Title:The Effect of a Four-Week Balance Training Program on Anticipatory Postural Adjustments in Older Adults: A Pilot Feasibility Study
VOLUME: 9 ISSUE: 4
Author(s):Sailee Jagdhane, Neeta Kanekar and Alexander S. Aruin
Affiliation:Department of Physical Therapy (MC 898), University of Illinois at Chicago, 1919 W. Taylor St., Chicago, IL 60612.
Keywords:Balance control, anticipatory postural adjustments, older adults, training, ball catching, rehabilitation.
Abstract:Background: Balance deterioration in older adults limits their activities
of daily living, community participation, and is a significant risk factor for
falls. One contributory element to this functional decline is impairment of anticipatory
postural adjustments (APAs).
Objectives: To evaluate the role and feasibility of a novel training program in
improving APAs for balance control of older adults.
Method: Six older adults (73.3±5.0 years) were randomly assigned into the Experimental
(EG) and Control groups (CG). The EG participated in four weeks of
APA-focused training involving catching a medicine ball while standing. All subjects
were exposed to predictable external and self-initiated perturbations before
and after training. EMG activity of eight trunk and leg muscles was recorded bilaterally and muscle
onsets were analyzed during the anticipatory phase of postural control. Clinical tests of balance
(Timed-Up and Go, Single limb stance, and Activities-specific Balance Confidence scale) were implemented.
Results: Early onsets of APA activity prior to the external perturbations were seen in the EG following
training. Moreover, early APA activity was observed in the EG prior to bilateral arm flexion, a
task that was not a part of training, indicating a transfer of the learning effect of training. The improvement
of APAs in the EG also resulted in improved performance on clinical outcome measures.
There were no improvements seen in the CG for both the APA activity and the clinical balance tests.
Conclusion: The study outcome suggests that a four-week APA-based training program is feasible
and could be effective in improving postural control, functional balance, mobility, and quality of life
in older adults.
