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PubMed2006

[Production of a fall prevention exercise programme considering suggestions from community-dwelling elderly].

OBJECTIVES: A fall prevention exercise programme, which elderly persons could undertake in their home alone to maintain and improve leg muscle strength, body balance ability and flexibility, was developed. The programme consisted of number of movements from which the best were selected on the basis of participant evaluation. The purpose of this report is to document the actual contents and an examination of the effects of this exercise programme in elderly people. METHODS: A total of 551 elderly persons, aged 75 years and over, not needing the support of elderly care insurance in S town, Miyagi Japan, were the subjects of this study. An intervention area and a non-intervention area were set in the study region. In the intervention area, 85 elderly people of high-risk for falls were selected to perform a longitudinal intervention study for one year. The selection criteria were as follows: 1) Maximum walking speed slower than median value, 2) Falls had been experienced in the past year. Forty elderly persons (15 men and 25 women) participated in the class. Thirty movements designed to improve flexibility, leg muscle strength, and body balance, and to prevent tripping were executed and evaluated. Effects of this intervention on participants in the fall prevention class were examined using a follow-up survey one year after the baseline survey. The outcome of the fall prevention exercise programme was measured in terms of incidence of falls. RESULTS: A final fall prevention exercise programme consisting of ten movements was produced by the intervention. In addition, seven movements using a chair were part of the exercise programme. METS of the exercise programme for students, leaders, and elderly persons were 3.41 +/- 0.37, 3.16 +/- 0.47, and 3.08 +/- 0.4, respectively. The incidence of falls over one year of the participants in the class significantly decreased from 48.4% at baseline survey to 25.8% at follow-up survey, but that of non-participants did not change. One-leg standing times with eyes open of the female participants significantly extended from the baseline survey to the follow-up survey, but not that of non-participants. CONCLUSIONS: This result of intervention suggested that incidence of falls was decreased by the execution of the exercise programme in twelve sessions of fall prevention class and at home.

Accidental Falls↗
PubMed1975

Response of institutionalized geriatric mental patients to a twelve-week program of regular physical activity.

Twenty-three geriatric patients from a mental institution were randomly assigned to three groups-a social group, an exercise group, and a control group. Subjects participated in the study for 12 weeks. Heart rate at rest, exercise and recovery, balancing ability, total daily activity level (diary method), and a self-care inventory were recorded for analysis. Data were collected at the start, the 8th and 12th weeks of the study, and 4 weeks after the termination of treatment. A Groups X Sex X Measurement Period factorial design, using multivariate analysis of variance tested the effect of the three factors. The trials effect was significant, as were several univariate tests for the sex effect and group by sex interaction. Data were discussed in terms of programmed physical activity for geriatrics, its value, and the limitations of evaluating such behavior in geriatric populations.

Activities of Daily Living↗
PubMed2005

Development of a quantitative assessment system for correlation analysis of footprint parameters to postural control in children.

It is known that neurological impairments impact postural stability, but few studies have observed the biomechanical influence of foot structure on balance. The aim of this study was to develop an integrated device for investigating the relationship between static balance and the foot structure, derived from a footprint image, under clinical tests of sensory interactions. Quantitative analysis of the footprint image acquired during balanced standing was developed as an indirect measure of the longitudinal arch, an important structural component of the foot. A data pool was collected from 64 children, 32 children from each of two age groups (4-5 years old versus 8-10 years old). Six common footprint parameters derived from the footprint angle or contact area were used to investigate the relationship between footprint parameters and postural stability. Postural balance ability was evaluated by analyzing sway area in posturography under visual or somatosensory confliction conditions. The footprint parameters, derived from the footprint image, inter-correlated well with each other (p < 0.01). The relationships between footprint parameters and sway area were correlated only for younger children under visually deprived (eye close) and cutaneous unreliable (standing on compliant foam) conditions. This implies that the correlations between footprint parameters and sway area are very subtle which can only be observed in unreliable visual and somatosensory conditions of younger children. In addition, younger children with a lower arch height would have a smaller sway area and better posture control which might result from more cutaneous somatosensation or a flexible biomechanical structure in low arch feet during conditioned static standing.

Child↗
PubMedDate not supplied

Physical function and health status among seniors with and without a fear of falling.

