Background: Body sway increases in the elderly because of normal aging and high incidence of disease such as diabetes. Prevalence of sway is greater in the elderly with diabetes because of damage to the central and peripheral nervous systems. Increase in body sway is associated with an elevated risk of falling. Falling is one of the major causes of morbidity and mortality in the elderly. The purpose of this study was to develop a new technique to improve body stability and decrease body sway in the elderly people with or without diabetes. Subjects and Methods: Twenty-two subjects-12 elderly (mean age, 75.5 -7.3 years) and 10 age-matched elderly with diabetes (mean age, 72.5 -5.3 years)-were recruited for this study. Subjects received tactile feedback as a tingling sensation resulting from electrical stimulation triggered by body sway. Results: The results showed a significant reduction in body sway in the elderly while standing on foam with eyes open (1.0 -0.31 vs. 1.9 -0.8; P = 0.006) and eyes closed (1.8 -0.7 vs. 3.3 -1.5; P = 0.001). In the group with diabetes, there was a significant reduction in body sway while standing on foam with eyes closed (1.4 -0.5 vs. 2.3 -0.8; P = 0.045) but not with eyes open. Conclusions: In this small study, this technique offers a new tool for training people with diabetes and elderly people to improve body stability and balance.

Background The hamstrings play a major role in body posture. Shortening or tightness of the hamstrings affects postural alignment and results in possible musculoskeletal pain. Objectives The aim of this study was to develop a novel approach to improve hamstring flexibility in young adults. Method A single-blinded randomised clinical trial included 60 participants aged 18–24 with shortened hamstrings recruited from the Hashemite University, Zarqa, Jordan. The range of motion of knee extension was measured with the hip at 90° flexion using a simple goniometer to detect the level of hamstring flexibility. Participants received either a passive hamstring stretch (PS), followed by two sets of 10 tibial nerve neurodynamic technique (ND), or PS followed by three sets of 10 repetitions of active knee extension–quadriceps activation (QA), or PS only. Results There was a significant improvement of hamstring flexibility in the QA group compared to the PS group (13.4 ± 12.1° vs. 6.2 ± 6.4°, p = 0.05). There was a significant improvement in hamstring flexibility post-intervention compared to pre-intervention in the PS group by 6.2 ± 6.4 (30.5 ± 10.8° vs. 36.6 ± 9.5°, p = 0.001), ND group by 9.3 ± 6.2 (26.7 ± 10.9° vs. 36.0 ± 9.5°, p = 0.001) and QA group by 13.4 ± 12.1 (20.3 ± 9.0° vs. 33.4 ± 8.9°, p = 0.001). Conclusion Quadriceps muscle activation following passive stretching of the hamstrings appears to be superior to the PS and ND techniques in improving hamstring muscle flexibility. Clinical implications Quadriceps activation following passive hamstring stretching can be used in physiotherapy settings to improve hamstring muscle flexibility.

Balance is a complicated mechanism aiming to maintain body posture during the presence of static and dynamic stressors [1].The balance system has 3 main components. The first component is the input including vision, the vestibular system, and the somato sensory system. The second component is the central processing of the received data. Central processing involves many pathways and integration between different areas in the cerebellum, cerebrum, and spinal cord [1]. The third component is the output which is projected through the musculoskeletal system. Deficits in any of these components or poor coordination between these components can result in postural instability indicated by an increase in body sway and increased risk of falling [1,2]. The elderly population