The Effects of Gender, and Functional and Cognitive Training on Postural Control in Middle-Aged People

Document Type : Original Articles

Authors
Mandana Sangari 1
Seyed Mohammadkazem Vaez-Mousavi 2
Mahdi Namazizadeh 3
1 PhD Student, Department of Physical Education and Sport Science, Central Tehran Branch, Islamic Azad University, Tehran, Iran
2 Professor, Department of Physical Education and Sport Sciences, Imam Hossein University, Tehran, Iran
3 Professor, Department of Physical Education and Sport Science, School of Physical Education and Sport Science, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
10.22122/jrrs.v13i5.2976
Abstract
Introduction: Postural control changes with ageing, and it is essential to study aging-related mechanisms. The aim of this research was to investigate the effects of gender, and functional and cognitive training on balance control in middle-aged people.Materials and Methods: This was a practical study with subimpirical method. The participants were 80 middle-aged people (40 men and 40 women), who were selected according to inclusion criteria, and randomly assigned to eight groups of internal and external focus guidelines in cognitive and functional supra-postural tasks. The postural status was evaluated by measuring the alignment of centre of gravity (COG) through a master balancing system using modified clinical test of sensory interaction and balance (mCTSIB).Results: Based on one-way analysis of variance, men and women who took the focal point of external attention in both functional and cognitive tasks had better postural control (P = 0.002). Men with external focus in functional task had better postural control than the other groups, and Women with internal focus in cognitive tasks had the weakest postural control function. Totally, men in functional and cognitive tasks had a better postural control function than women (P = 0.002).Conclusion: Adopting functional supra-postural strategy is better than cognitive supra-postural strategy in both middle-aged men and women in order to maintain balance. Regarding the fact that women with cognitive tasks with internal focus showed a significant difference in postural control than other groups, it is advisable to focus on stress management methods under stressful conditions for instructors. It seems that these findings are useful for mentors and therapists to design equilibrium exercises by considering age, gender, and type of attention instruction to avoid falling and performing dual tasks.

