Balance Performance In Older Adults Research Articles

Early sleep after action observation plus motor imagery improves gait and balance abilities in older adults

Action observation plus motor imagery (AOMI) is a rehabilitative approach to improve gait and balance performance. However, limited benefits have been reported in older adults. Early sleep after motor practice represents a strategy to enhance the consolidation of trained skills. Here, we investigated the effects of AOMI followed by early sleep on gait and balance performance in older adults. Forty-five older adults (mean age: 70.4 ± 5.2 years) were randomized into three groups performing a 3-week training. Specifically, AOMI-sleep and AOMI-control groups underwent observation and motor imagery of gait and balance tasks between 8:00 and 10:00 p.m. or between 8:00 and 10:00 a.m. respectively, whereas Control group observed landscape video-clips. Participants were assessed for gait performance, static and dynamic balance and fear of falling before and after training and at 1-month follow-up. The results revealed that early sleep after AOMI training sessions improved gait and balance abilities in older adults compared to AOMI-control and Control groups. Furthermore, these benefits were retained at 1-month after the training end. These findings suggested that early sleep after AOMI may represent a safe and easy-applicable intervention to minimize the functional decay in older adults.

Fear of Falling Avoidance Behavior, but Not Fall History, Is Associated with Balance and Dynamic Gait Performance in Community-Dwelling Older Adults: A Cross-Sectional Study

Purpose: The purpose of this study was to determine relationships among balance confidence, fear of falling (FoF) avoidance behaviour, and high-level balance performance in community-dwelling older adults. Method: Eighty-nine participants [76 ± 7 (mean ± standard deviation) years, 54 females] completed the Activities-specific Balance Confidence Scale, Fear of Falling Avoidance Behavior Questionnaire, Functional Gait Assessment (FGA), Community Balance and Mobility Scale (CB&M), and falls experienced in the past 12 months for this cross-sectional study. Results: Outcome measure (OM) scores did not differ between people who reported a fall and those without a fall. Correlations between all OMs varied from 0.52 to 0.88. FoF avoidance behaviour, but not fall history, was associated with lower scores on all measures. There were no floor or ceiling effects for the performance-based OMs. Conclusion: FoF avoidance behaviour did not differ between community-dwelling older adults with and without a previous fall. Participants who reported FoF avoidance behaviour had poorer balance performance, suggesting clinicians should assess high-level balance performance in older adults who exhibit FoF activity avoidance. Patient-reported OMs may identify older adults who need an assessment of dynamic balance and gait. The CB&M and FGA are appropriate to assess high-level balance in older adults.

Effects of virtual reality on the balance performance of older adults: a systematic review and meta-analysis.

[Purpose] Virtual reality has been increasingly used to improve the balance performance of older adults; however, the effect remains inconclusive. This study aimed to examine the effects of virtual reality on the balance performance of older adults through a systematic review and meta-analysis. [Methods] The PubMed, MEDLINE, CINAHL, Cochrane Library, and PEDro electronic databases were searched. Only randomized clinical trials published in English from January 1st, 1980, to September 30, 2022, were included and reviewed. Outcome measures included the Berg Balance Scale, Timed Up and Go Test and Activity-specific Balance Confidence scale. [Results] The results showed that virtual reality training for older adults led to significant improvements in Berg Balance Scale scores and Timed Up and Go Test times compared with non-virtual reality training. However, such an outcome was not observed with regard to the Activity-specific Balance Confidence scale. [Conclusion] Virtual reality training is effective in improving both static and dynamic balance among older adults. However, its effect on their self-confidence regarding balance is not significant.

