Tinetti Balance Assessment Tool Research Articles

Effects of a short-term wheelchair yoga intervention on balance in elderly women with neurodegenerative diseases: A preliminary study

Abstract Study aim: This study examined effects of practicing of the wheelchair yoga intervention for 4 weeks on static and dynamic balance and physical, mental and social health in elderly female wheelchair users with neurodegenerative diseases. Material and methods: Elderly females (n = 22, mean age 75.1 ± 5.8 years), users of a wheelchair participated in the 4-week wheelchair yoga intervention program. Medical anamnesis, bioimpedance body composition assessment, Tinetti balance assessment tool, and the RAND 36 Short Form Health Survey (SF-36) were used in the pre – and post-measurements. Results: Multivariate regression – orthogonal projections to latent structures (OPLS) and non-parametric comparisons revealed significant increase in the dynamic balance, total muscle mass, and the social score after the yoga program. Changes in the Tri-ponderal mass index and several indicators of mental health were the best mediators for the effect of the yoga program on dynamic balance. Conclusions: Wheelchair yoga intervention program could be a beneficial rehabilitation method for stimulation of neuromotor functions associated with balance control in elderly females – users of a wheelchair due to neurodegenerative diseases.

Current practices of physiotherapists in Switzerland regarding fall risk-assessment for community-dwelling older adults: A national cross-sectional survey.

Falls can strongly impact older people's quality of life, health, and lifestyle. Multifactorial assessment can determine an individual's risk of falling as the first step for fall prevention intervention. Physiotherapists have an essential role to play in assessing fall risk by older adults living in the community. In the absence of published data on this topic in Switzerland, this study investigated the current practices of physiotherapists to determine whether those are in line with recommendations. An anonymous cross-sectional survey was undertaken among physiotherapists practising in Switzerland between the 21st of November and the 31st of December 2020. A priori and exploratory hypotheses were tested. Responses to open-ended questions were grouped into themes for analysis. A total of 938 questionnaires from all three language regions of Switzerland was analysed. Participants worked in different settings, with a higher representation of private practice self-employees (56%). Standardised fall risk assessments or instruments were used by 580 (62%) participants, while 235 (25%) preferred subjective assessment of fall risk only. Differences in fall risk assessment were observed according to the workplace setting (adjusted OR 1.93, 95% CI 1.37 to 2.7) and education level (trend test, p<0.001). The standardised assessments most frequently employed were the Berg Balance Scale (58%), the Timed-Up-and-Go (57%) and the Tinetti Balance Assessment tool (47%). Risk factors for falls were frequently queried, particularly history of falls (88%), home hazards (84%), and functional ability (81%). Technical resources (40%), knowledge (30%), and time (22%) were common barriers to implement a systematic fall risk assessment. This study provides an overview of the current practices of physiotherapists in Switzerland in fall risk assessment. There is still room to optimise the standardisation and systematisation of this assessment to implement a best practice strategy and prevent avoidable falls.

Current practices of physiotherapists in Switzerland regarding fall risk-assessment for community-dwelling older adults: A national cross-sectional survey

Background: Falls can strongly impact older people’s quality of life, health, and lifestyle. Multifactorial assessment can determine an individual’s risk of falling as the first step for fall prevention intervention. Physiotherapists have an essential role to play in assessing fall risk by older adults living in the community. In the absence of published data on this topic in Switzerland, this study investigated the current practices of physiotherapists to determine whether those are in line with recommendations. Methods: An anonymous cross-sectional survey was undertaken among physiotherapists practising in Switzerland between the 21st of November and the 31st of December 2020. A priori and exploratory hypotheses were tested. Responses to open-ended questions were grouped into themes for analysis. Results: A total of 938 questionnaires from all three language regions of Switzerland was analysed. Participants worked in different settings, with a higher representation of private practice self-employees (56%). Standardised fall risk assessments or instruments were used by 580 (62%) participants, while 235 (25%) preferred subjective assessment of fall risk only. Differences in fall risk assessment were observed according to the workplace setting (adjusted OR 1.93, 95% CI 1.37 to 2.7) and education level (trend test, p&lt;0.001). The standardised assessments most frequently employed were the Berg Balance Scale (57.5%), the Timed-Up-and-Go (56.5%) and the Tinetti Balance Assessment tool (46.7%). Risk factors for falls were frequently queried, particularly history of falls (88.3%), home hazards (84.1%), and functional ability (81%). Technical resources (39.8%), knowledge (30.3%), and time (22.2%) were common barriers to implement a systematic fall risk assessment. Conclusions: This study provides an overview of the current practices of physiotherapists in Switzerland in fall risk assessment. There is still room to optimise the standardisation and systematisation of this assessment to implement a best practice strategy and prevent avoidable falls.

