Balance In Healthy Older Adults Research Articles

Effects of Repeated Bouts of Segmental Vibration Therapy on Balance in Parkinsons Disease

Background: One of the cardinal features of Parkinson’s disease is postural instability. This instability is believed to be due to abnormalities in processing afferent information from the vestibular, somatosensory and visual systems. Whole body vibration has been shown to improve balance in older adults. The goals of this study were to determine how sensory information affects balance and to examine if multiple sessions of segmental vibration therapy improved balance in individuals with Parkinson’s disease. Methods: Balance in healthy older adults and in individuals with Parkinson’s disease was assessed using the modified Clinical Test of Sensory Integration and Balance. After initial assessment, individuals with Parkinson’s disease were randomized into a control or segmental vibration therapy group. The segmental vibration therapy group completed twelve sessions, over four weeks, and was re-tested after that period. Results: Subjects with Parkinson’s disease showed the highest overall level of sway in the eyes closed soft surface condition, when compared to healthy older adults. However, repeated bouts of segmental vibration did not result in significant improvement in the sway scores. Conclusion: Although these individuals showed significant balance deficits, segmental vibration therapy did not promote improvements in balance, as measured with the modified Clinical Test of Sensory Integration and Balance test.

Standing on textured surfaces: effects on standing balance in healthy older adults

standing on textured surfaces or wearing textured shoe insoles can alter balance performance. This evidence, although inconclusive, offers a potential intervention for improving balance in older adults. This study explored the effect of standing on textured surfaces on double-limb balance in older adults and changes in muscle activity as a possible mechanism of effect. 50 healthy older adults (29 female, age mean [1SD] 75.1 [5.0]) stood quietly in six conditions-eyes open and closed on two different textured surfaces and a smooth surface control. Mediolateral sway, anterior-posterior sway and centre of pressure velocity were extracted from a force platform and lower limb muscle activity collected using surface electromyography (EMG) over 30 s. for mediolateral range with eyes closed, there was a statistically significant effect of texture (F [2, 47] = 3.840, P = 0.033). This was attributed to a 9.2% decrease with Texture 1 compared with Control. No such effects were seen in any other balance variable or lower limb EMG activity for either visual condition. the results suggest an effect of standing on textured surfaces on mediolateral sway in older adults, supporting further work to develop the therapeutic benefits of textured surfaces as an intervention to improve balance.

Use of computerized dynamic posturography to assess balance in older adults after nighttime awakenings using zolpidem as a reference

BackgroundComputerized dynamic posturography (CDP) has been used to detect balance and stability impairments in adults of all ages. The goal of the current pilot study was to evaluate balance in healthy older adults after a middle-of-the-night awakening and to assess the ability of CDP to measure effects of bedtime zolpidem administration.MethodsTwo studies used CDP to evaluate balance in healthy older adults (≥ 65 years) during middle-of-the-night awakenings. The first study used a drug-free, single-period, within-subject, repeated measures study design. Subjects were evaluated during the day, pre-sleep, and 2 hours after bedtime for dynamic standing balance using the NeuroCom EquiTest Sensory Organization Test (SOT). Pairwise comparisons were made using one-way ANOVA. The second study was a single-blind, randomized, placebo-controlled, crossover study evaluating the ability of the SOT to measure medication-induced dynamic standing balance impairments using the commonly prescribed sleep medication, zolpidem 10 mg, as a test medication. Assessments were performed at night before zolpidem administration and then again 2 hours after bedtime. Comparisons were made between the 2 groups using an ANCOVA model.ResultsTwelve older adults (mean age 68.4 years) were evaluated in the first study. There was no significant difference between pre-sleep and middle-of-the-night assessments for the SOT composite score (P = 0.439). Eleven older adults (mean age 68.9 years) were evaluated in the second study. Zolpidem administration significantly decreased the SOT composite score after a middle-of-the-night awakening compared with placebo (P < 0.001).ConclusionIn healthy older adults, getting up in the middle of the night did not have a significant effect on dynamic standing balance; however, bedtime administration of zolpidem 10 mg did lead to significant impairments. Thus, the SOT was able to measure medication-induced dynamic standing balance impairments and may be useful for future studies comparing balance effects of medications.

Direction-Induced Effects of Visually Guided Weight-Shifting Training on Standing Balance in the Elderly

Background: Controversial findings exist in the literature with respect to the efficacy of visually guided weight-shifting (WS) training as a means of improving balance in healthy older adults. Objective: The purpose of this study was to investigate the impact of two direction-specific, visually guided WS training protocols on standing balance of healthy elderly women. Methods: Forty-eight community-dwelling elderly women, all free of any neurological or musculoskeletal impairment, were randomly assigned into: a group that practiced WS in the anterior/posterior direction (A/P group, n = 19), a group that practiced WS in the medio/lateral direction (M/L group, n = 15) and a control group (n = 14). Participants performed 12 training sessions of visually guided WS (3 sessions a week for 25 minutes per session). Static balance was measured before and after training in normal (bipedal) quiet stance (NQS) and sharpened-Romberg stance (SRS) by recording center of pressure (CoP) variations and angular segment kinematics. Results: In NQS, neither of the two training protocols had a significant impact on postural sway measures, although a significant decrease in interlimb asymmetry of CoP displacement was noted for the A/P group. In SRS, A/P training induced a significant reduction of CoP displacement, lower limb pitch and upper trunk roll rotation. Conclusion: The results of the study stress the importance of using direction-specific WS tasks in balance training, particularly in the A/P direction, in order to improve control of static balance in elderly women.