Difficulties encountered in testing, scoring, and interpreting balance performance in older adults using clinical evaluation tools: a cross-sectional study

Abstract Background: Balance impairment is one of the primary intrinsic risk factors contributing to falls in older adults. Prior research has consolidated the prevalent clinical tools for detecting balance issues in this demographic. Nevertheless, only a few studies have recognized the constraints associated with current balance assessment methods. Materials and Methods: The current research was initiated due to a shortage of comprehensive knowledge concerning the hurdles clinicians faced when interpreting balance test results and the obstacles older adults encountered while undertaking these assessments. The methodology involved assessing the static and dynamic balance capabilities of 661 older individuals through tests including the four stage balance test (FSBT), star excursion balance test (SEBT), Four Square step test (FSST), timed up and go (TUG) test, and Tinetti performance-oriented mobility assessment (TPOMA). Results: All older adults were able to complete the TUG and TPOMA tests. . Fifteen percent encountered difficulty completing the entire FSBT; however, they managed to execute the initial two stages of this test. Additionally, 5% of older adults who utilized walking aids could not complete the FSST. Thirty four percent of young-old individuals and 56.3% of old-old individuals were unable to execute the SEBT in posterior directions. Moreover, 1% of 60-64-year-old and 2% of >/75-year-old individuals were unable to perform SET in all 8 directions. Conclusion: TPOMA and TUG emerged as the most suitable clinical assessment tool for older adults. Within the FSBT, maintaining tandem and one-leg stance positions posed challenges, whereas the SEBT proved to be the most demanding dynamic balance test for older adults. These current findings will aid clinicians in selecting the most suitable balance assessment tool for routine clinical evaluations of older adults.

Comparison of gait speed, dynamic balance, and dual-task balance performance according to kinesiophobia level in older adults

Purpose The presence of kinesiophobia was identified in older adults. Studies have examined the effects of kinesiophobia in older adults with chronic pain. Studies examining the effect of kinesiophobia on gait and balance performance in older adults without pain are insufficient. The aim of this study was to compare gait speed, dynamic balance, dual-task balance performance according to kinesiophobia level in community dwelling older adults without pain. Materials and methods Seventy-five older adults were included. The socio-demographic data (age, height, weight, fall history, etc.) was recorded. Older adults were divided into two groups based on Tampa Kinesiophobia Scale scores. Scores below 37 were grouped as low level, scores above 37 were grouped as high level. The mini-mental state examination (MMSE), gait speed test, modified Four Square Step Test (mFSST), Five Times Sit-to-Stand Test, dual-mFSSt test (additional cognitive and motor task) were applied for dual-task balance performance. Results Thirty-six participants(mean age 70.58 ± 5.59 years) had low kinesiophobia, the other 39 individuals(mean age70.94 ± 7.45 years) had high kinesiophobia. The age, gender, body mass index, cognitive status, and fall history were similar between groups (p > 0.05). The participants with low kinesiophobia were found to have better gait speed, dynamic balance, dual-task balance performance (p < 0.001). Conclusion This study results showed that the presence of high level of kinesiophobia affects gait speed, dynamic balance, dual-task balance performance, and dual-task cost in older adults. Therefore, a high level of kinesiophobia can lead to falls. It may be important to investigate the effects of kinesiophobia in older adults.

Effectiveness of exergaming-based interventions for mobility and balance performance in older adults with Parkinson's disease: systematic review and meta-analysis of randomised controlled trials.

exergaming-based interventions (EbIs) have been proposed to improve older adults' mobility and balance performance. However, the effectiveness of such interventions for older adults with Parkinson's disease (OAPD) remains unclear. seven databases (Web of Science, Medline, Academic Search Premier, CINAHL Complete, PsycINFO, PsychARTICLE and PubMed) were searched up to 7 April 2022. We assessed mobility and balance performance between EbIs groups and control groups or traditional physical training interventions (TPTIs) groups by comparing the outcomes of the Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), Berg Balance Scale (BBS), gait velocity, stride length and Functional Gait Assessment (FGA). we scanned 1,190 articles and meta-analysed 19 trials (sample size = 781). In general, the results revealed statistical differences between EbIs groups and TPTIs groups in the TUG [mean difference (MD) = -1.030s; 95% confidence interval (CI) = -2.029 to -0.031; P= 0.043; high quality of evidence], 6MWT (MD = 63.483m; 95% CI = 9.542 to 117.425; P= 0.021; moderate quality of evidence), BBS (MD = 2.129; 95% CI = -1.293 to 2.965; P< 0.001; high quality of evidence) and FGA (MD = 2.099 95% CI = -0.306 to 3.893; P= 0.022; moderate quality of evidence). No significant difference was discovered between EbIs groups and TPTIs groups in enhancing gait velocity and stride length. EbIs are statistically better than TPTIs in improving OAPD's performance in TUG, 6MWT, BBS and FGA, whereas only the change between EbIs and TPTIs in 6MWT can reach the value of minimal clinically important difference. Further studies are needed to better assess the effectiveness of exergaming-based interventions.

