Assessment Of Dynamic Postural Control Research Articles

Static and dynamic postural control assessment in schoolchildren: Reliability and reference values of the Modified Flamingo Test and Bar Test

IntroductionSingle-leg stance tests have been widely used to evaluate static balance, like the Modified Flamingo Test. The evaluation of dynamic balance on small support surfaces is the objective of some tests like the Bar Test. Research questionHow is the performance of postural control during the performance of these tests in schoolchildren between 6 and 11 years of age in both sexes? What are the reference values of these tests in this population? MethodA cross-sectional study in which a total of 282 children. The evaluation included both tests. ResultsThe relative reliability was excellent (Intraclass Correlation Coefficient = 0.84–0.98), and the absolute reliability ranged between 4.5% and 7.1% for coefficient variation and between 0.5 and 1.5 for the standard error of measurement. The average results were 3.8 ± 2.7 floor touches for the Modified Flamingo Test and 5 ± 3.5 m for the Bar Test. The results of both tests improve progressively with the increase of age. DiscussionIt can be asserted that children of different ages, as well as boys and girls of the same age, perform differently in these tests. Particularly, according to the analysis based on age subgroups, there were greater improvements in the performance of both tests between 8 and 11 years of age. ConclusionsThe girls obtained in both tests better results, although between 6 and 7 years of age the differences between sexes are not significant.

Copers adopt an altered dynamic postural control compared to individuals with chronic ankle instability and controls in unanticipated single-leg landing

BackgroundSeveral prior studies involving “expected” single-leg landings have not succeeded in establishing a difference between copers and a control group. Research questionDoes expected and unanticipated single-leg landing affect dynamic postural stability in lateral ankle sprain individuals with chronic ankle instability (CAI), copers, and controls? MethodsIn this prospective cross-sectional study, physically active adults with CAI (n = 12), copers (n = 12), and controls (n = 12) were included. Participants performed expected single-leg landing by stepping off a 30-cm box. They also performed unanticipated landings including side-step cutting, side-step cutting at 60°, single-leg landing, and forward stepping. The expected and unanticipated conditions of each groups were compared in terms of time to stabilization (TTS) and center of pressure (COP) for the anterior-posterior (AP) and medial-lateral (ML) conditions. To analyze the data, a mixed-model one-way analysis of variance and a Tukey-Kramer post hoc test were performed. ResultsA significant condition × group interaction was observed in only TTS ML, with the CAI group demonstrating a significantly longer TTS ML than the coper (p < 0.001) and control (p < 0.001) groups during unanticipated trials. In addition, group interaction effects were observed for COP AP and TTS AP. The coper group demonstrated significantly longer COP AP and TTS AP than the control group (p < 0.001). SignificanceThe CAI group demonstrated a significantly longer TTS ML than the coper and control groups during the unanticipated condition, and the coper group demonstrated significantly longer TTS AP and COP AP than the control group. Thus, longer COP AP and TTS AP sway time in the coper group may be a protection mechanism, allowing greater freedom in the AP plane while quickly controlling ML sway and preventing lateral ankle sprains. These findings can help in the prevention of lateral ankle sprains and assessment of dynamic postural control.

Sex and age influence on postural sway during sit-to-stand movement in children and adolescents: Cross-sectional study.

We investigated the influence of sex and age in postural sway during sit-to-stand (STS) in children and adolescents of 5-15years. We evaluated sway during STS in 86 typical participants. STS was divided into three phases: preparation, rising, and stabilization. We calculated for each phase: area, anterior-posterior, and medial-lateral velocity of center-of-pressure sway. We applied a stepwise multiple linear regression model to determine if age and sex might be predictors of postural sway during STS. Only age was associated with sway, accounting for between 6.5% and 14.6% of the variability in sway during STS. The age of the subject influences postural sway during STS, but in a small amount. This variable should be taken into account as a variable of control in the assessment of dynamic postural control. Moreover, postural stability during STS was not associated with the sex of the participants.

The development of postural control in 6-17 old years healthy children. Part II Postural control evaluation - Limits of Stability Test (LOS) in 6-17 old year children.

