Postural control among normal population of different age groups

Author(s):  
Naema Ismail ◽  
Gehan S. Abd El-Salam ◽  
Asmaa Fathi

<p class="abstract"><strong>Background:</strong> Postural control continues to change in later stages of life. Age-related changes may occur within or between sub-systems involved in postural control. It is thought clinically that these changes are important as they often result in falls &amp; injury. The aim of the work was to compare the balance characteristics among different age groups using computerized dynamic posturography to provide clinicians with normal references<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> Inclusion criteria were study group consisted of (30) normal healthy individuals, age range 16-79 years, with neither hearing nor vestibular complaints. It was divided into 3 age groups, each group consisted of 10 patients. Group (A) young- 16-39 years, group (B) middle- 40-59 years and group (C) elderly- 60-79 years. Exclusion criteria were history of neuromuscular or neuroskeletal disease, symptoms of unsteadiness, dizziness or vertigo, symptoms of impaired sensory function, symptoms of arthritis or lower limb problem, symptoms of uncorrected visual problems, symptoms of postural hypotension or diabetes, medication intake such as sedatives, hypnotics, anxiolytics &amp; antidepressants.  All participants were subjected to full history taking, otologic examination, basic audiologic evaluation, computerized dynamic posturography which included sensory organization test, limits of stability and rhythmic weight shift<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Sensory organization test: The elderly group (C) had lowest equilibrium score with eyes open, closed &amp; with conflicted visual cues on swayed surface (condition 6) and also this group have lowest percentage of SOT strategy. There was a statistically significant difference among A &amp; C groups when using sensory organization test strategy in all conditions. Limits of stability test: The elderly group has higher overall reaction time. There was statistically significant difference in all conditions of limits of stability as regards directional control. Rhythmic weight shift right and left test: There was a statistically significant difference between groups A &amp; C in low &amp; medium speed on on-axis velocity &amp; directional control. Rhythmic weight shift front &amp; back test: There was no statistically significant difference between all groups as regards on-axis velocity. There was highly statistically significant difference between all groups in all trials as regards directional control.</span></p><p class="abstract"><strong>Conclusions:</strong> Postural instability occurs frequently in healthy elderly subjects. Sensory organization test is the most effective test to compare balance function among different age groups<span lang="EN-IN">.</span></p>

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10239
Author(s):  
Yiyang Chen ◽  
Jing Xian Li ◽  
Lin Wang

Background High heel shoes (HHS) can affect human postural control because elevated heel height (HH) may result in plantar flexed foot and limit ankle joint range of motion during walking. Effects of HH and HHS wearing experience on postural stability during self-initiated and externally triggered perturbations are less examined in the literature. Hence, the objective of the present study is to investigate the influences of HH on human postural stability during dynamic perturbations, perceived stability, and functional mobility between inexperienced and experienced HHS wearers. Methods A total of 41 female participants were recruited (21 inexperienced HHS wearers and 20 experienced HHS wearers). Sensory organization test (SOT), motor control test (MCT), and limits of stability (LOS) were conducted to measure participant’s postural stability by using computerized dynamic posturography. Functional reach test and timed up and go test were performed to measure functional mobility. The participants’ self-perceived stability was assessed by visual analog scale. Four pairs of shoes with different HH (i.e., 0.8, 3.9, 7.0, and 10.1 cm) were applied to participants randomly. Repeated measures analysis of variance was conducted to detect the effects of HH and HHS wearing experience on each variable. Results During self-initiated perturbations, equilibrium score remarkably decreased when wearing 10.1 cm compared with flat shoes and 3.9 cm HHS. The contribution of vision to postural stability was larger in 10.1 cm HHS than in flat shoes. The use of ankle strategy worsened when HH increased to 7 cm. Similarly, the directional control of the center of gravity (COG) decreased for 7 cm HHS in LOS. Experienced wearers showed significantly higher percentage of ankle strategy and COG directional control than novices. Under externally triggered perturbations, postural stability was substantially decreased when HH reached 3.9 cm in MCT. No significant difference was found in experienced wearers compared with novices in MCT. Experienced wearers exhibited considerably better functional mobility and perceived stability with increased HH. Conclusions The use of HHS may worsen dynamic postural control and functional mobility when HH increases to 3.9 cm. Although experienced HHS wearers exhibit higher proportion of ankle strategy and COG directional control, the experience may not influence overall human postural control. Sensory organization ability, ankle strategy and COG directional control might provide useful information in developing a safety system and prevent HHS wearers from falling.