Association between endurance of the trunk extensor muscles and balance performance in community-dwelling older adults: a cross-sectional analysis

Background/Aims Previous research has disregarded the performance of the extensor muscle group of the trunk in balance control. The main purpose of this exploratory study was to assess the association between balance performance and endurance of the trunk extensor muscles in older adults, considering possible co-factors such as age and body mass index. Methods A correlational and predictive cross-sectional study was conducted with 61 community dwelling older adults (women n=45) with a mean age of 71 years (± standard deviation 6 years), and a mean body mass index of 28.1 kg/m2 (± standard deviation ± 4.7 kg/m2). The Berg Balance Scale was used to assess balance performance and Trunk Extensor Endurance Test to assess muscle endurance. Spearman's correlation coefficients (ρ) and single and multiple regression analyses were performed. Statistical significance was set at 0.05. Results The largest correlations were found between the Berg Balance Scale score and Trunk Extensor Endurance Test (ρ=0.41, P=0.001) and body mass index (ρ=−0.36, P=0.005). Muscle endurance alone predicted ~10% of the Berg Balance Scale score (R2=0.10, P=0.015). When combined with body mass index, it accounted for ~19% (R2=0.19, P=0.002). Adding the remaining variable (age) to the previous model increased the prediction by ~3% (R2=0.22, P=0.002). Conclusions Muscle endurance and body mass index significantly predicted (~19%) balance performance in older adults. Because these are modifiable factors, they should be routinely included in the screening of balance performance in older adults and addressed accordingly in preventive or rehabilitation programmes.

Balance Enhancement in Older Adults: Is Functional-Task Training Better Than Resistance Training in Enhancing Balance in Older Adults?

Background and purposeThe effects of various exercise training programs on balance in older adults are well established. This study aimed to compare the effect of functional-task training with resistance training in improving balance performance in older adults.MethodsA total of 100 community-dwelling older adults aged 65 years and above were randomly allocated into two groups: functional-task training (FTT) group and resistance training (RT) group. The FTT group (n = 50) performed functional task exercises and the RT group (n = 50) performed resistance exercises three times a week for 12 weeks. Balance was evaluated before and after the trial using the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test.ResultsA total of 87 subjects who completed the study were analyzed. Both the groups showed a significant change in BBS and TUG test (p < 0.05) from baseline to 12 weeks. However, post-intervention analysis between the groups showed a significant difference in both the BBS and TUG test (p < 0.05), i.e. improvement in the FTT group was better than the RE group at the end of training.ConclusionBoth the FTT and RT were effective in improving balance. However, the improvement achieved by the FTT group was better than the RT group.

Adaptations in Reactive Balance Strategies in Healthy Older Adults After a 3-Week Perturbation Training Program and After a 12-Week Resistance Training Program.

