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 163 records · Page 9Linked to original sources

PubMed2000

The reliability of balance tests performed on the kinesthetic ability trainer (KAT 2000).

The Kinesthetic Ability Trainer (KAT 2000) is a balance platform designed for training and functional testing of the neuromuscular control system. Forty healthy and sports-active persons were tested and 1 month later retested to investigate the reliability of the KAT 2000 testing "one-leg static balance" and "two-leg dynamic balance". A significant improvement at retesting on the same day was seen in both tests; furthermore the dynamic test result improved significantly with retesting 1 month later. The data obtained made it possible to calculate the 95% confidence limits for an unchanged test result for a single person and a group of persons. The results show a clear learning effect when the persons are retested, especially in the dynamic test. The KAT 2000 can be used as a tool for testing groups of persons both in short- and long-term studies, but it cannot be used for testing single persons due to the great variance in the test results. Further investigations involving injured persons are needed to determine the range of improvement after intervention.

Adolescent↗

PubMed1984

Decrease in timed balance test scores with aging.

This study investigated whether 184 volunteers from 20 to 79 years of age could perform eight timed balance tests and examined the relationship between test performance and age. All subjects were able to balance with their feet together and eyes closed for 30 seconds. The ability to balance on the right and left legs did not differ significantly. Subjects over 60 years of age were unable to balance on one leg, particularly when their eyes were closed, for as long a period as younger subjects. The Pearson product-moment and Spearman correlations of age and duration of one-legged balance were -.65 and -.71 (eyes opened) and -.79 and -.75 (eyes closed). The findings suggest that when timed balance tests are performed as a part of a patient's neurologic examination, the results should be interpreted in light of the patient's age. Information is provided to assist in this interpretation.

Adult↗

PubMed1987

Quality assurance and risk management in small and rural hospitals: the roles of trustees, administration, and medical staff.

Small and rural hospitals have unique considerations that affect their approach to quality assurance (QA) and risk management (RM). These concerns include proportionately high fixed costs, small patient loads that limit their ability to balance profits and losses from Medicare patients, small medical staffs that limit their ability to provide peer review, and the general increase in malpractice litigation. QA and RM programs are critical to the survival of these hospitals, but they should be integrated as much as possible with other hospital activities.

Financial Management↗

PubMed2005

Deep venous thrombosis prophylaxis: better living through chemistry--in opposition.

The best prophylactic regimens for thromboembolic disease continue to be debated despite years of investigation. The surgeon must balance the clinical risks and benefits. A decision depends on accurate data and our ability to balance the risks of fatal pulmonary embolism (PE) to the risk of bleeding. The current risk for fatal PE is 0.1% with most current prophylactic regimes. The risk of perioperative bleeding increases 1.8% to 5.2% with low molecular weight heparins or warfarin and generally is dose dependent. Most of the current prophylactic recommendations are based on the presence or absence of deep venous thrombosis (DVT). However, the correlation between the presence of a DVT and the risk of PE is low and inconsistent. Therefore, DVT may not be an accurate surrogate marker for the patient at risk after total joint surgery. Our experience with 2800 consecutive total knee arthroplasty patients, using aspirin as our principle agent, shows a fatal PE risk of 0.1% and a low risk of bleeding. Therefore, our current recommendation is aspirin.

Anticoagulants↗

PubMed2002

Physiological, metabolic, and performance implications of a prolonged hill walk: influence of energy intake.

We aimed to examine the effects of different energy intakes on a range of responses that are relevant to the safety of hill walkers. In a balanced design, 16 men completed a strenuous self-paced mountainous hill walk over 21 km, under either a low-energy (2.6 MJ; 616 kcal) intake (LEI) or high-energy (12.7 MJ; 3,019 kcal) intake (HEI) condition. During the hill walk, rectal temperatures were measured continuously, and blood samples for the analysis of metabolites and hormones were drawn before breakfast and immediately after the walk. Subjects also completed a battery of performance tests that included muscular strength, reaction times, flexibility, balance, and kinesthetic differentiation tests. During the LEI, mean blood glucose concentrations leveled off at the low-middle range of normoglycemia, whereas, on the HEI, they were significantly elevated compared with the LEI. The maintained blood glucose concentrations, during the LEI, were probably mediated via the marked fat mobilization, reflected by a two- to fivefold increase in nonesterified fatty acids, 3-hydroxybutyrate, and glycerol concentrations. The LEI group showed significantly slower one- and two-finger reaction time, had an impaired ability to balance, and were compromised in their ability to maintain body temperature, when compared with the HEI group. The modestly impaired performance (particularly with respect to balance) and thermoregulation during the LEI condition may increase susceptibility to both fatigue and injury during the pursuit of recreational activity outdoors.

