Dynamic Balance In Patients Research Articles

Effect of Whole-Body Vibration on Dynamic Balance of People With Flexible Flatfoot in Two Different Age Groups in Fatigue Conditions: A Randomized Clinical Trial

Background and Aims Whole body vibration (WBV) is a safe and effective method to improve balance and muscle strength. Considering to the effect of foot longitudinal arch on dynamic balance, and the effectiveness of WBV in improving balance, the present study aims to assess the effects of WBV on dynamic balance of patients with flexible flatfoot. Methods In this randomized clinical trial, 80 patients with flexible flatfoot; 40 aged <18 years (Mean±SD age= 15.25±1.24) and 40 aged >20 (Mean±SD age= 22.57±1.48). They were randomly divided into two intervention groups of <18 and >20 years and two control groups of <18 and >20 years. The intervention groups received four weeks of WBV. In the control groups, no intervention was carried out. The fatigue was induced by running on a treadmill at different speeds and inclinations according to the Bruce protocol. Dynamic balance was assessed using the Biodex Balance System at anterior-posterior and medial-lateral directions and in overall. Results The repeated measures analysis of variance and Bonferroni test results showed that the mean dynamic balance in overall and at anterior-posterior and medial-lateral directions were significantly increased in the intervention groups compared to the control groups (P<0.001). Moreover, the dynamic balance showed a significant increase in the intervention group aged <18 years compared to the intervention group aged >20 years (P<0.001). Conclusion The WBV can be used to improve the dynamic balance of people with flexible flatfoot even in fatigue conditions.

The effect of high intensity combined training on functional capacity, muscle strength, body composition, agility and dynamic balance in patients with coronary artery disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction There is still controversy regarding the exercise characteristics that are more effective for improving peak oxygen uptake (VO2 peak), cardiac and metabolic function. High- intensity interval exercise training (HIIT) has been shown to elicit comparable and/or superior performance on endurance capacity (EC), ventricular function (VF) and quality of life. By other side, there is robust evidence that combined endurance and strength training is significantly more effective than endurance training only for improving EC, muscle mass and muscle strength. There is no enough information if the combination of HIIT with high strength training (HST) could enhance the physical conditions of these patients. Purpose The purpose of our study was to analyze the combination of HIIT + HST and its effect on physical performance compared to different types of combined training: HIIT and MCT with low load resistance training (RT) and HIIT or MCT only. Methods We evaluated 140 male patients (p) with CAD documented by angiographic studies, clinically stables with medical treatment and sinus rhythm. All of them performed a stress testing in treadmill without handrail support using a ramp protocol until maximal effort. VO2 peak (ml/kg/min) was measured indirectly through ACSM formula. We used YMCA´s method of estimating body fat with measurement of skinfolds in four sites (BF %), 30-second chair stand test (CST), 8-foot up and go test (FUGT), six-minute walk test (T6min) and one maximum repetition for quadriceps extension (1RMq) .Training intervention: p were randomly allocated to HIIT + RT (n=30), MCT + RT (n=30), HIIT (n=30), MCT (n=30) and HIIT + HST (n=20) during 3 month period of training. HIIT: 4 x 4 (85-95% peak heart rate) and 60-70% during active breaks. (36 min) MCT: 70-75% peak heart rate.(36 min) RT: 40-50% 1RM for lower body with 12-15 repetitions in 2 sets HST: ≥ 70% 1RM for lower body with low number of repetitions. Statistical analysis: all data were analyzed using IBM SPSS V.24. Comparisons were performed by following one-way ANOVA(parametric distribution) with post-hoc Tuckey or Kruskal-Wallis(non parametric distribution). The level of statistical significance was P< 0.05. Results Analyzing values pretraining (PRE) vs. postraining (POST), VO2 peak increased significantly by 27,52% for HIIT + HST P< 0,03 vs. HIIT + RT- MCT + RT and MCT. A positive effect in HIIT + HST with FUGT P< 0,001 and CST P< 0,005 between group changes and favourable observations in relation to 1RMq (PRE 60,00 ± 9,07 vs. POST 73,00 ± 9,86) and %BF(PRE 26,60 ± 3,21 vs. POST 24,80 ± 3,72) compared to MCT and HIIT P < 0,05. We didn´t find statistical significant differences with both modalities of combined training (low workloads) and HIIT for T6min. Conclusions High intensity combined training (HIIT + HST) had an additional effect related to others aerobic and resistance exercises attributed to neuromuscular adaptations, increased power and muscle strength.

