Investigating Relationships between Balance Confidence and Balance Ability in Older Adults

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

PLoS ONE ◽

10.1371/journal.pone.0255780 ◽

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.

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Chinese Martial Art Training Failed to Improve Balance or Inhibit Falls in Older Adults

Perceptual and Motor Skills ◽

10.1177/0031512518824945 ◽

2019 ◽

Vol 126 (3) ◽

pp. 389-409 ◽

Cited By ~ 1

Author(s):

Ada W. W. Ma ◽

Hsing-Kuo Wang ◽

Duan-Rung Chen ◽

Ya-Mei Chen ◽

Yvonne T. C. Chak ◽

...

Keyword(s):

Older Adults ◽

Outcome Measures ◽

Muscle Activation ◽

Community Dwelling ◽

Peak Force ◽

Control Group ◽

Balance Performance ◽

Balance Confidence ◽

Martial Art ◽

Knee Flexors

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.

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The short version of the Activities-specific Balance Confidence (ABC) scale: Its validity, reliability, and relationship to balance impairment and falls in older adults

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2009.06.003 ◽

2010 ◽

Vol 51 (1) ◽

pp. 9-12 ◽

Cited By ~ 64

Author(s):

Stacey Schepens ◽

Allon Goldberg ◽

Melissa Wallace

Keyword(s):

Older Adults ◽

Short Version ◽

Balance Impairment ◽

Balance Confidence ◽

Falls In Older Adults ◽

Abc Scale

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Effects of Balance Training on Balance Performance in Healthy Older Adults: A Systematic Review and Meta-analysis

Sports Medicine ◽

10.1007/s40279-015-0375-y ◽

2015 ◽

Vol 45 (12) ◽

pp. 1721-1738 ◽

Cited By ~ 102

Author(s):

Melanie Lesinski ◽

Tibor Hortobágyi ◽

Thomas Muehlbauer ◽

Albert Gollhofer ◽

Urs Granacher

Keyword(s):

Systematic Review ◽

Older Adults ◽

Meta Analysis ◽

Balance Training ◽

Balance Performance ◽

Healthy Older Adults

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Concurrent and Discriminative Validity of the Mini Balance Evaluation Systems Test (miniBESTest) in People with Parkinson's Disease

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-26-2-43 ◽

2015 ◽

Vol 26 (2) ◽

pp. 43-48

Author(s):

Margaret KY Mak

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Healthy Subjects ◽

Balance Performance ◽

Discriminative Validity ◽

Evaluation Systems ◽

Balance Confidence ◽

Analysis Laboratory ◽

Abc Scale ◽

The University

Abstract Purpose To examine the concurrent and discriminative validity of the miniBESTest in individuals with Parkinson's disease (PD). Method Thirty-four individuals with PD participated in study 1. Thirty-one healthy subjects and 127 individuals with PD completed study 2. All participants were assessed at the University Balance and motion analysis laboratory. Balance performance was assessed using the miniBESTest and Berg's balance scale (BBS). Self-perceived balance confidence level of subjects was measured by the activities-specific balance confidence (ABC) scale. Results In study 1, results of Pearson's correlation showed that the scores of the miniBESTest correlated well with BBS (r=0.765; p<0.001) and moderately well with ABC scores (r=0.587; p<0.001). For study 2, results of one-way analysis of variance demonstrated significant differences in miniBESTest scores among healthy subjects, PD non-fallers (PD-NF) and PD fallers (PD-F). Healthy subjects obtained the highest mini-BESTest score of 88.2 ± 8.9%, followed by PD-NF (73.6 ± 14.7%) and PDF (57.1 ± 17.0%) (all p<0.001). Significant differences were also observed among healthy subjects, PD-NF and PD-F for each miniBESTest domain score (all p<0.05). Conclusion The miniBESTest is a valid method to document balance performance in individuals with PD. Both total and domain miniBESTest scores could differentiate between healthy subjects, PD-NF and PD-F.

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Comparing the short and original versions of the Activities-specific Balance Confidence (ABC) scale in older adults

Innovation in Aging ◽

10.1093/geroni/igab046.2891 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 790-790

Author(s):

Chad Tiernan ◽

Allon Goldberg

Keyword(s):

Older Adults ◽

Correlation Coefficient ◽

Strong Association ◽

Secondary Analysis ◽

Community Dwelling ◽

Tool Selection ◽

Balance Confidence ◽

Confidence Assessment ◽

Abc Scale ◽

Primary Predictor

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<.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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Balance training with multi-task exercises improves fall-related self-efficacy, gait, balance performance and physical function in older adults with osteoporosis: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215514544983 ◽

2014 ◽

Vol 29 (4) ◽

pp. 365-375 ◽

Cited By ~ 44

Author(s):

Alexandra Halvarsson ◽

Erika Franzén ◽

Agneta Ståhle

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Physical Function ◽

Self Efficacy ◽

Controlled Trial ◽

Balance Training ◽

Balance Performance ◽

Randomized Controlled

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75 Functional Mobility and Balance Confidence as Correlates of Fall Risk in Older Adults Attending a Primary Health Care Clinic

Age and Ageing ◽

10.1093/ageing/afz164.75 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Pavapriya Ponvel ◽

Devinder Kaur Ajit Singh ◽

Ee San Ng ◽

Sheela Bai Pannir Selvam

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Fall Risk ◽

Functional Mobility ◽

Care Clinic ◽

Balance Confidence ◽

Primary Health Care Clinic ◽

Primary Health ◽

Abc Scale

Abstract Background Fall is one of the leading cause of unintentional injury among older adults. Information regarding functional mobility and balance confidence as correlates of fall risk in older adults attending a primary health care clinic is limited. This information is vital for fall screening and prevention. We aimed to examine if functional mobility and balance confidence were correlates of fall risk in older adults attending a primary health care clinic. Methods 106 older adults (≥60 years old) attending a primary health care clinic at Cheras, Malaysia participated in this cross-sectional study. Socio-demographic details and falls history were obtained using a structured questionnaire. Functional mobility and balance confidence were assessed using Timed Up and Go (TUG) test and Activities-Specific Balance Confidence (ABC) scale respectively. Fallers were categorised based on history of at least a fall in the past 12 months. Differences between faller and non-faller groups were distinguished using Independent T and Mann Whitney tests. Binomial logistic regression and receiver operating curve were performed to identify if functional mobility and balance confidence were correlates of falls risk and the cut off values for measures were obtained. Results TUG test and ABC scores differed significantly between the two groups (p< 0.05). Both TUG test and ABC scale were identified as correlates of falls risk with r, R2 of 0.98, 0.26 (p< 0.001) and 0.95, 0.12 (p< 0.05) respectively. Cut off value of 9.02 seconds and above for TUG test and 82.81% and below for ABC score were identified as risk factor of falls among older adults. Conclusion The cut off values obtained from our study can be used as reference to screen older adults at risk of falls in Malaysian primary health care settings. Early fall risk screening and management is a part of falls prevention strategy in older adults.

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