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Jagger KL, Harper B. Center of Pressure Velocity and Dynamic Postural Control Strategies Vary During Y-Balance and Star Excursion Balance Testing. Int J Sports Phys Ther 2024; 19:849-855. [PMID: 38966829 PMCID: PMC11221329 DOI: 10.26603/001c.118943] [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: 12/15/2023] [Accepted: 05/29/2024] [Indexed: 07/06/2024] Open
Abstract
Background Dynamic postural control (DPC) describes an individual's ability to maintain balance within their base of support in both anticipatory and reactive balance situations and has been measured using center of pressure (COP) velocity. Common standardized DPC assessments for active adults include the modified Star Excursion Balance Test (MSEBT) and the Y-Balance Test (YBT). Hypothesis/Purpose The purpose of this study was to explore DPC during performance of the MSEBT, the YBT, and a modified version of the YBT, the MYBT. It was hypothesized that feedback from the YBT/MYBT reach indicator would enhance DPC. Study Design Cross-sectional study. Methods Twenty-one participants (9 females, 12 males, mean age 24.5±1.2 years) performed three trials in each direction (anterior-AN, posteromedial-PM, and posterolateral-PL) on each balance test during one session. The YBT frame was placed atop a force plate for all testing. Frontal and sagittal plane COP velocities (COPx and COPy, respectively) were recorded throughout each trial and resultant COP (COPr) velocities were calculated. Results Significant main effects were present for test (F=4.485, p\<0.001) and reach direction (F=61.594, p\<0.001). Post hoc analyses for test indicated significant differences in COPy between YBT and MSEBT (p=0.034) and between MYBT and MSEBT (p\<0.001), as well as significant differences in COPr between MYBT and MSEBT (p=0.002). Post hoc analyses for reach direction revealed significant differences in COPx between AN and both PM (p\<0.001) and PL (p\<0.001) directions, in COPy between AN and PM (p\<0.001) and PL (p\<0.001) directions, and COPr between AN and PL (p=0.043) directions only. Conclusion External proprioceptive feedback from the reach indicator improved DPC during the YBT and MYBT when compared to the MSEBT. Sagittal plane COP velocities were reduced when external proprioceptive feedback from the reach indicator was present, while frontal plane COP velocities were not affected in this group of participants. Level of Evidence 2b.
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Sasagawa S, Arakawa A, Furuyama A, Matsumoto Y. Age-related changes in static balance in older women aged in their early sixties to their late eighties: different aging patterns in the anterior-posterior and mediolateral directions. Front Aging Neurosci 2024; 16:1361244. [PMID: 38655430 PMCID: PMC11036885 DOI: 10.3389/fnagi.2024.1361244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Objective The aim of this study was to cross-sectionally investigate how static balance changes throughout the aging process in older women aged from their early sixties to their late eighties. Methods Forty-six older women (aged 62-89 years) were requested to stand barefoot and quietly on a force platform for 30 s with their eyes either open or closed. During the trials, the position of the center of foot pressure (CoP) and the acceleration of the body's center of mass (ACC) were measured. The root mean square (RMS) of the CoP and ACC values was calculated to evaluate the amplitude of postural sway and the level of regulatory activity, respectively. The mean power frequency of the ACC was also calculated to represent the temporal characteristics of regulatory activity. Results In the anterior-posterior direction, there was no significant relationship between the RMS of CoP and the participants' age, whereas the RMS of ACC significantly increased with increasing age. In the mediolateral direction, however, the RMS of CoP significantly increased with increasing age, whereas the RMS of ACC did not change with age. The mean power frequency of ACC did not exhibit any age-related change in either the anterior-posterior or the mediolateral direction. Conclusion The results indicate that static balance in older women aged in their early sixties to their late eighties exhibits distinctly contrasting aging patterns between the anterior-posterior and mediolateral directions. To prevent falls in older women, it is necessary to elucidate the physiological mechanisms responsible for the increase in mediolateral sway that occurs throughout old age.
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Affiliation(s)
- Shun Sasagawa
- Department of Human Sciences, Faculty of Human Sciences, Kanagawa University, Yokohama, Japan
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Ruiz V, Simoneau-Buessinger E, Gillet C, Elie D, Wallard L. Does an outdoor virtual environment projected in a head-mounted display affect balance in healthy young adults? J Bodyw Mov Ther 2024; 37:83-89. [PMID: 38432846 DOI: 10.1016/j.jbmt.2023.11.015] [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: 03/14/2023] [Revised: 09/24/2023] [Accepted: 11/11/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Virtual reality head-mounted display (VR-HMD) is increasingly used for balance evaluation and rehabilitation. However, more studies must be conducted on virtual environments (VE) effects. This study aimed to assess the impact of an outdoor VE projected in a high-quality VR-HMD and of the VR-HMD mass on postural stability, postural control and leaning. METHODS This study involved ten healthy young men who performed five 30-s stabilometric trials. Four experimental conditions were randomly performed: eyes open (EO) or eyes closed (EC), with (VR) or without (No VR) VR-HMD. Postural stability (antero-posterior (AP) and medio-lateral (ML) ranges of the center of pressure (CoP), 90% confidence ellipse area), postural control (CoP velocity (global, AP and ML)) and standard deviation of the CoP mean position), and postural leaning (AP/ML CoP mean position) were assessed. The comparisons between EO VR and EO No VR were used to analyze the VE effects and comparisons between EC VR and EC No VR for the VR-HMD mass effects. RESULTS Spatiotemporal parameters that characterised postural stability and postural control, except ML velocity (p > 0.05), were significantly influenced by the simulated VE with higher values in EO VR than EO No VR (p < 0.05), but not by the VR-HMD mass. The mean position of the CoP showed no significant differences between conditions. SIGNIFICANCE Postural stability and postural control modification due to the VE used in this study revealed that this VE could be interesting for VR-HMD rehabilitation and assessment. VR-HMD is not a factor to be considered for stabilometric analysis.
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Affiliation(s)
- Valentin Ruiz
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France.
| | | | - Christophe Gillet
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
| | - Dimitri Elie
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
| | - Laura Wallard
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
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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.
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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
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Jo D, Bilodeau M. Sex differences concerning the effects of ankle muscle fatigue on static postural control and spinal proprioceptive input at the ankle. Front Hum Neurosci 2023; 17:1015597. [PMID: 37476006 PMCID: PMC10355328 DOI: 10.3389/fnhum.2023.1015597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 06/21/2023] [Indexed: 07/22/2023] Open
Abstract
Aims The main aim of this study was to determine sex differences in postural control changes with ankle muscle fatigue during a standing forward leaning (FL) task under different vision conditions. The secondary aim was to examine sex differences in the effect of fatigue on soleus (SOL) H-reflex amplitude, a measure of motoneuron excitability with activation of Ia afferents. Methods Fifteen healthy young adult males (mean age: 28.0 years) and 16 healthy young adult females (mean age: 26.1 years) were asked to perform four consecutive FL tasks [30 s; two with eyes open (EO) and two with eyes closed (EC)] before, and immediately following a fatiguing exercise consisting of alternating ankle plantarflexion (6 s) and dorsiflexion (2 s) maximal isometric contractions, and at 5 and 10 min of recovery. Center of pressure (COP) sway variables (mean position, standard deviation, ellipse area, average velocity, and frequency), an ankle co-contraction index, and a ratio of SOL H-reflex to the maximum amplitude of the compound muscle action potential (M-max) were obtained during the FL tasks. A rating of perceived fatigue (RPF) was also documented at the different time points. Results Time to task failure (reduction of 50% in maximal voluntary isometric contraction torque of ankle plantar flexors) and the increase in RPF value were not significantly different between males and females. Both sex groups showed similar and significant increases (p < 0.05) in mean COP sway velocity with no significant changes in co-contraction indices. No significant effects of fatigue and related interactions were found for SOL H/M-max ratio. Discussion The absence of a significant sex difference in postural control change (sway and co-contraction) with fatigue could be explained by similar perceived (RPF) and performance fatigability (exercise duration) between males and females in the present study. Fatigue did not lead to significant changes in SOL spinal motoneuron excitability with activation of Ia afferents.
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Affiliation(s)
- Donguk Jo
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Aging and Movement Laboratory, Bruyère Research Institute, Ottawa, ON, Canada
| | - Martin Bilodeau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Aging and Movement Laboratory, Bruyère Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- LIFE Research Institute, University of Ottawa, Ottawa, ON, Canada
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Rizzato A, Gobbi E, Paoli A, Marcolin G. Validity and reliability of an unstable board for dynamic balance assessment in young adults. PLoS One 2023; 18:e0280057. [PMID: 36608060 PMCID: PMC9821791 DOI: 10.1371/journal.pone.0280057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/20/2022] [Indexed: 01/07/2023] Open
Abstract
Scientific literature is giving greater importance to dynamic balance in fall prevention. Recently, the validity and reliability of the most employed functional tests for dynamic balance assessment has been investigated. Although these functional tests are practical and require minimal equipment, they are inherently subjective, as most do not use instrumented measurement data in the scoring process. Therefore, this study aimed to assess the validity and reliability of an instrumented unstable board for dynamic balance objective assessment in young adults through double-leg standing trials. A test-retest design was outlined with the unstable board positioned over a force platform to collect objective Center of Pressure (CoP) related and kinematic parameters. Fifteen young adults participated in two evaluation sessions (7-day apart) that comprised ten trials per two dynamic conditions (anterior-posterior and medio-lateral oscillations) aiming to maintain the board parallel to the ground. Pearson's correlation coefficient (r) was employed to assess the validity of the kinematic parameters with those derived from the CoP. The test-retest reliability was investigated through Intraclass Correlation Coefficient (ICC), Standard Error of the measurement, Minimal Detectable Change, and Bland-Altman plots. Statistically significant correlations between the CoP and kinematic parameters were found, with r values ranging from 0.66 to 0.95. Good to excellent intrasession (0.89≤ICCs≤0.95) and intersession (0.66≤ICCs≤0.95) ICCs were found for the kinematics parameters. The Bland-Altman plots showed no significant systematic bias. The kinematics parameters derived from the unstable board resulted valid and reliable. The small size of the board makes it a suitable tool for the on-site dynamic balance assessment and a complement of computerized dynamic posturography.
