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Current Aging Science 2024The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity,...
BACKGROUND
The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity, disability, and bone fractures, especially hip fractures. This study aimed to investigate balancing ability using a multi-directional reach test (MDRT) in older adults with and without diabetes mellitus.
METHODS
72 older adults with and without diabetes mellitus were recruited, and divided into two groups, including older adults without diabetes mellitus (n = 36) and older adults with diabetes mellitus (n = 36). All subjects completed all directions of the MDRT.
RESULTS
There were no significant differences in MDRT scores in all directions between the two groups (p>0.05). Both groups achieved the highest MDRT scores in the forward direction. In contrast, the two groups had the lowest scores of MDRT in a backward direction. Furthermore, older adults with diabetes mellitus had lower MDRT scores in all directions than older adults without diabetes mellitus.
CONCLUSION
The current study indicated that MDRT could be used to investigate the ability of balance in individuals with diabetes mellitus.
Topics: Humans; Aged; Male; Female; Diabetes Mellitus; Postural Balance; Geriatric Assessment; Accidental Falls; Aged, 80 and over; Age Factors; Aging; Case-Control Studies; Predictive Value of Tests
PubMed: 38904153
DOI: 10.2174/0118746098253144231024052312 -
Cureus May 2024Acute suppurative otitis media can occasionally result in facial paralysis, which calls for prompt diagnosis and treatment. Facial paralysis, a synonym for Bell's palsy,...
Acute suppurative otitis media can occasionally result in facial paralysis, which calls for prompt diagnosis and treatment. Facial paralysis, a synonym for Bell's palsy, is a condition that causes rapid weakening of one side of the face muscles, leading to drooping of the face on that side. A major factor in determining the course of the condition is rehabilitation through physiotherapy. Here, we present a case of a 26-year-old female who felt discomfort in her left ear on February 21, 2024, but chose to ignore it then. She observed an abrupt deviation in her mouth and visited a rural hospital, where she was admitted. Facial asymmetry was observed during the examination, and she was found to have a grade V on the House-Brackmann scale. A near-normal muscle action was initiated by mime therapy, and proprioceptive stimulation was given by facial proprioceptive neuromuscular facilitation along with electrical stimulation. All these approaches benefited the patient in a significant manner.
PubMed: 38903317
DOI: 10.7759/cureus.60795 -
Clinical Nutrition ESPEN Aug 2024Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit an inability to maintain postural balance. However, the contribution of increased...
AIMS
Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit an inability to maintain postural balance. However, the contribution of increased intestinal permeability or leaky gut to the postural imbalance in COPD is not known.
METHODS
We measured plasma zonulin, a marker of leaky gut, with relevance to postural balance in male controls (n = 70) and patients with mild (n = 67), moderate (n = 66), and severe (n = 58) COPD. We employed a short physical performance battery to evaluate postural balance in supine, tandem, and semi-tandem positions. We also measured handgrip strength (HGS), gait speed, plasma c-reactive proteins (CRP), and 8-isoprostanes as potential mechanistic connections between postural imbalance and leaky gut.
RESULTS
COPD patients demonstrated higher plasma zonulin, CRP, and 8-isoprostanes levels and lower balance, HGS, and gait speed than controls (all p < 0.05). These findings were more robust in patients with moderate and severe than mild COPD. In addition, plasma zonulin exhibited significant potential in diagnosing poor balance, low HGS, and gait speed in COPD patients (all p < 0.05). We also found significant correlations of plasma zonulin with CRP and 8-isoprostanes, providing heightened inflammation and oxidative stress as mechanistic connections between leaky gut and postural imbalance.
CONCLUSION
Plasma zonulin may be helpful in evaluating postural imbalance in COPD patients. Repairing intestinal leaks can be a therapeutic target to improve postural control in COPD.
Topics: Humans; Male; Pulmonary Disease, Chronic Obstructive; Postural Balance; Aged; Haptoglobins; Middle Aged; C-Reactive Protein; Biomarkers; Hand Strength; Protein Precursors; Cholera Toxin; Case-Control Studies; Permeability; Dinoprost
PubMed: 38901937
DOI: 10.1016/j.clnesp.2024.05.018 -
Clinical Nutrition ESPEN Aug 2024Skeletal muscles are essential for postural retention and balance function. However, the relationship between trunk muscle mass (TMM) and balance function has not yet... (Observational Study)
Observational Study
BACKGROUND & AIMS
Skeletal muscles are essential for postural retention and balance function. However, the relationship between trunk muscle mass (TMM) and balance function has not yet been clarified. This study aimed to examine the impact of TMM on the change in balance function in patients with stroke from admission to a rehabilitation hospital to discharge.
