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PubMed1993

Chronic effects of monoamine oxidase-B inhibitors on the behaviour of aged mice.

In order to measure the chronic effects of monoamine oxidase-B (MAO-B) inhibitors on the physical and cognitive condition of 60 aged male mice, 1-deprenyl or N-methyl-N-(2-pentyl)-propargylamine (M-2-PP) were administered in drinking water (10 micrograms/ml/day) for 37 weeks. The spontaneous open-field locomotion, balancing ability and weight gain of the mice were assessed continuously. At the end of the study the spatial learning ability of all surviving mice was assessed in a Morris water maze. Both drug groups exhibited a reduction in spontaneous locomotion at the same rate as the control group, while there were no changes in balancing ability. The mice receiving 1-deprenyl, however, performed the water maze task less well than the control group. The mice receiving 1-deprenyl also gained weight at a significantly reduced rate compared to both the M-2-PP and water treated groups. A brain MAO assay indicated that MAO-B was completely inhibited by both drugs while MAO-A remained unchanged. The implications of these data on longevity studies using 1-deprenyl and other MAO-B inhibitors are discussed.

Aging↗

PubMed2000

Use of visual feedback in retraining balance following acute stroke.

BACKGROUND AND PURPOSE: Visual feedback related to weight distribution and center-of-pressure positioning has been shown to be effective in increasing stance symmetry following stroke, although it is not clear whether functional balance ability also improves. This study compared the relative effectiveness of visual feedback training of center-of-gravity (CoG) positioning with conventional physical therapy following acute stroke. SUBJECTS: Forty-six people who had strokes within 80 days before the study, resulting in unilateral hemiparesis, and who were in need of balance retraining participated. METHODS AND MATERIALS: Initially, subjects were randomly assigned to visual feedback or conventional physical therapy groups for balance retraining until 16 subjects per group were recruited. The next 14 subjects were assigned to a control group. All subjects received physical therapy and occupational therapy (regular therapy) 2 hours a day, and subjects in the 2 experimental groups received additional balance training 30 minutes a day until discharge. The visual feedback group received information about their CoG position as they shifted their weight during various activities. The conventional therapy group received verbal and tactile cues to encourage symmetrical stance and weight shifting. Static (postural sway) and activity-based measures of balance (Berg Balance Scale, gait speed, and the Timed "Up & Go" Test) were contrasted across the 3 groups at baseline, at discharge, and at 1 month following discharge using an analysis of variance for repeated measures. RESULTS: All groups demonstrated marked improvement over time for all measures of balance ability, with the greatest improvements occurring in the period from baseline to discharge. No between-group differences were detected in any of the outcome measures. CONCLUSION AND DISCUSSION: Visual feedback or conventional balance training in addition to regular therapy affords no added benefit when offered in the early stages of rehabilitation following stroke.

Acute Disease↗

PubMed2003

Does balance or motor impairment of limbs discriminate the ambulatory status of stroke survivors?

OBJECTIVE: This study was performed to determine if ambulatory function is governed by motor impairment of limbs or balance ability in subjects with hemiplegia caused by stroke. DESIGN: Seven patients who walked with physical assistance (FIM 4) after stroke and 13 who walked independently with assistive devices (FIM 6) were compared with 13 healthy subjects. Motor impairment of limbs was evaluated with the Fugl-Meyer Assessment. The Berg Balance Scale and limit of stability test of the Smart Balance Master were used to evaluate balance ability. RESULTS: The FIM 6 group and the controls were best differentiated by motor impairment of the paretic limbs and limit of stability in the backward direction. Motor impairment of the upper limb and limit of stability in direction toward the paretic side separated the FIM 4 from the FIM 6 group. Upper limb motor impairment and the Berg Balance Scale consistently separated the three subject groups. CONCLUSIONS: Motor impairment in the paretic upper limb and balance dysfunction should be addressed in treatments working toward independent ambulation.

Activities of Daily Living↗

PubMed2002

Evaluation of gene-finding algorithms by a content-balancing accuracy index.