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Affiliation(s)
- Alex Rizzato
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Erica Gobbi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Giuseppe Marcolin
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- * E-mail:
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D’Anna C, Varrecchia T, Ranavolo A, De Nunzio AM, Falla D, Draicchio F, Conforto S. Centre of pressure parameters for the assessment of biomechanical risk in fatiguing frequency-dependent lifting activities. PLoS One 2022; 17:e0266731. [PMID: 35947818 PMCID: PMC9365398 DOI: 10.1371/journal.pone.0266731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
Lifting tasks, among manual material handling activities, are those mainly associated with low back pain. In recent years, several instrumental-based tools were developed to quantitatively assess the biomechanical risk during lifting activities. In this study, parameters related to balance and extracted from the Centre of Pressure (CoP) data series are studied in fatiguing frequency-dependent lifting activities to: i) explore the possibility of classifying people with LBP and asymptomatic people during the execution of task; ii) examine the assessment of the risk levels associated with repetitive lifting activities, iii) enhance current understanding of postural control strategies during lifting tasks. Data were recorded from 14 asymptomatic participants and 7 participants with low back pain. The participants performed lifting tasks in three different lifting conditions (with increasing lifting frequency and risk levels) and kinetic and surface electromyography (sEMG) data were acquired. Kinetic data were used to calculated the CoP and parameters extracted from the latter show a discriminant capacity for the groups and the risk levels. Furthermore, sEMG parameters show a trend compatible with myoelectric manifestations of muscular fatigue. Correlation results between sEMG and CoP velocity parameters revealed a positive correlation between amplitude sEMG parameters and CoP velocity in both groups and a negative correlation between frequency sEMG parameters and CoP velocity. The current findings suggest that it is possible to quantitatively assess the risk level when monitoring fatiguing lifting tasks by using CoP parameters as well as identify different motor strategies between people with and without LBP.
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Affiliation(s)
- Carmen D’Anna
- Department of Engineering, Roma Tre University, Roma, Lazio, Italy
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Alessandro Marco De Nunzio
- LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., Differdange, Luxembourg
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, United Kingdom
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Silvia Conforto
- Department of Engineering, Roma Tre University, Roma, Lazio, Italy
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Dash R, Palanthandalam-Madapusi HJ. Change in task conditions leads to changes in intermittency in intermittent feedback control employed by CNS in control of human stance. BIOLOGICAL CYBERNETICS 2022; 116:447-459. [PMID: 35366107 DOI: 10.1007/s00422-022-00927-8] [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: 10/20/2021] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Event-driven intermittent feedback control is a form of feedback control in which the corrective control action is only initiated intermittently when the variables of interest exceed certain threshold criteria. It has been reported in the literature that the CNS uses an event-driven intermittent control strategy to stabilize the human upright posture. However, whether the threshold criteria may change under different postural task conditions is not yet well understood. We employ a numerical study with inverted pendulum models and an experimental study with 51 young healthy individuals (13 females and 38 males; age: 27.8 ± 6.5 years) with stabilogram-diffusion, temporal and spectral analysis applied to COP (Center of Pressure) trajectories measured from these experiments to examine this aspect. The present study provides compelling evidence that inducing a natural arm swing during quiet stance appears to lead to higher sensory dead zone in neuronal control reflecting higher intermittency thresholds in active feedback control and a corresponding lower sensory dependence. Beyond the obvious scientific interest in understanding this aspect of how CNS controls the standing posture, an investigation of the said control strategy may subsequently help uncover insights about how control of quiet stance degrades with age and in diseased conditions. Additionally, such an understanding will also be of interest to the humanoid robotics community as it may lead to insights leading to improving control strategies for posture control in robots.
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Affiliation(s)
- Ranjita Dash
- SysIDEA Robotics Lab, Mechanical Engineering, IIT Gandhinagar, Palaj, 382355, GJ, India
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Liang HW, Chi SY, Tai TL, Li YH, Hwang YH. Impact of age on the postural stability measured by a virtual reality tracker-based posturography and a pressure platform system. BMC Geriatr 2022; 22:506. [PMID: 35715732 PMCID: PMC9206268 DOI: 10.1186/s12877-022-03195-0] [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: 01/06/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Center of pressure (CoP) parameters are commonly used to evaluate age-related changes in postural control during standing. However, they mainly reflect ankle strategies and provide limited information about hip strategies, which are essential for postural control among the aged population. Body displacement at the lumbar level (LD) can be used as a proxy for hip strategies. OBJECTIVES We set up a virtual reality tracker-based posturography to measure LD and compared the CoP and LD parameters in two age groups to explore the roles of ankle and hip strategies during bipedal stance. METHODS Twenty-seven older healthy participants (63.8 ± 7.1 years old) and 27 younger controls (31.7 ± 9.9 years old) performed four standing tasks with their postural steadiness measured simultaneously with both systems under four stance conditions (combination of eyes-open/eyes-closed and wide-based/narrow-based). Five parameters were calculated from the trajectories of the CoP and LD. The difference in the parameters between two groups was analyzed with the Mann-Whitney U test. The discriminative ability of the parameters from the two systems was computed by the receiver operating characteristic curve analysis and area under the curve (AUC). We also used the intraclass correlation coefficient (ICC) to assess the correlation between two measures. RESULTS Most of the parameters obtained from both systems were significantly different between the younger and older groups. Mean velocity in the medial-lateral and anterior-posterior directions could effectively discriminate age-related changes, especially with the LD parameters. The receiver's operation curve analysis gained the largest AUC (0.85 with both systems) with mean velocity in the medial-lateral direction during narrow-based standing with eyes closed. Meanwhile, we observed a low correlation between parameters obtained from the two methods in velocity measures, with the lowest ICC in the mean velocity in the medial-lateral direction in the older group (ICC = 0.34 ~ 0.41). CONCLUSION Both systems could differentiate age-related changes in postural steadiness, but with dissociated information about mean velocity, especially the mean velocity in the medial-lateral direction in the older group. The results support the complimentary role of using tracker-based posturography to understand the effect of age on the mechanisms of postural control.
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Affiliation(s)
- Huey-Wen Liang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, Republic of China. .,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No 7, Chong-Shan South Road, Taipei, 100, Taiwan, Republic of China.
| | - Shao-Yu Chi
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No 7, Chong-Shan South Road, Taipei, 100, Taiwan, Republic of China.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan, Republic of China
| | - Tzu-Ling Tai
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No 7, Chong-Shan South Road, Taipei, 100, Taiwan, Republic of China
| | - Yue-Hua Li
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No 7, Chong-Shan South Road, Taipei, 100, Taiwan, Republic of China
| | - Yaw-Huei Hwang
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.,Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
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Johannsen L, Potwar K, Saveriano M, Endo S, Lee D. Robotic Light Touch Assists Human Balance Control During Maximum Forward Reaching. HUMAN FACTORS 2022; 64:514-526. [PMID: 32911982 DOI: 10.1177/0018720820950534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE We investigated how light interpersonal touch (IPT) provided by a robotic system supports human individuals performing a challenging balance task compared to IPT provided by a human partner. BACKGROUND IPT augments the control of body balance in contact receivers without a provision of mechanical body weight support. The nature of the processes governing the social haptic interaction, whether they are predominantly reactive or predictive, is uncertain. METHOD Ten healthy adult individuals performed maximum forward reaching (MFR) without visual feedback while standing upright. We evaluated their control of reaching behavior and of body balance during IPT provided by either another human individual or by a robotic system in two alternative control modes (reactive vs. predictive). RESULTS Reaching amplitude was not altered by any condition but all IPT conditions showed reduced body sway in the MFR end-state. Changes in reaching behavior under robotic IPT conditions, such as lower speed and straighter direction, were linked to reduced body sway. An Index of Performance expressed a potential trade-off between speed and accuracy with lower bitrate in the IPT conditions. CONCLUSION The robotic IPT system was as supportive as human IPT. Robotic IPT seemed to afford more specific adjustments in the human contact receiver, such as trading reduced speed for increased accuracy, to meet the intrinsic demands and constraints of the robotic system or the demands of the social context when in contact with a human contact provider.
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Affiliation(s)
- Leif Johannsen
- 9165 RWTH Aachen University, Germany
- University of East Anglia, Norwich, United Kingdom
| | | | | | | | - Dongheui Lee
- 9184 Technical University Munich, Germany
- German Aerospace Center (DLR), Weßling, Germany
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Student J, Engel D, Timmermann L, Bremmer F, Waldthaler J. Visual Perturbation Suggests Increased Effort to Maintain Balance in Early Stages of Parkinson’s to be an Effect of Age Rather Than Disease. Front Hum Neurosci 2022; 16:762380. [PMID: 35308620 PMCID: PMC8924037 DOI: 10.3389/fnhum.2022.762380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 02/02/2022] [Indexed: 12/01/2022] Open
Abstract
Postural instability marks a prevalent symptom of Parkinson’s disease (PD). It often manifests in increased body sway, which is commonly assessed by tracking the Center of Pressure (CoP). Yet, in terms of postural control, the body’s Center of Mass (CoM), and not CoP is what is regulated in a gravitational field. The aim of this study was to explore the effect of early- to mid-stage PD on these measures of postural control in response to unpredictable visual perturbations. We investigated three cohorts: (i) 18 patients with early to mid-stage PD [Hoehn & Yahr stage (1–3); 1.94 ± 0.70]; (ii) a group of 15 age-matched controls (ECT); and (iii) a group of 12 young healthy adults (YCT). Participants stood on a force plate to track their CoP, while the movement of their entire body was recorded with a video-based motion tracking system to monitor their CoM. A moving room paradigm was applied through a head-mounted virtual reality headset. The stimulus consisted of a virtual tunnel that stretched in the anterior-posterior direction which either remained static or moved back and forth in an unpredictable fashion.We found differences in mean sway amplitude (MSA) and mean velocities of CoP and CoM between the groups under both conditions, with higher MSA of CoP and CoM for PD and higher mean velocities of both variables for PD and ECT when compared with YCT. Visual perturbation increased mean CoP velocity in all groups but did not have effects on mean CoM velocity or MSA. While being significantly lower for the young adults, the net effect of visual perturbation on mean CoP velocity was similar between patients with PD and age-matched controls. There was no effect of the visual perturbation on mean CoM velocity for any of the groups.Our simultaneous assessment of CoP and CoM revealed that postural control is reflected differently in CoM and CoP. As the motion of CoM remained mostly unaffected, all groups successfully counteracted the perturbation and maintained their balance. Higher CoP velocity for PD and ECT revealed increased corrective motion needed to achieve this, which however was similar in both groups. Thus, our results suggest increased effort, expressed in CoP velocity, to be an effect of age rather than disease in earlier stages of PD.
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Affiliation(s)
- Justus Student
- Department of Neurophysics, University of Marburg, Marburg, Germany
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
- *Correspondence: Justus Student
| | - David Engel
- Department of Neurophysics, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus-Liebig-University of Gießen, Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus-Liebig-University of Gießen, Marburg, Germany
| | - Frank Bremmer
- Department of Neurophysics, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus-Liebig-University of Gießen, Marburg, Germany
| | - Josefine Waldthaler
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus-Liebig-University of Gießen, Marburg, Germany
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Lubetzky AV, Coker E, Arie L, Aharoni MMH, Krasovsky T. Postural Control under Cognitive Load: Evidence of Increased Automaticity Revealed by Center-of-Pressure and Head Kinematics. J Mot Behav 2021; 54:466-479. [PMID: 34902292 DOI: 10.1080/00222895.2021.2013768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
How postural responses change with sensory perturbations while also performing a cognitive task is still debatable. This study investigated this question via comprehensive assessment of postural sway, head kinematics and their coupling. Twenty-three healthy young adults stood in tandem with eyes open or wearing the HTC Vive Head-Mounted Display (HMD) with a static or dynamic (i.e., movement in the anterior-posterior direction at 5 mm or 32 mm at 0.2 Hz) 3-wall stars display. On half of the trials, participants performed a cognitive serial subtraction task. Medio-lateral center-of-pressure (COP) path significantly increased with the cognitive task, particularly with dynamic visuals whereas medio-lateral variance decreased with the cognitive task. Head path and velocity significantly increased with the cognitive task in both directions while variance decreased. Head-COP cross-correlations ranged between 0.78 and 0.66. These findings, accompanied by frequency analysis, suggest that postural control switched to primarily relying on somatosensory input under challenging cognitive load conditions. Several differences between head and COP suggest that head kinematics contribute an important additional facet of postural control and the relationship between head and COP may depend on task and stance position. The potential of HMDs for clinical assessments of balance needs to be further explored.
