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Core Muscle Strengthening's Improvement of Balance Performance in Community-Dwelling Older Adults: A Pilot Study
Abstract and Figures
To determine the effect of core muscle strengthening on balance in community-dwelling older adults, 24 healthy men and women between 65 and 85 years old were randomized to either exercise (EX; n = 12) or control (CON; n = 12) groups. The exercise group performed a core strengthening home exercise program thrice weekly for 6 wk. Core muscle (curl-up test), functional reach (FR) and Star Excursion Balance Test (SEBT) were assessed at baseline and follow-up. There were no group differences at baseline. At follow-up, EX exhibited significantly greater improvements in curl-up (Cohen's d = 4.4), FR (1.3), and SEBT (>1.9 for all directions) than CON. The change in curl-up was significantly correlated with the change in FR (r = .44, p = .03) and SEBT (r > .61, p .002). These results suggest that core strengthening should be part of a comprehensive balance-training program for older adults.
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... In 10 to 20% of the cases, falls result in bone fractures and head injuries and can lead to increased mortality. It may not be possible to prevent falls completely, but people who tend to fall frequently may be enabled to fall less often [26] . The fact that causes of falls are multifactorial loses in lower extremity muscle strength, power and balance seem to be the most prominent intrinsic (i.e. ...
... The results were found to be statistically highly significant (p<0.001) for all parameters in improving balance, fear of fall [23] . Nicole Kahle et al. (2014 ) Core muscle strengthening's conducted for improvement of balance performance in communitydwelling older adults and the study conclude that core strengthening should be part of a comprehensive balance-training program for older adults [28] . Yves J Gschwind et al. (2013) The study practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults and this study conclude that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults [7] . ...
... In this study to check the effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling. And this study conclude that home-based exercises programmes show positive effects in fall prevention in elderly persons [26] . Volume [15] . ...
Background: In the course of ageing, physical abilities decline and consequently there is an increase in risk of falling and fall incidence. Falls in India showed annual falls rates for older adults between 14 and 51 % . Loss of self- confidence, social isolation, increased dependence on others caused due to fear of fall are among the major consequences faced by elderly in day to day life. The fact that causes of falls are multifactorial loses in lower extremity muscle strength, power and balance seem to be the most prominent intrinsic (i.e. Personal - related) fall risk factor in older adults. Lower extremity resistance training can improve strength, balance and prevent fall in healthy adults. Lower extremity resistance training on unstable surface should be given on bosu ball and lower extremity resistance training on stable surface should be given on floor. Objective: The aim of this study is to study and compare the effects of lower extremity resistance training on unstable versus stable surface to prevent fall in healthy older adult. Material and Methodology: The study was conducted at Nanded Physiotherapy College and Research Centre. A convenient sampling was taken consisting of 48 participants, based on inclusion and exclusion criteria. Where they performed Double leg stance, Single leg stance, Marching, Mini-squats, Bridging on Bosuball for group A participants and on floor for group B participants. The subjects were assessed pre-intervention and post-intervention on the basis of Functional reach test and Berg balance scale. Total 48 participants were taken, who were aged 60 and above. These participants were divided into two groups. These participants were administered in lower extremity resistance training for 8 repetitions per set, 2 sets, 1 time a day, 2 days a week for 4 week. Result: For FRT and BBS the p-value was <0.0001. Hence there was statistical significance of treatment in pre and post within both groups. The study supports that effects of lower extremity resistance training on unstable surface is more effective than stable surface to prevent fall in healthy older adults. Key words: Falls, healthy adults, resistance training, unstable surface, stable surface, balance, strength.
... Although this study does not examine mechanisms that increase the ability to functional balance performance tests directly, but it can discuss the strengths from the designed posture training of Thai rhythm calisthenics movement. This pattern requires the principle of transferring weight during movement in rhythm with various gestures together with weighting on the heel and toes which will stimulate the senses and maintain a more balanced weight on the feet (Nicole & Michael, 2014), that individuals who practiced Thai dance spent more time turning the step inside and outside continually by focusing on components of dancing technique, including elements of meditation, body maintenance in extended periods of movement, weight transfer and base narrowing, coordination and control posture, which improved balance (Noopud et al., 2018). Thai rhythm calisthenics movement pattern was applied by the researcher using rhythm to control body movement together with contracting the abdominal muscles to help increase the stability of the core muscle while moving rhythmically at all times while performing the strength of the core muscles that are responsible for controlling body movement. ...
