Clinical Test Of Sensory Interaction Research Articles

Effects of rTMS to primary motor cortex and cerebellum on balance control in healthy adults.

Both the primary motor cortex (M1) and the cerebellum are crucial for postural stability and deemed as potential targets for non-invasive brain stimulation (NIBS) to enhance balance performance. However, the optimal target remains unknown. The purpose of this study was to compare the role of M1 and the cerebellum in modulating balance performance in young healthy adults using facilitatory 5Hz repetitive transcranial magnetic stimulation (rTMS). Twenty-one healthy young adults (mean age = 27.95 ±1.15 years) received a single session of 5Hz rTMS on M1 and the cerebellum in a cross-over order with a 7-day washout period between the two sessions. Three balance assessments were performed on the Biodex Balance system SD: Limits of Stability (LOS), modified Clinical Test of Sensory Interaction on Balance (mCTSIB), and Balance Error Scoring System (BESS). No significant effect of rTMS was found on the LOS. The effect of rTMS on the mCTSIB was mediated by stimulation target, proprioception, and vision (p = .003, ηp 2 = 0.37). Cerebellar rTMS improved the mCTSIB sway index under eyes closed-foam surface condition (p = .02), whereas M1 rTMS did not result in improvement on the mCTSIB. The effect of rTMS on the BESS was mediated by stimulation target, posture, and proprioception (p = .049, ηp 2 = 0.14). Cerebellar rTMS enhanced reactive balance performance during most sensory deprived conditions.

Correlation of postural stability with pain, disability and quality of life among patients with sacroiliac joint dysfunction- A cross-sectional study

Context-Sacroiliac (SI) joint dysfunction accounts for altered postural stability which can cause a continuously intense pain level and range of disabilities. AimTo investigate the correlation of postural stability with pain, disability & QOL among sufferers of sacroiliac joint dysfunction. SettingThis cross-sectional research was undertaken at Rehabilitation Centre, Jamia Hamdard University. MethodA total of fifty participants were recruited using sample of convenience according to inclusion and exclusion criteria. After obtaining informed consent, three pain provocative tests and one motion palpation test were used to determine sacroiliac joint dysfunction. Humac balance master system (CSMi USB powered, Stoughton, USA), Visual analogue scale (VAS), modified Oswestry Disability Index (ODI) & WHO QOL-BREF (US version) were used to assess postural stability, pain, disability & Quality of life (QOL) respectively. Data analysis was done for correlation by SPSS version 24.0. ResultStrong positive correlations were found between reaction time, VAS (r = 0.791) and modified ODI score (r = 0.576) and weak positive correlations between eyes closed solid surface (ECSS) component of modified clinical test of sensory interaction & balance with VAS (r = 0.333) and with modified ODI score (r = 0.304) and eyes open foam surface (EOFS) component with environmental component of QOL (r = 0.287). There were negative correlations between reaction time, physical health (r = −0.413), psychological health (r = −0.375), social relations (r = −0.305), and environment (r = −0.379) parameters of QOL. ConclusionAccording to the findings of the study, there were positive correlations of reaction time with pain and disability and negative correlations with QOL. Awareness of clinicians regarding the altered postural stability can help in improvising the assessment and treatment protocols for patients of SI dysfunction.

The Effects of Concussions on Static Postural Stability

Concussions among the athletic population are extremely common, which could lead to postural instabilities. The purpose of this study was to assess the effect of concussions on postural stability in young healthy adults. The static postural stability of thirty volunteers (age 21.63 ± 2.50 years; height 1.70 ± 0.14 m; weight 75.00 ± 15.58 kg; 17 with a history of concussions) was assessed using a force platform during three tests: baseline stability test, clinical test of sensory interaction and balance test, and unilateral stability test. Postural sway variables during each test were statistically analyzed using an independent t-test between the concussion group (CONC) and no concussion (NO CONC) groups. Two secondary analyses were performed with the CONC group: individuals who had one concussion (ONCE) vs. who had multiple concussions (MULTIPLE) and individuals who had their last concussion in 2023–2018 (RECENT) and in 2017–2011 (OLD). The CONC, MULTIPLE, and RECENT groups demonstrated greater postural sway than the NO CONC, SINGLE, and OLD groups. Concussions cause postural decrements in young healthy adults compared to their counterparts with no history of concussions. The results of the study exhibit that concussions could lead to imbalances, which is decisive in athletes’ performance and injury risk during play.