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Affiliation(s)
- Anat V Lubetzky
- Department of Physical Therapy, Steinhardt School of Culture Education and Human Development, New York University, New York, New York, USA
| | - Elizabeth Coker
- Department of Dance, Tisch School of the Arts, New York University, New York, New York, USA
| | - Liraz Arie
- Department of Physical Therapy, Steinhardt School of Culture Education and Human Development, New York University, New York, New York, USA
| | - Moshe M H Aharoni
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tal Krasovsky
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.,Pediatric Rehabilitation Department, Sheba Medical Center, Ramat Gan, Israel
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13
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Dewolf AH, Ivanenko YP, Mesquita RM, Willems PA. Postural control in the elephant. J Exp Biol 2021; 224:272578. [PMID: 34676869 DOI: 10.1242/jeb.243648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022]
Abstract
As the largest extant legged animals, elephants arguably face the most extreme challenge for stable standing. In this study, we investigated the displacement of the centre of pressure of 12 elephants during quiet standing. We found that the average amplitude of the oscillations in the lateral and fore-aft directions was less than 1.5 cm. Such amplitudes for postural oscillation are comparable with those of dogs and other species, suggesting that some aspects of sensorimotor postural control do not scale with size.
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Affiliation(s)
- A H Dewolf
- Laboratoire de physiologie et biomécanique de la locomotion, IoNS Université catholique de Louvain, 1348 Louvain-la-Neuve, Belgium.,Center of Space Biomedicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Y P Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - R M Mesquita
- Laboratoire de physiologie et biomécanique de la locomotion, IoNS Université catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - P A Willems
- Laboratoire de physiologie et biomécanique de la locomotion, IoNS Université catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
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14
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Matsuo H, Kubota M, Matsumura M, Takayama M, Mae Y, Kitazaki Y, Enomoto S, Ueno A, Ikawa M, Hamano T, Takahashi A, Tsubokawa M, Shimada S. Center of pressure velocities in patients with body lateropulsion: three case report series of Wallenberg's syndrome. Physiother Theory Pract 2021; 38:3264-3272. [PMID: 34661499 DOI: 10.1080/09593985.2021.1990448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE In patients with Wallenberg's syndrome who present with body lateropulsion (BL), whether the center of pressure (COP) position and velocity characterize postural dysregulation is unknown. We measured time-course changes in COP parameters in three BL patients. METHODS Three patients with acute Wallenberg's syndrome presented with BL. COP was measured for time-course changes during first standing and every week thereafter. COP positions, which indicate the deviation in the center of gravity, were calculated. COP velocities associated with dynamic movements of the center of gravity were analyzed separately for the BL and non-BL sides. RESULTS All patients showed that COP position shifted to the BL side in first standing and changed to the center over time. COP velocities to the BL side were fast in first standing. Two of the three patients had significantly faster COP velocities to the BL side than to the non-BL side (p < .05), and one did not. In all three cases, the faster COP velocities to the BL side decreased significantly after 2 weeks compared to the initial standing position (p < .001). The change seemed to be related to the time when independent walking became possible. CONCLUSIONS Fast COP velocity to the BL side might reflect postural dysregulation in patients with BL. These findings might be useful information for devising effective rehabilitation in patients with BL.
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Affiliation(s)
- Hideaki Matsuo
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Masafumi Kubota
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Mayumi Matsumura
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Mami Takayama
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Yuri Mae
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Yuki Kitazaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ai Takahashi
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan.,Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Misao Tsubokawa
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan.,Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Seiichiro Shimada
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
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15
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Fok KL, Lee JW, Unger J, Chan K, Musselman KE, Masani K. Co-contraction of ankle muscle activity during quiet standing in individuals with incomplete spinal cord injury is associated with postural instability. Sci Rep 2021; 11:19599. [PMID: 34599267 PMCID: PMC8486862 DOI: 10.1038/s41598-021-99151-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/20/2021] [Indexed: 11/09/2022] Open
Abstract
Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), soleus and medial gastrocnemius were collected bilaterally. The iSCI-group exhibited more co-contractions than the AB-group (EO: 0.208% vs. 75.163%, p = 0.004; EC: 1.767% vs. 92.373%, p = 0.016). Furthermore, postural sway was larger during co-contractions than during no co-contraction in the iSCI-group (EO: 1.405 cm/s2 vs. 0.867 cm/s2, p = 0.023; EC: 1.831 cm/s2 vs. 1.179 cm/s2, p = 0.030), but no differences were found for the AB-group (EO: 0.393 cm/s2 vs. 0.499 cm/s2, p = 1.00; EC: 0.686 cm/s2 vs. 0.654 cm/s2, p = 1.00). To investigate the mechanism, we performed a computational simulation study using an inverted pendulum model and linear controllers. An increase of mechanical stiffness in the simulated iSCI-group resulted in increased postural sway (EO: 2.520 cm/s2 vs. 1.174 cm/s2, p < 0.001; EC: 4.226 cm/s2 vs. 1.836 cm/s2, p < 0.001), but not for the simulated AB-group (EO: 0.658 cm/s2 vs. 0.658 cm/s2, p = 1.00; EC: 0.943 cm/s2 vs. 0.926 cm/s2, p = 0.190). Thus, we demonstrated that co-contractions may be a compensatory strategy for individuals with iSCI to accommodate for decreased motor function, but co-contractions may result in increased ankle mechanical joint stiffness and consequently postural sway.
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Affiliation(s)
- Kai Lon Fok
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jae W Lee
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Janelle Unger
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Katherine Chan
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Kristin E Musselman
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Kei Masani
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada. .,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
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16
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De Martino E, Salomoni SE, Hodges PW, Hides J, Lindsay K, Debuse D, Winnard A, Elliott J, Hoggarth M, Beard D, Cook JA, Ekman R, Hinterwaldner L, Scott J, Weber T, Caplan N. Intermittent short-arm centrifugation is a partially effective countermeasure against upright balance deterioration following 60-day head-down tilt bed rest. J Appl Physiol (1985) 2021; 131:689-701. [PMID: 34197228 DOI: 10.1152/japplphysiol.00180.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study investigated whether artificial gravity (AG), induced by short-radius centrifugation, mitigated deterioration in standing balance and anticipatory postural adjustments (APAs) of trunk muscles following 60-day head-down tilt bed rest. Twenty-four participants were allocated to one of three groups: control group (n = 8); 30-min continuous AG daily (n = 8); and intermittent 6 × 5 min AG daily (n = 8). Before and immediately after bed rest, standing balance was assessed in four conditions: eyes open and closed on both stable and foam surfaces. Measures including sway path, root mean square, and peak sway velocity, sway area, sway frequency power, and sway density curve were extracted from the center of pressure displacement. APAs were assessed during rapid arm movements using intramuscular or surface electromyography electrodes of the rectus abdominis; obliquus externus and internus abdominis; transversus abdominis; erector spinae at L1, L2, L3, and L4 vertebral levels; and deep lumbar multifidus muscles. The relative latency between the EMG onset of the deltoid and each of the trunk muscles was calculated. All three groups had poorer balance performance in most of the parameters (all P < 0.05) and delayed APAs of the trunk muscles following bed rest (all P < 0.05). Sway path and sway velocity were deteriorated, and sway frequency power was less in those who received intermittent AG than in the control group (all P < 0.05), particularly in conditions with reduced proprioceptive feedback. These data highlight the potential of intermittent AG to mitigate deterioration of some aspects of postural control induced by gravitational unloading, but no protective effects on trunk muscle responses were observed.NEW & NOTEWORTHY This study presents novel insights into the effect of artificial gravity (AG) on the deterioration of standing balance and anticipatory postural adjustments (APAs) of trunk muscles induced by 60-day strict head-down bed rest. The results indicated severe balance dysfunction and delayed APAs during rapid arm movement. AG partially mitigated the deterioration in standing balance and may thus be considered as a potential countermeasure for future planetary surface explorations. Optimization of AG protocols might enhance effects.
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Affiliation(s)
- Enrico De Martino
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Sauro E Salomoni
- National Health and Medical Research Council Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Paul W Hodges
- National Health and Medical Research Council Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Julie Hides
- School of Health Sciences and Social Work, Griffith University, Nathan Campus, Brisbane, Australia
| | - Kirsty Lindsay
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Dorothée Debuse
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Andrew Winnard
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - James Elliott
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Northern Sydney Local Health District and The University of Sydney, Faculty of Medicine and Health, The Kolling Research Institute Sydney, Australia
| | - Mark Hoggarth
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, Illinois
| | - David Beard
- National Institute for Health Research Oxford Biomedical Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Jonathan A Cook
- National Institute for Health Research Oxford Biomedical Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.,Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Robert Ekman
- European Astronaut Centre, Space Medicine Team (HRE-OM), European Space Agency, Cologne, Germany
| | - Luis Hinterwaldner
- European Astronaut Centre, Space Medicine Team (HRE-OM), European Space Agency, Cologne, Germany
| | - Jonathan Scott
- European Astronaut Centre, Space Medicine Team (HRE-OM), European Space Agency, Cologne, Germany.,KBR GmbH, Cologne, Germany
| | - Tobias Weber
- European Astronaut Centre, Space Medicine Team (HRE-OM), European Space Agency, Cologne, Germany.,KBR GmbH, Cologne, Germany
| | - Nick Caplan
- Aerospace Medicine and Rehabilitation Laboratory, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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17
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Displacement of Centre of Pressure during Rehabilitation Exercise in Adolescent Idiopathic Scoliosis Patients. J Clin Med 2021; 10:jcm10132837. [PMID: 34198971 PMCID: PMC8269167 DOI: 10.3390/jcm10132837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 01/03/2023] Open
Abstract
Background. Adolescent idiopathic scoliosis (AIS) is included into the category of pathologies that could affect postural control. Rarely AIS shows symptoms but often compromises the normal positioning of the head, trunk and, more generally, of the limbs in the space. We used a stabilometric platform to evaluate the motor control outcomes during a self-elongation in girls with AIS. Methods. In 10 girls with AIS, we evaluated the center of pressure (COP) modifications on a baropodometric platform in a standing position and after a self-elongation correction. Results. All the outcomes (except the eccentricity) showed an increasement during the self-elongation exercise even if the significant differences were not found. Conclusion. SE correction contributes to ameliorate the COP symmetry with a better repercussion on the balance management. This highlights the importance of repetitions during all activities of daily life.