Adult↗

PubMed2000

The transformative process of residency education.

The author explores a model for transformative learning proposed by the education scholar Victoria Marsick. He begins by outlining Marsick's eight principles (or outcomes) of transformative learning: increased autonomy; increased independence; the ability to separate one's feelings and opinions from those of others; the ability to critically and respectfully examine the views of others; the ability to set personal and professional goals; the ability to see how one's actions affect the system in which one works; the ability to balance and choose among conflicting priorities and at some point transcend self-interest; and the ability to acknowledge one's role in constructing one's reality. Using illustrative examples from his experiences as a resident and a teacher of residents, the author describes each principle of the transformative model. He then suggests how educators can use these principles to ensure a transformative residency experience by which novice professionals become reflective and confident practitioners.

Clinical Competence↗

PubMed1997

Age differences in using a rapid step to regain balance during a forward fall.

BACKGROUND: Earlier studies showed that healthy old adults have substantially reduced abilities to develop joint torques rapidly. We hypothesized that this age decline would reduce abilities to regain balance once a forward fall is underway. The present study examined whether aging in fact reduces ability to regain balance by taking a single, rapid step upon release from a forward lean. METHODS: Ten young (mean age 24.3 yr) and ten old (72.8 yr) healthy males were released from a forward-leaning position and instructed to regain standing balance by taking a single step forward. Lean angle was successively increased until a subject failed to regain balance as instructed. Lower extremity motions and foot-floor reactions were measured during the responses. Total response time was divided into reaction, weight transfer, and step times. RESULTS: At small lean angles, responses of old subjects were similar to those of the young. However, the mean maximum lean angle from which old could regain balance as instructed was significantly smaller than that for young (23.9 vs 32.5 deg, p < .0005). Within each age group, maximum lean angle correlated strongly with weight transfer time and step velocity. CONCLUSIONS: Substantial age-related declines in the ability to regain balance by taking a rapid step exist among healthy adults when the time available for recovery is short. The source of the decline seems largely to lie in the decrease with age of maximum response execution speed rather than in the sensory or motor programming processes involved in response initiation.

Accidental Falls↗

PubMed2006

Age-related degeneration in leg-extensor muscle-tendon units decreases recovery performance after a forward fall: compensation with running experience.

The goals of this study were to investigate whether the lower muscle-tendon units (MTUs) capacities in older affect their ability to recover balance with a single-step after a fall, and to examine whether running experience enhances and protects this motor skill in young and old adults. The investigation was conducted on 30 older and 19 younger divided into two subgroups: runners versus non-active. In previous studies we documented that the older had lower leg extensor muscle strength and tendon stiffness while running had no effect on MTUs capacities. The current study examined recovery mechanics of the same individuals after an induced forward fall. Younger were better able to recover balance with a single-step compared to older (P < 0.001); this ability was associated with a more effective body configuration at touchdown (more posterior COM position relative to the recovery foot, P <0.001). MTUs capacities classified 88.6% of the subjects into single- or multiple-steppers. Runners showed a superior ability to recover balance with a single-step (P < 0.001) compared to non-active subjects due to a more effective mechanical response during the stance phase (greater knee joint flexion, P <0.05). We concluded that the age-related degeneration of the MTUs significantly diminished the older adults' ability to restore balance with a single-step. Running seems to enhance and protect this motor skill. We suggested that runners, due to their running experience, could update the internal representation of mechanisms responsible for the control of dynamic stability during a forward fall and, thus, were able to restore balance more often with a single-step compared to the non-active subjects.

Accidental Falls↗

PubMed2006

Functional correlates of mild parkinsonian signs in the community-dwelling elderly: poor balance and inability to ambulate independently.

