Evaluation Of Balance Research Articles

Influência do excesso de peso sobre o equilíbrio postural e a mobilidade de candidatos à cirurgia bariátrica

Abstract Obesity is considered a risk factor to health and besides generating metabolic and cardiovascular alterations, it is related to mechanical complications. Since stability may be altered due to anthropometric and biomechanical factors, studies investigating the relationship of excess weight on the mobility and balance of obese adults are still scarce. The research aimed to evaluate the postural balance and mobility of obese individuals who are waiting for bariatric surgery. This is a cross-sectional and descriptive study, conducted at the Hospital das Clínicas of the Universidade Federal de Pernambuco. The sample consisted of 97 individuals, 81 women, 16 men, age 38.39 ± 10.60 years and body mass index 47.5 ± 6.9 kg/m2. The Timed Up and Go test, which evaluates the mobility, resulted in 7.6 ± 1.7 seconds as the average of the longest times spent to perform the test. Regarding the evaluation of dynamic balance and mobility, it was found that the domains of anticipatory postural adjustments, necessary to prevent postural disturbances (median 5, 95%CI 5-6) and the domain of dynamic movement, which corresponds to the balance necessary to walk (median 8, 95%CI 7-9) are the most impaired in the subjects with obesity. Positive correlations were found between weight and dynamic balance. The findings indicate that excess body fat interferes with dynamic balance.

Innovative Human Resource Management Strategies During the Covid-19 Pandemic: Telecommuting Practice

The purpose of this study is to analysis what is human resources management strategies during the covid-19 pandemic at PT Pengembangan Industri Logam. This study using qualitative research with 6 participants to make mini model. Mini-model theory was obtained that displays seven (7) latent variables that determine the success of human resource management strategies during covid-19 Mini Model Theory which are in the form of work from home, productivity and efficiency, information technology, work-life balance, communication, work facility and performance evaluation. Information technology and communication negatively affects human resources management strategies because of signal constraints experienced by employees when doing work at home. It also has an impact on work that cannot be interrupted on time and communication that is hampered.

The relationship between balance and flu-like symptoms: a medical condition that needs attention

Objective: In general, while upper respiratory tract viruses cause flu-like complaints, balance problems associated with these viruses are often overlooked. It has been a long time since the first appearance of Covid-19, but unfortunately, there is still no fully effective treatment for this disease. Along with balance manifestations, especially several vestibular symptoms such as dizziness, vertigo, and tinnitus are described as common clinical manifestations in COVID-19. In our study, we investigated the effects of Covid-19 on the balance system with routine balance tests and we tried to localize a possible disorder in the balance system. Materials and Methods: Volunteers were divided into two groups. The number of volunteers in each group was thirty. The first group consisted of SARS-CoV-2-positive patients and the second group consisted of healthy people. Spontaneous nystagmus determination, Romberg test, Fukuda stepping test (FST), head thrust test (HTT), head shake test (HST), finger-nose test, and tandem walking test were applied. Results: The lateral fall in the Romberg test, rotation in the FST, and nystagmus in the HST are significant in Group 1 (p<0.001), (p<0.001), (p<0.03). The relationship between the fall side in the Romberg test and the direction of rotation in the FST were found to be significant in Group 1 (p<0.001). Similarly, the relationship between the direction of rotation in the FST and the nys-tagmus direction in the HST, and the direction of the saccadic correction in the HTT were found to be sig-nificant (p<0.026), (p<0.010). Conclusion: In SARS-CoV-2 positive patients, the balance system, especially the peripheric vestibular system, may be affected even if the patients do not have obvious complaints about balance. Routine balance tests that can be performed quickly in the outpatient clinic can be used effectively for the evaluation of balance.

