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Areeudomwong P, Duangyod T, Sutalangka C, Buttagat V. Integrated Effects of Thai Essential Oil and Balance Exercise on Parameters associated with Falls in Older Adults at Risk of Falling: A Randomized Controlled Study. Ann Geriatr Med Res 2023; 27:141-150. [PMID: 37403317 DOI: 10.4235/agmr.23.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Reducing the risk of falling by improving balance and leg strength may be a preventive strategy. This study evaluated the integrated effects of Thai essential oil and balance exercises on parameters associated with Falls in community-dwelling older adults at risk of falling. METHODS Fifty-six participants were randomly allocated to either the intervention group (IG), which performed balance exercises while smelling Thai essential oil scents of Zanthoxylum limonella (Dennst.) Alston, or the control group (CG), which performed balance exercises while receiving a control patch. Balance exercises were practiced for 12, 30-minute sessions over 4 weeks. Static and dynamic balance with eyes open and eyes closed (EC), leg muscle strength, agility, and fear of falling were assessed at baseline, after the 4-week intervention, and at 1 month after the last intervention session. RESULTS Both groups showed significant improvements in static and dynamic balance, ankle plantarflexor strength, and agility after the 4-week intervention (p<0.05), which persisted at the 1-month follow-up (p<0.05). Compared to the CG, the IG demonstrated significantly better static balance in terms of elliptical sway area (p=0.04) and center of pressure (CoP) velocity (p=0.001) during EC, as well as ankle plantarflexor strength (p=0.01). The IG also maintained a significantly greater improvement in CoP velocity during EC (p=0.01). CONCLUSION Integrated Thai essential oil and balance exercises improved static balance and ankle plantarflexor strength compared to the balance exercise with a control patch in older adults at risk of falling.
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Affiliation(s)
- Pattanasin Areeudomwong
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Thidarat Duangyod
- Department of Applied Thai Traditional Medicine, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Chatchada Sutalangka
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Vitsarut Buttagat
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
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Zhou Z, Hu Z, Bao W, Yang Y, Chen K. Does the patellar tendon reflex affect the postural stability in stroke patients with blocked vision? Transl Neurosci 2023; 14:20220283. [PMID: 37082611 PMCID: PMC10111209 DOI: 10.1515/tnsci-2022-0283] [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] [Received: 10/14/2022] [Revised: 03/19/2023] [Accepted: 03/27/2023] [Indexed: 04/22/2023] Open
Abstract
Background Stroke patients often show postural instability. The patellar tendon reflex is a basic physical examination for stroke patients. This study aimed to explore the correlation between patellar tendon reflex grade and postural stability among stroke patients. Methods A total of 37 elderly stroke patients, each with the same quadriceps muscle strength but different patellar tendon reflex levels, were tested on a force platform under eyes-open (EO) and eyes-closed (EC) conditions. Parametric analysis, detrended fluctuation analysis (DFA), and power spectral density (PSD) analysis were used in centre of pressure (COP) signal processing. The correlation between the results of measured data processing and the level of patellar tendon reflex was analysed. Results All three parameters of COP (the length of the sway trajectory, the mean range of the sway trajectory in the mediolateral [ML] direction [R x ], and the mean range of the sway trajectory in the anterior-posterior [AP] directions [R y ]) were negatively correlated with the patient's patellar tendon reflex grade under the EC condition. The DFA results showed that a higher grade of patellar tendon reflex was associated with a smaller value of the crossover point in the AP direction. Only the PSD values of each frequency band in the AP direction were negatively correlated with patellar tendon reflex grade with EO and became negatively correlated in both AP and ML directions with EC. Overall, the results showed a strong correlation between patellar tendon reflex and postural stability in stroke patients when vision was blocked. Significance The strong correlation with EC may provide insights into clinic evaluation and treatment for rehabilitation or fall risks of stroke patients.
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Affiliation(s)
- Ziyou Zhou
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
| | - Zhen Hu
- Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai200000, China
| | - Wei Bao
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
| | - Ying Yang
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
| | - Kai Chen
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
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Ho JG, Kim Y, Min SD. Customized Textile Capacitive Insole Sensor for Center of Pressure Analysis. SENSORS (BASEL, SWITZERLAND) 2022; 22:9390. [PMID: 36502092 PMCID: PMC9739635 DOI: 10.3390/s22239390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Center of pressure refers to the centroid of the ground reaction force vector detected underneath the walking foot, which is a summary measure representing body segment movements during human locomotion. In this study, we developed a cost-effective, lightweight insole-type textile capacitive sensor (I-TCPs) to analyze plantar pressure (PP) distribution and center of pressure (COP) trajectory. To test the accuracy of I-TCPs, the measured pressure data was compared with that of F-scan. The sensor performance test was divided into a static baseline test and a dynamic gait experiment, both at two different gait speeds self-selected by the subjects. Static gait results showed that I-TCPs were capable of recognizing PP segments at different gait speeds. Dynamic gait results showed an average RMSE of 1.29 ± 0.47 mm in COPx (mediolateral shift) and 12.55 ± 5.08 mm in COPy (anteroposterior shift) at a comfortable gait speed. The COP correlation between I-TCPs and F-scan was 0.54 ± 0.09 in COPx and 0.92 ± 0.04 in COPy in comfortable gait speed conditions, in which COPy values presented a stronger correlation. RMSE and correlation in fast gait speed conditions also showed similar results. The findings of this study can be the basis for future research, including rehabilitation engineering, developing ICT devices, and creating smart wearable sensors to improve quality of life for patients and healthy individuals.
