Numerous interventions have been proposed to improve balance in older adults with varying degrees of success. A novel approach may be to use an off-the-shelf video game system utilizing real-time ...force feedback to train older adults. The purpose of this study is to investigate the feasibility of using Nintendo's Wii Fit for training to improve clinical measures of balance in older adults and to retain the improvements after a period of time.
Twelve healthy older adults (aged >70 years) were randomly divided into two groups. The experimental group completed training using Nintendo's Wii Fit game three times a week for 3 weeks while the control group continued with normal activities. Four clinical measures of balance were assessed before training, 1 week after training, and 1 month after training: Berg Balance Scale (BBS), Fullerton Advanced Balance (FAB) scale, Functional Reach (FR), and Timed Up and Go (TUG). Friedman two-way analysis of variance by ranks was conducted on the control and experimental group to determine if training using the Wii Balance Board with Wii Fit had an influence on clinical measures of balance.
Nine older adults completed the study (experimental group n = 4, control group n = 5). The experimental group significantly increased their BBS after training while the control group did not. There was no significant change for either group with FAB, FR, and TUG.
Balance training with Nintendo's Wii Fit may be a novel way for older adults to improve balance as measured by the BBS.
Background
Falls are a leading cause of injury and death for old adults, with one risk factor for falls being balance deficits. The low cost (<400 USD), wide availability, and ability to incorporate ...multiple training paradigms make gaming systems appealing as possible balance intervention tools.
Aims
To investigate the feasibility of using the Xbox Kinect for training to improve clinical measures of balance in old adults and retain improvements after a period of time.
Methods
Thirteen healthy old adults (aged 70+ years) were randomly divided into two groups. The experimental group completed Kinect training three times a week for 3 weeks while the control group continued with normal activities. Four clinical measures of balance were assessed before training, 1 week and 1 month after training: Berg balance scale (BBS), Fullerton advanced balance (FAB) scale, functional reach (FR), and timed up and go (TUG).
Results
The ability to implement the training program was successful. The experimental group significantly increased their BBS and FAB after training while the control group did not. There was no significant change for either groups with FR and TUG.
Conclusion
A training program using the Kinect with commercially available games was feasible with old adults. Kinect training may be an inexpensive way for old adults to receive helpful feedback encouraging them to continue with balance training program in their home.
Step-by-step (SBS) stair navigation is used by those with movement limitations or lower-limb prosthetics and by humanoid robots. Knowledge of biomechanical parameters for SBS gait, however, is ...limited. Inverted pendulum (IP) models used to assess dynamic stability have not been applied to SBS gait. This study examined the ability of the linear inverted pendulum (LIP) model and a closed-form, variable-height inverted pendulum (VHIP) model to predict capture-point (CP) stability in healthy adults executing a single stair climb. A second goal was to provide baseline kinematic and kinetic data for SBS gait. Twenty young adults executed a single step onto stairs of two heights, while attached marker positions and ground reaction forces were recorded. opensim software determined body kinematics and joint kinetics. Trials were analyzed with LIP and VHIP models, and the predicted CP compared to the actual center-of-pressure (CoP) on the stair. Lower-limb joint moments were larger than those reported for step-over-step (SOS) stair gait. Leading knee rather than trailing ankle was dominant. Center-of-mass (CoM) velocity peaked at push-off. The VHIP model accounted for only slightly more than half of the forward progression of the vertical projection of the CoM and was not better than LIP predictions. This suggests that IP models are limited in modeling SBS gait, likely due to large hip and knee moments. The results from this study may also provide target values and strategies to aid design of lower-limb prostheses and powered exoskeletons.
