The ability to control balance during activities of daily living (ADL) is impaired in older adults as a result of deterioration in the sensory systems (i.e., vestibular, visual, somatosensory), the cognitive system (central nervous system), and the musculoskeletal system. Consequently, many older adults face a risk of falling during their ADL. In most cases, falls and related injuries impair the quality of life and result in physical limitations, anxiety, loss of confidence, and fear of falling. Among a variety of fall prevention interventions, adapted physical activity programs have been suggested for improving balance control during ADL. These programs challenge the sensory, cognitive, and musculoskeletal systems while addressing balance constraints such as orientation in space, changes in direction, and the speed or height of the center of mass during static and dynamic situations resembling ADL. The above-mentioned elements can be dealt with through a combination of balance and coordination exercises that challenge the postural control systems in multiple dimensions—including vertical and horizontal changes of the center of mass, standing on unstable surfaces with a reduced base of support, and changing body directions. Consequently, such exercises require environmental information-processing. The combination of dual-task, function-oriented challenges while controlling balance stimulates the sensory and neuromuscular control mechanisms. Among older adults, these programs have been found to improve static and dynamic stability, as well as a number of aspects in the quality of life. Recently, they have also been found to improve cognitive functions such as memory and spatial cognition.

Background and Purpose. Reports have described the contribution of motor imagery (MI) practice for improving upper-extremity functions in patients with hemiparesis following stroke. The purpose of this case report is to describe the use of MI practice to attempt to improve walking in an individual with hemiparesis. Case Description. A 69-year-old man with left hemiparesis received MI gait practice for 6 weeks. Intervention focused on task-oriented gait and on impairments of the affected lower limb. Preintervention, midterm, postintervention, and follow-up measurements of temporal-distance stride parameters and sagittal kinematics of the knee joint were taken. Main Outcomes. At 6 weeks postintervention, the patient had a 23% increase in gait speed and a 13% reduction in double-support time. An increase in range of motion of the knees also was observed. No changes in gait symmetry were noted. Discussion. The outcomes suggest that MI may be useful for the enhancement of walking ability in patients following stroke. Because improvement was mainly in temporal-distance gait variables and knee movement, imagery practice probably should focus on its specific impairments during gait in order to affect the performance of the paretic lower extremity.

Balance ability among the elderly is a key component in the activities of daily living and is divided into two types: static and dynamic. For clinicians who wish to assess the risk of falling among their elderly patients, it is unclear if more than one type of balance test can be used to measure their balance impairment. In this study, we examined the association between static balance measures and two dynamic balance field tests. One hundred and twelve community-dwelling older adults (mean age 74.6) participated in the study. They underwent the Tetrax static postural assessment and then performed the Timed Up and Go (TUG) and the Functional Reach (FR) Test as dynamic balance tests. In general, low-moderate correlations were found between the two types of balance tests. For women, age and static balance parameters explained 28.1–40.4% of the variance of TUG scores and 14.6–24% of the variance of FR scores. For men, age and static balance parameters explained 9.5–31.2% of the variance of TUG scores and 23.9–41.7% of the variance of FR scores. Based on our findings, it is suggested that a combination of both static and dynamic tests be used for assessing postural balance ability.

The aim of this series of pilot case studies was to examine the feasibility of enhancing the walking of individuals with post-stroke hemiparesis through the imagery practice of gait activities at home. Four persons with chronic hemiparesis received imagery gait practice, 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task-specific gait training. Pre-intervention, mid-term, post-intervention and follow-up evaluations were performed. At 6 weeks from the beginning of treatment, the participants increased walking speed, stride length, cadence and single-support time on the affected lower limb, while decreasing double-support time. The findings appear to justify the institution of a larger-scale study in order to better delineate the contribution of motor imagery practice to gait performance in individuals with post-stroke hemiparesis.

Evidence from recent studies showed that acute aerobic exercise results in improvements in different cognitive functions. The goal of this study was to assess the influence of acute bouts of aerobic versus resistance exercise on attention and executive function in adults. Thirty-nine physically active adults (age = 52±8 yr) served as participants. Each participant visited the laboratory four times: on the first visit participants performed a cognitive test (NeuroTrax) followed by an aerobic fitness assessment, as well as maximal strength test composed of six exercises. During visits 2–4, participants completed the cognitive test before and after the experimental condition, which consisted of either 25 min of aerobic exercise or resistance exercise, or watching a recorded interview show in a seated position (control condition). Findings indicated significantly higher changes in scores of attention after acute aerobic exercise (mean change 3.46, 95% CI -0.32, 7.27) than following the control condition (mean change -0.64, 95% CI -2.23, 0.96). The changes following resistance exercise (mean change -0.67, 95% CI -4.47, 3.13) were not significantly different from the changes following the control condition. Executive function scores showed a marginally significant improvement following acute aerobic (mean change 4.06, 95% CI 1.68, 6.44) and resistance exercise (mean change 3.69, 95% CI 0.78, 6.60), but not after control (mean change 0.91, 95% CI -1.21, 3.02). We suggest that adults should consider augmenting both modalities into their training routines, which may improve their cognition in addition to providing other physical benefits.