Effects of Balance Training in Elderly Evaluated by Clinical Tests and Dynamic Posturography

Abstract

All persons aged 70 through 75 years (N = 457) in a Swedish community were invited to participate in a 9 week balance training study. Out of 55 interested subjects, 15 were chosen at random for a study group; 15 matched controls were also selected. Before and after the investigation period the balance function was assessed by clinical balance tests and dynamic posturography. In the clinical balance tests, the training group significantly improved their balance standing on one leg with eyes closed as well as standing on one leg while shaking the head; they also walked 15 m back and forth faster. In the dynamic posturography the training group significantly improved their equilibrium scores in the 3 most difficult test conditions. The results of the control group were unchanged except for one test condition in the dynamic posturography. The differences in one-leg standing with head shaking, walking 2 × 15 m, and the equilibrium score using sway-referenced platform in dynamic posturography were proved to be attributable to the training. The first investigation in all 29 subjects formed normative dynamic posturography data for the age group 70 through 75 years. The normative posturographic data of this age group differed from previously obtained data in the age groups 20 through 59 and 60 through 69 years. It is concluded that elderly may improve their balance by regular balance training exercises for as short a period as 9 weeks. This might prove to be of great value in improving balance and thereby preventing accidental falls and subsequent fractures in elderly.

Posturography does not Test Vestibulospinal Function

“…Vestibulo‐ocular tests, including ENG calorics and Barany chair vertical axis rotation, are the gold standard used to diagnose vestibulo‐ocular function 7 , 10 . Posturography reportedly enhances vestibular patient classifications and can monitor change after treatments such as rehabilitation 4 , 5 …”

“…Patients with peripheral vestibular hypofunction have difficulty orienting to gravity when visual inputs and somatosensory inputs are decreased 16 . Numerous studies conclude that rehabilitation increases these individuals' mobility at home and in the community, 4 , 6 , 14 , 16 , 17 but to date none has focused on how the SOT portion of posturography relates to traditional measures of balance and gait performance.…”

“…Posturography is intended to characterize postural control in general and vestibulospinal abnormalities in particular. [1][2][3][4][5] There is no "Barany chair" for vestibulospinal reflex (VSR) assessment: no single test evaluates vestibular deficits. 1,[6][7][8] Several authors suggest, however, that posturography characterizes VSRs, and electronystagmography (ENG) measures vestibulo-ocular responses (VORs).…”

“…7,10 Posturography reportedly enhances vestibular patient classifications and can monitor change after treatments such as rehabilitation. 4,5 Posturography is intended to measure the ability to maintain the body's center of gravity (CG) within the base of support 3,9 during alterations of ankle and visual sensory input. In functional activities such as gait, by contrast, the CG is outside the base of support except during the brief double-support phase.…”

The effect of body mass reduction on functional stability in young obese women

“…Firstly, less body mass means less body inertia and better movement control; secondly, it means a more advantageous ratio of muscle strength to body mass (as a result of fat loss and FFM increase), and reduced energy expenditure related to movement control. In addition, it should be taken into account that the weight loss program included recommendations to increase physical activity that could have also increased the efficiency of muscle work 30 .…”