Balance Disorders In Patients Research Articles

Significance of Selected Posturographic Methods in Diagnosis of Balance Disorders in Patients with Early-Stage Gonarthrosis.

Degenerative joint disease is a dynamic pathological process characterised by a destabilisation of the degradation and synthesis processes of articular cartilage and subchondral bone layer. Studies suggest that individuals with gonarthrosis experience deficits in proprioception, in addition to changes within their joints, which directly affects their ability to maintain posture and increases their risk of falling. Objectives: The aim of this study was to assess the functional status of patients with gonarthrosis through a posturographic examination conducted on a stabilometric platform (force plate) and a functional clinical examination. Methods: Participants were divided into two groups-a control group (n = 125) and a study group (n = 125). During the qualification process, subjective and objective examinations were conducted, including a functional assessment by means of such tests as the "Up and Go" Test, Functional Reach Test, Five Time Sit to Stand Test, and the Step Test. Subsequently, an assessment was conducted on the force plate by means of a posturographic test-the Romberg test performed with open and closed eyes in a standing position-and balance was evaluated using the Berg Balance Scale. The obtained data were analysed with the use of the IBM SPSS Statistics software version 27.0, by means of the Mann-Whitney test, and correlations were determined by means of Spearman's test. A significance level of p = 0.05 was adopted. Results: Statistically significant differences were observed among the assessed groups as a result of both functional and posturographic examinations, along with positive correlations for disease duration, age, and BMI index. Conclusions: Patients with gonarthrosis exhibited disturbances in balance, functionality, and posture compared to healthy individuals in the control group.

Fluctuations in Upper and Lower Body Movement during Walking in Normal Pressure Hydrocephalus and Parkinson's Disease Assessed by Motion Capture with a Smartphone Application, TDPT-GT.

We aimed to capture the fluctuations in the dynamics of body positions and find the characteristics of them in patients with idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD). With the motion-capture application (TDPT-GT) generating 30 Hz coordinates at 27 points on the body, walking in a circle 1 m in diameter was recorded for 23 of iNPH, 23 of PD, and 92 controls. For 128 frames of calculated distances from the navel to the other points, after the Fourier transforms, the slopes (the representatives of fractality) were obtained from the graph plotting the power spectral density against the frequency in log-log coordinates. Differences in the average slopes were tested by one-way ANOVA and multiple comparisons between every two groups. A decrease in the absolute slope value indicates a departure from the 1/f noise characteristic observed in healthy variations. Significant differences in the patient groups and controls were found in all body positions, where patients always showed smaller absolute values. Our system could measure the whole body's movement and temporal variations during walking. The impaired fluctuations of body movement in the upper and lower body may contribute to gait and balance disorders in patients.

The Effect of Motor Relearning Program on Daily Living Activity and Dynamic Balance in Non-Hemorrhagic Post Stroke Hemiparese Patients at Grandmed Lubuk Pakam Hospital

Stroke is a functional disorder of the brain that can occur suddenly or abruptly with focal or global neurological signs that can last 24 hours or more (if no surgery or death occurs) without any signs of non-vascular causes, which include signs of subarachnoid hemorrhage, intracerebral hemorrhage, ischemia or cerebral infarction. This can cause disturbances in vital brain functions such as coordination disorders, balance disorders, posture control disorders, sensation disorders and movement reflex disorders, thereby reducing the ability to carry out daily living activities and balance disorders. The motor relearning program method is a program for retraining specific motor controls by avoiding unnecessary or wrong movements that involve cognitive processes, the application of motor and psychological science, training, understanding of nervous anatomy and physiology and is not based on the theory of normal development (neuro development). The research aims to determine the effect of the motor relearning program on daily living activities and dynamic balance disorders in post-stroke patients. The method used in this research is a quasi experiment with one group pretest and post test design. The research sample consisted of 9 people. The samples will be observed and adjusted to the specified criteria so that they do not cause problems. Each respondent was measured 2 (two) times, namely before and after the intervention. Test the hypothesis using the Wilcoxon test. The research results obtained a value of p = 0.000 (p=<0.05), which means there is a significant influence of the motor relearning program intervention on daily living activities and dynamic balance disorders in post-stroke patients. The results of this research can be concluded that the motorbike relearning program can improve daily living activities and dynamic balance disorders in patients after non-hemorrhagic stroke. It is hoped that the results of this research can contribute to health services for the community in overcoming the problems of daily living activities and dynamic balance disorders in post-stroke patients.