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Affiliation(s)
- Jong-Gab Ho
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Republic of Korea
| | - Young Kim
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Republic of Korea
| | - Se-Dong Min
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Republic of Korea
- Department of Medical IT Engineering, Soonchunhyang University, Asan 31538, Republic of Korea
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Lo PY, Su BL, You YL, Yen CW, Wang ST, Guo LY. Measuring the Reliability of Postural Sway Measurements for a Static Standing Task: The Effect of Age. Front Physiol 2022; 13:850707. [PMID: 35634138 PMCID: PMC9138610 DOI: 10.3389/fphys.2022.850707] [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: 01/08/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background: A force plate is used to determine the ability to balance ability. However, only some medical centers or laboratories are equipped with force plates because they are costly so a low-cost force plate is required for home care or health care institutes. Few studies compare the reliability of postural sway measurements in terms of age. This study proposes a low-cost force plate to select reliable parameters to evaluate postural sway.Objectives: To determine the intra-rater reliability of a novel force plate and the effect of age difference on the intra-rater test-retest reliability for the center of pressure (COP).Methods: Forty participants were enrolled for this study: 20 youths and 20 older adults. Participants stood on a custom-made and low-cost force plate with eyes opened and eyes closed to measure COP-related parameters. The within-day test-retest reliability was measured at two sessions on the same day and the between-days reliability was measured on two different days. The COP-related parameters include the average velocity of COP, the average velocity in the antero-posterior and medio-lateral directions, the mean distance of COP and the mean distance in the antero-posterior and medio-lateral directions. An intra-class correlation coefficient test with one-way random model was performed to determine the reliability of different variables within-days and between-days. The results were presented in single measurement of intraclass correlation coefficient (ICC), the standard error of measurements, and the minimal detectable changes of each COP-related parameters.Results: The novel low-cost force plate demonstrates excellent reliability in terms of the COP velocity related parameters for within- and between-day measurements. The ICC of COP distance related parameters were good to excellent reliability for between-day measurements (range: 0.43–0.84). Older adults demonstrated excellent reliability in terms of the mean distance for antero-posterior and the results were better than those for younger participants for the eyes-opened and eyes-closed conditions. The reliability in terms of the mean distance for medio-lateral was poor to good for older adults (range: 0.38–0.55), and excellent for younger participants.Conclusion: The novel and low-cost force plate reliably measured balance and age affects the reliability of different COP variables, so the results of this study were pertinent to the selection of COP measures.
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Affiliation(s)
- Pei-Yi Lo
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Bo-Lin Su
- Department of Mechanical and Electro-mechanical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yu-Lin You
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Wen Yen
- Department of Mechanical and Electro-mechanical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Shih-Ting Wang
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lan-Yuen Guo
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Humanities and Social Sciences, National Pingtung University of Science and Technology, Pintung, Taiwan
- *Correspondence: Lan-Yuen Guo,
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Dobberke J, Baritello O, Hadzic M, Völler H, Eichler S, Salzwedel A. Test-retest reliability of center of pressure measures for postural control assessment in older cardiac patients. Gait Posture 2022; 92:359-363. [PMID: 34920361 DOI: 10.1016/j.gaitpost.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Elderly patients are a growing population in cardiac rehabilitation (CR). As postural control declines with age, assessment of impaired balance is important in older CR patients in order to predict fall risk and to initiate counteracting steps. Functional balance tests are subjective and lack adequate sensitivity to small differences, and are further subject to ceiling effects. A quantitative approach to measure postural control on a continuous scale is therefore desirable. Force plates are already used for this purpose in other clinical contexts, therefore could be a promising tool also for older CR patients. However, in this population the reliability of the assessment is not fully known. RESEARCH QUESTION Analysis of test-retest reliability of center of pressure (CoP) measures for the assessment of postural control using a force plate in older CR patients. METHODS 156 CR patients (≥75 years) were enrolled. CoP measures (path length (PL), mean velocity (MV), and 95% confidence ellipse area (95CEA)) were analyzed twice with an interval of two days in between (bipedal narrow stance, eyes open (EO) and closed (EC), three trials for each condition, 30 s per trial), using a force plate. For test-retest reliability estimation absolute differences (Δ: T0-T1), intraclass correlation coefficients (ICC) with 95% confidence intervals, standard error of measurement and minimal detectable change were calculated. RESULTS Under EO condition ICC were excellent for PL and MV (0.95) and good for 95CEA (0.88) with Δ of 10.1 cm (PL), 0.3 cm/sec (MV) and 1.5 cm2 (95CEA) respectively. Under EC condition ICC were excellent (≥ 0.95) for all variables with larger Δ (PL: 21.7 cm; MV: 0.7 cm/sec; 95CEA: 2.4 cm2). SIGNIFICANCE In older CR patients, the assessment of CoP measures using a force plate shows good to excellent test-retest reliability.
