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Cha E, Park JH. Spinopelvic Alignment as a Risk Factor for Poor Balance Function in Low Back Pain Patients. Global Spine J 2023; 13:2193-2200. [PMID: 35220778 PMCID: PMC10538310 DOI: 10.1177/21925682221076417] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Retrospective, observational study. OBJECTIVES This study aimed to examine the association between spinopelvic parameters and balance function in low back pain (LBP). METHODS Among patients in the rehabilitation medicine department, the data of 182 patients (mean age, 47.8 years; M/F = 64/118) was obtained retrospectively. Spinopelvic parameters were measured through a whole-body low-dose biplanar radiography using the EOS imaging system, and balance function was evaluated by the center of pressure (COP) movement using the Zebris treadmill system. Pearson correlations were used to determine the relationship between radiographic and balance function. Stepwise multiple linear regression analyses were conducted with the balance function as a dependent variable and age and spinopelvic parameters as independent variables. RESULTS Increased age, knee flexion (KF), pelvic tilt (PT), C7-central sacral line (C7-CSL) and C7 sagittal vertical axis (SVA), and decreased spino-sacral angle (SSA) were associated with both poor static and dynamic balance. Moreover, increased Cobb's angle and decreased thoracic kyphosis (TK) and lumbar lordosis (LL) was associated with poor static balance. Increased pelvic incidence (PI) was related to poor dynamic balance. Increased age, Cobb's angle, SVA, and decreased TK were risk factors for poor static balance. For dynamic balance, increased age, C7-CSL, and PT were risk factors for poor sagittal balance, whereas increased CAM-plumb line and PT were risk factors for poor coronal balance. CONCLUSIONS Balance function was associated with spinopelvic parameters in patients with LBP. Increased SVA, followed by increased PT, was the strongest independent factor associated with poor static and dynamic balance.
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Affiliation(s)
- Eunsil Cha
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Hyun Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
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Meras Serrano H, Mottet D, Caillaud K. Validity and Reliability of Kinvent Plates for Assessing Single Leg Static and Dynamic Balance in the Field. SENSORS (BASEL, SWITZERLAND) 2023; 23:2354. [PMID: 36850952 PMCID: PMC9967360 DOI: 10.3390/s23042354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
The objective of this study was to validate PLATES for assessing unipodal balance in the field, for example, to monitor ankle instabilities in athletes or patients. PLATES is a pair of lightweight, connected force platforms that measure only vertical forces. In 14 healthy women, we measured ground reaction forces during Single Leg Balance and Single Leg Landing tests, first under laboratory conditions (with PLATES and with a 6-DOF reference force platform), then during a second test session in the field (with PLATES). We found that for these simple unipodal balance tests, PLATES was reliable in the laboratory and in the field: PLATES gives results comparable with those of a reference force platform with 6-DOF for the key variables in the tests (i.e., Mean Velocity of the Center of Pressure and Time to Stabilization). We conclude that health professionals, physical trainers, and researchers can use PLATES to conduct Single Leg Balance and Single Leg Landing tests in the laboratory and in the field.
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Affiliation(s)
| | - Denis Mottet
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mine Alès, 34090 Montpellier, France
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Association between Anthropometric Variables, Sex, and Visual Biofeedback in Dynamic Postural Control Assessed on a Computerized Wobble Board. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11188370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Anthropometrics and sex influence balance performances, and visual information can change anthropometrics’ relation and the postural sway. Therefore, the aim of the present study was to evaluate the effect of anthropometric characteristics, sex, and visual biofeedback and/or their interaction on a computerized wobble board. Twenty-seven (14 females, 13 males) young adults performed three 30-s double leg stance trials on a wobble board during two conditions: with visual and without visual biofeedback. Visual biofeedback improved (p = 0.010) balance on a wobble board with respect to the condition without visual biofeedback. Regardless of sex, no differences between conditions were found (p = 0.088). When investigating the effect of anthropometrics variables, sex, and their interactions on conditions, a significant main effect of the lower limb/height ratio, sex, and their interaction on the condition without visual biofeedback was found (p = 0.0008; R2 = 0.57). For the visual biofeedback condition, significant effects for sex and body mass (p = 0.0012; R2 = 0.43) and sex and whole-body moment of inertia (p = 0.0030; R2 = 0.39) were found. Results from the present study showed (1) visual biofeedback improved wobble board balance performance; (2) a significant main effect of lower limb/height ratio, sex, and their interaction on the wobble board performances without visual biofeedback emerged; (3) significant effects were found for sex and body mass and sex and moment of inertia in the visual biofeedback condition. Findings from the present study could have an impact on training and evaluations protocols, especially when several populations such as children, athletes, older adults and people with balance disorders are involved.
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Marinkovic D, Belic A, Marijanac A, Martin-Wylie E, Madic D, Obradovic B. Static and dynamic postural stability of children girls engaged in modern dance. Eur J Sport Sci 2021; 22:354-359. [PMID: 33896398 DOI: 10.1080/17461391.2021.1922503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND : Postural stability (PS) has an important role in many athletic activities. However, modern dance demands a heightened PS because of the required aesthetic quality and speed of movement. The aim of the present study was to compare the static and dynamic PS of young dancers and participants of other sporting activities. METHOD : A total of 101 girls (age: 7.91 ± 0.7 year) were divided into a Dance group (N = 53) and a physically active Control group (N = 48). Static PS was assessed with a two-leg standing test on a Force plate, and dynamic PS was assessed with a Körperkoordinationstest für Kinder (KTK) - a walking backwards test on a balance beam. RESULTS : Multivariate analysis of variance showed a general difference between the groups (F = 21.95; p ≤ 0.0001). In static PS, the Dance group was better in Total distance of center of pressure (COP) (p ≤ 0.0001; ES = -1.70), Anterior-posterior oscillation (p ≤ 0.0001; ES = -1.40), Medial-lateral oscillation (p ≤ 0.0001; ES = 1.75) and Length in function of surface (p ≤ 0.0001; ES = -0.98). Both parameters of dynamic stability, the KTK test (p ≤ 0.0001; ES = 1.28) and Motor quotients KTK test (p ≤ 0.0001; ES = 1.45), were significantly better in the Dance group. CONCLUSION : The results from the present study indicate that children girls who participate mostly in dance develop better static and dynamic PS than children girls who participate in other sport activities. These findings underline the importance of training modification toward the improvement of PS in dance.
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Affiliation(s)
- Dragan Marinkovic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.,"Foro Italico", University of Rome, Rome, Italy
| | - Aleksandra Belic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Ana Marijanac
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Ellis Martin-Wylie
- Faculty of Dance, Trinity Laban Conservatoire of Music and Dance, London, UK
| | - Dejan Madic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Borislav Obradovic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
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Fusco A, Giancotti GF, Fuchs PX, Wagner H, Varalda C, Capranica L, Cortis C. Dynamic Balance Evaluation: Reliability and Validity of a Computerized Wobble Board. J Strength Cond Res 2020; 34:1709-1715. [PMID: 29481451 DOI: 10.1519/jsc.0000000000002518] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fusco, A, Giancotti, GF, Fuchs, PX, Wagner, H, Varalda, C, Capranica, L, and Cortis, C. Dynamic balance evaluation: reliability and validity of a computerized wobble board. J Strength Cond Res 34(6): 1709-1715, 2020-Computerized wobble boards (WBs) are inexpensive, transportable, and user-friendly devices to objectively quantify the dynamic balance performances out of laboratory settings, although it has not been established if they are reliable and valid tools. Therefore, the purpose of this study was to determine the reliability and validity of a computerized WB. Thirty-nine (18 females and 21 males) young adults (age: 23.3 ± 2.1 years; body mass: 65.9 ± 1.8 kg; height: 168.2 ± 8.8 cm; leg length: 78.8 ± 5.7 cm; and body mass index: 23.2 ± 2.1 kg·m) participated in the study. Subjects were assessed during 3 separate sessions on different days with a 48-hour rest in between. A total number of 2 WB single limb tests and 1 Y Balance Test (YBT) were performed. The WB performance was registered using the proprietary software and represented by the time spent in the target zone, which represented the 0° tilt angle measured by the triaxial accelerometer in the WB. YBT normalized reach distances were recorded for the anterior, posteromedial, and posterolateral directions. Intraclass correlation coefficient, 95% confidence interval, SEM, minimal detectable change, and Bland-Altman plots were used to evaluate intrasession and intersession reliability, whereas Pearson product moment correlation was used to determine concurrent validity. Reliability ranged from fair to excellent, showing acceptable levels of error and low minimal detectable change. However, all correlation coefficients between WB and YBT outcomes were poor. Despite the 2 methods addressing different aspects of balance performance, WB seems to validly serve its purpose and showed good reliability. Therefore, computerized WBs have the potential to become essential devices for dynamic balance assessment.
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Affiliation(s)
- Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy.,Department of Sports Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Giuseppe F Giancotti
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Philip X Fuchs
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy.,Department of Sports Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Herbert Wagner
- Department of Sports Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Carlo Varalda
- Italian Weightlifting Federation FIPE, Rome, Italy; and
| | - Laura Capranica
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
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Redelbach R, Mahnke A, Anders JO. Digital Measurement of Individual Motor and Proprioceptive Skills in Patients with Osteoarthritis of the Knee Prior to Total Knee Replacement. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2020; 159:513-520. [PMID: 32604422 DOI: 10.1055/a-1174-0946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE In spite of consistent improvement in operative methods for total knee arthroplasty, individual motor deficits may lead to a lower outcome. The preoperative classification in individual motoric capacity may get more significance for the future. Complementary to established questionnaires and clinical tests, this pilot study should demonstrate that it is possible to generate a preoperative motor score using a force platform measurement (KMP). Compared to questionnaires the new score represents digital values suitable for everyday clinical use. METHODS In total 63 Patients were randomized selected on the day before a bicondylar total knee replacement. A mobile force platform KMP (Motosana) measured the parameter maximum force, power and balance. Fluctuation area was measured in mm² and fluctuation path in mm. One leg standing without holding, transient help or permanent holding at armrests were registered. The force (Newton) was measured while a modified cross lift exercise and power (Watt) by performing five squads. RESULTS Based on comprehensive statistical consolidated data of maximum force, power and balance it was possible to create a new motor score "Knie Fit 1.0". Depending on interindividual performance patients were divided into those with higher or lower results. Regarding to their individual motor proprioceptive capacity we could also graduate patients into 4 different groups for force/power and balance. In total 17 of 63 patients offered a complex motor deficit, but on the other hand 17 different patients showed superior results in all categories. CONCLUSION It is possible to measure the motor capacity of patients using the mobile force platform (KMP) in everyday clinical practice. Based on this data a new motor score "KnieFit 1.0" was generated and groups of patients with different insufficiencies were created. Further follow-up studies should proof and compare the pre- and postoperative outcome in this field. With "KnieFit 1.0" it may be possible to create an individual perioperative rehabilitation program for compensation of detected deficits.
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Affiliation(s)
- Robert Redelbach
- Trauma Surgery - Orthopaedic Surgery, Friedrich Alexander University Erlangen Nuremberg, Erlangen
| | | | - Jens O Anders
- Trauma Surgery - Orthopaedic Surgery, Friedrich Alexander University Erlangen Nuremberg, Erlangen.,Orthopaedic Surgery, Dr. Erler Hospital, Nuremberg
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Marchetto J, Wright WG. The Validity of an Oculus Rift to Assess Postural Changes During Balance Tasks. HUMAN FACTORS 2019; 61:1340-1352. [PMID: 30917062 DOI: 10.1177/0018720819835088] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To investigate whether shifts in head position, measured via an Oculus Rift head-mounted display (HMD), is a valid measure of whole-body postural stability. BACKGROUND The inverted single-link pendulum model of balance suggests shifts in whole-body center of mass can be estimated from individual body segments. However, whether head position describes postural stability such as center-of-pressure (COP) remains unclear. METHOD Participants (N = 10) performed six conditions while wearing an HMD and performing a previously validated virtual reality (VR)-based balance assessment. COP was recorded with a Wii Balance Board force plate (WBB), while an HMD recorded linear and angular head displacement. Visual input was presented in the HMD (stable scene, dark scene, or dynamic scene) and somatosensory information (with or without foam) was varied across each condition. The HMD time series data were compared with the criterion-measure WBB. RESULTS Significant correlations were found between COP measures (standard deviation, range, sway area, velocity) and head-centered angular and linear displacements (roll, pitch, mediolateral and anteroposterior directions). CONCLUSIONS The Oculus Rift HMD shows promise as a measure of postural stability without additional posturography equipment. These findings support the application of VR HMD technology for assessment of postural stability across a variety of challenging conditions. APPLICATION The human factors and ergonomic benefit of such an approach is in its portability, low cost, and widespread availability for clinic and home-based investigation of postural disturbances. Fall injury affects millions of people annually, so assessment of fall risk and treatment of the underlying causes has enormous public health benefit.
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Comparison of posturographic outcomes between two different devices. J Biomech 2019; 86:218-224. [PMID: 30827702 DOI: 10.1016/j.jbiomech.2019.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/10/2019] [Accepted: 02/17/2019] [Indexed: 11/24/2022]
Abstract
The Interactive Balance System (IBS), a posturography device for assessing posture control, is widely used in clinical and rehabilitation settings. However, data on the validity of the device are unavailable. Fluctuations of the center of pressure (COP) were measured in 24 healthy participants (age: 29 ± 5 (mean ± SD) years, 12 females) synchronously using the IBS, which was rigidly mounted on a Kistler platform. Four different bipedal conditions were examined: eyes open or closed on stable or soft surfaces. Time series were compared using congruity (CON, proportion of the measurement time during which values of both devices changed similarly in direction), whereas IBS-specific postural outcomes were correlated with traditional postural control outcomes of the Kistler force platform. The time-displacement curves showed similar shapes for CON (>0.9) for each of the four standing conditions without differences between male and female participants (P > 0.39). The path length results of both devices showed very high linear associations, explaining on average 92% (medio-lateral) or 96% (anterior-posterior) of the common variance. The Kistler path length of the anterior-posterior direction revealed nearly perfect linear associations with the stability index of the IBS (r2 > 0.99). The results of this study indicate that the IBS provides valid posturographic results. Since the medial-lateral and anterior-posterior trajectories of the IBS can be used to calculate COP fluctuations, comparisons between different measurement systems are possible.
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Fusco A, Giancotti GF, Fuchs PX, Wagner H, Varalda C, Cortis C. Wobble board balance assessment in subjects with chronic ankle instability. Gait Posture 2019; 68:352-356. [PMID: 30579039 DOI: 10.1016/j.gaitpost.2018.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/13/2018] [Accepted: 12/12/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Wobble boards (WBs), commonly used to train postural control, have been recently equipped with accelerometers connected to a computer displaying real-time balance performances. However, little is known about their ability to detect balance deficits in subjects with unilateral chronic ankle instability (CAI). OBJECTIVE To determine if computerized WBs can detect balance deficits in subjects with unilateral CAI. METHODS Fifteen subjects with unilateral CAI and fifteen uninjured subjects performed one WB test and one Y Balance Test (YBT) during two separate randomized sessions. WB performance was assessed as the time (s) spent on the platform by keeping it flat at 0° during three 30-s trials for each limb. Normalized (%) reach distances values for anterior, posteromedial, posterolateral directions and composite were recorded for YBT. RESULTS WB has been shown to be a reliable and accurate device for detecting balance deficits between and within subjects with unilateral CAI. The area under the curve for receiver operating characteristic was 0.80 (asymptotic significance 0.001), suggesting that WBs have the capability to accurately discriminate between injured and uninjured limbs. SIGNIFICANCE Computerized WBs can fill the gap caused by limitations between subjective-based clinical assessment and laboratory-based testing, especially in field-based settings, where specificity, transportability and time constraints are crucial. The results of the present study suggest that WBs may facilitate the detection of balance impairments in subjects with unilateral CAI, without complexity in its use or data interpretation.
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Affiliation(s)
- Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043, Cassino FR, Italy; Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49 Hallein (Rif), A-5400, Salzburg, Austria.
| | - Giuseppe Francesco Giancotti
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043, Cassino FR, Italy.
| | - Philip X Fuchs
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043, Cassino FR, Italy; Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49 Hallein (Rif), A-5400, Salzburg, Austria.
| | - Herbert Wagner
- Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49 Hallein (Rif), A-5400, Salzburg, Austria.
| | - Carlo Varalda
- Italian Weightlifting Federation FIPE, Viale Tiziano 70, 00196, Roma, Italy.
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043, Cassino FR, Italy.
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Bickley C, Linton J, Sullivan E, Mitchell K, Slota G, Barnes D. Comparison of simultaneous static standing balance data on a pressure mat and force plate in typical children and in children with cerebral palsy. Gait Posture 2019; 67:91-98. [PMID: 30308334 DOI: 10.1016/j.gaitpost.2018.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Balance testing is an important component in treatment planning and outcome assessment for children with Cerebral Palsy (CP). Objective measurement for static standing balance is typically conducted in motion labs utilizing force plates; however, a plantar pressure mat may prove to be a viable alternative for this type of balance assessment. METHODS This study examined static standing balance simultaneously on a force plate and a plantar pressure mat in 30 typically developing (TD) and 30 children with CP to determine if valid measures of static standing balance could be obtained in children with CP using a pressure mat. RESULTS Examination of the data provided evidence that reliable and valid measures of static standing balance can be produced with a plantar pressure mat for both groups. Five variables out of the 21 variables examined were found to be reliable and valid on both devices (pressure mat and force plate) for both subgroups (TD and CP). The variables medial/lateral (ML) average radial displacement, range moved-ML, anterior/posterior average velocity, ellipse area, and area per second were found to have high test-retest reliability (ICC > .6) and possess discriminant validity between the subgroups (TD vs. CP). Additionally, the ellipse area and area per second variables also had the ability to discriminate between GMFCS levels. A normative center of pressure (CoP) balance data set using all 21 variables was also established for typically developing children for both devices (pressure mat and force plate) within this study. SIGNIFICANCE The ability to utilize a portable plantar pressure mat for quick and reliable standing balance measurement allows for expanded ability to capture objective data in a variety of settings thereby increasing opportunity for outcomes analysis.
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Affiliation(s)
- Christina Bickley
- Motion Analysis Center Physical Therapist, Shriners Hospitals for Children - Houston, Assistant Professor School of Physical Therapy, Texas Woman's University, Houston, TX, United States.
| | - Judith Linton
- Manager of Research Operations, Shriners Hospitals for Children, Houston, United States
| | - Elroy Sullivan
- Associate Professor and Director of Post Professional Studies, Texas Woman's University, Houston, TX United States
| | - Katy Mitchell
- Statistician and Software Designer, Shriners Hospitals for Children, Houston, United States
| | - Greg Slota
- Motion Analysis Center Engineer, Shriners Hospitals for Children, Houston, United States
| | - Douglas Barnes
- Chief of Staff and Medical Director of the Motion Analysis Laboratory, Shriners Hospitals for Children, Houston, United States
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Negus JJ, Cawthorne D, Clark R, Negus O, Xu J, March PL, Parker D. Validity and reliability of the Nintendo Wii Fit Stillness score for assessment of standing balance. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2018; 15:29-34. [PMID: 30581757 PMCID: PMC6300417 DOI: 10.1016/j.asmart.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/13/2018] [Accepted: 09/03/2018] [Indexed: 11/19/2022]
Abstract
Background/objective Standing balance has become an important clinical measure in patient populations who are at risk of falls or have osteoarthritis. With custom-written software, the Wii Balance Board (WBB) has been shown to be a valid and reliable force platform that can be used to assess standing balance. However, no studies to date have assessed the use of the more readily available Wii Stillness Score (WSS) as a measure of balance. Methods Twenty-four individuals without lower limb pathology performed a combination of unilateral and double leg standing balance tests with eyes open or closed on two separate occasions. At each session, data from the WBB were acquired on a laptop computer running custom software and then by Wii-Fit software on a Wii console. The reliability of the WSS was determined by assessing reproducibility, while the validity of the WSS was determined by comparing the results of the WSS to that of the custom-written software. Results We found that the WSS exhibited excellent intra and inter device reliability in three out of four stances tested. The Bland-Altman plots also showed good concurrent validity for the three analysed stances. However, there remain significant limitations with the use of the WSS such as its rigid thirty-second time parameter and single score result. Conclusion The readily available WBB may be a used as a portable and inexpensive device to assess standing balance with custom written software. However, with the current limitations of the WSS, we would discourage its use as a clinical measure of balance.
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Affiliation(s)
- Jonathan J. Negus
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia
- Faculty of Medicine, University of Sydney, NSW, Australia
- Jointworks, Orthopaedic Research, Sydney, NSW, Australia
- Corresponding author. Sydney Orthopaedic Research Institute, Level 1 The Gallery, 445 Victoria Avenue, Chatswood, NSW, 2067, Australia.
| | | | - Ross Clark
- Australian Catholic University, Melbourne, VIC, Australia
| | - Oliver Negus
- Jointworks, Orthopaedic Research, Sydney, NSW, Australia
| | - Joshua Xu
- Faculty of Medicine, University of Sydney, NSW, Australia
| | - Prof Lyn March
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia
- Faculty of Medicine, University of Sydney, NSW, Australia
| | - David Parker
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia
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Lee D, Kim H, An H, Jang J, Hong S, Jung S, Lee K, Choi MR, Lee KH, Lee G. Comparison of postural sway depending on balance pad type. J Phys Ther Sci 2018; 30:252-257. [PMID: 29545688 PMCID: PMC5851357 DOI: 10.1589/jpts.30.252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/15/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the present study was to compare the postural sway of healthy
adults standing on different types of balance pads. [Subjects and Methods] Nine healthy
adults participated in this study. Postural body sway was measured while participants were
standing on four different types of balance pads: Balance-pad Elite (BE), Aero-Step XL
(AS), Dynair Ballkissen Senso (DBS), and Dynair Ballkissen XXL Meditation and Yoga (DBMY).
A Wii Balance Board interfaced with Balancia software was used to measure postural body
sway. [Results] In the sway velocity, sway path length, and sway area, no significant
differences were found between baseline conditions (participants were standing on the
floor with no balance pad) and the use of the BE or AS. However, significant increases in
all parameters were found comparing baseline conditions to the use of either Dynair
balance pad. Furthermore, the use of either Dynair balance pad significantly increased
postural sway compared to both the BE and the AS. [Conclusion] These findings suggest that
the DBS and DBMY balance pads may serve as superior tools for providing unstable condition
for balance training than the BE and the AS balance pads.
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Affiliation(s)
- DongGeon Lee
- Department of Physical Therapy, Graduate School of Kyungnam University, Republic of Korea
| | - HaNa Kim
- Department of Physical Therapy, Kyungnam University: 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 51767, Republic of Korea
| | - HyunJi An
- Department of Physical Therapy, Kyungnam University: 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 51767, Republic of Korea
| | - JiEun Jang
- Department of Physical Therapy, Kyungnam University: 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 51767, Republic of Korea
| | - SoungKyun Hong
- Department of Physical Therapy, Graduate School of Kyungnam University, Republic of Korea
| | - SunHye Jung
- Department of Physical Therapy, Graduate School of Kyungnam University, Republic of Korea
| | - Kyeongbong Lee
- Physical and Rehabilitation Medicine, Samsung Medical Center, Republic of Korea
| | - Myong-Ryol Choi
- Department of Rehabilitation Medicine, Dongguk University Ilsan Medical Center, Republic of Korea
| | - Kyung-Hee Lee
- Department of Physical Therapy, Dongnam Health University, Republic of Korea
| | - GyuChang Lee
- Department of Physical Therapy, Kyungnam University: 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 51767, Republic of Korea
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Identification of the period of stability in a balance test after stepping up using a simplified cumulative sum. Med Eng Phys 2017; 49:14-21. [PMID: 28935262 DOI: 10.1016/j.medengphy.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/02/2017] [Accepted: 07/04/2017] [Indexed: 11/23/2022]
Abstract
Falls are a major cause of death in older people. One method used to predict falls is analysis of Centre of Pressure (CoP) displacement, which provides a measure of balance quality. The Balance Quality Tester (BQT) is a device based on a commercial bathroom scale that calculates instantaneous values of vertical ground reaction force (Fz) as well as the CoP in both anteroposterior (AP) and mediolateral (ML) directions. The entire testing process needs to take no longer than 12 s to ensure subject compliance, making it vital that calculations related to balance are only calculated for the period when the subject is static. In the present study, a method is presented to detect the stabilization period after a subject has stepped onto the BQT. Four different phases of the test are identified (stepping-on, stabilization, balancing, stepping-off), ensuring that subjects are static when parameters from the balancing phase are calculated. The method, based on a simplified cumulative sum (CUSUM) algorithm, could detect the change between unstable and stable stance. The time taken to stabilize significantly affected the static balance variables of surface area and trajectory velocity, and was also related to Timed-up-and-Go performance. Such a finding suggests that the time to stabilize could be a worthwhile parameter to explore as a potential indicator of balance problems and fall risk in older people.
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Gatica-Rojas V, Cartes-Velásquez R, Guzmán-Muñoz E, Méndez-Rebolledo G, Soto-Poblete A, Pacheco-Espinoza AC, Amigo-Mendoza C, Albornoz-Verdugo ME, Elgueta-Cancino E. Effectiveness of a Nintendo Wii balance board exercise programme on standing balance of children with cerebral palsy: A randomised clinical trial protocol. Contemp Clin Trials Commun 2017; 6:17-21. [PMID: 29740634 PMCID: PMC5936865 DOI: 10.1016/j.conctc.2017.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 02/11/2017] [Indexed: 11/25/2022] Open
Abstract
Background Patients with cerebral palsy (CP) typically receive limited physical therapy services. However, the Nintendo Wii system offers a simple and affordable mode of virtual reality therapy. There are no clinical trials assessing the Nintendo Wii balance board for improving standing balance in CP. Methods This randomised clinical trial will evaluate the effectiveness of an 18-session/six-week protocol using Wii therapy (W-t) compared with conventional therapy (C-t) in Chilean CP patients. The C-t group will perform the typical exercises prescribed by physical therapists for 40 min each session. W-t will consist of a virtual reality training session using the Nintendo Wii balance board console for 30 min each session. The primary outcome variable is the area of centre-of-pressure (CoP) sway (CoPSway). The secondary outcomes are the standard deviation (SDML; SDAP) and velocity (VML; VAP) of CoP in the ML and AP directions. For a mean difference of 21.5 cm2 (CoPSway) between the groups, we required a minimum of 16 participants in each group. Data will be collected at baseline (week 0), during the study (weeks 2 and 4), at the end of the study (week 6), and during the follow-up (weeks 8 and 10). Measurements of postural control during quiet standing for both groups will be assessed on a force platform AMTI OR67. Discussion This is the first trial that measures and compares the effects of a Nintendo Wii Balance Board exercise programme on standing balance in children with cerebral palsy compared to conventional therapy.
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Affiliation(s)
- Valeska Gatica-Rojas
- Human Motor Control Laboratory, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Ricardo Cartes-Velásquez
- Department of Preventive and Public Health Dentistry, School of Dentistry, Universidad de Concepción, Roosevelt 1550, Concepción, Chile
| | - Eduardo Guzmán-Muñoz
- School of Kinesiology, Faculty of Health Sciences, Universidad Santo Tomás, Carlos Schorr 255, Talca, Chile
| | - Guillermo Méndez-Rebolledo
- Department of Human Movement Sciences, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Alex Soto-Poblete
- Institute of Mathematics and Physics, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Ana Carolina Pacheco-Espinoza
- Department of Human Movement Sciences, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Carlos Amigo-Mendoza
- School of Kinesiology, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - M Eliana Albornoz-Verdugo
- Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Edith Elgueta-Cancino
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072, Brisbane, Australia
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15
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Howcroft J, Lemaire ED, Kofman J, McIlroy WE. Elderly fall risk prediction using static posturography. PLoS One 2017; 12:e0172398. [PMID: 28222191 PMCID: PMC5319679 DOI: 10.1371/journal.pone.0172398] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 02/03/2017] [Indexed: 11/17/2022] Open
Abstract
Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older people at risk of multiple falls.
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Affiliation(s)
- Jennifer Howcroft
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Canada
| | - Edward D Lemaire
- Centre for Rehabilitation Research and Development, Ottawa Hospital Research Institute, Ottawa, Canada.,University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - Jonathan Kofman
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Canada
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Ciria LF, Muñoz MA, Gea J, Peña N, Miranda JGV, Montoya P, Vila J. Head movement measurement: An alternative method for posturography studies. Gait Posture 2017; 52:100-106. [PMID: 27888694 DOI: 10.1016/j.gaitpost.2016.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 07/26/2016] [Accepted: 11/09/2016] [Indexed: 02/02/2023]
Abstract
The present study evaluated the measurement of head movements as a valid method for postural emotional studies using the comparison of simultaneous recording of center of pressure (COP) sway as criterion. Thirty female students viewed a set of 12 pleasant, 12 unpleasant and 12 neutral pictures from the International Affective Picture System, repeated twice, using a block presentation procedure while standing on a force platform (AMTI AccuSway). Head movements were recorded using a webcam (©KPC139E) located in the ceiling in line with the force platform and a light-emitting diode (LED) placed on the top of the head. Open source software (CvMob 3.1) was used to process the data. High indices of correlation and coherence between head and COP sway were observed. In addition, pleasant pictures, compared with unpleasant pictures, elicited greater body sway in the anterior-posterior axis, suggesting an approach response to appetitive stimuli. Thus, the measurement of head movement can be an alternative or complementary method to recording COP for studying human postural changes.
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Affiliation(s)
- L F Ciria
- Human Psychophysiology and Health Group, Mind, Brain and Behavior Research Center-CIMCYC, University of Granada, Spain
| | - M A Muñoz
- Human Psychophysiology and Health Group, Mind, Brain and Behavior Research Center-CIMCYC, University of Granada, Spain.
| | - J Gea
- Research Institute oF Health Sciences (IUNICS), University of Balearic Islands (UIB), Palma, Spain
| | - N Peña
- Department of Physiotherapy, Faculdade de Ciências da Saúde, Federal University of Bahia, Salvador, Brazil
| | - J G V Miranda
- Department of Physics of the Earth and the Environment, Instituto de Fisica Federal University of Bahia, Salvador, Brazil
| | - P Montoya
- Research Institute oF Health Sciences (IUNICS), University of Balearic Islands (UIB), Palma, Spain
| | - J Vila
- Human Psychophysiology and Health Group, Mind, Brain and Behavior Research Center-CIMCYC, University of Granada, Spain
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17
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Duchêne J, Hewson D, Rumeau P. Modified bathroom scale and balance assessment: a comparison with clinical tests. SPRINGERPLUS 2016; 5:472. [PMID: 27217987 PMCID: PMC4835412 DOI: 10.1186/s40064-016-2086-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/31/2016] [Indexed: 11/10/2022]
Abstract
Frailty and detection of fall risk are major issues in preventive gerontology. A simple tool frequently used in daily life, a bathroom scale (balance quality tester: BQT), was modified to obtain information on the balance of 84 outpatients consulting at a geriatric clinic. The results computed from the BQT were compared to the values of three geriatric tests that are widely used either to detect a fall risk or frailty (timed get up and go: TUG; 10 m walking speed: WS; walking time: WT; one-leg stand: OS). The BQT calculates four parameters that are then scored and weighted, thus creating an overall indicator of balance quality. Raw data, partial scores and the global score were compared with the results of the three geriatric tests. The WT values had the highest correlation with BQT raw data (r = 0.55), while TUG (r = 0.53) and WS (r = 0.56) had the highest correlation with BQT partial scores. ROC curves for OS cut-off values (4 and 5 s) were produced, with the best results obtained for a 5 s cut-off, both with the partial scores combined using Fisher’s combination (specificity 85 %: <0.11, sensitivity 85 %: >0.48), and with the empirical score (specificity 85 %: <7, sensitivity 85 %: >8). A BQT empirical score of less than seven can detect fall risk in a community dwelling population.
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Affiliation(s)
- Jacques Duchêne
- Institut Charles Delaunay, UMR CNRS 6279, University of Technology of Troyes, 12 Rue Marie Curie, CS 42060, 10004 Troyes, France
| | - David Hewson
- Institute for Health Research, University of Bedfordshire, University Square, Luton, Bedfordshire LU1 3JU UK
| | - Pierre Rumeau
- Department of Geriatrics, Gérontopôle, 170, Avenue de Casselardit, TSA 40031, 31059 Toulouse Cedex, France
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18
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Yang K, Xiong WX, Liu FT, Sun YM, Luo S, Ding ZT, Wu JJ, Wang J. Objective and quantitative assessment of motor function in Parkinson's disease-from the perspective of practical applications. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:90. [PMID: 27047949 DOI: 10.21037/atm.2016.03.09] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder with high morbidity because of the coming aged society. Currently, disease management and the development of new treatment strategies mainly depend on the clinical information derived from rating scales and patients' diaries, which have various limitations with regard to validity, inter-rater variability and continuous monitoring. Recently the prevalence of mobile medical equipment has made it possible to develop an objective, accurate, remote monitoring system for motor function assessment, playing an important role in disease diagnosis, home-monitoring, and severity evaluation. This review discusses the recent development in sensor technology, which may be a promising replacement of the current rating scales in the assessment of motor function of PD.
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Affiliation(s)
- Ke Yang
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Wei-Xi Xiong
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Feng-Tao Liu
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yi-Min Sun
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Susan Luo
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zheng-Tong Ding
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jian-Jun Wu
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jian Wang
- Department & Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
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Liuzzo DM, Peters DM, Middleton A, Lanier W, Chain R, Barksdale B, Fritz SL. Measurements of Weight Bearing Asymmetry Using the Nintendo Wii Fit Balance Board Are Not Reliable for Older Adults and Individuals With Stroke. J Geriatr Phys Ther 2015; 40:37-41. [PMID: 26288237 DOI: 10.1519/jpt.0000000000000065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Clinicians and researchers have used bathroom scales, balance performance monitors with feedback, postural scale analysis, and force platforms to evaluate weight bearing asymmetry (WBA). Now video game consoles offer a novel alternative for assessing this construct. By using specialized software, the Nintendo Wii Fit balance board can provide reliable measurements of WBA in healthy, young adults. However, reliability of measurements obtained using only the factory settings to assess WBA in older adults and individuals with stroke has not been established. PURPOSE To determine whether measurements of WBA obtained using the Nintendo Wii Fit balance board and default settings are reliable in older adults and individuals with stroke. METHODS Weight bearing asymmetry was assessed using the Nintendo Wii Fit balance board in 2 groups of participants-individuals older than 65 years (n = 41) and individuals with stroke (n = 41). Participants were given a standardized set of instructions and were not provided auditory or visual feedback. Two trials were performed. Intraclass correlation coefficients (ICC), standard error of measure (SEM), and minimal detectable change (MDC) scores were determined for each group. RESULTS The ICC for the older adults sample was 0.59 (0.35-0.76) with SEM95 = 6.2% and MDC95 = 8.8%. The ICC for the sample including individuals with stroke was 0.60 (0.47-0.70) with SEM95 = 9.6% and MDC95 = 13.6%. DISCUSSION Although measurements of WBA obtained using the Nintendo Wii Fit balance board, and its default factory settings, demonstrate moderate reliability in older adults and individuals with stroke, the relatively high associated SEM and MDC values substantially reduce the clinical utility of the Nintendo Wii Fit balance board as an assessment tool for WBA. CONCLUSIONS Weight bearing asymmetry cannot be measured reliably in older adults and individuals with stroke using the Nintendo Wii Fit balance board without the use of specialized software.
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Affiliation(s)
- Derek M Liuzzo
- Department of Exercise Science, Physical Therapy Program, University of South Carolina, Columbia
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20
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Tsaklis PV, Grooten WJ, Franzén E. Effects of Weight-Shift Training on Balance Control and Weight Distribution in Chronic Stroke: A Pilot Study. Top Stroke Rehabil 2015; 19:23-31. [DOI: 10.1310/tsr1901-23] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Golriz S, Hebert JJ, Foreman KB, Walker BF. The effect of hip belt use and load placement in a backpack on postural stability and perceived exertion: a within-subjects trial. ERGONOMICS 2014; 58:140-147. [PMID: 25265931 DOI: 10.1080/00140139.2014.960010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to assess the effects of hip belt use and load placement in a backpack on perceived exertion and postural stability. Thirty participants were instructed to stand on a force plate and walk along a designated route under five conditions: unloaded, high-load placement, low-load placement, hip belt on and hip belt off. The average velocity and sway area from the force plate were measured. Participants also rated their perceived stability and exertion. Compared to the unloaded condition, all loaded conditions significantly increased average velocity, sway area, perceived stability and exertion. Hip belt use did not affect average velocity and sway area; however, participants reported higher levels of stability and lower levels of exertion with hip belt use. Load placement did not affect average velocity, sway area, perceived stability or exertion. This study showed that wearing a backpack loaded to 20% of body weight reduced postural stability, while manipulation of load placement in a backpack did not affect subjective and objective measures of postural stability. Also, hip belt use only improved subjective measures of postural stability.
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Affiliation(s)
- Samira Golriz
- a School of Health Professions , Murdoch University , Perth , Australia
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22
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Lloréns R, Gil-Gómez JA, Alcañiz M, Colomer C, Noé E. Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke. Clin Rehabil 2014; 29:261-8. [PMID: 25056999 DOI: 10.1177/0269215514543333] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To study the clinical effectiveness and the usability of a virtual reality-based intervention compared with conventional physical therapy in the balance recovery of individuals with chronic stroke. DESIGN Randomized controlled trial. SETTING Outpatient neurorehabilitation unit. PARTICIPANTS A total of 20 individuals with chronic stroke. INTERVENTIONS The intervention consisted of 20 one-hour sessions, five sessions per week. The experimental group combined 30 minutes with the virtual reality-based intervention with 30 minutes of conventional training. The control group underwent one hour conventional therapy. MAIN MEASURES Balance performance was assessed at the beginning and at the end of the trial using the Berg Balance Scale, the balance and gait subscales of the Tinetti Performance-Oriented Mobility Assessment, the Brunel Balance Assessment, and the 10-m Walking Test. Subjective data of the virtual reality-based intervention were collected from the experimental group, with a feedback questionnaire at the end of the trial. RESULTS The results revealed a significant group-by-time interaction in the scores of the Berg Balance Scale (p < 0.05) and in the 10-m Walking Test (p < 0.05). Post-hoc analyses showed greater improvement in the experimental group: 3.8 ±2.6 vs. 1.8 ±1.4 in the Berg Balance Scale, -1.9 ±1.6 seconds vs. 0.0 ±2.3 seconds in the 10-m Walking Test, and also in the number of participants who increased level in the Brunel Balance Assessment (χ(2) = 2.5, p < 0.01). CONCLUSIONS Virtual reality interventions can be an effective resource to enhance the improvement of balance in individuals with chronic stroke.
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Affiliation(s)
- Roberto Lloréns
- Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia, Spain Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia, Spain
| | - Mariano Alcañiz
- Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia, Spain
| | - Carolina Colomer
- Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Valencia, Spain
| | - Enrique Noé
- Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Valencia, Spain
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El método Kinesio taping mejora inmediatamente el equilibrio monopodal en deportistas mayores sanos. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.ft.2013.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tyson S, Desouza L. The Measurement of Balance Post-Stroke. Part 3: Instrumented Measurement Tools. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331902235001994] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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25
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A Primary Care–Based Randomized Controlled Trial of 12-Week Whole-Body Vibration for Balance Improvement in Type 2 Diabetes Mellitus. Arch Phys Med Rehabil 2013; 94:2112-8. [DOI: 10.1016/j.apmr.2013.05.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 11/18/2022]
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Maribo T, Iversen E, Andersen NT, Stengaard-Pedersen K, Schiøttz-Christensen B. Intra-observer and interobserver reliability of One Leg Stand Test as a measure of postural balance in low back pain patients. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/175361409x12472218841040] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Donath L, Roth R, Zahner L, Faude O. Testing single and double limb standing balance performance: comparison of COP path length evaluation between two devices. Gait Posture 2012; 36:439-43. [PMID: 22565319 DOI: 10.1016/j.gaitpost.2012.04.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 04/02/2012] [Accepted: 04/04/2012] [Indexed: 02/02/2023]
Abstract
Center of pressure (COP) path length evaluation was commonly applied to measure postural sway and usually obtained from gold standard force plates. Thus, we comparatively investigated the feasible and less-expensive GKS® balance system (GKS) with the Kistler® force platform (KIS). 34 non-specifically trained but active adults (14 males, 20 females, age: 25.4±4.8 years; weight: 69.3±12.3 kg; height: 1.75±0.09 m, sports activity: 5.8±3.6 hours per week) were randomly tested on both devices during double and single limb stance with opened and closed eyes. Irrespective of the analysed time frame, repeated measures analyses of variances revealed higher path length readings for GKS compared to KIS for 30 s (F=6.8, p=0.01) and 10 s (F=21.2, p=0.001). Large effect sizes of the COP path length differences between GKS and KIS decreased from easy tasks (double limb, eyes open; d(30-s)=2.55, d(10-s)=2.04) to the most severe task (single limb, eyes closed; d(30-s)=0.02, d(10-s)=0.23). According to Bland and Altman, the limits of agreements indicated a high random variability component (between 29%, double limb, eyes open and 67%, single limb, eyes closed). The overall intraclass correlation coefficients (ICC) across all four standing balance tasks were moderate for the 30 s- (0.57) as well as the 10 s-analysis (0.65). In conclusion, the COP path length displacements obtained from the GKS balance system seem to differ with a considerable random variability from Kistler force platform data. Thus, measurements of the evaluated devices should not be used interchangeably. Further methodological investigations regarding balance measures seem warranted.
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Affiliation(s)
- Lars Donath
- Institute of Exercise and Health Sciences, University of Basel, Birsstrasse 320B, CH-4052 Basel, Switzerland.
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28
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Golriz S, Hebert JJ, Foreman KB, Walker BF. The reliability of a portable clinical force plate used for the assessment of static postural control: repeated measures reliability study. Chiropr Man Therap 2012; 20:14. [PMID: 22620678 PMCID: PMC3502132 DOI: 10.1186/2045-709x-20-14] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 03/27/2012] [Indexed: 12/31/2022] Open
Abstract
Background Force plates are frequently used for postural control assessments but they are expensive and not widely available in most clinical settings. Increasingly, clinicians are using this technology to assess patients, however, the psychometric properties of these less sophisticated force plates is frequently unknown. The purposes of the study were to examine the test-retest reliability of a force plate commonly used by clinicians and to explore the effect of using the mean value from multiple repetitions on reliability. Methods Thirty healthy volunteer adults were recruited. Postural control measures were obtained using the Midot Posture Scale Analyzer (MPSA). Data were collected in 2 sessions. Five successive repetitions each of 60 seconds duration were obtained from each participant in each session. Results The reliability coefficients obtained using single measures were low (ICC3,1 = 0.06 to 0.53). The average of two measures allowed for reliable measurements of COP mean velocity and average location of COP. The average of three and five measures was required to obtain acceptable reliability (ICC ≥ 0.70) of relative weight bearing on legs and sway area, respectively. Higher measurement precision values were seen by averaging four or five repetitions for all variables. Conclusion Single measures did not provide reliable estimates of postural sway, and the averaging of multiple repetitions was necessary to achieve acceptable levels of measurement error. The number of repetitions required to achieve reliable data ranged from 2 to 5. Clinicians should be wary of using single measures derived from similar equipment when making decisions about patients.
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Affiliation(s)
- Samira Golriz
- School of Chiropractic and Sports Science, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia.
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29
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Shin SS, Lee YW, Song CH. Effects of Lumbar Stabilization Exercise on Postural Sway of Patients with Adolescent Idiopathic Scoliosis during Quiet Sitting. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.211] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Yong Woo Lee
- Department of Physical Therapy, Sahmyook University
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Duchêne J, Hewson DJ. Longitudinal evaluation of balance quality using a modified bathroom scale: usability and acceptability. J Telemed Telecare 2011; 17:421-6. [PMID: 21979602 DOI: 10.1258/jtt.2011.110307] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We adapted a commercial bathroom scale in order to acquire the raw data from the weight sensors and then to send them to a server via a mobile phone. We investigated the usability and acceptability of the device in a long-term experiment with 22 elderly users that produced more than 5000 weight recordings. Four basic variables were extracted from the vertical force measurements and the stabilogram. The technology was accepted unreservedly, presumably because it did not differ from devices usually encountered in the home. The quantitative results showed a high variability of day-to-day measurement, which was countered by taking a moving average. A balance index was able to identify changes in balance over time. The preliminary results appear promising.
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Affiliation(s)
- Jacques Duchêne
- ICD-LM2S UMR CNRS 6279, Université de Technologie de Troyes, France.
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Gil-Gómez JA, Lloréns R, Alcañiz M, Colomer C. Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury. J Neuroeng Rehabil 2011; 8:30. [PMID: 21600066 PMCID: PMC3120756 DOI: 10.1186/1743-0003-8-30] [Citation(s) in RCA: 203] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 05/23/2011] [Indexed: 02/08/2023] Open
Abstract
Background Acquired brain injury (ABI) is the main cause of death and disability among young adults. In most cases, survivors can experience balance instability, resulting in functional impairments that are associated with diminished health-related quality of life. Traditional rehabilitation therapy may be tedious. This can reduce motivation and adherence to the treatment and thus provide a limited benefit to patients with balance disorders. We present eBaViR (easy Balance Virtual Rehabilitation), a system based on the Nintendo® Wii Balance Board® (WBB), which has been designed by clinical therapists to improve standing balance in patients with ABI through motivational and adaptative exercises. We hypothesize that eBaViR, is feasible, safe and potentially effective in enhancing standing balance. Methods In this contribution, we present a randomized and controlled single blinded study to assess the influence of a WBB-based virtual rehabilitation system on balance rehabilitation with ABI hemiparetic patients. This study describes the eBaViR system and evaluates its effectiveness considering 20 one-hour-sessions of virtual reality rehabilitation (n = 9) versus standard rehabilitation (n = 8). Effectiveness was evaluated by means of traditional static and dynamic balance scales. Results The final sample consisted of 11 men and 6 women. Mean ± SD age was 47.3 ± 17.8 and mean ± SD chronicity was 570.9 ± 313.2 days. Patients using eBaViR had a significant improvement in static balance (p = 0.011 in Berg Balance Scale and p = 0.011 in Anterior Reaches Test) compared to patients who underwent traditional therapy. Regarding dynamic balance, the results showed significant improvement over time in all these measures, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. There were no serious adverse events during treatment in either group. Conclusions The results suggest that eBaViR represents a safe and effective alternative to traditional treatment to improve static balance in the ABI population. These results have encouraged us to reinforce the virtual treatment with new exercises, so an evolution of the system is currently being developed.
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Affiliation(s)
- José-Antonio Gil-Gómez
- Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia, Spain.
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Williams B, Doherty NL, Bender A, Mattox H, Tibbs JR. The effect of nintendo wii on balance: a pilot study supporting the use of the wii in occupational therapy for the well elderly. Occup Ther Health Care 2011; 25:131-139. [PMID: 23899030 DOI: 10.3109/07380577.2011.560627] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
ABSTRACT This study explored the benefits that Nintendo's Wii Fit activities may have on the balance of 22 community living older adults. Over 4 weeks, participants completed twelve 20-min sessions using various programs in the Wii Fit. Pretest and posttest measurements were obtained using the Berg Balance Scale with participants scoring an average of 9.14 points higher on the postintervention. Posttest balance scores were significantly greater [t (21) = -9.861, p < .01] than pretest scores. Reports from the participants supported the positive use and possible improvements in quality of life. The results of this study suggest the potential effectiveness of utilizing the Nintendo Wii as a therapeutic agent in occupational therapy practice.
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Affiliation(s)
- Barbara Williams
- College of Nursing and Health Professions, University of Southern Indiana Occupational Therapy Program, Evansville, Indiana, USA
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Physical aspects of healthy aging: assessments of three measures of balance for studies in middle-aged and older adults. Curr Gerontol Geriatr Res 2011; 2010:849761. [PMID: 21437003 PMCID: PMC3062992 DOI: 10.1155/2010/849761] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 12/24/2010] [Accepted: 12/31/2010] [Indexed: 01/09/2023] Open
Abstract
Objectives. To investigate the reliability and correlations with age of the balance components of the EPESE, NHANES, and the Good Balance Platform System (GBPS) in a normal population of adults.
Design. Cross-sectional.
Setting. Urban Medical Center in the Pacific.
Participants. A random sample of 203 healthy offspring of Honolulu Heart Program participants, ages 38–71.
Measurements. Subjects were examined twice at visits one week apart using the balance components of the EPESE, NHANES, and the good balance system tests.
Results. The EPESE and NHANES batteries of tests were not sufficiently challenging to allow successful discrimination among subjects in good health, even older subjects. The GBPS allowed objective quantitative measurements, but the test-retest correlations generally were not high. The GBPS variables correlated with age only when subjects stood on a foam pad; they also were correlated with anthropometric variables. Conclusion. Both EPESE and NHANES balance tests were too easy for healthy subjects. The GBPS had generally low reliability coefficients except for the most difficult testing condition (foam pad, eyes closed). Both height and body fat were associated with GBPS scores, necessitating adjusting for these variables if using balance as a predictor of future health.
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Clark RA, Bryant AL, Pua Y, McCrory P, Bennell K, Hunt M. Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance. Gait Posture 2010; 31:307-10. [PMID: 20005112 DOI: 10.1016/j.gaitpost.2009.11.012] [Citation(s) in RCA: 533] [Impact Index Per Article: 38.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 11/10/2009] [Accepted: 11/15/2009] [Indexed: 02/02/2023]
Abstract
Impaired standing balance has a detrimental effect on a person's functional ability and increases their risk of falling. There is currently no validated system which can precisely quantify center of pressure (COP), an important component of standing balance, while being inexpensive, portable and widely available. The Wii Balance Board (WBB) fits these criteria, and we examined its validity in comparison with the 'gold standard'-a laboratory-grade force platform (FP). Thirty subjects without lower limb pathology performed a combination of single and double leg standing balance tests with eyes open or closed on two separate occasions. Data from the WBB were acquired using a laptop computer. The test-retest reliability for COP path length for each of the testing devices, including a comparison of the WBB and FP data, was examined using intraclass correlation coefficients (ICC), Bland-Altman plots (BAP) and minimum detectable change (MDC). Both devices exhibited good to excellent COP path length test-retest reliability within-device (ICC=0.66-0.94) and between-device (ICC=0.77-0.89) on all testing protocols. Examination of the BAP revealed no relationship between the difference and the mean in any test, however the MDC values for the WBB did exceed those of the FP in three of the four tests. These findings suggest that the WBB is a valid tool for assessing standing balance. Given that the WBB is portable, widely available and a fraction of the cost of a FP, it could provide the average clinician with a standing balance assessment tool suitable for the clinical setting.
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Affiliation(s)
- Ross A Clark
- Centre for Health, Exercise and Sports Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Victoria 3010, Australia.
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Kim JH, Chung YJ, Shin HK. Effects of Balance Training on Patients with Spinal Cord Injury. J Phys Ther Sci 2010. [DOI: 10.1589/jpts.22.311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jung-Hee Kim
- Department of Physical Therapy, The Graduate School, Sahmyook University
| | - Yi-Jung Chung
- Department of Physical Therapy, College of Health Wealfare, Sahmyook University
| | - Hwa-Kyung Shin
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu
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Tsai CL, Pan CY, Cherng RJ, Wu SK. Dual-task study of cognitive and postural interference: a preliminary investigation of the automatization deficit hypothesis of developmental co-ordination disorder. Child Care Health Dev 2009; 35:551-60. [PMID: 19638025 DOI: 10.1111/j.1365-2214.2009.00974.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of this study was to investigate whether children with developmental co-ordination disorder and balance problem (DCD-BP) had greater problems than controls in performing a primary balance task while concurrently completing different cognitive tasks varying in oral or listening cognitive complexity, as well as to investigate the automatization deficit hypothesis of DCD-BP. METHODS Children with DCD-BP (n= 39), along with age-matched control counterparts (n= 39), were placed on automatic processing situation under dual-task conditions. All children were required to perform a primary task, five dual-task paradigms (oral counting task, auditory-verbal reaction task, auditory-choice reaction task, auditory-memory task and articulation alone) and an eyes-closed balancing task. RESULTS In the primary task condition, the differences were not statistically significant (P= 0.393) between children with and without DCD-BP. However, children with DCD-BP were significantly more impaired on three of five dual-task conditions (oral counting task: P= 0.003; auditory-verbal reaction task: P= 0.011; auditory-memory task: P= 0.041) compared with the single-task situation, with the exception of the auditory-choice reaction task (P= 0.471) and articulation alone (P= 0.067). CONCLUSIONS These results suggest that children with DCD-BP were more cognitively dependant and may have an automatization deficit.
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Affiliation(s)
- C-L Tsai
- Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, Taiwan
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Tsai CL, Wu SK. Relationship of Visual Perceptual Deficit and Motor Impairment in Children with Developmental Coordination Disorder. Percept Mot Skills 2008; 107:457-72. [DOI: 10.2466/pms.107.2.457-472] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study explored the relations of visual perceptual deficits and motor impairments in 60 children with Developmental Coordination Disorder (120.8 ± 4.0 mo.) and 60 controls (121.0 ± 5.3 mo.), who were matched by sex (29 boys and 31 girls) and age. They were separately assessed on fine and gross motor-dexterity tasks of the Movement Assessment Battery for Children, static balance and reaction time of lower extremities with eyes open or closed, and the Test of Visual-Perceptual Skills–Revised. Analysis showed the children with Developmental Coordination Disorder performed significantly worse than the control group, but only the visual perception and motor skills with timed responses were significantly correlated. When visual information was controlled, no significant correlation was noted, so motor-free visual perception appears to be significantly related to motor performance having a speed component in these children.
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Affiliation(s)
- Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University
| | - Sheng-Kuang Wu
- Institute of Athletics, National Taiwan Sport University
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Static balance in children with developmental coordination disorder. Hum Mov Sci 2008; 27:142-53. [DOI: 10.1016/j.humov.2007.08.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Revised: 08/21/2007] [Accepted: 08/21/2007] [Indexed: 11/23/2022]
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TSAI CHIALIANG. RELATIONSHIP OF VISUAL PERCEPTUAL DEFICIT AND MOTOR IMPAIRMENT IN CHILDREN WITH DEVELOPMENTAL COORDINATION DISORDER. Percept Mot Skills 2008. [DOI: 10.2466/pms.107.6.457-472] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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A Combined Sensorimotor Skill and Strength Training Program Improves Postural Steadiness in Rhythmic Sports Athletes. HUMAN MOVEMENT 2008. [DOI: 10.2478/v10038-008-0006-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sims RJA, Taylor R, Masud T, Roe S, Cassidy MJD, Mockett S. The effect of a single haemodialysis session on functional mobility in older adults: a pilot study. Int Urol Nephrol 2007; 39:1287-93. [PMID: 17899429 DOI: 10.1007/s11255-007-9280-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Accepted: 08/16/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To undertake balance and functional mobility assessments in older maintenance haemodialysis patients before and after haemodialysis as a pilot study in order to gain initial data and to assess the feasibility and acceptability of this type of study. DESIGN Postural sway, three-metre timed "up and go" test (TGUGT), and dynamic single leg extensor power (LEP) were measured before and after a haemodialysis session. SETTING AND SUBJECTS Male and female maintenance haemodialysis patients aged over 60 years attending the Nottingham City Hospital. MAIN MEASURES Objective outcome measures were postural sway number and sway path (mm) by balance performance monitor, timed three-metre "up and go" test (s), and leg extensor power (W). Blood pressure and weight reductions were also measured. Subjective assessments of practicality and acceptability were made. RESULTS Twenty-two patients enrolled. Complete data sets were collected for 14 subjects (11 male, three female). Results were analysed using the Wilcoxon signed ranks test for nonparametric data. There was no significant difference before and after dialysis in postural sway, timed "up and go" or leg extensor power. Eight patients did not complete the study and the reasons are examined. CONCLUSIONS There was no significant single-session effect. Results suggest that haemodialysis patients may be weaker and have reduced postural stability when compared to historical data on comparable undialysed patients. The study was logistically complex and would be difficult to expand using these methods, but the issues merit further consideration.
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Affiliation(s)
- Rebecca J A Sims
- Department of Renal and Transplant Medicine, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, UK.
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Tessem S, Hagstrøm N, Fallang B. Weight distribution in standing and sitting positions, and weight transfer during reaching tasks, in seated stroke subjects and healthy subjects. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2007; 12:82-94. [PMID: 17536646 DOI: 10.1002/pri.362] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE The recovery of sitting balance after a stroke is assumed to be essential to obtain independence in other vital functions. The purpose of the present study was to investigate weight distribution while sitting and standing still, and weight transfer during seated reaching tasks performed by stroke subjects and healthy subjects. METHOD The study was cross-sectional. Twenty-one stroke subjects and 21 healthy subjects, matched by age and gender, participated. Main measures were weight distribution while standing and sitting still, and displacements of centre ofpressure (COP) during seated reaching tasks. Data were collected using a balance performance monitor (BPM), including software. RESULTS Stroke subjects had less symmetrical weight distribution in standing than that of healthy subjects (p < 0.001). No significant differences between the groups were found while sitting still, and no associations between asymmetries in standing still and sitting positions within individual stroke subjects were found. Neither did the degree of weight distribution in sitting correspond to COP displacements in seated reaching tasks. However, COP displacement patterns in reaching tasks in the seated position were different in stroke subjects from those of healthy subjects. Stroke subjects showed more lateral displacement when reaching forwards (p < 0.001), and less lateral displacement when reaching sideways to the unaffected side (p = 0.01). CONCLUSION COP displacement patterns in stroke subjects deviate more than those of healthy subjects in seated reaching tasks. The deviating COP displacement patterns are discussed as a possible dysfunction in the ability to make postural adjustments and learn an efficient movement pattern.
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Affiliation(s)
- Siri Tessem
- Physiotherapy Programme, Faculty of Health Sciences, Oslo University College, Oslo, Norway.
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Steadman J, Donaldson N, Kalra L. A randomized controlled trial of an enhanced balance training program to improve mobility and reduce falls in elderly patients. J Am Geriatr Soc 2003; 51:847-52. [PMID: 12757574 DOI: 10.1046/j.1365-2389.2003.51268.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of an enhanced balance training program in improving mobility and well-being of elderly people with balance problems. DESIGN Prospective, single-blind, randomized, controlled trial. SETTING District general hospital. PARTICIPANTS One hundred ninety-nine patients aged 60 and older with a Berg Balance Scale (BBS) score of less than 45. INTERVENTIONS Six weeks enhanced balance training consisting of a series of repetitive tasks of increasing difficulty specific to functional balance. The control group received physiotherapy conforming to existing practice in elderly patients with mobility problems. MEASUREMENTS Ten-meter timed walk test (TWT), BBS, Frenchay Activities Index (FAI), Falls Handicap Inventory (FHI), and European Quality of Life questionnaire (Euroqol) measured at 6, 12, and 24 weeks after intervention. RESULTS The mean age +/- standard deviation of subjects was 82.7 +/- 5.6, and baseline characteristics were comparable between the groups. Both groups showed improvements in TWT (intervention: 22.5-16.5 seconds, P =.001; control: 20.5-15.8 seconds, P =.054), BBS (intervention: 33.3-42.7, P =.001; control: 33.4-42.0, P <.0001), FAI (18-21, P =.02 in both groups), FHI score (intervention: 31-17, P =.0001; control: 33-17, P =.0001) and Euroqol score (intervention: 58-65, P =.04; control: 60-65, P =.07). There were no intergroup differences at any time. More patients reported increased confidence in walking indoors (36% vs 28%; P =.04) and outdoors (27% vs 18%; P =.02) in the enhanced balance-training group. CONCLUSION Exercise programs significantly improve balance and mobility in patients with balance problems, independent of strategy. Enhanced balance training may, in addition, improve confidence and quality of life but needs further investigation.
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Affiliation(s)
- Jayne Steadman
- Department of Physiotherapy, Orpington Hospital, Bromley Hospitals NHS Trust, Orpington, United Kingdom
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