Márcio Rogério de Oliveira

Effect of different types of exercise on postural balance in elderly women: A randomized controlled trial

Different types of exercise are indicated for the elderly to prevent functional capacity limitations due to aging and reduce the risk of falls. This study aimed to evaluate the effect of three different exercises (mini-trampoline, MT; aquatic gymnastics, AG and general floor gymnastics, GG) on postural balance in elderly women. Seventy-four physically independent elderly women, mean age 69±4 years, were randomly assigned to three intervention groups: (1) MT (n=23), (2) AG (n=28), and (3) GG (n=23). Each group performed physical training, including cardiorespiratory, muscular strength and endurance, flexibility and sensory-motor exercises for 12 weeks. To determine the effects on each intervention group, five postural balance tasks were performed on a force platform (BIOMEC 400): the two-legged stand with eyes open (TLEO) and two-legged stand with eyes closed (TLEC); the semi-tandem stand with eyes open (STEO) and semi-tandem stand with eyes closed (STEC) and the one-legged stand. Three trials were performed for each task (with 30s of rest between them) and the mean was used to compute balance parameters such as center of pressure (COP) sway movements. All modalities investigated such as the MT, AG and GG were significantly (P<0.05) efficient in improving the postural balance of elderly women after 12 weeks of training. These results provide further evidence concerning exercise and balance for promoting health in elderly women.

Relationship between force platform and two functional tests for measuring balance in the elderly

BACKGROUND Clinical and laboratory methods have been developed to assess the different dimensions of postural control with the aim to increase the clinical relevance of decisions about balance deficit. OBJECTIVES The purpose of this study was to correlate the force platform measurements with two functional tests used to evaluate balance in elderly. METHODS A total of 124 physically independent elderly volunteers participated in this study. Subjects performed the following three tests: 1) a traditional functional balance test, named the one-leg standing test, which measures the time in seconds at this position; 2) a functional agility/dynamic balance test, which quantifies the total time in seconds that a subject can stand up from a chair and move as quickly as possible around two cones; and 3) an unipodal balance test on a force platform. RESULTS The one-leg standing test yielded a mean of 12 seconds (SD=9 s), while the mean time observed in the functional agility/dynamic balance test was 26 seconds (SD=6 s). The correlations between the balance parameters of force platform and two functional tests varied between -0.28 and 0.20, which shows a weak association between them. CONCLUSIONS Our results support the idea that these functional tests do not necessarily furnish the same information regarding balance mechanisms as the force platform. This study contributes to the evaluation of balance in elderly and suggests that functional tests should be used with caution especially in regards to the purposes of the research and when conducting clinical assessments of the elderly.

Back muscle fatigue of younger and older adults with and without chronic low back pain using two protocols: A case-control study.

The purpose of this study was to compare back muscle fatigue of younger and older participants with and without chronic low back pain (CLBP). Twenty participants without and 20 with nonspecific CLBP participated in this study. Each group contained 10 younger (50% males; mean age: 31 ± 6 yrs) and 10 older adults (50% males; age mean: 71 ± 7 yrs). Two isometric fatigue protocols were presented randomly: (1) to maintain the unsupported trunk at the horizontal position while on a 45° Roman chair for a minute, and (2) to maintain a 10% of body weight box close to the trunk in the upright position for a minute. Surface electromyography (EMG) signals from the back (multifidus and iliocostalis) and one hip (biceps femoris) muscles were recorded bilaterally, and the median frequency fatigue estimate from linear regression slopes of the EMG time-series was computed. There were no significant (P > 0.05) age effects, and group-by-age interaction in both isometric and functional fatigue tasks. However, the CLBP groups (both younger and old) displayed more back fatigue than people without CLBP in both fatigue protocols (P < 0.01; effect size varying of d = 0.17-0.32). This study was sensitive to discriminate that individuals with CLBP did present significantly more pronounced EMG back fatigue than people without CLBP, in both younger and older adults. These results have significant clinical implications for low back pain rehabilitation programs with regard to endurance assessment in both younger and older.

Análise comparativa do equilíbrio unipodal de atletas de ginástica rítmica

ABSTRACT Introduction: Rhythmic gymnastics requires a high level of physical quality; therefore, good performance depends on muscular strength and endurance, motor coordination and postural balance. Objective: To develop a comparative analysis of postural balance in rhythmic gymnasts. Methods: 10 female rhythmic gymnasts were evaluated by a force platform on one foot and balance functional tests (Side Hop Test and Figure of Eight Hop Test). The following data of the force platform were analyzed: anteroposterior and mediolateral of the center of pressure parameters, while for the functional tests, the time in seconds was analyzed. Results: Significant difference (p = 0.01) was found between lower limbs in the median frequency parameter in the mediolateral direction, in which non dominant lower limb showed higher postural stability than the dominant one. For functional tests, there was no significant difference between limbs. Conclusion: The difference found in the balance control of mediolateral direction may be related to different muscular actions of the hip region, which is present during the sport practice for stabilization, trunk maintenance, and movement performance with lower limbs. These results indicate the need of a balance program and pelvic sta-bilization for the analyzed athletes in order to maintain muscular symmetry of the limbs for high sports performance.Keywords: postural balance, athletes, sports.

