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PubMed2001

Co-operative learning processes of students: a longitudinal multilevel perspective.

BACKGROUND: This article describes the outcomes of a longitudinal, multilevel observational study in which the relationship between the processes of co-operation and giving explanations was compared between classes trained in communication skills and classes that were untrained. AIMS: This study examined the effects of training in basic communication skills on the processes of co-operation and giving explanation in co-operative groups. In particular, the study investigated: (a) How the processes of co-operation and giving explanations develop over time; (b) How the underlying processes of co-operation and giving explanations are related; (c) Which factors at the student and class level facilitate or hinder these processes. SAMPLE: The study involved 192, Year 6 primary school children (mean age = 134.3 months) who worked in four-person, mixed ability, gender-balanced groups on a social studies unit of work for 12 weeks. RESULTS: The students in the trained classes were more co-operative and gave more explanations to each other than their peers in the untrained classes. Giving solicited explanations could be traced back to co-operation and this process was enhanced by ability. In other words, the higher the individual ability levels of the students, the more co-operation was transformed into giving solicited explanations. Furthermore, over and above the effects of student ability, the higher the class' ability level, the more explanations the students gave. CONCLUSION: The results of this study are useful in explaining why high-ability students benefit more from co-operative learning than low-ability students and why solicited explanations are more effective than unsolicited explanations. By opening the black box of co-operative learning, our analysis enables us to attribute the effects of co-operative learning to peer interactions with more able peers and this is promoted by class ability level. These factors have been mentioned in the literature as a possible explanation of 'contextual effects' but not investigated empirically.

Australia↗

PubMed2006

Measuring the effects of antiepileptic medications on balance in older people.

BACKGROUND: Dizziness and ataxia are among the most common adverse events associated with antiepileptic medications. Despite this, few studies have attempted to quantitatively assess the effects of antiepileptic therapies on equilibrium. This study was undertaken to prospectively compare quantitative measures of balance in older people taking carbamazepine, gabapentin and lamotrigine. METHODS: Thirty patients on monotherapy for idiopathic partial or generalized epilepsy were enrolled after giving informed consent. Patients had to be at least 50 years old, able to give consent, and on a stable dose of carbamazepine, gabapentin or lamotrigine for at least 30 days. Since this was a study of asymptomatic patients, all patients had to be without complaint of dizziness or imbalance. Patients with a history of alcohol or drug abuse or any medical or neurological condition expected to adversely affect equilibrium were excluded. Each patient underwent a history and examination, computerized dynamic posturography, the activities-specific balance confidence (ABC) scale, Fregly ataxia battery, and the Berg balance scale. Serum drug levels of carbamazepine were obtained to eliminate patients with toxic levels upon enrollment. Two-tailed paired t-tests were used to determined statistical significance among those on each antiepileptic medication. RESULTS: Thirty patients were enrolled: 10 on gabapentin, 10 on lamotrigine and 10 on carbamazepine monotherapy for epilepsy. There were no differences in age or sex among those in each treatment group. The average dosages were 1,120 mg/day for those on gabapentin, 335 mg for lamotrigine, and 640 mg for carbamazepine. There were no differences in the activities-specific balance confidence (ABC) or the Berg balance scale scores. All patients had normal vestibular function by quantitative testing. Posturography showed no statistically significant differences. The Fregly ataxia battery includes the sum of timed trials in the sharpened Romberg (SR) position, standing on one leg with eyes closed (SOLEC), and when walking in tandem with eyes closed (WITEC). The patients on lamotrigine exhibited ability to maintain balance in these positions significantly longer than did those on carbamazepine: SR (P<0.05), SOLEC (P<0.05) and WITEC (P<0.05). CONCLUSIONS: The effects of antiepileptic medications on equilibrium in asymptomatic older people may require more dynamic and challenging measures of equilibrium than are commonly employed in physical therapy to monitor risk of falls. Although the sample size is small, this study suggests that lamotrigine may induce less disequilibrium than does carbamazepine in older people on monotherapy for epilepsy. Further study in this area is needed, particularly given the risks of falling from imbalance in the elderly.

