Balance Function In Patients Research Articles

Assessment of balance and vestibular functions in patients with idiopathic sudden sensorineural hearing loss.

This study investigated the relationship among the severity of hearing impairment, vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). A total of 35 ISSNHL patients (including 21 patients with vertigo) were enrolled. All of the patients underwent audiometry, sensory organization test (SOT), caloric test, cervical vestibular-evoked myogenic potential (cVEMP) test and ocular vestibular-evoked myogenic potential (oVEMP) test. Significant relationship was found between vertigo and hearing loss grade (P=0.009), and between SOT VEST grade and hearing loss grade (P=0.001). The abnormal rate of oVEMP test was the highest, followed by the abnormal rates of caloric and cVEMP tests, not only in patients with vertigo but also in those without vertigo. The vestibular end organs were more susceptible to damage in patients with vertigo (compared with patients without vertigo). Significant relationship was found between presence of vertigo and SOT VEST grade (P=0.010). We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo. The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo. Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs. SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients. Apart from audiometry, the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL. Better assessment of the condition will help us in clinical diagnosis, treatment and prognosis evaluation of ISSNHL.

Importance of Strength Training of the Triceps Surae Muscles for Improvement of Walking Speed in Patients with Subacute Myelo-Optico-Neuropathy

Two patients with subacute myelo-optico-neuropathy (SMON) were evaluated by using the functional reach test (FRT) in the standing position, and by measuring the gait speed for 10m before and after strength training of the triceps surae muscles through calf-raise training in the standing position. The reach distance in FRT and the walking speed after strength training of the triceps surae muscles through calf raising were improved compared with those before the calf-raise training in both patients. The results of this study suggested that strength training of the triceps surae muscles improves not only the walking ability but also the balance function in patients with SMON.

Feasibility of Rehabilitation Training With a Newly Developed, Portable, Gait Assistive Robot for Balance Function in Hemiplegic Patients.

ObjectiveTo investigate the clinical feasibility of a newly developed, portable, gait assistive robot (WA-H, ‘walking assist for hemiplegia’) for improving the balance function of patients with stroke-induced hemiplegia.MethodsThirteen patients underwent 12 weeks of gait training on the treadmill while wearing WA-H for 30 minutes per day, 4 days a week. Patients' balance function was evaluated by the Berg Balance Scale (BBS), Fugl-Meyer Assessment Scale (FMAS), Timed Up and Go Test (TUGT), and Short Physical Performance Battery (SPPB) before and after 6 and 12 weeks of training.ResultsThere were no serious complications or clinical difficulties during gait training with WA-H. In three categories of BBS, TUGT, and the balance scale of SPPB, there was a statistically significant improvement at the 6th week and 12th week of gait training with WA-H. In the subscale of balance function of FMAS, there was statistically significant improvement only at the 12th week.ConclusionGait training using WA-H demonstrated a beneficial effect on balance function in patients with hemiplegia without a safety issue.

The effects of task-oriented training with altered sensory input on balance in patients with chronic stroke.

[Purpose] The purpose of this study was to identify the effects of task-oriented training with altered somatosensory input on the balance ability of chronic stroke patients. [Subjects and Methods] Twenty-six subjects with chronic stroke were divided into an experimental group (n=14) and a control group (n=12). Both groups attended physical therapy sessions five times a week for four weeks. The experimental group performed additional, task-oriented training with altered sensory input three times a week for four weeks. Limit-of-stability tests were conducted before and after the intervention. In addition, all subjects were evaluated using the Berg Balance Scale (BBS) and Korean Activities-Specific Balance Confidence Scale before and after the intervention. [Results] There was a significant interaction between time and group on BBS scores, on the total surface area of the limit of stability, and on the surface area of the limit of stability of the affected side. However, an analysis of covariance in which the baseline values of each variable served as the covariates showed that only the post-intervention BBS score of the experimental group was significantly higher than that of the control group. [Conclusion] Task-oriented training with altered somatosensory input can improve functional balance in patients with chronic stroke.

Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?