BACKGROUND: Fear of falling (FF) is pervasive among older people and is an independent risk factor for decreased mobility and loss of quality of life. Although it is a serious health concern, little is known about the severity of the physical and health-related deficits in high-functioning fearful seniors. OBJECTIVE: This study examined the physical correlates of FF in community-dwelling seniors in relation to their non-fearful counterparts and also explored the relevance of recent fall history. SUBJECTS: Twenty-five volunteers who stated that they had curtailed their activities due to a FF and who reported themselves to be healthy participated. Non-fearful, age- and gender-matched subjects were also recruited and served as a comparison group. METHODS: This cross-sectional study had participants come to the laboratory on one occasion for about 1.5 h. Limits of balance stability, walking speed, and lower limb muscle strength were measured in random order. In addition, the SF-36, the Activities-specific Balance Confidence (ABC) scale and the Human Activity Profile questionnaires were completed to provide measures of heath status, FF and activity levels, respectively. RESULTS: Subjects with a FF had lower ABC scores (69.8 +/- 10.2) than controls (90.2 +/- 7.9; p < 0.001), and although they reported activity curtailment, the groups presented similar activity profiles (p > 0.05). Balance ability was not compromised in seniors with a FF, although their walking speed was slower than that of control subjects (p < 0.004). Lower limb weakness was significant in the FF group, which also reported low physical health. Perceived physical health, activity and hip flexor torque in combination accounted for almost 62% of the variance in ABC scores. Secondary analysis of the data from the FF group revealed a tendency for those who had fallen in the past year to restrict their limits of stability compared to those who had not fallen; though generally the effect sizes were small to moderate. CONCLUSIONS: The marked deficits in strength and health status found among seniors living independently in the community, who are in good health, but report being fearful of falling underscores the seriousness of FF as a potential health risk factor in the well elderly.

Accidental Falls↗
PubMed2002

Attentional demands for static postural control after stroke.

OBJECTIVE: To assess the attentional demands associated with postural control among people who have had a stroke. DESIGN: Nonrandomized matched case-control study. SETTING: University research laboratory in Canada. PARTICIPANTS: Six individuals who had suffered a left or right cerebral ischemic attack in the past year and a sample of 6 age- and gender-matched controls. Participants in the stroke group had a mean age of 64.17+/-13.14 years; control participants had a mean age of 64.00+/-13.91 years. Mean National Institute of Health Stroke Scale scores for these patients were 7.67+/-4.92 at the time of stroke and 1.66+/-1.36 at the time of testing. None of the patients were taking medications that would alter cognitive status or balance abilities. INTERVENTION: Participants performed a verbal reaction-time test while engaged in 3 postural tasks (sitting, standing, standing with feet together). MAIN OUTCOME MEASURE: Reaction time: latency between visual stimulus and verbal response. RESULTS: Reaction times in the stroke group differed significantly in all conditions from the controls (410+/-72 ms vs 320+/-54 ms, P<.01). A significant interaction was found between group and postural task (P=.05), with reaction-time scores showing a progressive increase in postural task difficulty among participants who had suffered a stroke. Post hoc comparisons revealed that sitting reaction-time scores were significantly slower than reaction-time scores for feet together standing (P=.008) among participants in the stroke group. CONCLUSION: Individuals who have suffered a stroke showed increased attentional demands for tasks of static postural control compared with healthy, age-matched participants.

Aged↗
PubMed2006

Relationship between balance performance and musculoskeletal pain in lower body comparison healthy middle aged and older adults.

The purpose of this study was to determine relationship between balance performance and pain in lower body among healthy adults. Two hundred and forty volunteer subjects (125 middle aged and 115 elderly people) aged 50 years and above participated. The average age was 61.52+/-8.22 years (range 50-75 years). The functional reach test (FRT) was used to measure balance ability. The visual analog scale (VAS) was used to measure pain intensity. Subjects were also asked to indicate sites they experienced pain in their lower body (e.g., low back, hip, knee, ankle, toes). Falls history was also recorded. The elderly people had a lower FRT score as compared to the middle-aged adults (p<0.001). Knee, low back, and hip pain were most common in both groups. The elderly people reported more frequency of falls than the middle-aged adults. The score of the FRT was higher among men (20.67+/-7.16cm) than among women (18.77+/-6.59cm). In both groups; the women had a higher VAS score than those of matched the men. Although the middle-aged adults had higher and better scores than the elderly people, the data showed that the middle-aged adults are also at risk and should be prepared properly for healthy aging.

