Center Of Pressure Measures Research Articles

Use of an inertial sensor and a force platform to assess static balance in participants affected by multibacillary leprosy.

Leprosy is a chronic, slowly developing infectious disease that affects the peripheral nerves, specifically Schwann cells. Individuals with the multibacillary type exhibit a propensity for developing chronic pain and a decrease in sensitivity in the plantar region, which directly interferes with balance maintenance. The evaluation of static balance in this population is made through the measurement of the center of pressure (COP) oscillations. Therefore, there is a need to investigate the association between postural control and COP oscillations using a force platform and finding accelerations of the center of mass (COM) from inertial sensors for reliable and portable balance assessment in leprosy patients. To validate the application of inertial sensors for patients with leprosy by establishing a correlation with the outcomes obtained from a force platform. This is an observational study with a case-control design, in which 30 participants with leprosy and 30 healthy participants were recruited to evaluate static balance using an inertial sensor and a force platform. Participants underwent balance assessment under two conditions (Eyes Open: OE and Eyes Closed: CE), and data from the platform and sensor were processed using Matlab computational routines. The data were quantified using four parameters: Total Displacement (TD), Area, Antero-Posterior Displacement (APdisp), and Medio-Lateral Displacement (MLdisp). The evaluated parameters showed significantly different values between the groups, where the Leprosy group exhibited significantly higher values compared to the control group, both in the OE and CE conditions for all four parameters. The sensor corroborated the differences demonstrated by the platform and followed the same trend for medio-lateral displacements and accelerations. It can be observed that the evaluated parameters exhibited a varied correlation ranging from moderate to large between the platform and the sensor. Among the four variables, MLdisp had the lowest correlation. The results partially confirmed the first hypothesis of concurrent validation, showing a moderate to large correlation between the force platform and the inertial sensor. The second hypothesis of clinical validation was also partially confirmed, as not all group differences observed in the COP measurements from the force platform were reflected in the COM measurements from the inertial sensor. Specifically, the force platform indicated greater oscillations in participants with multibacillary leprosy compared to controls, a finding statistically confirmed by the sensor for all measures except MLdisp. This research confirmed the concurrent validity of the inertial sensor with the force platform and its clinical validation, demonstrating that this instrument can be applied in clinical settings due to its low cost and ease of use. The findings may contribute to public health by identifying postural control tools for patients with multibacillary leprosy.

Comparison of Measurements for Recording Postural Control in Standing and Seated Position in Healthy Individuals.

Background: A standard method of assessing postural control is to measure while standing. However, its implementation is usually limited. Recording postural control directly on the trunk in a seated position could provide an alternative diagnostic method for quantifying neuromuscular control. Methods: A comparison of center of pressure (CoP) measurements in the standing and sitting positions was performed on 66 healthy adult subjects. The reliability of the measurements in the sitting position was tested in 23 subjects. In addition, the extension force of all test subjects was recorded. Results: The assessments of CoP fluctuations in standing and seated positions showed adequate agreement (deviation 9.1%). Furthermore, good internal consistencies with a sufficient test-retest reliability could be demonstrated for the measurements in seated position. Both CoP measurement methods showed a comparable Spearman correlation to obtained extension force measurements (standing: 0.24, seated: 0.23). Conclusions: Our results show that recording CoP fluctuations in the sitting position is a reliable and valid adjunct to single-leg stance measurements. It could serve as an additional alternative to quantify neuromuscular control in impaired patients who cannot adequately perform the single-leg stance. In addition, measurement in the seated position allows direct recording of neuromuscular control at the trunk.

Age- and Parkinson-related differences in trunk and lower-limb muscle activation during four balance tasks: A case-control pilot study

BackgroundPoor postural control has been reported in people with Parkinson's disease, which could be explained by the changes in muscular activation patterns related to antigravitational muscles. This study aims to measure the muscle activation of antigravitational muscles during balance tasks in individuals, with and without Parkinson's. MethodsSixteen (16) participants (9 with Parkinson's), aged ≥65 yrs., performed 2 × 30-s trials of 4 balance tasks (bipodal and semi-tandem opened eyes and closed eyes) on a force platform (center of pressure measurement); while surface electromyography measurements were obtained bilaterally on the multifidus at L5, biceps femoris and medialis gastrocnemius. Electromyography amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance task, to determine each muscle's activity level. FindingsThe Parkinson's group reported lower muscle activation than control across tasks (in mean for multifidus = 8%, biceps femoris = 16%, gastrocnemius = 7%), although not statistically significant. Parkinson's reported significantly poorer postural control than control, mainly for the center of pressure sway ellipse area (p = 0.016) from challenge balance tasks such as semi-tandem. InterpretationPoor postural control was confirmed in the Parkinson's group, but not significantly associated by the changes from muscle activation of trunk and lower limbs, during balance performance.

