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Shimabukuro S, Miyake T, Tamaki E. Analyzing the Differences in the Degree of Force Application Between Novice and Expert Physiotherapists Using a Muscle Deformation Sensor. Cureus 2024; 16:e59801. [PMID: 38846215 PMCID: PMC11155435 DOI: 10.7759/cureus.59801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Training physiotherapists require substantial experience and a lengthy period of time to achieve proficiency. However, establishing an objective method for quantifying the degree of force applied during treatment remains elusive, making training difficult. OBJECTIVES This study aims to clarify the difference in the degree of force application between novice and expert physiotherapists using muscle deformation sensors and to assist in teaching. METHODS A muscle deformation sensor array was utilized to capture the muscle bulging (muscle deformation), and the degree of force was visualized. The experiment involved two types of physiotherapy: upper and lower extremity exercises. Subsequently, the muscle deformation value and standard deviations of the muscle deformation data obtained were compared. RESULTS Significant differences between novices and experts were observed in forearm muscle deformation values and standard deviations across both types of physiotherapies (p<0.05). Additionally, a distinction was observed in the left lower limb flexor muscles during upper extremity exercise (p<0.05). CONCLUSION The results of this survey showed notable differences in the degree of force application between novices and experts, as demonstrated by our findings. Moreover, these implications extend beyond physiotherapy to sports, hobbies, and the teaching of traditional skills.
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Affiliation(s)
- Satoshi Shimabukuro
- Graduate School of Engineering and Science, The University of the Ryukyus, Nishihara, JPN
| | - Tamon Miyake
- Future Robotics Organization, Waseda University, Tokyo, JPN
| | - Emi Tamaki
- Graduate School of Engineering and Science, The University of the Ryukyus, Nishihara, JPN
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2
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Iwasa S, Akaguchi R, Okuno H, Nakanishi K, Ueta K, Morioka S. Changes in Standing Postural Control Ability in a Case of Spinocerebellar Ataxia Type 31 With Physical Therapy Focusing on the Center of Gravity Sway Variables and Lower Leg Muscle Activity. Cureus 2023; 15:e51033. [PMID: 38264384 PMCID: PMC10805122 DOI: 10.7759/cureus.51033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2023] [Indexed: 01/25/2024] Open
Abstract
Spinocerebellar degeneration (SCD) is a progressive disease characterized by cerebellar ataxia or the posterior spinal cord. Among these, spinocerebellar ataxia type 31 (SCA31) is genetically more common in the Japanese population and is characterized by pure ataxia, resulting in severe disturbances in postural balance, with common falls. Therefore, rehabilitation is important to improve postural balance. Light touch is a known method of reducing postural sway, which acts with the light touching of an object with the body. We herein present a case of a patient with SCA31 who was trained in a standing position by lightly touching the back of the body to a wall surface. Dynamic interarticular coordination exercises were also performed as part of the rehabilitation program. As a result, even in the progressive SCA31, improvements in standing postural balance and activities of daily living contributed to improvements in the patient's postural balance. We followed the progress of postural control ability using the center of gravity sway measurement and electromyography and described some interesting characteristics of the patient's postural control ability in this report.
