Effects of balance recovery after square and semicircular turns on gait velocity and center of mass acceleration in older adults with differing visual acuity

Recent studies have shown balance recovery can be enhanced via task-specific training, referred to as perturbation-based balance training (PBT). These interventions rely on principles of motor learning where repeated exposure to task-relevant postural perturbations results in more effective compensatory balance responses. Evidence indicates that compensatory responses trained using PBT can be retained for many months and can lead to a reduction in falls in community-dwelling older adults. A notable shortcoming with PBT is that it does not transfer well to similar but contextually different scenarios (e.g., falling sideways versus a forward trip). Given that it is not feasible to train all conditions in which someone could fall, this limited transfer presents a conundrum; namely, how do we best use PBT to appropriately equip people to deal with the enormous variety of fall-inducing scenarios encountered in daily life? In this perspective article, we draw from fields of research that explore how general learning can be promoted. From this, we propose a series of methods, gleaned from parallel streams of research, to inform and hopefully optimize this emerging field where people receive training to specifically improve their balance reactions.

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Near-falls in Singapore community-dwelling older adults: a feasibility study

Pilot and Feasibility Studies ◽

10.1186/s40814-020-00748-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Shawn Leng-Hsien Soh ◽

Chee-Wee Tan ◽

Judith Lane ◽

Ting-Ting Yeh ◽

Benjamin Soon

Keyword(s):

Older Adults ◽

Retention Rate ◽

Community Dwelling ◽

Retention Rates ◽

Reach To Grasp ◽

Balance Recovery ◽

Recruitment And Retention ◽

Body Regions ◽

Near Falls ◽

Community Dwelling Older Adults

Abstract Background A near-fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near-falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near-fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near-fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near-falls and associated balance recovery manoeuvres. Texting and calling methods were explored as reporting methods. Methods This study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near-fall or fall incidence over 21 days using either daily texting or calling. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near-falls or falls. Secondary outcomes included the self-reported incidence of falls and near-falls. Results Thirty older adults were recruited in 5 weeks. All participants completed the study. They understood near-fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected calling as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near-falls were recorded. Sixteen participants (53.3%) experienced near-falls and half of this group experienced two or more near-falls. The use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. Conclusions The study provided evidence that studying near-falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near-falls and balance recovery manoeuvres. Both texting and calling were feasible reporting methods, but texting was preferred. Trial registration ClinicalTrials identifier: NCT04087551. Registered on September 12, 2019

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Visual Acuity’s Association With Levels of Leisure-Time Physical Activity in Community-Dwelling Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.20.1.1 ◽

2012 ◽

Vol 20 (1) ◽

pp. 1-14 ◽

Cited By ~ 4

Author(s):

Mark W. Swanson ◽

Eric Bodner ◽

Patricia Sawyer ◽

Richard M. Allman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Visual Acuity ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Cross Sectional Study ◽

Community Dwelling ◽

University Of Alabama ◽

Cross Sectional ◽

The University

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations while controlling for potential confounders. In multivariate analyses, each lower step in visual acuity below 20/50 was significantly associated with reduced odds of having a higher level of physical activity, OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults.

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Association of Affect and Gait Performance in Dual-Task Walking in Non-Demented Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.920 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 287-287

Author(s):

Deepan Guharajan ◽

Roee Holtzer

Keyword(s):

Older Adults ◽

Negative Affect ◽

Positive Affect ◽

Dual Task ◽

Task Demands ◽

Gait Velocity ◽

Positive And Negative Affect ◽

Increased Risk ◽

Aging Populations ◽

Task Conditions

Abstract Aging populations are at increased risk to experience mobility disability, which is associated with falls, frailty, and mortality. Previous studies have not examined the concurrent associations of both positive and negative affect with gait velocity. We examined whether individual differences in positive and negative affect predicted dual-task performance decrements in velocity in a dual-task (DT) paradigm in non-demented older adults. We hypothesize that positive affect would be associated with lower DT costs, and negative affect would be associated with higher DT costs. Participants (N = 403; mean age, = 76.22 (6.55); females = 56%) completed the Positive and Negative Affect Schedule (PANAS) and a DT paradigm that involved three task conditions: Single-Task-Walk (STW), Alpha (cognitive interference requiring participants to recite alternate letters of the alphabet), and Dual-Task-Walk (DTW) requiring participant to perform the two single tasks concurrently. Gait velocity was assessed via an instrumented walkway. As expected, results of a linear mixed effects model (LME) showed a significant decline in gait velocity (cm/s) from STW to DTW (estimate = -11.79; 95%CI = -12.82 to -10.77). LME results further revealed that negative affect was associated with greater decline in gait velocity from STW to DTW (ie., worse DT cost) (estimate = -0.38; 95%CI = -0.73 to -0.03). Positive affect did not, however, predict DT costs in gait velocity (estimate = -0.09; 95%CI = -0.23 to 0.05). These findings suggest that increased negative affect interferes with the allocation of attentional resources to competing task demands inherent in the DT paradigm.