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Affiliation(s)
- Jeanette Dobberke
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Germany.
| | - Omar Baritello
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Germany.
| | - Miralem Hadzic
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Germany.
| | - Heinz Völler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Germany; Klinik am See, Rehabilitation Center for Internal Medicine, Rüdersdorf, Germany.
| | - Sarah Eichler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Germany.
| | - Annett Salzwedel
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Germany.
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Savadkoohi M, Oladunni T, Thompson L. Deep Neural Networks for Human's Fall-risk Prediction using Force-Plate Time Series Signal. EXPERT SYSTEMS WITH APPLICATIONS 2021; 182:115220. [PMID: 36211616 PMCID: PMC9540455 DOI: 10.1016/j.eswa.2021.115220] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Early and accurate identification of the balance deficits could reduce falls, in particular for older adults, a prone population. Our work investigates deep neural networks' capacity to identify human balance patterns towards predicting fall-risk. Human balance ability can be characterized based on commonly-used balance metrics, such as those derived from the force-plate time series. We hypothesized that low, moderate, and high risk of falling can be characterized based on balance metrics, derived from the force-plate time series, in conjunction with deep learning algorithms. Further, we predicted that our proposed One-One-One Deep Neural Networks algorithm provides a considerable increase in performance compared to other algorithms. Here, an open source force-plate dataset, which quantified human balance from a wide demographic of human participants (163 females and males aged 18-86) for varied standing conditions (eyes-open firm surface, eyes-closed firm surface, eyes-open foam surface, eyes-closed foam surface) was used. Classification was based on one of the several indicators of fall-risk tied to the fear of falling: the clinically-used Falls Efficacy Scale (FES) assessment. For human fall-risk prediction, the deep learning architecture implemented comprised of: Recurrent Neural Network (RNN), Long-Short Time Memory (LSTM), One Dimensional Convolutional Neural Network (1D-CNN), and a proposed One-One-One Deep Neural Network. Results showed that our One-One-One Deep Neural Networks algorithm outperformed the other aforementioned algorithms and state-of-the-art models on the same dataset. With an accuracy, precision, and sensitivity of 99.9%, 100%, 100%, respectively at the 12th epoch, we found that our proposed One-One-One Deep Neural Network model is the most efficient neural network in predicting human's fall-risk (based on the FES measure) using the force-plate time series signal. This is a novel methodology for an accurate prediction of human risk of fall.
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Affiliation(s)
- M. Savadkoohi
- School of Engineering and Applied Sciences, University of District of Columbia, Washington DC, USA
| | - T. Oladunni
- Department of Computer Science, University of District of Columbia, Washington DC, USA
| | - L.A. Thompson
- Department of Mechanical Engineering, University of District of Columbia, Washington DC, USA
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The effects of mechanical noise bandwidth on balance across flat and compliant surfaces. Sci Rep 2021; 11:12276. [PMID: 34112840 PMCID: PMC8192913 DOI: 10.1038/s41598-021-91422-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/25/2021] [Indexed: 12/29/2022] Open
Abstract
Although the application of sub-sensory mechanical noise to the soles of the feet has been shown to enhance balance, there has been no study on how the bandwidth of the noise affects balance. Here, we report a single-blind randomized controlled study on the effects of a narrow and wide bandwidth mechanical noise on healthy young subjects’ sway during quiet standing on firm and compliant surfaces. For the firm surface, there was no improvement in balance for both bandwidths—this may be because the young subjects could already balance near-optimally or optimally on the surface by themselves. For the compliant surface, balance improved with the introduction of wide but not narrow bandwidth noise, and balance is improved for wide compared to narrow bandwidth noise. This could be explained using a simple model, which suggests that adding noise to a sub-threshold pressure stimulus results in markedly different frequency of nerve impulse transmitted to the brain for the narrow and wide bandwidth noise—the frequency is negligible for the former but significantly higher for the latter. Our results suggest that if a person’s standing balance is not optimal (for example, due to aging), it could be improved by applying a wide bandwidth noise to the feet.
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Hansen C, Beckbauer M, Romijnders R, Warmerdam E, Welzel J, Geritz J, Emmert K, Maetzler W. Reliability of IMU-Derived Static Balance Parameters in Neurological Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073644. [PMID: 33807432 PMCID: PMC8037984 DOI: 10.3390/ijerph18073644] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 01/03/2023]
Abstract
Static balance is a commonly used health measure in clinical practice. Usually, static balance parameters are assessed via force plates or, more recently, with inertial measurement units (IMUs). Multiple parameters have been developed over the years to compare patient groups and understand changes over time. However, the day-to-day variability of these parameters using IMUs has not yet been tested in a neurogeriatric cohort. The aim of the study was to examine day-to-day variability of static balance parameters of five experimental conditions in a cohort of neurogeriatric patients using data extracted from a lower back-worn IMU. A group of 41 neurogeriatric participants (age: 78 ± 5 years) underwent static balance assessment on two occasions 12-24 h apart. Participants performed a side-by-side stance, a semi-tandem stance, a tandem stance on hard ground with eyes open, and a semi-tandem assessment on a soft surface with eyes open and closed for 30 s each. The intra-class correlation coefficient (two-way random, average of the k raters' measurements, ICC2, k) and minimal detectable change at a 95% confidence level (MDC95%) were calculated for the sway area, velocity, acceleration, jerk, and frequency. Velocity, acceleration, and jerk were calculated in both anterior-posterior (AP) and medio-lateral (ML) directions. Nine to 41 participants could successfully perform the respective balance tasks. Considering all conditions, acceleration-related parameters in the AP and ML directions gave the highest ICC results. The MDC95% values for all parameters ranged from 39% to 220%, with frequency being the most consistent with values of 39-57%, followed by acceleration in the ML (43-55%) and AP direction (54-77%). The present results show moderate to poor ICC and MDC values for IMU-based static balance assessment in neurogeriatric patients. This suggests a limited reliability of these tasks and parameters, which should induce a careful selection of potential clinically relevant parameters.
