Balance Test Scores Research Articles

Using Clinical Balance Tests to Assess Fall Risk among Established Unilateral Lower Limb Prosthesis Users: Cutoff Scores and Associated Validity Indices.

Clinicians are routinely required to make decisions about fall risk among lower limb prosthesis (LLP) users. These decisions can be guided by standardized clinical balance tests but require population- and test-specific cutoff scores and validity indices to categorize individuals as probable fallers or nonfallers on the basis of test performance. Despite the importance of cutoff scores and validity indices to clinical interpretation of clinical balance test scores, they are rarely reported for LLP users. In their absence, clinicians cannot use results from clinical balance tests to assess the likelihood of a fall by any one patient. Derive cutoff scores, and associated validity indices, for clinical balance tests administered to established unilateral LLP users. Cross-sectional study. Outpatient clinic and research laboratory. Established ambulatory unilateral transtibial and transfemoral prosthesis users (n = 40). Not applicable. Optimal cutoff scores and related validity indices (ie, area under the curve, sensitivity, specificity, likelihood ratios) were computed for five balance tests, the activities-specific balance confidence scale (ABC), timed up and go (TUG), four square step test (FSST), Berg balance scale (BBS), and narrowing-beam walking test (NBWT). Cutoff scores were identified for the NBWT (≤.43/1.0), TUG (≥8.17 seconds], FSST (≥8.49 seconds), BBS (≤50.5/56), and ABC (≤80.2/100). Validity indices (ie, area under the curve, sensitivity, specificity, and likelihood ratios) for the NBWT, TUG, and FSST had greater diagnostic accuracy and provided more information about the probability of a fall than those for the BBS or ABC. Performance above or below identified cutoff scores for the NBWT, FSST, and TUG provides information about potentially important shifts in the probability of falling among established unilateral LLP users. These results can serve as initial benchmarks to reduce uncertainty surrounding fall risk assessment in established unilateral LLP users but require future prospective evaluation. III.

Intersession reliability of the upper quarter Y balance test score

Shoulder injuries occur frequently in sports involving upper extremities, leading to temporary retirement from sport for conservative or surgical treatment. The decision to return to sport after in...

Effect of footwear modification on postural symmetry and body balance in leg length Discrepancy: A randomized controlled study

BackgroundAlthough structural leg length discrepancy is a physical problem that affects all populations, its measurement and correction is difficult. ObjectivesThe purpose of this study was to investigate the effect of using a shoe insert for correcting mild structural leg length discrepancy on frontal and transverse plane spino-pelvic alignment and dynamic balance. Study designPre-test post-test control group design (randomized controlled study). MethodsThirty one patients with structural discrepancies of 5–20 mm were randomly divided into two groups, those who used a shoe insert (group(A)) and those who formed a control group (group(B)). Their mean age, mass, and height were 31.5 ± 10y, 77.8 ± 10.4 kg, and 1.69 ± 0.08 m respectively. Spino-pelvic alignment measures (pelvic tilt, pelvic torsion, surface rotation, and lateral deviation) were assessed using rasterstereography, while dynamic balance was assessed using Star Excursion Balance Test (SEBT). Patients were assessed pre- and post-intervention over the eight-week study duration. ResultsMixed Design MANOVA showed significant decreases in the mean values of all spino-pelvic alignment measures and significant increases in the mean (SEBT) scores with insert use (p < 0.01) in group(A) with opposite results being reported for group(B). In addition, group(A) showed significant decreases in all spino-pelvic alignment measures and significant increases in the balance test scores when compared with group(B) eight weeks post insert use (p < 0.01). ConclusionsUsing shoe insole for leg length discrepancy correction appears to assist in improving postural symmetry and dynamic balance. (Clinical trial registry www.pactr.org number PACTR201611001888975). Implications for practice•Insert use for LLD correction may assist with improving spinal alignment.•Insert use for LLD correction may assist with improving pelvic alignment.•Insert use for LLD correction may assist with improving dynamic balance.

Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability: A systematic review with meta-analysis?

QuestionCan manual therapy improve functional outcomes for individuals with chronic ankle instability? DesignSystematic review with meta-analysis of randomized controlled trials. ParticipantsIndividuals with chronic ankle instability. InterventionManual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement. Outcome measureThe primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control. ResultsFour studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6–8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95%CI -0.87 to 3.36), I2 = 96%) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95%CI -0.26 to 7.09),I2 = 43%), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95% CI 0.55, to 4.23), I2 = 93%). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95%CI (−0.96,5.05), I2 = 75%), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT). ConclusionsSix sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI. Trial registration numberPROSPERO CRD42017054715.

Comparison of balance in seated and non-seated employees of Shiraz University of Medical Sciences

IntroductionDevelopments in modern technology in occupational settings have resulted in prolonged sitting at the workplace. Prolonged sedentarism may cause musculoskeletal complications and impaired balance. The present study aimed to evaluate balance in employees working in a seated position for more than half of their working day compared with employees working in a non-seated position.MethodsOverall, 100 employees entered the study and were divided into the seated (&lt;i&gt;n&lt;/i&gt; = 50) and non-seated (&lt;i&gt;n&lt;/i&gt; = 50) groups. The star excursion balance test was used to measure dynamic balance in the lower extremities. Independent t-tests were applied for between-group comparisons.ResultsThe star excursion balance test scores were significantly lower in the seated position group compared with the non-seated position group.ConclusionsWe conclude that dynamic stability is lower in employees working in a seated position compared with their non-seated counterparts.

Preseason Y Balance Test Scores are not Associated with Noncontact Time-Loss Lower Quadrant Injury in Male Collegiate Basketball Players.

The Y-Balance Test-Lower Quarter has shown promise as a screening tool for identifying athletes at risk of injury. Subsequent studies, utilizing heterogeneous populations or different operational definitions of injury, have presented equivocal findings. Therefore, studies evaluating the efficacy of the Y-Balance Test to discriminate injury risk in a homogeneous population is warranted. One-hundred sixty-nine male (mean age 19.9 ± 1.5 y) collegiate basketball players were recruited during 2 consecutive seasons (2016–2017/2017–2018). Athletes completed the Y-Balance testing protocol at the start of each preseason. Athletic trainers tracked noncontact time-loss lower quadrant injuries over the course of the season. Receiver operator characteristic curves failed to identify cutoff scores; therefore, previously reported cutoff scores were utilized when calculating relative risk. There was no association between preseason Y-Balance Test scores and noncontact time-loss lower back or lower extremity injury in a population of male collegiate basketball players. This study adds to a growing body of evidence that demonstrates no relationship between preseason Y-Balance Test scores and subsequent injury.

Dynamic balance performance varies by position but not by age group in elite Rugby Union players – a normative study

ABSTRACTThis cohort study aimed to provide normative Y Balance Test scores for an elite Rugby Union population, while investigating the effect player age groups (senior/under-20), playing positions (forwards/backs) and anthropometrics (height and body mass) had on performance. Two-hundred and sixty-one elite male under-20 (n = 50) and senior (n = 211) players completed baseline Y Balance Test during the 2015/2016 season. One-way ANCOVA and post-hoc t-tests were used to investigate the effect playing position, player group, height and weight had on performance. The cohort was then stratified into groups (age group and/or playing position), and normative percentiles were presented. There was a statistically significant difference (p < 0.05) in Y Balance Test performance between playing positions, when controlling for age group. This difference did not remain when controlling for player body mass. Post-hoc analysis demonstrated that backs had a longer normalised reach distance, with medium-large and small-medium effect sizes for the under-20 and senior cohorts respectively. The one-way ANCOVA analysis suggests that this difference is likely due to the larger differences in player body mass between forward and back playing positions. The normative values presented in this paper may be used by clinicians and researchers to aid injury prevention and rehabilitation strategies.

