SEARCH · PubMed Health

Results for “Balance ability”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources

PubMed2003

Establishing the reliability of Mobility Milestones as an outcome measure for stroke.

UNLABELLED: Baer GD, Smith MT, Rowe PJ, Masterton L. Establishing the reliability of mobility milestones as an outcome measure for stroke. Arch Phys Med Rehabil 2003;84:977-81. OBJECTIVE: To establish intrarater, interrater, and test-retest reliability of a standardized measure of mobility, "mobility milestones," incorporating sitting balance, standing balance, and walking ability. DESIGN: Repeated-measures reliability study by using video data of patients with stroke. SETTING: Physiotherapy and rehabilitation departments in Scotland. PARTICIPANTS: Forty physiotherapists recruited from within the Lothian region: 20 senior physiotherapists with at least 3 years of experience working with neurologic patients and 20 staff grade physiotherapists with less than 12 months of experience working with neurologic patients. INTERVENTION: Videotape comprising 40 clips (36 original clips, 4 repeated clips) of stroke patients of differing levels of ability attempting the mobility milestones was produced. After a short training session in the interpretation and application of the mobility milestones, each physiotherapist viewed the tape separately and scored whether the milestone had been achieved or not. This was repeated at a separate test session 2 weeks later. MAIN OUTCOME MEASURE: Score for each mobility milestone. RESULTS: Kappa statistics were used to determine interrater reliability and showed good (.61-.80) to very good (.81-1.0) reliability for 3 of 4 milestones. Intraclass correlation coefficients (ICCs) were used to determine intrarater reliability of the 4 repeated clips and showed 75% of all subjects had high (ICC(2,1)=.91-1.0) reliability. The ICC(2,1) for test-retest reliability showed a similar pattern, with 70% of subjects showing good (.81-.90) or high (.91-1.0) reliability. CONCLUSIONS: The mobility milestones showed favorable levels of reliability when used by experienced or novice physiotherapists. The milestones can be adopted as a simple clinical outcome measure for use with stroke. Further research is required to establish reliability levels when the measure is used by different rehabilitation professionals.

Activities of Daily Living↗

PubMed1995

Maintenance of balance, gait patterns, and obstacle clearance in Alzheimer's disease.

Patients with cognitive impairment, particularly as a result of Alzheimer's disease (AD), are at increased risk for falls, but it is unclear how, or if, they differ from normal adults in their balance, gait, or ability to clear an obstacle in their path. Using an optoelectronic camera system, we compared body motions and force output at the feet in patients with probable AD (n = 17) with those in healthy older adults (n = 15) while they stood on a force plate or on a beam attached to the force plate that was either stationary or accelerating. Using the same camera system and comparing this AD group with another group of healthy older adults (n = 24), we observed the AD patients during normal walking and while clearing 25- and 152-mm-high obstacles. None of the AD patients had extrapyramidal signs or musculoskeletal impairments. Compared with healthy older adults, normal walking speed was significantly slower in the AD group (p < 0.0001). While clearing either obstacle, the AD patients were significantly slower in their approach (p < 0.0001) and crossing (p < 0.0001) speeds and landed closer to the obstacle after having crossed it (p < 0.02). Moreover, the percent of trials in which a subject made contact with an obstacle was significantly higher in patients with AD (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed2004

Effects of home exercises and group training on functional abilities in home-dwelling older persons with mobility and balance problems. A randomized study.

BACKGROUND AND AIMS: Exercise in older people may reduce falls and improve functional abilities. Less is known about the optimal amount of training. The aim of this study was to determine the effectiveness of home training, and whether group training in addition to home training enhances the effect. METHODS: This randomized trial included 77 persons aged 75 years and older (mean 81, SD 4.5), living at home. Home training (HT) comprised twice-daily functional balance and strength exercises and 3 group meetings. Combined training (CT) included group training twice weekly and the same home exercises. The trial lasted 12 weeks. Physical therapists ran both programs. Exercises and falls were recorded daily. We assessed function at baseline, 3 and 9 months, and falls at one year. RESULTS: Mean participation for group meetings was 2.5 out of 3 (HT group) and, for group training sessions, 21 out of 24 (CT group). The mean numbers of daily home sessions were 1.29 and 1.35 in the HT and CT groups. Overall improvement, but no group differences, were found at 3 months for walking speed, Figure of Eight, Timed Up & Go, Maximum Step Length, Timed Pick-up and Sit-to-stand (p<0.02). Posturography (p=0.85) and isometric quadriceps strength (p=0.26) showed no improvement. Function at 9 months was equivalent to baseline level. There were no group differences in fall rate (p=0.78) or time to first fall (p=0.84). CONCLUSIONS: Daily home training supervised by physical therapists improved functional abilities. Supplementary individualized group training gave no additional effect. The effect on function was not present 6 months after the end of the intervention.

