Investigating Relationships between Balance Confidence and Balance Ability in Older Adults.

Increasing balance confidence in older individuals is important towards improving their quality of life and reducing activity avoidance. Here, we investigated if balance confidence (perceived ability) and balance performance (ability) in older adults were related to one another and would improve after balance training. The relationship of balance confidence in conjunction with balance performance for varied conditions (such as limiting vision, modifying somatosensory cues, and also base of support) was explored. We sought to determine if balance confidence and ability, as well as their relationship, could change after several weeks of training. Twenty-seven healthy participants were trained for several weeks during standing and walking exercises. In addition, seven participants with a higher risk of imbalance leading to falls (survivors of stroke) were also trained. Prior to and after training, balance ability and confidence were assessed via the Balance Error Scoring System (BESS) and Activities Specific Balance Confidence (ABC) Scale, respectively. Both groups showed improvements in balance abilities (i.e., BESS errors significantly decreased after training). Balance confidence was significantly higher in the healthy group than in the stroke group; however, ABC results reflected that balance confidence did not significantly increase after training for each. The correlations between balance ability and balance confidence were explored. Encouragingly, healthy participants displayed a negative correlation between BESS errors and ABC (i.e., enhancements in balance confidence (increases in ABC Scale results) were related to improvements in balance ability (decreases in BESS errors)). For the stroke participants, despite improvements in balance ability, our results showed that there was no relation to balance confidence (i.e., no correlation between BESS errors and ABC) in this group.

Multidirectional Overground Robotic Training Leads to Improvements in Balance in Older Adults.

For the rapidly growing aging demographic worldwide, robotic training methods could be impactful towards improving balance critical for everyday life. Here, we investigated the hypothesis that non-bodyweight supportive (nBWS) overground robotic balance training would lead to improvements in balance performance and balance confidence in older adults. Sixteen healthy older participants (69.7 ± 6.7 years old) were trained while donning a harness from a distinctive NaviGAITor robotic system. A control group of 11 healthy participants (68.7 ± 5.0 years old) underwent the same training but without the robotic system. Training included 6 weeks of standing and walking tasks while modifying: (1) sensory information (i.e., with and without vision (eyes-open/closed), with more and fewer support surface cues (hard or foam surfaces)) and (2) base-of-support (wide, tandem and single-leg standing exercises). Prior to and post-training, balance ability and balance confidence were assessed via the balance error scoring system (BESS) and the Activities specific Balance Confidence (ABC) scale, respectively. Encouragingly, results showed that balance ability improved (i.e., BESS errors significantly decreased), particularly in the nBWS group, across nearly all test conditions. This result serves as an indication that robotic training has an impact on improving balance for healthy aging individuals.

Sensory integration training improves balance in older individuals.

With the massive growth of the aging population worldwide, of utmost importance is reducing falls. Critical to reducing fall risk is one's ability to weight incoming sensory information towards maintaining balance. The purpose of this research was to investigate if simple, targeted sensory training on aging individuals (50 - 80 years old), including twelve healthy and eight individuals with chronic stroke, could improve their balance. Repeated sensory training targeted visual (via eyesopen/closed) and somatosensory inputs (via light touch to the fingertip as well as hard, soft foam, and hard foam support surfaces to the feet) during standing and dynamic base-ofsupport (BOS) exercises. Study participants underwent six weeks of training. Prior to and post training, standing balance was assessed via a simple, clinical measure: the balance error scoring system (BESS). Following several weeks of training, participants showed significant improvements in BESS errors: healthy participants for small BOS with limited somatosensory information (i.e., tandem and single-leg standing on foam) and participants with stroke in all conditions.Clinical Relevance- This research study demonstrated that simple, accessible exercises, can positively impact balance in the aging population, a pressing need.