Aged↗
PubMed2003

[Influence of visual cues on upright postural control: differentiated effects of eyelids closure].

In most protocols aimed at testing balance abilities, patients are generally required to close their eyes in order to gain insight about proprioceptive cues and the way the central nervous system (CNS) uses this information. However, one should not exclude possible interaction with the physiological mechanisms involved in eyelid closure, thus leading to a biased neurological evaluation. To assess this possible involvement, 15 healthy adults were required to keep their eyes open in the dark (YOn), to close normally (YF) and forcibly their eyelids (YFF), respectively in random order. The analysis was focused on elementary motions computed from the complex center of pressure (CP) trajectories, i.e. the horizontal motions of the center of gravity (CG(h)) and the difference between the CP and the vertical projection of the center of gravity (CP-CG(v)). The former is recognized as the main variable in postural control whilst several interesting features can be extracted from the latter: their link with the horizontal accelerations communicated to the CG, the level of muscular activity and the implied ankle stiffness expressed by their frequential distribution. The results indicate that the amplitudes of the CP-CG(v) spectra are statistically reduced in YOn when compared to the YF condition, especially in the antero-posterior direction. On the other hand, no shift in the frequential bandwidth was observed on these spectra, signifying a constancy in ankle stiffness over all conditions. Interestingly, the CNS does not really seem to gain from these reduced horizontal accelerations at the CG level since the CG(h) amplitudes are only slightly reduced. However, it is important to emphasize that the CP trajectories alone are not able to demonstrate any statistical trend. It can thus be hypothesized that, despite the fact that visual information is still unavailable, the proprioceptive cues nonetheless continue to play a minor role in the detection-correction process aimed at controlling body sway. Past studies on the physiology of eyes blinking have suggested the probability that the cerebellar cortex or brain stem structures (such as the reticular formation) are involved in these commands. Because of its dual facilitating-inhibiting function, the latter is indeed a fair candidate for modulating the descending command operating through the postural muscles. These data are of interest for the practician in order to assess with precision the role played by proprioceptive and visual cues in possible balance disfunctioning.

Adult↗
PubMed2026

Effects of digital health-based exercise interventions on older adults with sarcopenia: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Sarcopenia, the progressive loss of muscle mass and function, impairs independence in older adults. Digital health exercise interventions are scalable solutions for older adults with sarcopenia. This systematic review and meta-analysis aimed to synthesize the evidence on their efficacy in populations with clinically diagnosed sarcopenia and identify influential intervention characteristics associated with treatment outcomes. METHODS: We systematically searched PubMed, EMBASE, Web of Science, Cochrane Library, CINAHL, CNKI, and Wanfang on May 20, 2026, with no date restrictions. We included randomized controlled trials involving adults aged &#x2265;60 with sarcopenia receiving digital exercise interventions. Two reviewers independently screened studies, extracted data, and assessed risk of bias; analyses were performed using R and Review Manager. RESULTS: Fourteen trials (n&#xa0;=&#xa0;927) were included. Digital interventions showed potential improvements in muscle mass (MD&#xa0;=&#xa0;0.25, 95%CI:0.03-0.46, 95% PI:-0.36 to 0.85), muscle strength (MD&#xa0;=&#xa0;2.14, 95% CI:1.18-3.11, P&#xa0;<&#xa0;0.001), balance ability (SMD&#xa0;=&#xa0;0.31, 95% CI:0.12-0.51, P&#xa0;=&#xa0;0.001), walking performance (SMD&#xa0;=&#xa0;0.55, 95% CI:0.21-0.89, 95% PI:-0.70 to 1.79), and physical function (SMD&#xa0;=&#xa0;0.89, 95% CI:0.08-1.71, 95% PI:-2.33 to 4.12), but not quality of life (SMD&#xa0;=&#xa0;0.08, 95% CI:-0.19 to 0.35, P&#xa0;=&#xa0;0.53). Exploratory subgroup analyses suggested that factors such as supervision, program duration, and measurement tools may influence outcomes; however, formal tests for subgroup differences were generally non-significant, and consistent patterns across all metrics were not observed. CONCLUSION: Digital exercise interventions show potential for managing sarcopenia in older adults, though the very low to moderate certainty of evidence indicates that true effects may differ substantially from observed estimates. This review explores potential roles of intervention design, supervision, and multimodal delivery. Future research should adopt rigorous designs and longer follow-up to validate results and enhance clinical application. TRIAL REGISTRATION: PROSPERO CRD420251135174.