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18
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Bousbaïne van de Kerckhove L, Lefaucheur JP, Sorel M. Differences in stabilometric correlates of pain relief after wearing postural insoles for six weeks between chronic nociceptive and neuropathic foot pain. An open-label pilot study. Neurophysiol Clin 2021; 51:267-278. [PMID: 34023188 DOI: 10.1016/j.neucli.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/25/2021] [Accepted: 04/25/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine if the use of postural insoles could result in a noticeable reduction in the foot pain intensity in patients with a chronic pain condition, either nociceptive (ankylosing spondylitis, AS) or neuropathic (small fiber neuropathy, SFN). METHOD In this open-label pilot study, patients were asked to wear postural insoles for a continuous period of 6 weeks. The primary endpoint was the mean daily pain intensity at foot mobilization measured using a visual analogue scale (VAS). The secondary endpoints included global pain intensity scores (at rest or under mobilization), clinical questionnaires on pain and daily functioning (including the Brief Pain Inventory (BPI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Neuropathic Pain Symptom Inventory (NPSI) and the DN4 questionnaire), and posturo-podiatric variables assessed on clinical examination or using a baro-stabilometric platform. RESULTS The study was completed by 17 patients with AS and 12 patients with SFN. After wearing postural insoles for 6 weeks, a significant improvement was observed on the primary endpoint (decrease in VAS pain score at the foot during mobilization) in both groups of patients (from 6.4 ± 2.4 to 3.6 ± 2.6 (p = 0.0004) in the AS group and from 5.7 ± 2.2 to 2.4 ± 1.6 (p = 0.0003) in the SFN group). Improvement was also observed for all other pain and activity scores (global pain at rest or during mobilization (VAS), BDI, and BASDAI for the AS group or NPSI and DN4 for the SFN group), as well as for posturo-podiatric clinical variables. However, we did not find any difference in any clinical pain score whether the posturo-podiatric clinical outcomes were positive or not. Regarding the stabilometric measures, the only significant change after the intervention was a reduced mean velocity of center of pressure displacement in the AS group only (mVel in mm/s: from 7.4 ± 2.0 vs. 6.7 ± 1.9, p = 0.017). In addition, the reduction in mVel correlated to that of the BPI score (r = 0.48, p = 0.0496). CONCLUSION In both groups of patients, wearing postural insoles for 6 weeks led to a significant decrease in local pain intensity at foot level and to more global analgesic effects and positive posturo-podiatric changes. However, these latter changes did not appear to be strongly associated with pain relief. Nevertheless, an index of a better postural control, i.e. mVel decrease, was found to be related to a reduction of pain interference in daily life activities in AS patients, but not in SFN patients. Therefore, in the context of neuropathic pain, mechanisms other than postural changes likely contribute to the analgesic effects of wearing postural insoles, in contrast to nociceptive pain due to spinal osteoarthritis.
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Affiliation(s)
- Leïla Bousbaïne van de Kerckhove
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; Osteopathic Office, 123 rue de l'Université, F-75007 Paris, France.
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
| | - Marc Sorel
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; CH Sud-Seine-et-Marne, Pain Clinic (Centre d'Evaluation et Traitement de la Douleur), F-77140 Nemours, France
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19
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Chen B, Liu P, Xiao F, Liu Z, Wang Y. Review of the Upright Balance Assessment Based on the Force Plate. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052696. [PMID: 33800119 PMCID: PMC7967421 DOI: 10.3390/ijerph18052696] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/26/2021] [Indexed: 12/15/2022]
Abstract
Quantitative assessment is crucial for the evaluation of human postural balance. The force plate system is the key quantitative balance assessment method. The purpose of this study is to review the important concepts in balance assessment and analyze the experimental conditions, parameter variables, and application scope based on force plate technology. As there is a wide range of balance assessment tests and a variety of commercial force plate systems to choose from, there is room for further improvement of the test details and evaluation variables of the balance assessment. The recommendations presented in this article are the foundation and key part of the postural balance assessment; these recommendations focus on the type of force plate, the subject's foot posture, and the choice of assessment variables, which further enriches the content of posturography. In order to promote a more reasonable balance assessment method based on force plates, further methodological research and a stronger consensus are still needed.
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20
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Tat NM, Tat AM, Oner AF, Karaman K, Kaplan S, Can F. Static postural balance evaluation and an investigation of the relationship with joint health in children with severe haemophilia: a controlled cross-sectional study. Haemophilia 2021; 27:e245-e252. [PMID: 33486846 DOI: 10.1111/hae.14240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Recurrent hemarthroses disturbing force/movement control are likely to impair postural balance. AIM To investigate the possible changes in static postural balance parameters in children with haemophilia (CwH) and to reveal its relationship with Haemophilia Joint Health Score (HJHS). METHODS Twenty-one CwH aged 6-18 who had haemophilic arthropathy in at least one lower limb joint and 21 healthy peers were evaluated by using a force platform. Centre of pressure (CoP) signals were displayed as a map in both anteroposterior direction (APD) and mediolateral direction (MLD) by statokinesigram. Accordingly, the amplitude, velocity and standard deviation of CoP displacements along with the perimeter and ellipse area were measured. Assessments were made under eyes opened and eyes closed in bipedal stance for 60 s. Joint health and muscle strength were evaluated with HJHS and digital dynamometer, respectively. RESULTS Velocity and amplitude of CoP displacements in MLD were increased in CwH (p˂0.05). It was also found that these parameters were moderate correlated with the clinical score of the lower limb joints (p˂0.05). In CwH, standard deviation of CoP displacements in the APD was significantly higher in eyes closed, while standard deviation in MLD was significantly higher in eyes opened (p˂0.05). CONCLUSION Disturbances during bipedal stance reveal the need for balance evaluation in CwH. Increased mediolateral oscillations may be an early sign of disorders of the musculoskeletal system in CwH. In addition to improving joint health, postural balance exercises that increase MLD stability have to be included in the rehabilitation programme of CwH.
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Affiliation(s)
- Necati M Tat
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Necmettin Erbakan University, Konya, Turkey
| | - Ayse M Tat
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Necmettin Erbakan University, Konya, Turkey
| | - Ahmet F Oner
- Faculty of Medicine, Department of Pediatric Hematology and Oncology, Yuzuncu Yil University, Van, Turkey
| | - Kamuran Karaman
- Faculty of Medicine, Department of Pediatric Hematology and Oncology, Yuzuncu Yil University, Van, Turkey
| | - Seyhmus Kaplan
- Faculty of Medicine, Department of Sports Medicine, Yuzuncu Yil University, Van, Turkey
| | - Filiz Can
- Faculty of Physical Therapy and Rehabilitation, Department of Orthopaedic Rehabilitation, Hacettepe University, Ankara, Turkey
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21
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Fujio K, Takeuchi Y. Discrimination of standing postures between young and elderly people based on center of pressure. Sci Rep 2021; 11:195. [PMID: 33420289 PMCID: PMC7794377 DOI: 10.1038/s41598-020-80717-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/23/2020] [Indexed: 11/25/2022] Open
Abstract
Posturography is utilized to assess the influence of aging on postural control. Although this measurement is advantageous for finding group-level differences between the young and the elderly, it is unclear whether it has the potential to differentiate elderly individuals who are affected by various impacts of aging. The purpose of this study was to determine the utility of posturography to discriminate elderly individuals from young adults. We investigated the performances of the random forest classifiers constructed from center of pressure (COP) indices for discriminating standing postures between healthy elderly and young people. Postural sways in 19 young and 31 community-dwelling elderly participants were measured using force plates in 4 standing conditions: bipedal standing, standing on a narrow base, standing on foam rubber, and standing with eyes closed. We further verified the informative predictors that contributed to the prediction model. As the results, the classifier based on the COP indices for standing on foam rubber showed the best performance (accuracy: 93.4%, sensitivity: 94.4%, specificity: 93.6%, area under the curve of receiving operator characteristics: 0.95), followed by the classifier for standing with eyes closed. The informative predictors varied depending on the postural conditions. Our findings demonstrated the potential of posturography for identifying elderly postures. The evaluation of sensory re-weighting using the appropriate COP indices would be a useful clinical tool for detecting the progress of aging on postural control.
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Affiliation(s)
- Kimiya Fujio
- Department of Rehabilitation for Movement Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.
| | - Yahiko Takeuchi
- Department of Rehabilitation Medicine, Chiba University Hospital, Chiba, Japan
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22
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Equimetrix Device: Criteria Based Validation and Reliability Analysis of the Center of Mass and Base of Support of a Human Postural Assessment System. SENSORS 2021; 21:s21020374. [PMID: 33430452 PMCID: PMC7826642 DOI: 10.3390/s21020374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/17/2022]
Abstract
Human postural control is a fundamental ability for static and dynamic tasks, especially in hiper- and hipo-functional populations, such as the elderly. The Equimetrix is a clinical device developed to assess both the base of support (BoS) and the center of mass (CoM) dynamics, thus allowing their use as new evaluation and training tools. This study aims to perform a criteria based validation of Equimetrix by comparing the BoS and CoM data with gold-standard equipment. A motion capture system, force platform, and pressure mat were used to calculate the CoM, center of pressure (CoP) and BoS during bipedal, unipedal, feet together and full tandem stances. Results demonstrate an excellent reliability of Equimetrix in terms of spatial accuracy of the CoM, although over-estimating the CoM height. Differences were found when comparing Mean velocity Path with the CoM, but not with the CoP, indicating a lower reliability in time-based parameters. The Equimetrix presents a tendency to overestimate the BoS, with mixed reliability values, which may be related to the different size of sensing elements between the Equimetrix and the pressure sensing mat. These are encouraging results that should be further explored during dynamic tasks.
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The Effects of Texting, Sitting Surface Stability, and Balance Training on Simulated Driving Performance and Perceived Workload in Young and Older Drivers. Motor Control 2021; 25:1-18. [DOI: 10.1123/mc.2019-0119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 07/13/2020] [Accepted: 08/02/2020] [Indexed: 11/18/2022]
Abstract
It has been shown that texting degrades driving performance, but the extent to which this is mediated by the driver’s age and postural stability has not been addressed. Hence, the present study examined the effects of texting, sitting surface stability, and balance training in young and older adults’ driving performance. Fifteen young (mean age = 24.3 years) and 13 older (mean age = 62.8 years) participants were tested in a driving simulator with and without texting on a smartphone and while sitting on a stable or unstable surface (i.e., a plastic wobble board), before and after a 30-min sitting balance training. Analyses of variance showed that texting deteriorated driving performance but irrespective of sitting surface stability. Balance training decreased the negative effects of texting on driving, especially in older adults. Perceived workload increased when drivers were texting, and balance training reduced perceived workload. Perceived workload was higher while sitting on the unstable surface, but less so after balance training. Path analyses showed that the effects on driving performance and perceived workload were (indirectly) associated with changes in postural stability (i.e., postural sway). The study confirms that texting threatens safe driving performance by challenging postural stability, especially in older adults. The study also suggests that it is important to further investigate the role balance training can play in reducing these negative effects of texting.
