Impaired Balance Research Articles

Probability of lateral instability while walking on winding paths

People with balance impairments often struggle performing turns or lateral maneuvers, which can increase risk of falls and injuries. Here we asked how people’s mediolateral balance is impacted when walking on non-straight winding paths. Twenty-four healthy adults (12F / 12M; 25.8±3.5 yrs) participated. Each walked on each of six paths projected onto a treadmill, comprised of three pseudo-random path oscillation frequency combinations (straight, slowly-winding, quickly-winding), each presented at either wide or narrow width. We quantified stepping errors as the percent of steps taken off each path. We quantified minimum mediolateral Margin of Stability (MoSL) at each step and calculated means (μ) and standard deviations (σ) for each trial. We calculated lateral Probability of Instability (PoIL) as participants’ statistical risk of taking unstable (MoSL < 0) steps. On narrower paths, participants made more stepping errors and walked with smaller μ(MoSL) for all path frequencies (p < 0.001), and exhibited increased PoIL on the straight and slowly-winding paths (p < 0.001). On winding paths, participants made progressively more stepping errors and walked with smaller μ(MoSL) as oscillation frequency increased on narrow paths (all p < 0.001) and on the wide quickly-winding paths (all p < 0.001). They also consistently walked with larger σ(MoSL), and increased PoILon higher sinuosity paths of both widths (all p < 0.001). Though many took numerous unstable steps, no participant fell. Our results demonstrate healthy adults’ ability both to trade off increased risk of lateral instability for greater maneuverability, and to employ highly-versatile stepping strategies to maintain balance while walking.

Development and Validation of SCACOMS, a Composite Scale for Assessing Disease Progression and Treatment Effects in Spinocerebellar Ataxia.

Spinocerebellar ataxias (SCA) are rare inherited neurodegenerative disorders characterized by a progressive impairment of gait, balance, limb coordination, and speech. There is currently no composite scale that includes multiple aspects of the SCA experience to assess disease progression and treatment effects. Applying the method of partial least squares (PLS) regression, we developed the Spinocerebellar Ataxia Composite Scale (SCACOMS) from two SCA natural history datasets (NCT01060371, NCT02440763). PLS regression selected items based on their ability to detect clinical decline, with optimized weights based on the item's degree of progression. Following model validation, SCACOMS was leveraged to examine disease progression and treatment effects in a 48-week SCA clinical trial cohort (NCT03701399). Items from the Clinical Global Impression-Global Improvement Scale (CGI-I), the Friedreich Ataxia Rating Scale (FARS) - functional stage, and the Modified Functional Scale for the Assessment and Rating of Ataxia (f-SARA) were objectively selected with weightings based on their sensitivity to clinical decline. The resulting SCACOMS exhibited improved sensitivity to disease progression and greater treatment effects (compared to the original scales from which they were derived) in a 48-week clinical trial of a novel therapeutic agent. The trial analyses also provided a SCACOMS-derived estimate of the temporal delay in SCA disease progression. SCACOMS is a useful composite measure, effectively capturing disease progression and highlighting treatment effects in patients with SCA. SCACOMS will be a powerful tool in future studies given its sensitivity to clinical decline and ability to detect a meaningful clinical impact of disease-modifying treatments.

Somatosensory and dynamic balance improvement in older adults with diabetic peripheral neuropathy through sensorimotor exercise: A multisite randomized controlled trial

PurposeTo examine the effect of the Feldenkrais method on lower legs and foot somatosensory postural control-related function, dynamic balance, fear of falling and quality of life in adults with diabetic polyneuropathy in the short and mid-term. MethodsA single-blinded, parallel, multicentric randomized control trial was conducted in two health hospitals. Subjects with diabetic polyneuropathy and older than 55 years with a history of falls or dynamic balance dysfunction were recruited from the hospital databases and randomly allocated to the experimental or control group. The experimental group received 16 sessions of sensorimotor training based on the Feldenkrais method. Both groups received diabetic foot care instructions. The results were measured at the 3 and 6-month follow-up periods. ResultsThe mean age was 70 ± 8. A total of 44 participants were enrolled in the study, and 27 completed the process. No adverse events were reported. After the intervention, significant somatosensory results were obtained (p < 0.001). The results of the Up and Go and POMA tests were significant after the intervention (p < 0.001) and during the 3-month follow-up period for POMA (p = 0.018). The fear of falling showed significant results at the 3-month follow-up period (p = 0.03), and the quality of life in all measurements. ConclusionsSignificant short-term effects were obtained on somatosensory postural control-related function, dynamic balance, and fear of falling. Significant short and mid-term effects were achieved on quality of life. Older adults with diabetic polyneuropathy, dynamic balance impairment, or a history of falls can improve their abilities through the Feldenkrais method. Trial registrationClinicaltrials.gov: NCT05262946.