The relationship of trunk control with balance, upper extremity and lower extremity functions in stroke patients

The center of the body is the trunk. For distal extremity movements, balance, and functional tasks, proximal trunk control is crucial. The aim of the study is to examine the relationship of trunk control with balance, upper extremity and lower extremity functions in stroke patients. Thirty-six stroke patients were included in this cross-sectional descriptive study. Trunk control was assessed using the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS) was used for balance evaluation, Fugl-Meyer Lower Extremity Scale (FML) was used for lower extremity function evaluation, Fugl-Meyer Upper Extremity Scale (FMU) was used for upper extremity function evaluation. The mean age of the included stroke patients was 62±11 years. There was a moderate negative correlation between TIS and BBS (r=-0.610, p<0.01). A moderate negative correlation was found between TIS and FML (r=-0.520, p=0.001). A low negative correlation was found between TIS and FMU (r=-0.372, p=0.025). Trunk control affects balance, lower extremity and upper extremity function. In the treatment of stroke patients, exercise approaches for trunk control should be added to rehabilitation programs in addition to basic neurophysiological approaches.

The impact of obesity on static and proactive balance and gait patterns in sarcopenic older adults: an analytical cross-sectional investigation.

Obesity is increasingly recognized as a significant factor in the susceptibility of older adults to falls and related injuries. While existing literature has established a connection between obesity and reduced postural stability during stationary stances, the direct implications of obesity on walking dynamics, particularly among the older adults with sarcopenia, are not yet comprehensively understood. Firstly, to investigate the influence of obesity on steady-state and proactive balance, as well as gait characteristics, among older adults with sarcopenic obesity (SO); and secondly, to unearth correlations between anthropometric characteristics and balance and gait parameters in the same demographic. A cohort of 42 participants was categorized into control (CG; n = 22; age = 81.1 ± 4.0 years; BMI = 24.9 ± 0.6 kg/m²) and sarcopenic obese (SOG; n = 20; age = 77.7 ± 2.9 years; BMI = 34.5 ± 3.2 kg/m²) groups based on body mass index (BMI, kg/m²). Participants were assessed for anthropometric data, body mass, fat and lean body mass percentages (%), and BMI. Steady-state balance was gauged using the Romberg Test (ROM). Proactive balance evaluations employed the Functional Reach (FRT) and Timed Up and Go (TUG) tests. The 10-m walking test elucidated spatiotemporal gait metrics, including cadence, speed, stride length, stride time, and specific bilateral spatiotemporal components (stance, swing, 1st and 2nd double support, and single support phases) expressed as percentages of the gait cycle. The time taken to complete the TUG and ROM tests was significantly shorter in the CG compared to the SOG (p < 0.05). In contrast, the FRT revealed a shorter distance achieved in the SOG compared to the CG (p < 0.05). The CG exhibited a higher gait speed compared to the SOG (p < 0.05), with shorter stride and step lengths observed in the SOG compared to the CG (p < 0.05). Regarding gait cycle phases, the support phase was longer, and the swing phase was shorter in the SOG compared to the CG group (p < 0.05). LBM (%) showed the strongest positive correlation with the ROM (r = 0.77, p < 0.001), gait speed (r = 0.85, p < 0.001), TUG (r = -0.80, p < 0.001) and FRT (r = 0.74, p < 0.001). Obesity induces added complexities for older adults with sarcopenia, particularly during the regulation of steady-state and proactive balance and gait. The percentage of lean body mass has emerged as a crucial determinant, highlighting a significant impact of reduced muscle mass on the observed alterations in static postural control and gait among older adults with SO.

Comparative Assessment of Gait and Balance in Patients with Parkinson's Disease and Normal Pressure Hydrocephalus.

