Dynamic Balance In Patients Research Articles

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.

Comparison of the Effects of Native Vitamin D and Eldecalcitol on Muscular Strength and Dynamic Balance in Patients with Postmenopausal Osteoporosis.

ABSTRACTObjectives:Previous studies have suggested that the effects of vitamin D in preventing osteoporotic fractures result in part from its influence on fall prevention. However, the effects of vitamin D on dynamic balance as a contributor to fall prevention have not been fully evaluated. Moreover, few studies have compared the effects of native and active forms of vitamin D. The objective of this preliminary randomized prospective study was to compare the effects of native vitamin D and eldecalcitol on muscular strength and dynamic balance in postmenopausal patients undergoing denosumab treatment for osteoporosis.Methods:A total of 30 women with postmenopausal osteoporosis were randomly assigned to a native D group (administered denosumab and native vitamin D with calcium) or an ELD group (administered denosumab and eldecalcitol) and were followed up for 6 months. The following parameters were compared: the strengths of the back extensor and lower extremity muscles; static balance evaluated using the one-leg standing test; and dynamic balance evaluated using the 10-m walk test, the functional reach test, the timed up and go test, and the total length of the trajectory of the center of gravity (LNG) measured using a dynamic sitting balance measurement device.Results:Compared to baseline measurements, back extensor and knee extensor strengths had significantly increased after 6 months of treatment in the native D group (P<0.05) but not in the ELD group. In contrast, LNG significantly improved in both groups after 6 months (P<0.05). No significant differences between the two groups were seen in any of these measured parameters after treatment.Conclusions:Both native vitamin D + denosumab and eldecalcitol + denosumab were effective for improving dynamic sitting balance in postmenopausal women with osteoporosis.

The Effect of Task-Oriented Training for Trunk Stabilization on Trunk Stability, Lower Extremity Coordination and Dynamic Balance of the Stroke Patient

Purpose: This study aimed to evaluate the effect of task-oriented training on trunk stabilization, coordination of the lower extremities, and dynamic balance of patients with stroke. Methods: Ten patients with stroke were randomly divided into two groups of five patients each who met the selection criteria. The training was conducted five times a week for 60 minutes. The experimental group received task-oriented training and general physical therapy, while the control group received only general physical therapy. The Mann-Whitney U test was used to compare differences between the groups, and the Wilcoxon signed-rank test was used to compare differences between pre- and post-intervention within each group. Results: Trunk stabilization was measured using the trunk impairment scale. Only the coordination assessment on the trunk impairment scale was statistically significant after intervention in the experimental group (p = 0.046) and between the experimental and control groups (p = 0.029). The LEMOCT, figure-of-8 walk test (F8WT), timed up-and-go (TUG) test results were not statistically significantly different in the group after intervention. However, the F8WT and TUG test results showed a statistically significant difference between the experimental and control groups (p = 0.029). Conclusion: The task-oriented training showed positive effects on the trunk stabilization, coordination of the lower extremities, and dynamic balance of the patients with stroke.

CORR Insights®: Do External Supports Improve Dynamic Balance in Patients with Chronic Ankle Instability? A Network Meta-analysis.

CORR Insights®: Do External Supports Improve Dynamic Balance in Patients with Chronic Ankle Instability? A Network Meta-analysis.

Effects of a 6-week intrinsic foot muscle exercise program on the functions of intrinsic foot muscle and dynamic balance in patients with chronic ankle instability.

We aimed to evaluate the effects of a 6-week intrinsic foot muscle exercise program on the activation of intrinsic foot muscle movement and dynamic balance in adults with chronic ankle stability. A total of 30 adults with chronic ankle instability were recruited. The participants were randomly assigned to a group performing intrinsic foot muscle exercises and a control group doing no exercises. We measured the activation rate and dynamic balance of the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis, and quadratus plantae before and after the intervention. We found that the activation rate and dynamic balance significantly increased in all intrinsic foot muscles in the experimental group. These results suggest that intrinsic foot muscle exercise for patients with chronic ankle stability is an effective treatment for improving the functions and balance ability of the intrinsic foot muscles.

