Search Results (6)

The specific postural control systems associated with falls and frailty in older adults remain poorly understood. This study aimed to examine whether postural control systems are associated with, and can predict, the presence of falls over a 1-year period and frailty after 1 year. We conducted a prospective cohort study involving 127 community-dwelling older adults. Balance was assessed using the Brief-Balance Evaluation Systems Test, and frailty was determined according to the Cardiovascular Health Study criteria. Data were collected at baseline and 1-year follow-up. The results suggested that lower baseline scores in anticipatory postural adjustments (APA) and gait stability were related to falls, and that a decrease of ≥2 points in gait stability assessed by the Timed Up and Go test may indicate the presence of falls. At baseline, several postural control systems—biomechanical constraints, stability limits/verticality, APA, postural responses, and gait stability—were significantly associated with frailty status after 1 year. Furthermore, 1-year declines in sensory orientation and gait stability were also significantly associated with frailty status and showed potential predictive ability for it. These preliminary findings suggest that specific systems of postural control may be differentially related to falls and frailty, supporting outcome-specific approaches to intervention. Full article

Study Design: Prospective observational study. Background: Lumbar spinal stenosis (LSS) impairs balance and gait function, increasing fall risk and limiting quality of life. Although postoperative recovery of balance is clinically important, longitudinal data using multidimensional balance assessments are limited. Methods: A prospective cohort study was conducted in 101 patients (mean age 74.9 ± 6.9 years) undergoing surgery for LSS. The Brief Balance Evaluation Systems Test (Brief BESTest), Oswestry Disability Index (ODI), Modified Falls Efficacy Scale (MFES), Zurich Claudication Questionnaire (ZCQ), and Visual Analog Scales (VAS) for pain/numbness were evaluated preoperatively and at 6 and 12 months postoperatively. Changes over time and correlations between Brief BESTest and PROMs were analyzed. Results: The total Brief BESTest score significantly improved from 13.3 ± 5.3 preoperatively to 16.1 ± 5.1 at 6 months and 16.0 ± 5.1 at 12 months (p < 0.01). Subdomains including Anticipatory Adjustments, Postural Responses, Sensory Orientation, and Stability in Gait improved significantly, while Stability Limits did not. At 12 months postoperatively, ODI decreased by 19.1%, ZCQ symptom and function scores improved by 0.8 and 0.9 points, respectively, and VAS scores improved by 17.1 mm for low back pain, 26.5 mm for lower limb pain, and 19.5 mm for numbness, all showing marked improvements from baseline. MFES also increased significantly postoperatively. The Brief BESTest score correlated significantly with MFES and ZCQ-PFS at baseline, and with ODI, ZCQ, and VAS scores at 12 months. Conclusions: Balance ability in LSS patients improved after surgery, as measured by the Brief BESTest, with clinically meaningful changes maintained for 12 months. Improvements in balance were significantly associated with reductions in pain, disability, and fear of falling, suggesting the Brief BESTest is a comprehensive indicator of postoperative recovery. Full article

Background/Objectives: Responsiveness and minimal important change (MIC) are key metrics that vary across conditions and should be determined for specific populations. However, these metrics have not yet been established for the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Brief-BESTest in people with subacute traumatic incomplete cervical spinal cord injury (iCSCI). In this study, we aimed to determine the responsiveness and MIC of the Mini-BESTest and Brief-BESTest in people with subacute iCSCI. Methods: This study included people with iCSCI who could maintain the standing position for 30 s without assistance within 7 days of injury at the university hospital’s advanced critical care center. Responsiveness was assessed by correlating Mini-BESTest and Brief-BESTest change scores with the Berg Balance Scale (BBS). MIC values were determined using the global rating of change scale as an anchor, employing receiver operating characteristic curve methods (MIC_ROC) and predictive modeling methods adjusted for the proportion of improved participants (MIC_adjusted). Results: Fifty people with iCSCI were included in the analysis. Changes in BBS scores were moderately positively correlated with changes in Mini-BESTest and Brief-BESTest scores. MIC_adjusted values were 3.7 for the Mini-BESTest and 2.2 for the Brief-BESTest. The MIC_ROC, based on an improvement rate of 64%, was deemed less appropriate for interpreting meaningful changes due to the high proportion of improved participants. Conclusions: MIC_adjusted benchmarks can help clinicians measure significant improvements in dynamic balance, design effective interventions, and evaluate rehabilitation outcomes in people with iCSCI. Full article