Investigating the Influence of Varying Surface Conditions on Human Postural Control and Sensory Integration Strategies.

This study investigated the effects of different surface conditions on postural stability in response to unexpected perturbations. Thirty healthy adults underwent balance assessments on flat, incline ramp, balance pad, and balance pad on incline ramp surfaces. The center of pressure (COP) displacement in the mediolateral (ML) and anteroposterior (AP) directions, the velocity, and the area were measured. We found that the flat and ramp conditions resulted in significantly lower COP ML (F(3, 87) = 38.272, p < 0.001, ηp2 = 0.569) and AP displacements (F(3, 87) = 89.177, p < 0.001, ηp2 = 0.755), velocity (F(3, 87) = 89.177, p < 0.001, ηp2 = 0.755), and area (F(3, 87) = 52.659, p < 0.001, ηp2 = 0.645) compared to the balance pad and balance pad on ramp conditions (p < 0.05). The use of a balance pad, particularly on a ramp, significantly increased all the COP measurements, suggesting greater challenges to postural control. Through these findings, we demonstrate the adaptability and limitations of the human postural control system in response to varying surface conditions and perturbations.

The effects of wearing textured versus smooth shoe insoles for 4-weeks in people with diabetic peripheral neuropathy: a randomised controlled trial

Purpose To determine whether short-term wear of textured insoles alters balance, gait, foot sensation, physical activity, or patient-reported outcomes, in people with diabetic neuropathy. Materials and Methods 53 adults with diabetic neuropathy were randomised to wear textured or smooth insoles for 4-weeks. At baseline and post-intervention, balance (foam/firm surface; eyes open/closed) and walking were assessed whilst barefoot, wearing shoes only, and two insoles (textured/smooth). The primary outcome was center of pressure (CoP) total sway velocity. Secondary outcomes included other CoP measures, spatiotemporal gait measures, foot sensation, physical activity, and patient-reported outcomes (foot health, falls efficacy). Results Wearing textured insoles led to improvements in CoP measures when standing on foam with eyes open, relative to smooth insoles (p ≤ 0.04). The intervention group demonstrated a 5% reduction in total sway velocity, indicative of greater balance. The intervention group also showed a 9-point improvement in self-perceived vigour (p = 0.03). Adjustments for multiple comparisons were not applied. Conclusions This study provides weak statistical evidence in favour of textured insoles. Wearing textured insoles may alter measures of balance, suggestive of greater stability, in people with diabetic neuropathy. Plantar stimulation, through textured insoles, may have the capacity to modulate the perception of foot pain, leading to improved well-being. IMPLICATIONS FOR REHABILITATION Short-term wear of textured insoles can lead to improvements in centre of pressure sway measures when standing on a compliant supporting surface. Wearing textured insoles may have the capacity to help relieve foot pain leading to enhanced self-perceived vitality in people with diabetic peripheral neuropathy.

Impact of plantar flexion resistive moment of dynamic ankle foot orthosis on measures of center of pressure and clinical gait outcomes in individuals with post-stroke hemiparesis

BackgroundAn ankle-foot orthosis (AFO) with plantar flexion resistance (PFR) can improve the first rocker function during gait, but the incremental changes in the resistive moment on balance and gait have not been well identified. ObjectivesTo investigate the effect of changing the PFR moment of dynamic AFO (DAFO) on measures of the center of pressure (COP) and clinical gait outcomes in individuals with post-stroke hemiparesis. MethodIn this randomized repeated measure study of 36 stroke individuals, the customized DAFO using foot drop ankle units set in three PFR situations (low, medium, and high) was evaluated. The balance parameters for COP measures were investigated by HUMAC® Balance & Tilt System. Gait parameters and ankle kinematics were recorded using the 3D motion analysis through force platform and optoelectronic system. The comparison was made using a parametric ANOVA test and the P value was set at 0.05 for statistical significance. ResultsSignificant differences were observed for COP average velocity (1.30 ± 0.64, 1.10 ± 0.05, and 1.37 ± 0.43), COP path length (43.3 ± 4.6, 33.4 ± 4.3, and 36.3 ± 5.4), walking velocity (11.0 ± 3.1, 13.2 ± 4.4, and 9.9 ± 3.5), and cadence (31.5 ± 2.0, 33.0 ± 3.1, and 29.0 ± 1.6) respectively for low, medium and high PFR settings (P < 0.05). Except for the COP path length and cadence, posthoc multiple comparisons revealed significant differences between low and medium (P < 0.05) and medium and high (P < 0.05) PFR grades. PFR with medium resistance demonstrated near-normal maximal peak ankle dorsiflexion (mean deviation of 8 degrees, P < 0.05). ConclusionMedium PFR grade should be encouraged since it can enhance balance parameters like path length and average velocity of COP, increase cadence and average velocity during gait, and improve maximal peak ankle dorsiflexion.

