Tai Chi Intervention Improves Dynamic Postural Control During Gait Initiation in Older Adults: A Pilot Study

2014 ◽  
Vol 30 (6) ◽  
pp. 697-706 ◽  
Author(s):  
Srikant Vallabhajosula ◽  
Beverly L. Roberts ◽  
Chris J. Hass
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Tai Chi ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Separation Distance ◽  
Gait Initiation ◽  
Mobility Disability ◽  
Post Intervention ◽  
Movement Characteristics

Tai Chi intervention has been shown to be beneficial for balance improvement. The current study examined the effectiveness of Tai Chi to improve the dynamic postural control among older adults with mobility disability. Six sedentary older adults with mobility disability participated in a 16-week Tai Chi intervention consisting of one hour sessions three times a week. Dynamic postural control was assessed pre- and post intervention as participants initiated gait in four stepping conditions: forward; 45° medially, with the stepping leg crossing over the other leg; 45° and 90° laterally. The center of pressure (CoP) displacement, velocity, and its maximum separation distance from the center of mass in the anteroposterior, mediolateral, and resultant directions were analyzed. Results showed that in the postural phase, Tai Chi increased the CoP mediolateral excursions in the medial (13%) and forward (28%) conditions, and resultant CoP center of mass distance in the medial (9%) and forward (19%) conditions. In the locomotion phase, the CoP mediolateral displacement and velocity significantly increased after the Tai Chi intervention (both by > 100% in the two lateral conditions). These results suggest that through alteration in CoP movement characteristics, Tai Chi intervention might improve the dynamic postural control during gait initiation among older adults.

scholarly journals Gait Initiation in Community-Dwelling Adults With Parkinson Disease: Comparison With Older and Younger Adults Without the Disease

2002 ◽  
Vol 82 (6) ◽  
pp. 566-577 ◽  
Author(s):  
Matthew Martin ◽  
Mindi Shinberg ◽  
Maggie Kuchibhatla ◽  
Laurie Ray ◽  
James J Carollo ◽  
...  
Keyword(s):  
Postural Control ◽  
Parkinson Disease ◽  
Analysis Of Variance ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Community Dwelling ◽  
Quiet Standing ◽  
Gait Initiation ◽  
Younger Adults ◽  
Analysis System

Abstract Background and Purpose. Initiation of gait requires transitions from relatively stationary positions to stability with movement and from double- to single-limb stances. These are deliberately destabilizing activities that may be difficult for people with early Parkinson disease (PD), even when they have no problems with level walking. We studied differences in postural stability during gait initiation between participants with early and middle stages of PD (characterized by Hoehn and Yahr as stages 1–3) and 2 other groups of participants without PD—older and younger adults. Subjects. The mean ages of the 3 groups of participants were as follows: subjects with PD, 69.3 years (SD=5.7, range=59–78); older subjects without PD, 69.0 years (SD=3.9, range=65–79); and younger subjects without PD, 27.5 (SD=3.9, range=22–35). Methods. A 3-dimensional motion analysis system was used with 2 force platforms to obtain data for center of mass (COM) and center of pressure (COP). The distance between the vertical projections of the COM and the COP (COM–COP distance) was used to reflect postural control during 5 events in gait initiation. Results. By use of multivariate analysis of variance, differences in COM–COP distance were found among the 3 groups. An analysis of variance indicated differences for 4 of the 5 events in gait initiation. A Scheffe post hoc analysis demonstrated differences in gait initiation between the subjects with PD and both groups of subjects without PD (2 events) and between the subjects with PD and the younger subjects without PD (2 events). Discussion and Conclusion. The COM–COP distance relationship was used to measure postural control during the transition from quiet standing to steady-state gait. Differences between groups indicated that individuals with impaired postural control allow less COM–COP distance than do individuals with no known neurologic problems. The method used could prove useful in the development and assessment of interventions to improve ambulation safety and enhance the independence of people with impaired postural control.

scholarly journals Effects of additional load at different heights on gait initiation: A statistical parametric mapping of center of pressure and center of mass behavior

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0242892
Author(s):  
Marcus Fraga Vieira ◽  
Fábio Barbosa Rodrigues ◽  
Alfredo de Oliveira Assis ◽  
Eduardo de Mendonça Mesquita ◽  
Thiago Santana Lemes ◽  
...  
Keyword(s):  
Time Series ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Statistical Parametric Mapping ◽  
Gait Initiation ◽  
Experimental Conditions ◽  
Distributed Load ◽  
Uniformly Distributed Load ◽  
Reaction Forces ◽  
Controlled Object