2005 ◽  
Vol 33 (8) ◽  
pp. 1174-1182 ◽  
Author(s):  
Amy S. N. Fu ◽  
Christina W. Y. Hui-Chan

Background Deficiencies in ankle proprioception and standing balance in basketball players with multiple ankle sprains have been reported in separate studies. However, the question of how ankle proprioceptive inputs and postural control in stance are related is still unclear. Hypothesis Ankle repositioning errors and the amount of postural sway in stance are increased in basketball players with multiple ankle sprains. Study Design Controlled laboratory study. Methods Twenty healthy male basketball players and 19 male basketball players who had suffered bilateral ankle sprains within the past 2 years were examined. Both groups were similar in age. Passive ankle joint repositioning errors at 5° of plantar flexion were used to test for ankle joint proprioception. The Sensory Organization Test was applied with dynamic posturography to assess postural sway angle under 6 sensory conditions. Results A significant increase in ankle repositioning errors was demonstrated in basketball players with bilateral ankle sprains (P < .05). The mean errors in the right and left ankles were increased from 1.0° (standard deviation, 0.4°) and 0.8° (standard deviation, 0.2°), respectively, in the healthy players to 1.4° (standard deviation, 0.7°) and 1.1° (standard deviation, 0.5°) in the injured group. A significant increase in the amount of postural sway in the injured subjects was also found in conditions 1, 2, and 5 of the Sensory Organization Test (P < .05). Furthermore, there were positive associations between averaged errors in repositioning both ankles and postural sway angles in conditions 1, 2, and 3 of the Sensory Organization Test (r = 0.39-0.54, P < .05). Conclusions Ankle repositioning errors and postural sway in stance increased in basketball players with multiple ankle sprains. A positive relationship was found between these 2 variables. Clinical Relevance Such findings highlight the need for the rehabilitation of patients with multiple ankle sprains to include proprioceptive and balance training.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Griet Vervoort ◽  
Evelien Nackaerts ◽  
Farshid Mohammadi ◽  
Elke Heremans ◽  
Sabine Verschueren ◽  
...  

This exploratory study aimed to identify which aspects of postural control are able to distinguish between subgroups of patients with Parkinson’s disease (PD) and controls. Balance was tested using static and dynamic posturography. Freezers (n=9), nonfreezers (n=10), and controls (n=10) stood on a movable force platform and performed 3 randomly assigned tests: (1) sensory organization test (SOT) to evaluate the effective use of sensory information, (2) motor control test (MCT) to assess automatic postural reactions in response to platform perturbations, and (3) rhythmic weight shift test (RWS) to evaluate the ability to voluntarily move the center of gravity (COG) mediolaterally and anterior-posteriorly (AP). The respective outcome measures were equilibrium and postural strategy scores, response strength and amplitude of weight shift. Patients were in the “on” phase of the medication cycle. In general, freezers performed similarly on SOT and MCT compared to nonfreezers. Freezers showed an intact postural strategy during sensory manipulations and an appropriate response to external perturbations. However, during voluntary weight shifting, freezers showed poorer directional control compared to nonfreezers and controls. This suggests that freezers have adequate automatic postural control and sensory integration abilities in quiet stance, but show specific directional control deficits when weight shifting is voluntary.


Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S3.3-S4
Author(s):  
John Heick

ObjectiveTo compare equilibrium scores between computerized dynamic posturography tests of the Sensory Organization Test (SOT) to the Head Shake-Sensory Organization Test (HS-SOT) in healthy adults.BackgroundApproximately 50% of the brain's pathways are related to vision and many of these pathways are susceptible to injury in concussion. Visual-motor disruptions occur in 65%–90% of concussed patients. These disruptions impair balance and can be measured. The SOT is a computerized postural test that evaluates balance by altering visual, proprioceptive, and vestibular cues. The HS-SOT modifies 2 of the standard SOT conditions by including dynamic head motions that stimulate the semicircular canals within the vestibular system.Design/MethodsParticipants completed the Dizziness Handicap Inventory, Activities of Balance Confidence Scale, SOT, and HS-SOT in one session.ResultsTwenty-five individuals (17 females, 8 males; mean age, 21.08 ± 4.10 years, range, 18–33 years) completed outcome measures and 3 trials of testing. There was a significant difference in mean values between the SOT and the HS-SOT for both condition 2 (t(16) = 3.034, p = 0.008) and 5 (t(16) = 5.706, p < 0.001). Additionally, there was a significant difference in mean values between the SOT and the foam HS-SOT for condition 2 (t(16) = 4.673, p < 0.001) and condition 5 (t(16) = 7.263, p < 0.001). There was not a significant difference in means between the foam and without foam for HS-SOT for condition 2 (t(16) = 1.77, p = 0.095) and condition 5 (t(16) = 1.825, p = 0.087).ConclusionsThe HS-SOT may quantify subtle balance deficits and enhance the clinical standard use of the SOT. Unlike the SOT where the head is static, the HS-SOT requires head movements, as if saying no repeatedly at approximately 100°/second as measured by an accelerometer. The HS-SOT may quantify subtle balance deficits and enhance the clinical standard use of the SOT.


1999 ◽  
Vol 9 (6) ◽  
pp. 435-444
Author(s):  
Rosemary A. Speers ◽  
Neil T. Shepard ◽  
Arthur D. Kuo

The Sensory Organization Test protocol of the EquiTest system (NeuroCom International, Clackamas Oregon) tests utilization of visual, vestibular, and proprioceptive sensors by manipulating the accuracy of visual and/or somatosensory inputs during quiet stance. In the standard Sensory Organization Test, both manipulation of sensory input (sway-referencing) and assessment of postural sway are based on ground reaction forces measured from a forceplate. The purpose of our investigation was to examine the use of kinematic measurements to provide a more direct feedback signal for sway-referencing and for assessment of sway. We compared three methods of sway-referencing: the standard EquiTest method based on ground reaction torque, kinematic feedback based on servo-controlling to shank motion, and a more complex kinematic feedback based on servo-controlling to follow position of the center of mass (COM) as calculated from a two-link biomechanical model. Fifty-one normal subjects (ages 20–79) performed the randomized protocol. When using either shank or COM angle for sway-referencing feedback as compared to the standard EquiTest protocol, the Equilibrium Quotient and Strategy Score assessments were decreased for all age groups in the platform sway-referenced conditions (SOT 4, 5, 6). For all groups of subjects, there were significant differences in one or more of the kinematic sway measures of shank, hip, or COM angle when using either of the alternative sway-referencing parameters as compared to the standard EquiTest protocol. The increased sensitivities arising from use of kinematics had the effect of amplifying differences with age. For sway-referencing, the direct kinematic feedback may enhance ability to reduce proprioceptive information by servo-controlling more closely to actual ankle motion. For assessment, kinematics measurements can potentially increase sensitivity for detection of balance disorders, because it may be possible to discriminate between body sway and acceleration and to determine the phase relationship between ankle and hip motion.


2021 ◽  
Author(s):  
Hung-Chieh Chang ◽  
Li-Ling Hsu ◽  
Wei-Liang Shih

Abstract This study uses an intersectionality lens to understand the inequality of medical use at the intersection of age and air pollution. Using national databases from Taiwan, the results show that the increase of the level of air pollution and age is related to higher percentage of high medical use. Through stratified analysis, we found that there is no significant difference in medical use among different age groups in low AQI (Air Quality Index) areas, Yet, in areas with increasing amounts of polluted air, the elderly have a significantly higher percentage in frequent medical use. Our results show that the elderly people are more susceptible to air pollution, and suggest that, to protect their health and reduce the use of medical care, not only is there a need to reduce air pollution, but also maintain the annual average AQI level to under the value of 50.


