Balance Performance In Adults Research Articles

Effectiveness of robotic rehabilitation for gait and balance in people with multiple sclerosis: a systematic review.

This review investigated the effectiveness of robotic-assisted gait training (RAGT) in improving gait and balance performance in adults with multiple sclerosis (MS). Databases and registers were searched from inception to December 2023 to identify randomized controlled trials (RCTs) that analyzed the effects of RAGT on gait speed, function, balance, fatigue, and adverse events. Three reviewers screened studies for eligibility and extracted key information such as participants and intervention characteristics, as well as outcomes of interest. The reviewers assessed the risk of bias of included studies using Cochrane Risk of Bias tool. From the 948 records identified, 8 RCTs were included, involving 335 participants. The studies have demonstrated significant heterogeneity in patient characteristics, intervention protocols, and outcomes measured. The risk of bias assessment revealed concerns, mainly in terms of performance and detection bias. The evidence is uncertain on the effectiveness of RAGT on balance and gait in people with MS, but a multimodal rehabilitation approach, including RAGT, should be encouraged. No serious adverse events seem to be associated with RAGT, suggesting that these interventions are generally safe for use in people with MS. Further studies of higher methodological quality should be led to confirm these positive results.

Ab. No. 72 Relationship Between Duration of Diabetes and Functional Balance in Adults – A Cross Sectional Study

Introduction: Diabetes is a major problem and Type-2 Diabetes(T2DM) is becoming more common in adults. Particularly in those with Diabetes and poorer glucose management, there was a higher prevalence of risk of falls. Hence this study has been designed to evaluate balance performance in adults and its correlation with Duration of Diabetes in T2DM. The purpose is to correlate duration of diabetes on functional balance in adults with T2DM.Very few research was done on determining balance with duration of diabetes. Literature shows balance is one of the impairment among diabetic individuals. Treating balance is a crucial role for a physiotherapist and thereby preventing falls and promoting functional independence to patients. Methods: A total 30 diabetic patients were recruited from Dhiraj General hospital, based on the inclusion criteria. Based on the duration of diabetes, Group 1(<5-Year) and Group 2 (>5-Year) were formed. Functional balance of both the groups was assessed though berg balance scale (BBS). Descriptive demographic and clinical data statistics were analysed by SPSS-26 software and quantitative comparison of Balance with Duration of Diabetes was made using two sample t-tests. Results: We evaluated 30 adults. After adjustment for age, sex, and HBA1C. longer duration (>5 years) of T2DM was associated with a higher risk of fall shows lower scores on BBS (Mean 45.00 ± 4.93; P = 0.0663) compared with those with duration <5 year (48.63 ± 5.40). Conclusion: In adults with T2DM, duration of diabetes impacts clinical, Balance, and functional status should be considered in development of management strategies for safety and quality of life. Implications: Altered balance can also lead to impaired function, which has a detrimental impact on patient’s quality of life. Physical exercise improves physical fitness, quality of life in patients with type T2DM.

Effect of psychostimulant medications on static balance performance in adults with attention deficit hyperactivity disorder: Within-subjects repeated-measure study

ObjectiveThis study examined the effect of psychostimulant medications nPS) on balance and functional motor performance in adults with attention-deficit/hyperactivity disorder (ADHD). MethodsParticipants completed two sessions (off-medication and on-medication) in a within-subjects repeated-measure study design. There was a minimum of seven days between the two sessions. During both sessions, participants stood for 30 s per condition on a force platform. The conditions were: feet-apart with 1) eyes-open and 2) eyes-closed; feet-together with 3) eyes-open and 4) eyes-closed. Participants performed three trials of timed up and go (TUG) and lateral step-up test (LSUT) during both sessions. Outcome measures were sway area (SA [cm2]), average sway velocity (SV [cm/s]), TUG average time (s), and average number of LSUT repetitions. Data were analyzed using multivariate repeated measures analysis of variance and paired t-tests for examining PS effects on balance (SA and SV) and functional motor performance (TUG and LSUT), respectively. ResultsThe sample included 45 adults (35 females; mean age = 28.4 ± 6.3 years). The repeated-measures MANOVA indicated that PS was associated with better SA [F(1,44) = 9.6; p = 0.003;ηp2 = 0.18] but not with SV [F(1,44) = 1.0; p = 0.319;ηp2 = 0.02]. PS was associated with significantly better SA with decreasing base-of-support [F(1,44) = 9.9; p = 0.003;ηp2 = 0.18]. Additionally, PS use was associated with better TUG [t(1,44) = 2.65; p = 0.014;Cohen's d = 0.39] but not LSUT performances [t(1,44) = −0.68; p = 0.499;Cohen's d = −0.10]. ConclusionsPS was associated with better SA and TUG in adults with ADHD. Further studies are needed to investigate the effects of PS on balance performance using rigorous designs in this population. ImpactHealthcare providers should screen for PS status and balance when treating adults with ADHD to enhance safe motor performance.

