scholarly journals Ability of the Four-square Step Test to Predict Falls among Community-dwelling Frail Elderly

2016 ◽  
Vol 31 (4) ◽  
pp. 615-620
Author(s):  
Isao SUGETA ◽  
Kazuhiro HARADA ◽  
Chie HORIKAWA ◽  
Yuki WATANABE ◽  
Chika SUZUKI ◽  
...  
2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Robert Webb ◽  
Luis Eduardo Cofré Lizama ◽  
Mary P. Galea

Objective. To investigate the effects of Feldenkrais Method classes on gait, balance, function, and pain in people with osteoarthritis.Design. Prospective study with pre-/postmeasures.Setting. Community.Participants. Convenience sample of 15 community-dwelling adults with osteoarthritis (mean age 67 years) attending Feldenkrais Method classes.Intervention. Series of Feldenkrais Method classes, two classes/week for 30 weeks. Main outcome measures: Western Ontario and McMaster Universities osteoarthritis scale, Human Activity Profile, stair climbing test, 6-minute walk test, timed up-and-go test, Four Square Step Test (4SST), gait analysis, and assessment of quality of life (AQoL).Results. Participants improved on the 4SST and on some gait parameters. They also reported a greater ease of movement.Conclusions. A 30-week series of Feldenkrais classes held twice per week was feasible in the community setting. The lessons led to improvements in performance of the four square step test and changes in gait.


Author(s):  
Moshe M. H. Aharoni ◽  
Anat V. Lubetzky ◽  
Liraz Arie ◽  
Tal Krasovsky

Abstract Background Persistent postural-perceptual dizziness (PPPD) is a condition characterized by chronic subjective dizziness and exacerbated by visual stimuli or upright movement. Typical balance tests do not replicate the environments known to increase symptoms in people with PPPD—crowded places with moving objects. Using a virtual reality system, we quantified dynamic balance in people with PPPD and healthy controls in diverse visual conditions. Methods Twenty-two individuals with PPPD and 29 controls performed a square-shaped fast walking task (Four-Square Step Test Virtual Reality—FSST-VR) using a head-mounted-display (HTC Vive) under 3 visual conditions (empty train platform; people moving; people and trains moving). Head kinematics was used to measure task duration, movement smoothness and anterior–posterior (AP) and medio-lateral (ML) ranges of movement (ROM). Heart rate (HR) was monitored using a chest-band. Participants also completed a functional mobility test (Timed-Up-and-Go; TUG) and questionnaires measuring anxiety (State-Trait Anxiety Inventory; STAI), balance confidence (Activities-Specific Balance Confidence; ABC), perceived disability (Dizziness Handicap Inventory) and simulator sickness (Simulator Sickness Questionnaire). Main effects of visual load and group and associations between performance, functional and self-reported outcomes were examined. Results State anxiety and simulator sickness did not increase following testing. AP-ROM and HR increased with high visual load in both groups (p < 0.05). There were no significant between-group differences in head kinematics. In the high visual load conditions, high trait anxiety and longer TUG duration were moderately associated with reduced AP and ML-ROM in the PPPD group and low ABC and  high perceived disability were associated with reduced AP-ROM (|r| =  0.47 to 0.53; p < 0.05). In contrast, in controls high STAI-trait, low ABC and longer TUG duration were associated with increased AP-ROM (|r| = 0.38 to 0.46; p < 0.05) and longer TUG duration was associated with increased ML-ROM (r = 0.53, p < 0.01). Conclusions FSST-VR may shed light on movement strategies in PPPD beyond task duration. While no main effect of group was observed, the distinct associations with self-reported and functional outcomes, identified using spatial head kinematics, suggest that some people with PPPD reduce head degrees of freedom when performing a dynamic balance task. This supports a potential link between spatial perception and PPPD symptomatology.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038203
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J Dijkstra ◽  
Barbara C van Munster ◽  
Sophia De Rooij

