Long-term living in unfavorable socioeconomic conditions impairs late-life gait performance.

BACKGROUND: Low socioeconomic status has been associated with individual health-related problems; however, no study has specifically investigated the impact of socioeconomic disparities on gait performance using an index that considers the population aggregation, as the Human Development Index (HDI). Thus, the aim of the present study was to assess gait parameters of older people living in cities with differences in socioeconomic conditions, identified by HDI. METHODS: Cross-sectional design study conducted with a sample of 233 older people from two Brazilians regions: Coari, state of Amazonas, Brazil (n= 124, low-HDI-Bra) and Ribeirão Preto, state of São Paulo, Brazil (n= 109, very high-HDI-Bra). The gait performance was assessed by an electronic walkway, and the interest variables were gait speed, cadence, stride time, step length and stride width. RESULTS: Low-HDI-Bra group presented worse gait performance as identified by slower gait speed (p = < .001), slower cadence (p = < .001), higher stride time (p = < .001), shorter step length (p = < .001), compared with the very high-HDI-Bra group. There was a positive association between HDI, and gait spend, cadence and step length, and there was a negative association between HDI and stride time and stride width. CONCLUSIONS: Long-term exposure to socioeconomic inequalities found in low HDI cities may impair gait performance in late life. Such information may be relevant to create public politics that use the gait parameter based on the region where the people live.

Effect of Aging on Trunk Muscle Function and Its Influence on Falls Among Older Adults.

The objective was to determine whether trunk muscle function is influenced by the aging process and to identify if the trunk can be an important factor in older people's falls over a period of 1 year. The peak torque, rate of torque development, and torque steadiness of the trunk extensors and flexors were compared between a young group, older group (older adults with no episodes of falls), and older faller group (older adults who had suffered at least one fall episode over a period of 1 year) by one-way analysis of variance, followed by the post hoc Tukey test. The adjusted multivariate linear regression was applied to verify the association between the number of falls and the trunk parameters in older adults. The young group showed higher extensors and flexors peak torque and rate of torque development, and lower extensor torque steadiness at 10% when compared with older groups. Only trunk flexor peak torque showed a negative association with the number of future falls (p = .042), but there was no difference in trunk muscle function between the older group and the older faller group.

Effects of the Use of Anchor Systems in the Rehabilitation of Dynamic Balance and Gait in Individuals With Chronic Dizziness of Peripheral Vestibular Origin: A Single-Blinded, Randomized, Controlled Clinical Trial.

OBJECTIVE: To assess the effectiveness of the anchors in the balance rehabilitation of participants with chronic peripheral vestibulopathy who failed to respond positively to conventional rehabilitation for dynamic balance and gait. DESIGN: Assessor-blind, randomized controlled trial. SETTING: Department of Otoneurology and Laboratory of Assessment and Rehabilitation of Equilibrium. PARTICIPANTS: Women with chronic dizziness of peripheral vestibular origin (N=42), who continued to show otoneurologic symptoms for more than 6 months after starting classic vestibular rehabilitation, with no clinical improvement observed. INTERVENTIONS: Participants were randomly assigned to receive a clinical intervention with the anchor system, a clinical intervention without the anchor system, or no intervention or anchor system. The intervention was based on multi-sensory exercises for 6 weeks, twice a week, totaling 12 sessions, in groups of up to 4 participants, with an average time of 40 minutes per session. MAIN OUTCOME MEASURES: The primary outcome was functional balance as assessed by the short version of the Balance Evaluation Systems Test. The secondary outcomes were gait parameters of step width in meters, step length in meters, and gait speed in meters per second. The measures were assessed preintervention and postintervention, and after a 3-month follow-up period. RESULTS: The proposed intervention was beneficial for dizziness, balance, and gait for both groups studied. At the 3-month follow-up, only the group that used anchors retained the benefits related to the physical aspects of dizziness, balance, and gait. CONCLUSIONS: The present study found that the proposed intervention protocol, with or without the use of anchors, was beneficial for improving the dizziness, balance, and gait. However, retention of the benefits achieved through the exercise protocol was observed only for those using the anchor system, which promotes the use of haptic information. The use of anchors was effective, in short protocols (12wk), with maintenance of results after 3 months.

The influence of vision and support base on balance during quiet standing in patients with adolescent idiopathic scoliosis before and after posterior spinal fusion.

BACKGROUND CONTEXT: Scoliosis is the most common postural alteration in adolescence and is characterized by deviations of the spine in three planes. Surgical treatment based on arthrodesis has been developed, but the effects of such restructuring on the systems involved in postural control need to be better understood. PURPOSE: To assess the influence of vision and the support base on balance in the quiet standing position in adolescents awaiting surgical treatment for idiopathic scoliosis. STUDY DESIGN/SETTING: Longitudinal study/Ribeirão Preto Clinics Hospital (HC-FMRP-USP) and Laboratory of Assessment and Rehabilitation of Equilibrium at the FMRP-USP. PATIENT SAMPLE: Adolescent idiopathic scoliosis patients and controls. OUTCOME MEASURES: Center of pressure (CoP) sway area of the 95% confidence ellipse. METHODS: Thirty female adolescents were divided into two groups according to their spinal alignment: control (n=15) and scoliosis groups (SGs) (n=15). The subjects with scoliosis were evaluated before and 7, 30, 60, and 90 days after surgery; the controls were evaluated once. The area of CoP oscillation was measured with the eyes open and closed and with two different support bases (feet apart or together). The force platform was purchased with funding support (US $8,375.00) provided by the Research Foundation of São Paulo (FAPESP). The study sponsors had no involvement in the study. Data were collected from the force platform and then statistically assessed through a linear model analysis of mixed effects. RESULTS: Data reveal that subjects in the SG oscillated more than controls, and postsurgery subjects had more oscillation than presurgery subjects. The results also indicated that both groups (control and scoliosis) showed more oscillation among those subjects with feet apart and eyes closed, but subjects with scoliosis were more affected by vision deprivation than by a reduced support base. CONCLUSIONS: Our results indicate that adolescents with idiopathic scoliosis are more dependent on visual information and that surgical correction does not change this relationship.