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24
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Test-retest reliability of force plate-derived measures of reactive stepping. J Biomech 2020; 115:110185. [PMID: 33385871 DOI: 10.1016/j.jbiomech.2020.110185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/11/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022]
Abstract
Characterizing reactive stepping is important to describe the response's effectiveness. Timing of reactive step initiation, execution, and termination have been frequently reported to characterize reactive balance control. However, the test-retest reliabilities of these measures are unknown. Accordingly, the purpose of this study was to determine the between- and within-session test-retest reliabilities of various force plate-derived measures of reactive stepping. Nineteen young, healthy adults responded to 6 small (~8-10% of body weight) and 6 large perturbations (~13-15% of body weight) using an anterior lean-and-release system. Tests were conducted during two visits separated by at least two days. Participants were instructed to recover balance in as few steps as possible. Step onset, foot-off, swing, and restabilization times were extracted from force plates. Relative test-retest reliability was determined through intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs). Absolute test-retest reliability was assessed using the standard error of the measurement (SEM). Foot-off and swing times had the highest between- and within-session test-retest reliabilities regardless of perturbation size (between-session ICC = 0.898-0.942; within-session ICC = 0.455-0.753). Conversely, step onset and restabilization times had lower ICCs and wider CIs (between-session ICC = 0.495-0.825; within-session ICC = -0.040-0.174). Between-session test-retest reliability was higher (ICC = 0.495-0.942) for all measures than within-session test-retest reliability (ICC = -0.040-0.753). Time to restabilization had the highest SEM, indicating the worst absolute reliability of the measures. These findings suggest multiple baseline sessions are needed for measuring restabilization and step onset times. The minimal detectable changes reported provide an index for measuring meaningful change due to an intervention.
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Ralston JD, Raina A, Benson BW, Peters RM, Roper JM, Ralston AB. Physiological Vibration Acceleration (Phybrata) Sensor Assessment of Multi-System Physiological Impairments and Sensory Reweighting Following Concussion. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:411-438. [PMID: 33324120 PMCID: PMC7733539 DOI: 10.2147/mder.s279521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/02/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To assess the utility of a head-mounted wearable inertial motion unit (IMU)-based physiological vibration acceleration (“phybrata”) sensor to support the clinical diagnosis of concussion, classify and quantify specific concussion-induced physiological system impairments and sensory reweighting, and track individual patient recovery trajectories. Methods Data were analyzed from 175 patients over a 12-month period at three clinical sites. Comprehensive clinical concussion assessments were first completed for all patients, followed by testing with the phybrata sensor. Phybrata time series data and spatial scatter plots, eyes open (Eo) and eyes closed (Ec) phybrata powers, average power (Eo+Ec)/2, Ec/Eo phybrata power ratio, time-resolved phybrata spectral density (TRPSD) distributions, and receiver operating characteristic (ROC) curves are compared for individuals with no objective impairments and those clinically diagnosed with concussions and accompanying vestibular impairment, other neurological impairment, or both vestibular and neurological impairments. Finally, pre- and post-injury phybrata case report results are presented for a participant who was diagnosed with a concussion and subsequently monitored during treatment, rehabilitation, and return-to-activity clearance. Results Phybrata data demonstrate distinct features and patterns for individuals with no discernable clinical impairments, diagnosed vestibular pathology, and diagnosed neurological pathology. ROC curves indicate that the average power (Eo+Ec)/2 may be utilized to support clinical diagnosis of concussion, while Eo and Ec/Eo may be utilized as independent measures to confirm accompanying neurological and vestibular impairments, respectively. All 3 measures demonstrate area under the curve (AUC), sensitivity, and specificity above 90% for their respective diagnoses. Phybrata spectral analyses demonstrate utility for quantifying the severity of concussion-induced physiological impairments, sensory reweighting, and subsequent monitoring of improvements throughout treatment and rehabilitation. Conclusion Phybrata testing assists with objective concussion diagnosis and provides an important adjunct to standard concussion assessment tools by objectively ascertaining neurological and vestibular impairments, guiding targeted rehabilitation strategies, monitoring recovery, and assisting with return-to-sport/work/learn decision-making.
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Affiliation(s)
| | - Ashutosh Raina
- Center of Excellence for Pediatric Neurology, Rocklin, CA 95765, USA.,Concussion Medical Clinic, Rocklin, CA 95765, USA
| | - Brian W Benson
- Benson Concussion Institute, Calgary, Alberta T3B 6B7, Canada.,Canadian Sport Institute Calgary, Calgary, Alberta T3B 5R5, Canada
| | - Ryan M Peters
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta T2N 1N4, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta T2N 1N4, Canada
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Liang HW, Chi SY, Chen BY, Hwang YH. Reliability and Validity of a Virtual Reality-Based System for Evaluating Postural Stability. IEEE Trans Neural Syst Rehabil Eng 2020; 29:85-91. [PMID: 33125332 DOI: 10.1109/tnsre.2020.3034876] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Postural stability is an important indicator of balance and is commonly evaluated in neurorehabilitation. We proposed a system based on a virtual reality (HTC Vive) system with a tracker at the lumbar area. The position data of the tracker were obtained through detection of the sensors on the tracker by the VR system. The reliability and validity of these sway parameters to measure postural stability were evaluated. Twenty healthy adults had their postural sway measured with this system and a force platform system under four stance conditions, with wide- or narrow-stance and eyes open or closed. The path data from both systems were computed to obtain the following parameters: the mean distance and the mean velocity in the medial-lateral and anterior-posterior directions and the 95% confidence ellipse area. The reliability of the Vive-based sway measures was tested with intraclass correlation coefficients (ICCs). The convergent validity was tested against the center of pressure (COP) parameters from the force platform system. Finally, the discriminative validity was tested for the above four conditions. The results indicated that the Vive-based sway parameters had moderate to high reliability (ICCs: 0.56 ~ 0.90) across four conditions and correlated moderately to very highly with the COP parameters ( r = 0.420 ∼ 0.959 ). Bland-Altman plotting showed generally good agreement, with negative offset for the Vive-based sway parameters. The sway parameters obtained by the Vive-based system also discriminated well among the tasks. In conclusion, the results support this system as a simple and easy-to-use tool to evaluate postural stability with acceptable reliability and validity.
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Monopodal Postural Stability Assessment by Wireless Inertial Measurement Units Through the Fast Fourier Transform. J Sport Rehabil 2020; 29:738-747. [PMID: 31629327 DOI: 10.1123/jsr.2018-0399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/08/2019] [Accepted: 05/27/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES (1) To describe the fast Fourier transform (FFT) multijoint as monopodal postural stability measurement in well-trained athletes, (2) to compare the within-subject FFT between laterality, joints, and body segments, and (3) to establish the within- and between-subject relationship between joints. METHODS Twelve national-level basketball players participated voluntarily in this investigation. The participants performed two 60-second repetitions of a monopodal stability test (1 repetition with each lower limb), separated by 3 minutes of active recovery. All tests were recorded by 4 WIMU PRO™ inertial devices located on the ankle, knee, lumbar spine, and thoracic spine. The main variable was total acceleration, where the FFT was applied. RESULTS The higher instability results were found in the ankle and in the nondominant lower limb (dominant = 1.131 [0.122] a.u. (arbitrary units); nondominant = 1.141 [0.172] a.u). In the body segment analysis, the greater percentage of differences (%diff) were shown between lumbar spine and knee in the dominant (%diff = -2.989%; d = 0.87) and nondominant (%diff = -3.243%; d = 0.90) lower limb. Finally, very large between-subjects variability was found in all joints and body segments. CONCLUSIONS The described protocol is proposed for monopodal postural stability assessment, being useful to provide information about the stability of joints and the body segment between joints. Besides, a within-subject analysis is recommended, and the FFT calculation will enable a linear analysis of each test.
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Abdou A, Pilkar R, Chen P, Yue G, Barrett A. Improved stability of long-duration sitting in spatial neglect after a single session of prism adaptation. Neurocase 2020; 26:201-210. [PMID: 32600098 DOI: 10.1080/13554794.2020.1786134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Spatial neglect after right brain stroke affects balance, and improvements in sitting balance after prism adaptation have been demonstrated using short-duration center of pressure (CoP) data. We present long-duration (5 min) CoP and trunk muscles electromyography recordings of a 61-year-old man with left-sided spatial neglect, before and after a single session of prism adaptation. His CoP-derived measures showed improved balance and postural stability in both the anterior-posterior and medial-lateral directions after prism adaptation. Concurrently, asymmetry in neuromuscular activations was reduced. The findings suggest that improved sitting balance may be associated with more symmetrical activation of trunk muscles after prism adaptation.
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Affiliation(s)
- Andrew Abdou
- Burke Rehabilitation Hospital , White Plains, NY, USA.,Department of Physical Medicine & Rehabilitation, Montefiore Medical Center , Bronx, NY, USA.,The Arthur S. Abramson Department of Rehabilitation Medicine, Albert Einstein College of Medicine , Bronx, NY, USA
| | - Rakesh Pilkar
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation , West Orange, NJ, USA.,eDepartment of Physical Medicine & Rehabilitation, Rutgers - New Jersey Medical School , Newark, NJ, USA
| | - Peii Chen
- eDepartment of Physical Medicine & Rehabilitation, Rutgers - New Jersey Medical School , Newark, NJ, USA.,Center for Stroke Rehabilitation Research, Kessler Foundation , West Orange, NJ, USA
| | - Guang Yue
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation , West Orange, NJ, USA.,eDepartment of Physical Medicine & Rehabilitation, Rutgers - New Jersey Medical School , Newark, NJ, USA
| | - A Barrett
- Department of Neurology, Emory School of Medicine , Atlanta, GA, USA.,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center , Decatur, GA, USA
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29
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Viseux FJF, Martins DF, Villeneuve P, Charpentier P, de Sant'Anna E Silva L, Salgado ASI, Lemaire A. Effect of sensory stimulation applied under the great toe on postural ability in patients with fibromyalgia. Somatosens Mot Res 2020; 37:172-179. [PMID: 32419591 DOI: 10.1080/08990220.2020.1765767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Fibromyalgia (FM) is a chronic pain syndrome, characterised by several symptoms. One of the most prevalent symptoms in FM is balance impairment that compromise the autonomy, function and performance status of patients.Purpose: The main objective of the present study was to evaluate the effect of sensory stimulation provided by the use of a low additional thickness of 0.8 mm placed under the great toes bilaterally on the centre of pressure (CoP) measures in patients with FM. It was hypothesised that postural ability would change with a low focal additional thickness used to compute these measures.Materials and Method: Twenty-four patients with FM voluntarily participated in this study. Postural performance during quiet standing was investigated through the CoP displacements recorded using a force-plate. Sensory stimulation was provided by a small additional thickness of 0.8 mm placed under the great toe bilaterally and two conditions were compared: additional thickness 0 (control) and 0.8 mm.Results: An improvement of body balance through spatial parameters with sensory cutaneous stimulation applied under the great toe bilaterally were observed in patients with FM. Our results showed a significant decrease of surface area and mean speed of CoP, associated to a significant decrease of variance of speed. An additional observation is that sagittal (Y) mean position of the CoP gets more anterior (+ 5 mm) relative to control condition.Conclusion: These findings brings new clinical perspectives in the development of intervention strategies in the management of patients with FM and balance disorders, completing validated therapeutic strategies.
