Acute effects of contract-relax proprioceptive neuromuscular facilitation stretching of hip abductors and adductors on dynamic balance

Background Balance control has been shown to play a fundamental role both in everyday life and many athletic activities. An important component of balance control is the somatosensory information gained from muscle spindles and Golgi tendon organs. The changes in the muscle-tendon unit stiffness could alter the ability to detect and respond promptly to changes of an unstable environment. One of the procedures affecting muscle stiffness is stretching, and contract-relax PNF stretching (CRS) is considered as one of the safest and most effective techniques. So far, there are no studies on the impact of CRS of hip adductor and abductor muscles on body balance. These muscle groups are responsible for maintaining mediolateral balance which is of particular interest, since it is more affected by ageing and disease and since its deterioration has been associated with an increased risk of falling. In light of the above, the aim of the present study was to investigate the effects of a single dose of contract-relax proprioceptive neuromuscular facilitation stretching of hip adductors and abductors on mediolateral dynamic balance. Methods The study involved 45 healthy individuals (age 19–23 years) assigned to the intervention group (IG) or the control group (CG). Balance testing was carried out before (Pre) and immediately after CRS in the intervention group or after 5-minute rest in the control group (Post). There were performed three repetitions of the CRS targeting the adductor and abductor muscles of the hip. Results Statistically significant differences between Pre and Post condition were observed only in the intervention group. The values of all measured variables defining the body’s dynamic balance were significantly lower immediately after the applied CRS, which indicates an improved body balance: Global Index (p = 0.0001), total area of sway (p = 0.0001), external area of sway (p = 0.00004), external time (p = 0.0004) and reaction time (p = 0.0003). Conclusions A single dose of contract-relax proprioceptive neuromuscular facilitation stretching of the hip adductor and abductor muscles improved mediolateral dynamic balance.

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Balance in children born prematurely currently aged 6–7

Biomedical Human Kinetics ◽

10.1515/bhk-2017-0025 ◽

2017 ◽

Vol 9 (1) ◽

pp. 181-186

Author(s):

Ewa Dziuba ◽

Justyna Drzał-Grabiec ◽

Aleksandra Truszczyńska-Baszak ◽

Katarzyna Guzek ◽

Katarzyna Zajkiewicz

Keyword(s):

Premature Birth ◽

Standardized Test ◽

Balance Control ◽

Dynamic Balance ◽

Control Group ◽

Body Balance ◽

Education Material ◽

Significant Difference ◽

The Right ◽

The Impact

SummaryStudy aim: Premature birth is one of the major problems of obstetrics, leading to numerous complications that are associated with prematurity, for instance balance disorders. The aim of the study was to assess the impact of premature birth on the ability to maintain balance in children commencing their school education. Material and methods: The study included children aged 6-7 years. The study group consisted of 59 children (31 girls and 28 boys, mean age 6.38 ± SD 0.73) born prematurely between 24 and 35 weeks of gestation. The control group consisted of 61 children (28 girls and 33 boys, mean age 6.42 ± 0.58) born at term. The research utilized standardized test tools - one-leg open-eyed and closed-eyed standing test, one-leg jumping test - and an original questionnaire survey. Results: The children born at term achieved better results in the majority of tests. The comparison of girls and boys born prematurely and at term showed no statistically significant difference between them in terms of dynamic balance, static balance or total balance control. The comparison of the tests performed on the right and left lower limb in prematurely born children showed no statistically significant differences. Conclusion: Premature birth affects the ability to maintain body balance. The results of the study indicate the need to develop coordination skills that shape body balance in prematurely born children.

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Oxidative Stress Biomarker Decreased in Preterm Neonates Treated With Kangaroo Mother Care

Biological Research For Nursing ◽

10.1177/1099800419900231 ◽

2020 ◽

Vol 22 (2) ◽

pp. 188-196 ◽

Cited By ~ 1

Author(s):

Dorothy Forde ◽

Douglas D. Deming ◽

John C. Tan ◽

Raylene M. Phillips ◽

Eileen K. Fry-Bowers ◽

...

