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BackgroundIn older adults, impaired control of standing balance in the lateral direction is associated with the increased risk of falling. Assessing the factors that contribute to impaired standing balance control may identify areas to address to reduce falls risk.AimTo investigate the contributions of physiological factors to standing lateral balance control.MethodsTwo hundred twenty-two participants from the Pittsburgh site of the Health, Aging and Body Composition Study had lateral balance control assessed using a clinical sensory integration balance test (standing on level and foam surface with eyes open and closed) and a lateral center of pressure tracking test using visual feedback. The center of pressure was recorded from a force platform. Multiple linear regression models examined contributors of lateral control of balance performance, including concurrently measured tests of lower extremity sensation, knee extensor strength, executive function, and clinical balance tests. Models were adjusted for age, body mass index, and sex.ResultsLarger lateral sway during the sensory integration test performed on foam was associated with longer repeated chair stands time. During the lateral center of pressure tracking task, the error in tracking increased at higher frequencies; greater error was associated with worse executive function. The relationship between sway performance and physical and cognitive function differed between women and men.DiscussionContributors to control of lateral balance were task-dependent. Lateral standing performance on an unstable surface may be more dependent upon general lower extremity strength, whereas visual tracking performance may be more dependent upon cognitive factors.ConclusionsLateral balance control in ambulatory older adults is associated with deficits in strength and executive function.

Context: Research in the area of dual-task paradigms to assess sport-related concussion (SRC) status is growing, but additional assessment of this paradigm in adolescents is warranted. Design: This case-control study compared 49 adolescent athletes aged 12–20 years with diagnosed SRC to 49 age- and sex-matched controls on visual–spatial discrimination and perceptual inhibition (PIT) reaction time tasks performed while balancing on floor/foam pad conditions. Methods: The SRC group completed measures at a single time point between 1 and 10 days postinjury. Primary outcomes were dual-task reaction time, accuracy, and sway. General linear models evaluated differences between groups (P <.05). Logistic regression identified predictors of concussion from outcomes. Area under the curve evaluated discriminative ability of identifying SRC. Results: Results supported significantly higher anterior–posterior (AP) sway values in concussed participants for visual–spatial discrimination and PIT when balancing on the floor (P =.03) and foam pad (P =.03), as well as mediolateral sway values on the floor during visual–spatial discrimination (P =.01). Logistic regression analysis (R2 =.15; P =.001) of all dual-task outcomes identified AP postural sway during the PIT foam dual task as the only significant predictor of concussed status (ß = −2.4; P =.004). Total symptoms (area under the curve = 0.87; P <.001) and AP postural sway on foam (area under the curve = 0.70; P =.001) differentiated concussed from controls. Conclusion: The AP postural sway on foam during a postural stability/PIT dual task can identify concussion in adolescents between 1 and 10 days from injury. [ABSTRACT FROM AUTHOR]

Background: The Dynamic Exertion Test (EXiT) was developed to inform return-to-play (RTP) decision-making following clinical recovery from sport-related concussion (SRC). The purpose of the current study was to document intrarater and test-retest reliability and minimal detectable change (MDC) scores for physiological [heart rate (HR) and blood pressure], performance (change-of-direction task completion time and errors), and clinical outcomes (endorsed symptoms, perceived exertion) of EXiT, and interrater reliability of performance outcomes. Hypothesis: Healthy athletes would exhibit stable physiological responses to the EXiT across visits, demonstrate consistent change-of-direction task completion time between consecutive trials at each visit, and the fastest time (of 2 trials) across visits, and endorse equivocal symptoms and effort across visits. Study Design: Cross-sectional, test-retest. Level of Evidence: Level 3. Methods: Seventy-nine (female: 34 [43%], 19.6 ± 5.0 years) athletes completed the EXiT at 2 study visits (8.7 ± 4.7 days between visits). Two-way, mixed, intraclass correlation coefficients (ICCs) were used to evaluate intrarater and test-retest reliability. Cronbach's alpha was used to document the internal consistency of symptoms at each visit, and MDC scores were calculated on the physiological, performance, and clinical outcomes. Results: Measured and percentage of age-estimated maximum HR were reliable following EXiT (ICC = 0.579-0.618). Change-of-direction task completion time (MDC range = 0.75-8.70 s) had good-to-excellent test-retest (ICC = 0.703-0.948) and interrater (ICC = 0.932-0.965) reliability. Symptoms had a high internal consistency at visits 1 (α = 0.894) and 2 (α = 0.805) and were reliable across visits (ICC = 0.588). Conclusion: The current investigation established test-retest reliability in addition to MDC scores of an objective dynamic exercise assessment among healthy adolescent and adult athletes. The EXiT may be an objective approach to inform RTP decision-making following SRC recovery. Clinical Relevance: The EXiT is a clinically feasible exertion-based assessment that can be readily administered in a variety of outpatient clinical settings. [ABSTRACT FROM AUTHOR]

The reliability of balance exercises performance in experimental and clinical studies has typically been confined to a small set of exercises. To advance the field of assessing balance exercise intensity, establishing the reliability of performance during a more diverse array of exercises should be undertaken. The purpose of this study was to investigate the test–retest reliability of postural sway produced during performance of 24 different balance tasks and to evaluate the reliability of different measures of postural sway. Sixty-two healthy subjects between the ages of 18 and 85 years (50% female and mean age = 55 [20] y) participated. Subjects were tested during 2 visits 1 week apart and performed 2 sets of the 24 randomized standing tasks per visit. The tasks consisted of combinations of the following factors: surface (firm and foam); vision (eyes open and eyes closed); stance (feet apart and semitandem); and head movement (no movement, yaw, and pitch). Angular position displacement, angular velocity, and linear acceleration postural sway in the pitch and roll planes were recorded by an inertial measurement unit. The postural sway measures demonstrated at fair to good test–retest reliability with few exceptions, and angular velocity measures demonstrated the greatest reliability. The between-visit reliability of 2 averaged trials was excellent for most tasks. The study indicates that the performance of most balance tasks used as part of balance rehabilitation is reliable and that quantitative assessment could be used to document change. [ABSTRACT FROM AUTHOR]