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Foot Problems in Older Adults

Journal of the American Podiatric Medical Association ◽

10.7547/15-186 ◽

2018 ◽

Vol 108 (2) ◽

pp. 126-139 ◽

Cited By ~ 15

Author(s):

Amy Muchna ◽

Bijan Najafi ◽

Christopher S. Wendel ◽

Michael Schwenk ◽

David G. Armstrong ◽

...

Keyword(s):

Older Adults ◽

Peripheral Neuropathy ◽

Motor Performance ◽

Fear Of Falling ◽

Center Of Mass ◽

Community Dwelling ◽

Lower Percentage ◽

Wearable Sensor ◽

Eyes Open ◽

Foot Problems

Background:Research on foot problems and frailty is sparse and could advance using wearable sensor–based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults.Methods:Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies.Results:Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) = 2.0], and 95% in frail [OR = 8.3]; P = .03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day.Conclusions:Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.

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Can Treadmill Slip-Perturbation Training Reduce Longer-Term Fall Risk Upon Overground Slip Exposure?

Journal of Applied Biomechanics ◽

10.1123/jab.2019-0211 ◽

2020 ◽

Vol 36 (5) ◽

pp. 298-306 ◽

Cited By ~ 1

Author(s):

Anna Lee ◽

Tanvi Bhatt ◽

Xuan Liu ◽

Yiru Wang ◽

Shuaijie Wang ◽

...

Keyword(s):

Older Adults ◽

Fall Risk ◽

Center Of Mass ◽

Control Group ◽

Initial Training ◽

Single Session ◽

Control Groups ◽

Perturbation Training ◽

Positive Effect ◽

Better Than

The purpose was to examine and compare the longer-term generalization between 2 different practice dosages for a single-session treadmill slip-perturbation training when reexposed to an overground slip 6 months later. A total of 45 older adults were conveniently assigned to either 24 or 40 slip-like treadmill perturbation trials or a third control group. Overground slips were given immediately after initial training, and at 6 months after initial training in order to examine immediate and longer-term effects. The performance (center of mass stability and vertical limb support) and fall percentage from the laboratory-induced overground slips (at initial posttraining and at 6 mo) were measured and compared between groups. Both treadmill slip-perturbation groups showed immediate generalization at the initial posttraining test and longer-term generalization at the 6-month retest. The higher-practice-dosage group performed significantly better than the control group (P < .05), with no difference between the lower-practice-dosage and the control groups at the 6-month retest (P > .05). A single session of treadmill slip-perturbation training showed a positive effect for reducing older adults’ fall risk for laboratory-induced overground slips. A higher-practice dosage of treadmill slip perturbations could be more beneficial for further reducing fall risk.

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The Association between High Neuroticism-Low Extraversion and Dual-Task Performance during Walking While Talking in Non-demented Older Adults

Journal of the International Neuropsychological Society ◽

10.1017/s1355617715000570 ◽

2015 ◽

Vol 21 (7) ◽

pp. 519-530 ◽

Cited By ~ 7

Author(s):

Brittany C. LeMonda ◽

Jeannette R. Mahoney ◽

Joe Verghese ◽

Roee Holtzer

Keyword(s):

Older Adults ◽

Task Performance ◽

Cognitive Performance ◽

Dual Task ◽

Stress Test ◽

Adverse Outcomes ◽

Task Demands ◽

Gait Velocity ◽

Older Individuals ◽

Dual Task Performance

AbstractThe Walking While Talking (WWT) dual-task paradigm is a mobility stress test that predicts major outcomes, including falls, frailty, disability, and mortality in aging. Certain personality traits, such as neuroticism, extraversion, and their combination, have been linked to both cognitive and motor outcomes. We examined whether individual differences in personality dimensions of neuroticism and extraversion predicted dual-task performance decrements (both motor and cognitive) on a WWT task in non-demented older adults. We hypothesized that the combined effect of high neuroticism-low extraversion would be related to greater dual-task costs in gait velocity and cognitive performance in non-demented older adults. Participants (N=295; age range,=65–95 years; female=164) completed the Big Five Inventory and WWT task involving concurrent gait and a serial 7’s subtraction task. Gait velocity was obtained using an instrumented walkway. The high neuroticism-low extraversion group incurred greater dual-task costs (i.e., worse performance) in both gait velocity {95% confidence interval (CI) [−17.68 to −3.07]} and cognitive performance (95% CI [−19.34 to −2.44]) compared to the low neuroticism-high extraversion group, suggesting that high neuroticism-low extraversion interferes with the allocation of attentional resources to competing task demands during the WWT task. Older individuals with high neuroticism-low extraversion may be at higher risk for falls, mobility decline and other adverse outcomes in aging. (JINS, 2015, 21, 519–530)

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