Are There Sex Differences in Balance Performance after a Short-Term Physical Intervention in Seniors 65+? A Randomized Controlled Trial

A systematic review and meta-analysis of studies demonstrated a relationship between sex and balance determinants in seniors; however, no study has focused on sex-related differences in static and dynamic balance performance after a physical intervention as primary interest. The aim was to investigate sex differences in the static and dynamic balance performance after a 4-week physical intervention based on yoga in seniors 65+ years of age. Five-hundred participants (234 males, 266 females) were assessed with the Tinetti Balance Assessment Tool in pre-and post-testing. The experimental group (122 males, 140 females) underwent the intervention, while the control group (112 males, 126 females) ran their usual daily program. ANCOVA model was used for the statistical evaluation of the results. No sex differences were found in balance performance after a short-term physical intervention in seniors 65+ years of age. At the same time, a significant positive shift was demonstrated in performance in both static and dynamic balance.

Yoga Exercise Intervention Improves Balance Control and Prevents Falls in Seniors Aged 65.

IntroductionBody balance control represents a key factor preventing falls and subsequent injuries in seniors aged 65+. Intervention based on yoga exercises seem to be effective in improving balance.ObjectiveThe objective is to analyse and compare changes in static, dynamic, and total balance scores, changes in body composition and social indices as effects of yoga-based intervention.MethodsA total of 500 participants (234 men aged 74.5 SD±7.74 and 266 women aged 76.9 SD±7.23) were assessed using the Tinetti Balance Assessment Tool, the InBody 230 bioimpedance body composition analyser, and the SF-36 Health Survey, applied to pre and post-testing. The experimental group (n=262; 122 males; 140 females) underwent a four-week yoga-based intervention, 30 minutes daily, while the control group (n=238; 112 males; 126 females) underwent its usual daily programme at senior homes or centres. The ANOVA model, consisting of the Group, Stage, Subject and Group × Stage interaction factors, was used for data evaluation.ResultsIntervention led to improvements in the static, dynamic and total balance scores in the experimental group compared to the control group. The results of SF-36 showed positive changes in the psychosocial aspects of health, such as promoting of calmness and happiness in male seniors and reducing fatigue, nervousness and depression in female seniors. The post-intervention decrease in body fat percentage and increase in muscle mass in seniors is discussed.ConclusionsThe four-week yoga-based intervention had positive effects on the static, dynamic and total balance scores, body composition and social status.

Yoga Meditation Enhances Proprioception and Balance in Individuals Diagnosed With Parkinson's Disease.

This study compared the effectiveness of two proprioceptive exercise programs for persons diagnosed with Parkinson's disease (PD). Thirty-three patients with mild to moderate PD were randomly assigned to a yoga meditation program (YoMed) or to an established proprioceptive training program (PRO). Both interventions included twice weekly sessions (45 minutes each), spanning a 12-week period. Outcome measures included: joint position sense (JPS45°, JPS55°, JPS65°) and joint kinesthesia (JKFlex and JKExt), the Tinetti Balance Assessment Tool (TIN), Falls Efficacy Scale (FES), Balance Error Scoring System (BESS), dynamic posturography (DMA and TIME) and the Timed Up-and-Go Test (TUG). Test administrators were blinded to group affiliation. Significant between-group differences favoring the YoMed group were observed for TIN (p = 0.01, d = 0.77) and JKFlex (p = 0.05, d = -0.72). DMA and TIME scores significantly improved for both groups, and no adverse events were reported. These findings indicate that the YoMed program is safe and effective for patients with PD. Researchers should continue to examine the clinical efficacy of mind-body techniques to improve movement control and body awareness in this population.

A short-term yoga-based intervention improves balance control, body composition, and some aspects of mental health in the elderly men

Background: Body balance control represents a key function for the physical activities of elderly people aged sixty-five and over. Due to the biological and psychosocial changes in this age group, yoga-based intervention appears to be beneficial to maintaining their ability to balance along with related mental aspects of health. Objective: The aim of the presented study was to examine the effects of the 4-week yoga-based intervention on balance, body composition and the mental health aspects of elderly men. Methods: 67-80-year-old elderly men (N = 234, mean age 72.5 ± 7.7 years) were assessed with The Tinetti Balance Assessment Tool, bioimpedance body composition analyser InBody 230 and the Health Survey SF-36, applied for the pre- and post-testing. The experimental group (n = 122) underwent the 4-week intervention based on yoga exercises, while the control group (n = 112) had a usual daily program at their senior homes or centers. Results: The yoga intervention led to significant improvement of both the static balance and gait scores compared to the control group, with medium effect size, ηp2 = .070 and .080. The intervention also had an effect on the decrease of body fat percentage (by 1.7%) and an increase in muscle mass (by 1.3 kg), with a large effect size, ηp2 = .214 and .301. Results of the Health Survey showed that overall mental health did not change significantly although positive improvement in two items connected with emotional problems. Conclusions: A short-term yoga-based intervention may have a significant positive influence on physical abilities such as balance control and body composition rather than on mental health aspects in elderly men aged sixty-five and over.

