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Kumar S, Singh R, Dutta A, Yadav MK. Enhancing BPPV Treatment Outcomes: A Comparative Study of the Epley Maneuver with and without the Dizzy-Fix Training Device. Indian J Otolaryngol Head Neck Surg 2024; 76:3424-3430. [PMID: 39130324 PMCID: PMC11306911 DOI: 10.1007/s12070-024-04710-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/15/2024] [Indexed: 08/13/2024] Open
Abstract
INTRODUCTION This study evaluates the effectiveness of combining the Epley Maneuver with the Dizzy-Fix Training Device in treating Benign Paroxysmal Positional Vertigo (BPPV), aiming to enhance treatment outcomes and patient satisfaction. METHODS In this randomized controlled trial, 50 patients diagnosed with posterior canal BPPV were allocated into two groups: one receiving the traditional Epley Maneuver and the other undergoing the Epley Maneuver supplemented with the Dizzy-Fix Training Device. Key measures included the proportion of symptom-free patients at one month, changes in the Visual Analogue Scale (VAS) and Dizziness Handicap Inventory (DHI) scores, the recurrence rate within one month, and patient satisfaction. RESULTS The Dizzy-Fix group achieved a significantly higher symptom resolution rate by day 7 (90% vs. 60%) and reported greater patient satisfaction (4.5/5 vs. 3.8/5) compared to the Epley Maneuver alone group. Additionally, this group exhibited a more substantial decrease in DHI scores (from an average of 30 to 5) and a lower recurrence rate (10% vs. 40%) within the first month post-treatment. CONCLUSION Incorporating the Dizzy-Fix Training Device with the Epley Maneuver significantly improves the management of BPPV, evidenced by faster symptom resolution, enhanced patient satisfaction, and reduced symptom recurrence. These findings underscore the value of integrating real-time visual feedback technologies in vestibular rehabilitation, promising better patient outcomes, and advancing the quality of care in BPPV treatment.
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Affiliation(s)
- Sanjay Kumar
- Dept of ENT-HNS, Command Hospital Air Force, Bangalore, India
| | - Ran Singh
- Dept of ENT-HNS, Army College of Medical Science, Delhi Cantt, New Delhi, India
| | - Angshuman Dutta
- Dept of ENT-HNS, Command Hospital Air Force, Bangalore, India
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Appiah-Kubi KO, Galgon A, Tierney R, Lauer R, Wright WG. Concurrent vestibular activation and postural training recalibrate somatosensory, vestibular and gaze stabilization processes. PLoS One 2024; 19:e0292200. [PMID: 38968181 PMCID: PMC11226066 DOI: 10.1371/journal.pone.0292200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 05/25/2024] [Indexed: 07/07/2024] Open
Abstract
Postural instability is a common symptom of vestibular dysfunction that impacts a person's day-to-day activities. Vestibular rehabilitation is effective in decreasing dizziness, visual symptoms and improving postural control through several mechanisms including sensory reweighting of the vestibular, visual and somatosensory systems. As part of the sensory reweighting mechanisms, vestibular activation exercises with headshaking influence vestibular-ocular reflex (VOR). However, combining challenging vestibular and postural tasks to facilitate more effective rehabilitation outcomes is under-utilized. Understanding how and why this may work is unknown. The aim of the study was to assess sensory reweighting of postural control processing and VOR after concurrent vestibular activation and weight shift training (WST) in healthy young adults. Forty-two participants (18-35years) were randomly assigned into four groups: No training/control (CTL), a novel visual feedback WST coupled with a concurrent, rhythmic active horizontal or vertical headshake activity (HHS and VHS), or the same WST with no headshake (NHS). Training was performed for five days. All groups performed baseline- and post-assessments using the video head impulse test, sensory organization test, force platform rotations and electro-oculography. Significantly decreased horizontal eye movement variability in the HHS group compared to the other groups suggests improved gaze stabilization (p = .024). Significantly decreased horizontal VOR gain (p = .040) and somatosensory downweighting (p = .050) were found in the combined headshake groups (HHS and VHS) compared to the other two groups (NHS and CTL). The training also showed a significantly faster automatic postural response (p = .003) with improved flexibility (p = .010) in the headshake groups. The concurrent training influences oculomotor function and suggests improved gaze stabilization through vestibular recalibration due to adaptation and possibly habituation. The novel protocol could be modified into progressive functional activities that would incorporate gaze stabilization exercises. The findings may have implications for future development of vestibular rehabilitation protocols.
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Affiliation(s)
- Kwadwo Osei Appiah-Kubi
- Health & Rehabilitation Sciences Department, Temple University, Philadelphia, Pennsylvania, United States of America
- Physical Therapy Department, Clarkson University, Potsdam, New York, United States of America
| | - Anne Galgon
- Physical Therapy Department, Saint Joseph’s University, Philadelphia, Pennsylvania, United States of America
| | - Ryan Tierney
- Health & Rehabilitation Sciences Department, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Richard Lauer
- Health & Rehabilitation Sciences Department, Temple University, Philadelphia, Pennsylvania, United States of America
| | - W. Geoffrey Wright
- Health & Rehabilitation Sciences Department, Temple University, Philadelphia, Pennsylvania, United States of America
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Coello-Villalón M, López-Muñoz P, Palomo-Carrión R, Hidalgo-Robles Á, Merino-Andrés J. Short-Term Effects of Vestibular Training on Gross Motor Function in Children and Youth with Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Phys Occup Ther Pediatr 2024; 44:615-625. [PMID: 38764313 DOI: 10.1080/01942638.2024.2350385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 04/09/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024]
Abstract
AIMS To review the literature on the effects of vestibular training on motor function and balance in children and youth with cerebral palsy. METHODS Eight databases (MEDLINE-PubMed, PEDro, Cochrane Library, OTSeeker, Web of Science, Scopus Database, CINAHL and SPORTDiscus.) were searched up to May 15th, 2023. Studies comparing vestibular training with other types of interventions. The DerSimonian and Laird method was employed using random effects models to calculate the pooled estimate of the effect size with confidence intervals of 95%. The risk of bias was assessed with the Cochrane Collaboration's tool and the Grading of Recommendations Assessment, Development and Evaluation approach was used to judge the certainty of the evidence for all outcomes. RESULTS Eight studies were included comprising 226 participants with cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of vestibular training program compared to other technique(s) for Gross Motor Function Measure (-0.471; 95% confidence intervals: -0.919 to -0.023) and balance (-0.546; 95% confidence intervals: -0.916 to -0.176). CONCLUSIONS Vestibular training has potential benefits in the short-term as a therapeutic approach for improving gross motor function and the balance in children and youth with cerebral palsy, but further research is needed.
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Affiliation(s)
| | - Purificación López-Muñoz
- Research in Pediatric Physiotherapy and Neurology Group, ImproveLab, Toledo, Spain
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Rocío Palomo-Carrión
- Research in Pediatric Physiotherapy and Neurology Group, ImproveLab, Toledo, Spain
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Álvaro Hidalgo-Robles
- International University of La Rioja, La Rioja, Spain
- PedPT Research Lab, Toledo, Spain
| | - Javier Merino-Andrés
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
- PedPT Research Lab, Toledo, Spain
- Toledo Physiotherapy Research Group (GIFTO), Department of Nursing, Physical Therapy and Occupational Therapy, Castilla-La Mancha University, Toledo, Spain
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Santos S, Melo F, Fernandes O, Parraca JA. The effect of Ashtanga-Vinyasa Yoga method on air force pilots' operational performance. Front Public Health 2024; 12:1334880. [PMID: 38751579 PMCID: PMC11094342 DOI: 10.3389/fpubh.2024.1334880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction In today's military landscape, optimizing performance and bolstering physical health and mental resilience are critical objectives. Introducing a 12-week Ashtanga Vinyasa Yoga Supta Method (AVYSM) to the training protocol of military trained Airforce pilots, we aim to assesses the feasibility and impact of the method. Materials and equipment Borg Scale assesses the intensity level of physical activity during the intervention. Flight simulator data gauges operational performance responses. Postural control responses are measured using a force platform, stress responses are monitored via heart monitor, and handgrip dynamometry will measure strength. Respiratory capacity is assessed using a spirometer, body composition is evaluated using impedance balance, and aviation-related questionnaires are administered before and after the intervention period. Methods In a randomized controlled trial, the totality of pilots from the "Masters in Military Aeronautics: aviator pilot specialist" course at the Portuguese Air Force Academy (PAA) were randomly assigned to the yoga intervention or the waiting list control groups, with participants providing written informed consent. The control group followed protocolized course classes for 12 weeks, while the intervention group integrated two weekly one-hour yoga sessions into their course. Results The PAA has approved the implementation of this intervention protocol at Airbase 11 in Beja, highlighting its significance for the organization's policy makers. We hypothesize that this method will enhance operational performance and, subsequently, elevate flight safety. Discussion This research's potential extends beyond the PAA, as it can be adapted for use in Airforce departments of other nations and various military contexts. Clinical trial registration Évora University research ethics committee-approval number 21050. Study registered on ClinicalTrials.gov under identifier NCT05821270, registered on April 19, 2023.
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Affiliation(s)
- Sara Santos
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - Filipe Melo
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
- Universidade de Lisboa Faculdade de Motricidade Humana: Cruz Quebrada, Lisboa, Portugal
| | - Orlando Fernandes
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - José Alberto Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
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D’Silva LJ, Phongsavath T, Partington K, Pickle NT, Marschner K, Zehnbauer TP, Rossi M, Skop K, Roos PE. A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises. Front Med (Lausanne) 2023; 10:1269874. [PMID: 38076248 PMCID: PMC10704144 DOI: 10.3389/fmed.2023.1269874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/06/2023] [Indexed: 02/12/2024] Open
Abstract
Introduction Vestibular hypofunction is associated with dizziness, imbalance, and blurred vision with head movement. Vestibular rehabilitation is the gold standard recommendation to decrease symptoms and improve postural stability. The Clinical Practice Guidelines for vestibular hypofunction suggest home exercises 3-5 times daily, but patient adherence is a problem, with compliance rates often below 50%. Methods An app was developed to increase engagement with home exercises by providing exercises as games. This study compared the accuracy of exercise performance in a one-time session using the app versus no-app and gathered participant feedback on using the app for vestibulo-ocular reflex (VOR) and balance exercises. The app was tested with 40 adults (20 women), mean age of 67 ± 5.7 years, with symptomatic unilateral or bilateral vestibular hypofunction. Participants completed VOR exercises in pitch and yaw planes, weight-shift, and single-leg balance exercises using an inertial motion unit to move the character on the tablet screen. Participants were randomly assigned to begin the exercises with or without the app. Results Results show that during VOR exercises, participants achieved the prescribed frequency of head motion for the yaw plane (p ≤ 0.001) and reduced variability of head movement frequency in both the yaw (p ≤ 0.001) and pitch plane (p ≤ 0.001) in the app compared to the no-app condition. During weight-shifting exercises, a larger range of body motion was noted in the anteroposterior and mediolateral directions in the app compared to the no-app condition (p < 0.05). During single-leg balance exercises, pelvic motion was lower in the app versus no-app condition (p = 0.02). Participants modified their exercise performance and corrected their mistakes to a greater extent when they used the app during the VOR exercises. Participants agreed that they felt motivated while playing the games (97%) and felt motivated by the trophies (92%). They agreed that the app would help them perform the exercises at home (95%), improve their rehab performance (95%) and that it was fun to do the exercises using the app (93%). Discussion The results of this study show that technology that is interactive and provides feedback can be used to increase accuracy and engagement with exercises.
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Affiliation(s)
- Linda J. D’Silva
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas, MO, United States
| | - Tarah Phongsavath
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas, MO, United States
| | - Kelly Partington
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas, MO, United States
| | - Nathan T. Pickle
- Biomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United States
| | - Katherine Marschner
- Biomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United States
| | - Timothy P. Zehnbauer
- Biomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United States
| | - Michael Rossi
- Biomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United States
| | - Karen Skop
- Physical Medicine and Rehabilitation Services, Department of Physical Therapy, James A. Haley Veterans’ Hospital, Tampa, FL, United States
- School of Physical Therapy, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Paulien E. Roos
- Biomedical, Energy and Materials, CFD Research Corporation, Huntsville, AL, United States
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Cedras AM, Moin-Darbari K, Foisy K, Auger S, Nguyen D, Champoux F, Maheu M. Questioning the Impact of Vestibular Rehabilitation in Mal de Debarquement Syndrome. Audiol Neurootol 2023; 29:107-113. [PMID: 37820609 DOI: 10.1159/000533684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 08/16/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION Mal de debarquement syndrome (MdDS) is a rare and poorly understood clinical entity defined as a persistent sensation of rocking and swaying that can severely affect the quality of life. To date, the treatment options are very limited. Even though vestibular rehabilitation (VR) efficacy following peripheral vestibular lesion is well-documented, little is known about its influence on MdDS. The objective of the study was to explore the influence of traditional VR program on postural control in a patient diagnosed with MdDS. METHODS We assessed 3 different participants: 1 healthy control; 1 participant with identified peripheral vestibular impairment (VI); 1 participant diagnosed with MdDS. Postural control was assessed using a force plate (AMTI, Accusway). Participants were assessed following the modified Clinical Test Sensory Integration Balance protocol (mCTSIB, eyes open on firm surface/eyes closed on firm surface/eyes open on foam/eyes closed on foam). The raw data were exported and analyzed in a custom-made Matlab script (Matlab R2020a). We retrieved the center of pressure velocity in both anterior-posterior and mediolateral directions and performed an analysis of the frequency content using Daubechies wavelet of order 4 with 6 levels of decomposition. Protocol VI and MdDS patients performed a 4-week VR program. Postural control, using a force plate, and Dizziness Handicap Inventory (DHI) were assessed before and after the VR program. Healthy control was assessed twice separated by 1 week without any specific intervention. RESULTS VI participant showed clear improvement on DHI and sway velocity on condition eyes closed with foam. Accordingly, a reduction of energy content within frequency bands (0.39-0.78 Hz and 0.78-1.56 Hz) was observed post-rehabilitation for VI participant in both conditions with foam. Interestingly, MdDS participant demonstrated a reduction in sway velocity in most of the conditions but the frequency content was not modified by VR and was comparable to healthy control. Accordingly, the DHI of the MdDS participant failed to demonstrate any difference following VR. CONCLUSION The results of the present study question the use of VR as an efficient treatment option for MdDS. Future studies must recruit a larger sample size and focus on the relationship between illusion of movement and postural characteristics such as sway velocity.
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Affiliation(s)
- Assan Mary Cedras
- School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Québec, Canada
- Institut Universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), pavillon Laurier, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
| | - Karina Moin-Darbari
- School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Québec, Canada
- Institut Universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), pavillon Laurier, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
| | - Kim Foisy
- Audiology Center-West, Montreal, Québec, Canada
| | | | - Don Nguyen
- Jewish General Hospital, Montreal, Québec, Canada
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Québec, Canada
| | - François Champoux
- School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Québec, Canada
- Institut Universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), pavillon Laurier, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Québec, Canada
| | - Maxime Maheu
- School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Québec, Canada
- Institut Universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), pavillon Laurier, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Loyd BJ, Dibble LE, Weightman MM, Pelo R, Hoppes CW, Lester M, King LA, Fino PC. Volitional Head Movement Deficits and Alterations in Gait Speed Following Mild Traumatic Brain Injury. J Head Trauma Rehabil 2023; 38:E223-E232. [PMID: 36731009 DOI: 10.1097/htr.0000000000000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Unconstrained head motion is necessary to scan for visual cues during navigation, for minimizing threats, and to allow regulation of balance. Following mild traumatic brain injury (mTBI) people may experience alterations in head movement kinematics, which may be pronounced during gait tasks. Gait speed may also be impacted by the need to turn the head while walking in these individuals. The aim of this study was to examine head kinematics during dynamic gait tasks and the interaction between kinematics and gait speed in people with persistent symptoms after mTBI. SETTING A clinical assessment laboratory. DESIGN A cross-sectional, matched-cohort study. PARTICIPANTS Forty-five individuals with a history of mTBI and 46 age-matched control individuals. MAIN MEASURES All participants were tested at a single time point and completed the Functional Gait Assessment (FGA) while wearing a suite of body-mounted inertial measurement units (IMUs). Data collected from the IMUs were gait speed, and peak head rotation speed and amplitude in the yaw and pitch planes during the FGA-1, -3, and -4 tasks. RESULTS Participants with mTBI demonstrated significantly slower head rotations in the yaw ( P = .0008) and pitch ( P = .002) planes. They also demonstrated significantly reduced amplitude of yaw plane head rotations ( P < .0001), but not pitch plane head rotations ( P = .84). Participants with mTBI had significantly slower gait speed during normal gait (FGA-1) ( P < .001) and experienced a significantly greater percent decrease in gait speed than healthy controls when walking with yaw plane head rotations (FGA-3) ( P = .02), but not pitch plane head rotations (FGA-4) ( P = .11). CONCLUSIONS Participants with mTBI demonstrated smaller amplitudes and slower speeds of yaw plane head rotations and slower speeds of pitch plane head rotations during gait. Additionally, people with mTBI walked slower during normal gait and demonstrated a greater reduction in gait speed while walking with yaw plane head rotations compared with healthy controls.
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Affiliation(s)
- Brian J Loyd
- School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula (Dr Loyd); Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City (Drs Dibble and Pelo); Courage Kenny Research Center-Allina Health, Minneapolis, Minnesota (Dr Weightman); Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, Texas (Dr Hoppes); Department of Physical Therapy, Texas State University, Round Rock (Dr Lester); School of Medicine, Oregon Health & Sciences University, Portland (Dr King); and Department of Health and Kinesiology, University of Utah, Salt Lake City (Dr Fino)
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Lilios A, Chimona T, Papadakis C, Chatziioanou I, Nikitas C, Skoulakis C. Different Vestibular Rehabilitation Modalities in Unilateral Vestibular Hypofunction: A Prospective Study. Otol Neurotol 2023; 44:e246-e255. [PMID: 36946364 DOI: 10.1097/mao.0000000000003836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To assess the effectiveness of three vestibular rehabilitation protocols in patients with chronic unilateral vestibular hypofunction. STUDY DESIGN Prospective randomized trial. SETTING Audiology-neurootology laboratory in a general public hospital. PATIENTS Eighty-one patients were randomly allocated into three groups: adaptation exercises (AEs), habituation exercises (HEs), and combined exercises (AE-HEs). INTERVENTIONS Each patient completed an 8-week vestibular rehabilitation program with exercise, depending on their allocation group. MAIN OUTCOME MEASURES Evaluations performed at baseline, 4 weeks, and 8 weeks with (a) Functional Gait Assessment (FGA), (b) Mini-BESTest, (c) Vestibular Rehabilitation Benefit Questionnaire, and (d) Dizziness Handicap Inventory. RESULTS FGA and Mini-BESTest scores showed significant improvement between the baseline and 8-week scores in all groups (p < 0.001), except for the FGA score in the HE group. The AE-HE group showed better scores for all measurements at 4 weeks and had significantly better FGA and Mini-BESTest scores than the AE group and better FGA scores than the HE group. The Vestibular Rehabilitation Benefit Questionnaire and Dizziness Handicap Inventory scores in the AE-HE group were significantly better (p ≤ 0.001) than those in the HE group at 8 weeks. CONCLUSIONS The AE-HE group showed faster improvement and significantly better outcomes for static balance, dynamic postural stability, and self-perceived disability than the single-exercise protocols in chronic unilateral vestibular hypofunction.
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Affiliation(s)
| | - Theognosia Chimona
- Otolaryngology, Head & Neck Surgery Department, Chania General Hospital, Chania, Greece
| | - Chariton Papadakis
- Otolaryngology, Head & Neck Surgery Department, Chania General Hospital, Chania, Greece
| | - Ioannis Chatziioanou
- Otolaryngology, Head & Neck Surgery Department, University Hospital of Larisa, Larisa, Greece
| | - Christos Nikitas
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Charalambos Skoulakis
- Otolaryngology, Head & Neck Surgery Department, University Hospital of Larisa, Larisa, Greece
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A classification framework for investigating neural correlates of the limit of stability during weight shifting in lower limb amputees. Neurocomputing 2022. [DOI: 10.1016/j.neucom.2022.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fritzsch B, Elliott KL, Yamoah EN. Neurosensory development of the four brainstem-projecting sensory systems and their integration in the telencephalon. Front Neural Circuits 2022; 16:913480. [PMID: 36213204 PMCID: PMC9539932 DOI: 10.3389/fncir.2022.913480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
Somatosensory, taste, vestibular, and auditory information is first processed in the brainstem. From the brainstem, the respective information is relayed to specific regions within the cortex, where these inputs are further processed and integrated with other sensory systems to provide a comprehensive sensory experience. We provide the organization, genetics, and various neuronal connections of four sensory systems: trigeminal, taste, vestibular, and auditory systems. The development of trigeminal fibers is comparable to many sensory systems, for they project mostly contralaterally from the brainstem or spinal cord to the telencephalon. Taste bud information is primarily projected ipsilaterally through the thalamus to reach the insula. The vestibular fibers develop bilateral connections that eventually reach multiple areas of the cortex to provide a complex map. The auditory fibers project in a tonotopic contour to the auditory cortex. The spatial and tonotopic organization of trigeminal and auditory neuron projections are distinct from the taste and vestibular systems. The individual sensory projections within the cortex provide multi-sensory integration in the telencephalon that depends on context-dependent tertiary connections to integrate other cortical sensory systems across the four modalities.
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Affiliation(s)
- Bernd Fritzsch
- Department of Biology, The University of Iowa, Iowa City, IA, United States
- Department of Otolaryngology, The University of Iowa, Iowa City, IA, United States
- *Correspondence: Bernd Fritzsch,
| | - Karen L. Elliott
- Department of Biology, The University of Iowa, Iowa City, IA, United States
| | - Ebenezer N. Yamoah
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, Reno, NV, United States
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12
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Sozzi S, Schieppati M. Balance Adaptation While Standing on a Compliant Base Depends on the Current Sensory Condition in Healthy Young Adults. Front Hum Neurosci 2022; 16:839799. [PMID: 35399363 PMCID: PMC8989851 DOI: 10.3389/fnhum.2022.839799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/03/2022] [Indexed: 01/06/2023] Open
Abstract
Background Several investigations have addressed the process of balance adaptation to external perturbations. The adaptation during unperturbed stance has received little attention. Further, whether the current sensory conditions affect the adaptation rate has not been established. We have addressed the role of vision and haptic feedback on adaptation while standing on foam. Methods In 22 young subjects, the analysis of geometric (path length and sway area) and spectral variables (median frequency and mean level of both total spectrum and selected frequency windows) of the oscillation of the centre of feet pressure (CoP) identified the effects of vision, light-touch (LT) or both in the anteroposterior (AP) and mediolateral (ML) direction over 8 consecutive 90 s standing trials. Results Adaptation was obvious without vision (eyes closed; EC) and tenuous with vision (eyes open; EO). With trial repetition, path length and median frequency diminished with EC (p < 0.001) while sway area and mean level of the spectrum increased (p < 0.001). The low- and high-frequency range of the spectrum increased and decreased in AP and ML directions, respectively. Touch compared to no-touch enhanced the rate of increase of the low-frequency power (p < 0.05). Spectral differences in distinct sensory conditions persisted after adaptation. Conclusion Balance adaptation occurs during standing on foam. Adaptation leads to a progressive increase in the amplitude of the lowest frequencies of the spectrum and a concurrent decrease in the high-frequency range. Within this common behaviour, touch adds to its stabilising action a modest effect on the adaptation rate. Stabilisation is improved by favouring slow oscillations at the expense of sway minimisation. These findings are preliminary to investigations of balance problems in persons with sensory deficits, ageing, and peripheral or central nervous lesion.
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Affiliation(s)
- Stefania Sozzi
- Centro Studi Attività Motorie (CSAM), Istituti Clinici Scientifici Maugeri SB (IRCCS), Pavia, Italy
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13
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Cochrane GD, Christy J, Sandroff B, Motl R. Cognitive and Central Vestibular Functions Correlate in People With Multiple Sclerosis. Neurorehabil Neural Repair 2021; 35:1030-1038. [PMID: 34560828 PMCID: PMC8595657 DOI: 10.1177/15459683211046268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Cognitive impairment is common, but poorly managed in people with multiple sclerosis (MS). Balance has been correlated with cognition in people with MS, potentially through shared utilization of central sensory integration pathways. Objective. This study characterized the relationship between central vestibular integration and cognition in people with MS through measurement of several clinical vestibular functions requiring central sensory integration and multiple cognitive domains. Methods. Forty people with MS and 20 controls completed a battery of vestibular and cognitive examinations targeting different central vestibular integration measures and different domains of cognition, respectively. Performance on these measures was compared between people with MS and controls, and then correlational analyses were undertaken between the vestibular and cognitive measures in the MS sample. Results. People with MS performed worse than controls on all vestibular and cognitive measures. There were consistent correlations between vestibular and cognitive measures in the MS sample. Factor analysis of vestibular functions yielded a single factor hypothesized to represent central vestibular integration that demonstrated a significant relationship with a composite cognitive measure in people with MS. Discussion. Our results suggest that vestibular and cognitive dysfunction may both arise from central sensory processing pathways in people with MS. This connection could be targeted through vestibular rehabilitation techniques that improve central sensory processing and both balance and cognition in people with MS.
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Affiliation(s)
- Graham D. Cochrane
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham AL, USA
- NIH Medical Scientist Training Program, School of Medicine, University of Alabama at Birmingham, Birmingham AL, USA
| | - Jennifer Christy
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham AL, USA
| | - Brian Sandroff
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, West Orange, NJ, USA
| | - Robert Motl
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham AL, USA
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14
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Cochrane GD, Christy JB, Motl RW. Central Vestibular Functions Correlate With Fatigue and Walking Capacity in People With Multiple Sclerosis. Phys Ther 2021; 101:pzab168. [PMID: 34174079 PMCID: PMC8485732 DOI: 10.1093/ptj/pzab168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/07/2021] [Accepted: 05/11/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Imbalance and fatigue are among the most common and disabling symptoms of multiple sclerosis (MS). Vestibular rehabilitation studies demonstrate not only improvements in balance but fatigue also, suggesting a relationship between central vestibular integration and fatigue. The objective of this study was to determine whether the relationship between balance and fatigue in people with MS is seen between other measures of central vestibular integration and fatigue and to understand how central vestibular integration measures interrelate. METHODS This cross-sectional study consisted of 40 people with MS (age = 27-55 years, Expanded Disability Severity Scale score = 1.0-6.5) who completed vestibular ocular reflex testing, subjective visual vertical testing, static posturography, dynamic gait, 2 self-report fatigue surveys, and a 6-Minute Walk Test to assess walking capacity/physical fatigue was completed. Spearman correlations were calculated between variables. RESULTS Measures of central vestibular integration were significantly correlated with measures of fatigue and walking capacity and with each other. The correlations between physical fatigue and central vestibular functions were larger than self-reported fatigue correlations with central vestibular functions. CONCLUSION The relationship between balance and fatigue extends to other measures requiring central vestibular integration, suggesting a deficit in central vestibular processing in people with MS. These measures may compliment balance assessment as outcome measures for vestibular rehabilitation in people with MS. Fatigue measures should be included in vestibular rehabilitation as secondary outcomes. IMPACT Correlations between central vestibular integration and fatigue in people with MS suggest that future studies of vestibular rehabilitation should include fatigue, as a secondary outcome measure as vestibular function and fatigue may share similar a similar etiology in people with MS.
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Affiliation(s)
- Graham D Cochrane
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Medical Scientist Training Program, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer B Christy
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert W Motl
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
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15
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Li Y, Yang Y, Zhang W, Sun J, Liu B, Chen M, Liu W, Liu S, Wang X, Li S, Zhang J, Ni X. Developmental performance between pediatric cochlear implantation candidates with and without large vestibular aqueduct syndrome. Acta Otolaryngol 2021; 141:250-255. [PMID: 33502272 DOI: 10.1080/00016489.2020.1862909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND We are inclined to pay special care and attention to children with large vestibular aqueduct syndrome (LVAS). However, it is not clear whether children with LVAS have more developmental delays than children without LVAS. OBJECTIVES To compare the developmental performance between pediatric cochlear implantation (CI) candidates with and without LVAS. MATERIALS AND METHODS Medical records of pediatric CI candidates were reviewed. Through propensity score matching analysis, 70 children with LVAS and 70 gender-, age-, and auditory-matched children were recruited as the LVAS and non-LVAS group, respectively. Developmental performances were compared between the two groups. RESULTS Compared with normal developmental metrics, both LVAS and non-LVAS groups had developmental delay in multiple domains (both p < .001). Although some differences in motor developments between children with LVAS and without LVAS, they demonstrated overall equal developmental levels in both verbal and nonverbal aspects (all p > .05). Age of intervention was the primary risk factor for developmental performance of LVAS children (β < 0, p < .05) with an obvious delay starting at 1 year of age. CONCLUSION Pediatric CI candidates with LVAS had both verbal and nonverbal developmental delays. However, they exhibited similar overall developmental performances to those without LVAS.
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Affiliation(s)
- Yanhong Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Yang Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Wanxia Zhang
- Department of Health Care, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
| | - Jihang Sun
- Department of Radiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Bing Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Min Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Wei Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Shanshan Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Xiaoxu Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Shilan Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Jie Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Xin Ni
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
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16
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Kozinc Ž, Šarabon N. The Effects of Leg Preference on Transient Characteristics of Body Sway During Single-Leg Stance: A Cross-Sectional Study. Front Hum Neurosci 2021; 14:617222. [PMID: 33505261 PMCID: PMC7829675 DOI: 10.3389/fnhum.2020.617222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/30/2020] [Indexed: 01/01/2023] Open
Abstract
Instrumented assessments of quiet-stance postural control typically involve recording and analyzing of body sway signal, most often the center of pressure (CoP) movement. It has been recently suggested that transient characteristics of body sway may offer additional information regarding postural control. In this study, we explored the relationship between whole-trial estimates of body sway (CoP velocity, amplitude, and frequency) and corresponding transient behavior indexes, as well as the effects of leg preference. A total of 705 healthy young athletes performed 30 s single-leg body sway trials for both legs. It was found that the transient characteristics of the body sway (expressed as relative differences between individual time intervals within the trial) are in negligible or weak correlation (r ≤ 0.26) with the corresponding variables, averaged across the whole trial. All CoP variables showed transient characteristics, reflected in statistically significant decrease (CoP velocity and amplitude) or increase (CoP frequency) throughout the trial. The preferred leg showed smaller body sway; however, the effect sizes were very small. Moreover, differences between the legs were also noted in terms of transient characteristics of body sway. In particular, the preferred leg showed earlier reduction in anterior–posterior body sway and larger reduction in medial–lateral body sway. Further studies should focus on examining the clinical utility of indexes of transient behavior of body sway, for instance, their sensitivity to aging-related changes and risk of falling.
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Affiliation(s)
- Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia.,Human Health Department, InnoRenew CoE, Izola, Slovenia.,S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana, Slovenia
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Postural control in paw distance after labyrinthectomy-induced vestibular imbalance. Med Biol Eng Comput 2020; 58:3039-3047. [PMID: 33079344 DOI: 10.1007/s11517-020-02276-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 10/14/2020] [Indexed: 12/22/2022]
Abstract
Balance control is accomplished by the anatomical link which provides the neural information for the coordination of skeletal muscles. However, there are few experimental proofs to directly show the neuroanatomical connection. Here, we examined the behavioral alterations by constructing an animal model with chemically induced unilateral labyrinthectomy (UL). In the experiment using rats (26 for UL, 14 for volume cavity, 355-498 g, male), the models were initially evaluated by the rota-rod (RR) test (21/26, 80.8%) and ocular displacement (23/26, 88.5%). The duration on the rolling rod decreased from 234.71 ± 64.25 s (4th trial before UL) to 11.81 ± 17.94 s (1st trial after UL). Also, the ocular skewed deviation (OSD) was observed in the model with left (5.79 ± 3.06°) and right lesion (3.74 ± 2.69°). Paw distance (PW) was separated as the front (FPW) and the hind side (HPW), and the relative changes of HPW (1.71 ± 1.20 cm) was larger than those of FPW (1.39 ± 1.06 cm), providing a statistical significance (p = 1.51 × 10-4, t test). Moreover, the results of the RR tests matched to those of the changing rates (18/21, 85.7%), and the changes (16/18, 88.9%) were dominantly observed in HPW (in FPW, 2/18, 11.1%). Current results indicated that the UL directly affected the changes in HPW more than those in FPW. In conclusion, the missing neural information from the peripheral vestibular system caused the abnormal posture in HPW, and the postural instability might reduce the performance during the voluntary movement shown in the RR test, identifying the relation between the walking imbalance and the unstable posture in PW. Graphical abstract.
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Balance Control in Obese Subjects during Quiet Stance: A State-of-the Art. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obese individuals are characterized by a reduced balance which has a significant effect on a variety of daily and occupational tasks. The presence of excessive adipose tissue and weight gain could increase the risk of falls; for this reason, obese individuals are at greater risk of falls than normal weight subjects in the presence of postural stress and disturbances. The quality of balance control could be measured with different methods and generally in clinics its integrity is generally assessed using platform stabilometry. The aim of this narrative review is to present an overview on the state of art on balance control in obese individuals during quiet stance. A summary of knowledge about static postural control in obese individuals and its limitations is important clinically, as it could give indications and suggestions to improve and personalize the development of specific clinical programs.
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