Sensitive Balance Parameters in Detecting Age-related Changes of Balance Control in Elderly

OBJECTIVE: To determine stability parameters in clinical balance tests and posturography that can assess age-related changes in posture control sensitively METHOD: Thirty nine healthy elderly people over 60 years old and twenty young controls were recruited. Elderly people were subdivided into 3 groups by age (aged 60~69, 70~79, over 80). Subjects were evaluated with clinical balance tests and posturography. In posturography, center of pressure (COP) parameters were obtained as total path distance, sway area, mean frequency of sway in comfortable standing. Visual feedback system (VFS) was added to posturography and then subjects were asked to move their COP into the target circle on monitor with active movement on force plate. In VFS, time to get in the circle, total path of deviation, time in the circle were measured. RESULTS: Time in the circle assessed by posturography with VFS showed significant difference between age groups (p<0.05). Significant correlations between time in the circle and clinical balance tests were also found (p<0.01). CONCLUSION: A posturography with VFS was considered to have clinical usefulness in sensitive evaluation of age-related change of balance control in healthy elderly people.

Assessments of Static Balance Using Virtual Moving Surround

OBJECTIVE: To assess the static balance under the virtual moving surround (VMS) in healthy young and elderly adults. METHOD: There were twenty four healthy young adults and thirty nine healthy elderly aged 60 and older. Each group was tested with forceplate during quite standing with eyes opened, closed and under the VMS for static balance. The VMS was stimulated with a head-mounted display (HMD). The parameters for static balance were total sway path distance and area. RESULTS: All static balance parameters of healthy elderly were significantly increased in all conditions when compared with parameters of young adults. In the young adults and elderly, total sway path distance and sway area were significantly different under the VMS. In the healthy elderly, total sway path distance and sway area were significantly increased under the VMS as much as eyes closed. CONCLUSION: In the healthy adults, the VMS could provoke the significant postural sway during static standing. VMS can be used as a tool to evaluate and treat of the patients with static balance dysfunction.

Static Posturographic Characteristics during Balance Control under Virtual Moving Surround in Patients with Chronic Ankle Sprain

OBJECTIVE: To investigate static posturographic characteristics during balance control under virtual moving surround (VMS) using force platform and head mount display (HMD) device in patients with chronic ankle sprain as compared with that of normal adults. METHOD: Ten patients with chronic ankle sprain and 24 healthy adults participated. Center of pressure (COP) parameters were obtained for 20 seconds using force platform as total path distance and total sway area in following conditions (1) comfortable standing with opened and closed eyes, (2) VMS delivered using HMD with four different moving patterns. The virtual moving patterns composed of close-far, superior-inferior tilting (pitch), right-left tilting (roll) and horizontal rotation (yaw) movement. RESULTS: No significant difference was found between patients with chronic ankle sprain and healthy adults on comfortable standing with both open and closed eyes. But, patients revealed significantly increased total path distance and sway area of COP on all VMS conditions. CONCLUSION: These results showed that under VMS conditions patients with the weaker balance control problem were more sensitive to balance control than simple comfortable standing conditions with opened and closed eyes.

Effect of Characteristics of Joint Motion of Lower Extremity according to Aging on Balance in Elderly

OBJECTIVE: To investigate the effect and the correlation of characteristics of joint motion of lower extremity according to aging on balance in elderly. METHOD: There were thirty nine healthy elderly subjects aged 60 and older. The subjects were divided into 3 groups by their age. Each group was measured with joint motion of bilateral lower extremities by goniometer. The subjects were evaluated with clinical balance tests [(Berg balance scale (BBS), Functional reach test (FRT), Tinetti's performance oriented mobility assessment (POMA), and one leg standing (OLS)]. RESULTS: The flexibilities of lower extremities were decreased according to the increase in age. The balance ability was also decreased according to the increase in age by tested clinical balance scores. The flexibility of the ankle joints showed the strongest correlation with clinical balance scores (BBS, FRT, POMA and OLS) according to the increase in age, and the flexibility of hip joints also correlated with clinical balance scores (POMA and OLS). CONCLUSION: Among clinically validated balance tests, the decline of balance performance related with aging. Correlation exists between ankle ROM and balance in healthy elderly people. Additional research is needed to add the ankle ROM to reflect the excise for balance tests and balance ability.

Effect of Dynamic Balance Training Using Visual Biofeedback of Center of Pressure in Patients with Stroke

OBJECTIVE: To investigate the effect of dynamic balance training with center of pressure (COP) games using visual biofeedback of COP movement in stroke patients. METHOD: Thirty-eight stroke patients were randomly as signed to the static or dynamic balance training group, or control group. Static group received weight-shift training with visual biofeedback of weight distribution bar. Dynamic group received dynamic balance training using COP games. Each training session lasted 30 minutes, 3 times in a week during 3 weeks. Control group received traditional rehabilitation only. The ability of balance control was assessed using posturography by total path distance, frequency of sway, and COP weight-spectrums during standing, and during presentation of virtual moving surround. Total patherror was also assessed during sine curve and dynamic circle trace test. RESULTS: In static group, there were significant improvement in the total path distance during comfortable standing and path error during sine curve tracing. In dynamic group, significant improvements were found in the path error during sine curve and dynamic circle tracing. CONCLUSION: Dynamic training group showed more improvement in dynamic balance ability, whereas static group showed more changes in the static balance ability. The visual biofeedback training is more specified for balance rehabilitation in stroke patients.