Keyword(s):

Oxidative Stress ◽

Maternal Separation ◽

Intervention Group ◽

Kangaroo Mother Care ◽

Energy Utilization ◽

Infrared Spectrometry ◽

Control Group ◽

Increased Risk ◽

The Impact ◽

Incubator Care

Objective: Due to physiological and metabolic immaturity, prematurely born infants are at increased risk because of maternal separation in many neonatal intensive care units (NICUs). The stress induced from maternal–infant separation can lead to well-documented short-term physiologic instability and potentially lifelong neurological, sociological, or psychological sequelae. Based on previous studies of kangaroo mother care (KMC) that demonstrated improvement in physiologic parameters, we examined the impact of KMC on physiologic measures of stress (abdominal temperature, heart rate, oxygen saturation, perfusion index, near-infrared spectrometry), oxidative stress, and energy utilization/conservation in preterm infants. Methods: In this randomized, stratified study of premature neonates, we compared the effects on urinary concentrations of biomarkers of energy utilization and oxidative stress of 1 hr of KMC versus incubator care on Day 3 of life in intervention-group babies ( n = 26) and control-group babies ( n = 25), respectively. On Day 4, both groups received 1 hr of KMC. Urinary samples were collected 3 hr before and 3 hr after intervention/incubator care on both days. Energy utilization was assessed by measures of adenosine triphosphate (ATP) degradation (i.e., hypoxanthine, xanthine, and uric acid). Oxidative stress was assessed using urinary allantoin. Mixed-models analysis was used to assess differences in purine/allantoin. Results: Mean allantoin levels over Days 3 and 4 were significantly lower in the KMC group than in the control group ( p = .026). Conclusions: Results provide preliminary evidence that KMC reduces neonatal oxidative stress processes and that urinary allantoin could serve as an effective noninvasive marker for future studies.

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Balance training and visual rehabilitation of age-related macular degeneration patients

Journal of Vestibular Research ◽

10.3233/ves-2007-17404 ◽

2008 ◽

Vol 17 (4) ◽

pp. 183-193

Author(s):

Xavier Radvay ◽

Stéphanie Duhoux ◽

Françoise Koenig-Supiot ◽

François Vital-Durand

Keyword(s):

Macular Degeneration ◽

Balance Control ◽

Reading Speed ◽

Balance Training ◽

Age Related Macular Degeneration ◽

Control Group ◽

Age Related ◽

Increased Risk ◽

Pointing Accuracy ◽

The Impact

Patients with Age-Related Macular Degeneration (AMD) experience a large scotoma precluding central vision. In addition, 2/3 of these patients present visuomotor and balance deficits resulting in clumsiness and increased risk of falls. On the basis of previous work demonstrating that visual, vestibular and somatosensory functions involved in balance control can be rehabilitated by training, we attempted to improve these functions by balance training. We measured the impact of balance training on several visuomotor functions and reading speed. We compared balance status of 54 AMD patients to 55 normal controls. Sixteen of these patients and 14 controls subsequently received balance training sessions on a postural platform (Multitest®) stressing sensorimotor coordination by selectively inhibiting or disturbing either, visual, vestibular or somatosensory input. Producing a conflict between two inputs reinforces the use of the third. We assessed postural sway, pointing accuracy, reading performance and, for the patients, the effect of low vision training and balance training on the shift from several spontaneous Preferred Retinal Loci (PRLs) to one or more Trained Retinal Loci (TRL). Even after a limited number of sessions of cross-modal balance training, the results show a significant improvement for the vestibular input and fixation stability. A decrease of visual dependency was observed only in the control group. Apart from these improvements, pointing accuracy and reading speed were not significantly improved compared to controls, leading to the conclusion that more training sessions may be necessary to gain more significant improvement of visuo-motor functions.