Changes in postural stability after cerebrospinal fluid tap test in patients with idiopathic normal pressure hydrocephalus.

In patients with idiopathic normal pressure hydrocephalus (iNPH), the characteristics of balance disturbance are not as well understood as those related to gait. This study examined changes in postural stability in quiet standing after the cerebrospinal fluid tap test (CSFTT) in these patients. Furthermore, the study explored the relationship between the amount of spontaneous body sway and both gait and executive function. All patients diagnosed with iNPH underwent CSFTT. We evaluated their center of pressure (COP) measurements on a force plate during quiet standing, both pre- and post-CSFTT. Following the COP measurements, we calculated COP parameters using time and frequency domain analysis and assessed changes in these parameters after CSFTT. At pre-CSFTT, we assessed the Timed Up and Go (TUG) and the Frontal Assessment Battery (FAB). We investigated the relationship between COP parameters and the TUG and FAB scores at pre-CSFTT. A total of 72 patients with iNPH were initially enrolled, and 56 patients who responded positively to CSFTT were finally included. Post-CSFTT, significant improvements were observed in COP parameters through time domain analysis. These included the velocity of COP (vCOP), root-mean-square of COP (rmsCOP), turn index, torque, and base of support (BOS), compared to the pre-CSFTT values (p < 0.05). In the frequency domain analysis of COP parameters post-CSFTT, there was a decrease in both the peak and average of power spectral density (PSD) values in both the anteroposterior (AP) and mediolateral (ML) directions below 0.5 Hz (p < 0.05). In addition, the TUG scores showed a positive correlation with vCOP, rmsCOP, turn index, torque, BOS, and both the peak and average PSD values in the AP and ML directions below 0.5 Hz (p < 0.05). The FAB scores demonstrated a negative correlation with vCOP, rmsCOP, turns index, BOS, and both peak and average PSD values in the AP direction below 0.5 Hz (p < 0.05). In patients with iNPH who responded to CSFTT, there was an improvement in spontaneous body sway during quiet standing after CSFTT. Increased spontaneous sway is associated with impaired gait and frontal lobe function. This may be linked to impaired cortico-cortical and cortico-subcortical circuits in patients with iNPH.

Effectiveness of X-box Gaming on Balance using One Leg Standing among Older Adults: A Mini Systematic Review

Introduction: The predominant challenge encountered by the elderly and older people is balance. This concern is not only affecting the quality of life for individuals but increasing their risk of falling. Literatures available determined the effect of various gaming apparatus on balance in older adults but these evidences need to be reviewed systematically to determine their overall effect. There is no systematic review assessing the effectiveness of X-box gaming on balance among older adults. Aim: To assess X-box gaming effectiveness on older adults balance. Materials and Methods: Searches in PUBMED, Physiotherapy Evidence Database (PEDro), and SCOPUS (2015-2023) included randomised controlled trials featuring participants, aged more than 55 years, using one-legged stance test as outcome measure, as assessing one’s balance through single-leg standing on various surfaces aids in determining the Center of Pressure (CoP). Greater variability in CoP measurements suggests poor overall balance control and an elevated risk of falls among individual. X-box gaming interventions were included. Results: Initially, 432 studies were screened; after eliminating duplicates and applying inclusion criteria, 2 eligible studies were selected for review. Conclusion: The reviewed trials showed diverse X-box and exercise intervention parameters. Future research should explore different treatment protocols for balance re-education and exercise therapy in older adults to establish optimal guidelines for enhancing balance and reducing fall risk.