Aged↗

PubMed1985

Gait and balance in the elderly. Two functional capacities that link sensory and motor ability to falls.

Neuromuscular function, which underlies efficient gait and balance, deteriorates with age and disease. A review of the literature and of data from the current study suggests the presence of poor gait and balance in elderly individuals who have a history of multiple falls. The tests of gait and balance are simple to perform and therefore may be widely applicable in evaluating individuals at risk of falls. Quantitative studies of motor and sensory function, vibratory sensation, and electrophysiologic studies of nerve integrity are discussed. Deteriorating motor and sensory control mechanisms appear to play an important role in falling.

Accidents↗

PubMed2005

Balance performance with a cognitive task: a dual-task testing paradigm.

PURPOSE: Athletic performance demands simultaneous use of cognitive and postural control capabilities. Decrements to both systems have been observed following concussion. This study evaluated a dual-task methodology to establish the tenability of using this testing model in concussed athletes. METHODS: Nonconcussed subjects were assessed over 2 d. Subjects were introduced to the task-switching cognitive assessment test and a NeuroCom Smart Balance Master postural control assessment protocol on day 1. In the following session, subjects were evaluated on postural control and cognitive function tests independently (single task), and then concurrently (dual task). RESULTS: Significant improvements were seen in three of the four balance conditions and in three of the four reaction times when the cognitive and balance task were performed simultaneously (P<0.05). No significant balance by cognitive task interaction was revealed (P>0.05); however, significant differences existed in reaction time based on stimulus position and increasing balance demands (P<0.05). CONCLUSION: Combining the cognitive and balance assessments resulted in healthy subjects showing improved performance when compared with individual task performance. The dual-task methodology brought about systematic changes to reaction time in relation to increasing balance demands. The ability of this protocol to detect changes in postural control or cognitive function following concussive injury requires further study.

Adult↗

PubMed1989

Cerebrovascular accidents.

CVA comprises a large number of clinical entities, depending on the site of infarction in the brain. Accurate evaluation of deficits in the patient's sensory and/or motor systems and the patient's intellectual status are paramount in establishing realistic rehabilitation goals. With respect to the motor system, two types of voluntary movement may occur. These include synergistic or pattern movement and selective movement. Spasticity in the affected lower extremity may result in a variety of lower-extremity deformities and contractures. Those most commonly encountered include hip flexion and adduction contracture, inadequate knee flexion and knee flexion contracture, and ankle equinus, varus, and equinovarus. Correct evaluation of deformities may be aided by the use of poly-EMG analysis and evaluation after nerve block or motor point blocks. In hemiplegic gait dysfunction, the basic requirements for functional ambulation include (1) ability to maintain standing balance; (2) voluntary hip flexion; (3) leg stability; and (4) ability to follow instructions and adequate motivation. Often a hemiplegic patient can be trained to ambulate if an adequate extensor synergy pattern develops, since mass extension can provide stability of the leg for weight bearing. Medical rehabilitative management of the CVA patient includes early mobilization, restorative exercises (including neuromuscular facilitation techniques), measures to prevent or correct contractures, the use of AFOs, and occasionally functional electrical stimulation. Orthopedic management of deformities in CVA is indicated where conservative measures fail. Surgical procedures seek to alter the forces causing shortening of the muscles and tendons. Hence, the most commonly performed surgical procedures include (1) tendon lengthening or release; (2) soft-tissue release; and (3) tendon transfer. Surgery for hip contractures is not common; however, occasional release of hip flexors is indicated when hip flexion contracture impedes ambulation or prone lying. Inadequate knee flexion, caused by dysphasic quadriceps contraction, can be corrected by release of the vastus medialis and rectus femoris muscles. Distal hamstring tendon release with or without knee joint capsule release is the surgical procedure of choice for severe knee flexion contractures. Surgical correction of an equinus deformity is by TAL, with or without neurectomy of tibial nerve branches to the gastrocsoleus muscles. Severe ankle varus may require a SPLATT procedure. Surgery for equinovarus includes the combined surgery for both equinus and varus (that is, TAL and SPLATT procedures). Toe curling is corrected by toe flexor releases.(ABSTRACT TRUNCATED AT 400 WORDS)

Cerebrovascular Disorders↗

PubMed1998

Video-oculography as part of the ENG battery.

