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Mullin RL, Smith R, Wood S, Swampillai A, Afridi S. Reliability of functional outcome measures in adults with neurofibromatosis 2. SAGE Open Med 2022; 10:20503121221118996. [PMID: 36003079 PMCID: PMC9393935 DOI: 10.1177/20503121221118996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To determine inter- and intra-rater reliability of functional performance outcome measures in people with neurofibromatosis 2. To ascertain how closely objective and subjective measures align. Methods Twenty-nine people with neurofibromatosis 2 were recorded performing the modified clinical test of sensory integration and balance, four square step test and modified nine-hole peg tests. Three raters scored each measure to determine inter-rater reliability. One rater scored the measures a second time to determine intra-rater reliability. Participants also completed a disease-specific quality of life questionnaire and dynamic visual acuity testing. Results Inter-rater and intra-rater reliability scores (intra-class correlation coefficient) were excellent for all tests (intra-class correlation coefficient r ⩾ 0.9). The four square step test correlated with perceived walking challenges and modified clinical test of sensory integration and balance correlated with perceived balance challenges in a neurofibromatosis 2 quality of life patient report outcome measure. Conclusion The modified clinical test of sensory integration and balance, four square step test and modified nine-hole peg tests are potentially useful measures for monitoring neurofibromatosis 2.
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Affiliation(s)
- Rebecca Louise Mullin
- National Centre for Neurofibromatosis, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Department of Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Rebecca Smith
- National Centre for Neurofibromatosis, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Department of Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Susan Wood
- National Centre for Neurofibromatosis, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Angela Swampillai
- National Centre for Neurofibromatosis, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Shazia Afridi
- National Centre for Neurofibromatosis, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Asai H, Murakami S, Morimoto H, Asai Y, Johnson EG, Yamashita Y, Horiba M, Mizutani Y, Kabaya K, Ueki Y. Effects of a walking program in patients with chronic unilateral vestibular hypofunction. J Phys Ther Sci 2022; 34:85-91. [PMID: 35221509 PMCID: PMC8860696 DOI: 10.1589/jpts.34.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/11/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Patients with chronic unilateral vestibular hypofunction show decreased
postural stability and low levels of physical activity and also experience much anxiety.
Physical activity is known to improve these symptoms; however, no study has reported any
positive effects of physical activity, such as symptom reduction or improvement in
function in these patients. In this study, we investigated the role of a walking program
in improvement of dizziness, anxiety, and postural stability in this patient population.
[Participants and Methods] This study included 21 patients with unilateral vestibular
hypofunction and chronic dizziness. Patients were instructed to walk 30 min daily for 3
months. Physical activity levels and questionnaires for clinical symptoms, anxiety, and
postural stability were evaluated before and after intervention. [Results] We observed
significant differences in the amount of moderate-to-vigorous physical activity, clinical
symptoms, and self-perceived handicap before and after the intervention. Additionally,
anxiety levels were significantly reduced and postural stability was significantly
improved in these patients. [Conclusion] A walking program improved physical activity
levels, clinical symptoms, and postural stability and reduced self-perceived handicap and
anxiety in patients with chronic unilateral vestibular hypofunction. These results
highlight the effectiveness of a walking program for these patients and emphasize its role
as a complementary vestibular rehabilitation strategy.
