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

Control of Stance and Developmental Coordination Disorder: The Role of Visual Information

2004 ◽  
Vol 21 (1) ◽  
pp. 19-33 ◽  
Author(s):  
Eryk P. Przysucha ◽  
M. Jane Taylor
Keyword(s):  
Visual Information ◽  
Path Length ◽  
Developmental Coordination Disorder ◽  
Postural Sway ◽  
Quiet Standing ◽  
Eyes Closed ◽  
Total Path Length ◽  
Eyes Open ◽  
Stability Limits ◽  
Coordination Disorder

The purpose of this study was to compare the postural sway profiles of 20 boys with and without Developmental Coordination Disorder (DCD) on two conditions of a quiet standing task: eyes open and eyes closed. Anterior-posterior (AP) sway, medio-lateral sway (LAT), area of sway, total path length, and Romberg’s quotient were analyzed. When visual information was available, there was no difference between groups in LAT sway or path length. However, boys with DCD demonstrated more AP sway (p < .01) and greater area of sway (p < .03), which resulted in pronounced excursions closer to their stability limits. Analysis of Romberg’s quotient indicated that boys with DCD did not over-rely on visual information.

scholarly journals Visual Information Effect to Control Body Sway in Older Adults in the Community. Magnitude of Body Sway with Eyes Open and Eyes Closed.

1999 ◽  
Vol 58 (6) ◽  
pp. 640-644
Author(s):  
Hideyuki Okuzumi ◽  
Taketo Furuna ◽  
Satoshi Nishizawa ◽  
Miho Sugiura
Keyword(s):  
Older Adults ◽  
Visual Information ◽  
Body Sway ◽  
Information Effect ◽  
Eyes Closed ◽  
Eyes Open ◽  
Control Body

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.

Head stability in older adults during walking with and without visual input

2001 ◽  
Vol 11 (2) ◽  
pp. 105-114
Author(s):  
Ronita L. Cromwell ◽  
Roberta A. Newton ◽  
Gail Forrest
Keyword(s):  
Older Adults ◽  
Frequency Spectrum ◽  
Sagittal Plane ◽  
Proprioceptive Information ◽  
Eyes Closed ◽  
Trunk Movements ◽  
Angular Velocities ◽  
Eyes Open ◽  
Walking Velocity ◽  
Head Stability

The purposes of this study were to 1) characterize head stabilization in older adults across the frequency spectrum of walking, and 2) assess the ability of older adults to adapt head-trunk coordination to maintain head stability in the absence of vision. Sagittal plane head and trunk angular velocities in space were measured for 17 healthy older adults while walking with eyes open (EO) and eyes closed (EC). Average walking velocity and cadence were also determined. Frequency analyses were used to examine head velocities in space and head-on-trunk with respect to trunk gain and phase values across the frequency spectrum of walking. Average walking velocity decreased with EC. Head stability was maintained during EO, but decreased during EC as indicated by increased head velocities across the frequency spectrum. Gain values increased while phase values remained similar during EC walking demonstrating diminished coordination of head-trunk movements. When relying on vestibular and proprioceptive information, older adults were unable to adapt head-trunk movements suggesting impaired plasticity of these systems with age.

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.

Postural sway with earth-fixed and body-referenced finger contact in young and older adults

1999 ◽  
Vol 9 (2) ◽  
pp. 103-109
Author(s):  
Reginald L. Reginella ◽  
Mark S. Redfern ◽  
Joseph M. Furman
Keyword(s):  
Older Adults ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Sensory Information ◽  
Body Sway ◽  
Support Surface ◽  
Proprioceptive Information ◽  
Postural Control System ◽  
Fixed Reference ◽  
Older Subjects

Sensory information from lightly touching a reference with the hand is known to influence postural sway in young adults. The primary aim of this study was to compare the influence of finger contact (FC) with an earth-fixed reference to the influence of FC with a body-fixed reference. A second goal of this study was to determine if FC is used differently by older adults compared to younger adults. Using a force plate, center of pressure at the feet was recorded from blindfolded young and older subjects during several conditions. Subjects either did or did not lightly touch a force-sensitive plate that was either earth-fixed or moved forward and backward in synchrony with body sway (that is, sway-referenced). In addition, support surface conditions were also varied, including a fixed floor and a sway-referenced floor using an EquitestTM. Results showed that the type of FC, floor condition, and age each had an effect on postural sway. Touching an earth-fixed plate decreased postural sway as compared to no touching, while touching a sway-referenced plate incresased sway. This influence of FC was enhanced when the floor was sway-referenced. Although older subjects swayed more than young subjects overall, no age-FC interactions occurred, indicating that FC was not utilized differently between the age groups. This study suggests that FC cannot be disregarded as erroneous, especially when proprioceptive information from the legs is distorted. Further, FC is integrated with other sensory information by the postural control system similarly in young and older persons.