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Affiliation(s)
- Clint Hansen
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
- Correspondence:
| | - Maximilian Beckbauer
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
| | - Robbin Romijnders
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
- Digital Signal Processing and System Theory, Institute of Electrical and Information Engineering, Kiel University, Kaiserstrasse 2, 24143 Kiel, Germany
| | - Elke Warmerdam
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
- Digital Signal Processing and System Theory, Institute of Electrical and Information Engineering, Kiel University, Kaiserstrasse 2, 24143 Kiel, Germany
| | - Julius Welzel
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
| | - Johanna Geritz
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
| | - Kirsten Emmert
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Strasse 3, Haus D, 24105 Kiel, Germany; (M.B.); (R.R.); (E.W.); (J.W.); (J.G.); (K.E.); (W.M.)
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Kohler BE, Baque E, Sandler CX, Brookes DSK, Terranova CO, Rixon M, Hassall T, Trost SG. Physical ACTivity in Survivorship (PACTS): study protocol for a randomized controlled trial evaluating a goal-directed therapeutic exercise program in pediatric posterior fossa brain tumor survivors. BMC Pediatr 2021; 21:105. [PMID: 33648474 PMCID: PMC7919081 DOI: 10.1186/s12887-021-02566-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Posterior fossa brain tumors (PFBT) are the most common solid tumor in children. Recent increases in survival rates are encouraging; however, survivors may experience a plethora of disease- and treatment-related complications that can persist into adulthood. Therapeutic exercise interventions have been shown to improve quality of survivorship in other pediatric cancer diagnoses. There is also evidence that goal-directed interventions are effective at improving motor activities, function, and self-care in children with complex health conditions. Yet, there is currently no evidence on the efficacy of goal-directed therapeutic exercise in pediatric PFBT survivors. The Physical ACTivity in Survivorship (PACTS) study aims to investigate the effects of a novel goal-directed therapeutic exercise program on cardiorespiratory fitness and physical activity-related goal attainment in pediatric survivors of PFBT. METHOD PFBT survivors, aged five to 17 years, who underwent surgery at least 12 months earlier and completed radiation therapy and/or chemotherapy at least 6 months prior will be recruited from the Queensland Children's Hospital (Brisbane, Australia) (target n = 48). Following baseline assessment, participants are randomized into either the intervention or usual care group. The intervention group will receive weekly individualized, goal-directed exercise therapy delivered face-to-face for 12 weeks, along with an accompanying home-based program (three sessions per week). Outcomes will be assessed at baseline, immediately post-intervention, and at 6- and 12-months post-intervention. The primary outcomes are cardiorespiratory fitness (Peak VO2) and physical activity-related goal attainment. Secondary outcomes are cardiorespiratory endurance, high-level mobility skills, functional muscle strength, habitual physical activity, gait, balance, quality of life, fatigue, participation, perceived movement skill competence and parameters of body composition. DISCUSSION PACTS is the first study to investigate the efficacy of goal-directed therapeutic exercise in children with PFBT and provide evidence needed to inform clinical practice recommendations for managing quality of survivorship in PFBT survivors. TRIAL REGISTRATION ACTRN12619000841178 .
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Affiliation(s)
- Brooke E Kohler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Emmah Baque
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Carolina X Sandler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Denise S K Brookes
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Caroline O Terranova
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Matthew Rixon
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Tim Hassall
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
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Park JH, Kia K, Srinivasan D, Kim JH. Postural balance effects from exposure to multi-axial whole-body vibration in mining vehicle operation. APPLIED ERGONOMICS 2021; 91:103307. [PMID: 33202332 DOI: 10.1016/j.apergo.2020.103307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 06/11/2023]
Abstract
Twenty participants (18 males and 2 females) completed postural stability assessments before and after 4-h exposure to whole body vibration (WBV) in four experimental conditions: (a) vertical-dominant WBV with vertical passive air suspension, (b) multi-axial WBV with vertical passive air suspension, (c) multi-axial WBV with multi-axial active suspension, and (d) no WBV condition. Center of pressure (COP)-based postural sway measures significantly increased following multi-axial WBV exposure. Increase in COP velocity and displacement following multi-axial WBV was significantly higher than the increase in all the other exposure conditions. However, no significant differences between the WBV conditions were observed in functional limits of stability and anticipatory postural adjustments. While our results show standing balance to be impaired following the multi-axial WBV exposure of off-road mining vehicles, dynamic stability across a broader range of conditions needs to be understood to causally link postural stability decrements to increased fall-risks associated with off-road vehicle operators.