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Affiliation(s)
- Hayato Asai
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University: 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Satona Murakami
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University: 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Hiroyuki Morimoto
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University: 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.,Department of Rehabilitation, Mizutani Hospital, Japan
| | - Yuji Asai
- Department of Physical Therapy, School of Health Science, Nihon Fukushi University, Japan
| | - Eric G Johnson
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, USA
| | - Yutaka Yamashita
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University: 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Mitsuya Horiba
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University: 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Yoko Mizutani
- Department of Orthopedic Surgery, Mizutani Hospital, Japan
| | - Kayoko Kabaya
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, Japan
| | - Yoshino Ueki
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University: 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
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Does sensorimotor training influence neuromuscular responses, balance, and quality of life in diabetics without a history of diabetic distal polyneuropathy? J Bodyw Mov Ther 2021; 27:148-156. [PMID: 34391226 DOI: 10.1016/j.jbmt.2021.01.012] [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: 08/06/2020] [Revised: 12/31/2020] [Accepted: 01/23/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the effect of supervised and home sensorimotor training on static postural balance (SPB), quality of life (QL), and neuromuscular responses of Type 2 Diabetics (DM-2). DESIGN Randomized controlled blind study with DM-2 patients, between 45 and 64 years old, of both sexes, divided into 3 groups: Control Group - CG (n = 27), Home Training Group - HTG (n = 27), and Supervised Training Group - STG (n = 26). The subjects were evaluated before and at the end of 3 months of treatment, with a four-week follow-up. The intervention was held twice a week, for 45 min, divided into three phases: warm-up, sensorimotor training, and cool-down. The primary outcome was SPB, using the force platform. Secondary outcome: questionnaires and clinical measures related to diabetic foot and knee flexor-extensors using isokinetic dynamometry. RESULTS In the baseline, the characteristics were similar between groups and between times. Tactile and vibratory sensitivity demonstrated the absence of symptoms of peripheral neuropathy in diabetic patients. In the intra-group comparison, there was a significant increase in the classification without symptoms of diabetic distal polyneuropathy in the HTG and STG groups (p < 0.05) and there were no significant effects on other clinical outcomes and QL and SPB, muscle strength, and sense of knee joint position. CONCLUSION The intervention showed no improvement in SPB, QL, and other clinical outcomes of DM-2 patients. Thus, no differences were found between the groups, considering that the patients did not present clinical characteristics of diabetic distal polyneuropathy.
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Borges NCDS, Pletsch AHM, Buzato MB, Terada NAY, Cruz FMFD, Guirro RRDJ. The effect of proprioceptive training on postural control in people with diabetes: A randomized clinical trial comparing delivery at home, under supervision, or no training. Clin Rehabil 2021; 35:988-998. [PMID: 33508955 DOI: 10.1177/0269215521989016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Analyze postural control in the bipedal position as well as during gait and functional tests in patients with type 2 diabetes mellitus after supervised and unsupervised proprioceptive training. DESIGN A three-group randomized controlled trial. SETTING Physiotherapeutic Resources Lab, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo. SUBJECTS Eighty patients with type 2 diabetes allocated to three groups: control, home training, and supervised training. INTERVENTIONS The supervised and home training groups performed two weekly sessions of proprioceptive exercises for 12 weeks. The control group was not submitted to any of treatment. MAIN MEASURES Bipedal balance, gait, and performance on functional tests were evaluated before and after 12 weeks using the Balance Evaluation Systems Test (BESTest) and the force plate. RESULTS No significant improvements were found regarding postural control, gait, or performance on the functional tests, as evidenced by the inter-group comparisons of the total BESTest score [control: 90.7 (81.5-92.6); home training: 85.2 (77.8-90.3); supervised training: 88.4 (82.6-91.4), P > 0.05] as well as the tests performed on the force plate (P > 0.05). The clinical effect size of the proposed intervention was less than 0.2, demonstrating no effect for the main outcome variable evaluated by the "Sensory Orientation" item of the BESTest and by the mCTSIB (pressure plate). CONCLUSIONS The proposed proprioceptive training did not lead to improvements in postural control in patients with type 2 diabetes with no clinical signs of diabetic distal polyneuropathy when analyzed using the BESTest clinical evaluation and a force plate. TRIAL REGISTRATION NCT01861392 (clinicaltrials.gov).
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Affiliation(s)
- Nathalia Cristina de Souza Borges
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Ariane Hidalgo Mansano Pletsch
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Mariana Barbosa Buzato
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Natalia Akemi Yamada Terada
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Fernanda Maria Ferreira da Cruz
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Rinaldo Roberto de Jesus Guirro
- Laboratory of Physiotherapeutic Resources, Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
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Boonsinsukh R, Khumnonchai B, Saengsirisuwan V, Chaikeeree N. The effect of the type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) on the accuracy in identifying older adults with fall history. Hong Kong Physiother J 2020; 40:133-143. [PMID: 33005077 PMCID: PMC7526061 DOI: 10.1142/s1013702520500134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background The type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) influences the accuracy with which elderly fallers are identified. Two types of foam are commonly used in practice: Airex and Neurocom foam. Objective The aim of this study was to assess the accuracy with which elderly fallers can be identified when the Airex foam and Neurocom foam are used in the mCTSIB. Methods One hundred eighty-four elderly participants with a mean age of 69 years were classified into faller and nonfaller groups based on their 12-month fall history. Balance stability was measured under four conditions of the mCTSIB for 120 s each: standing on a floor or a foam pad with their eyes open or eyes closed. The time needed to maintain stability was measured by a stopwatch, and postural sway characteristics were measured using an acceleration-based system. Comparisons between groups were performed by two-way mixed ANOVA. The accuracy of differentiating elderly fallers from nonfallers with different foam types was evaluated using receiver operating characteristic curve (ROC) analysis. The time to maintain stability under four conditions of the mCTSIB (composite score) and under two conditions on the foam (foam score) were used for the ROC analysis. Results The results showed that the nonfallers required more time to maintain stability and had a smaller sway area than the fallers ( p < 0 . 001 ). The foam led to a larger difference between groups, suggesting the use of foam in examining the risk of falls. The Airex and the Neurocom foam pads led to a large area under the curve (0.93 to 0.95) in identifying elderly fallers and nonfallers when the composite and foam scores were used. A cutoff score of 447/480 s for the composite score and 223/240 s for the foam score yielded a posttest accuracy of 88% to 89%, with a sensitivity of 0.80-0.92 and specificity of 0.88-0.95. Conclusion In conclusion, Airex and Neurocom foam can be used interchangeably with guidance in the mCTSIB, as they led to the accurate identification of elderly fallers among older persons who could walk and live independently in the community.