Humans↗
PubMed1977

Neurological and behavioral effects of intracranial administration of mercuric chloride on rats.

Mercuric chloride was injected intracranially into the rat brain in the region of the fourth ventricle via the foramen magnum. Responses to a single treatment of 0.3 mg/kg HgCl2, 0.03 mg/kg HgCl2, or carrier solution were followed for 10 days. Changes in the rats' behavior and motor coordination were observed 24-48 hr after treatment with HgCl2. Underwater swimming and decreased grooming and feeding were characteristic of mercury-treated rats. Decreased balancing ability and crossing of hind limbs suggested altered motor coordination. Rats treated with mercury often exhibited decreased body temperature, matting of fur about the eyes and perineal region, apparent visual impairment, decreased body weight, and diarrhea.

Animals↗
PubMed2004

Aging-induced shifts from a reliance on sensory input to muscle cocontraction during balanced standing.

BACKGROUND: Peripheral sensation is the most important sensory system in the maintenance of upright posture in all age groups. With aging, visual and somatosensory processing change their prospective contribution to the maintenance of quiet standing, at debated percentages. Aging is associated with a decrease in balance abilities that, in turn, increases the risk of falling. We used force plate data to show that, with aging, while vision plays a significant role in regulating postural stability (PS), the individual's perception of his/her stability becomes more significant than vision. Moreover, under experimental conditions, electromyography (EMG) of the ankle musculature of elderly people reveals the adoption of a different strategy, a cocontraction strategy, with or without visual input. The aim of this study was to look at two distinct age groups to determine whether or not a shift takes place in the sensory modality typically relied on while maintaining PS during a static, postural-related task. METHOD: The participants comprised two groups: a "young" (Y) group of 20 people aged 20-35, and an "old" (O) group of 32 people aged 65-84. The role of vision was tested with regard to two differently sized bases of support. They were tested during quiet upright standing on a single force plate in wide base and then in narrow base conditions. Surface EMG was recorded from the tibialis anterior, soleus, rectus femoris, and semitendinous muscles. RESULTS: The older group differed from the younger group when performing the task under the narrow base condition. When participants stood naturally, our EMG data indicated that, unlike the Y group, the O group used cocontraction around the ankle in order to deal with changing conditions and sensory inputs. Significant increases were found in the area, length, and mean velocity of body sway in the older group as compared with the younger group. DISCUSSION: The visual contribution to postural stabilization is significantly greater in the younger population than in the elderly population. Across the older group, lack of vision seemed to interfere less with PS; however, the EMG data indicated that, unlike the Y group, the O participants used cocontraction around the ankle in order to deal with changing conditions and sensory inputs. CONCLUSION: To cope with the deterioration in their sensory input and processing ability, elderly individuals seemed to have developed a strategy of stiffening and freezing their lower legs during upright standing.

Adult↗
PubMedDate not supplied

Residual effects of a traumatic brain injury on locomotor capacity: a first study of spatiotemporal patterns during unobstructed and obstructed walking.

OBJECTIVES: To understand the residual locomotor effects of a traumatic brain injury (TBI) on unobstructed and obstructed walking. PARTICIPANTS: Eight young, high-functioning adults with TBI and 4 healthy subjects. MAIN OUTCOME MEASURES: Spatiotemporal gait parameters and their relation to specific clinical measures of severity and locomotor and balance abilities. RESULTS: Subjects with TBI walked slower and showed a tendency for greater foot clearances in all conditions. Slower walking was due to decreased stride lengths and not cadence, while higher foot clearances were due to placing the trailing foot farther from the obstacle and increasing hip flexion angles during avoidance. CONCLUSIONS: The results suggest that this highly functional TBI population used increased caution. Measures of injury severity did not provide simple predictions of locomotor ability, but the one-legged stance test with eyes closed correlated to walking capacity.

