Open Eyes Research Articles

Static Balance Reliability Test with One Leg Stance Test in Knee Osteoarthritis Patients

Introduction: Osteoarthritis (OA) is the most common joint inflammation that often occurs in the knee region and its prevalence increases with age. The prevalence of knee OA is the highest compared to other regions. Static balance is one of the problems in OA patients which is evaluated by the One leg stance test, but the reliability of this measuring instrument for patients with knee OA has not been reported in Indonesia. Research objective: To determine the reliability of the intra rater and inter rater one leg stance test as a measure of static balance in patients with knee osteoarthritis. Materials and methods: The research method used was an observational study with a methodological research approach. There were 58 respondents who signed informed consent and were involved in this study. Results/findings: Intra rater reliability showed a very high internal consistency in both right and left eye open positions (?>0.9) with ICC=0.8-0.9. Whereas OLS in closed eyes shows moderate to low internal consistency and moderate ICC. The results of the inter-rater reliability analysis showed very high internal consistency and ICC for the right and left leg open eyes. Whereas in closed eyes it has internal consistency and moderate to high ICC for the right and left. Conclusion: The ability to maintain static balance in the closed eye position is something that is not easy for patients with knee OA to do, possibly due to pain and also reduced function in the elderly, this is indicated by the low consistency value for OLS in the closed eye position.

Functional reorganization of the brain in distinct frequency bands during eyes-open meditation

Meditation is a self-regulatory process practiced primarily to reduce stress, manage emotions and mental health. The objective of this work is to study the information exchange between electrodes within and across the hemispheres during meditation using functional connectivity (FC) measures. We investigate the changes in the coherence between EEG electrode pairs during the meditation with open eyes practiced by long-term Brahmakumaris Rajyoga meditators and during listening to music by controls as the comparable task. FC derived from coherency, pairwise phase consistency (PPC) is used to study the changes in intra and interhemispheric coherence. Integrating connectivity (IC) derived from node degree strength has also been analyzed. Meditators show increased PPC in higher theta and alpha bands both within and across hemispheres. However, the control subjects with no knowledge of meditation show no change in theta band during the music session. Further, during baseline conditions, higher interhemispheric anterior to posterior IC is found in meditators in higher beta and slow gamma bands than controls. Distinct patterns of changes are observed with the PPC and IC measures in different frequency bands during meditation in the meditators and music-listening session in the control subjects indicating varied information processing between the right and left hemispheres. Increased IC is found between the frontal electrodes implying increased self-awareness in meditators. The PPC between the occipital electrodes in meditators is less than the controls in baseline condition indicating a possible modified visual information processing in Rajyoga meditators due to the long-term practice of meditation with open eyes. Overall, the changes in PPC and associated IC indicate increased functional integration during meditation supporting the hypothesis of communication through coherence and cortical integration theory during the non-ordinary state of consciousness induced by meditation.

Comparison of different methods used in balance evaluation in children with diparetic cerebral palsy

ABSTRACTPurposeIn this study, we aimed to investigate the validity and reliability of Single Leg Stance (SLS), Tandem Stance (TS) and Pediatric Reach Tests (PRT) in children with Cerebral Palsy (CP).MethodsFifty-three children (31 boys, 22 girls, age:3-15 years, Gross Motor Function Classification System (GMFCS) Level I- II with diparetic CP were included the study. SLS, TS, PRT test used for balance evaluations. SLS test was made by standing on dominant (D) and non-dominant (ND) extremity both eyes opened (EO) and closed (EC).ResultsThe mean age of childrens were 7.88±3.43 years. The Cronbach’s - coefficients of all tests used to evaluate the internal consistency were found to excellent to acceptable level. SLS-D with EO/ EC, SLS-ND with EO/ EC and TS with EO had strong correlation, TS with EC and PRT-Forward moderate correlation, PRT-Right and eft low correlation with GMFCS. All tests except PRT-Right and PRT-Left were discriminate balance ability between GMFCS level I and level II (AUC>0.800).ConclusionIn this study, we used SLS, TS, PRT for balance evaluations and we investigated reliability and validity (construct and predictive) of each balance tests in childeren with diparetic CP. All tests were sensitive in distinguishing between GMFCS levels I and II, except PRT-Right and PRT-Left. As a result of the study, it was determined that the tests were valid and reliable, suggesting that physiotherapists will provide clinical advantage in order to quickly learn about the balance of children with CP.

