One-leg stance in healthy young and elderly adults: a measure of postural steadiness?
ABSTRACT 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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ABSTRACT: Whole body vibration (WBV) may enhance muscular strength and power but little is known about its influence on sensory-motor function. Vibration of a single muscle or tendon affects the afferent system in a manner that depends on amplitude and frequency. WBV stimulates many muscle groups simultaneously and the frequencies and amplitudes used are different from many of the studies on single musculotendinous units. We investigated the effects of WBV at two amplitudes on balance, joint position sense (JPS) and cutaneous sensation in young healthy subjects. Eighteen adults (24.3 ± 1.5 years, 15 females) were assessed before WBV (five 1 min bouts, 30 Hz) then immediately, 15 and 30 min afterwards. Two amplitudes (4 and 8 mm peak to peak) were investigated on different occasions. Standing balance was assessed with feet together and eyes closed, and standing on one leg with eyes open and closed. JPS at the knee and ankle was assessed by repositioning tasks while cutaneous sensation was recorded from six sites in the lower limb using pressure aesthesiometry. Neither amplitude affected JPS (P > 0.05). There were minimal effects on balance only in the vertical plane and only 30 min after WBV (P < 0.05). Low amplitude vibration only reduced sensation at the foot and ankle immediately after WBV (P < 0.008). High amplitude vibration impaired sensation at the foot, ankle and posterior shank for the entire test period (P < 0.008). In young healthy individuals WBV did not affect JPS or static balance, but reduced cutaneous sensation. These data may have implications for older and clinical populations with compromised postural control.Arbeitsphysiologie 04/2011; 111(12):3069-77. · 2.66 Impact Factor
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ABSTRACT: The objective of this study is to investigate whether vestibular rehabilitation can improve balance, reduce self-perceived handicap because of dizziness and, if possible, reduce falls among dizzy patients in primary healthcare. The study also finds out which of the balance measures and measure of self-perceived handicap, if any, predicted the risk of falls. The design of this study is an intervention study with control group. Fifty-eight patients, 65 years and older, with multisensory dizziness were taken as participants. The intervention group trained vestibular rehabilitation twice a week for 9 weeks. All patients were assessed at baseline and after 3 months, with four different balance measures and the Dizziness Handicap Inventory. After 6, 9 and 12 months, a follow-up by telephone was performed and, at 12 months, the patients also filled out a Dizziness Handicap Inventory questionnaire. Statistically significant differences were found between the groups between baseline and 3 months in one static balance measure and in one dynamic measure (P=0.038 and 0.044). In total, 40 falls were reported, 31 were classified as intrinsic falls, 26 of them caused by vertigo and nine falls were classified as extrinsic. No difference was found between the two groups in proportions of patients who fell. Poor ability to stand in tandem stance doubled the risk for falls. Vestibular rehabilitation can improve balance in elderly patients with multisensory dizziness. Vertigo is a common cause of falls in this group of patients and vestibular rehabilitation is a feasible treatment.International Journal of Rehabilitation Research 04/2008; 31(1):51-7. · 1.06 Impact Factor
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ABSTRACT: Objectives: To determine the effects of a single episode of whole body vibration among community dwelling older adults on balance, mobility, and joint position sense. Methods: Thirty six adults over the age of 50 were recruited and underwent measurement of single limb stance for right and left legs, Timed Up and Go test, and joint position sense of the knee before and after a single episode of Whole Body Vibration (WBV) using a frequency of 6Hz, amplitude of 5mm, applied for ten minutes. Results: There was a statistically significant change in single limb balance for both the right and left legs following the single episode of WBV. There was no statistically significant change in timed up and go and joint position sense following WBV. Conclusions: A single episode of WBV for ten minutes, at 6Hz and 5mm peak to peak amplitude, had an effect on single limb balance, but no effect on joint position sense or mobility. INTRODUCTION As people age, deterioration in balance, mobility, and joint position sense contribute to an increased risk of falling. 1 Approximately 28 to 35% of people aged 65 and over fall each year, increasing to 32 to 42% for those over 70 years of age. 2 At least 20 to 30% of those who fall sustain an injury such as bruises, fractures, and disability, which reduce their overall mobility and subsequently their independence. 3 The cost of falls to the health system is substantial. The projected health system cost of falls in Western Australia in 2021 is $174 million. The reported corresponding costs in 2001-02 was $83 million. 4 Balance problems and lower extremity weakness have been associated with a 2 to 4 times increased risk of falls in community dwellers. 5 Across all populations, impaired balance results in 3.2 times the risk of falling, and limited mobility results in 2.5 times the risk of falling. 6 Single limb balance has been shown to be an indicator of poor balance and has been used to assess the risk of falling in the older population. 7 Reported single limb balance mean values (95% confidence intervals) for 50 to 59 years of age are 41.2 ± 10.2 seconds, for the 60 to 69 years age group are 27.0 seconds (20.4 to 33.7), 8, 9 and 70 to 79 years of age 17.2 seconds (11.6 to 22.8). 8,10 The Timed Up and Go test is a sensitive indicator for poor mobility and therefore falls risk in the elderly. 11 The mean normative values (95% confidence intervals) determined for the Timed Up and Go test via meta-analysis are 8.1 seconds (7.1 to 9.0) for 60 to 69 years and 9.2 seconds (8.2 to 10.2) for 70 to 79 years of age. 9 Interventions that improve balance and mobility have the capacity to decrease fall rates, subsequent morbidity, and health spending.The Internet Journal of Allied Health Science and Practice. 01/2013; 11(3).