Balance Disorders in People with History of COVID-19 in Light of Posturographic Tests.

Our research aimed to assess the prevalence of balance disorders in patients who had suffered COVID-19. The study group consisted of 73 subjects with a history of SARS-CoV-2 infection. The control group consisted of 50 healthy people with similar demographics. A balance analysis was performed on a tensometric platform, using the Romberg test. Statistically significant differences between the results of the study group and the control group were obtained in the evaluation of the length of body sways and the area of gravity center, both with open and closed eyes, and in the case of maximum body sways with open eyes. Patients who have suffered COVID-19 may suffer from balance disorders detectable by posturographic tests.

Correction of the prooxidant-antioxidant balance disorders in patients with diabetic kidney disease

The present study aimed to evaluate the effect of sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin therapy on the prooxidant-antioxidant balance (PAB) in patients with diabetic kidney disease.
 Methods. A total of 88 patients with type 2 diabetes mellitus (DM) and diabetic nephropathy (DN) were included in this single-center randomized open-label prospective study. All patients were randomly divided into 2 groups: 45 patients received a standard course of treatment, which included antidiabetic drugs, renin-angiotensin-aldosterone system blockers, and HMG-CoA reductase inhibitors (statins). In addition to the standard therapy, the remaining 43 patients were prescribed the SGLT2 inhibitor dapagliflozin 10 mg per day. Patients were re-examined after 6 months of treatment. The blood PAB was calculated as the ratio of total hydroperoxides (THP) to total antioxidant activity (TAA). The level of THP and TAA was determined by the colorimetric method.
 Results. PAB was significantly elevated in type 2 DM patients with nephropathy due to TAA decrease and THP level increase when compared to the control group. The highest values of PAB were found in the late stages of DN in patients with glomerular filtration rates <60 ml/min/1.73m2. In patients who received dapagliflozin, significant PAB elevation by 30,55% (р < 0.05) was observed as well as THP decrease and TAA increase in blood. In the standard therapy group, no significant changes in PAB parameters were detected.
 Conclusions. Add-on treatment with dapagliflozin resulted in a more significant improvement of the PAB in patients with DN in comparison with standard treatment.

Resistance Training Combined with Balance or Gait Training for Patients with Parkinson's Disease: A Randomized Controlled Pilot Study.

Background Gait and balance disorders in patients with idiopathic Parkinson's disease (PD) lead to major mobility limitations. To counteract this, physical therapy such as gait, balance, or resistance training is applied. Integrative training methods, which combine these elements, could be particularly effective. Objective The objective of this study is to evaluate and compare the effects of two integrative interventions on gait and balance of patients with PD. Methods Twenty-six patients with PD received either resistance training in combination with gait training (gait resistance training, GRT) or resistance training in combination with balance training (stability resistance training, SRT) for six weeks. Gait and balance outcome parameters were assessed before, immediately after, and six weeks after the interventions. The primary outcome parameters were the functional reach test to evaluate balance and stride length to evaluate gait. Secondary outcomes included further gait analysis parameters, knee extension strength, the timed up and go test, and the six-minute walk test. Results The functional reach test results were significantly better after the intervention in both groups. Stride length increased significantly only in the GRT group. Several further gait parameters and the six-minute walk test improved in the GRT group, and the increase in gait speed was significantly higher than in the SRT group. The SRT group performed better after the intervention regarding the timed up and go test and knee extension strength, the latter being significantly more improved than in the SRT group. At six-week follow-up, the improvement in functional reach was maintained in the SRT group. Conclusions Integrative therapies, combining gait or balance training with resistance training, have specific positive effects in PD rehabilitation. More pronounced effects on gait parameters are achieved by GRT, while SRT has more impact on balance. Thus, the combination of both training methods might be particularly efficient in improving the mobility of PD patients.