Accidental Falls↗

PubMed2005

Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand Test.

BACKGROUND AND PURPOSE: People with balance disorders are characterized as having difficulty with transitional movements, such as the sit-to-stand movement. A valid and feasible tool is needed to help clinicians quantify the ability of people with balance disorders to perform transitional movements. The purpose of this study was to describe the concurrent and discriminative validity of data obtained with the Five-Times-Sit-to-Stand Test (FTSST). The FTSST was compared with the Activities-specific Balance Confidence Scale (ABC) and the Dynamic Gait Index (DGI). SUBJECTS AND METHODS: Eighty-one subjects without balance disorders and 93 subjects with balance disorders were recruited for the study. Each subject was asked to stand from a 43-cm-high chair 5 times as quickly as possible. The ABC and DGI scores were recorded. RESULTS: Subjects with balance disorders performed the FTSST more slowly than subjects without balance disorders. Discriminant analysis demonstrated that the FTSST correctly identified 65% of subjects with balance dysfunction, the ABC identified 80%, and the DGI identified 78%. The ability of the FTSST to identify subjects with balance dysfunction was better for subjects younger than 60 years of age (81%). DISCUSSION AND CONCLUSION: The FTSST displays discriminative and concurrent validity properties that make this test potentially useful in clinical decision making, although overall the ABC and the DGI are better than the FTSST at discriminating between subjects with and subjects without balance disorders.

Adolescent↗

PubMed1998

Clinimetrics of postural instability in Parkinson's disease.

Judgement of the ability to recover balance after a sudden shoulder pull is used as a clinical measure of postural instability in Parkinson's disease. To further evaluate its merits, we compared this 'retropulsion test' with dynamic posturography in 23 Parkinson patients. Dynamic posturography involved 20 serial 'toe-up' support surface rotations, which induced backward body sway. We found a moderate correlation (Spearman's p = 0.54; P < 0.05) between the retropulsion test and body sway after platform rotations during the 'off' phase, but no correlation during the 'on' phase (Spearman's p = 0.43; P = 0.11). These results cast doubt on the use of the retropulsion test as a measure of postural instability in Parkinson's disease.

Adult↗

PubMed2004

Randomized controlled trial of exercise intervention for the prevention of falls in community-dwelling elderly Japanese women.

Falls are common in elderly people. Possible consequences include serious injuries and the post-fall syndrome, with functional decline and limitation of physical activity. The present randomized controlled study sought to clarify the benefits of a combined long-term and home-based fall prevention program for elderly Japanese women. The subjects were individuals aged over 73 years, living at home in a western suburb of Tokyo, who had attended a comprehensive geriatric health check. Persons with a marked decline in the basic activities of daily living (ADL), hemiplegia, or those missing baseline data were excluded. Fifty-two subjects who expressed a wish to participate in the trial were randomized, 28 to an exercise-intervention group and 24 to a control group. Baseline data for age, handgrip force, walking speed, total serum cholesterol, serum albumin, basic ADL, visual and auditory impairments, self-rated health, and experience of falls did not differ significantly between the two groups. Beginning from June 2000, the intervention group attended a 6-month program of fall-prevention exercise classes aimed at improving leg strength, balance, and walking ability; this was supplemented by a home-based exercise program that focused on leg strength. The control group received only a pamphlet and advice on fall prevention. The average rate of attendance at exercise class was 75.3% (range, 64% to 86%). Participants showed significant improvements in tandem walk and functional reach after the intervention program, with enhanced self confidence. At the 8-month follow-up, the proportion of women with falls was 13.6% (3/22) in the intervention group and 40.9% (9/22) in the control group. At 20 months, the proportion remained unchanged, at 13.6% in the intervention group, but had increased to 54.5% (12/22) in the control group, which showed a statistically significant difference between the two groups (Fisher's exact test; P = 0.0097). The total number of falls during the 20-month follow-up period was 6 in the intervention group and 17 in the control group. We conclude that a moderate exercise intervention program plus a home-based program significantly decreases the incidence of falls in both the short and the long term, contributing to improved health and quality of life in the elderly.