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Affiliation(s)
- Frederic J F Viseux
- Laboratoire d'Automatique, de Mécanique et d'Informatique industrielle et Humaine (LAMIH) - UMR CNRS 8201, Université Polytechnique des Hauts-de-France, Valenciennes, France.,Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France.,Posture Lab, Paris, France
| | - Daniel F Martins
- Experimental Neuroscience Laboratory (LaNEx), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil
| | | | - Pascal Charpentier
- Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
| | | | - Afonso S I Salgado
- Institute of Integral Health, Londrina, Brazil.,Experimental Neuroscience Laboratory (LaNEx), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil
| | - Antoine Lemaire
- Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
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30
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Effect of Visual Condition on Performance of Balance-Related Tasks in Elite Dance Students. Motor Control 2020; 24:397-407. [PMID: 32384263 DOI: 10.1123/mc.2019-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 12/21/2019] [Accepted: 03/14/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to investigate the effects of visual condition (low light, full light, and full light with mirror) on balance control and technical form during two technical dance movements in a group of elite collegiate dance students. Dancers demonstrated higher center of pressure velocity indicating lower control while performing a static dance task (parallel relevé retiré) and a dynamic dance task (fondu relevé en croix) under low light conditions than either lighted condition. Measures of Western ballet technique (pelvic obliquity, knee extension, and ankle plantar flexion) showed no decrement under low light conditions. No effect of concurrent mirror feedback was found on either center of pressure velocity or technical requirements of the dance tasks.
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31
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Cheng YS, Chien A, Lai DM, Lee YY, Cheng CH, Wang SF, Chang YJ, Wang JL, Hsu WL. Perturbation-Based Balance Training in Postoperative Individuals With Degenerative Cervical Myelopathy. Front Bioeng Biotechnol 2020; 8:108. [PMID: 32154235 PMCID: PMC7044125 DOI: 10.3389/fbioe.2020.00108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/03/2020] [Indexed: 11/28/2022] Open
Abstract
Degenerative cervical myelopathy (DCM) is a common aging condition caused by spinal cord compression. Individuals with DCM often presented with residual balance and functional impairments postoperatively. Perturbation-based balance training (PBT) has been shown to have positive effects on populations with neurological disorders but has yet to be investigated in DCM. The objective of this study was therefore to evaluate the effects of PBT on balance and functional performance in postoperative individuals with DCM. Fifteen postoperative individuals with DCM (DCM group) and 14 healthy adults (healthy control group) were recruited. The DCM group received a 4-weeks PBT using a perturbation treadmill. The outcome measures included mean velocity of center of pressure (COP) during quiet standing; center of mass (COM) variance and reaction time to balance perturbation during standing with forward and backward perturbation; gait speed during level ground walking; Timed Up and Go Test (TUG) and disability questionnaire scores including Visual Analog Scale, Neck Disability Index, and Lower Extremity Function of Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. The assessments were conducted pre- and post-training postoperatively for the DCM group but only once for the healthy control group. Significant improvements were observed in the mean velocity of COP, COM variance, reaction time, gait speed, and TUG in the DCM group. Disability questionnaire scores were not significantly different after training in DCM group. For between-group comparisons, significant differences that were observed pre-training were not observed post-training. The 4-weeks PBT is a potential rehabilitation strategy for addressing balance and functional impairment in postoperative individuals with DCM. In addition, the post-training performance in the DCM group exhibited trends comparable to those of age-matched healthy controls. Furthermore, the training regimens offer a practical reference for future studies on populations with balance disorders. Future studies complemented with neurophysiological assessments could reveal more information of the underlying mechanisms of PBT.
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Affiliation(s)
- Yi-Shan Cheng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Andy Chien
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Dar-Ming Lai
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Yun Lee
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shwu-Fen Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Ju Chang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jaw-Lin Wang
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
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Changes in center of pressure velocities during obstacle crossing one year after bariatric surgery. Gait Posture 2020; 76:377-381. [PMID: 31901766 PMCID: PMC7017396 DOI: 10.1016/j.gaitpost.2019.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 11/05/2019] [Accepted: 12/14/2019] [Indexed: 02/07/2023]
Abstract
Adults with obesity have atypical gait with poor balance leading to an increase in fall risk. After massive weight loss, their gait improves. However, we know little about changes in postural stability after massive weight loss. The present study aimed to examine how massive weight loss after Roux-en-Y bariatric surgery affected adjustments in center of pressure (COP) velocities during flat ground walking and obstacle crossing. Before and one-year post-bariatric surgery, nineteen female adults walked under four conditions: baseline walking on flat ground and obstacle crossing with three different obstacle heights for a total of 20 trials. COP data were obtained from raw pressure time series data extracted from a gait carpet. Massive weight loss increased anteroposterior COP velocities under the midfoot of both trailing and leading legs (ps<.01) and decreased mediolateral COP velocities under the forefoot of trailing leg (p < .05). Decreased BMI from pre- to post-surgery was correlated with an increase in anterior-posterior and decrease in medial-lateral COP velocities and with increased velocity (ps<.05). Massive weight loss not only improved gait but also facilitated effective balance control strategies. Examining how massive weight loss affects adjustments in COP velocity may help create ways to better understand why individuals with obesity have atypical gait with poor balance and how we can facilitate participation in physical activities.
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Chumacero EA, Yang J. Basin of Attraction and Limit Cycle Amplitude of an Ankle-Hip Model of Balance on a Balance Board. J Biomech Eng 2019; 141:2732255. [PMID: 31017633 DOI: 10.1115/1.4043563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Indexed: 11/08/2022]
Abstract
The study of upright posture (UP) stability is of relevance to estimating risk of falls, especially among people with neuromuscular deficits. Several studies have addressed this problem from a system dynamic approach based on parameter bifurcation analyses, which provide the region of stability (RoS) and the delimiting bifurcation curves (usually Hopf and pitchfork) in some parameter-spaces. In contrast, our goal is to determine the effect of parameter changes on the size of the basin of attraction (BoA) of the UP equilibrium and the amplitude of the limit cycle oscillations (LCOs) emerging from the Hopf bifurcations (HBs). The BoA is an indicator of the ability of the UP to maintain balance without falling while LCOs may explain the sway motion commonly observed during balancing. In this study, a three degree of freedom model for a human balancing on a balance board was developed. Analysis of the model revealed the BoAs and the amplitude of the LCOs. Results show that physical parameters (time-delays and feedback control gains) have a large impact on the size of the BoA and the amplitude of the LCOs. Particularly, the size of the BoA increases when balancing on a rigid surface and decreases when either proprioceptive or combined visual and vestibular feedback gain is too high. With respect to the LCOs, it is shown that they emerge from both the subcritical and supercritical HBs and increase their amplitudes as some parameters vary.
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Affiliation(s)
- Erik A Chumacero
- Human-Centric Design Research Lab, Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79401
| | - James Yang
- ASME Fellow, Human-Centric Design Research Lab, Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79401
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Gorst T, Freeman J, Yarrow K, Marsden J. Assessing lower limb position sense in stroke using the gradient discrimination test (GradDT™) and step-height discrimination test (StepDT™): a reliability and validity study. Disabil Rehabil 2019; 42:2215-2223. [PMID: 30636492 DOI: 10.1080/09638288.2018.1554008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To evaluate the psychometric properties of two novel tests of lower limb position sense.Methods: Our newly developed tests assess the discrimination thresholds of under-foot slope and step height perception using a two alternative forced choice approach. Stroke participants (n = 32) and age matched controls (n = 32) were tested. Inter- and intra-rater reliability and agreement, sensitivity and specificity, discriminant and convergent validity were evaluated.Results: Intra-rater reliability for both variants of the gradient discrimination test was excellent; intraclass correlation coefficients (ICC) =0.91 and 0.89. The step height discrimination test had excellent intra-rater reliability and agreement: ICC =0.95. Inter-rater reliability was also excellent in both tests (ICC= 0.85-0.93). Discriminant validity was demonstrated with significant differences in test performance between stroke and control participants (p < 0.001). Our novel tests did not significantly correlate with the proprioceptive component of the Erasmus modified Nottingham Sensory Assessment. Receiver Operating Characteristic curve analysis indicated both novel tests to have greater sensitivity and specificity than the proprioceptive component of the Erasmus modified Nottingham Sensory Assessment in predicting the presence of self-reported sensory impairments. Functional reach test, 10 meter walk test, centre of pressure measurement and reported falls showed significant and moderate to strong correlations with novel test performance (r = 0.40-0.60); the Erasmus modified Nottingham Sensory Assessment did not.Conclusions: Our novel, functionally oriented tests of lower limb position sense are reliable, valid and feasible for use in an ambulatory chronic stroke and elderly population.Implications for rehabilitationThe GradDT™ and StepDT are two novel tests of lower limb position sense which are reliable and valid in a chronic stroke sample.They offer clinicians and researchers sensitive, accurate and clinically usable measures of lower limb position sense.
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Affiliation(s)
- Terry Gorst
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Jenny Freeman
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Kielan Yarrow
- Dept of Psychology, City, University of London, London, UK
| | - Jonathan Marsden
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
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Markström JL, Schelin L, Häger CK. A novel standardised side hop test reliably evaluates landing mechanics for anterior cruciate ligament reconstructed persons and controls. Sports Biomech 2018; 20:213-229. [PMID: 30526381 DOI: 10.1080/14763141.2018.1538385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We propose a novel one-leg standardised rebound side-hop test (SRSH) specifically designed for detailed analysis of landing mechanics. Anterior cruciate ligament reconstructed persons (ACLR, n = 30) and healthy-knee controls (CTRL, n = 30) were tested for within-session and test-retest (CTRL only, n = 25) reliability and agreement. Trunk, hip and knee angles and moments in sagittal, frontal, and transversal planes during landing, including time to stabilisation (TTS), were evaluated using intra-class correlations (ICCs), average within-person standard deviations (SW) and minimal differences. Excellent within-session reliability were found for angles in both groups (most ICCs > 0.90, SW ≤ 5°), and excellent to good for moments (most ICCs > 0.80, SW ≤ 0.34 Nm/kg). Only knee internal rotation moment showed poor reliability (ICC < 0.4). Test-retest results were excellent to fair for all angles and moments (ICCs 0.47-0.91, SW < 5° and ≤ 0.25 Nm/kg), except for peak trunk lateral bending angle and knee internal rotation moment. TTS showed excellent to fair within-session reliability but poor test-retest results. These results, with a few exceptions, suggest promising potential of evaluating landing mechanics during the SRSH for ACLR and CTRL, and emphasise the importance of joint-specific movement control variables in standardised tasks.