Is an Elastic Ankle Support Effective in Improving Jump Landing Performance, and Static and Dynamic Balance in Young Adults With and Without Chronic Ankle Instability?

In some patients, ankle sprains lead to chronic symptoms like pain or muscular weakness called chronic ankle instability (CAI). External ankle supports have shown to be effective in preventing sprains and reducing recurrence, but the underlying mechanisms are unclear. As sensorimotor variables are associated with injury incidence, an influence of external ankle support on landing performance and balance seems plausible. To analyze the effects of an elastic ankle support on jump landing performance and static and dynamic balance in patients with CAI and healthy controls. Crossover study. Functional tests in a laboratory setting. Twenty healthy students and 20 patients with CAI were included for study participation based on their scores in ankle stability and function questionnaires. Healthy and CAI participants performed each test with and without an elastic ankle support. (1)Jump landing performance was measured with the Landing Error Scoring System, (2)static balance was assessed with the Balance Error Scoring System, and (3)dynamic balance was assessed using the Y Balance Test. Linear mixed models were used to analyze the effects of the elastic ankle support on sensorimotor parameters. Healthy controls performed significantly better in the Landing Error Scoring System (P = .01) and Y Balance Test anterior direction (P = .01). No significant effects of elastic ankle support on Landing Error Scoring System, Balance Error Scoring System, or Y Balance Test performance were observed in the CAI or control group. There were no significant group-by-ankle support interactions. In the current study, the acute use of elastic ankle support was ineffective for enhancing jump landing performance, and static and dynamic balance. Further research is needed to identify the underlying mechanisms of the preventive effects of elastic ankle support.

Do External Supports Improve Dynamic Balance in Patients with Chronic Ankle Instability? A Network Meta-analysis.

To improve ankle stability in patients who have experienced an ankle sprain with residual symptoms of instability and/or objective joint laxity, external supports (such as taping, bracing, and orthotic insoles) are used sometimes. However, available randomized trials have disagreed on whether restraints improve balance in those individuals. In this situation, a network meta-analysis can help because it allows for comparing multiple treatments simultaneously, taking advantage not only of direct but also indirect evidence synthesis. The aim of this network meta-analysis was to assess (1) the impact of taping and orthotic devices on dynamic postural control in individuals with ankle instability and (2) the presence of a placebo effect in participants treated with sham taping and complications resulting from the administered treatments. We searched the PubMed, Scopus, and CENTRAL databases up to February 13, 2019 for completed studies. Randomized trials assessing the results of real and/or sham taping, wait-and-see protocols, ankle bracing, and foot orthotics for ankle instability as determined by one or more ankle sprains followed by ongoing subjective symptoms and/or mechanical laxity were included. We evaluated dynamic postural control in terms of the Star Excursion Balance Test in the posteromedial direction (SEBT-PM), which is considered the most representative of balance deficits in patients with ankle instability. Standardized mean differences were re-expressed to percentage differences in SEBT-PM, with higher scores representing possible improvement. Subsequently, those data were checked against the established minimal detectable change of 14% for this scale to make judgements on clinical importance. We also assessed the presence of a placebo effect by comparing the results of sham taping with no treatment and complications resulting from the administered treatments. Additionally, we judged the quality of trials using the Cochrane risk of bias tool and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. A total of 22 trials met our inclusion criteria, 18 of which were deemed to be at a low risk of bias. A network of treatments consisting of 13 studies was created, and the level of evidence was judged to be high. As far as participants' allocation to treatment arms, 85 patients followed a wait-and-see protocol, 29 received placebo taping, 99 were treated with taping, 16 were treated with bracing, 27 were administered insoles, and six individuals were offered a combination of insoles with bracing. Of note, with statistical power set at 80%, a minimum of 16 patients per treatment group was required to provide sufficient statistical power and detect a SEBT-PM percentage difference of 14%. A network meta-analysis did not demonstrate a benefit of taping or bracing over no treatment (percentage difference in SEBT-PM between taping and bracing versus control: -2.4 [95% CI -6 to 1.1]; p = 0.18, and -7.5 [95% CI -15.9 to 1]; p = 0.08, respectively). This was also the case for sham taping because the measurement increase failed to exceed the minimal detectable change (percentage difference in SEBT-PM between sham taping and untreated control: -1.1 [95% CI -6.9 to 4.7]; p = 0.72). Importantly, there were no reported adverse events after treatment application. Evidence of moderate strength indicated that external supports of any type were no more effective than controls in improving dynamic postural control in patients with at least one ankle sprain and residual functional or mechanical deficits. Therefore, implementing those tools as a standalone treatment does not appear to be a viable strategy for the primary management of ankle instability. It is conceivable that combinations of rehabilitation and external supports could be more effective than external supports alone, and future trials should evaluate the potential of such combinations in enhancing not only clinician-reported but also patient-oriented outcomes using long-term follow-up measurements. Level I, therapeutic study.