Recording and quantifying eye movement is the basis of audiologic balance testing. The ability to record and quantify eye movement is a key part of the electronystagmography (ENG) test battery. With computerization, eye movements can be more accurately detected and analysed--testing the limits of the standard recording technique. In response to this, manufacturers are introducing alternative recording protocols. Specifically, infra-red video technology allows an accurate and sophisticated recording and analysis of eye motion in response to balance-related stimuli. The purpose of this technical note is to discuss the limitations of the EOG recording method and discuss the advantages that video-oculography offers.

Caloric Tests↗

PubMed2006

Insulin delays the progression of Drosophila cells through G2/M by activating the dTOR/dRaptor complex.

In Drosophila and mammals, insulin signalling can increase growth, progression through G1/S, cell size and tissue size. Here, we analyse the way insulin affects cell size and cell-cycle progression in two haemocyte-derived Drosophila cell lines. Surprisingly, we find that although insulin increases cell size, it slows the rate at which these cells increase in number. By using BrdU pulse-chase to label S-phase cells and follow their progression through the cell cycle, we show that insulin delays progression through G2/M, thereby slowing cell division. The ability of insulin to slow progression through G2/M is independent of its ability to stimulate progression through G1/S, so is not a consequence of feedback by the cell-cycle machinery to maintain cell-cycle length. Insulin's effects on progression through G2/M are mediated by dTOR/dRaptor signalling. Partially inhibiting dTOR/dRaptor signalling by dsRNAi or mild rapamycin treatment can increase cell number in cultured haemocytes and the Drosophila wing, respectively. Thus, insulin signalling can influence cell number depending on a balance between its ability to accelerate progression through G1/S and delay progression through G2/M.

Animals↗

PubMed2006

Foot and ankle risk factors for falls in older people: a prospective study.

BACKGROUND: Foot problems are common in older people and are associated with impaired balance and functional ability. Few prospective studies, however, have been undertaken to determine whether foot problems are a risk factor for falls. METHODS: One hundred seventy-six people (56 men and 120 women, mean age 80.1, standard deviation 6.4 years) residing in a retirement village underwent tests of foot and ankle characteristics (including foot posture, range of motion, strength, and deformity) and physiological falls risk factors (including vision, sensation, strength, reaction time, and balance) and were followed for 12 months to determine the incidence of falls. RESULTS: Seventy-one participants (41%) reported falling during the follow-up period. Compared to those who did not fall, fallers exhibited decreased ankle flexibility, more severe hallux valgus deformity, decreased plantar tactile sensitivity, and decreased toe plantarflexor strength; they were also more likely to have disabling foot pain. Discriminant function analysis revealed that decreased toe plantarflexor strength and disabling foot pain were significantly and independently associated with falls after accounting for physiological falls risk factors and age. CONCLUSIONS: Foot and ankle problems increase the risk of falls in older people. Interventions to address these factors may hold some promise as a falls prevention strategy.

Accidental Falls↗

PubMed2006

Physical activity and body functionality: implications for obesity prevention and treatment.

Physical activity promotes metabolic adaptations that improve body functionality and contribute to the prevention of some diseases. With respect to energy and fat balance, physical activity facilitates the equilibrium between energy intake and expenditure as well as between fat intake and fat oxidation. When combined with a healthy diet that favors satiety with a reduced energy intake, exercise can induce a substantial mass loss in obese individuals. However, even the impact of an exemplary lifestyle does not seem to have the potential to decrease body mass in obese individuals down to the mass range of lean people. Up to now, we have not been able to induce mass changes exceeding 12%-15% initial body mass in obese male subjects under tolerable exercise and dietary habits, and this moderate success was accompanied by modifications in appetite and energy expenditure susceptible to compromise subsequent mass stability. As described in this paper, many environmental factors can influence energy balance and the ability to lose body fat in response to a healthy diet and (or) physical activity program. Particular attention is given to preliminary data obtained in our laboratory that suggest that knowledge-based work does not favor the same potential mass reducing effects as physical work. In fact, the acute effects of knowledge-based work suggest that this work modality may be rather susceptible to promote a more pronounced positive energy balance compared with what we may expect from a sedentary relaxing activity. This is problematic for obesity prevention in the future since knowledge-based work now represents the main working modality in a context of modernity.

