http://hdl.handle.net/2027.42/83334 2013-06-19T14:19:19Z http://hdl.handle.net/2027.42/83702 Age Differences in the Control of Posture and Movement During Standing Reach Huang, Min-Hui The performance of standing reach requires the maintenance of postural stability and the coordination of multiple joints. Although aging is associated with declines in postural stability, the impact of workspace target heights, reaching with the dominant versus non-dominant arm, and movement context on limb-posture control is not well understood in older adults. The first study of this dissertation examined anticipatory and dynamic postural control during standing reach to different heights with the dominant and non-dominant arm. Compared to younger individuals, older adults produced larger anticipatory postural adjustments (APAs), and center of pressure (COP) trajectories were less smooth, particularly when returning to an upright posture (Chapter 2). These results suggested that older adults used an active “over-control” strategy to increase the safety margin for balance, rather than relying on later, potentially inadequate compensatory postural responses. Older adults exhibited significant increases in APA amplitude and COP trajectory smoothness when reaching with the dominant compared to the non-dominant hand, perhaps reflecting handedness. In contrast, no differences between age groups were found when examining hand trajectory curvature, indicating that planning of multi-joint, standing reach movements was not affected by age (Chapter 3). Hand trajectories were more curved during reaching to low compared to higher targets regardless of age, suggesting that the biomechanical demands associated with controlling the trunk affects hand trajectory formation. The second study examined whether the movement context (pointing versus grasping) would affect postural control (Chapter 4). In older adults only, grasping was associated with a decrease in COP trajectory linearity, suggesting that aging affects the ability to anticipate and counteract the internal perturbations generated by grasping an object. From a rehabilitative perspective, the results of these studies indicate that standing balance training in older adults should incorporate different workspace locations, functional goals, as well as tasks involving reaching with both the dominant and non-dominant hands. Dissertation (Ph.D.)--University of Michigan. 2009-01-01T00:00:00Z http://hdl.handle.net/2027.42/64709 Age Differences in the Control of Posture and Movement During Standing Reach. Huang, Min-Hui The performance of standing reach requires the maintenance of postural stability and the coordination of multiple joints. Although aging is associated with declines in postural stability, the impact of workspace target heights, reaching with the dominant versus non-dominant arm, and movement context on limb-posture control is not well understood in older adults. The first study of this dissertation examined anticipatory and dynamic postural control during standing reach to different heights with the dominant and non-dominant arm. Compared to younger individuals, older adults produced larger anticipatory postural adjustments (APAs), and center of pressure (COP) trajectories were less smooth, particularly when returning to an upright posture (Chapter 2). These results suggested that older adults used an active “over-control” strategy to increase the safety margin for balance, rather than relying on later, potentially inadequate compensatory postural responses. Older adults exhibited significant increases in APA amplitude and COP trajectory smoothness when reaching with the dominant compared to the non-dominant hand, perhaps reflecting handedness. In contrast, no differences between age groups were found when examining hand trajectory curvature, indicating that planning of multi-joint, standing reach movements was not affected by age (Chapter 3). Hand trajectories were more curved during reaching to low compared to higher targets regardless of age, suggesting that the biomechanical demands associated with controlling the trunk affects hand trajectory formation. The second study examined whether the movement context (pointing versus grasping) would affect postural control (Chapter 4). In older adults only, grasping was associated with a decrease in COP trajectory linearity, suggesting that aging affects the ability to anticipate and counteract the internal perturbations generated by grasping an object. From a rehabilitative perspective, the results of these studies indicate that standing balance training in older adults should incorporate different workspace locations, functional goals, as well as tasks involving reaching with both the dominant and non-dominant hands. 2009-01-01T00:00:00Z http://hdl.handle.net/2027.42/61325 HIV/AIDS in the 21st century: what can we learn from each other? Gale, Judith R.; Pfalzer, Lucinda No abstract. 2008-12-01T00:00:00Z http://hdl.handle.net/2027.42/60215 Preoperative assessment enables the early diagnosis and successful treatment of lymphedema. Stout Gergich, Nicole L.; Pfalzer, Lucinda A.; McGarvey, Charles; Springer, Barbara; Gerber, Lynn H.; Soballe, Peter BACKGROUND The incidence of breast cancer (BC)-related lymphedema (LE) ranges from 7% to 47%. Successful management of LE relies on early diagnosis using sensitive measurement techniques. In the current study, the authors demonstrated the effectiveness of a surveillance program that included preoperative limb volume measurement and interval postoperative follow-up to detect and treat subclinical LE. METHODS LE was identified in 43 of 196 women who participated in a prospective BC morbidity trial. Limb volume was measured preoperatively and at 3-month intervals after surgery. If an increase >3% in upper limb (UL) volume developed compared with the preoperative volume, then a diagnosis of LE was made, and a compression garment intervention was prescribed for 4 weeks. Upon reduction of LE, garment wear was continued only during strenuous activity, with symptoms of heaviness, or with visible swelling. Women returned to the 3-month interval surveillance pathway. Statistical analysis was a repeated-measures analysis of variance by time and limb ( P ≤ .001) comparing the LE cohort with an age-matched control group. RESULTS The time to onset of LE averaged 6.9 months postoperatively. The mean (±standard deviation) affected limb volume increase was 83 mL (±119 mL; 6.5% ± 9.9%) at LE onset ( P = .005) compared with baseline. After the intervention, a statistically significant mean 48 mL (±103 mL; 4.1% ± 8.8%) volume decrease was realized ( P < .0001). The mean duration of the intervention was 4.4 weeks (±2.9 weeks). Volume reduction was maintained at an average follow-up of 4.8 months (±4.1 months) after the intervention. CONCLUSIONS A short trial of compression garments effectively treated subclinical LE. Cancer 2008. Published 2008 by the American Cancer Society. 2008-06-15T00:00:00Z