The Effect of Different Body Mass Index Levels on Static and Dynamic Postural Balance Performance in Adults

Background and Purpose: It was aimed to examine the static and dynamic postural balance performance in adults with different Body Mass Index (BMI) levels.
 Methods: Study was conducted in Üsküdar Diabetes and Obesity Treatment Center between September and October 2021. Participants were divided into 5 groups according to BMI scores: normal-weight, overweight, 1st degree obese, 2nd degree obese, and 3rd degree obese. The static and dynamic balance performance of participants were assessed by the Limits of Stability (LOS) and modified Clinical Test of Sensory Integration of Balance (m-CTSIB) tests.
 Results: For LOS parameters, there was a significant difference between groups in reaction time scores only for the backward direction (p

Psychostimulant Medications Improve Static Balance In Adults With Attention Deficit Hyperactivity Disorder

Adults with Attention Deficit Hyperactivity Disorder (ADHD) exhibit greater sway areas during bipedal standing tasks than healthy adults, which may indicate poor static balance. Using psychostimulant medication improves balance in children with ADHD. However, it is unknown if psychostimulants improve balance in adults with ADHD. PURPOSE: To examine the effects of psychostimulant medications on static balance in adults with ADHD. METHODS: We performed a prospective within-subject repeated measures study. We included adults aged 21 to 55 years and diagnosed with ADHD. We randomly assigned participants to complete an on-medication and off-medication testing sessions, with a minimum of 7 days between the two sessions. During the off-medication session, participants did not consume their ADHD medication 24 hours before the session whereas on the day they were on medication they took their ADHD medication as prescribed by their physician. On both days, participants stood for 30-seconds on a force platform for each of the following 4 conditions: feet apart with 1) eyes open and 2) eyes closed; feet together with 3) eyes open and 4) eyes closed. We calculated average sway area (cm2) for each test condition. Participants practice all of the tests prior to testing. We used a 2 (medication condition) X 2 (feet position) X 2 (eyes open or close) repeated-measure multiple analysis of variance (MANOVA) to main effect of medication on average sway areas and the interaction effects between the testing conditions. RESULTS: 37 adults participated (29 females; mean age=28.6 ± 6.3). Average sway area scores were significantly greater (4.81±2.8 cm2 vs. 3.66±1.7 cm2) when off versus on medication. The repeated-measure MANOVA denoted a significant main effect of medication on sway area [F(1,36)= 11.41; p=.002; η2= .24]. Additionally, there was a significant medication X foot positioning interaction effect [F(1,36)= 6.63; p=.014; η2= .16]. CONCLUSION: Psychostimulant medications significantly improved static balance performance in adults with ADHD. Specifically, using psychostimulant ADHD medication improves static balance when narrowing the base of support. Future studies should examine if psychostimulant medication improve balance in adults with ADHD with stronger interventional designs.

Gait and dynamic balance in adults with spina bifida

BackgroundSpina bifida (SB) is a complex congenital malformation, often causing impaired gait performance depending on the level and extent of malformation. Research regarding gait and balance performance in adults with SB, has not been sufficiently described yet. Research questionWhat are the characteristics of spatiotemporal gait parameters and balance performance in adults with SB? Further, do persons with muscle function (MF) level 3 differ regarding gait and balance performance from those with MF level 1–2? MethodsCross-sectional observational study at an outpatient clinic. 41 adults with SB (18–65 years), who walked regularly. Spatiotemporal parameters of gait was assessed with the APDM system and balance performance with the Mini Balance Evaluation Systems Test (Mini-BESTest). Muscle strength in the legs was assessed with 0–5 manual muscle test, and participants were classified according to level of MF into groups MF1, MF2, and MF3. Two-sided t-test was used for parametric independent variables, and Cohen’s d was used for effect sizes. The Mann-Whitney U test was used for non-parametric independent data and effect size was calculated by the z value (r = z/√n). ResultsMean gait speed was 0.96 (SD 0.20) m/s and mean stride length 1.08 m (SD 0.17), individuals with MF3 showed significantly slower gaitspeed and shorter stride length (p < 0.05). Lumbar rotation was 21° (SD 11), and thoracic lateral sway 15° (IQR 15) with significantley difference (p < 0.001 and p < 0.05) for individuals in MF3. Mini-BESTest showed a mean score of 11.3 (SD 6.9), and individuals with MF3 showed significantly lower scores (p ≤ 0.001). SignificanceGait and balance performance was reduced compared to normative data in almost all parameters, especially in persons with less muscle function. Increased knowledge from advanced gait analysis may help healthcare professionals to design rehabilitation programmes, in order to achieve and maintain a sustainable gait and balance performance.