Efficacy of Shockwave Therapy Versus Therapeutic Exercises on Pain and Dynamic Balance in Patients with Plantar Fasciitis

AbstractBackground: Plantar fasciitis (PF) is a painful disorder of the plantar fascia. It is the most common cause of plantar heel pain and accounts for approximately 11-15% of foot symptoms presenting to physicians.Aim of Study: The purpose of this study was to compare the effects of radial shock wave (RSW) alone, therapeutic exercises (stretching and strengthening) alone and RSW combined with therapeutic exercises (stretching and strength-ening) on pain severity and dynamic balance in patients with chronic plantar fasciitis (CPF).Methods: Forty five males and females patients with unilateral CPF participated in this study; their age ranged from 40-50 years. Patients randomly assigned into three groups. Group (A): Received three sessions of RSW therapy. Group (B): Received stretching and strengthening exercises as a home program. Group (C): Received three sessions of RSW therapy (one session every week), stretching and strength-ening exercises as a home program. Patients were evaluated for pain and dynamic balance before 1st session and at the end of treatment program.Results: There was a significant decrease in visual ana-logue scale (VAS) in favor of group C compared with that of group A and that of group B (p 0.05).Conclusion: RSW therapy only or combined with thera-peutic exercises are more effective than therapeutic exercises only on pain and dynamic balance in patients with CPF.

Static and dynamic balance of patients at 1 year after total knee arthroplasty

Static and dynamic balance of patients at 1 year after total knee arthroplasty

Alterations of static and dynamic balance in patients with lumbar radiculopathy

BackgroundLumbosacral radiculopathy (LR) is strongly associated with delayed recovery and persistent disability. Chronic LR may lead to somatosensory system impairment, resulting in decline of postural balance.PurposeThe aim of the study was to investigate static and dynamic postural balance alterations in individuals with LR owing to lumbar disc herniation.Participants and methodsIn this case–control study design, 12 patients presenting with unilateral LR were included, whereas 12 normal individuals were randomly selected for control. Static balance was assessed functionally using Functional Reach Test. Dynamic balance was assessed via Biodex Balance System, where postural stability indices and the dynamic limits of stability were evaluated. Dynamic limits of stability parameters were expressed as direction control and time required to complete the test.ResultsThere was significant reduction of mean values of Functional Reach Test in LR group (P<0.0001) when compared with the control. In addition, there was a significant increase of the mean values of overall stability index (P<0.0001) and postural stability indices (P<0.0002) and a significant decrease of the mean values of direction control (P<0.0001) in the LR group.ConclusionPatients with chronic LR have shown to have limited functional abilities and decreased postural balance both statically and dynamically when compared with normal individuals.