Current Updates in Implant Dentistry Materials

Background: Permanent tooth loss without replacement results in impaired chewing function, aesthetics, phonetics, and balance of the masticatory organs which can lead to more complex dental and oral health problems. Dental implants are the best treatment alternative today to restore masticatory function, aesthetics, and phonetics more perfectly. The use of implants allows tooth replacement that resembles the patient's previous natural teeth, both in terms of aesthetics and comfort. Until now, many types of materials have been studied and applied as dental implant materials. Objective: This review aims to analyze the latest developments regarding materials used for dental implants. Methods: A literature search was conducted on the PubMed, ScienceDirect, Cochrane, and Scopus databases until December 2023 using predetermined keywords and the results were limited to articles published in 2018-2023 with full-text open-access. Conclusion: The selection of ideal implant material for patients can be adjusted to the patient's needs taking into account the physical, mechanical, and biocompatibility properties of the material.

ROLE OF THE EMOTIONAL-MOTIVATIONAL COMPONENT IN THE DYNAMICS OF CNS FUNCTIONAL CAPACITY IN SECONDARY SCHOOL STUDENTS

The main clinical syndromes of chronic cerebral ischemia (CCI) are impaired gait and balance disorders, High morbidity level among school children, which has been recorded over the past decade in our country, necessitates a review of the contributing causes, mechanisms and factors. Objective. The purpose of the study is to assess CNS functional capacity in secondary school students taking into account anxiety and the motivational component. Materials and Methods. The study enrolled 424 secondary school students aged 10–17, living in Astrakhan. Simple and complex visual-motor reaction test was carried out. To study personality traits, anxiety and motivation levels of the participants, the authors used Junior Eysenck Personality Questionnaire (JEPQ), School Anxiety Test (Phillips Test), and Spielberg-Andreeva motivation questionnaire. Results. A significant decrease in the level of CNS functional capacity was noted when compared with the age norm. CNS functional level increases with age, while its values in the examined 12–13 and 14–15 year-old participants are below the average age ones. A decrease in the motivation level was revealed among the trial subjects. A positive attitude towards learning and effective motivation was revealed in 53.6 % of secondary school students aged 10–11; 38,6 % aged 12–13; 30,3 % aged 14–15 and 30 % aged 16–17. A high level of general anxiety was revealed in 40.9 % of secondary school students aged 10–11; 63.6 % aged 12–13; 12.8 % aged 14–15 and 6 % aged 16–17. Conclusion. The parameters of CNS functional capacity in most cases are characterized by below average values. The anxiety level significantly decreases with age, which indicates an adequate influence of learning environment on students. The highest anxiety level was revealed in the trial subjects aged 12–13. Motivation for learning decreases with age, which is probably due to psychological and motivational age-related changes in adolescence.

Effect of Whole-Body Vibration Versus Rhythmic Auditory Stimulation on Spasticity, Balance, and Lower Limb Motor Function in Hemiplegic Stroke Patients