&lt;b&gt;Introduction&lt;/b&gt;: The ability to Reach quickly to changing external stimuli, to move the body quickly and precisely in any direction and to maintain the centre of gravity above the support base, all contribute to maintaining balance in dynamic conditions. The Limits of Stability Test (LOS) provides information on the state of dynamic equilibrium in a standing position.&lt;br&gt; &lt;b&gt;Aim&lt;/b&gt; : Assessment of dynamic postural control in developmental age.&lt;br&gt; &lt;b&gt;Material&lt;/b&gt; : 127 healthy children (65 girls and 62 boys) aged 6 - 17years. &lt;br&gt; &lt;b&gt;Methods&lt;/b&gt;: All children underwent LOS test (posturograph NeuroCom) with registration of reaction time (RT), movement velocity (MVL), directional control (DCL) , maximum excursion (MXE) and endpoint excursion (EPE).&lt;br&gt; &lt;b&gt;Results&lt;/b&gt;: At the age of 6-7 years, not fully developed jumping strategy and visual feedback mechanism in the control of movement were observed. All tested parameters were significantly worse in children aged 6 - 9 years. After this period, a significant improvement in TR and MVL was observed, with no significant changes in subsequent age groups while significant improvement in MXE up to 12 , EPE and DCL up to 13 years of age was noted. No significant gender differences were fund in the LOS test parameters. &lt;br&gt; &lt;b&gt;Conclusions&lt;/b&gt;: 1 The LOS test showed significantly lower dynamic balance development in children aged 6 - 7 years. 2 The study showed a significant improvement in all parameters of the LOS test up to 13 years of age, which supports the termination of the function at that time.

Medical Resort Treatment Extended with Modern Feedback Exercises Using Virtual Reality Improve Postural Control in Breast Cancer Survivors. Preliminary Study

Introduction: Women with breast cancer have an increasing chance of survival for many years. Multimodal, extremely effective but also aggressive treatment, often leads to disorders of neuromuscular excitability and physical fitness of the patients. Therefore, when planning the physiotherapy process of women treated for breast cancer, one should look for the most effective methods of improvement with broad neurostimulatory and neuromodulatory effects. In recent years, more and more attention has been paid to the possibilities of using virtual reality exercises in therapy. Aim: The study was to understand the impact of medical resort treatment extended with modern feedback exercises using virtual reality to improve postural control in breast cancer survivors. M aterial and Methods: A clinical, pilot, non-controlled study was conducted at the Solanki Medical Resort in Inowroclaw. 46 women aged 36 to 63 completed the study (mean 51.67 ± 6.62 years). The patients participated in spa therapy for 3 weeks. For basic medical treatment, to improve postural control, physical exercises using feedback based on virtual reality were introduced. Postural control tests performed on the stabilometric platform were used to assess the progress of therapy. Results: In the assessment of dynamic postural control, the length of the center of foot pressure (COP) movement path before the treatment was on average 278.28 cm (± 147.13) and after treatment shortened to 209.60 cm (± 86.49) which was statistically significant (p = 0.0083). In the assessment of static postural control, no statistically significant differences were found between the length of the COP pathway before treatment compared to the condition before treatment (p&gt; 0.05). Conclusions: Medical treatment enriched with physical exercises using feedback based on virtual reality did not affect static postural control but contributed to the improvement of dynamic postural control. The results of the study should be confirmed in high-quality therapeutic experiments, including control groups.

An exploration of the use of Inertial Measurement Units in the assessment of dynamic postural control of the knee and the effect of bracing and taping

© 2018 IOS Press and the authors. BACKGROUND: The Star Excursion Balance Test (SEBT) is a common clinical test that can provide information about dynamic movement, but does not reflect movement quality or postural-control strategies, and does not report kinematics of the lower limb. PURPOSE: To assess the dynamic postural control of healthy subjects using inertial measurement units (IMUs) and clinical SEBT scores to determine the effect of knee bracing and taping. METHODS: Twenty-four healthy individuals performed the SEBT under three randomised conditions (patellar bracing, patellar taping, and control condition (no intervention). Clinical SEBT scores were recorded and normalised to leg length and angular velocities were measured using IMUs during SEBT. Composite scores were calculated as the sum of clinical scores in each direction divided by three. Descriptive statistics (mean±sd) were calculated for each variable and repeated measures ANOVA were used to identify differences between limb (dominant, non-dominant) and condition. MAIN RESULTS: Compared to the control condition, bracing and taping significantly improved dynamic postural control in the sagittal plane by 6% (1.5-10.5%) P = 0.011 and 8% (2.9-13%) P = 0.004 respectively. Bracing significantly improved coronal plane stability compared to the control condition by 9% (3.8-14.1%) P = 0.002, and taping by 7% (1.6-12.6%) P = 0.013. SEBT scores revealed small but statistically significant differences (P < 0.05) between conditions in the anterior, posteromedial and composite scores, all showing a difference of between 1-2%. PRINCIPAL CONCLUSIONS: Patellar soft bracing and taping can improve dynamic postural stability during SEBT. It is possible to detect clinically important changes in lower limb stability from angular velocity using IMUs.

