Analysis Of Postural Sway Research Articles

Impact of professional dance training on characteristics of postural sway.

The stability of human upright posture determines the range and dynamics of movements performed. Consequently, the repertoire and quality of the movements performed by a dancer are mainly determined by the efficiency of postural control. This is of particular importance in professional dance training that should focus on shaping optimal movement‑posture interaction. To get a deeper insight into this problem, the impact of the training on postural sway characteristics during quiet stance was analyzed in 16 female students in the seventh grade of a ballet school and compared with the size‑ and age‑matched group of secondary school students. Center of pressure trajectories were recorded for 25.6 s while standing quiet with eyes open (EO) and then with eyes closed (EC). The assessment of postural control was based on novel normalized sway parameters including sway vector (SV), sway anteroposterior (AP) and mediolateral (ML) directional indices (DIAP and DIML), and sway ratios (SRAP and SRML). The results document a significant contribution of vision to postural stability control in ballet students, which seems to compensate for training‑related changes in joint mobility and altered activity ranges of the legs' muscles. In the control group standing with EC, SV amplitude increased only by 18% whereas in the ballet students tested in the same conditions, the increase exceeded 72%. Under full control of standing posture (EO test), the training‑related increase of leg muscle forces allows dancers to maintain balance with lesser effort as documented here by 21% reduced SRAP. Additionally, the dancers while tested with their EC exhibited a 12% increase in the anteroposterior sway with a concomitant reduction of the mediolateral sway. The resulting changes in the postural control asymmetry were documented by both DIAP/DIML and SV azimuth. In conclusion, our novel analysis of postural sway seems a useful tool in monitoring the effects of training as well as the proper course of postural control development in children and adolescents.

Principal components analysis of postural sway in persons with unilateral lower limb amputation: A wearable sensor approach

Standing sway assessments can detect sensory imbalances which compromise postural control. Persons with lower limb amputation (LLA) often demonstrate impaired postural control, increasing fall risk. Here, principal features of postural sway were identified in persons with unilateral LLA using a single, commercially available wearable sensor. Sixty-one persons with LLA (n = 44 transtibial; n = 17 transfemoral) stood on a firm surface with eyes open/closed while wearing a single accelerometer mounted over the sacrum. Common parameters quantified spatiotemporal and spectral features of sway in anterior-posterior (AP) and mediolateral (ML) directions. Principal component (PC) dimensionality reduction was applied and loadings inspected to identify a reduced, non-redundant set among 14 original variables capturing 90 % variance. Six PCs described ≥ 90 % variance, with the first 3 explaining 75 %. With eyes open and closed, PC1 was loaded by variables characterizing trajectory planar size: area, jerk (i.e., sway smoothness), AP/ML RMS path distance, and AP/ML path range. With eyes open, PC2 was loaded by variables characterizing direction and spectral features: ellipse rotation, AP centroidal frequency, and ML jerk. With eyes closed, PC2 spectral loadings increased: ML centroidal frequency, ML frequency dispersion, and AP centroidal frequency. With eyes open, PC3 was loaded by ellipse rotation, jerk, ML velocity, ML centroidal frequency. With eyes closed, PC3 was loaded by ellipse rotation, ML centroidal frequency, ML frequency dispersion, and AP path velocity, characterizing off-axis error/corrections. RMS of path distance, ellipse rotation, centroidal frequency, frequency dispersion, path velocity, and jerk are a concise parameter set, derived from an accelerometer, to capture principal sway features in persons with LLA during standing balance with visual perturbations.

Recurrence quantification analysis of postural sway in patients with persistent postural perceptual dizziness.

Persistent postural perceptual dizziness (PPPD) is a common cause of chronic dizziness and imbalance. Emerging evidence suggests that changes in quantitative measures of postural control may help identify individuals with PPPD, however, traditional linear metrics of sway have yielded inconsistent results. Methodologies to examine the temporal structure of sway, including recurrent quantification analysis (RQA), have identified unique changes in dynamic structure of postural control in other patient populations. This study aimed to determine if adults with PPPD exhibit changes in the dynamic structure of sway and whether this change is modulated on the basis of available sensory cues. Twelve adults diagnosed with PPPD and twelve age-matched controls, completed a standard battery of quiet stance balance tasks that involved the manipulation of visual and/or proprioceptive feedback. For each group, the regularity and complexity of the CoP signal was assessed using RQA and the magnitude and variability of the CoP signal was quantified using traditional linear measures. An overall effect of participant group (i.e., healthy controls vs. PPPD) was seen for non-linear measures of temporal complexity quantified using RQA. Changes in determinism (i.e., regularity) were also modulated on the basis of availability of sensory cues in patients with PPPD. No between-group difference was identified for linear measures assessing amount and variability of sway. Participants with PPPD on average exhibited sway that was similar in magnitude to, but significantly more repeatable and less complex than, healthy controls. These data show that non-linear measures provide unique information regarding the effect of PPPD on postural control, and as a result, may serve as potential rehabilitation outcome measures.

