As part of the 'timed up and go' test participants will have a marker attached to their centre of mass in order to collect data on factors such as jerk and postural sway. The centre of mass is described as a balance point of an object (Gambino et al, 2006). However before we can do this we need to determine where abouts on the body the centre of mass will be. According to Gambino et al (2006) a person's centre of mass is just below the belly button, which is nearly the geometric centre of a person. In a trial run of our experiment we were placing the marker slightly above the participant's belly button so it is possible that the data we collected maybe be inaccurate as this could have been the wrong positioning for their centre of mass.
Gambino et al (2006) concluded that a female's centre of mass is slightly lower than a males centre of mass. Unfortunately we would not be able to perform the test they did to collect these results as we are working with the frail elderly. The test they completed involved lying on beams in order to record the weight and height of each participant. There is the possibility of an injury and this involves the use of a large amount of equipment.
According to McGinnis (2005) a person's centre of mass is estimated at between 55 and 57% of their height in the anatomical position. Similarly, McGinnis (2005) identifies that a females centre of mass will be slightly lower than a males centre of mass as a result of larger pelvic girdles and narrower shoulders. This way of calculating the centre of mass would be easier to carry out as it requires little of the participants and only a small amount of equipment. If the measurements are not carried out then at least we now have a better understanding of where the centre of mass is on the human body.
References
Gambino,S, Mirochnik, M and Schechter S. (2006) The Physics Factbook.
McGinnis, P.M. (2005) Biomechanics of sport and exercise. Human Kinetics. pp 133.
Showing posts with label older adults. Show all posts
Showing posts with label older adults. Show all posts
Thursday, 9 February 2012
Tuesday, 7 February 2012
Pilot data collection, TUG
For the "up and go" research into older adults, this week some preliminary data was colleceted on a group of 6 university students aged between 20-21. The pilot data was run to check that the set up of the experiment were suitable for the results to be obtained, to see any potential problems that could arise during the actual data collection, and to gather any feedback from the participants. The test was set up as it will be on the day; a line with a lentgh of 3 metres was set out, with a marker as an indicator of where to walk to at one end, and a chair at the other. The markers that collect the data were also set up appropriately, at 50cm from the ctart of the course, and 50cm from the end of the course, to detect what was happening in each segment of the walk. The participants also have a marker attatched to the using a velcro belt, which is place in the approxiate area of their centre of mass. The data was recorded using a programme specifically designed for this experiment, and the data collected was sent straight to a loptop where results can be formatted and analysed.
The participants were all walked through the test, and then given a chance for a practice run. Each participant did 3 runs of 4 different tests. The first was to get up from a sitting position, walk to the marker, turn, walk back to the chair and sit - they then had to repeat this for the second test, but had to do so whilst holding a glass of water. The third condition was to get up from the chair, walk to the marker, which was now covered by an obstacle, walk around that, walk back to the chair and sit back down. The fourth coniditon was the same yet holding a glass of water.
Some of the issues that became apparant during the test were:
1) people adopted different positions when sitting in the chair prior to starting the test, e.g. crossing their legs leaving only one foot on the ground.
2) People talking throughout the test lead them to turn to the person they were having a conversation with, which could effect the way the data is read from the marker.
3) At times, the marker became loose, and detatched from the belt.
4) They completed 12 different trials per person, and whilst it was no problem for them, for
a frail, elderly adult, this could be exhausting.
5) In the feedback, one participant felt the test was 'degrading' due to being attatched to a wire.
All of these issues need to be resolved to the best they can be, without affecting the results of the data collection or inhibiting the findings of the research.
The participants were all walked through the test, and then given a chance for a practice run. Each participant did 3 runs of 4 different tests. The first was to get up from a sitting position, walk to the marker, turn, walk back to the chair and sit - they then had to repeat this for the second test, but had to do so whilst holding a glass of water. The third condition was to get up from the chair, walk to the marker, which was now covered by an obstacle, walk around that, walk back to the chair and sit back down. The fourth coniditon was the same yet holding a glass of water.