Animals↗

PubMed2002

The health care professional as a manager: finding the critical balance in a dual role.

The health care professional who assumes a management role must recognize that he or she is adopting a second and concurrent career of equal importance to his or her primary occupation. Many such managers have considerable difficulty balancing the two sides of the role because most are well trained in their specialties but enter management with little or no preparation for management. Lack of preparation and inadequate understanding of the requirements of the management side of the role lead to discomfort in management matters and in turn frequently cause a manager to seek refuge in being more of a specialist than manager. The most successful managers will be those who develop the ability to appropriately balance the sides of the dual role.

Career Mobility↗

PubMed1982

Physiologic and anthropometric aspects of vestibular regulation in rowing.

The role of the vestibular system during physical exercise has only been rarely analyzed by scientific investigations. An investigation was carried out with the purpose of obtaining information on vestibular regulation in rowers. The process of maintaining balance in the boat and the limiting factors were examined. Twenty beginners and 20 well-trained rowers participated in standardized vestibular tests in the laboratory as well as in the boat (single) on the water. The results suggest that several mechanisms in the physiologic field (torque of the body) are affected by training. The well-trained oarsmen showed a significant minor nystagmus frequency, and this criterion for general vestibular regulation also showed a relationship with the specific ability for maintaining balance in the boat.

Electronystagmography↗

PubMed2006

Force platform measurements as predictors of falls among older people - a review.

BACKGROUND: Poor postural balance is one of the major risk factors for falling. A great number of reports have analyzed the risk factors and predictors of falls but the results have for the most part been unclear and partly contradictory. Objective data on these matters are thus urgently needed. The force platform technique has widely been used as a tool to assess balance. However, the ability of force platform measures to predict falls remains unknown. OBJECTIVE: The purpose of this systematic review was to extract and critically review the findings of prospective studies where force platform measurements have been used as predictors of falls among elderly populations. METHODS: The study was done as a systematic literature review. PubMed, the Cochrane Central Register of Controlled Trials, and CINAHL databases from 1950 to April 2005 were used. The review includes prospective follow-up studies using the force platform as a tool to measure postural balance. RESULTS: Nine original prospective studies were included in the final analyses. In five studies fall-related outcomes were associated with some force platform measures and in the remaining four studies associations were not found. For the various parameters derived on the basis of the force platform data, the mean speed of the mediolateral (ML) movement of the center of pressure (COP) during normal standing with the eyes open and closed, the mean amplitude of the ML movement of the COP with the eyes open and closed, and the root-mean-square value of the ML displacement of COP were the indicators that showed significant associations with future falls. Measures related to dynamic posturography (moving platforms) were not predictive of falls. CONCLUSION: Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various indicators of the lateral control of posture. However, the small number of studies available makes it difficult to draw definitive conclusions.

Accidental Falls↗

PubMed2003

Effects of training on functional performance in 65, 75 and 85 year-old women: experiences deriving from community based studies in Odense, Denmark.

The aim of the Odense training studies is to elucidate if regular physical training influences the expected decline in physical functional ability in order to assess capacity for postponing dependence in old age. All participants were healthy community-dwelling women representing three different age-cohorts of 65, 75 and 85 year-old subjects. The 65 and 85 year-old participants of the training group took part in physical class-based exercises for eight months with one session of 60 min a week, whereas the 75 year-old women trained twice a week over eight months. The multicomponent training consisted of various exercises typically involving body awareness, rhythm, aerobic performance (walking), muscle strength and muscle endurance, flexibility, reaction and balance exercises. Physical ability was measured as physical performance test (PPT), isometric muscle strength of the trunk, hip and leg, aerobic capacity and walking speed. This shows that regular training can significantly improve physical ability of elderly women with regard to PPT, maximal oxygen uptake and maximal walking speed, suggesting that both young-old and old-old women are able to benefit from regular tailored exercise training. Thus, physical training of old community-dwelling women appears to represent a prophylactic remedy that merits further research aimed at evaluating the preliminary findings of the present studies in larger, less selective groups of participants.