The effects of kinesiophobia on postural control with chronic ankle instability

BackgroundPatients with chronic ankle instability (CAI) often experience injury-related fear following ankle injuries, a condition known as kinesiophobia. Little research has investigated the impact of kinesiophobia in patients with CAI. Research questionHow does kinesiophobia impact the static and dynamic balance of individuals with CAI? MethodsFifty patients with CAI were divided into 2 subgroups based on their responses to the Tampa Scale of Kinesiophobia: 25 with kinesiophobia (CAI-K) and 25 without kinesiophobia (CAI-N). These groups were compared to 20 control participants. All participants performed a single-leg balance test with eyes open (EO) and eyes closed (EC). They also performed the Y-balance test (YBT) with EO. Romberg ratios were calculated as EC/EO and used for statistical analysis. ResultsNo differences in static balance with EO and EC were found among three groups. However, the CAI-K group displayed a higher Romberg ratio in the mediolateral direction during static balance than both CAI-N and control groups. Additionally, both CAI-K and CAI-N groups displayed higher Romberg ratio in the anterior–posterior than controls. During YBT, the CAI-K group showed reduced reach distance in the anterior direction than CAI-N and control groups. SignificanceThe CAI-K group relies more on visual feedback during static balance in the mediolateral direction than CAI-N and control groups. Furthermore, the CAI-K group displayed less anterior reach distance during YBT compared to the CAI-N and control groups. Clinicians should consider both psychological and physical factors when designing rehabilitation programs.

Correlation of balance posturographic parameters during quiet standing with the berg balance scale in patients with parkinson’s disease

BackgroundParkinson’s disease (PD) is often clinically associated with posture instability and more easily falling. The Berg balance scale is a clinical indicator commonly used to subjectively evaluate a patient’s balance ability. Meanwhile, computerized force platforms have been used in research on postural control. The various parameters obtained from posturography are interpreted to assess balance ability. The present study aims to explore the correlations between posturographic variables and the BBS, and furthermore to efficiently evaluate postural instability and fall risk of early and moderate PD patients.MethodsA total of 46 PD patients were involved in the experiment. Patients were asked to perform BBS tests and force platform tests under eye open (EO) and eye closed (EC) conditions. The recorded COP signal was analyzed with the time domain statistical method, the frequency domain method of Power Spectral Density (PSD), and structural methods of Stabilogram Diffusion Analysis (SDA), Sway Density Plot (SDP) to retrieve different posturographic variables. The correlation between posturographic variables under EO and EC conditions with BBS was compared statistically. The significantly correlated posturographic parameters were then applied to analyze posturographic differences between different groups: faller vs. non-faller (patients with/without a history of falls in the past 12 months).ResultsAmong the different posturographic parameters, the prediction ellipse area, the slope of the regression line at a high-frequency band of PSD in the medial-lateral (ML) direction, the crossover point of the regression lines of SDA in the anterior-posterior (AP) direction, and the distance between successive peaks of SDP had significant correlations with BBS. These selected BBS-related parameters also showed significant differences between faller and non-faller. The selected posturographic parameters can be used as effective indicators to evaluate the balance ability of Parkinson’s disease patients.

Analysis of Postural Control in Patients Diagnosed with Unilateral Knee Osteoarthrosis and Its Relationship with the Risk of Falls.