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Affiliation(s)
- Jang-Ho Park
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Kiana Kia
- School of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis, OR, USA
| | - Divya Srinivasan
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Jeong Ho Kim
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
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Quijoux F, Vienne-Jumeau A, Bertin-Hugault F, Zawieja P, Lefèvre M, Vidal PP, Ricard D. Center of pressure displacement characteristics differentiate fall risk in older people: A systematic review with meta-analysis. Ageing Res Rev 2020; 62:101117. [PMID: 32565327 DOI: 10.1016/j.arr.2020.101117] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 06/07/2020] [Accepted: 06/15/2020] [Indexed: 12/31/2022]
Abstract
Falling is the second most prevalent cause of accidental death in the world. Currently available clinical tests to assess balance in older people are insufficiently sensitive to screen for fall risk in this population. Laboratory tests that record the center of pressure (COP) trajectory could overcome this problem but despite their widespread use, the choice of COP trajectory features for use as a biomarker of fall risk lacks consensus. This systematic review and meta-analysis aimed at identifying the best COP characteristics to predict risk of falling in older adults. More than 4000 articles were screened; 44 (7176 older adults) were included in this study. Several COP parameters emerged as good indices to discriminate fallers from non-fallers. From sensitivity analysis, Sway area per unit time, anteroposterior mean velocity, and radial mean velocity were the best traditional features. In this study, identification of older people with a high fall risk was demonstrated using quiet-standing recordings. Such screening would also be useful for routine follow-up of balance changes in older fallers in clinical practice.
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Pérez-Gurbindo I, Angulo Carrere MT, Arribas Cobo P, Puerta M, Ortega M, Jaldo MT, de Sequera P, Alcázar R, Pérez-García R, Álvarez-Méndez AM. Haemodialysis patients have worse postural balance with an associated risk of falls. Nefrologia 2020; 40:655-663. [PMID: 32651084 DOI: 10.1016/j.nefro.2020.04.014] [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: 09/17/2019] [Revised: 02/07/2020] [Accepted: 04/03/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Postural balance is the result of a complex interaction of sensory input which keeps us upright. Haemodialysis patients have alterations which can lead to postural instability and a risk of falls. Our objective was to analyse postural stability and its relationship with the risk of falls in haemodialysis patients using a force platform. MATERIAL AND METHODS This was a prospective cross-sectional study. Postural balance was recorded using a force platform in prevalent haemodialysis patients. We collected epidemiological, dialysis, analytical and treatment data. The incidence of falls was recorded over the 6 months following the tests. The postural stability analysis was performed with a portable strain gauge platform (AMTI AccuGait®) and a specific software unit for stabilometry (Balance Trainer® program). We measured 31 balance parameters; the balance variables used were: Area95; AreaEffect; VyMax; Xrange and Yrange. The stabilometry studies were performed in 3 situations: with eyes open; with eyes closed; and with the patient performing a simultaneous task. We performed one study at the start of the dialysis session, and a second study at the end. Stabilometry was measured in a control group under similar conditions. RESULTS We studied 32 patients with a mean age of 68 years old; of this group, 20 subjects were male and 12 were female. Their mean weight was 74kg, with a mean BMI of 27.6kg/m2. In the controls, there were no significant differences in the stabilometry between the 3 situations studied. Both pre- and post-haemodialysis, patients with closed eyes showed greater imbalance, and there were significant differences with the other situations and controls. We found a significant increase in instability after the haemodialysis session, and greater instability in the 13 patients with diabetes (P<.05). The 4 patients with hyponatraemia (Na<136mmol/l) had worse balance in the simultaneous task situation (P=.038). Various drugs, such as insulin (P=.022), antiplatelet agents (P=.036) and beta-blockers (P=.029), were associated with imbalance. The 10 patients who suffered falls had greater imbalance, Yrange, Xrange, Area95 and AreaEffect, both pre- and post-haemodialysis (P<.05) than those without falls. CONCLUSIONS Haemodialysis patients have alterations which can lead to postural instability and a risk of falls. Prevention programmes which include specific exercises to improve balance could be beneficial in reducing the risk of falls in this population.
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Affiliation(s)
- Ignacio Pérez-Gurbindo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutenese de Madrid, Madrid, España.
