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Effect of Cognitive, Impairment-Oriented and Task-Specific Interventions on Balance and Locomotion Control.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Effect of Cognitive, Impairment-Oriented and Task-Specific Interventions on Balance and Locomotion Control./
作者:	Varas Diaz, Gonzalo.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
面頁冊數:	188 p.
附註:	Source: Dissertations Abstracts International, Volume: 83-02, Section: B.
Contained By:	Dissertations Abstracts International83-02B.
標題:	Physical therapy. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28722818
ISBN:	9798534687682

Effect of Cognitive, Impairment-Oriented and Task-Specific Interventions on Balance and Locomotion Control.
Varas Diaz, Gonzalo.

Effect of Cognitive, Impairment-Oriented and Task-Specific Interventions on Balance and Locomotion Control. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 188 p.

Source: Dissertations Abstracts International, Volume: 83-02, Section: B.

Thesis (Ph.D.)--University of Illinois at Chicago, 2021.

This item must not be sold to any third party vendors.

Falls, defined as an unexpected event in which individuals come or drop down to the ground, floor, or lower level, occur at least once annually in 29% of community-dwelling adults 65 years or older, representing a global public health concern for our aging societies (Bergen, Stevens, & Burns, 2016). On the other hand, in persons with stroke (PwS), falls correspond to a significant secondary complication with 40% of individuals experiencing a serious fall within the first year after being discharged (Persson, Hansson, & Sunnerhagen, 2011). Fall-related injuries can cause devastating outcomes such as hip fracture and traumatic head injury, requiring hospitalization and an extended stay in a long-term care facility (Scheffer, Schuurmans, Van Dijk, Van Der Hooft, & De Rooij, 2008). Additionally, after a fall, it has been reported that a fear of falling develops in 21 to 39% of those who previously had no such fear, which may restrict their activity and affect their quality of life and participation (Scheffer et al., 2008).Compensatory postural response has been described as one of the most important components of balance restoration after experience a loss of balance or a fall. In this context, it has been well described that changes in muscle strength, muscle coordination, and joint mobility along with impaired sensorimotor integration contribute to poor postural control (Mansfield, Wong, Bryce, Knorr, & Patterson, 2015), which ultimately impact the ability to rapidly and appropriately generate corrective muscle forces to recover from balance disturbances (Jacobs & Horak, 2007) (Shumway-Cook & Woollacott, 2007). Such reactions are referred to as compensatory or reactive postural responses and are defined as the ability to recover from instability through a rapid postural muscle corrective response, step, or grasp (Maki & McIlroy, 1997). Thus, compensatory postural responses play a major role in the recovery of balance from small perturbations (Maki & McIlroy, 1997) (Jensen, Brown, & Woollacott, 2001) and are considered the most important defense against large magnitude balance perturbations (Shumway-Cook & Woollacott, 2007).Trip and slip like perturbations have been described as the major contributors to falls (Kelsey, Procter-Gray, Hannan, & Li, 2012). Among to this line, it has been shown that muscle weakness, gait and balance problems, poor vision, psychoactive medications, and home hazards corresponds to modifiable risk factors that are susceptible to influence in fall risk (Tinetti, Speechley, & Ginter, 1988). In the last years, it has been reported that multimodal exercise programs are effective for fall prevention, reporting that evidence-based recommendations call for tailored progressive exercise providing a high level of challenge to balance, mobility, and lower extremity strength training (American Geriatric Society, 2001). However, recently, the recognized importance of task-specific training targeting balance recovery mechanisms and postural responses has led to interest in perturbation-based training for falls reduction among older adults (Bhatt, Espy, Yang, & Pai, 2011; Madehkhaksar et al., 2018; Patel & Bhatt, 2015). Perturbation-based training is an emerging paradigm based on the principle of task specificity, which consists of unexpected, repeated perturbation to simulate the accidental nature of falls (Gerards, McCrum, Mansfield, & Meijer, 2017). Specifically, after a trip, the body rotates forward while translating in the same direction. In contrast, after a slip, the body rotates backward while translation of the body continues in the forward direction. Biomechanical studies have suggested that perturbation-based training improves reactions to postural perturbations in the laboratory, reduces the risk of falling following simulated trips and slips, and can be retained over an extended period (Pai, Bhatt, Wang, Espy, & Pavol, 2010; Pai, Bhatt, Yang, Wang, & Kritchevsky, 2014). On the other hand, in persons with stroke (PwS) hemiparetic gait is a persistent problem that limits mobility and imposes higher energy demands for performing basic daily activities (Macko et al., 2001; Silver, Macko, Forrester, Goldberg, & Smith, 2000). Gait and balance deficits contribute to more than 70% of PwS sustaining a fall within 6 months (Forster & Young, 1995), leading to higher risks for hip and wrist fractures (Dennis, Lo, McDowall, & West, 2002; Kanis, Oden, & Johnell, 2001). Limited ankle range of motion (ROM) for the affected side is a common sequela after stroke. It is caused by weakness of dorsiflexors (e.g., tibialis anterior, extensor halluces longus, and extensor digitorum longus) and stiffness of plantarflexors (e.g., gastrocnemius, soleus, tibialis posterior, flexor halluces longus, and flexor digitorum longus) (An & Won, 2016). Ankles are located close to the body's base of support and assist in controlling balance (Karakaya, Rutbil, Akpinar, Yildirim, & Karakaya, 2015). Limited ankle ROM in most of PwS impairs balance control, becoming one of the major risk factors for falls (de Haart, Geurts, Huidekoper, Fasotti, & van Limbeek, 2004). Functional gait and symmetric gait rely on ankle ROM and well controlled contraction of dorsiflexors and plantarflexors (An & Won, 2016). Additionally, normal gait requires a minimum. (Abstract shortened by ProQuest).