Influences of Age, Obesity, and Adverse Drug Effects on Balance and Mobility Testing Scores in Ambulatory Older Adults.

The adverse effects of drugs may influence results on tests of mobility and balance, but the drug-specific impact is not identified when using these tests. We propose that a quantitative drug index (QDI) will assist in assessing fall risk based on these tests, when combined with other fall risk variables. Fifty-seven community-dwelling older adults who could walk independently on a treadmill and had Mini-Mental State Examination (MMSE) scores equal to or greater than 24 participated. Mobility and balance outcome measures included the Balance Evaluation Systems Test (BESTest), Berg Balance Scale (BBS), Timed Up and Go (TUG) and cognitive dual task TUG (TUGc). Fall history, current drug list, and Activity-Specific Balance Confidence (ABC) scale scores were also collected. Body mass index (BMI) was calculated. The QDI was derived from the drug list for each individual, and based on fall-related drug adverse effects. Multiple linear regression analyses were conducted using age, BMI, and QDI as predictor variables for determining mobility and balance test scores, and ABC scale scores. Subsequently, participants were divided into (QDI = 0) low-impact drug group (LIDG) and (QDI > 0) high-impact drug group (HIDG) for Mann-Whitney 2-group comparisons. Age, BMI, and QDI were all significant (P < .001) independent variables in multiple regression analyses for mobility and balance test scores, but not for the ABC scale. Separately, the 2 group comparisons for the BESTest, BBS, TUG, and TUGc demonstrated that HIDG scored significantly (P < .05) worse on these tests compared with the LIDG. Drug counts were also significantly higher for the HIDG than for the LIDG. In contrast, age, BMI, MMSE, and reported falls in the last 12 months were not significantly different between groups. Age, BMI, and QDI-all contributed independently to the mobility and balance test scores examined, and may provide health care professionals a screening tool to determine whether additional mobility and balance testing is required. In addition, the QDI is a more precise marker of adverse effects of drugs compared with drug counts, as the latter does not quantitate the influence of drugs on physiologic function.

The Comparison of Some Motoric Characteristics of Hearing Impaired Individuals Sports Athletic and Gymnastic

The purpose of this study was to compare some motoric characteristics as a result of participating in physical activity education of hearing impaired individuals aged 12-14 doing athletics and gymnastics. The study consists of 30 athletes and 30 gymnastics students at the Hearing Impairments in Malatya Province. In the pre-test and post-test measures of the participants, flamingo balance test, flexibility, lower extremity reaction time test, quadriceps muscle strength, abdominal and back muscle strength, height, body weight, Body Mass Index (BMI) measurements were performed. Each participant was given physical activity training 3 days per week for 14 weeks. The flamingo balance test score of the both groups showed a decrease and reaction time of right and left side of athletes showed a decrease (p 0.05). As a result of the study, athletics is superior to gymnastic because it has been observed that athletics is more effective than gymnastics on balance, reaction time and muscle strength in individuals with hearing impaired.

