Dynamic Balance In Patients Research Articles

Comparison Of The Effects Of Different Non-surgical Treatments For The Ability Of Foot And Ankle And Dynamic Balance In Patients With Chronic Ankle Instability: A Network Meta-analysis

Comparison Of The Effects Of Different Non-surgical Treatments For The Ability Of Foot And Ankle And Dynamic Balance In Patients With Chronic Ankle Instability: A Network Meta-analysis

프로이덴슈타인 방정식을 이용한 하지보조기가 만성 뇌졸중 환자의 보행속도 및 동적 균형에 미치는 영향 : 예비조사연구

프로이덴슈타인 방정식을 이용한 하지보조기가 만성 뇌졸중 환자의 보행속도 및 동적 균형에 미치는 영향 : 예비조사연구

Does Viewing Mirror-Reflected Body Image Affect Static and Dynamic Standing Balance?

In the present study, we examined the immediate effect of allowing healthy participants to view their mirror-reflected body image on static and dynamic balance. We placed a mirror to allow participants to frontally view their own body image while maintaining a quiet stance or while engaged in a dynamic postural standing task. On measures of body sway during quiet stance, there were no effects of this visual feedback, supporting the view that human beings have no central mechanism for viewing the mirror-reflected body image to control body sway during quiet stance. However, the body deviated forward during quiet stance while viewing the mirror-reflected body image, indicating that viewing the mirror-reflected body image contributed to the anterior-posterior positioning of the body, as mediated by an ankle control strategy. For the dynamic standing task, viewing the body image induced unstable peaks of rhythmic lateral shifting of the body weight over the feet. This indicates that viewing the body image caused unstable motor commands for rhythmic lateral weight shifting. When participants made a transition from a bipedal to a unipedal stance in response to a cue, viewing the body image shortened the onset latency of the body sway. Accordingly, viewing the body image seemed to accelerate the motor execution involved in lateral weight shifting, possibly due to predictive activation of the motor system before movement onset. Considered collectively, we found static and dynamic stance balance to be influenced by viewing one's mirror-reflected body image. Viewing the mirror-reflected body image may be a means of changing static and dynamic balance in patients with impaired postural control.

Lower limb lymphedema disrupts both static and dynamic balance

BackgroundThe impact of lower-limb-lymphedema on quality of life of patients regarding balance is unclear due to the scarcity of literature. The aim of this study was to determine the static and dynamic balance of patients with lower-limb-lymphedema in comparison with healthy subjects. MethodsThis case-control designed study included 30 lymphedema patients and 30 healthy individuals, of whom were 52 female and 8 male with a mean age of 50.63 ± 9.72 years. Static balance stability and anterior-posterior with lateral sway parameters on four conditions (eyes-opened-stable-ground, eyes-closed-stable-ground, eyes-opened-unstable-ground, eyes-closed-unstable-ground) and dynamic stability of all participants were evaluated. FindingsThe demographic variables were similar between the groups. Majority of the patients had lymphedema due to cancer surgery with a stage of 2. Dynamic stability was significantly disrupted in lymphedema group in comparison with controls (P = 0.049). Static balance parameters were impaired on all conditions except the eyes opened-stable ground in lymphedema patients (P = 0.048,P = 0.043,P = 0.017). The dynamic with static balance and lateral sway parameters were correlated with the duration of lymphedema(P = 0.046,P = 0.002,P = 0.005). Anterior-posterior sway on eyes-closed-unstable-ground condition was correlated with functional status (P = 0.02). Static balance on eyes-opened-unstable-ground condition and anterior-posterior sway parameters were correlated with physical activity level (P = 0.015,P = 0.016,P < 0.05). InterpretationClosing eyes and the deterioration of ground caused significant alteration of the static and dynamic balance both separately and together in patients with lower-limb-lymphedema compared to healthy subjects. Regarding the static and dynamic imbalance, we suggest the evaluation of balance and inclusion of balance exercises in routine lymphedema rehabilitation program, especially in the early period of disease.