Adult↗
PubMed2003

Injections of the neuroprotective peptide NAP to newborn mice attenuate head-injury-related dysfunction in adults.

The prophylactic neuroprotective effects of NAP, a femtomolar-acting neuroprotective peptide were tested in a mouse model of head trauma. NAP was injected for the first 3 weeks of life and head injury was initiated at 4 months. After trauma, mice were tested for their performance by evaluating damaged motor ability, balance and alertness. Comparison of the performance 1 h and 1 week after injury indicated that NAP treatment resulted in faster and enhanced recovery. In a 5-day Morris water maze test with mice suffering moderate to severe injuries, only the NAP-treated group learned to find the hidden platform in the maze. Furthermore, NAP treatment resulted in decreased mRNA expression of the inflammation marker, Mac-1. Thus, a potentially new prophylactic treatment against neurodegeneration is suggested.

Aging↗
PubMed2006

The effect of exercise of the affected foot in stroke patients--a randomized controlled pilot trial.

OBJECTIVE: To evaluate the effect of treatment with a portable device called Stimulo on range of motion, muscle strength and spasticity in the ankle joint and its effect on walking ability, balance, activities of daily living (ADL) and health-related quality of life in stroke patients. DESIGN: A randomized controlled pilot study. SETTING: A research centre. SUBJECTS: Ambulatory or partly ambulatory chronic stroke patients with remaining spasticity and/or decreased range of motion in the hemiparetic leg/ankle. INTERVENTIONS: Standardized and individualized programme including active and passive range of motion of the ankle with a portable device (Stimulo), performed three times a week for 30 min, over a six-week period. MAIN MEASURES: Range of motion, muscle strength, spasticity, gait variables, balance, ADL and health-related quality of life. RESULTS: Eighteen subjects were included in the study with a mean age of 75 years. The compliance rate was 94-99%. There were no significant differences between the groups. CONCLUSION: The study showed no significant effect of an ankle-exercise intervention programme with Stimulo. Further studies with a larger sample size are of importance before any further conclusions can be drawn.

Aged↗
PubMed2005

Relationship between the type of urinary incontinence and falls among frail elderly women in Japan.

Urinary incontinence and falls are serious problem among elderly people, because of restriction of the Activities of Daily Living (ADL) and Quality of Life. Previous studies have examined the association between urinary incontinence and falls. However, results have been inconsistent. In Japan, with the rapid aging of the society, the number of elderly women who have urinary incontinence and are at risk of falling is increasing. We investigated the relationship between type of urinary incontinence and risk of falls among elderly users of day-care services in a long-term care system. Our study population comprised 118 ambulatory women. At baseline, we evaluated incontinent status, lower extremity muscle strength, balance ability, ADL, and Instrumental ADL. We asked subjects about number of falls every 4 months during a year. In univariate analysis, lower extremity muscle strength (p = 0.001) and mixed incontinence (p = 0.050) differed significantly according to the fall status. Stress and urge incontinence were not significantly associated with falls. In logistic regression analysis, subjects who had mixed incontinence were 3.05 (95% confidence interval 1.01-10.2) times more likely to fall than those without. These results suggest that mixed incontinence have independent associations with falls. Incontinent status should be considered to prevent falls among elderly persons who are partially dependent and need support.

Accidental Falls↗
PubMed1998

Effectiveness of external ankle support. Bracing and taping in rugby union.

