The Effect of Balance and Coordination Exercises on Quality of Life in Older Adults: A Mini-Review

Ayelet Dunsky, Ayelet Dunsky

Abstract

The ability to control balance during activities of daily living (ADL) is impaired in older adults as a result of deterioration in the sensory systems (i.e., vestibular, visual, somatosensory), the cognitive system (central nervous system), and the musculoskeletal system. Consequently, many older adults face a risk of falling during their ADL. In most cases, falls and related injuries impair the quality of life and result in physical limitations, anxiety, loss of confidence, and fear of falling. Among a variety of fall prevention interventions, adapted physical activity programs have been suggested for improving balance control during ADL. These programs challenge the sensory, cognitive, and musculoskeletal systems while addressing balance constraints such as orientation in space, changes in direction, and the speed or height of the center of mass during static and dynamic situations resembling ADL. The above-mentioned elements can be dealt with through a combination of balance and coordination exercises that challenge the postural control systems in multiple dimensions-including vertical and horizontal changes of the center of mass, standing on unstable surfaces with a reduced base of support, and changing body directions. Consequently, such exercises require environmental information-processing. The combination of dual-task, function-oriented challenges while controlling balance stimulates the sensory and neuromuscular control mechanisms. Among older adults, these programs have been found to improve static and dynamic stability, as well as a number of aspects in the quality of life. Recently, they have also been found to improve cognitive functions such as memory and spatial cognition.

Keywords: balance; coordination; exercise; older adults; quality of life.

Copyright © 2019 Dunsky.

Figures

Figure 1
Figure 1
Flowchart of study selection.

