Validation of an Algorithm for Measurement of Sedentary Behaviour in Community-Dwelling Older Adults.

Accurate measurement of sedentary behaviour in older adults is informative and relevant. Yet, activities such as sitting are not accurately distinguished from non-sedentary activities (e.g., upright activities), especially in real-world conditions. This study examines the accuracy of a novel algorithm to identify sitting, lying, and upright activities in community-dwelling older people in real-world conditions. Eighteen older adults wore a single triaxial accelerometer with an onboard triaxial gyroscope on their lower back and performed a range of scripted and non-scripted activities in their homes/retirement villages whilst being videoed. A novel algorithm was developed to identify sitting, lying, and upright activities. The algorithm's sensitivity, specificity, positive predictive value, and negative predictive value for identifying scripted sitting activities ranged from 76.9% to 94.8%. For scripted lying activities: 70.4% to 95.7%. For scripted upright activities: 75.9% to 93.1%. For non-scripted sitting activities: 92.3% to 99.5%. No non-scripted lying activities were captured. For non-scripted upright activities: 94.3% to 99.5%. The algorithm could, at worst, overestimate or underestimate sedentary behaviour bouts by ±40 s, which is within a 5% error for sedentary behaviour bouts. These results indicate good to excellent agreement for the novel algorithm, providing a valid measure of sedentary behaviour in community-dwelling older adults.

The association between muscle mass quantity and its quality in physically active older women.

In this study, the authors aim to determine whether lower limb strength is related to lower limb lean mass and whether this relationship is affected by lower limb functionality in physically active older women. Twenty-six women underwent measures of knee muscles strength and lean mass of lower limbs. Bilateral strength of the knee flexors and extensors was measured by an isokinetic dynamometer. The concentric peak torque was measured at an angular velocity of 60°/s. Lean mass of the lower limbs was measured by bio-impedance analysis. Pearson's correlation analysis revealed significant association between the strength of the knee flexors and lean mass on non-dominant limb only (r = .427, p = .03). Researchers revealed that strategies aiming to prevent lean mass and muscle strength losses should be specifically targeted to individual muscles or muscle groups, even in physically active older women. To improve overall mobility, the strengthening of larger muscle such as hamstring is crucial.

Analysis of Whole-Body Coordination Patterning in Successful and Faulty Spikes Using Self-Organising Map-Based Cluster Analysis: A Secondary Analysis.

This study investigated the whole-body coordination patterning in successful and faulty spikes using self-organising map-based cluster analysis. Ten young, elite volleyball players (aged 15.5 ± 0.7 years) performed 60 volleyball spikes in a real-game environment. Adopting the cluster analysis, based on a self-organising map, whole-body coordination patterning was explored between successful and faulty spikes of individual players. The self-organising maps (SOMs) portrayed whole body, lower and upper limb coordination dissimilarities during the jump phase and the ball impact phases between the successful and faulty spikes. The cluster analysis illustrated that the whole body, upper limb and lower limb coordination patterning of each individual's successful spikes were similar to their faulty spikes. Range of motion patterning also demonstrated no differences in kinematics between spike outcomes. Further, the upper limb angular velocity patterning of the players' successful/faulty spikes were similar. The SPM analysis portrayed significant differences between the normalized upper limb angular velocities from 35% to 45% and from 76% to 100% of the spike movement. Although the lower limb angular velocities are vital for achieving higher jumps in volleyball spikes, the results of this study portrayed that the upper limb angular velocities distinguish the differences between successful and faulty spikes among the attackers. This confirms the fact that volleyball coaches should shift their focus toward the upper limb velocity and coordination training for higher success rates in spiking for volleyball attackers.

Kinematic differences between successful and faulty spikes in young volleyball players.