Alterations of Static and Dynamic Balance in Lumbar Radiculopathy

AbstractBackground: Lumbar radiculopathy is a benign, often self-limiting condition. It is characterized by low back pain radiating into one or both lower limbs, combined with one or more positive neurological signs (paresis, sensory impairment, or loss of reflexes) that indicate a nerve root irritation or neurological loss of function. This can be due to mechanical compression of the nerve by a disc herniation which may lead to balance disorders in standing position and to asymmetrical load of lower extremities results from pain radiating to lower extremities and leads to distorted postural stability, as well as to other motor deficits. The consequences are disability, reduced quality of health and reduced working capability.Aim of Study: The purpose of this study was to investigate the alterations of static and dynamic balance in patients with lumbar radiculopathy.Patients and Methods: Twelve patients, both genders with unilateral lumbar radiculopathy were included in the study with a mean age 47.25 (±5.61) years. They were assessed for impairments in static and dynamic balance, compared with twelve normal/healthy subjects. functional reach test” FRT” was used to test static balance by measuring (MAD) maximum anterior reaching distance measured in cm. and Biodex Balance System (BBS) was used to measure dynamic balance. The evaluation of dynamic balance included both Dynamic Balance Test (DBT) and the Dynamic Limits of Stability (DLOS). The (DBT) include the anterior/posterior stability index (APSI), the Medial/Lateral Stability Index (MLSI) and the Overall Stability Index (OASI). The DLOS parameters were expressed as overall Direction Control (DC) and time required for completing the test (T).Results: There was statistically significant differences in all measured variables of static and dynamic balance; between lumbar radiculopathy (A) and control group (B). There was a significant reduction of the mean values of OASI, APSI with (p>0.0001*), T with (p=0.0001*) and MLSI with (p>0.002*) in group (B) and significant increase of the mean values of F.R.T. in group (B). While, there was a signifi-cant increase of the mean values of D.C. with (p=0.0001 *) in group (B).Conclusion: There was a significant differences of all variables of static and dynamic balance between group A and B, which confirms that patients with lumbar radiculopathy due to disc herniation may suffer impaired postural stability, dynamic balance and reduced functional abilities when com-pared to normal subjects.

Gait Stability Training in a Virtual Environment Improves Gait and Dynamic Balance Capacity in Incomplete Spinal Cord Injury Patients.

Many patients with incomplete spinal cord injury (iSCI) have impaired gait and balance capacity, which may impact daily functioning. Reduced walking speed and impaired gait stability are considered important underlying factors for reduced daily functioning. With conventional therapy, patients are limited in training gait stability, but this can be trained on a treadmill in a virtual environment, such as with the Gait Real-time Analysis Interactive Lab (GRAIL). Our objective was to evaluate the effect of 6-weeks GRAIL-training on gait and dynamic balance in ambulatory iSCI patients. In addition, the long-term effect was assessed. Fifteen patients with chronic iSCI participated. The GRAIL training consisted of 12 one-hour training sessions during a 6-week period. Patients performed 2 minute walking tests on the GRAIL in a self-paced mode at the 2nd, and 3rd (baseline measurements) and at the 12th training session. Ten patients performed an additional measurement after 6 months. The primary outcome was walking speed. Secondary outcomes were stride length, stride frequency, step width, and balance confidence. In addition, biomechanical gait stability measures based on the position of the center of mass (CoM) or the extrapolated center of mass (XCoM) relative to the center of pressure (CoP) or the base of support (BoS) were derived: dynamic stability margin (DSM), XCoM-CoP distance in anterior-posterior (AP) and medial-lateral (ML) directions, and CoM-CoP inclination angles in AP and ML directions. The effect of GRAIL-training was tested with a one-way repeated measures ANOVA (α = 0.05) and post-hoc paired samples t-tests (α = 0.017). Walking speed was higher after GRAIL training (1.04 m/s) compared to both baseline measurements (0.85 and 0.93 m/s) (p < 0.001). Significant improvements were also found for stride length (p < 0.001) and stability measures in AP direction (XCoM-CoPAP (p < 0.001) and CoM-CoPAP−angle (p < 0.001)). Stride frequency (p = 0.27), step width (p = 0.19), and stability measures DSM (p = 0.06), XCoM-CoPML (p = 0.97), and CoM-CoPML−angle (p = 0.69) did not improve. Balance confidence was increased after GRAIL training (p = 0.001). The effects were remained at 6 months. Increased walking speed, stride length, AP gait stability, and balance confidence suggest that GRAIL-training improves gait and dynamic balance in patients with chronic iSCI. In contrast, stability measures in ML direction did not respond to GRAIL-training.

Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P96. Adult spinal deformity patients demonstrate impaired postural stability and dynamic balance compared to age-matched controls

BACKGROUND CONTEXT Postural stability (PS) is closely associated with quality of life and falls in the elderly. Recent work has demonstrated impaired gait and increased falls in patients with ASD, suggesting impaired postural stability due to biomechanical constraints of the spinal deformity. However, while previous studies have investigated the effect of spinal malalignment on static balance, no previous work has specifically focused on postural stability or dynamic balance in patients with ASD, nor the sensorimotor contribution to instability. Computerized dynamic posturography (CDP) is a widely used diagnostic and prognostic tool for assessment of postural instability in diseases of gait and imbalance such as Parkinson's disease, osteoarthritis, and vestibular dysfunction. PURPOSE The objective of our study was to assess postural stability of patients with adult spinal deformity (ASD) using cCDP and (1) compare with published normative controls, (2) determine the relationship between fall status and postural stability, and (3) determine the relationship between quality of life and postural stability in ASD STUDY DESIGN/SETTING Prospective analysis of postural stability using CDP. PATIENT SAMPLE Eleven consecutive patients with severe adult spinal deformity who were seen and evaluated in an outpatient clinic. OUTCOME MEASURES Equilibrium scores (ES) during Sensory Organization Testing (SOT) across 6 conditions with varying sensorimotor deprivation, motor latency during Motor Control Testing (MCT), and a history of falls in community setting. METHODS Eleven patients with ASD were prospectively enrolled. Inclusion criteria: coronal cobb (CC)≥20°, Pelvic incidence-lumbar lorodsis (PI-LL) >10°, sagittal vertical axis (SVA) ≥5 cm, pelvic tilt (PT)≥25°, and thoracic kyphosis (TK)≥60°. Exclusion criteria: inability to stand, presence of confounding neurological conditions. PS was determined using two randomly assigned tests with CDP: (1) SOT to evaluate the voluntary use of sensory information; and (2) motor control test (MCT) to assess involuntary postural reactions in response to external perturbations. Patient performance was compared to age-gender matched controls. QOL metrics included SRS-22 and SF-36 RESULTS Mean age was 65±4.6, and 6/13 (46%) were female. Mean PI-LL was 31.2±12.7, PT 32.8±8.0, SVA 11.8±6.3 cm, TK 27.3±16.6, and CC 14.5±16.7. Four patients reported falling in the previous 6 months (36%). Those patients who self reported falling in past 6 months demonstrated significantly lower SOT (Conditions 2–6, p CONCLUSIONS ASD patients demonstrate impaired postural stability and dynamic balance compared to normal controls. Further, postural stability and QOL metrics correlated with self-reported falls. These findings suggest that ASD patients have drastically altered balance, which predisposes these patients to elevated risk of falls and injury as well as decreased ambulatory confidence and quality of life.

The effect of intensive physical therapy with repetitive transcranial magnetic stimulation in patients with degenerative cerebellar disease

The studies of repetitive transcranial magnetic stimulation (rTMS) of the brain have demonstrated the modulation of cortical excitability. Combination of rTMS with physical therapy (PT) might affect the therapeutic effects for movement disorders. The aim of this study was to investigate the effect of combination of intensive PT with rTMS in patients with degenerative cerebellar disease. Twelve patients with degenerative cerebellar disease participated in the study. The rTMS and PT were carried out five days a week for three weeks. The gait parameters were determined using a three-dimensional motion analysis system, and the total length and the velocity of the center of pressure (COP) in standing position using a stabilometer and the International Cooperative Ataxia Rating Scale (ICARS) were assessed in all patients before and after the intervention. The changes in the walking speed, step width, the total length of the COP and the velocity of the COP in standing position were not significant. The amplitude of the lateral head and body sway when walking were reduced after intervention ( P < 0.01) and the ICARS was improved after the intervention ( P < 0.01). The correlations between the duration of disease and the improvement of walking speed and step width were not significant. The correlations between the disease severity and the improvement of walking speed and step width were significant. In our study, combination of intensive PT and rTMS conferred positive effects on the dynamic balance in patients with degenerative cerebellar disease in earlier stages of the disease.

