Agris Liepa, Undine Gudiņa, Evita Dubinina, Viesturs Larins, Aivars Kaupuzs


The researches indicate that core stability may play a substantial role in reducing fall risk in the elders. Nevertheless, cognition and functional performance has been identified with fall risks as well. The impact of functional performance elements and/or cognition on core stability, to complement the intervention programs for seniors in the future, has not been fully studied. This study aimed to assess the effects of leg strength, static balance, walking speed and cognition on the core stability scores. In a cross-sectional design study a sample of 62 participants were eligible for the study.  Elderly aged 60 or older living in Social care centers or autonomous were recruited. Independent variables included static balance, walking speed, leg strength measured by Short Physical Performance Battery, cognition (alertness, divided attention, selective attention, and working memory) evaluated with the Rehacom screening software and age. Dependent variable core stability (the ability to maintain appropriate contraction of muscle transversus abdominis) was assessed performing Prone test with Chattanooga Stabilizer Pressure Biofeedback. A hierarchical multiple regression was used for statistical analysis. Static balance and cognition presented greater effects significantly explaining 18% and 13% of the variability of core stability, whereas no significant effects of walking speed and leg strength were found on core stability. Exercise programs where static balance and cognition tasks are implemented to complement core stability performance might be worth investigating and compare with other intervention methods to reduce the risk of falling in the elderly population.


accidental falls; aging; cognition; physical functional performance; transversus abdominis

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Alvarez, J.A., & Emory, E. (2006). Executive function and the frontal lobes: a meta-analytic review. Neuropsychol Rev, 16(1), 17-42. DOI:10.1007/s11065-006-9002-x

Anderson, K., & Behm, D. G. (2005). The impact of instability resistance training on balance and stability. Sports Med, 35(1), 43-53.

Baker, M. K., Kennedy, D.J., Bohle, P.L., Campbell, D.S., Knapman, L., Grady, J., . . . Fiatarone Singh, M.A. (2007). Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial. J Am Geriatr Soc, 55(1), 1-10. DOI:10.1111/j.1532-5415.2006.01031.x

Barker, P., Briggs, C., & Bogeski, G. (2004). Tensile Transmission Across the Lumbar Fasciae in Unembalmed Cadavers. Spine (Phila Pa 1976), 29, 129-138. DOI:10.1097/01.BRS.0000107005.62513.32

Behm, D.G., Drinkwater, E.J., Willardson, J.M., & Cowley, P.M. (2010). The use of instability to train the core musculature. Appl Physiol Nutr Metab, 35(1), 91-108. DOI:10.1139/h09-127

Borghuis, A., Hof, A., & Lemmink, K.A.P.M. (2008). The Importance of Sensory-Motor Control in Providing Core Stability. Sports Med, 38, 893-916. DOI:10.2165/00007256-200838110-00002

Borroni, P., Montagna, M., Cerri, G., & Baldissera, F. (2008). Bilateral motor resonance evoked by observation of a one-hand movement: Role of the primary motor cortex. The European journal of neuroscience, 28, 1427-1435. DOI:10.1111/j.1460-9568.2008.06458.x

Cadore, E. L., Rodriguez-Manas, L., Sinclair, A., & Izquierdo, M. (2013). Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res, 16(2), 105-114. DOI:10.1089/rej.2012.1397

Cairns, M., Harrison, K., & Wright, C. (2000). Pressure Biofeedback: A useful tool in the quantification of abdominal muscular dysfunction? Physiotherapy, 86, 127-138. DOI:10.1016/S0031-9406(05)61155-8

Clark, B.C., & Manini, T.M. (2008). Sarcopenia ≠ Dynapenia. The Journals of Gerontology: Series A, 63(8), 829-834. DOI:10.1093/gerona/63.8.829

Clark, B.C., Taylor, J.L., Hong, S.L., Law, T.D., & Russ, D.W. (2015). Weaker Seniors Exhibit Motor Cortex Hypoexcitability and Impairments in Voluntary Activation. J Gerontol A Biol Sci Med Sci, 70(9), 1112-1119. DOI:10.1093/gerona/glv030

Drew, T., Prentice, S., & Schepens, B. (2004). Cortical and brainstem control of locomotion. Progress in brain research, 143, 251-261. DOI:10.1016/S0079-6123(03)43025-2

Ebenbichler, G.R., Oddsson, L.I., Kollmitzer, J., & Erim, Z. (2001). Sensory-motor control of the lower back: implications for rehabilitation. Med Sci Sports Exerc, 33(11), 1889-1898.