Postural Sway Characteristics in Static Balance Control of Youth Female Soccer Players

Purpose: Balance control, particularly in uni-lateral domain, is essential in soccer. Majority of the existing studies examined dynamic balance via clinical tools, and primarily involved male players. Thus, the purpose here was to examine the nature of Center of Pressure (COP) postural sway in youth female players across bipedal and unipedal conditions Methods: Sixteen pre-adolescent female competitive players (age 12.4±21.40 years) were asked to stand on a force plate in bi-pedal stance with the dominant and non-dominant legs respectively. Three, 10 second trials were carried out for each condition. Results: As expected, across the four COP measures bi-pedal stance resulted in least sway (P= .05). However, the subsequent analysis showed different center of pressure (COP) profiles in the dominant versus non-dominant condition across COP velocity (P= .003), path length (P= .001) and anterior-posterior (AP) sway (P= .003), with sway area revealing no statistical differences (P= .821). In addition, the analysis of stabilograms confirmed that in the non-dominant condition the pronounced COP oscillations were of lower amplitude and frequency as compared to the dominant leg. Conclusions: Overall, postural asymmetry was found as the sway characteristics on both legs differed, with dominant side exhibiting more sway and faster COP oscillations. In line with the inverted pendulum model, this may be due to less than optimal ability to modulate muscle torques generated at the ankle. It is hypothesized that the postural asymmetry between the dominant and non-dominant legs may result from muscular asymmetries that have been often reported in youth soccer players, as a result of their pronounced foot dominance.

Perceived cognitive fatigue has only marginal effects on static balance control in healthy young adults.

We examined the influence of perceived cognitive fatigue on static balance control in healthy young adults to gain greater clarity about this issue than provided in previous research. Based on the prevailing assumption in pertinent literature, we hypothesized that the influence of cognitive fatigue on balance control depends on the attentional effort required by the balance tasks being performed. To test this hypothesis, 44 young adults (24 women and 20 men) were alternately assigned to either the experimental group that was cognitively fatigued (using the 16-min TloadDback-task with individualized settings) or the control group (who watched a documentary). Before and after the intervention, the participants performed six balance tasks that differed in (attentional) control requirements, while recording the center of pressure (COP). From these time series, sway variability, mean speed, and sample entropy were calculated and analyzed statistically. Additionally, perceived cognitive fatigue was assessed using VAS scales. Statistical analyses confirmed that the balance tasks differed in control characteristics and that cognitive fatigue was elevated in the experimental group, but not in the control group. Nevertheless, no significant main effects of cognitive fatigue were found on any of the COP measures of interest, except for some non-robust interaction effects related primarily tosample entropy. These results suggest that, in young adults, postural control in static balance tasks is largely automatic and unaffected by task-induced state fatigue.

Postural stability measures in healthy miniature Dachshunds obtained using a pressure mat and a force platform: a validity and reliability study

BackgroundMiniature Dachshunds have a high prevalence of neurological and musculoskeletal diseases potentially affecting their balance. The postural stability of dogs in quiet standing is an indicator of postural control and can aid in diagnosing and monitoring lameness and other pathologies affecting balance. Measures of centre of pressure (CoP) can be obtained from force and pressure platform systems to evaluate postural stability, however the two systems have not been compared and the latter has not been validated in dogs. The aims of this study were to assess the validity and reliability of using a pressure mat compared to a force platform and report normative values of CoP measures in healthy miniature Dachshunds. Forty two healthy miniature Dachshunds of smooth, long and wire-haired breed types stood still on a pressure mat (Tekscan MatScan®) placed on a force platform and the two systems were synchronised. Maximum anterior-posterior (AP) and medial-lateral (ML) ranges, sway path and 95% area of a best-fit ellipse were computed. Bland-Altman plots and coefficients of correlation assessed validity; intra-class correlation coefficients (ICC) assessed inter-test reliability for both systems. Non-linear regression analyses were used to describe the relationship between CoP and demographic measures.ResultsStrong correlations for AP range, ML range and 95% ellipse area and moderate correlation for sway path were found between the two devices. ICC showed good reliability (0.75–0.90) for AP range and moderate (0.5–0.75) for ML range and the 95% ellipse area for both devices. Sway path reliability was excellent (> 0.90) with the force platform but moderate with the pressure mat. Age was positively correlated with balance (inversely correlated with all measures except sway path), while weight explained 94% (force platform) and 27% (pressure mat) of the variance in sway path.ConclusionsPressure mats can be used to obtain valid and reliable measures of CoP and replace use of force platforms. Older (non-senior) and heavier (non-obese) dogs show better postural stability. Clinical examinations should include the use of a range of CoP measures when assessing postural balance, while accounting for the effects of age and body weight.

Association between Objective and Subjective Sleep Parameters with Postural Control Responses among Brazilian Schoolteachers.