Effects of rehabilitation exercise program types on dynamic balance in patients with stroke: a meta-analysis of randomized controlled trials

ABSTRACT Purpose The purposes of meta-analysis are to evaluate evidence about the effects of Rehabilitation Exercise Program on the balance of post-stroke patients, evaluated by the Berg Balance Scale (BBS). Methods The search was conducted ‘stroke,’ ‘rehabilitation,’ ‘dynamic balance,’ ‘Berg Balance Scale,’ ‘exercise’ and ‘randomized controlled trial’using MEDLINE (accessed by PubMed), Web of Science (WoS), ProQuest, and Google Scholar for journal studies published from January 2018 to October 2022. Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. The main outcome was dynamic balance assessed by the Berg Balance scale. Results The review included 30 papers and a total of 540 patients. The overall effect size was 0.550, a medium effect size according to the Cohen’s standard. It was observed that gender has moderate effect size in male (0.551), female (0.458) and higher in male. Exercise type results showed large effect sizes in balance training (0.966), and aquatic activities (0.830), moderate effect sizes in virtual reality (0.762), moderate effect sizes in physically active (0.581), gait training (0.541), dual-task (0.478), trunk control (0.284), and small effect sizes in resistance training (0.128). Conclusions Exercise programs are effective in improving dynamic balance in stroke patients. Especially, the meta-analysis showed higher Effect Size for balance training and virtual reality than for other programs making this relevant interventions for future head to head superiority studies that compare different balance interventions in stroke.

The effect of combined balance and strength exercise program in patients with different grades of primary knee osteoarthritis

BackgroundKnee osteoarthritis (KOA) is a degenerative disease that affects all parts of the joint including the surrounding ligaments, tendons, and muscles. Biomechanical changes that occur in KOA cause aggravation of symptoms with further joint damage. Thus, modifying the biomechanics of the knee joint may help in the prevention and treatment of KOA. For that reason, our aim was to assess the effect of combined balance and strengthening exercise programs in patients with different grades of primary KOA.ResultsAll studied groups showed comparable significant improvement in quadricep muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (< 0.001), time-up and go score (< 0.001), 6-m walk time (< 0.001), and dynamic balance (< 0.001) at the end of exercise program. Furthermore, patients with mild-moderate KOA showed a significant improvement in pain, physical function, total WOMAC scores, and dynamic balance compared to those with more severe KOA.ConclusionCombined balance and strengthening exercise programs may help improve pain, physical function, and dynamic balance in patients with KOA regardless of its severity. However, following exercise patients with milder forms of KOA may show greater improvement compared to patients with severe KOA.

The Reliability and Validity of the Modified Four Square Step Test in Individuals with Anterior Cruciate Ligament Reconstruction.

The modified four square step test (mFSST) is frequently used in the evaluation of dynamic balance in individuals with balance problems. However, the reliability of the mFSST has not been examined in individuals undergoing anterior cruciate ligament reconstruction (ACLR) surgery. The aim of this study was to examine the test-retest reliability of the mFSST in individuals undergoing ACLR surgery. Forty-eight patients who had ACLR surgery were included in this study. Patients performed a total of four mFSSTs, two times each, by two different raters over seven days. In the current study, the mFSST demonstrated excellent test-retest and inter-rater reliability. The intraclass correlation coefficient for mFSST was 0.92. The standard error of measurement and minimal detectable change for mFSST were 0.15 and 0.41, respectively. The mFSST has excellent test-retest and inter-rater reliability in patients with ACLR. It is a valid and reliable tool for evaluating dynamic balance in patients with ACLR. We think that mFSST, which is a clinical evaluation test, can be preferred because it is easy to score and does not require special equipment.

Static and Dynamic Imbalance in Patients with Breast Cancer-Related Lymphedema.