scholarly journals Slowed sensory reweighting and postural illusions in older adults: the moving platform illusion

2019 ◽  
Vol 121 (2) ◽  
pp. 690-700 ◽  
Author(s):  
Chesney E. Craig ◽  
Michail Doumas
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Postural Sway ◽  
Age Groups ◽  
Age Group ◽  
Sensory Reweighting ◽  
Perceptual Illusion ◽  
Healthy Older Adults ◽  
Stable Conditions ◽  
Illusory Perception

We investigated whether postural aftereffects witnessed during transitions from a moving to a stable support are accompanied by a delayed perception of platform stabilization in older adults, in two experiments. In experiment 1, postural sway and muscle cocontraction were assessed in 11 healthy young, 11 healthy older, and 11 fall-prone older adults during blindfolded stance on a fixed platform, followed by a sway-referenced platform and then by a fixed platform again. The sway-referenced platform was more compliant for young adults, to induce similar levels of postural sway in both age groups. Participants were asked to press a button whenever they perceived that the platform had stopped moving. Both older groups showed significantly larger and longer postural sway aftereffects during platform stabilization compared with young adults, which were pronounced in fall-prone older adults. In both older groups elevated muscle cocontraction aftereffect was also witnessed. Importantly, these aftereffects were accompanied by an illusory perception of prolonged platform movement. After this, experiment 2 examined whether this illusory perception was a robust age effect or an experimental confound due to greater surface compliance in young adults, which could create a larger perceptual discrepancy between moving and stable conditions. Despite exposure to the same surface compliance levels during sway-reference, the perceptual illusion was maintained in experiment 2 in a new group of 14 healthy older adults compared with 11 young adults. In both studies, older adults took five times longer than young adults to perceive platform stabilization. This supports that sensory reweighting is inefficient in older adults. NEW & NOTEWORTHY This is the first paper to show that postural sway aftereffects witnessed in older adults after platform stabilization may be due to a perceptual illusion of platform movement. Surprisingly, in both experiments presented it took older adults five times longer than young adults to perceive platform stabilization. This supports a hypothesis of less efficient sensory reintegration in this age group, which may delay the formation of an accurate postural percept.

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.

scholarly journals Effect of induced hyperopia on fall risk and Fourier transformation of postural sway

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e8329 ◽  
Author(s):  
Byeong-Yeon Moon ◽  
Jae Hyeok Choi ◽  
Dong-Sik Yu ◽  
Sang-Yeob Kim
Keyword(s):  
Visual Acuity ◽  
Fourier Transformation ◽  
Fall Risk ◽  
Postural Sway ◽  
Risk Index ◽  
Refractive Errors ◽  
Body Balance ◽  
Risk Of Falls ◽  
Eyes Open ◽  
Full Correction

Background and Purpose Fall accidents are a social challenge in Korea and elsewhere. Most previous studies have focused on the effects of reduced visual acuity due to myopia on falls and body balance. The objective of this study was to investigate whether uncorrected hyperopia was a major risk factor for falls and to establish whether the risk of falls was absolutely correlated with visual acuity. Methods Fifty-one young subjects with a mean age of 22.75 ± 2.13 years were enrolled in this study. To induce hyperopic and myopic refractive errors, spherical lenses of ±1.0–6.0 D (1.0 D stepwise) were used. Under each induced condition, fall risk index and sway power were assessed via Fourier transformation of postural sway using a TETRAX system. Results The fall risk index for eyes-closed was significantly greater than that of eyes-open with full correction (t = −5.876, p < 0.05). The fall risk index increased significantly from hyperopia induced with −4.0 D lenses (with visual acuity of 0.69 ± 0.32) compared to eyes-open with full correction (F = 3.213, p < 0.05). However, there was no significant change in the induced myopia conditions, despite a drastic decline in decimal visual acuity. Sway power increased significantly in the low-to-medium frequency band derived from the peripheral vestibular system when hyperopia was induced. A significant difference was detected in hyperopia induced with −6.0 D lenses compared to eyes-open with full correction (F = 4.981, p = 0.017). Conclusion An uncorrected hyperopia rather than myopia may increase the risk of falls, although eyes may show normal visual acuity due to the inherent accommodation mechanism. Our findings suggest that the corrected state of refractive errors is more important than the level of visual acuity as the criteria for appropriate visual input, which contributes to stable posture. Therefore, clinicians should consider the refractive condition, especially the characteristics of hyperopia, when analyzing body balance, and appropriate correction of uncorrected hyperopia to prevent falls.

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