1
|
Fereshtenejad N, Saberi S, Pol F, Yeowell G, Sadeghi-Demneh E. Intersession reliability of center of pressure measurement during bipedal standing with different foot placement angles. J Bodyw Mov Ther 2024; 39:410-414. [PMID: 38876660 DOI: 10.1016/j.jbmt.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION The foot placement is a determinant of the base of support and influences standing balance. The reliability of postural stability tests with different foot placement angles is unclear. RESEARCH QUESTION To determine and compare the intra- and inter-day reliability of the center of pressure-based postural stability while standing with different foot placement angles. METHOD Twenty-five healthy adults (16 females and 9 males; age: 29 ± 6 years) completed 70 s trials of eyes open and eyes closed stability tests with 0°, 15°, 30°, and 45° angles between the feet while standing on a forceplate in three sessions: two sessions were in the same day, and the third session was one-week apart. The repeatability of measurements was tested using analysis of variance, interclass correlation, and standard error of measurements. RESULT Throughout the three study sessions, there was no difference in postural stability while participants stood with different foot placement angles. The interclass correlation scores ranged from 0.71 to 0.96, the standard error of measurements ranged from 2.1% to 12.9%, and no significant systematic changes (p < 0.05) occurred between the testing sessions for any foot placements. Standing with a 45° angle between the feet with closed eyes showed higher reliability values than other conditions. The intra-day reliability scores were greater than inter-day reliability. DISCUSSION The relative reliability of postural stability could be impacted by foot placement angles, which might alter ankle mobility and base of support dimensions. The advantages of larger foot placement angles on improving the relative reliability of postural stability could be better demonstrated in healthy people under challenging conditions such as standing with closed eyes. CONCLUSION Standing with foot placement angles between 0° and 45° are reliable and a quantitative assessment of the center of pressure could be used to monitor the changes in postural stability between sessions.
Collapse
Affiliation(s)
- Niloufar Fereshtenejad
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Saberi
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Pol
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Ebrahim Sadeghi-Demneh
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
2
|
Silva CFO, Obara K, Paixão L, Santos EH, Santos AIZ, Cardoso JR. Use of posturography in patients with ankylosing spondylitis: A systematic review. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2024; 80:1953. [PMID: 38841593 PMCID: PMC11151370 DOI: 10.4102/sajp.v80i1.1953] [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: 07/20/2023] [Accepted: 10/23/2023] [Indexed: 06/07/2024] Open
Abstract
Background Ankylosing spondylitis (AS) is characterised as a chronic inflammatory disease of the axial skeleton. The force platform is an option for performing the postural assessment of these individuals. Objectives To review and evaluate the behaviour of the centre of pressure (CoP) variables during the postural control examination in patients with AS compared to a control group. Method A systematic review, registered in PROSPERO, that followed the PRISMA Statement. A search was carried out in the following databases: Medline, Web of Science, Embase, Scopus, and Scielo, from 1945 to 2023. Studies were selected that aimed to understand the use of the force platform for the assessment of postural control. The risk of bias assessment was performed using the AXIS tool. Results Five studies were included, with a total of 247 participants. The assessment of risk of bias presented high scores in the AXIS tool. Patients with a diagnosis of AS presented increased thoracic kyphosis in most of the studies, as well as large displacements in the anteroposterior (AP) and mediolateral (ML) directions, and altered total mean velocity (TMV) and frequency, indicating worse postural stability. Regarding the functional status, the most used questionnaires were the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Disease Activity Index (BASDAI). Conclusion Patients with ankylosing spondylitis present postural instability, verified by means of higher values of centre of posture variables. Clinical implications Individuals with ankylosing spondylitis presented postural instability and balance deficit. Therefore, exercises for balance training and postural control are essential in the clinical management of these patients.
Collapse
Affiliation(s)
- Caroline F O Silva
- Department of Physical Therapy, Universidade Estadual de Londrina, Londrina, Brazil
| | - Karen Obara
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Brazil
| | - Luana Paixão
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Brazil
| | - Eduarda H Santos
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Brazil
| | - Amanda I Z Santos
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Brazil
| | - Jefferson R Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Brazil
| |
Collapse
|
3
|
Saraiva M, Vilas-Boas JP, Castro MA. Postural Control and Muscle Activity during Dual-Task in Young Adults. Behav Sci (Basel) 2024; 14:403. [PMID: 38785895 PMCID: PMC11117846 DOI: 10.3390/bs14050403] [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: 03/22/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
In everyday life, we recurrently perform two tasks simultaneously, which is called dual-tasking. A common dual task is smartphone use while standing or walking. According to previous studies, this task can compromise postural stability. However, few studies have analyzed lower limb muscle activity during dual-tasking using smartphones. This study aimed to assess the postural sway and muscle activity during dual-tasking in young adults. Thirty-six healthy young adults (23.08 ± 3.92 years) participated in this study. They performed a single task (ST: keeping a quiet standing posture) and a dual task (DT: keeping the ST while simultaneously performing a cognitive task on their smartphone). Postural sway was assessed through the center of pressure (CoP) analysis using a force platform: total CoP displacement, CoP displacement in the anterior-posterior and medial-lateral directions, mean total velocity of the CoP, mean velocity of the CoP in the anterior-posterior and medial-lateral directions, and 95% confidence ellipse sway area. A surface electromyography system recorded the muscle activity of the lumbar spinal erector and five muscles of the lower limb (bilaterally). The results showed an increase in postural sway from the ST to the DT in all CoP variables (p < 0.05), and muscle activity in most muscles analyzed decreased from the ST to the DT (p < 0.05). In conclusion, our results reflect a decentralization of attention from motor performance once postural sway increased and muscle activity decreased in dual-task conditions.
Collapse
Affiliation(s)
- Marina Saraiva
- Dr. Lopes Dias Health School, Sector of Physiotherapy, Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal;
- Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
| | - João Paulo Vilas-Boas
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal;
- LABIOMEP-UP, Faculty of Sports and CIFI2D, The University of Porto, 4200-450 Porto, Portugal
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal;
- Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal
- School of Health Sciences, Sector of Physiotherapy, ciTechCare, CDRSP, Polytechnic University of Leiria, 2411-901 Leiria, Portugal
| |
Collapse
|
4
|
Tanwar T, Aldabbas M, Iram I, Veqar Z. Sleep quality and its association with anxiety, stress, sleep-related beliefs and attitudes and postural control in young adults: a cross-sectional study. Int J Adolesc Med Health 2024; 36:169-176. [PMID: 38413222 DOI: 10.1515/ijamh-2023-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Adequate sleep is essential for young adults, as this age group primarily consists of students, job seekers, and working people constantly managing a hectic lifestyle. Poor quality of sleep, which is essential for physical and mental well-being in the short and long term, can result in impaired overall health. However, there exists a gap in the literature regarding the factors affecting sleep among young adults. Hence, the objective of this study was to find the prevalence of sleep-related parameters (sleep health, hygiene, and sleep-related beliefs and attitudes) and potential risk factors for sleep quality and to investigate the association between sleep and postural control in young adults. METHODS This prospective, cross-sectional, analytical study included 181 young adults, 113 (62.43 %) females, and 68 (37.57 %) males, with a mean age of 23.82 ± 2.88 years. Sleep quality, health, beliefs, hygiene, stress, anxiety, and depression were assessed using questionnaires. Postural control was assessed using center of pressure (COP) indices. RESULTS The overall prevalence of poor sleep quality was 79.01 % among young adults. Multiple linear regression showed that predictors explained 44 % of sleep quality variance (adjusted R square=0.44, f (12,168) = 20.91, p<0.05). Poor sleep-related beliefs and attitudes (95 % CI [0.037, 0.679], p=0.029), higher perceived stress (95 % CI [0.005, 0.219], p=0.039), higher anxiety severity (95 % CI [0.108, 0.526], p=0.003), and poor COP stability index A/P (95 % CI [4.986, 11.248], p=0.00) were found to be significant predictors of poor sleep quality. CONCLUSIONS High anxiety and stress, and poor dysfunctional beliefs and attitudes about sleep are predictors of poor sleep quality in young adults. These factors may significantly affect sleep quality and the experience of restful sleep among young adults. Also, poor sleep quality is associated with reduced postural control (decreased stability in the A/P direction). These findings are crucial for improving young adults' overall health and well-being, as poor sleep is highly prevalent among this age group.
Collapse
Affiliation(s)
- Tarushi Tanwar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
| | - Mosab Aldabbas
- Faculty of Applied Medical Sciences, Department of Physical Therapy, Al-Azhar University, Gaza, Palestine
| | - Iram Iram
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
| |
Collapse
|
5
|
Kwon IH, Shin WS, Choi KS, Lee MS. Effects of Real-Time Feedback Methods on Static Balance Training in Stroke Patients: A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:767. [PMID: 38610189 PMCID: PMC11011765 DOI: 10.3390/healthcare12070767] [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: 03/11/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effects of real-time feedback methods on static balance training in stroke patients. There are two types of real-time feedback methods, as follows: one is Knowledge of Result (KR), and the other is Knowledge of Performance (KP). METHOD Thirty stroke patients participated in this study and were randomly assigned to the KR group (n = 15) or the KP group (n = 15). All of the groups underwent real-time feedback training for four weeks (30 min per session, five sessions per week). The primary outcomes were sway length, sway velocity, and area 95%, which were assessed before and after the intervention. The secondary outcomes included the Berg Balance Scale, the Fugl Meyer Assessment for Lower Extremity, the Postural Assessment Scale for Stroke Trunk Impairment Scale, and the Fall Efficacy Scale. A group × time interaction was assessed using two-way ANOVA with repeated measures. RESULT There was a significant increase over time in all outcomes (p < 0.05). Significant differences were observed for a group × time interaction in sway length and area 95% (p < 0.05). CONCLUSIONS Real-time feedback training for static balance enhanced stroke patients' static balance abilities, clinical outcome assessments, and promoted self-efficacy against falls.
