Multiple Body System Analysis Across the Lifespan: Difference between revisions
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Table 1 provides examples of functional tests that can be used in the musculoskeletal system assessment for children/adolescents, adults and older adults. It also identifies changes that can occur in the system across the lifespan. | Table 1 provides examples of functional tests that can be used in the musculoskeletal system assessment for children/adolescents, adults and older adults. It also identifies changes that can occur in the system across the lifespan. | ||
{| class="wikitable" | {| class="wikitable" | ||
|+'''Table 1. Functional Tests for Musculoskeletal System Assessment''' | |+'''Table 1. Functional Tests for the Musculoskeletal System Assessment''' | ||
! | ! | ||
!'''Children/Adolescents''' | !'''Children/Adolescents''' | ||
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== Neurological System == | == Neurological System == | ||
<blockquote>"Neurons that fire together, wire together."<ref name=":4" /> | <blockquote>"Neurons that fire together, wire together."<ref name=":4" /></blockquote><blockquote>"Each time we practise that certain type of movement or certain type of action, we are laying down those pathways in our brain."<ref name=":4" /> -- Eena Kapoor </blockquote>Components of the neurological system examination include: | ||
* | * proprioception | ||
** | ** ability to determine a body segment's positions and movements in space<ref>Han J, Waddington G, Adams R, Anson J, Liu Y. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191985/pdf/main.pdf Assessing proprioception: A critical review of methods]. J Sport Health Sci. 2016 Mar;5(1):80-90. </ref> | ||
* | * vestibular system, including the ability to coordinate movement with balance | ||
** | ** static and dynamic balance | ||
* | * interoception | ||
Table 2 provides examples of functional tests | ** the detection of internal regulation, including heart rate, respiration, hunger, and digestion<ref>Camarata S, Miller LJ, Wallace MT. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726187/pdf/fnint-14-556660.pdf Evaluating Sensory Integration/Sensory Processing Treatment: Issues and Analysis.] Front Integr Neurosci. 2020 Nov 26;14:556660.</ref> | ||
Table 2 provides examples of functional tests that be part of the neurological system assessment for children/adolescents, adults and older adults. It also identifies changes that occur in the neurological system across the lifespan. | |||
{| class="wikitable" | {| class="wikitable" | ||
|+'''Table 2. Functional Tests for Neurological System Assessment''' | |+'''Table 2. Functional Tests for the Neurological System Assessment''' | ||
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!'''Children/Adolescents''' | !'''Children/Adolescents''' | ||
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|Proprioception | |Proprioception | ||
| | | | ||
* Difficulties with motor coordination and planning may be linked with | * Difficulties with motor coordination and planning may be linked with proprioception issues<ref name=":7">Chu VWT. Assessing Proprioception in Children: A Review. J Mot Behav. 2017 Jul-Aug;49(4):458-466. </ref> | ||
* Studies link poor proprioception to difficulties with handwriting | * Studies link poor proprioception to difficulties with handwriting<ref name=":7" /> | ||
* Poor proprioception | * Poor proprioception can occur in conditions such as cerebral palsy, developmental coordination disorder, autism spectrum disorder, and in children with joint hypermobility<ref name=":7" /> | ||
* Indirect | * Indirect assessments of proprioception include parent reports or clinician observation checklists<ref name=":7" /> | ||
* Direct | * Direct assessments of proprioceptive function include the Sensory Integration and Praxis Test<ref name=":7" /> | ||
* | * Assessing proprioceptive reflexes confirms if proprioceptive afferents are intact | ||
|There are three main testing techniques for assessing proprioception in adults: | |There are three main testing techniques for assessing proprioception in adults: | ||
* Threshold to detection of passive motion (TTDPM) | * Threshold to detection of passive motion (TTDPM) | ||
* Joint position reproduction (JPR), known as joint position matching | * Joint position reproduction (JPR), known as joint position matching<ref name=":8">Yang N, Waddington G, Adams R, Han J. Joint position reproduction and joint position discrimination at the ankle are not related. Somatosens Mot Res. 2020 Jun;37(2):97-105. </ref> | ||
