Team University of Dayton Engineering & Safety Lab No. 24: Interview with a Physical Therapist

In the field of prosthetics, balance is crucial to rehabilitation after a person undergoes an amputation. Melanie Welch, a licensed physical therapist at Dayton Artificial Limb, was interviewed about the significance of balance therapy.


The first step of balance therapy is finding out why an individual has poor balance. Balance is dependent on multiple factors including posture, strength, range of motion, sensory abilities, an individual’s reaction abilities, and vestibular effects. The physical therapist tests the person’s “ability to balance sitting, standing, and experiencing external forces,” says Welch. In these tests, a therapist looks for balance reactions in an individual’s ankles and hips, specifically. In her patients, poor balance often results from stiffness or weakness.

After determining the issue causing instability, the next step is to address the issue. Strength and mobility exercises are some of the most common tools for improving an individual’s balance. In some cases, a patient is instructed on the use of assistive devices which help them maintain a stable base of support. A stable base of support is an important factor in stability; a wide, shoulder-width stance is more stable than standing with the feet together. Balance is affected by many things, and being able to influence those factors using techniques such as balance therapy, allows a person to walk with good stability.

Team University of Dayton Engineering & Safety Lab No. 23:Change Up Your Routine

 Our bodies really benefit from different types of activities. You should regularly include endurance, strength, balance, and flexibility exercises in your routine.

Endurance activities increase your breathing and heart rate. These help improve your overall health and fitness, making daily activities like climbing stairs or mowing the lawn much easier. Try going for a swim or taking a long walk in one of Dayton’s Metroparks.

Strength exercises increase muscle strength. Even small improvements can make a big difference in your ability to perform everyday tasks like carrying shopping bags or hauling your suitcase around the airport. You can use weights or resistance bands for these exercises.

Balance practice can help prevent falls (but you already knew that!). Some lower body strength exercises also help improve your balance. Tai chi is one example of a balance exercise, and check out our recurring feature called “Balance Tune-Up” for more.

Flexibility exercises, or stretches, can help your body stay flexible. Stretching gives you freedom of movement so you can do things like bending down to tie your shoes or looking over your shoulder as you back out of the driveway. Yoga is a great example.  Be creative!

Team University of Dayton Engineering & Safety Lab No. 22: More than Fun and Games!

Physical activity, exercise, and making healthy food choices are the cornerstones for healthy aging. But emerging research also indicates that engaging in social and productive activities you enjoy may also help maintain your well-being.

A number of early studies found that people who are involved in hobbies and other social and leisure pursuits may be at lower risk for (and less likely to develop) some health problems, including dementia. They might even live longer.  Older adults who reported participating in social activities or meaningful, productive activities lived longer than people who did not. Researchers are exploring if participation in these kinds of activities can be the direct cause of positive health outcomes.

According to researchers, older adults who participate in what they believe are meaningful activities, like volunteering in their communities, say they feel healthier and happier. For example, older adult volunteers from an urban community worked approximately 15 hours a week in their neighborhood public elementary schools, in a special program designed to improve children’s school success. The older volunteers increased their cognitive, social, and physical activity levels. Over the long term the participants may have decreased their risk for disability, dependency, and dementia in later life.

Team University of Dayton Engineering & Safety Lab No. 21: What to Discuss with Your Doctor

 

 

 

 

 

 

 

 

Asking your doctor questions about your health, and particularly balance, can be a difficult task. Reasons for this could range from nervousness to uncertainty in questions you should ask. Balance is a serious issue that has a drastic effect on the quality of life. Because of this, we have a list of potential topics that can affect balance that you and your physician can discuss at your next appointment.

1. Your history of falling and all medications you take

2. Gait and balance difficulties

3. Vision

4. Lower body strength

5. Cardiovascular conditions

6. Review your use of walking aids, such as canes and walkers

After you address any concerns you might have about balance, your doctor can help review and examine the topics that are listed to determine your everyday stability and risk of falling. Asking about these topics is important if you are experiencing trouble with balance because your doctor may make recommendations for preventing future falls

Team University of Dayton Engineering & Safety Lab No. 20: Winter Fall Prevention

8 Winter Fall Prevention Tips (January)

 All the snow and ice we get here in Dayton can make for some dangerous conditions.  We have some tips to keep your feet under you this winter.