Background: Stroke can lead to spasticity, balance impairments, and lower limb motor dysfunction. Whole-body vibration (WBV) and rhythmic auditory stimulation (RAS) are two therapeutic interventions that may address these deficits.Objective: To compare the effects of WBV and RAS on spasticity, balance, and lower limb motor function in hemiplegic stroke patients.Methods: A single-blinded, randomized controlled trial was conducted with 104 chronic hemiplegic stroke patients, divided into two groups: Group A (WBV) and Group B (RAS). WBV was applied using a vibration platform at 30-40 Hz for 3-minute sessions, 3 days/week for 4 weeks. RAS involved 90-minute sessions of music-based exercises, incorporating rhythmic cues and conventional therapy, 3 days/week for 4 weeks. Spasticity, balance, and motor function were assessed using the Modified Ashworth Scale, Berg Balance Scale, and Fugl-Meyer Assessment, respectively. Data were analyzed using SPSS version 27.Results: Group A showed greater improvements in spasticity (MAS: 1.2±0.4 vs. 2.6±0.3), balance (BBS: 49±5 vs. 43±5), and motor function (FMA: 29±5 vs. 18.5±5) compared to Group B (p&lt;0.05).Conclusion: WBV is more effective than RAS in improving spasticity, balance, and motor function in chronic hemiplegic stroke patients.

Ferroptosis and Sarcopenia-Osteoporosis after Menopause: Research Status, Traditional Chinese Medicine Strategies, and Prospects

Ferroptosis, a precisely regulated cell death mechanism, is distinguished by its intimate link to iron overload and lipid peroxidation processes, playing a pivotal role in the pathological progression of a wide range of diseases. In postmenopausal women suffering from osteoporosis, reduced muscle strength and impaired balance lead to a heightened risk of fragility fractures, markedly diminishing their quality of life. Recent groundbreaking research has underscored the crucial role of the ferroptosis mechanism in the initiation and progression of musculoskeletal diseases. This discovery not only enriches our understanding of disease mechanisms but also heralds ferroptosis pathways as novel and promising therapeutic targets for treating these conditions. Traditional Chinese Medicine (TCM) has exhibited remarkable efficacy in managing musculoskeletal diseases, with studies validating its ability to modulate ferroptosis mechanisms and profoundly impact disease regulation. This portends vast research potential and significant therapeutic promise for the future. By delving deeper into the interplay between ferroptosis and sarcopenia-osteoporosis in postmenopausal women, and by developing innovative therapeutic strategies and TCM interventions, we aspire to forge new pathways for the treatment of sarcopenia-osteoporosis in this patient population.

Prevalence of Balance Impairment in Physically Active and Sedentary Lifestyle Children Aged 7-10 Years

Background: Balance impairment can significantly affect motor development in children, with lifestyle factors such as physical activity playing a crucial role. Physically active children may develop better balance than those leading sedentary lifestyles.Objective: To evaluate the prevalence of balance impairment in physically active and sedentary children aged 7-10 years.Methods: A cross-sectional study was conducted on 377 children aged 7-10 years from schools in Sheikhupura, Pakistan. The participants were divided into physically active (n=189) and sedentary (n=188) groups based on the International Physical Activity Questionnaire for Children (IPAQ-C). Balance was assessed using the Pediatric Balance Scale (PBS), a 14-item tool with a maximum score of 56. Data were analyzed using IBM SPSS version 25, with chi-square tests to determine statistical significance (p&lt;0.05).Results: In the physically active group, 79.4% (n=150) had good balance scores, while 67.6% (n=127) in the sedentary group showed moderate balance impairment. The difference between the two groups was statistically significant (p&lt;0.001).Conclusion: Physically active children demonstrated better balance compared to their sedentary peers, underscoring the importance of physical activity in childhood development

Metronome-Guided Balance Exercises to Aid in Dynamic Balance and Postural Control in a Novel Genetic Presentation of Niemann–Pick Disease Type C: A Case Report

Abstract Niemann–Pick disease type C is a rare progressive lysosomal lipid storage disorder. The disorder is characterized by a range of neurological consequences and complications at different points of its progression including spasticity, incoordination, ataxia, supranuclear gaze palsy, asthenia, and balance impairment, with a higher risk of falls. Among various approaches to managing such a debilitating condition, the role of physical therapy in managing the symptoms of such patients is often limited or underreported in the literature. A combination of spasticity and ataxia leads to impaired timing of agonist–antagonist control. Therefore, balance loss and falls are the most prevalent symptoms. We advocated a 12-week metronome-guided balance training program. Niemann–Pick type C disease is a rare genetic phenomenon that often presents with multi-system changes at structural and functional levels for the patient. Metronome-guided balance training is beneficial for improving dynamic balance variables, including movement velocity, center of gravity sway velocity, and step width.