Study of the effects of hearing on static and dynamic postural function in children using cochlear implants

ObjectiveThe present study aimed to evaluate the postural control perturbations by the center of pressure parameters in two main approaches, cochlear implant turned “on” and “off”. MethodsWe included 25 children aged 8–10 years with unilateral cochlear implants and bilateral vestibular hypofunction deficit. To evaluate the postural function, each children was asked to stand on the force plate under 3 different conditions and cochlear implant turned “on” and “off”: Condition (A) double stance from open eyes to closed eyes, Condition (B) double stance with open eyes engaging in the dual task and Condition (C) From double leg stance to one leg stance with open eyes for assessment of dynamic postural control. Also to calculate the center of pressure parameters, we designed new software for the force plate ResultsIn condition A: although the results demonstrated an overall reduction in the mean of center of pressure parameters when the cochlear implant was “on”, only the significant differences were seen in mean and standard deviations for anterior-posterior displacement, mediolateral displacement, area and mean velocity (P =0.00, P=0.04, P=0.02 and P=0.00, respectively) in open eyes In condition B: no significant difference was found between “on” and “off” cochlear implant in single or dual-task situations. In condition C: mean velocity variable demonstrated a significant difference (P=0.00) in the cochlear implant “on” condition in double leg stance only. Also, anterior-posterior displacement demonestrated a significant difference (P=0.00) when the cochlear implant was turned “on” in one leg stance situation. ConclusionThe results of our study show that auditory information can improve postural stability and reduce body sways in different situations as an underlying system for reinforcement of the postural control in children without complete normal balance subsystems.

ACUTE ANKLE SPRAIN INJURY ALTERS KINEMATIC AND CENTRE OF PRESSURE MEASURES OF POSTURAL CONTROL DURING THE STAR EXCURSION BALANCE TEST

BackgroundPostural control assessments are frequently used in clinical and research settings to evaluate movement deficits following acute lateral ankle sprain (LAS). The Star Excursion Balance Test (SEBT) is one such...

Dynamic Postural Control Assessment with Star Excursion Balance Test among Chronic Ankle Instability and Healthy Asymptomatic Participants

Background: Lateral ankle sprains (LAS) are among the most common injuries in the physically active population. The feeling of ankle “giving way” following ankle sprain and subsequent repetitive sessions of instability in several ankle sprains has been termed chronic ankle instability (CAI). Objectives: To compare the dynamic postural control among CAI and healthy asymptomatic participants using star excursion balance test (SEBT) and to compare the reach distance of injured dominant and injured non-dominant limb among CAI participants. Materials and Methods: Totally 60 participants (CAI=30 + Control=30) were requited for this study. CAI participants have had ankle sprain of more than two episodes on the same side and control group comprised of healthy asymptomatic participants who match in demographic details. The SEBT reach distances were measured in centimeters (cm) while the participants in standing and the score of 3 reach trials were averaged for data analysis. Results: The intra group comparison of SEBT reach scores demonstrated that the reach distances of injured limb was significantly decreased in all directions compared to uninjured limb (p=0.000) of CAI participants, however the control group did not show significant difference in the inter-limb reach distances (p>0.05). No significant difference (P>0.05) was noted in reach distances between the injured dominant and injured non-dominant limb of CAI participants. Conclusion: The SEBT seems to be efficient in detecting dynamic postural control in participants with or without chronic ankle instability. The reach distances of CAI participants were significantly decreased in all 8 directions when compared to that of healthy asymptomatic participants. The SEBT reach distances does not show significant difference whether the injured limb is either dominant or non-dominant.

Dynamic control of posture across locomotor tasks

Successful locomotion depends on postural control to establish and maintain appropriate postural orientation of body segments relative to one another and to the environment and to ensure dynamic stability of the moving body. This article provides a framework for considering dynamic postural control, highlighting the importance of coordination, consistency, and challenges to postural control posed by various locomotor tasks, such as turning and backward walking. The impacts of aging and various movement disorders on postural control are discussed broadly in an effort to provide a general overview of the field and recommendations for assessment of dynamic postural control across different populations in both clinical and research settings. Suggestions for future research on dynamic postural control during locomotion also are provided and include discussion of opportunities afforded by new and developing technologies, the need for long-term monitoring of locomotor performance in everyday activities, gaps in our knowledge of how targeted intervention approaches modify dynamic postural control, and the relative paucity of literature regarding dynamic postural control in movement disorder populations other than Parkinson's disease.

