Search

Objective: To investigate whether vestibular rehabilitation for patients with whiplash-associated disorder and dizziness had any effect on balance measures and self-perceived handicap.Design: Randomized, controlled trial.Subjects: Twenty-nine patients, 20 women and 9 men, age range 22–76 years.Methods: The patients were randomized to an intervention group or a control group. The intervention comprised vestibular rehabilitation. All patients were assessed at baseline, after 6 weeks and after 3 months with 4 different balance measures and the Dizziness Handicap Inventory.Results: After 6 weeks, the intervention group showed statistically significant improvements compared with the control group in the following measures: standing on one leg eyes open (p=0.02), blindfolded tandem stance (p=0.045), Dizziness Handicap Inventory total score (p=0.047), Dizziness Handicap Inventory functional score (p=0.005) and in Dizziness Handicap Inventory physical score (p=0.033). After 3 months, the intervention group showed statistically significant improvements compared with the control group in the following measures: standing on one leg eyes open (p=0.000), tandem stance (p=0.033) and Dizziness Handicap Inventory physical score (p=0.04).Conclusion: Vestibular rehabilitation for patients with whiplash-associated disorder can decrease self-perceived handicap and increase postural control. [ABSTRACT FROM AUTHOR]

Background: Earlier studies have shown that physical exercise and a higher workload increase muscle strength and improve gait and balance at all ages for both sexes. Published studies have, so far, failed to investigate the functional performance of elderly individuals concerning their long-term physical activity and variables of daily living.Objective: To compare elderly women who participate in long-term, moderate exercise programmes with two age-matched groups of women from an urban and a rural community.Methods: All participants answered a questionnaire about health, social circumstances and fractures. We measured the vibration threshold of the lower extremities, bone mineral density of the distal radius and functional performance such as muscle strength, balance and gait.Results: The elderly, active groups performed significantly better in all functional tests and had sustained fewer fractures than the urban control group. When the comparison was made with the rural control group the differences were less obvious. The active group rated their health as better than both the control groups.Conclusion: Elderly women, who continue with moderate exercise programmes over many years, sustain fewer fractures and have better muscle strength, balance, gait and health ratings than women in general. Whether this is the result of the exercise or inherited characters, remains to be proved. [ABSTRACT FROM AUTHOR]

Aim: To present gender-specific normative data on estimates of neuromuscular performance, such as muscle strength, vertical jump and standing unilateral balance, in pre-pubertal children., Methods: Lean body mass (kg) and fat mass (%) were estimated by dual-energy X-ray absorptiometry in 246 boys and 190 girls aged 6-12 years in Tanner stages 1 and 2. Isokinetic concentric peak torque at 60 and 180°/sec of the right knee extensors, and flexors were evaluated by a computerized dynamometer. Vertical jump height (VJH) was evaluated with an electronic mat and postural control with a one-leg stand test and a blindfolded one-leg stand test., Results: Anthropometry, muscle strength and VJH in both genders showed improved performance with advancing ages (all p < 0.01 for trend) but there were no constant gender differences across the age groups (all ns.). In boys and girls, the ratio muscle strength/muscle mass showed significantly higher ratios with higher ages (both p < 0.01, respectively), but with no constant gender discrepancy. The postural control tests also showed significantly better performance with higher ages in both boys and girls (both p < 0.01)., Conclusion: This report, which provides normative gender-specific data on muscle strength, muscle and fat mass and VJH, shows that in Swedish children aged 6-12 years, there seems to be a linear increase with age and no structural gender differences., (© 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.)

Objective: Fall risk assessment is important because the consequences, such as a fracture, may be devastating. The objective of this study was to find the test or tests that best predicted falls in a population-based sample of elderly women., Study Design and Setting: The fall-predictive ability of a questionnaire, a subjective estimate of biologic age and objective functional tests (gait, balance [Romberg and sway test], thigh muscle strength, and visual acuity) were compared in 984 randomly selected women, all 75 years of age., Results: A recalled fall was the most important predictor for future falls. Only recalled falls and intake of psycho-active drugs independently predicted future falls. Women with at least five of the most important fall predictors (previous falls, conditions affecting the balance, tendency to fall, intake of psychoactive medication, inability to stand on one leg, high biologic age) had an odds ratio of 11.27 (95% confidence interval 4.61-27.60) for a fall (sensitivity 70%, specificity 79%)., Conclusion: The more time-consuming objective functional tests were of limited importance for fall prediction. A simple clinical history, the inability to stand on one leg, and a subjective estimate of biologic age were more important as part of the fall risk assessment.

Background/methods: High biological age, or frailty, a possible risk factor for fragility fracture, and its relation to known risk factors for fracture (low bone mineral density (BMD), low muscle strength, poor gait performance and poor balance, previous falls, previous fractures and future risk of falls) were investigated in 993 randomly selected 75-year-old women. Frailty, which has no accepted definition, was here defined as a subjective immediate impression of an individual's general health appearance and was transferred into an arbitrary scale. 993 individuals were scored by at least one of four observers., Results: The frailty score and BMD were not correlated. A high frailty score was significantly correlated to poor gait (r = 0.53-0.59, p < 0.0001), poor balance (r = -0.49, p < 0.0001), low muscle strength (r = -0.25 to -0.41, p < 0.0001), low activity level (r = -0.43, p < 0.0001) and a high risk of falling (r = 0.24, p < 0.0001). The group of women who had experienced at least one fall the previous year had a higher frailty score (p < 0.0001) compared to those who had not. Women who had sustained a hip or femoral fracture after the age of 70 had a higher frailty score than women with no earlier fracture at all., Conclusions: Bone mass cannot be predicted by our subjective frailty score in elderly, ambulant women. Since a high frailty score correlates with factors that affect or are likely to affect fall propensity, this could indicate that a high frailty score is a risk factor for fracture, independent of bone mass. Frailty may be regarded as a complex risk factor, including several assessments that can be objectively measured. Whether estimation of frailty is a method to improve the assessment of the patient at risk for a fragility fracture is yet to be proven and can only be shown in a prospective study of fracture occurrence., (Copyright 2003 S. Karger AG, Basel)