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PubMed2003

The influence of premenstrual symptoms on postural balance and kinesthesia during the menstrual cycle.

Recent studies have indicated an increased incidence of female athletic injuries during the luteal phase and the first days of the menstrual period. The purpose of this study was to investigate whether postural sway and knee-joint kinesthesia very during the menstrual cycle, and whether premenstrual syndrome (PMS) influences postural balance and kinesthesia. A total of 13 subjects with regular menstrual cycles participated in the study. Postural sway and kinesthesia were measured in the early follicular phase, in the ovulation phase and in the mid-luteal phase. Postural sway was measured with an ankle disc placed on a Statometer, and kinesthesia was measured with a specially designed device. Menstrual cycle phases were determined by sex hormone analyses in serum and by luteinizing hormone (LH) detection in urine. The diagnosis of PMS was made prospectively using validated daily symptom ratings. Eight of 13 women were classified as having PMS. These women had a significantly greater postural sway (p = 0.002) and a greater threshold for detection of passive motion in the knee joints (p = 0.05) than women without PMS. A tendency (p = 0.06) towards greater postural sway in the mid-luteal phase was detected among women with PMS. This may explain the finding of an increased incidence of athletic injuries in the luteal phase, reported previously.

Adult↗
PubMed2004

Influence of perceptual learning on standing posture balance: repeated training for hardness discrimination of foot sole.

The current study investigated the influence of perceptual learning training for hardness discrimination of sponge rubber by the soles on postural sway. Subjects consisted of 30 healthy male volunteers. They were divided into two groups of 15 each at random: perceptual learning training group and a control group. For hardness discrimination training, rubber sponges 5, 10, and 20 mm thick were combined to change the thickness of rubber to 5, 10, 15, 20, and 25 mm. The hardness discrimination training was administered with eyes closed in the standing position for each day for 10 days. The center of pressure measured using a stabilometer was used as the indicator for postural sway. Postural sway was measured for 30 s with eyes open and closed before and after hardness discrimination training. Statistical analysis was performed for length, enveloped area, and rectangular area. Postural sway after training showed a significant decrease compared to sway before training in the perceptual learning training group. However, there was no change on postural sway in the control group. In conclusion, data indicate that the ability of the healthy subjects to regulate their standing posture improved with improvement of the perceptive ability of the soles.

Adult↗
PubMed1992

Clinical and laboratory measures of postural balance in an elderly population.

The objective of this cross-sectional study was to compare scores on the Balance Scale with laboratory measures of postural sway and other clinical measures of balance and mobility. Thirty-one elderly subjects were assessed on the clinical measures and the laboratory tests of postural sway while standing still and in response to pseudorandom movements of the platform. The average correlation between the Balance Scale and the spontaneous sway measures was -.55. It was slightly lower (r = -.38) for the same parameters measured during the pseudorandom tests. There were high correlations between the Balance Scale and the Balance Sub-Scale developed by Tinetti (r = .91), Barthel Mobility sub-scale (r = .67), and timed "Up and Go" (r = -.76). The Balance Scale was the most efficient measure (effect size > 1) to statistically discriminate between subjects according to their use of each type of mobility aide (walker, cane, no aids). These data contribute to existing information on the performance of the Balance Scale and supports the validity of the Balance Scale in this geriatric population.

Activities of Daily Living↗
PubMed2000

Disturbances in postural balance are common in postmenopausal women with vasomotor symptoms.

OBJECTIVES: To establish the prevalence of unsteadiness and rotatory vertigo in peri- and postmenopausal women, and whether balance disturbances are more common in women with vasomotor symptoms and without hormone replacement therapy (HRT). METHOD: A validated questionnaire was sent to all 1523 women aged 54 or 55 years in Linköping, Sweden. RESULTS: Daily or weekly unsteadiness was reported by 5%, and daily or weekly rotatory vertigo by 4% of all women. The frequency of vasomotor symptoms correlated with reported unsteadiness (rs = 0.23, p < 0.001). Fourteen per cent of women with daily vasomotor symptoms reported weekly or daily unsteadiness, compared with 3% of those without vasomotor symptoms (odds ratio (OR) 7.58, 95% confidence interval (CI) 3.72-15.45). The frequency of vasomotor symptoms correlated with rotatory vertigo (rs = 0.19, p < 0.001). Ten per cent of women with daily vasomotor symptoms reported weekly or daily rotatory vertigo, compared with 2% of women without vasomotor symptoms (OR 5.21, 95% CI 1.07-25.52). No correlation was seen between vasomotor symptoms and falls. Users of HRT had the same prevalence of balance disturbances as non-users. CONCLUSIONS: Women with frequent vasomotor symptoms seem to run a greater risk of unsteadiness and rotatory vertigo than do women without symptoms. This association may not be explained by means of a cross-sectional study, but there might exist a causal connection between vasomotor symptoms and balance disturbances.

Dizziness↗
PubMed1998

Postural balance measurements for children and adolescents.