This study was designated to investigate the kinematical differences between successful and faulty spikes, in order to identify the best strategies leading to better spike performance. Simulating a real-game condition, 13 elite youth attackers performed 6 spikes in the presence of 2 blocks. The kinematic variables of the spike performances were recorded using 6 optoelectronic cameras (Vicon Motion systems, Oxford, UK). The paired sample t-test was used to compare the kinematic variables recorded during the delivery of successful and faulty spikes. Among the successful trials, both the angular velocities of the knees (≈12.4%) and hips (≈13.3%), and the vertical velocity of the centre of mass at take-off (≈6.5%) and arm swing (≈8.2%) were considerably higher during the plant phase. Consequently, the jump (≈4.3%) and spike (≈1.5%) heights, as well as the wrist velocity (≈5.5%), were significantly higher during the jump phase of successful spikes. In successful spike performances, the attackers adopted higher hip and knee angular velocities, combined with efficient arm swings, to produce higher take-off velocities and reach higher jump heights. This approach provides them with the better position regarding the ball and the blockers to find the best path and hit the ball with higher arm velocities.

Acute Effect of Ankle Kinesio and Athletic Taping on Ankle Range of Motion During Various Agility Tests in Athletes With Chronic Ankle Sprain.

BACKGROUND: Taping is a preventive measure commonly used for protecting and strengthening the ankle joint to prevent further musculoskeletal damage. Ankle taping prevents excessive range of motion (ROM) of the ankle joint and allows the improvement of proprioception to adjust balance. Appropriate ankle stability is essential for various activities, such as sprinting, turning, cutting, and jumping, which are associated with agility. AIM: To assess the acute effect of Kinesio taping and athletic taping on the ankle ROM of athletes with chronic ankle sprain during various agility tests that include sprinting, turning, and cutting actions. METHODS: Twenty-five physically active volunteers with chronic ankle sprain performed the Illinois, 5-0-5, 10-m shuttle, hexagon, compass drill, and T agility tests in 3 ankle conditions (nontaped, Kinesio taped, and athletic taped), in random order. Ankle ROM was recorded using the Vicon motion capture system. RESULTS: In comparison with the nontaped ankle condition, in the ankle Kinesio-taping condition, the results showed a significant increase of ankle ROM in the sprinting part of the Illinois, 5-0-5, 10-m shuttle, and T agility tests (P ≤ .01), whereas in the ankle athletic-taping condition, no significant difference was found in ankle ROM during all agility tests. CONCLUSION: In sports that need linear sprinting, Kinesio taping seems to be a suitable intervention for the improvement of sports performance as it provides increased ankle ROM.

Acute Effect of Ankle Kinesio™ Taping on Lower-Limb Biomechanics During Single-Legged Drop Landing.

CONTEXT: Chronic ankle instability is documented to be followed by a recurrence of giving away episodes due to impairments in mechanical support. The application of ankle Kinesiotaping (KT) as a therapeutic intervention has been increasingly raised among athletes and physiotherapists. OBJECTIVES: This study aimed to investigate the impacts of ankle KT on the lower-limb kinematics, kinetics, dynamic balance, and muscle activity of college athletes with chronic ankle instability. DESIGN: A crossover study design. PARTICIPANTS: Twenty-eight college athletes with chronic ankle sprain (11 females and 17 males, 23.46 [2.65] y, 175.36 [11.49] cm, 70.12 [14.11] kg) participated in this study. SETTING: The participants executed 3 single-leg drop landings under nontaped and ankle Kinesio-taped conditions. Ankle, knee, and hip kinematics, kinetics, and dynamic balance status and the lateral gastrocnemius, medial gastrocnemius, tibialis anterior, and peroneus longus muscle activity were recorded and analyzed. RESULTS: The application of ankle KT decreased ankle joint range of motion (P = .039) and angular velocities (P = .044) in the sagittal plane, ground reaction force rate of loading (P = .019), and mediolateral time to stability (P = .035). The lateral gastrocnemius (0.002) and peroneus longus (0.046) activity amplitudes also experienced a significant decrease after initial ground contact when the participants' ankles were taped, while the application of ankle KT resulted in an increase in the peroneus longus (0.014) activity amplitudes before initial ground contact. CONCLUSIONS: Ankle lateral supports provided by KT potentially decreases mechanical stresses applied to the lower limbs, aids in dynamic balance, and lowers calf muscle energy consumption; therefore, it could be offered as a suitable supportive means for acute usage in athletes with chronic ankle instability.