Collapse
Affiliation(s)
- Il-Ho Kwon
- Department of Physical Therapy, Graduate School of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
| | - Won-Seob Shin
- Department of Physical Therapy, College of Health Medical Science, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Kyu-Seong Choi
- Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
| | - Myung-Sun Lee
- Department of Beauty Design, College of Design and Art, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
| |
Collapse
|
6
|
Kang S, Park I, Ha MS. Effect of dynamic neuromuscular stabilization training using the inertial load of water on functional movement and postural sway in middle-aged women: a randomized controlled trial. BMC Womens Health 2024; 24:154. [PMID: 38438927 PMCID: PMC10910739 DOI: 10.1186/s12905-024-02972-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/13/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Chronic stress and diseases occur more frequently in middle-aged compared to younger women and this is often the result of physical, psychological and socio-economic changes. These health consequences reduce lower body muscle mass and flexibility, leading to generalized impairments in functional movement and balance. Dynamic Neuromuscular Stabilization (DNS) training using the inertial load of water is known for its positive impact on functional strength improvement and muscle stabilization. OBJECTIVE This study aimed to determine the effect of DNS training using inertial water loads on functional movement and postural sway in middle-aged women. METHOD A sample of 24 middle-aged women participated in the study and were randomly divided into two groups: the experimental group, n = 12 (age: 58.33 ± 1.48 yrs, height: 162.16 ± 1.27 cm, weight: 61.77 ± 2.21 kg) and control group, n = 12 (age: 59.58 ± 1.13 yrs, height: 160.1 ± 1.13 cm, weight: 57.51 ± 1.12 kg). Center of Pressure (COP), moving distance, Root Mean Square (RMS), movement area and Functional Movement Screen (FMS) were conducted and analyzed pre- and post-examination. Participants engaged in the DNS training regimen, which utilized the inertial load of water, for 60 min each session, conducted twice weekly for 12 weeks. RESULTS There were significant differences in the COP distance (p < 0.001), RMS (p < 0.05), COP area and FMS test (p < 0.001) in the pre-post comparison of each group. And significant differences were found in COP distance (p < 0.05), RMS (p < 0.05), COP area (p < 0.05) and FMS test (p < 0.05) between groups. The DNS training improved the dynamic stability of single-leg standing, torso stability and functional movement in middle-aged women. CONCLUSION DNS training programs using the inertial load of water have been shown to be effective in movement improvement and posture retention ability, which is beneficial for functional movement, equilibrium strategy, and dynamic stability of middle-aged women. Furthermore, the DNS training method designed in this study can be useful for trainees who require posture correction in a safe and effective way regardless of their age and gender.
Collapse
Affiliation(s)
- Shuho Kang
- Department of Sports Rehabilitation, Busan University of Foreign Studies, 65 Geumsaem-Ro 485Beon-Gil, Geumjeong-Gu, Busan, 46234, Republic of Korea
| | - Ilbong Park
- Department of Sports Rehabilitation, Busan University of Foreign Studies, 65 Geumsaem-Ro 485Beon-Gil, Geumjeong-Gu, Busan, 46234, Republic of Korea
| | - Min-Seong Ha
- Laboratory of Sports Conditioning: Nutrition Biochemistry and Neuroscience, Department of Sports Science, College of the Arts and Sports, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-Gu, Seoul, 02504, Republic of Korea.
| |
Collapse
|
7
|
Valenzuela R, Corral J, Diez M, Campa FJ, Herrero S, Macho E, Pinto C. On-Screen Visual Feedback Effect on Static Balance Assessment with Perturbations. SENSORS (BASEL, SWITZERLAND) 2024; 24:1588. [PMID: 38475122 DOI: 10.3390/s24051588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024]
Abstract
In this study, the novel mobile dynamometric platform, OREKA, was utilized to perform an extensive analysis of the centre of pressure behaviour during different tilt motion exercises. This platform is based on a parallel manipulator mechanism and can perform rotations around both horizontal axes and a vertical translation. A group of participants took part in an experimental campaign involving the completion of a set of exercises. The aim was to evaluate the platform's potential practical application and investigate the impact of visual on-screen feedback on centre of pressure motion through multiple balance indicators. The use of the OREKA platform enables the study of the impact on a user's balance control behaviour under different rotational perturbations, depending on the availability of real-time visual feedback on a screen. Furthermore, it presented data identifying postural control variations among clinically healthy individuals. These findings are fundamental to comprehending the dynamics of body balance. Further investigation is needed to explore these initial findings and fully unlock the potential of the OREKA platform for balance assessment methodologies.
Collapse
Affiliation(s)
- Ruben Valenzuela
- Bilbao School of Engineering, University of the Basque Country UPV/EHU, 48013 Bilbao, Spain
| | - Javier Corral
- Bilbao School of Engineering, University of the Basque Country UPV/EHU, 48013 Bilbao, Spain
| | - Mikel Diez
- Bilbao School of Engineering, University of the Basque Country UPV/EHU, 48013 Bilbao, Spain
| | - Francisco J Campa
- Bilbao School of Engineering, University of the Basque Country UPV/EHU, 48013 Bilbao, Spain
| | - Saioa Herrero
- Bilbao School of Engineering, University of the Basque Country UPV/EHU, 48013 Bilbao, Spain
| | - Erik Macho
- Bilbao School of Engineering, University of the Basque Country UPV/EHU, 48013 Bilbao, Spain
| | - Charles Pinto
- Bilbao School of Engineering, University of the Basque Country UPV/EHU, 48013 Bilbao, Spain
| |
Collapse
|
8
|
Menici V, Scalise R, Fasano A, Falotico E, Dubbini N, Prencipe G, Sgandurra G, Filogna S, Battini R. Assessment of Postural Control in Children with Movement Disorders by Means of a New Technological Tool: A Pilot Study. Bioengineering (Basel) 2024; 11:176. [PMID: 38391662 PMCID: PMC10886107 DOI: 10.3390/bioengineering11020176] [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: 12/20/2023] [Revised: 02/01/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
Considering the variability and heterogeneity of motor impairment in children with Movement Disorders (MDs), the assessment of postural control becomes essential. For its assessment, only a few tools objectively quantify and recognize the difference among children with MDs. In this study, we use the Virtual Reality Rehabilitation System (VRRS) for assessing the postural control in children with MD. Furthermore, 16 children (mean age 10.68 ± 3.62 years, range 4.29-18.22 years) were tested with VRRS by using a stabilometric balance platform. Postural parameters, related to the movements of the Centre of Pressure (COP), were collected and analyzed. Three different MD groups were identified according to the prevalent MD: dystonia, chorea and chorea-dystonia. Statistical analyses tested the differences among MD groups in the VRRS-derived COP variables. The mean distance, root mean square, excursion, velocity and frequency values of the dystonia group showed significant differences (p < 0.05) between the chorea group and the chorea-dystonia group. Technology provides quantitative data to support clinical assessment: in this case, the VRRS detected differences among the MD patterns, identifying specific group features. This tool could be useful also for monitoring the longitudinal trajectories and detecting post-treatment changes.
Collapse
Affiliation(s)
- Valentina Menici
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy
- Ph.D. Programme in Clinical and Translational Sciences, University of Pisa, 56126 Pisa, Italy
| | - Roberta Scalise
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy
| | - Alessio Fasano
- The BioRobotics Institute, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy
| | - Egidio Falotico
- The BioRobotics Institute, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | | | - Giuseppe Prencipe
- Department of Computer Science, University of Pisa, 56127 Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Silvia Filogna
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| |
Collapse
|
9
|
Daffin L, Innes S, Stuelcken MC. An investigation of the reproducibility of a self-selected natural feet position when standing: Implications for the assessment of upright standing posture. Musculoskelet Sci Pract 2024; 69:102896. [PMID: 38101271 DOI: 10.1016/j.msksp.2023.102896] [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: 08/18/2023] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Photogrammetry is often used to evaluate standing static postural alignment. Patients are often instructed to self-select a natural feet position but it's unclear whether this position can be consistently replicated across repeated assessments. OBJECTIVE To determine whether people can replicate a self-selected natural feet position in upright standing across three sessions on different days. DESIGN Between days test-retest reliability. SETTING University laboratory. METHODS Three variables - Base of Support (BoS), Foot Width (FW), Feet Opening Angle (FOA) - were measured from foot tracings of 150 participants (18-30 years) using established procedures. BoS data were assessed for systematic bias (Analysis of Variance), and absolute (Coefficient of Variation - CV%) and relative (Intraclass Correlation Coefficient - ICC) reliability. RESULTS There was systematic bias in the BoS data across the three testing sessions. The CV% for the BoS data was 15.2%. The ICC (95% CI) for the BoS data was 0.84 (0.79-0.87). There were moderate-large correlations between the BoS and both FOA and FW respectively within each session. CONCLUSION If clinicians want to allow patients to use their self-selected natural feet position for repeated photogrammetric assessment of their static postural alignment it would be better to standardise the position of the feet, for example, by creating a tracing of a patient's self-selected natural feet position.
