scholarly journals Sensory Sub- and Suprathreshold TENS Exhibit No Immediate Effect on Postural Steadiness in Older Adults with No Balance Impairments

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Darja Rugelj ◽  
Marko Vidovič ◽  
Renata Vauhnik
Keyword(s):  
Older Adults ◽  
Postural Sway ◽  
Community Dwelling ◽  
Electrode Placement ◽  
Future Research ◽  
Conscious Perception ◽  
Time Intervals ◽  
Plantar Surface ◽  
Eyes Closed ◽  
Eyes Open

Transcutaneous electrical nerve stimulation (TENS) has been reported to attenuate postural sway; however, the results are inconclusive, with some indicating the effect and others not. The study aimed to evaluate the effect of sensory sub- and suprathreshold low-frequency TENS applied through the plantar surface and posterior aspect of shanks on postural sway. In a group of healthy community-dwelling older adults, TENS was delivered with two different current intensities: (1) subsensory which is below conscious perception and (2) suprasensory threshold which is within the range of conscious perception. Frequencies of the TENS stimulation were sweeping from 5 to 180 Hz and were delivered through the plantar surface and posterior shanks of both legs. Postural sway was measured with a force platform in eyes-open and eyes-closed conditions. To evaluate potential fast adaptability to TENS stimuli, the results were evaluated in two time intervals: 30 seconds and 60 seconds. The results indicated that TENS with the chosen frequencies and electrode placement did not affect postural sway in both the sub- and suprathreshold intensities of TENS, in eyes-open and eyes-closed conditions, and in 30-second and 60-second time intervals. In conclusion, given that in this study sub- and suprathreshold TENS applied via the plantar surface of the feet did not attenuate postural sway, it would be easy to conclude that this type of electrical stimuli is ineffective and no further research is required. We must caution against this, given the specificity of the electrode placements. We recommend that future research be performed consisting of individuals with balance impairments and with different positions of electrodes.

scholarly journals Postural Balance Effects Associated with 400, 4000 or 10,000 IU Vitamin D3 Daily for Three Years: A Secondary Analysis of a Randomized Clinical Trial

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 527 ◽  
Author(s):  
Lauren A. Burt ◽  
Leigh Gabel ◽  
Emma O. Billington ◽  
David A. Hanley ◽  
Steven K. Boyd
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Vitamin D3 ◽  
Postural Sway ◽  
Secondary Analysis ◽  
Vitamin D Supplementation ◽  
Community Dwelling ◽  
High Dose ◽  
Eyes Closed ◽  
Eyes Open

Vitamin D supplementation is proposed as a fall prevention strategy, as it may improve neuromuscular function. We examined whether three years of vitamin D supplementation (400, 4000 or 10,000 IU daily) affects postural sway in older adults. Three hundred and seventy-three non-osteoporotic, vitamin D-sufficient, community-dwelling healthy adults, aged 55–70 years, were randomized to 400 (n = 124), 4000 (n = 125) or 10,000 (n = 124) IU daily vitamin D3 for three years. Sway index was assessed at baseline, 12-, 24- and 36-months using the Biosway machine. We tested participants under four conditions: eyes open or eyes closed with firm (EOFI, ECFI) or foam (EOFO, ECFO) surfaces. Secondary assessments examined sway in the anterior-posterior (AP) and medio-lateral (ML) directions. Linear mixed effects models compared sway between supplementation groups across time. Postural sway under EOFO and ECFO conditions significantly improved in all supplementation groups over time. Postural sway did not differ between supplementation groups at any time under any testing conditions in normal, AP or ML directions (p > 0.05 for all). Our findings suggest that high dose (4000 or 10,000 IU) vitamin D supplementation neither benefit nor impair balance compared with 400 IU daily in non-osteoporotic, vitamin D-sufficient, healthy older adults.