Knee osteoarthrosis, whether subtle or marked, appears to alter the stability and performance of the knee joint in activities of daily living that prevent the maintenance of bipedal posture. However, there is still a gap in the literature as to how knee osteoarthritis can affect static balance. To analyze the performance of postural control in elderly diagnosed with unilateral knee osteoarthrosis. 40 elderly people of both sexes participated in this study, divided into two groups containing 20 elderly each. Group 1 (G1) consists of elderly patients who have received a diagnosis of unilateral knee osteoarthritis. Despite undergoing conservative treatment, their condition has shown insufficient improvement, leading to a clinical recommendation for total knee arthroplasty (TKA). The G2 group was made up of 20 elderly with an average age of 71.09 years, considered active, who do not have a diagnosis of osteoarthritis in the knee joint and practice physical activity. With the aid of a Baroscan pressure platform, the center of pressure (COP) displacement in the anteroposterior (COPAP) direction and mediolateral direction (COPML) and the area of center of pressure displacement were evaluated during bipedal postural control with eyes open and eyes closed. During postural control with eyes open and eyes closed, the G1 group showed greater displacement of the COP in the anteroposterior direction-COPAP (p = 0.007)-and mediolateral direction-COPML (p = 0.033)-when compared to the G2 group. As for the area of displacement of the COP, group G1 presented a larger area of displacement (p = 0.002) than group G2 during bipedal postural control with open eyes. For the condition with eyes closed, both groups showed similar behaviors, which resulted in no present statistically significant differences. The results suggest that unilateral knee osteoarthritis influences bipedal postural control and activities of daily living that require this static balance, since information from the somatosensory system is reduced, resulting in stability of tasks that require body control and promoting the risk of falls. From a clinical perspective, the results suggest that the assessment of bipedal postural control can assist orthopedic physicians in assessing joint stability in patients with unilateral knee osteoarthrosis.

Comparing the effectiveness of flexi-bar and stability exercises on postural control in chronic nonspecific low back pain: A randomized controlled study.

This study aimed to compare the effect of flexi-bar and stabilization exercises on static and dynamic postural control in patients with chronic nonspecific low back pain. In this randomized controlled study conducted between November 2019 and March 2020, 38 patients (19 males, 19 females; mean age: 33.8±6.2 years; range, 20 to 45 years) were randomly assigned into flexi-bar (n=19) and stabilization (n=19) groups. Both groups received general physiotherapy for three sessions per week, a total of 10 sessions. Besides, the flexi-bar group received flexi-bar exercises, and the stabilization group received stabilization exercises. Postural sway was assessed with a force platform in three difficult conditions, including open eye, close eye, and one-leg standing and dynamic posture with the modified Star Excursion Balance Test. After the intervention, both groups showed a significant improvement in static and dynamic postural control (p<0.05). However, no significant differences were found between groups after treatment, while only the phase-plane portrait of opened eyes condition was significantly improved (p=0.03), in the flexi-bar group compared to the stabilization group. Both flexi-bar and stabilization exercises effectively improved static and dynamic postural control, but none of the exercises was superior to the other. Flexi-bar is recommended as an effective tool in low back pain rehabilitation.

Impaired Dynamic Cerebral Autoregulation in Patients With Cerebral Venous Sinus Thrombosis: Evaluation Using Transcranial Doppler and Silent Reading Stimulation.

Cerebral venous sinus thrombosis (CVST) may impair dynamic cerebral autoregulation (dCA) of the middle cerebral artery (MCA). However, most studies have focused on dCA of the MCA; a few studies are based on the posterior cerebral artery (PCA) during silent reading and neurovascular coupling (NVC). This study explored the effects of CVST on dCA of the MCA and PCA during silent reading and NVC. From January 2021 to August 2022, 60 CVST patients and 30 controls were enrolled in this study. Non-invasive continuous beat-to-beat blood pressure, cerebral blood flow velocity and other associated information on the MCA and PCA during silent reading were collected using a transcranial Doppler. NVC assessment was performed by opening and closing the eyes periodically based on voice prompts, and eye-opening visual stimulation was achieved by silently reading Chinese tourism materials. Visual stimulation signals can selectively activate Brodmann's areas 17, 18, and 19 of the occipital when reading silently with open eyes, prompting them to release neurotransmitters and dilate PCA. dCA was determined by transfer function analysis. In dCA of the PCA during silent reading, the CVST group's very low frequency phase was lower than that of the control group (p=0.047). In NVC, the difference in the indexes of the cerebrovascular conductance and visually evoked flow response of the CVST group were lower than those of the control group (p=0.017 and p=0.019, respectively). Compared with the control group, dCA and NVC of the PCA during silent reading were impaired in CVST patients.

