The effect of foot somatosensory loss in postural control during Functional reach test in patients with diabetic polyneuropathy: A controlled study.

BACKGROUND: In patients with diabetic polyneuropathy (DPN), differences in postural control due to losing the lower limb somatosensory information were reported. However, it is still unclear by which mechanisms the dynamic postural instability is caused. OBJECTIVES: This study aimed to investigate postural control differences and neuromuscular adaptations resulting from foot somatosensory loss due to DPN. METHODS: In this controlled cross-sectional study, fourteen DPN patients and fourteen healthy controls performed the Functional Reach Test (FRT) as a dynamic task. The postural control metrics were simultaneously measured using force plate, motion capture system, and surface electromyography (sEMG). The main metrics including reach length (FR), FR to height ratio (FR/H), displacement of CoM and CoP, moment arm (MA), and arch height ratio. Also, kinematic (range of motion of ankle, knee, and hip joints), and sEMG metrics (latencies and root mean square amplitudes of ankle and hallux muscles) were measured. To compare variables between groups, the independent sample T-test for (normally distributed) and the Mann-Whitney U test (non-normally distributed) were used. RESULTS: The subjects' reach length (FR), FR to height ratio, absolute MA, and displacement of CoM were significantly shorter than controls, while displacement of CoP was not significant. Arch height ratio was found significantly lower in DPN patients. We observed that CoM was lagging CoP in patients (MA = + 0.89) while leading in controls (MA = -1.60). Although, the muscles of patients showed significantly earlier activation, root mean square sEMG amplitudes were found similar. Also, DPN patients showed significantly less hip flexion, knee extension, and ankle plantar flexion. CONCLUSIONS: This study presented that decreasing range of motion at lower limbs' joints and deterioration in foot function caused poor performance at motor execution during FRT in DPN patients.

Sensor-based systems for the measurement of Functional Reach Test results: a systematic review.

The measurement of Functional Reach Test (FRT) is a widely used assessment tool in various fields, including physical therapy, rehabilitation, and geriatrics. This test evaluates a person's balance, mobility, and functional ability to reach forward while maintaining stability. Recently, there has been a growing interest in utilizing sensor-based systems to objectively and accurately measure FRT results. This systematic review was performed in various scientific databases or publishers, including PubMed Central, IEEE Explore, Elsevier, Springer, the Multidisciplinary Digital Publishing Institute (MDPI), and the Association for Computing Machinery (ACM), and considered studies published between January 2017 and October 2022, related to methods for the automation of the measurement of the Functional Reach Test variables and results with sensors. Camera-based devices and motion-based sensors are used for Functional Reach Tests, with statistical models extracting meaningful information. Sensor-based systems offer several advantages over traditional manual measurement techniques, as they can provide objective and precise measurements of the reach distance, quantify postural sway, and capture additional parameters related to the movement.

Effect of controlled start position on the reach distance distribution range in the functional reach test among community-dwelling older adults.

[Purpose] This study investigated the effect of controlled start position (CSP) on the reach distance distribution range (RDDR) in the functional reach test (FRT) in community-dwelling older adults. [Participants and Methods] The participants were 34 community-dwelling older adults. We compared the RDDR in CSP and non-CSP and analyzed the relationship between the mean reach distance (MRD) and the length of movement of the center of pressure (LMCOP). [Results] The RDDR in CSP condition was significantly lower than non-CSP condition. A significant positive correlation was observed only for CSP condition. In the non-CSP condition, MRD was not reflected in the LMCOP. [Conclusion] The FRT in the CSP effectively reflects the standing balance ability of community-dwelling older adults.

Mobile Data Gathering and Preliminary Analysis for the Functional Reach Test.