Accidental Falls↗

PubMed1993

A method for measuring mechanical work and work efficiency during human activities.

A major limitation in understanding human energy balance is the ability to accurately quantify the amount of physical activity or work performed by human subjects. We describe the development and validation of a force platform (2.5 x 2.5 m) system for measuring external mechanical work performed by human subjects. The force platform system was constructed inside a whole-room indirect calorimeter, thus, allowing simultaneous measurement of the energy expenditure associated with physical activity. We demonstrated the accuracy of the system for measuring work performed using a solenoid (32 kg) to deliver controlled amounts of energy to the platform. In tests with human subjects we demonstrated that the system can accurately and reproducibly measure work performed, energy expenditure associated with work performed, and work efficiency (work performed divided by energy expenditure). Overall, we obtained high correlations (an average of 0.932 for 33 subjects), between mechanical work performed and energy expenditure. We believe this mechanical work-energy expenditure system will be useful in determining the importance of individual differences in amount and cost of physical activity in the regulation of body weight and in development of obesity.

Biophysics↗

PubMedDate not supplied

Neonatal ethanol exposure: functional alterations associated with cerebellar growth retardation.

The effects of alcohol exposure during the brain growth spurt on development and on behavioral assessments of functional alterations in the cerebellum were examined in the rat. Rat pups were exposed via an artificial rearing technique to either a 2.50% w/v or 2.15% w/v EtOH-milk formula during a period encompassing the brain growth spurt. An artificially reared control group and a suckle control group were also included. Peak blood alcohol concentrations for animals in the high and low dose alcohol exposure groups were approximately 300 mg/dl and 180 mg/dl, respectively. Reductions in brain minus cerebellum to body weight (BR-C/BD) and cerebellum to body weight (C/BD) ratios were noted in animals from each of the alcohol-treated groups. Some catch-up growth in terms of brain mass was noted in animals from each of the alcohol-exposed groups. Animals exposed to alcohol during the neonatal period displayed deficits on several tests of balance and motor ability. Alcohol-exposed animals performed more poorly than controls when traversing two parallel horizontal rods and on tests of hindlimb and head elevation. No differences were noted in the ability to remain on a rotating drum. These results suggest that some of the behavioral consequences of neonatal ethanol exposure might be due to ethanol's actions on the cerebellum.

Administration, Oral↗

PubMed1996

Measuring functional status: cross-sectional and longitudinal associations between performance and self-report (Zutphen Elderly Study 1990-1993).

We investigated cross-sectional as well as longitudinal associations between performance-based measures of functional status and self-reported measures of functional status. In the Zutphen Elderly Study, 494 men, born between 1900 and 1920, were examined in 1990, of whom 303 were reexamined in 1993. A performance score was constructed on the basis of four tests: standing balance, walking speed, ability to rise from a chair, and external shoulder rotation. Self-reported functional status was based on disabilities in basic activities of daily living, mobility, and instrumental activities of daily living. A hierarchic disability scale was constructed. Cross-sectional correlation coefficients between the performance score and the disability scale were 0.22 in 1990 and 0.39 in 1993. Correlations were highest between the test for walking speed and self-reported mobility and IADL, and between the test for external shoulder rotation and self-reported disabilities in basic activities of daily living. The correlation between the 3-year changes in performance and in self-report was 0.20 (p < 0.001). Both performance and self-report at baseline predicted performance and self-report after 3 years. Performance-based measures of functional status are cross-sectionally and longitudinally associated at modest levels with self-reported disabilities. Performance measures and self-reported measures are complementary, but do not measure the same construct.