Relação entre testes funcionais e plataforma de força nas medidas de equilíbrio em atletas

INTRODUCTION: Few studies have correlated the balance measurements based in functional tests and force platform in athletes.OBJECTIVE: to determine the relationship between three functional balance tests with the main measurements of the force platform in athletes.METHODOLOGY: Fifteen female athletes, indoor soccer and handball players, aged between 13 and 17 years, participated of this study. The athletes performed tree functional tests: 1) the star excursion balance test, 2) the lateral jump, and 3) the figure eight test; as well as the one leg-stance test on a force platform with the eyes open for 30 seconds. The parameters of center of pressure (COP) of the foot were calculated by stabilographic analysis. For all the tests (functional and platform), tree trials attempts were made, and the mean value retained for the analyses.RESULTS: The correlations between the functional tests and the force platform were from r = 0.01 to -0.69 (weak to moderate), depending on the COP variable. The best correlations (r = -0.69) were found between the star excursion balance test and the COP area, indicating that when a greater distance was reached, the better the postural balance. Secondly, a weak to moderate correlation was found between the figure eight test and COP area (e.g. r = 0.43). The side hop test did not present good correlation with the values obtained on the force platform.CONCLUSION: This study shows that to evaluate balance in athletes practicing indoor soccer and handball, the Star excursion balance test may be used in the absence of a force platform, to identify possible balance deficits.INTRODUCCION: Pocos estudios han correlacionado las medidas de equilibrio entre las principales pruebas funcionales y la plataforma de fuerza en los atletas. OBJETIVO: Determinar la relacion entre tres pruebas de equilibrio funcionales con las principales medidas de la fuerza en la plataforma de los atletas. METODO: Quince atletas del sexo femenino que practican el futbol de salon y balonmano, entre 13 y 17 anos participaron en el estudio. Los atletas realizaron tres pruebas funcionales: 1) Star excursion balance test, 2) salto lateral y 3) salto figura ocho, ademas de una prueba unipodal sobre una plataforma de fuerza con los ojos abiertos durante 30 segundos. Los parametros del centro de la presion de los pies (COP) se calcularon por analisis estabilografica. Para todas las pruebas (funcionales y plataforma), se llevaron a cabo tres ensayos y el promedio fue utilizado para su analisis. RESULTADOS: Las correlaciones entre las pruebas funcionales y la plataforma de fuerza fueron r = 0,01 a -0,69 (leve a moderada), en funcion de la variable COP. La mejor correlacion (r = -0,69) se encontro entre el rango de la prueba Star Excursion Balance y el area del COP, lo que indica que cuanto mayor es la distancia que se logra, mejor es el equilibrio. En segundo lugar, se encontro correlacion debil a moderada entre la prueba en figura de ocho y el area del COP (por ejemplo, r = 0,43). La prueba de salto lateral mostro una buena correlacion con las pruebas en la plataforma de fuerza. CONCLUSION: Este estudio demostro que para la evaluacion del equilibrio de los atletas del sexo femenino de futbol de salon y balonmano, el Star excursion balance test se puede utilizar en la ausencia de una plataforma de fuerza para identificar posibles deficiencias en el equilibrio.

People with chronic low back pain have poorer balance than controls in challenging tasks

Abstract Purpose: To compare the balance of individuals with and without chronic low back pain during five tasks. Method: The participants were 20 volunteers, 10 with and 10 without nonspecific chronic low back pain, mean age 34 years, 50% females. The participants completed the following balance tasks on a force platform in random order: (1) two-legged stance with eyes open, (2) two-legged stance with eyes closed, (3) semi-tandem with eyes open, (4) semi-tandem with eyes closed and (5) one-legged stance with eyes open. The participants completed three 60-s trials of tasks 1–4, and three 30-s trials of task 5 with 30-s rests between trials. The center of pressure area, velocity and frequency in the antero-posterior and medio-lateral directions were computed during each task, and compared between groups and tasks. Results: Participants with chronic low back pain presented significantly larger center of pressure area and higher velocity than the healthy controls (p < 0.001). There were significant differences among tasks for all center of pressure variables (p < 0.001). Semi-tandem (tasks 3 and 4) and one-leg stance (task 5) were more sensitive to identify balance impairments in the chronic low back pain group than two-legged stance tasks 1 and 2 (effect size >1.37 vs. effect size <0.64). There were no significant interactions between groups and tasks. Conclusions: Individuals with chronic low back pain presented poorer postural control using center of pressure measurements than the healthy controls, mainly during more challenging balance tasks such as semi-tandem and one-legged stance conditions. Implications for Rehabilitation People with chronic low back had poorer balance than those without it. Balance tasks need to be sensitive to capture impairments. Balance assessments during semi-tandem and one-legged stance were the most sensitive tasks to determine postural control deficit in people with chronic low back. Balance assessment should be included during rehabilitation programs for individuals with chronic low back pain for better clinical decision making related to balance re-training as necessary.

