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Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges’ g) standardized mean differences (SMD) = 0.31–0.66) were observed with the addition of noise in a Stochastic Resonance Stimulation Strategy (SRSS), in three populations (i.e., healthy young adults, older adults, and individuals with lower-limb injuries), and under different task constraints (i.e., unipedal, bipedal, and eyes open). A Textured Material Stimulation Strategy (TMSS) enhanced postural control in the most challenging condition—eyes-closed on a stable surface (SMD = 0.61), and in older adults (SMD = 0.30). The Wearable Garments Stimulation Strategy (WGSS) showed no or adverse effects (SMD = -0.68–0.05) under all task constraints and in all populations, except in individuals with lower-limb injuries (SMD = 0.20). Results of our systematic review and meta-analysis revealed that future research could consider combining two or more stimulation strategies in intervention treatments for postural regulation and balance problems, depending on individual needs.

Objective:This study compared occurrence of falls, cognitive function, and balance profiles across participants in elderly age categories, investigating associations between the 3 aspects in a sample of Singapore’s elderly population.Method:Community-dwelling elderly individuals (N = 385) were randomly recruited and grouped into “young-old (65-74 years),” “medium-old (75-84 years),” and “oldest-old (above 85 years)” groups. The Fallproof Health and Activity questionnaire, adapted Mini-Mental State Examination (MMSE), and Berg Balance Scale (BBS) tests were used to survey information related to falls, cognition, and balance profiles.Results:Findings revealed significant differences in MMSE and BBS scores across the age groups. Participants with mild cognitive impairment (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.08-3.25) and BBS score ≤40 (OR = 0.25, 95% CI = 0.14-0.46) were at the highest risk of falling.Conclusion:Community-dwelling elderly individuals with subtle cognitive impairment and BBS scores ≤40 displayed an increased risk of falling.

SummaryStudy aim: The aim of this study was to evaluate the effects of training while wearing socks differing in compression level (clinical, sub-clinical, regular) on performance of static and dynamic balancing and agility tasks in healthy, physically active people. We sought to understand whether socks with different compression properties supported postural regulation and agility task performance by enhancing somatosensory perception, unskewed by specific age range effects. Material and methods: Participants comprised 61 adults aged 18-75 years, divided into three groups (two experimental groups wearing clinical or sub-clinical level compression socks, and one control group wearing regular non-compression socks during training). An 8-week (2 × 1h per week) intervention programme was administered to train static and dynamic balance and postural control, leg strength and agility. Results: A mixed model ANOVA revealed no differences in static and dynamic balance and postural control and agility performance between clinical, sub-clinical, and control groups before and after training. All groups significantly improved their test performance, suggesting that training had some benefit on motor performance. Conclusions: These results raised interesting questions requiring further investigation to examine the effects of wearing socks (with and without different levels of compression) on motor behaviours in specific groups of elderly vs. young participants, in physically active vs. less physically active people, and in performance settings outside standardized laboratory tests to study applications in natural performance environments.

This finding indicates the positive immediate effects of garments on somatosensory system function and postural regulation in the elderly men and women, especially when standing on the unstable surface. Wearing compression KLS could be included as a viable intervention on top of other forms of balance training to reduce risk of falling in elderly people.

The provision of instructions is an important task constraint when altering movement behaviours. Using instructions as a form of task constraint could be an effective approach to help learners improve their performances. Specifically, changing running gait from a heel to forefoot strike pattern can reduce incidences of injuries. By providing different attentional instructions, external and internal focus instructions, which emphasise movement effect and movement form respectively, can be used to alter foot strike patterns in running gait. The purpose of this study was to investigate the effectiveness of external or internal focus instructions in facilitating a change from a heel strike to a forefoot strike pattern. Sixteen participants (9 males, 7 females), were randomly assigned to either an external focus condition (n=8) or an internal focus condition (n=8). Participants underwent six training sessions with their respective instructional conditions over three weeks with 10 one-minute running trials per session during the intervention phase. A 3D motion analysis system was used to determine kinematic changes between pre and post-test sessions. Both external (0.025m ± 0.006) and internal (0.027m ± 0.008) participants showed a significant change in calcaneus displacement at initial contact (IC) by post-test, which indicates the change from heel strike to forefoot strike pattern. However, cycle time and stride length were not significantly different at post-test for participants in internal and external conditions. The effectiveness of both focus instructions could be task and individual dependent.

Functional proprioceptive information is required to allow an individual to interact with the environment effectively for everyday activities such as locomotion and object manipulation. Specifically, research suggests that application of compression garments could improve proprioceptive regulation of action by enhancing sensorimotor system noise in individuals of different ages and capacities. However, limited research has been conducted with samples of elderly people thus far. This study aimed to examine acute effects of wearing knee-length socks (KLS) of various compression levels on ankle joint position sense in community-dwelling, older adults. A total of 26 participants (12 male and 14 female), aged between 65 and 84 years, were randomly recruited from local senior activity centres in Singapore. A repeated-measures design was used to determine effects on joint position awareness of three different treatments–wearing clinical compression socks (20–30 mmHg); wearing non-clinical compression socks (< 20 mmHg); wearing normal socks, and one control condition (barefoot). Participants were required to use the dominant foot to indicate 8 levels of steepness (2.5°, 5°, 7.5°, 10°, 12.5°, 15°, 17.5°, and 20°), while standing on a modified slope box, in a plantar flexion position. Findings showed that wearing clinical compression KLS significantly reduced the mean absolute errors compared to the barefoot condition. However, there were no significant differences observed between other KLS and barefoot conditions. Among the KLS of various compression levels, results suggested that only wearing clinical compression KLS (20–30 mmHg) improved the precision of estimation of ankle joint plantar flexion movement, by reducing absolute performance errors in elderly people. It is concluded that wearing clinical compression KLS could potentially provide an affordable strategy to ameliorate negative effects of ageing on the proprioception system to enhance balance and postural control in community-dwelling individuals.

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