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Effects of plantar hardness discrimination training on standing postural balance in the elderly: a randomized controlled trial [with consumer summary]
Morioka S, Hiyamizu M, Fukumoto T, Kataoka Y, Yagi F
Clinical Rehabilitation 2009 Jun;23(6):483-491
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effects of sensory perception exercises for discrimination of surface hardness by the soles of the feet on standing postural balance in the elderly. DESIGN: A randomized two-group parallel controlled trial. SUBJECTS: Twenty-four healthy people aged from 61 to 71 years were enrolled and randomly assigned to a perception exercise group (n = 12) or a control group (n = 12). INTERVENTION: The perception exercise group were given a task designed to train ability to discriminate different degrees of hardness of foam rubber. The training period was 10 days. Control group subjects were instructed to maintain a standing posture on foam rubber for 10 seconds for a total of 10 days. MEASUREMENTS: Before and after training we measured centre-of-gravity sway with the subject standing, obtaining sway path length and area of ellipse. The Functional Reach Test was used to measure the forward displacement distance of the centre of gravity. RESULTS: Our data revealed a significant reduction in centre-of-gravity sway post training in the perception exercise group as well as a significant increase in forward displacement of the centre of gravity. These parameters were unchanged in the control group. As to change values (difference between pre- and post-training values), the perception exercise group had significantly better values than the control group, indicating the efficacy of sensory perception exercises. CONCLUSIONS: We demonstrated that standing postural balance was improved by sensory perception exercises involving the soles of the feet. Used in addition to balance training, such training for hardness discrimination could be effective in the clinical setting to improve balance in the elderly.

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