A qualitative review of balance and strength performance in healthy older adults: impact for testing and training

Urs Granacher, Thomas Muehlbauer, Markus Gruber, Urs Granacher, Thomas Muehlbauer, Markus Gruber

Abstract

A continuously greying society is confronted with specific age-related health problems (e.g., increased fall incidence/injury rate) that threaten both the quality of life of fall-prone individuals as well as the long-term sustainability of the public health care system due to high treatment costs of fall-related injuries (e.g., femoral neck fracture). Thus, intense research efforts are needed from interdisciplinary fields (e.g., geriatrics, neurology, and exercise science) to (a) elucidate neuromuscular fall-risk factors, (b) develop and apply adequate fall-risk assessment tools that can be administered in clinical practice, and (c) develop and design effective intervention programs that have the potential to counteract a large number of fall-risk factors by ultimately reducing the number of falls in the healthy elderly. This paper makes an effort to present the above-raised research topics in order to provide clinicians, therapists, and practitioners with the current state-of-the-art information.

Figures

Figure 1
Figure 1
Age-related differences in strength. (a) Maximal isometric strength and rate of force development. (b) Rate of force development over time intervals of 0–30 ms and 0–100 ms. Young different from old: **P < 0.01. Adapted from Granacher et al. [15].
Figure 2
Figure 2
Age-related differences in normal and multitask balance performance. (a) CoP displacement during standing. (b) Gait velocity during walking. Young different from old: ***P < 0.001. CoP: center of pressure, CI: cognitive interference task, MI: motor interference task. Adapted from Granacher et al. [18, 40].
Figure 3
Figure 3
Age-related differences in reactive balance performance (i.e., perturbed walking). FRA: functional reflex activity, SO: m. soleus, TA: m. tibialis anterior. Young different from old: *P < 0.05. Adapted from Granacher et al. [15].
Figure 4
Figure 4
Assessment of maximal isometric strength and rate of force development using a leg press (i.e., force signals will be recorded by a separate force plates underneath the feet).
Figure 5
Figure 5
Assessment of steady-state balance performance. (a) 10 m walk test with concurrent cognitive interference task (i.e., counting backwards by three). (b) 10 m walk test with concurrent motor interference task (i.e., holding two interlocked sticks steady in front of the body).
Figure 6
Figure 6
Assessment of reactive balance performance using a motorized treadmill (i.e., unexpected decelerating gait perturbations during walking will be applied).

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