Both resistance training (RT) and perturbation-based training (PBT) have been proposed and applied as interventions to improve reactive balance performance in older adults. PBT is a promising approach but the adaptations in underlying balance-correcting mechanisms through which PBT improves reactive balance performance are not well-understood. Besides it is unclear whether PBT induces adaptations that generalize to movement tasks that were not part of the training and whether those potential improvements would be larger than improvements induced by RT. We performed two training interventions with two groups of healthy older adults: a traditional 12-week RT program and a 3-week PBT program consisting of support-surface perturbations of standing balance. Reactive balance performance during standing and walking as well as a set of neuro-muscular properties to quantify muscle strength, sensory and motor acuity, were assessed pre- and post-intervention. We found that both PBT and RT induced training specific improvements, i.e., standing PBT improved reactive balance during perturbed standing and RT increased strength, but neither intervention affected reactive balance performance during perturbed treadmill walking. Analysis of the reliance on different balance-correcting strategies indicated that specific improvements in the PBT group during reactive standing balance were due to adaptations in the stepping threshold. Our findings indicate that the strong specificity of PBT can present a challenge to transfer improvements to fall prevention and should be considered in the design of an intervention. Next, we found that lack of improvement in muscle strength did not limit improving reactive balance in healthy older adults. For improving our understanding of generalizability of specific PBT in future research, we suggest performing an analysis of the reliance on the different balance-correcting strategies during both the training and assessment tasks.

Effect of Core Stabilization Exercises on Balance Performance in Older Adults

Objective: Fall is defined as unintentional loss of balance that leads to failure of postural stability. Around30% of older adults aged over 65 years have an episode of falls each year.. All postural control componentsundergo changes with ageing. Any impairment in neuromuscular, central nervous system and sensorysystem leads to fall. So the aim of present study was to determine the effects of Core stabilization exerciseson balance performance in older adults. Methodology: Sixty participants both males and females agedbetween 65 -75 years were divided into 2 groups, Experimental and Control group (n=30). Experimentalgroup performed core stabilization exercises 5 times a week for 6 weeks, while control group carried ontheir routine daily activity for 6 weeks. Berg Balance Scale (BBS), Y-Balance Test, Functional Reach Testwere assessed at the baseline and after 6 weeks of intervention. Results: Statistical analysis revealed thatExperimental group showed significant improvement in BBS, Y – Balance Test and Functional Reach Testscores with (p ? 0.05) post 6 weeks of intervention. Control group showed no significant improvement inthe scores. Conclusion: Core stabilization exercises had significant improvement on balance variables inexperimental group when compared to control group.

Optimal exercise parameters of tai chi for balance performance in older adults: A meta-analysis.

Tai chi is considered a safe and low-cost treatment for improving balance ability among an older population. However, there is no existing evidence on the optimal exercise parameters of tai chi for improving balance in older adults. To investigate the optimal parameters of a tai chi intervention to improve balance performance of older adults. Systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Embase, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Periodical and China Biology Medicine were searched from inception until November 30, 2020. Adults aged 60 years and over. Two reviewers independently extracted the data and assessed the quality of the included studies according to the Physiotherapy Evidence Database (PEDro) scale. Subgroup analyses and meta-regressions were conducted to elucidate the impact of tai chi training programs on balance measures. Twenty-six eligible RCTs were included in the meta-analysis. Pooled results showed that tai chi has moderate effects for improving proactive balance (weighted mean standardized mean differences [SMDwm ]=0.61, 95% CI 0.33-0.89) and static steady-state balance (SMDwm =0.62, 95% CI 0.30-0.95) and small effects for improving dynamic steady-state balance (SMDwm =0.38, 95% CI 0.03-0.73) and balance test batteries (SMDwm =0.47, 95% CI 0.13-0.81) in adults over 60 years of age. The practice frequency could predict the effects of tai chi on static steady-state balance, and the 24-form simplified Yang style tai chi (45-60 min/session, more than four sessions per week and at least 8 weeks) was the most optimal. Tai chi is effective at improving the balance ability of adults over 60 years of age. A medium duration and high frequency of 24-form tai chi may be the optimal program for improving balance, but this evidence should be recommended with caution due to limitations of the methodology and small sample sizes.

Do motor-cognitive and motor-motor dual task training effect differently balance performance in older adults?