Some of the issues that became apparant during the test were:
1) people adopted different positions when sitting in the chair prior to starting the test, e.g. crossing their legs leaving only one foot on the ground.
2) People talking throughout the test lead them to turn to the person they were having a conversation with, which could effect the way the data is read from the marker.
3) At times, the marker became loose, and detatched from the belt.
4) They completed 12 different trials per person, and whilst it was no problem for them, for
a frail, elderly adult, this could be exhausting.
5) In the feedback, one participant felt the test was 'degrading' due to being attatched to a wire.
All of these issues need to be resolved to the best they can be, without affecting the results of the data collection or inhibiting the findings of the research.
Thursday, 20 October 2011
The ‘Timed Get-Up-And-Go’ test revisited: Measurement of the component tasks. Wall, J. Bell, C. Campbell, S and Davis, J.
The aim of the study was to compare the different results between the ‘Timed Get-Up-And-Go’ (TGUG) test and the ‘Expanded Timed Get-Up-And-Go’ (ETGUG) test on 3 groups. The TGUG only measures the time of the movement as a whole whereas the ETGUG could measure the component tasks of the test.
3 groups of 10 subjects participated on the study. Group 1 classified as the young control group aged between 19 and 29 years with a mean age of 25.5. Group 2 were classified as the elderly control group who were aged 65 and over with a mean age score of 72.7 years. Group 3 were classified as the at risk elderly group who were aged over 65 and had a mean age of 75.8 years. All of these subjects were receiving physical therapy, had a history of falls in the past two years or had been treated for gait pathologies or balance disorders.
The subjects all had to complete the ‘Timed Get-Up-And-Go’ test first. This involved standing up from a chair (seat height 46cm) and walking 3 meters at a normal pace, turning around walking back and returning to the seated position. The second test they all completed was the ‘Expanded Timed Get-Up-And-Go’ test. This involved them walking 10 meters so that component tasks could be timed using a multimemory stopwatch. The stopwatch was pressed at the following events: a) standing upright b) as the subject passed the 2m mark c) as the subject passed the 8m mark d) as the subject passes the 8m mark returning and e) as the subject passed the 2m mark returning.
The results displayed no significant differences in the times from the TGUG between the young control group and elderly control group. The young control group’s mean time was 7.36s. The mean time for the elderly control group was 8.74s and the at risk elderly group had a mean time of 18.14s to complete the task. Similar results were found for the ETGUG test. The mean time for the young control group was 15.36s, the elderly control group was 19.095s and the at risk elderly group was 34.52s. A significant difference was found between the young and at risk group and the elderly and the at risk group for every component task of the test. Both control groups were found to be significantly faster at each stage than the at risk group.
All the young and elderly control participants completed the TGUG test in less than 10 seconds which is consistent with previous findings therefore showing they are freely independent in physical mobility. In both of the tests it was found the elderly group and the at risk elderly group had difficulty standing up from the chair. Therefore it has been suggested that only this measure could be used in future research to predict a patient’s risk of falling. Additional research is needed to determine correlations between the increased time for specific component tasks and a decreased functional mobility.
The aim of the study was to compare the different results between the ‘Timed Get-Up-And-Go’ (TGUG) test and the ‘Expanded Timed Get-Up-And-Go’ (ETGUG) test on 3 groups. The TGUG only measures the time of the movement as a whole whereas the ETGUG could measure the component tasks of the test.
3 groups of 10 subjects participated on the study. Group 1 classified as the young control group aged between 19 and 29 years with a mean age of 25.5. Group 2 were classified as the elderly control group who were aged 65 and over with a mean age score of 72.7 years. Group 3 were classified as the at risk elderly group who were aged over 65 and had a mean age of 75.8 years. All of these subjects were receiving physical therapy, had a history of falls in the past two years or had been treated for gait pathologies or balance disorders.