Faul, F., Erdfelder, E., Buchner, A., & Lang, A.G. (2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods, 41(4), 1149-1160. DOI:10.3758/brm.41.4.1149

Fjell, A.M., McEvoy, L., Holland, D., Dale, A.M., & Walhovd, K.B. (2014). What is normal in normal aging? Effects of aging, amyloid and Alzheimer's disease on the cerebral cortex and the hippocampus. Prog Neurobiol, 117, 20-40. DOI:10.1016/j.pneurobio.2014.02.004

Fjell, A.M., Westlye, L.T., Amlien, I., Espeseth, T., Reinvang, I., Raz, N., . . . Walhovd, K.B. (2009). High consistency of regional cortical thinning in aging across multiple samples. Cereb Cortex, 19(9), 2001-2012. DOI:10.1093/cercor/bhn232

Grady, C. (2012). The cognitive neuroscience of ageing. Nat Rev Neurosci, 13(7), 491-505. DOI:10.1038/nrn3256

Granacher, U., Gollhofer, A., Hortobagyi, T., Kressig, R.W., & Muehlbauer, T. (2013). The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Med, 43(7), 627-641. DOI:10.1007/s40279-013-0041-1

Grillner, S. (2011). Control of locomotion in bipeds, tetrapods, and fish. Comprehensive physiology, 1179-1236.

Guralnik, J.M., Ferrucci, L., Simonsick, E.M., Salive, M.E., & Wallace, R.B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med, 332(9), 556-561. DOI:10.1056/nejm199503023320902

Guralnik, J.M., Simonsick, E.M., Ferrucci, L., Glynn, R.., Berkman, L.F., Blazer, D.G., . . . Wallace, R.B. (1994). A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol, 49(2), M85-94.

Haefeli, J., Vögeli, S., Michel, J., & Dietz, V. (2010). Preparation and performance of obstacle steps: Interaction between brain and spinal neuronal activity. The European journal of neuroscience, 33, 338-348. DOI:10.1111/j.1460-9568.2010.07494.x

Hodges, P.W., & Richardson, C.A. (1996). Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine (Phila Pa 1976), 21(22), 2640-2650.

Ivanenko, Y., Poppele, R., & Lacquaniti, F. (2006). Motor Control Programs and Walking. The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry, 12, 339-348. DOI:10.1177/1073858406287987

Yuan, P., & Raz, N. (2014). Prefrontal cortex and executive functions in healthy adults: a meta-analysis of structural neuroimaging studies. Neurosci Biobehav Rev, 42, 180-192. DOI:10.1016/j.neubiorev.2014.02.005

Norton‐old, K. J., Schache, A. G., Barker, P. J., Clark, R. A., Harrison, S. M., & Briggs, C. A. (2013). Anatomical and mechanical relationship between the proximal attachment of adductor longus and the distal rectus sheath. Clinical Anatomy, 26(4), 522-530. doi:10.1002/ca.22116

Laessoe, U., Hoeck, H. C., Simonsen, O., & Voigt, M. (2008). Residual attentional capacity amongst young and elderly during dual and triple task walking. Hum Mov Sci, 27(3), 496-512. DOI:10.1016/j.humov.2007.12.001

Markovic, G., Sarabon, N., Greblo, Z., & Krizanic, V. (2015). Effects of feedback-based balance and core resistance training vs. Pilates training on balance and muscle function in older women: a randomized-controlled trial. Arch Gerontol Geriatr, 61(2), 117-123. DOI:10.1016/j.archger.2015.05.009

Myers, T.W. (2013). Anatomy Trains E-Book: Myofascial Meridians for Manual and Movement Therapists: Elsevier Health Sciences.

