One-leg stance in healthy young and elderly adults: A measure of postural steadiness?

Karolinska Institutet, Neurotec Department, Division of Physiotherapy, Motor Control and Physical Therapy Research Laboratory, 23100, 141 83 Huddinge, Sweden.
Clinical Biomechanics (Impact Factor: 1.97). 09/2004; 19(7):688-94. DOI: 10.1016/j.clinbiomech.2004.04.002
Source: PubMed


To investigate postural steadiness during 30 s of one-leg stance in healthy young and elderly adults, by analysing the pattern of the ground reaction force variability.
A laboratory set-up was used to analyse the variability of the ground reaction forces in relation to time as a measure of postural steadiness.
The one-leg stance test is a measure considered to assess postural steadiness in a static position by a temporal measurement. The common notion is that a better postural steadiness, i.e. less force variability, allows for longer time standing on one leg. However, there is lack of evidence how postural steadiness during one-leg stance changes over time.
Twenty-eight healthy elderly and 28 healthy young adults were tested by means of force plates assessing ground reaction forces while performing one-leg stance.
During one-leg stance, two phases could be identified in both groups: First a dynamic phase, a rapid decrease of force variability, and thereafter a static phase, maintaining a certain level of force variability. During the first 5 s of one-leg stance the force variability decreased significantly more in the young group resulting in a lower force variability level during the static phase than in the elderly.
The difficulties in maintaining the static position in elderly seems dependent on the reduced initial decrease in force variability and/or musculoskeletal components. We suggest that the first 5 s are crucial when assessing balance during one-leg stance.

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    • "Raw data for mediolateral ground reaction force variability in individual participants with multiple sclerosis P. Ilett et al. Balance and Gait in People with Multiple Sclerosis stability (Goldie et al., 1989, Goldie et al., 1992, Jonsson et al., 2004 "

    Physiotherapy 05/2015; 101:e176. DOI:10.1016/ · 1.91 Impact Factor
    • "Raw data for mediolateral ground reaction force variability in individual participants with multiple sclerosis P. Ilett et al. Balance and Gait in People with Multiple Sclerosis stability (Goldie et al., 1989, Goldie et al., 1992, Jonsson et al., 2004 "
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    ABSTRACT: Background and purposeThe objective of this study is to compare the balance and gait of 11 people with multiple sclerosis (MS) to 11 healthy controls and to investigate the immediate change after a single intervention based on the Bobath concept on these activities in the MS group.Methods Balance was assessed by ground reaction forces (GRF) and centre of pressure movements during single limb standing (SLS), the Lateral Reach Test (LRT) and the Four Square Step Test (FSST). Gait was evaluated by GRF, ankle kinematics and spatiotemporal measures.ResultsBaseline measures in the MS group showed significantly greater vertical GRF variability (p = 0.008) during SLS reached less distance on the LRT (p = 0.001) and were slower completing the FSST (p < 0.001). During gait, the MS group walked slower (p = 0.005) and had less ankle plantarflexion (PF) (p = 0.001) than the control group. Less peak vertical GRF (p < 0.001) and peak propulsive GRF (p = 0.004) at terminal stance and increased vertical GRF in midstance (p = 0.005) were observed. The measures of balance and gait were re-assessed in the MS group immediately after a 20-min intervention based on the Bobath concept delivered to the most impaired foot and ankle. After the intervention, the MS group had significant changes towards the control group values with reduced mediolateral (p = 0.002) and vertical (p = 0.016) GRF variability in the SLS task, faster FSST time (p = 0.006) and increased ankle PF during gait (p = 0.002).DiscussionThis study provides further evidence of balance and gait limitations in people with MS and indicates that a single treatment based on principles of the Bobath concept to the foot and ankle can result in immediate improvements in balance and ankle PF during gait in people with MS. Copyright © 2015 John Wiley & Sons, Ltd.
    Physiotherapy Research International 02/2015; DOI:10.1002/pri.1624
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    • "We believe that our study provides a relationship between the results of Parreira et al. (2013) and Jonsson et al. (2004) who assumed that the difficulties of the older adults to maintain the SLS position depend on the initial five-second time frame. Our results show that older adults have not only increased initial values, but also less ability to reduce sway during the initial phase of SLS. "
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    ABSTRACT: Balance deteriorates with age and fall related injuries are often linked to long-term disability and loss of independence in older adults. This study focuses on the task of establishing single leg stance, which requires the ability to shift the center of mass onto the supporting leg.Methods Fifteen younger adults and eight older adults participated in the study. Subjects performed a step with self-selected step length onto the force plate to establish a single leg stance (SLS) on their dominant leg. The first four seconds of SLS were analyzed to investigate age related temporal dependencies of sway area, sway velocity, anterior-posterior sway, and medio-lateral sway.FindingsYounger adults show a rapid decrease of sway area, anterior-posterior sway, medio-lateral sway, and sway velocity within the first fours seconds while older adults show elevated initial values in anterior-posterior sway and sway velocity and less decrease over time.InterpretationOlder adults have not only diminished initial sway, but also less ability to control sway during the initial phase of single leg stance. The early phase of single leg stance is rather dynamic in older adults compared to younger adults who maintain their balance after three seconds with small adjustments.
    Clinical Biomechanics 11/2014; 30(1). DOI:10.1016/j.clinbiomech.2014.10.010 · 1.97 Impact Factor
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