Aging is associated with a higher risk of falls, and an impaired ability to recover balance after a postural perturbation is an important contributing factor. In turn, this impaired recovery ability ...likely stems from age-related decrements in lower limb strength. The purpose of this study was to investigate the effects of age-related strength loss on non-stepping balance recovery capability after a perturbation while standing, without constraining movements to the ankle as in prior reports. Two experiments were conducted. In the first, five young adults (ages 20-30) and six community-dwelling older adults (ages 70-80) recovered their balance, without stepping, from a backward displacement of a support surface. Balance recovery capability was quantified as the maximal backward platform displacement that a subject could withstand without stepping. The maximal platform displacement was 27% smaller among the older group (11.8±2.1 cm) vs. the young group (16.2±2.6 cm). In the second experiment, forward dynamic simulations of a two-segment, rigid-body model were used to investigate the effects of manipulating strength in the hip extensors/flexors and ankle plantar flexors/dorsiflexors. In these, typical age-related reductions in strength were included. The model predicted lower maximal platform displacements with age-related reductions only in plantar flexion and hip flexion strength. These findings support the previously reported age-related loss of balance recovery ability, and an important role for plantar flexor strength in this ability.
Contribution: This article measures the impact of a service-learning project in a first-year introduction to computing course on students' understanding of engineers' roles and responsibilities and ...their attitudes toward plastic pollution. Background: Service learning has been integrated into classrooms for many years, but its utilization in engineering courses is lacking. Furthermore, plastic pollution is a complex and multidisciplinary problem that requires social, political, environmental, and engineering solutions. This work provides a quantitative assessment on whether service learning through a litter pickup project impacts students' views of the role of engineers in solving complex sociotechnical problems. Research Questions: 1) How does service learning change students' perception of an engineer's role in solving sociotechnical problems? and 2) how can service learning be used to increase students' environmental awareness and action? Methodology: Surveys were administered to students before and after their participation in a service-learning project. The study was conducted across five sections of an introduction to a computer programming course that is required of first-year civil, electrical, and mechanical engineering students. Findings: After the service-learning project, students were more likely to agree that engineers have the skills, knowledge, and responsibility to solve societal problems. Students also demonstrated a more holistic understanding of plastic pollution and reported changes in their waste reduction behaviors.
The purpose of this study was to investigate the way in which anthropometric and fitness measures vary by class year before and after a Division I female field hockey competitive season. ...Anthropometric (mass and percent body fat) and fitness measures (vertical jump and Yo-Yo Intermittent Recovery Test 1 (Yo-Yo IR1) distance) were collected on 16 athletes (mean ± SD: age = 19.5 ± 0.9 years) before and after a competitive season. Class year, based on the athlete’s year in college, was used to group athletes in the study. Body mass, vertical jump height, and Yo-Yo IR1 distance all increased pre to post season (p < 0.05). First-year athletes had a significantly lower body mass, vertical jump height and Yo-Yo IR1 distance compared to other class years across the testing period (p < 0.05). Post season levels for first-years were lower than both pre and post season levels for sophomore or junior athletes. Team mean vertical jump increased 8.9%, with all but two athletes improving. Team mean Yo-Yo IR1 distance increased 16.4%. Athlete training over the course of the study was designed to improve on field playing performance and training was not directly select to improve measures in the study; therefore, the potential success of integrating fitness, speed, and strength development into technical training sessions is indicated. Coaches should be aware that first-year athletes may not be at the same level of conditioning as sophomores and juniors. Coaches should work specifically with the first-year athletes during the season to monitor their fitness levels.
Abstract Following a balance perturbation, a stepping response is commonly used to regain support, and the distance of the recovery step can vary. To date, no other studies have examined joint ...kinetics in young and old adults during increasing step distances, when participants are required to bring their rear foot forward. Therefore, the purpose of this study was to examine age-related differences in joint kinetics with increasing step distance. Twenty young and 20 old adults completed the study. Participants completed a step starting from double support, at an initial distance equal to the individual's average step length. The distance was increased by 10% body height until an unsuccessful attempt. A one-way, repeated measures ANOVA was used to determine the effects of age on joint kinetics during the maximum step distance. A two-way, repeated measures, mixed model ANOVA was used to determine the effects of age, step distance, and their interaction on joint kinetics during the first three step distances for all participants. Young adults completed a significantly longer step than old adults. During the maximum step, in general, kinetic measures were greater in the young than in the old. As step distance increased, all but one kinetic measure increased for both young and old adults. This study has shown the ability to discriminate between young and old adults, and could potentially be used in the future to distinguish between fallers and non-fallers.