ISBN: 9798534687682Subjects--Topical Terms:

588713
Physical therapy.
Subjects--Index Terms:

Reactive balance

Effect of Cognitive, Impairment-Oriented and Task-Specific Interventions on Balance and Locomotion Control.
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Additionally, after a fall, it has been reported that a fear of falling develops in 21 to 39% of those who previously had no such fear, which may restrict their activity and affect their quality of life and participation (Scheffer et al., 2008).Compensatory postural response has been described as one of the most important components of balance restoration after experience a loss of balance or a fall. In this context, it has been well described that changes in muscle strength, muscle coordination, and joint mobility along with impaired sensorimotor integration contribute to poor postural control (Mansfield, Wong, Bryce, Knorr, & Patterson, 2015), which ultimately impact the ability to rapidly and appropriately generate corrective muscle forces to recover from balance disturbances (Jacobs & Horak, 2007) (Shumway-Cook & Woollacott, 2007). Such reactions are referred to as compensatory or reactive postural responses and are defined as the ability to recover from instability through a rapid postural muscle corrective response, step, or grasp (Maki & McIlroy, 1997). Thus, compensatory postural responses play a major role in the recovery of balance from small perturbations (Maki & McIlroy, 1997) (Jensen, Brown, & Woollacott, 2001) and are considered the most important defense against large magnitude balance perturbations (Shumway-Cook & Woollacott, 2007).Trip and slip like perturbations have been described as the major contributors to falls (Kelsey, Procter-Gray, Hannan, & Li, 2012). Among to this line, it has been shown that muscle weakness, gait and balance problems, poor vision, psychoactive medications, and home hazards corresponds to modifiable risk factors that are susceptible to influence in fall risk (Tinetti, Speechley, & Ginter, 1988). In the last years, it has been reported that multimodal exercise programs are effective for fall prevention, reporting that evidence-based recommendations call for tailored progressive exercise providing a high level of challenge to balance, mobility, and lower extremity strength training (American Geriatric Society, 2001). However, recently, the recognized importance of task-specific training targeting balance recovery mechanisms and postural responses has led to interest in perturbation-based training for falls reduction among older adults (Bhatt, Espy, Yang, & Pai, 2011; Madehkhaksar et al., 2018; Patel & Bhatt, 2015). Perturbation-based training is an emerging paradigm based on the principle of task specificity, which consists of unexpected, repeated perturbation to simulate the accidental nature of falls (Gerards, McCrum, Mansfield, & Meijer, 2017). Specifically, after a trip, the body rotates forward while translating in the same direction. In contrast, after a slip, the body rotates backward while translation of the body continues in the forward direction. Biomechanical studies have suggested that perturbation-based training improves reactions to postural perturbations in the laboratory, reduces the risk of falling following simulated trips and slips, and can be retained over an extended period (Pai, Bhatt, Wang, Espy, & Pavol, 2010; Pai, Bhatt, Yang, Wang, & Kritchevsky, 2014). On the other hand, in persons with stroke (PwS) hemiparetic gait is a persistent problem that limits mobility and imposes higher energy demands for performing basic daily activities (Macko et al., 2001; Silver, Macko, Forrester, Goldberg, & Smith, 2000). Gait and balance deficits contribute to more than 70% of PwS sustaining a fall within 6 months (Forster & Young, 1995), leading to higher risks for hip and wrist fractures (Dennis, Lo, McDowall, & West, 2002; Kanis, Oden, & Johnell, 2001). Limited ankle range of motion (ROM) for the affected side is a common sequela after stroke. It is caused by weakness of dorsiflexors (e.g., tibialis anterior, extensor halluces longus, and extensor digitorum longus) and stiffness of plantarflexors (e.g., gastrocnemius, soleus, tibialis posterior, flexor halluces longus, and flexor digitorum longus) (An & Won, 2016). Ankles are located close to the body's base of support and assist in controlling balance (Karakaya, Rutbil, Akpinar, Yildirim, & Karakaya, 2015). Limited ankle ROM in most of PwS impairs balance control, becoming one of the major risk factors for falls (de Haart, Geurts, Huidekoper, Fasotti, & van Limbeek, 2004). Functional gait and symmetric gait rely on ankle ROM and well controlled contraction of dorsiflexors and plantarflexors (An & Won, 2016). Additionally, normal gait requires a minimum. (Abstract shortened by ProQuest).
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