Influence of Hamstring Facilitatory Taping on Knee Muscle Activation and Dynamic Balance in Patients with Anterior Cruciate Ligament Deficient Knee

Influence of Hamstring Facilitatory Taping on Knee Muscle Activation and Dynamic Balance in Patients with Anterior Cruciate Ligament Deficient Knee

The effects of proprioceptive neuromuscular facilitation in treating chronic low back pain: A systematic review and meta-analysis.

Proprioceptive neuromuscular facilitation (PNF) has been widely used in the clinical treatment of chronic low back pain (LBP) in recent years. However, its role remains controversial and it is unclear whether PNF offers more advantages for patients with chronic LBP. The purpose of this systematic review is to evaluate the evidence on the effect of PNF on pain, waist function, pulmonary function and dynamic balance in patients with chronic LBP. Seven English and Chinese electronic databases were searched to identify articles published from 1970 to February 2020. Relevant randomized controlled trials (RCTs) were selected by two independent reviewers to investigate PNF in treatment of chronic LBP. Data extraction was performed by the same reviewers. Twelve eligible trials involving 410 participants were included in this meta-analysis. Compared with the control group, the aggregated results suggested that PNF showed beneficial effects in relieving pain (SMD =-1.17; 95% CI: -1.50 to -0.84; p< 0.00001) and improving waist functional disability (MD =-1.63; 95% CI: -1.89 to -1.37; p< 0.00001). In addition, PNF was shown to have a significant effect on pulmonary function (MD = 0.65; 95% CI: 0.26 to 1.03; p= 0.001). However, the results of the study show that PNF could not significantly improve dynamic balance in patients with chronic LBP compared with the control group (MD =-0.04; 95% CI: -2.16 to 2.08; p= 0.97). A high risk of bias occurred in the areas of blinding (i.e., participants/personnel and outcome assessment). PNF showed more beneficial effects in pain relief and waist function improvement in patients with chronic LBP in the short term (4 to 8 weeks of intervention) or at 12-week follow-up and also played a positive role in pulmonary function. However, no significant effect of PNF on dynamic balance was found compared with the control group. However, these results have certain limitations, and these conclusions were supported by low-quality data. Therefore, articles that are methodologically reasonable and more authoritative are required to verify the effects. In addition, articles with long-term follow-up and other outcomes are needed to confirm additional findings.

The 2-Minute Step Test

Background: The 2-minute step test (2MST) evaluates aerobic endurance in patients with Parkinson's disease and can act as a dual test that also evaluates balance. The aim of this study was to observe how the 2MST behaves in the different Hoehn &amp; Yahr stages of patients with Parkinson's disease and ascertain whether this test can be used to assess the degree of balance presented by patients with Parkinson's disease. Methods: A total of 91 people with Parkinson's disease were studied using the 2MST, 8-Foot Up-and-Go, and 6-minute walk test. Results: The Pearson correlation was performed between the 2-MST and the other 2 tests (8-Foot Up-and-Go and 6-minute walk test). A significant correlation was observed for the 2MST and the 8-Foot-Up-and-Go, which increased as the disease stage advanced, but the 6-minute walk test showed a significant correlation for Hoehn &amp; Yahr stages I and II. Conclusion: We suggest that the 2MST assess both aerobic endurance and dynamic balance in patients with Parkinson's disease with Hoehn &amp; Yahr stages I and II but that it be used to assess balance in stages III and IV.

Effectiveness of physical exercise for improving static and dynamic balance in patients with osteoporosis

Abstract Background Osteoporosis is a metabolic disease widely spread both worldwide and in our country, being a major public health problem, with serious social and psychological consequences, by the huge costs involved, as well as by its high morbidity. Aim We intend to prove the effectiveness of using physical exercise for improving static and dynamic balance in patients with osteoporosis. Methods Our research includes 8 women aged between 50 and 70 years, diagnosed with postmenopausal osteoporosis. The patients were evaluated before and one month after the physical exercise program, using the “Timed Up and Go” Test and the Berg Balance Scale. Results All patients included in this research experienced improvements in postural stability, static and dynamic balance. Conclusions After performing a one-month program of specific physical exercise, with a frequency of 3-4 times a week, the risk of falls decreases, increasing the static and dynamic balance.