Tau P301S Transgenic Mice Develop Gait and Eye Movement Impairments That Mimic Progressive Supranuclear Palsy.

Progressive supranuclear palsy (PSP) is a neurodegenerative disorder with an estimated prevalence of 5-7 people in 100,000. Clinically characterized by impairments in gait, balance, and eye movements, as well as aggregated Tau pathology, PSP leads to death in approximately 5-8 years. No disease-modifying treatments are currently available. The contribution of Tau pathology to the symptoms of patients with PSP is poorly understood, in part due to lack of a rodent model that recapitulates characteristic aspects of PSP. Here, we assessed the hTau.P301S mouse for key clinical features of PSP, finding progressive impairments in balance and gait coordination. Additionally, we found impairments in fast vertical eye movements, one of the most distinctive features of PSP. Across animals, we found that Tau pathology in motor control regions correlated with motor deficits. These findings highlight the utility of the hP301S mouse in modeling key aspects of PSP.

Impaired Balance Predicts Cardiovascular Disease in 70-Year-Old Individuals-An Observational Study From the Healthy Aging Initiative.

Limited research has explored balance problems as a prospective risk factor for cardiovascular disease (CVD). This study aimed to characterize the association between balance measures and the risk of incident CVD in a population of 70-year-olds. From 2012 to 2022 a cohort of 4927 older individuals who were CVD free underwent balance assessments using a balance board. Measurements included lateral and anterior-posterior sway, along with a safety limit of stability in a subcohort (N=2782). Time to first hospitalization for CVD, encompassing stroke, myocardial infarction, or angina pectoris was the primary outcome. Multivariable regression models assessed associations between balance parameters and CVD risk. Over a mean follow-up of 4.9 years, 320 individuals were hospitalized for CVD. In a balance test with eyes open, increased lateral sway at baseline was associated with a higher risk of CVD (hazard ratio [HR], 1.014 [95% CI, 1.004-1.025], P=0.005, per mm increased sway), after adjustment for traditional risk factors for CVD. Similarly, individuals with CVD during follow-up exhibited higher lateral sway with eyes closed at baseline (HR, 1.015 [95% CI, 1.005-1.025], P=0.002, per mm increased sway), after multivariable adjustment. The 4 strongest independent predictors of CVD included lateral sway and were associated with a population attributable fraction of 61% (95% CI, 54-68). In community-dwelling 70-year-olds, impaired lateral balance was an independent predictor of later CVD, after adjustment for traditional risk factors. This may suggest that position balance could be used as an early risk marker for underlying atherosclerotic disease.

Smartphone Assessment of the Sitting Heel-Rise Test.

The study presents a new approach for assessing plantarflexor muscles' function using a smartphone. The test involves performing repeated heel raises for 60 s while seated. The seated heel-rise test offers a simple method for assessing plantarflexor muscles' function in those with severe balance impairment who are unable to complete tests performed while standing. The study aimed to showcase how gyroscopic data from a smartphone placed on the lower limb can be used to assess the test. Eight participants performed the seated heel-rise test with each limb. Gyroscope and 2D video analysis data (60 Hz) of limb motion were used to determine the number of cycles, the average rise (T-rise), lowering (T-lower), and cycle (T-total) times. The number of cycles detected matched exactly when the gyroscope and kinematic data were compared. There was good time domain agreement between gyroscopic and video data (T-rise = 0.0005 s, T-lower = 0.0013 s, and T-total = 0.0017 s). The 95% CI limits of agreement were small (T-total -0.1118, 0.1127 s, T-lower -0.1152, 0.1179 s, and T-total -0.0763, 0.0797 s). Results indicate that a smartphone placed on the thigh can successfully assess the seated heel-rise test. The seated heel-rise test offers an attractive alternative to test plantarflexor muscles' functionality in those unable to perform tests in standing positions.

High-Intensity Exercise Training Impact on Cardiorespiratory Fitness, Gait Ability, and Balance in Stroke Survivors: A Systematic Review and Meta-Analysis.

