Equilibrium Scores Research Articles

A Comparison of Central Sensory Reception and Integration Abilities between Older Females with and without Fibromyalgia: A Pilot Study

Purpose: Impaired postural control has been reported in females with fibromyalgia syndrome (FMS). This study aimed to investigate a) differences in central sensory reception and integration abilities for postural control between older females with and without FMS, and b) the influence of a secondary cognitive task on postural control in altered sensory environments. Methods: The performances of 10 older females with FMS were compared to eight age-matched healthy females across single and dual task conditions using the Sensory Organization Test®. Results: No significant group differences were evident for Composite Equilibrium Score (CES) in the single task condition (p = 0.06) but a large effect size (Cohen’s d = 0.96) was obtained, suggesting a clinically relevant difference existed between groups with respect to general sensory reception and integration abilities. Single trial Equilibrium Scores (ESs) for both groups declined significantly in the more complex sensory conditions across both task conditions (p < 0.01) with a greater decline evident for the FMS group in sensory condition 4 in the dual-task condition (p = 0.04). The FMS group also experienced multiple falls in sensory conditions 5 and 6 across both task conditions with a significantly higher percentage of falls evident for the FMS group in condition 6 across both task conditions (p = 0.04). Conclusions: Overall postural stability was significantly lower in the FMS group when compared to an age-matched control group. Postural stability declined further in the FMS group when attempting to perform a secondary cognitive task in both sensory conditions that primarily relied on vestibular inputs for postural control. A greater focus on multisensory and dual-task training in a balance environment may benefit older females with FMS.

The Mulligan ankle taping does not affect balance performance in healthy subjects: a prospective, randomized blinded trial.

[Purpose] The aim of this study was to evaluate the immediate effects of Mulligan fibular taping on static and dynamic postural balance in healthy subjects using computerized dynamic posturography (CDP). [Subjects and Methods] Forty-four volunteers (26 males and 18 females) aged 21 ±2 years participated in the study. The Mulligan tape was applied by a specialist in this technique. The placebo group received a treatment with a similar tape but with several cuts to avoid the fibular repositioning effect produced by Mulligan tape. Main outcome measures: The Sensory Organization Test (SOT) and the Motor Control Test (MCT) were performed by each subject at baseline and after the interventions. Outcome measures included equilibrium and strategy scores from each trial and condition of the SOT, and speed of reaction (latency period) from the MCT. [Results] Mulligan ankle taping did not have an impact on postural control during static and dynamic balance in subjects with healthy ankles when compared with placebo taping. [Conclusion] There was no difference in, equilibrium and strategy (SOT) and speed of reaction (MCT) in any of the subjects in this study. Therefore, this study suggests that Mulligan ankle taping does not have an impact on balance in healthy subjects.

Evaluation of dizzy adult patients using the Arabic dizziness questionnaire and its correlation with different vestibular test results

Objectives The aim of this study was to develop an Arabic dizziness questionnaire for adults and compare the questionnaire conclusion with the results of vestibular evaluation. Participants and methods Twenty dizzy adults, age 21-60 years, were subjected to an interview with patients using the Arabic dizziness questionnaire, otological examination, bedside examination for dizzy patients, basic audiological evaluation, and vestibular assessment, which included the following: videonystagmography, cervical vestibular-evoked myogenic potentials, and sensory organization testing through dynamic posturography. Parameters under study were questionnaire scores and conclusion, videonystagmography results including canal paresis, and cervical vestibular-evoked myogenic potentials latency, amplitude, and threshold. Sensory organization testing result analysis in the form of equilibrium scores and sensory analysis. Results Comparisons and correlations between the vestibular score of the questionnaire and results of the vestibular assessment were nonstatistically significant. The most common diagnoses for dizziness in the adult group were vestibular neuritis (four cases), Mιniθre's disease (four cases), benign paroxysmal positional vertigo (three cases), and migraine-associated dizziness (three cases). Conclusion Adult patients sharing the same diagnosis consistently answered certain questions positively in the questionnaire. We recommend the use of the dizziness questionnaire as a first step of the test battery for the evaluation of dizzy patients.