Collapse
Affiliation(s)
- Lee Daffin
- School of Allied Health, Murdoch University, 90 South St, Murdoch, WA, 6150, Australia.
| | - Stanley Innes
- Research Associate, Eastern Adult Health Mental Health and Wellbeing Program, Victoria, Australia; Faculty of Allied Health & Wellbeing, UCLAN, Preston, UK.
| | - Max C Stuelcken
- School of Health, University of the Sunshine Coast (UniSC), 90 Sippy Downs Dr, Sippy Downs, 4556, Queensland, Australia.
| |
Collapse
|
10
|
Da Cruz Junior ATV, Vasconcelos BHB, Barroso TGCP, Souza GS, Monteiro LCP, Xavier MB, Callegari B. Plantar pressure distribution and altered postural control in multibacillary leprosy patients. BMC Infect Dis 2024; 24:130. [PMID: 38267905 PMCID: PMC10809460 DOI: 10.1186/s12879-023-08749-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/25/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the peripheral nerves, resulting in sensory and motor deficits in the feet. Foot ulcers and imbalances are frequent manifestations in leprosy, often correlating with diminished sensitivity. While clinical scales and monofilament esthesiometers are conventionally utilized to evaluate foot sensitivity and balance in these patients, their discriminatory power is limited and their effectiveness is greatly dependent on the examiner's proficiency. In contrast, baropodometry and posturography offer a more comprehensive evaluation, aiming to preempt potential damage events. This study aimed was to assess the correlation between baropodometry and force plate measurements in leprosy patients and control participants, to improve the prevention and treatment of foot ulcers and complications associated with leprosy. METHODOLOGY This cross-sectional study was conducted during 2022 and enrolled 39 participants (22 patients with multibacillary leprosy and 17 non-leprosy controls). Demographic data were collected, and a monofilament esthesiometer was used to assess sensory deficits. In addition, physical examinations and balance and plantar pressure tests were conducted. The Student's t-test was used to compare mean and maximum plantar pressures between groups. For most COP variables, a Mann-Whitney Wilcoxon test was used, except for AP amplitude which was analyzed with the Student's t-test due to its normal distribution. The relationship between foot pressure and balance control was assessed using Spearman's correlation, focusing on areas with significant pressure differences between groups. PRINCIPAL FINDINGS Leprosy patients showed increased pressure in forefoot areas (T1, M1, T2-T5, and M2) and decreased pressure in hindfoot regions (MH and LH) compared to controls. These patients also displayed higher AP and ML amplitudes, suggesting poorer COP control. Correlation analyses between the two groups revealed that foot plantar pressures significantly impact balance control. Specifically, increased T1 region pressures correlated with greater sway in balance tasks, while decreased MH region pressures were linked to reduced COP control. CONCLUSIONS/SIGNIFICANCE The findings suggest a joint disturbance of plantar pressure distribution and static balance control in leprosy patients. These alterations may increase the risk of tissue injuries, including calluses and deformities, as well as falls.
Collapse
Affiliation(s)
- Alex Tadeu Viana Da Cruz Junior
- Laboratory of Human Motricity Studies, Health Science Institute, Federal University of Para, Belém, Brazil
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil
| | | | | | - Givago Silva Souza
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil
- Biological Science Institute, Federal University of Para, Belém, Brazil
| | | | - Marília Brasil Xavier
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil
- Biological and Health Sciences Center, State University of Pará (UEPA), Belém, Pará, Brazil
| | - Bianca Callegari
- Laboratory of Human Motricity Studies, Health Science Institute, Federal University of Para, Belém, Brazil.
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil.
| |
Collapse
|
11
|
Xue X, Wang Y, Xu X, Li H, Li Q, Na Y, Tao W, Yu L, Jin Z, Li H, Wang R, Hua Y. Postural Control Deficits During Static Single-leg Stance in Chronic Ankle Instability: A Systematic Review and Meta-Analysis. Sports Health 2024; 16:29-37. [PMID: 36872589 PMCID: PMC10732110 DOI: 10.1177/19417381231152490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
CONTEXT Postural control deficits arising from injured ankles are central to chronic ankle instability (CAI) and its persistent symptoms. This is usually measured by recording the center of pressure (CoP) trajectory during static single-leg stance using a stable force plate. However, existing studies have produced conflicting results on whether this mode of measurement adequately reveals the postural deficits in CAI. OBJECTIVE To determine whether postural control during static single-leg stance is impaired in CAI patients when compared with uninjured healthy controls. DATA SOURCES Literature databases, PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, and SPORTDiscus, were searched from inception to April 1, 2022, using ankle-, injury-, and posture-related terms. STUDY SELECTION Two authors independently performed the step-by-step screening of article titles, abstracts, and full texts to select peer-reviewed studies investigating CoP trajectory during static single-leg stance using a stable force plate in CAI patients and healthy controls. A total of 13,637 studies were reviewed, and 38 studies (0.003%) met the selection criteria. STUDY DESIGN Meta-analyses of descriptive epidemiological study. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION CoP parameters, sway directions, visual condition, and numerical data (means and standard deviations) were extracted. RESULTS The injured ankles of CAI patients had higher standard deviations of sway amplitude in both anterior-posterior and medial-lateral directions (standardized mean difference [SMD] = 0.36 and 0.31, respectively) under conditions of open eyes than controls. Higher mean sway velocity in anterior-posterior, medial-lateral, and total directions (SMD = 0.41, 0.37, and 0.45, respectively) with closed eyes was also found. CONCLUSION CAI patients had deficits of postural control during static single-leg stance, and these deficits were identified by the CoP trajectory. Further methodological explorations of CoP parameters and corresponding test conditions are required to enhance the sensitivity and reliability of postural deficit assessments in CAI using force plates.
Collapse
Affiliation(s)
- Xiao’ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiran Wang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoyun Xu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Hong Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyan Na
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Weichu Tao
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Le Yu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Zhengbiao Jin
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongyun Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ru Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China; Yiwu Research Institute, Fudan University, Yiwu, China
| |
Collapse
|
12
|
Arnold T, Johnston CS. An examination of relationships between vitamin B12 status and functional measures of peripheral neuropathy in young adult vegetarians. Front Nutr 2023; 10:1304134. [PMID: 38174111 PMCID: PMC10764020 DOI: 10.3389/fnut.2023.1304134] [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: 09/29/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Prevalence rates for vitamin B12 deficiency in U.S. adult vegetarians may exceed 30%, which is concerning given the role for this vitamin in numerous nervous system functions, including the synthesis of myelin sheaths. Defective myelin synthesis and repair are directly linked to peripheral neuropathy; yet, few investigations have examined how physical indicators of peripheral neuropathy (e.g., hand dexterity, vibration sensitivity and balance) are impacted in individuals adhering to vegetarian diets. This feasibility research explored the relationships between peripheral neuropathy and vitamin B12 status using a cross-sectional study design. In addition, a small pilot trial was conducted for limited-efficacy testing of vitamin B12 supplementation for reducing peripheral neuropathy. Methods Healthy, able-bodied adults (n = 38; 19-40 years of age) reported exclusive adherence to a vegetarian or vegan diet for 3 years. Peripheral neuropathy was measured using a force plate for assessing balance, and a vibration sensitivity tester and pegboard tests to assess hand dexterity. Serum vitamin B12 and folate were measured using standard radioimmunoassay techniques. Results Twenty-six percent of the sample displayed deficient or marginal vitamin B12 status (serum vitamin B12 <221 pmol/L). Participants with adequate vitamin B12 status scored 10% higher on the Purdue pegboard assembly test and 20% higher on the left hand adjusted functional dexterity test in comparison to participants with marginal-to-deficient vitamin B12 status (p < 0.05). Discussion These data provide preliminary evidence that peripheral neuropathy can be detected in individuals with marginal-to-deficient vitamin B12 status.
Collapse
Affiliation(s)
| | - Carol S. Johnston
- Nutrition Program, College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| |
Collapse
|
13
|
Bolovan AD, Onofrei RR, Hogea GB, Abu-Awwad A, Lazarescu EA, Abu-Awwad SA, Tapardea AR, Suba MI, Amaricai EC. Comparison between Exercise Program-Foot Orthoses Treatment and Exercise Program Alone after Pilon Fracture Surgery: Study Protocol for a Randomized Controlled Trial. Life (Basel) 2023; 13:2187. [PMID: 38004327 PMCID: PMC10672240 DOI: 10.3390/life13112187] [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: 09/06/2023] [Revised: 10/20/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
The management of tibial pilon fractures is challenging and often leads to complications and limitations in ankle function. The study aims to investigate myotonometric parameters and muscle strength of ankle muscles, as well as gait pattern and balance among patients following surgical treatment of pilon fractures. The randomized controlled study will analyze the differences between the patients who will follow a 3-month physical exercise program and will wear customized foot orthoses (i.e., customized orthotic arch support insoles) versus patients who will attend only the physical exercise program. For each group, at least 21 patients will be required. The assessment involves four different testing procedures: myotonometry (anterior tibialis, medial and lateral gastrocnemius, and longus peroneus assessed using MyotonPRO), muscle strength testing (ankle dorsiflexors, plantar flexors, and peroneal muscles assessed using MicroFET2 dynamometer), analysis of gait parameters (using Scheinworks treadmill), and double-leg and single-leg balance tests (using K-Force plate). After 3 months, the assessments will record which of the two treatments (physical exercise program with or without wearing customized foot orthoses) has better outcomes in regaining ankle muscle properties and tone, as well as the restoration of gait and balance.