Response of Knee Joint Biomechanics to Landing Under Internal and External Focus of Attention in Female Volleyball Players.

The aim of this study was to examine the effect of attentional focus instructions on the biomechanical variables associated with the risk of anterior cruciate ligament injury of the knee joint during a drop landing task using a time series analysis. Ten female volleyball players (age: 20.4 ± 0.8 years, height: 169.7 ± 7.1 cm, mass: 57.6 ± 3.1 kg, experience: 6.3 ± 0.8 years) performed landings from a 50 cm height under three different attentional focus conditions: (1) external focus (focus on landing as soft as possible), (2) internal focus (focus on bending your knees when you land), and (3) control (no-focus instruction). Statistical parameter mapping in the sagittal plane during the crucial first 30% of landing time showed a significant effect of attentional focus instructions. Despite the similarity in landing performance across foci instructions, adopting an external focus instruction promoted reduced vertical ground reaction force and lower sagittal flexion moment during the first 30% of execution time compared to internal focus, suggesting reduced knee loading. Therefore, adopting an external focus of attention was suggested to reduce most biomechanical risk variables in the sagittal plane associated with anterior cruciate ligament injuries, compared to internal focus and control condition. No significant differences were found in the frontal and horizontal planes between the conditions during this crucial interval.

Quiet eye training-based intervention can ameliorate inhibitory control but not visuospatial working memory in children with ADHD.

INTRO: The purpose of this study was to investigate the effects of quiet eye training (QET) on inhibitory control, visuospatial working memory (WM), and tonic attention in children with attention-deficit hyperactivity disorder (ADHD). METHODS: Forty-eight children with ADHD aged 9-12 years were randomly assigned to QET and control (CON) groups. The QET group practiced targeted hand-eye tasks within a QET protocol developed to optimize controlled attention and gaze through eye fixations. We used the go/no-go (GNG) test, the Corsi test, and the reaction test of alertness (RTA) to verify the effects of QET on inhibition control, WM, and tonic attention. RESULTS: QET group showed significantly shorter reaction times, a higher number of correct responses, and a lower number of omissions in the GNG inhibition test after QET as compared to the pre-measurements, whereas the CON group did not demonstrate significant changes in this test. The measures of WM (Corsi test) and tonic attention (RTA) did not change significantly with the QET-based intervention. CONCLUSION: The study demonstrated that the QET protocol, which includes instructions and a video demonstration to optimize eye fixation on a target during aiming tasks, is acceptable and usable for children with ADHD. Overall, a short-term, 5-week visuomotor training intervention based on the quiet eye paradigm was shown to be effective in improving inhibitory control and focused visual attention, but not visuospatial WM and intrinsic attention in 9-12-year-old children with inattentive or combined ADHD.

Whole body coordination patterning in volleyball spikes under various task constraints: exploratory cluster analysis based on self-organising maps.

Task and environment-related constraints can influence spike performance in volleyball players. This study was designated to investigate the impact of awareness of the presence or absence of a defensive block by the opponents on the performance and coordination pattern of spikes in elite volleyball attackers. Simulating a real-game scenario, 10 elite youth attackers (aged 15.5 ± 0.7 years) executed six spikes each with prior notification about the presence/absence of defences and six spikes without any notification. In each condition, they were blocked by two opponents in three trials. The coordination patterning of the attackers was explored using cluster analysis based on a Self-Organising Map (SOM). The SOMs and the cluster analysis showed that the coordination pattern of the spike execution was very individual-specific; however, in the third layer of the cluster analysis, it was revealed that the movement pattern of spike execution had similarities in the scenario wherein the players had prior awareness of the defences. Providing the attackers with information on the opponents' condition or performance could shift the attackers' focus from a game-oriented condition to the rivals' behaviour, which consequently resulted in deterioration of their spike performance.

