Balance confidence and activity of community-dwelling patients with transtibial amputation

This study examined gender differences in balance, gait, and muscle performance in seniors and identified gender-specific factors contributing to physical performance. Forty (20 men, 20 women) healthy, community-dwelling seniors (74.5 ± 5.3 years) participated. Limits of stability, gait speed, lower limb flexor and extensor isokinetic concentric peak torques, self-reported activity level, and balance confidence were measured. No gender differences were detected in gait speed, limits of stability when normalized to height, activity level, or balance confidence (p≥ .188). Women were weaker than men (p≤ .007), even after controlling for weight and body-mass index, suggesting that other gender-related factors contribute to strength. Gender accounted for 18–46% of the variance in strength and served as a modifier of the relationship between activity level and strength in some muscle groups. The primary factors relating to gender-specific strength was activity level in men and body weight in women.

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90 Falls Efficacy Related Instruments for Community-Dwellig Older Adults – Development and Content Validity: A Cosmin-Based Systematic Review

Age and Ageing ◽

10.1093/ageing/afz164.90 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27 ◽

Cited By ~ 1

Author(s):

Shawn Leng-Hsien Soh ◽

Chee-Wee Tan ◽

Lane Judith ◽

Nigel Gleeson ◽

Tim Xu

Keyword(s):

Older Adults ◽

Content Validity ◽

Community Dwelling ◽

High Quality ◽

Structural Validity ◽

Balance Confidence ◽

High Quality Evidence ◽

Community Dwelling Older Adults ◽

Quality Evidence ◽

Selection Of

Abstract Background Falls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. Empirical evidence is needed to justify the selection of a specific instrument to measure the intended construct. Objectives To summarize evidence on the development, content validity and structural validity of instruments measuring falls efficacy in community-dwelling older adults using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Study Design and Setting MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology guided the review of eligible studies and methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesized. A modified GRADE approach was applied to evidence synthesis. Results 35 studies on 18 instruments were included in the review. High quality evidence showed that modified Falls-Efficacy Scale (FES)–13 items (mFES-13) is relevant but not comprehensive for measuring falls efficacy. Moderate quality evidence supported the FES-10 had sufficient relevance and the mFES-14 had sufficient comprehensibility. Only the Activities-specific Balance Confidence (ABC) Scale–Simplified (ABC-15) had sufficient relevance of moderate quality evidence to measure balance confidence. Low to very low quality evidence underpinned content validity of other instruments. High quality evidence supported sufficient unidimensionality for eight instruments (FES-10, mFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES–International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)). Conclusion Content validity of the instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate the broader continuum of falls efficacy.

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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 role of attentional focus on walking efficiency among older fallers and non-fallers

Age and Ageing ◽

10.1093/ageing/afz113 ◽

2019 ◽

Vol 48 (6) ◽

pp. 811-816 ◽

Cited By ~ 3

Author(s):

Toby C T Mak ◽

William R Young ◽

Wing-Kai Lam ◽

Andy C Y Tse ◽

Thomson W L Wong

Keyword(s):