The functional reach test (FRT) is a clinical tool used to evaluate dynamic balance and fall risk in older adults and those with certain neurological diseases. It provides crucial information for developing rehabilitation programs to improve balance and reduce fall risk. This paper aims to describe a new tool to gather and analyze the data from inertial sensors to allow automation and increased reliability in the future by removing practitioner bias and facilitating the FRT procedure. A new tool for gathering and analyzing data from inertial sensors has been developed to remove practitioner bias and streamline the FRT procedure. The study involved 54 senior citizens using smartphones with sensors to execute FRT. The methods included using a mobile app to gather data, using sensor-fusion algorithms like the Madgwick algorithm to estimate orientation, and attempting to estimate location by twice integrating accelerometer data. However, accurate position estimation was difficult, highlighting the need for more research and development. The study highlights the benefits and drawbacks of automated balance assessment testing with mobile device sensors, highlighting the potential of technology to enhance conventional health evaluations.

Effects of noisy galvanic vestibular stimulation on functional reach test.

Balance disorders are a risk factor for falls in older individuals, and an increased center of pressure (COP) sway path length during standing and decreased reach distance in the functional reach test (FRT) predispose them to falls. Reportedly, noisy galvanic vestibular stimulation (nGVS) reduces COP sway path length during standing in young and community-dwelling older individuals and suggested to be a promising approach to improve balance function. However, the effect of nGVS on FRT remains unclear. Therefore, this study aimed to clarify the effect of nGVS on the FRT reach distance. This study has a cross-over design and included 20 healthy young adults. Interventions under nGVS (stimulation intensity: 0.2 mA) and sham (stimulation intensity: 0 mA) conditions were randomly administered to each participant. The participants underwent COP sway during standing measurements and FRT pre-intervention and post-intervention under each condition, and COP sway path length and the FRT reach distance were calculated. Statistical analysis revealed a significant decrease in post-intervention COP sway path length compared with pre-intervention COP sway path length under the nGVS condition. Conversely, the FRT reach distance remained the same under both nGVS and sham conditions. Thus, nGVS may improve the standing balance function but cannot change the FRT reach distance in healthy young individuals.

Chest and pelvis coordination during functional reach test: A possible indication of balance deficiency in older adults.

Falls in older adults represent the most common cause of injuries and a major cause of mortality in this vulnerable population. The morbidity and mortality rate of falls among older people makes balance analysis in older adults very important. Therefore, this study aims to explore different metrics that can potentially be used to identify early indications of balance loss and fall risk. To that end, the motion strategies and chest and pelvis coordination of a group of younger, a group of older non-faller and a group of older faller participants while conducting the functional reach test were investigated. To analyse the motion strategies of the different participant groups, four metrics of maximum angular rotation of chest, maximum angular rotation of pelvis, time warped chest and pelvis angular rotation difference, and the mean continuous relative phase of the chest and pelvis were assessed. In this study younger participants are found to have larger maximum chest rotation, maximum pelvis rotation, and time warped chest and pelvis angular rotation difference compared to older participants. However, these metrics were not significantly different in older non-fallers compared to older fallers. Meanwhile, the mean continuous relative phase of the chest and pelvis was the only metric found to be significantly different among all three participant groups. This metric is indicative of the chest and pelvis coordination which is associated with the ability to construct proper coordination and maintain balance. The mean continuous relative phase yielded the sensitivity of 92.3% and specificity of 73.7% in recognizing older fallers from older non-fallers. The results suggest that this metric might be useful in identifying the risk of falling in older population, thus, it should be further studied in a prospective study.

Effect of a controlled starting position on the relationship between the forward reach distance and movement distance of the center of pressure in the functional reach test using the ankle joint strategy.

[Purpose] This study aimed to clarify whether the distribution range of the forward reach distance and the relationship between the forward reach distance and the movement distance of the center of pressure differed depending on whether the controlled starting standing position during the functional reach test with an ankle joint strategy. [Participants and Methods] Sixteen healthy male volunteers participated in the study. The distribution range of the forward reach distance and the relationship between the forward reach distance and movement distance of the center of pressure in the controlled starting standing position and non-controlled starting standing position conditions were analyzed. [Results] The distribution range of the forward reach distance was significantly smaller in the controlled starting standing position than in the non-controlled starting standing position. In both groups, the forward reach distance was associated with the movement distance of the center of pressure. [Conclusion] The findings suggested that the use of an ankle joint strategy with a controlled starting standing position in the functional reach test may be a more accurate method to evaluate standing balance ability.