Collapse
Affiliation(s)
- Andrei-Daniel Bolovan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.-D.B.); (S.-A.A.-A.); (A.-R.T.); (M.-I.S.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (G.-B.H.); (E.-A.L.)
| | - Roxana-Ramona Onofrei
- Department of Rehabilitation, Physical Medicine and Rheumatology, Research Center for Assessment of Human Motion, Functionality and Disability, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (R.-R.O.); (E.-C.A.)
| | - Gheorghe-Bogdan Hogea
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (G.-B.H.); (E.-A.L.)
- Department XV—Discipline of Orthopedics—Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Center University Professor Doctor Teodor Șora, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Ahmed Abu-Awwad
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (G.-B.H.); (E.-A.L.)
- Department XV—Discipline of Orthopedics—Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Center University Professor Doctor Teodor Șora, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Emil-Adrian Lazarescu
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (G.-B.H.); (E.-A.L.)
- Research Center University Professor Doctor Teodor Șora, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Simona-Alina Abu-Awwad
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.-D.B.); (S.-A.A.-A.); (A.-R.T.); (M.-I.S.)
- Department XII—Discipline of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Alexandra-Roxana Tapardea
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.-D.B.); (S.-A.A.-A.); (A.-R.T.); (M.-I.S.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (G.-B.H.); (E.-A.L.)
| | - Madalina-Ianca Suba
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.-D.B.); (S.-A.A.-A.); (A.-R.T.); (M.-I.S.)
| | - Elena-Constanta Amaricai
- Department of Rehabilitation, Physical Medicine and Rheumatology, Research Center for Assessment of Human Motion, Functionality and Disability, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (R.-R.O.); (E.-C.A.)
| |
Collapse
|
14
|
Robles-Palazón FJ, Comfort P, Ripley NJ, Herrington L, Bramah C, McMahon JJ. Force plate methodologies applied to injury profiling and rehabilitation in sport: A scoping review protocol. PLoS One 2023; 18:e0292487. [PMID: 37812631 PMCID: PMC10561863 DOI: 10.1371/journal.pone.0292487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023] Open
Abstract
Musculoskeletal injuries are a common health problem among sporting populations. Such injuries come with a high financial burden to the involved organisations and can have a detrimental impact on the career attainment of injured individuals. Force plates are now a common tool available to sport and exercise science and medicine professionals to enable them to profile injury risk predisposition and modulate the rehabilitation process within sporting environments. This is because contemporary force plate technology is portable and affordable and often comes with software that enables the automatic and immediate feedback of test variables to key stakeholders. However, to our knowledge, to date, there has been no comprehensive review of the scientific literature pertaining to clinical applications of force plate technology. Therefore, this article presents a protocol and a methodological framework to perform a scoping review to identify and map the available scientific literature in which force plates have been applied to the injury profiling and rehabilitation of athletes. The specific aims of the scoping review are 1) to identify and describe the force plate tests, methodologies, and metrics used to screen for injury risk and guide the return of injured athletes to full-time training and competition, 2) to identify potential trends and/or differences by participants' age, sex, and/or level of performance in tests, methodologies, and metrics selected, and 3) to identify key gaps in the existing evidence base and new questions that should be addressed in future research. The global aim of the scoping review is to improve practitioner decision-making around force plate test and variable selection when applied to the injury prevention and rehabilitation of sporting populations.
Collapse
Affiliation(s)
- Francisco Javier Robles-Palazón
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
- Faculty of Sport Sciences, Department of Physical Activity and Sport, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
| | - Paul Comfort
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
- Centre for Exercise and Sport Science Research, Edith Cowan University, Joondalup, WA, Australia
| | - Nicholas J. Ripley
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - Lee Herrington
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - Christopher Bramah
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - John J. McMahon
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| |
Collapse
|
15
|
Ikeda T, Oka S, Tokuhiro J, Suzuki A, Matsuda K. Short-Term Cast Immobilization of a Unilateral Lower Extremity and Physical Inactivity Induce Postural Instability during Standing in Healthy Young Men. Healthcare (Basel) 2023; 11:2525. [PMID: 37761723 PMCID: PMC10531174 DOI: 10.3390/healthcare11182525] [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: 07/31/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Previous studies have reported an increased postural sway after short-term unilateral lower limb movement restriction, even in healthy subjects. However, the associations of motion limitation have not been fully established. The question of whether short-term lower limb physical inactivity and movement restriction affect postural control in the upright position remains. One lower limb of each participant was fixed with a soft bandage and medical splint for 10 h while the participant sat on a manual wheelchair. The participants were instructed to stand still for 60 s under eyes-open (EO) and eyes-closed (EC) conditions. Using a single force plate signal, we measured the center of pressure (COP) signal in the horizontal plane and calculated the total, anterior-posterior (A-P), and medial-lateral (M-L) path lengths, sway area, and mean COP displacements in A-P and M-L directions. The COP sway increased and the COP position during the upright stance shifted from the fixed to the non-fixed side after cast removal, compared to before the cast application, under both EO and EC conditions. These findings indicated that 10 h of unilateral lower limb movement restriction induced postural instability and postural control asymmetry, suggesting the acute adverse effects of cast immobilization.
Collapse
Affiliation(s)
- Takuro Ikeda
- Department of Physical Therapy, Faculty of Medical Sciences, Fukuoka International University of Health and Welfare, Fukuoka 814-0001, Japan
| | - Shinichiro Oka
- Department of Physical Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, Fukuoka 811-0213, Japan;
| | - Junya Tokuhiro
- Department of Rehabilitation, Gotanda Hospital, Oita 877-0037, Japan;
| | - Akari Suzuki
- Department of Physical Therapy, Faculty of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka 831-8501, Japan; (A.S.); (K.M.)
| | - Kensuke Matsuda
- Department of Physical Therapy, Faculty of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka 831-8501, Japan; (A.S.); (K.M.)
| |
Collapse
|
16
|
Jafari H, Gustafsson T, Nyberg L, Röijezon U. Predicting balance impairments in older adults: a wavelet-based center of pressure classification approach. Biomed Eng Online 2023; 22:83. [PMID: 37608334 PMCID: PMC10463618 DOI: 10.1186/s12938-023-01146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Aging is associated with a decline in postural control and an increased risk of falls. The Center of Pressure (CoP) trajectory analysis is a commonly used method to assess balance. In this study, we proposed a new method to identify balance impairments in older adults by analyzing their CoP trajectory frequency components, sensory inputs, reaction time, motor functions, and Fall-related Concerns (FrC). METHODS The study includes 45 older adults aged [Formula: see text] years who were assessed for sensory and motor functions. FrC and postural control in a quiet stance with open and closed eyes on stable and unstable surfaces. A Discrete Wavelet Transform (DWT) was used to detect features in frequency scales, followed by the K-means algorithm to detect different clusters. The multinomial logistic model was used to identify and predict the association of each group with the sensorimotor tests and FrC. RESULTS The study results showed that by DWT, three distinct groups of subjects could be revealed. Group 2 exhibited the broadest use of frequency scales, less decline in sensorimotor functions, and lowest FrC. The study also found that a decline in sensorimotor functions and fall-related concern may cause individuals to rely on either very low-frequency scales (group 1) or higher-frequency scales (group 3) and that those who use lower-frequency scales (group 1) can manage their balance more successfully than group 3. CONCLUSIONS Our study provides a new, cost-effective method for detecting balance impairments in older adults. This method can be used to identify people at risk and develop interventions and rehabilitation strategies to prevent falls in this population.
Collapse
Affiliation(s)
- Hedyeh Jafari
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå, Sweden.
| | - Thomas Gustafsson
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå, Sweden
| | - Lars Nyberg
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Ulrik Röijezon
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| |
Collapse
|
17
|
Terry ME, Shulman D, Vallis LA. What Is the Role of Sustained Visual Attention in the Maintenance of Postural Control in Young Adults? Exp Psychol 2023; 70:232-240. [PMID: 37946454 DOI: 10.1027/1618-3169/a000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Dual tasks requiring sustained visual attention and upright stance are common, yet their impact on standing balance is not well understood. We investigated the role of visual attention in the maintenance of postural control, using the multiple-object tracking (MOT) task. Healthy young adults (n = 12) performed the MOT task at three object movement speeds while seated or standing. MOT performance was assessed using tracking capacity (k). Metrics calculated to assess mediolateral (ML) and anterior-posterior (AP) postural control included: maximum difference between CoM and CoP position (CoM-CoP Max), root mean square distance for center of pressure and center of mass position (CoP and CoM RMS distance), and correlation between CoM and CoP time series signals (CoM/CoP correlation). As predicted, k decreased significantly as object movement speed increased for both standing and seated conditions. Object movement speed also significantly affected AP CoM-CoP Max in seated conditions (p = .021) and AP CoM/CoP correlation for standing conditions (p = .002). The results demonstrate utility of the MOT task in understanding the role of visual attention in postural control, even though healthy young adults were able to compensate for the addition of a sustained visual attention task, with minimal deficits to postural control.