Stroke survivors commonly face challenges such as reduced physical activity and cardiorespiratory fitness (CRF) as well as balance and gait impairments, exacerbating their disability. While high-intensity exercise interventions have demonstrated some potential, their effects on these items remain uncertain. Therefore, our study aimed to investigate the impact of high-intensity training protocols on CRF, gait ability, and balance in stroke survivor populations. Two independent investigators systematically searched five databases for relevant RCTs following the PICO model. Through a systematic review of 25 RCTs published up to 31 May 2023, including adult first-stroke survivors, comparing high-intensity exercise training versus low-to-mild or no exercises, we evaluated outcomes such as the Six-Minute Walking Test (6 MWT), peak oxygen uptake (VO2peak), Ten-Meter Walk Test (10 MWT), Berg Balance Scale (BBS), and Timed Up and Go test (TUG). The protocol was registered in PROSPERO (registration number CRD42023456773). Meta-analyses indicated significant enhancements in CRF, as measured by 6 MWT and VO2peak, following high-intensity exercise interventions. However, no significant differences were observed in BBS, 10 MWT, and TUG. Our findings underscore the potential of high-intensity exercise interventions in ameliorating CRF among stroke survivors, although further research involving standardized protocols and long-term follow-ups is imperative to optimize rehabilitation outcomes.

Effects of Haptic Feedback Interventions in Post-Stroke Gait and Balance Disorders: A Systematic Review and Meta-Analysis.

Background: Haptic feedback is an established method to provide sensory information (tactile or kinesthetic) about the performance of an activity that an individual can not consciously detect. After a stroke, hemiparesis usually leads to gait and balance disorders, where haptic feedback can be a promising approach to promote recovery. The aim of the present study is to understand its potential effects on gait and balance impairments, both after interventions and in terms of immediate effects. Methods: This research was carried out using the following scientific databases: Embase, Scopus, Web of Science, and Medline/PubMed from inception to May 2024. The Checklist for Measuring quality, PEDro scale, and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Results: Thirteen articles were chosen for qualitative analysis, with four providing data for the meta-analysis. The findings did not yield definitive evidence on the effectiveness of haptic feedback for treating balance and gait disorders following a stroke. Conclusions: Further research is necessary in order to determine the effectiveness of haptic feedback mechanisms, with larger sample sizes and more robust methodologies. Longer interventions and pre-post design in gait training with haptic feedback are necessary.

Characterizing the Longitudinal Impact of Backward Locomotor Treadmill Training on Walking and Balance Outcomes in Chronic Stroke Survivors: A Randomized Single Center Clinical Trial.

Walking and balance impairments after stroke are a global health concern, causing significant morbidity and mortality. However, effective strategies for achieving meaningful recovery in the chronic stages are limited. Backward locomotor treadmill training (BLTT) is a novel walking rehabilitation protocol that is safe, feasible, and likely beneficial in stroke survivors; however, its efficacy has not been tested. This single-center, randomized, assessor-blind clinical trial aims to test the preliminary efficacy of BLTT compared to forward locomotor treadmill training (FLTT) on walking speed, symmetry, and postural stability. Forty stroke survivors [BLTT (N=19), FLTT (N=21); mean age= 56.3 ± 8.6 years; 53% Female; 30% Non-Hispanic Black] with mild-moderate walking impairment were enrolled. Participants underwent nine 30-minute BLTT or FLTT sessions over three weeks. The primary outcome was the mean change in the 10-meter walk test (10 MWT) at 24 hours post-training (24 hr POST). Secondary outcome measures were changes in spatiotemporal walking symmetry and postural stability during quiet standing at 24 hr POST. Retention was explored at Days 30- and 90 POST. We report clinically meaningful (≥ 0.16 m/s) improvements in overground walking speed at 24 hr POST, with retention up to Day 90 POST with BLTT and FLTT. However, contrary to our working hypothesis, no between-group differences in walking speed were observed. Nonetheless, we found that BLTT resulted in offline improvements in spatial symmetry and retention of subcomponents of the modified clinical test of sensory interaction on balance (mCTSIB), including the testing of proprio-vestibular integration up to Day 30 POST. Among chronic stroke patients with mild-moderate walking impairment, BLTT and FLTT both resulted in long-lasting and clinically meaningful improvement in walking speed. However, preliminary findings suggest that BLTT may better comprehensively target walking asymmetry and sensory systems processing and integration.

