scholarly journals Enhancement of Anticipatory Postural Adjustments by Virtual Reality in Older Adults with Cognitive and Motor Deficits: A Randomised Trial

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 72
Author(s):  
Julien Bourrelier ◽  
Lilian Fautrelle ◽  
Etienne Haratyk ◽  
Patrick Manckoundia ◽  
Frédéric Mérienne ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Anticipatory Postural Adjustments ◽  
Training Phase ◽  
Nintendo Wii ◽  
Postural Adjustments ◽  
Frail Older Adults ◽  
Functional Reach ◽  
Functional Reach Test ◽  
Vr Training

Background: Postural activities involved in balance control integrate the anticipatory postural adjustments (APA) that stabilize balance and posture, facilitating arm movements and walking initiation and allowing an optimal coordination between posture and movement. Several studies reported the significant benefits of virtual reality (VR) exercises in frail older adults to decrease the anxiety of falling and to induce improvements in behavioural and cognitive abilities in rehabilitation processes. The aim of this study was thus to test the efficiency of a VR system on the enhancement of the APA period, compared to the use of a Nintendo Wii system. Methods: Frail older adults (n = 37) were included in this study who were randomized and divided into a VR exercises group (VR group) or a control group using the Nintendo Wii system (CTRL group). Finally, 22 patients were included in the data treatment. APA were studied through muscular activation timings measured with electromyographic activities. The functional reach test, the gait speed, and the time up and go were also evaluated before and after a 3-week training phase. Results and discussion: As the main results, the training phase with VR improved the APA and the functional reach test score along the antero-posterior axis. Together, these results highlight the ability of a VR training phase to induce neuromuscular adaptations during the APA period in frail older adults. Then, it underlines the effective transfer from learning carried out during the VR training movements to control balance abilities in a more daily life context.

scholarly journals Anticipatory Postural Adjustments in the Frail Older Adults When Postural Stability is Manipulated

2020 ◽  
Author(s):  
Bianca Callegari ◽  
Alexandre Kubicki ◽  
Ghislain Saunier ◽  
Manuela Brito Duarte ◽  
Gizele Cristina da Silva Almeida ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Stability ◽  
Motor Planning ◽  
Functional Independence ◽  
Anticipatory Postural Adjustments ◽  
The Body ◽  
Upright Posture ◽  
Postural Adjustments ◽  
Frail Older Adults ◽  
The Impact

Abstract Background: Anticipatory Postural Adjustments (APAs) are importantly affected by age and may represent restrictions for functional independence. Previous studies have already highlighted some delayed APAs during self-generated rapid arm movements in aged adults, as well as in cases of non-optimal aging, such as in frail older adults. In young (Y) adults, it was also previously demonstrated that changing the postural stability (i.e. seated vs. upright posture) affects the motor planning and APAs. Considering the clinical relevance of these balance tasks in the functional independence in frail older adults (FOA), and the lack of literature about this task, the present study aimed to investigate the impact of these different conditions of postural stability on APAs in FOA. Methods: In this paper, participants executed an arm-pointing task to reach a diode immediately after it turned on, under different conditions of stability (seated with and without feet support and in upright posture). Results: The main finding of this study is that the adopted posture and body stabilization in FOA did not reflect differences in APAs or kinematic features. In addition, they did not present an optimal APA, since postural muscles are recruited simultaneously with the deltoid. Conclusion: Thus, FOA seem to use a single non-optimal motor plan to assist the task performance and counterbalance perturbation forces, in which they present similar APAs and do not modify their kinematics features according to the body stabilization (i.e. less challenging task present greater finger velocity).

Anticipatory postural adjustments during a Fitts’ task: Comparing young versus older adults and the effects of different foci of attention

2019 ◽  
Vol 64 ◽  
pp. 366-377 ◽  
Author(s):  
Saleh M. Aloraini ◽  
Cheryl M. Glazebrook ◽  
Kathryn M. Sibley ◽  
Jonathan Singer ◽  
Steven Passmore
Keyword(s):  
Older Adults ◽  
Anticipatory Postural Adjustments ◽  
Postural Adjustments

scholarly journals Anticipatory postural adjustments and spatial organization of motor cortex: evidence of adaptive compensations in healthy older adults