Postural control and sensory information integration abilities of boys with two subtypes of attention deficit hyperactivity disorder: a case-control study

Background Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed psychiatric disorder in childhood. ADHD children with overlapping symptoms and signs of motor problems have more serious prognosis than that of children with ADHD only. However, the motor and sensory processing problems in children with ADHD have not been studied well. Few people adopt the technique of computerized dynamic posturography (CDP) in the study of ADHD, which is applied widely in clinical and laboratory research to objectively evaluate human's balance performance. This study aimed to assess the characteristics of postural control and sensory information processing of boys with two subtypes of ADHD by using CDP, so as to provide the proof for non-drug therapy of ADHD. Method From June 2003 to September 2004, a total of 73 boys (7–15 years of age) with ADHD and 73 normal developing boys matched by age and intelligence quotient from Peking University Institute of Mental Health were recruited in the study. The Sensory Organization Test was adopted to test the static balance performance under six sensory input conditions by SMART EquiTest 8.0 (NeuroCom) instrument. The sensory information from three sensory systems were available under condition 1, the visual inputs were removed or distorted under condition 2 or 3, the somatosensory inputs were in conflict with or without the visual inputs removed under condition 4 or 5, and both the visual and somatosensory inputs were in conflict under condition 6. The indexes of equilibrium score, somatosensory, vestibular, and visual ratios, and strategy scores were analyzed to indicate the subjects’ postural control ability. Results ADHD boys had significantly lower composite equilibrium score (CES) than the normal group (P &lt;0.05). Under condition 1 and conditions 3–6, the equilibrium scores (ES) of the ADHD group were significantly lower (all P &lt;0.05) than those of the control. Significantly lower visual and vestibular ratios and strategy scores under conditions 4–6 were found in boys with ADHD compared with the control group (P &lt;0.05). Boys of ADHD-predominantly inattentive (ADHD-I) type had a significantly lower CES and ES under conditions 4–6 than the controls (all P &lt;0.05) while the ESs of ADHD-combined type (ADHD-C) boys under each condition were similar with that of boys with ADHD-I and no significant difference was found between boys with ADHD-C and the control group (all P &gt;0.05). Compared with the control group, the ADHD-I boys showed significantly lower visual and vestibular ratios and strategy scores under conditions 4–6 whereas the ADHD-C boys showed a trend of lower visual ratio (all P &lt;0.05). Conclusions ADHD boys had a poorer static postural control ability and impaired function of processing visual and vestibular information compared with the normal control. Boys with ADHD-I showed particularly severe defect of static postural control and vestibular function integrating conflict information than normal boys. These deficits may be an important contributor to the clinical presentation of ADHD children and their cognitive deficits. Assessment and training of postural control function would be suggested during the diagnosis and treatment of ADHD children.

Gait and computerized dynamic posturography (CDP) aspects in early progressive supranuclear palsy (PSP) - a case report.

BACKGROUND: Posture and gait instability may cause of morbidity in individuals with progressive supranuclear palsy (PSP). OBJECTIVE: To quantitatively measure balance control by using computerized dynamic posturography (CDP) and to assess gait analysis in early PSP.CASE REPORT: She was evaluated for Berge balance scale, Functional Independence Measure (FIM) and postural stability using CDP device in early PSP with still able to walk or stand unassisted. Also, Gait analysis was conducted using an 8 M-camera Vicon 612 data capturing system set. Berge balance scale improved from 41/56 to 48/56. The score of FIM improved from 71/126 points to 95/126 points in early PSP. In CDP analysis, there was a decrease of composite equilibrium score (38 %). There was an increase of composite equilibrium score (59%) after three months of treatment. In gait analysis, there was no difference of gait parameters after three months of treatment in early PSP.CONCLUSIONS: Both CDP and gait analysis are important quantitative tools in the assessment of posture and gait instability as well as allow for early disclosure of the failure of the postural control system in early PSP.