A content-balancing accuracy index, called q(9), to evaluate gene-finding algorithms has been proposed. Here the concept of content-balancing means that the evaluation by this index is independent of the coding and non-coding composition of the sequence being evaluated. Since the coding and non-coding compositions are severely unbalanced in eukaryotic genomes, the performance of gene-finding algorithms is either over- or under-evaluated by the widely used accuracy indices, e.g., the correlation coefficient, due to the lack of content-balancing ability. Using the new accuracy index q(9), seven gene-finding algorithms, FGENES; Gene-Mark.hmm; Genie; Genescan; HMMgene; Morgan and MZEF, were compared and evaluated. It is shown that Genescan is still the best one, but with q(9)= 89%, averaged over the prediction for 195 sequences. In addition to the content-balancing ability, q(9) has the merit of having definition in all possible cases. It is also shown that the traditional specificity s(p) carries important information on the performance of the algorithm being evaluated. The set of sensitivity s(n), specificity s(p) and the accuracy q(9) constitutes a complete kit to evaluate gene-finding algorithms at nucleotide level. In addition, a graphic method to compare and evaluate gene-finding algorithms has been proposed, too. Its major advantage is that the overall performance of algorithms can be grasped quickly in a perceivable form. Additionally, the new accuracy index q(9) may be applied to evaluate the performance of weather forecast, clinical diagnosis, psychological examination and protein secondary structure prediction etc.

Algorithms↗

PubMed2005

Moving forward in fall prevention: an intervention to improve balance among older adults in real-world settings.

OBJECTIVES: We investigated the effectiveness of a group-based exercise intervention to improve balancing ability among older adults delivered in natural settings by staff in local community organizations. METHODS: The main component of the intervention consisted of biweekly group-based exercise sessions conducted over 12 weeks by a professional, coupled with home-based exercises. In a quasiexperimental design, 10 community organizations working with older adults offered the intervention to groups of 5 to 15 persons concerned about falls, while 7 organizations recruited similar groups to participate in the control arm of the study. Participants (98 experimental and 102 control) underwent balance assessments by a physiotherapist at registration and 3 months later. RESULTS: Eighty-nine percent of participants attended the 3-month measurement session (n=177). A linear regression analysis showed that after adjusting for baseline levels of balance and demographic and health characteristics, the intervention significantly improved static balance and mobility. CONCLUSION: Structured, group-based exercise programs offered by community organizations in natural settings can successfully increase balancing ability among community-dwelling older adults concerned about falls.

Accidental Falls↗

PubMed2002

Postural muscle responses following changing balance threats in young, stable older, and unstable older adults.

The authors determined the postural muscle response to support surface perturbations, in relation to aging and level of stability of 16 young adults and 32 older adults who were classified into stable (SOA) and unstable (UOA) groups on the basis of their functional balance abilities. Forward and backward support surface translations of various amplitudes and velocities were used so that postural responses of the standing adults could be elicited. The thigh and leg postural muscle responses were recorded with surface electromyography (EMG). The older groups had significantly longer onset latency in the anterior postural muscles, smaller integrated EMG in the posterior muscles, and greater extent of integrated EMG attenuation over time. The UOA showed longer onset latency in the gastrocnemius following slow backward perturbation and used a greater percentage of the functional capacity of the gastrocnemius muscle than the SOA did. Those findings indicate that the SOA and UOA had limited ability to adapt to changing balance threats; the UOA were more limited than the SOA. When designing balance training programs, therefore, therapists should consider the adult's level of functional stability.

Adult↗

PubMed2005

Reliability of simple portable tests of physical performance in older people after hip fracture.