The use of fractal dimension methods in clinical epidemiology: an application for postural assessment


 Background: this study considers the analysis of postural sway by comparing the use of a fractal dimension outcome (DBOX) with the usual sway ellipse area (SEA), calculated by the least squares method. Both the response variables come from centre of pressure (COP) dynamics detected by means of a force platform.
 Methods: recent literature regarding postural stability assessment in subjects with muscularskeletal disorders, or neuromuscular diseases affecting their motor skills, has suggested, both for practical and theoretical reasons, the use of some fractal dimension as a good outcome measurement for overall postural status. A sample group of 24 male subjects was recruited. The postural stabilogram was recorded both with eyes open (EO) and eyes closed (EC) while standing upright. A matched-pair comparison of the sway ellipse area with the COP dynamics box counting dimension was performed. A ROC analysis of the outcome variables was performed. Then, a ROC comparison of the tests, using the area under the curve (AUC) index, was conducted.
 Results: the comparison of paired groups showed a statistically significant difference between EO and EC status, according to the sway ellipse area and the fractal dimension (p<0.05). The ROC analysis, describing the test performance in terms of AUC difference, was statistically significant (p<0.05). The comparison of the AUCs showed an overall superior performance of the DBOX with respect to SEA (p<0.05).
 Conclusions: this study showed a statistically significant better overall performance of DBOX with respect to SEA, suggesting possible improvements of clinical practice, as well as theoretical insights into the response patterns.

The Feasibility of Equine Field-Based Postural Sway Analysis Using a Single Inertial Sensor.

(1) Background: Postural sway is frequently used to quantify human postural control, balance, injury, and neurological deficits. However, there is considerably less research investigating the value of the metric in horses. Much of the existing equine postural sway research uses force or pressure plates to examine the centre of pressure, inferring change at the centre of mass (COM). This study looks at the inverse, using an inertial measurement unit (IMU) on the withers to investigate change at the COM, exploring the potential of postural sway evaluation in the applied domain. (2) Methods: The lipopolysaccharide model was used to induce transient bilateral lameness in seven equines. Horses were monitored intermittently by a withers fixed IMU over seven days. (3) Results: There was a significant effect of time on total protein, carpal circumference, and white blood cell count in the horses, indicating the presence of, and recovery from, inflammation. There was a greater amplitude of displacement in the craniocaudal (CC) versus the mediolateral (ML) direction. A significant difference was observed in the amplitude of displacement in the ML direction between 4–12 h and 168 h. (4) Conclusions: The significant reduction in ML displacement during the acute inflammation period alongside greater overall CC displacement may be a compensatory behaviour for bilateral lameness.

A Multidimensional Approach to Develop Sway Index Using Gaussian Mixture Model: A Way of Postural Sway Measurement and Analysis in Different Age Groups

Many classical postural sway measures are based on linear analysis of different temporal characteristics of the body’s center of pressure (CoP). In some of the classical sway analysis methods, the anterior–posterior and the mediolateral aspects are analyzed separately. While these classical measures are found to be affected by aging, they cover different aspects of stability. Moreover, linear postural sway analysis is not efficient due to complexity of the human physiological functions. This study developed a single sway index based on the nonlinear analysis of the multidimensional CoP data and compared it in different participant age groups in different standing tests. The sway index performance was compared with six classical sway measures and six universal sway parameters. In all, 17 younger active lifestyle participants (31 ± 5.7), 12 participants age between 50 and 60 years (56.2 ± 3.3), and 32 older participants age 60 years and above (69.6 ± 6.2) were recruited for this study. Participants were asked to undergo three standing tests of double stance, single stance, and tandem stance all with eyes closed for 20 s. Using a global machine-learnt Gaussian mixture model, the multidimensional CoP data were clustered, and consequently an index was derived based on the results. Most classical and universal sway measures in the single stance and tandem stance were found to be significantly different in younger participants compared with the older ones. Our proposed sway index was significantly different in younger participants compared with 50–60 years participants in addition to older participants. The sway index also outperformed all classical and universal sway measures in the single and tandem stance tests with the sensitivity of 90.9% and 87.5%, the specificity of 82.4% and 84.3%, and AUC of 0.90 (95% CI, 0.81–1) and 0.91 (95% CI, 0.82–0.99), respectively. The findings demonstrated a strong potential of the sway index to be used as a single yet effective sway measurement.