Collapse
Affiliation(s)
- Mallory E Terry
- Department of Psychology, University of Guelph, Ontario, Canada
| | - David Shulman
- Department of Human Health and Nutritional Sciences, University of Guelph, Ontario, Canada
| | - Lori Ann Vallis
- Department of Human Health and Nutritional Sciences, University of Guelph, Ontario, Canada
| |
Collapse
|
18
|
Sonobe M, Inoue Y. Center of Mass Estimation Using a Force Platform and Inertial Sensors for Balance Evaluation in Quiet Standing. SENSORS (BASEL, SWITZERLAND) 2023; 23:4933. [PMID: 37430849 DOI: 10.3390/s23104933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 07/12/2023]
Abstract
Accurate estimation of the center of mass is necessary for evaluating balance control during quiet standing. However, no practical center of mass estimation method exists because of problems with estimation accuracy and theoretical validity in previous studies that used force platforms or inertial sensors. This study aimed to develop a method for estimating the center of mass displacement and velocity based on equations of motion describing the standing human body. This method uses a force platform under the feet and an inertial sensor on the head and is applicable when the support surface moves horizontally. We compared the center of mass estimation accuracy of the proposed method with those of other methods in previous studies using estimates from the optical motion capture system as the true value. The results indicate that the present method has high accuracy in quiet standing, ankle motion, hip motion, and support surface swaying in anteroposterior and mediolateral directions. The present method could help researchers and clinicians to develop more accurate and effective balance evaluation methods.
Collapse
Affiliation(s)
- Motomichi Sonobe
- Department of Intelligent Mechanical Systems Engineering, Kochi University of Technology, Kochi 782-8502, Japan
| | - Yoshio Inoue
- Department of Intelligent Mechanical Systems Engineering, Kochi University of Technology, Kochi 782-8502, Japan
| |
Collapse
|
19
|
Presley BM, Sklar JC, Hazelwood SJ, Berg-Johansen B, Klisch SM. Balance Assessment Using a Smartwatch Inertial Measurement Unit with Principal Component Analysis for Anatomical Calibration. SENSORS (BASEL, SWITZERLAND) 2023; 23:4585. [PMID: 37430500 DOI: 10.3390/s23104585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 07/12/2023]
Abstract
Balance assessment, or posturography, tracks and prevents health complications for a variety of groups with balance impairment, including the elderly population and patients with traumatic brain injury. Wearables can revolutionize state-of-the-art posturography methods, which have recently shifted focus to clinical validation of strictly positioned inertial measurement units (IMUs) as replacements for force-plate systems. Yet, modern anatomical calibration (i.e., sensor-to-segment alignment) methods have not been utilized in inertial-based posturography studies. Functional calibration methods can replace the need for strict placement of inertial measurement units, which may be tedious or confusing for certain users. In this study, balance-related metrics from a smartwatch IMU were tested against a strictly placed IMU after using a functional calibration method. The smartwatch and strictly placed IMUs were strongly correlated in clinically relevant posturography scores (r = 0.861-0.970, p < 0.001). Additionally, the smartwatch was able to detect significant variance (p < 0.001) between pose-type scores from the mediolateral (ML) acceleration data and anterior-posterior (AP) rotation data. With this calibration method, a large problem with inertial-based posturography has been addressed, and wearable, "at-home" balance-assessment technology is within possibility.
Collapse
Affiliation(s)
- Benjamin M Presley
- Mechanical Engineering, College of Engineering, California Polytechnic State University, San Luis Obispo, CA 93407, USA
| | - Jeffrey C Sklar
- Statistics, College of Science and Mathematics, California Polytechnic State University, San Luis Obispo, CA 93407, USA
| | - Scott J Hazelwood
- Mechanical Engineering, College of Engineering, California Polytechnic State University, San Luis Obispo, CA 93407, USA
- Biomedical Engineering, College of Engineering, California Polytechnic State University, San Luis Obispo, CA 93407, USA
| | - Britta Berg-Johansen
- Biomedical Engineering, College of Engineering, California Polytechnic State University, San Luis Obispo, CA 93407, USA
| | - Stephen M Klisch
- Mechanical Engineering, College of Engineering, California Polytechnic State University, San Luis Obispo, CA 93407, USA
- Biomedical Engineering, College of Engineering, California Polytechnic State University, San Luis Obispo, CA 93407, USA
| |
Collapse
|
20
|
Meyer BM, Cohen JG, Donahue N, Fox SR, O'Leary A, Brown AJ, Leahy C, VanDyk T, DePetrillo P, Ceruolo M, Cheney N, Solomon AJ, McGinnis RS. Chest-Based Wearables and Individualized Distributions for Assessing Postural Sway in Persons With Multiple Sclerosis. IEEE Trans Neural Syst Rehabil Eng 2023; 31:2132-2139. [PMID: 37067975 PMCID: PMC10408383 DOI: 10.1109/tnsre.2023.3267807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Typical assessments of balance impairment are subjective or require data from cumbersome and expensive force platforms. Researchers have utilized lower back (sacrum) accelerometers to enable more accessible, objective measurement of postural sway for use in balance assessment. However, new sensor patches are broadly being deployed on the chest for cardiac monitoring, opening a need to determine if measurements from these devices can similarly inform balance assessment. Our aim in this work is to validate postural sway measurements from a chest accelerometer. To establish concurrent validity, we considered data from 16 persons with multiple sclerosis (PwMS) asked to stand on a force platform while also wearing sensor patches on the sacrum and chest. We found five of 15 postural sway features derived from the chest and sacrum were significantly correlated with force platform-derived features, which is in line with prior sacrum-derived findings. Clinical significance was established using a sample of 39 PwMS who performed eyes-open, eyes-closed, and tandem standing tasks. This cohort was stratified by fall status and completed several patient-reported measures (PRM) of balance and mobility impairment. We also compared sway features derived from a single 30-second period to those derived from a one-minute period with a sliding window to create individualized distributions of each postural sway feature (ID method). We find traditional computation of sway features from the chest is sensitive to changes in PRMs and task differences. Distribution characteristics from the ID method establish additional relationships with PRMs, detect differences in more tasks, and distinguish between fall status groups. Overall, the chest was found to be a valid location to monitor postural sway and we recommend utilizing the ID method over single-observation analyses.
Collapse
|
21
|
Ni CL, Lin YT, Lu LY, Wang JH, Liu WC, Kuo SH, Pan MK. Tracking motion kinematics and tremor with intrinsic oscillatory property of instrumental mechanics. Bioeng Transl Med 2023; 8:e10432. [PMID: 36925695 PMCID: PMC10013767 DOI: 10.1002/btm2.10432] [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: 09/02/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
Tracking kinematic details of motor behaviors is a foundation to study the neuronal mechanism and biology of motor control. However, most of the physiological motor behaviors and movement disorders, such as gait, balance, tremor, dystonia, and myoclonus, are highly dependent on the overall momentum of the whole-body movements. Therefore, tracking the targeted movement and overall momentum simultaneously is critical for motor control research, but it remains an unmet need. Here, we introduce the intrinsic oscillatory property (IOP), a fundamental mechanical principle of physics, as a method for motion tracking in a force plate. The overall kinetic energy of animal motions can be transformed into the oscillatory amplitudes at the designed IOP frequency of the force plate, while the target movement has its own frequency features and can be tracked simultaneously. Using action tremor as an example, we reported that force plate-based IOP approach has superior performance and reliability in detecting both tremor severity and tremor frequency, showing a lower level of coefficient of variation (CV) compared with video- and accelerometer-based motion tracking methods and their combination. Under the locomotor suppression effect of medications, therapeutic effects on tremor severity can still be quantified by dynamically adjusting the overall locomotor activity detected by IOP. We further validated IOP method in optogenetic-induced movements and natural movements, confirming that IOP can represent the intensity of general rhythmic and nonrhythmic movements, thus it can be generalized as a common approach to study kinematics.
Collapse
Affiliation(s)
- Chun-Lun Ni
- Department of Neurology Columbia University New York New York USA.,The Initiative for Columbia Ataxia and Tremor New York New York USA.,Department of Biochemistry and Molecular Biology Indiana University School of Medicine Indianapolis Indiana USA
| | - Yi-Ting Lin
- Molecular Imaging Center, National Taiwan University Taipei City Taiwan.,Department of Psychology National Taiwan University Taipei City Taiwan
| | - Liang-Yin Lu
- Molecular Imaging Center, National Taiwan University Taipei City Taiwan.,Institute of Biomedical Sciences, Academia Sinica Taipei City Taiwan
| | - Jia-Huei Wang
- Molecular Imaging Center, National Taiwan University Taipei City Taiwan.,Institute of Biomedical Sciences, Academia Sinica Taipei City Taiwan.,Department and Graduate Institute of Pharmacology National Taiwan University College of Medicine Taipei City Taiwan
| | - Wen-Chuan Liu
- Molecular Imaging Center, National Taiwan University Taipei City Taiwan.,Institute of Biomedical Sciences, Academia Sinica Taipei City Taiwan.,Department and Graduate Institute of Pharmacology National Taiwan University College of Medicine Taipei City Taiwan
| | - Sheng-Han Kuo
- Department of Neurology Columbia University New York New York USA.,The Initiative for Columbia Ataxia and Tremor New York New York USA
| | - Ming-Kai Pan
- Molecular Imaging Center, National Taiwan University Taipei City Taiwan.,Institute of Biomedical Sciences, Academia Sinica Taipei City Taiwan.,Department and Graduate Institute of Pharmacology National Taiwan University College of Medicine Taipei City Taiwan.,Department of Medical Research National Taiwan University Hospital Taipei City Taiwan.,Cerebellar Research Center National Taiwan University Hospital, Yun-Lin Branch Yun-Lin Taiwan
| |
Collapse
|
22
|
Weissberger O, Orr E, Levy M, Kimel-Naor S, Plotnik M, Arbel T. Balancing new technology: Virtual reality for balance measurement case report. Medicine (Baltimore) 2023; 102:e32799. [PMID: 36749243 PMCID: PMC9901979 DOI: 10.1097/md.0000000000032799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
RATIONALE Falling and the inability to maintain balance are the second leading cause of unintentional injury deaths globally. There are a number of chronic and acute conditions characterized by balance difficulties, including neurological diseases, and sport injuries. Therefore, methods to monitor and quantify balance are critical for clinical decision-making regarding risk management and balance rehabilitation. New advances in virtual reality (VR) technology has identified VR as a novel therapeutic platform. VRSway is a VR application that uses sensors attached to a virtual reality headset, and handheld remote controllers for measurement and analysis of postural stability by measuring changes in spatial location relative to the center of mass and calculates various postural stability indexes. This case report evaluates balance measures in 2 healthy participants with no previous history of balance disorders using the VRSway software application and compares to output generated by the current gold standard of balance measurement, force platform technology. CASE PRESENTATION The primary objective of this case study was to validate the VRSway stability score for evaluation of balance. Here, we present posturography measures of the VRSway in comparison with force plate readouts in 2 healthy participants. Body Sway measurements were recorded simultaneously in both the force plate and VRSway systems. Data calculated by proprietary software is highly correlative to the data generated by force plates for each of the following measurements for participant-1 and participant-2, respectively: Sway index (r 1 = 0.985, P < .001; r 2 = 0.970, P < .001), total displacement (r 1 = 0.982, P < .001; r 2 = 0.935, P < .001), center of pressure mean velocity (r 1 = 0.982, P < .001; r 2 = 0.935, P < .001), ellipse radius 1 (r 1 = 0.979, P < .001; r 2 = 0.965, P < .001), ellipse radius 2 (r 1 = 0.982, P < .001; r 2 = 0.969, P < .001), and ellipse area (r 1 = 0.983, P < .001; r 2 = 0.969, P < .001). CONCLUSIONS Data from this case study suggest that VRSway measurements are highly correlated with output from force plate technology posing that VRSway is a novel approach to evaluate balance measures with VR. More research is required to understand possible uses of VR-based use for balance measurement in a larger and more diverse cohort.