Ostir, G.V., Volpato, S., Fried, L.P., Chaves, P., & Guralnik, J.M. (2002). Reliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women's Health and Aging Study. J Clin Epidemiol, 55(9), 916-921.

Panjabi, M.M. (1992). The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord, 5(4), 383-389; discussion 397.

Pfefferbaum, A., Rohlfing, T., Rosenbloom, M.J., Chu, W., Colrain, I.M., & Sullivan, E.V. (2013). Variation in longitudinal trajectories of regional brain volumes of healthy men and women (ages 10 to 85 years) measured with atlas-based parcellation of MRI. Neuroimage, 65, 176-193. DOI:10.1016/j.neuroimage.2012.10.008

Radebold, A., Cholewicki, J., Polzhofer, G.K., & Greene, H.S. (2001). Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Phila Pa 1976), 26(7), 724-730.

Ramnath, U., Rauch, L., Lambert, E.V., & Kolbe-Alexander, T.L. (2018). The relationship between functional status, physical fitness and cognitive performance in physically active older adults: A pilot study. PLoS One, 13(4), e0194918. DOI:10.1371/journal.pone.0194918

Raz, N. (1999). Aging of the brain and its impact on cognitive performance: Integration of structural and functional findings (Vol. 2).

Raz, N., Gunning, F.M., Head, D., Dupuis, J.H., McQuain, J., Briggs, S.D., . . . Acker, J.D. (1997). Selective aging of the human cerebral cortex observed in vivo: differential vulnerability of the prefrontal gray matter. Cereb Cortex, 7(3), 268-282.

Richardson, C., Toppenberg, R., & Jull, G. (1990). An initial evaluation of eight abdominal exercises for their ability to provide stabilisation for the lumbar spine. Aust J Physiother, 36(1), 6-11. DOI:10.1016/s0004-9514(14)60514-6

Richardson, C.A., & Jull, G. (1995). Muscle control - Pain control. What exercises would you prescribe? Manual therapy, 1, 2-10. DOI:10.1054/math.1995.0243

Stanton, R., Reaburn, P., & Humphries, B. (2004). The Effect of Short-Term Swiss Ball Training on Core Stability and Running Economy. Journal of strength and conditioning research / National Strength & Conditioning Association, 18, 522-528. DOI:10.1519/1533-4287(2004)18<522:TEOSSB>2.0.CO;2

Sturm, W. (2002). Diagnostik von Aufmerksamkeitsstörungen in der Neurologie. Aktuelle Neurologie, 29(01), 25-29.

Sturm, W., & Willmes, K. (2001). On the functional neuroanatomy of intrinsic and phasic alertness. Neuroimage, 14(1), S76-S84.

Sturm, W., Willmes, K., Orgass, B., & Hartje, W. (1997). Do specific attention deficits need specific training? Neuropsychological Rehabilitation, 7(2), 81-103.

Suri, P., Kiely, D.K., Leveille, S.G., Frontera, W.R., & Bean, J.F. (2009). Trunk muscle attributes are associated with balance and mobility in older adults: a pilot study. Pm r, 1(10), 916-924. DOI:10.1016/j.pmrj.2009.09.009

Van Vleet, T.M., DeGutis, J.M., Merzenich, M.M., Simpson, G.V., Zomet, A., & Dabit, S. (2016). Targeting alertness to improve cognition in older adults: A preliminary report of benefits in executive function and skill acquisition. Cortex, 82, 100-118. DOI:10.1016/j.cortex.2016.05.015

Zazulak, B.T., Hewett, T.E., Reeves, N.P., Goldberg, B., & Cholewicki, J. (2007). The effects of core proprioception on knee injury: a prospective biomechanical-epidemiological study. Am J Sports Med, 35(3), 368-373. DOI:10.1177/0363546506297909



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