Gait and Computerized Dynamic Posturography (CDP) Aspects in Early Progressive Supranuclear Palsy (PSP) - A Case Report

BACKGROUND: Posture and gait instability may cause of morbidity in individuals with progressive supranuclear palsy (PSP). OBJECTIVE: To quantitatively measure balance control by using computerized dynamic posturography (CDP) and to assess gait analysis in early PSP.CASE REPORT: She was evaluated for Berge balance scale, Functional Independence Measure (FIM) and postural stability using CDP device in early PSP with still able to walk or stand unassisted. Also, Gait analysis was conducted using an 8 M-camera Vicon 612 data capturing system set. Berge balance scale improved from 41/56 to 48/56. The score of FIM improved from 71/126 points to 95/126 points in early PSP. In CDP analysis, there was a decrease of composite equilibrium score (38 %). There was an increase of composite equilibrium score (59%) after three months of treatment. In gait analysis, there was no difference of gait parameters after three months of treatment in early PSP.CONCLUSIONS: Both CDP and gait analysis are important quantitative tools in the assessment of posture and gait instability as well as allow for early disclosure of the failure of the postural control system in early PSP.

Effect of a spinal brace on postural control in different sensory conditions in adolescent idiopathic scoliosis: A preliminary analysis

BackgroundDespite the positive effects of spinal braces on postural stability, they may constrain movement, resulting in poor balance control in patients with adolescent idiopathic scoliosis (AIS). Therefore, assessment of postural dynamics may aid in designing new less-constraining braces. ObjectivesThe effects of a spinal brace on postural stability and Cobb angle were investigated in this study. MethodsThirteen pediatric patients (10 females, three males) with AIS were recruited to participate in the study. Cobb angle was assessed by X-ray analyses, and postural stability was tested by computerized dynamic posturography in braced and unbraced conditions. A polyethylene underarm corrective spinal brace was fabricated for the subjects. ResultsThoracic and lumbar curvature decreased to 18.88±11.73° and 17.70±10.58°, respectively, after bracing (p<0.05). Lower equilibrium scores were observed in the “eyes closed” condition and higher scores in the “eyes closed with a swaying support” condition; higher composite equilibrium scores were also observed for the sensory organization test (p<0.05) in the braced condition. Lower scores were observed for the “toes-up adaptation test” in the braced condition (p<0.05). In the braced condition, the reaction time was slower in the right-backward direction and movement velocity was higher in the right-front direction on the limits of stability test (p<0.05). Furthermore, lower on-axis velocity during forward/backward dynamic balance control was observed in the braced condition (p<0.05). ConclusionsWearing a spinal brace improved postural stability in terms of increased proprioception, equilibrium performance, and rhythmic movement ability in patients with AIS.

Vestibular evoked myogenic potentials in evaluation of whiplash syndrome disability

Objective: Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck that may result from a rear-end or side impact, predominantly in motor vehicle accidents but also from other mishaps. Vertigo and dizziness after whiplash injury are the most frequent, persistent and disabling symptoms, even in the absence of anatomical and cervical spine damage. Vestibular disturbances in whiplash patients have been widely investigated; nevertheless, physiopathology of vertigo and dizziness still remains an unsolved problem. The aim of our study was to demonstrate that cVEMPs (cervical Vestibular Evoked Myogenic Potentials) represent a valid and non-invasive technique able to investigate vestibular function, in particular the vestibulo-collic reflex and macular function. Study design: We examined 25 patients affected by disabling post-whiplash injury by means of audiovestibular tests: audiometric and impedance tests, nystagmus evaluation, caloric test, dynamic posturography and cervical VEMPs. Data obtained were compared with those of a normal control group. Results: Audiological tests, impedance tests, nystagmus evaluation, and caloric tests were normal in all patients. Comparison of dynamic posturography values obtained in whiplash patients and in the normal control group demonstrated significant differences in the Composite Equilibrium Score and Visual Component. Finally, cVEMPs were bilaterally absent in 72% of patients, unilaterally absent in 16% and present in 12%. Conclusions: Based upon neurophysiological evidence and our results, we can hypothesize that a concussion of the macular receptors takes place and that the maculae are more sensitive than the ampulla or cochlea receptor to this kind of injury. We conclude that cervical VEMPs represent a valid and non-invasive technique to evaluate disability after whiplash injury.

