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1.
Diagnostic balance tests for assessing risk of falls and distinguishing older adult fallers and non-fallers : a systematic review with meta-analysis
Žiga Kozinc, Stefan Loefler, Christian Hofer, Ugo Carraro, Nejc Šarabon, 2020, review article

Abstract: : Falls are a major cause of injury and morbidity in older adults. To reduce the incidence of falls, a systematic assessment of the risk of falling is of paramount importance. The purpose of this systematic review was to provide a comprehensive comparison of the diagnostic balance tests used to predict falls and for distinguishing older adults with and without a history of falls. We conducted a systematic review of the studies in which instrumented (force plate body sway assessment) or other non-instrumented balance tests were used. We analyzed the data from 19 prospective and 48 retrospective/case-control studies. Among the non-instrumented tests, the single-leg stance test appears to be the most promising for discrimination between fallers and non-fallers. In terms of body sway measures, the center-of-pressure area was most consistently associated with falls. No evidence was found for increased benefit of the body sway test when cognitive tasks were added, or the vision was eliminated. While our analyses are limited due to the unbalanced representation of different test and outcome measures across studies, we can recommend the single-leg test for the assessment of the risk of falling, and the measurements of body sway for a more comprehensive assessment.
Keywords: older adults, falls, fall history, body sway, functional reach, single-leg test, Romberg test
Published in RUP: 10.09.2020; Views: 1270; Downloads: 61
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2.
A novel device to preserve physical activities of daily living in healthy older people
Wolfram Haslinger, Lisa Müller, Nejc Šarabon, Christian Raschner, Helmut Kern, Stefan Loefler, 2015, original scientific article

Abstract: Objective: To determine the effectiveness of exercise in improving sensorimotor function and functional performance as crucial part of activities of daily living in healthy older adults. Design: RCT. Setting: Laboratory. Participants: 39 subjects (M = 71.8 years, range: 61%89 years). Intervention: Task oriented visual feedback balance training. Primary outcome measure: Timed up & go (TUG). Secondary outcome measures: Chair stand test (CST), self-paced walk test, maximum isometric torque, quiet stand posturography and dynamic balance (DB). Results: Post intervention comparison of the treatment group (TG) and control group (CG) showed better TUG (p < .01), CST (p < .001) and DB (p < .025) for the TG. Pre%post intervention comparison of the TG showed better clinically relevant outcomes in TUG (p < .001), CST (p < .001) and DB (p < .001). Conclusion: Active driven visual feedback balance training is effective in improving functional performance and dynamic balance in older adults.
Keywords: posturalno ravnotežje, gibalna terapija, staranje, funkcionalna sposobnost, postural balance, exercise therapy, ageing, functional performance
Published in RUP: 03.04.2017; Views: 2372; Downloads: 204
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Strength training in elderly people improves static balance
Nejc Šarabon, Stefan Loefler, Jan Cvecka, Milan Sedliak, Helmut Kern, 2013, original scientific article

Abstract: Aim of this study was to investigate the effects of two different types of strength training programs on static balance in elderly subjects. Subjects older than 65 years of age were enrolled and assigned to control group (CG, n =19), electrical stimulation group (ES, n = 27) or leg press group (LP, n = 28). Subjects in both the training groups were exposed to training (2-3x/week) for a period of 9 weeks. In the ES group the subjects received neuromuscular electrical stimulation of the anterior thigh muscles. In the LP group the subjects performed strength training on a computer-controlled leg press machine. Before and after the training period, static balance of the subject was tested using a quiet stance task. Average velocity, amplitude and frequency of the center-of-pressure (CoP) were calculated from the acquired force plate signal. The data was statistically tested with analysis of (co)variance and t-tests. The three groups of subjects showed statistically significant differences (p < 0.05) regarding the pre-training vs. post-training changes in CoP velocity, amplitude and frequency. The differences were more pronounced for CoP velocity and amplitude, while they were less evident in case of mean frequency. The mean improvements were higher in the LP group than in the ES group. Our results provide supportive evidence to the existence of the strength-balance relationship. Additionally, results indicate the role of recruiting central processes and activation of functional kinetic chains for the better end effect
Keywords: balance, aging, falls, strength, training
Published in RUP: 15.10.2013; Views: 3205; Downloads: 237
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7.
The effect of vision elimination during quiet stance tasks with different feet positions
Nejc Šarabon, Jernej Rošker, Stefan Loefler, Helmut Kern, 2013, original scientific article

Abstract: Literature confirms the effects of vision and stance on body sway and indicates possible interactions between the two. However, no attempts have been made to systematically compare the effect of vision on the different types of stance which are frequently used in clinical and research practice. The biomechanical changes that occur after changing shape and size of the support surface suggest possible sensory re-weighting might take place. The purpose of this study was to assess the effect of vision on body sway in relation to different stance configurations and width. Thirty-eight volunteers performed four quiet stance configurations (parallel, semi-tandem, tandem and single leg), repeating them with open and closed eyes. Traditional parameters, recurrence quantification analysis and sample entropy were analyzed from the CoP trajectory signal. Traditional and recurrence quantification analysis parameters were affected by vision removal and stance type. Exceptions were frequency of oscillation, entropy and trapping time. The most prominent effect of vision elimination on traditional parameters was observed for narrower stances. A significant interaction effect between vision removal and stance type was present for most of the parameters observed (p < 0.05). The interaction effect between medio-lateral and antero-posterior traditional parameters differed in linearity between stances. The results confirm the effect of vision removal on the body sway. However, for the medio-lateral traditional parameters, the effects did not increase linearly with the change in width and stance type. This suggests that removal of vision could be more effectively compensated by other sensory systems in semi-tandem stance, tandem and single legged stance
Keywords: balance, Body sway, Sensory manipulation, vision
Published in RUP: 15.10.2013; Views: 3386; Downloads: 145
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8.
Reliability of novel postural sway task test
Milan Sedliak, Jan Cvecka, Veronika Tirpáková, Stefan Loefler, Nejc Šarabon, Helmut Kern, Dušan Hamar, 2013, original scientific article

Abstract: The purpose of this study was to examine the reliability of parameters obtained from a novel postural sway task test based on body movements controlled by visual feedback. Fifty-nine volunteers were divided into two groups. The first group consisted of young (n = 32, 16 females and 16 males, age: 25.2 3.4 years) and the second group of elderly individuals (n = 27, 17 females and 10 males, age: 75.7 6.9 years). Participants stood in parallel on a computer based stabilographic platform with the feet approximately a shoulder width apart, the toes slightly pointing outwards, the hands placed on the hips. The computer screen was placed approximately 1.5 meter from the platform at a height of subjects eyes. An instantaneous visual feedback of participants centre of pressure (COP) was given in a form of a blue cross visible on the screen. Participants were instructed to keep the blue cross driven by movements of their hips as close as possible to a predefined curve flowing on the screen. Out of the 6 parameters studied, only the average distance of COP from the curve line and the sum of the COP crossings through the curve line showed high reliability. Correlation between these two highly reliable parameters was -0.89. There was also a statistical difference (p<0.001) between young and elderly in both the average distance of COP from the curve line and the sum of the COP crossings through the curve. To conclude, the novel postural sway task provides a simple tool with relatively low time burden needed for testing. The suggested output parameters measured are highly reliable and easy to interpret
Keywords: balance, postural control, task test, visual feedback
Published in RUP: 15.10.2013; Views: 3680; Downloads: 244
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