We aim to compare balance and gait parameters in patients diagnosed with Parkinson's disease (PD) and normal pressure hydrocephalus (NPH). A total of 13 patients with NPH, 20 with PD, and 13 healthy controls (HC) recruited in the study. Three IMU sensors (Ambulatory PD Monitoring Inc., OR, USA) were placed on the lumbar area and the feet of the participants. The balance evaluations comprised eight successive standing tasks; the modified clinical test of sensory interaction on balance test. These tasks involved standing with feet apart and eyes open as well as eyes closed on a firm and foam surface, standing with feet together and eyes open as well as eyes closed, and tandem stance with the right foot front and the left foot front. Functional evaluations of gait were conducted using the 10-M Walk Test (10 MWT), the 2 min-Walk Test (2 MWT), and the timed-up and go (TUG). Parameters of the gait and balance were analyzed and then compared. NPH patients displayed a notable decrease in both stride length and gait speed as compared with both PD patients and healthy participants. The balance tests revealed that the NPH group demonstrated significantly poorer performance, specifically in the feet-apart eyes-closed foam-surface test, and the tandem stance test. During the tasks while eyes were open on firm and foam surfaces, PD and NPH groups showed an increase in root mean square sway, range, and mean velocity (p<0.05) of sway in the anteroposterior plane. In addition, during the TUG test, the NPH group exhibited a significant prolongation in the time needed to complete the task and a decline in turning velocity as compared to PD, but no notable difference was seen in comparison to the HC group. Our study indicated that the patients with NPH exhibited notably worse gait and balance measurements in comparison to both the PD patients and HC groups. These findings emphasize the significance of monitoring and managing gait and balance impairments in NPH patients. Sensor-based technologies may offer objective parameters for a more precise and efficient follow-up of these patients in terms of gait and balance.

개인맞춤형 낙상예방 주택개조방안 어플리케이션 컨텐츠 개발 연구

The purpose of this study is to develop an application contents personalized fall prevention home modification suggestion application based on the older adult’s physical status and housing condition. The application consisted of four parts: socio-demographic and housing characteristics, a health condition checklist, a housing condition checklist, and fall prevention home modification items. The health condition checklist, which was developed by three medical experts, included items about the senior’s musculoskeletal system, balance evaluation, and senility evaluation. They were evaluated by Five Times Sit to Stand Test (FTSST), the Timed Up and Go Test (TUG), the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale, and the Functional Reach Test. Three housing experts participated in compiling a housing condition checklist and fall prevention home modification items. This checklist included questions about whether the house had fall prevention housing design features in an entrance, living room, kitchen, master bedroom, master bathroom, and laundry room. A total of 81 fall prevention home modification options were derived. Some fall prevention home modification items included two possible options based on different budgets and/or construction methods. This personalized application was intended to simplify the process of home modification for older adults and service providers. It is necessary to evaluate the application’s effectiveness in the future.

Global Sagittal Spinal Compensation for Dropped Head Alignment.

This is a retrospective radiographic study of a consecutive series of cases in patients with dropped head syndrome (DHS) at a single tertiary referral center. The aim was to clarify the compensation among parameters of spinal sagittal alignment in patients with DHS. The treatment strategy for DHS should vary according to the types of global sagittal spinal alignment. However, theoretical evidence in consideration of spinal sagittal compensation against the dropped head condition is lacking. One hundred sixteen patients diagnosed with isolated neck extensor myopathy were enrolled. Radiographic measurements were made, including parameters of spinal sagittal alignment. The patients were divided into three groups according to sagittal spinal balance: C7SVA (sagittal vertical axis) ≥ +50mm (P-DHS; positive imbalanced DHS), -50mm ≤C7SVA <+50mm (B-DHS; balanced DHS), and C7SVA <-50mm (N-DHS; negative imbalanced DHS). Correlations among the various spinal parameters were analyzed. Among all types of DHS, there was no correlation between C2-C7 angle (C2-C7A) and T1 slope. In B-DHS, other correlations among the adjacent spinal segments were maintained. In N-DHS, there was no correlation between C2-C7A and TK, and in P-DHS, there was also no correlation between TK and lumbar lordosis. The loss of compensation at the cervicothoracic junction was observed in all DHS types. B-DHS showed decompensation only at the cervicothoracic junction. N-DHS presented additional decompensation of the thoracic spine, and P-DHS showed decompensation between the thoracic and lumbar spine. Evaluation of global sagittal spinal balance is important for determining global spinal compensation associated with DHS and when considering treatment strategy.

