Medicine and Health Sciences Commons^™

Assessment Of Gait, Balance, And Falls In Individuals With Neurodegenerative Diseases, Lauren Tueth

WUSM Theses and Dissertations – All Programs

Neurodegenerative diseases are a group of disorders that impact the brain and lead to neuronal degeneration. This degeneration causes many different symptoms, which are often grouped into motor, cognitive, and psychiatric domains. Individuals with these disorders can experience symptoms from multiple domains at the same time, but little is known about how these distinct symptoms may impact each other.

In Chapter 2, we explored the intersection of balance and cognitive impairment in individuals with Alzheimer disease (AD). AD is traditionally discussed in the context of the dementia symptoms, but people with AD also experience motor deficits. Falls are a huge …

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

Exploring The Relationship Between Hemispheric Prefrontal Cortex Activation, Standing Balance, And Fatigue In Individuals Post-Stroke: A Fnirs Study, Sarthak Kohli

Electronic Thesis and Dissertation Repository

Balance impairments are common after stroke. Reasons for this are multifactorial and include motor dysfunction and fatigue. Limited research has explored the combined effects of post-stroke fatigue and balance on brain activation patterns. Research has shown that prefrontal cortex (PFC) activation may be involved in both motor control and fatigue throughout the recovery process post-stroke. The aim of this thesis was to determine whether: (1) PFC activation levels change between standing balance tasks, (2) PFC hemispheric activation is asymmetric during standing balance tasks, and (3) fatigue levels are associated with task-based activation. Patients with hemiparesis were recruited from the inpatient …

Effects Of A 12-Week Remote Exercise Program On Balance In Adults With Down Syndrome, Kayla Kotake, Sherwin Cadiao, Nicole Kaes, Jayston Prudencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals …

Contributions Of Asymmetry And Instability To Transfer And Retention Following Locomotor Adaptation, Daniel L. Gregory

Doctoral Dissertations

Gait asymmetry resulting from neurological injury is more costly and less stable than healthy gait. Split-belt treadmills, which drive limbs at different speeds, lead to spatial and temporal gait asymmetries, and perturb walking balance, have been used to study locomotor adaptability and learning related to asymmetry and stability. This knowledge may be leveraged to design more effective rehabilitation protocols. In experiment 1, we asked how constraining stride-rates away from preferred during split-belt walking influences learning revealed in a retention test. We found that constraints to stride rate during asymmetric walking uncovered the capacity to leverage redundant degrees-of-freedom for walking control, …

Advancing The Assessment And Treatment Of Signs And Symptoms Of Parkinson Disease, David Scott May

WUSM Theses and Dissertations – All Programs

People with PD often report signs and symptoms that negatively impact quality of life. Among these are balance difficulties, impaired gait, and FOG. New treatment and assessment strategies for these signs and symptoms are needed, as current techniques are limited. While new treatment and assessment strategies continue to emerge, gaps in knowledge persist. Deep brain stimulation (DBS) has been utilized in many people with PD throughout the 21st century, but it is unknown specifically how subthalamic nucleus deep brain stimulation (STN-DBS) affects balance. Alternative treatment strategies, such as a dental mouthpiece, have also been proposed. While dental mouthpieces have shown …

Subjective Visual Vertical And Otolith Compensation: Evaluating Off-Axis Rotation Stimulus In Healthy Controls, Eva Price

Undergraduate Honors Theses

The vestibular system senses changes in head position and is responsible for the brain’s perception of verticality. Vestibular dysfunction is caused by deficits in the semicircular canals and/or otolith end-organs with resulting symptoms including dizziness, vertigo, and unsteadiness. Current vestibular rehabilitation focuses on compensation of the semicircular canal-mediated vestibulo-ocular reflex through gaze and balance exercises. Little is known about rehabilitation of otolith organ function, yet research findings suggest that fall risk may be related to otolith dysfunction. A recent case study demonstrated improvement of vertical perception and balance following off-axis rotation in a rotary chair, showing that such stimulation may …

Effects Of Generic Group-Based Versus Personalized Individual-Based Exercise Programs On Balance, Gait, And Functional Performance Of Older Adults With Mild Balance Dysfunction And Living In Residential Care Facilities - A Randomized Controlled Trial, Varatharajan Lingam

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). …

Effect Of Individual Height And Testing Methods On Outcome Of The Forward Functional Reach Test, Jill Elaine Heitzman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: With falls a leading cause of injuries among those over age 65, early recognition of risk is imperative to reduce rising rates. The Forward Functional Reach test (FFRT) (Duncan et al., 1990) is frequently used to identify fall risk, however, the variability in cut values found in the research may be related to height and reach strategies.

Purpose: The purpose of this study was to determine if FFRT is affected by an individual’s height and if bilateral reach to height ratio could more accurately identify fall risk.