Evaluating balance disorders with different levels of walking impairment in Multiple Sclerosis: correlation between IMU-based parameters and clinical scales

Gait and balance disorders are marked functional deficits in people with multiple sclerosis (MS) [1]. Walking limitations are frequently reported in people with MS despite the Expanded Disability Status Scale (EDSS) indicates normal walking autonomy [2]. To better identify changes due to disease severity, a combined instrumental assessment based on inertial measurement units (IMUs) and clinical scales during walking paths have been recommended [3,4]. The aim of this study is to verify the correlation between objective data extracted from IMUs during walking and scores of a routinely performed clinical scale in patients with MS with different levels of walking impairment. Thirty-three patients with MS (Class 1– mild disability, n=4, 2 F, 53.8±1.3 y, EDSS 0–1.5; Class 2– mild to moderate disability, n=16, 12 F, 50.5±9.7, EDSS 2.0–4.0; Class 3– moderate disability, n=13, 10 F, 49.5±10.4, EDSS 4.5–6.5) participated in this study. All participants performed a 10-meter Walk Test (10mWT) and a Figure-of-8 Walk Test (F8WT) [3] while wearing five IMUs (APDM, Opal, 128 Hz) on both lateral malleoli, pelvis, sternum, and head. Stride segmentation was performed from leg IMUs. Spatio-temporal (ST) parameters (stride frequency-SD and duration-SD) along with gait quality indices related to stability (Root Mean Square-RMS and Attenuation Coefficients-AC), symmetry (improved Harmonic Ratio-iHR), and smoothness (Spectral Arc Length-SPARC) of gait were obtained. In addition, the Mini-Balance Evaluation Systems Test (Mini-BESTest) was also administered. The correlation between biomechanical parameters and the clinical scale was investigated through Pearson’s correlation analysis after verifying for normal data distribution. Significant correlations (moderate to high correlations) were observed between spatio-temporal, stability, symmetry, and smoothness gait parameters and MiniBESTest, especially for patients with higher EDSS (Class 2&3) and for the F8WT (Table 1). In the clinical setting, instrumental gait analysis with IMUs is a useful tool for evaluating balance disorders in patients with MS, especially when clinical scales are not able to detect subtle impairments as in the earliest stages of the disease (Class 1,EDSS ≤ 1.5). Despite linear walking highlights several correlations between the clinical scale and dynamic gait indices, the F8WT confirms to be highly discriminant of the different levels of walking impairment since more challenging [3]. The IMU-based approach could be therefore integrated in clinical practice to quantify gait impairments when undetectable with a standard clinical measure.

Postural balance asymmetry and subsequent noncontact lower extremity musculoskeletal injuries among Tunisian soccer players with groin pain: A prospective case control study

