Directional Differences in Passive Balance Abilities among Middle-aged and Older Adults Revealed by a New Support-base Variation Device

Yoshinori Nagasawa^1, and Shinichi Demura²

¹Department of Health and Sports Science, Kyoto Pharmaceutical University, Kyoto, Japan

²College of Human and Social Sciences, Kanazawa University, Kanazawa, Japan

Cite this paper:
Yoshinori Nagasawa and Shinichi Demura. Directional Differences in Passive Balance Abilities among Middle-aged and Older Adults Revealed by a New Support-base Variation Device. American Journal of Sports Science and Medicine. 2025; 13(1):8-15. doi: 10.12691/ajssm-13-1-2

Abstract

Passive balance ability (PBA) maintains postural stability on unstable ground. The efficacy of this compensatory mechanism appears to differ among individuals and may also differ between directions (back–forth vs. left–right) and sexes, but variations in PBA during ground instability have not been assessed comprehensively under controlled laboratory conditions. The current study examined both the reproducibility and inter-relations among center of gravity sway (COGS) variables as measured on a new support-base variation device fluctuating downward slightly in the back–forth or left–right directions, and further if these variables differ between sexes and directions. Thirty-one middle-aged and older Japanese individuals participated in this study, including 17 males (mean age ± standard deviation, 61.8 ± 8.3 years) and 14 females (56.9 ± 9.6 years). Participants were instructed to maintain a stable standing posture for 1 min on the support-base variation device without the edges contacting an underlying sensor plate while the device measured COGS variables. Center of gravity variables were measured during two, one-minute trials separated by a one-min intertrial interval following one practice trial in either the back–forth or left–right device variation condition. The x-axis and y-axis trajectory lengths, total trajectory length, outer peripheral area, and rectangular area were selected as COGS variables. There were no significant differences in COGS variables between trials, but intraclass correlation coefficients (ICCs) were generally higher for the left–right device condition compared to the back–forth device condition (≥0.7 vs. <0.7) with the exception of the y-axis trajectory length during back–forth device variation (also >0.7). A two-way analysis of variance with main factors, sex and direction, revealed no significant direction × sex interaction but a significant main effect of direction on COGS distance variables. Post-hoc tests also revealed that in both sexes, the x-axis and total trajectory lengths were higher during left–right device variation than back–forth device variation, whereas the y-axis trajectory length was higher during back–forth device variation than left–right device variation. There were moderate to strong significant correlations among almost all COGS variables during back–forth device variation (r values ranging from 0.50 to 0.99). The x-axis trajectory during back–forth device variation also correlated moderately with COGS variables measured during left–right device variation (r values from 0.41 to 0.73), except for rectangular and peripheral areas. In conclusion, the COGS variables during left–right ground variation and the y-axis trajectory length during back–forth ground variation can be measured with high reliability. The strong associations among COGS variables for the same direction but weaker associations between back–forth and left–right COGS variables suggest direction differences in PBA. In contrast, no significant sex differences in PBA were observed.

Keywords:
center of gravity sway reproducibility inter-relations back–forth or left–right directions

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References:

[1]	Gusi, N., Adsuar, J. C., Corzo, H., del Pozo-Cruz, B., Olivares, P. R., and Parraca, J. A. (2012) Balance training reduces fear of falling and improves dynamic balance and isometric strength in institutionalized older people: a randomized trial. Journal of Physiotherapy, 58(2), 97-104.
[2]	Kuzuya, M. (2015) The Cutting-edge of Medicine; Sarcopenia and frailty in super-aged society. The Journal of the Japanese Society of Internal Medicine, 104(12), 2602-2607.
[3]	Morley, J. E. (2016) Frailty and sarcopenia in elderly. Springer-Verlag Wien, s439-s445.
[4]	Kasahara, M., Yamasaki, H., Aoki, U., Yokoyama, H., Omori, Y., and Hiraki, K. (2001) Relationship between one leg standing time and knee extension strength in elderly patients. The Japanese Journal of Physical Fitness and Sports Medicine, 50(3), 369-374.
[5]	Murata, S., Kai, Y., Mizota, K., Yamasaki, S., Yumioka, M., Otao, H., and Takeda, I. (2006) Relationship between one-leg standing duration with vision and physical function among community dwelling older adults. Rigakuryoho Kagaku, 21(4), 437-440.
[6]	Murata, S. and Tsuda, A. (2006) A prospective study of the relationship between physical and cognitive factors and falls in the elderly disabled at home. Journal of the Japanese Physical Therapy Association, 33(3), 97-104.
[7]	Takakura, S., Ohgi, S., and Akiyama, T. (2004) Standing postural control test using the elderly balance board type N and predicting falls. Journal of the Japanese Physical Therapy Association, 31(6), 364-368.
[8]	Murata, S., Tsuda, A., Inatani, F., and Tanaka Y. (2005) Physical and cognitive factors associated with falls among the elderly with disability at home. Journal of the Japanese Physical Therapy Association, 32(2), 88-95.
[9]	Hirase, T., Inokuchi, S., Shiozuka, J., Nakahara, K., and Matsusaka, N. (2008) Relationship between balance ability and lower extremity muscular strength in the elderly: comparison by gender, age, and Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. Rigakuryoho Kagaku, 23(5), 641-646.
[10]	Uchida, Y., Demura, S., and Hirai, H. (2018) Influence of hand help pressure on body sway and leg muscle activity during one-leg stance. Advances in Research, 17(5), 1-9.
[11]	Uchida, Y. and Demura, S. (2016) Body sway and muscle activity during assisted one-and two-leg stances in the elderly, Advances in Research, 7(3), 1-9.
[12]	Shibata, Y., Okada, E., Nakamura, M., and Ojima, T. (2021) Effects of locomotion training in community-dwelling older individuals attending clubs. Nihon Koshu Eisei Zasshi, 68(3), 180-185.
[13]	The Japanese Orthopedic Association (2021) The brochure of locomotion in Japan, 2013. https://www.med.or.jp/dl-med/ doctor/ ssi/sports25/sports25_k14.pdf (2021/9/11).
[14]	Kitabayashi, T., Shinichi, D., Yamaji, S., Nakada, M., Noda, M., and Imaoka, K. (2002) Gender differences and relationships between physical parameters on evaluating the center of foot pressure in static standing posture. Equilibrium Research, 61(1), 16-27.
[15]	Hayashi, F., Asai, Y., Morimoto, H., Maruyama, T., Watanabe, M., Lohman E. B., Johnson E. G., and Kashiwa, N. (2012) The postural control in different conditions among the healthy elderly person. Journal of health sciences, Nihon Fukushi University, 15, 11-16.
[16]	Suzuki, Y., Nakata, Y., Kato, H., Tanabe, Y., Iwabuchi, S., and Ishikawa, K. (2015) Association between age and dynamic balance capability assessed by use of force plates. The Japanese Journal of Physical Fitness and Sports Medicine, 64(4), 419-425.
[17]	Morita, M., Urabe, Y., Takeuchi, T., and Maeda, N. (2018) Effects on ankle muscle activity of the tilt direction of a balance board. Rigakuryoho Kagaku, 33(3), 395-400.
[18]	Oyama, Y., Murayama, T., and Ohta, T. (2019) Influence of standing posture on a stable surface affecting center-of-pressure sway and stability in standing posture on an unstable surface in middle-aged women. Japan Journal of Test and Evaluation of Physical Education and Sports, 18, 59-69.
[19]	Ministry of Health, Labor and Welfare (2019) II. Results of physical status survey, The National Health and Nutrition Survey in Japan, 2019, 115-168. https:// www.mhlw.go.jp/ stf/seisakunitsuite/ bunya/kenkou_iryou/ kenkou/eiyou/r1-houkoku_00002.html.
[20]	Demura S., Kitabayashi T., Noda M., Yamada T., and Imaoka K. (2005) Study of individual sway patterns based on Four body sway factors. Equilibrium Research, 64, 143-150.
[21]	Matsuda S., Demura S., and Demura T. (2010) Examining differences between center of pressure sway in one-legged and two-legged stances for soccer players and typical adults. Perceptual & Motor Skills, 110, 751-760.
[22]	Kitabayashi T., Demura S., and Aoki H. (2018) Examination of effective body sway parameters for healthy elderly. American Journal of Sports Science and Medicine, 6, 50-55.
[23]	Russo L., D'Eramo U., Padulo J., Foti C., Schiffer R., and Scoppa F. (2015) Day-time effect on postural stability in young sportsmen. Muscles Ligaments and Tendons Journal, 5, 38-42.
[24]	Cohen, J. (1988) Statistical power analysis in the behavioral sciences, 2nd Edition, Academic Press.
[25]	Jackson, A., Jackson A. S., and Bell, J. (1980) A comparison of alpha and the intraclass reliability coefficients. Research Quarterly for Exercise and Sport, 51(3), 568-571.
[26]	Tabachnick, B. G. and Fidell, L. S. (2006) Using multivariate statistics, 5th Edition, Pearson/Allyn & Bacon.
[27]	Demura, S., Yamaji, S., Noda, M., Kitabayashi, T., and Nagasawa, Y. (2001) Examination of parameters evaluating the center of foot pressure in static standing posture from the viewpoints of trial-to-trial reliability and interrelationships among parameters. Equilibrium Research, 60 (1), 44-55.
[28]	Aoki, H., Demura, S., Yamaji, S., Nagasawa, Y., Nakatani, T., and Nadamoto, M. (2023) Sex and age-level differences of center of pressure sway variables and their inter-relations during static standing posture in healthy people. Journal of Education Technology in Health Sciences, 68(4), 247-257.
[29]	Wiśniowska-Szurlej, A., Ćwirlej-Sozańska, A. B., Wilmowska-Pietruszyńska, A., Wołoszyn, N., and Sozański, B. (2019) Gender differences in postural stability in elderly people under institutional care. Acta of Bioengineering and Biomechanics, 21(2), 45-53.
[30]	Usuda S., Yamahata R., and Endo F. (1999) The relationship of balance to muscle strength and gait speed in community-dwelling elderly women. Rigakuryoho Kagaku, 14, 33-36.
[31]	Mano Y. (1999) Falls of the elderly and their countermeasures. Ishiyaku Publication, pp.13.
[32]	Takai I., Miyano M., Nakai T., Yamaguchi T., Yoshimura T., Shirai H., Murakami M., Inoue K., Tsuzaki R., and Shutou H. (2001) Postural change and posture control with aging. Japanese Journal of Physiological Anthropology, 6, 11-16.
[33]	Gatev, P., Thomas, S., Kepple, T., and Hallett, M. (1999) Feedforward ankle strategy of balance during quiet stance in adults. The Journal of Physiology, 514(3), 915-928.
[34]	Loram, I. D., Kelly, S. M., and Lakie, M. (2001) Human balancing of an inverted pendulum: is sway size controlled by ankle impedance? The Journal of Physiology, 532(3), 879-891.
[35]	Winter, D. A., Patla, A. E., Ishac, M., and Gage, W. H. (2003) Motor mechanisms of balance during quiet standing. Journal of Electromyography and Kinesiology, 13(1), 49-56.