* Active movement extent discrimination assessment (AMEDA) | * Active movement extent discrimination assessment (AMEDA)<ref name=":8" /> | ||
| | | | ||
* Ageing is associated with a decline in proprioceptive function | * Ageing is associated with a decline in proprioceptive function<ref name=":9">Ferlinc A, Fabiani E, Velnar T, Gradisnik L. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853739/pdf/MSM-31-219.pdf The Importance and Role of Proprioception in the Elderly: a Short Review.] Mater Sociomed. 2019 Sep;31(3):219-221.</ref> | ||
* Proprioception is required for a healthy body to function during | * Proprioception is required for a healthy body to function during movement and to maintain balance<ref name=":9" /> | ||
* | * A decline in proprioception due to ageing affects mobility and increases an individual's risk of falls<ref name=":9" /> | ||
* Balance deficits | * Balance deficits can be linked to declines in proprioceptive function during the ageing process<ref name=":9" /> | ||
|- | |- | ||
|Vestibular system | |Vestibular system | ||
| | | | ||
* '''"Static balance''' takes place when the center of gravity is maintained vertically above the base, without changing the base lengthwise | * '''"Static balance''' takes place when the center of gravity is maintained vertically above the base, without changing the base lengthwise"<ref name=":19">Yanovich E, Bar-Shalom S. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319221/pdf/children-09-00939.pdf Static and Dynamic Balance Indices among Kindergarten Children: A Short-Term Intervention Program during COVID-19 Lockdowns.] Children (Basel). 2022 Jun 22;9(7):939.</ref> | ||
* Static balance develops before the | * Static balance develops before the third year of age | ||
* Static balance tests include a ''flamingo test, a one-leg stance on a low beam, or a tandem stance on the force plate'' | * Static balance tests include a ''flamingo test, a one-leg stance on a low beam, or a tandem stance on the force plate'' | ||
* '''Dynamic balance''' is defined as "ability to maintain the center of gravity above the base during movement, with the body exiting the center of gravity | * '''Dynamic balance''' is defined as the "ability to maintain the center of gravity above the base during movement, with the body exiting the center of gravity"<ref name=":19" /> | ||
* Dynamic balance develops between the | * Dynamic balance develops between the third and seventh years | ||
* Dynamic balance tests include ''low-beam walking test | * Dynamic balance tests include the ''low-beam walking test'' | ||
| | | | ||
* Vestibular signal impairment is associated with balance disorders and spatial disorientation in neurodegenerative diseases, including Alzheimer's and Parkinson's disease | * Vestibular signal impairment is associated with balance disorders and spatial disorientation in neurodegenerative diseases, including Alzheimer's and Parkinson's disease<ref>Coto J, Alvarez CL, Cejas I, Colbert BM, Levin BE, Huppert J, Rundek T, Balaban C, Blanton SH, Lee DJ, Loewenstein D, Hoffer M, Liu XZ. [https://www.sciencedirect.com/science/article/pii/S1672293021000271 Peripheral vestibular system: Age-related vestibular loss and associated deficits.] J Otol. 2021 Oct;16(4):258-265. </ref> | ||
* Balance testing may include | * Balance testing may include: | ||
** Romberg test of standing balance on firm and compliant support surfaces | |||
** Balance test on a foam-padded surface with eyes closed | ** Balance test on a foam-padded surface with eyes closed | ||
| | | | ||
* 20-50% of older adults are diagnosed with balance impairment | * 20-50% of older adults are diagnosed with a balance impairment<ref name=":10">Nnodim JO, Yung RL. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773046/pdf/nihms754637.pdf Balance and its Clinical Assessment in Older Adults - A Review.] J Geriatr Med Gerontol. 2015;1(1):003.</ref> | ||
* 20 | * 20-30% of older adults experience one or more falls annually<ref name=":10" /> | ||
* Ageing is associated with a decline in organ function, and the widespread presence of diseases in the balance control systems predisposes older adults to balance | * Ageing is associated with a decline in organ function, and the widespread presence of diseases in the balance control systems predisposes older adults to balance impairments<ref name=":10" /> | ||
* | * Functional performance tests assess postural activities and movements that occur in the course of everyday life: | ||