Evaluation of Predictive Motor Control With Two Touchscreen Tablet-Based Tests: Reliability and Validity in School-Aged Children.

As predictive motor control is an important index of neuromotor development and maturation, we developed two touchscreen tablet-based tests of this function. Our aim was to investigate the reliability and validity of both a rapid manual interception test and a pursuit tracking test, using a sample of 124 children (62 boys and 62 girls) from two age groups (7-8-year-oldss and 9-10-year-olds). Participants performed both tablet tests with a stylus (sample rate 100 Hz) with both a visible and a temporarily invisible moving target. Confirmatory factor analyses and omega coefficients showed that both tests were univariate methods that provided a reliable assessment of the latent factor related to predictive visuomotor control. As would be expected, compared to younger children, older children performed better on both manual interception and pursuit tracking. The correlations between the latent factors of the two tests at 95% confidence intervals (-.276, -.608) suggested shared variance. Thus, the touchscreen-tablet based tests of rapid manual interception and manual pursuit tracking appear psychometrically suitable for assessing the neuromotor ability of predictive control in 7-10-year-old children.

Advancing age is associated with more impaired mediolateral balance control after step down task.

BACKGROUND: To prevent the risk of stair descent falls and associated injuries in the older adults, it is important to understand the factors that affect this frequent locomotion of daily living. The fact that falls are in most cases the result of the interaction between intrinsic and extrinsic factors is very often underestimated when designing test protocols. RESEARCH QUESTION: This study aimed at evaluating balance control during and immediately after step down onto an unstable surface. METHODS: Physically active men and women aged 60-69 years (n = 28) and 70-79 years (n = 18) were asked to perform a step down onto a foam pad and stand still for 30 s (restabilization phase). Centre of pressure (CoP) velocity and standard deviation of CoP sway in anteroposterior and mediolateral direction were evaluated during the step down (CoP VAP, CoP VML, CoP SDAP, CoP SDML) and in the first 5 s of restabilization (CoP VAP5, CoP VML5, CoP SDAP5, CoP SDML5). In addition, time to complete step was investigated. RESULTS: Participants aged 70-79 years presented worse ML balance control after step down onto an unstable surface than their younger counterparts. This was represented by the significantly higher values of CoP SDML5 and CoP VML5 (p = 0.022 and p = 0.017). No other significant differences were detected. SIGNIFICANCE: Age is associated with a more significant ML center of pressure velocity and sway after step down onto a foam pad in physically active older adults. Exercises aimed at improving ML balance control in unstable conditions should be the subject of physical interventions even in older adults with overall good state of health and physical fitness.

Analysis of change of direction performance with dominant and non-dominant leg using linear and nonlinear approaches.

This study was aimed to analyse the lower limb kinematics during the change of direction (COD) performance with the dominant (DL) and non-dominant (NDL) leg using linear (traditional kinematics) and nonlinear (Self Organising Map-based cluster analysis) approaches. Three 5-0-5 COD performances with the DL and three with the NDL were performed by 23 (aged 21.6 ± 2.3 years) collegiate athletes. No significant difference was observed between the COD duration, and approach speed of DL and NDL. Significantly greater ankle abductions, knee and hip external rotations were identified in COD with DL, compared to NDL (p < .001, d > 0.8). Self Organising Maps portrayed a completely different coordination pattern profile during change of direction performance with the DL and NDL. The cluster analysis illustrated similar inter-individual coordination patterning when participants turned with their DL or NDL. No visible relationship was observed in the cluster analysis of the lower limb joint angles and angular velocities. Outcomes of this study portrayed that coordination patterning (combination of joint angles and the rate of change of angles) could portray the movement patterning differences in different tasks, while a sole investigation on the joint angles or angular velocities may not reveal the underlying mechanisms of movement patterning.