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Affiliation(s)
- Rumpa Boonsinsukh
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Bodin Khumnonchai
- Faculty of Physical Therapy and Sport Medicine, Rangsit University, Pathum Thani, Thailand
| | | | - Nithinun Chaikeeree
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
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Comparison of posturographic outcomes between two different devices. J Biomech 2019; 86:218-224. [PMID: 30827702 DOI: 10.1016/j.jbiomech.2019.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/10/2019] [Accepted: 02/17/2019] [Indexed: 11/24/2022]
Abstract
The Interactive Balance System (IBS), a posturography device for assessing posture control, is widely used in clinical and rehabilitation settings. However, data on the validity of the device are unavailable. Fluctuations of the center of pressure (COP) were measured in 24 healthy participants (age: 29 ± 5 (mean ± SD) years, 12 females) synchronously using the IBS, which was rigidly mounted on a Kistler platform. Four different bipedal conditions were examined: eyes open or closed on stable or soft surfaces. Time series were compared using congruity (CON, proportion of the measurement time during which values of both devices changed similarly in direction), whereas IBS-specific postural outcomes were correlated with traditional postural control outcomes of the Kistler force platform. The time-displacement curves showed similar shapes for CON (>0.9) for each of the four standing conditions without differences between male and female participants (P > 0.39). The path length results of both devices showed very high linear associations, explaining on average 92% (medio-lateral) or 96% (anterior-posterior) of the common variance. The Kistler path length of the anterior-posterior direction revealed nearly perfect linear associations with the stability index of the IBS (r2 > 0.99). The results of this study indicate that the IBS provides valid posturographic results. Since the medial-lateral and anterior-posterior trajectories of the IBS can be used to calculate COP fluctuations, comparisons between different measurement systems are possible.
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Cripps A, Livingston S, Jiang Y, Mattacola C, Kitzman P, McKeon P, Dressler E, Quintana C. Visual perturbation impacts upright postural stability in athletes with an acute concussion. Brain Inj 2018; 32:1566-1575. [PMID: 30047794 DOI: 10.1080/02699052.2018.1497812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The impact that visual perturbation has on upright postural stability in an athlete with a concussion has not been established. The present study aimed to characterize the influence that visual perturbation stimuli have on upright balance among athletes with acute concussions. DESIGN A 2X2X2 repeated measure designed was used. METHOD The present study examined the influence visual perturbation has on individuals suffering from an acute concussion. Fourteen participants (7 with a concussion and 7 matched controls) underwent various balance assessments with and without visual perturbation. RESULTS Overall, athletes with acute concussions demonstrated impairments in balance 24-48 hours following a concussion. However, when assessed using a visual perturbation task, athletes with acute concussions demonstrated improved balance, while control subjects did not show any significant changes during the same visual perturbation task. CONCLUSION An athlete's ability to disregard visual perturbation stimuli is imperative for successful participation in sports. Due to the observed alterations in balance when given a visual perturbation task, it is suggested that athletes with acute concussions place more attention on the balance task and may disregard other less meaningful tasks.