Sleep with Open Eyes in Two Species of Deer, the Indian Sambar (Rusa unicolor) and Sika Deer (Cervus nippon)

Sleep with Open Eyes in Two Species of Deer, the Indian Sambar (Rusa unicolor) and Sika Deer (Cervus nippon)

Misperception of Visual Verticality Measured with a Virtual Reality Device in Patients with Fibromyalgia Syndrome: A Cross-Sectional Study

The objective of this study was to analyze the perception of visual verticality (VV) in subjects with Fibromyalgia Syndrome (FMS) and to correlate this with the symptoms of the disease and balance capacity. A cross-sectional study including 54 patients (51 female) was conducted. The evaluation of visual verticality was carried out with a virtual reality device by calculating the Mean Absolute Error (MAE) of degrees deviation in two tests: the Subjective Visual Vertical (SVV) test for the contribution of the vestibular system to the perception of verticality and the Rod and Frame test (RFT) for the contribution of the visual system. In total, 16 subjects (29.6%) presented good VV perception, 6 subjects (11.1%) presented an exclusive alteration of the SVV test, 19 subjects (35.2%) presented an exclusive alteration of the RFT and 13 subjects (24.1%) showed alteration in the two tests. The MAE in the SVV test showed medium correlations with several variables such as the Fibromyalgia Impact Questionnaire (FIQ) (Rho = 0.399, p = 0.003), the Pain Catastrophizing Scale (PCS) (Rho = 0.417, p = 0.002), the Dizziness Handicap Inventory (DHI) (Rho = 0.376, p = 0.005), and the Activities-Specific Balance Confidence Scale (ABC-16) (Rho = −0.367, p = 0.006). The MAE in the RFT showed medium correlations with the Instability Support Reduced (Rho = 0.327, p = 0.016) and Instability Gait Eyes Open (Rho = 0.312, p = 0.022) subscales of the JAEN (Joined Assessment of Equilibrium and Neuro-motor) Scale. Conclusions: Around 70% of the subjects with FMS showed some alteration in the perception of VV; 60% of these patients presented visual system dependence. The SVV test correlates with the impact and health status of FMS, and the RFT correlates with the alteration in the dynamic balance.

Short-Term Cast Immobilization of a Unilateral Lower Extremity and Physical Inactivity Induce Postural Instability during Standing in Healthy Young Men.

Previous studies have reported an increased postural sway after short-term unilateral lower limb movement restriction, even in healthy subjects. However, the associations of motion limitation have not been fully established. The question of whether short-term lower limb physical inactivity and movement restriction affect postural control in the upright position remains. One lower limb of each participant was fixed with a soft bandage and medical splint for 10 h while the participant sat on a manual wheelchair. The participants were instructed to stand still for 60 s under eyes-open (EO) and eyes-closed (EC) conditions. Using a single force plate signal, we measured the center of pressure (COP) signal in the horizontal plane and calculated the total, anterior-posterior (A-P), and medial-lateral (M-L) path lengths, sway area, and mean COP displacements in A-P and M-L directions. The COP sway increased and the COP position during the upright stance shifted from the fixed to the non-fixed side after cast removal, compared to before the cast application, under both EO and EC conditions. These findings indicated that 10 h of unilateral lower limb movement restriction induced postural instability and postural control asymmetry, suggesting the acute adverse effects of cast immobilization.

Postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer: A case-control study

PurposeTo compare postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer with a matched control group. MethodsTwenty-seven women with unilateral lower extremity lymphedema (lymphedema group, age: 54.14 ± 5.80 years) and 30 healthy women (control group, age: 51.90 ± 6.54 years) were included. The lymphedema severity was evaluated with circumferential measurements. Postural stability with the Biodex Balance System SD and the spinal alignment, mobility, and postural competency with the Spinal Mouse device were assessed. ResultsIn the lymphedema group, it was found that 3.7% of the women had mild lymphedema, 7.4% had moderate lymphedema, and 88.9% had severe lymphedema. Static eyes open (EO) (overall, medio-lateral and antero-posterior) and eyes closed (EC) (antero-posterior) stability scores and dynamic EO and EC stability scores (overall and antero-posterior) were detected to be higher in the lymphedema group than in the controls (p < 0.05). Spinal mobility and postural competency scores were lower in the lymphedema group than in the control group (p < 0.05). In other parameters, there were no significant differences between the groups (p > 0.05). ConclusionDecreased postural stability, spinal mobility, and postural competency were detected in women with unilateral lower extremity lymphedema; however, no difference was seen in spinal alignment. These changes should be taken into account in the assessment and the treatment of unilateral lower extremity lymphedema.

