Factors of balance determining the risk of falls in physically active women aged over 50 years.

BACKGROUND: Balance disorders are believed to be one of the main reasons for falls in older adults. They are related to natural processes of ageing, resulting in deterioration of information integration and processing from the vestibular, somatosensory and visual systems. The consequence is an increased number of postural sways, which are some of balance factors. Balance control in static and dynamic activities is an essential element of daily functioning of older citizens. It seems that balance assessment is essential to determine the risk of falls, as well as to determine which factors of balance have greatest impact on the risk of falls. METHODS: The study involved physically active female students (n = 36, mean age 67,11 ± 5,35) of a University of the Third Age. We used the Balance System SD platform to assess their balance in four tests with eyes open and with eyes closed and to determine the risk of falls. We assessed the relationships between individual balance indices (overall stability index, anterior/posterior stability index, medial/lateral stability index) and the falls risk index. We also determined those factors which predicted the risk of falls the most. RESULTS: The studied subjects had low risk of falls for their age category. In most measurements there were relationships between the risk of falls and the size of sways in the coronal plane and the overall stability index. We also found that the overall stability index calculated in measurements with eyes closed predicted the risk of falls of the studied physically active females most accurately (R2 0.391 F(1.34)=23.475; <0.000). The subjects were physically active and their falls risk index was low - this allowed us to presume that there was a relationship between these two factors. Preventive programmes should include exercise performed with eyes closed, and tests conducted with eyes closed seem to be most sensitive in determining balance disorders in physically active women.

Role of vision in static balance in persons with and without visual impairments.

BACKGROUND: Vision is one of the elements of the system responsible for maintaining static balance. Any visual impairments or conditions hampering the reception of visual stimuli may affect static balance. It would be interesting to identify to what extent people with different degrees of dysfunction and in different conditions are able to compensate for the inability to receive visual stimuli while maintaining balance. AIM: The aim of this study was to determine the role of the vision in maintaining static balance. This study sought to assess balance and the degree of compensation when the possibility of receiving visual stimuli is limited in persons without visual impairments and persons with varying degrees of visual impairments. DESIGN: Controlled observational study. SETTING: Main University Laboratory. POPULATION: The study included 122 individuals, 81 of whom were visually impaired. The participants with visual impairments were divided into three groups according to their levels of disability. METHODS: Subjects performed tests on a stabilographic platform: standing on both feet with eyes open and closed, single right- and left-leg stance with eyes open and closed. The center of pressure path length and the visual inspection indicator were analysed. Significance of differences between the groups regarding the visual inspection indicator and tests performed with eyes open and closed was assessed with the use of the Mann-Whitney U test. The effects and interactions between variables were verified using the ANOVA test for the main effects and factorial designs. RESULTS: Differences were noted in balance of persons without visual impairments in single-leg stance tests with eyes open and closed as well as when standing on both feet with eyes open and closed. In persons with visual impairment, significant differences were observed in the single left-leg stance test with eyes open and closed only. Testing conditions and disability levels exerted a significant influence on static balance in single-leg tests. CONCLUSIONS: The findings of the study confirm the role of vision in maintaining balance in the context of factors that may affect it, i.e. conditions (eyes open or closed) and possibilities of receiving visual stimuli (disability level). CLINICAL REHABILITATION IMPACT: The significance of the visual effect was noted in single-leg tests. More demanding tests detect compensatory mechanisms of balance more accurately.

Effects of sport on static balance in athletes with visual impairments.