OBJECTIVE: To investigate the test-retest reliability of measures of strength, balance, gait and functional performance when used with older people following hip fracture. SUBJECTS: Thirty people (16 hospital inpatients and 14 community dwellers). DESIGN: Subjects underwent two assessments: one day apart for the hospital inpatients and one week apart for the community dwellers. MEASUREMENT: Strength (dynamometer, sphygmomanometer, spring balance, lateral step-up ability), balance (sway-meter, Functional Reach Test, single leg stance time, Step Test), gait (timed 6-m walk with steps taken, base of support and step length), and functional performance (PPME total score and timed supine-to-sit and sit-to-stand) were measured. RESULTS: Eleven of the 14 continuously scaled measurement tools achieved excellent reliability (intraclass correlation coefficient (ICC) > 0.75) for one or more tests. A hand-held dynamometer was found to be the tool with the highest test-retest reliability for measuring hip muscle strength (ICC (3,1) 0.86 for affected hip abduction). For measurement of knee extension strength, a spring balance (ICC (3,1) 0.94 affected leg) was the most reliable. For testing balance, the Step Test (ICC (3,1) 0.94 for stepping with affected leg) and Functional Reach Test (ICC (3,1) 0.89) had the highest test-retest reliability. The ICC (3,1) values were 0.97 for walking velocity (comfortable pace) and 0.96 for the total score of the Physical Performance and Mobility Examination. CONCLUSION: The test-retest reliability of a number of simple measures of physical performance is excellent when used with this population.

Aged↗

PubMed2005

Postural steadiness during quiet stance does not associate with ability to recover balance in older women.

BACKGROUND: Fall risk depends on ability to maintain balance during daily activities, and on ability to recover balance following a perturbation such as a slip or trip. We examined whether similar neuromuscular variables govern these two domains of postural stability. METHODS: We conducted experiments with 25 older women (mean age=78 yrs, SD=7 yrs). We acquired measures of postural steadiness during quiet stance (mean amplitude, velocity, and frequency of centre-of-pressure movement when standing with eyes open or closed, on a rigid or compliant surface). We also measured ability to recover balance using the ankle strategy after release from a forward leaning position (based on the maximum release angle where recovery was possible, and corresponding values of reaction time, rate of ankle torque generation, and peak ankle torque). FINDINGS: We found that balance recovery variables were not strongly or consistently correlated with postural steadiness variables. The maximum release angle associated with only three of the sixteen postural steadiness variables (mean frequency in rigid, eyes open condition (r=0.36, P=.041), and mean amplitude (r=0.41, P=.038) and velocity (r=0.49, P=.015) in compliant, eyes closed condition). Reaction time and peak torque did not correlate with any steadiness variables, and rate of torque generation correlated moderately with the mean amplitude and velocity of the centre-of-pressure in the compliant, eyes closed condition (r=0.48-0.60). INTERPRETATION: Our results indicate that postural steadiness during quiet stance is not predictive of ability to recover balance with the ankle strategy. Accordingly, balance assessment and fall prevention programs should individually target these two components of postural stability.

Adaptation, Physiological↗

PubMed2026

Response-optimised training improves learning of a complex motor task and closely related motor tasks.

Regular physical exercise is essential for promoting healthy aging and longevity. In older adults with varying physical and cognitive decline, optimising exercise interventions is crucial to maximise benefits. A promising approach to achieve this goal is by adjusting task demands to individual abilities in turn preventing over- or underloading their abilities. In the field of motor learning, it is currently unclear whether such an optimised training improves not only performance on the trained task but also transfers to untrained motor and cognitive tasks. We conducted a randomized, single-blinded, 6-week dynamic balance training (DBT) with healthy older adults (n = 30). Training was tailored to individual balance ability. Participants were assigned to either suboptimal (high or low difficulty) or optimal (moderate difficulty) training groups. Transfer effects were assessed via cognitive tasks (memory and executive) and motor tasks (untrained DBT variations and other balance tasks) measured pre-, mid- and post-intervention. Multivariate longitudinal statistical analysis showed higher performance gains in the optimal training group in three out of six sessions compared to the suboptimal groups, especially under testing conditions with high task demands. The optimal group also showed greater improvements in near motor transfer tasks mid- and post-intervention, while no significant differences were observed in the cognitive tasks. Within-group DBT learning positively correlated with transfer gains, highlighting the role of training response in achieving transfer. In conclusion, optimised task difficulty in balance training enhances both task-specific performance and related motor skills, supporting the use of personalised interventions to maintain function and independence in older adults.