BackgroundRecent studies reported postural balance disorders in patients and soccer players with groin pain (GP) compared to controls. Since postural balance asymmetry identified after an initial injury contributes for subsequent injuries, identification of this asymmetry in soccer players with GP may highlight the risk of sustaining subsequent noncontact lower extremity musculoskeletal injuries in these players. Therefore, the aims of this study were to (i) examine static and dynamic unipedal postural balance asymmetry in soccer players with GP compared to healthy ones, and (ii) quantify the risk of subsequent noncontact lower extremity injuries in these players. Research questionDo soccer players with GP exhibit higher static and dynamic unipedal postural balance asymmetry, and higher risk of sustaining subsequent injuries compared to controls? MethodsIn this prospective case control study, 27 soccer players with non-time loss GP (GP group: GPG), and 27 healthy ones (control group: CG) were enrolled. Static and dynamic unipedal postural balance asymmetry were evaluated with a force platform using symmetry index (SI), and Y-balance test (Y-BT), respectively. Additionally, subsequent noncontact lower extremity musculoskeletal injuries were tracked for 10 months. ResultsThe GPG revealed higher (p < 0.01) SI in eyes closed condition, higher (p < 0.001) side-to-side asymmetry in anterior, posteromedial and posterolateral reach distances and in composite Y-BT score compared to CG. They showed lower (p < 0.001) composite score for injured limb and higher (p < 0.001) side-to-side asymmetry in posteromedial reach distance compared to the cut-off values of 89.6 % and 4 cm, respectively. Moreover, GPG exhibited higher odds (OR= 7.48; 95 % CI = 2.15, 26.00; p < 0.01) of sustaining subsequent injuries compared to CG. SignificanceThe Y-BT should be instituted into existing pre-participation physical examinations to screen for soccer players with non-time loss GP at an elevated risk of sustaining subsequent injuries. This could help coaches and clinicians make valid return to play decisions.

Periventricular white matter hyperintensities are associated with gait and balance in patients with minor stroke.

ObjectiveCerebral small vessel disease (CSVD) is associated with gait and balance deficits in older adults. However, the effect of CSVD-related brain injury on post-stroke mobility is unknown. This study aimed to investigate the association of CSVD with gait and balance impairment after a minor stroke.MethodsA total of 273 patients with a minor stroke (NIHSS ≤ 5 points) who were hospitalized at the Affiliated Hospital of Qingdao University were enrolled. The manifestations of white matter hyperintensities (WMH), lacunes, enlarged perivascular spaces (EPVS), and cerebral microbleeds (CMB) were statistically analyzed according to magnetic resonance imaging results, and the total burden score of CSVD was calculated. Gait function was assessed by a 6-m walking speed test, and balance function was assessed by the timed-up-and-go (TUG) test. Linear regression analysis was applied to determine the association after adjusting for key variables.ResultsThe correlation results showed that in patients with minor stroke, age, sex, smoking history, and the infarct site were associated with gait speed, and age and the infarct site were associated with the TUG test. In the univariate linear regression model, periventricular white matter hyperintensities (PVWMH), deep white matter hyperintensities (DWMH), and the total burden of CSVD were correlated with gait speed, while only PVWMH correlated with the TUG test. After adjusting for confounders, only PVWMH were independent predictors of gait speed (β = −0.089, p < 0.05) and the TUG test (β = 0.517, p < 0.05).ConclusionsOur study confirmed that CSVD is associated with gait and balance disorders after a minor stroke. PVWMH are independent predictors of gait and balance disorders in patients with minor stroke. These findings should be confirmed in larger prospective studies.

Balance disorders in patients with multiple sclerosis and possible rehabilitation therapy – current findings from controlled clinical trials

Balance disorders in patients with multiple sclerosis and possible rehabilitation therapy – current findings from controlled clinical trials

전정재활훈련의 임상적 적용

For patients suffering from dizziness and postural instability, vestibular rehabilitation(VR) is an excellent treatment. VR promotes central compensation after acute vestibular dysfunction and improves the function of vestibular ocular reflex, and balance and gait. Recently, customized vestibular rehabilitation exercise(cVE) was recognized as a new medical technology in 2017 and can be prescribed as a non-deductible for the purpose of improving dizziness and balance disorders in patients with vestibular dysfunction. cVE is effective for unilateral vestibular dysfunction, but it can be applied to various diagnosis of dizziness. cVE prescription for persons with balance and vestibular disorders is complex. The exercise prescription depends on the deficits that the patient exhibits, rather than the presenting diagnosis. Treatment is divided into pre-treatment evaluations, exercise prescriptions, and post-treatment evaluations. Depending on the time required, it is classified as the first exercise prescription and the second exercise prescription, and includes symptom, posture, and gait evaluation. cVE is recommended that the proper level of difficulty setting and self-experience the effects of exercise through regular visits to improve compliance. (J Clinical Otolaryngol 2021;32:20-25)

