Biofeedback for training balance and mobility tasks in older populations: a systematic review

<p>Abstract</p> <p>Context</p> <p>An effective application of biofeedback for interventions in older adults with balance and mobility disorders may be compromised due to co-morbidity.</p> <p>Objective</p> <p>To evaluate the feasibility and the effectiveness of biofeedback-based training of balance and/or mobility in older adults.</p> <p>Data Sources</p> <p>PubMed (1950-2009), EMBASE (1988-2009), Web of Science (1945-2009), the Cochrane Controlled Trials Register (1960-2009), CINAHL (1982-2009) and PsycINFO (1840-2009). The search strategy was composed of terms referring to biofeedback, balance or mobility, and older adults. Additional studies were identified by scanning reference lists.</p> <p>Study Selection</p> <p>For evaluating effectiveness, 2 reviewers independently screened papers and included controlled studies in older adults (i.e. mean age equal to or greater than 60 years) if they applied biofeedback during repeated practice sessions, and if they used at least one objective outcome measure of a balance or mobility task.</p> <p>Data Extraction</p> <p>Rating of study quality, with use of the Physiotherapy Evidence Database rating scale (PEDro scale), was performed independently by the 2 reviewers. Indications for (non)effectiveness were identified if 2 or more similar studies reported a (non)significant effect for the same type of outcome. Effect sizes were calculated.</p> <p>Results and Conclusions</p> <p>Although most available studies did not systematically evaluate feasibility aspects, reports of high participation rates, low drop-out rates, absence of adverse events and positive training experiences suggest that biofeedback methods can be applied in older adults. Effectiveness was evaluated based on 21 studies, mostly of moderate quality. An indication for effectiveness of visual feedback-based training of balance in (frail) older adults was identified for postural sway, weight-shifting and reaction time in standing, and for the Berg Balance Scale. Indications for added effectiveness of applying biofeedback during training of balance, gait, or sit-to-stand transfers in older patients post-stroke were identified for training-specific aspects. The same applies for auditory feedback-based training of gait in older patients with lower-limb surgery.</p> <p>Implications</p> <p>Further appropriate studies are needed in different populations of older adults to be able to make definitive statements regarding the (long-term) added effectiveness, particularly on measures of functioning.</p

Assessing palaeobathymetry and sedimentation rates using palynomaceral analysis: a study of modern sediments from the Gulf of Papua, offshore Papua New Guinea

© 2015 © 2015 AASP - The Palynological Society. Palynologists interested in better understanding the sedimentation and energy of depositional environments have often included studies of palynomaceral fragments, particularly when performing palynofacies analyses. Due to the difficult nature of classifying these fragments, researchers have developed numerous, often overlapping, classification schemes. These different schemes make it difficult to compare and contrast between research projects. Determining the appropriate scheme to apply when counting these fragments can be confusing, and application of these schemes can yield inconclusive results, especially when sedimentation and energy are in constant flux. A scheme of five categories, including brown wood (palynomaceral 1-2), leaf cuticle (palynomaceral 3), black debris (palynomaceral 4), structureless organic matter (SOM) and resin, is utilised here. It is applied to the analysis of 64 modern samples from the top 0-4 cm of sediment collected throughout the Gulf of Papua, Papua New Guinea. These samples span a suite of common marine depositional environments: river mouths and deltas, the proximal portion of the continental shelf dominated by a large clinoform, and turbidite and hemipelagic/pelagic deposits on the slope and in the deep ocean basin. Principal component analysis (PCA) confirms this simplified classification scheme provides an indirect means of assessing distance from shore and shelf-slope break, overall water depth and sediment accumulation rate, but other factors, such as processing technique, marine productivity, sediment source, time in transport and residence and bioturbation, are taken into account to fully explain distribution