The purpose of this study was to investigate the effects of different vertical positions of an asymmetrical load on the anticipatory postural adjustments phase of gait initiation. Sixty-eight college students (32 males, 36 females; age: 23.65 ± 3.21 years old; weight: 69.98 ± 8.15 kg; height: 1.74 ± 0.08 m) were enrolled in the study. Ground reaction forces and moments were collected using two force platforms. The participants completed three trials under each of the following random conditions: no-load (NL), waist uniformly distributed load (WUD), shoulder uniformly distributed load (SUD), waist stance foot load (WST), shoulder stance foot load (SST), waist swing foot load (WSW), and shoulder swing foot load (SSW). The paired Hotelling’s T-square test was used to compare the experimental conditions. The center of pressure (COP) time series were significantly different for the SUD vs. NL, SST vs. NL, WST vs. NL, and WSW vs. NL comparisons. Significant differences in COP time series were observed for all comparisons between waist vs. shoulder conditions. Overall, these differences were greater when the load was positioned at the shoulders. For the center of mass (COM) time series, significant differences were found for the WUD vs. NL and WSW vs. NL conditions. However, no differences were observed with the load positioned at the shoulders. In conclusion, only asymmetrical loading at the waist produced significant differences, and the higher the extra load, the greater the effects on COP behavior. By contrast, only minor changes were observed in COM behavior, suggesting that the changes in COP (the controller) behavior are adjustments to maintain the COM (controlled object) unaltered.

scholarly journals Influence of the length of institutionalization on older adults' postural balance and risk of falls: a transversal study

2014 ◽  
Vol 22 (4) ◽  
pp. 645-653 ◽  
Author(s):  
Wagner Oliveira Batista ◽  
Edmundo de Drummond Alves Junior ◽  
Flávia Porto ◽  
Fabio Dutra Pereira ◽  
Rosimere Ferreira Santana ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Postural Balance ◽  
Center Of Pressure ◽  
Berg Balance Scale ◽  
Clinical Tests ◽  
Risk Of Falls ◽  
Elliptical Area ◽  
Professional Model ◽  
Transversal Study

OBJECTIVE: to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls.METHOD: to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (α<0.05) were used.RESULTS: there was no significant correlation between the length of institutionalization and the tests for evaluation of risk of falling, neither was there difference between groups and within subgroups, stratified by length of institutionalization and age. In the stabilometric measurements, there was a negative correlation between the parameters analyzed and the length of institutionalization, and difference between groups and within subgroups.CONCLUSION: this study's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged.

Alterations in Gait Initiation Are Present in Those With Posttraumatic Ankle Osteoarthritis: A Pilot Study

2013 ◽  
Vol 29 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Erik A. Wikstrom ◽  
Robert B. Anderson
Keyword(s):  
Motor Control ◽  
Pilot Study ◽  
Postural Control ◽  
Center Of Pressure ◽  
Gait Initiation ◽  
Static Balance ◽  
Control Mechanisms ◽  
Ankle Osteoarthritis ◽  
Sf 36 ◽  
Balance Trials

The purpose of this investigation was to determine if stereotypical patterns of gait initiation are altered in those with posttraumatic ankle osteoarthritis. Ten subjects, five with unilateral ankle osteoarthritis and five uninjured controls, participated. Subjects completed the SF-36 and Ankle Osteoarthritis Scale to quantify self-reported disability as well as 10 dual-limb static stance trials and 10 gait initiation trials with each leg. Center of pressure outcomes were calculated for static balance trials while the peak center of pressure excursions were calculated for each phase of gait initiation. The results indicate greater self-reported disability (P< .05) and worse static postural control (P< .05) in the ankle osteoarthritis group. Nonstereotypical patterns were also observed during the first and third phases of gait initiation in those with ankle osteoarthritis. The results of this pilot study suggest that supraspinal motor control mechanisms may have changed in those with posttraumatic ankle osteoarthritis.

scholarly journals Comparison of Center of Pressure and Center of Mass of Gait Initiation between Children with Typical Development and Children with Diplegia