Objective To investigate the impact of sleep quality on postural control in teachers. Methods Cross-sectional study with 41 schoolteachers (mean age 45.7 ± 10.4 years). Sleep quality was assessed in two ways: objectively (through actigraphy), and subjectively (through the Pittsburgh Sleep Quality Index). Postural control was assessed in an upright posture during 3 trials of 30s (bipedal and semitandem stances in rigid and foam surfaces with eyes open) with a period of rest across trials, on a force platform, based in the center of pressure measurements in the anteroposterior and mediolateral directions. Results The prevalence of poor sleep quality in this study sample was 53.7% ( n = 22). No differences were found between Poor and Good sleep in the posturographic parameters (p > 0.05). Although, there was moderate correlation between postural control in the semitandem stance and subjective sleep efficiency for center of pressure area (rs = -0.424; p = 0.006) and amplitude in anteroposterior direction (rs = -0.386; p = 0.013). Discussion There is correlation between poor sleep quality and postural control in schoolteachers, as sleep efficiency decreases, postural sway increases. Poor sleep quality and postural control were investigated in other populations, but not in teachers. Several factors such as work overload, insufficient time for physical activities, among others, can contribute to a worse perception of sleep quality, as well as deterioration in postural control. Further studies with larger populations are needed to confirm these findings.

Smartphone Technology to Remotely Measure Postural Sway during Double- and Single-Leg Squats in Adults with Femoroacetabular Impingement and Those with No Hip Pain.

The COVID-19 pandemic has accelerated the demand for utilising telehealth as a major mode of healthcare delivery, with increasing interest in the use of tele-platforms for remote patient assessment. In this context, the use of smartphone technology to measure squat performance in people with and without femoroacetabular impingement (FAI) syndrome has not been reported yet. We developed a novel smartphone application, the TelePhysio app, which allows the clinician to remotely connect to the patient's device and measure their squat performance in real time using the smartphone inertial sensors. The aim of this study was to investigate the association and test-retest reliability of the TelePhysio app in measuring postural sway performance during a double-leg (DLS) and single-leg (SLS) squat task. In addition, the study investigated the ability of TelePhysio to detect differences in DLS and SLS performance between people with FAI and without hip pain. A total of 30 healthy (nfemales = 12) young adults and 10 adults (nfemales = 2) with diagnosed FAI syndrome participated in the study. Healthy participants performed DLS and SLS on force plates in our laboratory, and remotely in their homes using the TelePhysio smartphone application. Sway measurements were compared using the centre of pressure (CoP) and smartphone inertial sensor data. A total of 10 participants with FAI (nfemales = 2) performed the squat assessments remotely. Four sway measurements in each axis (x, y, and z) were computed from the TelePhysio inertial sensors: (1) average acceleration magnitude from the mean (aam), (2) root-mean-square acceleration (rms), (3) range acceleration (r), and (4) approximate entropy (apen), with lower values indicating that the movement is more regular, repetitive, and predictable. Differences in TelePhysio squat sway data were compared between DLS and SLS, and between healthy and FAI adults, using analysis of variance with significance set at 0.05. The TelePhysio aam measurements on the x- and y-axes had significant large correlations with the CoP measurements (r = 0.56 and r = 0.71, respectively). The TelePhysio aam measurements demonstrated moderate to substantial between-session reliability values of 0.73 (95% CI 0.62-0.81), 0.85 (95% CI 0.79-0.91), and 0.73 (95% CI 0.62-0.82) for aamx, aamy, and aamz, respectively. The DLS of the FAI participants showed significantly lower aam and apen values in the medio-lateral direction compared to the healthy DLS, healthy SLS, and FAI SLS groups (aam = 0.13, 0.19, 0.29, and 0.29, respectively; and apen = 0.33, 0.45, 0.52, and 0.48, respectively). In the anterior-posterior direction, healthy DLS showed significantly greater aam values compared to the healthy SLS, FAI DLS, and FAI SLS groups (1.26, 0.61, 0.68, and 0.35, respectively). The TelePhysio app is a valid and reliable method of measuring postural control during DLS and SLS tasks. The application is capable of distinguishing performance levels between DLS and SLS tasks, and between healthy and FAI young adults. The DLS task is sufficient to distinguish the level of performance between healthy and FAI adults. This study validates the use of smartphone technology as a tele-assessment clinical tool for remote squat assessment.

Design, Calibration, and Control of Compliant Force-Sensing Gripping Pads for Humanoid Robots

Abstract This paper introduces a pair of low-cost, light-weight, and compliant force-sensing gripping pads used for manipulating box-like objects with smaller-sized humanoid robots. These pads measure normal gripping forces and center of pressure (CoP). A calibration method is developed to improve the CoP measurement accuracy. A hybrid force-alignment-position control framework is proposed to regulate the gripping forces and to ensure the surface alignment between the grippers and the object. Limit surface theory is incorporated as a contact friction modeling approach to determine the magnitude of gripping forces for slippage avoidance. The integrated hardware and software system is demonstrated with an NAO humanoid robot. Experiments show the effectiveness of the overall approach.