METHODS
This retrospective observational study included patients aged ≥65 years with cerebral infarction admitted to our rehabilitation hospital from May 2018 to July 2022. The trunk muscle mass index (TMI) was calculated at admission and discharge using bioelectrical impedance analysis. Patients were divided into low and high TMI groups according to the median TMI at admission. The primary outcome was the change in the Berg Balance Scale (BBS) score (BBS score at discharge - BBS score at admission).
RESULTS
A total of 315 patients (mean age, 78.9 ± 8.0 years; 172 men and 143 women) were included. The median TMI was 7.31 kg/m in men and 6.30 kg/m in women. Among male patients, the high TMI group had higher BBS scores at admission (31.2 ± 18.2 vs. 23.4 ± 17.7, P = 0.005) and discharge (43.0 ± 15.3 vs. 33.4 ± 19.0, P < 0.001) than those in the low TMI group. After adjusting for confounding factors, TMI at admission was independently associated with the change in BBS score (β = 0.587, P = 0.002).
CONCLUSIONS
Reduced TMM negatively influences balance function recovery in patients after stroke. A strategy aimed at increasing TMM could have beneficial effects on balance function.
Topics: Humans; Male; Female; Aged; Postural Balance; Retrospective Studies; Muscle, Skeletal; Recovery of Function; Stroke; Stroke Rehabilitation; Aged, 80 and over; Torso
PubMed: 38901932
DOI: 10.1016/j.clnesp.2024.05.004 -
PloS One 2024Minimalist shoes (MS) are beneficial for foot health. The foot is a part of the posterior chain. It is suggested that interventions on the plantar foot sole also affect... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Minimalist shoes (MS) are beneficial for foot health. The foot is a part of the posterior chain. It is suggested that interventions on the plantar foot sole also affect the upper segments of the body. This study aimed to investigate the local and remote effects along the posterior chain of four weeks of MS walking in recreationally active young adults.
METHODS
28 healthy participants (15 female, 13 male; 25.3 ± 5.3 years; 70.2 ± 11.9 kg; 175.0 ± 7.8 cm) were randomly assigned to a control- or intervention group. The intervention group undertook a four-week incremental MS walking program, which included 3,000 steps/day in the first week, increasing to 5,000 steps/day for the remaining three weeks. The control group walked in their preferred shoe (no MS). We assessed the following parameters in a laboratory at baseline [M1], after the four-week intervention [M2], and after a four-week wash-out period [M3]: Foot parameters (i.e., Foot Posture Index-6, Arch Rigidity Index), static single-leg stance balance, foot-, ankle-, and posterior chain range of motion, and muscle strength of the posterior chain. We fitted multiple hierarchically built mixed models to the data.
RESULTS
In the MS group, the Foot Posture Index (b = -3.72, t(51) = -6.05, p < .001, [-4.94, 2.51]) and balance (b = -17.96, t(49) = -2.56, p = .01, [-31.54, 4.37]) significantly improved from M1 to M2, but not all other parameters (all p >.05). The improvements remained at M3 (Foot Posture Index: b = -1.71, t(51) = -2.73, p = .009, [-4,94,0.48]; balance: b = -15.97, t(49) = -2.25, p = .03, [-29.72, 2.21]).
DISCUSSION
Walking in MS for four weeks might be advantageous for foot health of recreationally active young adults but no chronic remote effects should be expected.
Topics: Humans; Female; Male; Walking; Foot; Adult; Postural Balance; Shoes; Young Adult; Posture; Range of Motion, Articular; Muscle Strength
PubMed: 38900749
DOI: 10.1371/journal.pone.0304640 -
IEEE Open Journal of Engineering in... 2024The pathophysiology of Adolescent Idiopathic Scoliosis (AIS) is not yet fully understood, but multifactorial hypotheses have been proposed that include defective central...
The pathophysiology of Adolescent Idiopathic Scoliosis (AIS) is not yet fully understood, but multifactorial hypotheses have been proposed that include defective central nervous system (CNS) control of posture, biomechanics, and body schema alterations. To deepen CNS control of posture in AIS, electroencephalographic (EEG) activity during a simple balance task in adolescents with and without AIS was parsed into EEG microstates. Microstates are quasi-stable spatial distributions of the electric potential of the brain that last tens of milliseconds. The spatial distribution of the EEG characterised by the orientation from left-frontal to right-posterior remains stable for a greater amount of time in AIS compared to controls. This spatial distribution of EEG, commonly named in the literature as class B, has been found to be correlated with the visual resting state network. Both vision and proprioception networks provide critical information in mapping the extrapersonal environment. This neurophysiological marker probably unveils an alteration in the postural control mechanism in AIS, suggesting a higher information processing load due to the increased postural demands caused by scoliosis.