Various types of vertigo and balance disorders in patients with Meniere's disease

Vertigo and balance disorders in Meniere's disease (MD) may have various etiology. The aim of the review is discussing pathogenetic mechanisms of the typical vertiginous paroxysms in MD, resulting from endolymphatic hydrops as well as analysis of etiology, pathogenesis, clinical course and basic treatment of paroxysmal and permanent forms of vertigo and balance disorders, caused by other conditions, associated with MD. We discussed the course of MD complicated by vestibular migraine, benign positional paroxysmal vertigo, functional dizziness, bilateral vestibulopathy and vestibular drop-attacks.

Relationship Between Chronic Conditions and Balance Disorders in Outpatients with Dizziness: A Hospital-Based Cross-Sectional Study.

BackgroundBalance dysfunction is common in adult outpatients with dizziness, especially those who are older, which can lead to catastrophic outcomes such as falls. The aim of this study was to investigate the association between chronic conditions and balance disorders in patients with dizziness, especially those who are elderly.Material/MethodsA cross-sectional study was conducted in adult outpatients diagnosed with dizziness referred to the Department of Otolaryngology at Beijing Tongren Hospital from September 2017 to August 2018. All of the patients completed a self-administered, structured questionnaire. Demographic data and information on history of chronic conditions were collected and the patients were divided into 2 groups based on whether their balance was normal or abnormal.ResultsThree hundred and thirty-two patients were included in this study, 168 in the normal balance group and 164 in the abnormal balance group. The incidence of chronic conditions, including hypertension and diabetes, in the abnormal balance group was higher than that in the normal balance group (all P<0.05). In subgroup analysis based on age, in those who were aged ≥60 years, the prevalence of chronic diseases was higher in the abnormal balance group than in the normal balance group (P=0.002), while there was no difference in age between the groups with abnormal and normal balance. Hypertension (OR: 2.268; 95%CI: 1.038–4.957; P<0.05) was a risk factor for balance disorders in elderly patients rather than those who were younger (P>0.05).ConclusionsOur results show that chronic conditions are associated with balance function in older patients with dizziness. Thus, specialists should consider chronic conditions, especially hypertension, in elderly patients with dizziness.

Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results.

PurposeTinnitus and equilibrium disorders such as dizziness and vertigo have been reported by patients with COVID-19; however, they have been rarely investigated. The aim of this study was to study the prevalence of subjective tinnitus and dizziness in a sample of COVID-19 patients using an online 10-item close-ended questionnaire. MethodsA multicentric study that included 15 Italian hospitals in different regions was conducted using an online 10-item close-ended questionnaire developed to identify the presence of tinnitus and balance disorders in patients with COVID-19 between May 5 and June 10, 2020. The questionnaire was administered to 185 patients in a period of > 30 – < 60 days after diagnosis of COVID-19; responses were recorded in an online Excel spreadsheet. The questionnaire was composed of three sections: (1) demographic information; (2) presence and characteristics of tinnitus and dizziness after COVID-19 diagnosis; (3) possible association with migraine. ResultsThirty-four patients (18.4%) reported equilibrium disorders after COVID-19 diagnosis. Of these, 32 patients reported dizziness (94.1%) and 2 (5.9%) reported acute vertigo attacks. Forty-three patients (23.2%) reported tinnitus; 14 (7.6%) reported both tinnitus and equilibrium disorders.ConclusionThis study suggests that the presence of subjective otoneurological symptoms such as tinnitus and balance disorders can affect COVID-19 patients; further studies are necessary to investigate the prevalence and pathophysiological mechanisms underlying these subjective symptoms in COVID-19 patients.

Spanish version of the mini-BESTest: a translation, transcultural adaptation and validation study in patients with Parkinson's disease.