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Effect of a 10-Week Traditional Dance Program on Static and Dynamic Balance Control in Elderly Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.17.2.167 ◽

2009 ◽

Vol 17 (2) ◽

pp. 167-180 ◽

Cited By ~ 50

Author(s):

Giorgos Sofianidis ◽

Vassilia Hatzitaki ◽

Stella Douka ◽

Giorgos Grouios

Keyword(s):

Center Of Pressure ◽

Balance Control ◽

Dynamic Balance ◽

Effective Means ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Elderly Adults ◽

Healthy Elderly ◽

Traditional Dance

This preliminary study examined the effect of a 10-wk traditional Greek dance program on static and dynamic balance indices in healthy elderly adults. Twenty-six community-dwelling older adults were randomly assigned to either an intervention group who took supervised Greek traditional dance classes for 10 wk (1 hr, 2 sessions/week,n= 14), or a control group (n= 12). Balance was assessed pre- and postintervention by recording the center-of-pressure (COP) variations and trunk kinematics during performance of the Sharpened-Romberg test, 1-leg (OL) stance, and dynamic weight shifting (WS). After practice, the dance group significantly decreased COP displacement and trunk sway in OL stance. A significant increase in the range of trunk rotation was noted during performance of dynamic WS in the sagittal and frontal planes. These findings support the use of traditional dance as an effective means of physical activity for improving static and dynamic balance control in the elderly.

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The Impact of a Foot-Toe Orthosis on Dynamic Balance: An Exploratory Randomized Control Trial

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0321 ◽

2020 ◽

Vol 29 (7) ◽

pp. 871-878

Author(s):

Adam Kelly ◽

Justin Stanek

Keyword(s):

Randomized Control Trial ◽

Daily Living ◽

Dynamic Balance ◽

Intervention Group ◽

Control Group ◽

Control Groups ◽

Balance Test ◽

Randomized Control ◽

And Control ◽

The Impact

Context: The influence of custom and over-the-counter foot orthoses on dynamic balance has been investigated in the past. However, there has not been an exploration of the use of a foot-toe orthosis for improving balance. The ability of clinicians to influence balance could have important implications for injury prevention and rehabilitation. Objective: To determine the impact of a foot-toe orthosis on dynamic balance in healthy, young adults. Design: Randomized control trial. Setting: Athletic training laboratory. Participants: In total, 64 healthy, recreationally active participants aged 18–29 years were randomly allocated to one of the following groups: the foot-toe orthosis and laboratory-issued shoe group, the laboratory-issued shoe only (SO) group, or the control group. Interventions: Subjects in the intervention group wore the foot-toe orthosis and laboratory-issued shoe with activities of daily living for 4 weeks. Subjects in the SO intervention group wore the laboratory-issued shoe with activities of daily living for 4 weeks. Participants in the control group did not receive any intervention. Main Outcome Measures: The instrumented version of the Star Excursion Balance Test, known as the Lower Quarter Y-Balance Test, was used to quantify the dynamic balance at baseline and follow-up. Reaches were normalized for leg length. Results: There were statistically significant differences in postintervention scores on the Lower Quarter Y-Balance Test for both the dominant (P = .03, effect size = 0.84; 95% confidence interval, 0.25 to 1.43) and nondominant (P = .002, effect size = 0.74; 95% confidence interval, 0.15 to 1.32) legs when comparing dynamic balance scores of the foot-toe orthosis and laboratory-issued shoe group with the SO and control groups. No significant differences were observed when comparing dynamic balance between the SO and control groups. Conclusions: A 4-week intervention with a foot-toe orthosis and laboratory-issued shoe resulted in improved dynamic balance in a healthy young adult population. These findings suggest a novel intervention for increasing balance.

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The effect of balance training on audio–visual integration in older adults

Seeing and Perceiving ◽

10.1163/187847612x647865 ◽

2012 ◽

Vol 25 (0) ◽

pp. 155

Author(s):

Niamh A. Merriman ◽

Caroline Whyatt ◽

Annalisa Setti ◽

Nicholas Gillian ◽

William Young ◽

...