2018 ◽  
Vol 120 (6) ◽  
pp. 2796-2805 ◽  
Author(s):  
Jo Armour Smith ◽  
Beth E. Fisher
Keyword(s):  
Older Adults ◽  
Motor Cortex ◽  
Spatial Organization ◽  
Gluteus Medius ◽  
Anticipatory Postural Adjustments ◽  
Temporal Organization ◽  
Postural Adjustments ◽  
Healthy Older Adults ◽  
History Of ◽  
External Oblique

During anticipated postural perturbations induced by limb movement, the central nervous system generates anticipatory postural adjustments (APAs) in the trunk and hip musculature to minimize disturbances to equilibrium. Age-related changes in functional organization of the nervous system may contribute to changes in APAs in healthy older adults. Here we examined if altered APAs of trunk/hip musculature in older adults are accompanied by changes in the representation of these muscles in motor cortex. Twelve healthy older adults, 5 with a history of falls and 7 nonfallers, were compared with 13 young adults. APAs were assessed during a mediolateral arm raise task in standing. Temporal organization of postural adjustments was quantified as latency of APAs in the contralateral external oblique, lumbar paraspinals, and gluteus medius relative to activation of the deltoid. Spatial organization was quantified as extent of synergistic coactivation between muscles. Volume and location of the muscle representations in motor cortex were mapped using transcranial magnetic stimulation. We found that older adults demonstrated significantly delayed APAs in the gluteus medius muscle. Spatial organization of the three muscles in motor cortex differed between groups, with the older adults demonstrating more lateral external oblique representation than the other two muscles. Separate comparisons of the faller and nonfaller subgroups with young adults indicated that nonfallers had the greatest delay in gluteus medius APAs and a reduced distance between the representational areas of the lumbar paraspinals and gluteus medius. This study indicates that altered spatial organization of motor cortex accompanies altered temporal organization of APA synergies in older adults. NEW & NOTEWORTHY Anticipatory postural adjustments are a critical component of postural control. Here we demonstrate that, in healthy older adults with and without a history of falls, delayed anticipatory postural adjustments in the hip musculature during mediolateral perturbations are accompanied by altered organization of trunk/hip muscle representation in motor cortex. The largest adaptations are evident in older adults with no history of falls.

scholarly journals Efficacy of an Integrated Training Device in Improving Muscle Strength, Balance, and Cognitive Ability in Older Adults

2021 ◽  
Vol 45 (4) ◽  
pp. 314-324
Author(s):  
Choong-Hee Roh ◽  
Da-Sol Kim ◽  
Gi-Wook Kim ◽  
Yu-Hui Won ◽  
Sung-Hee Park ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Mini Mental State Examination ◽  
Berg Balance Scale ◽  
Training Device ◽  
Timed Up And Go ◽  
Functional Reach ◽  
Functional Reach Test ◽  
State Examination ◽  
Healthy Participants

Objective To determine the effects of an integrated training device for strength and balance on extremity muscle strength, postural balance, and cognition in older adults using a combination with various rehabilitation training games, in which balance, strength, and cognitive training were configured in a single device.Methods This prospective study included 20 healthy participants aged 65–85 years. Participants trained for 30 minutes daily, 3 days weekly, for 6 weeks with an integrated training device for strength and balance (SBT-120; Man&Tel Inc., Gumi, Korea). Main outcomes were measured using the Korean Mini-Mental State Examination (K-MMSE), Korean version of the Montreal Cognitive Assessment (K-MoCA), Timed Up and Go Test (TUG), Functional Reach Test (FRT), Berg Balance Scale (BBS), and Manual Muscle Test. Measurements were taken at three time points: T0 (pretreatment), T1 (immediately after treatment), and T2 (4 weeks after treatment).Results All 20 patients completed the training, and TUG, FRT, and BBS scores significantly improved at T1 and T2 compared to T0. Mean TUG scores decreased by 0.99±2.00 at T1 and 1.05±1.55 at T2 compared to T0. Mean FRT scores increased by 6.13±4.26 at T1 and 6.75±4.79 at T2 compared to T0. BBS scores increased by 0.60±0.94 at T1 and 0.45±1.15 at T2 compared to T0. Moreover, muscle strength and cognition (K-MMSE and K-MoCA scores) increased after training.Conclusion Our findings suggest that an integrated training device for strength and balance can be a safe and useful tool for older adults.

