A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

BACKGROUND: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall.STUDY DESIGN: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments.RESULTS: Balance game training had a significant effect on levels of functional balance and balance confidence (P Peer reviewedFinal Published versio

Physical activity programs for balance and fall prevention in elderly: A systematic review

BACKGROUND: Due to demographic changes the world's population is progressively ageing. The physiological decay of the elderly adult may lead to a reduction in the ability to balance and an increased risk of falls becoming an important issue among the elderly. In order to counteract the decay in the ability to balance, physical activity has been proven to be effective. The aim of this study is to systematically review the scientific literature in order to identify physical activity programs able to increase balance in the elderly. METHODS: This review is based on the data from Medline-NLM, Pubmed, ScienceDirect, and SPORTDiscuss and includes randomized control trials that have analyzed balance and physical activity in healthy elderly over 65 years of age during the last decade. A final number of 8 manuscripts were included in the qualitative synthesis, which comprised 200 elderly with a mean age of 75.1 ± 4.4 years. The sample size of the studies varied from 9 to 61 and the intervention periods from 8 to 32 weeks. RESULTS: Eight articles were considered eligible and included in the quantitative synthesis. The articles investigated the effects of resistance and aerobic exercise, balance training, T-bow© and wobble board training, aerobic step and stability ball training, adapted physical activity and Wii Fit training on balance outcomes. Balance measures of the studies showed improvements between 16% and 42% compared to baseline assessments. CONCLUSIONS: Balance is a multifactorial quality that can be effectively increased by different exercise training means. It is fundamental to promote physical activity in the aging adult, being that a negative effect on balance performance has been seen in the no-intervention control groups

A business case for work-life balance in retail management.

Retail is one of New Zealand’s largest sectors, employing close to 200,000 people full-time, but with changes in competition and growth in the industry, the expectations of retail managers are increasing, along with their workload. This research looks at why work-life balance is unattainable for some retail managers. Looking wholly at the retail industry, not one specific organisation, the research aims to show the impacts on performance when work-life balance is not achieved and to provide strategies for businesses that encourage work-life balance in retail managers. Using both secondary and experiential research, this study highlights how poor work-life balance is directly linked to poor performance and what it is costing businesses that have no work-life balance initiatives in place. Provisional results show that work arrangements and lack of training are key reasons for work-life balance being difficult to maintain in retail management roles. The researcher shares two recommendations that will improve retail managers’ work-life balance; re-evaluating work arrangements to use rotational rostering and companies investing in the development of managers, through specific training available in New Zealand

Action for Rehabilitation from Neurological Injury (ARNI): A pragmatic study of functional training for stroke survivors

This article has been made available through the Brunel Open Access Publishing Fund. Copyright @ 2013 Cherry Kilbride et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This study evaluated the effectiveness of a twelve-week community-based functional training on measures of impairment, activity and participation in a group of stroke survivors. Isometric strength of the knee musculature, Centre-Of-Pressure (COP) based measures of balance, Berg Balance Scale (BBS), 10 m walk test, and the Subjective Index of Physical and Social Out come (SIPSO), were recorded at baseline, post-intervention, and after twelve weeks (follow-up). Exercise instructors delivered training once a week in a group format at a community centre. Significant improvement was noted in the BBS (p < 0.002), and 10 m walk speed (p = 0.03) post intervention which remained unchanged at follow-up. Total SIPSO score improved significantly post-intervention (p = 0.044). No other significant differences and no adverse effects were observed. It is possible that functional training provided more opportunity for the improvement of dynamic aspects of balance control that could be captured by the BBS but not with the traditional measures of balance using COP data. Results also suggest positive effects on the level of participation, and lack of association between measures of impairment and activity. Community based functional training could be effective and used to extend access to rehabilitation services beyond the acute and sub-acute stages after stroke.London Borough of Hillingdo

The Impact of Power Training on Balance and Visual Feedback Removal

Because power training has been known to augment stability, the purpose of this study was to assess whether the removal of visual input affects lower limb muscle power production in young women who are resistance trained to the same degree it affects the untrained. This provided insight as far as the need for resistance training protocols in a largely untrained visually impaired population. To study this, fourteen college-aged female participants (18-23 years) performed a seated double-leg press on a leg sled machine, isolating power production of the lower limbs. After establishing baselines, which involved finding an average of power produced during five trials, the subjects were asked to close their eyes for the following set of five pushes. The power production was assessed by utilizing a Tendo Unit, with placement on one of the limbs of the machine, to measure power output during leg extension (measured in Watts). Statistics analyzed in SPSS determined the average power deficit of the athletic population to be 11.57 Watts, whereas the general population had an average power deficit of 37.43 Watts. The deficits experienced by each respective group upon visual removal were significantly different from one another, as evidenced by a p-value of .048. This accentuated the power-trained group’s resilience. A suggested training plan regimen including cardiorespiratory, resistance, flexibility, and neuromotor exercises has been appended for persons experiencing visual impairment and seeking to better their balance through power

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

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

Which strength and balance activities are safe and efficacious for individuals with specific challenges (osteoporosis, vertebral fractures, frailty, dementia)?: A Narrative review