Keyword(s):

Older Adults ◽

Visual Information ◽

Balance Control ◽

Intervention Group ◽

Balance Training ◽

Berg Balance Scale ◽

Control Group ◽

Intervention Programme ◽

Visual Integration ◽

Increased Risk

Although the vestibular system is involved in maintaining balance and posture control, recent studies have provided evidence for a crucial role of other sensory modalities in this task. In older adults, reduced visual capacity, specifically impaired depth perception and contrast sensitivity, has been associated with an increased risk of falls. Moreover, using the auditory-flash illusion (Shams et al., 2000) we recently reported that auditory–visual perception is less efficient in fall-prone older adults than in their age-matched counterparts (Setti et al., 2011) and that susceptibility increases with ageing. The aim of this study was to investigate whether balance training is associated with changes in how efficiently auditory and visual information is integrated in older adults. We tested 58 older (65+ years) adults, half of whom took part in a balance training intervention programme over a series of 5 weeks and half of whom were controls. Pre- and post-training measures of balance control (e.g., Berg Balance Scale) and movement-based signals (e.g., displacement of centre of pressure) across groups suggested that the intervention was successful in improving overall balance control. Furthermore, we found that susceptibility to the auditory-flash illusion did not increase for the intervention group, but did increase in the control group over time. Furthermore, following balance training our data suggest that audio–visual integration becomes relatively more efficient in fall-prone than in non-fall prone older adults. Our findings suggest important links between balance control and multisensory interactions in the ageing brain.

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Effect of Virtual Reality on Postural and Balance Control in Patients with Stroke: A Systematic Literature Review

BioMed Research International ◽

10.1155/2016/7309272 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 26

Author(s):

Ling Chen ◽

Wai Leung Ambrose Lo ◽

Yu Rong Mao ◽

Ming Hui Ding ◽

Qiang Lin ◽

...

Keyword(s):

Systematic Review ◽

Virtual Reality ◽

Science Studies ◽

Balance Control ◽

Dynamic Balance ◽

Chronic Phase ◽

Control Group ◽

Subacute Stroke ◽

Evidence Database ◽

The Impact

Objective. To critically evaluate the studies that were conducted over the past 10 years and to assess the impact of virtual reality on static and dynamic balance control in the stroke population.Method. A systematic review of randomized controlled trials published between January 2006 and December 2015 was conducted. Databases searched were PubMed, Scopus, and Web of Science. Studies must have involved adult patients with stroke during acute, subacute, or chronic phase. All included studies must have assessed the impact of virtual reality programme on either static or dynamic balance ability and compared it with a control group. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies.Results. Nine studies were included in this systematic review. The PEDro scores ranged from 4 to 9 points. All studies, except one, showed significant improvement in static or dynamic balance outcomes group.Conclusions. This review provided moderate evidence to support the fact that virtual reality training is an effective adjunct to standard rehabilitation programme to improve balance for patients with chronic stroke. The effect of VR training in balance recovery is less clear in patients with acute or subacute stroke. Further research is required to investigate the optimum training intensity and frequency to achieve the desired outcome.

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The impact of various physiotherapy programs on static and dynamic balance for patients after stroke

Baltic Journal of Sport and Health Sciences ◽

10.33607/bjshs.v4i111.676 ◽

2018 ◽

Vol 4 (111) ◽

pp. 39-44

Author(s):

Dalia Mickevičienė ◽

Erika Masiulytė ◽

Neringa Švedaitė

Keyword(s):