Dynamic balance in patients with degenerative lumbar spinal stenosis; a cross-sectional study

BackgroundDegenerative lumbar spinal stenosis (LSS) is a prevalent condition in adults over the age of 55 years. The condition is associated with activity limitations that are related to increased pain when engaging in weight-bearing activities, such as walking and standing, and release of pain while sitting down or bending forward. The limitation on ambulation is also associated with impaired balance although the types of balance problems are sparsely described in this patient group. The purpose of this study was to assess dynamic balance in persons with LSS by the Mini-BESTest and explore the associations with self-reported balance and functional disability.MethodsSixty two participants were included in this cross-sectional study. The main outcome measure was the Mini-BESTest, providing a total score and sub-scores for 4 balance control systems (Anticipatory Adjustment, Reactive Response, Sensory Orientation, Stability of Gait). The Swiss Spinal Stenosis Questionnaire provided sub-scores for self-reported balance problems and walking function (FUNC).ResultsThe participants showed large inter-individual variation in all measures of balance. The Mini-BESTest score ranged from very good to poor and the mean value was 22.8 (SD 3.5). Nineteen participants (31%) reported having frequent balance problems. Logistic regression analyses showed that both the total Mini-BESTest score (OR (95% CI) 1.6 (1.2, 2.0)(P = .001) and 3 of the 4 balance control systems (Anticipatory Adjustment, Sensory Orientation, Stability in Gait) were significantly associated with self-reported balance problems (.001 ≤ P ≤ .01). The strongest association was seen between Sensory Orientation and balance problems, implying that it is 4.4 times more likely that persons would have no or occasional balance problems with each unit of increase in Sensory Orientation. The total score for the Mini-BESTest was significantly associated with FUNC (P = .042).ConclusionsThe dynamic balance of persons with LSS showed a large heterogeneity with a large fraction of the participants displaying no balance impairments. The test results were associated with the participants’ self-reported balance problems and walking function. The Mini-BESTest thus appears to provide additional information to self-reported disability, and by identifying different kind of balance control impairments, the Mini-BESTest could be useful for physiotherapists working with person-centered rehabilitation in persons with LSS.

A study on the immediate effects of plantar vibration on balance dysfunction in patients with stroke.

The aim of this study was to estimate the immediate effects of plantar vibration, applied to the more affected foot, on balance impairment in patients post-stroke. This pretest-posttest clinical study included 18 patients (13 men) poststroke; mean age 56.0±8.9 years (range, 41–71 years). One session of 5-min vibratory stimuli (frequency, 100 Hz) was applied to the plantar region of the more affected foot of all participants. The plantar vibration significantly improved the Timed UP and Go test (P=0.03, Cohen d=0.15), ankle plantar flexor muscle spasticity (P=0.008), and ankle passive range of motion (P<0.001, Cohen d=0.74). The posturography measures and Functional Reach Test did not improve significantly (P>0.05). Vibration stimuli applied to the plantar region of the more affected foot had significant effects on spasticity, ankle passive range of motion and dynamic balance as evaluated by the Timed Up and Go test in patients poststroke. There was no effect on static balance performance. Based on the results, the focal vibratory stimuli applied directly to the plantar region of the more affected foot may be recommended to improve the functional mobility and dynamic balance in patients with stroke.

Effects of Posturographic Platform Biofeedback Training on the Static and Dynamic Balance of Older Stroke Patients

The aim of the experiment was to analyze the influence of posturographic platform biofeedback training on the static and dynamic balance of patients who experienced ischemic stroke. The study included 20 patients treated at the Rehabilitation Center of the District Hospital in Białogard, in the Ward of Neurological Rehabilitation with the Stroke Division. The age of the patients (10 in the experimental group and 10 in the control group) ranged between 60 and 72 years. The level of balance was determined with one-leg standing test and timed up & go test. The experimental group was subjected to the biofeedback training, practicing maintenance of body balance ("forced sway training") on posturographic platform for 15 consecutive days. The static balance on right leg and dynamic balance in group E improved to a markedly greater extent (P < .05) compared with conventionally rehabilitated group C. The effects of feedback mechanisms during training on a posturographic platform can be reflected by enhanced stimulation and further improvement of the control of different, more complicated performed motor tasks.