The effects of mobile phone use on motor variability patterns during gait.

Mobile phone use affects the dynamics of gait by impairing visual control of the surrounding environment and introducing additional cognitive demands. Although it has been shown that using a mobile phone alters whole-body dynamic stability, no clear information exists on its impacts on motor variability during gait. This study aimed at assessing the impacts of various types of mobile phone use on motor variability during gait; quantified using the short- and long-term Lyapunov Exponent (λS and λL) of lower limb joint angles and muscle activation patterns, as well as the centre of mass position. Fourteen females and Fifteen males (27.72 ± 4.61 years, body mass: 70.24 ± 14.13 Kg, height: 173.31 ± 10.97 cm) walked on a treadmill under six conditions: normal walking, normal walking in low-light, walking while looking at the phone, walking while looking at the phone in low-light, walking and talking on the phone, and walking and listening to music. Variability of the hip (p λS = .015, λL = .043) and pelvis (p λS = .039, λL = .017) joint sagittal angles significantly increased when the participants walked and looked at the phone, either in normal or in low-light conditions. No significant difference was observed in the variability of the centre of mass position and muscle activation patterns. When individuals walk and look at the phone screen, the hip and knee joints are constantly trying to adopt a new angle to regulate and maintain gait stability, which might put an additional strain on the neuromuscular system. To this end, it is recommended not to look at the mobile phone screen while walking, particularly in public places with higher risks of falls.

External focus of attention enhances arm velocities during volleyball spike in young female players.

The aim of this study was to investigate the effect of different volleyball-specific attentional focus instructions on arm velocities of a volleyball spike in young female volleyball players using the Statistical Parametric Mapping method. Twelve young female volleyball players (13.6 ± 0.6 years old, 1.8 ± 0.8 years of experience in volleyball training) were asked to perform a volleyball spike in a standing position in three different attentional focus conditions including internal focus (IF, i.e., pull back your elbow prior to transfer momentum), external focus, (EF, i.e., imagine cracking a whip to transfer momentum), and control (CON, i.e., no-focus instruction). A Qualisys 3D motion capture-system was used to track reflective markers attached to the arm, forearm, and hand. Consequently, four phases of the volleyball spike including wind-up, cocking, acceleration, and follow-through were analyzed. A one-way repeated-measure ANOVA using one-dimensional statistical parametric mapping (SPM1d) showed that players achieved greater velocities in the hand (p < 0.01), forearm (p < 0.01), and arm (p < 0.01) using the EF instructions from the start of the wind-up phase to the acceleration phase. Post-hoc (SPM1d-t-tests-paired) analyses indicated significantly greater arm, forearm, and hand velocities during the EF condition, compared to CON (p < 0.01, p < 0.01, and p < 0.01 respectively) and IF (p < 0.01, p < 0.01, and p < 0.01 respectively) conditions. These findings suggest that EF instructions had an immediate impact on increasing volleyball spike velocity from the start of the wind-up phase to the acceleration phase prior to ball contact.

Hamstring and ACL injuries impacts on hamstring-to-quadriceps ratio of the elite soccer players: A retrospective study.