Methods: Sixty-six participants (60 and older) were recruited from a senior center …

Using Virtual Reality To Improve Sitting Balance, Alice Kay Barnes

MSU Graduate Theses

This thesis focuses on using virtual reality (VR) to enhance sitting balance and core strength. It is a study in how to create a VR exercise program which is interesting enough to keep players/patients motivated, but comfortable to play and not overwhelming to the senses. The software used for this study was written with the hope that a later version of it might be used with occupational/physical therapy patients one day. For this master’s thesis, the initial testing has been done with healthy volunteers. The software incorporates what developers know thus far about designing for VR, and it is hoped …

Effects Of A Balance And Strength Training Program On Functional Proprioceptive And Motor Control Abilities In Young Adults With Neurodevelopmental Disorders, Victoria Timmons

Undergraduate Distinction Papers

he objective of this study was to determine if young adults, ages 18-22, with neurodevelopmental disorders, including Autism Spectrum Disorder, Intellectual Disabilities, Communication Disorders, Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, and Motor Disorders, would benefit by adding a propioceptive intervention program to an already existing strength training program. Benefits hypothesized from this intervention were int he areas of agility and balance, two of the three components of propioceptive abilities. Increased agility and balance has been proved to increase functionality and safety as it can decrease fall risks. Subjects were all apart of a transitional program from high school into the adult …

Balance Confidence And Fear Of Falling Avoidance Behavior Are Most Predictive Of Falling In Older Adults: A Prospective Analysis, Sarrie Oscar, Jessica Sasaoka, Kyle Vaughn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Evidence suggests that there are several fall predictors in the elderly population, including previous fall history and balance impairment. To date, however, the role of psychological factors has not yet been thoroughly vetted in conjunction with physical factors as predictors of future falls. Objective: The purpose of this study was to determine which measures, physical and psychological, are most predictive of falling in older adults. Design: This was a prospective cohort study. Methods: Sixty-four participants (mean age=72.2 years, SD=7.2; 40 women, 24 men) with and without pathology (25 healthy, 17 with Parkinson disease, 11 with cerebrovascular accident, 6 with …

Effect Of Stance Symmetry On Perturbation-Induced Protective Stepping In Persons Poststroke And Controls, Katherine M. Martinez

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Stepping is a common strategy after a perturbation. Stroke survivors display a predilection for stepping with non-paretic leg. Insight into induced stepping between stroke survivors and age-matched control may guide our understanding for reactive postural control training post stroke. Purpose: To investigate the difference in perturbation-induced stepping between chronic stroke survivors and age-matched controls at three phases of the stepping response: preparation, execution, and landing and association with clinical outcome measures. Procedure: Twenty-one community-dwelling chronic stroke survivors (mean age 59y/o ±13yrs) and 17 age- and gender-matched controls (mean age 54.4y/o ±17yrs) completed this study. Clinical measures of gait, …

Postural Responses To Perturbations Of The Vestibular System During Walking In Healthy Young And Older Adults, Jung Hung Chien

Theses & Dissertations

It has been shown that approximate one-third of US adults aged 40 years and older (69 million US citizens) have some type of vestibular problems. These declining abilities of the vestibular system affect quality of life. Difficulties in performing daily activities (dressing, bathing, getting in and out of the bed and etc.) have been highly correlated to loss of balance due to vestibular disorders. The exact number of people affected by vestibular disorders is still difficult to quantify. This might be because symptoms are difficult to describe and differences exist in the qualifying criteria within and across studies. Thus, it …

Differences In Balance And Muscle Activation Strategies During Gait Initiation At Different Speeds Between Young And Middle-Aged Adults, Lynn Curtis-Vinegra

Seton Hall University Dissertations and Theses (ETDs)

Middle-age adults’ (MA) self-report of falls are greater compared to younger adults (YA) during ambulation. A previous study found that MA compared to YA use different strategies taking one-step forward at a fast speed. No other studies have compared the effect of two different speeds on balance variables and muscle activity during gait initiation in the MA compared to YA using an instrumented walkway. The objectives of this study were to assess the effects of age and speed on balance by measuring a) the Center of Pressure (COP) in two planes: COPx (sagittal) and COPy (frontal) and the Center of …

The Effect Of A Multiple Modality Mind-Motor Exercise Intervention On Single And Dual-Task Gait, Balance, And Executive Function, In Community Dwelling Older Adults With A Subjective Cognitive Complaint: A Randomized Controlled Trial., John P. Bocti

Electronic Thesis and Dissertation Repository

Cognitive decline disorders are becoming increasingly prevalent, with older adults at increased risk. Combined exercise has been recently explored as an intervention to help to prevent the decline, however cognitive activation in combination with physical activity has yet to be explored. Therefore, the purpose of the study is to determine the effects of multiple modality exercise programs in combination with a mind-motor task and their effects on mobility and cognitive variables. A total of (n=89) older adults (55+ yrs), with subjective cognitive complaints participated in a multiple modality exercise class, three days a week over six months, with the intervention …

The Effects Of Enhanced And Decreased Expectations On Balance Performance In Those With And Without Parkinson’S Disease, Joshua Ostrander, Granuaile Parrish, Jacob Blood

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: It has been reported individuals typically perform well on a task when enhanced expectancy was provided prior to task performance. It has also been reported people with Parkinson’s disease (PD) are especially susceptible to pre-task placebo cuing and suggestion. Evidence of this susceptibility has been previously demonstrated through brain imaging studies and with demonstration by individuals with PD improved balance performance.