PubMed: 38899012
DOI: 10.1109/OJEMB.2024.3399469 -
Journal of Orthopaedic Surgery and... Jun 2024The zero-profile implant system (Zero-P) and conventional plates have been widely used in anterior cervical discectomy and fusion (ACDF) to treat cervical spondylosis.... (Comparative Study)
Comparative Study
BACKGROUND
The zero-profile implant system (Zero-P) and conventional plates have been widely used in anterior cervical discectomy and fusion (ACDF) to treat cervical spondylosis. The purpose of this study was to compare the effects of the application of Zero-P and new conventional plates (ZEVO, Skyline) in ACDF on the sagittal imaging parameters of cervical spondylosis patients and to analyze their clinical efficacy.
METHODS
We conducted a retrospective study on 119 cervical spondylosis patients from January 2018 to December 2021, comparing outcomes between those receiving the Zero-P device (n = 63) and those receiving a novel conventional plate (n = 56, including 46 ZEVO and 10 Skyline plates) through ACDF. Cervical sagittal alignment was assessed pre- and postoperatively via lateral radiographs. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were recorded at baseline, after surgery, and at the 2-year follow-up to evaluate patient recovery and intervention success.
RESULTS
There were significant differences in the postoperative C0-C2 Cobb angle and postoperative sagittal segmental angle (SSA) between patients in the novel conventional plate group and those in the Zero-P group (P < 0.05). Postoperatively, there were significant changes in the C2‒C7 Cobb angle, C0‒C2 Cobb angle, SSA, and average surgical disc height (ASDH) compared to the preoperative values in both patient groups (P < 0.05). Dysphagia in the immediate postoperative period was lower in the Zero-P group than in the new conventional plate group (0% in the Zero-P group, 7.14% in the novel conventional plate group, P = 0.046), and the symptoms disappeared within 2 years in both groups. There was no statistically significant difference between the two groups in terms of complications of adjacent spondylolisthesis (ASD) at 2 years postoperatively (3.17% in the Zero-P group, 8.93% in the novel conventional plate group; P = 0.252). According to the subgroup analysis, there were significant differences in the postoperative C2‒C7 Cobb angle, C0‒C2 Cobb angle, T1 slope, and ASDH between the ZEVO group and the Skyline group (P < 0.05). Compared with the preoperative scores, the JOA, NDI, and VAS scores of all groups significantly improved at the 2-year follow-up (P < 0.01). According to the subgroup analysis, the immediate postoperative NDI and VAS scores of the ZEVO group were significantly better than those of the Skyline group (P < 0.05).
CONCLUSION
In ACDF, both novel conventional plates and Zero-P can improve sagittal parameters and related scale scores. Compared to the Zero-P plate, the novel conventional plate has a greater advantage in correcting the curvature of the surgical segment, but the Zero-P plate is less likely to produce postoperative dysphagia.
Topics: Humans; Female; Retrospective Studies; Male; Spinal Fusion; Middle Aged; Bone Plates; Diskectomy; Cervical Vertebrae; Treatment Outcome; Spondylosis; Aged; Adult; Postural Balance; Follow-Up Studies
PubMed: 38898467
DOI: 10.1186/s13018-024-04857-y -
Journal of Sport Rehabilitation Jul 2024Dual-task (simultaneous cognitive-motor activities) assessments have been adapted into reliable and valid clinical concussion measures. However, abundant motor and...
CONTEXT
Dual-task (simultaneous cognitive-motor activities) assessments have been adapted into reliable and valid clinical concussion measures. However, abundant motor and cognitive variations leave researchers and clinicians uncertain about which combinations elicit the intended dual-task effect. Our objective was to examine differences between commonly employed dual-task motor and cognitive combinations among healthy, college-aged individuals.
DESIGN
Cross-sectional laboratory study.
METHODS
Twenty participants (age: 21.3 [2.4] y; height: 176.0 [9.1] cm; mass: 76.0 [16.4] kg; 20% with concussion history) completed 4 motor tasks (gait, tandem gait, single-leg balance, and tandem balance) under 5 cognitive conditions (single task, subtraction, month reversal, spelling backward, and visual Stroop) in a research laboratory. The motor performance outcomes were spatiotemporal variables for gait and tandem gait and center of pressure path length (in centimeters) for single-leg and tandem balance. Cognitive outcomes were response rate (responses/second) and cognitive accuracy. We used separate repeated-measures analyses of variance for each motor and cognitive outcome with post hoc Tukey t tests.
