Efficacy of different postural control training in elderly people with chronic cerebral ischemia

Litvina L.D.; Koneva E.S.

doi:https://doi.org/10.17116/rbpdpm2024102142

Close metadata

OBJECTIVE

To evaluate the effectiveness of hardware training for postural control in elderly patients with chronic cerebral ischemia.

MATERIAL AND METHODS

We reviewed the Russian- and English-language articles in the PubMed, eLIBRARY.RU, CyberLeninka and Google Scholar databases over the past 15 years using the following keywords, as well as appropriate translations. The review included the studies that examined balance and postural control training in older patients with chronic cerebral ischemia and/or cognitive impairment.

RESULTS

Training on stable-platform improves proprioceptive control and basic stance performance with open and closed eyes. Treadmills with biofeedback have a positive effect on reactive balance and walking performance. Perturbation-based training is especially interesting since this method imitates situations of everyday life and forms optimal neuronal adaptations for prevention of falls due to specificity of objectives. Efficacy of virtual reality-based training is currently unclear and requires larger randomized trials regarding effectiveness in improving postural control in elderly patients with chronic cerebral ischemia.

CONCLUSION

Despite positive effect of hardware training of postural control, available studies are few in number and characterized by small sample size and short-term follow-up. Thus, we cannot draw clear conclusions about their effectiveness in elderly people with chronic cerebral ischemia. In addition, the most optimal combination of various hardware methods and their integration with traditional rehabilitation measures are still debatable. Thus, development and scientific substantiation of comprehensive postural control training program with hardware methods in elderly patients with chronic cerebral ischemia remains an urgent task today.

Keywords:

elderly

stable-platform

treadmill

biofeedback

perturbation-based training

chronic cerebral ischemia

postural disorders

Authors:

Litvina L.D.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-9019-3525

Koneva E.S.

Sechenov First Moscow State Medical University;
A Group of Companied «MEDSI»

ORCID: 0000-0002-9859-194X

Received:

05.04.2024

Accepted:

27.04.2024

Close metadata

References:

Kamchatnov PR, Evzelman MA. Chronic cerebral ischemia: modern ideas about pathogenesis and treatment. Neurology, neuropsychiatry, psychosomatics. 2017;9(3):4-9. (In Russ.).
Parfenov VA, Starchina YuA. Walking and balance disorders in the elderly. Neurology, neuropsychiatry, psychosomatics. 2019;11(3):127-132. (In Russ.).
Tiozzo E, Youbi M, Dave K, Perez-Pinzon M, Rundek T, Sacco RL, Loewenstein D, Lewis JE, Wright CB. Aerobic, Resistance, and Cognitive Exercise Training Poststroke. Stroke. 2015;46(7):2012-2016. https://doi.org/10.1161/STROKEAHA.114.006649
Yatar GI, Yildirim SA. Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial. Journal of Physical Therapy Science. 2015;27(4):1145-1151. https://doi.org/10.1589/jpts.27.1145
Tarakci D, Ersoz Huseyinsinoglu B, Tarakci E, Razak Ozdincler A. Effects of Nintendo Wii-Fit video games on balance in children with mild cerebral palsy. Pediatrics International. 2016;58(10):1042-1050. https://doi.org/10.1111/ped.12942
Yen CY, Lin KH, Hu MH, Wu RM, Lu TW, Lin CH. Effects of virtual reality-augmented balance training on sensory organization and attentional demand for postural control in people with Parkinson disease: a randomized controlled trial. Physical Therapy. 2011;91(6):862-874. https://doi.org/10.2522/ptj.20100050
Bao T, Carender WJ, Kinnaird C, Barone VJ, Peethambaran G, Whitney SL, Kabeto M, Seidler RD, Sienko KH. Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults: a randomized preliminary study. Journal of NeuroEngineering and Rehabilitation. 2018;15(1):5. https://doi.org/10.1186/s12984-017-0339-6
Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy. 2000;80(9):896-903.
Dunsky A, Dickstein R. Postural control in older adults: clinical aspects. Physical Therapy Reviews. 2018;23(3):125-134. https://doi.org/10.3389/fnagi.2019.00318
Martínez-Amat A, Hita-Contreras F, Lomas-Vega R, Caballero-Martínez I, Alvarez PJ, Martínez-López E. Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial. Journal of Strength and Conditioning Research. 2013;27(8):2180-2188. https://doi.org/10.1519/JSC.0b013e31827da35f
Cuevas-Trisan R. Balance problems and fall risks in the elderly. Physical Medicine and Rehabilitation Clinics of North America. 2017;28(4):727-737. https://doi.org/10.1016/j.pmr.2017.06.006
Concha-Cisternas Y, Castro-Piñero J, Leiva-Ordóñez AM, Valdés-Badilla P, Celis-Morales C, Guzmán-Muñoz E. Effects of Neuromuscular Training on Physical Performance in Older People: A Systematic Review. Life. 2023;13(4):869. https://doi.org/10.3390/life13040869
Chittrakul J, Siviroj P, Sungkarat S, Sapbamrer R. Multi-system physical exercise intervention for fall prevention and quality of life in pre-frail older adults: a randomized controlled trial. International Journal of Environmental Research and Public Health. 2020;17(9):3102. https://doi.org/10.3390/ijerph17093102
Li X, Zhang Y, Tian Y, Cheng Q, Gao Y, Gao M. Exercise interventions for older people with cognitive frailty-a scoping review. BMC Geriatrics. 2022;22(1):721. https://doi.org/10.1186/s12877-022-03370-3
Xing L, Bao Y, Wang B, Shi M, Wei Y, Huang X, Dai Y, Shi H, Gai X, Luo Q, Yin Y, Qin D. Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies. Frontiers in Neurology. 2023;14:1128092. https://doi.org/10.3389/fneur.2023.1128092
Thomas E, Battaglia G, Patti A, Brusa J, Leonardi V, Palma A, Bellafiore M. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine. 2019;98(27):e16218. https://doi.org/10.1097/md.0000000000016218
Senderovich H, Bayeva N, Montagnese B, Yendamuri A. Managing Fall Prevention through Exercise in Older Adults Afflicted by Cognitive and Strength Impairment. Dementia and Geriatric Cognitive Disorders. 2021;50(6):507-518. https://doi.org/10.1159/000521140
Chan WC, Yeung JW, Wong CS, Lam LC, Chung KF, Luk JK, Lee JS, Law AC. Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: a systematic review and meta-analysis. Journal of the American Medical Directors Association. 2015;16(2):149-154. https://doi.org/10.1016/j.jamda.2014.08.007
Montero-Odasso M, van der Velde N, Martin FC, Petrovic M, Tan MP, Ryg J, Aguilar-Navarro S, Alexander NB, Becker C, Blain H, Bourke R, Cameron ID, Camicioli R, Clemson L, Close J, Delbaere K, Duan L, Duque G, Dyer SM, Freiberger E, Ganz DA, Gómez F, Hausdorff JM, Hogan DB, Hunter SMW, Jauregui JR, Kamkar N, Kenny RA, Lamb SE, Latham NK, Lipsitz LA, Liu-Ambrose T, Logan P, Lord SR, Mallet L, Marsh D, Milisen K, Moctezuma-Gallegos R, Morris ME, Nieuwboer A, Perracini MR, Pieruccini-Faria F, Pighills A, Said C, Sejdic E, Sherrington C, Skelton DA, Dsouza S, Speechley M, Stark S, Todd C, Troen BR, van der Cammen T, Verghese J, Vlaeyen E, Watt JA, Masud T; Task Force on Global Guidelines for Falls in Older Adults. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing. 2022;51(9):afac205. https://doi.org/10.1093/ageing/afac205
Sherrington C, Fairhall N, Wallbank G, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb S. Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. British Journal of Sports Medicine. 2020;54(15):885-891. https://doi.org/10.1136/bjsports-2019-101512
Okubo Y, Schoene D, Lord SR. Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. British Journal of Sports Medicine. 2017;51(7):586-593.