Adapting Balance Training by Changing the Direction of the Tensile Load on the Lumbar Region

In this study, we investigated trainees’ adaptation by conducting static balance training in a tandem standing posture. The horizontal tensile force loads in the front, back, left, and right directions were applied using pneumatic artificial muscles. We analyzed the adaptation that occurred during training by changing the direction of the horizontal tensile load on the lumbar region according to the tendency of the trainee. We conducted the experiments using the following protocol. Ten trainees participated in the experiment. In Phase 1, we applied loads in four directions the same number of times in random order to investigate the weak direction in the balance of each trainee. In Phase 2, we measured five trainees in each group: Group 1 was trained in the same way as Phase 1, and Group 2 was intensively trained in two directions in which the balance found in Phase 1 was difficult to maintain. In Phase 3, we performed the same experiment as in Phase 1. We analyzed the adaptation of the trainees using the margin of stability (MoS), a balance evaluation index. We compared the experimental results of Phases 1 and 3. In Group 1, the tendency for improvement in balance was unclear. On the other hand, the balance index in Group 2 improved in four out of five trainees in both the front-back and left-right directions. These results suggest that the training method concentrating on the weak direction could provide a clear directionality to the training effect.

Characterisation of the auxiliary heating power delivered by the 40 keV neutral beam injectors on the COMPASS tokamak

Two identical neutral beam injectors (NBIs) have been installed on the COMPASS tokamak. Each of them is capable of producing a deuterium (or hydrogen, helium) neutral beam with nominal power of up to 400 kW at 40 keV. Since the COMPASS tokamak is a compact machine, the design of the neutral beams was carefully optimized to fit the neutral beam through the narrow ports of the tokamak. However, once the neutral beams are operated out of the scope of their optimal parameters, additional power losses occur due to neutral beam scraping. This article investigates the amount of power loss due to neutral beam scraping. The losses are calculated using the neutral beam models and measured neutral beam parameters. The calculated results are compared with the measured power delivered into the plasma. Two different neutral beam models are employed. One describes the neutral beam as a sum of small beamlets, which are Gaussian-like. The second one describes the neutral beam as a single Gaussian beam. The amount of the power lost to scraping is determined by both models and compared. Neutral beam parameters, the input parameters for both models, are derived from the Doppler-shifted spectra emitted by fast neutral atoms. It is shown that when operating NBIs at nominal parameters, the scraping losses are negligible (5% ). If the NBIs are operated too far from the nominal parameters, the scraping losses can reach up to ∼60% of the NBI output power. As the highest fractional losses occur with low power NBI, the beam duct is capable of withstanding the corresponding power loads. The expected auxiliary heating power , the power entering the tokamak chamber carried by fast neutrals, is benchmarked against the additional plasma input power observed in the measured plasma parameters . The additional plasma input power is derived from the plasma power balance. The power balance terms are independent of the neutral beam model used for the auxiliary heating power calculation . The results of the power balance evaluation reveal a difference between two NBIs installed on COMPASS. One of the injectors systematically delivers 17% less power than the other into the plasma given the same beam parameters. It is concluded that the additional losses occur before the beam enters the tokamak chamber.

Cutoff Point of Mini-Balance Evaluation Systems Test Scores for Elderly Estimated by Center of Pressure Measurements by Linear Regression and Decision Tree Classification.

Understanding balance ability and assessing the risk of possible falls are very important for elderly rehabilitation. The Mini-Balanced Evaluation System Test (Mini-BESTest) is an important survey for older adults to evaluate subject balance, but it is not easy to complete due to various limitations of physical activities, including occasional fear of injury. A center of pressure (CoP) signal can be extracted from a force pressure plate with a short recording time, and it is relatively achievable to ask subjects to stand on a force pressure plate in a clinical environment. The goal of this study is to estimate the cutoff score of Mini-BESTest scores from CoP data. CoP signals from a human balance evaluation database with data from 75 people were used. Time domain, frequency domain, and nonlinear domain parameters of 60 s CoP signals were extracted to classify different cutoff point scores for both linear regression and a decision tree algorithm. Classification performances were evaluated by accuracy and area under a receiver operating characteristic curve. The correlation coefficient between real and estimated Mini-BESTest scores by linear regression is 0.16. Instead of linear regression, binary classification accuracy above or below a cutoff point score was developed to examine the CoP classification performance for Mini-BESTest scores. The decision tree algorithm is superior to regression analysis among scores from 16 to 20. The highest area under the curve is 0.76 at a cutoff point score of 21 for the CoP measurement condition of eyes opened on the foam, and the corresponding classification accuracy is 76.15%. CoP measurement is a potential tool to estimate corresponding balance and fall survey scores for elderly rehabilitation and is useful for clinical users.