Which features of postural sway are effective in distinguishing Parkinson's disease from controls? A systematic review

BackgroundPostural sway may be useful as an objective measure of Parkinson's disease (PD). Existing studies have analyzed many different features of sway using different experimental paradigms. We aimed to determine what features have been used to measure sway and then to assess which feature(s) best differentiate PD patients from controls. We also aimed to determine whether any refinements might improve discriminative power and so assist in standardizing experimental conditions and analysis of data.MethodsIn this systematic review of the literature, effect size (ES) was calculated for every feature reported by each article and then collapsed across articles where appropriate. The influence of clinical medication status, visual state, and sampling rate on ES was also assessed.ResultsFour hundred and forty‐three papers were retrieved. 25 contained enough information for further analysis. The most commonly used features were not the most effective (e.g., PathLength, used 14 times, had ES of 0.47, while TotalEnergy, used only once, had ES of 1.78). Increased sampling rate was associated with increased ES (PathLength ES increased to 1.12 at 100 Hz from 0.40 at 10 Hz). Measurement during “OFF” clinical status was associated with increased ES (PathLength ES was 0.83 OFF compared to 0.21 ON).ConclusionsThis review identified promising features for analysis of postural sway in PD, recommending a sampling rate of 100 Hz and studying patients when OFF to maximize ES. ES complements statistical significance as it is clinically relevant and is easily compared across experiments. We suggest that machine learning is a promising tool for the future analysis of postural sway in PD.

Prodromal Spinocerebellar Ataxia Type 2 Subjects Have Quantifiable Gait and Postural Sway Deficits.

The search for valid preclinical biomarkers of cerebellar dysfunction is a key research goal for the upcoming era of early interventional approaches in spinocerebellar ataxias. This study aims to describe novel preclinical biomarkers of subtle gait and postural sway abnormalities in prodromal spinocerebellar ataxia type 2 (pre-SCA2). Thirty pre-SCA2 patients and their matched healthy controls underwent quantitative assessments of gait and postural sway using a wearable sensor-based system and semiquantitative evaluation of cerebellar features by SARA (Scale for the Assessment and Rating of Ataxia) score. Quantitative analysis of natural gait showed a significantly larger variability of the swing period, toe-off angle and toe-out angle in pre-SCA2, and larger mean coronal and transverse ranges of motion of the trunk at the lumbar location and of the sagittal range of motion of the trunk at the sternum location compared to controls. During tandem gait, pre-SCA2 subjects showed larger lumbar, trunk, and arm ranges of motion than controls. Postural sway analysis showed excessive body oscillation that was increased in tandem stance. Overall, these abnormalities were detected in pre-SCA2 patients without clinical evidence of abnormalities in SARA. The toe-off angle and swing time variability were significantly correlated with the time to ataxia onset, whereas the toe-off angle and transverse range of motion at trunk position during tandem gait were significantly associated with the SARA score. This study demonstrates early alteration of gait and postural sway control in prodromal SCA2 using a wearable sensor-based system. This offers new pathophysiological hints into this early disease stage and provides novel potential biomarkers for future clinical trials. © 2020 International Parkinson and Movement Disorder Society.

Mini-Logger- A Wearable Inertial Measurement Unit (IMU) for Postural Sway Analysis.

Postural instability assessment is an important tool in fall risk analysis and for timely intervention of falls to reduce or prevent fall injuries. Traditionally fall risk is measured though postural sway assessment and is collected through forceplates by mapping Center of Pressure (COP) excursions or using motion analysis camera system for marker sway trajectories. However, both of these systems are expensive and lack portability to their usage in clinical environments. In this study, we developed a novel wearable low-cost MEMS inertial sensor and validated its usage for human postural sway assessment in standing posture with eyes open/closed, vibration/no vibration, and proprioception /low proprioception conditions. The two objectives of this study were: 1) To develop and validate an Inertial Measurement Unit (IMU) for sway analysis 2) To determine the feasibility of the system in detecting human postural imbalances such as reduced proprioception or presence of stochastic resonance induced through subthreshold vibrations on the feet. The novel IMU was tested for sway against infra-red marker on a specialized platform with 4-degrees of freedom. Many parameters of postural sway such as sway velocity, Root Mean Square (RMS), and sway path length could successfully detect subtle postural changes due to varying proprioceptive and sub-threshold vibration conditions. We found agreement in sway signal determinism from the two methods.Clinical Relevance- This wearable sensor technology has potential to determine balance in reliable, easy and accurate way in clinical environments.