Dual-task training (DTT) have been showed that have satisfying effects on older adults. The aim of this study was to compare the effect of motor-cognitive DTT (mCdtt) and motor-motor DTT (mMdtt) on balance, fear of falling, walking functionality and muscle strength in older adults. A total of 50 participants aged 60 and over (mean age: 67.72 ± 7.33years), having a score ≥ 24 on the Mini-Mental State Exam (MMSE), being in the category of walking ability ≥ 4 according to the Functional Ambulation Category (FAC), having no problem in visual ability and hearing were included for this study. The participants who received mCdtt (Group 1) counted back from the two-digit number; and the participants who received mMdtt (Group 2) held half-filled glasses with both hands near the trunk with 90° flexion of elbow while performing exercises. The intervention program had lasted for 8weeks. To assess balance, fear of falling, walking functionality and muscle strength of participants; Berg Balance Scale (BBS), Falls Efficacy Scale International (FES-I), Timed Up and Go (TUG) and the Hand-held dynamometer were used, respectively. The results of our study showed that 8-week mCdtt and mMdtt program did not differ in balance fear of falling, walking functionality and muscle strength in older adults, although both trainings had improved balance ability. It can be interpreted that both training programs can be suggested to enhance abovementioned parameters in older adults. Further studies are needed to elucidate the difference of clinical outcomes between the mCdtt and mMdtt program in older adults. NCT04577092. 09/30/2020 "Retrospectively registered".

The Effect of Acute Caffeine Ingestion on Cognitive Dual Task Performance during Assessment of Static and Dynamic Balance in Older Adults.

The present work aimed to evaluate the effect of 3 mg·kg−1 caffeine consumption on the standing and dynamic balance performance of older adults and sought to establish if caffeine ingestion can modulate the influence of a cognitive dual task on balance performance. Twelve apparently healthy participants (8 females) aged >65 years (72 ± 3.7 years) completed the study. Bipedal postural sway, four square step test, timed up and go, Y-balance (anterior reach only) and force-time characteristics of sit-to-stand performance were used to assess standing and dynamic balance. Attention and working memory were assessed using a serial 3s and 7s subtraction task during seated rest and completion of the bipedal standing assessment and Y-balance test. This battery of assessments was completed on two separate occasions, once following the consumption of a non-ergogenic placebo and again following the consumption of 3 mg·kg−1 caffeine. The administration of treatments was randomised, counterbalanced and double-blind. Caffeine reduced performance in the bipedal standing balance assessments, evidenced by an increase in COPML, COPPath, COPVelocity. Performance during the dynamic balance tests was unaffected, other than rate of force development during the sit-to-stand, which was improved following caffeine ingestion. The introduction of a cognitive dual task had either limited effects, or improved facets of bipedal standing balance, whilst performance during the dynamic balance task was significantly reduced. In both balance assessments, there was evidence for a reduction in the performance of the cognitive task when both the balance and cognitive tests were performed simultaneously, with this effect not modulated by caffeine consumption. These findings refute the idea that caffeine ingestion may have positive effects on balance performance. However, despite a caffeine-induced reduction in bipedal standing balance, it is unlikely that caffeine ingestion would exacerbate fall risk given the limited effects in the dynamic balance tests. Future work should establish if these effects are generalisable to older frail participants and if caffeine can modulate the detrimental effects of an acute exercise bout on balance performance.

Relationship Between Body Composition and Balance Performance in Older Adults with Hyperkyphosis

Older adults with hyperkyphosis might have a high risk of falls since their whole body center of mass may shift to the boundary of the base of support. Body composition changes, such as low bone mineral content (BMC), decreased muscle mass, high body mass index (BMI), and increased fat mass are common in older adults with hyperkyphosis. This study aimed to investigate the relationship between body composition and balance performance using a biomechanical analysis in older adults with hyperkyphosis. Thirty older adults with hyperkyphosis were recruited. BMC, muscle mass, BMI, and fat mass were measured for body composition. Balance performances were determined with walking, quiet standing, and forward reach. Gait speed, step length, center of mass–center of pressure inclination angle of heel strike (Inc-HS) and toe off (Inc-TO) during walking, center of mass–center of pressure inclination angle during quiet standing (Inc-QS), and reaching distance were calculated. BMC had a moderately positive correlation with gait speed (r = 0.48, p < 0.01) and a moderately positive correlation with step length (r = 0.43, p = 0.01). Muscle mass had a moderately positive correlation with step length (r = 0.41, p = 0.02), moderately positive correlation with Inc-HS (r = 0.36, p = 0.04), and moderately positive correlation with reaching distance (r = 0.43, p = 0.01). No significant correlations were found among BMI, fat mass and balance performance. BMC and muscle mass should be considered as factors that might affect walking and forward reach in older adults with hyperkyphosis.