The subjects all had to complete the ‘Timed Get-Up-And-Go’ test first. This involved standing up from a chair (seat height 46cm) and walking 3 meters at a normal pace, turning around walking back and returning to the seated position. The second test they all completed was the ‘Expanded Timed Get-Up-And-Go’ test. This involved them walking 10 meters so that component tasks could be timed using a multimemory stopwatch. The stopwatch was pressed at the following events: a) standing upright b) as the subject passed the 2m mark c) as the subject passed the 8m mark d) as the subject passes the 8m mark returning and e) as the subject passed the 2m mark returning.
The results displayed no significant differences in the times from the TGUG between the young control group and elderly control group. The young control group’s mean time was 7.36s. The mean time for the elderly control group was 8.74s and the at risk elderly group had a mean time of 18.14s to complete the task. Similar results were found for the ETGUG test. The mean time for the young control group was 15.36s, the elderly control group was 19.095s and the at risk elderly group was 34.52s. A significant difference was found between the young and at risk group and the elderly and the at risk group for every component task of the test. Both control groups were found to be significantly faster at each stage than the at risk group.
All the young and elderly control participants completed the TGUG test in less than 10 seconds which is consistent with previous findings therefore showing they are freely independent in physical mobility. In both of the tests it was found the elderly group and the at risk elderly group had difficulty standing up from the chair. Therefore it has been suggested that only this measure could be used in future research to predict a patient’s risk of falling. Additional research is needed to determine correlations between the increased time for specific component tasks and a decreased functional mobility.
Wednesday, 19 October 2011
The timed “Up & Go”: A test of basic functional mobility for frail elderly persons
The objective of this study was to examine the clinical usefulness of the timed “Up & Go” as a short test of basic mobility skills in population of frail elderly adults. The test being administered is very quick and practical to complete and covers the basic bodily movement. Mathias et al proposed this test before however his test had problems with the scoring system. But in this test conducted by Podsiadlo & Richardson a new scoring system was implemented to make the test more reliable and valid.
The test consisted of sixty participants from the community to the geriatric day hospital. Twenty three of the sixty were male and thirty seven of the sixty were female. Ten active, healthy, normal volunteers over the age of seventy were also tested. The subjects varied widely in their ability to perform all of the mobility tasks. The test was performed on patients attending the day hospital over a two month period. Those who had stage four Parkinson’s disease and were medically unstable were excluded from the study.
The test required the participants to stand up from a regular arm chair walk a distance of 3m, turn, walk back to the chair and sit down again. The subject is allowed to begin the test when they are given their cue to go. The subjects wear their normal footwear and are allowed to use their walking aid to assist them with the task. The subjects walk through the test once and then at the next attempt are timed for the real thing.
The results show that the time scores varied between ten to twenty seconds in fifty seven participants. Three of the participants were unable to perform the test. One could not get out of the chair and the other two could not walk without assistance. Seven participants did not have the stamina levels to complete the test. The results of the study seem to support the hypothesis of the timed “Up & Go” score would correlate with the patients balance, gait speed and functional capacity.
The timed “Up & Go” test is a useful screening test or a descriptive test. It gives information about the patients balance, gait speed and functional ability. It places the patients into a functional category and indicates those requiring further assessment. The timed “Up & Go” can indicate a lack of improvement or even a deterioration of which the patient or health care provider may be unaware. The test is reliable both between raters and over time. The test is adequate for a fragile elderly person because it is a simple task to complete which does not require a massive amounts of exertion.
Thursday, 13 October 2011
The Timed “Up and Go” : A Test of Basic Functional Mobility for Frail Elderly Persons. Podsiadlo. D & Richardson. S.
The aim of the study was to assess the functional capacity in the elderly using a modified timed version of a previous test proposed by Mathias et al. The validity and the reliability of such tests has been questioned therefore a new scoring system was implemented as a result of the imprecise scoring systems used previously.
60 patients from a Geriatric Hospital in Montreal took part in the study, 23 male and 37 female, with a mean age of 79.5 years. Their instructions were to stand up from a seated position in an armchair (approximate seat height of 46cm) walk a distance of 3 meters, turn around and walk back to the chair and return to the seated position. 10 active volunteers over 70 years old were also tested and these were used as control subjects. All the other patients had been diagnosed with major medical problems such as Parkinson’s disease and osteoarthritis.