Identifying neural correlates of balance impairment in traumatic brain injury using partial least squares correlation analysis

Objective.Balance impairment is one of the most debilitating consequences of traumatic brain injury (TBI). To study the neurophysiological underpinnings of balance impairment, the brain functional connectivity during perturbation tasks can provide new insights. To better characterize the association between the task-relevant functional connectivity and the degree of balance deficits in TBI, the analysis needs to be performed on the data stratified based on the balance impairment. However, such stratification is not straightforward, and it warrants a data-driven approach.Approach.We conducted a study to assess the balance control using a computerized posturography platform in 17 individuals with TBI and 15 age-matched healthy controls. We stratified the TBI participants into balance-impaired and non-impaired TBI usingk-means clustering of either center of pressure (COP) displacement during a balance perturbation task or Berg Balance Scale score as a functional outcome measure. We analyzed brain functional connectivity using the imaginary part of coherence across different cortical regions in various frequency bands. These connectivity features are then studied using the mean-centered partial least squares correlation analysis, which is a multivariate statistical framework with the advantage of handling more features than the number of samples, thus making it suitable for a small-sample study.Main results.Based on the nonparametric significance testing using permutation and bootstrap procedure, we noticed that the weakened theta-band connectivity strength in the following regions of interest significantly contributed to distinguishing balance impaired from non-impaired population, regardless of the type of stratification:left middle frontal gyrus, right paracentral lobule, precuneus, andbilateral middle occipital gyri. Significance.Identifying neural regions linked to balance impairment enhances our understanding of TBI-related balance dysfunction and could inform new treatment strategies. Future work will explore the impact of balance platform training on sensorimotor and visuomotor connectivity.

Clinical, Radiological and Pathological Features of a Large American Cohort of Spinocerebellar Ataxia (SCA27B).

Spinocerebellar ataxia 27B due to GAA repeat expansions in the fibroblast growth factor 14 (FGF14) gene has recently been recognized as a common cause of late-onset hereditary cerebellar ataxia. Here we present the first report of this disease in the US population, characterizing its clinical manifestations, disease progression, pathological abnormalities, and response to 4-aminopyridine in a cohort of 102 patients bearing GAA repeat expansions. We compiled a series of patients with SCA27B, recruited from 5 academic centers across the United States. Clinical manifestations and patient demographics were collected retrospectively from clinical records in an unblinded approach using a standardized form. Post-mortem analysis was done on 4 brains of patients with genetically confirmed SCA27B. In our cohort of 102 patients with SCA27B, we found that SCA27B was a late-onset (57 ± 12.5 years) slowly progressive ataxia with an episodic component in 51% of patients. Balance and gait impairment were almost always present at disease onset. The principal finding on post-mortem examination of 4 brain specimens was loss of Purkinje neurons that was most severe in the vermis most particularly in the anterior vermis. Similar to European populations, a high percent of patients 21/28 (75%) reported a positive treatment response with 4-aminopyridine. Our study further estimates prevalence and further expands the clinical, imaging and pathological features of SCA27B, while looking at treatment response, disease progression, and survival in patients with this disease. Testing for SCA27B should be considered in all undiagnosed ataxia patients, especially those with episodic onset. ANN NEUROL 2024.

A confounding pediatric spinal cord injury: Anterior, central, or both?