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Affiliation(s)
- Shiori Iwasa
- Physical Therapy, Faculty of Health Sciences, Kio University, Nara, JPN
| | - Ryo Akaguchi
- Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, JPN
- Rehabilitation, Setsunan General Hospital, Osaka, JPN
| | | | - Koji Nakanishi
- Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, JPN
| | - Kozo Ueta
- Physical Medicine and Rehabilitation, Neurorehabilitation Research Center, Kio University, Nara, JPN
| | - Shu Morioka
- Physical Medicine and Rehabilitation, Neurorehabilitation Research Center, Kio University, Nara, JPN
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3
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Alammari BJ, Lee Y, Aruin AS. The effect of a contralateral foot touch on stability of one-leg stance in young adults: an exploratory study. Somatosens Mot Res 2023:1-10. [PMID: 37965723 DOI: 10.1080/08990220.2023.2280541] [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: 10/19/2022] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Previous studies demonstrated that providing light finger touch to a stationary object leads to reduced body sway. The focus of the current exploratory study was on the investigation of postural sway during one-leg stance when light touch is provided by the contralateral foot. METHODS Eleven healthy young adults participated in the study. They stood on the top of the force platform with eyes open and on their dominant leg with no touch and with a touch from the contralateral foot applied to the stance leg. Medial arch, heel, and big toe of the contralateral foot were used to touch the medial malleolus or mid shank of the stance leg. The excursion, velocity, and sway area of the centre of pressure were obtained and analysed. RESULTS Standing with light touch from the contralateral foot to the medial malleolus resulted in significantly smaller postural sway as compared to standing with no touch (p < 0.05). There was no difference in the study outcomes between conditions of standing with a touch applied by the medial arch, heel, or big toe to the stance leg. CONCLUSIONS The results of the study suggest that the application of light touch provided by a contralateral foot could be an effective strategy for enhancing body stability when no external support is available. The study outcome provides a foundation for future studies exploring ways to enhance balance control during one-leg stance.
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Affiliation(s)
- Balsam J Alammari
- Department of Physical Therapy, University of Illinois Chicago, Chicago, IL, USA
| | - Yunju Lee
- School of Engineering and Department of Physical Therapy & Athletic Training, Grand Valley State University, Grand Rapids, MI, USA
| | - Alexander S Aruin
- Department of Physical Therapy, University of Illinois Chicago, Chicago, IL, USA
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Fujikawa J, Morigaki R, Yamamoto N, Oda T, Nakanishi H, Izumi Y, Takagi Y. Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials. Front Aging Neurosci 2022; 14:807909. [PMID: 35462692 PMCID: PMC9020378 DOI: 10.3389/fnagi.2022.807909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background Pharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease. Methods We first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices. Results Our review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark. Conclusion Invasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.
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Affiliation(s)
- Joji Fujikawa
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Ryoma Morigaki
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- *Correspondence: Ryoma Morigaki,
| | - Nobuaki Yamamoto
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- Department of Neurology, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Teruo Oda
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Hiroshi Nakanishi
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Yuishin Izumi
- Department of Neurology, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Yasushi Takagi
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
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Staying UpRight in Parkinson's disease: A pilot study of a novel wearable postural intervention. Gait Posture 2022; 91:86-93. [PMID: 34656009 DOI: 10.1016/j.gaitpost.2021.09.202] [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: 01/18/2021] [Revised: 09/22/2021] [Accepted: 09/29/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This interventional pilot study aimed to 1) examine whether a novel wearable vibro-tactile feedback device ('UpRight Go') is effective and feasible to improve postural alignment in Parkinson's disease (PD); 2) explore relationships between postural alignment and attention in PD; 3) explore effect of vibro-tactile device on balance and gait; and 4) gain initial feedback on the use of the vibro-tactile device in the laboratory and at home. METHODS 25 people with PD sat, stood and walked for two-minutes without and with the UpRight device attached to their upper backs to provide feedback on postural alignment in the laboratory. A sub-group (n = 12) wore the UpRight device at home for 60 min. per day for 7-days of postural feedback. Subjective feedback on use of the device was obtained in the laboratory and at the end of the 7-day period. The primary outcome for this study was posture measured by verticality of inertial measurement units (IMUs) at the neck, trunk and low back, which was done with and without the UpRight device. Secondary outcomes included clinical measures of posture, subjective feedback on the device, computerized attention measures, gait and balance. RESULTS Neck postural alignment in PD was significantly improved (reduced neck flexion) with the UpRight during sitting and standing in both clinical measures (p = 0.005) and IMU outcomes (p = 0.046), but trunk and low back posture did not change. There was no change in postural alignment during walking with the UpRight. Postural alignment response was related to attentional capabilities. Many subjects (68 %) reported that they felt a benefit from the UpRight and most participants reported that the device was acceptable (Lab use; 72 %, Home use; 75 %). CONCLUSION The UpRight Go feedback device may improve neck/upper-back posture in PD during sitting and standing, but not during walking. Postural alignment response to the device may depend on attentional mechanisms.