Mild tremor, rigidity, and bradykinesia (mild parkinsonian signs, MPS) are commonly detected during the clinical examination of elderly people without known neurological disease. The functional correlates of these incidental findings are not well understood. Balance and ability to ambulate independently are important functions in the elderly. The objective of this study is to examine whether MPS were associated with impaired balance. Balance was assessed using a subjective measure (complaint of poor balance) and a functional measure (the need to use a walker, cane, or wheelchair). Our methods included the neurological evaluation of nondemented older people in Washington Heights-Inwood, NY. Of 2,251 participants, 527 (23.4%) complained of poor balance; 538 (23.9%) required a cane, walker, or wheelchair; and 363 (16.1%) had MPS. In adjusted logistic regression analyses, MPS were associated with a complaint of poor balance (OR=1.5, 95% CI=1.1-2.0) and the need to use a cane, walker, or wheelchair (OR=1.9, 95% CI=1.4-2.6). The need to use a cane, walker, or wheelchair was associated with changes in axial function (OR=5.5, 95% CI=2.6-11.6) as well as rigidity (OR=1.5, 95% CI=1.07-2.2). Although they are incidental and subtle, signs of bradykinesia, rigidity, and tremor are associated with impaired function. The elderly in whom these signs have been detected are 50% more likely to complain of poor balance and 90% more likely to require a cane, walker, or wheelchair than are their counterparts without these signs.

Aged↗

PubMed2004

Radiographic and functional outcome after surgical management of severe scoliosis in skeletally immature patients with muscular dystrophy.

OBJECTIVE: Most patients with muscular dystrophy (MD) develop progressive scoliosis after losing ambulatory status, but some cases develop severe scoliosis at a skeletally immature age before losing ambulatory status. Only a few studies have been conducted in skeletally immature patients with severe scoliosis. The purpose of this study was to assess the functional and cosmetic outcome in skeletally immature patients with severe scoliosis. METHODS: Preoperative, immediate postoperative, and final follow-up radiographs were analyzed in 10 consecutive skeletally immature patients with respect to the Cobb angle degree and the pelvic obliquity angle correction, how long the correction was maintained, and the development of the crankshaft phenomenon. In the functional assessment, the ability to sit balanced, according to the Mulcahy method, and the ability to use hands, according to the Rhyu method, were evaluated. Furthermore, the degree of subjective satisfaction was evaluated in these patients. RESULTS: The average age of the patients was 10.4 years, and the average follow-up period was 33 months with minimum 2 years' follow-up. All 10 patients survived and were available at the follow-up. The mean Cobb and pelvic obliquity angles were 80 degrees and 17 degrees at the time of the surgery, 31 degrees and 3.7 degrees immediately after the surgery, and 35 degrees and 4.7 degrees at the time of the final follow-up, respectively. The initial mean Cobb angle correction averaged 61%, with 78% of pelvic obliquity corrected. These corrections were maintained over time in most cases. At the time of the surgery, the mean volume of blood loss was 1111 mL, with an average operation time of 411 minutes. There were no major complications. At the time of the last follow-up, no patient showed development of the crankshaft phenomenon. The average score for the ability to sit balanced improved from 4.4 to 6.6 according to the Mulcahy evaluation method. The scores for hand use were 2.2-2.7. However, the forced vital capacity of the lungs decreased from a preoperative 48% to 46.1%. CONCLUSIONS: These results indicate that even in very young MD patients with severe scoliosis, acceptable curve correction can be achieved and maintained with surgery. The improved pelvic obliquity and scoliosis angle stabilized the spine, freeing the upper extremities and allowing productive activities characteristic of childhood.

Adolescent↗

PubMed2006

Post-stroke motor and functional evaluations: a clinical correlation using Fugl-Meyer assessment scale, Berg balance scale and Barthel index.

UNLABELLED: Stroke is one of the major causes of morbidity and mortality. Sequels deriving from this event may lead to motor disability and from mild to severe deficits. In order to better classify sensory-motor dysfunction, balance and ability to perform activities of daily living, quantitative and qualitative evaluation scales have been used. OBJECTIVE: To correlate the scales Fugl-Meyer assessment scale, Berg balance scale and Barthel index. Twenty subjects with sequel after a single, unilateral stroke in chronic phase (>6 months post ictus) were evaluated for about one hour. RESULTS: Barthel scale was statistically related to the total motor score of Fugl-Meyer assessment (r=0.597, p=0.005). The lower limb section at Fugl-Meyer had positive correlation with Berg scale (r=0.653, p=0.002) and with the balance section of Fugl-Meyer own scale (r=0.449, p=0.047). Both balance scales were correlated one with other (r=0.555, p=0.011). Statistical divergence appeared when Barthel's Index was correlated with Berg's Scale (r=0.425, p=0.062), and it is not statistically significant. CONCLUSION: The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general clinical performance of the patient, especially when positively related joint evaluations are applied.

Activities of Daily Living↗

PubMed2003

The Federal Nursing Services Award. Enlisted women with breast cancer: balancing demands and expectations.