Effect of Treadmill Training with Visual Biofeedback on Selected Gait Parameters in Subacute Hemiparetic Stroke Patients

Functional limitations after a stroke are unique to each person and often include impaired independent mobility. A reduction in existing gait deficits after a stroke is often one of the main goals of rehabilitation. Gait re-education after stroke is a complex process, which consists of the effects of many therapeutic interventions. The study aimed to analyze the effects of using a treadmill with visual feedback in gait re-education in the sub-acute stroke period and assess the impact of biofeedback treadmill training on selected gait parameters, improving static balance and reducing the need for orthopedic aids. The study included 92 patients (F: 45, M: 47) aged 63 ± 12 years, with post-ischemic sub-acute (within six months onset) stroke hemiparesis, treated at a neurological rehabilitation ward. All patients participated in a specific rehabilitation program, and in addition, patients in the study group (n = 62) have a further 10 min of treadmill training with visual feedback. Patients in the control group (n = 30) participated in additional conventional gait training under the direct supervision of a physiotherapist. The evaluation of static balance was assessed with the Romberg Test. A Biodex Gait Trainer 3 treadmill with biofeedback function was used to evaluate selected gait parameters (walking speed, step length, % limb loading, and traveled distance). The use of an orthopedic aid (walker or a crutch) was noted. After four weeks of rehabilitation, step length, walking speed, traveled distance, and static balance were significantly improved for the study and control group (p < 0.05). Treadmill gait training yielded significantly better results than a conventional rehabilitation program. Only the study group observed a corrected walking base (p < 0.001). All participants showed a reduction in the use of walking aids (p = 0.006). There was no asymmetry in the % of limb loading for either group prior to or following rehabilitation. The treadmill with visual biofeedback as conventional gait training has resulted in a significant improvement in parameters such as step length, walking speed, static balance, and a reduction in the use of locomotion aids. However, the achieved improvement in gait parameters is still not in line with the physiological norm.

Feasibility and Application of the B.E.A.T. Testbed for Assessing the Effects of Lower Limb Exoskeletons on Human Balance

Assessing the performance of exoskeletons in assisting human balance is important for their design process. This study proposes a novel testbed, the B.E.A.T (Balance Evaluation Automated Testbed) to address this aim. We applied the B.E.A.T to evaluate how the presence of a lower limb exoskeleton influenced human balance. The B.E.A.T. consists of a robotic platform, standardized protocols, and performance indicators. Fifteen healthy subjects were enrolled and subjected to repeatable step-type ground perturbations in different directions using the multi-axis robotic platform. Each participant performed three trials, both with and without the exoskeleton (EXO and No-EXO conditions). Nine performance indicators, divided into kinematic and body stability indicators, were computed. The reliability of performance indicators was assessed by computing the Inter Class Correlation (ICC). The indicators showed good (0.60 ≤ ICC &lt; 0.75) to excellent (ICC ≥ 0.75) reliability. The comparison between the EXO and No-EXO conditions revealed a significant increase in the joint range of motion and the center of pressure displacement while wearing the exoskeleton. The main differences between the EXO and No-EXO conditions were found in the range of motion of the knee joints, with an increment up to 17° in the sagittal plane.