Background: Breast cancer-related lymphedema (BCRL) was associated with postural imbalance, but the immature knowledge introduced debate about which component of the balance was affected by BCRL in the literature. The aim of this study was to determine the static and dynamic balance of patients with BCRL in comparison with healthy subjects. Methods and Results: This case-control designed study recruited 30 BCRL patients and 30 healthy individuals. The demographic and clinical variables of the subjects were recorded. The static balance stability parameters on four conditions (eyes opened-stable ground, eyes closed-stable ground, eyes opened-unstable ground, eyes closed-unstable ground) and dynamic stability of all participants were evaluated. The values of both stable ground conditions were similar between the groups (p < 0.05). However, values of both eyes opened-unstable ground (p = 0.032) and eyes closed-unstable ground (p = 0.034) conditions were significantly impaired in BCRL in comparison with controls. Besides, comparison of sway area of the opened versus closed eyes conditions on unstable ground (p = 0.036), and movement speed while correcting the center of pressure on unstable ground (with opened and closed eyes, p = 0.014 and p = 0.004 respectively) revealed increased values in the BCRL group. Likewise, the dynamic stability was significantly disrupted in the BCRL group (p = 0.043). Conclusion: Closing eyes did not affect the postural balance in patients with BCRL, whereas the deterioration of ground altered the balance significantly in the BCRL group compared with healthy subjects. We suggest the inclusion of balance exercises and guidance for selection of correct shoes and insoles in routine lymphedema rehabilitation program.

Medical Rehabilitation Impact Towards Dynamic Balance in Lateral Ankle Sprain Patients

Background: Lateral ankle sprain (LAS) is one of the most prevalent and recurring injuries occurring during physical activities, especially sports. The resulting morbidity forces individuals to limit or change their physical activities. Medical rehabilitation can prevent recurrent injuries by restoring dynamic balance deficits. Previous studies have shown contradictory results. We investigated the effect of medical rehabilitation on dynamic balance in patients with LAS.Methods: This was a numerical, analytical study with a prospective cohort design. Two groups, consisting of 13 LAS subjects each, were purposively chosen. Only the former participated in the three sessions of the rehabilitation program. The modified star excursion balance test was performed initially and three weeks later. Normalized composite scores were recorded in Microsoft Excel and statistically analyzed using SPSS 24 with a 5% significance level.Results: LAS was commonly found in males (57.69%), with an average age of 20.62 ± 6.24 years old, on the dominant foot side (57.69%). Both groups were matched for age (p = 0.292), sex (p = 0.247), and dominant injured foot (p = 0.193). The rehabilitation group presented a greater increase in normalized composite score than the control (∆ = 3.10 ± 4.71 vs. 2.04 ± 7.05, p = 0.654).Conclusion: Dynamic balance increased more in the rehabilitation group than in the control group, but the difference was insignificant. Medical rehabilitation should not be mandatory but optional for patients with LAS with limited resource access. Nevertheless, rehabilitation should be continued for other important aspects of treatment.

The test-retest reliability and minimal clinically important difference of the Dubousset Functional Test and its correlation with Rolland Morris disability questionnaire in chronic non-specific low back pain.

This study examines the test-retest reliability, the minimal clinically important difference (MCID), and its correlation with the Rolland Morris Disability Questionnaire (RMDQ) of the Dubousset Functional Test (DFT) in evaluating the functional capacity and dynamic balance of patients with chronic non-specific low back pain (cnsLBP). Seventy-five patients with cnsLBP aged 18years and over were included. The Five-Repetition Sit-To-Stand Test (5R-STS), the subcomponents of the DFT (the Up and Walk Test, the Steps Test, the Down and Sitting Test, and the Dual-Tasking Test) were administered to the patients. Patients were rested for 1h, and the DFT was applied again. Pain level was evaluated with the Visual Analogue Scale before the tests started and after the tests were completed. Self-report function assessment was made using the RMDQ. The test-retest reliability of the subcomponents of the DFT was excellent. The ICCs were: 0.91, 0.86, 0.89, and 0.89, respectively. The standard measurement errors of the subcomponents of the DFT were 0.32, 0.12, 0.14, and 0.25, respectively. The subcomponents of the DFT were highly correlated with the RMDQ and 5R-STS with the correlation coefficients of 0,83, 0,83, 0,79, 0,83 and 0,81, 0,75, 0,73, and 0,82, respectively (p < 0.01). The MCIDs of the subcomponents were 0,60, 0,23, 0,27, and 0,48, respectively. The DFT is reliable in evaluating patients' functional capacity and dynamic balance with cnsLBP without causing discomfort. It is simple, quick, and simultaneously assesses multiple areas contributing to spinal alignment, muscle integrity, and balance.