scholarly journals Age suit simulation replicates in healthy young adults the functional challenges to balance experienced by older adults: an observational study

2021 ◽  
pp. bmjstel-2021-000867
Author(s):  
Carole Anne Watkins ◽  
Ellie Higham ◽  
Michael Gilfoyle ◽  
Charley Townley ◽  
Sue Hunter
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Berg Balance Scale ◽  
Normative Values ◽  
Timed Up And Go ◽  
Falls Risk ◽  
Functional Reach ◽  
Functional Reach Test ◽  
Age Simulation ◽  
Positive Effect

BackgroundAge simulation can have a positive effect on empathic understanding and perception of ageing. However, there is limited evidence for its ability to replicate objectively the physical and functional challenges of ageing.ObjectiveTo observe whether age suit simulation can replicate in healthy young adults the physical and physiological balance disturbance and falls risk experienced by older adults.MethodologyHealthy young adults aged 20–40 years (16 male) were recruited to the study using convenience sampling from a student population. Participants performed three validated balance tests—Functional Reach Test (FRT), Timed Up and Go (TUG) and Berg Balance Scale (BBS)—first without the age suit and then with the age suit, using a standardised protocol, following the same sequence.Results30 participants completed all tests. Statistically significant differences between without-age-suit and with-age-suit performance were recorded for FRT distance (p<0.000005), time taken to complete the TUG (p<0.0005) and BBS score (p<0.001). A comparison of participant scores with normative FRT and TUG scores identified that the suit had ‘aged’ the majority of participants to the normative values for older adults (60+), with some reaching the values for individuals aged 70–89. However, no scores achieved the values indicative of increased falls risk.ConclusionsThe age suit is a valid educational tool that extends the value of age simulation beyond a more general empathising role, enabling those working with an older population to experience and understand the functional challenges to balance experienced by older adults as part of their training.

scholarly journals Virtual Reality (VR)-Based Environmental Enrichment in Older Adults with Mild Cognitive Impairment (MCI) and Mild Dementia

2021 ◽  
Vol 11 (8) ◽  
pp. 1103
Author(s):  
Waleed Riaz ◽  
Zain Yar Khan ◽  
Ali Jawaid ◽  
Suleman Shahid
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Environmental Enrichment ◽  
Mental Wellbeing ◽  
Mild Dementia ◽  
Error Ratio ◽  
Before And After ◽  
Vr Training ◽  
Input Error

Background: Despite an alarming rise in the global prevalence of dementia, the available modalities for improving cognition and mental wellbeing of dementia patients remain limited. Environmental enrichment is an experimental paradigm that has shown promising anti-depressive and memory-enhancing effects in pre-clinical studies. However, its clinical utility has remained limited due to the lack of effective implementation strategies. Objective: The primary objective of this study was to evaluate the usability (tolerability and interactivity) of a long-term virtual reality (VR)- based environmental enrichment training program in older adults with mild cognitive impairment (MCI) and mild dementia. A secondary objective was to assess the effect of VR-based environmental enrichment on stabilization of cognitive functioning and improvement of mental wellbeing in older adults with MCI and mild dementia. Methods: A total of seven participants (four patients with MCI and three with mild dementia) received biweekly VR-based environmental enrichment over a course of 6 months. The tolerability and interactivity of the participants in the VR training was serially assessed via virtual reality sickness questionnaire (VRSQ) and recording of input-error ratio. Cognitive functioning was assessed through Montreal cognitive assessment (MoCA) before and after the study. Mental wellbeing was assessed through Warwick-Edinburgh Mental Well Being Scale (WEMWBS). Results: VR-based environmental enrichment was well-tolerated by the patients with significant decrease in VRSQ scores (p < 0.01) and input-error ratio (p < 0.001) overtime. VR training was also effective in stabilization of MoCA scores over the course of therapy (non-significant difference in the MoCA scores before and after the therapy) and was associated with a trend (p < 0.1) towards improvement in WEMWBS scores between the first and the last assessments. Qualitative observations by the care-givers further corroborated a noticeable improvement in mental wellbeing of patients. Conclusions: This pilot study shows that VR can be a feasible, tolerable, and potentially effective tool in long-term support of older adults with MCI and mild dementia.

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