Production, physiological response, and calcium and magnesium balance of lactating Holstein cows fed different sources of supplemental magnesium with or without ruminal buffer

The objective of this study was to evaluate the effects of dietary replacement of magnesium oxide (MgO) with calcium-magnesium hydroxide [CaMg(OH)2] and its interaction with ruminal buffer (sodium sesquicarbonate) supplementation on production, Ca and Mg balance, and overall physiological response of mid-lactation Holstein dairy cows. Sixty cows averaging 40.5 ± 7.0 kg of milk/d were used. Treatments were assigned following a 2 × 2 factorial arrangement: (1) MgO, (2) MgO + buffer, (3) CaMg(OH)2, or (4) CaMg(OH)2 + buffer. Diets were formulated to have 16.5% of crude protein, 1.82 Mcal/kg of net energy for lactation, 0.67% Ca, 0.39% P, and 0.25% Mg, all on a dry matter (DM) basis. Treatments were individually top dressed. Milk production, composition, and DM intake were evaluated. A subsample of 20 cows were randomly selected for the evaluation of Ca and Mg balance, blood gases, and electrolytes. Ruminal fluid was also collected for evaluation of pH and Ca and Mg solubility. Effects of Mg source, buffer, and the interaction Mg source × buffer were analyzed through orthogonal contrasts. An interaction of Mg source × buffer was found for DM intake and feed efficiency, in which cows fed CaMg(OH)2 had a similar feed efficiency regardless of ruminal buffer inclusion; however, when cows were fed MgO, the inclusion of buffer reduced feed efficiency. No effects on body weight and milk yield were observed. Buffer addition tended to increase the concentrations of fat, protein, and solids-not-fat, without affecting the yields of these milk components. Magnesium source and buffer did not affect ruminal fluid, blood, urine, or fecal pH; however, buffer supplementation increased urinary pH. Treatment with CaMg(OH)2 increased blood concentration of HCO3-, total CO2, and base excess compared with cows fed MgO. No differences were observed in the ruminal solubility of Ca and Mg or on milk or urinary Ca and Mg excretion. Greater plasma Mg concentration was observed for animals fed MgO compared with cows fed CaMg(OH)2; however, both sources were above the threshold recommended in the literature for dairy cows. Also, a reduction in fecal Mg excretion was observed in animals fed CaMg(OH)2. In summary, we provide evidence that CaMg(OH)2 could replace MgO without affecting performance, overall physiological response, or Ca and Mg balance of mid-lactating dairy Holstein cows.

Utilisation du dronabinol dans le traitement des douleurs neuropathiques réfractaires : retour d’expérience des patients suivis dans un Centre d’évaluation et de traitement de la douleur

Dronabinol is a drug composed of synthetic delta-9-tetrahydrocannabinol. In France, dronabinol requires a named Temporary Utilisation Authorisation (TUA), for the treatment of refractory neuropathic pain. Few data currently exist concerning its efficacy and tolerance. We present our feedback on its use for chronic pain patients, the multidisciplinary supervision and the monitoring set up by the clinical pharmacist. This retrospective monocentric study presents Patients Global Impression of Change and tolerance data from patients treated with dronabinol in a pain center between October 2020 and July 2021. We present their satisfaction towards the care process. Nineteen patients were treated with dronabinol during the study period. - The clinical pharmacist issued 180 advices for patients and doctors. Patients reported a positive impact of the telephone follow-up carried out by the clinical pharmacist. - 75% (n=9/12) of patients who continued treatment for more than 3 months reported improvement in their health. - 74% (n=14/19) of patients had at least one adverse event, six patients needed to discontinue the treatment. Dronabinol represents an alternative that can improve the quality of life of some patients suffering from refractory neuropathic pain. Nevertheless, as with any medicine, its initiation requires a rigorous evaluation of the benefit-risk balance. The close collaboration between the physician and the clinical pharmacist allows a secure management patients and makes this complex drug circuit easer.