Postural balance problems in people with intellectual disabilities: Do not forget the sensory input systems.

This pilot study aimed to explore the impact of visual, auditory and vestibular dysfunctions on the postural balance performance in adults with intellectual disabilities. Additionally, a comparison was made between the subjects with intellectual disabilities and a control group concerning static and dynamic balance tasks. Thirty adults with intellectual disabilities and 25 control subjects received a postural balance assessment. Additionally, the experimental group was subjected to a visual, auditory and vestibular screening. The experimental group performed significantly worse and/or showed more sway compared to the control group for all balance tasks (p < .01) except the timed up and go test. Within the experimental group, a significant positive correlation (rs (24)=0.513, p=.007) was observed between the number of failed sensory screening items and the number of failed balance tasks. These findings suggest significant involvement of peripheral sensorial deficits in the balance problems that people with intellectual disabilities often experience.

Associations between Subtalar Muscle Strength and Balance Performance in Healthy Young and Old Adults

Background: Associations between lower limb muscle strength and balance performance in adults have previously been reported. However, the function of the foot muscles for postural control has not been understood, yet. Objective: The purpose of the present study was to investigate associations between pronator and supinator muscle strength, subtalar range of motion (ROM) and postural stability while standing under various conditions in young versus old adults. Methods: Using a custom-built apparatus equipped with a force transducer and an electrogoniometer, maximum voluntary isometric subtalar pronator and supinator strength as well as ROM tests were administered to 30 young (mean age: 25.1 years) and 30 old (mean age: 65.2 years) volunteers. Total active subtalar ROM, peak pronator and peak supinator torques were measured. While standing on a force plate, limits of stability (LOS) were determined during anterior–posterior (AP) and medio-lateral (ML) leaning tasks. Furthermore, sway distance and velocity during single-legged standing were measured. Correlation and regression analyses were conducted. Results: In both age groups, subtalar pronator muscle strength was related to AP-LOS (young: r = 0.36; old: r = 0.49). In young adults, subtalar supinator muscle strength was associated with ML-LOS (r = 0.41). The regression analyses revealed that summed subtalar muscle strength predicts 13 and 20% of the variance of AP-LOS in young and old adults, respectively. Summed subtalar muscle strength was found to predict 18% of the variance in ML-LOS in young but not in old adults. There were no correlations and no predictors found concerning subtalar muscle strength and postural sway during single-legged standing for both age groups. Conclusions: Longitudinal studies have to proof whether pronator muscle strength training might positively affect balance performance during AP leaning, specifically in old adults.

Textured shoe insoles to improve balance performance in adults with diabetic peripheral neuropathy: study protocol for a randomised controlled trial

IntroductionPeripheral neuropathy is a major risk factor for falls in adults with diabetes. Innovative footwear devices which artificially manipulate the sensory environment at the feet, such as textured shoe insoles,...

Superior Effects of Modified Chen-Style Tai Chi versus 24-Style Tai Chi on Cognitive Function, Fitness, and Balance Performance in Adults over 55.

Background: Cognitive decline and balance impairment are prevalent in the aging population. Previous studies investigated the beneficial effects of 24-style Tai Chi (TC-24) on either cognitive function or balance performance of older adults. It still remains largely unknown whether modified Chen-style TC (MTC) that includes 18 complex movements is more beneficial for these age-related health outcomes, as compared to TC-24. Objective: We investigated if MTC would show greater effects than TC-24 on global cognitive function and balance-related outcomes among older adults. Methods: We conducted a randomized trial where 80 eligible adults aged over 55 were allocated into two different styles of Tai Chi (TC) arms (sixty-minute session × three times per week, 12 weeks). Outcome assessments were performed at three time periods (baseline, Week 6, and Week 12) and included the Chinese Version of the Montreal Cognitive Assessment (MoCA) for overall cognitive function, One-leg Standing Test (LST) for static balance, Timed Up and Go Test (TUGT) for dynamic balance, chair Stand Test (CST) for leg power, and the six-meter Walk Test (6MWT) for aerobic exercise capacity. Results: Compared to TC-24 arm, MTC arm demonstrated significantly greater improvements in MoCA, LST, TUGT, CST, and 6MWT (all p < 0.05). Conclusions: Both forms of TC were effective in enhancing global cognitive function, balance, and fitness. Furthermore, MTC was more effective than TC-24 in enhancing these health-related parameters in an aging population.