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Khobkhun F, Hollands K, Hollands M, Ajjimaporn A. Effectiveness of exercise-based rehabilitation for the treatment of axial rigidity in people with Parkinson’s disease: A Scoping Review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1816127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Fuengfa Khobkhun
- Brain and Behaviour Lab, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand
- Department of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Kristen Hollands
- Centre for Health Sciences Research Allerton Building, University of Salford, Salford, UK
| | - Mark Hollands
- Brain and Behaviour Lab, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Amornpan Ajjimaporn
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand
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Ditthaphongphakdee S, Gaogasigam C. The effects of light touch cue on gait initiation in patients with Parkinson's disease. J Bodyw Mov Ther 2020; 26:187-192. [PMID: 33992243 DOI: 10.1016/j.jbmt.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 08/17/2020] [Accepted: 08/28/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION One of the common impairments in patients with Parkinson's disease (PD) is disturbance of gait initiation. A light touch cue improves postural stability in patients with PD. Little is known about the effects of a light touch cue on gait initiation. This study investigated the effects of a light touch on gait initiation in patients with PD. METHODS This study was a cross-sectional study design. Sixteen patients with PD (Hoehn & Yahr stage 2-3) participated in the study and were evaluated two gait conditions (no touch (NT) and light touch (LT) conditions). Gait initiation was divided into 5 events including event A, B, C, D, and E. Outcome measures included maximum center of pressure (COP) displacement and velocity in anteroposterior (AP) and mediolateral (ML) directions, and the first step time. RESULTS Participants with LT had greater COP displacement compared with the NT condition in all events of gait initiation except COP-AP displacement in event D. Additionally, the COP velocity in LT condition was faster than the NT condition in COP-ML velocity in event A, COP-AP velocity in event B, COP-AP velocity and COP-ML velocity in event C. Moreover, participants with LT presented significantly shorter the first step time than the NT condition. CONCLUSIONS These findings demonstrated that a light touch cue improved gait initiation in patients with PD by increased weight shifting to initial stance limb, increased postural stability of stance limb, increased velocity of weight transfer toward stance limb, and a shortened first step time.
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Affiliation(s)
| | - Chitanongk Gaogasigam
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand.
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Oates AR, Arora T, Lanovaz JL, Musselman KE. The effects of light touch on gait and dynamic balance during normal and tandem walking in individuals with an incomplete spinal cord injury. Spinal Cord 2020; 59:159-166. [PMID: 32647327 DOI: 10.1038/s41393-020-0516-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Prospective cross-sectional study OBJECTIVES: To investigate the effect of adding haptic input during walking in individuals with incomplete spinal cord injury (iSCI). SETTING Research laboratory. METHODS Participants with iSCI and age- and sex-matched able-bodied (AB) individuals walked normally (SCI n = 18, AB n = 17) and in tandem (SCI n = 12, AB n = 17). Haptic input was added through light touch on a railing. Step parameters, and mediolateral and anterior-posterior margins of stability (means and standard deviations) were calculated. Surface electromyography data were collected bilaterally from the tibialis anterior (TA), soleus (SOL), and gluteus medius (GMED) and integrated over a stride. Repeated measures ANOVAs examined within- and between-group differences (α = 0.05). Cutaneous and proprioceptive sensation of individuals with iSCI were correlated to changes in outcome measures that were affected by haptic input. RESULTS When walking normally, adding haptic input decreased stride velocity, step width, stride length, MOSML, MOSML_SD, MOSAP, and MOSAP_SD, and increased GMED activity on the limb opposite the railing. During tandem walking, haptic input had no effect; however, individuals with iSCI had a larger step width SD and MOSML_SD compared with the AB group. Sensory abilities of individuals with iSCI were not correlated to any of the outcome measures that significantly changed with added haptic input. CONCLUSIONS Added haptic input improved balance control during normal but not in tandem walking. Sensory abilities did not impact the use of added haptic input during walking.