The functional reach test in people with multiple sclerosis: a reliability and validity study.

BACKGROUND: Limits of stability (LOS) is a major component of balance dysfunction in people with multiple sclerosis (MS). The functional reach test (FRT) is a clinical LOS assessment; however, its psychometric properties have not been investigated in people with MS yet. Objectives: To investigate: (1) the intrarater, interrater, and test-retest reliability of the FRT in people with MS; (2) the minimum detectable change (MDC) in the FRT distances; (3) the concurrent and discriminant validity of the FRT; and (4) the cutoff distance that best discriminates people with MS from healthy people and fallers from non-fallers with MS. METHODS: Forty-three people with MS and 36 healthy people participated in this study. The FRT was administered along with the instrumented LOS test, Berg Balance Scale, Four Square Step Test, Timed Up and Go Test, and Expanded Disability Status Scale. The FRT was repeated by the same rater after 2 min from the first test session to determine the intrarater reliability and was simultaneously conducted by two independent raters to determine the interrater reliability. The FRT was also repeated after 7-10 days to determine the test-retest reliability. The reliability was quantified using intraclass correlation coefficients (ICC), Bland-Altman plots, and the MDC. The validity was assessed by correlating the FRT distances with the scores of other measures and by comparing the FRT distances between the MS group and healthy people, and between the fallers and non-fallers in the MS group. RESULTS: The FRT demonstrated good to excellent intrarater, interrater, and test-retest reliability with an ICC (3,1) of 0.80-0.88 (p < .001), an ICC (3,2) of 0.94-0.97 (p < .001), an ICC (2,3) of 0.84-0.86 (p < .001), respectively. Bland-Altman analyses showed no systematic bias between the assessments. The MDC was 8.28 centimeters. The FRT was correlated with the other outcome measures (correlation coefficients ranged from 0.31 to 0.79, p < .05 for all). Significant differences in the FRT distances were found between people with MS and healthy people; however, no significant difference was found between the fallers and non-fallers with MS (p < .001 and p = .09, respectively). The cutoff distance of 35.5 centimeters best discriminates healthy people from people with MS while of 28.5 centimeters did not discriminate between the fallers and non-fallers with MS. CONCLUSIONS: The FRT is a reliable, valid, and easy-to-administer tool for assessing LOS in people with MS.

Correlation between community balance and mobility scale (CB&M) with a battery of outcome measures to assess balance in Parkinson's disease - a cross-sectional study.

BACKGROUND: Evaluating balance in a functional context that integrates challenging tasks frequently performed in the community is essential to identify community-dwelling individuals who are at risk of falls in early Parkinson Disease (PD) than a simple balance measure. Community Balance and Mobility (CB&M) scale is one such measure that evaluates severe deficits in gait, balance, and mobility. The risk of falling and fear of fall is common among PD individuals and this affects the day to day functioning as well as the quality of life. Early identification of individuals who may be at risk to fall will lead to intervention strategies that can help to with balance issues. The aim of this study was to correlate between Community Balance and Mobility with a battery of outcome measures commonly used to assess balance in Parkinson's disease. METHODS: A cross sectional study design; with individuals referred to Outpatient physiotherapy department, diagnosed with idiopathic Parkinson's disease, independently mobile and on a stable drug regimen referred by the neurologist; were screened and recruited by convenience sampling. With written informed consent, demographic data gathered and scales such as Berg Balance scale, Community balance & mobility scale, Functional Reach test and Timed up and go test were administered with an ample amount of rest. RESULTS: The results obtained were documented and analysed using Karl Pearson's correlation coefficient. Significant correlation between CB&M and BBS (r = 0.795) was found, CB&M and TUG (r = - 0.755), CB&M and FRT (r = 0.772). CONCLUSION: CB&M is a useful measure which integrates items that challenge balance in the community context. It has been used to assess high functioning community dwelling individuals and hence may be apt for individuals with early Parkinson's, since the tasks to be performed in CB&M are challenging and these simulate community level activities where the risk of falls is higher. It may well be a good tool to assess early Parkinson's; their level of balance, community level activity and without need for sophisticated & expensive equipment.