ObjectivesTo support the shift from disease-oriented towards goal-oriented care, we aimed to develop a tool which is capable both to identify priorities of an individual older hospitalised patient and to measure the outcomes relevant to him.DesignMixed-methods design with open interviews, three step test interviews (TSTIs) and a quantitative field test.SettingUniversity teaching hospital and a regional teaching hospital.ParticipantsHospitalised patients ages 70 years and older.ResultsThe Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) consists of a baseline questionnaire and an evaluation questionnaire. Items were based on 15 qualitative interviews with hospitalised older patients. Feedback from a panel of four community-dwelling older persons resulted in some adaptations to wording and one additional item. Twenty-six hospitalised older patients participated in TSTIs with Version 1 of the baseline questionnaire, revealing indications for a good content validity and barriers in completion behaviour, global understanding and understanding of individual items, which were solved with several adaptations. Four additions were made by participants. After TSTIs with ten patients with the evaluation questionnaire, one adaptation was made. A field test with 91 hospitalised older patients revealed a small number of missing values.To enhance the feasibility, the number of items was reduced from 32 to 22, based on correlations and mean impact score. The field test was repeated with 104 other patients in a regional teaching hospital. To enhance the understanding, the tool was split into two phases. This version was tested with TSTIs with eight patients and appeared to be understandable. The final version was an interview-based tool and took about 11 min to complete.ConclusionsThe P-BAS HOP is a potentially suitable tool to identify priorities and relevant outcomes of the individual patient. Further research is needed to investigate its validity, reliability and responsiveness.


2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 518-518
Author(s):  
H Mutchie ◽  
D Orwig ◽  
B Beamer ◽  
V Conroy ◽  
J Guralnik ◽  
...  
Keyword(s):  

Author(s):  
Kristina Zaičenkovienė ◽  
Renata Rakovaitė

Research background. Falling is one of the most important problems in the elderly’s mobility disorder, which is most often affected by the loss of balance. It is known that Pilates exercises could help to increase the deep muscle strength, improve posture and proprioception, which affects the improvement of the balance. Objective – to evaluate the effects of Pilates exercises on the elderly’s static and dynamic balance. Methodology. The study population consisted of 20 volunteers, men and women, who were divided into Pilates exercises (n = 10, age 65.1 ± 2.6) and control (n = 10, age 68.6 ± 4.9) groups. The study group participated in Pilates classes 2 times per week for six weeks (session duration 60 minutes). The control group did not participate in any physical activity, but they were physically active as usually in their daily life. The main outcome measures were assessed before and after the intervention. The static balance was assessed by measuring posturographic parameters using the force platform, dynamic balance was measured with the Timed up and Go Test (TUG) and the Four Square Step Test (FSST). Results. The results showed signifcant improvement in static balance of the experimental group after the Pilates exercises during standing tests when the feet were apart, eyes opened and closed and when the feet together with eyes opened, and when the foot was in front of the other foot. The results of the control group did not differ during both tests. The results of both groups did not differ in the static balance tests before and after the study, but after the Pilates exercises, the results of the Pilates group signifcantly differed from the control group test results when the feet were in shoulder line with open eyes. The results of the dynamic balance after Pilates exercises signifcantly improved in both tests in the study group. Before the study, there were not statistically signifcant differences in the dynamic balance results between the groups. Conclusions. Six-week Pilates exercises had a positive effect on the elderly’s static and dynamic balance.Keywords: Pilates training, static balance, dynamic balance.


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Tomohiro Nishimura ◽  
Atsushi Hagio ◽  
Kanako Hamaguchi ◽  
Toshiyuki Kurihara ◽  
Motoyuki Iemitsu ◽  
...  

Abstract Background Locomotive syndrome (LS) is a condition of reduced mobility due to a disorder of the locomotive system. Increasing moderate to vigorous physical activity (MVPA) has been recommended to prevent LS. However, to increase daily MVPA is difficult for older people with LS. The MVPA consists of not only locomotive activities such as walking but also non-locomotive activities such as household activities. The aim of this study was to examine the associations between locomotive/non-locomotive MVPA and physical performance in older females with and without LS. Methods Participants of this cross-sectional study were 143 older community-dwelling Japanese females. The participants were divided into two groups based on the results of the stand-up test: the normal group (NL) (n = 86) and the LS group (n = 57). Both the locomotive and non-locomotive PA seperately measured with its intensity. The intensity of physical activity (PA) was calculated as METs and classified as sedentary behavior (SB 1–1.5 metabolic equivalent tasks (METs)), low-intensity physical activity (LPA 1.6–2.9 METs), and MVPA (≥ 3 METs). For example, locomotive LPA is slow walking speed of 54 m/min, and locomotive MVPA is walking speed of 67 m/min. While non-locomotive LPA is office work and cooking, non-locomotive MVPA is housecleaning. Physical function was evaluated by handgrip strength, walking speed, and 2-step test. Results Walking speed, hand-grip strength, 2-step test, daily step counts, and all PA measurements were not significantly different between two groups. In the LS, locomotive MVPA (r = 0.293, p < 0.05) and total MVPA (r = 0.299, p < 0.05) was significantly correlated with walking speed, but not in the NL. Conclusions Walking speed was positively correlated with locomotive MVPA and total MVPA in the LS group, but not in NL group. This result suggests that slow walking speed in older people with LS occur in connection with lower locomotive MVPA and total MVPA.


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