Effect of Osteopathic Manipulative Treatment Protocol on Balance in the Elderly

2011 ◽  
Author(s):  
Daniel Lopez ◽  
Hollis King ◽  
Janice Knebl ◽  
Victor Kosmopoulos ◽  
DeRaan Collins ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Postural Stability ◽  
Balance Control ◽  
Treatment Protocol ◽  
The Elderly ◽  
Osteopathic Manipulative Treatment ◽  
Control Structures ◽  
Outcome Measurements

The purpose of this study it to understand the effect of Osteopathic Manipulative Treatment (OMT) on vestibular balance control structures. It was hypothesized that following an OMT treatment protocol, elderly patients would show significant improvement in empirical outcome measurements used to quantify postural stability.

scholarly journals The Role of Spinal Orthoses in Osteoporotic Vertebral Fractures of the Elderly Population (Age 60 Years or Older): Systematic Review

2020 ◽  
pp. 219256822094803
Author(s):  
Barry Ting Sheen Kweh ◽  
Hui Qing Lee ◽  
Terence Tan ◽  
Joost Rutges ◽  
Travis Marion ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Vertebral Fractures ◽  
Postural Stability ◽  
Elderly Population ◽  
The Elderly ◽  
Functional Improvement ◽  
Osteoporotic Vertebral Fractures ◽  
Spinal Orthoses

Study Design: Systematic review. Objective: Spinal orthoses have been generally used in the management of osteoporotic vertebral fractures in the elderly population with purported positive biomechanical and functional effects. To our knowledge, this is the first systematic review of the literature examining the role of spinal orthoses in osteoporotic elderly patients who sustain low energy trauma vertebral fractures. Methods: A systematic literature review adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Methodical searches utilizing MEDLINE, EMBASE, Google Scholar, and Cochrane Databases was performed. Results: Of the 2019 articles initially retrieved, 7 published articles (4 randomized controlled trials and 3 prospective cohort studies) satisfied the inclusion criteria. Five studies reported improvement in quantitative measurements of spinal column stability when either a rigid or semirigid orthosis was used, while 1 study was equivocal. The studies also showed the translation of biomechanical benefit into significant functional improvement as manifested by improved postural stability and reduced body sway. Subjective improvement in pain scores and quality of life was also noted with bracing. Conclusion: The use of spinal orthoses in neurologically intact elderly patients aged 60 years and older with osteoporotic compression vertebral fractures results in improved biomechanical vertebral stability, reduced kyphotic deformity, enhanced postural stability, greater muscular strength and superior functional outcomes.

Estimation of Hip and Ankle Visco-Elastic Parameters During Quiet Standing

2018 ◽  
Author(s):  
Angel Cerda-Lugo ◽  
Alejandro Gonzalez ◽  
Antonio Cardenas ◽  
Davide Piovesan
Keyword(s):  
Postural Stability ◽  
Degrees Of Freedom ◽  
Balance Control ◽  
The Elderly ◽  
The United States ◽  
Second Order ◽  
Quiet Standing ◽  
Control Parameters ◽  
Inverted Pendulum Model ◽  
Modes Of Vibration

Balance control naturally deteriorates with age, so it comes as no surprise that nearly 30% of the elderly population in the United States report stability problems that lead to difficulty performing daily activities or even falling. Postural stability is an integral task to daily living which is reliant upon the control of the ankle and hip. To this end, the estimation of ankle and hip parameters in quiet standing can be a useful tool when analyzing compensatory actions aimed at maintaining postural stability. Using an analytical approach, this work builds upon the results obtained by the authors and expands it to a two degrees of freedom system where the first two modes of vibration of a standing human are considered. The physiological parameters a second-order Kelvin-Voigt model were estimated for the actuation of the ankle and hip. Estimates were obtained during quiet standing when healthy volunteers were subjected to a step-like perturbation. This paper presents the analysis of a second-order nonlinear system of differential equations representing the control of lumped muscle-tendon units at the ankle and hip. This paper utilizes motion capture measurements to obtain the estimates of the control parameters of the system. The dynamic measurements are utilized to construct a simple time-dependent regression that allows calculating the time-varying estimates of the control and body segment parameters with a single perturbation. This work represents a step forward in estimating the control parameters of human quiet standing where, usually, the analysis is either restricted to the first vibrational mode of an inverted pendulum model or the control parameters are assumed to be time-invariant. The proposed method allows for the analysis of hip related movement in the control of stability and highlights the importance of core muscle training.