1.  Check your footwear.  Do your shoes have good traction?  Rubber stays grippy in cold weather while other materials become harder and more slippery. 

2.  Keep your shovel and salt inside. If you have to walk on an icy walkway to get to your shovel and salt, they aren’t helping you. 

3.  Bring a cell phone.  If you fall, it can sometimes be hard to get up.  A cell phone can bring peace of mind.

4.  Take it slow.  Hurrying challenges your body’s balance just as much as ice. 

5.  Check the railings.  Make sure your railings  are sturdy.  If you slipped, could they support you?

6.  Ask for help.  If you have to walk across an icy parking lot or sidewalk, don’t be afraid to ask for a steady arm to lean on. 

 7.  Have a plan.  When you’re going out ask yourself, “If I slipped and fell here, what would I do?”

8.  Strengthen your legs.  Strong leg muscles can help you steady yourself if you slip.  And if you do fall, they make it a lot easier to get back up.  When used together, these simple things can make this winter a little less daunting.               

Team University of Dayton Engineering & Safety Lab No. 19: Arthritis in the Winter



Müller, E. "Salzburg Skiing for the Elderly Study.

" Scandinavian Journal of Medicine & Science in Sports (2011).

 Reducing the Effects of Arthritis in Winter (December)


The old wives’ tale states that aching joints tell of a change in the weather. While little scientific evidence exists to support this, there are many things you can do to reduce the effects of arthritis this winter. Make sure to consult a doctor first!

1. Swim/soak in warm water— Swimming is great low-impact exercise too, just don’t venture into cold weather immediately after.

2. Exercise indoors—Don’t let your activities fall by the wayside as temperatures drop. Invest in a treadmill for your home or walk the local mall.

3. Make sure you’re getting enough Vitamin D—ask your doctor if you need a supplement in winter, when you’re less likely to get your recommended dose from the sun.

4. Try a glucosaminechondroitin supplement—this pricey herbal supplement hasn’t been proven, but many arthritis patients swear by it, and it has lower risky side effects than other medications.

5. Add 2,000-3,000mg of fish oil daily—The omega-3 fatty acids they contain reduce inflammation.

Team University of Dayton Engineering & Safety Lab No. 18: VA-PAMAID Robotic Walker!

A few researchers had a brilliant idea that a walker could be much more than a device that can help someone keep their balance. This walker of the future does everything a regular walker does but it can also locate itself by reading signs, spot and avoid small objects in its walking path, and prevent collisions with large objects.


How does it do this? It uses ultrasonic sensors to virtually map out its surroundings, basically the same thing we do with our eyes when we want to walk somewhere. It detects obstacles and then does its best to navigate around them.

As of right now, this walker is called the VA-PAMAID, and it is still in the testing period. It has been determined to be very safe, and can accommodate all weather conditions. It has a range of 10.9km with a maximum speed of 1.2m/s. Research is still being conducted in order to make improvements. An example of a possible improvement is a GPS system that has a map of an institution such as a senior center so it can navigate through complicated hallways and corridors with ease. So be on the lookout for the release of this product in the future!

“The SmartCane System.” UCLA. 2011. www.cs.ucla.edu/~alireza/BodyNets08.pdf

Team University of Dayton Engineering & Safety Lab No. 17: How hard are you Working?

The amount of effort you need to do an activity will depend on your fitness level, strength, and how active you’ve been. For example, walking a mile in 15 minutes will be a lot easier for someone who does it every day compared with someone who has never done it. You can use these informal guidelines to estimate how much effort you are putting into your endurance activities:


• Brisk walking is a moderate activity, while jogging is a vigorous activity.

• Talking is easy during moderate activity but difficult during vigorous activity.

• If you tend to sweat, you probably won’t sweat during light activity. You will sweat during vigorous or sustained moderate activity. Remember to drink fluids even if you don’t sweat.

