Balance impairment is one of the biggest risk factors for falls reducing inactivity, resulting in nursing care. Therefore, balance ability is crucial to maintain the activities of independent daily living of older adults. Many tests to assess balance ability have been developed. However, few reports reveal the structure underlying results of balance performance tests comparing young and older adults. Covariance structure analysis is a tool that is used to test statistically whether factorial structure fits data. This study examined aging effects on the factorial structure underlying balance performance tests. Participants comprised 60 healthy young women aged 22 ± 3 years (young group) and 60 community-dwelling older women aged 69 ± 5 years (older group). Six balance tests: postural sway, one-leg standing, functional reach, timed up and go (TUG), gait, and the EquiTest were employed. Exploratory factor analysis revealed that three clearly interpretable factors were extracted in the young group. The first factor had high loadings on the EquiTest, and was interpreted as `Reactive'. The second factor had high loadings on the postural sway test, and was interpreted as `Static'. The third factor had high loadings on TUG and gait test, and was interpreted as `Dynamic'. Similarly, three interpretable factors were extracted in the older group. The first factor had high loadings on the postural sway test and the EquiTest and therefore was interpreted as `Static and Reactive'. The second factor, which had high loadings on the EquiTest, was interpreted as `Reactive'. The third factor, which had high loadings on TUG and the gait test, was interpreted as `Dynamic'. A covariance structure model was applied to the test data: the second-order factor was balance ability, and the first-order factors were static, dynamic and reactive factors which were assumed to be measured based on the six balance tests. Goodness-of-fit index (GFI) of the models were acceptable (young group, GFI=0.931; older group, GFI=0.923). Static, dynamic and reactive factors relating to balance ability had loadings 0.21, 0.24, and 0.76 in the young group and 0.71, 0.28, and 0.43 in the older group, respectively. It is suggested that the common factorial structure of balance abilities were static, dynamic and reactive, and that for young people reactive balance ability was characterized and explained by balance ability, whereas for older people it was static balance ability.
Objective: This study compared efficacy of combinations of Back Muscles Endurance Exercise (BMEE) and McKenzie Exercise (ME) and McKenzie Back Care Education (MBE) in the management of long term mechanical Low Back Pain (LBP). Subjects and Methods: A single-blind randomized controlled comparative trial was employed. Seventy three participants mean age 45.3 ± 8.1 years were recruited for the study but only 53 completed the study. Participants in group A were treated with a combination of BMEE, ME and MBE. Group B: A combination BMEE and MBE. Group C: A combination of ME and MBE. Group D: MBE only. Participants were seen thrice weekly for 8 weeks. They were measured for pain intensity, lumbar flexibility, activities limitation and self esteem. Data were analysed using descriptive and inferential statistics of F-test. Significance was set at 0.05 alpha-level. Results: At the end of the study, the four treatment groups had significant reduction in pain intensity p<0.05. Post hoc analysis showed groups A, B, and C had significantly greater reduction than D, and groups A and C had significantly greater reduction than B. Groups A, B and C also had significant improvement in activities limitation p<0.05. Post hoc analysis showed groups A, B and C had significantly greater improvement than D, and group B significantly greater improvement than C. Conclusion: Combination physiotherapy regimens proved effective in the management of long- term mechanical LBP. Regimen A is recommended in managing long-term mechanical LBP.