35 The Impact of Postural Hyperkyphosis on Postural Stability and Cognition

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Krista Burns
Keyword(s):  
Vestibular System ◽  
Postural Stability ◽  
Muscle Activation ◽  
Treatment Protocol ◽  
The Elderly ◽  
Lower State ◽  
Muscle Activation Patterns ◽  
Injurious Falls ◽  
Postural Correction ◽  
The Impact

Abstract Background Postural Hyperkyphosis results from flexor dominant posture habits. Flexor dominance occurs due to dysfunction of the pontomedullary reticular formation (PMRF) of the brainstem and the vestibular system. The role of the PMRF is to inhibit anterior flexion above T6 spinal level, and the vestibular system stimulates upright postural extension and balance. When patients present with flexor dominance they have a Postural Hyperkyphosis postural distortion pattern and abnormal muscle activation patterns. To correct flexor dominance, practitioners should perform brain-based exercises, not just structural exercises. Brain based stimulation of the vestibular system and the brainstem stimulates upright extension of the Posture System and inhibition of anterior flexion to reduce Postural Hyperkyphosis. Postural Hyperkyphosis contributes to multiple health discrepancies. According to Cohen, Vasavada, and Wiest et al. (2016) in the Frontiers of Neuroscience, Postural Hyperkyphosis is associated with a lower state of cognition. According to Kado, Huang, and Nguyen et al. (2007) in the Journals of Gerontology hyperkyphosis is associated with poor balance and injurious falls in the elderly. Brainstem and vestibular activation reduces flexion and improves extension for better postural correction outcomes. Results Brain Based exercises reduce Postural Hyperkyphosis and improve postural stability and cognition of elderly patients. Brain Based exercises are safe for the elderly to perform and can be easily implemented into physical rehabilitation treatment plans for better postural correction results. Conclusion Correcting Postural Hyperkyphosis to improve Postural Stability and cognition requires a Brain Based treatment protocol.

scholarly journals Can hearing amplification improve presbyvestibulopathy and/or the risk-to-fall ?

2020 ◽  
Author(s):  
Arne Ernst ◽  
Dietmar Basta ◽  
Philipp Mittmann ◽  
Rainer O. Seidl
Keyword(s):  
Cochlear Implants ◽  
Hearing Aids ◽  
Postural Stability ◽  
Standardized Test ◽  
Balance Control ◽  
The Elderly ◽  
Future Research ◽  
Temporal Orientation ◽  
Auditory Information ◽  
Spatio Temporal

Abstract Purpose The decline of sensory systems during aging has been widely investigated and several papers have correlated the visual, hearing and vestibular systems and the consequences of their functional degeneration. Hearing loss and presbyvestibulopathy have been found to be positively correlated as is with the risk-to-fall. Material and methods The present study was therefore designed as systematic review (due to PRISMA criteria) which should correlate hearing amplification by hearing aids and/or cochlear implants with balance outcome. However, the literature review (Cochrane, PubMed) revealed ten paper (prospective, controlled trials and acute trials) with heterogenous patient popiulations and non-uniform outcome measures (i.e., gait analysis, questionnaires, postural stabilometry) so that no quantitative, statistical analysis could be performed. Results The qualitative analysis oft he identified studies showed that hearing amplification in the elderly improves spatio-temporal orientation (particularly with cochlear implants) and that the process of utilizing auditory information for balance control takes some time (i.e., the neuroplasticity-based, learning processes), usually some months in cochlear implantees. Discussion Hearing and balance function degenerate independently from each other and large interindividual differences require a separate neurotological examination of each patient. However, hearing amplification is most helpful to improve postural stability, particularly in the elderly. Future research should focus on controlled, prospective clinical trials where a standardized test battery covering the audiological and neurotological profile of each elderly patient pre/post prescription of hearing aids and/or cochlear implantation should be followed up (for at least 1 year) so that also the balance improvements and the risk-to-fall can be reliably assessed (e.g., by mobile posturography and standardized questionnaires, e.g., the DHI).

106 Precipitating factors in the elderly patients admitted with the diagnosis of heart failure. Are easy to find?

2006 ◽  
Vol 5 (1) ◽  
pp. 25-26
Author(s):  
R VIDALPEREZ ◽  
E ABUASSI ◽  
M PARAMODEVEGA ◽  
P VELOSO ◽  
A VARELAROMAN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
The Elderly ◽  
Precipitating Factors

Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 1-6
Author(s):  
Truc Phan ◽  
Tram Huynh ◽  
Tuan Q. Tran ◽  
Dung Co ◽  
Khoi M. Tran
Keyword(s):  
Elderly Patients ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
The Elderly ◽  
Free Survival ◽  
Non Hodgkin Lymphoma ◽  
Common Sign ◽  
Related Mortality

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam. Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed. Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens. Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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