P2.080 Training divided attention to improve dual-task balance in healthy older adults

P2.080 Training divided attention to improve dual-task balance in healthy older adults

Power Training Improves Balance in Healthy Older Adults

Age-related decline in muscle power may be an early indicator of balance deficits and fall risk, even in nonfrail adults. This study examined the dose-dependent effect of power training on balance performance in healthy older adults. One hundred twelve community-dwelling healthy older adults (69 +/- 6 years) were randomized to 8-12 weeks of power training at 20% (LOW), 50% (MED), or 80% (HIGH) of maximal strength, or a nontraining control (CON) group. Participants trained twice weekly (five exercises; three sets of eight rapid concentric/slow eccentric repetitions) using pneumatic resistance machines. Balance, muscle performance (strength, power, endurance, contraction velocity), and body composition were measured. Power training significantly improved balance performance (p =.006) in participants who underwent power training compared to controls. Low intensity power training produced the greatest improvement in balance performance (p =.048). Average contraction velocity at low load (40% one repetition maximum [1RM]) at baseline independently predicted improvement in balance following training (r = -.29, p =.004). Power training improves balance, particularly using a low load, high velocity regimen, in older adults with initial lower muscle power and slower contraction. Further studies are warranted to define the mechanisms underlying this adaptation, as well as the optimum power training intensity for a range of physiological and clinical outcomes in older adults with varying levels of health status and functional independence.

The Effects of Training on Balance in Healthy Elderly Females

0204 PURPOSE: To determine the effects of a group-based, weight-bearing exercise program on measures of standing balance in healthy older adults. METHODS: One AMTI force platform was used to measure static balance measures (left/right displacement, fore/aft displacement, vector displacement, and total sway) in 10 healthy elderly women (mean age = 74.6 ± 7.48 years; height = 158.88 ± 4.42 cm; body mass = 72.68 ±16.69 kg). Subjects were instructed to stand upright with their heels together and their arms crossed over their chest and eyes open focusing on a point approximately 5 meters away at eye level. Each subject performed five trails, each of which lasted 10 seconds. Following pre-testing, subjects participated in a groupbased, progressive exercise program consisting of resistance and balance exercises. Elastic bands were utilized to provide resistance and a chair was used to assist with simple balance exercises. Three, one-hour sessions were conducted each week for six weeks for a total of 18 sessions (average compliance = 16.29 ± 2.11 sessions). After completion of the training program, the post-test procedures were performed, as per the pre-test session. For each balance measure, the mean of the 5 trials was calculated, as well as the normalized coefficient of variation [(SD/mean) × 100%]. RESULTS: A paired samples t-test revealed that total sway variability (Pre-test = 22.23 ± 6.8 cm; Post-test = 14.07 ± 6.32 cm) significantly decreased as a result of training (t9 = 2.63, p = 0.03). All other sway variables were not significantly different between the pretest and post-test measurements. CONCLUSION: The major findings of this study demonstrated that although measures of average standing balance performance were not improved following training, the variability of total sway significantly decreased. These results suggest that a group-based, weight bearing exercise intervention may be beneflcial to healthy older adults by improving the consistency of standing balance performance.

The Effects of Training on Balance in Healthy Elderly Females

0204 PURPOSE: To determine the effects of a group-based, weight-bearing exercise program on measures of standing balance in healthy older adults. METHODS: One AMTI force platform was used to measure static balance measures (left/right displacement, fore/aft displacement, vector displacement, and total sway) in 10 healthy elderly women (mean age = 74.6 ± 7.48 years; height = 158.88 ± 4.42 cm; body mass = 72.68 ±16.69 kg). Subjects were instructed to stand upright with their heels together and their arms crossed over their chest and eyes open focusing on a point approximately 5 meters away at eye level. Each subject performed five trails, each of which lasted 10 seconds. Following pre-testing, subjects participated in a groupbased, progressive exercise program consisting of resistance and balance exercises. Elastic bands were utilized to provide resistance and a chair was used to assist with simple balance exercises. Three, one-hour sessions were conducted each week for six weeks for a total of 18 sessions (average compliance = 16.29 ± 2.11 sessions). After completion of the training program, the post-test procedures were performed, as per the pre-test session. For each balance measure, the mean of the 5 trials was calculated, as well as the normalized coefficient of variation [(SD/mean) × 100%]. RESULTS: A paired samples t-test revealed that total sway variability (Pre-test = 22.23 ± 6.8 cm; Post-test = 14.07 ± 6.32 cm) significantly decreased as a result of training (t9 = 2.63, p = 0.03). All other sway variables were not significantly different between the pretest and post-test measurements. CONCLUSION: The major findings of this study demonstrated that although measures of average standing balance performance were not improved following training, the variability of total sway significantly decreased. These results suggest that a group-based, weight bearing exercise intervention may be beneflcial to healthy older adults by improving the consistency of standing balance performance.