium-sized correlation. Thus, we found an association of better walking ability (represented by the measured gait parameters) with better balance (BBC) and balance confidence (ABC) overall scores via linear regression. This results from the fact that the BBS incorporates both static and dynamic balance measures and thus, only partly reflects functional requirements for walking. For the ABC score, this effect was even more pronounced. As this is to our best knowledge the first evaluation of the association between gait parameters and these balance scores, we will further investigate this phenomenon and aim to integrate further measures into the aTUG to achieve an increased sensitivity for balance ability.

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Role Wii Fit exer-games in improving balance confidence and quality of life in elderly population

Journal of the Pakistan Medical Association ◽

10.47391/jpma.319 ◽

2021 ◽

Vol 71 (9) ◽

pp. 1-10

Author(s):

Kiran Khushnood ◽

Shafaq Altaf ◽

Nasir Sultan ◽

Malik Muhammad Ali Awan ◽

Riafat Mehmood ◽

...

Keyword(s):

Quality Of Life ◽

Fall Risk ◽

Elderly Population ◽

Balance Training ◽

Control Group ◽

Balance Confidence ◽

Wii Fit ◽

And Control ◽

Experimental Group

Objective: To determine the effects of Wii Fit exer-gaming on balance confidence, quality of life and fall risk in elderly population Methods: A double blinded randomized control was conducted at Kulsum International Hospital, Islamabad from July 31st to October 30th, 2018. Following screening, 90 subjects fulfilled inclusion criteria and gave consent to be part of trial. Subjects were randomly allocated into experimental and control group by concealed envelope method. After baseline assessment, experimental group received Wii fit gaming while controls received balance training for 30 minutes twice a week for 8 weeks. Activities balance confidence (ABC), Euro 5Q5L, timed up and go (TUG) and Fukuda were used as outcome measures. Data was analysed by SPSS 21. Results: ABC improved in experimental group from 76.47±3.69 to 86.53±3.99, and in control group from 77.51±3.01 to 82.70±2.78 with significance < 0.001. The components of Euro 5Q5L; mobility, self-care, usual activities, pain/discomfort, anxiety/depression have changed with intergroup significance of 0.05, 0.006, 0.595, <0.001, 0.001 respectively. TUG and Fukuda improved in experimental and control group as 15.73±2.30 to 12.02±1.40 and 16.24±1.75 to 13.68±1.58 with significance <0.001, and from 41.78±6.to 71 to 30.09±8.05 and 43.36±5.59 to 38.68±5.75 with significance <0.001 respectively. Conclusion: Wii fit improves balance confidence and quality of life reducing fall risk in elderly. Clinical Trial Number: IRCT20180417039344N1 Keywords: Balance training, Elderly, Exer-gaming, Quality of life, Wii fit Continuous...

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