scholarly journals Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Niklas Sörlén ◽  
Andreas Hult ◽  
Peter Nordström ◽  
Anna Nordström ◽  
Jonas Johansson
Keyword(s):  
Older Adults ◽  
Postural Sway ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Eyes Closed ◽  
Balance Exercise

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.

scholarly journals POSTURAL SWAY IN LOWER EXTREMITY AMPUTEES AND OLDER ADULTS MAY SUGGEST INCREASED FALL RISK IN AMPUTEES

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Hamid Bateni
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Lower Extremity ◽  
Frequency Domain ◽  
Visual Information ◽  
Fall Risk ◽  
Postural Sway ◽  
Proprioceptive Information ◽  
Eyes Closed ◽  
Eyes Open

BACKGROUND: Falls can be detrimental to overall health and quality of life for lower extremity amputees. Most previous studies of postural steadiness focus on quantification of time series variables extracted from postural sway signals. While it has been suggested that frequency domain variables can provide more valuable information, few current studies have evaluated postural sway in amputees using frequency domain variables. OBJECTIVE: To determine time and frequency domain variables of postural sway among lower extremity amputees vs. healthy young and older adult controls. METHODOLOGY: Participants were assigned to 3 groups:  lower extremity amputation (n=6), healthy young adults (n=10), and healthy older adults (n=10). Standing barefoot on a force platform, each individual completed 3 trials of each of 3 standing conditions: eyes open, eyes closed, and standing on a foam balance pad. Time and frequency domain variables of postural sway were computed and analyzed. RESULTS: Comparison of older adults, younger adults, and amputees on the three conditions of standing eyes open, eyes closed, and on foam revealed significant differences between groups. Mean mediolateral (ML) sway distance from the center of pressure (COP), total excursions and sway velocity was significantly higher for amputees and older adults when compared to young adults (p<0.05). Furthermore, power of sway signal was substantially lower for both amputees and older adults. When compared to that of older adults, postural steadiness of amputees was more affected by the eyes closed condition, whereas older adults’ was more affected when sensory and proprioceptive information was perturbed by standing on foam.  CONCLUSION: Our findings showed that fall risk is greater in amputees than in young adults without amputation. Additionally, amputees may rely more heavily on visual information than proprioceptive information for balance, in contrast to older and young adults without amputation.  Layman's Abstract Falls can be detrimental to overall health and quality of life for lower extremity amputees. We evaluated postural sway and concluded that amputees have an increased fall risk and may rely more heavily on visual information for balance than do individuals without amputation. Article PDF Link:https://jps.library.utoronto.ca/index.php/cpoj/article/view/33804/26600 How To Cite: Bateni H. Postural sway in lower extremity amputees and older adults may suggest increased fall risk in amputees. Canadian Prosthetics & Orthotics Journal. 2020;Volume 3, Issue 2, No.4. https://doi.org/10.33137/cpoj.v3i2.33804 Corresponding Author: Hamid Bateni, PhD Physical Therapy Program, School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois, USA.E-mail: [email protected]: https://orcid.org/0000-0001-9083-1817

Postural-Sway Responses in Learning-Disabled Children: Pilot Data

1987 ◽  
Vol 7 (1) ◽  
pp. 37-51 ◽  
Author(s):  
H. J. Polatajko ◽  
Theresa Sullivan
Keyword(s):  
Postural Sway ◽  
Normal Subjects ◽  
Learning Disabled ◽  
Future Research ◽  
Eyes Closed ◽  
Significant Difference ◽  
Eyes Open ◽  
Posterior Direction ◽  
Independent Variable ◽  
Anterior Posterior