23. Frailty assessment in patients with cirrhosis: a pilot study

Background and Aims: Patients with cirrhosis are vulnerable to an increased risk of functional decline. Frailty is a validated geriatric construct that objectively measures progressive functional decline. In this prospective study, we aimed to determine the prevalence and degree of frailty in patients with cirrhosis. Methods: Consecutive adult patients (>18 years) with cirrhosis were included in the study. Four measure frailty testing using Fried Frailty Instrument, Short Physical Performance Battery (SPPB) and Instrumental Activities of Daily Living Scale (IADL) were administered at a single time point. Furthermore, Karnofsky's performance status and Eastern Cooperative Oncology Group (ECOG) performance status was calculated. Results: Thirty-three adults were included in the study (27 males, 6 females; age 54.03 ± 11.68 years). Etiology of cirrhosis was Non-alcoholic steato-hepatitis in 12, ethanol in 10, Hepatitis B in 5 and Hepatitis C, cryptogenic and autoimmune in 2 patients each. Nine patients belonged to Child-Turcotte-Pugh (CTP) class A, 18 to class B and 6 to class C. The average Model for End Stage Liver Disease-sodium (MELDNa) score was 12.2 ± 4.8. Twenty-three patients were frail and 10 were intermediate frail. Frail patients had more prevalence of ascites (18 vs. 4 patients; p = 0.049), weight loss (p = 0.001) and lower physical energy (p = 0.039). They also had a higher MELDNa score (12.9 ± 5.3 vs. 10.2 ± 2.2; p = 0.05) and higher CTP score (p = 0.082). Additionally, frail patients had lower grip strength (10.78 ± 8.71 kg vs. 22.08 ± 13.94 kg; p = 0.035), lower balance test score (p = 0.007), lower gait speed score for 4-meter walk (p = 0.001), lower chair stand score (p = 0.001) and lower total SPPB score (p = 0.001). Total IADL score (p = 0.0001), Karnofsky Performance status (p = 0.0010) and ECOG performance score (p = 0.0001) was lower in frail patients. Conclusions: Frailty is an important problem amongst patients with cirrhosis. Frailty assessment and interventions directed towards improving performance status should be an essential part of management of patients with cirrhosis. The authors have none to declare.

Availability of vestibular myogenic evoked potential (VEMP) and blink reflex study in evaluating vestibular pathways of patients with cerebellar and brain stem lesion

Patients with cerebellar and brain stem lesions present symptoms of vestibular dysfunction, due to involvement of vestibular pathways. To investigate the relationship and availability of the VEMP and blink reflex study with vestibular pathways, we evaluated patients with cerebellar and brain stem lesion, analyzed the results of VEMP and blink reflex studies, which reflects vestibular dysfunction and vestibular nerve pathways. Sixteen Patients with cerebellar or brain stem stroke diagnosed by MRI were enrolled. VEMP and blink reflex study was performed using Nicolet.Viking IV D ® and DantecKeypointMedtronics ® . Clinical evaluation to check vestibular function and Berg balance scale was conducted. Participants were divided into normal and abnormal groups by comparing P13, N13 latency and amplitude of VEMP and latency difference of R1 and R2 of blink reflex, of the affected side against the sound side. McNemar and Wilcoxon rank sum test was done to confirm the correlation of abnormal VEMP, blink reflex studies and Berg balance test scores. ( P < 0.05). Participants with abnormal blink reflex, 37.5% (3/8) revealed abnormal VEMP results. 50% (3/6) of participants with abnormal VEMP, also revealed abnormal blink reflex results. Among the patients with brain stem lesion, 53.8% (7/13) showed abnormal blink reflex, while 46.2% (6/13) showed abnormal VEMP. There was no statistical correlation with the results of abnormal VEMP and abnormal blink reflex, but tendency of positive correlation was present. Brainstem stroke patients with abnormal blink reflex showed average of 6 in berg balance score, indicating very severe balance impairment, respectively. The tendency of positive correlation of abnormal blink reflex and VEMP suggests the overlap of vestibular pathway and brainstem pathway. This infers the possibility of utilizing VEMP instead of blink reflex as an evaluation tool for brain stem lesion, since the VEMP is more painless and simply conducted than blink reflex. Further study with more participants is needed.

The Effect of Core Stability Training on Functional Movement Patterns in College Athletes.