Ankle inversion sprain is common in rugby. This review outlines research evidence relating to the effects of external ankle support by means of bracing and taping, on the incidence of ankle injuries, how performance is affected by support, how support may act at the joint (with respect to end range of motion, strength, resistive torque, muscle activation patterns and proprioception) to prevent injury, and how exercise changes the effectiveness of support. In addition, the implications of the laws of rugby for the use of external support are discussed. Prospective epidemiological studies have shown a decrease in the incidence of ankle injury with external ankle support use. The effectiveness of external ankle support was dependent upon the material properties and application method of the tape or brace, and on the athlete's status of ankle stability or previous injury. Experimental studies have indicated that the degree of ankle inversion restriction provided, and the degree of loss of restriction after exercise, were dependent upon the external support tested. External ankle support has been reported to have no effect on performance, or to have an adverse effect on performance in a variety of movement tasks. No prophylactic external ankle support has been shown to improve performance. If an external support is to provide mechanical support to a ligament it should exceed the strength of the ligament, which for the anterior fibular ligament is a force limit of between 6 and 56 kg. Tape can provide only limited mechanical support of the ankle joint complex, but it may have proprioceptive effects. Taping may work as a psychological reminder, so that the athlete consciously moderates lower limb-loading behaviour. There is equivocal evidence of the effect of brace use on ground reaction force excursions, balance ability and ankle strength. It is concluded that while there have been many investigations of the effects of tape and some forms of brace on ankle range of motion with and without exercise, there is equivocal evidence regarding the mechanism by which an external support acts. It is recommended that future research address the effects of external ankle support during dynamic exercise and that brace manufacturers utilise the information in the development of future brace designs to help reduce the risk of ankle inversion sprain injury. As external support can decrease the incidence of ankle inversion sprain the International Rugby Board should consider the use of ankle braces in rugby, allowing for stiff lateral components of the brace.

Ankle↗
PubMed2004

Safety of Curcuma aromatica oil gelatin microspheres administered via hepatic artery.

AIM: To evaluate the safety of Curcuma aromatica oil gelatin microspheres (CAO-GMS) infused via hepatic artery against primary liver cancer. METHODS: The safety of CAO-GMS was evaluated in view of its acute toxicity in rats, long-term toxicity in Beagle dogs and general pharmacology in rats and mongrel dogs. RESULTS: The 50% lethal dose (LD50) of CAO-GMS infused via the hepatic artery was 17.19 mg/kg, and the serum biochemical indices of dying rats after the administration changed markedly while those of survived rats did not. Subsequent pathological examination of the tissues from the dead rats indicated improper embolism. Similar edema and small necrotic foci in the hepatic lobule were found in the hepatic tissue of rats receiving 10 and 5 mg/kg CAO-GMS and GMS 60 d after the last administration, while not in the rats of the blank control group, indicating that microspheres infused via the hepatic artery may induce irreversible liver damage dose-dependently. General pharmacological study showed that the activities (posture and gait), respiration frequency, blood pressure or heart rate of the dogs were not affected by CAO-GMS, nor were salivation, tremor or pupil changes of the rats observed or their balancing ability compromised, suggesting CAO-GMS infused via the hepatic artery did not significantly affect the nervous, respiratory and cardiovascular systems. CONCLUSION: CAO-GMS embolization administered via the hepatic artery is safe but undesired embolization induced by vascular variation should be given due attention in its clinical application. Individualized embolization dosage and super-selective catheterization technique are recommended to avoid undesired embolism and reduce complications.

Acute Disease↗
PubMed2004

Performance on the Balance Error Scoring System Decreases After Fatigue.

OBJECTIVE: To determine the immediate effects of a whole-body fatigue protocol on performance of the Balance Error Scoring System (BESS), a postural-stability test commonly used as part of a concussion-assessment battery. DESIGN AND SETTING: Subjects were assigned to a fatigue or control group and were assessed before and immediately after a 20-minute fatigue protocol or rest period. SUBJECTS: Fourteen fatigue subjects and 13 control subjects participated in this study. All subjects were male and free of vestibular disorders, and none had suffered a mild head injury or lower extremity injury in the preceding 6 months, as described through self-report. MEASUREMENTS: We measured performance on the BESS for 9 stance-surface conditions and summed each condition to obtain a total score. Using the Borg scale, we also measured ratings of perceived exertion before, during, and after the fatigue protocol or rest period. RESULTS: We found a significant increase in total errors from pretest to posttest in the fatigue group (14.36 +/- 4.73 versus 16.93 +/- 4.32), a significant decrease in errors in the control group (13.32 +/- 3.77 versus 11.08 +/- 3.88), and a significant difference between groups on the posttest. The rating of perceived exertion scores were significantly different between the fatigue and control groups at the middle (13.29 +/- 1.59 versus 6.23 +/- 0.83) and end (15.86 +/- 2.38 versus 6.15 +/- 0.55) of the fatigue or rest period. CONCLUSIONS: The BESS error scores increased immediately after the fatigue protocol, demonstrating that balance ability diminished. Clinicians who use the BESS as part of their sideline assessment for concussion should not administer the test immediately after a concussion due to the effects of fatigue.

Journal Article↗