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Intervention Principles to Improve Postural Stability in Older Adults

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The purpose of this paper was to review existing literature on exercise interventions to improve postural stability in older adults in order to assist with the development of a novel intervention with the same function. A brief review of balance changes with aging is followed by a summary of the…

The purpose of this paper was to review existing literature on exercise interventions to improve postural stability in older adults in order to assist with the development of a novel intervention with the same function. A brief review of balance changes with aging is followed by a summary of the methods and findings of various interventions. Many types of interventions are discussed, including resistance training, balance training, t'ai chi, and whole body vibration. The studies show promising results, but none utilize the approach of the proposed intervention. This intervention being developed involves the use of a weighted vest to raise one's center of mass, creating a more unstable posture. Performing exercises or daily activities with the vest may improve balance by training muscles in unsteady conditions. The intervention principles to improve postural stability in older adults are beneficial to the foundation of future studies.
ContributorsWiedemann, Ava Marie (Author) / Dounskaia, Natalia (Thesis director) / Ringenbach, Shannon (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor) / School of International Letters and Cultures (Contributor)
Created2014-12
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Relating Reactive Stepping Characteristics to Falls in Older Community Dwelling Adults

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Background: Falls are a leading cause of injury in older adults with roughly 1 in 4 American's over the age of 65 experiencing a fall. Research that looks at reactive stepping, or the steps a person takes when they encounter a loss of balance, is sparse. Whether a specific aspect…

Background: Falls are a leading cause of injury in older adults with roughly 1 in 4 American's over the age of 65 experiencing a fall. Research that looks at reactive stepping, or the steps a person takes when they encounter a loss of balance, is sparse. Whether a specific aspect of reactive stepping can be linked to falls has yet to be determined. Purpose: The purpose of this study was to determine which reactive stepping characteristics may be correlated with falls in from community dwelling older adults. Methods: 54 older adults (11 fallers & 43 non-fallers) underwent 3 "postural perturbations", in which they leaned back into the testers hands and were released, resulting in one or more reactive steps. Inertial sensors (APDM, inc.) were used to measure participant movement and Quantify reactive steps. Step length and step latency, which is the time it takes for an individual to perform a step, were the primary outcomes measured, along with time to stabilization, number of steps taken, and time until first foot strike. Results: Neither step length or step latency were significantly different in fallers compared to non-fallers (p=0.537 and p=0.431, respectively). However, four square step test was significantly different between the populations (p= 0.045). Conclusions: These results showed that four square step test may be more closely related to falls than step length or latency. When performing fall prevention training, or working with an individual at risk for falling, it may be more beneficial to focus on four square step test and the changes in direction associated with it, as opposed to other stepping characteristics in order to improve their fall risk.
ContributorsPreschler, Rachael (Author) / Peterson, Daniel (Thesis director) / Schaefer, Sydney (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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The Effect of an Exercise Program for Adults with Down Syndrome (ExDS) on Balance

Description
Individuals with Down Syndrome (DS) are subject to a spectrum of behavioral, cognitive and physical impairments. This population is more predisposed to comorbidity and typically has an increased risk of inactivity resulting in a lower level of fitness. Previous studies on physical activity have shown that routine exercise has similar…

Individuals with Down Syndrome (DS) are subject to a spectrum of behavioral, cognitive and physical impairments. This population is more predisposed to comorbidity and typically has an increased risk of inactivity resulting in a lower level of fitness. Previous studies on physical activity have shown that routine exercise has similar health benefits for those with DS as those individuals without a disability and in turn progresses their balance ability. Due to limited exercise program opportunities and studies that intentionally investigate the benefits of specific modes of exercise on the DS population, a community-based Exercise Program for Adults with DS (ExDS) was created with the goal of improving their physical and mental health and measuring changes in their balance capabilities throughout the program. ExDS partnered with Arizona State University (ASU) students to create biweekly customized workouts, that followed exercise prescription guidelines, consisting of an aerobic warm-up, main aerobic exercise bout, resistance training, balance training, and stretching for each participant with DS. Participant dynamic and static balance ability was measured using the Berg Balance Scale (BBS) during program pre- and post-assessments. The BBS composite score did not change and no significant improvement was seen in the p-values for each line item of the BBS from pre- to post-testing. For follow-up analyses, the participants with low treatment fidelity were removed. Follow-up analyses showed significant increases in BBS composite score and line item 13 from pre- to post-testing. Treatment fidelity was a limitation in this study and future studies should aim to increase fidelity and consistency of tester for pre- and post-testing. In conclusion, holistic exercise programming for adults with DS appears to benefit balance as long as treatment fidelity is high. It is unclear which mode of exercise had the greatest impact on changes in balance.
ContributorsShikles, Ann Kelly (Author) / Holzapfel, Simon (Thesis director) / Ringenbach, Shannon (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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Sit-to-stand task with physical and cognitive perturbations: A comparison of linear and nonlinear methods of analyzing postural data

Description
Variability is inherent in human movement, and poses a challenge to researchers attempting to measure balance. Human movement variability was analyzed using two methods: standard deviation and largest Lyapunov exponent. The experiment was a sit-to-stand task with physical and cognitive perturbations. The physical perturbation consisted of stable and unstable platform…