** Romberg | ** Romberg test | ||
** | ** Uni pedal stance test (UST) | ||
** | ** Four-square step test (FSST) | ||
** | ** Timed up-and-go test | ||
** Functional reach test (FRT) | ** Functional reach test (FRT) | ||
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=== | === Interoception === | ||
Interoception is the ability to perceive internal bodily states. Our perception of internal body signals influences our emotions, decision-making, and sense of self. | |||
This optional video explores the concept of interception: | This optional video explores the concept of interception: | ||
Line 197: | Line 204: | ||
{{#ev:youtube|v=rms5I02Rzg0&t=39s|300}}<ref>Neuroscience News. Exploring Interoception: The Neuroscience of Internal Body Signals - Neuroscience News. Available from: https://www.youtube.com/watch?v=rms5I02Rzg0&t=39s [last accessed 23/3/2024]</ref> | {{#ev:youtube|v=rms5I02Rzg0&t=39s|300}}<ref>Neuroscience News. Exploring Interoception: The Neuroscience of Internal Body Signals - Neuroscience News. Available from: https://www.youtube.com/watch?v=rms5I02Rzg0&t=39s [last accessed 23/3/2024]</ref> | ||
For a detailed assessment of the neurological system, please | For a detailed assessment of the neurological system, please see: [[Neurological Screen]]. | ||
== Integumentary System == | == Integumentary System == | ||
Adequate skin and other connective tissue mobility is needed for free movement of the underlying structures to provide postural support and assure proper ventilation.<ref name=":2" /> | Adequate skin and other connective tissue mobility is needed for free movement of the underlying structures to provide postural support and assure proper ventilation.<ref name=":2" /> Multiple impairments can be associated with fascial restrictions. | ||
The [[Skin Anatomy, Physiology, and Healing Process|skin]] is one of the largest organs of the body. It has many functions, including the following:<ref>Lucas K, Todd P, Ness BM. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720252/pdf/ijspt_2022_17_1_29454.pdf A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Integumentary System]. Int J Sports Phys Ther. 2021 Dec 1;17(1):74-80.</ref> | The [[Skin Anatomy, Physiology, and Healing Process|skin]] is one of the largest organs of the body. It has many functions, including the following:<ref>Lucas K, Todd P, Ness BM. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720252/pdf/ijspt_2022_17_1_29454.pdf A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Integumentary System]. Int J Sports Phys Ther. 2021 Dec 1;17(1):74-80.</ref> | ||
* | * structural barrier | ||
* | * thermoregulation | ||
** | ** an impact on the cardiovascular system because it regulates body's temperature. | ||
* | * contributes to sensation for neuromuscular control | ||
* | * provides fascial mobility for the range of motion of the joint | ||
Skin diseases such as atopic dermatitis, psoriasis, and allergic or irritant contact dermatitis affect skin transepidermal water loss (TEWL, the amount of water loss through the epidermis through evaporation), hydration, and acidity.<ref name=":11">King A, Balaji S, Keswani SG. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654382/pdf/nihms-426592.pdf Biology and function of fetal and pediatric skin]. Facial Plast Surg Clin North Am. 2013 Feb;21(1):1-6.</ref> | Skin diseases such as atopic dermatitis, psoriasis, and allergic or irritant contact dermatitis affect skin transepidermal water loss (TEWL, the amount of water loss through the epidermis through evaporation), hydration, and acidity.<ref name=":11">King A, Balaji S, Keswani SG. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654382/pdf/nihms-426592.pdf Biology and function of fetal and pediatric skin]. Facial Plast Surg Clin North Am. 2013 Feb;21(1):1-6.</ref> | ||
Revision as of 05:17, 5 April 2024
Original Editor - Ewa Jaraczewska based on the course by Eena Kapoor
Top Contributors - Ewa Jaraczewska, Jess Bell and Kim Jackson
Introduction[edit | edit source]
Throughout the lifespan, the body experiences many changes in its cells, tissues, and organs. These changes can impact the functioning of all body systems. Everyone ages differently, and healthcare providers must be able to recognise these differences. This article explores multi-system characteristics, impairments, and interventions for children, adolescents, adults, and older adults.
Musculoskeletal System[edit | edit source]
A full musculoskeletal examination will be performed to assess the musculoskeletal system. Functional tests are an important part of this assessment.