Pediatric spinal cord injury (SCI) most commonly affects the cervical region. Central cord syndrome most often occurs in the lower cervical injury due to hyperextension injury, while anterior cord syndrome is primarily due to vascular infarction after hyperextension injury. An unusual case of a pediatric patient who physically presented with central cord syndrome but radiologically had evidence of anterior spinal artery syndrome is described. A two-year-old male presented after a fall from three feet with flaccid upper extremities and dysesthesias but maintained functional strength in bilateral lower extremities. Although his clinical presentation was that of central cord syndrome, he was found to have an anterior spinal artery infarct spanning from C2-T3 with a ligamentous injury at C3 and an incidental finding of Chiari I malformation on MRI. Given the negative evaluation for a cardiac or hematologic source of embolus and normal angiography, it was theorized that compression of vertebral arteries by previously undiagnosed Chiari I malformation in the setting of trauma could have made the patient more vulnerable to this complication. During inpatient rehabilitation, he regained scapular movement and shoulder flexion. However, he regained distal movement in supination, wrist extension, and finger flexion instead of the more usual proximal-to-distal motor recovery observed in SCI. While he had a relative sparing of strength in his legs, he had impaired proprioception and balance, leading to gait impairment. This case highlights the complexity of pediatric cervical SCI diagnosis and prognostication. While classic SCI subtypes are well described, many pediatric and adult patients will present and recover in unexpected ways. All with SCI should be evaluated thoroughly for common etiologies and transitioned to rehabilitation therapies to assist in recovery.

Assessment of fall risk, cognitive impairment, fear of falling in relation to functional mobility, and balance impairments in older adults

Among older adults, falls are the most common injury and may increase the risk of mortality. This study aimed to investigate factors associated with functional mobility and balance impairments among community-dwelling older adults. A cross-sectional study was conducted among a total of 515 older adults. The questionnaires recorded demographic characteristics and health data, including the mental state examination T10 version (MSET10) and fear of falling (FOF). Functional mobility and balance impairments were assessed using the timed up and go (TUG) test. Leg strength and endurance were assessed using the sit to stand (STS) test. Demographic factors that were associated with significant differences for TUG and TUG-cognitive included age, education, occupation, history of falls in the previous year, and comorbidities. The TUG-cognitive, STS, and TUG tests at higher risk of falling were 42.5%, 18.6%, and 14.2%, respectively. The Pearson correlation coefficient analysis showed that STS and FOF were positively associated with TUG and TUG-cognitive, while the MSET10 was negatively associated with TUG and TUG-cognitive. Multiple linear regression analysis showed that increasing FOF was associated with increasing TUG and TUG-cognitive after adjusting for confounding variables (p &lt; 0.001 and p = 0.015, respectively). Several risk factors need to be considered to determine the effectiveness of preventive measures and interventions to reduce the risk of falling. In particular, interventions for older adults should focus on functional mobility and balance impairments.

The association between dietary antioxidant quality score and intensity and frequency of migraine headaches among women: a cross-sectional study

BackgroundMigraine is an episodic disorder and a frequent form of headache. An impaired balance between free radical production and an impaired antioxidant defense system leading to oxidative damage may play a major role in migraine etiology. We sought to investigate whether dietary antioxidant quality score (DAQS) is associated with migraine intensity and frequency among women suffering from migraine.MethodsThis cross-sectional study was conducted on 265 women. The data related to anthropometric measures and dietary intake were collected. DAQS score was calculated based on FFQ (food frequency questionnaire) vs. the reference daily intake (RDI) quantity. To measure migraine intensity, the migraine disability assessment questionnaire (MIDAS) and visual analog scale (VAS) were used. The frequency of headaches was defined as the days the participants had headaches in the last month and a 30-day headache diary was used.ResultsThe results of the study demonstrated that VAS, MIDAS, and frequency of headaches were reduced significantly from the low DAQS (poor quality of antioxidants) to high DAQS (high quality of antioxidants) after adjusting covariates. Also, multinomial regression showed there was an inverse association between higher DAQS and the frequency of headaches. In the adjusted model, subjects with the higher DAQS were 69% less likely to have moderate migraine disability, compared with those with the lower DAQS. Linear regression showed, there was an inverse association between vitamin C intake and the grades of pain severity.َAlso in a crude model, a negative association was found between vitamin E and the frequency of headaches.ConclusionIn conclusion, Participants with higher DAQS had lower migraine intensity and headache frequency. In addition, the consumption of vitamin C may potentially associate with decreasing the severity of headaches. Dietary antioxidants should be monitored closely in individuals suffering from migraine.