Humans↗

PubMed2003

Dynamic balance training during standing in people with trans-tibial amputation: a pilot study.

Falls and fear of falling are significant problems arising from impaired balancing abilities that affect people with lower limb amputation during unassisted transfer manoeuvres and ambulation. It is important to develop and evaluate efficient therapeutic interventions aimed at improving balancing and coordination skills. A group of 14 persons after trans-tibial amputation, fitted with trans-tibial prostheses, were included in a balance-training programme, consisting of approximately 20 minutes of balance training per day for five consecutive days on BalanceReTrainer--a novel balance-training, fall-safe mechanical apparatus. Before and after the training period three outcome measures were taken: duration of standing only on the prosthetic leg, timed up and go test and 10m walk. Each measurement was repeated five times and the mean value was used in the subsequent calculation of mean values and standard deviations for the group. Before training the group was able to stand on the prosthetic leg for 2.98 +/- 2.75s, they needed 6.15 +/- 1.9s for accomplishing timed up and go test and they needed 5.51 +/- 1.5s to cover the distance of 10m. After the treatment period the values were 4.3 + 4.5s, 5.4 +/- 1.5s and 4.5 +/- 0.9s, respectively. The results indicate improved performance in all three measured tasks, thereby indicating that the applied treatment programme improves balancing and ambulation abilities in people after trans-tibial amputation.

Accidental Falls↗

PubMed2004

Postural balance and health-related factors in middle-aged and older women with injurious falls and non-fallers.

BACKGROUND AND AIMS: Older fallers aged over 70 years have shown impaired balance abilities, but it is unclear if impairment in balance control can be detected among fallers who are in their 50's and 60's. The aim of this study was to analyze possible differences in balance control and other health-related factors between female fallers and non-fallers aged 50-68 years. METHODS: Women 50-68 years of age (N=40) who had fallen outside and needed medical attention were recruited through a larger fall accident study. Non-fallers (N=97) were women representing the same age group who had not fallen during the preceding 12 months. A battery of standing force platform balance tests were administered together with an interview on health status, use of medication, dizziness, vision, hearing, and physical activity. RESULTS: Significant differences were not found between women with injurious falls and non-fallers in the various balance tests. In the younger age group (50-58 years), chronic illnesses, use of medication, dizziness, and self-reported problems with vision and hearing were more common in fallers than in non-fallers. CONCLUSIONS: Our results suggest that, in active and independent women aged 50-68 years, it is not possible to use standing force platform balance tests to detect differences between fallers and non-fallers. However, younger women (50-58 years) with injurious falls reported more health-related problems than other groups, a fact which should be taken into consideration to prevent further development of fall-related problems.

Accidental Falls↗

PubMed1999

Stance balance control with orthoses in a group of children with spastic cerebral palsy.

Although ankle-foot orthoses (AFOs) are frequently prescribed to correct skeletal malalignment in children with spastic diplegia, their effect on standing balance abilities has not been documented. This study investigated balance differences related to the presence of pathology and orthotic conditions during conditions of unexpected stance perturbation by comparing four children aged between 3 1/2 and 15 years with spastic cerebral palsy and four control children matched for years of independent walking experience. Electromyographic and kinematic data were collected and compared between groups and in three orthotic conditions (no AFOs, solid AFOs, dynamic AFOs). Results revealed that balance responses of children with spasticity were characterized by: increased coactivation of muscles as opposed to distal to proximal recruitment, decreased presence of upright posture in stance, increased use of 'on-toes' strategies, and different sway characteristics compared with the typically developing children. In both groups of children, the use of solid AFOs during perturbed stance resulted in: decreased activation of gastrocnemius muscles, disorganized muscle-response patterns, decreased use of ankle strategies, and increased joint angular velocities at the knee compared with conditions without AFOs or with dynamic AFOs. These preliminary results support the use of dynamic AFOs to correct skeletal malalignment in children with spastic diplegia.