BackgroundCorrect evaluation of orthostatic hypotension (OH) is crucial in geriatric practice, since OH is associated with mortality and morbidity. The study aimed to determine the most appropriate method for measuring blood pressure in transition from supine to upright position in order to diagnose OH in older adults.MethodsActive standing test (AST) and head-up tilt table (HUT) test as well as comprehensive geriatric assessment (CGA), including mini-mental state examination or the cognitive state test, mini-nutritional assessment, basic and instrumental activities of daily living, and Tinetti performance-oriented mobility assessment indexes, were performed in 290 geriatric patients.ResultsThe prevalence of OH during HUT and AST was 19% and 37%, respectively. In patients with OH during HUT, the frequency of dementia and recurrent falls were higher (P<0.05); on the other hand, the levels of serum vitamin D and albumin and estimated glomerular filtration rate were lower (P<0.05). However, all these parameters for OH during AST were not significant (P>0.05). Comparison of the groups according to CGA measurements revealed significant differences in terms of cognition, nutritional status, activities of daily life, and balance function in patients with OH only during HUT (P<0.05), but not during AST (P>0.05). The sensitivity, specificity, positive predictive value, and negative predictive values of AST were 49.0%, 65.5%, 25.0%, and 84.6% respectively, according to HUT.ConclusionThe results suggest that orthostatic blood pressure changes determined by HUT might be of higher clinical significance than that by AST in older adults. It might be important that the evaluation of OH by HUT should be included in daily geriatric practice.

Effects of Pulsed Electromagnetic Field Therapy Versus Extra Corporeal Shock Wave Therapy on Peripheral Circulation and Functional Balance in Patients with Diabetic Peripheral Neuropathy: RCT

Effects of Pulsed Electromagnetic Field Therapy Versus Extra Corporeal Shock Wave Therapy on Peripheral Circulation and Functional Balance in Patients with Diabetic Peripheral Neuropathy: RCT

The Effect of Balance Training based on the Berg Balance Scale for the Balance Function in Patients with Cerebellar Ataxia

Objective: This paper aims to evaluate the effects of balance training on Berg balance scale on balance function in patients with cerebellar ataxia. Methods/Statistical analysis: A total of 21 patients with cerebellar ataxia were randomly assigned to the experimental group (n=14) for balance training based on Berg Balance Scale and to the control group (n=7) for therapeutic exercise based on neurodevelopmental treatment. Each patient received 14 treatment sessions of 30 minutes each. Patients were evaluated by physical therapist before and after treatment as well as 1-month post-treatment using the Berg balance scale and Timed up and go test. Findings: At the end of treatment, the experimental and control groups showed significant improvements in all outcome measures. Berg balance scale (BBS) group showed the better clinical outcomes for balance training compared to neurodevelopmental treatment(NDT) group and NDT-BBS group. Improvements/ Applications: Balance training based on berg balance scale can improve balance ability in patients with cerebellar ataxia.

State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma.

Evidence is emerging for a significant clinical and neuroanatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety, and there is a relationship between increased state anxiety and worsening balance function. (1) To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit. (2) To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. Two separate cohorts of vestibular schwannoma (VS) patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials, and caloric responses) and questionnaire assessments [vertigo handicap questionnaire (VHQ), vertigo symptom scale (VSS), and state-trait anxiety inventory (STAIY)]. Fifteen post-resection VS patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1). Forty-five patients with VS in situ formed the cohort for Experiment 2 (Aim 2). Experiment 1: VS subjects (N = 15) with a complete post-resection unilateral vestibular deafferentation completed a state anxiety questionnaire before caloric assessment and again afterward with the point of maximal vertigo as the reference (Aim 1). Experiment 2: state anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of patients with VS in situ presenting with balance symptoms (Group 1, N = 26) and without balance symptoms (Group 2, N = 11) (Aim 2). The presence of balance symptoms was defined as having a positive score on the VSS-VER. In Experiment 1, a significant difference (p < 0.01) was found when comparing STAIY at baseline and at the peak of the subjective vertiginous response in post-resection patients with a unilateral vestibular deafferentation. In Experiment 2, VS in situ patients with balance symptoms had significantly worse state anxiety at the peak vertiginous response than patients without balance symptoms (p < 0.001), as did patients with a balance-related handicap (p < 0.001). Anxiety symptoms during a vestibular stimulus may contribute to a priming effect that could explain worsening balance function.