Effect of fatigue on postural sway in sport-specific positions of young rhythmic gymnasts

In rhythmic gymnastics, balance represents a key element in achieving optimal performance. However, there is a lack of data on the modalities with which postural control is impaired by fatigue originated by actual competitive performance. This study aims to analyze the effect of fatigue consequent to a competitive performance on static balance of rhythmic gymnasts (quantitatively assessed by means of postural sway analysis) for several sport-specific positions. Fifteen rhythmic gymnasts (mean age 12.7 years) who compete at national and regional levels participated in the study. Their balance was assessed before and after a 90 s performance for 4 unipedal positions (i.e., “ring with hand support”, “back split without hand support”, “arabesque”, and “split with hand support”) using a pressure platform. Center-of-pressure (COP) time series acquired for 10 s was processed to calculate sway area, COP path length, and COP displacements in the antero-posterior and medio-lateral directions. After the performance, a generalized increase in postural sway was detected for all the positions tested, with the exception of “arabesque”. Sway area doubled for most positions after the performance, while fatigue appears to have a reduced effect on COP displacements in the ML direction, which were found significantly increased only for the “split with hand support” position. The physical effort associated with the performance influences the effectiveness of the postural control system. Coaches could include specific balance exercises even when gymnasts are fatigued to improve their adaptations to competitive conditions and reduce the risk of injuries.

Development and Validation of Wearable Inertial Sensor System for Postural Sway Analysis

Postural sway is a fall risk assessment tool traditionally measured using forceplates. However, it is expensive and lack portability to usage in clinical environments. In this study, a wearable low-cost MEMS inertial sensor was developed and validated for sway assessment. This study had two principal objectives (1) To develop and validate an Inertial Measurement Unit (IMU) for sway analysis (2) To assess the feasibility of IMU in detecting slight balance impairments due to reduced proprioception or induced subthreshold vibrations on the feet. A total of 10 healthy young adults (five males and five females) participated in this study. We found that sway velocity, Root Mean Square (RMS), and sway path length could successfully differentiate postural changes due to varying proprioceptive and sub-threshold vibration conditions. We conclude that new cheap wearable sensors can be designed for accurate clinical postural sway assessments and have potential to diagnose postural impairments.

Demonstration of the Effect of Centre of Mass Height on Postural Sway Using Accelerometry for Balance Analysis

The effect of center of mass (COM) height on stand-still postural sway analysis was studied. For this purpose, a measurement apparatus was set up that included an accelerometry device attached to a rod: three plumb lines, positioned at 50, 75 and 100 cm to an end of the rod, each supported a plumb bob. Using a vice mechanism, the rod was inclined from vertical (0 degree inclination) in steps of 5 degrees to 90 degrees. For each inclination, the corresponding inclination angle was manually measured by a protractor and the positions of the three plumb bobs on the ground surface were also manually measured using a tape measure. Algebraic operations were used to calculate the inclination angle and the associated displacements of the plumb bobs on the ground surface from the accelerometry data. For each inclination angle, the manual and accelerometry calculated ground displacement were close. The height of COM, where the measurement was taken, affected the projected displacement on the ground surface. The COM height had a nonlinear double-effect relationship with sway as it can affect both the angle and projected sway. Normalization of the COM height was used to reduce this effect for comparison purposes.

Inter-trial phase coherence of visually evoked postural responses in virtual reality

Vision plays a central role in maintaining balance. When humans perceive their body as moving, they trigger counter movements. This results in body sway, which has typically been investigated by measuring the body’s center of pressure (COP). Here, we aimed to induce visually evoked postural responses (VEPR) by simulating self-motion in virtual reality (VR) using a sinusoidally oscillating “moving room” paradigm. Ten healthy subjects participated in the experiment. Stimulation consisted of a 3D-cloud of random dots, presented through a VR headset, which oscillated sinusoidally in the anterior–posterior direction at different frequencies. We used a force platform to measure subjects’ COP over time and quantified the resulting trajectory by wavelet analyses including inter-trial phase coherence (ITPC). Subjects exhibited significant coupling of their COP to the respective stimulus. Even when spectral analysis of postural sway showed only small responses in the expected frequency bands (power), ITPC revealed an almost constant strength of coupling to the stimulus within but also across subjects and presented frequencies. Remarkably, ITPC even revealed a strong phase coupling to stimulation at 1.5 Hz, which exceeds the frequency range that has generally been attributed to the coupling of human postural sway to an oscillatory visual scenery. These findings suggest phase-locking to be an essential feature of visuomotor control.