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Affiliation(s)
- Alison R Oates
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Tarun Arora
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Joel L Lanovaz
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kristin E Musselman
- Lyndhurst Centre, Toronto Rehabilitation Institute, University of Toronto, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Lim HK, Ko J, Lee D, Han DU. Modified desk height helps children with cerebral palsy perform sit-to-stand. Disabil Rehabil Assist Technol 2020; 17:221-227. [PMID: 32574122 DOI: 10.1080/17483107.2020.1775315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: Children with cerebral palsy (CP) have difficulties performing activities that require the use of fundamental motor skills such as sit-to-stand (STS). In this study, we used a height adjustable chair and desk to investigate the role of desk support in STS and how it might benefit children with CP. Methods: Seventeen typically developing children (TDC), average age = 9.7 years, and 28 children with CP (Gross Motor Function Classification System [GMFCS] I and II), average age = 10.3 years, participated in the test. Elapsed time and body sway were measured using a pressure mat and load cell while each child performed a STS task. Two different desk heights were tested for time consumption and sway under the condition of hands-on-desk and arms-crossed. Results: We found that the elapsed time of hands-on-desk with the elbow flexion height was the shortest (p < 0.05). Sway amount was also significantly reduced for all children when they used the table for STS (p < 0.05). Conclusion: Results of this study may be a useful reference in rehabilitation training and designing a desk height beneficial for children with CP.Implications for RehabilitationBetter performance of sit-to-stand for a child with cerebral palsy could be made by a desk supportElapsed time during preparation period for sit-to-stand could be reduced by desk support for all CP childrenSway amount during sit-to-stand could be reduced by desk support, especially for the CP children with GMFCS level IIDesk height is an important parameter and should be studied in detail.
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Affiliation(s)
- Hyun Kyoon Lim
- Center for Medical Convergence Metrology, Korea Research Institute of Standards and Science, Daejeon, Republic of Korea.,Department of Medical Physics, University of Science and Technology, Daejeon, Republic of Korea
| | - Jooyeon Ko
- Department of Physical Therapy, Daegu Health College, Daegu, Republic of Korea
| | - Donghyun Lee
- Center for Medical Convergence Metrology, Korea Research Institute of Standards and Science, Daejeon, Republic of Korea.,Department of Medical Physics, University of Science and Technology, Daejeon, Republic of Korea
| | - Dong-Uk Han
- Center for Medical Convergence Metrology, Korea Research Institute of Standards and Science, Daejeon, Republic of Korea.,Department of Medical Physics, University of Science and Technology, Daejeon, Republic of Korea.,Ministry of Food and Drug Safety, Osong, Korea
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10
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Cabrera-Martos I, Jiménez-Martín AT, López-López L, Rodríguez-Torres J, Ortiz-Rubio A, Valenza MC. Effects of a core stabilization training program on balance ability in persons with Parkinson's disease: a randomized controlled trial. Clin Rehabil 2020; 34:764-772. [PMID: 32349543 DOI: 10.1177/0269215520918631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the effects of an eight-week core stability program on balance ability in persons with Parkinson's disease. DESIGN Randomized controlled trial. SETTING A local Parkinson's association. SUBJECTS A total of 44 participants with a clinical diagnosis of Parkinson's disease were randomly assigned to an experimental (n = 22) or control group (n = 22). INTERVENTION The experimental group received 24 sessions of core training, while the control group received an intervention including active joint mobilization, muscle stretching, and motor coordination exercises. MAIN MEASURES The primary outcome measure was dynamic balance evaluated using the Mini-Balance Evaluation Systems Test. Secondary outcomes included the balance confidence assessed with the Activities-specific Balance Confidence Scale and standing balance assessed by the maximal excursion of center of pressure during the Modified Clinical Test of Sensory Interaction on Balance and the Limits of Stability test. RESULTS After treatment, a significant between-group improvement in dynamic balance was observed in the experimental group compared to the control group (change, 2.75 ± 1.80 vs 0.38 ± 2.15, P = 0.002). The experimental group also showed a significant improvement in confidence (change, 16.48 ± 16.21 vs 3.05 ± 13.53, P = 0.047) and maximal excursion of center of pressure in forward (change, 0.86 ± 1.89 cm vs 0.17 ± 0.26 cm, P = 0.048), left (change, 0.88 ± 2.63 cm vs 0.07 ± 0.48 cm, P = 0.010), and right (change, 1.63 ± 2.82 cm vs 0.05 ± 0.17 cm, P = 0.046) directions of limits of stability compared to the control group. CONCLUSION A program based on core stability in comparison with non-specific exercise benefits dynamic balance and confidence and increases center of mass excursion in patients with Parkinson's disease.
