Balance Control in Older Adults

Dieën, Jaap H. van; Pijnappels, Mirjam

doi:10.1007/978-3-319-48980-3_16

Cited by 11 publications

(7 citation statements)

References 120 publications

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“…A highly important physical function that is reduced with age is balance control. The balance control system consists of several components such as sensory information acquisition, information processing as well as production of an adequate motor response ( Van Dieën and Pijnappels, 2017 ), all of which show age-related impairments. As a result, older adults frequently face difficulties in controlling their balance ( Sturnieks et al, 2008 ), e.g., executing adequate stepping responses.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study

Altorfer

Adcock

Bruin

et al. 2021

Front. Aging Neurosci.

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Objective: The aim of this pilot randomized clinical trial was to test the feasibility and efficacy of an exergame-based cognitive-motor training program in geriatric inpatients.Methods: The study participants were randomly allocated to either the exergame intervention group or the control group. The control group received the standard rehabilitation treatment offered in the clinic. In addition to the standard rehabilitation program, the intervention group conducted supervised exergame training on 5 days per week using the Dividat Senso, an exergame system specifically designed for older adults. The primary outcome was feasibility, as measured by e.g., adherence rate, attrition rate, occurrence of adverse events, System Usability Scale (SUS) and NASA-TLX score. Secondary outcomes included measures of physical and cognitive functioning such as comfortable walking speed, maximal walking speed, dual task walking speed, Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), Color-Word Interference test (D-KEFS), Trail Making test A and B (TMT), Go/No-Go test and Step Reaction Time test (SRTT). All secondary outcome measures were assessed pre- and post-intervention.Results: Thirty-nine persons were included in the study. Average adherence rate was 99%, there were no intervention-related dropouts and no adverse events. The mean System Usability Scale (SUS) score was 83.6 and the mean NASA-TLX score 45.5. Significant time-group interaction effects were found for the dual task walking speed, the Go/No-Go test and Step Reaction Time test (SRTT).Conclusion: Exergaming is a feasible, safe and effective cognitive-motor training approach in inpatient rehabilitation of geriatric patients. Incorporating exergaming in the rehabilitation program of geriatric patients offers potential to reduce fall risk factors and to increase patients’ exercise motivation and rehabilitation success.

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Section: Introductionmentioning

confidence: 99%

Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study

Altorfer

Adcock

Bruin

et al. 2021

Front. Aging Neurosci.

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“…Furthermore, the overall stability of the CoP trajectories appeared to be strongly affected, as TT showed a significant difference with the lowest p-values between young and older adults in all testing conditions (p-value ≤ 0.01). This can be interpreted as an increase in postural sway in older adults compared to young adults regardless of the condition, relating to a decrease in balance control [3].…”

Section: A Main Findingsmentioning

confidence: 99%

“…Balance control is also affected when the sources of sensory information required to maintain balance are altered or restricted. In general, the central nervous system integrates information from visual, vestibular, cutaneous, and proprioceptive stimuli during balance control [3], [38]. Depriving an individual of these information sources allows to assess its contribution to balance control.…”

Section: A Main Findingsmentioning

confidence: 99%

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Recurrence Quantification Analysis of Center of Pressure Trajectories for Balance and Fall-Risk Assessment in Young and Older Adults

Fernandez-Cervantes

Montesinos²,

González-Nucamendi

et al. 2023

IEEE Trans. Neural Syst. Rehabil. Eng.

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The prevalence and impact of balance impairments and falls in older adults have motivated several studies on the characterization of human balance. This study aimed to determine the ability of recurrence quantification analysis (RQA) measures to characterize balance control during quiet standing in young and older adults and to discriminate between different fall risk groups. We analyze center pressure trajectories in the medial-lateral and anterior-posterior directions from a publicly available static posturography dataset that contains tests acquired under four vision-surface testing conditions. Participants were retrospectively classified as young adults (age<60, n=85), non-fallers (age≥60, falls=0, n=56), and fallers (age≥60, falls≥1, n=18). Mixed ANOVA and post hoc analyzes were performed to test for differences between groups. For CoP fluctuations in the anterior-posterior direction, all RQA measures showed significantly higher values for young than older adults when standing on a compliant surface, indicating less predictable and stable balance control among seniors under testing conditions where sensory information is restricted or altered. However, no significant differences between non-fallers and fallers were observed. These results support the use of RQA to characterize balance control in young and old adults, but not to discriminate between different fall risk groups.

