Abstract

Increasing balance confidence in older individuals is important towards improving their quality of life and reducing activity avoidance. Here, we investigated if balance confidence (perceived ability) and balance performance (ability) in older adults were related to one another and would improve after balance training. The relationship of balance confidence in conjunction with balance performance for varied conditions (such as limiting vision, modifying somatosensory cues, and also base of support) was explored. We sought to determine if balance confidence and ability, as well as their relationship, could change after several weeks of training. Twenty-seven healthy participants were trained for several weeks during standing and walking exercises. In addition, seven participants with a higher risk of imbalance leading to falls (survivors of stroke) were also trained. Prior to and after training, balance ability and confidence were assessed via the Balance Error Scoring System (BESS) and Activities Specific Balance Confidence (ABC) Scale, respectively. Both groups showed improvements in balance abilities (i.e., BESS errors significantly decreased after training). Balance confidence was significantly higher in the healthy group than in the stroke group; however, ABC results reflected that balance confidence did not significantly increase after training for each. The correlations between balance ability and balance confidence were explored. Encouragingly, healthy participants displayed a negative correlation between BESS errors and ABC (i.e., enhancements in balance confidence (increases in ABC Scale results) were related to improvements in balance ability (decreases in BESS errors)). For the stroke participants, despite improvements in balance ability, our results showed that there was no relation to balance confidence (i.e., no correlation between BESS errors and ABC) in this group.

Highlights

  • With increases in average life expectancy, the importance of improving and maintaining balance has significant societal relevance for the aging population [1]

  • All study activities were conducted within the Center for Biomechanical and Rehabilitation Engineering (CBRE) laboratory at the University of the District of Columbia, the protocol was approved by the Institutional Review Board (979744-1), and all participants gave their informed consent prior to participating in the study

  • Firm Foam Firm Foam Firm Foam (DL) (DL) (T) (T) (SL) (SL). Both lack of balance ability and lack of balance confidence are two major challenges which can contribute to falls and activity avoidance. e purpose of this study was to investigate both balance ability and balance performance in older adults and their relationships before and after training. is topic is relevant in that healthy individuals and patients may receive balance training to improve their balance abilities; if balance confidence is not improved in parallel, their capacity to do daily activities still would remain limited

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Summary

Introduction

With increases in average life expectancy, the importance of improving and maintaining balance has significant societal relevance for the aging population [1]. Since the 1980s, the term fear of falling (FOF), defined as a persisting overconcern and anxiety regarding falls, had emerged and gained recognition as a health problem in aging individuals [8]. FOF was thought to be a consequence of falling and was reported to range from 29 to 92% [8] in older adults that had previously fallen [9,10,11,12]. FOF exists even in individuals that have not previously fallen (i.e., FOF symptoms may exist regardless of any previous physical trauma) [5, 6]. The FOF evolves from relationships tied to multifactorial influences (e.g., physical, psychological, and functional) [6]

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