Document Type : Research Paper


1 Associate Professor, Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, Shahid Beheshti University, Teheran, Iran

2 M.Sc. of Motor Behavior, Shahid Beheshti University, Tehran, Iran


The purpose of present study was to determine the effect of different levels of balance task difficulty and visual feedback on balance in elderly women. Fourteen healthy elderly women (mean age 57/65 yr) were selected voluntarily. Participants were asked to stand still on a stability platform under each of two conditions (with visual feedback and without visual feedback) in three levels of difficulty (6, 8, 10). Stability index scores (Overall, Anterior- Posterior and Medial- Lateral) were calculated by Biodex Balance System. Duration of each test was 20 seconds and rest times were 20 seconds. Results showed that with increasing task difficulty, score of Medial- Lateral balance (p= 0/02) increased significantly. In addition, There was a significant reduction in the scores of Overall balance (p= 0/001), anterior - posterior balance (p= 0/01) and medial - lateral balance (p= 0/01) in visual feedback condition compared with without feedback condition. Overall, the results of this study showed that increasing task difficulty increases postural sway and availability of visual feedback can improve balance and reduce the postural sway.


  1. باقری، رسول؛ سرمدی، علیرضا؛ داداشی آرانی، لیلا (1391). بررسی تأثیرات یادگیری سیستم تعادلی بایودکس هنگام ارزیابی تکلیف پوسچرال در آزمون‌های مکرر. کومش 13، ص 361- 354.
  2. سرحدی، محسن؛ ابوطالبی شهرام؛ حسینی، سید علی (1387). بررسی تأثیر نوع سطح اتکا و نوع موضع توجه بر تعادل مردان سالمند با سابقۀ افتادن. سالمندی ایران، سال سوم، ش نهم و دهم، ص 46-37.
  3. کهلایی، امیرحسین؛ بحرپیما فرید؛ استکی، علی؛ مبینی، بهرام (1390). اثر خستگی وکاهش ثبات سطح اتکا بر متغیرهای کنترل وضعیتی در وضعیت ایستاده در افراد سالم و مبتلا به کمر درد مزمن غیراختصاصی. مجلۀ تحقیقات علوم پزشکی زاهدان. 13 (7)، ص 12-7.
  4. Anand, V., J., Buckley, G. , Scally A. & Elliott, D., B. (2003). “Postural Stability in the Elderly during Sensory Perturbations and Dual Tasking: The Influence of Refractive Blur”. Investigative Ophthalmology & Visual Science. 44(7): 2885- 289.
  5. Beissner, K. L., Collins, J. E., & Holmes, H. (2000). “Muscle force & rang of motion as predictors of function in older adults”. Physical therapy. 80(6): 556-563.
  6. Berger, L., Chuzel, M., Buisson, G., Rougier, P. (2005). “Undisturbed upright stance control in the elderly: part I: age-related changes in undisturbed upright stance control”. Journal of Motor Behavior. 37(5):348–358.
  7. Boudrahem, R., & Rougier P. (2009). “Relation between postural control assessment with eyes open and centre of pressure visual feedback effects in healthy individuals”. Experimental Brain Research. 195(1): 145–152.
  8. Bottaro, A., Yasutake, Y., Nomura, T., Casadio, M., Morasso, P. (2008). “Bounded stability of the quiet standing posture: an intermittent control model”. Human Movement Science. 27:473–495.
  9. Brandt, T. P. (1983). “Visual acuity, visual field and visual scene characteristics affect postural balance”. Vestibular and Visual Control on Posture and Locomotor Equilibrium. 93–98.
  10. Bruno, M., Matheus , J., Generosi , A., Marco , A., & Junior , C. (2011). “Effect of muscle fatigue on posture control in soccer Players during the short-pass movement”. Review Brasilian Cineantropometria Desempenho Hu. 13(5): 53-348.
  11. Dault, C., Haart M, de, Geurts A , C. H., & Arts Ils. (2003). “Effects of visual center of pressure feedback on postural control in young and elderly healthy adults and in stroke patients”. Human Movement Science. 22(3): 221-236.
  12. Freitas, S. M. S. F., Duarte, M. (2012). “Joint coordination in young and  older adults during quiet stance: Effect of visual feedback of the center of pressure”. Gait & Posture. 35: 83–87.
  13. Gatev, P. T. (1999). “Feedforward ankle strategy of balance during quiet stance in adults”. Journal of Physiology. 514(3): 915–928.
  14. Gimmon , Y., Riemer , R., Oddsson, L., & Melzer, I. (2011). “The effect of plantar flexor muscle fatigue on postural control”. Journal of Electromyography and Kinesiology. 21(6): 922-928.
  15. Kennedy, M. W., Crowell, C. R., Striegel, A. D., Villano, M., Schmiedeler, J. P. (2013). “ Relative efficacy of various strategies for visual feedback in standing balance activities”. Experimental Brain Research. 230 (1): 117-125.