Effect of body mass index and fat mass on balance force platform measurements during a one-legged stance in older adults

The purpose of this study was to evaluate the impact of body mass index (BMI) and fat mass on balance force platform measurements in older adults. The sample consisted of 257 participants who were stratified into four groups by BMI: low weight, normal weight, pre-obesity and obesity. For fat mass variables, older individuals were classified into low and high-fat mass. All groups investigated performed three trials of one-legged stance balance on a force platform. Center of pressure (COP) domain parameters were computed from the mean across trials. Analysis of variance results revealed no significant interactions for groups and sexes for all COP parameters. Comparable balance results were found for BMI and fat groups for all COP parameters. A statistical effect (P < 0.05) was only reported for sex differences for COP parameters, regardless of BMI and fat mass variables. Overall, women presented better balance than men. In conclusion, BMI and fat mass do not seem to influence the balance of older adults during a one-leg stance task.

Relationship between foot posture measurements and force platform parameters during two balance tasks in older and younger subjects

[Purpose] The aim of this study was to compare age-related differences in balance and anthropometric posture measurements of the foot and to determine any relationship between them. [Subjects and Methods] Sixty-eight older and 42 younger adults participated in this study. Foot posture was tested for four domains: 1) hallux flexion and extension range of motion using a goniometer, 2) navicular height and 3) length of the foot using a pachymeter, and 4) footprint (width of forefoot, arch index and hallux valgus). Balance was tested under two conditions on a force platform: bipodal in 60-s trials and unipodal in 30-s trials. The sway area of the center of pressure and velocity in the anteroposterior and mediolateral directions were computed. [Results] Older individuals showed significantly poorer balance compared with younger adults under in the unipodal condition (center of pressure area 9.97 vs. 7.72 cm2). Older people presented a significantly lower hallux mobility and higher values for width of the forefoot and transverse arch index than younger adults. The correlations between all foot posture and center of pressure parameters varied across groups, from weak to moderate (r −0.01 to −0.46). Low hallux mobility was significantly related to higher center of pressure values in older people. [Conclusion] These results have clinical implications for balance and foot posture assessments.

Postural control during one-leg stance in active and sedentary older people

Physical inactivity and aging are functional disability factors for older individuals, causing loss of balance and increasing the risk of falls. The purpose of this study was to compare the balance of physically independent older individuals, both participants and non-participants in a regular exercise program. Fifty six physically independent older participants were divided into G1ACTIVE = 28 individuals who participate in a regular exercise program and G2SEDENTARY = 28 individuals who did not participate in any physical exercise program. All participants underwent an eyes-open during one-leg balance test on a force platform. The postural oscillation parameters included center of pressure (COP); sway mean velocity and frequency of COP oscillations. G2 SEDENTARY showed higher postural instability than G1ACTIVE. Significant differences were observed for the main balance parameters. The results of this study support the concept that participation in regular physical activity is beneficial for postural balance of older individuals.

Older adults present better back endurance than young adults during a dynamic trunk extension exercise

BACKGROUND AND OBJECTIVE Poor back endurance is a predictor of low back pain. Few studies have investigated back muscle fatigue in older people. The purpose of this study was to compare the back muscle fatigue by endurance time and perceived effort between young and older adults during dynamic exercise. METHOD Sixteen older and 16 young adults, all healthy, participated in this study. The subjects performed a fatiguing trunk extension-flexion exercise on a Roman chair until exhaustion. Endurance time and perceived muscle fatigue (Borg CR-10 scale) were used as fatigue criteria. RESULTS The older adults were significantly (T_{(30)} = -2,073; p = 0.039) more resistant to back muscle fatigue (time in mean 133 ± 52 s) than the young adults (mean 97 ± 27 s). In general, both groups had the same perception of high-level fatigue during the exercise bout (T_{(29)} = 1.73; p=0.092). CONCLUSION The older adults presented better back endurance than young adults during a dynamic trunk extension exercise. These results have implications for back endurance in the primary prevention of low back pain in both young and older adults.