Activities of Daily Living↗

PubMed1997

Critical thermal limits, temperature tolerance and water balance of a sub-Antarctic caterpillar, Pringleophaga marioni (Lepidoptera: Tineidae).

Thermal tolerance, supercooling point, water balance and osmoregulatory ability of Pringleophaga marioni Viette (Lepidoptera: Tineidae) are investigated in this study. Field-fresh larvae had a mean CT(Min) (cold stupor) of -0.6 degrees C and a mean CT(Max) (heat coma) of 38.7 degrees C. The mean supercooling point of field-fresh individuals was -5.0 degrees C. Caterpillars showed 100% survival of freezing to -6.5 degrees C, but at -12 degrees C mortality rose to 100%. Survival of a 30h exposure to -6.0 degrees C was 80%, but declined to 30% in the 6-12h interval at -7.5 degrees C. No caterpillars survived for longer than 12h at -9.0 degrees C. Survival of high temperatures (35 degrees C and above) was poor. Tolerance of water loss (46% of fresh mass) and rates of water loss (1% fresh massh(-1)) were similar to those found in other mesic insects. P. marioni larvae were incapable of metabolizing lipids to replenish lost water and showed no haemolymph osmoregulatory ability. It is suggested that the preponderance of freeze tolerance in high-latitude southern hemisphere species may be associated with their occurrence in moist habitats, and that the "freeze tolerance" category be re-examined in the light of the range of strategies adopted by such arthropods.

Journal Article↗

PubMed1997

Changing reversed-phase high performance liquid chromatography selectivity. Which variables should be tried first?

When carrying out HPLC method development, it is often necessary to vary the relative retention of the sample (values of alpha) by changing some experimental variable, e.g., solvent type, pH, etc. The choice of which variable will be most suitable for a change in selectivity depends on two conflicting goals: (a) the attainment of maximum changes in alpha for the better control of resolution and (b) the avoidance of practical problems associated with the use of a given variable to optimize selectivity. This study provides a quantitative evaluation of different variables for their effect on selectivity (alpha). Various practical problems which must be balanced against this ability of a variable to change value of alpha are also discussed. The selection of any two variables for their simultaneous use in controlling alpha is also examined.

Chromatography, High Pressure Liquid↗

PubMed2000

Nonselective beta-adrenergic blocking agent, carvedilol, improves arterial baroflex gain and heart rate variability in patients with stable chronic heart failure.

OBJECTIVES: The purpose of this study was to investigate in a case-controlled study whether carvedilol increased baroreflex sensitivity and heart rate variability (HRV). BACKGROUND: In chronic heart failure (CHF), beta-adrenergic blockade improves symptoms and ventricular function and may favorably affect prognosis. Although beta-blockade therapy is supposed to decrease myocardial adrenergic activity, data on restoration of autonomic balance to the heart and, particularly, on vagal reflexes are limited. METHODS: Nineteen consecutive patients with moderate, stable CHF (age 54 +/- 7 years, New York Heart Association [NYHA] class II to III, left ventricular ejection fraction [LVEF] 24 +/- 6%), treated with optimized conventional medical therapy, received carvedilol treatment. Controls with CHF were selected from our database on the basis of the following matching criteria: age +/- 3 years, same NYHA class, LVEF +/- 3%, pulmonary wedge pressure +/- 3 mm Hg, peak volume of oxygen +/- 3 ml/kg/min, same therapy. All patients underwent analysis of baroreflex sensitivity (phenylephrine method) and of HRV (24-h Holter recording) at baseline and after six months. RESULTS: Beta-blockade therapy was associated with a significant improvement in symptoms (NYHA class 2.1 +/- 0.4 vs. 1.8 +/- 0.5, p < 0.01), systolic and diastolic function (LVEF 23 +/- 7 vs. 28 +/- 9%, p < 0.01; pulmonary wedge pressure 17 +/- 8 vs. 14 +/- 7 mm Hg, p < 0.05) and mitral regurgitation area (7.0 +/- 5.1 vs. 3.6 +/- 3.0 cm2, p < 0.01). No significant differences were observed in either clinical or hemodynamic indexes in control patients. Phenylephrine method increased significantly after carvedilol (from 3.7 +/- 3.4 to 7.1 +/- 4.9 ms/mm Hg, p < 0.01) as well as RR interval (from 791 +/- 113 to 894 +/- 110 ms, p < 0.001), 24-h standard deviation of normal RR interval and root mean square of successive differences (from 56 +/- 17 to 80 +/- 28 ms and from 12 +/- 7 to 18 +/- 9 ms, all p < 0.05), while all parameters remained unmodified in controls. During a mean follow-up of 19 +/- 8 months a reduced number of cardiac events (death plus heart transplantation, 58% vs. 31%) occurred in those patients receiving beta-blockade. CONCLUSIONS: Besides the well-known effects on ventricular function, treatment with carvedilol in CHF restores both autonomic balance and the ability to increase reflex vagal activity. This protective mechanism may contribute to the beneficial effect of beta-blockade treatment on prognosis in CHF.