Aim: The aim of this study was to compare balance performance and electromyographic activity in individuals with COPD, with and without sarcopenia. Method: Thirty-five patients with COPD were classified with and without sarcopenia according to EWGSOP criteria. Balance was assessed using a force platform under four conditions: standing with feet apart and eyes opened (FHEO), eyes closed (FHEC), on an unstable surface (US), and on one leg (OLS). The surface electromyography activity of lower limb muscles and trunks was recorded. Additionally, the timed up and go test (TUG) and the Brief Balance Evaluation Systems Test (Brief-BESTest) were also utilized. Results: Under the FHEO, FHEC, and US conditions, individuals with sarcopenia demonstrated increased velocities, larger oscillation amplitudes, and greater center of pressure displacements under the US condition (p ≤ 0.02). They also showed a higher activation of the scalene, sternocleidomastoid, and abdominal muscles during OLS, along with a reduced activation of the tibialis anterior during OLS and US, and a decreased activation of the vastus medialis during FHEC and US (p ≤ 0.04). Furthermore, sarcopenic COPD patients exhibited poorer performance on the TUG and Brief-BESTest compared to their non-sarcopenic counterparts (p ≤ 0.02). Conclusions: Individuals with COPD and sarcopenia demonstrated greater instability in both bipedal stances and on unstable surfaces, as well as poorer performance in both dynamic and static balance assessments. Furthermore, these individuals exhibited reduced muscular activation in the lower limbs compared to those without sarcopenia. Full article

Locomotive Syndrome (LS), a condition related to impaired mobility, is influenced by balance control, which comprises six components. Deficiencies in these components can lead to reduced mobility and decreased quality of life. This study aimed to evaluate the relationship between the components of postural control and LS in older adults using the Brief-BESTest. Therefore, this cross-sectional study involved 122 elderly participants from Tha Sala District, Nakhon Si Thammarat Province, both with and without LS. Participants underwent assessments using the Instrumental Activities of Daily Living (IADL) assessment, the Thai Mental State Examination (TMSE), the Two-Step Test, and the Brief-BESTest. The Brief-BESTest covers six balance components: Biomechanical Constraints, Stability Limits, Anticipatory Postural Adjustments, Postural Responses, Sensory Orientation, and Stability in Gait. Descriptive statistics were used to summarize participant characteristics, and Chi-square tests were conducted to examine the relationship between each balance component and LS. Cramer’s V was used to assess the strength of the relationships. The results showed the average age of the sample was 67.67 ± 6.01 years with 85.20 percent female and 14.80 percent male. There were significant relationships between LS and three balance components: Biomechanical Constraints (Chi-square = 5.35, p = 0.021, Cramer’s V = 0.209), Stability Limits (Chi-square = 5.00, p = 0.025, Cramer’s V = 0.204), and Anticipatory Postural Adjustments (left: Chi-square = 4.12, p = 0.042, Cramer’s V = 0.213; right: Chi-square = 5.50, p = 0.019, Cramer’s V = 0.213). No significant associations were found for Reactive Postural Response, Sensory Orientation, and Stability in Gait. These findings suggest that targeted interventions focusing on specific balance components consist of Biomechanical Constraints, Stability Limits, and Anticipatory Postural Adjustments could help reduce the risk of LS in older adults. Full article

Background: Balance disorders and postural control treatments play an important role in fall prevention. The Brief-BESTest is a short-scale employed to evaluate balance and fall risk in different populations. Balance assessment is a fundamental element in patients with Acquired Brain Injury rehabilitation since postural alteration is one of the most frequent sequelae. The objective was to validate the Spanish version of the Brief-BESTest questionnaire in the stroke population. Methods: Subjects of both sexes aged over 18 years with a diagnosis of acute/chronic stroke were included. The BESTest, Mini-BESTest, Brief-BESTest, Berg Balance Scale, and Timed Up & Go Test were used to assess balance. The scales were implemented once. Cronbach’s alpha coefficient was used to assess the internal consistency and confirmatory factorial analysis was employed to assess validity. Results: A total of 44 patients with a mean age of 65.35 years (SD = 10.665) participated. Cronbach’s alpha coefficient showed a high internal consistency with a value of 0.839. In the criterion validity, there was a high positive correlation between the Brief-BESTest and BESTest (r = 0.879), Mini-BESTest (r = 0.808), and Berg Balance Scale (r = 0.711). Conclusion: The Spanish version of the Brief-BESTest scale is valid and reliable, showing adequate psychometric properties for balance assessment in patients with acute or chronic stroke. Full article