BJMB
Brazilian Journal of Motor Behavior
Special issue:
“Control of Gait and Posture: a tribute to Professor Lilian T. B.
Gobbi”
!
Kimura, Dascal
2023
VOL.17
N.4
164 of 172
Acute effect of boing balance board on postural control in older adults
ROBSON Y. KIMURA
1
| JULIANA B. DASCAL
2
1
Physical Education School, Center of Physical Education and Sport, State University of Londrina, PR, Brasil
2
Physical Education Department, Center of Physical Education and Sport, State University of Londrina, PR, Brasil
Correspondence to:!Juliana Bayeux Dascal. Center of Physical Education and Sport, State University of Londrina – Rodovia Celso Garcia Cid, PR445, km380,
Campus Universitário, CEP: 86057-970 – Londrina – Paraná.
email: jbdascal@uel.br
https://doi.org/10.20338/bjmb.v17i4.356
HIGHLIGHTS
• Acute exercise training organized in blocks improved
postural control in elderly individuals
• Dot and root mean square demonstrated improvements
as a result of the acute motor intervention
• Intervention utilizing a balance apparatus proved
effective in enhancing postural control performance
• The Boing session had an acute influence on postural
control.
ABBREVIATIONS
ANOVA Analysis of variance
AP Antero-posterior
CG Control Group
COP Center of pressure
DOT Total displacement
EMG Electromyography
FT Feet together
FA Feet apart
IG Intervention Group
ML Medio-lateral
RMS Root mean square
ST Semi-tandem position
PUBLICATION DATA
Received 31 03 2023
Accepted 08 06 2023
Published 20 06 2023
BACKGROUND: Balance training has demonstrated a positive effect on older adults.
However, the specific types and durations of interventions needed to effectively address
postural deficits in aging individuals remain important areas of study. It is crucial to impact
their motor performance quickly to bring about changes in postural control.
AIM: This study aims to investigate the effect of an acute motor intervention using a balance
board called the "Boing" on postural control in elderly individuals.
METHOD: Twenty senior women between the ages of 60 and 78 were divided into two
groups: Intervention Group (IG, n = 10) and Control Group (CG, n = 10). Both groups
performed a pretest postural task on a force plate, including conditions with feet together, feet
apart, and semi-tandem stance. Participants in the IG then underwent the motor intervention
on the Boing balance board, which disturbed balance in the antero-posterior and medio-lateral
directions, similar to the pretest conditions. The intervention consisted of 6 blocks of 10 trials,
organized randomly, and lasted for 20 minutes with 1 minute of rest between each block. After
the intervention, a posttest was conducted for both groups using the same procedure as the
pretest. One week later, a retention test was performed. Analysis of center of pressure (COP)
was conducted, examining total displacement (DOT) and root mean square (RMS) in the
medio-lateral and antero-posterior directions.
RESULTS: A two-way repeated measures ANOVA revealed that during the posttest phase,
there were significant differences between the groups in DOT and ML RMS specifically in the
semi-tandem condition. The IG group exhibited lower values.
INTERPRETATION: The Boing balance board shows promise as a useful apparatus for
improving postural control through acute motor intervention. Further studies comparing old
adults' postural control with existing research are suggested to expand our understanding in
this area.
KEYWORDS: Old adults| Motor control | Balance | Exercise
INTRODUCTION
Physical exercise has been shown to promote cognitive benefits
1
as well as motor benefits
2
for the elderly. However, the type,
frequency, and delivery method of motor stimulus are still questions that need to be addressed, especially in determining which approach
is more effective in preserving functions during old age. Various types of motor interventions
3–6
could be employed to promote motor
functions that typically decline with aging
7,8,9
. These interventions aim to preserve the most compromised functions while enabling the
performance of other, sometimes more challenging, motor activities.
Balance is one of the functions most affected by aging, and falls among older adults are a common cause of morbidity
1
.
Delayed muscle activity is a common occurrence among the elderly, which can result in a greater displacement of the center of mass
following a perturbation. However, exercise has the potential to impact postural control in a positive way. It can improve anticipatory
postural adjustments, enhance compensatory mechanisms, and activate muscles
10
.
Interventions targeting balance improvement, such as task-specific training, have demonstrated positive effects in older adults
11,12
. Various manipulations, including oscillating boards
3,11,13
, slacklines
12
, body vibration exercises
14
, digital games
15
, Pilates
16,
treadmill training
2
, and general training
10
, have yielded significant findings in reducing balance deficits associated with aging. In a study
BJMB! ! ! ! ! ! ! ! !