Efficacy of chest expansion resistance exercise on respiratory function, trunk control and dynamic balance in patients with chronic stroke: A Comparative study.

BackgroundMotor impairments caused by stroke result in impaired diaphragmatic and respiratory muscle function, changes in thoracic biomechanics on the hemiparetic side ultimately resulting in decreased efficiency of lung ventilation. This study aimed to examine the efficacy of chest expansion resistance exercise (CERE) on respiratory function, trunk control ability, and balance in patients with chronic stoke. Following a purposive sampling, thirty-five patients with chronic stroke were randomly allocated into two groups, i.e., the experimental group receiving CERE with conventional therapy and the control group receiving conventional therapy alone. Both the groups received therapy four times per week for a period of four weeks (total 16 sessions). Following assessments were done before and after treatment in both the groups: chest expansion ( axillary, nipple, xiphisternal levels) using measure tape, respiratory muscle strength using micro-respiratory pressure meter, trunk control using the Trunk Impairment Scale, and balance using mini-Balance Evaluation Systems Test.ResultsBoth groups had 17 participants each (n = 34, drop-outs = 1) consisting of 12 males and 5 females having a mean age of 56.5 ± 12.98 years and 59.7 ± 10.2 years, respectively. Intra-group analysis showed a statistically significant increase in mean values of chest expansion, respiratory muscle strength, trunk control ability, and balance in the experimental group whereas the control group showed improvement only in trunk control ability and balance. Inter-group comparison revealed a better improvement in all the outcome variables in experimental group compared to the control group.ConclusionsBased on these results, this study proved that CERE was more effective in improving respiratory function, trunk control, and balance in patients with chronic stroke.

The Impact of Strengthening Exercise on Dynamic Balance in Patients with Knee Osteoarthritis

Background: Knee osteoarthritis is characterised clinically by usage-related pain and/or functional limitation. OA that is associated with physical dysfunction and decline in health-related quality of life caused the main disability worldwide and is expected to increase due to aging and obesity rates and further load on the population and health system. The strengthening exercises that normally used is knee flexion and extensions, isometric quadriceps exercise, isometric hamstring exercise, and sit to stand to improve the balance. Objectives: is to find out the impact of Strengthening exercise on Balance in patients with knee Osteoarthritis Study Design: Quasi experimental study Methods: Fifty-six (n=56) of knee OA patients were involved in this study by judgemental sampling design. Researcher will first demonstrate and explain the Y-balance tools testing procedure based on Plisky and colleagues study. Participants are given to practice six trials before the formal testing, stated that SEBT have a significant learning effect and found that the reaching distances reached the longest distance after six trials and then will be constant. Results: Independent t-test shows significant difference in only anterior direction. In the experimental group the mean value is 69.83 with a SD of 11.62 while in the control group the mean value is 63.51 with a SD of 11.36; p-value of .045 and t-value of 2.056. In postero-lateral directions result shows there is no significant difference, experimental group the mean value is 91.10 with a SD of 9.74 while in control group mean value is 90.88 with SD value of 12.68; p-value of .947 and t-value of .067. Result of postero-medial shows no significant difference too, in experimental group the mean value of 95.16 with SD of 10.92 while in control group the mean value is 93.40 with SD of 8.20; p=value of .501 and t-value of .678. Conclusion: This study has proven strengthening exercise using YBT improved only anterior direction of YBT but no significant difference in postero-lateral and postero-medial direction. Key Words: Knee Osteoarthritis, Strengthening exercise, Dynamic Balance, Star excursion test

Non-Immersive Virtual Reality to Improve Balance and Reduce Risk of Falls in People Diagnosed with Parkinson’s Disease: A Systematic Review

(1) Objective: To evaluate the effectiveness of non-immersive virtual reality in reducing falls and improving balance in patients diagnosed with Parkinson’s disease. (2) Methods: The following databases were searched: PUBMED, PEDro, Scielo, CINAHL, Web of Science, Dialnet, Scopus and MEDLINE. These databases were searched for randomized controlled trials published using relevant keywords in various combinations. The methodological quality of the articles was evaluated using the PEDro scale. (3) Results: A total of 10 studies with a total of 537 subjects, 58.7% of which (n = 315) were men, have been included in the review. The age of the participants in these studies ranged between 55 and 80 years. Each session lasted between 30 and 75 min, and the interventions lasted between 5 and 12 weeks. These studies showed that non-immersive virtual reality is effective in reducing the number of falls and improving both static and dynamic balance in patients diagnosed with Parkinson’s disease. Results after non-immersive virtual reality intervention showed an improvement in balance and a decrease in the number and the risk of falls. However, no significant differences were found between the intervention groups and the control groups for all the included studies regarding balance. (4) Conclusions: There is evidence that non-immersive virtual reality can improve balance and reduce the risk and number of falls, being therefore beneficial for people diagnosed with Parkinson’s disease.