Acute Changes in Postural Control after Soccer Heading

This study intended to determine if an acute bout of soccer heading alters postural control and pronounced self-reported symptoms of cerebral concussion. Collegiate soccer players were randomly assigned to one of 2 groups. Each participant completed a baseline postural control assessment prior to heading. Participants either simulated (control group; CG) or performed (experimental group; EG) 10 headers at 11.2 m/s in 10 min. The postural assessment was repeated post heading at hrs 1, 24, and 48. The postural control parameter assessed was the root mean square (RMS) of the center of mass (COM). COM RMS were calculated for the anterior-posterior (AP) and medial-lateral (ML) time series. Compared to the CG, for the AP and ML time series COM RMS values were significantly higher in the EG at hr 24 (p <0.05). An acute bout of heading results in quantifiable alterations in postural control that are detectable 24 h post heading and dissipate within an additional 24 h. The significant findings may be due to the dynamic postural control assessment that incorporated robust discordant environmental conditions.

Reliability and Responsiveness of the Star Excursion Balance Test in those with Chronic Ankle Instability

The Star Excursion Balance Test (SEBT) is a dynamic postural control assessment which examines lower extremity maximal reach distances while maintaining contralateral single limb stance. This test has detected postural control deficits and improvements following rehabilitation in those with chronic ankle instability (CAI). Despite these findings, the reliability and standards for determining meaningful change have not been reported for this group. PURPOSE: To determine test-retest reliability and minimal detectable change (MDC) scores for the SEBT in those with CAI. METHODS: The SEBT was assessed on 2 separate days (∼6 days apart) in 8 individuals with self-reported CAI (2 males, 6 females, age 23 ± 5 yrs). Subjects were included if they reported at least 1 ankle sprain, 2 episodes of ankle "giving way" in the past 3 months, and disability scores of ≤90% on the Foot and Ankle Ability Measure (FAAM) and ≤80% on the FAAM-Sport. The anterior (ANT), posteromedial (PM), and posterolateral (PL) reach directions of the SEBT were selected based on previous studies. All trials were performed barefoot with the stance leg centered in the star. In each test session, subjects performed 4 consecutive practice trials in each direction. Following the practice trials, 3 trials were performed in each direction and used for analysis. In the event of an error, the trial was discarded and repeated. Reach distances were measured in cm and normalized to leg length. Reliability was determined using intraclass correlation coefficients (ICC 2,1) and standard error of measurement (SEM). MDC was calculated with a 95% level of confidence. RESULTS: The ANT direction had the highest reliability (ICC = 0.92, SEM = 1.66) and the lowest MDC score (4.72%) followed by the PM direction (ICC = 0.86, SEM = 2.56; MDC = 7.32%). The PL direction was associated with the lowest reliability (ICC = 0.74, SEM = 3.83) and highest MDC score (10.79%). CONCLUSION: The results of this study indicate the SEBT has suitable reliability for assessing dynamic postural control in those with CAI. MDC scores suggest alterations in reach distance ranging from 4.72 -10.79% are required to identify changes which exceed the variability associated with the measure. MDC values are important for outcome assessment and goal setting when using the SEBT to monitor rehabilitation progression.

New quantitative and qualitative measures on functional mobility prediction for stroke patients

The purpose of this study was to explore whether we could provide supportive laboratory evidence for clinical observations that a stroke patient has lost functional mobility/locomotion capability based on dynamic balance responses (centre of pressure, COP sway patterns) and motor control activities (EMG patterns) during the motor task of sit-to-stand. A computerized controlled dynamic postural control assessment system was developed and used in this study. Various dynamic balance indices were introduced and derived from COP sway patterns expressed in four domains (i.e. space, time, force, and frequency). Motor control was assessed by multi-channel surface electromyography of each side of the lower limb during the same motor task. The functional mobility capability was evaluated using a traditional FIM method. Fourteen stroke patients with right hemiplegia and nine healthy elderly were recruited as the experimental and control groups respectively. Muscle activity was recorded for quadriceps, hamstrings, anterior tibialis, and triceps surae muscles and used for analysis. Centre of pressure sway patterns and ground reaction forces were registered. All signals were synchronized at ‘seat-off. Surface electromyographic patterns of activities recorded during sit-to-stand and dynamic balance indices computed from centre of pressure sway patterns were categorized and compared with the functional mobility scores. The results show that both the motor control patterns and dynamic balance indices correlated well to the extent of mobility impairment evaluated using the traditional FIM method. An important conclusion for rehabilitation medicine is that the functional mobility capability of stroke patients may he quantified analytically using dynamic balance indices and visualized graphically through EMG motor patterns.