Association of Bergmeister Papilla and Deep Optic Nerve Head Structures With Prelaminar Schisis of Normal and Glaucomatous Eyes

To investigate factors associated with the severity of prelaminar schisis (PLS) in heathy subjects and glaucoma patients. Prospective cross-sectional study. A total of 217 eyes of 217 subjects (110 normal eyes and 107 open angle glaucoma eyes) were studied. Frequency and severity of PLS were compared between normal and glaucomatous eyes. Multivariate logistic models were used to assess factors associated with the severity of PLS. Factors considered were age, axial length, glaucomatous damage indices, Bruch membrane opening (BMO) and anterior scleral canal opening parameters, tractional forces (posterior vitreous staging and presence of Bergmeister papilla), circumpapillary choroidal thickness, lamina cribrosa (LC) parameters, and peripapillary scleral (PPS) angle. The frequency of PLS was 70.9% in normal eyes and 72.0% in glaucomatous eyes. There was no difference in frequency and severity between the groups. The presence of Bergmeister papilla was the strongest predictor of a more severe PLS in both normal and glaucomatous eyes (odds ratio [OR]+9.78, 12.5; both P < .001). A larger PPS angle in normal eyes (OR=1.19; P=.003) and a larger BMO area and a deeper LC depth in glaucomatous eyes (OR=1.08, 1.05; both P=.038) were associated with severity of PLS. The severity of PLS was strongly associated with the presence of Bergmeister papilla, suggesting a traction-related phenomenon. Correlation of PLS severity with larger BMO area and deeper LC depth, which are optic nerve head structures associated with glaucoma, suggested its possible relationship with glaucomatous damage.

SLEEP WITH OPEN EYES IN TWO SPECIES OF DEER, THE INDIAN SAMBAR (&lt;i&gt;RUSA UNICOLOR&lt;/i&gt;) И SIKA DEER (&lt;i&gt;CERVUS NIPPON&lt;/i&gt;)

The relationship between postures, sleep stages and eye state was established in two species of deer, the Indian sambar (Rusa unicolor) and sika deer (Cervus nippon), based on video recording. In both species, the state of rest or behavioral sleep was recorded in the sternal position, holding the head above the ground, and in the lateral position, with the head resting on the croup or on the ground. Rest accounted for at least 80% of the time in these positions. Based on behavior criteria a substantial portion of rest represented slow-wave sleep. Episodes of rapid eye movements (REM sleep) were recorded in the lateral position. They did not exceed 2 min. When the deer were in the sternal posture, they kept their eyes open most of the time: on average 96% of the time in sambars and 82% in sika deer. Episodes of the open eye in this posture lasted up to 8.4 min in sambars and up to 3.3 min in sika deer. In the lateral position, such episodes were 4 and 1.5 times shorter. Sleeping with open eyes in ungulates may be an important mechanism of maintaining vigilance.

Do visual and step height factors cause imbalance during bipedal and unipedal stances? A plantar pressure perspective.

Objective: The plantar pressure analysis technique was used to explore the static balance ability and stability of healthy adult males under the influence of visual and step height factors during bipedal and unipedal stances. Methods: Thirty healthy adult males volunteered for the study. Experiments used the F-scan plantar pressure analysis insoles to carry out with eyes open (EO) and eyes closed (EC) at four different step heights. The plantar pressure data were recorded for 10s and pre-processed to derive kinematic and dynamic parameters. Results: For unipedal stance, most of kinematic parameters of the subjects' right and left feet were significantly greater when the eyes were closed compared to the EO condition and increased with step height. The differences in toe load between right and left feet, open and closed eyes were extremely statistically significant (p < 0.001). The differences in midfoot load between the EO and EC conditions were statistically significant (p = 0.024) and extremely statistically significant between the right and left feet (p < 0.001). The difference in rearfoot load between EO and EC conditions was extremely statistically significant (p < 0.001) and statistically significant (p = 0.002) between the right and left feet. For bipedal stance, most of kinematic parameters of the subjects' EO and EC conditions were statistically significant between the right and left feet and increased with step height. The overall load's difference between EO and EC states was statistically significant (p = 0.003) for both feet. The overall load's difference between the right and left feet was extremely statistically significant (p < 0.001) in the EC state. The differences between the right and left feet of the forefoot and rearfoot load with EO and EC suggested that the right foot had a smaller forefoot load, but a larger rearfoot load than the left foot (p < 0.001). The differences between the forefoot and rearfoot load of the subjects' both feet with EO and EC were extremely statistically significant (p < 0.001). Conclusion: Both visual input and step height factors, even the dominant foot, act on kinematic and dynamic parameters that affect the maintenance of static balance ability.

