Current research suggests that there are complex interactions between intrinsic factors related to the individual and extrinsic environmental factors, all of which contribute to falls in the older adult. A new approach to balance assessment, the task-oriented conceptual framework for clinical intervention, takes into account many of these intrinsic and extrinsic variables in assessing balance function. It contains three levels of assessment of balance and gait function: performance-based functional assessment, strategy assessment, and impairment assessment. This approach quantifies performance on functional tests of balance, determines the strategies used by the individual to carry out functional tasks, and evaluates the relative contribution of specific neural and musculoskeletal variables to normal postural control. Results of recent experiments suggest that older adults who are given a sensory training program that is designed to improve the organization of sensory inputs contributing to balance control (strategy level) are able to significantly improve sway and that this training effect transfers to other balance conditions.
Marjorie H. Woollacott and Anne Shumway-Cook
Heidi Sveistrup, Patricia A. Burtner and Marjorie H. Woollacott
Children in physical education classes, special education classes, and rehabilitation programs have extremely varied abilities and deficits in motor tasks. Among the problems faced by the teachers, therapists, and other specialists is the identification of the underlying mechanisms that produce the problems observed in these children. In addition, teachers and others must design an appropriate intervention strategy. This paper discusses two approaches being used to study the underlying systems and computations that contribute to the control and regulation of movement. The systems approach focuses on the problems that children with specific pathologies have in regulating their balance and equilibrium. The computational or modular approach addresses the motor deficits observed in certain children in terms of three possible computational units: timing, force production, and motor sequencing. These approaches may provide additional techniques for identifying the pathology underlying the behavioral deficits of children with motor impairment. Also, with these tools it may be possible to design alternative programs that will address the causes as well as the effects of the deficits observed in certain groups of children.