Psychostimulant Medications for Physical Function and Spasticity in Children With Cerebral Palsy: Protocol for a Randomized Controlled Trial.

Cerebral palsy (CP) is a prevalent nonprogressive disorder that leads to impaired movement (ie, spasticity), posture, and balance, which affects functions such as walking and upper extremity tasks. Current medical treatments show efficacy in improving motor performance but have considerable side effects. Emerging off-label use of central nervous system (CNS) medications for improving motor performance has shown promising results in children with CP and other populations. The aim of this study is to describe a protocol for a pilot randomized controlled trial (RCT) to examine the safety, tolerability, and efficacy of methylphenidate (MPH) and modafinil on spasticity and motor performance in children with CP. This will be a protocol study for a pilot, triple-masked, placebo-controlled RCT (a class I trial following the American Academy of Neurology criteria) with blinded patients, outcome assessors, and intervention delivery team. Eligible children should be diagnosed with CP levels I or II based on the Gross Motor Function Classification System and be aged between 7 and 12 years. Thirty-six children with CP will be randomized into 3 groups to receive (1) MPH (2.5 mg of MPH + 100 mg placebo), (2) modafinil (100 mg modafinil + 2.5 mg placebo), or (3) a placebo (2.5 mg placebo + 100 mg placebo), in addition to physical therapy for 12 weeks. Primary outcomes include the Gross Motor Function Measure-66 and the Modified Ashworth Scale. Secondary outcomes include the Timed Up and Go test, 5 Time Sit to Stand test, Modified Clinical Test for Sensory Interaction of Balance, and 10-Meter Walk Test. The protocol has been accepted by Kuwait University (VDR/EC-225) and the Ministry of Health of Kuwait (2022/2157). The inclusion of participants will start in June 2024. The combination of CNS stimulant medications and controlling for rehabilitation has not been studied yet. The findings of this study may determine if using CNS stimulant medications is beneficial for the reduction of spasticity and improvement of physical function in children with spastic CP. ClinicalTrials.gov NCT05675098; https://clinicaltrials.gov/study/NCT05675098. PRR1-10.2196/53728.

Comparison of Effects of Balance Training Exercise and Gaze Stability Exercises on Balance and Postural Control in Elderly With Fall Risk: A Randomized Controlled Trial

Aim To compare the changes in outcomes of balance and postural control after balance training exercise and gaze stability exercise in the elderly population with fall risk. Methods After the screening process, 44 subjects were randomized into three groups: Experimental Group A (Balance training exercises, BTE); Experimental Group B (Gaze stability exercises, GSE), and Control Group C (Fall prevention education only). The outcome measures were center of pressure (COP) range, COP sway, reaction time, proprioception, static balance, Clinical Test for Sensory Interaction in Balance (CTSIB), and Short Falls Efficacy Scale (SFES). The pre and post-data were recorded at baseline and after 8 weeks. The normality of the distribution was assessed using the Shapiro-Wilk test. Demographic data and baseline measures were compared using one-way ANOVA considering group as between factor and mixed model ANOVA was used to find out the group effect and time effect and time × group interaction effect. Statistical significance was indicated if p ≤ 0.05. Results GSE had significant changes only in CTSIB 4 whereas BTE had significant changes in CTSIB 4, 5, and 6. COP range showed a significant time effect in the front direction (p = 0.02). For proprioception, there was a significant time effect in the left (p = 0.018) and right direction (p = 0.005), whereas changes in front and back directions were found to be insignificant. SFES showed a significant time effect (p < 0.001), group effect (p = 0.21), and time × group interaction effect (p < 0.001). Conclusion Balance training exercises may be a more effective form of intervention to improve balance and postural control in the elderly population.