The Effect of Exercise on Balance Function of Patients with Type 2 Diabetes

&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The objective of the study is to evaluate the effects of exercise on balance function with people who have Type 2 diabetes. &lt;strong&gt;Methods: &lt;/strong&gt;The subjects in the study were 26 patients with Type 2 diabetes exercise regularly and 27 patients with Type 2 diabetes who do not exercise. The two groups were compared based on the following: the fall index (FI), the low frequency of Fourier transformation (F1, F2) under natural standing on solid surface with eyes opened,the frequency of Fourier transformation (F1, F2, F5, F6)under Standing on the soft mat with eyes opened（PO），the high frequency of Fourier transformation (F5, F6) under natural standing on solid surface with eyes closed (NC)，the frequency of Fourier transformation (F3, F4)under natural standing on solid surface with eyes closed and head turn to right(HR). &lt;strong&gt;Results&lt;/strong&gt;: The fall index (FI), the frequency of Fourier transformation (F1, F5, F6)under Standing on the soft mat with eyes opened（PO）,the high frequency of Fourier transformation（F6) under natural standing on solid surface with eyes closed(NC) were statistically different for the two groups. The other parameters have no significant differences. The balance function of patients who exercise regularly were better than those who don’t exercise.&lt;/p&gt;

The Effect of Exercise on Balance Function of Patients with Type 2 Diabetes

Purpose: The objective of the study is to evaluate the effects of exercise on balance function with people who have Type 2 diabetes. Methods: The subjects in the study were 26 patients with Type 2 diabetes exercise regularly and 27 patients with Type 2 diabetes who do not exercise. The two groups were compared based on the following: the fall index (FI), the low frequency of Fourier transformation (F1, F2) under natural standing on solid surface with eyes opened,the frequency of Fourier transformation (F1, F2, F5, F6)under Standing on the soft mat with eyes opened（PO），the high frequency of Fourier transformation (F5, F6) under natural standing on solid surface with eyes closed (NC)，the frequency of Fourier transformation (F3, F4)under natural standing on solid surface with eyes closed and head turn to right(HR). Results : The fall index (FI), the frequency of Fourier transformation (F1, F5, F6)under Standing on the soft mat with eyes opened（PO）,the high frequency of Fourier transformation（F6) under natural standing on solid surface with eyes closed(NC) were statistically different for the two groups. The other parameters have no significant differences. The balance function of patients who exercise regularly were better than those who don’t exercise.

Effects of mirror therapy integrated with task-oriented exercise on the balance function of patients with poststroke hemiparesis: a randomized-controlled pilot trial.

This study aimed to explore the effects of mirror therapy integrated with task-oriented exercise on balance function in poststroke hemiparesis. Twenty patients with poststroke hemiparesis were assigned randomly to an experimental group (EG) and a control group (CG), with 10 individuals each. Participants of the EG and CG received a task-oriented exercise program with a focus on the strengthening of the lower limb and the practice of balance-related functional tasks. An additional option for the EG was front and side wall mirrors to provide visual feedback for their own movements while performing the exercise. The program was performed for 30 min, twice a day, five times per week for 4 weeks. Outcome measures included the Berg balance scale, the timed up-and-go test, and quantitative data (balance index and dynamic limits of stability). In the EG and CG, all variables showed significant differences between pretest and post-test (P<0.05), and post-test values of all variables appeared to be significantly different between two groups (P<0.05). Furthermore, in the EG, the change values between pretest and post-test values of Berg balance scale (13.00±3.20 vs. 6.60±4.55 scores), and timed up-and-go test (6.45±3.00 vs. 3.61±1.84 s), balance index (2.29±0.51 vs. 0.96±0.65 scores), dynamic limits of stability (7.70±3.83 vs. 3.70±4.60 scores) were significantly higher than those of the CG (P<0.05). The findings suggest that a mirror therapy may be used as a beneficial therapeutic option to facilitate the effects of a task-oriented exercise on balance function of patients with poststroke hemiparesis.

Effect of Tai Chi Exercise on Balance Function of Patients with Stroke:a Systematic Review

Effect of Tai Chi Exercise on Balance Function of Patients with Stroke:a Systematic Review

Effects of Repetitive Transcranial Magnetic Stimulation Over Trunk Motor Spot on Balance Function in Stroke Patients.

ObjectiveTo assess the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) on balance function in patients with chronic stroke.MethodsThirty participants with chronic stroke were enrolled in this study. High frequency (10 Hz) rTMS was delivered with butterfly-coil on trunk motor spot. Each patient received both real and sham rTMS in a random sequence. The rTMS cycles (real or sham) were composed of 10 sessions each, administered over two weeks, and separated by a 4-week washout period. Balance function was measured by Berg Balance Scale and computerized dynamic posturography to determine the effect of rTMS before and one day after the end of each treatment period, as well as at a 1-month follow-up.ResultsThe balance function was significantly improved after high frequency rTMS as compared with that after sham rTMS (p<0.05). There was no serious adverse effect in patients during the treatment period.ConclusionIn the chronic stroke patients, high frequency rTMS to the trunk motor area seems to be a helpful way to improve balance function without any specific adverse effects. Further studies are needed to identify the underlying mechanism and generate a detailed protocol.