Sport dependent effects on the sensory control of balance during upright posture: a comparison between professional horseback riders, judokas and non-athletes.

Compared to judokas (JU) and non-athletes (NA), horseback riders (HR) may develop specific changes in their sensory control of balance. Thirty-four international-level JU, twenty-seven international-level HR and twenty-one NA participated. Participants stood upright on a plateform (static condition) or on a seesaw device with an instability along the mediolateral (ML) or the anteroposterior (AP) direction (dynamic conditions). These conditions were carried out with eyes opened (EO) or closed (EC), and with (wF) or without a foam (nF). Experimental variables included conventional (linear), non-linear center-of-pressure (COP) parameters, Romberg Quotient (RQ) and Plantar Quotient (PQ). Group effects. COP Surface (COPS) and standard deviation of COP along AP (SDY) were lower in HR than in JU in Static. SD Y was lower in HR than in JU in Dynamic AP. COP velocity (COPV) was lower in both HR and JU than in NA in Static and Dynamic. Sample entropy along AP and ML (SampEnY and SampEnX) were higher in HR than in JU in Static. SampEnY was higher in HR than in JU in Dynamic ML. Sensory effects. In EC, COPV was lower in JU than in NA in Dynamic AP, and lower in JU than in both HR and NA in Dynamic ML. In EO, COPV was lower in both JU and HR than in NA in Dynamic ML. RQ applied to COPS was lower in JU than in both HR and NA in Dynamic AP, and lower in JU than in HR in Dynamic ML. RQ applied to COPV was lower in JU than in both HR and NA in Static and Dynamic. PQ applied to COPS was higher in JU than in both HR and NA in Dynamic ML. Results showed that the effects of sport expertise on postural control could only be revealed with specific COP variables and were directionally oriented and sport-dependant. HR seem to rely more on vision than JU, thus revealing that the contribution of the sensory inputs to balance control is also sport-dependent. Results open up new knowledge on the specificity of sport practice on multisensory balance information during upright posture.

Smart Driver Fatigue Detection System Using CNN

Abstract: Road accidents frequently result from fatigued or sleepy drivers. More people die and are killed worldwide each year. Driver fatigue is a major factor in many accidents. It is currently one of the major causes of accidents. Numerous facial expressions, such as frequent yawning, frequent eye blinking, and head positioning, might indicate how tired someone is. Computer vision is the most suitable and practical technology to solve this issue since it uses these sensory properties. The suggested methodology employs Dlib, CNN, and OpenCV. Dlib estimates the positions of 68 coordinates (x,y) that help in mapping the facial points on a person’s face. The 2904 pictures that make up the collections classified are Open Eyes, Closed Eyes, Yawning,or No-Yawning. A convolutional neural network (CNN) will be used to determine the mouth and eye states from the Regionof Interest (ROI) photographs. The amount of mouth opening (FOM) and the percentage of eyelid closure (PERCLOS) overthe pupil are the measures used to measure weariness over time. The recommended system determines whether the driver is sleepyand sounds a warning when it detects their eyes and yawns fora certain amount of time. The accuracy of the model has been discussed.