Context: Preparticipation examinations are the standard approach for assessing poor movement quality that would increase musculoskeletal injury risk. However, little is known about how core stability influences functional movement patterns. Objective: The primary purpose of this study was to determine the effect of an 8-week core stability program on functional movement patterns in college athletes. The secondary purpose was to determine if the core stability training program would be more effective in those with worse movement quality (ie,≤14 baseline functional movement screen [FMS] score). Design: Quasi-experimental design. Setting: Athletic training facility. Participants: One-hundred college athletes. Main Outcome Measures: Functional movement patterns included the FMS, lateral step-down, and Y balance test and were assessed before and after the 8-week program. Intervention: Participants were placed into one of the 2 groups: intervention and control. The intervention group was required to complete a core stability training program that met 3 times per week for 8 weeks. Results: Significant group × time interactions demonstrated improvements in FMS, lateral step-down, and Y balance test scores in the experimental group relative to the control group (P < .001). Independent sample t tests demonstrate that change scores were larger (greater improvement) for the FMS total score and hurdle step (P < .001) in athletes with worse movement quality. Conclusions: An 8-week core stability training program enhances functional movement patterns and dynamic postural control in college athletes. The benefits are more pronounced in college athletes with poor movement quality.

Multisensory training for postural sway control in non-injured elderly females

Elderly adults demonstrate increased postural sway, which may ultimately lead to falls. The present study used a randomized controlled intervention to investigate whether the three-week multisensory training program lead to a decreased postural sway. A total of 24 non-injured elderly females (60-80 years) volunteered to participate. They were randomly assigned to either a training group (ETG) who received one hour of training twice weekly for three weeks or to a control group (ECG) who received no training. At post-training, the results showed significant improvement in the trained ETG when compared to the untrained ECG for all three postural sway measures for all six training factors. The findings demonstrated that the trained ETG improved in their total Berg Balance Test (BBT) scores indicated that the training program successfully improved postural sway control for non-injured elderly females. Keywords : multisensory training, postural sway control, balance ability, visual input; vestibular input, somatosensory input

The relationship between balance performance, lumbar extension strength, trunk extension endurance, and pain in participants with chronic low back pain, and those without

BackgroundChronic low back pain is associated with lumbar extensor deconditioning. This may contribute to decreased neuromuscular control and balance. However, balance is also influenced by the hip musculature. Thus, the purpose of this study was to examine balance in both asymptomatic participants and those with chronic low back pain, and to examine the relationships among balance, lumbar extension strength, trunk extension endurance, and pain. MethodsForty three asymptomatic participants and 21 participants with non-specific chronic low back pain underwent balance testing using the Star Excursion Balance Test, lumbar extension strength, trunk extension endurance, and pain using a visual analogue scale. FindingsSignificant correlations were found between lumbar extension strength and Star Excursion Balance Test scores in the chronic low back pain group (r = 0.439–0.615) and in the asymptomatic group (r = 0.309–0.411). Correlations in the chronic low back pain group were consistently found in posterior directions. Lumbar extension strength explained ~19.3% to ~37.8% of the variance in Star Excursion Balance Test scores for the chronic low back pain group and ~9.5% to ~16.9% for the asymptomatic group. InterpretationThese results suggest that the lumbar extensors may be an important factor in determining the motor control dysfunctions, such as limited balance, that arise in chronic low back pain. As such, specific strengthening of this musculature may be an approach to aid in reversing these dysfunctions.

Improvement of Th17/Treg balance and Asthma Control Test score by Nigella sativa supplementation in asthmatic children: a new approach to managing asthma

Improvement of Th17/Treg balance and Asthma Control Test score by Nigella sativa supplementation in asthmatic children: a new approach to managing asthma

Validity, reliability and minimal detectable change of the balance evaluation systems test (BESTest), mini-BESTest and brief-BESTest in patients with end-stage renal disease