Keywords

  1. Hadjistavropoulos T, Delbaere K, Fitzgerald TD. Reconceptualizing the role of fear of falling and balance confidence in fall risk. J Aging Health 2011; 23(1): 3-23.
  2. Young WR, Mark WA. How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations. Gait Posture 2015; 41(1): 7-12.
  3. Shumway-Cook A, Woollacott MH. Motor Control: Translating research into clinical practice. Philadelphia, PA: Lippincott Williams and Wilkins; 2007.
  4. Balaguer GR, Pitarch CS, Baydal Bertomeu JM, Morales Suarez-Varela MM. Static posturography with dynamic tests. Usefulness of biomechanical parameters in assessing vestibular patients. Acta Otorrinolaringol Esp 2012; 63(5): 332-8.
  5. Boisgontier MP, Beets IA, Duysens J, Nieuwboer A, Krampe RT, Swinnen SP. Age-related differences in attentional cost associated with postural dual tasks: Increased recruitment of generic cognitive resources in older adults. Neurosci Biobehav Rev 2013; 37(8): 1824-37.
  6. Huang CY, Hwang IS. Behavioral data and neural correlates for postural prioritization and flexible resource allocation in concurrent postural and motor tasks. Hum Brain Mapp 2013; 34(3): 635-50.
  7. Abrahamova D, Hlavacka F. Age-related changes of human balance during quiet stance. Physiol Res 2008; 57(6): 957-64.
  8. Kim G, Ferdjallah M, Harris GF. fast differential analysis of center of pressure data in normal children and children with cerebral palsy. Berlin, Heidelberg: Springer Berlin Heidelberg; 2009 p. 341-2.
  9. Boulanger M, Giraudet G, Faubert J. Interaction between the oculomotor and postural systems during a dual-task: Compensatory reductions in head sway following visually-induced postural perturbations promote the production of accurate double-step saccades in standing human adults. PLoS One 2017; 12(3): e0173678.
  10. Yu SH, Huang CY. Improving posture-motor dual-task with a supraposture-focus strategy in young and elderly adults. PLoS One 2017; 12(2): e0170687.
  11. Wulf G, Tollner T, Shea CH. Attentional focus effects as a function of task difficulty. Res Q Exerc Sport 2007; 78(3): 257-64.
  12. Stoffregen TA, Pagulayan RJ, Bardy BeG, Hettinger LJ. Modulating postural control to facilitate visual performance. Human Movement Science 2000; 19(2): 203-20.
  13. Chiviacowsky S, Wulf G, Wally R. An external focus of attention enhances balance learning in older adults. Gait Posture 2010; 32(4): 572-5.
  14. Polskaia N, Richer N, Dionne E, Lajoie Y. Continuous cognitive task promotes greater postural stability than an internal or external focus of attention. Gait Posture 2015; 41(2): 454-8.
  15. Wulf G, Chiviacowsky S, Drews R. External focus and autonomy support: two important factors in motor learning have additive benefits. Hum Mov Sci 2015; 40: 176-84.
  16. Mujdeci B, Turkyilmaz D, Yagcioglu S, Aksoy S. The effects of concurrent cognitive tasks on postural sway in healthy subjects. Braz J Otorhinolaryngol 2016; 82(1): 3-10.
  17. Wulf G, Weigelt M, Poulter D, McNevin N. Attentional focus on suprapostural tasks affects balance learning. Q J Exp Psychol A 2003; 56(7): 1191-211.
  18. McNevin N, Weir P, Quinn T. Effects of attentional focus and age on suprapostural task performance and postural control. Res Q Exerc Sport 2013; 84(1): 96-103.
  19. Huxhold O, Li SC, Schmiedek F, Lindenberger U. Dual-tasking postural control: aging and the effects of cognitive demand in conjunction with focus of attention. Brain Res Bull 2006; 69(3): 294-305.
  20. Lindenberger U, Marsiske M, Baltes PB. Memorizing while walking: increase in dual-task costs from young adulthood to old age. Psychol Aging 2000; 15(3): 417-36.
  21. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189-98.
  22. Seyedian M, Fallah M, Norouzian M, Nejat S, Delavar A, Ghasemzadeh H. Preparation and validation of the Persian version of Mini-Mental State Examination. J Med Counc I.R. Iran 2008; 25(4): 408-14. [In Persian].
  23. Gholami Fesharaki M, AzadMarzabadi E. Evaluation of the reliability and validity of Azad-Fesharaki's physical activity questionnaire (AFPAQ). J Arak Uni Med Sci 2011; 14(3): 36-44. [In Persian].
  24. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003; 35(8): 1381-95.
  25. Namba T, Tabuchi A. Study on vision and static physical balance function report 1: Healthy young and middle-elder people. Kawasaki Journal of Medical Welfare 2015; 20(2): 42-53.
  26. Burcal CJ, Drabik EC, Wikstrom EA. The effect of instructions on postural-suprapostural interactions in three working memory tasks. Gait Posture 2014; 40(2): 310-4.
  27. Chiviacowsky S, Wulf G, Avila LT. An external focus of attention enhances motor learning in children with intellectual disabilities. J Intellect Disabil Res 2013; 57(7): 627-34.
  28. Flores FS, Menezes KM, Katzer JI. Influences of gender on attention and learning of motor skills. Journal of Physical Education 2016; 27: e2706.
  29. Rodrigues ST, Polastri PF, Carvalho JC, Barela JA, Moraes R, Barbieri FA. Saccadic and smooth pursuit eye movements attenuate postural sway similarly. Neurosci Lett 2015; 584: 292-5.
  30. Wulf G, Prinz W. Directing attention to movement effects enhances learning: A review. Psychon Bull Rev 2001; 8(4): 648-60.
  31. Jackson BH, Holmes AM. The effects of focus of attention and task objective consistency on learning a balancing task. Res Q Exerc Sport 2011; 82(3): 574-9.
  32. Wulf G, Lewthwaite R, Hooyman A. Can ability conceptualizations alter the impact of social comparison in motor learning? Journal of Motor Learning and Development 2013; 1(1): 20-30.
  33. Wollesen B, Voelcker-Rehage C. Training effects on motorcognitive dual-task performance in older adults. Eur Rev Aging Phys Act 2014; 11(1): 5-24.
  34. Berger L, Bernard-Demanze L. Age-related effects of a memorizing spatial task in the adults and elderly postural control. Gait Posture 2011; 33(2): 300-2.
  35. Sullivan EV, Rose J, Rohlfing T, Pfefferbaum A. Postural sway reduction in aging men and women: relation to brain structure, cognitive status, and stabilizing factors. Neurobiol Aging 2009; 30(5): 793-807.
  36. Mitra S, Fraizer EV. Effects of explicit sway-minimization on postural--suprapostural dual-task performance. Hum Mov Sci 2004; 23(1): 1-20.
Journal of Research in Rehabilitation Sciences
Volume 13, Issue 5 - Serial Number 5
January 2018
Pages 278-286