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Affiliation(s)
- Irene Cabrera-Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Laura López-López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Janet Rodríguez-Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Araceli Ortiz-Rubio
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Watanabe M, Tani H. Effects of active and passive light-touch support on postural stability during tandem standing. J Phys Ther Sci 2020; 32:55-58. [PMID: 32082030 PMCID: PMC7008021 DOI: 10.1589/jpts.32.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023] Open
Abstract
[Purpose] Light-touch support (consisting of a load <100 g) is useful for reducing
postural sway while standing and walking. However, it is unclear which types of touch and
somatosensory inputs are more effective for improving postural control. This study aimed
to clarify the effects of active and passive light-touch support, with and without visual
information, on postural stability during tandem standing. [Participants and Methods]
Eleven young healthy adults maintained tandem standing for 30 s under six conditions. The
independent variables were light-touch condition (no, active or passive) and visual
condition (eyes open or closed). Postural sway, as measured using a force plate, was
considered to indicate postural stability. [Results] There was significantly less postural
sway with active light touch compared with passive and no touch. Passive light touch
resulted in significantly less sway than no touch. In addition, there was less postural
sway with active light compared to passive light touch, especially with the eyes closed.
The light-touch support force did not differ between conditions. [Conclusion] Both active
and passive light-touch improved postural stability in comparison to no-touch. Active
light-touch support significantly improved postural stability. These results could be used
to inform therapeutic interventions within clinical settings.
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Affiliation(s)
- Miyoko Watanabe
- International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara City, Tochigi Prefecture 324-8501, Japan
| | - Hiroaki Tani
- International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara City, Tochigi Prefecture 324-8501, Japan
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Saini A, Burns D, Emmett D, Song YS. Trunk velocity-dependent Light Touch reduces postural sway during standing. PLoS One 2019; 14:e0224943. [PMID: 31697773 PMCID: PMC6837461 DOI: 10.1371/journal.pone.0224943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 10/24/2019] [Indexed: 02/06/2023] Open
Abstract
Light Touch (LT) has been shown to reduce postural sway in a wide range of populations. While LT is believed to provide additional sensory information for balance modulation, the nature of this information and its specific effect on balance are yet unclear. In order to better understand LT and to potentially harness its advantages for a practical balance aid, we investigated the effect of LT as provided by a haptic robot. Postural sway during standing balance was reduced when the LT force (~ 1 N) applied to the high back area was dependent on the trunk velocity. Additional information on trunk position, provided through orthogonal vibrations, further reduced the sway position-metric of balance but did not further improve the velocity-metric of balance. Our results suggest that limited and noisy information on trunk velocity encoded in LT is sufficient to influence standing balance.