Adrenergic beta-Antagonists↗

PubMed2004

Physical activity interventions to prevent falls among older people: update of the evidence.

Injuries resulting from falls are a significant public health issue, particularly for older people. This review provides an update of the evidence on the effects of various physical activity (PA) or exercise intervention strategies for the prevention of unintentional falls among older people. Six systematic reviews, and three randomised controlled trials not incorporated in previous reviews, were located with a literature search. There is clear evidence that a targeted supervised home exercise program of strength and balance exercise and walking practice, prescribed by a trained health professional, can prevent falls among older community dwellers. There is also an indication that untargeted group exercise (ie, not individually prescribed) can prevent falls among community dwellers, particularly if it involves Tai Chi or other exercises which challenge balance. There is some indication that individual prescription of PA is more important in frailer groups. Further investigation is required to establish the effects of PA in residential aged care, and the relative effects of different types of PA in different populations. In addition, multidisciplinary, multifactorial. health/environmental risk factor screening/intervention programs have been found to be effective in preventing falls. For many individuals with physical risk factors for falls (eg, impaired strength, balance or functional ability), PA alone is likely to reduce the risk of falls. For those with additional risk factors (eg, visual impairments, psychoactive medication use), other interventions may also be required.

Accidental Falls↗

PubMed2002

Systemic administration of interferon-gamma-expressing plasmid reduces late allergic bronchitis in a mouse model of asthma.

Asthma might be caused by a helper T(Th)2 immune response. We hypothesized that the systemic administration of the Th1 cytokines may reduce the Th2 type late asthmatic response (LAR). We examined the effect of the intraperitoneal injection of interferon(IFN)-gamma-expressing plasmid, a Th1 cytokine, or interleukin(IL)-4-expressing plasmid, a Th2 cytokine, at the time of sensitization on a mouse model of asthma induced by ovalbumin in BALB/c mice. We demonstrated that the IFN-gamma-expressing plasmid reduced the LAR, whereas the IL-4-expressing plasmid enhanced the LAR as compared with the saline or plasmid-only treated group. The present study suggests that the systemic administration of IFN-gamma-expressing plasmid may have a modulating ability of Th1/Th2 balance to down-regulate Th2 response by a mutual inhibitory mechanism between Th1 and Th2 cells, leading to the reduction of the LAR.

Animals↗

PubMed2000

Postural coordination in elderly subjects standing on a periodically moving platform.