Adolescent↗

PubMed2004

Functional, postural and perceived balance for predicting the work ability of firefighters.

OBJECTIVE: The importance of balance abilities for firefighting and rescue work has already been recognized, but there are no valid balance tests available in the test batteries for the physical work capacity of firefighters. Moreover, few studies have examined the associations between balance and work ability in general. Valid work-related balance tests are needed for the purpose of screening in occupational health care and in rehabilitation for assessing the effects of balance training. This study aimed to investigate the predictive value of functional, postural and perceived balance in respect to work ability among firefighters at baseline and after a 3-year follow-up. METHODS: The subjects were 135 male firefighters aged 33-56 years. The outcome variables were the work ability index and perceived physical work ability (PWA), determined by questionnaire in 1996 and 1999. The predictors assessed in 1996 were postural balance (tested with a force platform), functional balance (measured during walking on a wooden plank), and perceived balance abilities, enquired about through a questionnaire. RESULTS: Most of the balance test results and the perceived balance ability were associated with the perceived PWA at baseline. The final logistic regression models showed that the best predictors of decreased work ability among firefighters after 3 years were poor-to-moderate perceived balance [odds ratios (ORs) 2.4, 95% confidence interval (CI) 0.9-6.6]; more than one error in the functional balance test (OR 3.6, 95% CI 1.0-12.7); and a high mean amplitude of postural sway with the eyes closed (OR 2.7, 95% CI 0.9-6.1). CONCLUSIONS: The results support the work-related and predictive validity, in terms of perceived work ability, perceived balance, errors in the functional balance test and amplitude of postural sway with the eyes closed, of measuring balance among firefighters.

Adult↗

PubMed2004

Berg Balance Scale and Functional Reach: determining the best clinical tool for individuals post acute stroke.

OBJECTIVE: To begin the process of determining the best clinical tool for measuring balance in individuals post stroke. DESIGN: Prospective with descriptive and relational analyses. SETTING: Rehabilitation centres and stroke support group meetings. SUBJECTS: Seventy-five subjects who had suffered a stroke were divided into four groups based on the Duncan classification for stroke severity. MAIN OUTCOME MEASURES: The motor section of the Fugl-Meyer Assessment of Physical Performance was completed for each person to classify the motor deficit. Subjects performed Functional Reach twice with the nonparetic arm and the average was recorded. Subjects performed the Berg Balance Scale and the total score on the first attempt was recorded. RESULTS: As motor impairment increased, balance ability declined and both the Functional Reach and Berg Balance Scale proved sensitive to this decline. Spearman rank correlation coefficient was excellent among the entire sample (r(s) =0.78). CONCLUSION: Subjects' performance on the Berg Balance Scale was closely associated with performance on the Functional Reach. Therefore, the clinician may elect to use the shorter Functional Reach as a measure of balance where efficient use of time is the primary goal.

Humans↗

PubMed2002

Changes in center-of-pressure dynamics during upright standing related to decreased balance control in young adults: fractional Brownian motion analysis.

We investigated the relationships between the ability to maintain balance in an upright stance and center-of-pressure (COP) dynamic properties in young adults. Included in this study were 10 healthy male subjects in each of two groups with respect to balance ability. Balance ability was evaluated according to the length of time a subject stood on one leg with his eyes closed. The means and ranges of this one-leg balancing time were 17.9 s (3-43 s) and 118.3 s (103-120 s) for the off-balance and balance groups, respectively. The time-varying displacements of the COP under a subject's feet during quiet two-leg (normal) standing were measured by an instrumented force platform. Each subject was tested in both the eyes-open and eyes-closed conditions. The COP trajectories were analyzed as fractional Brownian motions according to the procedure of 'stabilogram-diffusion analysis', proposed by Collins and De Luca (1993). The extracted parameters were the effective diffusion coefficients (D) for the short-term (less than about 1.0 s) and long-term intervals, respectively, as well as the Hurst exponents (H) for the short-term and long-term intervals, and some critical-point coordinates (i.e., critical mean square displacements and critical time intervals). The off-balance group showed significantly higher values for short-term D, short-term H, and critical mean square displacements than the balance group. No significant differences between the groups were found in the long-term D and H or in the critical time intervals. That is, for the off-balance subjects, an increase in the stochastic activity and positively correlated (persistent) behavior of the postural sway during shorter timescales may cause postural instability. These results suggest that the difference in balance ability for young adults is related to the open-loop (i.e., short-term) control mechanisms but not to the corrective feedback (i.e., long-term) mechanisms used to maintain balance in an upright stance.

