A Qualitative Review of Balance and Strength Performance in Healthy Older Adults: Impact for Testing and Training

A continuously greying society is confronted with specific age-related health problems (e.g., increased fall incidence/injury rate) that threaten both the quality of life of fall-prone individuals as well as the long-term sustainability of the public health care system due to high treatment costs of fall-related injuries (e.g., femoral neck fracture). Thus, intense research efforts are needed from interdisciplinary fields (e.g., geriatrics, neurology, and exercise science) to (a) elucidate neuromuscular fall-risk factors, (b) develop and apply adequate fall-risk assessment tools that can be administered in clinical practice, and (c) develop and design effective intervention programs that have the potential to counteract a large number of fall-risk factors by ultimately reducing the number of falls in the healthy elderly. This paper makes an effort to present the above-raised research topics in order to provide clinicians, therapists, and practitioners with the current state-of-the-art information

Side differences of upper quarter Y balance test performance in sub-elite young male and female handball players with different ages

Background Handball is characterised by repetitive passing and shooting actions mainly performed with the throwing arm. This can lead to side differences (inter-limb asymmetry) in upper quarter mobility/stability between the throwing and non-throwing arm, which could even increase with advancing age (i.e., playing experience). However, side differences in upper quarter mobility/stability is associated with an increased musculoskeletal injury risk. Therefore, we assessed side differences in upper quarter mobility/stability in young handball players at different ages using a cross-sectional study design. Methods Upper Quarter Y Balance test performance of the throwing and non-throwing arm was assessed in 190 sub-elite young female and male handball players (13–18 years). Per arm, relative maximal reach distances (% arm length) for all three directions (i.e., medial, inferolateral, superolateral) and the composite score (CS) were calculated and used for an age × side analysis of variance. Additionally, partial eta-squared (ηp2) was calculated as an effect size measure. Results Irrespective of measure, statistically significant main effects of age (except for the composite score) and side but no statistically significant age × side interaction effects were detected. Further, limb asymmetry in the inferolateral reach direction was above the injury-related cut-off value (i.e., ≥ 7.75% arm length) in 13- and 14-year-olds but not in the older players. Conclusion The detection of limb asymmetry above the proposed injury-related cut-off value in younger players (13- and 14-year-olds) but not in older players (15- to 18-year-olds) may be indicative for an increased injury risk for the younger age group. Thus, prevention programs should be implemented in the handball training routine, especially for the younger ones

Effect of arm movement and task difficulty level on balance performance in healthy children:are there sex differences?

OBJECTIVE: In children, studies have shown that balance performance is worse in boys compared to girls and further studies revealed inferior performance when arm movement was restricted during balance assessment. However, it remains unclear whether restriction of arm movement during balance testing differentially affects children’s balance performance (i.e., boys more than girls). Thus, we compared the influence of arm movement on balance performance in healthy boys versus girls (mean age: ~ 11.5 years) while performing balance tasks with various difficulty level. RESULTS: In nearly all tests, balance performance (i.e., timed one-legged stance, 3-m beam walking backward step number, Lower Quarter Y-Balance test reach distance) was significantly worse during restricted compared to free arm movement but without any differences between sexes or varying levels of task difficulty. These findings indicated that balance performance is negatively affected by restriction of arm movement, but this does not seem to be additionally influenced by children’s sex and the level of task difficulty

LOAD EFFECTS OF FAST LONGITUDINAL ROTATIONS

Pirouettes, jumps in figure skating and twisting somersaults are fascinating movements in sports. But there is a lack of investigations in the field of motor control and load effects of fast longitudinal rotations. The purpose of the present study was to analyze load effects during and after longitudinal rotations. A "Longitudinal Rotation Simulator", posturography, and video nystagmography were used to analyze the rotational load. Six gymnasts, eleven figure skaters, and nineteen non-athletes were investigated. There were significant differences in the postural control between gymnasts and non-athletes. Per-rotatory nystagmus amplitude was significantly lower after three rotations than after ten rotations. The posturography and the video nystagmography are valid methods to characterize the rotational load

Effect of arm movement on balance performance in children: role of expertise in gymnastics

OBJECTIVE: Studies have shown that balance performance is better in gymnasts compared to age-/sex-matched controls and further studies revealed superior performance when arms were free to move during assessment of balance. However, it is unknown whether free arm movement during balance testing differentially affects balance performance with respect to sports expertise (i.e., gymnasts are less affected than age-/sex-matched controls). Therefore, we investigated the effect of arm movement on balance performance in young female gymnasts compared to age-/sex-matched controls while performing balance tasks with various difficulty levels. RESULTS: In both samples, balance performance (except for the timed one-legged stance) was significantly better during free compared to restricted arm movement conditions and this was especially observed in the highest task difficulty condition of the 3-m beam walking backward test. These findings revealed that balance performance is positively affected by free arm movements, but this does not seem to be additionally influenced by the achieved expertise level in young gymnasts

