Keep it simple: comparing functional assessments in individuals with Down syndrome.

BACKGROUND: A number of assessments exist that evaluate function in ambulatory adults. However, these assessments take for granted the cognitive abilities required for the participant to understand what is being asked of them in order to demonstrate their functional abilities. It has been shown that individuals with Down syndrome (DS) demonstrate lower functional levels when asked to perform additional tasks while walking. Therefore, measurements of function may not be reflective of actual function if the assessment requires additional tasks in those with DS. It is for these reasons the current investigation sought to evaluate four common functional assessments, two with [modified Berg balance test (mBERG) and Functional Gait Assessment (FGA)] and two without [Timed Up and Go (TUG) and Established Populations for Epidemiologic Study in the Elderly (EPESE)] complex tasks. METHODS: Adults with DS (n = 19) completed four functional assessments, which were later compared using bivariate Pearson correlation coefficients. RESULTS: There were large associations between simple assessments (TUG-EPESE: r = -0.525, P = 0.021) and complex assessments (FGA-mBERG: r = 0.612, P = 0.005), respectively. The TUG also inversely correlated with the FGA (r = -0.476, P = 0.039), and the EPESE had a large association with mBERG (r = 0.508, P = 0.027). CONCLUSIONS: The mBERG may be the best test to replicate real-world scenarios through its tasks, although it may also be confounded by the cognitive load required to perform the movements as asked. The TUG and EPESE may be more appropriate as mobility assessments because they require very little cognitive attention when completing the tasks. True assessments of mobility ought to err on the side of simple so to not confuse the outcomes with executive functionality.

Effect of balance training in older adults using Wii fit plus.

The Nintendo Wii-fit plus is a type of Virtual Reality exer-gaming with graphical and auditory response system. A case series was conducted at Shifa Tamer-e-Millat University Islamabad from January-July 2016. Sixteen adults more than 60 years age (07 males and 09 females) were recruited through convenient sampling. The specified Wii fit plus training was provided to all patients and the games included the Soccer heading, Ski slalom, table tilt and yoga. Berg balance test, time up and go and functional reach test were used before and after 06 weeks of treatment (4 days / week). Data was analysed by SPSS V-20. The mean age of the sample was 67.56±7.29 years, with 56% female and 44% males were in sample. There was a statistically significant difference in pre and post Berg Balance Score, time up and go test and functional reach. In this case series Wii-fit plus training was effective in improving dynamic balance and mobility in older adults. This should be explored further in large trials.

Task oriented training improves the balance outcome & reducing fall risk in diabetic population.

OBJECTIVES: The objective was to determine the balance impairments and to compare task oriented versus traditional balance training in fall reduction among diabetic patients. METHODS: The randomized control trial with descriptive survey and 196 diabetic patients were recruited to assess balance impairments through purposive sampling technique. Eighteen patients were randomly allocated into two groups; task oriented balance training group TOB (n=8) and traditional balance training group TBT (n=10). The inclusion criteria were 30-50 years age bracket and diagnosed cases of Diabetes Mellitus with neuropathy. The demographics were taken through standardized & valid assessment tools include Berg Balance Scale and Functional Reach Test. The measurements were obtained at baseline, after 04 and 08 weeks of training. RESULTS: The mean age of the participants was 49 ±6.79. The result shows that 165(84%) were at moderate risk of fall and 31(15%) were at mild risk of fall among total 196 diabetic patients. There was significant improvement (p <0.05) in task oriented balance training group for dynamic balance, anticipatory balance and reactive balance after 8 weeks of training as compare to traditional balance training. CONCLUSION: Task oriented balance training is effective in improving the dynamic, anticipator and reactive balance. The task oriented training reduces the risk of falling through enhancing balance outcome.