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Affiliation(s)
- Anirudh Saini
- Department of Mechanical and Aerospace Engineering, Missouri University of Science and Technology, Rolla, Missouri, United States of America
| | - Devin Burns
- Department of Psychological Science, Missouri University of Science and Technology, Rolla, Missouri, United States of America
| | - Darian Emmett
- Department of Mechanical and Aerospace Engineering, Missouri University of Science and Technology, Rolla, Missouri, United States of America
| | - Yun Seong Song
- Department of Mechanical and Aerospace Engineering, Missouri University of Science and Technology, Rolla, Missouri, United States of America
- * E-mail:
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Silva CR, Magalhães FH, Kohn AF. Fingertip-Coupled Spindle Signaling Does Not Contribute to Reduce Postural Sway Under Light Touch. Front Physiol 2019; 10:1072. [PMID: 31507441 PMCID: PMC6713998 DOI: 10.3389/fphys.2019.01072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Abstract
The details of how light touch (LT) of a stable surface reduces postural sway are still not well known. We hypothesized that removal of feedback provided by muscle afferents of the touching fingertip would increase postural sway in standing subjects. Eleven participants stood upright on a force plate with eyes closed and on an unstable surface. The experimental conditions involved two different finger positions: with partial muscle afferents (PMA), which includes sensory information from the fingertip flexor muscles, and no muscle afferents (NMA), without information from either fingertip flexor or extensor muscles. In the control condition, the participants kept the same posture, but with no finger touch (NT). Postural sway in both anteroposterior (AP) and mediolateral (ML) axes were recorded. Results showed that LT decreased all sway quantifiers as compared with the NT condition. The withdrawal of information from the touch finger muscle afferents (NMA condition) did not increase postural sway. Actually, there was a small, albeit statistically significant, decrease in the variability of center of pressure displacement in the AP direction. These results indicate that in some cases, muscle afferent input may either not contribute or even worsen the overall quality of sensory feedback from a given body segment, leading to no improvement or even a slightly decreased performance of the motor control system (evaluated by means of levels of postural sway in the present investigation). The results suggest that non-spindle fingertip afferents provide the bulk of the sensory feedback associated with the fingertip that is touching a ground-referenced object during quiet standing under LT.
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Affiliation(s)
- Cristiano Rocha Silva
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, São Paulo, Brazil.,Neuroscience Program, Universidade de São Paulo, São Paulo, Brazil
| | - Fernando Henrique Magalhães
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, São Paulo, Brazil.,Neuroscience Program, Universidade de São Paulo, São Paulo, Brazil.,School of Arts, Sciences and Humanities, Universidade de São Paulo, EACH-USP, São Paulo, Brazil
| | - André Fabio Kohn
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, São Paulo, Brazil.,Neuroscience Program, Universidade de São Paulo, São Paulo, Brazil
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Garbus RBSC, Alouche SR, Prado-Rico JM, Aquino CM, Freitas SMSF. From One to Two: Can Visual Feedback Improve the Light Touch Effects on Postural Sway? J Mot Behav 2018; 51:532-539. [PMID: 30395794 DOI: 10.1080/00222895.2018.1528201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The postural control is improved by implicit somatosensory information from lightly touching a rigid bar or explicit visual information about the postural sway. Whether these two additional sources provided at the same time further reduce the postural sway is still unknown. Participants stood on a force plate as quiet as possible lightly touching the bar while received or not visual feedback of the center of pressure position on a monitor screen. Postural sway reduced similarly with the light touch regardless of the additional visual feedback. The findings suggested that providing explicit visual feedback of the center of pressure does not increase the light touch effects on the postural sway. The importance of the implicit somatosensory information on postural control is discussed.
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Affiliation(s)
- Rafaela B S C Garbus
- a Graduate Program in Physical Therapy , Universidade Cidade de São Paulo , São Paulo , Brazil
| | - Sandra R Alouche
- a Graduate Program in Physical Therapy , Universidade Cidade de São Paulo , São Paulo , Brazil
| | - Janina M Prado-Rico
- a Graduate Program in Physical Therapy , Universidade Cidade de São Paulo , São Paulo , Brazil
| | - Camila M Aquino
- a Graduate Program in Physical Therapy , Universidade Cidade de São Paulo , São Paulo , Brazil
| | - Sandra M S F Freitas
- a Graduate Program in Physical Therapy , Universidade Cidade de São Paulo , São Paulo , Brazil .,b Department of Kinesiology , The Pennsylvania State University , University Park , Pennsylvania , USA .,c Department of Neurology , The Pennsylvania State University - Milton S. Hershey Medical Center , Hershey , Pennsylvania , USA
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15
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Forghani A, Preuss R, Milner TE. Short-latency muscle response patterns to multi-directional, unpredictable perturbations to balance applied to the arm are context dependent. Neuroscience 2017; 352:170-179. [PMID: 28396008 DOI: 10.1016/j.neuroscience.2017.03.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 03/30/2017] [Accepted: 03/30/2017] [Indexed: 02/06/2023]
Abstract
A number of studies have shown that sensory inputs from the hand can have a profound effect in stabilizing upright posture. This suggests that the central nervous system can extract information about body motion and external forces acting on the body from cutaneous sensory signals. We have recently shown that the central nervous system determines the direction of an unpredictable force applied to the hand so rapidly that it is able to activate ankle muscles in advance of the perturbing effect that this force has at the ankles. In this study we investigate whether this rapid change in activation of lower limb muscles is an invariant response determined by the pattern of somatosensory information arising from sensory receptors in the hand or whether it adapts to changes in postural stability. We manipulated lateral stability of upright stance by changing stance width which had no effect on the activation of upper limb muscles or hand kinematics, but produced profound changes in the activation patterns of lower limb muscles when perturbations were in the medial/lateral direction without affecting the activation patterns of muscles when perturbations were in the anterior/posterior direction.