The results displayed a wide range of times amongst the 60 patients with major medical diagnoses. However, the 10 active elderly volunteers all managed to complete the timed “up and go” in 10 seconds or less. The times between 57 of the patients ranged from 10 seconds to 240 seconds. There were 3 patients who were unable to complete the task and a further 7 who started but could not finish the test. No relationship was found between the score from the timed “up and go” test and their medical diagnosis. The scores were then divided into less than 10 seconds, 20 – 29 seconds and over 30 seconds as in indication of how independent in basic transfers they were.
The timed “up and go” test is very simple in that it is easy to administer as it requires no special equipment or training. The test is reliable as the results showed little variance in their times scores either between raters or over time. However further investigation is needed with regards to the group described as a ‘grey zone’. The scores in the 20-29 seconds category vary widely, therefore making it difficult to clarify their balance, gait speed and functional capacity. The test is valid as it measures everyday life activities. It is also a good screening tool as it may reveal no improvement in the time scores, displaying a deterioration in functional mobility that a neuromuscular examination may be unable to tell us.
60 patients from a Geriatric Hospital in Montreal took part in the study, 23 male and 37 female, with a mean age of 79.5 years. Their instructions were to stand up from a seated position in an armchair (approximate seat height of 46cm) walk a distance of 3 meters, turn around and walk back to the chair and return to the seated position. 10 active volunteers over 70 years old were also tested and these were used as control subjects. All the other patients had been diagnosed with major medical problems such as Parkinson’s disease and osteoarthritis.
The results displayed a wide range of times amongst the 60 patients with major medical diagnoses. However, the 10 active elderly volunteers all managed to complete the timed “up and go” in 10 seconds or less. The times between 57 of the patients ranged from 10 seconds to 240 seconds. There were 3 patients who were unable to complete the task and a further 7 who started but could not finish the test. No relationship was found between the score from the timed “up and go” test and their medical diagnosis. The scores were then divided into less than 10 seconds, 20 – 29 seconds and over 30 seconds as in indication of how independent in basic transfers they were.
The timed “up and go” test is very simple in that it is easy to administer as it requires no special equipment or training. The test is reliable as the results showed little variance in their times scores either between raters or over time. However further investigation is needed with regards to the group described as a ‘grey zone’. The scores in the 20-29 seconds category vary widely, therefore making it difficult to clarify their balance, gait speed and functional capacity. The test is valid as it measures everyday life activities. It is also a good screening tool as it may reveal no improvement in the time scores, displaying a deterioration in functional mobility that a neuromuscular examination may be unable to tell us.
Wednesday, 12 October 2011
What is an ‘older adult’?
It may seem like a fairly simple question and as soon as it’s asked many of you will instantly conjure up an image of what you perceive an older adult to be. No doubt as you yourself get older, the image or perception of an older adult is also pushed back and gradually gets older.
So when does someone become an older adult?
Is it at retirement age? I would suggest not as people retire at different ages and for different reasons. Is there a milestone or magical age where we become an older adult? Again maybe not as time and ageing treats us all differently depending on our lifestyle and genetic make-up among other things. So does this leave some measure of cognitive and/or physical functioning, that once we reach or drop below we are classified as an older adult? This seems in some part logical but there appears to be no such standard for which one is considered old or young.
It therefore seems that as beauty is in the eyes of the beholder, so is the classification of an older adult. The reason I ask this is because with my current study and recruitment drive for participants, the boundaries for older are at best vague. Using pilot data the boundaries set for this study is 50-60 but is this right? In a review article by Voelcker-Rehage (2008) there are approximately 20 different age groups categorised as older adults. These range from 50-59 to 59-81 with the oldest set at 62-95. Of the age ranges set only two cover the same period of time and these are ages 60-69. At the largest end of the scale 33 years is the difference between the extremes of older adulthood. This is so varied that at the other end of the scale, Mark Zuckerberg (aged 27) the founder of facebook has been born, educated and created a global phenomena that gives him a personal wealth of approximately $17.5 billion with 6 years left. So it seems that so much can be achieved and changed in that period of time, that maybe 33 years is just too long.