Variability is inherent in human movement, and poses a challenge to researchers attempting to measure balance. Human movement variability was analyzed using two methods: standard deviation and largest Lyapunov exponent. The experiment was a sit-to-stand task with physical and cognitive perturbations. The physical perturbation consisted of stable and unstable platform conditions, while the cognitive perturbation consisted of a counting task. The data were collected from 24 healthy young adults. The purpose of this study was to compare the standard deviation and largest Lyapunov exponent as measures of stability, and to determine the Lyapunov exponent's sensitivity to cognitive perturbation. Evidence suggests that the Lyapunov exponent serves as a more accurate indicator of stability than standard deviation, and that it lacks sensitivity to the counting task.
ContributorsJohnson, Jennifer Jeanne (Author) / Amazeen, Polemnia (Thesis director) / Amazeen, Eric (Committee member) / Stone, Gregory (Committee member) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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The Effects of Acute Resistance Training (RT) and Assisted Cycle Therapy (ACT) on Balance and Gait in Adults with Down syndrome

Description

Down syndrome (DS) is caused by either an extra copy of chromosome 21 or by extra material on chromosome 21. This causes various levels of intellectual disability and issues with gross motor skill development which can prevent these individuals from participating in activities of daily living (ADL) such as getting…

Down syndrome (DS) is caused by either an extra copy of chromosome 21 or by extra material on chromosome 21. This causes various levels of intellectual disability and issues with gross motor skill development which can prevent these individuals from participating in activities of daily living (ADL) such as getting dressed, self-care, or grocery shopping. People with DS have a decreased ability to balance, an abnormal and slower gait pattern, difficulty adapting to new environments, and a lack of improvement in these areas with growth and development when compared to their neurotypical peers. The objective of this study was to determine the immediate effects of resistance training (RT) and assisted cycle therapy (ACT) on adults with DS’s balance ability and gait speed. Each participant completed one session of RT, ACT (stationary cycling with the assistance of a motor to maintain a cadence of at least 35% greater than their voluntary cycling speed), and no training in a randomly selected order. Balance and gait speed were measured by a Clinical Test of Sensory Interaction on Balance (CTSIB) (i.e., eyes open firm surface, eyes closed firm surface, eyes open foam surface, eyes closed foam surface) on a Balance Tracking System Board (Btracks board) and by a Timed Up and Go (TUG) test. A total of ten participants’ data was used for analysis. The measures of total path length (cm), anterior-posterior (AP) excursion, and medial-lateral (ML) excursion were used to analyze the CTSIB. The average time was used to analyze the TUG test. The results showed that the eyes closed foam surface balance task was the most challenging balance task for every participant in every intervention. Furthermore, the most improvement was evident in the eyes closed foam surface balance task from pre to post intervention in all of the interventions. Post hoc tests also indicated statistically significant improvements of path length from pre to post in the RT intervention with the eyes closed foam surface balance task as well as with AP excursion in the ACT intervention with the eyes closed foam surface balance task. Possible explanations for improvements from pre to post in the eyes closed foam balance task across all interventions will be discussed with respect to the length of the intervention, and the effect of strength, social and learned factors on balance in adults with DS.
ContributorsKeim, Jeannette Danielle (Author) / Ringenbach, Shannon (Thesis director) / Peterson, Daniel (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12

The Effects of Ballet Specific Training on Balance in Young Individuals with Down syndrome

Description
The genetic disorder Down syndrome (DS), clinically known as Trisomy 21, is characterized by the presence of either a part or full extra copy of chromosome 21. When compared with children of typical development, children with DS consistently score lower on gross motor skill tasks. Balance specifically is one of…

The genetic disorder Down syndrome (DS), clinically known as Trisomy 21, is characterized by the presence of either a part or full extra copy of chromosome 21. When compared with children of typical development, children with DS consistently score lower on gross motor skill tasks. Balance specifically is one of the hardest skills for individuals with DS (especially children) to acquire, and neglecting to train balance early on can predispose individuals with DS to further movement instabilities, injuries, social struggles from activity limitations, and an overall lack of independence. One of the more unique forms of physical activity that requires a large amount of both static and dynamic balance is ballet. Dance-specific therapy has been shown to improve gross motor control functioning and specifically balance in a variety of populations with neuromuscular condions, but the research around ballet-specific therapy for those with DS is lacking. The purpose of this pilot study was to further investigate the effects of ballet-specific training on balance ability and general motor functioning in young students with DS as measured by the Four Square Step Test (FSST), Pediatric Balance Scale (PBS), and the gross and fine motor domains of the Vineland Adaptive Behavior Scale lll (VABS lll). It was hypothesized that participation in the 6-week summer cohort of Ballet Arizona’s Adaptive Dance Program would lead to improved scores on the PBS and VABS lll and decreased test times in the FSST. Improvements were observed for all measures for both participants (sample size n=2), except for P1's FSST, which increased in post-testing by 2.25s. Due to the study design, no conclusive statements can be made about whether the ballet program was responsible for the improvements observed in post-testing. More rigorous research with larger sample sizes (>30) is warranted to more fully understand the impact of an adapted ballet program on the balance ability of young individuals with DS. However, the program is still recommended for young individuals with DS because of the benefits it provides outside of motor skill development.
ContributorsMitrovic, Jelena (Author) / Peterson, Daniel (Thesis director) / Holzapfel, Simon (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2022-12