References

    1. Arampatzis A., Peper A., Bierbaum S. (2011). Exercise of mechanisms for dynamic stability control increases stability performance in the elderly. J. Biomech 44, 52–58. 10.1016/j.jbiomech.2010.08.023
    1. Bisson E., Contant B., Sveistrup H., Lajoie Y. (2007). Functional balance and dual-task reaction times in older adults are improved by virtual reality and biofeedback training. Cyberpsychol. Behav. 10, 16–23. 10.1089/cpb.2006.9997
    1. Cesari M., Vellas B., Gambassi G. (2013). The stress of aging. Exp. Gerontol. 48, 451–456. 10.1016/j.exger.2012.10.004
    1. Chang S. F., Lin P. L. (2015). Frail phenotype and mortality prediction: a systematic review and meta-analysis of prospective cohort studies. Int. J. Nurs. Stud. 52, 1362–1374. 10.1016/j.ijnurstu.2015.04.005
    1. de Labra C., Guimaraes-Pinheiro C., Maseda A., Lorenzo T., Millán-Calenti J. C. (2015). Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr. 15:154. 10.1186/s12877-015-0155-4
    1. de Vries A. W., Faber G., Jonkers I., Van Dieen J. H., Verschueren S. M. P. (2018). Virtual reality balance training for elderly: similar skiing games elicit different challenges in balance training. Gait Posture 59, 111–116. 10.1016/j.gaitpost.2017.10.006
    1. de Vries N. M., van Ravensberg C. D., Hobbelen J. S., Olde Rikkert M. G., Staal J. B., Nijhuis-van der Sanden M. W. (2012). Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res. Rev. 11, 136–149. 10.1016/j.arr.2011.11.002
    1. Dizdar M., Irdesel J. F., Dizdar O. S., Topsaç M. (2018). Effects of balance-coordination, strengthening and aerobic exercises to prevent falls in postmenopausal patients with osteoporosis: a 6-month randomized parallel prospective study. J. Aging Phys. Act. 26, 41–51. 10.1123/japa.2016-0284
    1. Dunsky A., Yahalom T., Arnon M., Lidor R. (2017a). The use of step aerobics and the stability ball to improve balance and quality of life in community-dwelling older adults-a randomized exploratory study. Arch. Gerontol. Geriatr. 71, 66–74. 10.1016/j.archger.2017.03.003
    1. Dunsky A., Zeev A., Netz Y. (2017b). Balance performance is task specific in older adults. Biomed. Res. Int. 2017:6987017. 10.1155/2017/6987017
    1. Gao J. H., Parsons L. M., Bower J. M., Xiong J., Li J., Fox P. T. (1996). Cerebellum implicated in sensory acquisition and discrimination rather than motor control. Science 272, 545–547. 10.1126/science.272.5261.545
    1. Gottwald B., Mihajlovic Z., Wilde B., Mehdorn H. M. (2003). Does the cerebellum contribute to specific aspects of attention? Neuropsychologia 41, 1452–1460. 10.1016/s0028-3932(03)00090-3
    1. Gouveia B. R., Gouveia É. R., Ihle A., Jardim H. G., Martins M. M., Freitas D. L., et al. . (2018). The effect of the ProBalance programme on health-related quality of life of community-dwelling older adults: a randomised controlled trial. Arch. Gerontol. Geriatr. 74, 26–31. 10.1016/j.archger.2017.08.012
    1. Guizelini P. C., de Aguiar R. A., Denadai B. S., Caputo F., Greco C. C. (2018). Effect of resistance training on muscle strength and rate of force development in healthy older adults: a systematic review and meta-analysis. Exp. Gerontol. 102, 51–58. 10.1016/j.exger.2017.11.020
    1. Halvarsson A., Dohrn I. M., Ståhle A. (2015a). Taking balance training for older adults one step further: the rationale for and a description of a proven balance training programme. Clin. Rehabil. 29, 417–425. 10.1177/0269215514546770
    1. Halvarsson A., Franzén E., Ståhle A. (2015b). Balance training with multi-task exercises improves fall-related self-efficacy, gait, balance performance and physical function in older adults with osteoporosis: a randomized controlled trial. Clin. Rehabil. 29, 365–375. 10.1177/0269215514544983
    1. Halvarsson A., Franzén E., Farén E., Olsson E., Oddsson L., Ståhle A. (2013). Long-term effects of new progressive group balance training for elderly people with increased risk of falling-a randomized controlled trial. Clin. Rehabil. 27, 450–458. 10.1177/0269215512462908