2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Manish Suryapalam ◽  
Mohammed Kashem ◽  
Val Rakita ◽  
Yoshiya Toyoda

Introduction: As the prevalence of heart failure increases among older patients, the potential role of heart transplant (HTx) in this demographic demands further investigation. Survival outcome analysis of the elderly has primarily been analyzed in single-center studies, and the few long term studies performed have included a timeframe to the 1980s, introducing substantial variance from much poorer survival outcomes. We investigated the 5 to 10 year survival outcomes of more modern heart transplantation patients by analyzing the UNOS database. Methods: Heart transplantation data for 32,337 patients (2000-2014) was divided into three different age groups- <60, 60-69, and ≥70 years old. Gender, ethnicity, height, weight, BMI, ICU stay, ischemic time, length of stay (LOS), and creatinine level were evaluated for significance using Chi-Squared and H-Tests as appropriate (p<0.05). Survival outcome was assessed using a Kaplan-Meier Curve and log-rank tests. Results: 23,267 were <60, 8,459 were 60-69, and 611 were ≥70, with mean ages of 38±0.1, 64±0.0, and 72±0.1 respectively. The distribution of gender, ethnicity, ischemic time, BMI, height, and weight was significantly different between the cohorts, with p=0.000 for all. Survival analysis indicated complete pairwise significance at 10 years post-HTx, with overall significance of p=0.000. At 5 years post-HTx, only 60-69 vs ≥70 did not have pairwise significance in survival. Conclusion: Contrary to prior studies, results indicate a statistically significant difference in survival the older and younger cohorts. This difference is especially prominent at the 10 th year post-transplant, but can be seen even at the 5 th year.


2010 ◽  
Vol 68 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Gilson de Vasconcelos Torres ◽  
Luciana Araújo dos Reis ◽  
Luana Araújo dos Reis

OBJECTIVE: To assess the functional capacity and to determine the difference between the means of functional capacity (basic and instrumental activities of daily living) and the age groups of elderly residents in an outlying area in the hinterland of Bahia/Northeast of Brazil. METHOD: Analytical study with cross-sectional design and a sample of 150 elderly individuals enrolled in four Health Units in the municipality of Jequié, Bahia, Brazil. The instrument consisted of sociodemographic and health data, the Barthel Index and the Lawton scale. RESULTS: In all, 78.00% of the elderly were classified as dependent in the basic activities and 65.33% in the instrumental activities of daily living. Using the Kruskal-Wallis test, we found a statistically significant difference between the means of instrumental activities and the age groups (p=0.011). CONCLUSION: An elevated number of elderly were classified as dependent in terms of functional capacity and increased age is related to greater impairment in the execution of instrumental activities of daily living.


2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093686
Author(s):  
Chaohui Lian ◽  
Peng Li ◽  
Ning Wang ◽  
Yi Lu ◽  
Wangning Shangguan

Objective To explore the basic values of regional cerebral oxygen saturation (rSO2) among different age groups. Methods One hundred twenty patients who were scheduled for elective surgery aged 0 to 80 years (American Society of Anesthesiologists [ASA] physical status I or II) or neonates just after birth via cesarean section were enrolled and divided into the following six groups: infant (0 month and ≤12 months), toddler (>1 and ≤3 years old), preschool (>3 and ≤6 years old), school age (>6 and ≤18 years old), adult (>18 and ≤65 years old), and elderly (>65 and ≤80 years old) groups. There were 20 patients in each group. Results The basic values of rSO2 in infant, toddler, preschool, school age, adults, and elderly groups were 70.41% ± 4.66%, 72.43% ± 3.81%, 70.77% ± 3.27%, 70.62% ± 2.20%, 69.76% ± 6.02%, and 62.69% ± 3.14%, respectively. The basic value in the elderly group was lower compared with other five groups. There was no significant difference among infant, toddler, preschool age, school age, and adult groups. Conclusions The basic value of rSO2 in elderly patients is lower. Age is an important factor that affects the underlying value of rSO2.


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