This however, still does not answer the question... What is an older adult? The review article by Voelcker-Rehage (2008) suggests that various studies found declines through all these ages with the youngest older adult group of 50-59 showing declines in their abilities to learn. This coupled with the pilot data we have used suggests that the age range of 50-60 years old we have set is right. But are they strictly an older adult? Either way when exactly should the title or classification of older adult be used to describe a vastly varied group of individuals?
This however, still does not answer the question... What is an older adult? The review article by Voelcker-Rehage (2008) suggests that various studies found declines through all these ages with the youngest older adult group of 50-59 showing declines in their abilities to learn. This coupled with the pilot data we have used suggests that the age range of 50-60 years old we have set is right. But are they strictly an older adult? Either way when exactly should the title or classification of older adult be used to describe a vastly varied group of individuals?
Voelcker-Rehage, C., Motor-skill learning in older adults - a review of studies on age-related differences. European Review of Aging and Physical Activity, 2008. 5(1): p. 5-16.
Tuesday, 11 October 2011
Motor skill learning in older adults - a review of studies on age related differences. Voelcker & Rehage.
The aim of the paper is to review studies that focus on age related differences in motor learning across life span, particularly those focused on older aged adults. Motor development; the growth of muscular co-ordination from being a child, is considered generally, yet the main focus is motor plasticity; which is the ability of the Central Nervous System to acquire different pathways for sensory perception or motor skills.
A large number of studies are considered, focusing on a number of different aspects of motor learning. For example, for motor learning of fine motor skills, accuracy, sub movements, life-span studies, force variability, and augmented feedback. The rest of the studies consider motor learning of gross motor skills. many of them are comparative between older and younger adults, highlighting the differences of how we learn as we get older.
The findings from the studies suggest that older adults are able to gain in terms of their performance, yet the extent to which plasticity varies with age has to be carefully considered. A common result in studies of motor function show that performance levels drop in older adults compared to younger adults, regardless of any learning gains. Learning and performance differences are related to the structure, complexity, difficulty and familiarity of the task. Fine motor skill studies showed that performance gain diminished in older adults, and that performance differences between the young and old increased with practice. However, for the Gross motor skills, the results were contradictory, as some studies showed the highest improvement in older adults and others in the young.
A general overview of the findings are that decreased motor skill learning gains were interpreted as an age related performance loss in older adults, and occur due to a reduction in cognitive or motor plasticity. The causes of this are due to neuro-physiological changes; reduced nerve conduction and reaction speed, increased lateralization, diminished inhibition processes, and diminished tactile sensitivity. Despite these changes, there are considered to be compensatory processes in the cortical and sub cortical function that allow maintenance of performance. Brain imaging of the prefrontal , medio-frontal frontostriatal networks, which all relate to attention, showed age related decline.
In summary, all studies showed that performance does decline with age, yet considerable performance gains can still be seen, and that from the life span studies, we can see that decreases that occur in motor plasticity in older age can also occur in younger and middle aged adults.
A large number of studies are considered, focusing on a number of different aspects of motor learning. For example, for motor learning of fine motor skills, accuracy, sub movements, life-span studies, force variability, and augmented feedback. The rest of the studies consider motor learning of gross motor skills. many of them are comparative between older and younger adults, highlighting the differences of how we learn as we get older.
The findings from the studies suggest that older adults are able to gain in terms of their performance, yet the extent to which plasticity varies with age has to be carefully considered. A common result in studies of motor function show that performance levels drop in older adults compared to younger adults, regardless of any learning gains. Learning and performance differences are related to the structure, complexity, difficulty and familiarity of the task. Fine motor skill studies showed that performance gain diminished in older adults, and that performance differences between the young and old increased with practice. However, for the Gross motor skills, the results were contradictory, as some studies showed the highest improvement in older adults and others in the young.