Land cover change evaluation based on eco-economic balance modeling

Abstract Water supply is one of the important functions provided to humans by the ecosystem. Water supply by the ecosystem leads to sustainable economic development, ecological restoration and food security for human societies. Therefore, the evaluation of the water supply capacity of the ecosystem and the analysis of its spatial distribution features play an important role in the implementation of the plan for the protection and exploitation of water resources. Evaluation of ecological economic balance is of great importance in sustainable ecosystem management. This paper was conducted to develop the ecological economic balance structure based on the water supply and land cover changes. Land use was considered in four time periods from 2000 to 2021 with seven-year intervals to evaluate the process of land cover change and water availability. The results showed that the southern and eastern regions addressed a negative trend in the ecological economic balance. These areas have been affected by population growth and urbanization.

Physical ability, cervical function, and walking plantar pressure in frail and pre-frail older adults: An attentional focus approach.

Aging and increased vulnerability define the clinical condition of frailty. However, while the cervical function is recognized as a determinant of balance and walking performance, no study simultaneously physical ability, cervical function, balance, and plantar pressure distribution in walking in nursing house population. Thus, the present study aimed to compare these parameters between Frail and Pre-Frail aged people. Thirty-one (12 men and 19 women) institutionalized participants (age: 89.45 ± 5.27years, weight: 61.54 ± 9.99kg, height: 160.34 ± 7.93cm) were recruited and divided into Pre-Frail and Frail groups according to SPPB (Short Physical Performance Battery) score (Frail <6, Pre-Frail ≥6). Participants performed the Timed Up and Go Test (TUGT) and a static balance evaluation. The cervical range of motion (COM), knee extensor strength, and walking plantar pressure distribution have been measured. The Pre-Frail group showed a higher gait speed (ES = 0.78, p ≤ 0.001) and a better TUGT, as well as higher knee extensor strength (ES = 0.4, p = 0.04). Furthermore, the Pre-Frail group presented a center of pressure (COP) displacement velocity on the sagittal axis (ES = 0.43, p = 0.02) and a more COP projection on this axis (ES = 0.43, p = 0.02). No significant difference has been observed between the two groups concerning the total contact time and most of the plantar pressure parameters except for the rear foot relative contact time which was lower in the Pre-Frail group. The Pre-Frail group also showed better cervical tilt mobility (ES = 0.35, p = 0.04). This study highlights the influence of some new parameters on frailty in older people, such as cervical mobility and plantar pressure distribution in walking.

Assessment of balance in people with mild traumatic brain injury using a balance systems model approach

PurposeMeasuring persistent imbalance after mTBI is challenging and may include subjective symptom-reporting as well as clinical scales. Clinical assessments for quantifying balance following mTBI have focused on sensory orientation. It is theorized that balance control goes beyond sensory orientation and also includes subdomains of anticipatory postural adjustments, reactive postural control, and dynamic gait. The Mini Balance Evaluation Systems Test (Mini-BESTest) is a validated balance test that measures balance according to these subdomains for a more comprehensive assessment. The purpose of this study was to compare Mini-BESTest total and subdomain scores after subacute mTBI with healthy controls. MethodsSymptomatic mTBI (n = 90, 20 % male, age=36.0 ± 12.0, 46.3.4 ± 22.1 days since injury) and healthy control (n = 45, 20 % male, age=35.4 ± 12.5) participants completed the Mini-BESTest for balance. Mini-BESTest between-group differences were evaluated using Wilcoxon rank-sum tests. ResultsThe mTBI group (Median[minimum,maximum]) had a significantly worse Mini-BESTest total score than the healthy controls (24[18,28] vs 27[23–28], p < 0.001). The mTBI group performed significantly worse in 3 of the 4 subdomains compared to the healthy controls: reactive postural control: 5[2–6] vs 6[3–6], p = 0.003; sensory orientation: 6[5,6] vs 6[6], p = 0.005; dynamic gait: 8[5–10] vs 9[8–10], p < 0.001. There was no significance difference between groups in the anticipatory postural adjustments domain (5[3–6] vs 5[3–6], p = 0.12). ConclusionsThe Mini-BESTest identified deficits in people with subacute mTBI in the total score and 3 out of 4 subdomains, suggesting it may be helpful to use in the clinic to identify balance subdomain deficits in the subacute mTBI population. In combination with self-reported assessments, the mini-BESTest may identify balance domain deficits in the subacute mTBI population and help guide treatment for this population.