RESULTS
Gait velocity, gait stride length, and tandem gait velocity demonstrated significant cognitive-motor interactions (P's < .001) such that all dual-task conditions resulted in varyingly slower or shorter movement than single task. Conversely, single-leg balance (P = .627) and tandem balance (P = .434) center of pressure path length did not significantly differ among the dual-task cognitive conditions or relative to single task. Statistically significant cognitive-motor interactions were observed only for spelling backward accuracy (P = .004) and response rates for spelling backward, month reversal, and visual Stroop (P's < .001) such that worse accuracy, but faster response rates, occurred during motor tasks.
CONCLUSIONS
Gait and tandem gait motor tasks accompanied with spelling backward or subtraction cognitive tasks demonstrated consistently strong dual-task effects and, therefore, may be the best suited for clinical and research use following concussion.
Topics: Humans; Brain Concussion; Male; Cross-Sectional Studies; Young Adult; Female; Postural Balance; Gait; Cognition; Task Performance and Analysis; Adult; Neuropsychological Tests
PubMed: 38897580
DOI: 10.1123/jsr.2023-0292 -
Arthroscopy : the Journal of... Jun 2024Posterior shoulder instability (PSI) is an uncommon condition accounting for 2-12% of shoulder instability cases. However, PSI might be more common and possibly accounts...
Posterior shoulder instability (PSI) is an uncommon condition accounting for 2-12% of shoulder instability cases. However, PSI might be more common and possibly accounts for up to 24% of all young, active patients treated for shoulder instability. The etiology of PSI is complex and multifactorial, making accurate diagnosis, classification and treatment challenging. The accurate diagnosis of PSI is problematic and varies with symptoms ranging from pain, decreased strength or endurance to mechanical symptoms such as clicking or popping and only a minority of patients present after a posterior shoulder dislocation. Appropriate imaging is necessary and should include radiographs and advanced imaging with MRI, preferably MRI arthrography. The goal of treatment is to reduce pain, improve function, and prevent or reduce recurrence. Both surgical and conservative treatment is demanding and both osseous and soft tissue pathology needs to be addressed adequately. Typically, a conservative approach should be considered first for the first six months, with a focus on proprioceptive exercises, strengthening of the dynamic stabilizers and improving scapulothoracic mechanics. The primary indication for surgery is recurrent symptoms. Controversies exist regarding the choice between open and arthroscopic stabilization of soft tissue defects, the treatment of the McLauglin lesion and the management of osseous defects.
PubMed: 38897485
DOI: 10.1016/j.arthro.2024.06.009 -
Disability and Rehabilitation Jun 2024To translate the Berg Balance Scale (BBS) to Hungarian and to evaluate the psychometric characteristics of the Hungarian version (HU-BBS).
PURPOSE
To translate the Berg Balance Scale (BBS) to Hungarian and to evaluate the psychometric characteristics of the Hungarian version (HU-BBS).
METHODS
In total, 150 institutionalised older adults were recruited for the study. Eighty-one participants completed the retesting. Internal consistency, intra- and inter-rater reliability, and 95% limits of agreement of the HU-BBS were examined. Construct validity was assessed through convergent, discriminant, and known-group validity.
RESULTS
The overall Cronbach's alpha was 0.943. The intra- and inter-rater reliability was excellent (intraclass correlation coefficient > 0.92). The Bland-Altman analysis revealed a mean inter-rater difference of 0.284 [-2.193-2.744] and a mean intra-rater difference of 0.259 [-2.657-3.162]. Regarding convergent validity, the HU-BBS was correlated with the functional status ( = 0.833), Timed Up and Go test (r= -0.824), and age (r= -0.606). The HU-BBS scores of women were similar to those of men ( = 0.104), showing discriminant validity. Additionally, the HU-BBS scores were lower among faller than among non-faller participants ( ˂ 0.0001), establishing known-group validity.
CONCLUSIONS
Translation and cultural adaptation of the original scale was successful. The HU-BBS proved to be a reliable, valid tool confirming that it can be used in future clinical and scientific work on Hungarian older adults.Implications for rehabilitationInstitutionalised older adults are vulnerable and at a high risk of developing further decline in postural control, contributing to an increase in limited functional mobility and risk for falls.The Berg Balance Scale is a widely used tool originally developed to measure postural control in older adults.The Hungarian version of the Berg Balance Scale tested on institutionalised older adults shows excellent test-retest reliability, good internal consistency, and acceptable convergent construct validity.The Hungarian version of the Berg Balance Scale is a valid and reliable tool for measuring postural control among Hungarian-speaking institutionalised older adults both in clinical practice and scientific studies.
Topics: Humans; Female; Male; Postural Balance; Hungary; Aged; Reproducibility of Results; Psychometrics; Aged, 80 and over; Geriatric Assessment; Cross-Cultural Comparison; Translations; Translating; Accidental Falls; Institutionalization
PubMed: 38896556
DOI: 10.1080/09638288.2023.2232717