Balance is affected in numerous neurologic disorders, like stroke, multiple sclerosis and Parkinson's disease contributing to falls, and diminishing quality of life and functionality. The mini-BESTest is one of the most recommended scales to detect balance disorders in people with Parkinson's disease, which has solid psychometric properties. Unfortunately, this scale has not been validated in Chile and there are no other validated scales that can determine balance disorders in patients with Parkinson's disease to date. The study objective was to validate the mini-BESTest scale in Chilean Parkinson's disease patients. The translation and adaptation to Chilean Spanish of the mini-BESTest scale were made following a cross-cultural adaptation process, to then obtain face and content validity by an expert committee. Afterwards, the demographic data and psychometric properties of internal consistency and ceiling and floor effects were measured with a sample of 50 subjects with Parkinson's disease. Furthermore, 10 subjects of the sample were evaluated with the purpose of measuring inter rater reliability. The scale presented a good internal consistency (Cronbach's alpha = 0.845), and an excellent inter rater reliability (intraclass correlation coefficient = 0.97), no ceiling or floor effects were found. The results of the face and content validity and psychometric properties are adequate, achieving the validation of the mini-BESTest scale for balance in Chilean people with Parkinson's disease.

Postural stability and functional disorders in patients with loosened hip prosthesis

The number of primary hip arthroplasties is growing every year. One of the most common long complications is the aseptic loosening of the prosthesis leading to serious complications in patients life, pain and following surgeries. In the literature, there is a lack of studies regarding balance impairment in this group of patients, which is why there was a need to conduct the study in order to find possible falling risk factors and simple functional, diagnostic test. The aim of the study was to assess functional state and static balance disorders in patients admitted to orthopaedic department due to loosened hip prosthesis prior to its replacement or removal. The study population were 30 patients (15 women and 15 men) admitted to Orthopaedic Department for diagnosis and treatment of loosened hip prosthesis. Patients' mean age was 71.67 ± 9.21, body height 169.20 ± 8.75 cm, body weight 77.83 ± 12.96 kg. The clinical control group consisted of 30 healthy subjects age-, body height- and weight-matched, without degenerative disorders of lower extremities. Function was assessed with Harris Hip score. The static balance test was conducted in the mornings, in quiet separate room on bi-modular stabilometric platform CQStab2P, registering the movement of centre of foot pressure (COP). Measurements with eyes open and closed showed significant differences in limb loads - the load to the healthy limb was several times greater. Results of tests on the platform with eyes closed showed significantly worse balance in patients group. Their total statokinesiogram path was longer, and their COP sways number was greater. Similarly to the test with eyes open, the load of the healthy limb was much greater. Hip replacement loosening results in significant worsening of balance parameters. Balance assessment could be an additional useful diagnostic tool for hip replacement loosening available for physiotherapists.

Normal and pathological neuronal distribution of the human mesencephalic locomotor region.

Deep brain stimulation of the pedunculopontine nucleus has been performed to treat dopamine-resistant gait and balance disorders in patients with degenerative diseases. The outcomes, however, are variable, which may be the result of the lack of a well-defined anatomical target. The objectives of this study were to identify the main neuronal populations of the pedunculopontine and the cuneiform nuclei that compose the human mesencephalic locomotor region and to compare their 3-dimensional distribution with those found in patients with Parkinson's disease and progressive supranuclear palsy. We used high-field MRI, immunohistochemistry, and in situ hybridization to characterize the distribution of the different cell types, and we developed software to merge all data within a common 3-dimensional space. We found that cholinergic, GABAergic, and glutamatergic neurons comprised the main cell types of the mesencephalic locomotor region, with the peak densities of cholinergic and GABAergic neurons similarly located within the rostral pedunculopontine nucleus. Cholinergic and noncholinergic neuronal losses were homogeneous in the mesencephalic locomotor region of patients, with the peak density of remaining neurons at the same location as in controls. The degree of denervation of the pedunculopontine nucleus was highest in patients with progressive supranuclear palsy, followed by Parkinson's disease patients with falls. The peak density of cholinergic and GABAergic neurons was located similarly within the rostral pedunculopontine nucleus not only in controls but also in pathological cases. The neuronal loss was homogeneously distributed and highest in the pedunculopontine nucleus of patients with falls, which suggests a potential pathophysiological link. © 2018 International Parkinson and Movement Disorder Society.