Effects of elastic taping on kyphosis and body balance in the elderly: a randomized crossover study

Kyphosis produces abnormal posture and reduced body balance in the elderly. Elastic tape may be useful at improving kyphotic posture and body balance. This study aims to evaluate the effects of elastic taping on kyphosis and body balance in the elderly. Ten elderly participants with degenerative kyphotic posture were recruited and randomly assigned to two groups (back taped with stretched elastic tape for 15 min and back taped with non-stretched elastic tape for 15 min). After a 1-h washout period, the groups were swapped over to receive the other intervention. The outcomes measured after each taping technique were Cobb’s angle measurement by inclinometer, perceived pain, and balance measurements by single leg stance test, time up and go test, center of gravity alignment (COG) and modified clinical test of sensory interaction on balance test (mCTSIB). There was a significant reduction in kyphotic angle and back pain in both the stretched and non-stretched taping groups (p < 0.05). We also found both taping techniques significantly reduced sway velocity on a foam surface with eyes closed and open (p < 0.05). However, there was no significant difference between taping groups for kyphotic angle, pain reduction or balance. The application of 15 min of stretched and non-stretched elastic tape in the elderly reduced kyphotic angle, back pain, and sway velocity while standing on foam surface in the mCTSIB test. If these changes persist over the long term (days and weeks) taping may be a useful intervention for elderly patients with kyphosis.

Nintendo Ring Fit Adventure improves balance ability in sedentary young adults

IntroductionExercising with a game console is a novel type of exercise. One game that is currently popular is Nintendo Ring Fit Adventure, but its impact on balancing ability in young adults who are sedentary has yet to be investigated. This study aimed to investigate the effects of Nintendo Ring Fit Adventure exercise on balance ability in young adults with sedentary lifestyles.MethodsThirty participants were randomly divided into two groups: the Nintendo and control groups. The experimental group completed a workout routine using the Nintendo Ring Fit for 30 minutes per day, three times per week for four weeks, while the control group received no intervention. Participants’ balance abilities were evaluated pre- and post-intervention by the single leg stance test, Modified Clinical Test of Sensory Interaction in Balance (MCTSIB), and limit of stability. A one-way ANCOVA with the pre-intervention value as a covariate was used to compare groups.ResultsComparisons between groups after the intervention revealed a significant decrease in MCTSIB sway for the firm surface with eyes open condition (p = 0.043) and a significant increase in endpoint excursion in the backward direction (p = 0.038). The other variables did not show statistically significant differences between groups.ConclusionsExercise with Nintendo Ring Fit improved the participants’ ability to balance in certain dimensions. Nintendo Ring Fit may increase the balance ability of young adults with sedentary behaviour.

Objective estimation of m-CTSIB balance test scores using wearable sensors and machine learning.