Physical activity guidelines advocate the inclusion of strength and balance activities, twice a week, for adults and older adults, but with caveat that in some individuals there will be certain movements and activities that could lead to adverse events. This scoping review summarizes the evidence about how safe and efficacious these activities are in older adults with specific challenges that might make them more prone to injury (e.g. having recently fractured or at risk of fracture (osteoporosis) or those who are frail or who have cognitive impairment). The review identified that for prevention of falls in people with a falls history and/or frailer older adults, structured exercise programmes that incorporate progressive resistance training (PRT) with increasing balance challenges over time are safe and effective if performed regularly, with supervision and support, over at least 6 months. Some minor adverse effects mainly transient musculoskeletal pain) have been reported. For those with a higher risk of falls and fractures (very poor balance, vertebral fractures), supervised structured exercise programmes are most appropriate. People with diagnosed osteoporosis should be as active as possible and only avoid activities with a high risk of falls if they are naive to those activities. For those in transition to frailty who have poor strength and balance, exercises that are known to help maintain strength and balance (such as Tai Chi) are effective in preventing a decline in falls risk. For the very frail older adult, supervised structured exercise that has PRT, balance training and some endurance work, supervised and progressed by a trained person are advocated

Dynamic balance training with sensory electrical stimulation in chronic stroke patients

A case study investigating the impact of sensory electrical stimulation during perturbed stance in one chronic stroke patient is presented. A special apparatus called the BalanceTrainer was used. It allows the application of perturbations to neurologically impaired people during standing, while protecting the subject from falling. The subject underwent two different periods of perturbation training, each lasting ten days. During the first period the subject was perturbed in eight different directions. During the second period the subject was also perturbed, but was assisted by sensory electrical stimulation of the soleus, tibialis anterior, tensor fascia latae, and vastus muscles in the impaired leg. After each period of training an assessment was carried out to measure the forces the subject applied on the ground via two force plates. The subject improved his ability to balance throughout the training, with the largest improvements during the final period when electrical stimulation was used

Hints

The systematic use of hints in the learning-from-examples paradigm is the subject of this review. Hints are the properties of the target function that are known to us independently of the training examples. The use of hints is tantamount to combining rules and data in learning, and is compatible with different learning models, optimization techniques, and regularization techniques. The hints are represented to the learning process by virtual examples, and the training examples of the target function are treated on equal footing with the rest of the hints. A balance is achieved between the information provided by the different hints through the choice of objective functions and learning schedules. The Adaptive Minimization algorithm achieves this balance by relating the performance on each hint to the overall performance. The application of hints in forecasting the very noisy foreign-exchange markets is illustrated. On the theoretical side, the information value of hints is contrasted to the complexity value and related to the VC dimension

The social balance sheet 2008

There was an average annual increase in employment of 1.7 p.c. in 2008, according to the statistics gleaned from a reduced population of enterprises that filed their social balance sheet by 16 September 2009 at the latest. End-of-year results (+0.8 p.c.) point to a significant slowdown in growth during the course of the year, reflecting the economic downturn which began at the end of 2007. Full-time staff numbers stabilised, but the number of part-time workers continued to grow. The expansion of this part-time working arrangement is not only attributable to the recruitment of workers on shorter hours ; shifts between full-time and part-time working arrangements have also been observed, especially in large firms that have restructured. As a result of the economic downturn, the share of temporary work has fallen. In firms filing a full-format social balance sheet, a reduction in the use of temporary agency workers has also been noted. The overall wage bill in the firms included in the reduced population grew by 5.3 p.c. in 2008. At the same time, the volume of labour expanded by 1.6 p.c., so that costs per hour worked increased by 3.7 p.c. on average. This article includes an assessment, by branch of activity, of how closely the indicative wage norm set for the period 2006-2008 has been followed. This survey was carried out on the basis of a population of firms that had filed a social balance sheet for the three consecutive years. For the first time ever, thanks to the introduction of a new version of the social balance sheet, it has been possible to have a breakdown of staff numbers by educational level. On average, women tend to have a more intensive level of training than men. Workers’ educational requirements vary considerably according to the branch of activity. Since the year 2008, training activities have been broken down between formal and informal vocational training and initial training, whereas before only formal training and a very small proportion of informal training had been taken into account. Participation rates for these three types of training come to respectively 37, 21 and 1 p.c. of the workforce. Budgets for training accounted for a total of 1.7 p.c. of staff expenses, including 1.2 p.c. for formal training alone, which is still well below the target for the private sector that had been set at 1.9 p.c. for 2006. Major differences in training policy can be observed in firms classified by size and branch of activity, whether it is a question of ranging from the volume of training activities, the size of budget, or type of training selected. An analysis of individual data shows that the probability for an enterprise to provide formal or informal training depends above all on its size, with the branch of activity ranking second. Whether it is linked to a non-resident firm and the composition of the workforce (notably the relative share of staff with higher education qualifications) also play a significant role. Within firms that do offer training, the dispersion of training costs depends very much on firm-specific factors, which cannot be taken into consideration by a general model.employment, staff costs, training, working hours, employment contract, full-time, part-time, skills, temporary worker