Static and Dynamic Balance Disorders in Patients With Rheumatoid Arthritis and Relationships With Lower Extremity Function and Deformities: A Prospective Controlled Study.

This study aims to evaluate the static and dynamic balance disorders of patients with rheumatoid arthritis (RA) and to disclose the relationships with clinical, functional, and radiological findings of lower extremities. A total of 81 patients with RA (15 males, 66 females; mean age 48.9±10.4 years; range 22 to 67 years) were compared with 84 age and sex-matched healthy controls (14 males, 70 females; mean age 45.9±12.1 years; range 24 to 70 years). Radiographic assessments of feet were performed to evaluate the presence of pes planus, hallux valgus, metatarsus primus varus, and splaying foot deformities. Foot functions of patients were determined with Foot and Ankle Outcome Score. The balance disorders of the subjects were evaluated with three static (modified clinical test of sensory interaction and balance, unilateral stance, weight bearing squat) and three dynamic (step-up-and-over, sit-to-stand, tandem walk) balance tests via the 'Neurocom Balance Master' device. Rheumatoid arthritis patients had significantly higher sway velocity in unilateral stance and modified clinical test of sensory interaction and balance tests, higher step width and lower speed when walking on a line, lower rising index and higher movement time in step-up-and-over test compared to healthy controls (p<0.05). Performances on the sit-to-stand and weight bearing squat tests were comparable between both groups. Of the patients, although 61% had hallux valgus, 52% had metatarsus primus varus, 33% had pes planus, and 26% had splaying foot, these deformities were not correlated with Foot and Ankle Outcome Score or balance disorders. Presence of swollen joint was determined as the most relevant factor for balance disorders of RA patients. Patients with RA may have increased risk for balance disorders due to cumulative effect of the lower extremity impairments seen in the course of disease.

The evaluation of the static and dynamic balance disorders in patients with psoriatic arthritis.

To evaluate the static and dynamic balances in psoriatic arthritis (PsA) and to investigate their relationship with clinical and functional parameters. Patients diagnosed with PsA and healthy controls were recruited consecutively into the study. The demographic variables such as age, sex, body mass index of the subjects were noted. Radiographic images were examined for the detection of foot deformities. 'Foot and Ankle Outcome Score' (FAOS) was used to assess foot function. The dynamic and static balance of the patients was evaluated by 'Berg Balance Scale' (BBS) and 'Neurocom Balance Master' device. The fatigue (Multidimensional Assessment of Fatigue: MAF), depression (Beck Depression Inventory: BDI) and sleep disorders (Pittsburgh Sleep Quality Index: PSQI) of all patients were evaluated. This study included 50 PsA patients and 50 healthy controls with mean ages of 45.02 (SD 12.81) and 45.12 (SD 10.56), respectively. Demographic data of both groups were similar. Concerning the balance tests, there were significant differences (p < 0.05) between patient and control groups about the all tests of sway velocity (except on foam surface eyes closed test), end sway of tandem walk test, movement time of bilateral step up over test and lift up index of left step up over test. There was no significant correlation between static and dynamic balance parameters with MAF, BDI, PSQI, foot deformities and FAOS. The static and dynamic balance impairments are seen in PsA. As the balance parameters had no significant correlation with functional and clinical data, they are acceptable as independent parameters during the course of the disease.

Факторы, сопутствующие нарушениям постурального баланса у пациентов с хронической ишемией мозга

Факторы, сопутствующие нарушениям постурального баланса у пациентов с хронической ишемией мозга