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Affiliation(s)
- Ali Forghani
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2S 1S4, Canada.
| | - Richard Preuss
- Department of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5, Canada.
| | - Theodore Edgar Milner
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2S 1S4, Canada.
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16
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Arora T, Musselman KE, Lanovaz J, Oates A. Effect of haptic input on standing balance among individuals with incomplete spinal cord injury. Neurosci Lett 2017; 642:91-96. [DOI: 10.1016/j.neulet.2017.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 01/31/2017] [Accepted: 02/01/2017] [Indexed: 02/06/2023]
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Conradsson D, Paquette C, Lökk J, Franzén E. Pre- and unplanned walking turns in Parkinson's disease - Effects of dopaminergic medication. Neuroscience 2016; 341:18-26. [PMID: 27867059 DOI: 10.1016/j.neuroscience.2016.11.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/07/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
Abstract
Although dopaminergic medication improves functional mobility in individuals with Parkinson's disease (PD), its effects on walking turns are uncertain. Our goals was to determine whether dopaminergic medication improves preplanned and unplanned walking turns in individuals with PD, compared to healthy controls. Nineteen older adults with mild-to-moderate PD and 17 healthy controls performed one of the following three tasks, presented randomly: walking straight, or walking and turning 180° to the right or left. The walking direction was visually cued before starting to walk (preplanned) or after (unplanned, i.e., 0.6m before reaching the turning point). Subjects with PD were assessed off dopaminergic medication (OFF) and on dopaminergic medication (ON) medication. Turning strategy (step and spin turns), turning performance (turning distance and body rotation) and walking pattern were analyzed for three turning steps. Irrespective of medication state and turning condition, step and spin turns followed a nearly 50:50 distribution. After intake of dopaminergic medication, subjects with PD increased their turning distance but not the amount of body rotation or their walking pattern. Compared to controls, turning impairments in subjects with PD remained while ON medication and problems regulating step width were the most prominent features of their walking pattern. Specifically, subjects with PD turned with narrower cross-over steps, i.e. when the external foot crossed over the line of progression of the internal leg. We conclude that turning impairments remained even after dopaminergic medication and problems modulating step width appears to be a critical feature for turning in PD.
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Affiliation(s)
- David Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Alle 23, 141 83 Huddinge, Sweden; Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden.
| | - Caroline Paquette
- Department of Kinesiology and Physical Education, McGill University, and Interdisciplinary Research Center in Rehabilitation (CRIR), 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada.
| | - Johan Lökk
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Novum Pl 5, Blickagången 6/Hälsovägen 7 14157 Huddinge, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden.
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Alle 23, 141 83 Huddinge, Sweden; Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden.