Biomechanics of Vertical Posture and Control with Referent Joint Configurations

Our study compared the results of two methods of analysis of postural sway during human quiet standing, the rambling-trembling (Rm-Tr) decomposition and the analysis of the point of intersection of the ground reaction forces (zIP analysis). Young, healthy subjects were required to stand naturally and with an increased level of leg/trunk muscle co-activation under visual feedback on the magnitude of a combined index of muscle activation (muscle mode). The main findings included the shift of zIP toward higher frequencies and strong correlations between Tr and zIP when the subjects stood with increased muscle co-activation. We interpret the results within the idea of whole-body control with a set of primitives associated with referent coordinates in the joint configuration space.

094 Towards objective testing in parkinson’s disease: a systematic review of the literature looking at assessment of postural sway

IntroductionParkinson’s Disease (PD) is associated with increased mortality and reduced quality of life. There is currently no accurate objective measure for use in diagnosis or assessment of severity. Analysis of postural sway may help in this regard. This systematic review aimed to assess the effectiveness of the various features currently used to analyse postural sway.MethodsFive databases were searched for articles that examined postural sway in both PD patients and controls. An effect size (ES) was derived for every feature reported in each article. The most effective features and feature-families were determined, along with the influence on these measures of data sampling rate and experimental condition.Results441 papers were initially retrieved, of which 31 met the requirements for analysis. The most commonly-used features were not the most effective (e.g. PathLength had an ES of 0.47 while TotalEnergy had an ES of 1.78). Decreased sampling rate was associated with decreased ES (e.g. ES of PathLength lowered from 1.12 at 100 Hz to 0.40 at 10 Hz). Being off medication was associated with a larger ES (e.g. ES of PathLength was 0.21 on medication and 0.83 off medication).ConclusionsSome measures of postural sway are better able to distinguish PD patients from controls than others. ES is enhanced by using a higher sampling rate and studying patients off medication. These results will inform future studies looking at postural sway in PD and contribute to the aim of finding an objective marker of the disease.

Body postural sway analysis in older people with different fall histories.

A cross-sectional study of postural sway analysis in older non-fallers, once-fallers and multiple-fallers using five common standing tests was conducted. Eighty-six older subjects with an average age of 80.4years (SD ± 7.9) participated in the study. The angular rotation and velocity of the trunk of the participants in the roll (lateral) and pitch (sagittal) planes were recorded using an inertial sensor mounted on their lower backs. The Gaussian Mixture Models (GMM), Expectation-Maximisation (EM) and the Minimum Message Length (MML) algorithms were applied to the acquired data to obtain an index indicative of the body sway. The standing with feet together and standing with one foot in front, sway index distinguished older fallers from non-fallers with specificity of 75.7% and 77.7%, respectively, and sensitivity of 78.6% and 82.1%, respectively. This compares favourably with the Berg Balance Scales (BBS) with specificity of 70.5% and sensitivity of 75.3%. The results suggest that the proposed method has potential as a protocol to diagnose balance disorder in older people. Graphical abstract.

Back off! The effect of emotion on backward step initiation

The distance regulation (DR) hypothesis states that actors are inclined to increase their distance from an unpleasant stimulus. The current study investigated the relation between emotion and its effect on the control of backward step initiation, which constitutes an avoidance-like behavior. Participants stepped backward on a force plate in response to neutral, high-arousing pleasant and high-arousing unpleasant visual emotional stimuli. Gait initiation parameters and the results of an exploratory analysis of postural sway were compared across the emotion categories using significance testing and Bayesian statistics. Evidence was found that gait initiation parameters were largely unaffected by emotional conditions. In contrast, the exploratory analysis of postural immobility showed a significant effect: highly arousing stimuli (pleasant and unpleasant) resulted in more postural sway immediately preceding gait initiation compared to neutral stimuli. This suggests that arousal, rather than valence, affects pre-step sway. These results contradict the DR hypothesis, since avoidance gait-initiation in response to unpleasant stimuli was no different compared to pleasant stimuli.