Risk Factors for Falls in Patients with Alzheimer Disease: A Retrospective Study of Balance, Cognition, and Visuospatial Ability.

AIM: This study aimed to determine the main risk factors for falls in patients with Alzheimer disease (AD) by comparing balance, cognition, and visuospatial ability between those who have experienced a fall and those who have not. METHODS: Forty-seven AD patients were admitted to a ward for patients with dementia (22 men and 25 women). The balance of patients was evaluated using the Functional Reach Test (FRT), the one-leg standing duration, and the Timed Up and Go (TUG) test. The Mini-Mental State Examination-Japanese (MMSE-J) was used to evaluate cognition. For visuospatial ability assessment, the Clock-Drawing Test (CDT) as well as overlapping figure identification and shape discrimination in the Visual Perception Test for Agnosia (VPTA) were used. The patients were allocated to either the fall group or the nonfall group based on their history of falls in the past year. The relationships between patients' characteristics and evaluation outcomes were compared and examined. Logistic regression analysis was performed using a fall as the objective variable. The area under the curve (AUC) and the cutoff value were calculated. RESULTS: Of the 47 participants, 22 had experienced falls within the past year (46.8%). The results of the FRT, one-leg standing duration, the TUG, the CDT, and the VPTA were significantly lower in the fall group. No significant difference between the MMSE-J scores of the fall group and those of the nonfall group was observed. The results of the logistic regression analysis indicated that falls in AD patients were significantly associated with the FRT. It was found that a shorter FRT distance (cm) had a significant impact on falls. For the FRT, the fall-related AUC was 0.755. At a cutoff value of 24.5 cm, the level of sensitivity was 68.0%, and the level of specificity was 77.3%. CONCLUSIONS: The findings of this study indicate that balance and visuospatial abilities are risks factors for falls in AD patients. In contrast, cognitive impairment was not a risk factor for falls. It was demonstrated that the FRT could be an appropriate risk predictor for falls in AD patients. In particular, falls in AD patients were strongly affected by a reduced dynamic balance.

Reliability of measurement using Image J for reach distance and movement angles in the functional reach test.

[Purpose] The purpose of this study was to examine the test-retest reliability and minimal detectable change (MDC) of reach distance and movement angle analyses using Image J. [Participants and Methods] Thirty-eight healthy young males performed the functional reach test (FRT) twice, and their reach movements were recorded using a digital video camera. Image J was used to combine the digital photographs taken at the start position and maximum reach and to measure each movement. The measurements recorded were the movement distance of the third metacarpal bone (reach distance), anterior-superior iliac spine, and trochanter major, and the angles recorded were the acromion-malleolus lateralis, acromion-trochanter major, and trochanter major-malleolus lateralis. The reliability of all the measurements was analyzed using intraclass correlation coefficients (ICCs), Bland-Altman plots, and MDCs. [Results] The ICCs (1, 1) were >0.80 for all the outcomes. The Bland-Altman analysis revealed no systematic bias in any outcome. The MDC of reach distance was 18.3 mm. [Conclusion] Measurement using Image J for reach distance and movement angles in the FRT showed acceptable high test-retest reliability. Measurement of the FRT and the MDC calculated in this study could be used as a reference for further research.

Advance in Application of Functional Reach Test (review) / 中国康复理论与实践

The evaluation of balance includes clinical observation, scales and instrumental measures. Functional Reach Test is simple and can be carried out in both standing and sitting, but the error of reading the measuring ruler is large, which results in new moving rulers and inertial sensors. The factors influencing the results of Functional Reach Test are moving strategy, age, moving efficiency, goal orientation, single or double arms, human characteristics, number of experiments and others. In the future, combination of electromyogram and inertia sensor can be used to discuss the variety of muscles and the changes of muscle strength, and more influence factors for the test are needed to research.

Epidural Electrical Stimulation of the Lumbosacral Spinal Cord Improves Trunk Stability During Seated Reaching in Two Humans With Severe Thoracic Spinal Cord Injury.