... Thai rhythm calisthenics movement pattern was applied by the researcher using rhythm to control body movement together with contracting the abdominal muscles to help increase the stability of the core muscle while moving rhythmically at all times while performing the strength of the core muscles that are responsible for controlling body movement. This causes the motion recognition mechanism to work harmoniously (coordination movement) both the arms and legs, resulting in the control of the coordination of muscles (neuromuscular control) awareness of joints (proprioceptive sense) according to the rhythm repeatedly throughout the training period (Nicole & Michael, 2014;Komagata & Newton, 2003). That is to say, exercise in a muscle group that is primarily responsible for controlling the movement of the arms, legs, or core muscle groups, including abdominal muscles, back, pelvic floor and oblique, resulting better balance of the participants (Kwon, 2015). ...
Background: Regular physical activity reduces emotional stress that represents long-term enzyme alpha-amylase values in daily life in the elderly. Objective: This study examined the efficiency of Thai rhythm calisthenics movement on Salivary alpha-amylase (sAA) and health performance in 70 elderly people, aged 60 - 75 years old. Methods: This research is a quasi-experimental research design with two group pre-test/post-test design; Thai rhythm calisthenics movement (TCM) and brisk walking exercise (BWE). The training was undertaken three times a week over 12 weeks, 45 minutes each session, 60 - 80% of MHR for each training activity. Both groups were tested for the sAA and health performance variables composed of Physiological, Balance and Mobility assessed using standardized tests including Functional reach test (FRT), Timed up and go test, (TUG), Chair stand test (CST) and Arm curl test (ACT) for 30 seconds, 6-minute walk test (6WT). Results: The sAA in both groups increased in the initial stages of exercise and was likely to decrease after the follow up period (p ≤ .05). At the end of 12 weeks, TCM decreased rapidly in the sAA level (p ≤ .05). Moreover, physiological variables including HR, SBP decreased while VO2max increased higher than the pre-test (p ≤ .05). In addition, testing FRT showed better scores for those in TCM compared to the BWE (p ≤ .001). Also faster movement took shorter time score in the TUG after training (p ≤ .05). 6WT, CST had a higher performance in both experimental groups (p ≤ .05). Conclusion: This study showed that TCM can improve mental health and enhance balance and mobility among the elderly. Additionally, it helps prevent decline as well as related fall risk.
... The heating of the muscle tissue enhances the regenerative processes through activating satellite cells (SC), muscle-delivered stem cells, which induce differentiation of the muscle fibers and increase blood flow to boost metabolic exchange [29]. The superior effects of HIFEM+RF have been shown on the abdomen [30], gluteal muscles [31], inner [32] and outer thighs [33], and upper arms [34]. Using a standalone HIFEM procedure over the pelvis and simultaneous application of HIFEM+RF over the abdomen aims to strengthen the abdominal and pelvic floor muscles, aka the core muscles. ...
... The strength of the core muscles is associated with an increase in comfortable and maximum gait speeds [31] and balance, including the step test as a measurement of dynamic balance and the TUG test [32,33]. This presented study showed a significant improvement in all primary outcomes, with more profound results in the group over 60 years old. ...
... Five studies tested the effect of home-based activity on mobility using different outcomes: (1) functional mobility using the Timed Up and Go (TUG) test, (2) gait (walking) speed, (3) muscle strength through handgrip strength, and (4) strength endurance (curl-up test). 7,22,25,30,41 All studies reported positive and significant improvements in physical functioning, muscle strength, strength endurance, changes in usual walking speed, and an average decrease in TUG. There is very low certain evidence these results indicate an improvement in functional mobility in communitydwelling older adults (Appendix Table A2, available online). ...
... There is very low certain evidence these results indicate an improvement in functional mobility in communitydwelling older adults (Appendix Table A2, available online). 7,22,25,30,41 ...
Context:
Home-based exercise programs are a good strategy to promote benefits to health for people who cannot visit gyms, clinics, or have limited time for physical activity outside.
Objective:
To synthesize the effect of home-based indoor physical activity on psychosocial outcomes and mobility in community-dwelling older adults.