The effect of single-task and dual-task balance exercise programs on balance performance in adults with osteoporosis: a randomized controlled preliminary trial.

The aims of this study were to compare the effect of single- and dual-task balance exercise programs on static balance, dynamic balance, and activity-specific balance confidence in adults with osteoporosis and to assess the effectiveness of dual-task balance training on gait speed under dual-task conditions. Older adults (N = 42) (age range, 45-88 years) with osteoporosis were randomly assigned into two groups. Single-task balance training group was given single-task balance exercises for 4 weeks, whereas dual-task balance training group received dual-task balance exercises. Participants received 45-min individualized training session, three times a week. Static balance was evaluated by one-leg stance (OLS) and a kinesthetic ability trainer (KAT) device. Dynamic balance was measured by the Berg Balance Scale (BBS), Time Up and Go (TUG) test, and gait speed. Self-confidence was assessed with the Activities-specific Balance Confidence (ABC-6) scale. Assessments were performed at baseline and after the 4-week program. At the end of the treatment periods, KAT score, BBS score, time in OLS and TUG, gait speeds under single- and dual-task conditions, and ABC-6 scale scores improved significantly in all patients (p < 0.05). However, BBS and gait speeds under single- and dual-task conditions showed significantly greater improvement in the dual-task balance training group than in the single-task balance training group (p < 0.05). ABC-6 scale scores improved more in the single-task balance training group than in the dual-task balance training group (p < 0.05). A 4-week single- and dual-task balance exercise programs are effective in improving static balance, dynamic balance, and balance confidence during daily activities in older adults with osteoporosis. However, single- and dual-task gait speeds showed greater improvement following the application of a specific type of dual-task exercise programs. 24102014-2.

Different Method, Different Results?

To the Editor: I read with great interest the article by Daubney and Culham entitled “Lower Extremity Muscle Force and Balance Performance in Adults Aged 65 Years and Older” (December 1999). After reading the article and reviewing the data presented, I found several sections of the article that lead me to question the authors' results and conclusions. According to their own data, the 3 measures of balance—the Berg Balance Scale (BBS), the Timed Get Up & Go Test (GUG), and the Functional Reach Test (FRT)—failed to yield significant differences between subjects with a history of falling and subjects without a history of falling (Tab. 1). Intuitively, that result would suggest either that (1) the measures were not valid for the population being tested or (2) the authors' assumption that there is a relationship between balance and the incidence of falling is not valid. In either case, these measures should not have been used, because they failed to detect significant differences between the groups. If the muscle testing methods showed a difference between groups, what would that mean? From the initial question, I went on to investigate the methodology and findings for the measurements of muscle force, which provoked several more questions. Why were of all the muscle groups tested in the midrange of joint motion? The principles of biomechanics and exercise physiology clearly dictate that the maximal force of the muscles in question would have been best tested in the position of function, standing, or at 90 degrees to the joint axis. In addition, and perhaps most perplexing, is why the authors performed all the tests with the subjects positioned supine. Logically, if you want to determine the relationship of muscle force to the 3 tests of standing balance, then the muscle force measurements should be performed in a standing …

Was Torque Measured?

To the Editor: We read with interest the article by Daubney and Culham entitled “Lower-Extremity Muscle Force and Balance Performance in Adults Aged 65 Years and Older” in the December 1999 issue. We generally found the work of interest and quite commendable, with one exception. In the article, the authors indicate that they measured force via a dynamometer, reporting these values as being measured at a location …

Lower-Extremity Muscle Force and Balance Performance in Adults Aged 65 Years and Older

Measures of postural control may be useful for determining fall risk in older people and for determining the outcomes of treatments aimed at improving balance. Commonly used tools measure the output of the postural control system. The purpose of this study was to determine the degree to which one component of postural control (muscle force) contributes to scores on 3 functional balance measures. Fifty community-dwelling volunteers between 65 and 91 years of age (mean = 74.82, SD = 6.11) participated. Based on their histories, 11 subjects were classified as being at risk for falling. Measures were the Berg Balance Scale (BBS), the Functional Reach Test (FRT), and the Timed Get Up & Go Test (GUG). The force generated by 12 lower-extremity muscle groups was measured using a handheld dynamometer. In the group reporting no falls, dorsiflexor and subtalar evertor force accounted for 58% of the score on the BBS, ankle plantar-flexor and subtalar invertor force accounted for 48.4% of the score on the GUG, and ankle plantar-flexor force accounted for 13% of the score on the FRT. Ankle dorsiflexor and hip extensor forces were lower in subjects reporting falls, and force of the ankle dorsiflexors predicted fall status. Distal muscle force measures may be able to contribute to the prediction of functional balance scores; however, the muscles involved in the prediction differ depending on the measure of balance.