Accurate balance assessment is important in healthcare for identifying and managing conditions affecting stability and coordination. It plays a key role in preventing falls, understanding movement disorders, and designing appropriate therapeutic interventions across various age groups and medical conditions. However, traditional balance assessment methods often suffer from subjectivity, lack of comprehensive balance assessments and remote assessment capabilities, and reliance on specialized equipment and expert analysis. In response to these challenges, our study introduces an innovative approach for estimating scores on the Modified Clinical Test of Sensory Interaction on Balance (m-CTSIB). Utilizing wearable sensors and advanced machine learning algorithms, we offer an objective, accessible, and efficient method for balance assessment. We collected comprehensive movement data from 34 participants under four different sensory conditions using an array of inertial measurement unit (IMU) sensors coupled with a specialized system to evaluate ground truth m-CTSIB balance scores for our analysis. This data was then preprocessed, and an extensive array of features was extracted for analysis. To estimate the m-CTSIB scores, we applied Multiple Linear Regression (MLR), Support Vector Regression (SVR), and XGBOOST algorithms. Our subject-wise Leave-One-Out and 5-Fold cross-validation analysis demonstrated high accuracy and a strong correlation with ground truth balance scores, validating the effectiveness and reliability of our approach. Key insights were gained regarding the significance of specific movements, feature selection, and sensor placement in balance estimation. Notably, the XGBOOST model, utilizing the lumbar sensor data, achieved outstanding results in both methods, with Leave-One-Out cross-validation showing a correlation of 0.96 and a Mean Absolute Error (MAE) of 0.23 and 5-fold cross-validation showing comparable results with a correlation of 0.92 and an MAE of 0.23, confirming the model's consistent performance. This finding underlines the potential of our method to revolutionize balance assessment practices, particularly in settings where traditional methods are impractical or inaccessible.

Zinc Deficiency: A Harbinger of Vestibular Dysfunction?

Background: Role of zinc in the maintenance of redox homeostasis have been explored &amp; is established to have antioxidant effects in the body. Presence of zinc in auditory system &amp; its role in deafness &amp; tinnitus is well established. Zinc supplementation has shown to not only improve tinnitus but also dizziness associated with it which marks the presence of zinc in vestibular system 4. The possible role of zinc in modulating neurotransmission across the glutaminergic synapses in vestibulo cerebellar, vestibulo-occular pathways are established. So, this study aims to assess serum zinc levels in vestibular disorder patients &amp; correlate with severity of the vestibular dysfunction Methodology: This was Cross sectional comparative study, 40 patients with vestibular disorders &amp; 40 subjects without vestibular dysfunction were included in the study. After thorough history taking, these patients were subjected to Dix Hallpike test, Head Impulse test Romberg test on foam with eyes closed /The Clinical Test of Sensory Interaction and Balance (CTSIB) to confirm vestibular dysfunction. After that, Dizziness handicap inventory (DHI) to assess the severity of the vestibular dysfunction. Serum zinc levels along with other, micronutrients like magnesium, calcium &amp; Serum vitamin B12 &amp; vitamin D were also assessed. Serum zinc levels were compared with age matched controls. Results: Out of 40 patients, 24 had mild &amp; 16 had moderate scores according to DHI. Serum zinc levels in study group was 60.63±10.10 which was significantly (p&lt;0.005) lower than compared control group 70.50±19.1. Also, Serum zinc levels were corelated with the severity of the vestibular dysfunction, (r=0.89, p&lt;0.00) which shows that more severe the dysfunction lesser the serum zinc levels. Conclusion: Role of zinc as an antioxidant is well established and deficiency of zinc is linked with the pathogenesis of various diseases. Since evidences suggest involvement of zinc in vestibular system, zinc supplementation in vestibular disorder patients can be considered as add on therapy, which might have a beneficial role with respect to cognitive function as well.

Sensory Reweighting for Postural Control in Older Adults with Age-Related Hearing Loss.

There is growing evidence linking hearing impairments and the deterioration of postural stability in older adults. To our knowledge, however, no study to date has investigated the effect of age-related hearing loss on the sensory reweighting process during postural control. In the absence of data, much is unknown about the possible mechanisms, both deleterious and compensatory, that could underly the deterioration of postural control following hearing loss in the elderly. The aim of this study was to empirically examine sensory reweighting for postural control in older adults with age-related hearing loss as compared to older adults with normal hearing. The center of pressure of all participants was recorded using a force platform and the modified clinical test of sensory interaction and balance protocol. The results suggest that individuals with age-related hearing loss displayed increased somatosensory reliance relative to normal hearing younger adults. This increased reliance on somatosensory input does not appear to be effective in mitigating the loss of postural control, probably due to the concomitant deterioration of tactile and proprioceptive sensitivity and acuity associated with aging. Beyond helping to further define the role of auditory perception in postural control, these results further the understanding of sensory-related mechanisms associated with postural instability in older adults.