A general overview of the findings are that decreased motor skill learning gains were interpreted as an age related performance loss in older adults, and occur due to a reduction in cognitive or motor plasticity. The causes of this are due to neuro-physiological changes; reduced nerve conduction and reaction speed, increased lateralization, diminished inhibition processes, and diminished tactile sensitivity. Despite these changes, there are considered to be compensatory processes in the cortical and sub cortical function that allow maintenance of performance. Brain imaging of the prefrontal , medio-frontal frontostriatal networks, which all relate to attention, showed age related decline.
In summary, all studies showed that performance does decline with age, yet considerable performance gains can still be seen, and that from the life span studies, we can see that decreases that occur in motor plasticity in older age can also occur in younger and middle aged adults.
The timed "up and go": A test of basic functional mobility for frail elderly persons. Podsialdo.D & Richardson.S.
The aim of the study was to assess physical mobility in the elderly, using a reliable method. Many other tests had already been developed, yet there seemed to be problems in terms of validity and reliability.
The method used was to see how long it took a frail elderly patient to stand up from an armchair (approximately 45cm), walk 3 metres, turn round, walk back and sit again. 60 patients were observed from a Geriatric Hospital in Montreal. 23 men and 37 women took part, and the mean age of the subjects was 79.5. All participants were aged between 60 and 90. 10 were considered healthy and active, and were aged over 70. The rest were affected by one of the following; A cerebral vascular accident, Parkinson's disease, rheumatoid osteoarthritis, cerebellar degeneration, post surgical hip fractures or general deconditioning.
The results showed that all the 'healthy' participants performed the test in 10 seconds or less. Time scores ranged between 10 and 240 seconds in 57 patients, as 3 were unable to even perform the test. 7 participants began the test but didn't have the stamina to finish. The results showed no relationship between the scores of the test and their diagnosis.
The hypothesis was supported by the results, in the fact that the timed "up and go" score correlated with patients scores on balance, gait speed and functional capacity.
The patients were divided in to 3 groups depending on their score. Those who took less than 20 seconds were considered independent, and could do everyday task without help, climb stairs, and leave the house alone. The second group consisted of those who took between 20 and 29 seconds to complete the task , who were considered mostly independent, needing help in areas such as getting off the toilet etc. The final group was those who took 30 seconds or more to complete the task, and these were considered dependant as they struggled getting up and walking without assistance.
The test proved to be practical, in the sense that it was simple to carry out, no special equipment was needed and it was quick. It was also reliable, as it gave a good indication of an individuals physical mobility, correlating with scores for gait speed and balance tests.
Those who scored lower than 30 and more than 20 were harder to categorize into a certain group, as such variation was seen in their tests for balance gait speed and functional capacity, so further assessment was needed to clarify their functional level.
If this test were to be used at the beginning of an examination, they could save a lot of professional time as irrelevant questions and tests could be eliminated and can focus on the specific area causing the issue.
As a descriptive tool it is good at describing level of functional capacity, it is quick and easy to carry out and has been proven to be reliable and valid.
The method used was to see how long it took a frail elderly patient to stand up from an armchair (approximately 45cm), walk 3 metres, turn round, walk back and sit again. 60 patients were observed from a Geriatric Hospital in Montreal. 23 men and 37 women took part, and the mean age of the subjects was 79.5. All participants were aged between 60 and 90. 10 were considered healthy and active, and were aged over 70. The rest were affected by one of the following; A cerebral vascular accident, Parkinson's disease, rheumatoid osteoarthritis, cerebellar degeneration, post surgical hip fractures or general deconditioning.
The results showed that all the 'healthy' participants performed the test in 10 seconds or less. Time scores ranged between 10 and 240 seconds in 57 patients, as 3 were unable to even perform the test. 7 participants began the test but didn't have the stamina to finish. The results showed no relationship between the scores of the test and their diagnosis.
The hypothesis was supported by the results, in the fact that the timed "up and go" score correlated with patients scores on balance, gait speed and functional capacity.