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Affiliation(s)
- Jonas L Markström
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University , Umeå, Sweden
| | - Lina Schelin
- Umeå School of Business, Economics and Statistics, Department of Statistics, Umeå University , Umeå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University , Umeå, Sweden
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36
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Nguyen N, Phan D, Pathirana PN, Horne M, Power L, Szmulewicz D. Quantification of Axial Abnormality Due to Cerebellar Ataxia with Inertial Measurements. SENSORS (BASEL, SWITZERLAND) 2018; 18:E2791. [PMID: 30149564 PMCID: PMC6164665 DOI: 10.3390/s18092791] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/13/2018] [Accepted: 08/17/2018] [Indexed: 01/01/2023]
Abstract
Cerebellar Ataxia (CA) leads to deficiencies in muscle movement and lack of coordination that is often manifested as gait and balance disabilities. Conventional CA clinical assessments are subjective, cumbersome and provide less insight into the functional capabilities of patients. This cross-sectional study investigates the use of wearable inertial sensors strategically positioned on the front-chest and upper-back locations during the Romberg and Trunk tests for objective assessment of human postural balance due to CA. The primary aim of this paper is to quantify the performance of postural stability of 34 patients diagnosed with CA and 22 healthy subjects as controls. Several forms of entropy descriptions were considered to uncover characteristics of movements intrinsic to CA. Indeed, correlation with clinical observation is vital in ascertaining the validity of the inertial measurements in addition to capturing unique features of movements not typically observed by the practicing clinician. Both of these aspects form an integral part of the underlying objective assessment scheme. Uncertainty in the velocity contained a significant level of information with respect to truncal instability and, based on an extensive clustering and discrimination analysis, fuzzy entropy was identified as an effective measure in characterising the underlying disability. Front-chest measurements demonstrated a strong correlation with clinical assessments while the upper-back measurements performed better in classifying the two cohorts, inferring that the standard clinical assessments are relatively influenced by the frontal observations. The Romberg test was confirmed to be an effective test of neurological diagnosis as well as a potential candidate for objective assessment resulting in a significant correlation with the clinical assessments. In contrast, the Trunk test is observed to be relatively less informative.
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Affiliation(s)
- Nhan Nguyen
- Networked Sensing and Control Lab, School of Engineering, Deakin University, Waurn Ponds, VIC 3216, Australia.
| | - Dung Phan
- Networked Sensing and Control Lab, School of Engineering, Deakin University, Waurn Ponds, VIC 3216, Australia.
| | - Pubudu N Pathirana
- Networked Sensing and Control Lab, School of Engineering, Deakin University, Waurn Ponds, VIC 3216, Australia.
| | - Malcolm Horne
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia.
| | - Laura Power
- Balance Disorders and Ataxia Service, Royal Victorian Eye and Ear Hospital, St Andrews Place, East Melbourne, VIC 3002, Australia.
| | - David Szmulewicz
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia.
- Balance Disorders and Ataxia Service, Royal Victorian Eye and Ear Hospital, St Andrews Place, East Melbourne, VIC 3002, Australia.
- Cerebellar Ataxia Clinic, Caufield Hospital, Alfred Health, Caufield, VIC 3162, Australia.
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Dynamic Fluctuation of Truncal Shift Parameters During Quiet Standing in Healthy Young Individuals. Spine (Phila Pa 1976) 2018; 43:E746-E751. [PMID: 29215505 DOI: 10.1097/brs.0000000000002521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective analysis. OBJECTIVE To describe the dynamic fluctuation of truncal shift parameters during quiet standing in healthy young individuals using biomechanical analyses. SUMMARY OF BACKGROUND DATA Coronal decompensation (CD) and sagittal vertical axis (SVA) are the key radiographic parameters to assess static truncal stability, with the known cut-off value of 4 cm for SVA in determining severity of spinal deformity. These values are obtained at a specific moment during quiet standing, when the posture innately changes. Thus, unassessed truncal sway could potentially compromise the reliability of these measurements. METHODS Previously obtained biomechanical data with 11 male, healthy participants aged 16 to 29 were used to quantify the dynamic sway of standing posture. The participants were instructed to quietly stand with surface reflective markers for 130 seconds. The midpoint of bilateral acromia was used as a surrogate for C7 vertebral body. The time series of coronal and sagittal shifts of C7 to sacrum were measured as quasi-coronal decompensation (CD) and quasi-sagittal vertical axis (SVA) to simulate CD and SVA on radiographs. A force platform was also used to measure the center of pressure (COP) displacement. RESULTS The group averages of the dynamic sway range were 20.2 ± 4.1 mm (range: 15.1-28.6) in the sagittal plane (quasi-SVA) and 9.8 ± 3.2 mm (range: 5.5-15.2) in the coronal plane (quasi-CD). There were significant correlations between quasi-CD sway and medial-lateral COP velocity (Pearson r = 0.65, P = 0.03), as well as between quasi-SVA sway and COP sway area (r = 0.65, P = 0.03). CONCLUSION Given the considerable fluctuation of quasi-SVA and quasi-CD during quiet standing, the reliability of radiographic measurement using CD and SVA at a specific moment can be substantially compromised. The assessment based on the currently proposed cut-off values should be interpreted with caution, and repeat examinations are warranted. LEVEL OF EVIDENCE 4.
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Sánchez-Sánchez ML, Belda-Lois JM, Mena-Del Horno S, Viosca-Herrero E, Igual-Camacho C, Gisbert-Morant B. A new methodology based on functional principal component analysis to study postural stability post-stroke. Clin Biomech (Bristol, Avon) 2018; 56:18-26. [PMID: 29775954 DOI: 10.1016/j.clinbiomech.2018.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 05/04/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND A major goal in stroke rehabilitation is the establishment of more effective physical therapy techniques to recover postural stability. Functional Principal Component Analysis provides greater insight into recovery trends. However, when missing values exist, obtaining functional data presents some difficulties. The purpose of this study was to reveal an alternative technique for obtaining the Functional Principal Components without requiring the conversion to functional data beforehand and to investigate this methodology to determine the effect of specific physical therapy techniques in balance recovery trends in elderly subjects with hemiplegia post-stroke. METHODS A randomized controlled pilot trial was developed. Thirty inpatients post-stroke were included. Control and target groups were treated with the same conventional physical therapy protocol based on functional criteria, but specific techniques were added to the target group depending on the subjects' functional level. Postural stability during standing was quantified by posturography. The assessments were performed once a month from the moment the participants were able to stand up to six months post-stroke. FINDINGS The target group showed a significant improvement in postural control recovery trend six months after stroke that was not present in the control group. Some of the assessed parameters revealed significant differences between treatment groups (P < 0.05). INTERPRETATION The proposed methodology allows Functional Principal Component Analysis to be performed when data is scarce. Moreover, it allowed the dynamics of recovery of two different treatment groups to be determined, showing that the techniques added in the target group increased postural stability compared to the base protocol.
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Affiliation(s)
- M Luz Sánchez-Sánchez
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain.
| | - Juan-Manuel Belda-Lois
- Biomechanics Institute of Valencia, Universitat Politécnica de Valéncia, Camí de Vera s/n, edificio 9C, 46022, Valencia, Spain.
| | - Silvia Mena-Del Horno
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain.
| | - Enrique Viosca-Herrero
- Hospital Universitari i Politècnic La Fe, Avinguda de Fernando Abril Martorell, 106, 46026, Valencia, Spain.
| | - Celedonia Igual-Camacho
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain.
| | - Beatriz Gisbert-Morant
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain.
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Effect of sensory-motor latencies and active muscular stiffness on stability for an ankle-hip model of balance on a balance board. J Biomech 2018; 75:77-88. [PMID: 29861093 DOI: 10.1016/j.jbiomech.2018.04.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 03/29/2018] [Accepted: 04/26/2018] [Indexed: 11/22/2022]
Abstract
To achieve human upright posture (UP) and avoid falls, the central nervous system processes visual, vestibular, and proprioceptive information to activate the appropriate muscles to accelerate or decelerate the body's center of mass. In this process, sensory-motor (SM) latencies and muscular deficits, even in healthy older adults, may cause falls. This condition is worse for people with chronic neuromuscular deficits (stroke survivors, patients with multiple sclerosis or Parkinson's disease). One therapeutic approach is to recover or improve quiet UP by utilizing a balance board (BB) (a rotating surface with a tunable stiffness and time delay), where a patient attempts to maintain UP while task difficulty is manipulated. While BBs are commonly used, it is unclear how UP is maintained or how changes in system parameters such as SM latencies and BB time delay affect UP stability. To understand these questions, it is important that mathematical models be developed with enough degrees-of-freedom to capture the many responses evoked during the maintenance of UP on a BB. This paper presents an ankle-hip model of balance on a BB, which is used to study the combined effect of SM latencies and active muscular stiffness of the ankle and hip joints, and the BB stiffness and time delay on UP stability. The analysis predicts that people with proprioceptive, visual, vestibular loss, or increased SM latencies may show either leaning postures or larger body-sway. The results show that the BB time delay and the visual and vestibular feedback have the largest impact on UP stability.
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Gorst T, Rogers A, Morrison SC, Cramp M, Paton J, Freeman J, Marsden J. The prevalence, distribution, and functional importance of lower limb somatosensory impairments in chronic stroke survivors: a cross sectional observational study. Disabil Rehabil 2018; 41:2443-2450. [PMID: 29726732 DOI: 10.1080/09638288.2018.1468932] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: To investigate the prevalence and distribution of lower limb somatosensory impairments in community dwelling chronic stroke survivors and examine the association between somatosensory impairments and walking, balance, and falls. Methods: Using a cross sectional observational design, measures of somatosensation (Erasmus MC modifications to the (revised) Nottingham Sensory Assessment), walking ability (10 m walk test, Walking Impact Scale, Timed "Get up and go"), balance (Functional Reach Test and Centre of Force velocity), and falls (reported incidence and Falls Efficacy Scale-International), were obtained. Results: Complete somatosensory data was obtained for 163 ambulatory chronic stroke survivors with a mean (SD) age 67(12) years and mean (SD) time since stroke 29 (46) months. Overall, 56% (n = 92/163) were impaired in the most affected lower limb in one or more sensory modality; 18% (n = 30/163) had impairment of exteroceptive sensation (light touch, pressure, and pin-prick), 55% (n = 90/163) had impairment of sharp-blunt discrimination, and 19% (n = 31/163) proprioceptive impairment. Distal regions of toes and foot were more frequently impaired than proximal regions (shin and thigh). Distal proprioception was significantly correlated with falls incidence (r = 0.25; p < 0.01), and centre of force velocity (r = 0.22, p < 0.01). The Walking Impact Scale was the only variable that significantly contributed to a predictive model of falls accounting for 15-20% of the variance. Conclusion: Lower limb somatosensory impairments are present in the majority of chronic stroke survivors and differ widely across modalities. Deficits of foot and ankle proprioception are most strongly associated with, but not predictive, of reported falls. The relative contribution of lower limb somatosensory impairments to mobility in chronic stroke survivors appears limited. Further investigation, particularly with regard to community mobility and falls, is warranted. Implications for Rehabilitation Somatosensory impairments in the lower limb were present in approximately half of this cohort of chronic stroke survivors. Tactile discrimination is commonly impaired; clinicians should include an assessment of discriminative ability. Deficits of foot and ankle proprioception are most strongly associated with reported falls. Understanding post-stroke lower limb somatosensory impairments may help inform therapeutic strategies that aim to maximise long-term participation, minimise disability, and reduce falls.