Dynamic Balance ◽

Intervention Group ◽

Balance Training ◽

Gait Training ◽

Average Score ◽

Control Group ◽

Training Methods ◽

Balance Test ◽

Physiotherapy Program ◽

The Impact

Background. The imbalance in many scientific sources is described as a major disorder in patients with a history of stroke. Often, the importance or disruption of torso control is also indicated on balance impairments. We believe that both physiotherapy programs will have impact on balance however better results on balance tests will be in group which balance training composed of unstable planes. Research aim was to measure impact of various physiotherapy programs on static and dynamic balance for patients after stroke. Methods. To evaluate changes of static and dynamic balance we used: Berg balance test, Tinetti test, PASS test, dynamic gait index, trunk impairment scale, special STREAM movements test for patients after stroke, Mini balance evaluation test for patients after stroke. Training methods of balance were for two different physiotherapy programs: intervention group (basic physiotherapy program with exercises on unstable planes) and control group (basic physiotherapy program with gait training elements). Results. When evaluating balance, results in both groups were almost equal, which shows that balance was disturbed and there was a huge risk of falls, moreover all patients walked with aid measures. At the beginning of rehabilitation, the average of all balance evaluating tests in both groups scored 16.92 and 15.05. All results were statistically significant (p < .05). At the end of research, variations between all test results were defined statistically significant. Repeatedly evaluating results of both groups at the end of rehabilitation, all test averages were improved: at the beginning, the intervention group average score was 16.92 and after rehabilitation, it was 34.79. For control group results, the average score of all tests was 15.05 and at the end it was 31.90. Summing up, it was established that in both groups balance in rehabilitation period improved. Conclusions. Physiotherapy programs based on exercises on unstable planes or gait training elements improve balance for patients after stroke. Many studies have confirmed the hypothesis of our study that using unstable planes or walking training methods improve balance, but for a statistically significant change in improving the balance, it will be necessary to use unstable planes.

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The effect of the implementation of a good medical practice booklet on nursing home residents’ drug prescriptions: a difference-in-differences analysis based on data from electronic pill dispensers (Preprint)

10.2196/preprints.13507 ◽

2019 ◽

Author(s):

Stéphane Sanchez ◽

Cécile Payet ◽

Marie Herr ◽

Anne Dazinieras ◽

Caroline Blochet ◽

...

Keyword(s):

Nursing Homes ◽

Medical Practice ◽

Intervention Group ◽

Medication Use ◽

Nursing Home Residents ◽

Control Group ◽

Multilevel Regression ◽

Difference In Differences ◽

Good Medical Practice ◽

The Impact

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.

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Effectiveness of a web-based medication adherence tool with patient centered communication: Results of a clustered randomized controlled trial (Preprint)

10.2196/preprints.16141 ◽

2019 ◽

Author(s):

Jan van Lieshout ◽

Joyca Lacroix ◽

Aart van Halteren ◽

Martina Teichert

Keyword(s):

Randomized Controlled Trial ◽

Medication Adherence ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Community Pharmacies ◽

Web Based ◽

Randomized Controlled ◽

Tailored Interventions ◽

Increased Risk

BACKGROUND Growing numbers of people use medication for chronic conditions; non-adherence is common, leading to poor disease control. A newly developed web-based tool to identify an increased risk for non-adherence with related potential individual barriers might facilitate tailored interventions and improve adherence. OBJECTIVE To assess the effectiveness of the newly developed tool to improve medication adherence. METHODS A cluster randomized controlled trial assessed the effectiveness of this adherence tool in patients initiating cardiovascular or oral blood glucose lowering medication. Participants were included in community pharmacies. They completed an online questionnaire comprising an assessments of their risk for medication non-adherence and subsequently of barriers to adherence. In pharmacies belonging to the intervention group, individual barriers displayed in a graphical profile on a tablet were discussed by pharmacists and patients at high non-adherence risk in face to face meetings and shared with their general practitioners and practice nurses. Tailored interventions were initiated by the healthcare providers. Barriers of control patients were not presented or discussed and these patients received usual care. The primary outcome was the difference in medication adherence at 8 months follow-up between patients with an increased non-adherence risk from intervention and control group, calculated from dispensing data. RESULTS Data from 492 participants in 15 community pharmacies were available for analyses (intervention 253, 7 pharmacies; control 239, 8 pharmacies). The intervention had no effect on medication adherence (-0.01; 95%CI -0.59 – 0.57; P= .96), neither in the post hoc per protocol analysis (0.19; 95%CI -0.50 – 0.89; P=.58). CONCLUSIONS This study showed no effectiveness of a risk stratification and tailored intervention addressing personal barriers for medication adherence. Various potential explanations for lack of effect were identified. These explanations relate for instance to high medication adherence in the control group, study power and fidelity. Process evaluation should elicit possible improvements and inform the redesign of intervention and implementation. CLINICALTRIAL The Netherlands National Trial Register: NTR5186. Date: May 18, 2015 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5186)

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