The effectiveness of motor-cognitive dual-task training in reducing risk falls on elderly

The aging process causes a setback of various aspects of the body that makes the elderly vulnerable to fall. The dual-task exercise amalgamates physical and cognitive training together and induces synergistic effects. This study aims to determine the effect of dual-task training on the risk of falls on elderly. The method used was pre-experimental design with 3 times a week intervention for 4 weeks. Before and after treatment, respondents measured the level of balance and risk of falling using the Berg Balance Scale (BBS), Timed-Up-and-Go test (TUGT), and Tinetti Balance Assessment Tool. The results showed an increase in the balance after 12 times of exercises. The risk of falls seems to decline after 12 treatments, and the highest reduction occurred after the first 6 treatments. It can be concluded that dual-task motor-cognitive training is significantly influential in reducing risk falls on elderly.

Interplay among physical balance ability, physical activities realization, anthropometric parameters and psychosocial indices in relation to gender and age of seniors 65+

Introduction: The study is aimed to analyze the interplay among the physical balance level, physical activities realization, anthropometric determinants and psychosocial indices in relation to gender and age of seniors 65+. Methods: The participants comprised 500 seniors in age 65+ (234 males and 266 females) participated voluntarily in the research. For data collection we used methods of the “Medical anamnesis”, “Tinetti Balance Assessment Tool”, “Health Survey SF-36”. For statistics analyses the multivariate regression with reduction of dimensionality and orthogonal projection to latent structure was used. Results: Analyzed disabilities “Depression”, “Type 2 diabetes mellitus”, “Hypertension” and “Vertigo” significantly negatively interplay with the Tinneti summary balance score in both genders. Results of the anthropometric parameters of female seniors, in a contrast to the male seniors parameters, proved that body high and muscle mass correlate significantly positively with the performance of the Tinneti summary balance test (p&lt;0.01) in female seniors. Conclusion: Performing of physical activities positively correlates with the performance in the Tinneti summary balance test in both genders of seniors. There are differences between male and female seniors according the psychosocial factors interplay with performance in the Tinneti summary balance test, when more interplaying psychosocial factors were analyzed in females.

Examining conscious motor processing and the effect of single-task, dual-task and analogy training on walking during rehabilitation by older adults at risk of falling in Hong Kong: Design and methodology of a randomized controlled trial

Walking is a common activity among older adults. Fallers were discovered to have a higher propensity to conscious motor processing (reinvestment) than age-matched non-fallers, leading to movement disruption, possibly by constraining or interfering with automatic motor control mechanisms. However, gait rehabilitation programs by implicit motor learning methodologies may ameliorate reinvestment propensity while improving gait ability in older adults. One hundred and five older adults, with moderate to high risk of falling, will be recruited from different community centres in Hong Kong to investigate the effect of single-task, dual-task and analogy training (implicit motor learning methodologies) on walking during rehabilitation in the context of reinvestment propensity, balance, walking ability and fear of falling. Participants will be randomly allocated and received 12 training sessions in either a Single-task Walking Group (STWG), a Dual-task Walking Group (DTWG) or an Analogy Walking Group (AGWG). Reinvestment propensity, walking ability, balance and fear of falling will be assessed by the Chinese version Movement Specific Reinvestment Scale (MSRS-C), 10-meter Walk Test, Tinetti Balance Assessment Tool, Timed ‘Up & Go’ Test (TU&G), Berg Balance Scale (BBS) and 13-item Falls Efficacy Scale (FES-13), respectively at baseline before training (T0), just after completion of all training sessions (T1), and 6 months after completion of all training sessions (T2). Participants' number of falls between T1 and T2 will also be recorded. The results could establish a solid foundation for further development and implementation of a novel and effective gait rehabilitation program in fall prevention for older adults at risk of falling.