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18
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Löfgren N, Lenholm E, Conradsson D, Ståhle A, Franzén E. The Mini-BESTest--a clinically reproducible tool for balance evaluations in mild to moderate Parkinson's disease? BMC Neurol 2014; 14:235. [PMID: 25496796 PMCID: PMC4272769 DOI: 10.1186/s12883-014-0235-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 12/01/2014] [Indexed: 11/25/2022] Open
Abstract
Background The Mini-BESTest is a clinical balance test that has shown a high sensitivity in detecting balance impairments in elderly with Parkinson's disease (PD). However, its reproducibility between different raters and between test occasions has yet to be investigated in a clinical context. Moreover, no one has investigated the reproducibility of the Mini-BESTest's subcomponents (i.e. anticipatory postural adjustments; postural responses; sensory orientation and dynamic gait). We aimed to investigate the inter-rater and test-retest reproducibility (reliability as well as agreement) of the Mini-BESTest, as well as its subcomponents, in elderly with mild to moderate PD, performed under conditions assimilating clinical practice. Method This was an observational measurement study with a test-retest design. Twenty-seven individuals with idiopathic PD (66 - 80 years, mean age: 73; Hoehn & Yahr: 2-3; 1-15 years since diagnosis) were included. Two test administrators, having different experiences with the Mini-BESTest, administered the test individually, in separate rooms in a hospital setting. For the test-retest assessment, all participants returned 7 days after the first test session to perform the Mini-BESTest under similar conditions. Intra-class correlation coefficients (ICC2.1), standard error of measurement (SEMagreement), and smallest real difference (SRD) were analyzed. Results The Mini-BESTest showed good reliability for both inter-rater and test-retest reproducibility (ICC = 0.72 and 0.80). Regarding agreement, the measurement error (SRD) was found to be 4.1 points (accounting for 15% of the maximal total score) for inter-rater reproducibility and 3.4 points (12% of the maximal total score) for test-retest reproducibility. The investigation of the Mini-BESTest's subcomponents showed a similar pattern for both inter-rater and test-retest reproducibility, where postural responses had the largest proportional measurement error, and sensory orientation showed the highest agreement. Conclusions Our findings indicate that the Mini-BESTest is able to distinguish between individuals with mild to moderate PD; however, when used in clinical balance assessments, the large measurement error needs to be accounted for.
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Affiliation(s)
- Niklas Löfgren
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, SE-14183, Huddinge, Sweden.
| | - Emma Lenholm
- Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
| | - David Conradsson
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, SE-14183, Huddinge, Sweden. .,Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
| | - Agneta Ståhle
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, SE-14183, Huddinge, Sweden. .,Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
| | - Erika Franzén
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, SE-14183, Huddinge, Sweden. .,Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
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Baldan AMS, Alouche SR, Araujo IMG, Freitas SMSF. Effect of light touch on postural sway in individuals with balance problems: a systematic review. Gait Posture 2014; 40:1-10. [PMID: 24674637 DOI: 10.1016/j.gaitpost.2013.12.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 10/31/2013] [Accepted: 12/31/2013] [Indexed: 02/06/2023]
Abstract
The aim of the present review was to examine the experimental, case-control studies that investigated the effect of light touch on postural sway in individuals with balance problems due to aging, brain lesion or other motor or sensory deficits. Articles published before the end of March of 2013 were searched in PubMed, Scielo and Lilacs databases using terms related to postural control and sensory information. Twelve studies that assessed the postural sway of individuals with balance problems during quiet standing with the light touch using a force plate were reviewed. Two reviewers rated all selected articles as having good quality. The effect of light touch on postural control was reported by all eligible studies regardless of the cause of the balance problem of the participants. Such effect was more evident when the applied vertical force was greater than 1N, but if individuals with poor balance took more advantage of the light touch than healthy ones it depended on the source of their balance problems and not the amount of the applied force. These findings suggested that the maintenance of the fingertip lightly touching an external surface could provide additional somatosensory information for individuals with poor balance and then it could be used as a strategy to improve the control of upright standing during intervention programs.
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Affiliation(s)
- A M S Baldan
- Programa de Pós-Graduação em Fisioterapia, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - S R Alouche
- Programa de Pós-Graduação em Fisioterapia, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - I M G Araujo
- Graduação em Fisioterapia, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - S M S F Freitas
- Programa de Pós-Graduação em Fisioterapia, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
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