OBJECTIVE: To test body segment coordination during dynamic equilibrium on a moving platform, and assess age-related differences in the performance. DESIGN: Subjects had infrared light-emitting diode (LED) markers fixed on their temporomandibularjoint, greater trochanter, and lateral malleolus. Subjects stood upright on a sinusoidally translating platform with both feet, either with eyes open (EO) or eyes closed (EC). The platform was displaced horizontally in an anteroposterior direction at frequencies of 0.2 or 0.6Hz. Each trial, for either visual condition, was repeated twice, lasted 30 seconds, with 30-second intervals, for up to 1 hour. PARTICIPANTS: Fifty-three healthy subjects, aged 17 to 89 years. MAIN OUTCOME MEASURES: Kinematics of head and hip were analyzed by measuring periodic shift of LED markers using an optoelectronic device. Standard deviation on traces of the markers were taken as a comprehensive index of segment placement. Cross-correlation between marker traces was determined to obtain measures of degrees of coupling between body segments. RESULTS: At the low translation frequency (0.2Hz), with EO, subjects behaved like a noninverted pendulum, whereby the head tended to be stabilized more than the hip, and the legs taking up most of the imposed displacement. Aging was associated with greater head stabilization, and a looser coupling between head and hip. With EC, the body attitude changed to an inverted pendulum, whereby the head overshot the platform displacement. Aging was associated with reduced head stabilization, and a stronger coupling between head and hip. When the frequency of the platform translation increased to 0.6Hz, with EC, the general picture was similar to the above, but in older subjects vision was no longer able to counteract the imposed head displacement. At this frequency, with both EO and EC, there was a poor coupling between body segments across all ages. CONCLUSIONS: Periodic shift of the support base may be a valid protocol to test the ability to control balance in the elderly, and may be a useful tool to assess age-related changes of the sensorimotor mechanisms underlying dynamic equilibrium.

Adolescent↗

PubMed2001

Tanzanian midwives' views on becoming a good resource and support person for postpartum women.

OBJECTIVES: to explore midwives' views in relation to the provision of systematic postpartum care. DESIGN: qualitative focus group study using grounded theory approach. SETTING: Dar es Salaam, Tanzania. PARTICIPANTS: 49 nurse/midwives in five focus group discussions, each having 9-11 participants. FINDINGS: eight categories were identified: 'reflecting', 'getting ready', 'defining abilities', 'networking', 'integrating', 'balancing', 'dealing with reality', and 'caring'. The identified core category that integrated and encapsulated all other categories was 'becoming a good resource and support person for postpartum woman'. The mediating factors found to have potential for influencing how a midwife can function in order to become a good resource and support person were: a) the structure and approach in maternal and child health services, b) midwives' knowledge, attitude and skills, c) informal sources of knowledge to parents, and d) cultural beliefs and practices. CONCLUSION: the findings of this study provide an understanding of the way midwives feel and think about the provision of postpartum care. The findings demonstrate that midwives need support in their efforts to achieve what they consider necessary for postpartum care. Interventions for educating and supporting midwives should be targeted at enabling them to deal with all the factors that influence their role and help them to identify and use better strategies to provide quality care.

Anecdotes as Topic↗

PubMedDate not supplied

Balancing within various discourses--the art of being old and living as a Sami woman.

The aim of this part of the Umeå 85+ Study was to explore how indigenous women narrate their lives and their experience of being old as Sami women. Interviews with 9 old Sami women were analyzed using grounded theory. The categories identified were "reindeer as the basis of life," "longing for significant Sami values," "feeling valued as a Sami woman," and "changing for survival;" these evolved into the core category: "balancing within various discourses-the art of being old and living as a Sami woman." Knowing how to balance provided the ability to make use of available opportunities.

Aged↗

PubMed1994

Behavioral deficits following experimental subarachnoid hemorrhage in the rat.

To characterize some of the short-term and long-term functional consequences of subarachnoid hemorrhage (SAH) in rats, we employed a battery of well-characterized tests for assessment of acute and chronic behavioral and neurologic performances. Three groups of 10 rats (blood injected, mock CSF injected and sham-operated controls) were studied. During the acute stage, simple nonpostural somatomotor reflexes (pinna and corneal reflexes), simple postural responses (paw flexion, tail flexion, and head support), startle response, and postural functions (righting reflex) did not differ significantly between the experimental groups. Assessments of body weight, beam walking ability, and beam balancing revealed significant disturbances in blood-injected rats. This work demonstrates that this single-hemorrhage rodent model of SAH is associated with the induction of enduring neurologic and behavioral deficits. Because of the significant interspecies difference, a direct extrapolation of our results to humans may not be appropriate. However, we suggest that the observed behavioral and neurologic changes may parallel those seen in humans after SAH. Results reported here further confirm the rat model of SAH as a viable laboratory instrument for the study of the pathophysiology of SAH and provide normative values for the evaluation of new treatment modalities.

Acute Disease↗