Diagnosis with breast cancer is not an automatic cause for discharge from the military. Therefore, it is important to know how this disease impacts enlisted women in the military. This study describes how enlisted women manage diagnosis and treatment within the context of their military careers. Grounded theory guided the study methodology. Audiotaped semistructured interviews were conducted three times over 9 months to learn how treatment impacted work demands. Data saturation was attained after 46 interviews were conducted. Participants had to balance demands and expectations among the Military Career and Military Medical Subsystems and their Social Support Subsystem. Support from the chain of command was critical in women's ability to balance demands and expectations of career, family, and illness. Military nurses are in a unique position to create strategies that will assist enlisted women in coping with breast cancer.

Activities of Daily Living↗

PubMed2005

Relationships among display features, eye movement characteristics, and reaction time in visual search.

The relative contribution of number of fixations and fixation duration to reaction time in visual search was investigated. Ten participants (age 20-24 years) took part in each of two experiments. In Experiment 1, the experimental factors were display type (icon and file name), organization (arrangements with and without grouping), and number of stimuli presented (4, 8, and 16). In Experiment 2, a search task for a target stimulus (three prespecified random letters) was conducted, and the experimental factor was the display's layout complexity. Multiple regression analysis was used to examine whether reaction time was explained by a mediational model in which reaction time is mediated by eye movements and display features are not directly related to reaction time. The mediational model was not supported, and the effects of display features on reaction time were not attributable solely to eye movements. The interaction between number of fixations and fixation duration was also explored as a function of display features. As the display feature changed and the task became more difficult, the contribution of the number of fixations to explain the variation in reaction time became dominant for both experiments. Potential applications include measurements of cognitive ability, eye muscle balance disorders, and binocular fusion ability.

Adult↗

PubMed2003

Preserving ambulatory potential in pediatric patients with cerebral palsy who undergo spinal fusion using unit rod instrumentation.

STUDY DESIGN: A retrospective study investigated 24 ambulatory pediatric patients with spastic cerebral palsy and neuromuscular scoliosis. OBJECTIVE: To evaluate the effect of spinal fusion from T1-T2 to the sacrum with pelvic fixation using unit rod instrumentation on the ambulatory potential of these patients. SUMMARY OF BACKGROUND DATA: Spinal deformities in patients with cerebral palsy and good ambulatory capacity are infrequently associated with pelvic obliquity, so instrumented spinal fusions traditionally do not extend to the pelvis. METHODS: The medical charts and radiographs were reviewed, and the patients' ambulatory ability was assessed clinically with videotape or complete gait analysis. A questionnaire assessing patients' functional improvement was given to the caretakers. RESULTS: The study group included 17 female and 7 male patients, among whom were 19 quadriplegics and 5 diplegics. The mean age at surgery was 15.4 years. Of the 24 patients, 20 underwent posterior spinal fusion and 4 had combined anteroposterior procedures. The patients were evaluated clinically before surgery and after surgery. Follow-up evaluations of ambulatory function occurred at a mean of 2.86 years after surgery. No alteration in the ambulatory status of the patients was found, except in one patient who experienced bilateral hip heterotopic ossification and gradually lost her ability to ambulate. Preoperative and postoperative gait analysis was performed for 12 patients, showing no change in their ambulatory function. The surgical outcome survey demonstrated significant improvement in the patients' physical appearance, head and trunk balance, sitting ability, and respiration, with no change in ambulatory capacity. CONCLUSIONS: Spine surgery with fusion extending to the pelvis in ambulatory patients with cerebral palsy provided excellent deformity correction and preserved their ambulatory function.

Adolescent↗

PubMed2001

In their own words: a model of healthy aging.

Many previous studies have assessed the aging process by measuring clinical and functional variables. To supplement that quantitative understanding, we asked older people what constitutes their health and contributes to it. Using grounded theory-type methods, we analyzed semi-structured interviews with 22 study subjects, who were randomly selected from among those whose reported perceived health differed from that predicted by a regression model constructed from data from a randomized trial of a primary care intervention. We focused on disparate cases to identify factors that best discriminate between more and less healthy aging. Interview questions targeted perceptions of health; well-being; valued abilities, activities, and relationships; social support; control; sense of coherence; and personal outlook. A model of healthy aging emerged. To these older people health meant going and doing something meaningful, which required four components: something worthwhile to do, balance between abilities and challenges, appropriate external resources, and personal attitudinal characteristics (e.g., positive attitude vs. "poor me"). By reframing healthy aging in older people's own terms, this model encourages interdisciplinary support of their desired goals and outcomes rather than only medical approaches to deficits and challenges.