Effects of Tai Chi and Multimodal Exercise Training on Movement and Balance Function in Mild to Moderate Idiopathic Parkinson Disease.

The primary aim of this study was to investigate the effects of two different patterns of rehabilitation training on movement and balance function in patients with idiopathic Parkinson disease. Forty patients with Parkinson disease were randomized into the tai chi group (n = 20) or the multimodal exercise training group (n = 20). Outcome measures were assessed at baseline and after 12 wks of exercise. Balance was assessed using the Berg Balance Scale, and movement was assessed by the Unified Parkinson's Disease Rating Scale-Motor Examination, stride length, gait velocity, and Timed Up and Go Test. The multimodal exercise training group improved significantly in movement from baseline, and a reduction in balance impairment was observed for the multimodal exercise training group. The questionnaire results after training showed that the multimodal exercise training is easy to learn and adhere to. No major adverse events were noted in both groups. This multimodal exercise training could improve motion function and benefit balance function in patients with Parkinson disease. The multimodal exercise training is easy to learn and practice.

Balance function in patients who had undergone allogeneic hematopoietic stem cell transplantation

A previous study reported a 45% incidence of falling among allogeneic haematopoietic stem cell transplantation (allo-HSCT) patients during hospitalisation. We investigated balance and physical function in allo-HSCT patients. Thirty patients (18 men and 12 women) who underwent allo-HSCT between February 2013 and September 2014 were included in this study. Patients were evaluated for up to 3 weeks before and 7 weeks after transplantation. Balance was evaluated using the Timed Up and Go test (TUG) and length of centre of pressure (CoP). Physical function was assessed using hand-grip strength, knee-extensor strength tests, and the 6min walk test (6MWT). TUG and length of CoP were significantly increased following HSCT (P<0.01). Hand-grip strength, knee-extensor strength, and the 6MWT score decreased significantly after allo-HSCT (P<0.01). TUG and length of CoP were negatively correlated with hand grip and knee-extensor strength (P≤0.05). The allo-HSCT patients in this study had worsened dynamic and static movements of the CoP after transplantation as well as decline of physical function. Rehabilitation staff, nurses, and physicians should recognize the decreased balance function of patients who have undergone allo-HSCT.

Influence of MOTOmed training on balance function among patients with thoracolumbar spinal cord injuries patients

Objective To study the effect of MOTOmed training on balance function among patients with thoracolumbar spinal cord injuries. Methods A total of 60 patients with thoracolumbar spinal cord injuries were selected by random number from January 2009 to August 2013, and they were divided into the observation group and the control group, with 30 cases in each group. The control group was given the conventional rehabilitation training, while the observation group was given the MOTOmed training. Before rehabilitation, and four courses and eight courses after rehabilitation training, the Berg Balance Scale (BBS) was used to evaluate the balance function. Results Four courses and eight courses after rehabilitation training, the BBS score of the observation group were (27.37±5.38) and (33.30±4.90), which were significantly higher than those of the control group (t=7.569, 7.796, respectively; P<0.01). Conclusions The MOTOmed training combined with routine rehabilitation training can improve the balance function in patients with thoracolumbar spinal cord injury. Key words: MOTOmed training; Spinal cord injury; Balance function

Effects of integrating mirror therapy into task-oriented training on balance function of patients with post-stroke hemiparesis: a randomized controlled trial

the lower the lumbar spine ROM in flexion and extension respectively. Implications: From this study, it is recommended that physical therapy assessment and management of LBP patients should not only focus on pain reduction and improve mobility at the lumbar spine but other spinal segments as well.

Assessing Balance Function in Patients With Total Knee Arthroplasty.

