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Trunk muscle attributes are associated with balance and mobility in older adults: a pilot study.

ABSTRACT: To determine whether trunk muscle attributes are associated with balance and mobility performance among mobility-limited older adults.Cross-sectional analysis of data from a randomized clinical trial.Outpatient rehabilitation research center.Community-dwelling older adults (N = 70; mean age 75.9 years) with mobility limitations as defined by the Short Physical Performance Battery (SPPB).Independent variables included physiologic measures of trunk extension strength, trunk flexion strength, trunk extension endurance, trunk extension endurance, and leg press strength. All measures were well tolerated by the study subjects without the occurrence of any associated injuries or adverse events. The association of each physiologic measure with each outcome was examined by the use of separate multivariate models to calculate the partial variance (R(2)) of each trunk and extremity measure.Balance measured by the Berg Balance Scale and Unipedal Stance Test and mobility performance as measured by the SPPB.Trunk extension endurance (partial R(2) = .14, P = .02), and leg press strength (partial R(2) = .14, P = .003) accounted for the greatest amount of the variance in SPPB performance. Trunk extension endurance (partial R(2) = .17, P = .007), accounted for the greatest amount of the variance in BBS performance. Trunk extension strength (R(2) = .09, P = .03), accounted for the greatest amount of the variance in UST performance. The variance explained by trunk extension endurance equaled or exceeded the variance explained by limb strength across all three performance outcomes.Trunk endurance and strength can be safely measured in mobility-limited older adults and are associated with both balance and mobility performance. Trunk endurance and trunk strength are physiologic attributes worthy of targeting in the rehabilitative care of mobility-limited older adults.

SUBMITTER: Suri P

PROVIDER: S-EPMC2964353 | biostudies-literature | 2009 Oct

REPOSITORIES: biostudies-literature

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Trunk muscle attributes are associated with balance and mobility in older adults: a pilot study.

Suri Pradeep P Kiely Dan K DK Leveille Suzanne G SG Frontera Walter R WR Bean Jonathan F JF

PM & R : the journal of injury, function, and rehabilitation 20091001 10

<h4>Objective</h4>To determine whether trunk muscle attributes are associated with balance and mobility performance among mobility-limited older adults.<h4>Design</h4>Cross-sectional analysis of data from a randomized clinical trial.<h4>Setting</h4>Outpatient rehabilitation research center.<h4>Participants</h4>Community-dwelling older adults (N = 70; mean age 75.9 years) with mobility limitations as defined by the Short Physical Performance Battery (SPPB).<h4>Methods</h4>Independent variables in ...[more]

PMID: 19854420

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Project description:ObjectivesCross-sectional studies have found some built environmental attributes to be associated with residents' lower levels of mobility (functional capacity to walk outside the home). However, less is known about what environmental attributes are related to mobility decline. This longitudinal study examined area-level associations of specific environmental attributes with mid-to-older aged adults' changes in walking mobility.MethodsData collected from 4,088 adults (aged 46-71 years at baseline) who participated in a cohort study in Brisbane, Australia were used. The outcome was the change in self-reported mobility score (SF-36) from 2013 to 2016, which were aggregated at the neighborhood (N = 156) and suburb (N = 99) levels, due to the known lack of sensitivity in SF-36 subscales to individual changes. Linear regression analysis examined associations of mobility change with seven environmental attributes measured at baseline (residential density, intersection density, land use mix, density of walking/bike paths, park density, bus stop density, density of social incivilities), adjusting for confounding variables.ResultsParticipants on average reported 4% of mobility decline during the 3-year study period. It was found that greater land use diversity was consistently associated with less decline in walking mobility, while greater density of social incivilities was associated with more decline in walking mobility. The latter finding was significant only at the neighborhood level. No consistent associations were observed for residential density, intersection density, density of walking/bike paths, park density, and bus stop density.DiscussionOur findings suggest that mid-to-older aged adults who live in areas with lower land use diversity and more social incivilities may be at risk of developing mobility limitations. Recommended policies to slow residents' mobility decline and to achieve aging in place include improving these environmental attributes where needed and advising older adults to relocate to safer, mixed-use neighborhoods.

Project description:BackgroundImpaired balance leading to falls is common in the older adults, and there is strong evidence that balance training reduces falls and increases independence. Reduced resources in health care will result in fewer people getting help with rehabilitation training. In this regard, the new technology augmented reality (AR) could be helpful. With AR, the older adults can receive help with instructions and get feedback on their progression in balance training. The purpose of this pilot study was to examine the feasibility of using AR-based visual-interactive tools in balance training of the older adults.MethodsSeven older adults (66-88 years old) with impaired balance trained under supervision of a physiotherapist twice a week for six weeks using AR-based visual-interactive guidance, which was facilitated through a Microsoft HoloLens holographic display. Afterwards, participants and physiotherapists were interviewed about the new technology and their experience of the training. Also, fear of falling and balance ability were measured before and after training.ResultsFive participants experienced the new technology as positive in terms of increased motivation and feedback. Experiences were mixed regarding the physical and technical aspects of the HoloLens and the design of the HoloLens application. Participants also described issues that needed to be further improved, for example, the training program was difficult and monotonous. Further, the HoloLens hardware was felt to be heavy, the application's menu was difficult to control with different hand manoeuvres, and the calibration took a long time. Suggestions for improvements were described. Results of the balance tests and self-assessment instruments indicated no improvements in balance performance after AR training.ConclusionsThe study showed that training with the new technology is, to some extent, feasible for the older adults, but needs further development. Also, the technology seemed to stimulate increased motivation, which is a prerequisite for adherence to training. However, the new technology and training requires further development and testing in a larger context.

Project description:As the population ages, the prevention of falls is an increasingly important public health problem. Balance assessment forms an important component of fall-prevention programs for older adults. The recent development of cost-effective and highly responsive virtual reality (VR) systems means new methods of balance assessment are feasible in a clinical setting. This proof-of-concept study made use of the submillimeter tracking built into modern VR head-mounted displays (VRHMDs) to assess balance through the use of visual-vestibular conflict. The objective of this study was to evaluate the validity, acceptability, and reliability of using a VRHMD to assess balance in older adults.Validity was assessed by comparing measurements from the VRHMD to measurements of postural sway from a force plate. Acceptability was assessed through the use of the Simulator Sickness Questionnaire pre- and postexposure to assess possible side effects of the visual-vestibular conflict. Reliability was assessed by measuring correlations between repeated measurements 1 week apart. Variables of possible importance that were found to be reliable (r?0.9) between tests separated by a week were then tested for differences compared to a control group. Assessment was performed as a cross-sectional single-site community center-based study in 13 older adults (?65 years old, 80.2±7.3 years old, 77% female, five at risk of falls, eight controls). The VR balance assessment consisted of four modules: a baseline module, a reaction module, a balance module, and a seated assessment.There was a significant difference in the rate at which participants with a risk of falls changed their tilt in the anteroposterior direction compared to the control group. Participants with a risk of falls changed their tilt in the anteroposterior direction at 0.7°/second vs 0.4°/second for those without a history of falls. No significant differences were found between pre/postassessment for oculomotor score or total Simulator Sickness Questionnaire score. Both the force plate and the head-mounted display balance-assessment system were able to detect differences between conditions meant to mask visual and proprioceptive information.This VRHMD is both affordable and portable, causes minimal simulator sickness, and produces repeatable results that can be used to assess balance in older adults.

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Trunk muscle attributes are associated with balance and mobility in older adults: a pilot study.

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Trunk muscle attributes are associated with balance and mobility in older adults: a pilot study.

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