Collapse
Affiliation(s)
- Omer Weissberger
- XR Health Ltd, Tel Aviv, Israel
- * Correspondence: Omer Weissberger, XR Health LTD, Tel Aviv, Israel (e-mail: )
| | | | | | - Shani Kimel-Naor
- The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel
| | - Meir Plotnik
- The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | | |
Collapse
|
23
|
The Effect of a Comprehensive Corrective Exercise Program on Kyphosis Angle and Balance in Kyphotic Adolescents. Healthcare (Basel) 2022; 10:healthcare10122478. [PMID: 36554002 PMCID: PMC9778671 DOI: 10.3390/healthcare10122478] [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: 11/07/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
This study aimed to investigate the effects of a comprehensive corrective exercise program on the kyphosis angle and balance in kyphotic adolescents. A total of 62 male adolescents (between the ages of 10 and 18, mean BMI 21.7 kg/m2) with a thoracic kyphosis (TK) angle of ≥ 50° were divided into three groups using the simple randomization method: CCEP (comprehensive corrective exercise program), TEP (thoracic exercise program) and control group. The CCEP program consisted of corrective exercises plus postural perception training (PPT). Exercise programs were applied for 40−50 min, 3 days a week for 12 weeks. The kyphosis angle was measured using a flexible ruler, and balance was assessed using the Romberg index obtained from pedobarography. After training, a highly significant reduction in the kyphosis angle was observed in the CCEP and TEP groups (p < 0.001). Comparison among the groups showed a greater reduction in the kyphosis angle in the CCEP group (p < 0.020). Postural perception improved in the CCEP group versus other groups (p < 0.001). Improvement of the Romberg index (balance) was found only in the CCEP group upon within-group comparison (p < 0.001), with no difference among the groups (p > 0.05). The use of postural perception in combination with corrective exercise programs for thoracic kyphosis represents a comprehensive approach, and PPT can increase the effectiveness of the intervention.
Collapse
|
24
|
Saraiva M, Fuentes-García JP, Vilas-Boas JP, Castro MA. Relationship between physical activity level and sleep quality with postural control and hemodynamic response in the prefrontal cortex during dual-task performance. Physiol Behav 2022; 255:113935. [PMID: 35931196 DOI: 10.1016/j.physbeh.2022.113935] [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: 06/17/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/28/2022]
Abstract
Understanding the cortical activation and postural control behavior during dual-task (DT) has been an object of study. However, despite the multiple benefits of exercise and good sleep quality, less is known about the correlation between physical activity (PA) and sleep quality (SQ) on postural control and brain activation under dual-task performance. This study aimed to analyze the correlation between PA level and SQ with postural control performance and hemodynamic response in the prefrontal cortex during the DT performance in young adults. Thirty-four healthy young adults (mean age ± SD = 22.91 ± 3.90 years) participated in this study, and they performed a single-task and cognitive and motor DT using their smartphones. Postural control was assessed using a force plate to record the center of pressure (CoP) data (total excursion of CoP (TOTEX CoP), displacements of the CoP in anterior-posterior (CoP-AP) and medial-lateral (CoP-ML) directions, mean total velocity displacement of CoP (MVELO CoP), mean displacement velocity of CoP in anterior-posterior (MVELO CoP-AP) and medial-lateral (MVELO CoP-ML) directions, amplitude of CoP in anterior-posterior (A-AP) and medial-lateral (A-ML) directions, and 95% confidence ellipse sway area (CEA)). The hemodynamic response was measured by the oxyhemoglobin and deoxyhemoglobin concentrations using the functional near-infrared spectroscopy. The Pittsburg Sleep Quality Index and International Physical Activity Questionnaire-Short Form questionnaires assessed SQ and level of PA, respectively. Results indicated a positive correlation between SQ and cognitive DT cost for CoP-ML (rs = 0.422, p = 0.013), MVELO CoP-ML (rs = 0.422, p = 0.013) and A-ML (rs = 0.579, p < 0.001). There were no significant relations between the other outcomes (p > 0.05). In conclusion, poor sleep quality was associated with a worse postural control performance in CoP-ML, MVELO CoP-ML and A-ML parameters under cognitive dual-task conditions. The differences found in the postural control and hemodynamic response during dual-task performance do not correlate with physical activity level.
Collapse
Affiliation(s)
- Marina Saraiva
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, Coimbra 3046-854, Portugal; Faculty of Sports and CIAFEL, University of Porto, Porto 4200-450, Portugal.
| | | | - João Paulo Vilas-Boas
- Faculty of Sports and CIAFEL, University of Porto, Porto 4200-450, Portugal; LABIOMEP-UP, Faculty of Sports and CIFI2D, the University of Porto, Porto 4200-450, Portugal
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, Coimbra 3046-854, Portugal; Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, Coimbra 3030-788, Portugal; Physiotherapy, School of Health Sciences, Polytechnic Institute of Leiria, Leiria 2411-901, Portugal
| |
Collapse
|
25
|
Tatemoto T, Sugiura T, Kumazawa N, Ii T, Kitamura S, Tanabe S, Hirayama Y, Shimomura H, Mizuno K, Otaka Y. Shock-absorbing effect of flooring-adopted mechanical metamaterial technology and its influence on the gait and balance of older adults. Inj Prev 2022; 28:410-414. [PMID: 35387842 PMCID: PMC9510406 DOI: 10.1136/injuryprev-2021-044450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/18/2022] [Indexed: 12/02/2022]
Abstract
Objective To elucidate the performance of a shock-absorbing floor material with a mechanical metamaterial (MM-flooring) structure and its effect on the gait and balance of older adults. Methods The drop-weight impact was applied to evaluate the shock-absorbing performance. The falling weight was adjusted equivalent to the energy exerted on the femur of an older woman when she falls, which was evaluated on the MM-flooring and six other flooring materials. Nineteen healthy people over the age of 65 years participated in the gait and balance evaluations. The timed up and go and two-step tests were adopted as gait performance tests, and the sway-during-quiet-balance test with force plates and the functional reach test (FRT) were adopted as balance tests. All the participants underwent these tests on the MM-flooring, shock-absorbing mat and rigid flooring. Results The shock-absorbing performance test revealed that MM-flooring has sufficient shock-absorbing performance, and suggesting that it may reduce the probability of fractures in the older people when they fall. The results of the gait performance test showed that the participants demonstrated the same gait performance on the MM-flooring and the rigid floor. In the quiet standing test, MM-flooring did not affect the balance function of the participants to the same extent as the rigid floor, compared with the shock-absorbing mat. In the FRT, no significant differences were found for any of the flooring conditions. Conclusions MM-flooring has the potential to prevent fractures attributed to falls and does not affect the gait or balance of older adults.