The effects of mirror neuron system-based self-observation training on lower limb muscle activity and dynamic balance in patients with chronic stroke.

[Purpose] This study aimed to investigate the effects of mirror neuron system-based self-observation training on lower limb muscle activity and dynamic balance in patients with chronic stroke. [Participants and Methods] Twenty patients with chronic stroke were randomly assigned to a self-observation training group (n=10) or a control group (n=10). Both groups followed a routine 30-minute exercise therapy regimen five days a week for four weeks. The self-observation training group additionally watched video clips of their balance and functional gait training and performed physical training twice over a 10-minute time span. Each self-observation training session was performed for 30 minutes, three times a week for four weeks. Muscle activity was evaluated using surface electromyography; dynamic balance was evaluated using timed up and go and 10-meterwalk tests. [Results] Within-group comparisons showed significant differences in muscular activities of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius and dynamic balance. Comparing between groups, the muscle activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius and dynamic balance were significantly different between experimental and control groups. [Conclusion] Self-observation training improved lower limb muscle activity and dynamic balance in patients with chronic stroke.

Reliability and Validity of the Japanese Version of the Mini-balance Evaluation Systems Test in Patients with Subacute Stroke.

The objective of the current study was to evaluate the reliability and validity of the Japanese version of the Mini-Balance Evaluation Systems Test (J-Mini-BESTest) in patients with subacute stroke. Eighteen patients who had suffered a first hemiplegic stroke (mean age, 59.1 ± 27.0 years) and had been admitted to convalescent rehabilitation wards were enrolled. The J-Mini-BESTest, the Berg Balance Scale (BBS), and the functional reach test (FRT) were used to assess balance. Four physical therapists (PTs) observed and scored the J-Mini-BESTest while another PT conducted the test. The interrater reliability of the J-Mini-BESTest was assessed using intraclass correlation coefficients (ICC[2,1]) for the total and section scores, and kappa statistics for each item. Internal consistency of the five raters was assessed using Cronbach's alpha. Concurrent validity of the J-Mini-BESTest was assessed against the BBS and FRT using Spearman's correlation coefficients. The ICC[2,1] of the total and section scores were 0.90 (95% confidence interval: 0.81-0.95) and 0.63-0.85, respectively. Cronbach's alphas were 0.80-0.87. The kappa statistics were 0.47-1.00. The scores of the J-Mini-BESTest were significantly correlated with those of the BBS (rho=0.66, p=0.006) but not with those of the FRT (rho=-0.36, p=0.189). The J-Mini-BESTest showed excellent inter-rater reliability and internal consistency. Although the J-Mini-BESTest was not correlated with the FRT, it was significantly correlated with the BBS. The J-Mini-BESTest is a reliable and valid tool for evaluating dynamic balance in patients with subacute stroke.

Effect of a Mat Pilates Program with TheraBand on Dynamic Balance in Patients with Parkinson's Disease: Feasibility Study and Randomized Controlled Trial.

The aim of this study was to assess the effect of a physical exercise program based on Mat Pilates (MP) with TheraBand® on the dynamic balance of a sample population diagnosed with Parkinson's disease (PD). After random selection, 26 participants were allocated to a MP group or a control group where they performed calisthenics exercises. Both interventions lasted 12 weeks and involved 2 weekly sessions of 60 minutes. Assessments took place at baseline, 12 weeks after the intervention started and 4 weeks after the intervention was completed using the body mass index (BMI), the Timed Up and Go (TUG) test with Wiva® sensors, the 30 Second Chair Stand test, and the Five Times Sit to Stand test. The group that completed the MP program presented significant improvements in BMI (F1,21 = 3.986; p = 0.038), the 30 Second Chair Stand test (F1,21 = 6.716; p = 0.014), the Five Times Sit to Stand test (F1,21 = 5.213; p = 0.032), and the time required to complete the TUG dynamic balance test (F1,21 = 5.035; p = 0.035). The MP program performed by a sample population with PD led to improvements in dynamic balance, and participants in the MP group showed increased strength in the lower limbs, but such improvements were not permanent after the activity ceased.