Data sources:
A comprehensive search was conducted in the MEDLINE, PubMed, Embase, SPORTDiscus, Cochrane Library, Scopus, and Google Scholar databases.
Study selection:
A total of 11 studies (13 publications) were included involving a total of 1004 older adults.
Study design:
A systematic review of randomized controlled trials was conducted using the aforementioned 7 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
Level of evidence:
Level 2.
Data extraction:
Two authors independently selected studies, extracted data, and determined the risk of bias and evidence level using the Grading quality of evidence and strength of recommendations (GRADE) guidelines. We conducted a synthesis without meta-analysis (SWiM) to assess the outcome.
Results:
There is moderately certain evidence that home-based exercise programs reduced the fear of falling. Psychosocial (mental health and quality of life) and mobility outcomes may improve after participating in the intervention inside the home.
Conclusion:
The review found very low to certain evidence that home-based exercises programs improved psychosocial outcomes (mental health and quality of life) and walking speed (mobility). Moderately certain evidence suggests that home-based exercises improved fear of falling.
Protocol register number:
CRD42020182008.
... Study participants were noninstitutionalized community-dwelling older adults with an average age of 73.6 ± 5.8 years. Most study participants were described as independent walkers.[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] Some studies included participants who had previously fallen36,38,40,43,52 or were described as functionally limited,[53][54][55] inactive,41,[56][57][58] or frail/sarcopenic.44,[59][60][61][62] ...
Background and Purpose
The international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) tool is a new instrument developed to evaluate the therapeutic quality of exercise interventions. Home-based exercise has been shown to improve physical fitness in older adults, but its effects may be influenced by therapeutic quality. The purpose of this systematic review was to describe the therapeutic quality of home-based exercise interventions for community-dwelling older adults and examine the relationship between therapeutic quality and changes in physical fitness.
Methods
Six electronic databases and 2 clinical trial registries were searched for randomized controlled trials investigating the effects of home-based exercise on physical fitness in community-dwelling older adults (≥60 years). Therapeutic quality was evaluated using the i-CONTENT tool for items of patient selection, type of exercise, safety, type/timing of outcomes, exercise dose, and adherence. International Consensus on Therapeutic Exercise aNd Training items were used to explain heterogeneity in meta-regression analyses. Risk of bias, certainty of evidence and credibility of analyses were assessed.
Results
Thirty-six trials (n = 6157 participants) were identified. Most studies (≥66.7%) had high or probably high therapeutic quality for i-CONTENT items, except exercise dose (47.2%) and adherence (16.7%). Interventions improved upper- (N = 20 trials; standardized mean difference [SMD] = 0.39; 95% CI, 0.13-0.64; low certainty of evidence) and lower-body strength (N = 28; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty), and aerobic fitness (N = 8; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty). For exercise dose, low- or probably low-quality studies negatively influenced effects on upper- (estimated β = –.48; P = .049; moderate credibility) and lower-body strength (estimated β = –.77; P = .048; moderate credibility). For adherence, low- or probably low-quality studies negatively influenced effects on aerobic fitness (estimated β = –.97; P = .02; low credibility).
Conclusions
Home-based exercise may improve upper- and lower-body strength, as well as aerobic fitness in older adults. However, the effectiveness of interventions is affected by inadequate dosing of exercise programs and adherence issues. Physical therapists should have the best available evidence to support their clinical decision making, especially when designing and monitoring home programs.
... Postural changes and lower-extremity weakness in patients with lung disease limit postural stability and balance. 42,43 In the COPD population, balance training in addition to participation in pulmonary rehabilitation has been reported to improve balance, strength, and physical function. 44 However, balance and postural stability training have not typically been part of posttransplant rehabilitation programs. ...
Purpose
Functional recovery after lung transplant is crucial to long-term outcomes. Despite rehabilitation, few reach the threshold of healthy function. The purpose of this study was to assess the potential benefit of rehabilitation in the Center of Life for Thoracic Transplant (COLTT) program by (1) measuring time to functional recovery, (2) identifying factors associated with functional recovery, (3) examining program outcomes, and (4) examining COLTT impact on unplanned hospital readmission.
Methods
The study retrospectively examined 105 patients in COLTT after hospital discharge. Functional measures collected at enrollment and completion included 6-minute walk distance, walking speed, 1-minute sit-to-stand test, and single-leg stance. Demographic and hospital stay data were examined for associations between time to achieve COLTT goals and readmissions.