Immediate effects of footwear with vibration applied to the swing phase of the gait cycle on dynamic balance in patients with diabetic peripheral neuropathy

Sensory and sub-sensory foot vibration have beneficial effects on the static and dynamic balance of patients with diabetic peripheral neuropathy (DPN). Previous foot vibration during walking was applied at sub-sensory threshold in both stance and swing phases of the gait cycle in DPN. This study aimed to investigate the effects of footwear with vibration above the sensory threshold applied to the swing phase of the gait cycle on the dynamic balance of DPN. Fifteen patients with DPN and 10 matched healthy control participants were enrolled in this study. Dynamic balance assessment was investigated by the sit to stand and turn tests while electromyography activity (root mean square, RMS) of the vastus lateralis (VL), tibialis anterior (TA), and peroneus longus (PL) muscles were recorded at baseline, after 10 min of wearing the vibratory sandal without vibration, and after 10 min of wearing the sandal with vibration. Repeated measure analysis of variance was conducted for data analysis. Wearing the vibratory sandal slightly increased the speed of weight transfer in both groups and COP sway in DPN (P > 0.05), and close to significant decrease of turn sway (P = 0.07) in both groups. There were significant differences of the PL RMS in turn test (P = 0.03) in DPN and peak RMS of the PL after 10 min of wearing the sandal with vibration in both groups (P < 0.05). The results of the present study demonstrated that PL activity was significantly influenced by the vibratory sandal as its tendon passing across the sole and in direct contact with the source of the vibration.

Assessment of static and dynamic balance in patients after total hip arthroplasty based on the Tinetti Test

Introduction: A degenerative disease of a hip joint (osteoarthritis) is a chronic affliction which causes progressive degeneration of a hip joint and tissue located around it. It inflicts limitation of locomotor skills, deteriorates life quality to a significant extent, and prevents a patient from normal activities in daily life. In Poland, more than 3 million people suffer from osteoarthritis. The disease symptoms are pain, limitation of mobility scope in a joint, postural and gait disorders, and positioning of a lower limb in non-functional position. The aim of the study was to analyze the gait pattern and to assess the static and dynamic balance of people qualified for hip joint arthroplasty, as well as possibility of falling.Material and methods: The Tinetti Test has been used for the research in question. This test has been completed in patients awaiting for hip joint arthroplasty, and once more on a third day upon completion of arthroplasty, in the Department and Clinic of Orthopaedics, Traumatology and Oncology of Locomotor System of the Pomeranian Medical University in Szczecin. This test has included a group of 31 – 11 women and 20 men.Results: The mean age of the research group was 65.1 years. The intensity of pain in the hip joint, based on the VAS scale before and after the procedure, was 6.53 and 5.22 points, respectively. The average number of points obtained by the patient in the Tinetti Test before the surgery was 22.71 points. On the third day of hip surgery, the mean number of points decreased to 18.81 points.Conclusions: Patients treated with alloplastic surgery of a hip joint show lower static and dynamic balance. Upon completion of the surgery, the patients are more prone to fall. The patients with completed hip joint arthroplasty show symptoms of locomotor system disorders.

The effect of virtual reality on restoring the balance of adult patients with spinal cord injury

Spinal cord injury (SCI) is a type of injury that presents a high degree of disability and causes motor and sensory deficits. Applying virtual reality (VR) therapy can help better rehabilitate patients with SCI by improving their balance and other functional parameters. The aim of this review is to describe recent research data on the efficacy of this method in improving balance in adult patients with SCI. The Google Scholar, PubMed, Scopus and PEDro databases were searched for articles published from 2015 to date in English with the following keywords: spinal cord injury, virtual reality, balance, rehabilitation. The review included 10 articles (five clinical trials and five systematic reviews). Discussion-Conclusions: The application of VR can significantly contribute to the improvement of static, postural and dynamic balance in patients with SCI. The results of this review show that approximately 20 sessions of 30-60 minutes each are able to improve balance in these patients. More clinical studies are needed to draw safer conclusions.