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Affiliation(s)
- Andrea Cripps
- a School of Human Movement Sport and Leisure Studies , Bowling Green State University , Bowling Green , OH , USA
| | - Scott Livingston
- b Defense of Veterans Brain Injury , Defense Center of Excellence for Psychological Health and Traumatic Brain Injury Center , Silver Springs , MD , USA
| | - Yang Jiang
- c Behavioral Science , University of Kentucky , Lexington KY , USA
| | - Carl Mattacola
- d Department of Rehabilitation Science , University of Kentucky , Lexington KY , USA
| | - Patrick Kitzman
- d Department of Rehabilitation Science , University of Kentucky , Lexington KY , USA
| | - Patrick McKeon
- e School of Health Science and Human Performance , Ithaca College , Ithaca , NY , USA
| | - Emily Dressler
- f Department of Biostatistical Sciences Wake Forest University , Winston Salem , NC , USA
| | - Carolina Quintana
- d Department of Rehabilitation Science , University of Kentucky , Lexington KY , USA
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Morimoto H, Asai Y, Johnson EG, Koide Y, Niki J, Sakai S, Nakayama M, Kabaya K, Fukui A, Mizutani Y, Mizutani T, Ueki Y, Mizutani J, Ueki T, Wada I. Objective measures of physical activity in patients with chronic unilateral vestibular hypofunction, and its relationship to handicap, anxiety and postural stability. Auris Nasus Larynx 2018; 46:70-77. [PMID: 30691599 DOI: 10.1016/j.anl.2018.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 05/13/2018] [Accepted: 06/22/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Dizziness is one of the most common symptoms in the general population. Patients with dizziness experience balance problems and anxiety, which can lead to decreased physical activity levels and participation in their daily activities. Moreover, recovery of vestibular function from vestibular injury requires physical activity. Although there are reports that decreased physical activity is associated with handicap, anxiety, postural instability and reduced recovery of vestibular function in patients with chronic dizziness, these data were collected by self-report questionnaires. Therefore, the objective data of physical activity and the relationships between physical activity, handicap, anxiety and postural stability in patients with chronic dizziness are not clear. The purpose of this research was to objectively measure the physical activity of patients with chronic dizziness in daily living as well as handicap, anxiety and postural stability compared to healthy adults. Additionally, we aimed to investigate the relationships between physical activity, handicap, anxiety and postural stability in patients with chronic dizziness. METHODS Twenty-eight patients with chronic dizziness of more than 3 months caused by unilateral vestibular hypofunction (patient group) and twenty-eight age-matched community dwelling healthy adults (healthy group) participated in this study. The amount of physical activity including time of sedentary behavior, light physical activity, moderate to vigorous physical activity and total physical activity using tri-axial accelerometer, self-perceived handicap and anxiety using questionnaires, and postural stability were measured using computerized dynamic posturography. RESULTS The results showed worse handicap, anxiety and postural stability in the patient group compared to the healthy group. Objective measures of physical activity revealed that the patient group had significantly longer time of sedentary behavior, shorter time of light physical activity, and shorter time of total physical activity compared to the healthy group; however, time of moderate to vigorous physical activity was not significantly different between groups. Moreover, there were correlations between physical activity and postural stability in the patient group, while there were no correlations between physical activity, handicap or anxiety in the patient group. CONCLUSION These results suggest that objectively measured physical activity of the patients with chronic unilateral vestibular hypofunction is lower compared to the healthy adults, and less active patients showed decreased postural stability. However, the details of physical activity and causal effect between physical activity and postural stability were not clear and further investigation is needed.