This study aimed to compare the angle-specific (AS) and non-angle-specific (NAS) hamstring to quadriceps conventional and functional ratios between healthy, hamstring- and ACL-injured elite soccer players. One hundred and eleven players (27.42 ± 8.01 years, 182.11 ± 6.79 cm, 75.93 ± 7.25 kg) completed a series of concentric knee flexor and extensor strength in addition to eccentric knee flexor strength was measured at an angular velocity of 60°.s-1. Normalized and raw peak torque values, and the torque-angle profiles were extracted for analysis. Conventional and functional NAS (peak values) and AS (waveform ratios) hamstring to quadriceps ratios were calculated and compared between the groups. Healthy players produced greater functional and conventional ratios compared to players with either ACL or hamstring injury. Players with hamstring injury produced a lower AS functional ratios between 46° and 54° of knee flexion. Players suffering from ACL injury depicted a lower value for the AS functional ratio between 33° and 56° of knee flexion. Although NAS can identify soccer players with previous hamstring or ACL injury, the range where there is a strength deficiency is eluded. With the use of AS the range where the deficiency is present can be identified, and clinicians can benefit from this analysis to design robust rehabilitation protocols.

Age-related differences in stair descent balance control: Are women more prone to falls than men?

Stair descent is one of the most common forms of daily locomotion and concurrently one of the most challenging and hazardous daily activities performed by older adults. Thus, sufficient attention should be devoted to this locomotion and to the factors that affect it. This study investigates gender and age-related differences in balance control during and after stair descent on a foam mat. Forty-seven older adults (70% women) and 38 young adults (58% women) performed a descent from one step onto a foam mat. Anteroposterior (AP) and mediolateral (ML) centre of pressure velocity (CoP) and standard deviation of the CoP sway were investigated during stair descent and restabilization. A two-way analysis of variance (ANOVA) revealed the main effects of age for the first 5 s of restabilization. Older women exhibited significantly higher values of CoP sway and velocity in both directions compared to the younger individuals (CoP SDAP5, 55%; CoP SDML5, 30%; CoP VAP5, 106%; CoP VML5, 75%). Men achieved significantly higher values of CoP sway and velocity only in the AP direction compared to their younger counterparts (CoP SDAP5, 50% and CoP VAP5, 79%). These findings suggest that with advancing age, men are at higher risk of forward falls, whereas women are at higher risk of forward and sideways falls.

Lower limb joint angles and their variability during uphill walking.

BACKGROUND: Adaptation of the walking pattern to uphill walking demands immediate coordination between the lower limb segments. Nonetheless, knowledge about individual joints' responses and variability in response to the new slope angles are missing. AIMS: This study investigated the impacts of uphill walking on the ankle, the knee and the hip joints angles and their variability. METHODS: Twenty-three collegiate athletes (age: 22.04 ± 3.43years, body mass: 62.14 ± 9.26Kg, height: 168.29 ± 7.06 cm) walked on an inclined treadmill at 0 ° (level walking -LW), 5 ° (low-slope-walking -LSW), and 10 ° (high-slope-walking -HSW) slopes at their preferred walking speed (4.2 ± 0.51 km.h-1). The ankle, knee and hip joints angles and their variability (standard deviations) were calculated and analysed throughout the gait cycles in LW, LSW, and HSW. RESULTS: Repeated measure ANOVA portrayed significant differences between the ankle joint angles in sagittal (p < .001, ηp2>.14), frontal (p < .05, ηp2>.14), and transverse (p < .005, .14 < ηp2>.01) planes. In the knee joint, the sagittal (p < .001, ηp2>.14), frontal (p < .05, ηp2>.14), and transverse (p < .05, ηp2>.14) angles were significantly different (p < 0.05). Similarly, in the hip joint, the sagittal (p < .05, ηp2>.14), frontal (p < .05, ηp2>.14), and transverse (p < .05, ηp2>.14) angles were significantly different. Ankle angle variability was significantly different in sagittal (P < .001, ηp2>.14), frontal (p = .002, ηp2>.14) and horizontal (P < .001, ηp2>.14) planes, as well as knee joint angle variability in sagittal, frontal and horizontal planes p < 0.001, ηp2>.14. The hip joint variability was considerably different in sagittal (p = .031, ηp2>.14) and horizontal (p < .05, ηp2>.14) planes. CONCLUSION: Uphill walking involves further modifications in the ankle, knee and hip joints angle to adjust the whole-body movements to a new slope. This adjustment resulted in a firm base of support, provided by the ankle, to regulate the knee and hip joints modifications. Nevertheless, it caused less ankle movement variability and could end up with injuries over long-term uphill walking.