Background: Quality of life measurements indicate that independent performance of activities of daily living, such as reaching to manipulate objects, is a high priority of individuals living with motor impairments due to spinal cord injury (SCI). In a small number of research participants with SCI, electrical stimulation applied to the dorsal epidural surface of the spinal cord, termed epidural spinal electrical stimulation (ES), has been shown to improve motor functions, such as standing and stepping. However, the impact of ES on seated reaching performance, as well as the approach to identifying stimulation parameters that improve reaching ability, have yet to be described. Objective: Herein, we characterize the effects of ES on seated reaching performance in two participants with chronic, complete loss of motor and sensory functions below thoracic-level SCI. Additionally, we report the effects of delivering stimulation to discrete cathode/anode locations on a 16-contact electrode array spanning the lumbosacral spinal segments on reach distance while participants were seated on a mat and/or in their wheelchair. Methods: Two males with mid-thoracic SCI due to trauma, each of which occurred more than 3 years prior to study participation, were enrolled in a clinical trial at Mayo Clinic, Rochester, MN, USA. Reaching performance was assessed, with and without ES, at several time points throughout the study using the modified functional reach test (mFRT). Altogether, participant 1 performed 1,164 reach tests over 26-time points. Participant 2 performed 480 reach tests over 17-time points. Results: Median reach distances during ES were higher for both participants compared to without ES. Forward reach distances were greater than lateral reach distances in all environments, mat or wheelchair, for both participants. Stimulation delivered in the caudal region of the array resulted in improved forward reach distance compared to stimulation in the rostral region. For both participants, when stimulation was turned off, no significant changes in reach distance were observed throughout the study. Conclusion: ES enhanced seated reaching-performance of individuals with chronic SCI. Additionally, electrode configurations delivering stimulation in caudal regions of the lumbosacral spinal segments may improve reaching ability compared to rostral regions.

Augmented reality-assisted training with selected Tai-Chi movements improves balance control and increases lower limb muscle strength in older adults: A prospective randomized trial.

BACKGROUND: Tai-Chi benefits older adults by enhancing balance control and increasing the muscle strength of the lower limbs. However, a complete set of traditional Tai-Chi exercises is sometimes too difficult for beginners. We investigated whether practicing augmented reality-assisted training with selected Tai-Chi movements tailored to the practitioner's ability (selected Tai-Chi, or sTC) is as effective as performing a complete set of Tai-Chi sequences (complete traditional Tai-Chi, or tTC). METHODS: In this prospective randomized trial carried out in the Beitou District of Taipei City, Taiwan, community-dwelling adults aged ≥65 and without any debilitating diseases (n = 28) were included. Participants were randomly assigned to the sTC group (n = 14) or the tTC group (n = 14). Participants in the sTC group practiced selected Tai-Chi movements using the augmented reality Tai-Chi training system. Participants of the tTC group were asked to complete the 24-form Yang-style Tai-Chi following the instructions of Tai-Chi masters. Each training session lasted 30 min, with 3 sessions per week for 8 weeks. Pre- and post-intervention evaluations included functional balance tests, comprising the Berg Balance Scale (BBS), Timed Up and Go test (TUG), and Functional Reach Test (FRT), as well as muscle strength measurements of the lower extremities. RESULTS: Pre-intervention evaluations showed significant differences in FRT (p = 0.034) and left hip abductor muscle strength (p = 0.046) between the sTC and tTC groups. After 8 weeks of training, the BBS, TUG, and FRT scores in the sTC group showed significant improvement overall. Although all three functional balance test scores improved in the tTC group, only the improvement in BBS was statistically significant (p = 0.001). After 8 weeks, all muscle strength measurements increased by an average of 3.1 ± 1.0 kgw in the sTC group and 1.6 ± 0.8 kgw in the tTC group. CONCLUSIONS: The augmented reality-assisted training with selected Tai-Chi movements, designed based on objective measurements of the practitioner's capability, improved balance control and muscle strength of lower limbs at least as effectively as the complete sequence of traditional Tai-Chi exercises. TRIAL REGISTRATION: This study was approved by the Institutional Review Board of National Yang-Ming University (IRB number: 1000087). Written informed consent was obtained from all participants.