Aged↗

PubMed2002

The role of functional capacity evaluation in management of foot and ankle dysfunction.

Both job-specific and comprehensive FCEs can be valuable tools in clinical decision-making for the injured worker with foot and ankle dysfunction; however, FCE is an extremely complex and multifaceted process. There are many considerations when selecting or developing a testing protocol or selecting an FCE provider. A myriad of approaches are commercially available and an even greater variety of homegrown tests exists. Little is known about the reliability and validity of these tests and more research is needed. Comparing functional abilities with functional job demands is a process that can provide objective data regarding the relationship of worker abilities to job demands. Balancing this relationship so that work demands do not exceed worker abilities is extremely important for preventing re-injury or re-exacerbation of work-related injuries.

Ankle↗

PubMed1999

[Postural balance following stroke: towards a disadvantage of the right brain-damaged hemisphere].

In the light of studies published in the last ten years, we have suspected a differential influence of the sides of hemispheric cerebral lesions on posture and balance. A study was aimed at verifying this hypothesis, the method of which being original because many possible confounding factors such as age, sex as well as topography and size of the brain lesion have been taken into account in the statistical analysis. Inclusion criteria were: right-handed patients, first stroke, no previous disease which might have affected balance. Their postural abilities (ranging from 0 to 36) were assessed 90 +/- 3 days after stroke onset on a clinical scale. This clinical assessment was used here because it could be easily performed in all patients, irrespective of the severity of their impairment. Lesion locations were determined using the Atlas by Talairach and Tournoux and the number of cerebral areas altered gave an estimation of the lesion size. The first fifty patients consecutively admitted to rehabilitation and responding to the inclusion criteria were thus examined (25 with a right and 25 with a left hemispheric lesion; 14 women and 36 men; mean age 57.2 = yrs). The main result was lower postural performances in right brain-damaged patients than in left brain damaged patients (21.5 vs 29.4; p = 0.01). Postural abilities were also inversely related to age (r = -0.28; p = 0.04), lesion size (r = -0.41; p = 0.003) and were lower in women than in men (22.1 vs 28.8; p = 0.02). This study therefore confirms the existence of a right hemispheric dominance for postural control. The existence of inverse correlation between postural abilities and the number of omitted targets in cancellation task on one hand (r = -0.63, p < 0.001), the ipsilesional bias in line bissection on the other hand (r = -0.36; p = 0.01), argued for a relationship between the main result of this study and the well known cerebral organization of spatial information processing, based on a right hemisphere dominance for spatial attention and/or representation. The 'postural neglect' concept is discussed.

Aged↗

PubMed1998

Opposite effects on cytosolic Ca2+ of antitumor phospholipids by induction of calcium influx and activation of endoplasmic reticulum Ca(2+)-ATPase.

The ability of four different antitumor phospholipids, 1-O-hexadecyl-2-chloro-2-deoxyglycero-3-phosphocholine (ET16CIPC), hexadecylphosphocholine (C16OPC), hexadecylphospho-L-serine analogs (C16OPS, C16OPS-N-Ac) and cytidine-5'-hexadecylphosphonophosphate (C16PCMP) to modulate the cytosolic Ca2+ concentration [Ca2+]i was studied in an immortalized human mammary epithelial cell line H184 A1N4. The compounds induced different modes of activity depending on their structure and concentration. ET16CIPC induced between 0.31 and 5 microM a concentration dependent transient increase which was followed by a sustained increase at 10 microM. Studies using LaCl3 and Mn2+ quench of the Fura-2 fluorescence indicated that both effects are the result of an extracellular Ca2+ influx. Low concentrations of C16OPC, C16OPS and C16OPS-N-Ac induced no, or only a small, transient increase, whereas C16PCMP caused a decrease in [Ca2+]i. Thapsigargin and cyclopiazonic acid, specific inhibitors of the endoplasmic reticulum Ca(2+)-ATPase, prolonged the transient [Ca2+]i increase following ET16CIPC concentration dependently, increased markedly the small transient increase following C16OPC and the C16-phosphoserine analogs and converted the decrease in the basal [Ca2+]i level induced by C16PCMP to an increase. The identical effects with thapsigargin and cyclopiazonic acid provide evidence that the [Ca2+]i response observed is an expression of the balance between the ability of an analog to raise [Ca2+]i and to remove Ca2+ by activation of the endoplasmic reticulum Ca(2+)-ATPase. This behaviour might contribute to the antiproliferative effectiveness of antitumor phospholipids.