Ankle-knee coupling responses to ankle Kinesio™ taping during single-leg drop landings in collegiate athletes with chronic ankle instability.

BACKGROUND: Ankle Kinesio-taping (KT) is being globally used an intervention to provide the ankle joint complex with sufficient support against sudden excessive mechanical stress during various activities. However, its effects on proximal joints are unclear. This study investigated the impact of ankle KT on ankle-knee joint coupling in sagittal, frontal and transverse planes. METHODS: Adopting a pretest post-test study design, 30 collegiate athletes with chronic ankle instability performed 3 single-leg drop landings in each non-taped and Kinesio-taped conditions and their movement kinematics were recorded using 6 optoelectronic cameras. RESULTS: The ankle angular velocities in sagittal (P=0.038, d=0.64) and transverse planes (P=0.001, d=0.95) decreased after KT application, while the knee internal rotation velocities increased (P=0.020, d=0.51). The coupling angles revealed that the ankle movement ratios significantly decreased in 3 planes in comparison with knee movement ratios. CONCLUSIONS: Outcomes of this study illustrated that application of ankle KT leaves the individuals with a stiffer ankle joint, which increases the mechanical stresses to this joint and decreases its stiffness in absorbing the applied shocks. Further, ankle KT application resulted in more knee internal rotation moments and may increase the risk of knee injuries during landing after a long-term usage in patients with instability ankle sprain.

Strength Training to Prevent Falls in Older Adults: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.

We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus and Web of Science), without limitations on language or publication date. Eligibility criteria were as follows: RCTs with humans ≥60 years of age of any gender with one group performing supervised ST and a group performing another type of exercise training, reporting data pertaining falls. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis used a random effects model to calculate the risk ratio (RR) for number of falls. Five RCTs with six trials were included (n = 543, 76% women). There was no difference between ST and alternative exercise interventions for falls (RR = 1.00, 95% CI 0.77-1.30, p = 0.99). The certainty of evidence was very low. No dose-response relationship could be established. In sum, ST showed comparable RR based on number of falls in older adults when compared to other multimodal or unimodal exercise modalities, but evidence is scarce and heterogeneous, and additional research is required for more robust conclusions. Registration: PROSPERO CRD42020222908.

Balance control during stair descent on compliant surface is associated with knee flexor and ankle plantar flexor strength in older adults.

Balance and lower limb strength deficits are associated with a high incidence of falls in older adults. This study investigated the association between balance control during and after stair descent onto a compliant surface and lower limb strength. Thirty-five women and 14 men participated in this study. Stair descent time, mean center of pressure velocity in anteroposterior and mediolateral direction during stair descent (CoP VAP and CoP VML), and CoP velocity in the first 5 s of restabilization phase (CoP V5) were evaluated. Bilateral strength of the knee flexors and extensors, and ankle plantar and dorsal flexors was evaluated. Spearman correlation analysis with Bonferroni correction yielded a significant association between the strength of the knee flexors on the trailing limb and stair descent time in women (r = 0.502, p = 0.002, R2 = 0.246). The same analysis in men revealed a significant association between the strength of the knee flexors on the trailing limb and CoP VAP (r = -0.820, p < 0.001, R2 = 0.280) and CoP VML (r = -0.697, p = 0.006, R2 = 0.359). The strength of the ankle plantar flexors on the trailing limb was significantly associated with stair descent time (r = 0.684, p = 0.007, R2 = 0.429) and CoP VAP (r = -0.723, p = 0.003, R2 = 0.408) in men. Stair descent balance control is associated with knee flexion strength on trailing limb in women, and with ankle plantar flexion and knee flexion strength on the same limb in men.