One doctor who specializes in exercise for older adults tells her patients the following: “If you can’t talk while you’re exercising, it’s too difficult. If you can sing a song, it’s too easy

Team University of Dayton Engineering & Safety Lab No. 16: Measuring Balance!

If you’ve participated in one of our studies, we probably asked you to stand on something called a balance plate. The balance plate that we use in the lab looks like a scale or a Wii Fit. Since human balance is a complex system, clinicians and researchers have historically had difficulty measuring it. The balance plate overcomes this challenge through the use of sensors called load cells.


When a test subject steps on the plate, the load cells measure vertical force and the movement of the subject’s center of pressure (kind of like your center of gravity). Generally, we conduct tests that last 30 to 90 seconds.

This gives us objective and accurate measurements of medial-lateral (left-right) sway and anterior-posterior (back and forth) sway. This data goes directly to a computer program that graphs the data. The data can be represented a few ways, and the picture to the right shows a common representation of sway.

If the subject had absolutely no sway, there would just be a red dot in the center of the graph. However, everyone has some kind of circle or ellipse. In other words, no human being is perfectly balanced. In fact, having just Yellow circle represents the body’s center of pressure (COP), and red lines show the path that the COP took as the subject stood still. She swayed about 1/2” in each direction

Team University of Dayton Engineering & Safety Lab No. 15: Tai Chi

Do you need a new and exciting exercise? Tai Chi is a type of exercise that has immense health benefits especially for balance stability because it works on vital core muscles. Tai Chi is described as a self-paced system of gentle physical exercise and stretching. It is made up of organic, nature-like poses and movements.


Most forms of Tai Chi are very calm and are easy for all ages. It requires no extra equipment and can be done alone or in a group. It’s a low impact form of exercise but consult your doctor before trying it if you have joint, spine or heart problems or severe osteoporosis.

In addition to improving balance and reducing falls, Tai Chi can improve sleep, relieve chronic pain, reduce anxiety and overall offer well-being.

To get started, check The Franciscan Center schedule to see when they offer classes. Start with a basic beginning instructor to learn the movements safely and correctly. To gain all the advantages of Tai Chi, think about practicing it daily at a regularly scheduled time.

Team University of Dayton Engineering & Safety Lab No. 14: What Does This Research Mean to Me?

When results of medical studies are reported to the public, some of the information can be misleading. In particular, studies that are researching new types of drugs seem the most confusing. Is it possible that one drug could be “300% more effective” than another? How do we know what is worth paying attention to?


First, see if the study was a “randomized controlled clinical trial”. This type is usually the most reliable because it involves a large number of subjects randomly put into test groups and control groups. Neither the doctors nor the subjects know which group the subjects are placed in. Randomized controlled clinical trials minimize bias.

Two other tell-tale terms are “relative risk” and “absolute risk.” Absolute risk shows the actual number of people the drug helps, but relative risk just indicates the likelihood that the drug helps. Saying “Relative risk” can make a drug seem more effective than it actually was. Lastly, make sure the subjects were similar to you in age, gender, and medical history.

“The bottom line is: talk to your doctor. He or she can help you understand the results and what they could mean for your health.”

Team University of Dayton Engineering & Safety Lab No. 13: Try Swimming This Summer!

Exercising three times a week is a widely recognized method for improving health, but the type of exercise performed can greatly affect what aspects of your health are improved. Recently researchers have compared different aerobic activities such as jogging and swimming to determine what types of exercise can help improve balance and hand eye coordination and to what extent.


It has been found by H. -C. Hsu and his lab that swimming three times a day can significantly improve balance and reaction time due to improved hand eye coordination. The study was carried out with two groups of people all between the ages of 60 and 75. Both groups exercised regularly three times a week, but while one group swam for their exercise, the other performed activities such as jogging and rock climbing. The evaluators were blind to the type of exercise each participant had been performing.

This finding is extremely accommodating to the members of the population that are frail or have joint problems because swimming, unlike most other physical activities, does not put any significant pressure on the joints and bones of the human body. The best way to start exercising by swimming would be to practice until you can swim for ten minutes at a time, and then swim 500 yards, or thirty minutes, three times a week for an extended period of time alternating non-exercising and exercising days.