The functional capacity of the musculoskeletal system should be assessed within the context of a person's school, play, work, daily activities, and sports. Because functional tests vary in terms of their reliability and validity, using a combination of a questionnaire and a functional test appears to be the most effective means to evaluate the functional capacity of the musculoskeletal system.[1] The following questionnaires are recommended:[1]
- Oswestry Disability Index
- Pain Disability Index
- Roland-Morris Disability Questionnaire
- Upper Extremity Functional Scale
Table 1 provides examples of functional tests that can be used in the musculoskeletal system assessment for children/adolescents, adults and older adults. It also identifies changes that can occur in the system across the lifespan.
Children/Adolescents | Adults | Older Adults | |
---|---|---|---|
Muscle strength
(functional assessment to include sit-to-stand and stairs) |
|
1MSTST: norm values range from 8.1 in individuals with stroke to 24 in individuals with advanced lung disease[6] or 50 in healthy adult males[7] |
|
Flexibility / range of motion
(spinal and chest wall mobility) |
Chest wall mobility:
Age 3 years through to adulthood: Chest wall mobility measurements for tidal volume excursion:[12]
Paediatric:
Chest wall measurement for vital capacity:[12]
Spinal mobility:
|
Chest wall mobility:
Spinal mobility: Measured in standing using the inclinometer technique:[14]
|
Chest wall mobility:
Spinal mobility: Measurement as for adults.
|
Pain |
|
|
|
Bone mineral density |
|
| |
Core stability |
|
Same as in children/adolescents | Same as in children/adolescents |
Neurological System[edit | edit source]
"Neurons that fire together, wire together."[10]
"Each time we practise that certain type of movement or certain type of action, we are laying down those pathways in our brain."[10] -- Eena Kapoor
Components of the neurological system examination include:
- proprioception
- ability to determine a body segment's positions and movements in space[23]
- vestibular system, including the ability to coordinate movement with balance
- static and dynamic balance
- interoception
- the detection of internal regulation, including heart rate, respiration, hunger, and digestion[24]
Table 2 provides examples of functional tests that be part of the neurological system assessment for children/adolescents, adults and older adults. It also identifies changes that occur in the neurological system across the lifespan.
Children/Adolescents | Adults | Older Adults | |
---|---|---|---|
Proprioception |
|
There are three main testing techniques for assessing proprioception in adults: |
|
Vestibular system |
|
|
|
Interoception[edit | edit source]
Interoception is the ability to perceive internal bodily states. Our perception of internal body signals influences our emotions, decision-making, and sense of self.
This optional video explores the concept of interception:
For a detailed assessment of the neurological system, please see: Neurological Screen.
Integumentary System[edit | edit source]
Adequate skin and other connective tissue mobility is needed for free movement of the underlying structures to provide postural support and assure proper ventilation.[12] Multiple impairments can be associated with fascial restrictions.
The skin is one of the largest organs of the body. It has many functions, including the following:[32]
- structural barrier
- thermoregulation
- an impact on the cardiovascular system because it regulates body's temperature.
- contributes to sensation for neuromuscular control
- provides fascial mobility for the range of motion of the joint
Skin diseases such as atopic dermatitis, psoriasis, and allergic or irritant contact dermatitis affect skin transepidermal water loss (TEWL, the amount of water loss through the epidermis through evaporation), hydration, and acidity.[33]
Table 3 provides examples of differences in integumentary systems across the lifespan.
Children/Adolesents | Adults | Older Adults | |
---|---|---|---|
|
|
|
Read more about the integumentary system in this Physiopedia article.
Gastrointestinal System[edit | edit source]
- The gastrointestinal system occupies the majority of space in the abdominal compartment.
- The following structures surround the abdominal compartment:
- The diaphragm and abdominal wall anteriorly
- Spine posteriorly
- Costal arch on both sides
- Pelvis on the bottom
- The abdominal compartment contains multiple solid and hollow organs, adipose tissue, and major blood vessels. It is located intra- and/ or retroperitoneally.
- The healthy functioning of the GI system depends on the body's ability to generate intra-abdominal pressure.
Table 4 provides examples of differences in the gastrointestinal system across the lifespan.