Insufficiencies in sensory systems reweighting is associated with walking impairment severity in chronic stroke: an observational cohort study.

Walking and balance impairment are common sequelae of stroke and significantly impact functional independence, morbidity, and mortality. Adequate postural stability is needed for walking, which requires sufficient integration of sensory information between the visual, somatosensory, and vestibular centers. "Sensory reweighting" describes the normal physiologic response needed to maintain postural stability in the absence of sufficient visual or somatosensory information and is believed to play a critical role in preserving postural stability after stroke. However, the extent to which sensory reweighting successfully maintains postural stability in the chronic stages of stroke and its potential impact on walking function remains understudied. In this cross-sectional study, fifty-eight community-dwelling ambulatory chronic stroke survivors underwent baseline postural stability testing during quiet stance using the modified Clinical test of Sensory Interaction in Balance (mCTSIB) and assessment of spatiotemporal gait parameters. Seventy-six percent (45/58) of participants showed sufficient sensory reweighting with visual and somatosensory deprivation for maintaining postural stability, albeit with greater postural sway velocity indices than normative data. In contrast, survivors with insufficient reweighting demonstrated markedly slower overground walking speeds, greater spatiotemporal asymmetry, and limited acceleration potential. Adequate sensory system reweighting is essential for chronic stroke survivors' postural stability and walking independence. Greater emphasis should be placed on rehabilitation strategies incorporating multisensory system integration testing and strengthening as part of walking rehabilitation protocols. Given its potential impact on outcomes, walking rehabilitation trials may benefit from incorporating formal postural stability testing in design and group stratification.

The Effects of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions, and Postural Control in Children With Hearing Loss: A Randomized Controlled Trial.

To evaluate the effects of core stabilization training on respiratory muscle strength, respiratory functions, and postural control in children with hearing loss. We conducted a randomized controlled trial at Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation. Thirty children with hearing loss who were diagnosed with prelingual sensorineural hearing loss were randomly allocated to the study (n = 15, 12.20 ± 1.69 years) and control (n = 15, 11.87 ± 2.20 years) groups. Core stabilization training protocol was performed by the study group for 8 weeks, 5 days/week, whereas the control group received no training. The primary outcome measure was respiratory muscle strength. The secondary outcome measures were: spirometry, postural control tests on Biodex Balance System, and Balance Error Scoring System (BESS). Exercise adherence was recorded via a diary for home sessions. Outcomes were assessed at baseline and the end of the 8 weeks. In the study group, a significant improvement was observed in force vital capacity, peak expiratory flow of the spirometry test, maximum inspiratory pressure/expiratory pressure (MEP) of the respiratory muscle strength test; postural stability test except "anterior/posterior stability index", limits of stability test except "backward" and "forward/right", all parameters of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) test except "eyes closed firm surface" of the Biodex Balance System, and total score of BESS. Group × time interaction was found in MEP, "overall" stability index in postural stability test, "overall," "left," and "backward left" of limits of stability test, all parameters of the mCTSIB, and BESS total. Core stabilization exercises were effective in improving respiratory muscle strength, spirometry, and postural control in children with hearing loss.

Time of day and athlete status effects on the modified clinical test of sensory integration and balance (mCTSIB) and stability evaluation test (SET)