Concurrent validity of the Wii Stillness Test as a measure of balance performance in older adults

Concurrent validity of the Wii Stillness Test as a measure of balance performance in older adults

To Compare the Effect Between Two Different Priorities Dual Task Balance Training in Older Adults with Balance Impairment

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Background &lt;/strong&gt;and Purpose: Balance is controlled through a complex process involving sensory, visual, vestibular and cerebral functioning which get affected by various neurological disorders such as fall. The purpose of the study was to compare the efficiency of three different balance training strategies in an effort to understand the mechanisms underlying training-related changes in dual task balance performance of older adults with balance impairment.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 45 older adults with balance impairment were recruited and randomly assigned to three groups. Group one received single task balance training, group two received dual task training balance training under fixed priority, group three received dual task balance training under variable priority. Subjects received one-hour individualized training sessions, five times in a week for two weeks. Berg balance scale and time up and go test were the outcome measure and their scores for all groups were taken prior and after the training.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results:&lt;/strong&gt; One-way analysis of variance was used to analyse the difference among the balance improvement in Group one, two and three. And the results revealed that post intervention scores were highly significant (p£ 0.05) in group two and group three performed better than group one.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; In conclusion, dual task training is effective in improving balance under dual task context in older adults with balance impairment, and single task training may not generalize to balance performance under dual task conditions.&lt;/p&gt;

Fear of Falling, Lower Extremity Strength, and Physical and Balance Performance in Older Adults with Diabetes Mellitus.

Fear of falling (FoF) is known to affect the physical activities and quality of life of older adults with type 2 diabetes mellitus (DM). Many complications of DM, especially ones distressing lower extremity (LE), could lead to increased fall risk and FoF. This study aimed to explore the relationship between FoF, LE muscle strength, and physical performance in older adults without diabetes mellitus (ONDM) and with DM (ODM) with varying degrees of balance impairment. The participants comprised 20 ONDM and 110 ODM. The ODM was grouped by the number of failed performances of the modified clinical test of sensory interaction and balance (mCTSIB). The scores of FoF, balance performance of mCTSIB, physical performance of TUG, and LE muscle strength were compared between groups. The results showed that FoF was present in 30% and 60% of the ONDM and ODM, respectively. Forty percent of the ODM failed one condition of the mCTSIB, while 18% and 16% failed two and three conditions, respectively. As the number of failed performances on the mCTSIB increased, the proportions of participants with FoF significantly increased. The psychosocial domain of FoF, LE muscle strength, and TUG score was significantly different between groups and more affected in the ODM with a greater number of failed performances on the mCTSIB. In conclusion, the mCTSIB can differentiate the varying degrees of balance impairment among ODM. FoF, LE muscle strength, and physical performance are more affected as the degree of balance impairment increases. Comprehensive management related to balance and falls in the ODM should include a regular evaluation and monitoring of standing balance, LE muscle strength, physical performance, and FoF.

Effects of Cognitive and Physical Loads on Dynamic and Static Balance Performance of Healthy Older Adults Under Single-, Dual-, and Multi-task Conditions.