Complexity of human postural control in subjects with unilateral peripheral vestibular hypofunction

Complexity is a new measure for identifying the adaptability of a complex system to meet possible challenges. For a center of pressure (COP) time series, the complexity measure represents the stability of postural control. In this study, multiscale entropy (MSE) was used to evaluate the complexity of COP time series in six test conditions of sensory organization test (SOT). Complexity index (CI) is defined as the summation of entropies with coarse-graining scales 1–20 by MSE. A total of 51 subjects belonging to 3 groups – healthy-young, healthy-elderly and dizzy – were recruited in this study. The COP signals in both anteroposterior (AP) and mediolateral (ML) directions were analyzed respectively. According to our results, the CI of AP-direction COP time series is significantly correlated to the equilibrium score, which represents the stability of postural control in SOT. The AP-direction sway is significant larger than the ML-direction sway, particularly in the test conditions with sway-surface. In additions, the CI of AP-direction COP for the healthy-elderly and dizzy groups are significantly lower than those for the healthy young group in the test conditions 1–4. The CI of ML-direction COP for the healthy-elderly group is significantly lower than those for the healthy-young and dizzy groups under test conditions 3 and 6. These results show that the complexity loss is a common status of AP-direction COP time series for both healthy-elderly and dizzy groups, and the complexity of ML-direction COP time series for subjects with unilateral vestibular dysfunction is higher than that for the healthy-elderly group specifically under test conditions 3 and 6.

Computerized Dynamic Posturography in Patients with Diabetic Peripheral Neuropathy and Visual Feedback-Based Balance Training Effects

BACKGROUND: Diabetic peripheral neuropathy (DPN) often has reduced stability during standing conditions.AIM: To compare balance control in diabetic patients and normal subjects using computerized dynamic posturography and to assess effect of visual feedback-based balance training in DPN.MATERIALS AND METHODS: A total of 57 patients of type 2 diabetes mellitus and 30 age-matched normal control subjects were recruited. The sensory organization test was done before and after the training program.RESULTS: There was a significant decrease of mean (± SD) of composite equilibrium score and somatosensory ratio score between subgroups of DPN and control healthy group (p &lt; 0.05). There was a significant increase of mean (± SD) of composite equilibrium score and the somatosensory ratio score after treatment as compared to results before training (p &lt; 0.05) in mild DPN. Moreover, there were a significant correlation between composite equilibrium score and disease duration before training in the severe DPN (r = 0.368, p &lt; 0.05). CONCLUSIONS: Computerized dynamic posturography is an important quantitative tool in the assessment of posture instability and allows for early disclosure of the failure of the postural control system. Visual feedback-based balance training was shown to be a promising method for fall prevention among early diabetes mellitus with peripheral neuropathy.

The influence of caffeine on the sensory organization test.