2011 ◽  
Vol 23 (3) ◽  
pp. 469-475 ◽  
Author(s):  
Soontharee Taweetanalarp ◽  
Saipin Prasertsukdee ◽  
Roongtiwa Vachalathiti ◽  
Jaranit Kaewkungwal
Keyword(s):  
Center Of Pressure ◽  
Center Of Mass ◽  
Gait Initiation ◽  
Typical Development

scholarly journals Auditory feedback alters postural control and functional ability in patients with chronic stroke

2020 ◽  
Author(s):  
Hee Sung Lim ◽  
Jiseon Ryu ◽  
Sihyun Ryu
Keyword(s):  
White Noise ◽  
Inclination Angle ◽  
Auditory Feedback ◽  
Exercise Intervention ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Effective Means ◽  
Center Of Mass ◽  
Chronic Stroke ◽  
Post Intervention

Abstract Background: This study aimed to investigate the effect of white noise on dynamic balance in patients with stroke and the pre- and post-intervention changes in dynamic balance during walking by analyzing the anterior-posterior (A-P) and medial-lateral (M-L) center of pressure (CoP) range and velocity, center of mass (CoM), and A-P/M-L inclination angle using CoM-CoP and to establish the basis for using auditory feedback as an effective means of exercise intervention by bringing changes in dynamic balance abilities of patients with chronic stroke and retain the necessary abilities for maintaining independent and functional daily living.Methods: Nineteen patients with chronic stroke (age: 61.2±9.8 years, height: 164.4±7.4 cm, weight: 61.1±9.4 kg, paretic side (R/L): 11/8, duration: 11.6±4.9 years) were included as study participants. Auditory feedback used white noise, and all participants listened for 20 minutes mixing six types of natural sounds with random sounds. The dynamic balancing ability was evaluated during the walking, and the variables were the center of pressure (CoP), the center of mass (CoM), CoP-CoM inclined angle.Results: There is a significant increase in the A-P CoP range, A-P inclination angle, and gait speed on the paretic and non-paretic sides following white noise intervention (p<.05). In addition, the changes in CoP velocity on the paretic and non-paretic sides increased in both the A-P and M-L directions but not significantly.Conclusion: Our findings confirmed the positive effect of using white noise as auditory feedback through a more objective and quantitative assessment using CoP-CoM inclination angle as an evaluation indicator for assessing dynamic balance in patients with chronic stroke. The A-P and M-L inclination angle can be employed as a useful indicator for evaluating other exercise programs and intervention methods for functional enhancement of patients with chronic stroke in terms of their effects on dynamic balance and effectiveness.

scholarly journals Automatic Quantification of Tandem Walking Using a Wearable Device: New Insights Into Dynamic Balance and Mobility in Older Adults

2020 ◽  
Vol 76 (1) ◽  
pp. 101-107
Author(s):  
Natalie Ganz ◽  
Eran Gazit ◽  
Nir Giladi ◽  
Robert J Dawe ◽  
Anat Mirelman ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Dynamic Balance ◽  
Principal Component ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Sensor Data ◽  
Quiet Standing ◽  
Mobility Disability ◽  
Community Dwelling Older Adults

Abstract Background Wearable sensors are increasingly employed to quantify diverse aspects of mobility. We developed novel tandem walking (TW) metrics, validated these measures using data from community-dwelling older adults, and evaluated their association with mobility disability and measures of gait and postural control. Methods Six hundred ninety-three community-dwelling older adults (age: 78.69 ± 7.12 years) wore a 3D accelerometer on their lower back while performing 3 tasks: TW, usual-walking, and quiet standing. Six new measures of TW were extracted from the sensor data along with the clinician’s conventional assessment of TW missteps (ie, trip other loss of balance in which recovery occurred to prevent a fall) and duration. Principal component analysis transformed the 6 new TW measures into 2 summary TW composite factors. Logistic regression models evaluated whether these TW factors were independently associated with mobility disability. Results Both TW factors were moderately related to the TW conventional measures (r &lt; 0.454, p &lt; .001) and were mildly correlated with usual-walking (r &lt; 0.195, p &lt; .001) and standing, postural control (r &lt; 0.119, p &lt; .001). The TW frequency composite factor (p = .008), but not TW complexity composite factor (p = .246), was independently associated with mobility disability in a model controlling for age, sex, body mass index, race, conventional measures of TW, and other measures of gait and postural control. Conclusions Sensor-derived TW metrics expand the characterization of gait and postural control and suggest that they reflect a relatively independent domain of mobility. Further work is needed to determine if these metrics improve risk stratification for other adverse outcomes (eg, falls and incident disability) in older adults.