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Affiliation(s)
- Hiroyuki Morimoto
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; Department of Rehabilitation, Mizutani Hospital, 3-4-1, Kanayama-cho, Atsuta-ku, Nagoya 456-0002, Japan
| | - Yuji Asai
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; Department of Physical Therapy, School of Health Science, Nihon Fukushi University, 2-26, Higashihaemi-cho, Handa 475-0012, Japan
| | - Eric G Johnson
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, 24951, Circle Drive, Loma Linda, CA 92354, USA
| | - Yoshinori Koide
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Junichi Niki
- Department of Rehabilitation, Mizutani Hospital, 3-4-1, Kanayama-cho, Atsuta-ku, Nagoya 456-0002, Japan
| | - Shigeki Sakai
- Department of Rehabilitation, Mizutani Hospital, 3-4-1, Kanayama-cho, Atsuta-ku, Nagoya 456-0002, Japan
| | - Meiho Nakayama
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
| | - Kayoko Kabaya
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Ayako Fukui
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Yoko Mizutani
- Department of Orthopedics, Mizutani Hospital, 3-4-1, Kanayama-cho, Atsuta-ku, Nagoya 456-0002, Japan
| | - Takehiko Mizutani
- Department of Orthopedics, Mizutani Hospital, 3-4-1, Kanayama-cho, Atsuta-ku, Nagoya 456-0002, Japan
| | - Yoshino Ueki
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Jun Mizutani
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Takatoshi Ueki
- Department of Integrative Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Ikuo Wada
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
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Carender WJ, Grzesiak M. Vestibular rehabilitation following surgical repair for Superior Canal Dehiscence Syndrome: A complicated case report. Physiother Theory Pract 2017; 34:146-156. [PMID: 28891720 DOI: 10.1080/09593985.2017.1374491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Superior Canal Dehiscence Syndrome (SCDS) causes auditory and vestibular symptoms. Following surgical repair of the dehiscence, patients often experience dizziness and imbalance. This case report describes a postoperative vestibular exercise program, focusing on the principles of central compensation and habituation, and how it was modified for a patient with delayed progress secondary to strabismus and visual vertigo. A 63-year-old male with history of strabismus eye surgery, right hearing loss, aural fullness, and sensitivity to loud sounds was referred for vestibular rehabilitation (VR). He was seen for one preoperative and six postoperative PT visits over eight months. Outcome measures two weeks postoperative were as follows: Dizziness Handicap Inventory (DHI) 38/100; Timed Up & Go (TUG) 9.92 seconds; Dynamic Gait Index (DGI) 16/24; and a 3-line difference in Dynamic Visual Acuity (DVA). Improved outcomes at discharge included: DHI 18/100; TUG 6.87 seconds; DGI 23/24; and 1-line difference in DVA. He was able to return to work and previously enjoyed recreational activities. Postoperative vestibular rehabilitation programs are functionally and symptomatically beneficial following surgical repair for SCDS. Deviations from expected recovery should be addressed to achieve optimal outcomes as demonstrated in this complicated case report.
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Affiliation(s)
- Wendy J Carender
- a Department of Otolaryngology-Head and Neck Surgery , University of Michigan , Ann Arbor , MI , USA
| | - Melissa Grzesiak
- a Department of Otolaryngology-Head and Neck Surgery , University of Michigan , Ann Arbor , MI , USA
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Gur G, Ozkal O, Dilek B, Aksoy S, Bek N, Yakut Y. Effects of Corrective Taping on Balance and Gait in Patients With Hallux Valgus. Foot Ankle Int 2017; 38:532-540. [PMID: 28271903 DOI: 10.1177/1071100716683347] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Taping is an effective temporary therapy for improving hallux valgus (HV) in adults. Although HV has been demonstrated to impair postural balance, there is a lack of information about how corrective taping affects balance and gait patterns in adults with HV deformity. METHODS Eighteen middle-aged female patients (average age, 53.5 years) with HV were included. Corrective tape was applied to correct HV angulation. A series of balance and gait stability tests were performed before applying tape and 1 hour after the tape was applied with a Balance Master computerized posturography device. The study involved the following tests: modified clinical test of sensory interaction and balance (mCTSIB), unilateral stance (US), limit of stability (LoS), step up/over (SUO), and walk across (WA) tests. RESULTS No significant difference was found between the no-tape and taped condition in the static balance mCTSIB and US tests ( P > .05). The taping intervention resulted in significant improvement in the dynamic balance measures for the LoS test's backward reaction time and left maximum excursion ( P < .05), a significantly higher impact index bilaterally in the SUO assessment ( P < .05), and an increase in step width mean and variability in the WA test ( P < .05). CONCLUSIONS Taping for correcting HV angulation had negative acute effects on dynamic balance in the SUO and WA tests and positive effects in the LoS test. CLINICAL RELEVANCE Corrective taping, although a form of conservative treatment for hallux valgus, has been insufficiently studied in terms of effects on balance. Our results show that taping, as an acute effect, may impair balance in middle-aged adults when walking or ascending and descending stairs.