BackgroundConcussions or musculoskeletal injuries may impair postural control, which is one diagnostic to help determine return-to-activity decisions. Postural control may be affected by diurnal rhythm. Research questionDoes time of day influence postural control as measured by two Neurocom Balance Master diagnostic protocols, the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) and the Stability Evaluation Test (SET)? MethodsFollowing Institutional Review Board (IRB) approval, consented participants completed the SET and mCTSIB twice: between 0700 and 1000; and between 1600 and 1900. We randomized and balanced testing order. Familiarization trials were completed for the mCTSIB and SET. Assessments were completed in a controlled laboratory environment. We instructed participants to get a normal night’s sleep prior to testing and refrain from caffeine use and exhaustive exercise on the day of testing. Sixty-nine participants (48 female, 21 male: age = 21.42±2.56 years, height = 168.20±7.53 cm, mass = 72.05±16.60 kg) completed the study. Thirty-one of the participants were National Association of Intercollegiate Athletes (NAIA) student-athletes from the sports of baseball, soccer and softball. Average postural sway velocity was measured and compared by time of day for each of the balance conditions in the mCTSIB and SET protocols. ResultsAccording to repeated measures ANOVA, there were no significant postural sway velocity main effects by time of day for any of the balance conditions. We found significant postural sway main effects by foam, stance and eyes. We also noted significant ANOVA between participants’ differences for athlete status, but not for sex. SignificanceThese results inform practitioners about the importance of controlling time-of-day between baseline and post-injury testing, which may allow for more flexible, accurate and reliable diagnosis and return-to-activity decisions. Athletes displayed better static postural control, possibly warranting different normative values for diagnostic comparison.

Development and Application of a Stability Index Estimation Algorithm Based on Machine Learning for Elderly Balance Ability Diagnosis in Daily Life.

The stability index estimation algorithm was derived and applied to develop and implement a balance ability diagnosis system that can be used in daily life. The system integrated an approach based on sensory function interaction, called the clinical test of sensory interaction with balance. A capacitance and resistance sensing type force mat was fabricated, and a stability index prediction algorithm was developed and applied using the center of pressure variables. The stability index prediction algorithm derived a center of pressure variable for 103 elderly people by Nintendo Wii Balance Board to predict the stability index of the balance system (Biodex SD), and the accuracy of this approach was confirmed. As a result of testing with the test set, the linear regression model confirmed that the r-value ranged between 0.943 and 0.983. To confirm the similarity between the WBB and the flexible force mat, each measured center of pressure value was inputted and calculated in the developed regression model, and the result of the correlation coefficient validation confirmed an r-value of 0.96. The system developed in this study will be applicable to daily life in the home in the form of a floor mat.

Individual-based predominance of visual input in multisensorial integration for balance is correlated with proprioceptive drift in rubber hand illusion.

Rubber hand illusion (RHI) is a traditional task that examines multisensory integration. The visual capture of tactile stimulus given to the seen rubber hand was considered to predominate the sensory processing and interfere with the bottom-up proprioceptive and tactile inputs received from the unseen real hand that results in mislocalization of participants hand towards rubber hand, namely proprioceptive drift (PD). Another task that requires multisensorial integration and shows a predominance of visual input is the maintenance of body posture. However, if the predominance of visual input in one task is generalizable to another task is yet to be elucidated. We aimed to examine if individual dependency on visual inputs in multisensorial integration in balance correlated with PD in RHI. Twenty healthy participants were recruited for the study and completed the RHI task. The contribution of visual inputs to the static body balance was measured with the instrumented clinical test of sensory interaction for balance and indexed with Romberg Quotient (RQ). We found a moderate positive correlation between PD and RQ. Individuals with more dependence on visual information in maintaining body posture had higher PD in RHI. Our results indicate that there can be an individual-based dependence on particular domains of sensory input preserved during different tasks of multisensorial integration. Future studies must clarify whether this tendency relates to certain physical or physiological traits.