Reliability and validity of the glittre activities of daily living test in fully ambulatory multiple sclerosis patients.

Evaluation of activities of daily living (ADL) and functional exercise capacity in patients with multiple sclerosis (pwMS) is crucial in demonstrating the effectiveness of interventions. To investigate the reliability and validity of the Glittre ADL Test in pwMS. Twenty-five pwMS and 26 healthy adults were included in this methodological study. The Glittre ADL Test was applied. Six-Minute Walk Test (6MWT) and Nottingham Extended Activities of Daily Living Index (NEADL) were applied for concurrent validity. Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Mini Balance Evaluation Systems Test (Mini BESTest), Multiple Sclerosis Quality of Life Scale-54 (MSQoL-54), and Five Times Sit-to-Stand Test (5 STST) were applied for construct validity. The Glittre ADL Test was repeated after 3-6days for test-retest reliability. The test-retest reliability of the Glittre ADL Test was excellent (ICC = 0.941). There was strong correlation of the Glittre ADL Test with 6MWT (rho = - 0.710, p < 0.001), NEADL (rho = - 0.841, p < 0.001), EDSS, (rho = 0.836, p = < 0.001), Mini BESTest (rho = 0.792, p < 0.001), and 5 STST scores (rho = 0.720, p < 0.001). There was a moderate correlation between the Glittre ADL Test and the physical health sub-item score of the MSQoL-54 (rho = - 0.591, p = 0.002). No correlation was found between the Glittre ADL Test and FSS (rho = 0.348, p = 0.096). There was a difference in the Glittre ADL Test results between the pwMS and the healthy adults (p = 0.001). The Glittre ADL Test has excellent reliability and strong construct and criterionvalidity for assessing functional exercise capacity and ADL in fully ambulatory pwMS. TRN: NCT04182269.

Smartphone-based gait and balance accelerometry is sensitive to age and correlates with clinical and kinematic data

BackgroundThe Gait&Balance (G&B) App has produced valid and reliable measures of gait and balance in young healthy adults but has not been tested in older adults. Research questionIn healthy middle-to-older aged adults, are G&B App measurements sensitive to age, valid against clinical and kinematic measures, and reliable? MethodHealthy participants (n = 34, 14 male, 42–94 years) completed the G&B App protocol three times within a single session. 3D kinematics were collected concurrently. Clinical balance measures were collected (Modified Clinical Test of Sensory Interaction in Balance (mCTSIB), Mini Balance Evaluation Systems Test (MBT), and Functional Gait Assessment (FGA)). Sensitivity to age was assessed with Pearson’s correlations. Validity tests included Pearson’s correlations and Bland-Altman limits of agreement. Reliability tests included intra-class correlation coefficients and standard error of the measure. ResultsDuring quiet stance on a compliant surface, the G&B App was sensitive to age-related differences not detectable with the mCTSIB. During walking tasks, there was adequate convergent validity between the MBT and G&B App measures of step length, and between the FGA and G&B App measures of walking speed, step length, and periodicity. The G&B App had moderate-to-excellent validity against 3D kinematics for postural stability during quiet stance (r 0.98 [0.98, 0.99]), step time (r 0.97 [0.96, 0.98]), walking speed (r 0.79 [0.7, 0.86]), and step length (r 0.73 [0.61, 0.81]). Test-retest reliability was moderate-to-excellent for G&B App measures of postural stability, walking speed, periodicity, step length, and step time. G&B App measures of step length asymmetry, step length variability, step time asymmetry, and step time variability had poor validity and reliability. SignificanceThe G&B App was sensitive to age-related differences in balance not detectable with clinical measurement. It provides valid and reliable measures of postural stability, step length, step time, and periodicity, which are not currently available in standard practice.