Collapse
Affiliation(s)
- Tsuyoshi Tatemoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.,Department of Rehabilitation, Tokyo Bay Rehabilitation Hospital, Narashino, Chiba, Japan
| | | | - Nobuhiro Kumazawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Takuma Ii
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Shin Kitamura
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | | | | | - Koji Mizuno
- Department of Mechanical Systems Engineering, School of Engineering, Nagoya University, Nagoya, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
26
|
Estévez-Pedraza ÁG, Hernandez-Laredo E, Millan-Guadarrama ME, Martínez-Méndez R, Carrillo-Vega MF, Parra-Rodríguez L. Reliability and Usability Analysis of an Embedded System Capable of Evaluating Balance in Elderly Populations Based on a Modified Wii Balance Board. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11026. [PMID: 36078742 PMCID: PMC9518410 DOI: 10.3390/ijerph191711026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
This paper analyzes the reliability and usability of a portable electronic instrument that measures balance and balance impairment in older adults. The center of pressure (CoP) metrics are measured with a modified Wii Balance Board (mWBB) platform. In the intra- and inter-rater testing, 16 and 43 volunteers (mean 75.66 and standard deviation (SD) of 7.86 years and 72.61 (SD 7.86) years, respectively) collaborated. Five volunteer raters (5.1 (SD 3.69) years of experience) answered the System Usability Scale (SUS). The most reliable CoP index in the intra-examiner tests was the 95% power frequency in the medial-lateral displacement of the CoP with closed-eyes. It had excellent reliability with an intraclass correlation coefficient ICC = 0.948 (C.I. 0.862-0.982) and a Pearson's correlation coefficient PCC = 0.966 (p < 0.001). The best index for the inter-rater reliability was the centroidal frequency in the anterior-posterior direction closed-eyes, which had an ICC (2,1) = 0.825. The mWBB also obtained a high usability score. These results support the mWBB as a reliable complementary tool for measuring balance in older adults. Additionally, it does not have the limitations of laboratory-grade systems and clinical screening instruments.
Collapse
Affiliation(s)
- Ángel Gabriel Estévez-Pedraza
- Faculty of Medicine, Universidad Autónoma del Estado de México, Toluca de Lerdo 50180, Mexico
- Faculty of Engineering, Universidad Autónoma del Estado de México, Toluca de Lerdo 50100, Mexico
| | | | | | | | | | | |
Collapse
|
27
|
Postural sway does not differentiate individuals with chronic low back pain, single and multisite chronic musculoskeletal pain, or pain-free controls: a cross-sectional study of 229 subjects. Spine J 2022; 22:1523-1534. [PMID: 35504568 DOI: 10.1016/j.spinee.2022.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Physical activity in its various forms are the most recommended prevention and treatment strategy for chronic low back pain (CLBP). Standing postural stability is a prerequisite for many types of physical activities. Systematic reviews have investigated the evidence for an association between CLBP and postural stability but results remain inconclusive. PURPOSE Our primary objective was to compare postural stability between pain-free controls and subjects with CLBP with or without leg pain and single and multisite chronic musculoskeletal pain subjects. The secondary objectives were to evaluate the association between postural stability with CLBP intensity and duration, demographics, physical characteristics and validated health and pain-related patient-reported outcome measures (PROMs). STUDY DESIGN/SETTING Cross-sectional study in a private chiropractic clinic setting PATIENT SAMPLE: Subjects included 42 pain-free controls and 187 patients with chronic musculoskeletal pain divided into CLBP with or without leg pain and single and multisite pain groups. OUTCOME MEASURES Pain intensity was measured using the numerical pain rating scale, PROMs Central Sensitization Inventory, Tampa Scale of Kinesiophobia, The Depression Scale, EuroQol-5D, Roland-Morris Disability Questionnaire, and Pain and Sleep Questionnaire Three-Item Index disability. Group differences were measured using area and velocity of sway on the force plate. METHODS Postural stability was assessed using a force plate on four 60-second bipedal quiet stance tests: eyes open on a stable surface, eyes closed on a stable surface, eyes open on an unstable foam surface, eyes closed on an unstable foam surface. Following the clinic visit, subjects completed an online web-based data entry detailing pain history, demographic data, physical characteristics, pain intensity via the numerical pain rating scale, and PROMS. RESULTS Postural sway parameters did not differ between pain-free controls and subjects with CLBP with or without leg pain and single and multisite chronic musculoskeletal pain subjects. Furthermore, severity and duration of CLBP pain in addition to central sensitization, kinesiophobia, depression, quality of life, disability, and effect of pain on sleep only had very weak associations with postural stability. CONCLUSIONS Chronic musculoskeletal pain appears not to influence bipedal postural stability.
Collapse
|
28
|
Standing Posture in Motor and Cognitive Dual-Tasks during Smartphone Use: Linear and Nonlinear Analysis of Postural Control. Eur J Investig Health Psychol Educ 2022; 12:1021-1033. [PMID: 36005222 PMCID: PMC9407520 DOI: 10.3390/ejihpe12080073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Analysis of the center of pressure (CoP) during cognitive or motor dual-tasking is widely used to characterize postural control. Most studies use traditional measures of CoP to quantify postural control, but given its complexity, nonlinear analysis of CoP is of growing interest in the area. This study aims to analyze CoP behavior in healthy young adults during standing posture performance while simultaneously performing motor or cognitive tasks on a smartphone, using linear and nonlinear analysis of CoP. Thirty-six healthy participants (23.08 ± 3.92 years) were found eligible for this study. They performed a single task (ST), cognitive dual-task (cog-DT), and motor dual-task (mot-DT). The total excursion of CoP, displacement of CoP in the anterior-posterior and medial-lateral directions, mean total velocity of CoP, and mean anterior-posterior and medial-lateral velocities of CoP were measured with a force plate. Approximate entropy (ApEn) of the anterior-posterior (ApEn-AP) and medial-lateral (ApEn-ML) displacement of CoP were also calculated. The results showed that dual-task costs for the total excursion, displacement in the anterior-posterior direction, mean total velocity, and mean anterior-posterior velocity of CoP were greater during the cog-DT than the mot-DT (p < 0.05). In the nonlinear analysis of the CoP, there was no difference (p > 0.05) between the cog-DT and mot-DT for ApEn values of the anterior-posterior and medial-lateral time series of the CoP. Both linear and nonlinear analyses showed differences between the cog-DT and ST (p < 0.05), revealing a decline in postural control during the cog-DT compared with the ST. In conclusion, performing a cog-DT causes sway impairments and lower postural control efficacy compared with motor single and dual-tasks. Furthermore, both linear and nonlinear analyses were able to distinguish between conditions.
Collapse
|
29
|
McCabe JP, Pundik S, Daly JJ. Targeting CNS Neural Mechanisms of Gait in Stroke Neurorehabilitation. Brain Sci 2022; 12:brainsci12081055. [PMID: 36009118 PMCID: PMC9405607 DOI: 10.3390/brainsci12081055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 01/17/2023] Open
Abstract
The central nervous system (CNS) control of human gait is complex, including descending cortical control, affective ascending neural pathways, interhemispheric communication, whole brain networks of functional connectivity, and neural interactions between the brain and spinal cord. Many important studies were conducted in the past, which administered gait training using externally targeted methods such as treadmill, weight support, over-ground gait coordination training, functional electrical stimulation, bracing, and walking aids. Though the phenomenon of CNS activity-dependent plasticity has served as a basis for more recently developed gait training methods, neurorehabilitation gait training has yet to be precisely focused and quantified according to the CNS source of gait control. Therefore, we offer the following hypotheses to the field: Hypothesis 1. Gait neurorehabilitation after stroke will move forward in important ways if research studies include brain structural and functional characteristics as measures of response to treatment. Hypothesis 2. Individuals with persistent gait dyscoordination after stroke will achieve greater recovery in response to interventions that incorporate the current and emerging knowledge of CNS function by directly engaging CNS plasticity and pairing it with peripherally directed, plasticity-based motor learning interventions. These hypotheses are justified by the increase in the study of neural control of motor function, with emerging research beginning to elucidate neural factors that drive recovery. Some are developing new measures of brain function. A number of groups have developed and are sharing sophisticated, curated databases containing brain images and brain signal data, as well as other types of measures and signal processing methods for data analysis. It will be to the great advantage of stroke survivors if the results of the current state-of-the-art and emerging neural function research can be applied to the development of new gait training interventions.
Collapse
Affiliation(s)
- Jessica P. McCabe
- Brain Plasticity and NeuroRecovery Laboratory, Cleveland VA Medical Center, Cleveland, OH 44106, USA
| | - Svetlana Pundik
- Brain Plasticity and NeuroRecovery Laboratory, Cleveland VA Medical Center, Cleveland, OH 44106, USA
- Department of Neurology, Case Western Reserve University, Cleveland, OH 44016, USA
| | - Janis J. Daly
- Brain Plasticity and NeuroRecovery Laboratory, Cleveland VA Medical Center, Cleveland, OH 44106, USA
- Department of Neurology, Case Western Reserve University, Cleveland, OH 44016, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL 32608, USA
- Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32608, USA
- Correspondence: or
| |
Collapse
|
30
|
Receiver Operating Characteristic Curve Analysis of the Somatosensory Organization Test, Berg Balance Scale, and Fall Efficacy Scale–International for Predicting Falls in Discharged Stroke Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159181. [PMID: 35954533 PMCID: PMC9368624 DOI: 10.3390/ijerph19159181] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/13/2022] [Accepted: 07/24/2022] [Indexed: 11/30/2022]
Abstract
Background: Although fall prevention in patients after stroke is crucial, the clinical validity of fall risk assessment tools is underresearched in this population. The study aim was to determine the cut-off scores and clinical validity of the Sensory Organization Test (SOT), the Berg Balance Scale (BBS), and the Fall Efficacy Scale–International (FES-I) in patients after stroke. Methods: In this prospective cross-sectional study, we analyzed data for patients admitted to a rehabilitation unit after stroke from 2018 through 2021. Participants underwent SOT, BBS, and FES-I pre-discharge, and the fall incidence was recorded for 6 months. We used an area under the receiver operating characteristic curve (AUC) to calculate predictive values. Results: Of 84 included patients (median age 68.5 (interquartile range 67–71) years), 32 (38.1%) suffered a fall. All three tests were significantly predictive of fall risk. Optimal cut-off scores were 60 points for SOT (AUC 0.686), 35 and 42 points for BBS (AUC 0.661 and 0.618, respectively), and 27 and 29 points for FES-I (AUC 0.685 and 0.677, respectively). Conclusions: Optimal cut-off scores for SOT, BBS, and FES-I were determined for patients at risk for falls after a stroke, which all three tools classified with a good discriminatory ability.