Adult↗

PubMed2004

Analysis of postural stability in collegiate soccer players before and after an acute bout of heading multiple soccer balls.

The aim of our study was to determine if any immediate changes in balance were discernable in college soccer players after a specially designed heading session. Eight male and two female skilled collegiate soccer players had a baseline balance pre-test using the Balance Master, followed by heading 20 balls kicked consecutively by a teammate from the touchline to a point near the goal, which was followed by a post-test using the same testing technique. Paired t-tests were used to compare balance ability between pre- and post-test conditions. There was no difference in balance pre- to post-test (85.3% and 86.2% respectively). No significant difference was noted from pre- to post-test in the mean equilibrium scores for conditions three through six on the Sensory Organization Test, with the exception of condition four, which revealed a significant increase from pre- to post-test. We concluded that an acute session of heading soccer balls may not result in balance changes in collegiate soccer players.

Adult↗

PubMed2005

Association between sensorimotor function and functional and reactive balance control in the elderly.

OBJECTIVES: Postural disturbances can arise from performing functional tasks and from external perturbations. Identification of sensorimotor factors associated with both types of balance control in the elderly can help us to understand better the balance problems facing older adults. DESIGN: Cross-sectional. SUBJECTS: Healthy young, stable older, and functionally unstable older adults with 16 participants in each group. METHODS: Clinical vibration sense and muscle strength of the lower extremity, and functional balance (FB) tests were conducted. The timing and amplitude of the reactive postural muscle responses of the leg postural muscles, recorded from standing subjects following support surface backward translation, were also examined. RESULTS: Young and older subjects differed significantly in the amplitude of their postural muscle responses, while the two older groups differed significantly in muscle strength and FB. When age was controlled, the strength of the ankle dorsi- and plantar-flexors was the only significant predictor for FB. For reactive postural muscle responses, none of the sensorimotor factors was significant. CONCLUSION: Functional and reactive balance abilities differed in their associating factors. The difference in the patterns of association for functional and reactive balance implies the need for separate assessment for these two categories of balance control clinically.

Adult↗

PubMed2004

Impact of middle ear effusion on balance performance in children.

UNLABELLED: Middle ear effusion (MEE) is a common childhood disease characterized by accumulation of fluid in the middle ear. MEE treatment focuses on the resultant conductive hearing loss. Recently, researchers have investigated the potential effects of MEE on balance. PURPOSE: The purpose of this study was to compare balance of children with MEE to that of healthy children and to examine whether a relation exists between balance skills and the degree of muscle strength. METHODS: Twenty children with MEE and twenty healthy children aged 4.5 - 7.5 years underwent balance and strength sub-tests of Bruininks - Oseretsky Test of Motor Performance (BOTMP) and electronystagmography recordings (ENG). Parents completed a questionnaire designed to elicit their perceptions of their child's balance abilities in daily living activities. RESULTS: MEE children performed significantly worse than did the control group on BOTMP balance sub-test. BOTMP strength subtest indicated that children with MEE had poorer muscle strength than the control group, although the difference was not significant. ENG results showed no pathologic recordings in both study group and control group. Finally, a significant correlation was found between parents' responses on the questionnaire and their child's performance on BOTMP balance subtest. CONCLUSIONS: MEE may negatively impact children's balance, while muscle strength is less affected. Furthermore, the BOTMP appears to be a sensitive assessment of balance disturbances in children with MEE.

Activities of Daily Living↗