Older Adults ◽

Behavioural Change ◽

Attentional Focus ◽

Community Dwelling ◽

Thigh Muscle ◽

Balance Confidence ◽

Functional Balance ◽

History Of ◽

And Control ◽

Community Dwelling Older Adults

Abstract Background This study evaluated the effect of attentional focus instructions on movement efficiency during a level-ground walking task in older adults with and without a history of falls. Methods One hundred and thirty-four community-dwelling older adults were categorised into older fallers (OF) (n = 37) and older non-fallers (ONF) (n = 97). Each participant was instructed to walk at a self-selected pace along a 6 m walkway under three attentional focus conditions (i.e. internal, goal-directed and control) for a total of nine trials. Average muscle activity indices of lower limb co-contractions were measured using surface electromyography. Results Both shank and thigh muscle co-contractions were higher in OF than in ONF in all three conditions. OF also demonstrated higher shank muscle co-contraction under the internal relative to the goal-directed condition, with no such change observed in ONF. Conclusion Despite no significant between-group differences in functional balance and balance confidence, relative walking inefficiencies were observed in OF compared with ONF. This finding demonstrates the debilitating consequences of falling that can occur with relative independence from various physiological or psychological factors that are commonly associated with falling and used to rationalise behavioural change. We also provide evidence that OF are more susceptible to conditions that provoke them to allocate attention internally. Therefore, in clinical contexts (e.g. gait rehabilitation), verbal instructions that refer to body movements (internal focus) might serve to compromise movement efficiency in older adults with a history of falls. Such changes will, theoretically, lessen the ability to react efficiently to changing environments experienced in daily life.

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The Effect of Functional Electrical Stimulation on Balance Function and Balance Confidence in Community-Dwelling Individuals with Stroke

Physiotherapy Canada ◽

10.3138/physio.62.2.114 ◽

2010 ◽

Vol 62 (2) ◽

pp. 114-119 ◽

Cited By ~ 11

Author(s):

Jennifer A. Robertson ◽

Janice J. Eng ◽

Chihya Hung

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Community Dwelling ◽

Balance Function ◽

Balance Confidence

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Musculoskeletal Strength, Balance Performance, and Self-Efficacy in Elderly Ving Tsun Chinese Martial Art Practitioners: Implications for Fall Prevention

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/402314 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Shirley S. M. Fong ◽

Shamay S. M. Ng ◽

Karen P. Y. Liu ◽

Marco Y. C. Pang ◽

H. W. Lee ◽

...

Keyword(s):

Bone Strength ◽

Fall Prevention ◽

Lower Limb ◽

Self Efficacy ◽

Muscular Strength ◽

Community Dwelling ◽

Balance Performance ◽

Balance Confidence ◽

Functional Balance ◽

Martial Art

Objectives.To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants.Methods.Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups.Results.Elderly VT practitioners had higher radial bone strength on the dominant side(P<0.05), greater lower limb muscular strength(P=0.001), better functional balance performance(P=0.003), and greater balance confidence(P<0.001)than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score(r=-0.575, P=0.013).Conclusions.VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.

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Determinants of Balance Confidence in Community-Dwelling Elderly People

Physical Therapy ◽

10.1093/ptj/83.12.1072 ◽

2003 ◽

Vol 83 (12) ◽

pp. 1072-1079 ◽

Cited By ~ 126

Author(s):

Janine Hatch ◽

Kathleen M Gill-Body ◽

Leslie G Portney

Keyword(s):

Elderly People ◽

Fear Of Falling ◽

Pearson Correlation ◽

Community Dwelling ◽

Functional Mobility ◽

Balance Performance ◽

Related Factors ◽

Balance Confidence ◽

Balance Scale ◽

Performance Functional

Background and Purpose. The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study. Subjects. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (X̄=81.7, SD=6.7). Methods. Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up & Go Test. The Activities-specific Balance Scale was used to assess balance confidence. Data were analyzed using Pearson correlation, multiple regression analysis, and t tests. Results. Fifty-seven percent of the variance in balance confidence could be explained by balance performance. Functional mobility and subject characteristics examined in this study did not contribute to balance confidence. Discussion and Conclusion. Balance performance alone is a strong determinant of balance confidence in community-dwelling elderly people.

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Self-Reported Functional Mobility, Balance Confidence, and Prosthetic Use Are Associated With Daily Step Counts Among Individuals With a Unilateral Transtibial Amputation

Journal of Physical Activity and Health ◽

10.1123/jpah.2017-0196 ◽

2018 ◽

Vol 15 (6) ◽

pp. 423-429 ◽

Cited By ~ 7

Author(s):

Jaclyn Megan Sions ◽

Elisa Sarah Arch ◽

John Robert Horne

Keyword(s):

Functional Mobility ◽

Daily Step ◽

Transtibial Amputation ◽

Balance Confidence ◽

Step Counts

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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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