Clinicians often request that patients refrain from consuming caffeinated beverages 24 h before vestibular function testing. However, there is limited research regarding how caffeine may affect the results of these tests. The sensory organization test (SOT) evaluates how well an individual is able to maintain his or her balance during several different conditions that manipulate vestibular, visual, or somatosensory information. This study evaluated whether caffeine consumption affects the results of the SOT in a group of healthy young adults. Individuals were evaluated under two conditions: (1) after consuming ∼300 mg of caffeine before testing, and (2) without consuming a caffeinated beverage for 24 h before testing. Regular caffeine intake and caffeine withdrawal symptoms were assessed in these individuals. Participants were stratified into a no/low or a moderate/high caffeine intake group through the use of a self-reported 1-week caffeine diary. Thirty healthy control participants (mean age = 23.28 yr; males = 9) without any history of vestibular or balance impairment participated in the present study. The NeuroCom SMART Equitest was used to administer the SOT, whereas paired t-tests, completed with IBM SPSS Statistics 20, were used to analyze the data for statistical significance. Analysis of the data revealed a statistically significant difference between the caffeine and no-caffeine sessions during (1) condition 5 (C5): eyes closed, platform sway-referenced; and (2) the total composite score. Statistically significant differences were also noted for the vestibular and somatosensory preference ratios. In general, the participants performed better (i.e., higher equilibrium/composite scores) during the caffeine session. When significant results were found, the participants were stratified by weekly caffeine intake into a no/low caffeine (LC) intake group versus a moderate/high caffeine (HC) intake group. After this stratification, a statistically significant difference remained for C5, the composite score, and the somatosensory/vestibular preference ratios for the LC intake group, whereas no statistically significant results were found in the HC intake group. In addition, further analysis revealed less of a change in the equilibrium score as the amount of weekly caffeine intake increased. Despite these significant results, the mean differences were small in magnitude, and C5, the composite score, as well as the sensory analysis ratios, fell within normal limits for all participants during both sessions. The ingestion of caffeine did not produce a clinically significant effect in healthy young control participants. Future research is needed to determine if these same results occur in older adults, or in individuals with a history of vestibular impairment.

Dizziness and Loss of Balance in Individuals With Diabetes: Relative Contribution of Vestibular Versus Somatosensory Dysfunction.

The authors studied patients with diabetes and complaints of dizziness to determine whether peripheral neuropathy or inner ear dysfunction was more likely to disturb balance. Quantitative testing showed that the majority failed to maintain balance in vestibular-related conditions and had normal equilibrium scores in conditions relying on somatosensory input. Vestibular dysfunction should be an immediate consideration in patients with diabetes and complaints of dizziness regardless of the presence of peripheral neuropathy.

Core stability exercise is as effective as task-oriented motor training in improving motor proficiency in children with developmental coordination disorder: a randomized controlled pilot study

Objective: To compare the effectiveness of a core stability program with a task-oriented motor training program in improving motor proficiency in children with developmental coordination disorder (DCD). Design: Randomized controlled pilot trial. Setting: Outpatient unit in a hospital. Participants: Twenty-two children diagnosed with DCD aged 6-9 years were randomly allocated to the core stability program or the task-oriented motor program. Intervention: Both groups underwent their respective face-to-face training session once per week for eight consecutive weeks. They were also instructed to carry out home exercises on a daily basis during the intervention period. Main measures: Short Form of the Bruininks-Oseretsky Test of Motor Proficiency (Second Edition) and Sensory Organization Test at pre- and post-intervention. Results: Intention-to-treat analysis revealed no significant between-group difference in the change of motor proficiency standard score (P=0.717), and composite equilibrium score derived from the Sensory Organization Test (P=0.100). Further analysis showed significant improvement in motor proficiency in both the core stability (mean change (SD)=6.3(5.4); p=0.008) and task-oriented training groups (mean change(SD)=5.1(4.0); P=0.007). The composite equilibrium score was significantly increased in the task-oriented training group (mean change (SD)=6.0(5.5); P=0.009), but not in the core stability group (mean change(SD) =0.0(9.6); P=0.812). In the task-oriented training group, compliance with the home program was positively correlated with change in motor proficiency (ρ=0.680, P=0.030) and composite equilibrium score (ρ=0.638, P=0.047). Conclusion: The core stability exercise program is as effective as task-oriented training in improving motor proficiency among children with DCD.