Results
The median number of visits in COLTT was 18 (9–53). Significant functional gains were made across all outcome measures and near thresholds for healthy individuals. Age, hospital and intensive care unit (ICU) length of stay (LOS), lung disease type, and ventilation time were significantly associated with COLTT visits. The 30-day hospital readmission free rate after hospital discharge was 71.4%.
Conclusions
Healthy adult functional outcomes were achieved in 18 visits. Age, hospital and ICU LOS, lung disease type, and prolonged ventilation are associated with functional recovery.
... The core, which serves as a link between the upper and lower limbs, is important for maintaining balance, functional mobility, and postural stability [18]. Core strength and endurance may be influenced by a variety of factors, such as spinal alignment, neural control, level of exercise and training, as well as the presence of lower back pain [19][20][21]. ...
Background
One of the most prevalent musculoskeletal issues in dentistry is forward head posture (FHP). Proprioception and core endurance are crucial for maintaining proper posture.
Objective
The aim of this study was to compare dental students with and without FHP in terms of their core endurance and shoulder proprioception.
Methods
Using kinovea software, a cross-sectional study was conducted on 30 dental students who had FHP with a craniovertebral angle less than 49 degrees. The control group consisted of 30 additional dental students without FHP. Trunk anterior flexor, posterior extensor, right and left flexors were tested using the McGill method to determine core endurance. The isokinetic Biodex system was used to measure shoulder proprioception.
Results
Independent t-test results revealed that core endurance was significantly lower in the group with forward head posture compared to the control group ( p 0.05), while shoulder proprioception did not differ significantly between groups ( p > 0.05).
Conclusion
In comparison to dental students without forward head posture, male dental students with FHP have normal shoulder joint proprioception and impaired core endurance holding time. This could be a risk factor for a variety of musculoskeletal issues in dentists.
Background:
There is a need for comprehensive programs that address both the physical and psychosocial aspects of fall prevention for the elderly.
Objective:
This study assessed the efficacy of the exercise regimen on various health metrics for elderly community dwellers.
Methods:
Forty-four participants were divided into experimental and control groups. The experimental group adhered to a 9-step core exercise regimen for fall prevention, practicing three times a week for 30 minutes across 10 weeks, while the control group maintained their regular daily activities without any specific exercise program. Before and after the intervention, participants underwent the timed up-and-go t est to evaluate the physical function, the berg balance scale (BBS) and one-legged stance test (OLST) for balance assessment, the activity-specific balance confidence scale for fall-related self-efficacy, and measures for health-related quality of life.
Results:
Participants in the experimental group showed significant improvements in physical function (p = .04, Cohen's effect size (d) = 0.2). and balance ability on BBS (p < .01, d = 0.2) and OLST (p < .01, d = 1.3) compared to the control group. Furthermore, there was a notable enhancement in the quality of life indicators for this group, especially in areas such as physical function (p = .04, d = 0.2), physical-role limitation (p = .04, d = 0.2), mental health (p = .01, d = 0.3), vitality (p = .02, d = 0.4), body pain (p = .04, d = 0.5), and general health (p = .04, d = 0.4).
Conclusion:
These findings highlight the potential of the fall prevention exercise program in improving physical health aspects, but its influence on specific psychosocial elements remains to be determined.
Purpose
Resistance training (RT) can intervene in aging, which can effectively improve trainees’ life. However, unhealthy living habits such as irregular life, obesity and hyperlipidemia, and chronic diseases lead to a significant decline in the energy level of the population, seriously affecting the health of the population. Our research identifies the research hotspots of RT to intervene in aging from the perspective of bibliometrics, predicts research frontiers and development trends, and provides more perspectives for research on aging populations.
Methods
In this study, we used CiteSpace and VOSviewer visualization software to draw the scientific knowledge map of countries/regions, institutions, authors, co-occurrence keywords, and co-cited references of published articles, and explore the Web of Science core collection database all about the RT intervention aging research status, hotspots, frontiers, and development trends of articles on aging.