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Affiliation(s)
- Gozde Gur
- 1 Orthotics and Biomechanics Department, School of Physical Therapy and Rehabilitation Sciences, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ozden Ozkal
- 1 Orthotics and Biomechanics Department, School of Physical Therapy and Rehabilitation Sciences, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Burcu Dilek
- 2 Medipol University, Department of Physical Therapy and Rehabilitation, Kavacik, Istanbul, Turkey
| | - Songul Aksoy
- 3 Department of Audiology, Voice and Speech Disorders, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Nilgun Bek
- 1 Orthotics and Biomechanics Department, School of Physical Therapy and Rehabilitation Sciences, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Yavuz Yakut
- 4 Physiotherapy and Rehabilitation Department, Hasan Kalyoncu University, Gaziantep, Turkey
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Rahal MA, Alonso AC, Andrusaitis FR, Rodrigues TS, Speciali DS, Greve JMDA, Leme LEG. Analysis of static and dynamic balance in healthy elderly practitioners of Tai Chi Chuan versus ballroom dancing. Clinics (Sao Paulo) 2015; 70:157-61. [PMID: 26017644 PMCID: PMC4449465 DOI: 10.6061/clinics/2015(03)01] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 12/08/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To determine whether Tai Chi Chuan or ballroom dancing promotes better performance with respect to postural balance, gait, and postural transfer among elderly people. METHODS We evaluated 76 elderly individuals who were divided into two groups: the Tai Chi Chuan Group and the Dance Group. The subjects were tested using the NeuroCom Balance Master¯ force platform system with the following protocols: static balance tests (the Modified Clinical Tests of Sensory Interaction on Balance and Unilateral Stance) and dynamic balance tests (the Walk Across Test and Sit-to-stand Transfer Test). RESULTS In the Modified Clinical Test of Sensory Interaction on Balance, the Tai Chi Chuan Group presented a lower sway velocity on a firm surface with open and closed eyes, as well as on a foam surface with closed eyes. In the Modified Clinical Test of Sensory Interaction on Unilateral Stance, the Tai Chi Chuan Group presented a lower sway velocity with open eyes, whereas the Dance Group presented a lower sway velocity with closed eyes. In the Walk Across Test, the Tai Chi Chuan Group presented faster walking speeds than those of the Dance Group. In the Sit-to-stand Transfer Test, the Tai Chi Chuan Group presented shorter transfer times from the sitting to the standing position, with less sway in the final standing position. CONCLUSION The elderly individuals who practiced Tai Chi Chuan had better bilateral balance with eyes open on both types of surfaces compared with the Dance Group. The Dance Group had better unilateral postural balance with eyes closed. The Tai Chi Chuan Group had faster walking speeds, shorter transfer times, and better postural balance in the final standing position during the Sit-to-stand Test.
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Affiliation(s)
- Miguel Antônio Rahal
- Instituto de Ortopedia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Angélica Castilho Alonso
- Movement Studies Laboratory, Instituto de Ortopedia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Felix Ricardo Andrusaitis
- Movement Studies Laboratory, Instituto de Ortopedia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Thuam Silva Rodrigues
- Movement Studies Laboratory, Instituto de Ortopedia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Danielli Souza Speciali
- Movement Studies Laboratory, Instituto de Ortopedia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Schwesig R, Fischer D, Becker S, Lauenroth A. Intraobserver reliability of posturography in patients with vestibular neuritis. Somatosens Mot Res 2013; 31:28-34. [PMID: 23952248 DOI: 10.3109/08990220.2013.822364] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to establish the intraobserver reliability of a posturographic method in patients (n = 34) with vestibular neuritis. Intraclass correlation coefficients (relative reliability) for all parameters and test positions (ALL(mean)) ranged from 0.71 (95% CI: 0.41-0.85) to 0.92 (95% CI: 0.84-0.96). Absolute reliability (coefficient of variation) ranged between 3.1% (95% CI: 2.60-8.67) and 42.3% (95% CI: 40.7-74.5). Reliability of single test positions is much lower. The posturographic system showed good relative and satisfactory absolute intraobserver reliability for ALL(mean).
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Affiliation(s)
- René Schwesig
- Sport-Science, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale) , Halle , Germany
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Schwesig R, Becker S, Fischer D. Intraobserver reliability of posturography in healthy subjects. Somatosens Mot Res 2013; 31:16-22. [PMID: 23914808 DOI: 10.3109/08990220.2013.819797] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Reliability of posturography is essential for the identification of intervention effects in any setting (e.g., sport, rehabilitation). The purpose was to establish the intraobserver reliability of a posturographic method in asymptomatic subjects (n = 30). Intraclass correlation coefficients (relative reliability) for every parameter and all test positions (ALL(mean)) ranged from 0.78 (95% CI: 0.53-0.90) to 0.95 (95% CI: 0.89-0.97). Absolute reliability, quantified by using the coefficient of variation, ranged between 3.5 and 19.8. Reliability of single test positions is much lower. The posturographic system showed good relative and satisfactory absolute intraobserver reliability for ALL(mean).