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Affiliation(s)
- Terry Gorst
- a School of Health Professions , University of Plymouth , Plymouth , UK
| | - Alison Rogers
- b Faculty of Medicine and Health Sciences , Keele University , Keele , UK
| | | | - Mary Cramp
- d Department of Allied Health Professions , University of the West of England , Bristol , UK
| | - Joanne Paton
- a School of Health Professions , University of Plymouth , Plymouth , UK
| | - Jenny Freeman
- a School of Health Professions , University of Plymouth , Plymouth , UK
| | - Jon Marsden
- a School of Health Professions , University of Plymouth , Plymouth , UK
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Abstract
Gaze-stabilization exercise (GSE) is often conducted in vestibular rehabilitation, but its effect on vestibular function in postural control is not clear. We investigated whether GSE affects vestibular function during static upright standing and vestibulospinal reflex (VSR) in healthy young adults. First, the center of pressure of the total trajectory length (CoP-L) was measured before each GSE task or control (only standing) task (pre), immediately after (post), and 10 min after (post10) in the static standing position on foam rubber with the eyes open or closed (EC). Second, the H-reflex on the soleus muscle was measured after the onset of ipsilateral anodal galvanic vestibular stimulation before and after a GSE or a control task to estimate the amount of VSR induced by electrical vestibular input. CoP-L for the pre, post, and post10 control tasks and the GSE in EC did not differ significantly; the CoP-L for the post and post10 tasks in EC were significantly lower than that for the pretask. The H-reflex was inhibited by galvanic vestibular stimulation in the pre-GSE tasks. The inhibition increased after GSE, but not during control tasks. These findings suggest that GSE immediately improves the postural stability required for vestibular function and can be mediated by VSR improvements.
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van Kooten D, Hettinga F, Duffy K, Jackson J, Taylor MJD. Are there associations with age and sex in walking stability in healthy older adults? Gait Posture 2018; 60:65-70. [PMID: 29161624 DOI: 10.1016/j.gaitpost.2017.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 02/02/2023]
Abstract
The variability of the centre of pressure (COP) during walking can provide information in relation to stability when walking. The aim of this study was to investigate if age and sex were associated with COP variability, COP excursions, and COP velocities during walking. One-hundred and fourteen older adults (age 65.1±5.5 yrs.) participated in the study. A Kistler force platform (1000Hz) recorded the ground reaction forces and COPs during walking at a self-selected walking speed. The stance phase was divided, using the vertical GRF, into four sub-phases: loading response (LR), mid-stance (MSt), terminal stance (TSt), and pre-swing (PSw). The standard deviations of the COP displacement (variability), the COP velocity, and COP excursion in the medial-lateral and anterior-posterior directions, as well as the resultant magnitude were assessed. When controlling for walking speed, a greater age was associated with a higher variability and excursion of the COP during LR only suggesting that stability is maintained during the majority of the stance phase. During LR lower COP velocity was significantly associated for females for anterior-posterior and total COP, which may be a strategy to facilitate stability before, and moving into, MSt and TSt.
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Affiliation(s)
- Daan van Kooten
- School of Sport, Exercise, and Rehabilitation Sciences, University of Essex, Colchester, UK
| | - Florentina Hettinga
- School of Sport, Exercise, and Rehabilitation Sciences, University of Essex, Colchester, UK
| | - Kim Duffy
- School of Sport, Exercise, and Rehabilitation Sciences, University of Essex, Colchester, UK
| | - Jo Jackson
- School of Sport, Exercise, and Rehabilitation Sciences, University of Essex, Colchester, UK
| | - Matthew J D Taylor
- School of Sport, Exercise, and Rehabilitation Sciences, University of Essex, Colchester, UK.
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Postural stability during long duration quiet standing in post stroke hemiplegia. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Moorman VJ, Kawcak CE, King MR. Evaluation of a portable media device for use in determining postural stability in standing horses. Am J Vet Res 2017; 78:1036-1042. [DOI: 10.2460/ajvr.78.9.1036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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45
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Jeong H, Ohno Y. Symmetric lifting posture recognition of skilled experts with linear discriminant analysis by center-of-pressure velocity. INTEL SERV ROBOT 2017. [DOI: 10.1007/s11370-017-0227-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lim HS, Kim YL, Lee SM. The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial. J Phys Ther Sci 2016; 28:1819-24. [PMID: 27390424 PMCID: PMC4932065 DOI: 10.1589/jpts.28.1819] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 03/12/2016] [Indexed: 01/13/2023] Open
Abstract
[Purpose] The purpose of this study was to analyze the effects of Pilates exercise on
static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen
individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height,
161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates
exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise
sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway
and COP velocity were measured one week before and after the exercise program and compared
to assess training effects. [Results] Pilates exercise positively affected both static and
dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity
in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly
decreased in the PG after training while no significant differences were found in the CG.
For dynamic balance, measured during treadmill walking, the PG showed significantly
reduced COP sway and velocity in the M-L and A-P directions for both the paretic and
non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise
can enhance static and dynamic balance in patients with chronic stroke.
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Affiliation(s)
- Hee Sung Lim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - You Lim Kim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
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Abstract
The authors evaluated the short-term (within-day, between-days) repeatability of center of pressure (COP) displacements. COP sway area and speed were obtained in the morning and afternoon of two separate days, both with open (EO) and closed (EC) eyes, in 10 healthy adults. Agreement and variability among conditions were tested by ANOVA and Bland-Altman plots. Mode (EO/EC, area: p = .032; speed: p < .004), and day (day1/day2, area: p = .006; speed: p = .02) showed significant differences. The EC condition and the second test day showed the largest values, with medium-large effect sizes. Time-of-day did not influence COP displacements. Speed had better agreement than area (Bland-Altman plots). COP displacements were well reproducible within-day, but had significant between-days variations. COP assessments should be performed in the same session.
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Affiliation(s)
- Nicola Lovecchio
- a Functional Anatomy Research Center (FARC), Department of Biomedical Sciences for Health, Università degli Studi di Milano , Milano , Italy
| | - Matteo Zago
- a Functional Anatomy Research Center (FARC), Department of Biomedical Sciences for Health, Università degli Studi di Milano , Milano , Italy
| | - Laura Perucca
- b Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milano , Italy.,c Unità Clinica e Laboratorio di Ricerche di Riabilitazione Neuromotoria, Ospedale San Luca, Istituto Auxologico Italiano-IRCCS , Milano , Italy
| | - Chiarella Sforza
- a Functional Anatomy Research Center (FARC), Department of Biomedical Sciences for Health, Università degli Studi di Milano , Milano , Italy.,d Institute of Molecular Bioimaging and Physiology, National Research Council , Segrate , Italy
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Effort to reduce postural sway affects both cognitive and motor performances in individuals with Parkinson’s disease. Hum Mov Sci 2016; 47:135-140. [DOI: 10.1016/j.humov.2016.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 02/19/2016] [Accepted: 03/04/2016] [Indexed: 11/23/2022]
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49
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Techniques and Methods for Testing the Postural Function in Healthy and Pathological Subjects. BIOMED RESEARCH INTERNATIONAL 2015; 2015:891390. [PMID: 26640800 PMCID: PMC4659957 DOI: 10.1155/2015/891390] [Citation(s) in RCA: 266] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/05/2015] [Accepted: 10/21/2015] [Indexed: 12/15/2022]
Abstract
The different techniques and methods employed as well as the different quantitative and qualitative variables measured in order to objectify postural control are often chosen without taking into account the population studied, the objective of the postural test, and the environmental conditions. For these reasons, the aim of this review was to present and justify the different testing techniques and methods with their different quantitative and qualitative variables to make it possible to precisely evaluate each sensory, central, and motor component of the postural function according to the experiment protocol under consideration. The main practical and technological methods and techniques used in evaluating postural control were explained and justified according to the experimental protocol defined. The main postural conditions (postural stance, visual condition, balance condition, and test duration) were also analyzed. Moreover, the mechanistic exploration of the postural function often requires implementing disturbing postural conditions by using motor disturbance (mechanical disturbance), sensory stimulation (sensory manipulation), and/or cognitive disturbance (cognitive task associated with maintaining postural balance) protocols. Each type of disturbance was tackled in order to facilitate understanding of subtle postural control mechanisms and the means to explore them.
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Milosevic M, Masani K, Wu N, McConville KMV, Popovic MR. Trunk muscle co-activation using functional electrical stimulation modifies center of pressure fluctuations during quiet sitting by increasing trunk stiffness. J Neuroeng Rehabil 2015; 12:99. [PMID: 26555128 PMCID: PMC4641430 DOI: 10.1186/s12984-015-0091-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 10/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the impact of functional electrical stimulation (FES) induced co-activation of trunk muscles during quiet sitting. We hypothesized that FES applied to the trunk muscles will increase trunk stiffness. The objectives of this study were to: 1) compare the center of pressure (COP) fluctuations during unsupported and FES-assisted quiet sitting - an experimental study and; 2) investigate how FES influences sitting balance - an analytical (simulation) study. METHODS The experimental study involved 15 able-bodied individuals who were seated on an instrumented chair. During the experiment, COP of the body projected on the seating surface was calculated to compare sitting stability of participants during unsupported and FES-assisted quiet sitting. The analytical (simulation) study examined dynamics of quiet sitting using an inverted pendulum model, representing the body, and a proportional-derivative (PD) controller, representing the central nervous system control. This model was used to analyze the relationship between increased trunk stiffness and COP fluctuations. RESULTS In the experimental study, the COP fluctuations showed that: i) the mean velocity, mean frequency and the power frequency were higher during FES-assisted sitting; ii) the frequency dispersion for anterior-posterior fluctuations was smaller during FES-assisted sitting; and iii) the mean distance, range and centroidal frequency did not change during FES-assisted sitting. The analytical (simulation) study showed that increased mechanical stiffness of the trunk had the same effect on COP fluctuations as the FES. CONCLUSIONS The results of this study suggest that FES applied to the key trunk muscles increases the speed of the COP fluctuations by increasing the trunk stiffness during quiet sitting.
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Affiliation(s)
- Matija Milosevic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, ON, M5S 3G9, Canada. .,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, ON, M4G 3V9, Canada.
| | - Kei Masani
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, ON, M5S 3G9, Canada. .,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, ON, M4G 3V9, Canada.
| | - Noel Wu
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, ON, M5S 3G9, Canada. .,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, ON, M4G 3V9, Canada.
| | - Kristiina M V McConville
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, ON, M5S 3G9, Canada. .,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, ON, M4G 3V9, Canada. .,Department of Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.
| | - Milos R Popovic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, ON, M5S 3G9, Canada. .,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, ON, M4G 3V9, Canada.
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