Common balance measures and fall risk scores among older adults in Pakistan: Normative values and correlation.

The objective of this study was to assess the balance and fall risk among the community dwelling healthy older adults in Pakistan and to determine the correlation between balance measures and fall risk, for which a crosssectional correlation study was conducted at Foundation University Islamabad and Fauji Foundation Hospital from March 2016 to February 2017. A total of 77 individuals over 50 years were included via convenience sampling. I n di vi d u al s w i t h he a r i ng /v is ua l an d c o gn it ive impairments, infections, and orthopaedic and severe comorbid conditions were excluded. Data collection tools included Berg Balance Scale (BBS), Timed Up and Go (TUG) test, Functional Reach Test (FRT) and Fall Risk Score (FRS). Independent t-test and Bivariate Pearson Correlation (CI=95%, P<0.05) were used for analysis. Mean value of the BBS, FRS, TUG and FRT was 41.36±2.96, 3.40±1.47, 15.90±2.68 and 13.34±3.45 respectively. Age had a significant (p<0.05) positive correlation with FRS and negative correlation with BBS. A significant correlation (P<0.05) was found only between FRT & TUG and TUG & BBS.

Relationship of Functional Reach Test scores and falls in Special Olympics athletes.

BACKGROUND: The Functional Reach Test is used to assess balance of Special Olympic athletes as part of the FUNfitness screens held at Special Olympics games. However, it is unknown if the Functional Reach Test is an accurate assessment of balance in this population. The objective of this study was to explore the relationship between Functional Reach Test scores and falls in Special Olympic athletes. METHODS: Data were collected as a part of the FUNfitness screens during Arizona Special Olympics games. The Functional Reach Test scores of 272 Special Olympic athletes were recorded. Athletes were asked to report the number of falls they experienced in the last 12 months. RESULTS: A two-tailed Kendall tau test revealed little to no relationship between number of falls and Functional Reach Test scores of either the left upper extremity (n = 263, τ = -0.063, P = 0.202) or the right upper extremity (n = 263, τ = -0.107, P = 0.030). Sensitivity of the Functional Reach Test to identify fallers was 28.8%, and specificity was 83.5%. CONCLUSIONS: Scores of the Functional Reach Test did not correlate with actual falls. The relatively high specificity indicates the assessment is good at identifying non-fallers, while the low sensitivity results in a high number of fallers not being recognised as such. Therefore, the cut-off scores used for the Functional Reach Test in FUNfitness screenings may need to be altered to more accurately identify balance deficits in this population. FUNfitness screens need to be quick, efficient and accurate. As such, selection of the most appropriate assessment tools is essential. Consideration should be given on how to make the Functional Reach Test the most beneficial as a FUNfitness screen.

Effects of anterior weight-shifting methods on sitting balance in wheelchair-dependent patients with spinal cord injury.

[Purpose] This study aimed to compare changes in the center of pressure between healthy subjects and patients with spinal cord injury and to provide basic information to these patients for improving their sitting balance. [Subjects and Methods] A total of 12 healthy subjects without histories of neurological or psychiatric disorders and 12 patients with spinal cord injuries were recruited. In all subjects, a change in the center of pressure during the performance of the modified functional reach test was measured using a Force Sensing Array system while the subjects were seated in a wheelchair. In the spinal cord injury group, the change in the center of pressure was highest when subjects reached forward while holding a gym ball. [Results] In the spinal cord injury group, the change in the center of pressure was highest when subjects reached forward while holding a gym ball. A significant correlation between forward reaching of the upper limbs with shoulders at 90° flexion and a change in the center of pressure was found. [Conclusion] Our findings suggest that the combination of functional reaching and the change in the center of pressure assessment is novel enough to be attempted to achieve sitting balance control in patients with spinal cord injury. The findings can provide clinical interventions that contribute to the improvement in the balance ability of wheelchair-dependent individuals.

Associations of dietary patterns with bone mass, muscle strength and balance in a cohort of Australian middle-aged women.

