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Background: We conducted a cross-sectional study to examine two-leg- and one-leg-type balance characteristics in athletes and explore factors related to their balance ability. Methods: A total of 213 participants, including athletes from various sports (gymnastics, boat racing, swimming, soccer, judo, and baseball) and non-athletes, were included (142 men, 71 women, average age 21.5 ± 2.1 years). Balance ability was classified into two-leg and one-leg types using the modified index of postural stability (mIPS) in a two-leg stance and the one-legged stance duration with eyes closed (OLS). Body composition, upper and lower limb strength, and lower limb sensation were also measured. To examine the balance characteristics of each sport, the mIPS and OLS were used as dependent variables in a multiple regression model with age, height, weight, and sex as independent variables. Results: The results showed a significantly higher mIPS in gymnastics (estimate: 0.22) and boat racing (0.14), and it was lower in swimming (−0.25). The OLS was significantly higher in soccer (16.98), judo (16.23), gymnastics (9.77), and baseball (9.12) and significantly lower in swimming (7.93). Additionally, the mIPS was independently associated with knee extension strength (0.12), sensory motor variables (−0.004), and height (−0.01). The OLS was associated with skeletal muscle mass (1.85) and height (−1.42). Conclusions: In summary, gymnasts showed superior two-leg and one-leg balance; boat racers excelled in two-leg balance; swimmers showed inferior two-leg but better one-leg balance; and soccer, judo, and baseball athletes demonstrated superior one-leg balance. Additionally, the mIPS was associated with knee extensor strength, plantar pressure sensation, and height, whereas the OLS was associated with skeletal muscle mass and height.

This study determined the cut-off time for the one-leg standing test (OLST) to simply screen the severity of locomotive syndrome (LS). We conducted this cross-sectional study on 1860 community-dwelling residents (age, 70.5 ± 9.5 years old; males, n = 826; females, n = 1034) who underwent the OLST and completed the 25-question geriatric locomotive function scale (GLFS-25). Multivariate linear regression and multivariate logistic regression analyses were conducted to assess the relationship between the OLST and the GLFS-25 score and LS after adjusting for age, sex, and body mass index. A receiver operating characteristic (ROC) curve analysis was performed to calculate the optimal cut-off time of the OLST for determining LS severity. The multivariate linear regression and multivariate logistic regression analyses showed that the OLST was significantly associated with the GLFS-25 score and a diagnosis of LS. The optimal cut-off times of the OLST to screen LS-1, LS-2, and LS-3 were 42 s (sensitivity 65.8%, specificity 65.3%), 27 s (sensitivity 72.7%, specificity 72.5%), and 19 s (sensitivity 77.4%, specificity 76.8%), respectively. We developed a simplified screening tool for the OLST to determine LS severity.

BackgroundIdentification of simple screening tools for detecting lower skeletal muscle mass may be beneficial for planning effective interventions in the elderly.AimsWe aimed to (1) establish a threshold for one-leg standing balance test (OLST) time for low muscle mass, and (2) test the ability of that threshold to assess muscular impairments in a poor balance group.MethodsEyes-open OLST (maximum duration 30 s) was performed with right and left legs in 291 women (age 71 ± 6 years). OLST time was calculated as the sum of the OLST time of right and left legs. Fat-free mass (FFM), skeletal muscle mass (SMM), fat mass, biceps brachii and vastus lateralis sizes; handgrip strength (HGS), elbow flexion maximum torque (MVCEF) and knee extension maximum torque (MVCKE) were measured. Muscle quality was calculated as MVCKE/FFM and physical activity was assessed by questionnaire. Low muscle mass was defined as SMMrelative of 22.1%, a previously established threshold for pre-sarcopenia.ResultsThe OLST threshold time to detect low muscle mass was 55 s (sensitivity: 0.63; specificity: 0.60). The poor balance group (OLST < 55 s) had higher fat mass (3.0%, p < 0.001), larger VL thickness (5.1%, p = 0.016), and lower HGS (− 10.2%, p < 0.001), MVCEF (− 8.2%, p = 0.003), MVCKE (− 9.5%, p = 0.012), MVCKE/FFM (− 11.0%, p = 0.004) and physical activity (− 8.0%, p = 0.024) compared to the normal balance group. While after adjusting age, the differences exist for HGS, fat mass and VL thickness only.DiscussionAn OLST threshold of 55 s calculated as the summed score from both legs discriminated pre-sarcopenic characteristics among active, community-dwelling older women with limited potential (sensitivity 0.63, specificity 0.60).ConclusionOLST, which can be performed easily in community settings without the need for more complex muscle mass measurement, may help identify women at risk of developing sarcopenia.