This investigation examined the postural-sway response of a matched group of learning-disabled and normal subjects. The subjects were evaluated on a force platform both with their eyes open and with their eyes closed. Four dependent variables, the measures of sway, were subjected to multivariate analysis of variance (MANOVA), with group as the independent variable. The analysis revealed F= 4.25 ( p <.07). The Univariate F test revealed Root Mean Square Y (EC) to be significant at p <. 002. A t test revealed Romberg Y to be significant at p <. 026. The results indicated a significant difference in postural sway between the two groups. The learning-disabled group appeared to be using visual input to compensate for postural problems and experiencing significant difficulty controlling posture in an anterior/posterior direction, especially with their eyes closed. Limitations of the study are discussed, and implications for occupational therapy and future research are outlined.

scholarly journals Foot Problems in Older Adults

2018 ◽  
Vol 108 (2) ◽  
pp. 126-139 ◽  
Author(s):  
Amy Muchna ◽  
Bijan Najafi ◽  
Christopher S. Wendel ◽  
Michael Schwenk ◽  
David G. Armstrong ◽  
...  
Keyword(s):  
Older Adults ◽  
Peripheral Neuropathy ◽  
Motor Performance ◽  
Fear Of Falling ◽  
Center Of Mass ◽  
Community Dwelling ◽  
Lower Percentage ◽  
Wearable Sensor ◽  
Eyes Open ◽  
Foot Problems

Background:Research on foot problems and frailty is sparse and could advance using wearable sensor–based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults.Methods:Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies.Results:Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) = 2.0], and 95% in frail [OR = 8.3]; P = .03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day.Conclusions:Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.

scholarly journals Altering Visual Feedback Conditions Impacts Postural Sway Performance in Children After Controlling for Body Mass Index and Habitual Physical Activity

2017 ◽  
Vol 5 (2) ◽  
pp. 267-279 ◽  
Author(s):  
Michael Duncan ◽  
Elizabeth Bryant ◽  
Mike Price ◽  
Samuel Oxford ◽  
Emma Eyre ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
Visual Feedback ◽  
Postural Sway ◽  
Habitual Physical Activity ◽  
Eyes Closed ◽  
Computerized Posturography ◽  
Eyes Open ◽  
Anterior Posterior

This study examined postural sway in children in eyes open (EO) and eyes closed (EC) conditions, controlling for body mass index (BMI) and physical activity (PA). Sixty two children (aged 8–11years) underwent sway assessment using computerized posturography from which 95% ellipse sway area, anterior/posterior (AP) sway, medial/lateral (ML) sway displacement and sway velocity were assessed. Six trials were performed alternatively in EO and EC. BMI (kg/m2) was determined from height and mass. PA was determined using sealed pedometry. AP amplitude (p = .038), ML amplitude (p = .001), 95% ellipse (p = .0001), and sway velocity (p = .012) were higher in EC compared with EO conditions. BMI and PA were not significant as covariates. None of the sway variables were significantly related to PA. However, sway velocity during EO (p = .0001) and EC (p = .0001) was significantly related to BMI. These results indicate that sway is poorer when vision is removed, that BMI influences sway velocity, but that pedometer-assessed PA was not associated with postural sway.

Contribution of Somatosensory and Parietal Association Areas in Improving Standing Postural Stability Through Standing Plantar Perception Training in Community-Dwelling Older Adults

2020 ◽  
pp. 1-10
Author(s):  
Satoshi Matsuno ◽  
Takuya Yoshiike ◽  
Atsushi Yoshimura ◽  
Sachiyo Morita ◽  
Yusuke Fujii ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Stability ◽  
Near Infrared ◽  
Postural Sway ◽  
Cortical Activity ◽  
Community Dwelling ◽  
Training Outcomes ◽  
Before And After ◽  
Association Area ◽  
Perception Training

Although standing plantar perception training (SPPT) may improve standing postural stability, the underlying neural mechanisms remain unclear. The authors investigated the relationship between regional cortical responses to SPPT using a balance pad and training outcomes in 32 older participants (mean ± SD:72.2 ± 6.0, range:60–87). Regional cortical activity was measured in the bilateral supplementary motor area, primary sensorimotor area, and parietal association area using near-infrared spectroscopy. Postural sway changes were compared before and after SPPT. Changes in two-point plantar discrimination and regional cortical activity during SPPT, associated with standing postural stability improvements, were examined using multiple regression and indicated improved standing postural stability after SPPT (p < .0001). Changes in right parietal association area activity were associated with standing postural stability improvements while barefoot. Overall, the results suggest that right parietal association area activation during SPPT plays a crucial role in regulating standing postural stability and may help develop strategies to prevent older adults from falling.