Measurements of standing balance were determined for 92 children and adolescents, 5-18 years old, while they stood on a force plate with eyes open or eyes closed. The measurements included center-of-pressure calculations for path length per second, average radial displacement, anterior-posterior and mediolateral amplitudes, area per second, mean frequency of sway, Brownian random motion measure of short-term diffusion coefficient, and long-term scaling exponent. All balance parameters improved from youngest to oldest subjects, and the parameters improved when measured with the subjects' eyes open compared with closed. The mean values for data from three trials varied by only 5% when compared with the mean values from 10 trials. Data from this study suggest that force-plate center-of-pressure data can be used to determine differences in standing balance between children and adolescents of different ages and those with movement and balance abnormalities.

Adolescent↗
PubMed2002

Postural balance in children with cerebral palsy.

Postural control deficits have been suggested to be a major component of gait disorders in cerebral palsy (CP). Standing balance was investigated in 23 ambulatory children and adolescents with spastic diplegic CP, ages 5 to 18 years, and compared with values of 92 children without disability, ages 5 to 18 years, while they stood on a force plate with eyes open or eyes closed. The measurements included center of pressure calculations of path length per second, average radial displacement, mean frequency of sway, and Brownian random motion measures of the short-term diffusion coefficient, and the long-term scaling exponent. In the majority of children with CP (14 of 23) all standing balance values were normal. However, approximately one-third of the children with CP (eight of 23) had abnormal values in at least two of the six center of pressure measures. Thus, mean values for path length, average radial displacement, and diffusion coefficient were higher for participants with CP compared with control individuals with eyes open and closed (p<0.05). Mean values for frequency of sway and the long-term scaling exponent were lower for participants with CP compared with control participants (p<0.05). Increased average radial displacement was the most common (nine of 23) postural control deficit. There was no increase in abnormal values with eyes closed compared with eyes open for participants with CP, indicating that most participants with CP had normal dependence on visual feedback to maintain balance. Identification of those children with impaired standing balance can delineate factors that contribute to the patient's gait disorder and help to guide treatment.

Adolescent↗
PubMed1995

An optimal control model for analyzing human postural balance.

The question posed in this study is whether optimal control and state estimation can explain selection of control strategies used by humans, in response to small perturbations to stable upright balance. To answer this question, a human sensorimotor control model, compatible with previous work by others, was assembled. This model incorporates linearized equations and full-state feedback with provision for state estimation. A form of gain-scheduling is employed to account for nonlinearities caused by control and biomechanical constraints. By decoupling the mechanics and transforming the controls into the space of experimentally observed strategies, the model is made amenable to the study of a number of possible control objectives. The objectives studied include cost functions on the state deviations, so as to control the center of mass, provide a stable platform for the head, or maintain upright stance, along with a cost function on control effort. Also studied was the effect of time delay on the stability of controls produced using various control strategies. An objective function weighting excursion of the center of mass and deviations from the upright stable position, while taking advantage of fast modes of the system, as dictated by inertial parameters and musculoskeletal geometry, produces a control that reasonably matches experimental data. Given estimates of sensor performance, the model is also suited for prediction of uncertainty in the response.

Biomechanical Phenomena↗
PubMed1996

Postural balance and its sensory-motor correlates in 75-year-old men and women: a cross-national comparative study.

BACKGROUND: There are no earlier cross-national comparative studies analyzing the functions of the posture control mechanisms and its sensory-motor correlates in elderly subjects. We investigated whether there are differences in balance between elderly subjects living in different geographical areas, and analyzed the sensory-motor associates of balance in men and women separately. METHOD: Using a force platform method, the functioning of the posture control system under three standardized conditions (normal standing, eyes open; normal standing, eyes closed; and tandem standing, eyes open) was studied among samples of 75-year-old residents in three Nordic localities, namely Glostrup in Denmark, Göteborg in Sweden, and Jyväskylä in Finland. The associations of the variables describing performance in each test with other sensory and motor functions were studied using correlation analyses and multivariate regression models. RESULTS: Differences between the populations were observed in both tests with visual control, favoring the participants from Glostrup and Jyväskylä compared with those from Göteborg. However, only minor differences between the subjects from different localities were observed in the test performed with the eyes closed. In all localities there was a primary sex difference in favor of the women which, however, mainly disappeared when body height was taken into the analyses as a covariate. A good performance in the balance tests (body height-adjusted values) was associated with good visual acuity, low vibrotactile thresholds, and high psychomotor speed. Also, isometric muscle strength, especially hand grip and body extension, was positively associated with good performance in the balance tests. Among the women, a poorer balance was observed in women with a smaller body mass. The results of the multivariate analyses showed that among the men, the most important predictors of good performance in the balance tests were low vibrotactile threshold on the foot, high isometric hand grip strength, and low body stature. Among the women, the most important predictors were low body stature, high body mass, high isometric body extension strength, and high psychomotor speed. However, only a small proportion of the variance in balance (about 13% in the men and 11% in the women) could be explained by the help of these factors. CONCLUSIONS: As the same procedure was applied to the analysis of postural balance, some differences between the populations living in different localities could be detected in some of the tests. The better performance of the women in the balance tests may partly be explained by anthropometric factors, especially differences in body height. There may also be differences in sensory-motor associates of balance in elderly men and women. On the basis of the associations observed, it is difficult to explain the differences in balance between the sexes or subjects living in different localities. Within the sexes, only a small proportion (10-13%) of the variation in balance during normal standing with eyes open could be explained by the factors included in the study.