    1. Halvarsson A., Olsson E., Farén E., Pettersson A., Stahle A. (2011). Effects of new, individually adjusted, progressive balance group training for elderly people with fear of falling and tend to fall: a randomized controlled trial. Clin. Rehabil. 25, 1021–1031. 10.1177/0269215511411937
    1. Hayes K. C. (1982). Biomechanics of postural control. Exerc. Sport Sci. Rev. 10, 363–391. 10.1249/00003677-198201000-00011
    1. Horak F. B. (2006). Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 35, ii7–ii11. 10.1093/ageing/afl077
    1. Ishiyama G. (2009). Imbalance and vertigo: the aging human vestibular periphery. Semin. Neurol. 29, 491–499. 10.1055/s-0029-1241039
    1. Kojima G. (2015). Frailty as a predictor of future falls among community-dwelling older people: a systematic review and meta-analysis. J. Am. Med. Dir. Assoc. 16, 1027–1033. 10.1016/j.jamda.2015.06.018
    1. Kwok T. C., Lam K. C., Wong P. S., Chau W. W., Yuen K. S., Ting K. T., et al. . (2011). Effectiveness of coordination exercise in improving cognitive function in older adults: a prospective study. Clin. Interv. Aging 6, 261–267. 10.2147/CIA.s19883
    1. Landi F., Calvani R., Cesari M., Tosato M., Martone A. M., Bernabei R., et al. . (2015). Sarcopenia as the biological substrate of physical frailty. Clin. Geriatr. Med. 31, 367–374. 10.1016/j.cger.2015.04.005
    1. Lelard T., Ahmaidi S. (2015). Effects of physical training on age-related balance and postural control. Neurophysiol. Clin. 45, 357–369. 10.1016/j.neucli.2015.09.008
    1. Lelard T., Doutrellot P. L., David P., Ahmaidi S. (2010). Effects of a 12-week Tai Chi Chuan program versus a balance training program on postural control and walking ability in older people. Arch. Phys. Med. Rehabil. 91, 9–14. 10.1016/j.apmr.2009.09.014
    1. Lord S. R. (2006). Visual risk factors for falls in older people. Age Ageing 35, ii42–ii45. 10.1093/ageing/afl085
    1. Lord S. R., Lloyd D. G., Keung Li S. E. K. (1996). Sensori-motor function, gait patterns and falls in community-dwelling women. Age Ageing 25, 292–299. 10.1093/ageing/25.4.292
    1. Manto M., Bower J. M., Conforto A. B., Delgado-García J. M., da Guarda S. N., Gerwig M., et al. . (2012). Consensus paper: roles of the cerebellum in motor control-the diversity of ideas on cerebellar involvement in movement. Cerebellum 11, 457–487. 10.1007/s12311-011-0331-9
    1. Mouthon A., Taube W. (2019). Intracortical inhibition increases during postural task execution in response to balance training. Neuroscience 401, 35–42. 10.1016/j.neuroscience.2019.01.007
    1. Nagy E., Feher-Kiss A., Barnai M., Domján-Preszner A., Angyan L., Horvath G. (2007). Postural control in elderly subjects participating in balance training. Eur. J. Appl. Physiol. 100, 97–104. 10.1007/s00421-007-0407-x
    1. Nascimento C. M., Ingles M., Salvador-Pascual A., Cominetti M. R., Gomez-Cabrera M. C., Viña J. (2019). Sarcopenia, frailty and their prevention by exercise. Free Radic. Biol. Med. 132, 42–49. 10.1016/j.freeradbiomed.2018.08.035
    1. Navas-Enamorado I., Bernier M., Brea-Calvo G., de Cabo R. (2017). Influence of anaerobic and aerobic exercise on age-related pathways in skeletal muscle. Ageing Res. Rev. 37, 39–52. 10.1016/j.arr.2017.04.005
    1. Netz Y., Zeev A., Dunsky A. (2018). Postural control and posture-unrelated attention control in advanced age—An exploratory study. Maturitas 116, 130–136. 10.1016/j.maturitas.2018.08.003
    1. Niemann C., Godde B., Voelcker-Rehage C. (2014). Not only cardiovascular, but also coordinative exercise increases hippocampal volume in older adults. Front. Aging Neurosci. 6:170. 10.3389/fnagi.2014.00170
    1. Rendon A. A., Lohman E. B., Thorpe D., Johnson E. G., Medina E., Bradley B. (2012). The effect of virtual reality gaming on dynamic balance in older adults. Age Ageing 41, 549–552. 10.1093/ageing/afs053
    1. Robbins A. S., Rubenstein L. Z., Josephson K. R., Schulman B. L. (1989). Predictors of falls among elderly people: results of two population based studies. Arch. Intern. Med. 149, 1628–1633. 10.1001/archinte.149.7.1628
    1. Rogge A. K., Röder B., Zech A., Hötting K. (2018). Exercise-induced neuroplasticity: balance training increases cortical thickness in visual and vestibular cortical regions. Neuroimage 1, 471–479. 10.1016/j.neuroimage.2018.06.065
