Falling is one of the most common causes of hip fracture and death in older adults. A comparison of the biomechanics of the gait in fallers and non-fallers older adults, especially joint coordination and coordination variability, enables the understanding of mechanisms that underpin falling. Therefore, we compared lower-extremity intra-joint coordination and its variability between fallers and non-fallers older adults during gait. A total of 26 older adults, comprising 13 fallers, took part in this study. The participants walked barefoot at a self-selected speed on a 10-m walkway. Gait kinematics in the dominant leg during 10 cycles were captured with 10 motion tracking cameras at a sampling rate of 100 Hz. Spatiotemporal gait parameters, namely, cadence, walking speed, double support time, stride time, width, and length, as well as intra-joint coordination and coordination variability in the sagittal plane were compared between the two groups. Results showed that fallers walked with significant lower cadence, walking speed, and stride length but greater double support and stride time than non-fallers. Significant differences in the ankle-to-knee, knee-to-hip, and ankle-to-hip coordination patterns between fallers and non-fallers and less coordination variability in fallers compared to non-fallers in some instants of the gait cycles were observed. The differences in spatiotemporal gait parameters in fallers compared to non-fallers may indicate an adaptation resulting from decreased efficiency to decrease the risk of falling. Moreover, the differences in segment coordination and its variability may indicate an inconsistency in neuromuscular control. It may also indicate reduced ability to control the motion of the leg in preparation for foot contact with the ground and the knee and ankle motions during loading response. Finally, such differences may show less control in generating power during the push-off phase in fallers.

Context: Individuals with chronic ankle instability (CAI) demonstrate reduced spinal reflex modulation and corticospinal excitability of the soleus, which may contribute to decreased balance performance. Objective: To determine the effects of a single session of balance training on Spinal-reflexive excitability modulation and corticospinal excitability in those with CAI. Design: Randomized controlled trials. Setting: Research laboratory. Participants: Thirty participants with CAI were randomly assigned to the balance training (BAL) or control (CON) group. Main Outcome Measures: Modulation of soleus spinal-reflexive excitability was measured by calculating relative change in normalized Hoffmann reflexes (ratio of the H-reflex to the M-wave) from prone to single-leg standing. Corticospinal excitability was assessed during single-leg stance using transcranial magnetic stimulation, outcomes of which included active motor threshold (AMT), motor evoked potential, and cortical silent period (CSP). Balance performance was measured with center of pressure velocity in anterior to posterior and medial to lateral directions. Separate 2 × 2 repeated-measures analyses of variance were employed to determine the effect of group (BAL and CON) and time (baseline and posttraining) on each dependent variable. Results: There were significant group by time interactions in the modulation of soleus spinal-reflexive excitability (F_1,27 = 4.763, P = .04); CSP at 100% AMT (F_1,27 = 4.727, P = .04); and CSP at 120% AMT (F_1,27 = 16.057, P < .01). A large effect size suggests increased modulation of spinal-reflexive excitability (d = 0.81 [0.03 to 1.54]) of the soleus in BAL compared with CON at posttest, while CSP at 100% (d = 0.95 [0.17 to 1.70]) and 120% AMT (d = 1.10 [0.29 to 1.84]) was reduced in BAL when compared with CON at posttest. Conclusion: After a single session of balance training, individuals with CAI initiated increases in spinal reflex modulation and corticospinal excitability of the soleus. Thus, individuals with CAI who undergo balance training exhibit positive neural adaptations that are linked to improvements in balance performance.

There is evidence in the literature to suggest that low back pain may change spine–pelvis coordination during activities of daily living. This study aimed to compare the variability of the spine–pelvis coordination during sit-to-stand in people with and without LBP. Ten healthy individuals with a history of LBP and ten individuals without history of LBP participated in this study. Three-dimensional kinematic data of the upper trunk (UT), lower trunk (LT), lower back (LB), and pelvis segments during sit-to-stand and stand-to-sit were recorded using a multi-segmental spine and pelvis models using a motion capture system. The coordination patterns and the variability of the adjacent segments (UT, LT, LB, and pelvis) were calculated using the modified vector coding method that was implemented through a custom MATLAB code. An independent sample t-test was utilized to assess the differences in the coordination pattern, and a statistical parametric mapping method was used to quantify the differences in coordination variability between the two groups. The results indicate that there are some differences in coordination patterns between groups during sit-to-stand and stand-to-sit. However, a significant difference in coordination variability was only observed during sit-to-stand. The results showed that LBP can alter the kinematics coordination even in the upper (pain-free) parts of the spine during sit-to-stand by changing the coordination between UT and LT in a way that can lead to an increase in the loading on these segments. Additionally, people with LBP showed more coordination variability during sit-to-stand, which can be associated with a coordination strategy that facilitates an optimal and possibly pain-free coordination pattern.

Introduction: Falling is a serious concern among elderly which have made a lot of discussions between gerontologists and physical therapists. Falling is common, dangerous, and costly among the elderly population. Fear of falling again among elderly faller leads to decrease self-confidence, loss of life quality, and inability. The purpose of this study was to find the effects of core stability exercise on balance and functional mobility among elderly with a history of falling. Materials and Methods: Thirty elderly people with a history of falling were randomly divided into control (n = 15) and experimental (n = 15) groups. The experimental group performed a 40-minute core stability exercise for eight weeks and three sessions per week. Before and after eight weeks of exercise program, static balance with open and closed eyes, Timed Up and Go (TUG) test for dynamic balance, and 10-meter walking were taken in both groups. The control group only have the daily activities. The two-way ANOVA test was used to compare the mean differences between groups. Results: Central stability training had a significant effect on static balance with open and closed eye, TUG, and 10-meter walking (P = 0.001). The control group did not show a significant effect on the factors of static balance with open eyes, static balance of closed eyes, TUG, and 10-meter walking. Following training period, the experimental group showed significantly better status in all variables compared to control group (0.91 ≤ η² ≤ 0.94, P = 0.001). Conclusion: It seems that strengthening the muscles in the central area of the body leads to maintaining balance in the elderly during daily activities. Since independency is very important in people with a history of falling, it can improve their independence and active participation by performing these exercises as simple, low-cost, and appropriate activities for home exercise.