Purpose: This study determined the validity, test–retest reliability and minimal detectable change of the balance evaluation systems test (BESTest), mini-balance evaluation systems test (Mini-BESTest) and brief-balance evaluation systems test (Brief-BESTest) in patients with end-stage renal disease.Methods: A cross-sectional study with 74 patients with end-stage renal disease (male 66.2%; 63.9 ± 15.1 years old) was conducted. Participants were asked to report the number of falls during the previous 12 months and to complete the activity-specific balance confidence (ABC) scale. The BESTest was administered, and the Mini-BESTest and Brief-BESTest scores were computed based on the BESTest performance. Validity was assessed by correlating balance tests with each other and with the ABC scale. Test–retest relative reliability and agreement were explored with the intraclass correlation coefficient (ICC) equation (2,1) and the Bland and Altman method. Minimal detectable changes at the 95% confidence level were established.Results: Balance test scores were significantly correlated with each other (spearman’s correlation = 0.89–0.92) and with the ABC scale (spearman’s correlation = 0.49–0.59). Balance tests presented high test–retest reliability (ICC = 0.84–0.94), with no evidence of bias. Minimal detectable change values were 10.8 (expressed as a percentage 13.5%), 5.3 (23.7%) and 5.6 (34%) points for the BESTest, Mini-BESTest and Brief-BESTest, respectively.Conclusions: All tests are valid and reliable to assess balance in patients with end-stage renal disease. Nevertheless, based on the minimal detectable changes found, BESTest and Mini-BESTest may be the most recommended tests for this specific population.Implications for RehabilitationBalance evaluation systems test (BESTest), mini-balance evaluation systems test (Mini-BESTest) and brief-balance evaluation systems test (Brief-BESTest) are reliable and valid in patients with end stage renal disease (ESRD).The minimal detectable changes of 10.8 for the BESTest, 5.3 for the Mini-BESTest and 5.6 for the Brief-BESTest can be used by clinicians to identify a true change in balance over time or in response to interventions.Based on the minimal detectable changes found, BESTest and Mini-BESTest may be the most recommended; and the selection of one of them may be based on time and equipment availability.

Investigating the effects of maximal anaerobic fatigue on dynamic postural control using the Y-Balance Test.

The Y Balance Test is one of the most commonly used dynamic balance assessments, providing an insight into the integration of the sensorimotor subsystems. In recent times, there has been an increase in interest surrounding it's use in various clinical populations demonstrating alterations in motor function. Therefore, it is important to examine the effect physiological influences such as fatigue play in dynamic postural control, and establish a timeframe for its recovery. Descriptive laboratory study. Twenty male and female (age 23.75±4.79years, height 174.12±8.45cm, mass 69.32±8.76kg) partaking in competitive sport, completed the Y Balance Test protocol at 0, 10 and 20min, prior to a modified 60s Wingate fatiguing protocol. Post-fatigue assessments were then completed at 0, 10 and 20 min post-fatiguing intervention. Intraclass correlation coefficients demonstrated excellent intra-session reliability (0.976-0.982) across the three pre-fatigue YBT tests. Post-hoc paired sample t-tests demonstrated that all three reach directions demonstrated statistically significant differences between pre-fatigue and the first post-fatigue measurement (anterior; p=0.019, posteromedial; p=0.019 & posterolateral; p=0.003). The anterior reach direction returned to pre-fatigue levels within 10min (p=0.632). The posteromedial reach direction returned to pre-fatigue levels within 20min (p=0.236), while the posterolateral direction maintained a statistically significant difference at 20min (p=0.023). Maximal anaerobic fatigue has a negative effect on normalised Y balance test scores in all three directions. Following the fatiguing protocol, dynamic postural control returns to pre-fatigue levels for the anterior (<10min), posteromedial (<20min) and posterolateral (>20min).

Sarcopenia and relationships between muscle mass, measured glomerular filtration rate and physical function in patients with chronic kidney disease stages 3-5.

