Subthreshold white noise vibration alters trembling sway in older adults

Background Somatosensory deficit is a significant contributor to falls in older adults. Stochastic resonance has shown promise in recent studies of somatosensation-based balance disorders, improving many measures of stability both inside and outside of the clinic. However, our understanding of this effect from a physiological perspective is poorly understood. Therefore, the primary goal of this study is to explore the influence of subthreshold vibratory stimulation on sway under the rambling-trembling framework. Methods 10 Healthy older adults (60–65 years) volunteered to participate in this study. Each participant underwent two randomized testing sessions on separate days, one experimental and one placebo. During each session, the participants' baseline sway was captured during one 90-s quiet standing trial. Their sensation threshold was then captured using a custom vibratory mat and 4–2-1 vibration perception threshold test. Finally, participants completed another 90-s quiet standing trial while the vibratory mat vibrated at 90% of their measured threshold (if experimental) or with the mat off (if placebo). While they completed these trials, an AMTI force plate collected force and moment data in the anteroposterior (AP) and mediolateral (ML), from which the center of pressure (COP), rambling (RM), and trembling (TR) time series were calculated. From each of these time series, range, variability (root-mean-square), and predictability (sample entropy) were extracted. One-tailed paired t-tests were used to compare baseline and during-vibration measures. Results No significant differences were found during the placebo session. For the experimental session, significant increases were found in AP TR range, ML TR RMS, AP COP predictability, and AP & ML TR predictability. The TR time series was particularly sensitive to vibration, suggesting a strong influence on peripheral/spinal mechanisms of postural control. Significance Though it is unclear whether observed effects are indicative of “improvements” or not, it does suggest that there was a measurable effect of subthreshold vibration on sway. This knowledge should be utilized in future studies of stochastic resonance, potentially acting as a mode of customization, tailoring vibration location, duration, magnitude, and frequency content to achieve the desired effect. One day, this work may aid in our ability to treat somatosensation-based balance deficits, ultimately reducing the incidence and severity of falls in older adults

Adequate Management of type two diabetes creates minor complications in Cardio-Postural Profile in Latinx-Hispanic People

Diabetes is recognized to lead to a series of metabolic abnormalities in the body. These alterations will affect balance, body composition, and cardiovascular performance, heightening the risk of various medical complications. The problem is that the primary instruction for those with diabetes is to monitor glucose levels, paying very insufficient consideration to other fundamental factors and health profiles that could influence the quality of life in these individuals. Identify body composition, balance, and cardiovascular components in controlled type two diabetics compared to an age-matched control group. 15 participants with controlled type II diabetes without peripheral neuropathy (CT2DM) and 18 non-diabetic subjects control (CG) were recruited. Both groups had an age average of roughly 56 years old. The CT2DM subjects had an average A1c level of 6.7+/-0.5%. Body composition, cardiovascular, and balance data were collected, analyzed, and compared among groups. Minimal alterations in balance components, body composition and cardiovascular factors were identified in the CT2DM group aside from higher SBP values and decreased BBS scores contrasted to the CG group. We can attribute the analogous outcomes in both groups to CT2DM participants managing their diabetes effectively. Our examination has prompted us to establish that the cardiovascular and balance components in middle-aged Latinx-Hispanic participants with CT2DM are proportionate to CG subjects because of effectiveness in dealing with diabetes. Further, we encourage establishing more age appropriate and complex assessment tools to identify early adaptations caused by diabetes

Real-time human ambulation, activity, and physiological monitoring:taxonomy of issues, techniques, applications, challenges and limitations

Automated methods of real-time, unobtrusive, human ambulation, activity, and wellness monitoring and data analysis using various algorithmic techniques have been subjects of intense research. The general aim is to devise effective means of addressing the demands of assisted living, rehabilitation, and clinical observation and assessment through sensor-based monitoring. The research studies have resulted in a large amount of literature. This paper presents a holistic articulation of the research studies and offers comprehensive insights along four main axes: distribution of existing studies; monitoring device framework and sensor types; data collection, processing and analysis; and applications, limitations and challenges. The aim is to present a systematic and most complete study of literature in the area in order to identify research gaps and prioritize future research directions