Effect of hip joint mobilisations and strength training on pain, physical function and dynamic balance in patients with Knee Osteoarthritis: A randomized controlled trial.

To determine the effects of hip joint mobilisations and strengthening exercises on pain, physical function and dynamic balance in patients with knee osteoarthritis. The single-blind three-arm parallel randomised controlled trial was conducted at Sindh Institute of Physical Medicine and Rehabilitation, the outpatient department of Dow University of Health Sciences' Ojha Campus, Rabia Moon Memorial Welfare Trust and the Civil Hospital, Karachi, from January to July 2021. The sample comprised patients aged at least 50 years having knee osteoarthritis grade 1-3. The patients were randomised into 3 equal groups, with group A receiving hip mobilisations along with strengthening exercises of hip and conventional knee exercises, group B receiving strengthening exercises of hip along with conventional knee interventional exercises, and group C receiving conventional knee exercises only. Pain, physical function and dynamic balance were assessed using visual analogue scale, knee injury osteoarthritis outcome score and four-step square test, respectively, at baseline and after 18th session. Data was analysed using SPSS 21. Of the 74 subjects assessed, 66(89.2%) were included; 22(33.3%) in each of the three groups. The sample had 19(28.8%) male subjects and 47(71.2%) female. The mean age in groups A, B and C were 55.64±3.56 years, 53.64±4.65 years and 54.91±4.30 years, respectively. There was significant difference among groups post-treatment (p<0.001). Significant improvement was also found in inter-group analyses of all outcomes (p<0.001). Addition of hip joint mobilisations provided better results compared to the other two groups. https://clinicaltrials.gov/ct2/show/NCT04769531.

The association between kinesiophobia and dynamic balance in patients with patellofemoral pain syndrome.

The aim of the study was to examine the relationship between Kinesiophobia and dynamic balance in patients with patellofemoral pain syndrome (PFPS). Forty subjects with PFPS [20 Low Kinesiophobia (LK), 20 High Kinesiophobia (HK)], and 20 pain-free subjects (control group) were enrolled in the study. All subjects performed a Y-balance test to measure the dynamic balance. Normalized reach distance and balance parameters were recorded. Our findings indicated that patients with PFPS who have a greater Kinesiophobia showed a poorer dynamic balance. In addition, the HK group showed a significantly lower mean reach distance score in the anterior, posterolateral, and posteromedial directions compared to LK and healthy groups. Addressing the psychological factors such as Kinesiophobia during examination and treatment of people with PFPS may be important to improve the dynamic balance.

Influence of surgical reduction on dynamic balance in patients after unstable ankle fracture.

Influence of surgical reduction on dynamic balance in patients after unstable ankle fracture.

The test-retest reliability and concurrent validity of 360° turn test in patients with knee osteoarthritis

Purpose The aim of this study is to determine whether the 360° turn test is a reliable and valid evaluator that can be used to assess dynamic balance in patients with early (radiographic grades I and II) and advanced (radiographic grades III and IV) knee osteoarthritis. Materials and Methods This study is a methodological research. For the test time and step count of 360° turn test; test-retest reliability were determined by calculating the intraclass correlation coefficient and concurrent validity in patients with knee osteoarthritis was investigated by correlation with the timed up and go test time. Results The final analysis was made on 117 participants. The intraclass correlation coefficient values for the test time and step count of 360° turn test in patients with early knee osteoarthritis are 0.931 and 0.902, respectively, while they are 0.923 and 0.943 in patients with advanced knee osteoarthritis. The Pearson correlation coefficients between the time and step count of 360° turn test and the test time of the timed up and go test in patients with early knee osteoarthritis, respectively; while they are 0.547 and 0.388, the correlation in patients with advanced knee osteoarthritis are 0.697 and 0.700, respectively (p < 0.01). Conclusions The 360° turn test is a evaluator that has excellent test-retest reliability and moderate to strong concurrent validity in patients with both early and advanced knee osteoarthritis and can be used in the assessment of dynamic balance in this population.