To investigate the efficacy of perturbation-based balance training (PBBT) on time to stabilization (TTS) after a nonstepping response to a postural perturbation in older adults at a high risk for ...falls.
Single-subject design. Participants completed 4 baseline tests, 1 month of PBBT, and posttraining tests both 1 week and 1 month after training.
Assisted-living facility.
Older adults (N=5; mean ± SD age, 85±6.5y; residents of assisted-living facility) at a high risk for falls.
PBBT involved 3 sessions a week for 4 weeks. Each session involved standing for 50 trials on a pneumatic instrumented moving platform that translated 0 to 0.08m forward or 0 to 0.13m backward in approximately 390ms (average velocity, 0.25m/s).
Time to stabilization of center of pressure (COP) after a perturbation on the moving platform.
TTS of COP was 41.6% shorter than baseline tests (P<.001) 1 week after completing PBBT and 46.3% shorter than baseline tests (P<.001) 1 month after completing PBBT.
PBBT improved TTS after a postural perturbation in older adults at a high risk for falls, and these improvements were retained for 1 month.
Abstract The goal of this study was to determine if practicing recovery from a simulated trip improved the ability of older adults to recover from an actual trip. Twelve healthy older adults ranging ...in age from 63 to 83 years were randomly assigned to either a control or an experimental group. Each group performed one trip before and one trip after an intervention. The experimental group received trip recovery training on a modified treadmill while the control group walked on a treadmill for 15 min. Compared to the control group, the experimental group showed greater reduction in maximum trunk angle ( p = 0.027) and time to maximum trunk angle ( p = 0.043), as well as increased minimum hip height ( p = 0.020). Although the results showed beneficial effects of trip recovery training on actual trip recovery, future studies should explore the ability to retain improvements over extended periods.
Balance-recovery stepping is often necessary for both a human and humanoid robot to avoid a fall by taking a single step or multiple steps after an external perturbation. The determination of where ...to step to come to a complete stop has been studied, but little is known about the strategy for initiation of forward motion from the static position following such a step. The goal of this study was to examine the human strategy for stepping by moving the back foot forward from a static, double-support position, comparing parameters from normal step length (SL) to those from increasing SLs to the point of step failure, to provide inspiration for a humanoid control strategy. Healthy young adults instrumented with joint reflective markers executed a prescribed-length step from rest while marker positions and ground reaction forces (GRFs) were measured. The participants were scaled to the Gait2354 model in opensim software to calculate body kinematic and joint kinetic parameters, with further post-processing in matlab. With increasing SL, participants reduced both static and push-off back-foot GRF. Body center of mass (CoM) lowered and moved forward, with additional lowering at the longer steps, and followed a path centered within the initial base of support (BoS). Step execution was successful if participants gained enough forward momentum at toe-off to move the instantaneous capture point (ICP) to within the BoS defined by the final position of both feet on the front force plate. All lower extremity joint torques increased with SL except ankle joint. Front knee work increased dramatically with SL, accompanied by decrease in back-ankle work. As SL increased, the human strategy changed, with participants shifting their CoM forward and downward before toe-off, thus gaining forward momentum, while using less propulsive work from the back ankle and engaging the front knee to straighten the body. The results have significance for human motion, suggesting the upper limit of the SL that can be completed with back-ankle push-off before additional knee flexion and torque is needed. For biped control, the results support stability based on capture-point dynamics and suggest strategy for center-of-mass trajectory and distribution of ground force reactions that can be compared with robot controllers for initiation of gait after recovery steps.
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