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Affiliation(s)
- René Schwesig
- Sport-Science, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale) , Halle , Germany and
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Tomomitsu MSV, Alonso AC, Morimoto E, Bobbio TG, Greve JMD. Static and dynamic postural control in low-vision and normal-vision adults. Clinics (Sao Paulo) 2013; 68:517-21. [PMID: 23778351 PMCID: PMC3634964 DOI: 10.6061/clinics/2013(04)13] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 12/23/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the influence of reduced visual information on postural control by comparing low-vision and normal-vision adults in static and dynamic conditions. METHODS Twenty-five low-vision subjects and twenty-five normal sighted adults were evaluated for static and dynamic balance using four protocols: 1) the Modified Clinical Test of Sensory Interaction on Balance on firm and foam surfaces with eyes opened and closed; 2) Unilateral Stance with eyes opened and closed; 3) Tandem Walk; and 4) Step Up/Over. RESULTS The results showed that the low-vision group presented greater body sway compared with the normal vision during balance on a foam surface (p≤0.001), the Unilateral Stance test for both limbs (p≤0.001), and the Tandem Walk test. The low-vision group showed greater step width (p≤0.001) and slower gait speed (p≤0.004). In the Step Up/Over task, low-vision participants were more cautious in stepping up (right p≤0.005 and left p≤0.009) and in executing the movement (p≤0.001). CONCLUSION These findings suggest that visual feedback is crucial for determining balance, especially for dynamic tasks and on foam surfaces. Low-vision individuals had worse postural stability than normal-vision adults in terms of dynamic tests and balance on foam surfaces.
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Affiliation(s)
- Mônica S V Tomomitsu
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Institute of Orthopedics and Traumatology, Movement Study Laboratory, São Paulo/SP, Brazil
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Rahal MA, Andrusaitis FR, Rodrigues TS, Alonso AC, Greve JMDA, Leme LEG. Gait, posture and transfer assessment among elderly practitioners and non-practitioners of Tai Chi Chuan. Health (London) 2013. [DOI: 10.4236/health.2013.512a016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Quantification of Static and Dynamic Balance While Maintaining and Changing Body Position. TOPICS IN GERIATRIC REHABILITATION 2012. [DOI: 10.1097/tgr.0b013e318233e879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Relationship between dynamic balance measures and functional performance in community-dwelling elderly people. Phys Ther 2010; 90:748-60. [PMID: 20223944 DOI: 10.2522/ptj.20090100] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Poor balance control, mobility restrictions, and fall injuries are serious problems for many older adults. OBJECTIVE The purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults. DESIGN This was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital. METHOD A Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed "Up & Go" Test, gait speed, and the Six-Minute Walk Test. Participants were classified as "fallers" or "nonfallers" based on a self-report. RESULTS No significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed "Up & Go" Test was able to differentiate between the faller and nonfaller groups. Limitations A prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample. CONCLUSIONS The findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.
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A Case-Oriented Approach Exploring the Relationship Between Visual and Vestibular Disturbances and Problems of Higher-Level Mobility in Persons With Traumatic Brain Injury. J Head Trauma Rehabil 2010; 25:193-205. [DOI: 10.1097/htr.0b013e3181dc82fa] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Getting Grounded Gracefully©: Effectiveness and Acceptability of Feldenkrais in Improving Balance. J Aging Phys Act 2009; 17:57-76. [DOI: 10.1123/japa.17.1.57] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The Getting Grounded Gracefully© program, based on the Awareness Through Movement lessons of the Feldenkrais method, was designed to improve balance and function in older people. Fifty-five participants (mean age 75, 85% women) were randomized to an intervention (twice-weekly group classes over 8 wk) or a control group (continued with their usual activity) after being assessed at baseline and then reassessed 8 wk later. Significant improvement was identified for the intervention group relative to the control group using ANOVA between-groups repeated-measures analysis for the Modified Falls Efficacy Scale score (p= .003) and gait speed (p= .028), and a strong trend was evident in the timed up-and-go (p= .056). High class attendance (88%) and survey feedback indicate that the program was viewed positively by participants and might therefore be acceptable to other older people. Further investigation of the Getting Grounded Gracefully program is warranted.
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