Effects of One Session of Balance Exercises Combined With Olfactory Stimulation on the Static and Dynamic Balance of Patients With Stroke: A Randomized Clinical Trial

Background and Aims: Balance disorder in patients with stroke can cause the loss of independence and increase possibility of falling. The olfactory stimuli can activate the brain areas involved in balance activities. This study aims to investigate the effect of balance exercises combined with olfactory stimuli on the balance of patients with stroke. Methods: In this randomized clinical trial, 32 patients with stroke were randomly assigned into groups of balance+olfactory stimulation and balance. The first group performed the balance exercises while wearing a mask containing the lavender essential oil. The second group performed the balance exercises while wearing a mask containing distilled water. Both groups performed the exercises for 20 min at one session. The timed up &amp; go (TUG) test, 10-m walk test with self-selected speed, and Mini-Balance Evaluation Systems Test (Mini-BEST) were used for assessments. The data were analyzed in SPSS software, version 22. P&lt;0.05 was statistically significant. Results: The mean score of 10-m walk test before and after the intervention was significantly different (decreased) in the combined group (P=0.001) and balance group (P&lt;0.001). The mean TUG score before and after the intervention was also significantly different (decreased) in the combined group (P= 0.008) and balance group (P=0.003). The mean score of mini-BEST before and after the intervention was also significantly different (increased) in the combined group (P=0.001) and balance group (P= 0.008). No significant difference was observed in the mean scores of 10-m walk test (P=0.386), TUG test (P=0.720) and mini-BEST (P=0.152) between the two groups before and after the intervention. Conclusion: One session of balance exercise can improve the static and dynamic balances of patients with stroke. Including the olfactory stimulation by the lavender essential oil in the balance exercise program has no significant effect. It is recommended that the effects of long-term use of different olfactory stimuli on the balance of patients with stroke should be investigated in the future studies.

Biomechanical Asymmetry of Strength and Dynamic Balance Kinetics in Middle-Ages with Adhesive Capsulitis of the Hip.

The representative clinical features of adhesive capsulitis of the hip (ACH) are restricted range of motion (ROM) and pain. However, reports on kinetics such as strength and dynamic balance that explain physical functions are rare. This study compared subjective hip scores using Copenhagen Hip and Groin Outcome Score (HAGOS) and ROM using a manual goniometer as well as strength using isokinetic equipment, and dynamic balance through the Y-balance test, between patients with ACH and healthy individuals. Data of 193 middle-aged participants (men: 99 and women: 94) were analyzed. The ACH group scored significantly lower in all six HAGOS sub-sections. Hip joint flexion, abduction, internal and external rotation ROM were significantly lower in ACH compared to healthy group. These results were the same for men and women. In the strength of men and women, flexion, adduction, and abduction, and dynamic balance in all three directions were significantly decreased in ACH. Meanwhile, there were no significant between-group differences in the functional decrease in extension and adduction of ROM, and extension strength. In conclusion, subjective evaluation and dynamic balance of patients with ACH were decreased in the all parts. In ROM, flexion, abduction, internal rotation, and external rotation were restricted except for extension and adduction. Men and women with ACH maintained extensor strength, but had weakened strength in flexion, adduction and abduction. This information will be useful for therapists to understand the biomechanical properties of ACH and to design effective rehabilitation programs.