The Balance Evaluation Systems Test (BESTest) is a relatively new balance assessment tool. Recently, the Mini-BESTest and the Brief-BESTest, which are shortened versions of the BESTest, were developed. The purpose of this study was to estimate interrater and intrarater-interoccasion reliability, internal consistency, concurrent and convergent validity, and floor and ceiling effects of the 3 BESTests and other related measures, namely, the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), and Activities-specific Balance Confidence (ABC) Scale, among patients with total knee arthroplasty (TKA). This was an observational measurement study. To establish interrater reliability, the 3 BESTests were administered by 3 independent raters to 25 participants with TKA. Intrarater-interoccasion reliability was evaluated in 46 participants with TKA (including the 25 individuals who participated in the interrater reliability experiments) by repeating the 3 BESTests, BBS, and FGA within 1 week by the same rater. Internal consistency of each test also was assessed with Cronbach alpha. Validity was assessed in another 46 patients with TKA by correlating the 3 BESTests with BBS, FGA, and ABC. The floor and ceiling effects also were examined. The 3 BESTests demonstrated excellent interrater reliability (intraclass correlation coefficient [ICC] [2,1]=.96-.99), intrarater-interoccasion reliability (ICC [2,1]=.92-.96), and internal consistency (Cronbach alpha=.96-.98). These values were comparable to those for the BBS and FGA. The 3 BESTests also showed moderate-to-strong correlations with the BBS, FGA, and ABC (r=.35-.81), thus demonstrating good concurrent and convergent validity. No significant floor and ceiling effects were observed, except for the BBS. The results are generalizable only to patients with TKA due to end-stage knee osteoarthritis. The 3 BESTests have good reliability and validity for evaluating balance in people with TKA. The Brief-BESTest is the least time-consuming and may be more useful clinically.

Effects of High Frequency Repetitive Transcranial Magnetic Stimulation on Function in Subacute Stroke Patients

The aim of the present study was to examine the effects of high and low frequency repetitive transcranial magnetic stimulation on motor cortical excitability and the balance function in subacute stroke patients. Twenty-four subjects were randomly assigned to either the high frequency (HF) rTMS group, or the low frequency (LF) rTMS group, with 12 subjects each. All subjects received routine physical therapy. In addition, both groups performed a total of 20 sessions of rTMS for 20 minutes, once a day, 5 times per week, for a 4- week period. In the HF rTMS group, 10 Hz rTMS was applied daily to the hotspot of the lesional hemisphere; and in the LF rTMS group, 1 Hz rTMS was applied daily to the hotspot of the nonlesional hemisphere. Motor cortex excitability was determined by motor evoked potentials, and the balance function was evaluated by use of the Balance Index (BI) and the Berg Balance Scale (BBS), before and after the intervention. The change rate in the value of each variable differed significantly between the two groups ( p<0.05). Furthermore, significant differences were observed between all post-test variables of the two groups ( p<0.05). In the HF rTMS, significant differences were found in all the pre- and post-test variables ( p<0.05). On the other hand, in the LF rTMS, significant difference was observed only between the pre- and post-test results of BI and BBS ( p<0.05). The findings demonstrate that HF rTMS can be more helpful in improving the motor cortical excitability and balance function of patients with subacute stroke treatment than LF rTMS, and that it may be used as a practical adjunct to routine rehabilitation.

Randomized Comparison Trial of Balance Training by Using Exergaming and Conventional Weight-Shift Therapy in Patients With Chronic Stroke

ObjectiveTo compare the effects of exergaming with conventional weight-shift training on balance function in patients with chronic stroke. DesignSingle-blind randomized controlled trial. SettingMedical center. ParticipantsPatients (N=30) with chronic stroke and balance deficits. InterventionsTwelve weeks of Wii Fit training or conventional weight-shift training. Main Outcome MeasuresStatic balance was assessed using posturography. We recorded the stability index and percentage of weight bearing on the affected leg in 8 positions. We also used the timed Up and Go and forward reach tests for dynamic balance evaluation, Falls Efficacy Scale-International for fear of falling assessment, and Physical Activity Enjoyment Scale for estimating the enjoyment of training. ResultsThe exergaming group showed more improvement in stability index than the control group in head straight with eyes open while standing on a foam surface, eyes closed while standing on a solid surface with head turned 30° to the left, and eyes closed while standing on a solid surface with head turned up positions (time-group interaction P=.02, .04, and .03, respectively); however, the effects were not maintained. At 3-month follow-up, the control group showed more improvement in weight-bearing symmetry in the head straight with eyes open while standing on a solid surface position than the exergaming group (time-group interaction P=.03). Both groups showed improvement in the timed Up and Go test, forward reach test, and fear of falling. The improvement in fear of falling was not maintained. The exergaming group enjoyed training more than the control group (P=.03). ConclusionsExergaming is enjoyable and effective for patients with chronic stroke.