Adaptation, Psychological↗

PubMed2002

Effect of strength and speed of torque development on balance recovery with the ankle strategy.

In the event of an unexpected disturbance to balance, the ability to recover a stable upright stance should depend not only on the magnitude of torque that can be generated by contraction of muscles spanning the lower extremity joints but also on how quickly these torques can be developed. In the present study, we used a combination of experimental and mathematical models of balance recovery by sway (feet in place responses) to test this hypothesis. Twenty-three young subjects participated in experiments in which they were supported in an inclined standing position by a horizontal tether and instructed to recover balance by contracting only their ankle muscles. The maximum lean angle where they could recover balance without release of the tether (static recovery limit) averaged 14.9 +/- 1.4 degrees (mean +/- SD). The maximum initial lean angle where they could recover balance after the tether was unexpectedly released and the ankles were initially relaxed (dynamic recovery limit) averaged 5.9 +/- 1.1 degrees, or 60 +/- 11% smaller than the static recovery limit. Peak ankle torque did not differ significantly between the two conditions (and averaged 116 +/- 32 Nm), indicating the strong effect on recovery ability of latencies in the onset and subsequent rates of torque generation (which averaged 99 +/- 13 ms and 372 +/- 267 N. m/s, respectively). Additional experiments indicated that dynamic recovery limits increased 11 +/- 14% with increases in the baseline ankle torques prior to release (from an average value of 31 +/- 18 to 54 +/- 24 N. m). These trends are in agreement with predictions from a computer simulation based on an inverted pendulum model, which illustrate the specific combinations of baseline ankle torque, rate of torque generation, and peak ankle torque that are required to attain target recovery limits.

Adolescent↗

PubMed1984

Membrane-disordering potency and anticonvulsant action of valproic acid and other short-chain fatty acids.

The cell membrane-disordering potencies of sodium valproate, the sodium salts of other short-chain fatty acids, and ethanol were compared using fluorescence polarization with the probe 1,6-diphenyl-1,3,5-hexatriene. Valproate was about 7 times more potent in fluidizing synaptosomal plasma membranes than ethanol, a prototypic disordering agent. The disordering potency of the straight-chain fatty acids pentanoate through octanoate increased by a factor of 2.2 with each additional methylene group. The sedative potencies of the drugs were assessed by determining the brain concentration at which Swiss Webster mice lost the ability to balance on a stationary wooden dowel. Relative anticonvulsant potency was measured by determining the ED50 for protection against pentylenetetrazol-induced seizures and then determining the brain levels of drug that were actually achieved at the time of seizure protection. The ability of the fatty acids and ethanol to disorder membranes in vitro correlated closely with their ability to cause sedation and protect mice against pentylenetetrazol-induced seizures. These data suggest that valproic acid might exert some of its effects by disordering brain cell membranes--the proposed mechanism of action of ethanol and the general anesthetics.

Animals↗

PubMed1996

Psychological indicators of balance confidence: relationship to actual and perceived abilities.

BACKGROUND: This study compares several psychological indicators of balance confidence in relation to physical performance, past and current experience, gender bias, and other perceptions of daily functioning. METHODS: Sixty community-dwelling ambulatory elders (aged 65-95) were administered the Falls Efficacy Scale (FES), the Activities-Specific Balance Confidence Scale (ABC), and three dichotomous questions on fear of falling, activity avoidance, and perceived need for personal assistance to ambulate outdoors. Performance measures on walking (average speed) and balance (static posturography) were obtained on a subsample of 21 subjects. RESULTS: Balance confidence assessed by the ABC and self-perceived need for personal assistance with outdoor ambulation were the only indicators significantly associated with the performance measures. As expected, perceived balance capabilities were more strongly related to current behavior (frequency of doing specific activities) than to past experience (fall history). Gender differences in self-report emerged for the global fear-of-falling indicator but not for the two efficacy ratings. CONCLUSIONS: Psychological indicators of balance confidence are important to measure both in conjunction with balance test performance and as a legitimate focus of rehabilitation. Of the various indicators assessed here, the dichotomous fear-of-falling question appears to have the least utility. Perceived need for personal assistance to ambulate outdoors has merit as an initial clinical screening question for discriminating persons on the basis of both physical ability and confidence. The ABC scale appears to have the greatest utility as an evaluative index for older persons at a moderate to high level of functioning.

Accidental Falls↗