Effect of oscillatory whole-body vibration versus neuromuscular exercise on static and dynamic balance in patients with knee osteoarthritis

Objective: This study aimed to compare the effect of Whole body vibration (WBV) versus neuromuscular exercise (NEMEX) to prove which treatment produced significant effect on pain, knee function disability, static and dynamic postural stability in patients with knee osteoarthritis (KOA). Method: Forty-five patients (39 women and 6 men) aged 45 to 62 years with grade 2 KOA were randomly assigned into the following three groups (all n = 15): group A (control group) received traditional treatment only (US, stretching and strengthening exercise); group B received NEMEX and traditional treatment and group C received WBV exercise and traditional treatment. Outcome measures were assessed pre and post treatment and included pain severity using the Arabic numerical pain rating scale (ANPRS), functional disability by the Western Ontario and McMaster Universities Osteoarthritis index, static balance (close and open eye) by Unipedal Stance Test and dynamic stability by Biodex Balance System (BBS). Results: The within-group analysis showed significant changes in pain severity, functional disability, static and dynamic stability index in groups B and C pre and post treatment (p &lt; 0.05).

Comparative Effects of Neuromuscular- and Strength-Training Protocols on Pathomechanical, Sensory-Perceptual, and Motor-Behavioral Impairments in Patients with Chronic Ankle Instability: Randomized Controlled Trial.

(1) Background: Chronic ankle instability (CAI) is a complex condition that includes limited mobility, perceived instability, and recurrent ankle sprains are common characteristics that reduce the quality of life in subjects who suffer from CAI. Neuromuscular training and strength training have been recommended in CAI management interventions. However, there are contradictory findings on results when comparing neuromuscular training, strength training, and the control group. The objective of this study was to compare the effectiveness of 8 weeks of neuromuscular intervention training, strength training, and no intervention in a sporting population with reported CAI. (2) Methods: Sixty-seven athletes with CAI were randomly assigned to a neuromuscular training group (NG), strength training group (SG), or control group (CG). Participants completed 8 weeks of neuromuscular training (a combination of static and dynamic exercises), strength training (resistance band exercises), or no training. Outcome measures were assessed at baseline and after 8 weeks and included selfs-reported instability feeling (CAIT), dynamic balance (SEBT), ankle dorsiflexion range of motion (WBLT), and functional status (FAAM and FAAM-SPORT). (3) Results: There were significant differences between strength and control groups in the posteromedial direction of SEBT, FAAM, and FAAM-SPORT after 8 weeks of intervention. (4) Conclusions: Neuromuscular training and strength training based on resistance bands exercises showed significant improvements in ankle dorsiflexion, subjective feeling of instability, functional status, and dynamic balance in patients with CAI.

Effects of Extracorporeal Shock Wave Therapy on Ankle Function, Range of Motion, and Dynamic Balance in Patients with Chronic Ankle Instability

Effects of Extracorporeal Shock Wave Therapy on Ankle Function, Range of Motion, and Dynamic Balance in Patients with Chronic Ankle Instability

Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs

BackgroundTotal knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectively quantify these balance parameters in a clinical setting.Therefore, this pilot study aimed to evaluate the feasibility of using wearable devices in a clinical setting to examine whether people with MP-TKA have better postoperative outcomes than PS-TKA, and their balance control is more akin to age-matched asymptomatic controls.MethodsThe current cross-sectional pilot study recruited 57 participants with 2 different prosthesis designs (20 PS-TKA, 18 MP-TKA) and 19 asymptomatic controls. At 1-year post-TKA, pain, knee stiffness, and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Static balance, mobility, and gait stability of the participants were evaluated based on data collected from wearable motion sensors during the near tandem stance, timed-up-and-go, and 6-min walk tests.ResultsCompared to asymptomatic controls, both TKA groups reported significantly more pain and stiffness and demonstrated reduced functional mobility, increased stride-time-variability, and impaired balance. After Bonferroni adjustment, no significant differences in pain, balance, and mobility performance were observed between PS-TKA and MP-TKA participants 1 year after surgery. However, there was a trend for increased anteroposterior sway of the lumbar and head regions in the MP-TKA participants when undertaking the near tandem stance test. The wearable motion sensors were easy to use without any adverse effects.ConclusionsIt is feasible to use wearable motion sensors in a clinical setting to compare balance and mobility performance of patients with different TKA prothesis designs. Since this was a pilot study and no definite conclusions could be drawn, future clinical trials should determine the impacts of different TKA prosthesis designs on post-operative outcomes over a longer follow-up period.