Effects of whole-body vibration on postural control in elderly: a systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>This systematic review was performed to summarize the current evidence for whole body vibration (WBV) interventions on postural control in elderly.</p> <p>Methods</p> <p>English and German language papers in Medline, PEDro, Cinahl and the Cochrane databases were searched. Two reviewers extracted data on patients' characteristics, type of WBV intervention and outcomes. Two independent reviewers rated the methodological quality of these studies. Data were pooled using random-effects meta-analysis.</p> <p>Results</p> <p>Fifteen papers reporting quantitative data were included. Results from 15 papers could be pooled for a meta-analysis. The studies involved 933 participants. In 7 studies the authors investigated the effects of vibration plates generating vertical sinusoidal vibrations (VS-WBV) and 7 papers described the use of side-alternating sinusoidal vibrations (SS-WBV). One study investigated both VS-WBV and SS-WBV.</p> <p>Weak to moderate evidence of an overall effect as a result of VS-WBV and SS-WBV was observed for (a) static balance for post-intervention values with a standardized mean difference (SMD) -0.06, 95% CI -0.31 to 0.18 and for change values SMD -0.26, 95% CI -1.09 to 0.57, and (b) dynamic balance for post-intervention-values SMD -0.34, 95% CI -0.60 to -0.08. For functional balance (c) an overall outcome for post-intervention values with SMD of 0.34, 95% CI -0.19 to 0.87 was found.</p> <p>Conclusions</p> <p>The 15 studies reviewed were of moderate methodological quality. In summary, SS-WBV seems to have a beneficial effect on dynamic balance in elderly individuals. However, the current results should be interpreted with caution because of the observed heterogeneity of training parameters and statistical methods. Future studies are warranted to evaluate the effects of WBV on postural control in an elderly population.</p

Building Strategic Capacity and Collaborative Leadership in Blue Light Organisations

It is increasingly considered that an organisation’s ability to form and manage strategic partnerships significantly contributes in enhancing its overall performance. Coordination, communication and ability to develop interpersonal relationships (bonding) are considered as three critical components of collaborative capabilities. The collaborative capabilities develop over a period of time, and they enable the organisation to purposefully create, extend or modify existing organisational routines that underpin the activities pertaining to coordination, communication and relationship building. Development of collaborative capabilities necessitates exploring alternative approaches to leadership in organisations. Emergency services leadership has been characterised as ‘top-down’, hierarchical, ‘heroic’, with a command and control approach prevalent in the organisations. There has been reliance on historical and hierarchical models of ‘heroic’ and ‘top-down’ leadership and absence of a distributive and pluralist approach to leadership. Current thinking and models are often based around individual services without much joined-up approach. Greater collaboration entails an approach different from leadership development, which needs to be facilitated at multiple levels within the organisations. Development of collaborative culture in organisations will necessarily involve cultivating future leaders, who will encourage greater collaboration within and amongst the collaborating organisations