Results
Among the 760 articles that meet the inclusion criteria, the number of articles published and the frequency of citations have increased steadily in the past 5 years. Judging from the countries/regions, institutions, scholars, and journals that published articles, the ones with the largest numbers are the USA, Univ Estadual Londrina, Cyrino ES, and Exp Gerontol. The ones with the highest influence are England, Univ Arkansas Med Sci, Frontera WR, and Biochem Biophys Rep Co. The top five co-occurrence keywords of include exercise, strength, resistance training, skeletal muscle, and muscle strength. The research frontier is physical function.
Conclusion
In the field of RT intervention aging research, relevant scholars deserve further in-depth research and exploration. The United States, Brazil, Canada, and other economically developed countries/regions, institutions, and authors have greater influence and productivity. These quantitative research results can provide references for relevant scholars’ follow-up research and government departments to formulate and modify health policies or measures.
Middle-aged women have less postural control than younger women. The Star Excursion Balance Test is a functional and inexpensive postural control measurement tool that is sensitive to age-related changes in balance.
The middle-aged females will experience lower excursion scores compared with the younger women.
Fifty-three healthy, recreationally active women were divided into 2 groups: adult-aged (n = 29; age range, 23-39 years) and middle-aged (n = 24; age range, 40-54 years). Each participant performed 3 reaches for 3 trials (anteromedial, medial, posteromedial) in a randomized order. The 3 reach trials were converted to a normalized value (percentage of participant's height) and assessed as an overall mean for the 1-way analysis of variance. Intraclass correlation coefficients and 95% confidence intervals were calculated.
No differences were found for body mass index and height; however, age was different between groups (P < 0.01). Intraclass correlation coefficient(2,3) values for the 3 directions ranged from 0.72 to 0.97. The adult-aged women were able to reach farther in all 3 directions when tested with the Star Excursion Balance Test (6.8-7.6 cm, P < 0.05).
Lower postural control scores based on the Star Excursion Balance Test were found for the older women. The younger women were able to reach approximately 7 cm farther during the anterior, anteromedial, and posteromedial excursions.
In older adults, diminished balance is associated with reduced physical functioning and an increased risk of falling. This is an update of a Cochrane review first published in 2007.
To examine the effects of exercise interventions on balance in older people, aged 60 and over, living in the community or in institutional care.
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL (The Cochrane Library 2011, Issue 1), MEDLINE and EMBASE (to February 2011).
Randomised controlled studies testing the effects of exercise interventions on balance in older people. The primary outcomes of the review were clinical measures of balance.
Pairs of review authors independently assessed risk of bias and extracted data from studies. Data were pooled where appropriate.
This update included 94 studies (62 new) with 9,917 participants. Most participants were women living in their own home.Most trials were judged at unclear risk of selection bias, generally reflecting inadequate reporting of the randomisation methods, but at high risk of performance bias relating to lack of participant blinding, which is largely unavoidable for these trials. Most studies only reported outcome up to the end of the exercise programme.There were eight categories of exercise programmes. These are listed below together with primary measures of balance for which there was some evidence of a statistically significant effect at the end of the exercise programme. Some trials tested more than one type of exercise. Crucially, the evidence for each outcome was generally from only a few of the trials for each exercise category. 1. Gait, balance, co-ordination and functional tasks (19 studies of which 10 provided primary outcome data): Timed Up & Go test (mean difference (MD) -0.82 s; 95% CI -1.56 to -0.08 s, 114 participants, 4 studies); walking speed (standardised mean difference (SMD) 0.43; 95% CI 0.11 to 0.75, 156 participants, 4 studies), and the Berg Balance Scale (MD 3.48 points; 95% CI 2.01 to 4.95 points, 145 participants, 4 studies).2. Strengthening exercise (including resistance or power training) (21 studies of which 11 provided primary outcome data): Timed Up & Go Test (MD -4.30 s; 95% CI -7.60 to -1.00 s, 71 participants, 3 studies); standing on one leg for as long as possible with eyes closed (MD 1.64 s; 95% CI 0.97 to 2.31 s, 120 participants, 3 studies); and walking speed (SMD 0.25; 95% CI 0.05 to 0.46, 375 participants, 8 studies).3. 