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

The Effect of Peripheral Neuropathy on Balance Performance in Community-Dwelling Adults with Type I Diabetes Mellitus

Purpose: Balance is affected by visual, somatosensory, proprioceptive, and vestibular input. Anything that alters one of these elements could potentially cause a decrease in postural stability. One disease which reduces the somatosensory input from the foot and ankles is diabetic neuropathy. The purpose of this study is to determine the correlation between Type I DM and balance performance, thereby adding to the current knowledge of postural control and the impact, if any, DM has on balance. Methods: Twenty-five volunteer subjects with Type I DM and 25 age-matched control subjects participated in the study. Semmes-Weinstein monofilaments were used to determine plantar sensation. Following this the Berg Balance Assessment was administered to assess functional balance performance. A Pearson Correlation multiple regression was used to determine the correlation between sensation, DM, and balance performance. Results: Significance was established between reduced sensation and decreased balance control in both the experimental and control groups. A significant correlation was also found between an increase in age and decreased sensation scores. Conclusion: Assessing the balance of all patients who are at risk for reduced sensation should be implemented as a screening procedure for determining any decrease in postural stability

A Comparative study to find the Effectiveness of PNF and Simple Balance Training to Improve Dynamic Balance in Diabetic Neuropathy

INTRODUCTION: Diabetic Neuropathy plays a significant role in falling among elderly patients. People with peripheral neuropathy caused by diabetes often experience balance disorder, postural sway in these patients is increased, especially with the eyes closed. Peripheral neuropathy caused by diabetes causes significantly impaired sensation in the feet, reducing patients ability to control their balance properly during daily activities. Poor balance can be due to proprioception impairment. Balance problems are also caused by movement strategy impairment, biomechanical structural disorders and disorientation. AIM OF THE STUDY: The aim of the study is to compare the effectiveness of Proprioceptive Neuromuscular Facilitation and Simple Balance Training to improve Dynamic Balance in Diabetic Neuropathy. Need for the study: Very few studies have been conducted to show the effects of balance training in diabetic neuropathy. METHOD: Sample size: 30 patients. Group A - Proprioceptive Neuromuscular Facilitation , Group B - Simple Balance Training. Inclusion Criteria: Age group 50-70 years, Diabetic, Michigan Neuropathy Screening Instrument score >7 to >4. Exclusion Criteria: Foot ulcers, Vision impairment, History of dizziness, Internal otitis ( Labrynthitis), Any other vestibular diseases, Musculo-skeletal disorders, Rheumatic disorders, Total/ Partial amputation of lower extremities, Fractures, History of spinal injury/ surgery, History of lower limb surgery. Evaluation of Diabetic Neuropathy: Michigan Neuropathy Screening Instrument. Procedure: Group A: PNF techniques; 1. Rhythmic initiation, 2. Sustain-Relax, 3. Reversal of Antagonists. Protocol: 1st week - 10 Repetitions. 2nd week - 2 sets of 10 Repetitions. 3rd & 4th week - 3 sets of 10 Repetitions. Duration: 40 minutes. 5 days per week for 4 weeks. Group B: Simple Balance Training; Protocol: 1. Walking training section, 2. Balance training section, 3. Muscle strength training section. Duration: 40 minutes, 5 days per week for 4 weeks. Variables: The 3m Timed up and go test, The Functional Reach test. CONCLUSION: Going by the results of the analysis, we see that both the PNF and Simple Balance Training exercises are individually effective in increasing the scores of FRT and reducing the scores of TUG. That is the scores of all the standard measures (i). FRT are significantly increased (ii). TUG are significantly reduced, due to the either treatments of the PNF and Simple Balance Training. However, by comparing the increase and decrease in scores of standard measures due to these two treatments, it was found that the treatment of PNF is more effective in terms of decreased TUG scores and increased FRT scores. On the whole, we conclude that the PNF is found to be more effective than Simple Balance Training in terms of decreasing the scores of TUG and increasing the scores of FRT in dynamic balance in Diabetic Neuropathy