The patients were divided in to 3 groups depending on their score. Those who took less than 20 seconds were considered independent, and could do everyday task without help, climb stairs, and leave the house alone. The second group consisted of those who took between 20 and 29 seconds to complete the task , who were considered mostly independent, needing help in areas such as getting off the toilet etc. The final group was those who took 30 seconds or more to complete the task, and these were considered dependant as they struggled getting up and walking without assistance.
The test proved to be practical, in the sense that it was simple to carry out, no special equipment was needed and it was quick. It was also reliable, as it gave a good indication of an individuals physical mobility, correlating with scores for gait speed and balance tests.
Those who scored lower than 30 and more than 20 were harder to categorize into a certain group, as such variation was seen in their tests for balance gait speed and functional capacity, so further assessment was needed to clarify their functional level.
If this test were to be used at the beginning of an examination, they could save a lot of professional time as irrelevant questions and tests could be eliminated and can focus on the specific area causing the issue.
As a descriptive tool it is good at describing level of functional capacity, it is quick and easy to carry out and has been proven to be reliable and valid.
Wednesday, 24 August 2011
Performing and learning 90° in older adults
Despite a wealth of knowledge regarding coordinated rhythmic movements in a healthy population of adolescents and younger adults this is not the case for their older counterparts. Following a review of the minimal literature the understanding of older adult populations appears inconclusive. From reviewing the main two papers similarities between the elderly and young populations are present. Firstly the elderly possess the ability to perform 0° and 180° at relative ease with little to no difference to the younger populations. With both populations able to learn the least stable phase of 90° when exposed to specific training.
However this is where the similarities cease and the differences begin. Despite both groups fully understanding the movement demands of a 90° phase the ability to produce this is diminished in older adults. Firstly older adults are more sensitive to different feedback types than younger adults. For example older adults did not improve when using augmented terminal feedback when the younger adults did. Furthermore, older adults show a greater improvement and retention of 90° when using concurrent augmented feedback when compared to other feedback methods used during training. Additionally learning 90° occurs at a slower rate in older adults, with the elderly initially drawn to perform at 180°; consequently leading to higher error rates during learning 90° in older adults. These error rates exist in variable movement frequencies, amplitudes and reduced accuracy with a 70° variation from the desired movement patterns. Therefore 90° cannot be considered stable but does become more so throughout training. However, the performance difference between the younger participants and the elderly becomes more pronounced with training.
So with poor performance by the elderly present in both papers when compared to the younger participants the question is, why? This may be explained through exploration of the feedback methods. Throughout training both terminal and concurrent augmented feedback was provided using a Lissajous display. In both papers subjects were tested at baseline and post training with differing perceptual information available. They were exposed to normal visual conditions, no vision of the hands and augmented feedback. The greatest performance in retention tests within older adults occurred under augmented concurrent feedback conditions. This was coupled with no significant difference between the no vision of the hands and normal vision conditions. Consequently this suggests that the perception of 90° or the requisite movement information is impeded in older adults. However, in slight contradiction to this, Swinnen et al. (1998) suggest that augmented visual feedback yields greater stability in retention under normal visual conditions. This may still suggest that older adults have improved their perceptual ability and are more able to gain the required requisite information due to training with augmented visual feedback.
In conclusion, by increasing the perceptual information available to older adults, novel coordinated rhythmic movements can be learnt. This may not result in movement stability on a par with younger populations, but yields improved performance when the augmented feedback is removed. However the research remains inconclusive and underwhelming in its amount and requires greater exploration within older adults.
References
Swinnen, S.P., S.M.P. Verschueren., H. Bogaerts., N. Dounskaia. (1998). Age-related deficits in motor learning and differences in feedback processing during the production of a bimanual coordination pattern. Cognitive neuropsycholocy, 15(5), 439-466.
Wishart, L.R., T.D. Lee., S.J. Cunningham., J.E. Murdoch. (2002). Age-related differences and the role of augmented visual feedback in learning a bimanual coordination pattern. Acta psychological, 110, 247-263.
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