BACKGROUND: Proper balance is crucial for postural control and physical activity performance. Issues related to balance as well as effects of various factors on balance are in the center of attention of specialists in a number of fields including sport. Research results show that every sports discipline demands different motor preparation (including balance) and persons with visual impairments exhibit worse balance compared to their sighted counterparts. Therefore, this study sought to assess static balance in athletes with visual impairments with reference to the type of sport they did, the length of their training experience, training loads and dysfunction level. METHODS: The study involved 57 men (shooters, tandem cyclists, football and goalball players) with visual impairments. AMTI stabilographic platform was used to assess static balance. The study participants performed the following tests: standing on both feet with eyes open and closed and single-leg stance with eyes open and closed. RESULTS: Balance in tests performed while standing on both feet did not differentiate athletes in terms of the sport they did. Static balance of athletes with visual impairments significantly differs in the single leg stance. Better balance was observed in tests with eyes open. Taking into consideration sports disciplines practiced by the athletes, significant differences in balance in single left leg tests with eyes open and closed were observed. Athletes training more than five hours per week manifested better balance compared to those who practiced less than five hours per week. CONCLUSIONS: The findings indicate that athletes performing particular sports may use strategies of maintaining balance that result from the structure of these sports. The lack of differences in balance among athletes with different degrees of dysfunction may indicate their high fitness levels and show how balance is affected by physical activity performance. Results of the analysis of balance with regard to the length of training experience may suggest that it is not this factor but rather the quality of training that may exert an influence on this ability.

Bilateral Coordination of Children who are Blind.

The purpose of this study was to evaluate the bilateral coordination in children and adolescents with visual impairments aged 7 to 18 years in comparison to their sighted peers. An additional objective was to identify the influence of sex and age on bilateral coordination. Seventy-five individuals with congenital severe visual impairment (40 girls and 35 boys) comprised the visually impaired group. The Sighted group comprised 139 youth without visual impairment. Subtest 4 of the Bruininks-Oseretsky Test of Motor Proficiency was administered to test bilateral coordination. To analyze the effect of the independent variables in the results obtained in the Subtest 4, four linear regression models were applied according to group and sex. The results indicated that severe visual impairment and lack of visual sensation had a negative effect on the development of participants' bilateral coordination, which however did not depend on sex or age.

Game Performance Evaluation in Male Goalball Players.

Goalball is a Paralympic sport exclusively for athletes who are visually impaired and blind. The aims of this study were twofold: to describe game performance of elite male goalball players based upon the degree of visual impairment, and to determine if game performance was related to anthropometric characteristics of elite male goalball players. The study sample consisted of 44 male goalball athletes. A total of 38 games were recorded during the Summer Paralympic Games in London 2012. Observations were reported using the Game Efficiency Sheet for Goalball. Additional anthropometric measurements included body mass (kg), body height (cm), the arm span (cm) and length of the body in the defensive position (cm). The results differentiating both groups showed that the players with total blindness obtained higher means than the players with visual impairment for game indicators such as the sum of defense (p = 0.03) and the sum of good defense (p = 0.04). The players with visual impairment obtained higher results than those with total blindness for attack efficiency (p = 0.04), the sum of penalty defenses (p = 0.01), and fouls (p = 0.01). The study showed that athletes with blindness demonstrated higher game performance in defence. However, athletes with visual impairment presented higher efficiency in offensive actions. The analyses confirmed that body mass, body height, the arm span and length of the body in the defensive position did not differentiate players' performance at the elite level.

Balance Functional Assessment in People with Visual Impairment.

The aims of this study were twofold: to assess the level of balance of people with visual impairment against the BOT-2 standard scores for the able-bodied, and to identify in which trials subjects had the greatest difficulties in maintaining balance with respect to the degree of vision loss and age categories. One hundred twenty-seven subjects with visual impairment aged 6-16 years, participated in the study (68 girls and 59 boys). The division for partially sighted people (61) and the blind (66) was made according to the WHO classification. Functional balance assessment was made using a balance subtest from the Bruininks-Oseretsky test. Significant relationships were noticed between age and the level of balance (χ2 = 8.35 p <0,05), as well as between the degree of vision loss and the level of balance (χ2 = 24.53 p <0,001). The level of balance of almost all blind subjects was below (20%) or well-below (60%) the average for the able-bodied. The subjects' ability to maintain balance was not dependent on gender and was associated primarily with the degree of visual impairment and age. Partially sighted people had better balance than the blind and the decrease in visual acuity resulted in reduction of balance skills. The lowest level of balance was observed in blind students aged 7-11 years. Elaborating physical fitness improvement programs for children and adolescents with visual impairment, diversity of age, the degree of vision loss and limitations of ablility to maintain balance should be taken into account.