Balance performance of healthy young individuals in real versus matched virtual environments:a systematic scoping review

Background: Due to technological advancements and the development of consumer-oriented head mounted displays (HMDs), virtual reality (VR) is used in studies on balance performance and balance trainability more and more frequently. Yet, it may be assumed that balance performance is affected by the physical characteristics of the HMD (e.g., weight) as well as by the virtual visual environment. Moreover, it has been shown that balance is age-dependent with children and adolescents showing worse performances compared to young adults, which may also affect their balance performance in virtual environments.Objectives: The present systematic scoping review aims to provide an overview on the current evidence regarding balance performance of healthy, young individuals (6–30 years) in real and matched virtual environments.Methods: A systematic literature search in the electronic databases PubMed, Web of Science, and SPORTDiscus (from their inception date to February 2024) resulted in 9,554 studies potentially eligible for inclusion. Eligibility criteria were: (i) investigation of healthy, young individuals (6–30 years), (ii) balance assessment in the real and a matched virtual environment, (iii) use of a fully immersive HMD, (iv) reporting of at least one balance parameter. A total of 10 studies met the predefined inclusion criteria and were thus included in this review. All studies were conducted with healthy, young adults (19–30 years).Results: Five studies assessed static balance, four studies quantified dynamic balance, and one study measured static as well as dynamic balance performance. In healthy young adults, static balance performance was similar with and without VR during simple standing tasks (e.g., two-legged stance), but worse in VR during more challenging tasks (e.g., one-legged stance). Concerning dynamic balance, four out of five studies reported worse performance in VR, while one study did not find differences between visual environments. Most importantly, none of the studies investigating healthy children (6–12 years) and/or adolescents (13–18 years) met the predefined inclusion criteria.Conclusion: In healthy young adults, balance performance seems to be affected by VR only during challenging static (e.g., one-legged stance) as well as during dynamic balance tasks. The underlying causes remain unclear, but factors such as perceived presence in VR, a shift in sensory organization and/or perceptual distortion may play a role. Of particular importance is the finding that there is a void in the literature on the influence of VR on balance performance of healthy children and adolescents

Acute effects of a single unilateral balance training session on ipsi- and contralateral balance performance in healthy young adults

Objective While there is evidence on the short-term effects of unilateral balance training (BT) on bipedal balance performance, less is known on the acute effects of unilateral BT on unilateral (i.e., ipsi- and contralateral) balance performance. Thus, the present study examined the acute effects of a single unilateral BT session conducted with the non-dominant, left leg or the dominant, right leg on ipsilateral (i.e. retention) and contralateral (i.e., inter-limb transfer) balance performance in healthy young adults (N = 28). Results Irrespective of practice condition, significant improvements (p < 0.001, d = 1.27) in balance performance following a single session of unilateral BT were observed for both legs. Further, significant performance differences at the pretest (p = 0.002, d = 0.44) to the detriment of the non-dominant, left leg diminished immediately and 30 min after the single unilateral BT session but occurred again 24 h following training (p = 0.030, d = 0.36). These findings indicate that a single session of unilateral BT is effective to reduced side-to-side differences in balance performance, but this impact is only temporary

Effect of low versus high balance training complexity on balance performance in male adolescents

Objective: The current study aimed to determine the effects of low (i.e., balance task only) versus high (i.e., balance task combined with an additional motor task like dribbling a basketball) balance training complexity (6 weeks of training consisting of 2 × 30 min balance exercises per week) on measures of static and dynamic balance in 44 healthy male adolescents (mean age: 13.3 ± 1.6 years). Results: Irrespective of balance training complexity, significant medium- to large-sized pretest to posttest improvements were detected for static (i.e., One-Legged Stance test, stance time [s], 0.001 &lt; p ≤ 0.008) and dynamic (i.e., 3-m Beam Walking Backward test, steps [n], 0.001 &lt; p ≤ 0.002; Y-Balance-Test-Lower-Quarter, reach distance [cm], 0.001 &lt; p ≤ 0.003) balance performance. Further, in all but one comparison (i.e., stance time with eyes opened on foam ground) no group × test interactions were found. These results imply that balance training is effective to improve static and dynamic measures of balance in healthy male adolescents, but the effectiveness seems unaffected by the applied level of balance training complexity