Effect of dual-task training on balance in patients with multiple sclerosis: A systematic review and meta-analysis

Objective: To evaluate the effects of dual-task training on static and dynamic balance in patients with multiple sclerosis. Data sources: PubMed/MEDLINE, EMBASE, Scopus, and PEDro databases were searched from inception to March 1, 2021. Methods: This study was conducted in agreement with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers assessed studies for inclusion and extracted data. We used the Physiotherapy Evidence Database scale to evaluate the methodological quality and the risk-of-bias. Randomized clinical trial data were pooled for the meta-analysis. The effect sizes and 95% confidence interval (CI) were calculated by random-effect models. Egger regression and Begg-Mazumdar rank correlation test were used for publication bias. Results: A total of 13 studies involving 584 patients (42.3 ± 9 years mean ± SD; 377 females) met the inclusion criteria for the systematic review, while nine were included in the meta-analysis. People who received dual-task training interventions showed significant improvements in the Timed Up & Go test 0.44 [(95% CI = 0.22; 0.65), P-value<0.001], and in the Berg Balance scale 0.46 [(95% CI = 0.07; 0.85), P-value = 0.02]. Low and moderate heterogeneity between the studies was found for the Timed Up & Go test and the Berg Balance scale, respectively. Conclusion: The findings from the current meta-analysis support dual-task training as a beneficial therapy for improving dynamic balance and functional mobility in patients with multiple sclerosis. The limited number of studies that investigated static balance performance after dual-task training do not currently allow us to draw a conclusion about any possible improvements in this ability.

Effect of Auditory Stimulus using White Nosie on Dynamic Balance in Patients with Chronic Stroke during Walking

Objective: This study aimed to investigate the effect of white noise on dynamic balance in patients with stroke during walking. Method: Nineteen patients with chronic stroke (age: 61.2±9.8 years, height: 164.4±7.4 cm, weight: 61.1±9.4 kg, paretic side (R/L): 11/8, duration: 11.6±4.9 years) were included as study participants. Auditory stimulus used white noise, and all participants listened for 40 minutes mixing six types of natural sounds with random sounds. The dynamic balancing ability was evaluated while all participants walked before and after listening to white noise. The variables were the center of pressure (CoP), the center of mass (CoM), CoP-CoM inclined angle. Results: There is a significant increase in the antero-posterior (A-P) CoP range, A-P inclination angle, and gait speed on the paretic and non-paretic sides following white noise intervention (p<.05). Conclusion: Our findings confirmed the positive effect of using white noise as auditory stimulus through a more objective and quantitative assessment using CoP-CoM inclination angle as an evaluation indicator for assessing dynamic balance in patients with chronic stroke. The A-P and M-L inclination angle can be employed as a useful indicator for evaluating other exercise programs and intervention methods for functional enhancement of patients with chronic stroke in terms of their effects on dynamic balance and effectiveness.

Effect of Body Weight Support Treadmill Training on Gait Recovery, Lower Limb Function and Dynamic Balance in Patients with Chronic Stroke: A Randomised Controlled Trial

Introduction: Stroke is an omnipresent health problem that causes impairments in multiple domains and often leads to serious long-lasting consequences like pathological gait patterns. Gait rehabilitation is an important criterion for improvement in functionality. Body Weight Supported Treadmill Training (BWSTT) is being used as a method of gait rehabilitation, but efficiency of this method beyond traditional training is lacking evidence. Aim: To evaluate the effect of body weight supported treadmill training on gait recovery, lower limb function and dynamic balance in chronic stroke patients. Materials and Methods: A randomised controlled trial conducted in the Department of Neurorehabilitation of a specialty hospital, on 30 ambulatory chronic stroke patients having post stroke duration of six months or more. Study subjects were randomised into two groups. Group A received BWSTT with conventional rehabilitation for four weeks. Group B received only conventional rehabilitation for four weeks. Duration of conventional rehabilitation was 40 minutes in each group. Along with that group A received 20 minutes BWSTT and group B received 20 minutes of conventional gait training. Therapy was given three days a week. Assessment tools were Timed Up and Go test (TUG), Cadence, 10 metre Walk Test and Berg Balance Scale (BBS). The paired t-test was used for intragroup analysis and the unpaired t-test was used for intergroup analysis. Results: Total of 30 patients were registered in the study with mean age (years) 52.07±3.6736 and 52.40±3.906 for group A and group B, respectively. There was significant improvement in all outcome measures, e.g., BBS, TUG, 10 metre walk test and Cadence, in both the groups, pre and post intervention, but group A showed statistically significant improvement in parameters like dynamic balance, walking speed, and postural control and walking function (p&lt;0.05). Conclusion: The BWSTT offers improvement in gait, in terms of walking speed, dynamic balance, posture control, that is significantly more than that of conventional gait training, as found in this study. The BWSTT might be included as a part of stroke rehabilitation program. Further multicentre studies with larger samples can throw more light on the intensity, dosage and methods of using BWSTT.