Distinctive phases and variability of vibration-induced postural reactions highlighted by center of pressure analysis.

The vibration-induced postural reaction paradigm (VIB-PR) offers a unique way for investigating sensorimotor control mechanisms. Measures of VIB-PR are usually calculated from the whole VIB period, yet recent evidence proposed that distinctive mechanisms are likely at play between the early vs. later phases of the postural reaction. The present work verified if spatiotemporal analyses of center of pressure (COP) displacements can detect differences between these early/later phases of VIB-PR. Also, we further characterized the intra/inter-individual variability of COP measurements, since the underlying variability of VIB-PR remains largely unexplored. Twenty young volunteers realized two experimental conditions of bipodal stance with eyes closed: (i) bilateral VIB of tibialis anterior (TIB) and (ii) Achilles' (ACH) tendons. Each condition consisted of five trials and lasted 30 s as follows: 10 s baseline, 10 s VIB and 10 s post-VIB. Linear COP variables (antero-posterior (AP) amplitude & velocity) were computed for both VIB and post-VIB periods using the following time-windows: early 2 s, the later 8 s and the whole 10 s duration. Intra- and inter-individual variability were respectively estimated using the standard error of the measurement and the coefficient of variation. Both variability metrics were obtained using five vs. the first three trials. Significant contrasts were found between time-windows for both VIB and post-VIB periods. COP variables were generally higher during the early 2 s phase compared to the later 8 s phase for both TIB [mean difference between 8 s- 2 s phases: Amplitude AP = -1.11 ± 1.14 cm during VIB and -2.99 ± 1.31 during post-VIB; Velocity AP = -1.17 ± 0.86 cm/s during VIB and -3.13 ± 1.31 cm/s during post-VIB] and ACH tendons [Amplitude AP = -0.37 ± 0.98 cm during VIB and -3.41 ± 1.20 during post-VIB; Velocity AP = -0.31 ± 0.59 cm/s during VIB and -3.89 ± 1.52 cm/s during post-VIB]. Most within- and between-subject variability scores were below 30% and using three instead of five trials had no impact on variability. VIB-PR patterns were quite similar within a same person, but variable behaviors were observed between individuals during the later phase. Our study highlights the relevance of identifying and separately analyzing distinct phases within VIB-PR patterns, as well as characterizing how these patterns vary at the individual level.

Cutoff Point of Mini-Balance Evaluation Systems Test Scores for Elderly Estimated by Center of Pressure Measurements by Linear Regression and Decision Tree Classification.

Understanding balance ability and assessing the risk of possible falls are very important for elderly rehabilitation. The Mini-Balanced Evaluation System Test (Mini-BESTest) is an important survey for older adults to evaluate subject balance, but it is not easy to complete due to various limitations of physical activities, including occasional fear of injury. A center of pressure (CoP) signal can be extracted from a force pressure plate with a short recording time, and it is relatively achievable to ask subjects to stand on a force pressure plate in a clinical environment. The goal of this study is to estimate the cutoff score of Mini-BESTest scores from CoP data. CoP signals from a human balance evaluation database with data from 75 people were used. Time domain, frequency domain, and nonlinear domain parameters of 60 s CoP signals were extracted to classify different cutoff point scores for both linear regression and a decision tree algorithm. Classification performances were evaluated by accuracy and area under a receiver operating characteristic curve. The correlation coefficient between real and estimated Mini-BESTest scores by linear regression is 0.16. Instead of linear regression, binary classification accuracy above or below a cutoff point score was developed to examine the CoP classification performance for Mini-BESTest scores. The decision tree algorithm is superior to regression analysis among scores from 16 to 20. The highest area under the curve is 0.76 at a cutoff point score of 21 for the CoP measurement condition of eyes opened on the foam, and the corresponding classification accuracy is 76.15%. CoP measurement is a potential tool to estimate corresponding balance and fall survey scores for elderly rehabilitation and is useful for clinical users.

