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Associations Between Types of Balance Performance in Healthy Individuals Across the Lifespan: A Systematic Review and Meta-Analysis.

ABSTRACT: Background: The objective of this systematic review and meta-analysis was to quantify and statistically compare correlations between types of balance performance in healthy individuals across the lifespan. Methods: Literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus. Studies were included if they investigated healthy individuals aged ?6 years and reported measures of static/dynamic steady-state, proactive, and/or reactive balance. The included studies were coded as follows: age group, gender, and balance type, test, parameter. Pearson's correlation coefficients were extracted, transformed (i.e., Fisher's z-transformed r _z -value), aggregated (i.e., weighted mean r _z -value), back-transformed to r-values, classified according to their magnitude, and statistically compared. The methodological quality of each study was assessed using the Appraisal tool for Cross-Sectional Studies. Results: We detected twenty-six studies that examined associations between types of balance and exclusively found small-sized correlations, irrespective of the age group considered. More specifically, the weighted mean r _z-values amounted to 0.61 (back-transformed r-value: 0.54) in old adults for the correlation of dynamic steady-state with proactive balance. For correlations between dynamic and static steady-state balance, the weighted mean r _z-values amounted to 0.09 in children (r-value: 0.09) and to 0.32 in old adults (r-value: 0.31). Further, correlations of proactive with static steady-state balance revealed weighted mean r _z-values of 0.24 (r-value: 0.24) in young adults and of 0.31 (r-value: 0.30) in old adults. Additionally, correlations between reactive and static steady-state balance yielded weighted mean r _z-values of 0.21 (r-value: 0.21) in young adults and of 0.19 (r-value: 0.19) in old adults. Moreover, significantly different correlation coefficients (z = 8.28, p < 0.001) were only found for the association between dynamic and static steady-state balance in children (r = 0.09) compared to old adults (r = 0.31). Lastly, we detected trivial to considerable heterogeneity (i.e., 0% ? I² ? 83%) between studies. Conclusions: Our systematic review and meta-analysis showed exclusively small-sized correlations between types of balance performance across the lifespan. This indicates that balance performance seems to be task-specific rather than a "general ability." Further, our results suggest that for assessment/training purposes a test battery/multiple exercises should be used that include static/dynamic steady-state, proactive, and reactive types of balance. Concerning the observed significant age differences, further research is needed to investigate whether they are truly existent or if they are caused by methodological inconsistencies.

SUBMITTER: Kiss R

PROVIDER: S-EPMC6172339 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Associations Between Types of Balance Performance in Healthy Individuals Across the Lifespan: A Systematic Review and Meta-Analysis.

Kiss Rainer R Schedler Simon S Muehlbauer Thomas T

Frontiers in physiology 20180928

<b>Background:</b> The objective of this systematic review and meta-analysis was to quantify and statistically compare correlations between types of balance performance in healthy individuals across the lifespan. <b>Methods:</b> Literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus. Studies were included if they investigated healthy individuals aged ≥6 years and reported measures of static/dynamic steady-state, proactive, and/or reactive balance. The ...[more]

PMID: 30323769

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Project description:BACKGROUND:A well-learned motor skill is characterized by the efficient activation of muscles that are involved in movement execution. However, it is unclear if practice-related changes in motor performance correlate with those in quantitative markers of muscle activity and if so, whether the association is different with respect to the investigated muscle (i.e., agonist and antagonist) and quantitative myoelectric parameter. Thus, we conducted a systematic review and characterized associations between practice-related changes in motor performance and muscle activity in healthy individuals. METHODS:A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus up to September 2017 to capture all relevant articles. A systematic approach was applied to evaluate the 1670 articles identified for initial review. Studies were included only if they investigated healthy subjects aged 6 years and older and tested at least one measure of motor performance (e.g., error score, movement time) and quantitative muscle activity (i.e., amplitude domain: iEMG [integrated electromyography], RMS [root mean square]; time domain: duration of muscle activity, time to peak muscle activation). In total, 24 studies met the inclusionary criteria for review. The included studies were coded for the following criteria: age, learning task, practice modality, and investigated muscles (i.e., agonist and antagonist). Correlation coefficients for the relationship of motor performance changes with changes in electromyography (EMG) amplitude, and duration were extracted, transformed (i.e., Fisher's z-transformed rz value), aggregated (i.e., weighted mean rz value), and back-transformed to r values. To increase sample size, we additionally extracted pre and post practice data for motor performance and myoelectric variables and calculated percent change values as well as associations between both. Correlations were classified according to their magnitude (i.e., small r???0.69, medium r???0.89, large r???0.90). RESULTS:Five studies reported correlation coefficients for the association between practice-related alterations in motor performance and EMG activity. We found small associations (range r?=?0.015-0.50) of practice-related changes in motor performance with measures of agonist and antagonist EMG amplitude and duration. A secondary analysis (17 studies) that was based on the calculation of percent change values also revealed small correlations for changes in motor performance with agonist (r?=?-?0.25, 11 studies) and antagonist (r?=?-?0.24, 7 studies) EMG amplitude as well as agonist (r?=?0.46, 8 studies) and antagonist (r?=?0.29, 5 studies) EMG duration. CONCLUSIONS:Our systematic review showed small-sized correlations between practice-related changes in motor performance and agonist and antagonist EMG amplitude and duration in healthy individuals. These findings indicate that practice-related changes can only partly be explained by quantitative myoelectric measures. Thus, future studies investigating biomechanical mechanisms of practice-related changes in motor performance should additionally include qualitative measures of muscle activity (e.g., timing of muscle activity, level of coactivation) and other biomechanical variables (i.e., kinetics, kinematics).