Antineoplastic Agents↗

PubMed2003

Forceplate and accelerometer measures for evaluating the effect of muscle fatigue on postural control during one-legged stance.

BACKGROUND AND PURPOSE: The control of balance is vital in many sporting activities as well as in activities of daily life. In order to treat deficiencies properly valid and reliable methods are needed to evaluate different aspects of stability. Muscle fatigue has been proposed to cause a change in postural control strategy, and the use of different tools and variables might therefore elucidate these changes. The aims of the present study were: to investigate if forceplate and accelerometer measurements about postural control during one-legged stance indicate changes in postural control strategy after fatiguing exercise; and to investigate the correlation between forceplate and accelerometer measurements obtained before and after fatiguing exercise. METHOD: The study used an experimental design. Twenty-three healthy women (mean age 26.8 years; range 20-34 years) were studied. Forceplate and accelerometer data were obtained simultaneously and consisted of measures of centre of pressure movements and horizontal trunk acceleration in medio-lateral and antero-posterior directions. The calf muscles of the right leg were fatigued by repeated heel rises. RESULTS: The average amplitude of centre of pressure movements and trunk acceleration increased, whereas the average velocity of centre of pressure movements decreased during fatigue. These changes indicate a change of movement strategy. Moderate correlation between trunk acceleration and centre of pressure movements was seen, confirming the link between the variables, but indicating that different aspects of the ability to control balance were measured. CONCLUSIONS: Calf muscle fatigue has a short-lasting effect on body balance, with measurements indicating a change in postural control strategy. Different tools and variables are needed to identify different balance control strategies. The procedures used in the present study may be modified to identify subjects with inadequate capacity to choose between balance control strategies; they are also applicable in clinical settings outside a laboratory environment.

Acceleration↗

PubMed2000

Impact of follicular aspiration on folliculogenesis as influenced by dietary energy and stage of lactation.

Prolonged dietary energy restriction has been shown to influence the secretion of ovarian hormones and follicular development. Energy balance affects the ability of the cow to support a functional reproductive system during early lactation. Follicular aspiration is a tool that can be used to assess the impact of dietary energy and stage of lactation on follicle development in dairy cattle. Follicular aspiration was conducted twice weekly from d 30 to 100 postpartum in cows fed either 104 or 80% of NRC energy requirements. Oocyte numbers recovered increased linearly from d 30 to 100 postpartum. Cows on high energy diets produced more high quality oocytes, but also produced more poor quality oocytes than cows fed the lower energy diet. Follicles < 5 mm predominated throughout. Cows in early (d 28) and mid (d 117) lactation were used to assess stage of lactation effects on serum and follicular fluid hormones, and quality of oocytes recovered by follicular aspiration procedures for 10 wk. Serum IGF-1 decreased in early lactation cows, but increased in midlactation cows. Follicular fluid progesterone in early lactation cows decreased from 275 to 235 ng/ml, whereas in midlactation cows it increased from 65 to 550 ng/ml at aspiration wk 10. The percentage of high quality ova was higher in early lactation cows (11%) than midlactation cows (6%), but fell to 1% by aspiration wk 7 and increased to 10% by wk 10, whereas percentage of high quality ova in midlactation cows steadily declined to 2% by wk 10. Milk yield and energy balance affect patterns of folliculogenesis in lactating dairy cows.

Animals↗