Sarcopenia and poor physical function are common in patients with chronic kidney disease (CKD). Our aim was to investigate the relationships between muscle mass and measured glomerular filtration rate (GFR) and between muscle mass and strength and balance, respectively, in patients with CKD stages 3-5. This is a baseline data analysis of a randomized controlled clinical trial. A total of 148 adult patients with an estimated GFR <30 mL/min/1.72 m2, not on renal replacement therapy, irrespective of the number of comorbidities were included from the Department of Nephrology, Skåne University Hospital, Lund, from 2011 to 2016. Body composition was measured by dual-energy X-ray absorptiometry (DEXA). GFR was measured by iohexol clearance. Balance was measured by functional reach and the Berg balance test and strength by handgrip strength and isometric quadriceps strength. Measured GFR ranged from 8 to 55 mL/min/1.73 m2. Lean mass (P < 0.05), fat mass (P < 0.05), appendicular skeletal muscle (P < 0.001) and appendicular skeletal muscle index (P < 0.05) were associated with GFR. Functional reach was associated with leg lean mass (P < 0.05) and the Berg balance test score was associated with trunk lean mass (P < 0.05). Handgrip strength was associated with arm lean mass (P < 0.001). Isometric quadriceps strength was associated with leg lean mass (P < 0.001). More men (44%) suffered from low muscle mass than women (22%), whereas more women (36%) suffered from low muscle strength than men (26%). However, when combining both, men (16%) suffered from sarcopenia to a greater extent than women (8%). Among patients with CKD stages 3-5, loss of lean body mass, especially appendicular skeletal muscle, was significantly related to GFR decline. Two important markers of physical function, balance and strength, were significantly related to muscle mass. Moreover, men were more prone to sarcopenia than women during kidney function decline.

Effect of a 4-week balance exercise with medio-lateral unstable sole on ankle joint functional ability.

[Purpose] This study examined the effects of 4-week of balance exercise with medio-lateral unstable sole on ankle muscle activation and functional ability. [Subjects and Methods] Thirty university students without current or past ankle injuries were assigned to either an experimental group or control group. The experimental group participated in a balance exercise program 3 times a week over 4 weeks, which consisted of one-leg stands and semi-squat exercises with medio-lateral unstable sole. The control group continued with their regular life activities without participation in the program. Electromyographic activities of peroneus longus and brevis muscles were recorded during stair descending immediately before and after the exercise program. Functional balance was tested with the Star Excursion Balance test immediately before and after the exercise program. Paired t-tests were used to assess statistical significance. [Results] Activation of peroneus longus and brevis and Star Excursion Balance Test scores in both groups did not show a significant difference between pre- and post-exercise. [Conclusion] A future study is suggested with increased level of medio-lateral perturbation during outcome measurements and exercises with addition of supervision in the exercise training and home program.

Curative effect of normative ankle balance training in treatment of chronic ankle instability

Objective To investigate the efficacy of normative ankle balance training on chronic ankle instability (CAI). Methods Ninety patients were randomized into control group (17 males, 28 females; 13-26 years, mean 19.6 years) and experiment group (18 males, 27 females; 14-27 years, mean 20.3 years) according to the random number table. There were 19 left ankles and 26 right ankles injured in control group, and 19 left ankles and 26 right ankles injured in experiment group. Patients in control group only completed routine muscle strength training. Besides the routine muscle strength training, balance training (rubber band, spongy cushion, balance pedal, rubber balance ball and jump ball) were added in experiment group. The two groups were compared with respect to foot and ankle disability index (FADI), anterior, posterior-median and 45° to posterolateral direction reach distance of star excursion balance test (SEBT) and visual analogue score (VAS). Results After training, comparison of experiment and control groups showed significant differences in FADI (35.16±3.23 and 22.33±1.36), SEBT distance in posterior median direction [(78.59±7.22)% and (71.89±7.11)%], SEBT distance in 45° to posterolateral direction [(75.79±8.27)% and (68.95±8.03)%] and VAS [(3.01±0.91)scores and (3.42±1.02)scores] (P<0.05). For intragroup comparison, FADI, SEBT and VAS in experimental group showed significant differences before and after training (P<0.05), but only FADI in control group differed significantly before and after training (P<0.05). Conclusion Normative balance training can improve CAI patients’ self-feelings of dynamic balance and instability with satisfactory therapeutic efficacy, and is worthy to be popularized. Key words: Ankle; Joint instability; Treatment outcome