Postural Sway, Balance Confidence, and Fear of Falling in Women With Knee Osteoarthritis in Comparison to Matched Controls

BackgroundOsteoarthritis (OA) is a chronic degenerative disease that commonly affects the knee joints. Individuals older than 65 years of age with knee OA have a greater risk of falls. However, there has been limited examination of the parameters of postural sway (increased time, speed, and postural sway area [center of pressure{CoP}]), and OA of the knee. ObjectivesThe primary objective of this study was to determine whether the CoP variables discriminate between patients with knee OA and matched healthy volunteers, and to correlate the CoP variables with the Activities-Specific Balance Confidence Scale (ABC) and Falls Self-Efficacy Scale (FES). The secondary objective was to compare the CoP of older women with OA with a control group in bipedal support condition with eyes opened and closed. DesignCross-sectional study. SettingUniversity Biomechanics Laboratory. ParticipantsA total of 22 participants were divided into the following 2 groups of 11 participants each: an OA group (mean = 68 years, standard deviation = 7.4 years) and a control group (mean = 66 years, standard deviation = 4.4 years). MethodsStatic postural balance was measured by a portable force platform. Data were collected in both visual conditions (eyes open and closed), in random order. Three attempts of 30 seconds were allowed for each participant on the force platform, with a 1-minute interval between attempts. Main Outcome MeasureVariables were the CoP total displacement of sway (TDS, in centimeters), anteroposterior amplitude displacement (APAD, in centimeters), medial-lateral amplitude displacement (MLAD, in centimeters), total mean velocity (TMV, in centimeters per second), and dispersion of the center of pressure (AREA, in centimeters squared). ResultsThe postural sway analysis found statistically significant differences in the eyes open condition for the TDS (P = .020), APAD (P = .042), TMV (P = .010), and AREA (P = .045). In the discriminant analysis, none of the CoP variables were able to classify the groups (P = .15). The correlation analysis showed that only the AREA with eyes closed was associated with the ABC Scale (rho = −0.42). ConclusionsWomen with knee OA had greater postural sway when compared with a control group for the eyes open condition. CoP variables could not discriminate between the groups. The AREA was negatively correlated with the ABC Scale, when the eyes were closed. Level of EvidenceIII

Nonlinear analysis of postural sway in subjects with below knee amputation during opened and closed eye conditions

ObjectiveThe aim of this study was to compare the structure of postural sway in healthy people and amputees with SACH foot (solid ankle cushion heel) and single axis foot during standing. MethodsTwenty healthy, 10 amputees with single axis foot, and 10 amputees with SACH foot participated in this study. The structure of postural sway of the subjects was evaluated using approximate entropy (ApEn). ResultsPeople with SACH foot prosthesis exhibit increased regularity in postural sway compared to healthy people and people with single axis foot. ConclusionAmputees who used single axis prosthesis achieved appropriate adaptation to their prosthesis device.

Comparison of Shod vs Nonshod Training on Balance and Postural Sway in Older Adults

Among older adults, falls are the leading cause of death due to injury and hospitalization. With age, cutaneous sensation in the foot sole diminishes, contributing to balance impairment. Discovering an effective method for retraining the mechanoreceptors of the feet will possibly increase balance control. Training the different physiological systems involved in balance maintenance is important for decreasing fall risks. PURPOSE: To investigate whether a balance training intervention involving barefoot training (BT) yields better static and dynamic balance, and postural sway values than a group wearing shoes (WS). METHODS: Twelve older adults (65-92 years) were randomly assigned into a BT or WS group. Both groups participated in 50 minute exercise sessions three days a week for six weeks. The sessions included strength, balance, and stretching exercises based on the Stay Active and Independent for Life program. All participants completed a functional reach test (FRT), single-leg stance (SLS), timed up and go (TUG), 30 second chair stand (CS), and postural sway analysis with eyes open (SEO) and eyes closed (SEC). RESULTS: A 2x6 ANOVA found no significant difference between the two groups for the FRT, SLS, TUG, CS, SEO, or SEC tests. Pearson correlations were run to identify relationships between variables. As would be expected there was a positive significant correlation between the static balance measures of SLS and FRT (r = .634, p = 0.027), as well as SEO and SEC in the postural sway test (r = .780, p = .003). There were negative significant correlations between the chair stand and TUG (r = -.848, p = .000), and SEC (r = -.577, p = .050). CONCLUSION: There was no difference in static and dynamic balance and postural sway between the two groups, but leg strength had an impact on dynamic balance and postural sway with visual input. Future research should consider a larger sample size and a longer intervention.