Correlation between center of pressure and functional balance in non-faller elderly practitioners of Tai Chi Chuan

Telerehabilitation in Low-Resource Settings to Improve Postural Balance in Older Adults: A Non-Inferiority Randomised Controlled Clinical Trial Protocol

Background: Several exercise methods with virtual reality devices have been used in treatments for older adults and patients with neurodegenerative diseases, although the mechanisms continue to be elucidated. The aim of this study is to establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural balance in older adults. It also seeks to compare low-cost virtual reality under two delivery modalities, telerehabilitation (TR) in elderly centres and face-to-face (FtF) in rehabilitation centres. Methods: The study is set up as a non-inferiority two-arm parallel triple-blind randomised controlled clinical trial. Sixteen persons aged 65 to 75-years-old will be included. Eighteen Wii therapy sessions (25-30 min) will be provided through both FtF (control group, n = 8) and TR (exposure group, n = 8), both with a Nintendo Wii balance board. Data will be collected at baseline (week 0), during the Wii therapy sessions (weeks 2, 4, and 6), and during the follow-up (weeks 8 and 10). The primary outcome will be the area of centre-of-pressure (CoP) sway; secondary outcomes will be medial-lateral and anterior-posterior velocity and standard deviation of CoP; and tertiary outcomes will be clinical measures: single-leg stand, timed up-and-go tests, Barthel Index, and Tinetti's scale. Statistical analyses will be performed using SPSS 20.00 for Windows. The trial adheres to the Declaration of Helsinki and the Chilean laws of rights and duties of the patient and research in humans. Ethical approval was obtained from the Ethics Committee of the University of Talca. Written informed consent will be obtained from participants. Discussion: In this trial, older adults from a Chilean city with a large rural and underserved population share will be included to test the feasibility and effectiveness of a rehabilitation programme using low-cost VR aimed at improving postural balance to generate evidence to support decision makers generating public health policy. Trial registration: Australian New Zeeland Clinical Trials Registration (ACTRN12621001380886).

Postural control telerehabilitation with a low-cost virtual reality protocol for children with cerebral palsy: Protocol for a clinical trial

OBJECTIVE

To establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral palsy-spastic hemiplegia. It also aims to compare the effectiveness of this programme under two delivery modalities, telerehabilitation (TR) and face-to-face (FtF).

METHODS

This is a registered randomized controlled clinical trial protocol (ACTRN12621000117819). Eighteen sessions of low-cost virtual reality therapy will be provided through both, FtF and TR modalities using a Nintendo Wii balance board. Each programme will last for 6 weeks and will consist of 3 sessions per week of 25 minutes each. Twenty patients diagnosed with cerebral palsy-spastic hemiplegia will be recruited for each group: FtF or TR (n = 40). Participants will be assessed at baseline, by the end of weeks 2, 4, and 6, and at weeks 8 and 10 (post-intervention follow-ups). The primary outcome will be the Center of Pressure sway area (CoParea); secondary outcomes will be standard deviation and velocity of the CoP in the mediolateral and anterior-posterior directions; tertiary outcomes will include the Modified-Modified Ashworth Scale for lower limbs, Modified Ashworth Scale for upper limbs, timed up-and-go tests, the timed one-leg standing and 6-minute walk test.

RESULTS

This study provides an assessment of the feasibility and effectiveness of an affordable rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral palsy.

CONCLUSION

The designed rehabilitation programme using low-cost virtual reality may improve postural control in children with cerebral palsy-spastic hemiplegia. The TR modality is likely to be as effective as the FtF modality. The TR programme has been designed to overcome access barriers to physiotherapy services for children with cerebral palsy in low-resource settings, remote areas, and in restricted mobility contexts.

Functional Electrical Stimulation of Peroneal Muscles on Balance in Healthy Females

Balance improvement could contribute to ankle stability for the prevention of ankle sprains. Functional electrical stimulation (FES) is an effective way of augmenting muscle activity and improving balance. This study investigated the effect of FES of peroneal muscles on single-and double-leg balance. Fifteen healthy females (age = 23.1 ± 1.6 years, height = 1.63 ± 0.07 m, and weight = 63.7 ± 9.9 kg) performed single- and double-leg standing balance tests with eyes open and closed before and after 15-minute FES intervention during treadmill running at a comfortable, self-selected pace. FES of peroneal muscles was provided bilaterally, using an Odstock Dropped Foot Stimulator. The total excursion of the centre of pressure (COP) was calculated to assess the standing balance control ability. The total excursion of COP in single- and double-leg stance with eyes open reduced significantly after FES intervention by 14.7% (p < 0.001) and 5.9% (p = 0.031), respectively. The eyes-closed condition exhibited a 12.7% (p = 0.002) reduction in single-leg stance but did not significantly change in double-leg stance (p > 0.05). Limb preference did not account for balance postintervention. No significant difference in total excursion of COP was found between preferred and less preferred limbs with both visual conditions (p > 0.05). FES of peroneal muscles improved standing balance control with eyes open in double-leg and single-leg stance and with eyes closed in double-leg stance. The improvements in balance control with FES treatment did not vary concerning limb preference.