| | | | | | - Marta Puerta
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Mayra Ortega
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Maria Teresa Jaldo
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Patricia de Sequera
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Roberto Alcázar
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Rafael Pérez-García
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Ana María Álvarez-Méndez
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutenese de Madrid, Madrid, España
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Boerhout C, van Busschbach JT, Vermerris SM, Troquete NAC, Hof AL, Hoek HW. Force production parameters as behavioural measures for anger expression and control: The Method of Stamp Strike Shout. PLoS One 2018; 13:e0206494. [PMID: 30427896 PMCID: PMC6235295 DOI: 10.1371/journal.pone.0206494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 10/15/2018] [Indexed: 11/18/2022] Open
Abstract
This study presents first test results of a new performance-based, psychomotor method to measure anger expression and control, based on voice expression and physical force production in directional movement of arms and legs, called the Method of Stamp Strike Shout (MSSS). Recorded are the standardized impact of stamping on a force plate, hitting a punching bag, and the amplitude of shouting in a microphone at various force levels. The premise is, that these body behaviours stand for the ‘urge to act or shout’ that belongs to anger-related emotions. The MSSS is meant to be applied in addition to potentially biased self-report questionnaires and has been designed for diagnostic as well as therapeutic purposes in clinical practice. First, this paper focusses on the instrumentation, internal structure and reliability of the MSSS. An explorative study in a student sample (n = 104) shows correlation patterns between increasing and decreasing levels of force production within each subtest (Stamp, Strike and Shout) and between the three subtests. We found excellent internal consistency of the three subtests and high test-retest reliability. The parameters of increasing and decreasing force levels form the slopes of what we call a force pyramid. To adjust for the clustering within persons, aggregated outcomes were calculated: sum scores per subtest as an indication of total force produced, two linear contrast scores to indicate the rate of increase / decrease, and two quadratic contrast scores as measures of the curvature of the slopes. On all subtests, all aggregated scores showed differences between men and women, also when controlled for weight. To test the validity of the MSSS, the second part of the paper examines the relationship between force parameters and anger coping style, measured by the Self-Expression and Control Scale (SECS). The results suggest that the Shout subtest was the most sensitive indicator for anger coping style, showing negative correlations with Anger In, for women as well as men. For women, higher amplitude was also associated with higher Anger Out and lower amplitude with higher Anger Control. The Stamp subtest showed weak positive correlations with the Anger In subscales, whereas no correlations were found on the Strike subtest. Further, a more robust comparison was made between two groups of participants who reported to have an internalizing versus an externalizing anger coping style. Results indicated that internalizing women as well as men used less force than externalizing participants on all three subtests, especially on the Shout subtest. This was confirmed by lower mean sum scores on the Shout subtest for internalizing women compared with externalizing women. No differences in linear contrast scores were shown between internalizing and externalizing participants. The quadratic contrast scores suggested differences of the curvation of the slopes between women with more or less anger control when stamping, and men with more or less anger control when striking. As this is an explorative study, findings should be interpreted with caution.
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Affiliation(s)
- Cees Boerhout
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Lentis Psychiatric Institute, Groningen, The Netherlands
- * E-mail:
| | - Jooske T. van Busschbach
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | | | | | - At L. Hof
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hans W. Hoek
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Areeudomwong P, Buttagat V. Proprioceptive neuromuscular facilitation training improves pain-related and balance outcomes in working-age patients with chronic low back pain: a randomized controlled trial. Braz J Phys Ther 2018; 23:428-436. [PMID: 30361077 DOI: 10.1016/j.bjpt.2018.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Proprioceptive neuromuscular facilitation training and general trunk exercises have been applied to treat chronic low back pain patients. However, there is currently little study to support the use of one treated intervention over the other to improve clinical outcomes and balance ability. OBJECTIVE To examine the effects of proprioceptive neuromuscular facilitation training on pain intensity, disability and static balance ability in working-age patients with chronic low back pain. METHODS Forty-four chronic low back pain participants aged 18-50 years were randomized either to a three-week proprioceptive neuromuscular facilitation training or to a control group receiving general trunk exercises. Pain intensity, disability and static balance ability were measured before and after the three-week intervention. RESULTS The proprioceptive neuromuscular facilitation training intervention showed a statistically significantly greater reduction in pain intensity and improved functional disability than the controls at three weeks (between-group difference: pain intensity 1.22 score, 95% CI: 0.58 to 1.88, p<0.001; disability 2.23 score, 95% CI: 1.22 to 3.24, p<0.001. The proprioceptive neuromuscular facilitation training intervention also had statistically better parameters of static balance ability than the control group (between-group difference: ellipse sway area during eye opened and closed conditions 129.09mm2, 95% CI: 64.93 to 175.25, p<0.01 and 336.27mm2, 95% CI: 109.67 to 562.87, p<0.05, respectively; the centre of pressure velocity during eye opened and eye closed conditions 6.68mm/s, 95% CI: 4.41 to 8.95, p<0.01 and 6.77mm/s, 95% CI: 4.01 to 9.54, p<0.01, respectively). CONCLUSION The three-week proprioceptive neuromuscular facilitation training provides better pain intensity, disability and static balance ability than general trunk exercises for working-age individuals with chronic low back pain but the effects do not reach the clinical meaningful level. The therapists should consider carefully when making recommendations regarding these interventions, taking into account effectiveness and costs.
