Abstract
Balance impairment is a major mechanism behind falling along with environmental hazards. Under physiological conditions, ageing leads to a progressive decline in balance control per se. Moreover, various neurological disorders further increase the risk of falls by deteriorating specific nervous system functions contributing to balance. Over the last 15 years, significant advancements in technology have provided wearable solutions for balance evaluation and the management of postural instability in patients with neurological disorders. This narrative review aims to address the topic of balance and wireless sensors in several neurological disorders, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, stroke, and other neurodegenerative and acute clinical syndromes. The review discusses the physiological and pathophysiological bases of balance in neurological disorders as well as the traditional and innovative instruments currently available for balance assessment. The technical and clinical perspectives of wearable technologies, as well as current challenges in the field of teleneurology, are also examined.
Highlights
Countries are globally experiencing a demographic shift in the distribution of the population towards older ages [1] and every year up to 35% of people aged 65 and over fall, often requiring hospital admission after mild to severe injuries [2]
Pathophysiological mechanisms leading to balance impairment in various neurological disorders are summarized in Table 1 along with the main nervous system structures underpinning postural dysfunction
Three main types of wireless sensors) sensors are available for motion and balance assessment, including mechanical
Summary
Countries are globally experiencing a demographic shift in the distribution of the population towards older ages [1] and every year up to 35% of people aged 65 and over fall, often requiring hospital admission after mild to severe injuries [2]. Balance impairment frequently affects patients with neurological disorders who are twice as likely to fall compared to an age-matched healthy population [7]. Several authors have made a great effort to use wireless sensors in the study of balance impairment in patients with neurological disorders, offering new solutions for diagnosis and rehabilitation [12]. Despite several previous reviews discussing specific technical or clinical aspects of balance assessment through wearables, this narrative review aims to discuss the whole topic of balance evaluation, through wireless sensors, in patients with neurological disorders. In this review, we first introduce the physiology and pathophysiology of balance, including the main mechanisms underlying postural dysfunction in several neurological disorders, and report clinical tools commonly used for balance assessment. We analyse wearable technologies available for balance assessment in neurological disorders. We speculate about prospects and challenges of wireless sensors for balance assessment in teleneurology and telerehabilitation
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