Testing the validity and reliability of a new android application-based accelerometer balance assessment tool for community-dwelling older adults

BackgroundPostural instability is a risk factor for falls in older adults. It is possible to detect postural stability using an integrated accelerometer (ACC) sensor in a smartphone. Therefore, a novel ACC-based smartphone application running on the Android operating system called BalanceLab was created and tested. PurposeThis study aimed to determine the validity and reliability of a novel ACC-based Android smartphone application for assessing balance in older adults. MethodsUsing BalanceLab, 20 older adults completed three balance assessments: the Modified Clinical Test of Sensory Interaction in Balance (MCTSIB), a single-leg stance test (SLST), and a limit of stability test (LOS). The validity of this mobile application was investigated using a three-dimensional (3D) motion analysis system and the Fullerton Advanced Balance (FAB) scale. The test-retest reliability of this mobile application was determined on two separate occasions within one day, at least two hours apart. ResultsThe two static balance assessments (the MCTSIB and SLST) demonstrated moderate to excellent correlation with the 3D motion analysis system (r = 0.70–0.91) and the FAB scale (r = 0.67–0.80). However, the majority of the dynamic balance tests (the LOS tests) did not demonstrate any correlation with the 3D motion analysis system or the FAB scale. This novel ACC-based application demonstrated good to excellent test-retest reliability (ICC = 0.76–0.91). ConclusionA static, but not dynamic, balance assessment tool that uses a novel ACC-based application for Android can be used to measure balance in older adults. This application has moderate to excellent validity and test-retest reliability.

Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial

BackgroundMuscle stretching exercises preserve corporal flexibility and decrease the retraction and shortening of myofascial and articular structures. These exercises are recommended for the treatment of fibromyalgia (FM). The purpose of the study was to verify and compare the effect of muscle stretching exercises on FM patients based on the global posture reeducation method against segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy.MethodsForty adults with FM were randomly allocated into two groups: global and segmental. The two kinds of therapies were performed in 10 individual sessions once a week. Two assessments were made: one at baseline and one at the end of therapy. The primary outcome variable was pain intensity (Visual Analog Scale). The secondary outcome variables were multidimensional pain (McGill Pain Questionnaire), the pain threshold at tender points (dolorimetry), attitudes toward chronic pain (Survey of Pain Attitudes-Brief Version), body posture (Postural Assessment Software Protocol), postural control (Modified Clinical Test of Sensory Interaction on Balance), flexibility (sit-and-reach test), the impact of FM on quality of life (Fibromyalgia Impact Questionnaire, FIQ), and self-reported perceptions and body self-care.ResultsAt the end of treatment, there were no statistically significant differences between the groups in the outcome variables. Furthermore, the groups presented lower pain intensity (baseline vs. final; global group: 6 ± 1.8 vs. 2.2 ± 1.6 cm, p<0.01; segmental group: 6.3 ± 2.1 vs. 2.5 ± 1.7 cm, p<0.01), higher pain threshold (p ≤ 0.01), lower total FIQ score (p < 0.01), and greater postural control (p < 0.01) after treatment.ConclusionsMuscle stretching exercises based on global posture reeducation and segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy, reduced the pain intensity and impact of FM on quality of life. These exercises also improved FM patients’ pain threshold at tender points, attitudes toward chronic pain, and postural control. There were no differences between global posture reeducation and segmental muscle stretching exercises.Trial registrationClinicalTrials.gov NCT02384603. Registered on 10 March 2015.

Reliability, validity and normal ranges of the Zur Balance Scale for detecting mild postural control differences: introducing the modified, short version mZBS.