Influences of dietary patterns on musculoskeletal health are poorly understood in middle-aged women. This cross-sectional analysis from a cohort of 347 women (aged 36-57 years) aimed to examine associations between dietary patterns and musculoskeletal health outcomes in middle-aged women. Diet was measured by the Cancer Council of Victoria FFQ. Total body bone mineral content (TB BMC), femoral neck and lumbar spine bone density (dual-energy X-ray absorptiometry), lower limbs muscle strength (LMS) and balance tests (timed up and go test, step test, functional reach test (FRT) and lateral reach test) were also measured. Exploratory factor analysis was used to identify dietary patterns and scores for each pattern generated using factor loadings with absolute values ≥0·20. Associations between food pattern scores and musculoskeletal outcomes were assessed using multivariable linear regression. Three dietary patterns were identified: 'Healthy' (high consumption of a plant-based diet - vegetables, legumes, fruit, tomatoes, nuts, snacks, garlic, whole grains and low intake of high-fat dairy products), 'high protein, high fat' (red meats, poultry, processed meats, potatoes, cruciferous and dark-yellow vegetables, fish, chips, spirits and high-fat dairy products) and 'Processed foods' (high intakes of meat pies, hamburgers, beer, sweets, fruit juice, processed meats, snacks, spirits, pizza and low intake of cruciferous vegetables). After adjustment for confounders, Healthy pattern was positively associated with LMS, whereas Processed foods pattern was inversely associated with TB BMC and FRT. The associations were not significant after accounting for multiple comparisons. There were no associations with any other outcomes. These results suggest that maintaining a healthy diet could contribute to bone acquisition, muscle strength and balance in adult life. However, while they provide some support for further investigating dietary strategies for prevention of age-related loss of muscle and deterioration in balance, the exploratory nature of the analyses means that confirmation in longitudinal studies and/or trials with pre-specified hypotheses is needed.

Analysis of the muscular activities of the tibialis anterior and gastrocnemius muscles in functional reach.

[Purpose] This study aimed to examine the changes in the muscle activities of each section of the tibialis anterior and gastrocnemius muscles in the functional reach test. [Subjects and Methods] This study selected those who can walk independently, can reach out their arm up to over 25 cm, can show over 90° shoulder joint bending, have not undergone an operation in the lower limb joint, and are not taking any medication affecting their ability to keep their balance from among 24 elderly males and 24 elderly females. The muscular activities of the tibialis anterior and gastrocnemius muscles were measured using the functional reach test and electromyogram. The functional reach test was conducted at a total of four sections: 0, 15, 20, and 25 cm. [Results] Gender and age affected the muscular activity by section in the functional reach test. It was also found that the gastrocnemius muscle was used more than the tibialis anterior muscle to keep the balance, and the aged subjects with good balance ability showed no great change in muscular activity on both stable and unstable ground. [Conclusion] It was found that the subjects used the tibialis anterior muscle more, and the lower limbs of the frequently used part, to keep their balance. As the aged subjects had good balance ability, they showed no great change in muscular activity on both stable and unstable ground.

Effects of Peripheral Vestibular Dysfunction on Dynamic Postural Stability Measured by the Functional Reach Test and Timed Up and Go Test.

OBJECTIVE: To investigate the influence of vestibular function on dynamic postural stability assessed by the functional reach test (FRT) and the timed up and go test (TUG). STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center. SUBJECTS AND METHODS: The FRT and TUG were performed in 399 patients with dizziness. The effects of peripheral vestibular dysfunction assessed by the caloric test and cervical vestibular evoked myogenic potentials (cVEMPs) to air-conducted sound (500 Hz, tone burst) on the results of FRT and TUG were analyzed. RESULTS: Neither FRT nor TUG scores showed significant differences in relation to the results of the caloric test ( P > .3). The FRT scores in patients who showed abnormal cVEMP responses on both sides were significantly smaller than those in patients who showed normal cVEMP responses ( P < .01). The TUG scores in patients who showed abnormal cVEMP responses on both sides were significantly greater than those in patients who showed normal cVEMP responses ( P < .05). CONCLUSION: The vestibulo-spinal reflex mediated by the saccule and its afferents is one of the factors that influence the maintenance of dynamic postural stability as measured by FRT and TUG.