Brazilian(Journal(of(Motor(Behavior(
(
Kimura, Dascal
2023
VOL.17
N.4
165 of 172
Special issue:
“Control of Gait and Posture: a tribute to Professor Lilian T. B. Gobbi”
by Egger et al (2021)
3
, it was observed that balance tasks learned in a single session showed greater interference when subsequently
tested with different balance tasks and non-postural tasks. This indicates that similar demands for controlling the center of gravity are
crucial for inducing interference in balance tasks. However, while specific training may lead to specific improvements, other studies
involving older adults have shown opposite results. A more generalized approach to training may ensure broader benefits, encompassing
other functions affected by aging, including motor, psychological, and cognitive functions
17
.
Furthermore, the use of different apparatus
3,11,13
for balance training is still an area requiring further understanding, as it may
accelerate postural control improvement for older adults who need prompt improvement. In a training intervention involving young adults,
a custom-made tilt board was used, which introduced perturbations in both the antero-posterior and medio-lateral directions
11
. The study
11
measured the time at equilibrium and platform displacement and demonstrated better performance in the post-test compared to the
pre-test in young adults. Another kind of stability board was employed
13
, which showed improvements in balance during and after the
practice sessions for children, adolescents, and young adults.
Another type of exercise, such as slackline, requires the ability to balance on a narrow nylon ribbon, maintaining an upright
posture on a small and unstable base of support. This activity can serve as an alternative motor activity to enhance postural control and
muscle strength
12
. Slackline has been studied in various populations, including older adults, using measures such as COP displacements
and standing time. Although this exercise does not involve a specific board, it can be considered a form of apparatus that stimulates
balance, particularly because it is performed on an unstable support. The improvements observed in slackline performance may have
relevance to postural control, as it increases the demand for sensorial integration, neuromuscular control, and coordination of balance
adjustments.
Additionally, the question of short-term or acute interventions
9,18,19
versus long-term interventions needs to be explored.
Identifying interventions that can quickly enhance motor functions, particularly balance, which is crucial for daily activities, could yield
valuable knowledge for advanced motor training in older adults.
Considering all the aforementioned aspects, particularly the improvement of balance in older adults after interventions involving
specific apparatus and conducted acutely, further research is warranted in this field. The present study aims to investigate the postural
control of elderly individuals before and after an acute motor intervention using a balance board called "Boing." We expect that older
adults engaged in the motor intervention will demonstrate better postural control in the variables measured in this study (COP total
displacement and root mean square) compared to those who did not participate in the intervention.
METHODS
Participants
The study included 20 female participants residing in the city of Londrina (PR) with ages ranging from 60 to 78 years. Out of the
total sample, 10 participants were assigned to the Intervention Group (IG, n=10) with a mean age of 65.3 years (SD=3.68), mean height
of 1.53 meters (SD=0.05), and mean BMI of 22.93 (SD=3.55). The remaining 10 participants formed the Control Group (CG, n=10) with a
mean age of 71.8 years (SD=4.29), mean height of 1.51 meters (SD=0.025), and mean BMI of 21.01 (SD=1.16). All participants were
female and engaged in dance activities at the Seicho-no-ie church, attending classes once a week for an average duration of 2 hours per
class. The classes were led by a physiotherapist. It is worth noting that there were no male participants involved in these dance activities.
No participants were lost during the evaluation phases.
The inclusion criteria were as follows: a) being female; b) being classified as physically independent (elderly level three in the
functional status classification), according to Spirduso (2005)
20
; c) not having any musculoskeletal limitations that would prevent
independent standing; d) being able to perform the proposed test protocols; and e) participating in both intervention days. This research
received approval from the Research Ethics Committee at the State University of Londrina under opinion number 3.531.503.
Postural control assessment
The participants underwent testing using a force platform (AMTI, AccuSway Portable Platform, USA). The tests were conducted
under three experimental conditions, which were randomized as follows: condition 1 involved standing with feet together (FT, joined by
the medial part) in the center of the platform; condition 2 required standing with feet apart (FA, at waist-width distance); condition 3
involved standing with feet in a semi-tandem position (ST, feet together, joined at the medial part, with one foot positioned in front of the
other) in the center of the platform. Each participant performed two trials
19,21–23
for each condition, with each trial lasting 36 seconds. The
same sequence of conditions was performed on all test days.
Intervention with the Boing balance board