The aim of this study is to examine the effects of cognitive and physical loads on dynamic and static balance performance of healthy older adults under single-, dual-, and multi-task conditions. Previous studies on postural control in older adults have generally used dual-task methodology, whereas less attention has been paid to multi-task performance, despite its importance in many daily and occupational activities. The effects of single versus combined (dual-task and multi-task) cognitive (to speak out the name of the weekdays in a reverse order) and physical (with three levels including handling weights of 1, 2, and 3 kg in each hand) loads on dynamic and static balance performance of 42 older adults (21 males and 21 females) aged ≥60 years were examined. Dynamic and static balance measures were evaluated using the Timed Up and Go (TUG) and stabilometer (sway index) tests, respectively. The TUG speed of female participants was generally slower than that of male participants. Age had no effect on balance performance measures. Under dual-task conditions, cognitive load decreased the dynamic balance performance, while the physical task levels had no effect. The dual-task conditions had no impact on the static balance performance. The effects of cognitive and physical loads on dynamic balance performance varied under dual- and multi-task conditions. The findings highlight differences between dual- and multi-task protocols and add to the understanding of balance performance in older adults under cognitive and physical loads. The present study highlights differences between dual- and multi-task methodologies that need to be considered in future studies of balance and control in older adults.

The Effect of External Attentional Focus and Self-Controlled Feedback on Motor Learning in Older Adults

Abstract Introduction. External focus instruction and self-controlled feedback have beneficial effects on motor learning. The purpose of the present study was to investigate the benefits of combined effects of external focus instruction and self-controlled feedback on balance performance in older adults. Material and Methods. Forty older adults (mean age: 63.21 ± 3.6 years; all female) were selected and randomly divided into 4 groups: self-controlled feedback, external attention, external attention/self-controlled feedback and control group. The task of standing on the platform of the stabilometer device and trying to keep the platform horizontally as much as possible was performed in each 30-sec. trial. The participants of self-controlled group received feedback on the timing of balance after the trials. In the external focus of attention, participants noticed the signs that were located horizontally ahead of their feet. The test was conducted in two sessions. In the acquisition phase, 10 trials of 30 seconds were performed and the retention test was completed 24 hours later as 5 trials of 30 seconds. Results. The results of mixed ANOVA on time data as an indicator of balance in the acquisition phase showed that the mixed group of external focus of attention and self-controlled feedback had better performance than the other groups (p = 0.004). In the retention test, the results of mixed ANOVA showed that the participants in the combined group of external focus and self-controlled feedback had better performance than the other groups (p = 0.006). The external focus of attention and self-controlled feedback performed similarly, and both were superior to the control group (p &lt; 0.05). Conclusions. The results of this study, supporting the OPTIMAL theory of motor learning in the elderly, showed that the combination of two factors of external focus and self-controlled feedback has a double advantage over the presence of each of the factors. Therefore, it is suggested that the combinations of external focus instructions and self-controlled feedback should be used to improve performance and motor learning in the classes of practical and clinical rehabilitation fields.

Statin use is associated with poorer static balance performance in older adults

Introduction Several medications have been associated with an increased risk of balance deficits and greater likelihood to sustain a fall. Statins are regularly prescribed to prevent strokes and heart attacks, but the impact of Statins on balance is unknown. The aim of this paper was to determine whether Statin use is associated with poorer balance performances in older adults. Material and methods Participants 60 years and above were separated into two groups, one group was taking Statins (n = 34), and the other group was not taking Statins (n = 31). All participants completed an eyes closed and eyes open balance assessment on a Matscan pressure sensing mat. Center of Pressure (CoP) velocity, peak to peak distance and standard deviation were collected in both anteroposterior (AP) and mediolateral (ML) directions. Multivariate regression analyses were performed in order to determine if Statin use predicted balance performance while controlling for several other risk factors associated with balance or Statin intake. Results After controlling for covariates, Statin intake significantly predicted both CoP ML amplitude (B = 0.638, P = 0.004) and ML velocity (B = 0.653, P = 0.002) in the eyes open condition. Discussion–conclusion The findings of this study suggest that caution should be taken when prescribing Statins in older adults, as this could decrease ML stability and ultimately increase fall risk.