Brüll L, Hezel N, Arampatzis A, Schwenk M. Comparing the Effects of Two Perturbation-Based Balance Training Paradigms in Fall-Prone Older Adults: A Randomized Controlled Trial. Gerontology. 2023;69(7):910-922. https://doi.org/10.1159/000530167
Devasahayam AJ, Farwell K, Lim B, Morton A, Fleming N, Jagroop D, Aryan R, Saumur TM, Mansfield A. The Effect of Reactive Balance Training on Falls in Daily Life: An Updated Systematic Review and Meta-Analysis. Physical Therapy. 2022;103(1):pzac154. https://doi.org/10.1093/ptj/pzac154
Horlings CG, Carpenter MG, Küng UM, Honegger F, Wiederhold B, Allum JH. Influence of virtual reality on postural stability during movements of quiet stance. Neuroscience Letters. 2009;451(3):227-231.
Litvina LD, Koneva ES, Zhumanova EN, Gridin LA, Lyadov KV, Shitova AA. Experience of incorporating hardware training of postural control into comprehensive rehabilitation programs for elderly patients. Spa medicine. 2023;2:69-79. (In Russ.). https://doi.org/10.51871/2304-0343_2023_2_69
Litvina LD, Konev SM, Koneva ES, Butko DYu, Lyadov KV, Zhumanova EN, Gridin LA, Korchazhkina NB, Kotenko KV. The effect of apparatus-based balance training techniques on the risk of falls, postural control and cognitive function in older adults with chronic cerebral ischemia. (Randomized controlled trial). Issues of balneology, physiotherapy and therapeutic physical culture. 2023;100(6):31-39. (In Russ.).
Markovic G, Sarabon N, Greblo Z, Krizanic V. Effects of feedback-based balance and core resistance training vs. Pilates training on balance and muscle function in older women: A randomized-controlled trial. Archives of Gerontology and Geriatrics. 2015;61(2):117-123. https://doi.org/10.1016/j.archger.2015.05.009
Sidorovich EK, Likhachev SA, Klishevskaya NN, Pavlovskaya TS. Results of training postural and cognitive functions in patients with chronic ischemic cerebrovascular accidents using static and dynamic stabilization platforms. Neurology and neurosurgery. Eastern Europe. 2015;25(1). (In Russ.).
Rieger MM, Papegaaij S, Steenbrink F. Effects of Perturbation-Based Treadmill Training on Balance Performance, Daily Life Gait, and Falls in Older Adults: REACT Randomized Controlled Trial. Physical Therapy. 2024;104(1):136.
Lurie JD, Zagaria AB, Ellis L, Pidgeon D, Gill-Body KM, Burke C, Armbrust K, Cass S, Spratt KF, McDonough CM. Surface Perturbation Training to Prevent Falls in Older Adults: A Highly Pragmatic, Randomized Controlled Trial. Physical Therapy. 2020;100:1153-1162. https://doi.org/10.1093/ptj/pzaa023
Litvina LD, Konev SM, Koneva ES, Shapovalenko TV, Mikhailova AA, Lyadov KV. Hardware methods for training dynamic walking stereotypes in patients of older age groups. Physiotherapist. 2023;1. (In Russ.).
Wang Y, Wang S, Lee A, Pai YC, Bhatt T. Treadmill-gait slip training in community-dwelling older adults: mechanisms of immediate adaptation for a progressive ascending-mixed-intensity protocol. Experimental Brain Research. 2019;237(9):2305-2317. https://doi.org/10.1007/s00221-019-05582-3
Klochkov AS, Khizhnikova AE, Kotov-Smolensky AM, Chernikova LA, Suponeva NA. Correction of static and dynamic balance using a virtual reality system in patients with cerebrovascular diseases. Nervous diseases. 2018;3:28-32. (In Russ.). https://doi.org/10.24411/2071-5315-2018-12030
Schwenk M, Grewal GS, Honarvar B, Schwenk S, Mohler J, Khalsa DS, Najafi B. Interactive balance training integrating sensor-based visual feedback of movement performance: a pilot study in older adults. Journal of NeuroEngineering and Rehabilitation. 2014;11:164. https://doi.org/10.1186/1743-0003-11-164
Dermody G, Whitehead L, Wilson G, Glass C. The role of virtual reality in improving health outcomes for community-dwelling older adults: systematic review. Journal of Medical Internet Research. 2020;22:e17331. https://doi.org/10.2196/17331
Lamichhane PM, Sukralia SM, Alam BM, Shaikh SB, Farrukh SM, Ali SM, Ojha RM. Augmented Reality-Based Training Versus Standard Training in Improvement of Balance, Mobility and Fall Risk: A Systematic Review and Meta-Analysis. Annals of Medicine and Surgery. 2023;85:4026-4032. https://doi.org/10.1097/MS9.0000000000000986
Wiloth S, Lemke N, Werner C, Hauer K. Validation of a Computerized, Game-based Assessment Strategy to Measure Training Effects on Motor-Cognitive Functions in People With Dementia. JMIR Serious Games. 2016;4(2):e12. https://doi.org/10.2196/games.5696
Lesinski M, Hortobágyi T, Muehlbauer T, Gollhofer A, Granacher U. Effects of Balance Training on Balance Performance in Healthy Older Adults: A Systematic Review and Meta-analysis. Sports Medicine. 2015;45(12):1721-1738. https://doi.org/10.1007/s40279-015-0375-y
Psychocorrective effect of using combined methods of medical rehabilitation in patients who have suffered an ischemic stroke/A.A. Mikhailova, N.B. Korchazhkina, E.S. Koneva, K.V. Kotenko//Physiotherapy, balneology and rehabilitation. – 2020. – T. 19, No. 6. – P. 380-383. – DOI 10.17816/1681-3456-2020-19-6-5. – EDN UBARKW.
Korchazhkina N.B. Features of the use of stabiloplatforms with biofeedback for various socially significant diseases/N.B. Korchazhkina, A.A. Mikhailova//Physiotherapy, balneology and rehabilitation. – 2019. – T. 18, No. 2. – P. 103-106. – DOI 10.17816/1681-3456-2019-18-2-103-106. – EDN KXDZOQ].