Balance is achieved through interactions between the vestibular, somatosensory, and visual systems. There are several clinical tests to measure postural stability. However, most of them do not assess postural stability with head movements, which is the main function of the vestibular system, and those that do, require the use of sizeable, expensive equipment. Therefore, an applicable, easy-to-perform test that challenges the function of the visual, somatosensory and vestibular systems, using head movements, is needed. The Zur Balance Scale (ZBS) contains ten conditions, which are a combination of surfaces (floor or Styrofoam with subject standing on its width in Romberg position or its length in tandem position), stances (Romberg or tandem), tasks (no head movement with eyes open or closed and horizontal or vertical head movements with eyes open). The purpose of this study was to determine the validity, inter- and intra-examiner reliability, and normal performance values of the ZBS among individuals 29-70-years of age and to introduce the modified version: the mZBS, using kinetic measurements. Healthy participants ages 29-70 years were evaluated for inter- and intra-tester reliability (n = 65), kinetic measurements on a force plate, and validity compared to the modified clinical test of sensory interaction and balance (mCTSIB) (n = 44) and characterization of normal values (n = 251). Zur Balance Scale head movements, duration of each condition (up to 10 s) and the total ZBS score agreed across examiners (ICC > 0.8). Normal ZBS scores were negatively correlated with age (r = -0.34; P < 0.0001). Older subjects (60-70 years) had a median score of 95.5 compared with younger subjects, where medians ranged from 97.6 to 98.9. Kinetic parameters showed positive correlations between ZBS and the mCTSIB scores, with the highest correlation between the five Romberg tasks (modified ZBS). Zur Balance Scale is a valid and reliable test. Its advantages include using head movements and the ability to detect minimal differences in postural control, even in healthy populations. Kinetic evaluation of the ZBS enables the use of a modified, shorter version of the ZBS (mZBS).

Neurophysiological Effects of Repeated Soccer Heading in Youth.

Repeated head loading in sports is associated with negative long-term brain health, and there is growing evidence of short-term neurophysiological changes after repeated soccer heading. The objective of this study was to quantify the head kinematics and effects of repetitive soccer headers in adolescents using an instrumented mouthguard. Adolescent soccer players aged 13-18 years were randomly assigned to a kicking control, frontal heading, or oblique heading group. Participants completed neurophysiological assessments at three-time points: immediately prior to, immediately after, and approximately 24 h after completing 10 headers or kicks. The suite of assessments included the Post-Concussion Symptom Inventory, visio-vestibular exam, King-Devick test, modified Clinical Test of Sensory Interaction and Balance with force plate sway measurement, pupillary light reflex, and visual evoked potential. Data were collected for 19 participants (17 male). Frontal headers resulted in significantly higher peak resultant linear acceleration (17.4 ± 0.5 g) compared to oblique headers (12.1 ± 0.4 g, p < 0.001), and oblique headers resulted in significantly higher peak resultant angular acceleration (frontal: 1147 ± 45 rad/s2, oblique: 1410 ± 65 rad/s2, p < 0.001). There were no neurophysiological deficits for either heading group or significant differences from controls at either post-heading timepoint, and therefore, a bout of repeated headers did not result in changes in the neurophysiological measures evaluated in this study. The current study provided data regarding the direction of headers with the goal to reduce the risk of repetitive head loading for adolescent athletes.

Effect of Hearing Status on Static Postural Control Performance of College Athletes.

Due to the close proximity of the cochlea, vestibular apparatus and shared neurovascular structures, static postural control of athletes who are deaf or hard-of-hearing (D/HoH) may be different than that of athletes who are hearing. Limited research is available to quantify differences between these athletes. Determine the effect of hearing status and stance condition on static postural control performance of athletes. Cross-sectional study. Athletic training facilities. Fifty-five collegiate varsity athletes who are D/HoH (20.62±1.80 yrs., 1.73±0.08 m., 80.34±18.92 kg.) and 100 university club athletes who are hearing (20.11±1.59 yrs., 1.76±0.09 m., 77.66±14.37 kg.) participated in the study. Participants completed the Modified Clinical Test of Sensory Interaction and Balance (mCTSIB) on a tri-axial force plate. Antero-posterior (AP) and medio-lateral (ML) center of pressure (CoP) velocity, AP and ML CoP amplitude root-mean-square (RMS), and 95% ellipse sway area were calculated. Athletes who are D/HoH had a larger CoP velocity, larger ML RMS, and larger sway area than those who are hearing (p < .01 for all). A significant main effect of stance condition was observed for all postural control variables (p < .01 for all). Athletes who are D/HoH demonstrated larger sway compared to athletes who are hearing during the mCTSIB. Therefore, individualized baseline assessments for static postural control performance may be warranted for athletes who are D/HoH as opposed to comparisons to existing normative data.