Children/Adolesents | Adults | Older Adults | |
---|---|---|---|
|
|
|
Cardiopulmonary System[edit | edit source]
The following functions of the cardiopulmonary system should be considered when assessing the system across the lifespan:
- Breathing mechanics and patterns
- Sleep quality
- Oxygen saturation and blood pressure
Children/Adolescents | Adults | Older Adults | |
---|---|---|---|
Breathing mechanics and patterns |
|
|
|
Sleep Quality |
|
||
Oxygen saturation and blood pressure |
|
Mental Health System[edit | edit source]
“Without mental health there can be no true physical health”.---Dr Brock Chisholm, the first Director-General of the World Health Organization (WHO.
The World Health Organization defines mental health as comprehensive physical, psychological and social well-being. [58] Economic and social circumstances significantly influence complete mental health, resilience and social support across the lifespan.[59] Mental health-related quality of life (MHRQoL) shows a lower score in older adults in addition to reports of the highest stress and depression in this age group. Stress, depression, and subjective health status influence mental health-related quality of life in adolescents and adults. [60]
Role of physiotherapists in mental health:[61]
- Prevention and promotion of health, including mental health
- Education about mental health
- Referral to specialists in mental health when necessary
- Providing person-centred approach for children, adolescents, adults, and older adults to enhance physical and emotional well-being through improving posture, respiration and concentration.
- The following low-impact activities are recommended for all patients:
- Yoga (mind-body therapy)
- The Pilates method (balancing of the body and mind)
- Feldenkreis method (use of the self through awareness)
- Tai-Chi
- Mindfulness-based therapies
- Breathing therapies
- The following low-impact activities are recommended for all patients:
Resources[edit | edit source]
- https://www.researchgate.net/profile/Margaret-Schenkman/publication/20341766_A_Model_for_Multisystem_Evaluation_Treatment_of_Individuals_with_Parkinson%27s_Disease/links/0c96051786d5fb1da5000000/A-Model-for-Multisystem-Evaluation-Treatment-of-Individuals-with-Parkinsons-Disease.pdf
- https://www.masserypt.com/wp-content/uploads/2016/02/MasseryCh28AsthmaCampbellPedPTTextbook2006.pdf
References[edit | edit source]
- ↑ 1.0 1.1 Wind H, Gouttebarge V, Kuijer PP, Frings-Dresen MH. Assessment of the functional capacity of the musculoskeletal system in the context of work, daily living, and sport: a systematic review. J Occup Rehabil. 2005 Jun;15(2):253-72.
- ↑ Falk B, Dotan R. Child-adult differences in the recovery from high-intensity exercise. Exerc Sport Sci Rev. 2006 Jul;34(3):107-12.
- ↑ Haile SR, Fühner T, Granacher U, Stocker J, Radtke T, Kriemler S. Reference values and validation of the 1-minute sit-to-stand test in healthy 5-16-year-old youth: a cross-sectional study. BMJ Open. 2021 May 7;11(5):e049143.
- ↑ 4.0 4.1 Mall MP, Wander J, Lentz A, Jakob A, Oberhoffer FS, Mandilaras G, et al. Step by step: evaluation of cardiorespiratory fitness in healthy children, young adults, and patients with congenital heart disease using a simple standardized stair climbing test. Children (Basel). 2024 Feb 12;11(2):236.
- ↑ Schorling DC, Rawer R, Kuhlmann I, Müller C, Pechmann A, Kirschner J. Mechanographic analysis of the timed 4 stair climb test - methodology and reference data of healthy children and adolescents. J Musculoskelet Neuronal Interact. 2023 Mar 1;23(1):4-25.
- ↑ Watson K, Winship P, Cavalheri V, Vicary C, Stray S, Bear N, Hill K. In adults with advanced lung disease, the 1-minute sit-to-stand test underestimates exertional desaturation compared with the 6-minute walk test: an observational study. J Physiother. 2023 Apr;69(2):108-113.
- ↑ Bohannon RW, Crouch R. 1-Minute Sit-to-Stand Test: Systematic review of procedures, performance and clinimetric properties. J Cardiopulm Rehabil Prev. 2019 Jan;39(1):2-8.
- ↑ Strassmann A, Steurer-Stey C, Lana KD, Zoller M, Turk AJ, Suter P, Puhan MA. Population-based reference values for the 1-min sit-to-stand test. Int J Public Health. 2013 Dec;58(6):949-53.
- ↑ Gagliano-Jucá T, Li Z, Pencina KM, Traustadóttir T, Travison TG, Woodhouse L, Basaria S, Tsitouras PD, Harman SM, Bhasin S, Storer TW. The Stair Climb Power Test as an Efficacy Outcome in Randomized Trials of Function Promoting Therapies in Older Men. J Gerontol A Biol Sci Med Sci. 2020 May 22;75(6):1167-1175.
- ↑ 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 10.11 Kapoor E. Multiple Body System Analysis Across the Lifespan. Plus course 2024
- ↑ Brodowski H, Andres N, Gumny M, Eicher C, Steinhagen-Thiessen E, Tannen A, Kiselev J.Reliability of stair-climbing speed in two cohorts of older adults.International Journal of Therapy and Rehabilitation 2021; 28(11):1-15.
- ↑ 12.0 12.1 12.2 Massery, M. "If You Can't Breathe, You Can't Function" continuing education class 20 hrs. 2008, Chicago, IL. USA www.MasseryPT.com
- ↑ 13.0 13.1 Kondratek M, Krauss J, Stiller C, Olson R. Normative values for active lumbar range of motion in children. Pediatr Phys Ther. 2007 Fall;19(3):236-44.
- ↑ Waddell G, Somerville D, Henderson I, Newton M. Objective clinical evaluation of physical impairment in chronic low back pain. Spine 1992;17:617–28.
- ↑ Saidu IA, Maduagwu SM, Abbas AD, Adetunji OO, Jajere AM. Lumbar spinal mobility changes among adults with advancing age. J Midlife Health. 2011 Jul;2(2):65-71.
- ↑ Sansone L, Gentile C, Grasso EA, Di Ludovico A, La Bella S, Chiarelli F, Breda L. Pain Evaluation and Treatment in Children: A Practical Approach. Children (Basel). 2023 Jul 13;10(7):1212.
- ↑ Adeboye A, Hart R, Senapathi SH, Ali N, Holman L, Thomas HW. Assessment of Functional Pain Score by Comparing to Traditional Pain Scores. Cureus. 2021 Aug 3;13(8):e16847.
- ↑ BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet. Available from https://instruct.uwo.ca/kinesiology/9641/Assessments/Biological/FPS.html [last access 22.03.2024]
- ↑ 19.0 19.1 McVey MK, Geraghty AA, O'Brien EC, McKenna MJ, Kilbane MT, Crowley RK, Twomey PJ, McAuliffe FM. The impact of diet, body composition, and physical activity on child bone mineral density at five years of age-findings from the ROLO Kids Study. Eur J Pediatr. 2020 Jan;179(1):121-131.
- ↑ Padilla Colón CJ, Molina-Vicenty IL, Frontera-Rodríguez M, García-Ferré A, Rivera BP, Cintrón-Vélez G, Frontera-Rodríguez S. Muscle and Bone Mass Loss in the Elderly Population: Advances in diagnosis and treatment. J Biomed (Syd). 2018;3:40-49.
- ↑ 21.0 21.1 Liu CK, Leng X, Hsu FC, et al. The impact of sarcopenia on a physical activity intervention: the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P) J Nutr Health Aging. 2014;18(1):59–64.
- ↑ Johnston AP, De Lisio M, Parise G. Resistance training, sarcopenia, and the mitochondrial theory of ageing. Appl Physiol Nutr Metab. 2008 Feb;33(1):191-9.
- ↑ Han J, Waddington G, Adams R, Anson J, Liu Y. Assessing proprioception: A critical review of methods. J Sport Health Sci. 2016 Mar;5(1):80-90.
- ↑ Camarata S, Miller LJ, Wallace MT. Evaluating Sensory Integration/Sensory Processing Treatment: Issues and Analysis. Front Integr Neurosci. 2020 Nov 26;14:556660.
- ↑ 25.0 25.1 25.2 25.3 25.4 Chu VWT. Assessing Proprioception in Children: A Review. J Mot Behav. 2017 Jul-Aug;49(4):458-466.
- ↑ 26.0 26.1 Yang N, Waddington G, Adams R, Han J. Joint position reproduction and joint position discrimination at the ankle are not related. Somatosens Mot Res. 2020 Jun;37(2):97-105.
- ↑ 27.0 27.1 27.2 27.3 Ferlinc A, Fabiani E, Velnar T, Gradisnik L. The Importance and Role of Proprioception in the Elderly: a Short Review. Mater Sociomed. 2019 Sep;31(3):219-221.
- ↑ 28.0 28.1 Yanovich E, Bar-Shalom S. Static and Dynamic Balance Indices among Kindergarten Children: A Short-Term Intervention Program during COVID-19 Lockdowns. Children (Basel). 2022 Jun 22;9(7):939.
- ↑ Coto J, Alvarez CL, Cejas I, Colbert BM, Levin BE, Huppert J, Rundek T, Balaban C, Blanton SH, Lee DJ, Loewenstein D, Hoffer M, Liu XZ. Peripheral vestibular system: Age-related vestibular loss and associated deficits. J Otol. 2021 Oct;16(4):258-265.
- ↑ 30.0 30.1 30.2 Nnodim JO, Yung RL. Balance and its Clinical Assessment in Older Adults - A Review. J Geriatr Med Gerontol. 2015;1(1):003.
- ↑ Neuroscience News. Exploring Interoception: The Neuroscience of Internal Body Signals - Neuroscience News. Available from: https://www.youtube.com/watch?v=rms5I02Rzg0&t=39s [last accessed 23/3/2024]
- ↑ Lucas K, Todd P, Ness BM. A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Integumentary System. Int J Sports Phys Ther. 2021 Dec 1;17(1):74-80.
- ↑ 33.0 33.1 33.2 33.3 King A, Balaji S, Keswani SG. Biology and function of fetal and pediatric skin. Facial Plast Surg Clin North Am. 2013 Feb;21(1):1-6.
- ↑ Fluhr JW, Darlenski R, Lachmann N, Baudouin C, Msika P, De Belilovsky C, Hachem JP. Infant epidermal skin physiology: adaptation after birth. Br J Dermatol. 2012 Mar;166(3):483-90.
- ↑ Giusti F, Martella A, Bertoni L, Seidenari S. Skin barrier, hydration, and pH of the skin of infants under 2 years of age. Pediatr Dermatol. 2001 Mar-Apr;18(2):93-6.
- ↑ 36.0 36.1 36.2 36.3 Knaggs H, Lephart ED. Enhancing Skin Anti-Aging through Healthy Lifestyle Factors. Cosmetics. 2023; 10(5):142.
- ↑ 37.0 37.1 37.2 37.3 37.4 37.5 Russell-Goldman E, Murphy GF. The Pathobiology of Skin Aging: New Insights into an Old Dilemma. Am J Pathol. 2020 Jul;190(7):1356-1369.
- ↑ Arlen AM, Nawaf C, Kirsch AJ. Prune belly syndrome: current perspectives. Pediatric Health Med Ther. 2019 Aug 6;10:75-81.
- ↑ Cerebral Palsy Digestive Issues and Health. Available from https://www.cerebralpalsyguidance.com/cerebral-palsy/associated-disorders/digestive-issues-and-health/ [last access 24.03.2024]
- ↑ Cresswell AG, Blake PL, Thorstensson A. The effect of an abdominal muscle training program on intra-abdominal pressure. Scand J Rehabil Med. 1994 Jun;26(2):79-86.
- ↑ 41.0 41.1 41.2 41.3 Bajaj JS, Long M. Exploring GI Diseases Across the Lifespan. The American Journal of Gastroenterology 118(3):p 381-382, March 2023.
- ↑ 42.0 42.1 Trachsel D, Erb TO, Hammer J, von Ungern-Sternberg BS. Developmental respiratory physiology. Paediatr Anaesth. 2022 Feb;32(2):108-117.
- ↑ How are children different? Available from https://www.rch.org.au/trauma-service/manual/how-are-children-different/ [last access 25.3.2024]
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