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Affiliation(s)
- Pattanasin Areeudomwong
- Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
| | - Vitsarut Buttagat
- Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
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15
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Reguera-García MM, de Souza-Teixeira F, Fernández JADP. Test-retest reliability of static postural control in people with multiple sclerosis. J Phys Ther Sci 2017; 29:1399-1404. [PMID: 28878471 PMCID: PMC5574355 DOI: 10.1589/jpts.29.1399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/24/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to analyse the intraday test-retest reliability of stabilometric measurements on the Centre of Pressure (CoP) in persons with Multiple Sclerosis. [Subjects and Methods] The measurements were taken with the subject standing on the force platform with both feet together, in four different conditions: eyes open and closed whilst standing on both a rigid surface and then on foam. The measurements were taken on three occasions with intervals of 20 minutes between them. 18 persons with confirmed Multiple Sclerosis (MS), (aged 44.4 ± 13.3 years and 3.5 ± 1.5 EDSS) participated in the study. Relative reliability was measured using the intraclass correlation coefficient (ICC) and the 95% confidence interval (95% CI); and the absolute reliability using the coefficient of variation (CV) and standard error of measurement (SEM). [Results] The measurements of the CoP in all of the variables in each of the four conditions, showed a reliability of good to excellent (ICC=0.69-0.92) in the intraday test-retest. The variables which showed greatest consistency with repetition were X Speed, Y Speed and Side Length. [Conclusion] Given the results it would seem that the best variables for monitoring postural control in persons with MS are Speed on X and Y along with Side Length.
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Affiliation(s)
| | - Fernanda de Souza-Teixeira
- School of Physical Education, Departament of Physical Education and Health, Federal University of Pelotas, Brazil
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Validation of the HUMAC Balance System in Comparison with Conventional Force Plates. TECHNOLOGIES 2017. [DOI: 10.3390/technologies5030044] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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17
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Goble DJ, Hearn MC, Baweja HS. Combination of BTrackS and Geri-Fit as a targeted approach for assessing and reducing the postural sway of older adults with high fall risk. Clin Interv Aging 2017; 12:351-357. [PMID: 28228655 PMCID: PMC5312691 DOI: 10.2147/cia.s131047] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Atypically high postural sway measured by a force plate is a known risk factor for falls in older adults. Further, it has been shown that small, but significant, reductions in postural sway are possible with various balance exercise interventions. In the present study, a new low-cost force-plate technology called the Balance Tracking System (BTrackS) was utilized to assess postural sway of older adults before and after 90 days of a well-established exercise program called Geri-Fit. Results showed an overall reduction in postural sway across all participants from pre- to post-intervention. However, the magnitude of effects was significantly influenced by the amount of postural sway demonstrated by individuals prior to Geri-Fit training. Specifically, more participants with atypically high postural sway pre-intervention experienced an overall postural sway reduction. These reductions experienced were typically greater than the minimum detectable change statistic for the BTrackS Balance Test. Taken together, these findings suggest that BTrackS is an effective means of identifying older adults with elevated postural sway, who are likely to benefit from Geri-Fit training to mitigate fall risk.
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Affiliation(s)
- Daniel J Goble
- School of Exercise and Nutritional Sciences, College of Health and Human Services, San Diego State University, San Diego, CA, USA
| | - Mason C Hearn
- School of Exercise and Nutritional Sciences, College of Health and Human Services, San Diego State University, San Diego, CA, USA
| | - Harsimran S Baweja
- School of Exercise and Nutritional Sciences, College of Health and Human Services, San Diego State University, San Diego, CA, USA
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18
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Goble DJ, Manyak KA, Abdenour TE, Rauh MJ, Baweja HS. AN INITIAL EVALUATION OF THE BTRACKS BALANCE PLATE AND SPORTS BALANCE SOFTWARE FOR CONCUSSION DIAGNOSIS. Int J Sports Phys Ther 2016; 11:149-155. [PMID: 27104048 PMCID: PMC4827358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND As recently dictated by the American Medical Society, balance testing is an important component in the clinical evaluation of concussion. Despite this, previous research on the efficacy of balance testing for concussion diagnosis suggests low sensitivity (∼30%), based primarily on the popular Balance Error Scoring System (BESS). The Balance Tracking System (BTrackS, Balance Tracking Systems Inc., San Diego, CA, USA) consists of a force plate (BTrackS Balance Plate) and software (BTrackS Sport Balance) which can quickly (<2 min) perform concussion balance testing with gold standard accuracy. PURPOSE The present study aimed to determine the sensitivity of the BTrackS Balance Plate and Sports Balance Software for concussion diagnosis. STUDY DESIGN Cross-Sectional Study. METHODS Preseason baseline balance testing of 519 healthy Division I college athletes playing sports with a relatively high risk for concussions was performed with the BTrackS Balance Test. Testing was administered by certified athletic training staff using the BTrackS Balance Plate and Sport Balance software. Of the baselined athletes, 25 later experienced a concussion during the ensuing sport season. Post-injury balance testing was performed on these concussed athletes within 48 of injury and the sensitivity of the BTrackS Balance Plate and Sport Balance software was estimated based on the number of athletes showing a balance decline according to the criteria specified in the Sport Balance software. This criteria is based on the minimal detectable change statistic with a 90% confidence level (i.e. 90% specificity). RESULTS Of 25 athletes who experienced concussions, 16 had balance declines relative to baseline testing results according to the BTrackS Sport Balance software criteria. This corresponds to an estimated concussion sensitivity of 64%, which is twice as great as that reported previously for the BESS. CONCLUSIONS The BTrackS Balance Plate and Sport Balance software has the greatest concussion sensitivity of any balance testing instrument reported to date. LEVEL OF EVIDENCE Level 2 (Individual cross sectional diagnostic study).