scholarly journals CHARACTERISTICS OF THE GAIT INITIATION PHASE IN OLDER ADULTS WITH DIABETIC PERIPHERAL NEUROPATHY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S474-S474
Author(s):  
Gu Eon Kang ◽  
Hung Nguyen ◽  
Mohsen Zahiri ◽  
He Zhou ◽  
Changhong Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Wearable Sensors ◽  
Center Of Mass ◽  
Gait Initiation ◽  
Initiation Phase ◽  
Upright Standing ◽  
Risk Of Falls

Abstract Impairment in steady-state gait in older adults with diabetic peripheral neuropathy (OADPN) is well-known, however little attention has been paid to the gait initiation phase in which postural transitions occur from upright standing to steady-state gait. Given the risk of falls in the gait initiation phase in older adults, knowing its characteristics may be as important as steady-state gait. The aim of this study was to investigate kinematic characteristics of the gait initiation phase in OADPN compared to healthy older adults (HOA). Thirteen OADPN (72.9±6.1 years; 33.0±4.8 kg/m2), and 11 HOA (71.8±2.7 years; 26.5±4.3 kg/m2; no cardiovascular, neurological or orthopedic condition, no history of falling) performed gait on level ground for minimum 10 meters at self-selected comfortable speed. We collected kinematic data using five wearable sensors (LEGSysTM, BioSensics LLC, Watertown, MA) attached on the shanks, thighs and lower back. We used previously validated algorithm to analyze kinematic parameters for the gait initiation phase. Our statistical model showed that the number of steps, stride velocity, gait cycle time, double limb support and mediolateral center-of-mass sway during the gait initiation phase is significantly different between HOA (2.4±0.7 steps; 1.16±0.15 m/s; 1.12±0.10 seconds; 20.3±4.8%; 4.0±1.5°, respectively) and OADPN (4.0±2.1 steps; 0.92±0.29 m/s; 1.23±0.12 seconds; 29.2±10.3%; 7.0±2.9°, respectively) (all p&lt;0.05). The results suggest that OADPN take more, slower and more unstable steps to reach steady-state gait from upright standing compared to HOA. The results also provide implications for needs to develop new interventions targeting the gait initiation phase in OADPN.

POSTURE CONTROL AND BALANCE DURING TAI CHI CHUAN PUSH HANDS MOVEMENTS IN A FIXED STANCE

2012 ◽  
Vol 12 (05) ◽  
pp. 1250030 ◽  
Author(s):  
LIN-HWA WANG ◽  
KUO-CHENG LO ◽  
FONG-CHIN SU
Keyword(s):  
Tai Chi ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Reaction Force ◽  
Whole Body ◽  
Expert Group ◽  
Tai Chi Chuan ◽  
Kinematic Data ◽  
Analysis System ◽  
Force Data

The present study investigated the adequacy of the interaction between the center of mass (COM) and the center of pressure (COP) for maintaining dynamic stability during Tai Chi Chuan (TCC) Push Hands movements in a fixed stance. The COM of the whole body and COP were calculated. Four TCC experts, with 10.3 ± 1.7 years' experience in the Push Hands technique, and 4 TCC beginners, with 2.5 ± 1.3 years' Push Hands experience, were recruited. An Expert Vision Eagle motion analysis system collected kinematic data and 4 Kistler force plates collected the ground reaction force data. The expert group of TCC practitioners showed a significantly more vertical (P = 0.001) direction in the neutralizing circle, and significantly larger values for anterior–posterior (A–P) (P = 0.006) and vertical (P = 0.0004) displacement in the enticing circle, than the beginner group. Compared with the beginner group, the expert group demonstrated significantly greater velocity A–P (P = 0.001) and vertical (P = 0.001) COM displacements in the enticing circle. A significant extent main effect (P = 0.0028) was observed for the COPA–P excursion between the expert and beginner groups during Push Hands movements. The greater A–P force generated by both groups during the initiation of the Push Hands cycle probably reflects the more rapid and forward-oriented nature of this movement. The TCC beginners might have difficulties with movement transfers because of disruptions in the temporal sequencing of the forces. Overall, results indicated that the initial experience-related differences in COM transfers are reflected in the Push Hands movement cycle.

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