Objective: This study was designed to further previous studies’ results for improved task performance with enhanced expectancy. The purpose of this study was to investigate if the pre-task verbal delivery of enhanced expectancy, decreased expectancy and no expectancy …

The Effect Of Balance-Based Torso-Weighting On Mobility, Gait, Balance, Postural Control, And Falls Efficacy In Mobility Limited Older Adults, Jennifer L. Vincenzo

Graduate Theses and Dissertations

Exercise is a known intervention to prevent fall risk among older adults; however, adherence is poor. Therefore, it is of interest to determine if other interventions improve function and decrease fall risk among older adults. Balance-Based Torso-Weighting (BBTW) is a non-exercise intervention that improves functional measures among adults with multiple sclerosis, yet the effectiveness of BBTW has not been assessed among older adults without progressive neurological disorders. We conducted a double-blind, randomized study to analyze the effect of BBTW on functional measures and falls efficacy among community-dwelling, mobility limited older adults after 5 days of wearing BalanceWear® for 4 hours …

Modern Technology And An Aging Population: Can The Use Of The Wii Fit Gaming System Improve Functional Balance In Community Dwelling Seniors?, Curtis N. Phillips

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in …

Alterations In Visual Processing And Its Impact On Upright Postural Stability In Athletes Following Sport-Related Concussion, Andrea E. Cripps

Theses and Dissertations--Rehabilitation Sciences

Athletes are at risk of sustaining a concussion in all sports and at all competitive levels which may lead to balance impairments. Balance results from the integration of visual, vestibular, and somatosensory information. The underlying pathophysiology for balance impairments is not well understood and visuo-motor processing impairments and how these impairments contribute to balance in concussed athletes has not been reported. Objectives: (1) to investigate the influence of visual perturbation on upright postural stability and balance in athletes who have recently suffered a sports-related concussion, (2) to establish the test-retest reliability of a simple visuo-motor processing task. Design: A longitudinal, …

Use Of A Video Game Based Balance Training Intervention On The Balance And Function Of Children With Developmental Disabilities, Gina C. Siconolfi-Morris

Theses and Dissertations--Rehabilitation Sciences

Many children with developmental disabilities (DD) have physical impairments and limitations in their participation. Rehabilitation research often focuses on either physical impairments or participation restrictions, when both need to be investigated. The purposes of these two studies were to evaluate an at home therapist directed video game balance training intervention on balance, gait velocity (GV), hip strength and activities of children with DD. The pilot study was a single-subject non-concurrent multiple baseline design. Balance measures included: weight bearing symmetry; center of pressure area and velocity; time to boundary mean minima and standard deviation; and timed up and go. The participant’s …

The Acute Effects Of Static Stretching Of The Gastrocnemius On Limits Of Stability In Young Adults Versus Elderly Adults, Matt Bugnet, Kirk Player

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Balance is an important part of everyday life for all individuals with many body systems interacting to achieve optimal balance. Proprioceptive organs aid in this interaction, while also acting as stretch receptors. Therefore, it is possible that stretching may influence the overall balance of the individual. The purpose of this study was to investigate the acute effects of stretching on dynamic balance of healthy young and elderly adults. The two groups were used to determine if stretching may discriminately affect balance at different ages.

Subjects: Thirty healthy adults between the ages of 18 and 35 …

The Able Scale: The Development And Psychometric Properties Of A New Outcome Measure For The Spinal Cord Injury Population, Elizabeth Ardolino

Seton Hall University Dissertations and Theses (ETDs)

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The Effect Of An Incline Walking Surface And The Contribution Of Balance On Spatiotemporal Gait Parameters Of Older Adults, Richard A. Ferraro

Seton Hall University Dissertations and Theses (ETDs)

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Visual Contributions To The Vestibulo-Ocular Reflex During Balance Recovery Tasks, Mark D. Diehl

Theses and Dissertations

Introduction: The Vestibulo-ocular reflex (VOR) is quantified by computing the ratio of head angular velocity and eye angular velocity (VOR Gain). This measure only includes head angular movements; linear translations are not accounted for. These investigations postulate an alternative method of VOR quantification, one that assesses retinal image stability during head angular and linear movements (Foveal fixation (FF)). This method was used to assess the role of vision in balance reactions. Methods: Experiment 1 : Ten Young subjects were fitted with an eye tracker linked to an EM kinematic recording system. This allowed for the recording of head, trunk and …