Effect of Systematic Corrective Exercises on the Static and Dynamic Balance of Patients with Pronation Distortion Syndrome: A Randomized Controlled Clinical Trial Study.

Background:The purpose of this study was to determine the effect of systematic corrective exercises on the static and dynamic balance of students with pronation distortion syndrome.Methods:In this randomized controlled clinical trial study, 30 volunteers were selected and randomly divided into the control and experimental groups (15 subjects per group). The experimental group performed systematic corrective exercises for 12 weeks, while the control group performed the routine exercise. Static and dynamic balance was evaluated before and after the interventions. The data were analyzed using independent and paired t-tests (P < 0.05).Results:The results showed significant improvement (P < 0.05) in the static and dynamic balance in the experimental group, but not in the control group. A significant difference was evident between the experimental and control groups in terms of static and dynamic balances, in static balance including Flamingo balance test (42.26 ± 5.35 vs. 10.13 ± 1.92) stabilometr (1.23 ± 0.48 vs. 3.71 ± 1.02), and in dynamic balance including star excursion balance test (anterior direction 82.4 ± 6.2 vs. 66.7 ± 6.9, Posterior-internal direction 87.8 ± 4.7 vs. 69.6 ± 6.3, posterior-external direction 86.06 ± 6.93 vs. 67.2 ± 6.2), stabilometr (3.8 ± 0.6 vs. 11.18 ± 1.8) (P < 0.05 for all variables).Conclusions:It can be concluded that systematic corrective exercises improve static and dynamic balance in students with pronation distortion syndrome and it could be recommended as modalities for these people.

Quantifying balance deficit in people with ankle fracture six months after surgical intervention through the Y-Balance test

BackgroundAnkle fractures are among the most common traumatic fractures and have a great socio-economic impact. Consequences of an ankle fracture requiring surgical treatment (e.g. pain, reduced ankle range of motion (ROM), muscle weakness, etc.) lead to balance deterioration, which has a profound impact on activities of daily living. However, to the best of the authors' knowledge, no reliable clinical tests are available to monitor balance in patients after ankle surgery. ObjectivesTo quantify single-leg dynamic balance in patients with bimalleolar ankle fracture through the Y-Balance test (YBT). The second objective was to analyze the impact of ankle dorsiflexion ROM and hip strength on balance to optimize balance rehabilitation programs. DesignCross-sectional study. Methods22 participants, who had undergone surgery after bimalleolar ankle fractures, were assessed for ankle ROM, hip strength, and dynamic balance six-months after the surgical intervention. The within-session reliability of YBT was calculated through the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM). Student's t-tests were used to assess leg differences. A multiple regression analysis was performed to evaluate the role of ankle dorsiflexion ROM and hip abductor and adductor strength in predicting balance performance. ResultsYBT showed high-to-excellent within-session relative reliability (Healthy leg: 0.85 ≤ ICC≤0.96; Operated leg: 0.84 ≤ ICC≤0.96). SEM values were below 3.3 %. The operated leg showed significant lower YBT scores for anterior reach direction (−9.0 %; g=−0.70) and composite score (-4.5 %; g=−0.34). Multiple regression analysis showed that both, ankle dorsiflexion and hip abductor and adductor strength explained 66 % of the variance in the YBT anterior direction of the operated leg. ConclusionsThe YBT is a reliable tool that allows the quantification of single-leg dynamic balance impairments from 6-months after surgery in patients with bimalleolar ankle fracture. Between-leg YBT differences in the anterior direction can be used as reference scores (3.3 %) for balance restoration. Balance rehabilitation programs should focus on improving ankle functionality and reducing hip muscle weakness with specific hip strength exercises and balance exercises with similar demands to the reaching tasks of the YBT to promote a faster recovery.