Selective skin sensitivity changes and sensory reweighting following short-duration space flight

Skin sensory input from the foot soles is coupled with vestibular input to facilitate body orientation in a gravitational environment. Anecdotal observations suggest that foot sole skin becomes hypersensitive following space flight. The veritable level of skin sensitivity and its impact on postural disequilibrium observed post space flight have not been documented. Skin sensitivity of astronauts (n = 11) was measured as vibration perception at the great toe, fifth metatarsal and heel. Frequencies targeted four classes of receptors: 3 and 25 Hz for slow-adapting (SA) receptors and 60 and 250 Hz for fast-adapting (FA) receptors. Data were collected pre- and post-space flight. We hypothesized that skin sensitivity would increase post-space flight and correlate to balance measures. Decreased skin sensitivity was found on landing day at 3 and 25 Hz on the great toe. Hypersensitivity was found for a subset of astronauts (n = 6) with significantly increased sensitivity to 250 Hz at the heel. This subset displayed a greater reduction in computerized dynamic posturography (CDP) equilibrium (EQ) scores (-54%) on landing vs. non-hypersensitive participants (-11%). Observed hyposensitivity of SA (pressure) receptors may indicate a strategy to reduce pressure input during periods of unloading. Hypersensitivity of FAs coupled with reduced EQ scores may reflect targeted sensory reweighting. Altered gravito-inertial environments reduce vestibular function in balance control which may trigger increased weighting of FAs (that signal foot contact, slips). Understanding modulations to skin sensitivity has translational implications for mitigating postural disequilibrium following space flight and for on-Earth preventative strategies for imbalance in older adults.

Effect of strabismus on vestibular functions: value of its correction

Objective Studies that evaluate the relationship between strabismus and vestibular functions are very scarce with no consensus between their results. Hence, this study was designed to evaluate vestibular functions in patients with strabismus and to find out the effect of surgical correction of strabismus on vestibular functions. Materials and methods Thirty patients with strabismus aged between 10 and 33 years constituted the study group. The following procedures were carried out: otological examinations, detailed vertigo history, neurological and ophthalmological examinations, basic audiological evaluation, office tests for vestibular evaluation, videonystagmography, and computerized dynamic posturography. These vestibular tests either office tests or laboratory tests were performed three times, before eye surgery and 1 month and 2 months after eye surgery. Results Before surgery, in office tests for vestibular function, 36.6% of patients had abnormal results in dynamic visual acuity, whereas 26.7 and 16.7% had abnormalities in head thrust and head shake tests. In addition, 43.3% had abnormal sharpened Fukuda stepping test, whereas 33.3 and 13.3% had abnormal CTSIB and Fukuda stepping test. Reduction in equilibrium scores as well as condition 3, 5, and 6 of sensory organization test in all patients showed abnormal videonystagmography test results. Improvement occured postoperatively in office as well as laboratory tests. Conclusion Vestibular functions in strabismus patients are globally better in postoperative than in preoperative conditions, and this improvement appeared to be stable.

체성감각계 중재가 노인들의 자세조절 능력에 미치는 영향

Swaying and postural instability apparently associated with aging represent risk factors for osteoporotic fracture. To evaluate the influence of somatosensory input on postural control in old adults. Computerized dynamic posturography(EquiTest) was adopted to test equilibrium, balance strategy, and center of gravity(COG). They were each divided into two groups of mediation group (n=17), and control group(n=16) who have been participating in not regular exercise in 2 times a week. Results of this study were as following. First, mediation`s equilibrium score was higher than control group, and especially C3(eye open, base fix, and visual surrounded) were significantly difference(p.05). Second, the result of balance score were gradually lower from C 1 to C6, and do not significantly difference between groups. Third, and mediation group were lower sway than control group in COG, and especially C4(eye open, base surrounded) were significantly difference(p.05). It was concluded that elderly may improve their balance by somatosensory input. This might prove to be of great value in improving balance and thereby preventing accidental falls and subsequent fracture in elderly.