scholarly journals Reactive Postural Responses to Continuous Yaw Perturbations in Healthy Humans: The Effect of Aging

Sensors ◽  
2019 ◽  
Vol 20 (1) ◽  
pp. 63 ◽  
Author(s):  
Ilaria Mileti ◽  
Juri Taborri ◽  
Stefano Rossi ◽  
Zaccaria Del Prete ◽  
Marco Paoloni ◽  
...  
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Center Of Mass ◽  
Community Dwelling ◽  
Body Segments ◽  
Healthy Humans ◽  
Eyes Closed ◽  
Age Related ◽  
Postural Responses ◽  
Mass Displacement

Maintaining balance stability while turning in a quasi-static stance and/or in dynamic motion requires proper recovery mechanisms to manage sudden center-of-mass displacement. Furthermore, falls during turning are among the main concerns of community-dwelling elderly population. This study investigates the effect of aging on reactive postural responses to continuous yaw perturbations on a cohort of 10 young adults (mean age 28 ± 3 years old) and 10 older adults (mean age 61 ± 4 years old). Subjects underwent external continuous yaw perturbations provided by the RotoBit1D platform. Different conditions of visual feedback (eyes opened and eyes closed) and perturbation intensity, i.e., sinusoidal rotations on the horizontal plane at different frequencies (0.2 Hz and 0.3 Hz), were applied. Kinematics of axial body segments was gathered using three inertial measurement units. In order to measure reactive postural responses, we measured body-absolute and joint absolute rotations, center-of-mass displacement, body sway, and inter-joint coordination. Older adults showed significant reduction in horizontal rotations of body segments and joints, as well as in center-of-mass displacement. Furthermore, older adults manifested a greater variability in reactive postural responses than younger adults. The abnormal reactive postural responses observed in older adults might contribute to the well-known age-related difficulty in dealing with balance control during turning.

Validation of a Portable Force Plate for Evaluating Postural Sway

2020 ◽  
pp. 003151252094509
Author(s):  
Mark Walsh ◽  
Caroline Church ◽  
Audrey Hoffmeister ◽  
Dean Smith ◽  
Joshua Haworth
Keyword(s):  
Postural Sway ◽  
Center Of Pressure ◽  
Intraclass Correlation ◽  
Force Plate ◽  
Disease Status ◽  
Community Dwelling ◽  
Sport Training ◽  
Eyes Open ◽  
Ground Plate ◽  
Absolute Agreement

Measurements of postural sway are used to assess physiological changes due to therapy or sport training, or to describe group differences based on activity history or disease status. Portable force plates have been widely adopted for this purpose, leading us in this study to validate with linear and nonlinear metrics the posturographic data derived from both a portable plate (Natus) when compared to an in-ground plate (Bertec). Twenty participants stood on each plate for two trials each, with and without a foam perturbation and with and without eyes open on each surface. We calculated measures of path length, range, root mean squares, sample entropy, and correlation dimensions from center of pressure traces on each plate. An intraclass correlation coefficient across trials from each plate in each condition indicated satisfactory overall reliability (ICC consistency), supporting the use of either plate for postural sway research and interventions. Additionally, our results generally supported common validity (ICC absolute agreement), though, the specific degree of similarity differed for each of the tested metrics of postural sway, especially when considering whether or not data was filtered. For situations in which participants cannot visit a laboratory (e.g. performing athletes, community dwelling clinical patients, and virus risk concerns) an in-home portable force plate is a trusted and valuable data collection tool.

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