    1. Rogge A. K., Röder B., Zech A., Nagel V., Hollander K., Braumann K. M., et al. . (2017). Balance training improves memory and spatial cognition in healthy adults. Sci. Rep. 7:5661. 10.1038/s41598-017-06071-9
    1. Rubenstein L. Z. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 35, ii37–ii41. 10.1093/ageing/afl084
    1. Segev D., Hellerstein D., Carasso R., Dunsky A. (2019). The effect of a stability and coordination training programme on balance in older adults with cardiovascular disease: a randomised exploratory study. Eur. J. Cardiovasc. Nurs. [Epub ahead of print]. 10.1177/1474515119864201
    1. Sibley K. M., Salbach N. M. (2015). Applying knowledge translation theory to physical therapy research and practice in balance and gait assessment: case report. Phys. Ther. 95, 579–587. 10.2522/ptj.20130486
    1. Sieber C. C. (2017). Frailty-from concept to clinical practice. Exp. Gerontol. 87, 160–167. 10.1016/j.exger.2016.05.004
    1. Smith P. F., Darlington C. L., Zheng Y. (2010). Move it or lose it-is stimulation of the vestibular system necessary for normal spatial memory? Hippocampus 20, 36–43. 10.1002/hipo.20588
    1. Smith P. F., Zheng Y. (2013). From ear to uncertainty: vestibular contributions to cognitive function. Front. Integr. Neurosci. 7:84. 10.3389/fnint.2013.00084
    1. Spinella M., Yang B., Lester D. (2004). Prefrontal system dysfunction and credit card debt. Int. J. Neurosci. 114, 1323–1332. 10.1080/00207450490476011
    1. Stimpson N. J., Davison G., Javadi A. H. (2018). Joggin’ the noggin: towards a physiological understanding of exercise-induced cognitive benefits. Neurosci. Biobehav. Rev. 88, 177–186. 10.1016/j.neubiorev.2018.03.018
    1. Taguchi N., Higaki Y., Inoue S., Kimura H., Tanaka K. (2010). Effects of a 12-month multicomponent exercise program on physical performance, daily physical activity and quality of life in very elderly people with minor disabilities: an intervention study. J. Epidemiol. 20, 21–29. 10.2188/jea.je20081033
    1. Tarazona-Santabalbina F. J., Gómez-Cabrera M. C., Pérez-Ros P., Martínez-Arnau F. M., Cabo H., Tsaparas K., et al. . (2016). A multicomponent exercise intervention that reverses frailty and improves cognition, emotion and social networking in the community-dwelling frail elderly: a randomized clinical trial. J. Am. Med. Dir. Assoc. 17, 426–433. 10.1016/j.jamda.2016.01.019
    1. Taube W., Gruber M., Beck S., Faist M., Gollhofer A., Schubert M. (2007). Cortical and spinal adaptations induced by balance training: correlation between stance stability and corticospinal activation. Acta Physiol. 189, 347–358. 10.1111/j.1748-1716.2007.01679_1.x
    1. Taylor-Piliae R. E., Haskell W. L., Waters C. M., Froelicher E. S. (2006). Change in perceived psychosocial status following a 12-week Tai Chi exercise programme. J. Adv. Nurs. 54, 313–329. 10.1111/j.1365-2648.2006.03809.x
    1. Tinetti M. E., Williams T. F., Mayewski R. (1986). Fall risk index for elderly patients based on chronic disabilities. Am. J. Med. 80, 429–434. 10.1016/0002-9343(86)90717-5
    1. Tomlinson S. P., Davis N. J., Morgan H. M., Bracewell R. M. (2014). Cerebellar contributions to verbal working memory. Cerebellum 13, 354–361. 10.1007/s12311-013-0542-3
    1. Voelcker-Rehage C., Godde B., Staudinger U. M. (2011). Cardiovascular and coordination training differentially improve cognitive performance and neural processing in older adults. Front. Hum. Neurosci. 5:26. 10.3389/fnhum.2011.00026
    1. Wong A. M., Lin Y. C., Chou S. W., Tang F. T., Wong P. Y. (2001). Coordination exercise and postural stability in elderly people: effect of Tai Chi Chuan. Arch. Phys. Med. Rehabil. 82, 608–612. 10.1053/apmr.2001.22615
    1. World Health Organization (2007). WHO Global Report on Falls Prevention in Older Age. Geneva: WHO Press, World Health Organization.
    1. Zech A., Hübscher M., Vogt L., Banzer W., Hänsel F., Pfeifer K. (2010). Balance training for neuromuscular control and performance enhancement: a systematic review. J. Athl. Train 45, 392–403. 10.4085/1062-6050-45.4.392

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera