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Yamagata M, Taniguchi M, Nakazato K, Wang Z, Yagi M, Fukumoto Y, Okada S, Okada S, Ichihashi N. Fall assessment in healthy older adults: Approach using rambling-trembling decomposition method. Clin Biomech (Bristol, Avon) 2024; 120:106355. [PMID: 39326068 DOI: 10.1016/j.clinbiomech.2024.106355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 09/18/2024] [Accepted: 09/20/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND This study explored useful indices of potential fall risk in healthy older adults based on comprehensive clinical and simple quantitative posturographic measurements. METHODS A total of 64 community-dwelling older adults aged ≥65 years were classified into fallers and non-fallers based on previous fall history. After excluding two participants due to missing data, 16 and 46 participants were included in the faller and non-faller groups, respectively. We conducted major clinical measurements, including timed up and go test, 10-m walk test, functional reach test, one-leg stand test, isometric muscle strength tests, open-close stepping test, and sit-to-stand test. For quantitative posturographic measurements, participants performed standing tasks with their eyes open and closed. In the standing tasks, the time series of the center of pressure in the anteroposterior and mediolateral directions were measured and decomposed into rambling and trembling components to evaluate postural control in detail, separately. The mean velocity and root mean square of the center of pressure, rambling, and trembling were calculated and compared between fallers and non-fallers. FINDINGS A significant fall-related difference was found only in the mean velocity of the rambling in the anteroposterior direction; fallers displayed greater values than non-fallers, especially while standing with their eyes closed. INTERPRETATION The clinical measures failed to distinguish differences in fall risk, whereas the rambling component in the anteroposterior direction could detect substantial differences. The mean velocity of the rambling component could be useful as a sensitive screening biomarker for potential fall risks in healthy older adults.
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Affiliation(s)
- Momoko Yamagata
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.; Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan..
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kaede Nakazato
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.; Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Zimin Wang
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.; Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihiro Fukumoto
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.; Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shogo Okada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.; Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Sayaka Okada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Gerber ED, Huang CK, Moon S, Devos H, Luchies CW. Sensory reweighting of postural control requires distinct rambling and trembling sway adaptations. Gait Posture 2024; 112:16-21. [PMID: 38723391 DOI: 10.1016/j.gaitpost.2024.04.028] [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: 12/07/2023] [Revised: 04/18/2024] [Accepted: 04/25/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Implementation of the Sensory Organization Test (SOT) under the rambling-trembling (RM-TR) framework allows for an examination of both individual sensory contributions and compensatory mechanisms, a valuable insight in research and clinical settings. Such investigation could substantially improve our ability to assess and treat fall risk in older adults and people living with neurological disorders. RESEARCH QUESTION How are RM and TR components of sway influenced by SOT-induced challenges in healthy adults? METHODS Twenty-three healthy adults (27.4±8 years; 10 male) volunteered to participate in this cross-sectional study. Each participant completed a VR-based SOT program, which included six conditions with varied visual environments (normal, blacked-out, conflict) and support surfaces (stable, unstable foam), while a force plate captured forces at the plantar surface. Center of pressure (COP) was calculated and decomposed into RM-TR components. For each time series, range, root-mean-square (RMS) and sample entropy (SampEn) were extracted. Individual contributions of somatosensation, vision, and vestibular sense, as well as the preference ratio, were calculated. Repeated measures ANOVA were used to compare the effects of time series type (COP, RM, TR) and SOT condition. Paired t-tests were used to assess the difference in preference ratio between RM and TR components. RESULTS AND SIGNIFICANCE TR sway behavior was impacted significantly by the sensory challenges induced by the SOT procedure, while RM was largely unaffected. Such findings are characteristic of healthy individuals, capable of competently re-weighting sensory input, but still facing challenge-based adaptations. Additionally, the mediolateral SampEn preference ratio was higher in TR compared to RM, indicating potential differences in compensation strategies between supraspinal and spinal/peripheral control mechanisms. These findings serve as a foundation for future RM-TR analyses using SOT procedures, aiding in our ability to implement targeted diagnostic and treatment methods, ultimately reducing the incidence of falls in aging and individuals with neurological conditions.
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Affiliation(s)
- Eryn D Gerber
- Biodynamics Research Laboratory, University of Kansas, Lawrence, KS, USA
| | - Chun-Kai Huang
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA
| | - Sanghee Moon
- Department of Kinesiology, College of Health and Human Services, University of New Hampshire, NH, USA
| | - Hannes Devos
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA
| | - Carl W Luchies
- Biodynamics Research Laboratory, University of Kansas, Lawrence, KS, USA; Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, KS, USA.
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Vermette MJ, Prince F, Bherer L, Messier J. Concentrating to avoid falling: interaction between peripheral sensory and central attentional demands during a postural stability limit task in sedentary seniors. GeroScience 2024; 46:1181-1200. [PMID: 37482601 PMCID: PMC10828328 DOI: 10.1007/s11357-023-00860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/25/2023] [Indexed: 07/25/2023] Open
Abstract
Evidence suggests falls and postural instabilities among seniors are attributed to a decline in both the processing of afferent signals (e.g., proprioceptive, vestibular) and attentional resources. We investigated the interaction between the non-visual and attentional demands of postural control in sedentary seniors. Old and young adults performed a postural stability limit task involving a maximal voluntary leaning movement with and without vision as well as a cognitive-attentional subtraction task. These tasks were performed alone (single-task) or simultaneously (dual-task) to vary the sensory-attentional demands. The functional limits of stability were quantified as the maximum center of pressure excursion during voluntary leaning. Seniors showed significantly smaller limits of postural stability compared to young adults in all sensory-attentional conditions. However, surprisingly, both groups of subjects reduced their stability limits by a similar amount when vision was removed. Furthermore, they similarly decreased their anterior-posterior stability limits when concurrently performing the postural and the cognitive-attentional tasks with vision. The overall average cognitive performance of young adults was higher than seniors and was only slightly affected during dual-tasking. In contrast, older adults markedly degraded their cognitive performance from the single- to the dual-task situations, especially when vision was unavailable. Thus, their dual-task costs were higher than those of young adults and increased in the eyes-closed condition, when postural control relied more heavily on non-visual sensory signals. Our findings provide the first evidence that as posture approaches its stability limits, sedentary seniors allot increasingly large cognitive attentional resources to process critical sensory inputs.
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Affiliation(s)
- Marie Julie Vermette
- École de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Université de Montréal, 2100 Boul. Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada
| | - François Prince
- Département de Chirurgie, Faculté de Médecine, Université de Montréal, CP6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Louis Bherer
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada
- Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Institut de Cardiologie de Montréal, Montréal, QC, Canada
| | - Julie Messier
- École de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Université de Montréal, 2100 Boul. Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada.
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Gerber ED, Giraldo C, Whorley B, Nichols P, Ring S, Luchies CW. Subthreshold white noise vibration alters trembling sway in older adults. Hum Mov Sci 2023; 90:103119. [PMID: 37390770 DOI: 10.1016/j.humov.2023.103119] [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: 12/30/2022] [Revised: 04/14/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Somatosensory deficit is a significant contributor to falls in older adults. Stochastic resonance has shown promise in recent studies of somatosensation-based balance disorders, improving many measures of stability both inside and outside of the clinic. However, our understanding of this effect from a physiological perspective is poorly understood. Therefore, the primary goal of this study is to explore the influence of subthreshold vibratory stimulation on sway under the rambling-trembling framework. METHODS 10 Healthy older adults (60-65 years) volunteered to participate in this study. Each participant underwent two randomized testing sessions on separate days, one experimental and one placebo. During each session, the participants' baseline sway was captured during one 90-s quiet standing trial. Their sensation threshold was then captured using a custom vibratory mat and 4-2-1 vibration perception threshold test. Finally, participants completed another 90-s quiet standing trial while the vibratory mat vibrated at 90% of their measured threshold (if experimental) or with the mat off (if placebo). While they completed these trials, an AMTI force plate collected force and moment data in the anteroposterior (AP) and mediolateral (ML), from which the center of pressure (COP), rambling (RM), and trembling (TR) time series were calculated. From each of these time series, range, variability (root-mean-square), and predictability (sample entropy) were extracted. One-tailed paired t-tests were used to compare baseline and during-vibration measures. RESULTS No significant differences were found during the placebo session. For the experimental session, significant increases were found in AP TR range, ML TR RMS, AP COP predictability, and AP & ML TR predictability. The TR time series was particularly sensitive to vibration, suggesting a strong influence on peripheral/spinal mechanisms of postural control. SIGNIFICANCE Though it is unclear whether observed effects are indicative of "improvements" or not, it does suggest that there was a measurable effect of subthreshold vibration on sway. This knowledge should be utilized in future studies of stochastic resonance, potentially acting as a mode of customization, tailoring vibration location, duration, magnitude, and frequency content to achieve the desired effect. One day, this work may aid in our ability to treat somatosensation-based balance deficits, ultimately reducing the incidence and severity of falls in older adults.
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Affiliation(s)
- Eryn D Gerber
- Bioengineering Graduate Program, School of Engineering, University of Kansas, Lawrence, KS, USA
| | - Camilo Giraldo
- Department of Engineering, Messiah University, Mechanicsburg, PA, USA
| | - Brett Whorley
- Bioengineering Graduate Program, School of Engineering, University of Kansas, Lawrence, KS, USA
| | - Paris Nichols
- Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, KS, USA
| | - Scott Ring
- Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, KS, USA
| | - Carl W Luchies
- Bioengineering Graduate Program, School of Engineering, University of Kansas, Lawrence, KS, USA; Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, KS, USA.
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Michalska J, Szuplak Ż, Słomka KJ, Juras G. How partnering changes the process of postural control? J Biomech 2023; 154:111621. [PMID: 37178495 DOI: 10.1016/j.jbiomech.2023.111621] [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: 11/28/2022] [Revised: 04/29/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
The aim of the study was to identify changes in the mechanism of postural control among ballroom dancers between standing solo and standing with a partner during specific standard dance positions. Specifically, the study attempted to determine whether the male partner plays a stabilising role in the dance couple. A total of seven competitive dance couples participated in the study. The experimental procedure comprised four dance positions characteristic of international standard dances: standard, starting, chasse and contra check. The dance positions were staged twice - while standing solo and while standing with a partner. The assumption of the assessed position was preceded by a dance phase after which the participants were instructed to freeze on a force plate and hold the position for 30 s. To examine whether subjects standing solo or with partners had greater rambling (RM) or trembling (TR) components in their dance postural profile, the ratios of RM to the center of foot pressure (COP) and TR to COP were computed for velocity. No significant differences were observed in the velocity of COP between standing solo and standing with a partner (p > 0.05). However, during the standard and starting positions, female and male dancers standing solo were characterised by higher values of the velocity of RM/COP ratio and lower values of the velocity of TR/COP ratio than those standing with a partner (p < 0.05). According to the theory behind the RM and TR decomposition, an increase in TR components could indicate a higher reliance on spinal reflexes, which would suggest greater automaticity.
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Affiliation(s)
- Justyna Michalska
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland.
| | - Żaneta Szuplak
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Kajetan J Słomka
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
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Yamako G, Punchihewa NG, Arakawa H, Tajima T, Chosa E. Evaluation of Sit-to-Stand Movement in Older Adults with Locomotive Syndrome Using the Nintendo Wii Balance Board. SENSORS (BASEL, SWITZERLAND) 2023; 23:3368. [PMID: 37050428 PMCID: PMC10098528 DOI: 10.3390/s23073368] [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: 01/25/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
Standing up from a chair is a mechanically demanding daily motion, and its biomechanics represent motor performance. In older adults with locomotive syndrome (LS), sit-to-stand (STS) movement with adequate postural control is essential to prevent falls. This study evaluated the characteristics of dynamic balance during STS movement on older adults with LS. A total of 116 participants aged ≥65 years were divided into Non-LS, LS stage 1, and LS stage 2 groups using the LS risk test. The participants were instructed to stand on the Nintendo Wii Balance Board as quickly as possible, and the STS movement was quantified using the vertical ground reaction force (VGRF) and center of pressure (CoP). The STS score, which represented dynamic balance, was significantly different among the groups (p < 0.001). The rate of VGRF development was significantly lower in the LS stages 1 and 2 than in the Non-LS group (p < 0.001). On the other hand, the total distance of the CoP path did not differ among the groups (p = 0.211). These findings indicated a reduction of postural control in older adults with LS. The STS score emphasized the importance of balance training to prevent falls in older adults with LS.
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Affiliation(s)
- Go Yamako
- Department of Mechanical Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki 889-2192, Japan
| | - Niroshan G. Punchihewa
- Department of Materials and Informatics, Interdisciplinary Graduate School of Agriculture and Engineering, University of Miyazaki, Miyazaki 889-2192, Japan
| | - Hideki Arakawa
- Department of Rehabilitation, Faculty of Medicine, University of Miyazaki, Miyazaki 889-2192, Japan
| | - Takuya Tajima
- Department of Medicine of Sensory and Motor Organs, Division of Orthopedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-2192, Japan
| | - Etsuo Chosa
- Department of Medicine of Sensory and Motor Organs, Division of Orthopedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-2192, Japan
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Danna-Dos-Santos A, Driusso P, Degani AM. Long-term effects of mTBIs includes a higher dependency on visual inputs to control vertical posture. Brain Inj 2022; 37:1-10. [PMID: 36524739 DOI: 10.1080/02699052.2022.2158223] [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: 10/11/2021] [Revised: 08/25/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
This study investigated the hypothesis that individuals living with long-term effects of mild traumatic brain injury (mTBI) develop an increased dependency on visual inputs to control upright posture. To test this hypothesis, we quantified visuo-postural dependency indices (VPDIs) calculated for multiple postural behavioral markers extracted from the body's center of pressure coordinates signals. These signals were recorded during the execution of a quiet bipedal stance under Vision and No-Vision experimental conditions. VPDIs were calculated as the normalized pair-wise subtraction of recordings obtained under Vision and No-Vision. A total of one hundred and twenty-nine volunteers were organized into two groups: mTBI group (n = 50) and neurotypical control group (n = 79). Consistent with our hypothesis, the results reveal that balance behavior of participants with mTBI deteriorate more abruptly in the absence of visual inputs when compared to neurotypical controls. These impairments might increase the likelihood of recurrent injuries and falls when time-constrained reactions are needed in daily activities, sports practice, or military operations. Additionally, the methodology used in this study shows to be potentially useful to aid future investigations of neural circuitry impaired by mTBI. It also provides indices of recovery for future clinical trials testing mTBI-related clinical interventions.
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Affiliation(s)
| | | | - Adriana Menezes Degani
- Laboratory for Advances of Rehabilitation Sciences, Western Michigan University, Kalamazoo, Michigan, USA
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Seo JW, Kim JI, Kim T, Jang KM, Jeong Y, Do JH. Sensory Interaction and Balancing Ability Evaluation of the Elderly Using a Simplified Force Plate System. SENSORS (BASEL, SWITZERLAND) 2022; 22:8883. [PMID: 36433479 PMCID: PMC9695926 DOI: 10.3390/s22228883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 05/14/2023]
Abstract
The Wii balance board (WBB) is a simplified force plate system used to evaluate the balancing ability of the elderly via a sensory interaction task to confirm a significant standing balance index. The accuracy of this system has been verified in previous studies. In this study, an instrumented and modified clinical test of sensory interaction on balance (i-mCTSIB) was performed on 84 elderly subjects, and the variables for center of pressure (CoP) were calculated using WBB for each task condition. The results indicate that the visual condition has a significant effect on the sway proprioceptive sensory variables with a foam condition as their complexity increases. In addition, the correlation between the variable and Berg Balance Scale was not confirmed since CTSIB is a sensory interaction on balance ability. Therefore, WBB can be used to evaluate balancing ability based on sensory interactions consisting of the surface condition.
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Affiliation(s)
- Jeong-Woo Seo
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
- Open XR Platform Convergence Research Center, National Research Council of Science and Technology, Daejeon 34141, Republic of Korea
| | - Joong Il Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
- Open XR Platform Convergence Research Center, National Research Council of Science and Technology, Daejeon 34141, Republic of Korea
| | - Taehong Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Kyoung-Mi Jang
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
- Open XR Platform Convergence Research Center, National Research Council of Science and Technology, Daejeon 34141, Republic of Korea
| | - Youngjae Jeong
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
- Open XR Platform Convergence Research Center, National Research Council of Science and Technology, Daejeon 34141, Republic of Korea
| | - Jun-Hyeong Do
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
- Open XR Platform Convergence Research Center, National Research Council of Science and Technology, Daejeon 34141, Republic of Korea
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Costa EDC, Santinelli FB, Moretto GF, Figueiredo C, von Ah Morano AE, Barela JA, Barbieri FA. A multiple domain postural control assessment in people with Parkinson's disease: traditional, non-linear, and rambling and trembling trajectories analysis. Gait Posture 2022; 97:130-136. [PMID: 35932689 DOI: 10.1016/j.gaitpost.2022.07.250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/06/2022] [Accepted: 07/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Postural impairment is one of the most debilitating symptoms in people with Parkinson's disease (PD), which show faster and more variable oscillation during quiet stance than neurologically healthy individuals. Despite the center of pressure parameters can characterize PD's body sway, they are limited to uncover underlying mechanisms of postural stability and instability. RESEARCH QUESTION Do a multiple domain analysis, including postural adaptability and rambling and trembling components, explain underlying postural stability and instability mechanisms in people with PD? METHOD Twenty-four individuals (12 people with PD and 12 neurologically healthy peers) performed three 60-s trials of upright quiet standing on a force platform. Traditional and non-linear parameters (Detrended Fluctuation Analysis- DFA and Multiscale Entropy- MSE) and rambling and trembling trajectories were calculated for anterior-posterior (AP) and medial-lateral (ML) directions. RESULTS PDG's postural control was worse compared to CG, displaying longer displacement, higher velocity, and RMS. Univariate analyses revealed largely longer displacement and RMS only for the AP direction and largely higher velocity for both AP and ML directions. Also, PD individuals showed lower AP complexity, higher AP and ML DFA, and increased AP and ML displacement, velocity, and RMS of rambling and trembling components compared to neurologically healthy individuals. SIGNIFICANCE Based upon these results, people with PD have a lower capacity to adapt posture and impaired both rambling and trembling components compared to neurologically healthy individuals. These findings provide new insights to explain the larger, faster, and more variable sway in people with PD.
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Affiliation(s)
- Elisa de Carvalho Costa
- São Paulo State University (Unesp), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, SP, Brazil
| | - Felipe Balistieri Santinelli
- São Paulo State University (Unesp), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, SP, Brazil; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Gabriel Felipe Moretto
- São Paulo State University (Unesp), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, SP, Brazil
| | - Caique Figueiredo
- São Paulo State University (Unesp), School of Technology and Sciences, Department of Physical Education, Physical Education, Exercise and Immunometabolism Research Group, Presidente Prudente, SP, Brazil
| | - Ana Elisa von Ah Morano
- São Paulo State University (Unesp), School of Technology and Sciences, Department of Physical Education, Physical Education, Exercise and Immunometabolism Research Group, Presidente Prudente, SP, Brazil
| | - José Angelo Barela
- São Paulo State University (Unesp) - Institute of Biosciences, Department of Physical Education, Campus Rio Claro, SP, Brazil
| | - Fabio Augusto Barbieri
- São Paulo State University (Unesp), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, SP, Brazil.
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Imaoka Y, Hauri L, Flury A, de Bruin ED. Linking cognitive functioning and postural balance control through virtual reality environmental manipulations. Front Aging Neurosci 2022; 14:954050. [PMID: 36118684 PMCID: PMC9476829 DOI: 10.3389/fnagi.2022.954050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Dementia is becoming a relevant problem worldwide. A simple screening at an early stage will be important to detect the risk of developing dementia. Vestibular dysfunction is likely to be associated with cognitive impairment. Since head-mounted display (HMD) virtual reality (VR) technology has the potential to activate the vestibular function, assessing postural sway with visual stimulation using HMD VR technology could be potentially useful for dementia screening. Objective The purpose of this study is to evaluate the effect of HMD-based VR visual stimuli on posture in older adults and the relationship between the stimulated body sway behaviors and cognitive performance. Method Using a cross-sectional study design, we investigated the effect of an optokinetic design-based room with stripes (OKR) VR environment oscillating forwards and backwards at 23/60Hz. Center of pressure (COP) displacement was measured in older adults aged 65 years and over in the OKR VR environment. The frequency response of COP was compared to the cognitive performance of the Montreal Cognitive Assessment (MoCA). Results 20 healthy older adults (70.4 ± 4.9 years; 27.2 ± 1.6 MoCA score) and 3 people with mild cognitive impairment (74.7 ± 4.0 years; 20.3 ± 2.1 MoCA score) were assessed. The results reveal that the oscillating OKR VR environment induced different postural sway in the anterior-posterior direction in the real world. Correlation analysis shows that the cognitive test score was associated with the frequency response of stimulated postural sway in the anterior-posterior direction (frequency Band 1 of 0−0.5Hz related to the visual and vestibular systems: rs = 0.45, P = 0.03). Conclusion Outcomes would suggest that a potential link may emerge between cognition and posture when the HMD-based VR visual stimuli are applied. The simple screening of stimulated postural sway could explain cognitive functioning. Further studies are warranted to clarify the vestibular system and spatial cognitive function more specifically in the proposed assessment system.
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Affiliation(s)
- Yu Imaoka
- Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- *Correspondence: Yu Imaoka
| | - Laura Hauri
- Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andri Flury
- Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- School of Health Professions, Eastern Switzerland University of Applied Sciences, St.Gallen, Switzerland
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Pinho JP, Azevedo APS, Serrão JC, Forner-Cordero A, Amadio AC, Mezêncio B. Aging effects of haptic input on postural control under a dual-task paradigm. Exp Gerontol 2022; 168:111928. [PMID: 35987475 DOI: 10.1016/j.exger.2022.111928] [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: 04/11/2022] [Revised: 07/27/2022] [Accepted: 08/11/2022] [Indexed: 11/15/2022]
Abstract
Postural control relies on three principal sensory systems: vision, vestibular and proprioceptive; that are affected by aging. When performing a cognitive task concomitantly with a motor task, those sensory impairments lead to even greater deleterious effects on balance. We aimed to study the effects of a sensory aid (a light touch) on a dual task paradigm and sought to understand the different responses on balance due to aging. Fifty healthy and highly physical active women were divided in two groups: young (N = 25, 24.2 ± 4.0 years) and older adults (N = 25, 67.3 ± 4.2 years). In a random and balanced order, all participants performed five tasks: Stroop test while seated (Seated); Stroop test while standing quiet (ST); Standing quiet (BL); Standing quiet with a haptic input (LT); and Stroop test with a haptic input while standing quiet (SL). In the Stroop test, older women committed more errors (50 vs 11 errors, p < 0.001) and had higher reaction time (1.001 ± 0.191 vs 0.699 ± 0.081 s, p < 0.001). The haptic input (LT) reduced all body sway parameters, in both groups, regardless the condition. This means that postural control under a dual task paradigm (ST) deleterious effect can be mitigated by a haptic input.
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Affiliation(s)
- João Pedro Pinho
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil; Biomechatronics Laboratory, Department of Mechatronics and Mechanical Systems, Escola Politécnica of the University of São Paulo, Brazil.
| | - Ana Paula Silva Azevedo
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
| | - Júlio Cerca Serrão
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
| | - Arturo Forner-Cordero
- Biomechatronics Laboratory, Department of Mechatronics and Mechanical Systems, Escola Politécnica of the University of São Paulo, Brazil.
| | - Alberto Carlos Amadio
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
| | - Bruno Mezêncio
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
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12
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Taylor Z, Walsh GS, Hawkins H, Inacio M, Esser P. Perturbations during Gait: A Systematic Review of Methodologies and Outcomes. SENSORS (BASEL, SWITZERLAND) 2022; 22:5927. [PMID: 35957484 PMCID: PMC9371403 DOI: 10.3390/s22155927] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite extensive literature regarding laboratory-based balance perturbations, there is no up-to-date systematic review of methods. This systematic review aimed to assess current perturbation methods and outcome variables used to report participant biomechanical responses during walking. METHODS Web of Science, CINAHL, and PubMed online databases were searched, for records from 2015, the last search was on 30th of May 2022. Studies were included where participants were 18+ years, with or without clinical conditions, conducted in non-hospital settings. Reviews were excluded. Participant descriptive, perturbation method, outcome variables and results were extracted and summarised. Bias was assessed using the Appraisal tool for Cross-sectional Studies risk of bias assessment tool. Qualitative analysis was performed as the review aimed to investigate methods used to apply perturbations. RESULTS 644 records were identified and 33 studies were included, totaling 779 participants. The most frequent method of balance perturbation during gait was by means of a treadmill translation. The most frequent outcome variable collected was participant step width, closely followed by step length. Most studies reported at least one spatiotemporal outcome variable. All included studies showed some risk of bias, generally related to reporting of sampling approaches. Large variations in perturbation type, duration and intensity and outcome variables were reported. CONCLUSIONS This review shows the wide variety of published laboratory perturbation methods. Moreover, it demonstrates the significant impact on outcome measures of a study based on the type of perturbation used. REGISTRATION PROSPERO ID: CRD42020211876.
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Affiliation(s)
- Zoe Taylor
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
| | - Gregory S. Walsh
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
| | - Hannah Hawkins
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
| | - Mario Inacio
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Research Centre in Sport Sciences, Health Sciences and Human Development, University Institute of Maia, 4475-690 Maia, Portugal
| | - Patrick Esser
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
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13
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Sozzi S, Ghai S, Schieppati M. Incongruity of Geometric and Spectral Markers in the Assessment of Body Sway. Front Neurol 2022; 13:929132. [PMID: 35923830 PMCID: PMC9339954 DOI: 10.3389/fneur.2022.929132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/21/2022] [Indexed: 01/15/2023] Open
Abstract
Different measurements of body oscillations in the time or frequency domain are being employed as markers of gait and balance abnormalities. This study investigates basic relationships within and between geometric and spectral measures in a population of young adult subjects. Twenty healthy subjects stood with parallel feet on a force platform with and without a foam pad. Adaptation effects to prolonged stance were assessed by comparing the first and last of a series of eight successive trials. Centre of Foot Pressure (CoP) excursions were recorded with Eyes Closed (EC) and Open (EO) for 90s. Geometric measures (Sway Area, Path Length), standard deviation (SD) of the excursions, and spectral measure (mean power Spectrum Level and Median Frequency), along the medio-lateral (ML) and antero-posterior (AP) direction were computed. Sway Area was more strongly associated than Path Length with CoP SD and, consequently, with mean Spectrum Level for both ML and AP, and both visual and surface conditions. The squared-SD directly specified the mean power Spectrum Level of CoP excursions (ML and AP) in all conditions. Median Frequency was hardly related to Spectrum Level. Adaptation had a confounding effect, whereby equal values of Sway Area, Path Length, and Spectrum Level corresponded to different Median Frequency values. Mean Spectrum Level and SDs of the time series of CoP ML and AP excursions convey the same meaning and bear an acceptable correspondence with Sway Area values. Shifts in Median Frequency values represent important indications of neuromuscular control of stance and of the effects of vision, support conditions, and adaptation. The Romberg Quotient EC/EO for a given variable is contingent on the compliance of the base of support and adaptation, and different between Sway Area and Path Length, but similar between Sway Area and Spectrum Level (AP and ML). These measures must be taken with caution in clinical studies, and considered together in order to get a reliable indication of overall body sway, of modifications by sensory and standing condition, and of changes with ageing, medical conditions and rehabilitation treatment. However, distinct measures shed light on the discrete mechanisms and complex processes underpinning the maintenance of stance.
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Affiliation(s)
- Stefania Sozzi
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
| | - Shashank Ghai
- Department of Physical Therapy, Rsgbiogen, New Delhi, India
| | - Marco Schieppati
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
- *Correspondence: Marco Schieppati
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14
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Otomi Y, Irahara S, Inoue H, Shinya T, Otsuka H, Harada M. Increased 18F-FDG Uptake in the Axillary Lymph Nodes of the Vaccinated Side Associated with COVID-19 Vaccination. Mol Imaging Radionucl Ther 2022; 31:169-171. [PMID: 35771098 PMCID: PMC9246311 DOI: 10.4274/mirt.galenos.2021.22590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 50-year-old female patient underwent (18fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) following modified radical mastectomy for cancer of the left breast. Ten days before the PET/CT, the coronavirus disease-2019 (COVID-19) vaccine was injected intramuscularly into the right deltoid muscle. Increased (18F-FDG uptake of maximum standardized uptake value (11.0) was observed in the lymph nodes of the right axilla, which had not been observed in the previous PET/CT. The size of the oval-shaped lymph nodes was up to approximately 11×9 mm; however, it was larger than that observed on the previous PET/CT. We contemplate that the increased (18F-FDG uptake was a reactive change in the lymph nodes associated with the COVID-19 vaccine.
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Affiliation(s)
- Yoichi Otomi
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Saho Irahara
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Hiroaki Inoue
- Tokushima University, Department of Thoracic and Endocrine Surgery and Oncology, Tokushima, Japan
| | | | - Hideki Otsuka
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Masafumi Harada
- Tokushima University, Department of Radiology, Tokushima, Japan
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15
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Biathletes present repeating patterns of postural control to maintain their balance while shooting. PLoS One 2022; 17:e0267105. [PMID: 35503761 PMCID: PMC9064080 DOI: 10.1371/journal.pone.0267105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/01/2022] [Indexed: 11/19/2022] Open
Abstract
Balance can be a main factor contributing to success in many disciplines, and biathlon is a representative example. A more stable posture may be a key factor for shooting scores. The center of foot pressure (COP) is commonly recorded when evaluating postural control. As COP measurements are highly irregular and non-stationary, non-linear deterministic methods, such as entropy, are more appropriate for the analysis of COP displacement. The aim of our study was to investigate whether the longitudinal effects of biathlon training can elicit specific changes in postural control. Eight national-level biathletes, 15 non-athletes who prior to the experiment took part in 3 months of shooting training, and 15 non-athletes with no prior rifle shooting experience took part in our study. The data was collected with the use of a force plate. Participants performed three balance tasks in quiet standing, the shooting position (internal focus-participants concentrated on maintaining the correct body position and rifle), and aiming at the target (external focus-participants concentrated on keeping the laser beam centered on the targets). Biathletes obtained significantly lower values of sample entropy compared to the other groups during the shooting and aiming at the target trials (p<0.05). External and internal focuses influenced the process of postural control among participants who had prior rifle shooting experience and the control group; they obtained significantly higher values of sample entropy while shooting and aiming at the target compared to the quiet standing trial (p<0.05). The biathletes obtained significantly lower values of sample entropy in the aiming at the target position compared to the quiet standing trial. Specific balance training is associated with the ability to deal with a more challenging, non-specific task. The biathletes seemed to employ a different motor control strategy than the beginners and control group, creating repeating patterns (more regular signal for COP) to keep one's balance during the shooting and aiming at the target positions.
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16
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Marchesi G, De Luca A, Squeri V, De Michieli L, Vallone F, Pilotto A, Leo A, Casadio M, Canessa A. A Lifespan Approach to Balance in Static and Dynamic Conditions: The Effect of Age on Balance Abilities. Front Neurol 2022; 13:801142. [PMID: 35265025 PMCID: PMC8899125 DOI: 10.3389/fneur.2022.801142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/05/2022] [Indexed: 11/23/2022] Open
Abstract
Postural control is a complex sensorimotor skill that is fundamental to our daily life. The abilities to maintain and recover balance degrade with age. However, the time decay of balance performance with age is not well understood. In this study, we aim at quantifying the age-dependent changes in standing balance under static and dynamic conditions. We tested 272 healthy subjects with ages ranging from 20 to 90. Subjects maintained the upright posture while standing on the robotic platform hunova®. In the evaluation of static balance, subjects stood on the fixed platform both with eyes open (EO) and eyes closed (EC). In the dynamic condition, subjects stood with eyes open on the moving foot platform that provided three different perturbations: (i) an inclination proportional to the center of pressure displacements, (ii) a pre-defined predictable motion, and (iii) an unpredictable and unexpected tilt. During all these tests, hunova® measured the inclination of the platform and the displacement of the center of pressure, while the trunk movements were recorded with an accelerometer placed on the sternum. To quantify balance performance, we computed spatio-temporal parameters typically used in clinical environments from the acceleration measures: mean velocity, variability of trunk motion, and trunk sway area. All subjects successfully completed all the proposed exercises. Their motor performance in the dynamic balance tasks quadratically changed with age. Also, we found that the reliance on visual feedback is not age-dependent in static conditions. All subjects well-tolerated the proposed protocol independently of their age without experiencing fatigue as we chose the timing of the evaluations based on clinical needs and routines. Thus, this study is a starting point for the definition of robot-based assessment protocols aiming at detecting the onset of age-related standing balance deficits and allowing the planning of tailored rehabilitation protocols to prevent falls in older adults.
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Affiliation(s)
- Giorgia Marchesi
- Spinal Cord Italian Lab (SCIL), Unità Spinale Unipolare, Santa Corona Hospital, Pietra Ligure, Italy.,Department of Informatics, Bioengineering, Robotics, and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | | | | | | | - Francesco Vallone
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy
| | - Alessandra Leo
- Unità Spinale Unipolare, Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maura Casadio
- Spinal Cord Italian Lab (SCIL), Unità Spinale Unipolare, Santa Corona Hospital, Pietra Ligure, Italy.,Department of Informatics, Bioengineering, Robotics, and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Andrea Canessa
- Spinal Cord Italian Lab (SCIL), Unità Spinale Unipolare, Santa Corona Hospital, Pietra Ligure, Italy.,Department of Informatics, Bioengineering, Robotics, and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
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17
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COVID-19 and Postural Control—A Stabilographic Study Using Rambling-Trembling Decomposition Method. Medicina (B Aires) 2022; 58:medicina58020305. [PMID: 35208628 PMCID: PMC8877894 DOI: 10.3390/medicina58020305] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 01/16/2023] Open
Abstract
Background and Objectives: Some respiratory viruses demonstrate neurotropic capacities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently taken over the globe, causing coronavirus disease 2019 (COVID-19). The aim of the study was to evaluate the impact of COVID-19 on postural control in subjects who have recently recovered from the infection. Materials and Methods: Thirty-three convalescents who underwent COVID-19 within the preceding 2–4 weeks, and 35 healthy controls were enrolled. The ground reaction forces were registered with the use of a force platform during quiet standing. The analysis of the resultant center of foot pressure (COP) decomposed into rambling (RAMB) and trembling (TREMB) and sample entropy was conducted. Results: Range of TREMB was significantly increased in subjects who experienced anosmia/hyposmia during COVID-19 when the measurement was performed with closed eyes (p = 0.03). In addition, subjects who reported dyspnea during COVID-19 demonstrated significant increase of length and velocity of COP (p < 0.001), RAMB (p < 0.001), and TREMB (p < 0.001), indicating substantial changes in postural control. Conclusions: Subjects who had experienced olfactory dysfunction or respiratory distress during COVID-19 demonstrate symptoms of balance deficits after COVID-19 recovery, and the analysis using rambling-trembling decomposition method might point at less efficient peripheral control. Monitoring for neurological sequelae of COVID-19 should be considered.
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18
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Assessment of postural sway with a pendant-mounted wearable sensor. Gait Posture 2022; 92:199-205. [PMID: 34864485 DOI: 10.1016/j.gaitpost.2021.11.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/01/2021] [Accepted: 11/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Body-worn inertial measurement unit (IMU) sensors have been widely used in postural stability and balance studies because of their low cost and convenience. In most of these studies, a single IMU sensor is attached to a waist belt near the body's center of mass. Some populations such as pregnant women, however, may find a waist belt challenging in terms of fit and comfort. For this reason it may be useful to identify an alternative location for placement of an IMU and a more comfortable means for attaching the sensor to the body. Research question Does placing an IMU sensor in a pendant worn around the neck permit discrimination between conditions with varying postural stability? METHODS Twenty-six healthy participants performed three standing tasks (double-leg, tandem, and single-leg standing) under eyes-open and eyes-closed vision conditions to preliminarily assess the ability of the pendant sensor to discriminate between balance conditions. Discrimination based upon data from a belt-mounted IMU was assessed in the same trials. Differences in standard deviation of acceleration components, sway area, and jerkiness due to trial condition and sensor were evaluated using analysis of variance followed by post hoc comparisons. These data were also incorporated into receiver-operator characteristic (ROC) curve analysis to assess the effectiveness of each sensor at discriminating between conditions. RESULTS Stability was found to vary across conditions, but there was no interaction between stability and sensor location (all p ≥ 0.323). ROC curve analysis showed that sensors in both locations were good discriminators between conditions. Significance Placing an IMU in a pendant may be feasible for studying and monitoring postural instability. This approach may be especially valuable when considering populations for which wearing a belt is uncomfortable.
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19
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Magalhães GV, Razuk M, Vieira LA, Rinaldi NM. Postural control performance of active and inactive older adults assessed through postural tasks with different levels of difficulty. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220015421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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20
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Quijoux F, Nicolaï A, Chairi I, Bargiotas I, Ricard D, Yelnik A, Oudre L, Bertin‐Hugault F, Vidal P, Vayatis N, Buffat S, Audiffren J. A review of center of pressure (COP) variables to quantify standing balance in elderly people: Algorithms and open-access code. Physiol Rep 2021; 9:e15067. [PMID: 34826208 PMCID: PMC8623280 DOI: 10.14814/phy2.15067] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
Postural control is often quantified by recording the trajectory of the center of pressure (COP)-also called stabilogram-during human quiet standing. This quantification has many important applications, such as the early detection of balance degradation to prevent falls, a crucial task whose relevance increases with the aging of the population. Due to the complexity of the quantification process, the analyses of sway patterns have been performed empirically using a number of variables, such as ellipse confidence area or mean velocity. This study reviews and compares a wide range of state-of-the-art variables that are used to assess the risk of fall in elderly from a stabilogram. When appropriate, we discuss the hypothesis and mathematical assumptions that underlie these variables, and we propose a reproducible method to compute each of them. Additionally, we provide a statistical description of their behavior on two datasets recorded in two elderly populations and with different protocols, to hint at typical values of these variables. First, the balance of 133 elderly individuals, including 32 fallers, was measured on a relatively inexpensive, portable force platform (Wii Balance Board, Nintendo) with a 25-s open-eyes protocol. Second, the recordings of 76 elderly individuals, from an open access database commonly used to test static balance analyses, were used to compute the values of the variables on 60-s eyes-open recordings with a research laboratory standard force platform.
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Affiliation(s)
- Flavien Quijoux
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- ORPEA GroupPuteauxFrance
| | - Alice Nicolaï
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | - Ikram Chairi
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- Groupe MSDAUniversité Mohammed VI PolytechniqueBenguerirMaroc
| | - Ioannis Bargiotas
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | - Damien Ricard
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- Service de Neurologie de l’Hôpital d’Instruction des Armées de PercySSAClamartFrance
- Ecole du Val‐de‐GrâceEcole de Santé des ArméesParisFrance
| | - Alain Yelnik
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- PRM DepartmentGH Lariboisière F. WidalAP‐HPUniversité de ParisUMR 8257ParisFrance
| | - Laurent Oudre
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | | | - Pierre‐Paul Vidal
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- Institute of Information and ControlHangzhou Dianzi UniversityZhejiangChina
| | - Nicolas Vayatis
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | - Stéphane Buffat
- Laboratoire d’accidentologie de biomécanique et du comportement des conducteursGIE Psa Renault GroupesNanterreFrance
| | - Julien Audiffren
- Department of NeuroscienceUniversity of FribourgFribourgSwitzerland
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21
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The effects of mechanical noise bandwidth on balance across flat and compliant surfaces. Sci Rep 2021; 11:12276. [PMID: 34112840 PMCID: PMC8192913 DOI: 10.1038/s41598-021-91422-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/25/2021] [Indexed: 12/29/2022] Open
Abstract
Although the application of sub-sensory mechanical noise to the soles of the feet has been shown to enhance balance, there has been no study on how the bandwidth of the noise affects balance. Here, we report a single-blind randomized controlled study on the effects of a narrow and wide bandwidth mechanical noise on healthy young subjects’ sway during quiet standing on firm and compliant surfaces. For the firm surface, there was no improvement in balance for both bandwidths—this may be because the young subjects could already balance near-optimally or optimally on the surface by themselves. For the compliant surface, balance improved with the introduction of wide but not narrow bandwidth noise, and balance is improved for wide compared to narrow bandwidth noise. This could be explained using a simple model, which suggests that adding noise to a sub-threshold pressure stimulus results in markedly different frequency of nerve impulse transmitted to the brain for the narrow and wide bandwidth noise—the frequency is negligible for the former but significantly higher for the latter. Our results suggest that if a person’s standing balance is not optimal (for example, due to aging), it could be improved by applying a wide bandwidth noise to the feet.
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22
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De la Torre J, Marin J, Polo M, Gómez-Trullén EM, Marin JJ. MCQ-Balance: a method to monitor patients with balance disorders and improve clinical interpretation of posturography. PeerJ 2021; 9:e10916. [PMID: 33665033 PMCID: PMC7908886 DOI: 10.7717/peerj.10916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/18/2021] [Indexed: 11/20/2022] Open
Abstract
Background An estimated 20% to 30% of the global population has suffered a vertiginous episode. Among them, 20% do not receive a clear diagnosis. Improved methods, indicators and metrics are necessary to assess the sensory systems related to balance, especially when patients are undergoing treatment for vertiginous episodes. Patients with balance disorders should be monitored for changes at the individual level to gather objective information. In this study, we evaluate the use of the MCQ-Balance (Measure, Classify and Qualify) assessment for examining a patient’s balance progression using tests to measure static balance control and dynamic postural balance with a stabilometric platform. Materials and Methods The MCQ-Balance assessment comprises three stages: (i) measuring the progression of each variable between two separate and consecutive days (called sessions) using the Magnitude-Based Decision analysis; (ii) classifying the progression of the patient’s balance with a score; and (iii) qualifying the progression of the patient’s balance from the resulting scores using a set of rules. This method was applied to 42 patients with balance disorders of peripheral or central origin characterised by vertigo as the cardinal symptom. Balance progression was measured using the MCQ-Balance assessment over the course of three months, and these results were compared with the assessment of a clinical expert. Results The MCQ-Balance assessment showed an accuracy of 83.4% and a Cohen’s Kappa coefficient of 0.752 compared to the assessment of a clinical expert. Conclusion The MCQ-Balance assessment facilitates the monitoring of patient balance and provides objective information that has the potential to improve medical decision making and the adjustment of individual treatment.
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Affiliation(s)
- Juan De la Torre
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), Zaragoza, Spain.,Department of Biomedical Engineering, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Marin
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), Zaragoza, Spain.,Department of Design and Manufacturing Engineering, Universidad de Zaragoza, Zaragoza, Spain
| | - Marco Polo
- MD Physical Medicine and Rehabilitation, Hospital of Alcañiz, Teruel, Spain
| | - Eva M Gómez-Trullén
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), Zaragoza, Spain.,Department of Physical Medicine and Rehabilitation and Nursing, Health Sciences Faculty, Universidad de Zaragoza, Zaragoza, Spain
| | - Jose J Marin
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), Zaragoza, Spain.,Department of Design and Manufacturing Engineering, Universidad de Zaragoza, Zaragoza, Spain
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23
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Sarvestan J, Kovacikova Z, Linduska P, Gonosova Z, Svoboda Z. Contribution of lower limb muscle strength to walking, postural sway and functional performance in elderly women. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-203105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Aging-related deterioration of the lower limb muscle strength could highly influence the functional performance of elderly individuals. OBJECTIVE: To investigate how advancing age impacts the lower limb muscle strength and consequently affects the balance and walking performance. METHODS: Twenty-seven community-dwelling elderly females underwent isokinetic ankle dorsi/plantar flexion (ADF/APF), inversion/eversion (AIN/AEV), knee flexion/extension (KFL/KEX), hip flexion/extension (HFL/HEX), and abduction/adduction (HAB/HAD) tests, the six-minute walk test, open-eyed biped balance test on foam rubber and the performance-oriented mobility assessment (POMA). RESULTS: The Pearson’s product-moment correlation coefficients demonstrated that advancing age negatively influenced the relative work and moment produced in all the muscle groups, the POMA score (r=-0.51), walking speed (r=-0.62), and the vertical (r= 0.55) and anteroposterior (r= 0.54) postural sway velocities. The peak moment and work values of AINs and APFs; KFLs and KEXs; and HABs, HFLs, and HEXs showed a significantly positive correlation with the walking speed (α⩽ 0.05). CONCLUSION: The strength of HFLs, HEXs and HABs, as the important contributors to the walking performance, underwent attenuation as the age increased, consequently resulting in impairments of stepping profiles of elderly females. Elderly females are needed to be trained to reach the optimum levels of lower limb muscular strength to overcome premature incapacitation and have control over their independence in daily activities.
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Danna-Dos-Santos A, Ribeiro Dos Santos MM, Magalhães AT, Cardoso VS, Driusso P, Mochizuki L, Degani AM. Visuo-postural dependency index (VPDI) in human postural control. BMC Sports Sci Med Rehabil 2021; 13:7. [PMID: 33499932 PMCID: PMC7836177 DOI: 10.1186/s13102-021-00235-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/17/2021] [Indexed: 11/12/2022]
Abstract
Background Computerized stabilometry has been utilized to investigate the effect of vision on the neuromechanisms of human postural control. However, this approach lacks operational methods to quantify visual dependency during upright stance. This study had three goals: (1) To introduce the concept of visuo-postural dependency indices (VPDI) representing balance sway characteristics in multiple analytical domains (spatial, temporal, frequency, and structural), (2) To investigate the age and gender effects on VPDIs, and (3) To investigate the degree of relationships between VPDI and both subjective visual vertical and horizontal perception (SVV and SVH, respectively). Methods 102 participants (16 to 80 years old) performed bipedal stances on a force platform with eyes open and closed. Response variables included the VPDIs computed for each postural index. In addition, 29 participants also performed SVV and SVH assessments. Results Fifteen VPDIs showed to be robust indicators of visual input modulation, and the variation across their magnitudes of modulation revealed a non-homogeneous response to changes in visual stimuli. Gender and age were not found to be a significant factor to VPDI modulation. Conclusions VPDIs revealed to be potential measures capable to quantitatively assess visuo-postural dependency and aid the assessment of fall risks and balance impairments.
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Affiliation(s)
- Alessander Danna-Dos-Santos
- Laboratory for Advances in Rehabilitation Sciences, Department of Physical Therapy, Western Michigan University, 1903 W Michigan Av., Office # 3454, Kalamazoo, MI, 49008-5383, USA.
| | | | - Alessandra T Magalhães
- BioSignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, PI, Brazil
| | - Vinicius S Cardoso
- BioSignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, PI, Brazil
| | - Patricia Driusso
- Physical Therapy Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Luis Mochizuki
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - Adriana M Degani
- Laboratory for Advances in Rehabilitation Sciences, Department of Physical Therapy, Western Michigan University, 1903 W Michigan Av., Office # 3454, Kalamazoo, MI, 49008-5383, USA
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Maurer C, Holzgreve F, Erbe C, Wanke EM, Kopp S, Groneberg DA, Ohlendorf D. Influence of dental occlusion conditions on plantar pressure distribution during standing and walking - A gender perspective. Med Eng Phys 2021; 88:47-53. [PMID: 33485513 DOI: 10.1016/j.medengphy.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 12/01/2022]
Abstract
The aim of this study was to investigate gender-specific influences of different symmetric and asymmetric occlusion conditions on postural control during standing and walking. The study involved 59 healthy adult volunteers (41 f/19 m) aged between 22 and 53 years (30.2 ± 6.3 years). Postural control measurements were carried out using a pressure plate by measuring plantar pressure distribution during standing and walking test conditions. Seven different occlusion conditions were tested. Prior to a MANOVA model analysis, the relationship between the two test conditions were checked using a factor analysis with a varying number of factors (between 2 and 10). The plantar pressure distributions during walking and standing are independent test conditions. The coefficient of variance across all variables between the conditions and genders was not significant: t(46) = 1.51 (p = 0.13). No statement can be made whether, or not, the influence of gender is greater than the influence of the conditions. Healthy male and female test subjects did not show any difference between seven occlusion conditions on the plantar pressure distribution while standing or walking. No differences between the genders were found for any of the investigated variables. In contrast to custom-made occlusion splints, simple cotton rolls appear not to influence the neuromuscular system in a systematic manner.
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Affiliation(s)
- C Maurer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - F Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - C Erbe
- Department for Orthodontics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - E M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - S Kopp
- School of Dentistry, Department of Orthodontics, Goethe-University Frankfurt, Germany
| | - D A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - D Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany.
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Fujio K, Takeuchi Y. Discrimination of standing postures between young and elderly people based on center of pressure. Sci Rep 2021; 11:195. [PMID: 33420289 PMCID: PMC7794377 DOI: 10.1038/s41598-020-80717-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/23/2020] [Indexed: 11/25/2022] Open
Abstract
Posturography is utilized to assess the influence of aging on postural control. Although this measurement is advantageous for finding group-level differences between the young and the elderly, it is unclear whether it has the potential to differentiate elderly individuals who are affected by various impacts of aging. The purpose of this study was to determine the utility of posturography to discriminate elderly individuals from young adults. We investigated the performances of the random forest classifiers constructed from center of pressure (COP) indices for discriminating standing postures between healthy elderly and young people. Postural sways in 19 young and 31 community-dwelling elderly participants were measured using force plates in 4 standing conditions: bipedal standing, standing on a narrow base, standing on foam rubber, and standing with eyes closed. We further verified the informative predictors that contributed to the prediction model. As the results, the classifier based on the COP indices for standing on foam rubber showed the best performance (accuracy: 93.4%, sensitivity: 94.4%, specificity: 93.6%, area under the curve of receiving operator characteristics: 0.95), followed by the classifier for standing with eyes closed. The informative predictors varied depending on the postural conditions. Our findings demonstrated the potential of posturography for identifying elderly postures. The evaluation of sensory re-weighting using the appropriate COP indices would be a useful clinical tool for detecting the progress of aging on postural control.
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Affiliation(s)
- Kimiya Fujio
- Department of Rehabilitation for Movement Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.
| | - Yahiko Takeuchi
- Department of Rehabilitation Medicine, Chiba University Hospital, Chiba, Japan
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Applying the Minimal Detectable Change of a Static and Dynamic Balance Test Using a Portable Stabilometric Platform to Individually Assess Patients with Balance Disorders. Healthcare (Basel) 2020; 8:healthcare8040402. [PMID: 33066627 PMCID: PMC7712175 DOI: 10.3390/healthcare8040402] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/09/2020] [Accepted: 10/12/2020] [Indexed: 12/29/2022] Open
Abstract
Balance disorders have a high prevalence among elderly people in developed countries, and falls resulting from balance disorders involve high healthcare costs. Therefore, tools and indicators are necessary to assess the response to treatments. Therefore, the aim of this study is to detect relevant changes through minimal detectable change (MDC) values in patients with balance disorders, specifically with vertigo. A test-retest of a static and dynamic balance test was conducted on 34 healthy young volunteer subjects using a portable stabilometric platform. Afterwards, in order to show the MDC applicability, eight patients diagnosed with balance disorders characterized by vertigo of vestibular origin performed the balance test before and after a treatment, contrasting the results with the assessment by a specialist physician. The balance test consisted of four tasks from the Romberg test for static balance control, assessing dynamic postural balance through the limits of stability (LOS). The results obtained in the test-retest show the reproducibility of the system as being similar to or better than those found in the literature. Regarding the static balance variables with the lowest MDC value, we highlight the average velocity of the center of pressure (COP) in all tasks and the root mean square (RMS), the area, and the mediolateral displacement in soft surface, with eyes closed. In LOS, all COP limits and the average speed of the COP and RMS were highlighted. Of the eight patients assessed, an agreement between the specialist physician and the balance test results exists in six of them, and for two of the patients, the specialist physician reported no progression, whereas the balance test showed worsening. Patients showed changes that exceeded the MDC values, and these changes were correlated with the results reported by the specialist physician. We conclude that (at least for these eight patients) certain variables were sufficiently sensitive to detect changes linked to balance progression. This is intended to improve decision making and individualized patient monitoring.
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Ohlendorf D, Pflaum J, Wischnewski C, Schamberger S, Erbe C, Wanke EM, Holzgreve F, Groneberg DA. Standard reference values of the postural control in healthy female adults aged between 31 and 40 years in Germany: an observational study. J Physiol Anthropol 2020; 39:27. [PMID: 32907627 PMCID: PMC7488048 DOI: 10.1186/s40101-020-00229-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To detect deviations from a normal postural control, standard values can be helpful for comparison purposes. Since the postural control is influenced by gender and age, the aim of the present study was the collection of standard values for women between 31 and 40 years of age. METHODS For the study, 106 female, subjectively healthy, German subjects aged between 31 and 40 years (35 ± 2.98 years) were measured using a pressure measuring platform. RESULTS Their average BMI was 21.60 ± 4.65 kg/m2. The load distribution between left and right foot was almost evenly balanced with a median 51.46% load on the left [tolerance interval (TR) 37.02%/65.90%; confidence interval (CI) 50.06/52.85%] and 48.54% [TR 43.10/62.97%; CI 47.14/49.93%] on the right foot. The median forefoot load was 33.84% [TR 20.68/54.73%; CI 31.67/37.33%] and the rearfoot load was measured at 66.16% [TR 45.27/79.33%; CI 62.67/68.33%]. The median/mean body sway in the sagittal plane was measured 12 mm [TR 5.45/23.44 mm; CI 11.00/14.00 mm] and 8.17 mm in the frontal plane [TR 3.33/19.08 mm; CI 7.67/9.33 mm]. The median of the ellipse area is 0.72 cm2 [TR 0.15/3.69 cm2; CI 0.54/0.89°]. The ellipse width has a median of 0.66 cm [TR 0.30/1.77 cm; CI 0.61/0.78 cm] and the height of 0.33 cm [TR 0.13/0.71 cm; CI 0.30/0.37 cm]. The ellipse angle (sway, left forefoot to right rearfoot) has a mean of - 19.34° [TR - 59.21/- 0.44°; CI - 22.52/- 16.16°] and the ellipse angle sway from right forefoot to left rearfoot has a mean of 12.75° [TR 0.09/59.09°; CI 9.00/16.33°]. CONCLUSION The right-to-left ratio is balanced. The forefoot-to-rearfoot ratio is approximately 1:2. Also, the body sway can be classified with 12 and 8 mm as normal. The direction of fluctuation is either approx. 19° from the left forefoot to the right rearfoot or approx. 13° the opposite. Body weight, height, and BMI were comparable to the German average of women in a similar age group, so that the measured standard values are representative and might serve as baseline for the normal function of the balance system in order to support the diagnosis of possible dysfunctions in postural control.
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Affiliation(s)
- Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Building 9a, 60596 Frankfurt, Germany
| | - Julia Pflaum
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Building 9a, 60596 Frankfurt, Germany
| | - Christina Wischnewski
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Building 9a, 60596 Frankfurt, Germany
| | - Sebastian Schamberger
- School of Dentistry, Department of Orthodontics, Goethe University Frankfurt, Frankfurt, Germany
| | - Christina Erbe
- University Medical Center, Department for Orthodontics, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eileen M. Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Building 9a, 60596 Frankfurt, Germany
| | - Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Building 9a, 60596 Frankfurt, Germany
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Building 9a, 60596 Frankfurt, Germany
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A performance study of a wearable balance assistance device consisting of scissored-pair control moment gyroscopes and a two-axis inclination sensor. J Biomech 2020; 109:109957. [PMID: 32807319 DOI: 10.1016/j.jbiomech.2020.109957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/26/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022]
Abstract
Excessive postural sway while standing can lead to falls and injuries. A designed wearable balance assistance device which consists of scissored-pair control moment gyroscopes and a two-axis inclination sensor is introduced to reduce fall risk from excessive sway among the elderly. The prototype has dimensions of H50cm × W44cm × D30cm and weighs 15.03 kg. This study aims to investigate the effects of generated torque of the prototype on human subjects and aims to determine if the two-axis inclination sensor can detect sway amplitude and sway direction during an occurrence of excessive sway. Two healthy male subjects participated in the study. According to the results, the detected body incline angle related to the acquired sway amplitude of COP trajectories with correlation factors of 0.92 and 0.88 for the two subjects. The detected sway angle related to the acquired sway direction of COP trajectories with the correlation factors of 0.99 and 0.98 for the two subjects. The maximum-allowable generated torque of the prototype with an assigned actuating angle varying within ±15.6° from the acquired sway direction of COP trajectories was able to drive the COP of 60-kilogram-weighted healthy subject maintaining balance at posterolateral limits of stability with an average body incline angle of 5.74° to pass his standing secure zone. The results indicate that the prototype has the potential of being a wearable balance assistance device which can reduce fall risk from excessive sway among the elderly; however, some improvements are still required in regards to shape, size, mass, generated torque, and strength.
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Degani AM, Cardoso VS, Magalhães AT, Assunção ALS, Soares EDC, Danna-Dos-Santos A. Postural Behavior in Medicated Parkinson Disease Patients: A Preliminary Study Searching for Indicators to Track Progress. J Cent Nerv Syst Dis 2020; 12:1179573520922645. [PMID: 32536782 PMCID: PMC7268163 DOI: 10.1177/1179573520922645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/16/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose: The establishment of early diagnostic methods for Parkinson disease (PD) is one of the key features to clinically control the rate of PD progression. This study aimed to give a first step toward recognizing the efficacy of multiple postural indices of balance control in differentiating medicated PD patients from health participants. Methods: Nine individuals with PD (Hoehn and Yahr Stage up to 2), 9 staged 2.5 and up, and 9 healthy age-matched Controls performed bipedal stances for 120 seconds with eyes either open or closed on a stable force platform. All participants with PD were under anti-Parkinsonian medication. Non-parametric tests investigated the effects of PD and visual input on postural indices extracted from the center of pressure coordinates. Results: Independent of the stage of the disease, individuals with PD presented faster and shakier body sway compared with Controls. Advanced stages of PD also revealed increased body sway length and variability. In addition, medio-lateral postural instability was more pronounced in all stages of PD when visual inputs were not allowed. Conclusion and Significance: Body sway velocity, jerkiness, length, and its variability revealed to be potential markers for subclinical signs of adjustments in the neuromechanisms of balance control and postural instability even at early stages of disease and under anti-Parkinsonian medication. Results produced here will direct future studies aiming to investigate the efficacy of these same indices on recognizing subclinical development of PD as well as those individuals susceptible to faster rates of progression.
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Affiliation(s)
- Adriana Menezes Degani
- Department of Physical Therapy, Western Michigan University, Kalamazoo, MI, USA.,Unified Clinics, Western Michigan University, Kalamazoo, MI, USA.,Synergy Applied Medical & Research, Missoula, MT, USA
| | - Vinicius Saura Cardoso
- BioSignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Brazil
| | | | | | | | - Alessander Danna-Dos-Santos
- Department of Physical Therapy, Western Michigan University, Kalamazoo, MI, USA.,Synergy Applied Medical & Research, Missoula, MT, USA
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Assessment of Static Plantar Pressure, Stabilometry, Vitamin D and Bone Mineral Density in Female Adolescents with Moderate Idiopathic Scoliosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062167. [PMID: 32214036 PMCID: PMC7143889 DOI: 10.3390/ijerph17062167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 12/11/2022]
Abstract
(1) Background: Adolescent idiopathic scoliosis (AIS) can be associated with vitamin D deficiency and osteopenia. Plantar pressure and stabilometry offer important information about posture. The objectives of our study were to compare static plantar pressure and stabilometric parameters, serum 25-OH-vitamin D3 and calcium levels, and bone mineral densitometry expressed as z-score in patients with moderate AIS and healthy subjects. (2) Methods: 32 female adolescents (idiopathic S shaped moderate scoliosis, main lumbar curve) and 32 gender and age-matched controls performed: static plantar pressure, stabilometry, serum 25-OH-vitamin D3 and calcium levels, and dual X-ray absorptiometry scans of the spine. (3) Results: In scoliosis patients, significant differences were recorded between right and left foot for total foot, first and fifth metatarsal, and heel loadings. Stabilometry showed a poorer postural control when compared to healthy subjects (p < 0.001). Patients had significantly lower vitamin D, calcium levels, and z-scores. Lumbar Cobb angle was significantly correlated with the z-score (r = −0.39, p = 0.02), with right foot fifth metatarsal load (r = −0.35, p = 0.04), center of pressure CoPx (r = −0.42, p = 0.01), CoP displacement (r = 0.35, p = 0.04) and 90% confidence ellipse area (r = −0.38, p = 0.03). (4) Conclusions: In our study including female adolescents with idiopathic S shaped moderate scoliosis, plantar pressure and stabilometric parameters were influenced by the main scoliotic curve.
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Cohen RG, Baer JL, Ravichandra R, Kral D, McGowan C, Cacciatore TW. Lighten Up! Postural Instructions Affect Static and Dynamic Balance in Healthy Older Adults. Innov Aging 2020; 4:igz056. [PMID: 32226825 PMCID: PMC7092748 DOI: 10.1093/geroni/igz056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Indexed: 02/01/2023] Open
Abstract
Background and Objectives Increased fall risk in older adults is associated with declining balance. Previous work showed that brief postural instructions can affect balance control in older adults with Parkinson's disease. Here, we assessed the effects of brief instructions on static and dynamic balance in healthy older adults. Research Design and Methods Nineteen participants practiced three sets of instructions, then attempted to implement each instructional set during: (1) quiet standing on foam for 30 s with eyes open; (2) a 3-s foot lift. "Light" instructions relied on principles of reducing excess tension while encouraging length. "Effortful" instructions relied on popular concepts of effortful posture correction. "Relax" instructions encouraged minimization of effort. We measured kinematics and muscle activity. Results During quiet stance, Effortful instructions increased mediolateral jerk and path length. In the foot lift task, Light instructions led to the longest foot-in-air duration and the smallest anteroposterior variability of the center of mass, Relax instructions led to the farthest forward head position, and Effortful instructions led to the highest activity in torso muscles. Discussion and Implications Thinking of upright posture as effortless may reduce excessive co-contractions and improve static and dynamic balance, while thinking of upright posture as inherently effortful may make balance worse. This may partly account for the benefits of embodied mindfulness practices such as tai chi and Alexander technique for balance in older adults. Pending larger-scale replication, this discovery may enable physiotherapists and teachers of dance, exercise, and martial arts to improve balance and reduce fall risk in their older students and clients simply by modifying how they talk about posture.
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Affiliation(s)
- Rajal G Cohen
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho.,Department of Biological Sciences, University of Idaho, Moscow, Idaho
| | - Jason L Baer
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho.,Department of Biological Sciences, University of Idaho, Moscow, Idaho
| | - Ramyaa Ravichandra
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho
| | - Daniel Kral
- Department of Psychology and Communication, University of Idaho, Moscow, Idaho
| | - Craig McGowan
- Department of Biological Sciences, University of Idaho, Moscow, Idaho.,WWAMI Medical Education Program, University of Idaho, Moscow, Idaho
| | - Timothy W Cacciatore
- Sobell Department of Motor Neuroscience, Institute of Neurology, University College London, London, UK
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Amaricai E, Onofrei RR, Suciu O, Marcauteanu C, Stoica ET, Negruțiu ML, David VL, Sinescu C. Do different dental conditions influence the static plantar pressure and stabilometry in young adults? PLoS One 2020; 15:e0228816. [PMID: 32045439 PMCID: PMC7012393 DOI: 10.1371/journal.pone.0228816] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/23/2020] [Indexed: 11/18/2022] Open
Abstract
Background Posture is influenced by many factors and dental occlusion seems to have its role on postural stabilization. Our rationale to perform the study was to find out if there are differences of static plantar pressure and stabilometric parameters depending on different dental conditions. Methods The observational study consisted in plantar pressure assessment and stabilometric analysis of 95 right-handed healthy volunteer subjects (mean age 22.94 ± 2.52 years) by using the PoData system. Each subject followed four measurements with open eyes: mandibular postural position, maximum intercuspation, biting on cotton rolls and maximum mouth opening. Plantar pressure was recorded on 1st and 5th metatarsal heads and heel, and was expressed as percentage of weight distribution on each foot. The recorded centre of pressure (CoP) parameters were: CoP path length, 90%confidence ellipse area and maximum CoP speed. Statistical analysis used repeated-measures ANOVA with Bonferroni posthoc analysis and Friedman test. Results Loading on the left 5th metatarsal head was significantly higher in maximum mouth opening condition when compared to maximum intercuspation and to biting on cotton rolls. The left heel loading was significantly lower in the maximum mouth opening in comparison to maximum intercuspation. The CoP path length and maximum CoP speed were significantly higher in maximum mouth opening compared to the other three conditions. Confidence ellipse area had significantly lower values in maximum intercuspation and in the biting on cotton rolls conditions compared to the mandibular postural position, and in maximum intercuspation compared to maximum mouth opening. Conclusion In young adults with an optimum functional occlusion the static plantar pressure is influenced by the maximum mouth opening. An improved postural stability was recorded in maximum intercuspation (a condition used during swallowing) in comparison to mandibular postural position (a condition that allows relaxation of the masticatory muscles after functional moments).
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Affiliation(s)
- Elena Amaricai
- Department of Rehabilitation, Physical Medicine and Rheumatology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Roxana Ramona Onofrei
- Department of Rehabilitation, Physical Medicine and Rheumatology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- * E-mail:
| | - Oana Suciu
- Department of Rehabilitation, Physical Medicine and Rheumatology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Corina Marcauteanu
- Department of Occlusiology, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Eniko Tunde Stoica
- Department of Occlusiology, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Meda Lavinia Negruțiu
- Dental Materials and Dental Prosthesis Department, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Vlad Laurentiu David
- Department of Pediatric Surgery and Orthopedics, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Cosmin Sinescu
- Dental Materials and Dental Prosthesis Department, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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Amăricăi E, Suciu O, Onofrei RR, Iacob ER, Iacob D, Popoiu CM, Negru M, Belei O, Bădițoiu L, Boia E. Static plantar pressure and functional capacity in children with femoral shaft fractures treated by titanium elastic nailing. BMC Musculoskelet Disord 2019; 20:565. [PMID: 31771558 PMCID: PMC6880557 DOI: 10.1186/s12891-019-2951-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/15/2019] [Indexed: 11/30/2022] Open
Abstract
Background Femoral shaft fractures represent common fractures of the lower limb in the paediatric population. The objectives of our study were to analyse the static plantar pressure and functional capacity in children with surgically treated unilateral femoral shaft fractures, 1 month after the metallic implant removal. Methods Our study included 24 children with unilateral femoral shaft fracture (fracture site contralateral to the dominant leg) treated by titanium elastic nailing (TEN) implants, with the removal of the implant 6 months after initial surgery. The patients were divided into two groups: Group 1 (12 patients without inpatient rehabilitation) and Group 2 (12 patients who attended inpatient rehabilitation). The patients and 12 gender and age-matched healthy controls performed plantar pressure analysis and functional capacity testing (6-min walk test: 6MWT). For patients in Group 1 and 2 the assessments were performed 1 month after the TEN implant removal. Paired t-tests were used to compare the intragroup data. A one-way ANOVA test for independent measures was performed to assess the differences for plantar pressure, and 6MWT among study groups and controls. Results All study patients had left femoral shaft fractures (affected limb). The patients and controls were all right leg dominant. In both Group 1 and Group 2 total foot loading was significantly higher on the non-affected limb compared with the affected limb. When compared to the non-affected limb, the loadings on the affected limb were significantly increased on the first and fifth metatarsal in Group 1, and on the fifth metatarsal in Group 2, with a significantly smaller heel loading. When compared with the controls we found significant differences for all pressure parameters, except for the right foot load for the rehabilitation group. Although the functional capacity values were higher in the rehabilitation group the two patients groups had significantly lower 6MWT values. Conclusions When compared to healthy controls children with surgically treated unilateral femoral shaft fractures, although assessed after 7 months, had a different weight distribution on the feet and a decreased functional capacity. A rehabilitation programme included in the management of these patients is important for regaining their functional level.
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Affiliation(s)
- Elena Amăricăi
- Department of Rehabilitation, Physical Medicine and Rheumatology, "Victor Babes" University of Medicine and Pharmacy, "Louis Țurcanu" Emergency Children's Hospital, Timisoara, Romania
| | - Oana Suciu
- Department of Rehabilitation, Physical Medicine and Rheumatology, "Victor Babes" University of Medicine and Pharmacy, "Pius Brînzeu" Emergency County Hospital, Timisoara, Romania.
| | - Roxana Ramona Onofrei
- Department of Rehabilitation, Physical Medicine and Rheumatology, "Victor Babes" University of Medicine and Pharmacy, "Pius Brînzeu" Emergency County Hospital, Timisoara, Romania
| | - Emil Radu Iacob
- Department of Paediatric Surgery, "Victor Babes" University of Medicine and Pharmacy, "Louis Țurcanu" Emergency Children's Hospital, Timisoara, Romania
| | - Daniela Iacob
- Department of Neonatology, "Victor Babes" University of Medicine and Pharmacy, "Pius Brînzeu" Emergency County Hospital, Timisoara, Romania
| | - Călin Marius Popoiu
- Department of Paediatric Surgery, "Victor Babes" University of Medicine and Pharmacy, "Louis Țurcanu" Emergency Children's Hospital, Timisoara, Romania
| | - Marius Negru
- "Louis Țurcanu" Emergency Children's Hospital, Timisoara, Romania
| | - Oana Belei
- 1st Pediatric Department, "Victor Babes" University of Medicine and Pharmacy, "Louis Țurcanu" Emergency Children's Hospital, Timisoara, Romania
| | - Luminița Bădițoiu
- Epidemiology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Eugen Boia
- Department of Paediatric Surgery, "Victor Babes" University of Medicine and Pharmacy, "Louis Țurcanu" Emergency Children's Hospital, Timisoara, Romania
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Richer N, Lajoie Y. Automaticity of Postural Control while Dual-tasking Revealed in Young and Older Adults. Exp Aging Res 2019; 46:1-21. [PMID: 31744403 DOI: 10.1080/0361073x.2019.1693044] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Postural control improvements in external focus and cognitive task conditions are thought to occur because directing attention away from postural control allows greater automaticity. We aimed to support this theory by using three dynamic measures of postural control that may reveal changes in the structure or composition of sway: the discrete wavelet transform, sample entropy, and rambling trembling analyses.Methods: We analyzed the center of pressure data from twenty-two healthy young adults (20.8 ± 2.82 years) and twenty healthy older adults (69.02 ± 3.47 years). Participants stood with feet together in five conditions: baseline standing, internal focus, external focus, easy cognitive task, and difficult cognitive task. Analyses of variance were used to examine the effect of condition and age on the three dynamic measures.Results: The wavelet transform revealed a shift toward greater contributions from higher frequency bands in cognitive task conditions, suggesting greater automaticity. Sample entropy was higher in cognitive task conditions, suggesting more complex sway and automatic control. The external focus and difficult cognitive tasks increased trembling in young adults, suggesting increased contributions from spinal reflex components.Conclusion: Results support the theory that stability improvements in cognitive task conditions were due to automaticity in young and older adults. They also suggest that tasks that are more difficult are better at promoting automaticity than tasks requiring less cognitive involvement.
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Affiliation(s)
- Natalie Richer
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Yves Lajoie
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Cieślik B, Chamela-Bilińska D, Ostrowska B, Szczepańska-Gieracha J. Postural instability in cognitively impaired elderly during forward and backward body leans. J Phys Ther Sci 2019; 31:573-577. [PMID: 31417224 PMCID: PMC6642884 DOI: 10.1589/jpts.31.573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/22/2019] [Indexed: 01/09/2023] Open
Abstract
[Purpose] The aim of this study was to determine whether there are differences in
postural stability control while leaning forward and backward between healthy elderly
participants and elderly participants with cognitive impairment. [Participants and
Methods] Postural stability was analyzed in 36 participants. According to the Mini-Mental
State Examination results, participants were divided into the cognitive impairment group
and the control group. A force plate was used to register the center of pressure in the
sagittal and frontal plane, during two trials of maximum forward and backward body
leaning. [Results] Significant differences were shown in both forward and backward leaning
between the control and cognitive impairment groups. [Conclusion] The control of stability
in the sagittal plane during maximum forward and backward lean of the body in cognitively
impaired patients is similar to the results obtained by their healthy peers. However,
individuals with cognitive impairment demonstrated larger lateral oscillations, which may
be the reason for postural instability in this group, leading to an increased occurrence
of falls.
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Affiliation(s)
- Błażej Cieślik
- Faculty of Pedagogy, Jan Długosz University: Armii Krajowej 13/15, 42-200 Częstochowa, Poland
| | | | - Bożena Ostrowska
- Faculty of Physiotherapy, The University School of Physical Education, Poland
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Camara CTP, de Freitas SMSF, Lima CA, Amorim CF, Prado-Rico JM, Perracini MR. The walking cane length influences the postural sway of community-dwelling older women. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 25:e1804. [PMID: 31322813 DOI: 10.1002/pri.1804] [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: 11/23/2018] [Revised: 04/30/2019] [Accepted: 07/04/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Mobility-related problems in older people may be relieved by the use of walking canes. However, the influence of the cane length on the postural stability of cane users has not been explored. OBJECTIVE The objective of this study is to examine the influence of a single-point cane with different lengths on the postural sway of regular cane users, older women during two stance positions, with feet parallel and semi-tandem stance. METHODS Eighteen older women, who used a single-point walking cane for at least 6 months, stood on a force plate with feet parallel or in semitandem position for 40 s. They always used a cane that was adjusted to one of three different lengths resulting from the distance between the wrist crease and the floor, named WF, or this distance plus 7.5 or 10 cm. Amplitude and speed of the centre of pressure (COP) and its components (rambling and trembling) in the anterior-posterior and medial-lateral directions and mean vertical force applied to the cane were compared across cane lengths. RESULTS The amplitude and velocity of COP, rambling and trembling increased with the cane length. This effect was observed for the anterior-posterior with the feet parallel and in the medial-lateral direction with the semi-tandem position. More force was applied on the shorter cane (WF) in semitandem position. CONCLUSION Longer canes increased the postural sway in the older women and restricted the body weight loaded on the cane. Improper cane length influences the postural sway particularly in a semitandem stance of regular cane users. This may cause a negative impact on postural stability required in daily life activities. The current findings may contribute to the prescription of this assistive device for older adults.
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Affiliation(s)
- Camila Thais Pinto Camara
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Sandra Maria Sbeghen Ferreira de Freitas
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.,Department of Kinesiology, The Pennsylvania State University, PA, USA
| | - Camila Astolphi Lima
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - César Ferreira Amorim
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | | - Monica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.,Master's and Doctoral Programs in Gerontology, Faculty of Medicine, Universidade Estadual de Campinas, São Paulo, Brazil
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38
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Migliarese S, White E. Review of Forward-Head Posture and Vestibular Deficits in Older Adults. CURRENT GERIATRICS REPORTS 2019. [DOI: 10.1007/s13670-019-00292-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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McGough EL, Hsu LY, Thompson H, Teri L. Concurrent Validity of Postural Sway Measures in Older Adults with Cognitive Impairment. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2019; 36:399-410. [PMID: 31598029 DOI: 10.1080/02703181.2018.1556231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Aims To examine concurrent validity of inertial sensor (APDM ISway) versus force plate center of pressure (COP) measures of postural sway in cognitively impaired older adults. Methods Participants, mean age 85.6 (SD 4.8), were tested in 4 static standing conditions: (1) eyes open/normal base, (2) eyes open/narrow base, (3) eyes closed/normal base, and (4) eyes closed/narrow base. ISway and COP measures were collected. Results Strong correlations between ISway trunk sway smoothness [ISway JERK, (m 2 /s 5 )] and COP path length (r = 0.67-0.85) and COP mean velocity (r = 0.77-0.87); also ISway total sway acceleration path length/trail duration [ISway PATH, (m2/s2)] and COP path length (r = 0.77-0.87) and COP mean velocity (r = 0.77-0.91). Increased sway was detected in narrow versus normal base and eyes closed versus open conditions (P = .001). Conclusions APDM ISway demonstrated concurrent validity to force-plate COP and changes in postural sway were detected between conditions.
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Affiliation(s)
- Ellen L McGough
- Department of Rehabilitation Medicine, University of Washington
| | - Lin-Ya Hsu
- Department of Rehabilitation Medicine, University of Washington
| | | | - Linda Teri
- School of Nursing, University of Washington
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40
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Yamagata M, Popow M, Latash ML. Beyond rambling and trembling: effects of visual feedback on slow postural drift. Exp Brain Res 2019; 237:865-871. [PMID: 30635703 DOI: 10.1007/s00221-019-05470-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/04/2019] [Indexed: 11/24/2022]
Abstract
We explored one of the unusual predictions of the concept of back-coupling within the theoretical scheme of the control of posture and movement with setting referent coordinates for the effectors. This concept implies slow drifts of referent coordinates toward actual coordinates leading to unintentional drift in performance. During standing, such slow drifts may lead to a protective step or even a fall and, therefore, corrections are expected leading to body sway at frequencies under 0.1 Hz. Young healthy subjects stood on the force platform quietly for 60 s under two single-task conditions, with eyes open and closed, and two double-task conditions, matching an irrelevant muscle activation signal to a target (MATCH) and performing a subtraction task. The latter was performed with eyes open and closed. The rambling-trembling decomposition was applied to the displacements of the center of pressure in the anterior-posterior direction. Spectral analysis was used to quantify power within typical ranges for Tr and Rm, as well as for a slow Rm component (under 0.1 Hz) addressed as Drift. Closing eyes led to a significant increase in Rm and Tr, but no effects on Drift. Drift increased significantly in the MATCH task with no changes in Rm and a drop in Tr. No effects of the subtraction task were seen on Drift. Overall, our findings suggest that unintentional slow drift of referent body orientation towards the actual body orientation leads to Drift, a specific example of back-coupling reflected in postural sway. This observation can be also seen as an example of physiological minimization of activity of motoneurons. Natural visual feedback is used to avoid the COP drift and/or correct it quickly and effectively; this ability is compromised when vision is used for an unrelated task.
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Affiliation(s)
- Momoko Yamagata
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-268N, University Park, PA, 16802, USA.,Department of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Marta Popow
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-268N, University Park, PA, 16802, USA
| | - Mark L Latash
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-268N, University Park, PA, 16802, USA.
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Danna-Dos-Santos A, Magalhães AT, Silva BA, Duarte BS, Barros GL, Silva MDFC, Silva CS, Mohapatra S, Degani AM, Cardoso VS. Upright balance control strategies during pregnancy. Gait Posture 2018; 66:7-12. [PMID: 30134216 DOI: 10.1016/j.gaitpost.2018.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/16/2018] [Accepted: 08/07/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Morphological and physiological changes during pregnancy are considered to interfere with the mechanisms of postural control and potentially increase the risk of falling. A clear understanding of these mechanisms is important to improve pre-natal care and reduce the fall risk in this population. OBJECTIVES This study focused on investigating how pregnancy affects postural control in each trimester of pregnancy by analyzing pelvic inclination and body sway behavior. Our main hypothesis was that balance control and posture would change during pregnancy. More specifically, pregnancy would increase sway amplitude, anterior pelvic tilt, and body sway regularity in time. STUDY DESIGN Forty women formed four groups: non-pregnant women (NP) and women at their first, second, and third trimester of pregnancy (P1, P2, and P3, respectively). All participants performed (1) postural evaluation of the pelvic inclination using a digital system of postural analysis and (2) instrumented posturography using a force platform to collect the coordinates of the body's center of pressure (COP) during quiet bipedal stance for 120 s. Kruskal-Wallis H test and post-hoc Mann-Whitney U tests were used to investigate the effects of pregnancy (NP, P1, P2, and P3) on pelvic inclination angle and postural indices computed from the COP signals. RESULTS Results revealed significant larger body sway accompanied by a more regular medial-lateral pattern of oscillation and a more synchronized anterior-posterior and medial-lateral sway already at the first trimester of pregnancy. The averaged COP migrated posteriorly at third trimester of pregnancy and the anterior pelvic tilt increased at second and third trimesters. CONCLUSIONS Our results indicate the existence of changes in posture and balance metrics even at early stages of pregnancy. We suggest the use of posturography as one of screening tools for postural instability and fall risk during pregnancy.
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Affiliation(s)
- Alessander Danna-Dos-Santos
- Department of Physical Therapy, Western Michigan University, 1903W Michigan Ave., Kalamazoo, MI 49008-5383, USA; Synergy Applied Medical and Research, Missoula, MT, USA.
| | - Alessandra T Magalhães
- Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil.
| | - Baldomero A Silva
- Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil.
| | - Biara S Duarte
- Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil.
| | - Glena L Barros
- Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil.
| | - Maria De Fátima C Silva
- Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil.
| | - Cristiano S Silva
- Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil.
| | | | | | - Vinicius S Cardoso
- Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil.
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Antônio AM, Guirro ECDO, Dos Santos TP, Ferreira VTK, Silva MLD, de Araujo JE. Lower limb auriculotherapy points improves balance in young healthy subjects-assessed by computerized baropodometry. Complement Ther Clin Pract 2018; 32:46-50. [PMID: 30057056 DOI: 10.1016/j.ctcp.2018.05.001] [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: 02/05/2018] [Revised: 04/26/2018] [Accepted: 05/03/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To analyze the effects of Lower Limb (LL) auricular stimulation points on the static equilibrium of healthy subjects, assessed by computerized baropodometry. METHODS AND MATERIALS Forty volunteers were assigned to one of two groups: Auriculotherapy (AT) who received unilateral needle stimulation of the coxofemoral, knee, and ankle points. Control (C) who did not receive any stimulation. We analyzed the contact area (CA) and the peak pressure (PP) for both feet at baseline, 20 and 25 min after the baseline was recorded. Three-Way ANOVA (P < 0.05) was used for data analysis. RESULTS AT showed an increase in CA (F:6.49) and a decrease in PP (F:3.11) at 20 and 25 min, when compared to C. The PP decreased was only for the right LL at 20 and 25 min (F:6.45). CONCLUSION The auriculotherapy points were able to modify the ipsilateral weight discharge on the same side of the stimulated auricular pavilion.
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Affiliation(s)
- Amanda Machado Antônio
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Elaine Caldeira de Oliveira Guirro
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Tamyris Padovani Dos Santos
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Vânia Tiê Koga Ferreira
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Marcelo Lourenço da Silva
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - João Eduardo de Araujo
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
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