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“…For example, we see that mobility loss is accompanied by general degradation of sensory, motor and central nervous system functions with aging leading to numerous gait problems. In elderly we observe markedly poor balance control, increased chance of falling (van Dieën JH et al, 2017, Pijnappels, Bobbert, & Van Dieën, 2005Pijnappels, van der Burg, Reeves, & van Dieën, 2008;Andersen, 2012) (https://ec.europa.eu/eurostat/cache/digpub/ageing/) and an increased Metabolic Cost of Walking (MCoW) Hortobágyi, Finch, Solnik, Rider, & DeVita, 2011;. This thesis, which is part of the 'MOVE-AGE' program of the Erasmus Mundus Joint Doctoral scheme of the European Commission, is an attempt to quantify the elevation in MCoW with a systematic review and meta-analysis and then see if there is an increased MCoW overground for elderly compared to young, since overground walking is ecologically relevant.…”

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confidence: 74%

The Metabolic Cost of Overground and Treadmill Walking in Healthy Young and Older Adults

Gupta¹

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The Metabolic Cost of Walking (MCoW) is typically expressed either in terms of Gross Cost of Walking (GCoW) or Net Cost of Walking (NCoW). MCoW is defined as the metabolic energy expended per meter travelled and is an important variable in daily life. From the literature we can see that increased MCoW for elderly compared to young might lead to elderly becoming fatigued and sedentary. Increased fatigue and sedentarism limits their functional possibilities, thereby affecting the overall quality of life. The motivation for this doctoral project was that we wanted to know the reasons why elderly have a higher MCoW compared to young, especially during overground walking. We were interested in overground walking since it is the ecologically relevant mode of walking. However, before trying to know why elderly have a higher MCoW than young we wanted to see whether this finding of elevated MCoW for elderly was valid in the first place and if so, specifically for overground walking. To answer our research questions, we conducted three studies in this thesis. We started with a systematic review and meta-analysis and reported on this study in Chapter 1 of this thesis. Then we followed it up with two experimental studies and then reported on them in Chapters 2 and 3 of this thesis. To summarise, from the studies conducted in this thesis, we were able to show that the commonly reported elevation in MCoW for Older Adults (OA) over Young Adults (YA) is not due to age per se but is probably due to the differential reaction to treadmills by healthy YA and OA. In Chapters 2 and 3 we have shown that OA react differently to overground and treadmill walking (elevated MCoW on treadmills compared to overground) at their overground Preferred Walking Speed (PWS), which we directly imposed on the treadmills. YA do not react differently to overground and treadmill walking at the same speed as they have similar MCoW. Due to this differential reaction to overground and treadmill walking by YA and OA walking energetics are different between the two groups. In conclusion, through this thesis we have shown how to have age as the only differentiating factor between YA and OA while trying to learn about the differences in MCoW between the cohorts. There were no differences in anthropometrics, physical activity and fitness levels and overground PWS between our YA and OA. Our main finding is that we have shown there are no differences in overground MCoW between them. As overground walking is the ecologically relevant mode of walking, overground MCoW should be considered important. Due to the differential reaction of YA and OA to treadmills, treadmills are not suitable for comparison of MCoW between the two populations. The results of similar overground MCoW of YA and OA could have some clinical implications. For example, these results could be interpreted in the way that if people adopt a healthy and active lifestyle from an early age, when they grow old, they can have similar levels of PWS and MCoW like a young person. Comparable levels of PWS would generally mean that mobility and daily life gait will not be affected and similar levels of MCoW will mean that elderly will expend the same amount of energy after walking the same distance as a young person. Overall this will imply that elderly will be able to lead a normal healthy lifestyle, not become fatigued and sedentary, and we can achieve the goals of healthy aging in our society.

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Balance Control in Older Adults

Cited by 11 publications

References 120 publications

Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study

Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study

Recurrence Quantification Analysis of Center of Pressure Trajectories for Balance and Fall-Risk Assessment in Young and Older Adults

The Metabolic Cost of Overground and Treadmill Walking in Healthy Young and Older Adults

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