A telerehabilitation program by virtual reality-video games improves balance and postural control in multiple sclerosis patients

Balance and postural control (PC) disorders are frequent motor disorder symptoms associated with multiple sclerosis (MS). To demonstrate the potential improvements in balance and PC among patients with MS who complete a virtual reality telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. 50 patients was recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received telerehabilitation treatment using the Xbox 360® console monitored via videoconference. Experimental group attended 40 sessions, four sessions per week (20 min per session). The treatment schedule lasted 10 weeks for both groups. A computerised dynamic posturography and clinical outcomes (Berg Balance and Tinettti scales) were used at baseline and at the end of the treatment. Results showed an improvement over general balance in both groups. Visual preference, the contribution of vestibular information, mean response time and Tinetti test yielded significant differences in the experimental group. An ANOVA revealed significant between-group post-treatment differences in the composite equilibrium score, Berg and Tinetti scales in the experimental group. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.

The Influence of Foot Sizes on Human Balance

This study investigated the relationship between foot size and human balance performance. The balance performances of 30 female subjects (15 young, 15 elderly) were assessed by a force platform system. Mean sway velocity, balance strategy score and composite equilibrium score (CES) were used to quantify balance performances from three different aspects. Correlation analysis was conducted to analyze the relationship between foot sizes and human balance measures. The results showed that most foot size measures (with or without normalizations) have significant correlations on mean sway velocity and balance strategy score, but no relationship with CES. In general, the bigger the foot size, the lower mean sway velocity and the bigger the normalized foot size, the higher balance strategy score (more ankle strategy), especially for the young group.

Elder Chinese Martial Art Practitioners Have Higher Radial Bone Strength, Hand-Grip Strength, and Better Standing Balance Control

This study explored the feasibility of using Ving Tsun (VT) martial art as a fall-prevention exercise for male seniors. We compared the radial bone strength, hand-grip strength, and standing balance control of senior VT practitioners and nonpractitioners under various sensory environments. Sixteen male VT practitioners (mean age ± SD: years) and 17 sex- and age-matched control adults (mean age ± SD: years) participated in the study. The bone strength of the distal radius, hand-grip strength, and standing balance control were assessed using an ultrasound bone sonometer, a Jamar dynamometer, and sensory organization test (SOT) on the NeuroCom Balance Master, respectively. A multivariate analysis of variance (MANOVA) was used to compare the outcome variables between the two groups. Results revealed that VT practitioners had significantly higher radial bone strength (-score) on the dominant side (), hand-grip strength (dominant side, ; nondominant side, ), and standing balance control (SOT composite equilibrium score, ) than the control participants. Male elder VT practitioners had higher radial bone strength, hand-grip strength, and better standing balance control than nonpractitioners. Our findings shed light on the use of VT exercise to prevent falls and fall-related fractures of the distal radius in male elders.

Computerized dynamic posturography analysis of balance in individuals with a shoulder stabilization sling.

Sling immobilization of the upper limb may affect balance. Computerized dynamic posturography (CDP) provides a validated, objective assessment of balance control and postural stability under dynamic test conditions. We tested the balance of individuals with a shoulder stabilization sling (SSS) using an EquiTest machine to objectively assess imbalance while wearing a sling. Forty-two right hand dominant (RHD) adults (16 females, 26 males; average age 22 years; range 20-35years) were included in the study, comprising six controls and two SSS groups with 18 dominant hands (DH) and 18 non dominant hands (NDH). CDP assessed balance by the Sensory Organization Test (SOT), Motor Control Test (MCT), and Adaptation Test (ADT). The composite equilibrium scores (CES) were as follows: controls 80.8%, sling DH 71.1 versus sling NDH 69.6%. Sling use has lower CES compared to controls (p=0.025). The use of a sling caused 31% of subjects to have decreased CES. 22.9% of sling users had imbalances. Among sling users, the DH group had 19.1% imbalances compared to 26.8% for the NDH group (p=0.044). There were six absolute falls in the DH group versus 12 in the NDH group. Wearing a sling causes balance decompensation in almost one-third of healthy volunteers, and this is greater when worn in the non dominant hand, with double the number of falls. This has significant implications for patients having prolonged use of a sling. Consideration should be given to operative procedures or conservative management of shoulder pathology where sling use is required and promotion of the early discontinuation of sling use can be considered.