3D (3 dimensional) exercise (including Tai Chi, qi gong, dance, yoga) (15 studies of which seven provided primary outcome data): Timed Up & Go Test (MD -1.30 s; 95% CI -2.40 to -0.20 s, 44 participants, 1 study); standing on one leg for as long as possible with eyes open (MD 9.60 s; 95% CI 6.64 to 12.56 s, 47 participants, 1 study), and with eyes closed (MD 2.21 s; 95% CI 0.69 to 3.73 s, 48 participants, 1 study); and the Berg Balance Scale (MD 1.06 points; 95% CI 0.37 to 1.76 points, 150 participants, 2 studies).4. General physical activity (walking) (seven studies of which five provided primary outcome data). 5. General physical activity (cycling) (one study which provided data for walking speed). 6. Computerised balance training using visual feedback (two studies, neither of which provided primary outcome data). 7. Vibration platform used as intervention (three studies of which one provided primary outcome data).8. Multiple exercise types (combinations of the above) (43 studies of which 29 provided data for one or more primary outcomes): Timed Up & Go Test (MD -1.63 s; 95% CI -2.28 to -0.98 s, 635 participants, 12 studies); standing on one leg for as long as possible with eyes open (MD 5.03 s; 95% CI 1.19 to 8.87 s, 545 participants, 9 studies), and with eyes closed ((MD 1.60 s; 95% CI -0.01 to 3.20 s, 176 participants, 2 studies); walking speed (SMD 0.04; 95% CI -0.10 to 0.17, 818 participants, 15 studies); and the Berg Balance Scale ((MD 1.84 points; 95% CI 0.71 to 2.97 points, 80 participants, 2 studies).Few adverse events were reported but most studies did not monitor or report adverse events.In general, the more effective programmes ran three times a week for three months and involved dynamic exercise in standing.
There is weak evidence that some types of exercise (gait, balance, co-ordination and functional tasks; strengthening exercise; 3D exercise and multiple exercise types) are moderately effective, immediately post intervention, in improving clinical balance outcomes in older people. Such interventions are probably safe. There is either no or insufficient evidence to draw any conclusions for general physical activity (walking or cycling) and exercise involving computerised balance programmes or vibration plates. Further high methodological quality research using core outcome measures and adequate surveillance is required.
To determine whether trunk extension endurance changes with training are associated with clinically meaningful improvements in balance among mobility-limited older adults.
Longitudinal data from a randomized controlled trial.
Outpatient rehabilitation research center.
Community-dwelling older adults (N=64; mean age, 75.9y) with mobility limitations as defined by a score of 4 to 10 on the Short Physical Performance Battery.
Sixteen weeks of progressive resistance training.
Outcomes were the Berg Balance Scale (BBS) and the Unipedal Stance Time (UST). Predictors included leg strength, leg power, trunk extension endurance, and the product of heart rate and blood pressure (RPP) at the final stage of an exercise tolerance test. We performed an analysis of data from participants who completed 16 weeks of training by using binary outcomes defined by a clinically meaningful change (CMC) from baseline to completion of the intervention (BBS=4 units; UST=5s). The association of predictor variables with balance outcomes was examined separately and together in multivariate adjusted logistic regression models.
Trunk extension endurance in seconds (1.04 [1.00-1.09]) was independently associated with CMC on the BBS. Trunk extension endurance (1.02 [1.00-1.03]) was independently associated with CMC on the UST. Other physical attributes were not associated with meaningful change in balance.
Improvements in trunk extension endurance were independently associated with CMCs in balance in older adults. Leg strength, leg power, and RPP were not associated with CMC in balance. Poor trunk extension endurance may be a rehabilitative impairment worthy of further study as a modifiable factor linked to balance among older adults.
The aim of this review was to examine the contribution of muscle weakness to postural stability in healthy older adults and to determine the relationship between muscle weakness and balance impairment.
A comprehensive search of electronic databases was performed from earliest record to February 2010. All study designs that contained a measure of muscle strength or muscle power and balance performance in older adults were examined. Population. Participants (>or=60 years) included healthy, community-dwelling cohorts, nursing home residents, frail, mobility- or functionally-limited adults but not persons with pathophysiological conditions or disease.
Interventions of progressive resistance or power training to increase muscle strength/power were examined but studies that included balance or multimodal training were excluded.
A total of 74 papers were eligible for review; 45 with strength measures only; 5 with power measures only and 24 papers containing both strength and power outcomes. Overall, 54% (27/50) of studies reported significantly improved strength and balance measures and 73% (16/22) showed improved power and balance following resistance/power training intervention, whereas 84% and 86% of cross sectional studies observed significant associations between balance and strength/power outcomes respectively.