Aged↗
PubMed2006

Postural balance changes in on-duty firefighters: effect of gear and long work shifts.

OBJECTIVE: The objective of this study was to investigate the impact of long work shifts and turnout gear, including the self-contained breathing apparatus (SCBA) on firefighters' postural stability. METHODS: Sixteen firefighters were assessed using a portable forceplate system at the fire station. Postural sway parameters were recorded at the beginning of the work shift and repeated until the work shift ended. RESULTS: Task had the greatest impact on postural stability for all sway parameters. Turnout gear, with and without SCBA, improved postural stability. Postural stability decreased as firefighters spent more time on duty. CONCLUSIONS: Prolonged work shifts may be an important contributor to the high prevalence of slips and falls among firefighters. In all, the results indicate that many aspects of the firefighters' job may adversely impact their postural stability and potentially increase the risk of falling.

Adult↗
PubMed2004

Relationship between postural balance and knee and toe muscle power in young women.

Muscle power in the lower extremities and body sway were measured in 57 healthy young women volunteers in their 20's. Body sway was measured with a stabilimeter for 30 sec during two-leg standing, and for 10 sec during one-leg standing with the eyes open or closed, alternating between right and left legs (5 times each). The measured parameters of body sway were locus length per time unit, locus length per environmental area, environmental area, rectangle area, root mean square area, and the ratio of sway with eyes closed to sway with eyes open. Knee flexor and extensor power and toe flexor and abductor power were the measures representing lower extremity muscle power. The increase in sway with the eyes closed was more marked during one-leg standing than two-leg standing, as expected. We found that 36 of 57 subjects (62%) were unable to maintain one-leg standing with their eyes closed, and this failure correlated with marked body sway (P = 0.0086). Many subjects had one leg that was classified as stable and the other leg classified as unstable. Clearly, testing of both legs alternately with eyes closed is necessary to measure the full range of sway in subjects. Lower extremity muscle power did not appear to be the dominant factor in maintaining balance in these young subjects.

Adult↗
PubMed2005

Critical dose of lead affecting postural balance in workers.

BACKGROUND: The threshold blood lead (BPb) level for nervous system dysfunction in adults has been estimated to be 30-40 microg/dl. This study was carried out to estimate the critical dose of lead affecting the neuromotor function in workers by introducing the benchmark dose (BMD) approach, as well as to identify the specific postural sway to lead exposure. METHODS: Postural sway parameters with spectral analysis were compared between 121 lead workers with BPb levels of 6-89 (mean 40) microg/dl and 60 unexposed controls. RESULTS: All sway parameters, except for sagittal sways with eyes open, were significantly larger in the lead workers than in the controls; also, the Romberg quotient for sagittal sway was significantly higher in the lead workers. The BPb level in the lead workers was significantly related to sagittal sways at 1-2 Hz and 2-4 Hz with eyes open, and sagittal and transversal sways at 1-2 Hz and 2-4 Hz with eyes closed. The BMD levels of BPb (i.e., lower 95% confidence limits of BMD) were estimated to be 12.1-17.3 (mean 14.4) microg/dl for postural sway. CONCLUSIONS: Neuromotor dysfunction in lead workers may be initiated at BPbs below the level previously accepted as effectless, and be characterized mainly by an increased sway of high frequency (1-4 Hz) in the sagittal direction with eyes closed (high Romberg quotient).

Case-Control Studies↗
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↗
PubMed1980

Aldosterone regulation in primary aldosteronism: influence of salt balance, posture and ACTH.

The response of aldosterone to manipulations of the renin-angiotensin and hypothalamic-pituitary-adrenal systems has been studied in thirteen patients with primary aldosteronism due to a single adenoma (ten patients) or bilateral hyperplasia (three patients). The aldosterone response to dietary sodium restriction was small and variable, although urinary aldosterone excretion increased in nine out of twelve studies. The response of patients with hyperplasia could not be distinguished from those with adenoma. All patients were unresponsive to salt loading. By contrast, plasma aldosterone fell in all patients after overnight dexamethasone (1 mg) and increased after brief (1 h) physiological ACTH stimulation. During prolonged erect posture, plasma aldosterone increased in the three patients with hyperplasia and decreased or remained unchanged in patients with ademona. Changes in plasma renin activity were similar in both groups. These studies show that patients with primary aldosteronism, while largely unresponsive to manipulations of sodium balance, retain sensitivity to small and acute changes in ACTH. The different behaviour of patients with hyperplasia to prolonged erect posture cannot be explained by insensitivity to ACTH, but could be due to a relative increase in sensitivity to angiotensin.

Adenoma↗