Team University of Dayton Engineering & Safety Lab No. 12: The Astronaut Who Works to Prevent Falls!

Dr. Sienko's prototype- a vibrotactile feedback device for improving balance!


Kathleen Sienko is a researcher at the University of Michigan who specializes in technology to stabilize both elderly people and post-flight astronauts. Her current project uses a cell phone to provide vibrational cues to a person when he or she begins to lose balance.

What inspired you to choose this field? I am passionate about space exploration, and after working on a balance-related study that employed individuals with vestibular deficits as analogs for astronauts returning from long-duration spaceflight, I came to appreciate the daily challenges associated with inner ear disease and was inspired to pursue research that would have a positive impact on the quality of life for persons with balance deficits.

What are the benefits of your research? My research focuses on the design and assessment of devices for improving balance and the development of low-cost, easy-to-use technologies to benefit global health.

What about your field would most surprise people? The amount of travel. During the past year, work has taken me to Washington, D.C., Pittsburgh, Minneapolis, Morgantown, Geneva, Copenhagen, Kampala, Dar es Salaam, Kumasi, Reykjavik, Bangkok and New Delhi.

Gonzales, Cecile. "Astronauts and the Elderly Share Balance Issues." ScienceLives 26 Aug 2010. www.livescience.com/11167-astronauts-elderly-share-balance-issues.html

Team University of Dayton Engineering & Safety Lab No. 11: Wii Bowling!

Physical therapists use many different types of interventions to treat elderly adults with an increased risk of falling. Typically, they will do so by creating a regimen that uses various exercises. However, a recent case study tested a new and exciting way to improve balance.

It investigated the effect a Nintendo Wii bowling simulation had on the balance of a resident at a nursing home. The resident was an 89 year old woman with a history of falling and was recently diagnosed with an unknown balance disorder. The subject performed six, one hour bowling sessions over a two week period.

After two weeks, the intervention helped to decrease the subject’s risk of falling and her balance. Even though this approach to improving balance seems very unusual, the use of new technology not geared towards balance, such as the Nintendo Wii, might be the future for improving people’s balance and decreasing their risk of falling.

"Tips to Avoid Falls When in the Hospital." Partners.org. Partners Healthcare.2011. www.partners.org/cird/FallsPrevention/pdfs/AVOIDING_FALLS.pdf

Team University of Dayton Engineering & Safety Lab No. 10: Fall Prevention in Hospitals

In the past, the hospitalized elderly had more to worry about than simply getting healthy; they also had to worry about how to avoid falling while in the hospital. Until recently, hospitals focused on drugs and restraints when it came to fall prevention. Medication was often given with the intent to decrease agitation, restlessness, and the risk for falls, but that same medication actually increased falls by altering judgment, balance, and gait. Likewise, physical restraints such as side rails on hospital beds have been shown to cause or worsen agitation, combativeness, and confusion, leading to more falls.

Recently, hospitals have shifted their fall prevention focus and incorporated the following strategies into patient care: integrate physical and occupational therapy and nursing into fall assessments, enlist the pharmacy to label medications associated with increased risk of falls, question family members about patients’ typical daily routines, and increase hourly rounds to address patients’ personal needs.

Elderly patients can also play a role in increasing their own safety. They can discuss their risk for falls with their doctor to devise a fall prevention plan such as asking for help when getting out of bed, walking, or toileting, avoiding sudden movements, wearing properly fitting shoes, checking for clear paths when walking, utilizing the call button on hospital beds, and using assistive devices such as canes and walkers.

Together hospitals and elderly patients can reduce the risk of falls and make hospitals safer for the elderly so they can focus on what is most important, getting healthy.

Team University of Dayton Engineering & Safety Lab No. 9: Falls

Have You Fallen in the Past Year? You’re not alone

As our age increases, so does our risk of falling. Do not think you are alone if you have fallen in the past year, about one third of people over 65 have. The causes of falls have a very wide range starting from poor lighting to balance disorders. There is no standard to classify these risk factors but they can be categorized into intrinsic or extrinsic risk factors.