Effect of Balance Exercise on Risk of Falls among Institutionalized Elders In Lattakia, Syria

Poor balance is a major risk factor for falls. Exercise which specifically improves balance is the most effective intervention for preventing falls. Objective: Determine the effect of balance exercise on risk of falls among institutionalized elderly in Lattakia, Syria. Setting: The study was carried out in the three available homes for elderly people in Lattakia, Syria. Subjects: The study subjects comprised 40 elderly persons. They were divided randomly into two equal groups: study and control. Each group comprised 20 elders where elders in the control group were left to their routine while those in the study group were subjected to balance exercise program for three months. Tools: Two tools were used for data collection: 1) the Tinetti Balance Assessment Tool and 2) the sociodemographic and clinical structure interview schedule. Results: The implemented exercise had a positive effect on risk of fall among elders where about a quarter showed no risk of falls and about a quarter showed improvements in their balance and gait status. Conclusion: The balance exercise succeeded in decreasing the risk of fall among elders. This improvement was significantly affected by the previous history of fall. Recommendations: Encourage elders to perform balance exercise in their daily routine to maintain balance and improve gait status and consequently prevent fall.

Differences in fitness level between women aged 60 and over participating in three different supervised exercise programs and a sedentary group

ABSTRACTThe aim of this study was to compare fitness levels in women aged 60 and over participating in a supervised exercise program (involving tai chi, recreational gymnastics, and/or aquatic fitness) with those in a sedentary group. An observational, descriptive, cross-sectional study was performed on a total of 171 women aged from 60 to 92 who attended public community clubs for older adults. The instruments used included the Senior Fitness Test, the Tinetti Balance Assessment Tool, the Katz Index, and the Lawton & Brody Activities of Daily Living Scale. Significant differences in fitness levels were observed when we compared the exercise groups with the sedentary group. Women with better fitness levels had a lower risk of suffering falls and greater autonomy in performing activities of daily living and instrumental activities of daily living. Agility and gait control were found to be independently associated with exercise groups.

Variability of spatial temporal gait parameters and center of pressure displacements during gait in elderly fallers and nonfallers: A 6-month prospective study.

Considering that most of the falls in elderly population arise during walking, tests derived from walking performance would be desirable for comprehensive fall risk assessment. The analysis of spatial temporal parameters and the center of pressure displacement, which represents the interaction between the human body and the ground, would be beneficial. The aim of this study was to compare spatial temporal gait parameters and their variability and the variability of the center of pressure displacement between elderly fallers and nonfallers during gait at self-selected, defined and fast speeds. A prospective study design was used. At the baseline, measurements of ground reaction force during gait at self-selected, defined and fast walking speeds by two force plates were performed. In addition, the Tinetti balance assessment tool, the Falls Efficacy Scale-International and the Activities-Specific Balance Confidence Scale were used. Mean and coefficient of variation of spatial temporal gait parameters and standard deviations of center of pressure displacement during loading response, midstance, terminal stance and preswing phases were calculated. Comparison of the fallers and nonfallers exhibited no significant difference in clinical tool, scales or spatial temporal parameters. Compared to nonfallers’ increased variability of walking speed at self-selected and defined speed, step width at fast walking speed and center of pressure displacement during preswing phase in medial-lateral directions at defined walking speed was found in fallers. However, application of the Holm-Bonferroni procedure for multiple comparisons exhibited no significant effect of group in any of the gait parameters. In general, our study did not observe an effect of group (fallers vs. nonfallers) on variability of spatial temporal parameters and center of pressure movement during gait. However, walking speed, step width as well as standard deviation of COP displacement in the medial-lateral direction during preswing exhibited a certain potential for distinguishing between elderly fallers and nonfallers.

Multiscale and Shannon entropies during gait as fall risk predictors—A prospective study

Although entropy-based measurements of gait dynamics are becoming widely used tools for fall risk assessment, their relationship to fall occurrence is still unclear. The aim of this study was hence to compare fallers and non-fallers in terms of gait dynamics assessed by the multiscale and Shannon entropy. This study included 139 participants, aged 60–80 years, divided into two groups according to fall occurrence during a 6-month prospective observation (38 fallers, 101 non-fallers). The methodology involved the use of the Tinetti balance assessment tool (TBAT) and 5min of overground walking with 3D accelerometers located near the L5 vertebra and shanks. We analyzed 150 strides for gait complexity, an index of complexity (CI), computed from multiscale entropy (MSE) and Shannon entropy (ShE) derived from the recurrence quantification analysis. We found no significant differences between groups in MSE and CI. The TBAT total score was significantly higher in non-fallers (P=0.033), however, both groups showed low risk of falls. ShE in the anterior-posterior direction from trunk and in the medial-lateral direction from the shanks were both significantly higher in fallers (P=0.020; P=0.024). ShE was negatively correlated with CI, the shank ShE in the vertical direction was positively correlated with TBAT. Taken together, our findings suggest that MSE is not able to distinguish between highly functional groups, whereas Shannon entropy seems to be sufficient in fall risk prediction.