Improving physical balance among older workers is essential for preventing falls in workplace. We aimed to elucidate the age-related decline in one-leg standing time with eyes closed, an indicator of static balance, and mitigating influence of daily walking habits on this decline in Japan. This longitudinal study involved 249 manufacturing workers, including seven females, aged 20–66 years engaged in tasks performed at height in the aircraft and spacecraft machinery industry. The participants underwent a one-leg standing test and annual health checkups through the Kanagawa Health Service Association between 2017 and 2019. The outcome measure was one-leg standing time up to 30 s. The coefficient (β) of one-leg standing time against aging was estimated using two-level multilevel linear regression with random intercepts. We also estimated the β of daily walking habits at least one hour per day. The quadratic spline curve showed an almost linear trend of one-leg standing time with age. The one-leg standing time significantly decreased with age (adjusted β = − 0.22; 95% confidence interval [CI] − 0.31 to − 0.14). Meanwhile, walking habits showed a preventive effect (β = 1.76; 95% CI 0.49 to 3.04). Age-related decline in one-leg standing time may be mitigated by simple daily walking habits.

Background The one leg standing test (OLST) is one of the most widely used balance function tests for assessing decline in motor function in older adults. With aging, OLST performance decreases, and difference between the left and right sides becomes more noticeable. The lower limbs have been divided into dominant and non-dominant limbs, following the example of the upper limbs. This study investigated the relationship between the dominant foot and OLST performance in older adults. Methods A total of 519 orthopedic outpatients participated in this study. The participants completed a self-report questionnaire (Waterloo footedness questionnaire-revised; WFQ-R) to determine the dominant foot. They also completed a locomotor functional questionnaire (Geriatric Locomotive Function Scale; GLFS-25) and were assessed for their stage of locomotive syndrome using the two-step test and standing-up test. The righting reflex was objectively investigated to determine which foot they step forward when pushed from behind. Finally, participants performed the OLST, and both standing time and left-right difference were assessed. Results Although it was difficult to unambiguously determine the dominant foot from the results of the WFQ-R, the agreement rate between simplified self-recognition and objective findings was relatively high. The locomotive grade classification showed the relation to decline of OLST, but there was no clear difference tendency between the left and right sides, regardless of age. When analyzing the decline in standing time for both legs, away from the dominant and non-dominant legs, no single leg consistently demonstrated longer standing time. Instead, the leg with the longer standing time switched at approximately the 35-36 s mark in 158 cases (30.4%). Conclusions As motor function declines with age, OLST performance decreases, and there was a group in which the left-right difference becomes more noticeable. However, no consistent pattern was found in the magnitude of this difference. Notably, when the decline begins, the leg that takes longer to stand may shift to the other side.

SummaryIn women of ages 75–80 years, a low one leg standing time (OLST) was associated with an increased risk of incident fractures, independently of bone mineral density and clinical risk factors. OLST contributed substantially to fracture probability, indicating that the test should be considered when evaluating fracture risk in older women.IntroductionPhysical function and risk of falls are important risk factors for fracture. A few previous studies have suggested that a one leg standing time (OLST) less than 10 s predicts fracture risk, but the impact of OLST, in addition to known clinical risk factors, for fracture probability is unknown. The aim of this study was to determine the independent contribution of OLST to fracture probability in older women.MethodsThe Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures (SUPERB) is a prospective population-based study of 3028 women 75–80 years old, recruited from the greater Gothenburg area in Sweden. At baseline, information on risk factors was collected using questionnaires, bone mineral density was measured with dual-energy X-ray absorptiometry (DXA), and OLST was performed.ResultsDuring a median follow-up of 3.6 years (IQR 1.5 years), X-ray-verified incident fractures were identified using health records. OLST was available in 2405 women. OLST less than 10 s was associated with an increased risk for incident hip fracture (Hazard Ratio (HR) 3.02, 95% Confidence Interval (CI) [1.49–6.10]), major osteoporotic fracture (HR 95% CI 1.76 [1.34–1.46]), and nonvertebral fracture (HR 95% CI 1.61 [1.26–2.05]) in Cox regression analyses adjusted for age, height, and weight. Depending on BMD, the 4-year fracture probability increased by a factor of 1.3 to 1.5 in a 75-year-old woman with a low OLST (<10 s).ConclusionA low OLST has a substantial impact on fracture probability and should be considered when evaluating fracture risk in older women.

Background Fear of falling (FOF) is associated with an increased risk of functional decline; however, findings remain inconsistent regarding its effects on balance control mechanisms. The aim of our study was to compare dominant limb differences in postural control, as indicated by sway distances between the center of pressure (COP) and center of gravity (COG), in adults with and without FOF. Methods Twenty-one subjects with FOF and 22 control subjects participated in three dominant and non-dominant limb standing tasks on force plates. The outcome measures included the separation sway distance (COP-COG) and the ranges of COP and COG sway during the tasks. Results There was a significant interaction between groups, directions, and repeated trials for COP sway distance during non-dominant limb standing (F = 4.95, p  = 0.03), particularly in the first trial in the mediolateral direction (t = -1.77, p  = 0.04) and the third trial in the anteroposterior (AP) direction (t = -2.30, p  = 0.02). Conclusions The FOF group exhibited increased sway distances and sway range asymmetries, particularly in the AP direction during the third trial of non-dominant limb standing. These findings emphasize the importance of neuromuscular trunk control, particularly in relation to increased COG and COP sway ranges observed for the non-dominant limb. Such understanding is crucial for assessing postural adaptations following repeated trials and mitigating fall risks among adults with FOF.