Collapse
|
31
|
Sozzi S, Ghai S, Schieppati M. Incongruity of Geometric and Spectral Markers in the Assessment of Body Sway. Front Neurol 2022; 13:929132. [PMID: 35923830 PMCID: PMC9339954 DOI: 10.3389/fneur.2022.929132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/21/2022] [Indexed: 01/15/2023] Open
Abstract
Different measurements of body oscillations in the time or frequency domain are being employed as markers of gait and balance abnormalities. This study investigates basic relationships within and between geometric and spectral measures in a population of young adult subjects. Twenty healthy subjects stood with parallel feet on a force platform with and without a foam pad. Adaptation effects to prolonged stance were assessed by comparing the first and last of a series of eight successive trials. Centre of Foot Pressure (CoP) excursions were recorded with Eyes Closed (EC) and Open (EO) for 90s. Geometric measures (Sway Area, Path Length), standard deviation (SD) of the excursions, and spectral measure (mean power Spectrum Level and Median Frequency), along the medio-lateral (ML) and antero-posterior (AP) direction were computed. Sway Area was more strongly associated than Path Length with CoP SD and, consequently, with mean Spectrum Level for both ML and AP, and both visual and surface conditions. The squared-SD directly specified the mean power Spectrum Level of CoP excursions (ML and AP) in all conditions. Median Frequency was hardly related to Spectrum Level. Adaptation had a confounding effect, whereby equal values of Sway Area, Path Length, and Spectrum Level corresponded to different Median Frequency values. Mean Spectrum Level and SDs of the time series of CoP ML and AP excursions convey the same meaning and bear an acceptable correspondence with Sway Area values. Shifts in Median Frequency values represent important indications of neuromuscular control of stance and of the effects of vision, support conditions, and adaptation. The Romberg Quotient EC/EO for a given variable is contingent on the compliance of the base of support and adaptation, and different between Sway Area and Path Length, but similar between Sway Area and Spectrum Level (AP and ML). These measures must be taken with caution in clinical studies, and considered together in order to get a reliable indication of overall body sway, of modifications by sensory and standing condition, and of changes with ageing, medical conditions and rehabilitation treatment. However, distinct measures shed light on the discrete mechanisms and complex processes underpinning the maintenance of stance.
Collapse
Affiliation(s)
- Stefania Sozzi
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
| | - Shashank Ghai
- Department of Physical Therapy, Rsgbiogen, New Delhi, India
| | - Marco Schieppati
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
- *Correspondence: Marco Schieppati
| |
Collapse
|
32
|
Otomi Y, Irahara S, Inoue H, Shinya T, Otsuka H, Harada M. Increased 18F-FDG Uptake in the Axillary Lymph Nodes of the Vaccinated Side Associated with COVID-19 Vaccination. Mol Imaging Radionucl Ther 2022; 31:169-171. [PMID: 35771098 PMCID: PMC9246311 DOI: 10.4274/mirt.galenos.2021.22590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 50-year-old female patient underwent (18fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) following modified radical mastectomy for cancer of the left breast. Ten days before the PET/CT, the coronavirus disease-2019 (COVID-19) vaccine was injected intramuscularly into the right deltoid muscle. Increased (18F-FDG uptake of maximum standardized uptake value (11.0) was observed in the lymph nodes of the right axilla, which had not been observed in the previous PET/CT. The size of the oval-shaped lymph nodes was up to approximately 11×9 mm; however, it was larger than that observed on the previous PET/CT. We contemplate that the increased (18F-FDG uptake was a reactive change in the lymph nodes associated with the COVID-19 vaccine.
Collapse
Affiliation(s)
- Yoichi Otomi
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Saho Irahara
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Hiroaki Inoue
- Tokushima University, Department of Thoracic and Endocrine Surgery and Oncology, Tokushima, Japan
| | | | - Hideki Otsuka
- Tokushima University, Department of Radiology, Tokushima, Japan
| | - Masafumi Harada
- Tokushima University, Department of Radiology, Tokushima, Japan
| |
Collapse
|
33
|
Utility of the Novel MediPost Mobile Posturography Device in the Assessment of Patients with a Unilateral Vestibular Disorder. SENSORS 2022; 22:s22062208. [PMID: 35336379 PMCID: PMC8953915 DOI: 10.3390/s22062208] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/02/2022] [Accepted: 03/10/2022] [Indexed: 12/28/2022]
Abstract
Balance disorders are a growing problem worldwide. Thus, there is an increasing need to provide an inexpensive and feasible alternative to standard posturographic platforms (SP) used for the assessment of balance and to provide a possible solution for telemonitoring of patients. A novel mobile posturography (MP) MediPost device was developed to address these issues. This prospective study used a Modified Clinical Test of Sensory Interaction on Balance to evaluate healthy individuals and patients with a unilateral vestibular disorder through SP and MP simultaneously. The control group included 65 healthy volunteers, while the study group included 38 patients diagnosed with a unilateral vestibular deficit. The angular velocity values obtained from both methods were compared by intraclass correlation coefficients (ICC) and Bland−Altman plot analysis. Diagnostic capabilities were measured in terms of sensitivity and specificity. The ICC between the two methods for conditions 2−4 was indicative of excellent reliability, with the ICC > 0.9 (p < 0.001), except for Condition 1 (standing stance, eyes open) ICC = 0.685, p < 0.001, which is indicative of moderate reliability. ROC curve analysis of angular velocity for condition 4 represents the most accurate differentiating factor with AUC values of 0.939 for SP and 0.953 for MP. This condition also reported the highest sensitivity, specificity, PPV, and NPV values with 86.4%, 87.7%, 80%, and 90.5% for SP, and 92.1%, 84.6%, 77.8%, and 94.8% for MP, respectively. The newly developed MediPost device has high sensitivity and specificity in distinguishing between healthy individuals and patients with a unilateral vestibular deficit.
Collapse
|
34
|
Evaluation of vestibular function in children with purulent media otitis by computer stabilometry. EUREKA: HEALTH SCIENCES 2021. [DOI: 10.21303/2504-5679.2021.002172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of the research – assessment of vestibular function in children with acute purulent otitis media by computer static stabilometry compared with typically developed children of the same age.
Materials and methods: 22 children with purulent otitis media aged 4 to 7 years and 30 practically healthy peers were examined by static stabilometry on the device “MPFI stabilograph 1” (Kharkiv, Ukraine). Indicators of variation and shape of the pressure center distribution, spectral-correlation indicators of stabilograms, as well as integral indicators of stability (length, velocity and angle of postural oscillations) were taken into account and the equilibrium functions of the two sensory states (open and closed eyes) are calculated in the StabiliS software.
Results: purulent otitis media causes posterior displacement of the absolute coordinates of the pressure center. In the state with closed eyes, children with purulent otitis differ from their healthy coevals by 14 of 24 stabilometric parameters, including stabilogram length, speed, angle and amplitude of oscillations, giving way to them in the stability of equilibrium. Children with purulent otitis media are more sensitive to the visual canal of postural control than their coevals. Involvement of visual afferents in postural control significantly improves balance maintenance in children with purulent otitis by reducing deviations of postural oscillations, which is reflected in the probable changes of 9 out of 24 stabilometric parameters compared to control.
Conclusions: In preschool age, purulent otitis media leads to latent vestibular dysfunction, which is manifested by a violation of the stability of the vertical posture in a state with closed eyes and is compensated by visual-vestibulo-proprioceptive integration in the process of postural control.
Collapse
|
35
|
A Velostat-Based Pressure-Sensitive Mat for Center-of-Pressure Measurements: A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115958. [PMID: 34199360 PMCID: PMC8199542 DOI: 10.3390/ijerph18115958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 11/17/2022]
Abstract
Center-of-pressure (CoP) displacements play a key role in studies assessing postural stability. The accepted instrument to measure CoP trajectories is the force platform, but pressure-sensitive mats (PSMs) are an alternative composed of a matrix of sensitive cells. A typical cell comprises two electrodes with piezoresistive material in between, while a force platform has a force sensor at each of its corners. In this paper, we compare a homemade Velostat-based PSM and an affordable commercial mat with a commercial force platform in a test series with 42 healthy volunteers in single-legged trials (29 males, 13 females; height 1.74 (0.09) m, weight 74.3 (16.34) kg, age 31.21 (12.66) years). The aim of the research was to perform a preliminary study of the performance of our prototype to measure CoP, and more specifically, the standard deviation of the CoP path on both axes, the medial-lateral and anterior-posterior. We could thus discover several improvements for future clinical applications. The intraclass correlation coefficient (ICC) for agreement in the base experiment showed a moderate value for the prototype (0.38 to 0.63) and lower values for the commercial mat (0.11 to 0.12). However, we identified several factors that were relevant to improve ICC and reduce error by considering several processing options: (i) the known crosstalk problem between cells that appears in this kind of mats must be eliminated; (ii) the response time of the sensor has to be taken into account; and (iii) increasing the mat resolution also improves agreement. Therefore, as future work, we plan to test the improved version of the prototype in a clinical environment.
Collapse
|