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Affiliation(s)
- Daniel J Goble
- San Diego State University, School of Exercise and Nutritional Sciences, College of Health and Human Sciences, San Diego, CA, USA
| | - Kristin A Manyak
- San Diego State University, Department of Athletics, San Diego, CA, USA
| | - Thomas E Abdenour
- San Diego State University, Department of Athletics, San Diego, CA, USA
| | - Mitchell J Rauh
- San Diego State University, School of Exercise and Nutritional Sciences, College of Health and Human Sciences, San Diego, CA, USA
| | - Harsimran S Baweja
- San Diego State University, School of Exercise and Nutritional Sciences, College of Health and Human Sciences, San Diego, CA, USA
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Nalci A, Khodamoradi A, Balkan O, Nahab F, Garudadri H. A computer vision based candidate for functional balance test. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:3504-8. [PMID: 26737048 DOI: 10.1109/embc.2015.7319148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Balance in humans is a motor skill based on complex multimodal sensing, processing and control. Ability to maintain balance in activities of daily living (ADL) is compromised due to aging, diseases, injuries and environmental factors. Center for Disease Control and Prevention (CDC) estimate of the costs of falls among older adults was $34 billion in 2013 and is expected to reach $54.9 billion in 2020. In this paper, we present a brief review of balance impairments followed by subjective and objective tools currently used in clinical settings for human balance assessment. We propose a novel computer vision (CV) based approach as a candidate for functional balance test. The test will take less than a minute to administer and expected to be objective, repeatable and highly discriminative in quantifying ability to maintain posture and balance. We present an informal study with preliminary data from 10 healthy volunteers, and compare performance with a balance assessment system called BTrackS Balance Assessment Board. Our results show high degree of correlation with BTrackS. The proposed system promises to be a good candidate for objective functional balance tests and warrants further investigations to assess validity in clinical settings, including acute care, long term care and assisted living care facilities. Our long term goals include non-intrusive approaches to assess balance competence during ADL in independent living environments.
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Wai AAP, Duc PD, Syin C, Zhang H. iBEST: intelligent Balance assessment and Stability Training system using smartphone. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:3683-6. [PMID: 25570790 DOI: 10.1109/embc.2014.6944422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Patients with postural instability could lead to falls and injuries while walking due to balance disorders. So those patients need regular balance training and evaluation to improve and examine balance deficiencies. But many do not notice such balance issues; resulting lack of timely preventive measures. This shows the needs of affordable and accessible solution for balance training and assessment. So iBEST (intelligent Balance assessment and Stability Training) is proposed enabling to train and assess balance conveniently anywhere anytime. Moreover, therapists can remotely evaluate and manage their recovery progress. These benefits can be realized leveraging sensors from smartphone, cloud-based data analytics and web applications. iBEST employs sensorised automated balance assessment in digitizing Berg Balance Scale (BBS) clinical risk assessment tool. The initial feasibility study showed average accuracy of 90.22% using smartphone in classifying the specified BBS test items.
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Lipsitz LA, Lough M, Niemi J, Travison T, Howlett H, Manor B. A shoe insole delivering subsensory vibratory noise improves balance and gait in healthy elderly people. Arch Phys Med Rehabil 2014; 96:432-9. [PMID: 25450133 DOI: 10.1016/j.apmr.2014.10.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/29/2014] [Accepted: 10/10/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To test whether subsensory vibratory noise applied to the sole of the foot using a novel piezoelectric vibratory insole can significantly improve sensation, enhance balance, and reduce gait variability in elderly people, as well as to determine the optimal level of vibratory noise and whether the therapeutic effect would endure and the user's sensory threshold would remain constant during the course of a day. DESIGN A randomized, single-blind, crossover study of 3 subsensory noise stimulation levels on 3 days. SETTING Balance and gait laboratory. PARTICIPANTS Healthy community-dwelling elderly volunteers (N=12; age, 65-90y) who could feel the maximum insole vibration. INTERVENTIONS A urethane foam insole with the piezoelectric actuators delivering subsensory vibratory noise stimulation to the soles of the feet. MAIN OUTCOME MEASURES Balance, gait, and timed Up and Go (TUG) test. RESULTS The vibratory insoles significantly improved performance on the TUG test, reduced the area of postural sway, and reduced the temporal variability of walking at both 70% and 85% of the sensory threshold and during the course of a day. Vibratory sensation thresholds remained relatively stable within and across study days. CONCLUSIONS This study provides proof of concept that the application of the principle of stochastic resonance to the foot sole sensory system using a new low-voltage piezoelectric technology can improve measures of balance and gait that are associated with falls. Effective vibratory noise amplitudes range from 70% to 85% of the sensory threshold and can be set once daily.
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Affiliation(s)
- Lewis A Lipsitz
- Hebrew SeniorLife, Institute for Aging Research, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
| | - Matthew Lough
- Hebrew SeniorLife, Institute for Aging Research, Boston, MA
| | - James Niemi
- Harvard Medical School, Boston, MA; Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA
| | - Thomas Travison
- Hebrew SeniorLife, Institute for Aging Research, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA
| | | | - Brad Manor
- Hebrew SeniorLife, Institute for Aging Research, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA
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