Anticipatory postural adjustments in older versus young adults: a systematic review and meta-analysis

BackgroundAnticipatory postural adjustments (APAs) are a feedforward mechanism triggered in advance to a predictable perturbation, to help the individual counteract mechanical effects that the disturbance may cause. Whether or not this strategy is compromised in the elderly is not a consensus in the literature.MethodsIn this systematic review with meta-analysis, we investigated aging effects on postural control, based on anticipatory postural adjustments (APAs). We selected 11 eligible articles of the following databases: Lilacs, SciELO, PubMed, Cochrane Central, Embase, and CINAHL, involving 324 research participants, assessing their methodological quality and extracting electromyographic, posturographic, and kinematic measurements. We included studies that investigated the occurrence of APAs in healthy younger and older adults, published before 10th August 2022, in English. Studies involving participant with conditions that may affect balance or that did not report measures of onset or amplitude of electromyography (EMG), COP, or kinematics were excluded. To analyze the aggregated results from these studies, we performed the analysis based on the outcome measures (EMG, COP, or kinematic measures) used in individual studies. We calculated differences between younger and older adult groups as the mean differences between the groups and the estimated effect. Egger’s test was conducted to evaluate whether this meta-analysis had publication bias.ResultsThrough this review, older adults showed no significant difference in the velocity to perform a movement compared to the younger adults (MD 0.95, 95% CI −0.86, 2.76, I2 = 82%), but both muscle onset and center of pressure (COP) onset were significantly more delayed in older than in younger adults: erector spinae (MD −31.44, 95% CI −61.79, −1.09, I2 = 95%); rectus abdominis (RA) (MD −31.51, 95% CI −70.58, −3.57, I2 = 85%); tibialis anterior (TA) (MD −44.70, 95% CI −94.30, 4.91, I2 = 63%); soleus (SOL) (MD −37.74, 95% CI −65.43, −10.05, I2 = 91%); gastrocnemius (GAS) (MD −120.59, 95% CI −206.70, −34.49, I2 = 94%); quadriceps (Q) (MD −17.42, 95% CI −34.73, −0.12, I2 = 0%); biceps femoris (BF) (MD −117.47, 95% CI −192.55, −42.70, I2 = 97%); COP onset (MD −45.28, 95% CI −89.57, −0.98, I2 = 93%), and COP apa (COPapa) (MD 2.35, 95% CI −0.09, 4.79, I2 = 64%). These changes did not seem to be linked to the speed of movement but possibly to age-related physiological changes that indicated decreased motor control during APAs in older adults.ConclusionsOlder adults use different postural strategies that aim to increase the safety margin and stabilize the body to perform the movement, according to the requirements imposed, and this should be considered in rehabilitation protocols.Systematic review registrationPROSPERO CRD420119143198

Comparing measurements of head motion and centre of pressure for body sway induced by optic flow on a head-mounted display

We compared two measures of visually induced body sway—head motion and centre of pressure (CoP)—that were simultaneously measured while observing optic flow on a head-mounted display (HMD). Head motion can be conveniently tracked with HMDs, but may have some features different from those of conventional CoP measurements, because of the complex joint structures of the human body. In this analysis, the responses were very similar (except for response gain), and we did not find any significant differences in time or frequency domains. Our results support the use of head motion as a potential predictor of variability in body sway, at least in studies of visually guided postural control.

Effect Of Tai Chi Participation On Prefrontal Cortex Activation During Precision Fitting Task

PURPOSE: The purpose of this study was to investigate the group effects on balance performance and prefrontal cortex (PFC) activation level when performing fitting task among Tai Chi (TC), older (OG), and young (YG) groups. METHODS: TC (67.5 ± 3.6 yrs), OG (66.9 ± 3.4 yrs) and YG (19.5 ± 0.6 yrs) were recruited. Each participant performed four different fitting tasks: (1) close-large (CL), (2) close-small (CS), (3) far-large (FL), and (4) far-small (FS) conditions. The order of opening size was random, but the distance was following from close to far conditions. Each task was required to repeat five times. Meanwhile, the center of pressure (CoP) was recorded by the force plate (2000 Hz, Kistler 9285BA), as well as the oxygenation levels of the PFC were recorded by the fNIRS device (50 Hz, Brite 24). Two three-way mixed models of ANOVA with repeated measure were used to examine the group, distance, and size effects on CoP measures and PFC activation, respectively. RESULTS: There was no significant group difference on time to complete. In the CL condition, TC and YG showed significantly smaller average CoP velocity (TC: 28.1 ± 11.4, YG: 26.6 ± 10.8, & OG: 42.8 ± 13.5 mm/s) in the Medial-Lateral (ML) direction than OG (p < .05). Additionally, in the CS condition, YG also presented smaller average CoP velocity than OG in the Anterior-Posterior (AP) direction (YG: 52.7 ± 17.0, & OG: 77.0 ± 30.1 mm/s) (p < .05). In the FS condition, YG exhibited smaller average CoP velocity than OG in the AP (YG: 43.1 ± 16.6, & OG: 61.8 ± 13.0 mm/s) and ML (YG: 27.0 ± 12.4, & OG: 61.8 ± 13.0 mm/s) directions (p < .05). In the FL and FS conditions, OG had significant larger activation levels in the right/left dorsolateral PFC (YG: 0.8 ± 0.9/0.3 ± 0.6, & OG: 1.8 ± 1.3/1.2 ± 0.8 μm), left dorsomedial PFC (YG: 0.3 ± 1.0, & OG: 1.0 ± 1.4 μm), and left ventrolateral PFC (YG: 0.5 ± 1.1, & OG: 1.9 ± 1.1 μm) than YG (p < .05). In addition, OG also had a higher activation level in the right dorsolateral PFC (TC: 0.8 ± 1.1 μm) than TC (p < .05). CONCLUSION: In the far condition, healthy older adults presented an alternative control strategy using additional PFC activation in fitting task compared to young adults. However, Tai Chi group adopted similar control strategy with young adults, thereby can be considered as a feasible intervention approach to reduce falling risks.