The findings suggest that there is some evidence for the contribution of muscle strength and muscle power to balance performance in older adults. There is, however, weak evidence for the cause and effect relationship between muscle function and balance performance. Clinical Rehabilitation Impact. Inconsistencies in the literature can be attributed to methodological limitations.
Objective: To estimate intratester and intertester reliability and learning effects during the Star Excursion Balance Tests (SEBTs). Setting: A university athletic training research laboratory. Subjects: Sixteen healthy volunteers with no history of balance disorders or significant lower extremity joint pathology. Measurements: Length of excursion was measured manually for each trial. Results: ICCs for intratester reliability were .78-.96 on day 1 and .82-.96 on day 2. ICCs for intertester reliability were .35-.84 on day 1 and .81-.93 on day 2. Significant learning effects were identified for 4 of the 8 tests. Conclusions: Estimates of intratester and intertester reliability were high, but adequate practice trials should be performed before taking baseline measures.
The intersegmental and multisegmental musculature of the lumbar spine was studied in a biomechanical model to compare their lateral stabilizing potential. By approximating the active and passive behavior of the stretch reflex as a variable stiffness spring whose stiffness was proportional to activation, the critical muscle stiffness required for mechanical stability was calculated. The model demonstrated that the intersegmental muscles were the least efficient at laterally stabilizing the spine. At any given load, multisegmental muscles were more efficient, and their efficiency increased with the number of segments spanned. The most efficient muscles were those that originated from the pelvis, spanning the maximum number of segments. The muscular model was unstable, regardless of the muscular stiffness, when any vertebral segment was devoid of muscle. Moreover, when the load on the spine is increased, buckling can be prevented most efficiently with the pelvic muscles and least efficiently with the intersegmental muscles.
The ability to balance is closely related to functional status and safety. It is of particular concern in the elderly as balance may be impaired due to disease or aging. The primary objective of this paper is to review existing laboratory and clinical measures of balance. To facilitate this review, the dimensions of balance and the properties of good measurement are described. Situations requiring balance can be divided into three general classifications: maintenance of a position, postural adjustment to voluntary movements, and reactions to external stresses. This complex motor skill may be viewed from a biomechanical, neurophysiological, or a functional perspective. In the laboratory, investigators have measured sway patterns and examined strategies of regaining balance after a perturbation. Recent clinical studies have shown a trend to performance based assessment. To data there is no one universally acceptable laboratory or clinical method to measure balance. Because of its importance in functional activities, the need for a good measure of balance is evident.
Screening should have simple and easy-to-administer methods that identify impairments associated with future fall risk, but there is a lack of literature supporting validation for their use.
The aim of this study was to evaluate the independent contribution of balance assessment on future fall risk, using 5 methods to quantify balance impairment, for the outcomes "any fall" and "any injurious fall" in community-dwelling older adults who are higher functioning.
This was a prospective cohort study.
A sample of 210 community-dwelling older adults (70% male, 30% female; mean age=79.9 years, SD=4.7) received a comprehensive geriatric assessment at baseline, which included the Berg Balance Scale to measure balance. Information on daily falls was collected for 12 months by each participant's monthly submission of a falls log calendar.
Seventy-eight people (43%) fell, of whom 54 (30%) sustained an injurious fall and 32 (18%) had recurrent falls (> or =2 falls). Different balance measurement methods identified different numbers of people as impaired. Adjusted relative risk (RR) estimates for an increased risk of any fall were 1.58 (95% confidence interval [CI]=1.06, 2.35) for self-report of balance problems, 1.58 (95% CI=1.03, 2.41) for one-leg stance, and 1.46 (95% CI=1.02, 2.09) for limits of stability. An adjusted RR estimate for an increased risk of an injurious fall of 1.95 (95% CI=1.15, 3.31) was found for self-report of balance problems. Limitations The study was a secondary analysis of data.
Not all methods of evaluating balance impairment are associated with falls. The number of people identified as having balance impairment varies with the measurement tool; therefore, the measurement tools are not interchangeable or equivalent in defining an at-risk population. The thresholds established in this study indicate individuals who should receive further comprehensive fall assessment and treatment to prevent falls.