Project description:Background: Postural balance represents a fundamental movement skill for the successful performance of everyday and sport-related activities. There is ample evidence on the effectiveness of balance training on balance performance in athletic and non-athletic population. However, less is known on potential transfer effects of other training types, such as plyometric jump training (PJT) on measures of balance. Given that PJT is a highly dynamic exercise mode with various forms of jump-landing tasks, high levels of postural control are needed to successfully perform PJT exercises. Accordingly, PJT has the potential to not only improve measures of muscle strength and power but also balance. Objective: To systematically review and synthetize evidence from randomized and non-randomized controlled trials regarding the effects of PJT on measures of balance in apparently healthy participants. Methods: Systematic literature searches were performed in the electronic databases PubMed, Web of Science, and SCOPUS. A PICOS approach was applied to define inclusion criteria, (i) apparently healthy participants, with no restrictions on their fitness level, sex, or age, (ii) a PJT program, (iii) active controls (any sport-related activity) or specific active controls (a specific exercise type such as balance training), (iv) assessment of dynamic, static balance pre- and post-PJT, (v) randomized controlled trials and controlled trials. The methodological quality of studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. This meta-analysis was computed using the inverse variance random-effects model. The significance level was set at p <0.05. Results: The initial search retrieved 8,251 plus 23 records identified through other sources. Forty-two articles met our inclusion criteria for qualitative and 38 for quantitative analysis (1,806 participants [990 males, 816 females], age range 9-63 years). PJT interventions lasted between 4 and 36 weeks. The median PEDro score was 6 and no study had low methodological quality (≤3). The analysis revealed significant small effects of PJT on overall (dynamic and static) balance (ES = 0.46; 95% CI = 0.32-0.61; p < 0.001), dynamic (e.g., Y-balance test) balance (ES = 0.50; 95% CI = 0.30-0.71; p < 0.001), and static (e.g., flamingo balance test) balance (ES = 0.49; 95% CI = 0.31-0.67; p < 0.001). The moderator analyses revealed that sex and/or age did not moderate balance performance outcomes. When PJT was compared to specific active controls (i.e., participants undergoing balance training, whole body vibration training, resistance training), both PJT and alternative training methods showed similar effects on overall (dynamic and static) balance (p = 0.534). Specifically, when PJT was compared to balance training, both training types showed similar effects on overall (dynamic and static) balance (p = 0.514). Conclusion: Compared to active controls, PJT showed small effects on overall balance, dynamic and static balance. Additionally, PJT produced similar balance improvements compared to other training types (i.e., balance training). Although PJT is widely used in athletic and recreational sport settings to improve athletes' physical fitness (e.g., jumping; sprinting), our systematic review with meta-analysis is novel in as much as it indicates that PJT also improves balance performance. The observed PJT-related balance enhancements were irrespective of sex and participants' age. Therefore, PJT appears to be an adequate training regime to improve balance in both, athletic and recreational settings.

Project description:Introduction Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson's disease (PD). Computerized posturography employing a force platform system provides objective, quantitative assessments of postural control impairments. This study examines balance performance as measured by force platform (FP) tests in persons with PD compared to age-matched healthy adults. Secondarily, we examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population. Methods Participants—42 individuals with PD (Hoehn and Yahr stage = 2.33 ± 0.77) and 55 age-matched healthy adults—were assessed on three standardized balance measures on a computerized force platform system. Between groups, comparisons of FP performance were analyzed using independent t-test. Within the group, comparisons for the PD cohort were analyzed using ANOVA for comparing disease stage and Mann–Whitney U test for PD subtypes. Results The PD cohort demonstrated significantly greater postural instability on the sensory organization test (SOT) measures (P=0.013, CI-95% = 1.286 to 10.37) and slower movement velocity on the limits of stability (LOS) test (P=0.001, CI-95% = 0.597 to 1.595) than the healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. Within the PD group, the SOT differentiated between H&Y stages 1–3. The motor control test (MCT) detected changes in reactive postural control mainly in later disease stages. All three FP tests distinguished between PD subtypes, with the Posture Gait Instability subtype demonstrating poorer balance performance than Tremor Dominant subtype. Conclusion These findings suggest FP measures provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk in persons with PD.

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Associations Between Types of Balance Performance in Healthy Individuals Across the Lifespan: A Systematic Review and Meta-Analysis.

Publications

Associations Between Types of Balance Performance in Healthy Individuals Across the Lifespan: A Systematic Review and Meta-Analysis.

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