39. Preliminary assessment of lumbar discectomy patient balance recovery: Is a force plate necessary or will a yard stick suffice?

<h3>BACKGROUND CONTEXT</h3> Lumbar disc herniations (LDH) cause significant deficits in health-related quality of life and can greatly impact physical activity level. Considering that balance ability has been shown to be negatively impacted by LDH, balance testing provides meaningful assessment of preoperative functional deficits and postoperative recovery. Objective assessment of balance can be done using both simple clinical tests or sophisticated equipment like force plates. Guidance is needed on whether force plate analysis is necessary to adequately assess LDH patient balance before and after treatment or if simpler tests suffice. <h3>PURPOSE</h3> Determine if the Y-Balance test (YBT) provides comparable assessment of LDH patient balance recovery to force plate analysis following lumbar discectomy. <h3>STUDY DESIGN/SETTING</h3> Preliminary analysis of a prospective, concurrent-cohort study at a single institution. <h3>PATIENT SAMPLE</h3> LDH patients undergoing lumbar discectomy and healthy (H) controls. <h3>OUTCOME MEASURES</h3> PROMs: VAS pain, ODI; Force plate center of pressure (COP) measures: sagittal (s) and coronal (c) range of sway (ROS) normalized to base of support, 95% sway ellipse area (SE), average sway velocity (AV); YBT reach distances. <h3>METHODS</h3> LDH patients were evaluated 4 times: before (P0), 2 weeks after (P2w), 6 weeks after (P6w) and 3 months after (P3m) surgery. Subjects completed patient-reported outcome measures (PROMs), a 60s standing balance test, and YBT. Standing balance measures included force plate COP measures. YBT measures forward (F), back-lateral (BL), and back-medial (BM) leg reach distances of the dominant leg normalized by leg length. <h3>RESULTS</h3> A total of 51 LDH (12F/39M, 45±12yr, 95±22kg, 1.8±0.1m, 30±7kg/m2) and 10 H (8F/2M, 34±18yr, 70±10kg, 1.7±0.1m, 25±3kg/m2) subjects were included. PROMs showed significant improvements (all p 0.05). LDH AVc (5.6±5.7m/s, p=0.998) and AVs (8.7±4.0m/s, p=0.612) were not significantly different than H (AVc=5.6±2.6m/s; AVs=8.0±3.6m/s) at P0 and remained so across all follow-ups (all p >0.05). All P0 LDH YBT distances (F=56.1±10.3%; BL=76.0±12.5%; BM=55.4±14.9%, all p <0.001) were shorter than H (F=71.5±11.2%; BL=95.1±9.6%; BM=87.0±7.7%). After surgery, all LDH YBT reach distances showed significant improvements at P2w (F=61.4±8.9%, p=0.027; BL=83.3±11.2%, p=0.013; BM=64.1±14.5%, p=0.015) and P6w (F=65.1±8.8%, p=0.001; BL=83.4±12.3%, p=0.032; BM=64.9±18.4%, p=0.032) relative to P0. All directions remained significantly shorter than H (all p <0.05) at all follow-ups, except F at P6w which normalized (p=0.069). <h3>CONCLUSIONS</h3> COP and YBT both found immediate improvements in balance following LDH surgery. YBT provides a comparable assessment of LDH patient balance recovery to force plate analysis and should be considered a viable alternative. Objective functional measures for LDH surgery provide important indicators of postoperative recovery and treatment outcome. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.