  1. khosravi, J. (1386). “Four-year health status for older workers employed in the field of urban services and green spaces Tehran Municipality in 1381-1384”. Journal of health aging. 2:67-88.
  2. Lamoth, C. J., van Lummel, R. C., & Beek, P. J. (2009). “Athletic skill level is reflected in body sway: A test case for accelometry in combination with stochastic dynamics”. Gait and Posture. 29(4): 546–551.
  3. Laughton, C. A., Slavin, M., Katdare , K., Nolan, L., Jonathan , B., Kerrigan , D. C., Col, J. J. (2002). “Aging, muscle activity, and balance control: physiologic changes associated with balance impairment”. Gait and Posture. 18(2): 101_108.
  4. Meshkati , Z., Namazizadeh , M., Salavati, M., & Meshkati , L. (2010). “The comparison of the role of vision on static postural stability in athletes and non-athletes”. Journal of Iranian Rehabilitatio. 8(11): 50-63.
  5. Melzer, I., Kurz, I., & Oddsson , L. I. (2010). “A retrospective analysis of balance control parameters in elderly fallers and non-fallers”. Clinical Biomechanics. 25(10): 984–988.
  6. Murillo , D. B., Solana , R. S., Vera-Garcia , F. J., & Fuertes , N. G. (2012). “Effect of increasing difficulty in standing balance tasks with visual feedback on postural sway and EMG: Complexity and performance”. Human Movement Science. 31(5):1224-1237
  7. Negahban, H., Salavati, M., Mazaheri, M., Sanjari, M. H., Hadian, M. R., & Parnianpour, M. (2010). “Non-linear dynamical features of center of pressure extracted by recurrence quantification analysis in people with unilateral anterior cruciate injury”. Gait and Posture. 31(4): 450–455.
  8. Onambe´le´, G., L., Narici, M., V., Rejc, E. & Maganaris, C. , N. (2006). “Contribution of calf muscle–tendon properties to single-leg stance ability in the absence of visual feedback in relation to ageing”. Gait & Posture. 26(3): 343–348.
  9. Palm, H., G., Strobel, J., & Achatz , G. (2009). “The role and interaction of visual and auditory afferents in postural stability”. Gait & Posture. 30(3): 328–333.
  10. Poulain, I., & Giraudet, G. (2007). “Age-related changes of visual contribution in posture control”. Gait & Posture. 27(1): 1–7.
  11. Rougier, P. (2003). “Visual feedback induces opposite effects on elementary centre of gravity and centre of pressure minus centre of gravity motions in undisturbed upright stance”. Clinical Biomechanics. 18(4): 341–349.
  12. Rougier, P. (2005). “Compatibility of postural behavior induced by two aspects of visual feedback: time delay and scale display”. Experimental Brain Research 165: 193–202.


  1. Salsabili , H., Bahrpeyma, F., Forogh, B., & Rajabali, S. (2011). “Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes”. Journal of Rehabilitation Research & Developmen. 48(7): 775-786.
  2. Stanton, R., Ada, L., Dean, C. M., Preston, E. (2011). “Biofeedback improves activities of the lower limb after stroke: a systematic review”. Journal of Physiotherapy. 57: 145- 155.


  1. Stins, J. F., Michielsen, M. E., Roerdink, M., & Beek, P. J. (2009). “Sway regularity reflects attentional involvement in postural control: Effects of expertise, vision and cognition”. Gait and Posture. 30(1): 106–109.
  2. Stins, J. F., Ledebt, A., Emck, C., & van Dokkum, E. (2009). “Patterns of postural sway in high anxious children”. Behavioral and Brain Function. 5: 42.
  3. Timmann, D., Belting, C., Schwarz, M., & Diener H, C. (1993). “Influence of visual and soatosensory input on leg EMG responses in dynamic posturography in normals”. Electroencephalography and clinical Neurophysiology. 93(1): 7-14.
  4. Tucker M, G., Kavanagh J, J., Steven, M., & Barrett R, S. (2010). “Differences in Rapid Initiation and Termination of Voluntary Postural Sway Associated with Ageing and Falls-Risk”. Journal of Motor Behavior. 42(5): 277-287
  5. Walker, C., Brouwer, B., J., & Culham, E., G. (2000). “Use of Visual Feedback in Retraining Balance Following Acute Stroke”. journal of the American Physical Therapy Association. 80(9):886-895
  6. Yaggie , J., & Gregor , S. (2002). “Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits”. Archivesof Physical Medicine and Rehabilitation. 83(2): 224–228.