Backgrounds One-leg standing time (OLST) has been frequently used physical performance measure; however, what muscular characteristics OLST represents remains uncertain. Aim This cross-sectional study aimed to investigate the association between OLST and muscle characteristics to clarify the possibility of using OLST as a physical performance measure. Methods Study participants comprised 1144 older adults aged 65 years or older. Computed tomography images provided mid-thigh skeletal muscle cross-sectional area and mean attenuation value. OLST was measured for a maximum of 60 s. Static postural instability was assessed using a posturography. Results A frequency of OLST < 20 s was increased by quartiles of muscle cross-sectional area (Q1: 33.6, Q2: 12.8, Q3: 13.6, Q4: 11.9%, P  < 0.001) and mean attenuation value (Q1: 32.3, Q2: 21.7, Q3: 14.3, Q4: 7.7%, P  < 0.001). Results of the multinomial regression analysis indicated that muscle cross-sectional area and mean attenuation value were independently associated with an OLST of less than 20 s. The crude odds ratio of OLST less than 20 s for the lowest quartiles of both cross-sectional area and mean attenuation value was 4.19 (95% CI: 3.01 − 5.84). The cross-sectional area of muscles with greater fat deposition was inversely associated with OLST, while that with smaller fat deposition showed a positive association with OLST, indicating why mean attenuation value and cross-sectional area were independently associated with OLST. No clear relationship was observed with static postural instability. Conclusion OLST was a simply measurable quantifiable physical measure representing the loss of muscle mass and quality in older adults.

Early and self-identification of locomotive degradation facilitates us with awareness and motivation to prevent further deterioration. We propose the usage of nine squat and four one-leg standing exercise features as input parameters to Machine Learning (ML) classifiers in order to perform lower limb skill assessment. The significance of this approach is that it does not demand manpower and infrastructure, unlike traditional methods. We base the output layer of the classifiers on the Short Test Battery Locomotive Syndrome (STBLS) test used to detect Locomotive Syndrome (LS) approved by the Japanese Orthopedic Association (JOA). We obtained three assessment scores by using this test, namely sit-stand, 2-stride, and Geriatric Locomotive Function Scale (GLFS-25). We tested two ML methods, namely an Artificial Neural Network (ANN) comprised of two hidden layers with six nodes per layer configured with Rectified-Linear-Unit (ReLU) activation function and a Random Forest (RF) regressor with number of estimators varied from 5 to 100. We could predict the stand-up and 2-stride scores of the STBLS test with correlation of 0.59 and 0.76 between the real and predicted data, respectively, by using the ANN. The best accuracies (R-squared values) obtained through the RF regressor were 0.86, 0.79, and 0.73 for stand-up, 2-stride, and GLFS-25 scores, respectively.

AimsIn this study, the effects of licorice flavonoid oil (LFO) supplementation on mobility functions were evaluated in middle-aged and older women who underwent daily physical exercise.MethodsThe 73 women aged 59–85 years (71.2 ± 5.2 years) were randomly assigned to the LFO group (n = 37) or the placebo group (n = 36). For 16 weeks, the LFO group consumed a daily capsule containing 300 mg of LFO, while the placebo group consumed a placebo capsule. All participants were instructed to complete a strength training program during the 16 weeks and to increase their daily step count by 1000. 10-m walking speed (with/no obstruction), one-leg standing time with eyes open, handgrip strength, isometric knee extension strength, and body composition were evaluated at baseline and every eight weeks.ResultsIn the 10-m walking speeds (with/no obstruction), LFO supplementation did not show significant improvements. One-leg standing time was significantly prolonged with LFO intake (LFO: baseline 73.9 s vs 16 weeks 93.5, placebo: baseline 82.8 vs 16 weeks 87.1, p = 0.03). In addition, a significant decrease in BMI and body fat percentage with LFO was found (p = 0.01, p = 0.03, respectively).DiscussionSince a lower BMI corresponds to a lighter physical load on the lower limb, in addition, since LFO might improve skeletal muscle function by antioxidant activity, participants could stand longer and body balance control was improved.ConclusionLFO supplementation improved body balance control and may contribute to fall prevention in healthy middle-aged and older women having daily physical exercise.Trial RegistrationUMIN Clinical Trial Registry No. 000029712.