Preliminary Clinical Trial of Balance Compensation System for Improvement of Balance in Patients With Spinocerebellar Ataxia.

ObjectiveTo determine the immediate and short-term impact of the application of wearable balance compensation system (BCS) on balance impairment in patients with spinocerebellar ataxia (SCA).MethodsThe study enrolled 6 participants with SCA with varying degrees of balance impairment. After adjustment for individual fitting, wearable BCS with up to 3% body weight was placed in a garment on the trunk. Sway direction and magnitude were measured with sensors placed posteriorly at the lumbosacral junction, immediately before and after, and at day 1, day 2, and day 7 after wearing the BCS. Timed Up & Go test (TUG) and 25-foot timed walk test were performed, and static foot pressure was measured.ResultsA significant improvement in static and dynamic balance was found during the 25-foot timed walk and in static foot pressure measurement results after wearing the BCS, when compared with that at baseline (p=0.044 vs. p=0.011). Anterior and posterior sway showed improvements from baseline after wearing the BCS. Improvement in the lateral swaying movement control was also seen.ConclusionApplication of the BCS might be beneficial in the improvement ofthe static and dynamic balance in patients with SCA. Further research on long-term effects and with a larger sample size is indicated.

Effects of eight-week water versus mat pilates on female patients with chronic nonspecific low back pain: Double-blind randomized clinical trial

ObjectiveTo evaluate the effects of water and mat Pilates on pain, disability, and static and dynamic balance in patients with chronic nonspecific low back pain (CNLBP). MethodsTwenty-four participants with CNLBP were randomly allocated into two groups (n = 12) that perform water and mat Pilates exercises for 24 sessions (8-week, 3 sessions per week). The value for pain, disability and balance were measured before and after the exercise program using the Visual Analogue Scale, Oswestry Disability Questionnaire and Biodex Balance System respectively. ResultsA paired t-test revealed significant differences in pain severity and disability in both groups after they performed the Pilates program (P ≤ 0.05). Mat Pilates improved static balance as the participants performed the tests with their eyes open and closed (P = 0.02, P = 0.04). Its effect on dynamic balance, however, was not statistically significant (ES = 0/33, P = 0/34). The same Pilates program performed in water did not show significant effects on balance despite a decline in body sway (P˃0/05). There was no difference between the two groups (P˃0/05). ConclusionThe results suggest that both mat and water Pilates exercise program have beneficial effects on the treatment of LBP. Nevertheless, the low impact of the mat and water Pilates program on balance improvement suggests more investigation on Pilates training or complementary exercises to improve balance in patients with CNLBP.

Gait training with auditory feedback improves trunk control, muscle activation and dynamic balance in patients with hemiparetic stroke: A randomized controlled pilot study.

Auditory feedback enables an individual to identify and modify the differences between actual and intended movement during the motor learning process. We investigated the effects of gait training with auditory feedback on trunk control, muscle activation, and dynamic balance in patients with hemiparetic stroke. Twenty participants with hemiparetic stroke were recruited in this study and randomly assigned to the experimental (n= 10) or control (n= 10) group. The subjects in the experimental group participated in gait training with auditory feedback for 30 minutes, 5 times a week, for 4 weeks, whereas those in the control group received conventional gait training for 30 minutes, 5 times a week, for 4 weeks. During auditory feedback training, a beeping sound is produced every time a patient loaded weight that was higher than the preset threshold on the cane. Activation of the erector spinae muscle was measured using surface electromyography, and trunk control was evaluated using the Trunk Impairment Scale (TIS). Dynamic balance was measured using the Timed Up and Go (TUG) test. Muscle activation was significantly higher in the experimental group than in the control group (6.6 ± 9.2% vs 1.4 ± 5.4% nonparetic peak activity). No significant difference was found in the TIS score between the experimental and control groups. Based on the TUG test, a significant improvement was observed in the experimental group compared to the control group (12.1 ± 11.4 vs 3.8 ± 4.7 s). Our findings indicate that gait training with auditory feedback was beneficial for improving trunk control and muscle activation in patients with hemiparetic stroke.