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Trunk motion visual feedback during walking improves dynamic balance in older adults: Assessor blinded randomized controlled trial.

Gait & posture
May 1, 2018
Eric Anson et al. (7 authors)
Journal ArticleRandomized Controlled TrialResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether trunk motion visual feedback (VFB) during treadmill walking improves over-ground balance in older adults with self-reported balance problems.

Results Summary

The experimental group using trunk motion VFB showed significant improvements in dynamic balance (BESTest and mini-BESTest), while the control group did not. Individuals with more profound sensory impairments benefited more from the intervention.

Population

Older adults (mean age 75.8 years) with self-reported balance difficulties or a history of falling.

Effective Dosage

Treadmill walking 3 times per week for 4 weeks in 2-minute bouts separated by seated rest.

Duration

4 weeks

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
trunk motion visual feedback treadmill walking
increase
BESTest
older adults with self-reported balance problems
p = 0.031
significantly improved
#1
trunk motion visual feedback treadmill walking
increase
mini-BEST
older adults with self-reported balance problems
p = 0.019
significantly improved
#2
control treadmill walking (looking at stationary bulls-eye)
no change
any measure
older adults with self-reported balance problems
no significant change
did not improve significantly
#3
trunk motion visual feedback treadmill walking
increase
dynamic balance subtests of the BESTest
individuals with more profound sensory impairments
-
had a larger improvement
#4
trunk motion visual feedback treadmill walking
increase
dynamic balance
older adults with self-reported balance problems
-
improve
#5
trunk motion visual feedback during walking
increase
-
individuals with worse sensory function
-
may benefit more
#6
Abstract

BACKGROUND: Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes. RESEARCH QUESTION: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems. METHODS: 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk. RESULTS: There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest. SIGNIFICANCE: Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function.

Medical Subject Headings (MeSH)
Accidental FallsAgedAged, 80 and overExercise TestExercise TherapyFeedback, SensoryFemaleFollow-Up StudiesHumansMaleOutcome Assessment, Health CarePostural BalanceSingle-Blind MethodTorsoWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations14
Citations/Year2.0
Relative Citation Ratio1.31
NIH Percentile60.2%
Research Impact Scores
APT Score0.75
Weight Score2.07
Normalized Score0.66
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