Intrinsic risk factors encompass anything within the body. For example, blindness or lesser visual deficits, hip and knee weaknesses, weakened grip strength, or even functional and cognitive impairments. These types of risks are best discussed with your doctor.

Extrinsic factors include environmental issues like poor lighting, throw rugs, lack of safety equipment, smooth surfaced floors, or even the type of shoes you wear. Other extrinsic factors consist of taking pharmaceutical medications that have negative side effects.

These risk factors are different for each person’s case and if multiple factors are involved, the risk that you will fall increases. It has been shown that assistive devices like walkers or canes have helped prevent falls but they have not proven to be the sole reason of fall preventions. Thus it is important to be aware of all the risk factors that could affect you so you can prevent a fall. -Alex Brogan

Team University of Dayton Engineering & Safety Lab No. 8: 8 Winter Fall Prevention Tips!

For help keeping your walkways safe, call up a local snow removal service

All the snow and ice we get here in Dayton can make for some dangerous conditions. We have some tips to keep your feet under you this winter.

1. 
   Check your footwear. Do your shoes have good traction? Rubber stays grippy in cold weather while other materials become harder and more slippery.
2. 
   Keep your shovel and salt inside. If you have to walk on an icy walkway to get to your shovel and salt, they aren’t helping you.
3. 
   
   Bring a cell phone. If you fall, it can sometimes be hard to get up. A cell phone can bring peace of mind.
4. 
   
   Take it slow. Hurrying challenges your body’s balance just as much as ice.
5. 
   
   Check the railings. Make sure your railings are sturdy. If you slipped, could they support you?
6. 
   
   Ask for help. If you have to walk across an icy parking lot or sidewalk, don’t be afraid to ask for a steady arm to lean on.
7. 
   
   Have a plan. When you’re going out ask yourself, “If I slipped and fell here, what would I do?”
8. 
   
   Strengthen your legs. Strong leg muscles can help you steady yourself if you slip. And if you do fall, they make it a lot easier to get back up.

When used together, these simple things can make this winter little less daunting-Erin Sutton

Team University of Dayton Engineering & Safety Lab No. 7: Precision Contact!

You may have noticed that some balance exercises are easier if you have a chair or railing to lightly hold on to. Why is it that sometimes even just a fingertip touching a railing is enough to keep you steady?

Five subjects with vestibular balance deficits and five control subjects participated in a study called “Precision Contact of the Fingertip Reduces Postural Sway of Individuals with Bilateral Vestibular Loss.” To ensure that vision wasn’t a factor, all balance testing took place in a dark room. Participants stood with one foot in front of the other on a balance plate that recorded their sway. For some trials, participants were permitted to lightly touch a bar, and for other trials they could apply as much force to the bar as they needed.

The results showed the powerful benefit of a light touch in keeping the body stable, even in the dark. In fact, the vestibular loss subjects went from “teetering out of control” without touch to being more stable than the control subjects could in the dark without touch. Both groups had significantly less sway when they were able to use just one fingertip to stabilize themselves. So there’s just one more reason to always use a handrail!

James, Lackner R. "Precision Contact of the Fingertip Reduces Postural Sway of Individuals with Bilateral Vestibular Loss." Exp Brain Res (1999). www.smpp.northwestern.edu/savedLiterature/LacknerDizioJekaHorakEtcEBR99(91260459).pdf

Team University of Dayton Engineering & Safety Lab No. 7: Non-slip Products

At just $2.99 a pair,

these replacement tips
are a great way to
reduce fall risk

The incidence of falls in the home can be greatly reduced with the use of nonslip products. Thankfully, slip-resistant solutions are being created. These products include non-slip mats to be used under rugs and bathroom. New additions often do more than just decrease the likelihood of losing your footing.

There are brightly colored mats with treads for the stairs that better indicate where one step ends and the next begins. The easiest, most inexpensive solution we found are small rubber feet you can be attach to the end of canes and walkers to increase grip.

One of the latest products is a coating that can be used on bath tubs and hard floors to make them less slippery. They are easy to apply and essentially invisible once dry. Overall, the market for non -slip products has greatly expanded and a little research, along with a few modifications to your home, can decrease your risk of falling.

- Julia Schaeffer