Standard versus innovative robotic balance assessment for people with multiple sclerosis: a correlational study

IntroductionBalance disorders are common in people with Multiple Sclerosis (PwMS) and, together with other impairments and disabilities, often prevent PwMS from performing their daily living activities. Besides clinical scales and performance tests, robotic platforms can provide more sensitive, specific, and objective monitoring. Validated technologies have been adopted as gold standard, but innovative robotic solutions would represent an opportunity to detect balance impairment in PwMS.AimStudy’s aim was to compare postural assessment of 46 PwMS with a relapsing–remitting form during static tasks performed with the novel robotic platform hunova® and the gold standard EquiTest®,MethodsPearson’s r was run on Center of Pressure (COP)-related parameters and global static balance measures computed from hunova® and EquiTest® in eyes-open (EO) and eyes-closed (EC) conditions. In addition, agreeableness level toward the use of both devices was tested through numeric rating scale.ResultsConsidering COP-related parameters, correlations were significant for all measures (p < .001). Interestingly, in EO, a strong correlation was shown for sway area (r = .770), while Medio-Lateral (ML) and Anterior–Posterior (AP) oscillation range, path length, ML and AP speed, ML and AP root mean square distance had a relatively strong association (.454 ≤ r ≤ .576). In EC, except for ML oscillation range showing a relatively strong correlation (r = .532), other parameters were strongly associated (.603 ≤ r ≤ .782). Correlations between global balance indexes of hunova® and EquiTest® revealed a relatively strong association between the Somatosensory Score in EquiTest® and the Somatosensory Index in hunova® (r = − .488). While in EO Static Balance Index from hunova® was highly correlated with Equilibrium score of EquiTest® (r = .416), Static Balance Index had a relatively strong association with both the Equilibrium (r = .482) and Strategy Score (r = .583) of EquiTest® in EC. Results from agreeableness rating scale revealed that hunova® was highly appreciated compared to EquiTest® (p = .044).Conclusionshunova® represents an innovative adjunct to standard robotic balance evaluation for PwMS. This confirms that combining traditional and robotic assessments can more accurately detect balance impairments in MS.

Brain and cognitive reserve mitigate balance dysfunction in multiple sclerosis.

Approximately two-thirds of patients with multiple sclerosis (MS) complain different degrees of balance dysfunction, but some of them are able to withstand considerable disease burden without an overt balance impairment. Here, we tested the hypothesis that brain and cognitive reserve lessen the effect of MS-related tissue damage on balance control. We measured the postural sway of 148 patients and 74 sex- and age-matched healthy controls by force platform under different conditions reflecting diverse neuro-pathological substrates of balance dysfunction: eyes opened (EO), eyes closed (EC), and while performing the Stroop test, i.e., dual-task (DT). Lesion volumes on T2-hyperintense and T1-hypointense sequences, and normalized brain volume provided estimations of MS-related tissue damage in patients with MS. Hierarchical linear regressions explored the protective effect against the MS-related tissue damage of intracranial volume and educational attainment (proxies for brain and cognitive reserve, respectively) on balance. Larger intracranial volume and high educational attainment mitigated the detrimental effect of MS-related tissue damage on postural sway under EO (adjusted-R2=0.20 and 0.27, respectively, p<0.01) and DT (adjusted-R2=0.22 and 0.30, respectively, p<0.06) conditions. Neither educational level nor brain size was associated with postural sway under EC condition. Our findings suggest a protective role of brain and cognitive reserve even on balance, an outcome that relies on both motor control and higher order processing resources. The lack of a protective effect on postural sway under EC condition confirms that this latter outcome is closer associated with spinal cord rather than brain damage.

The Metamorphosis, struggling to adapt to a new condition. The lived experience of patients with Thrombotic microangiopathies diagnosed in the ICU. A qualitative study

BackgroundUsing qualitative interviews, our objective was to better understand the experience of patients with Thrombotic microangiopathies (TMA), from discovering their disease in the ICU to the psychological, emotional, and social specifics of living with this rare disorder. Material and methodsPatients were recruited at seven TMA centers belonging to the French national TMA referral network. A total of 15 patients, 15 relatives and 12 healthcare professionals participated.A majority of patients (n = 11/15) were women, median age was 41 (range 29–62) years, and median time elapsed since diagnosis was 6 (range 2–11) years. Interviews were analysed using thematic analysis. ResultsWe derived 3 major themes from qualitative analysis: 1) Discovering TMA: experiencing a life-threatening emergency with open eyes; 2) TMA: a complex and diverse disease and care plan; 3) Living with TMA: taming fear and loneliness. ConclusionsPatients with TMA share common experiences with patients with other rare diseases, but also specific experiences related to their illness. Improved information at the onset and during the course of the illness, associated with enhanced care coordination plans would help TMA patients better cope with their illness and adhere to their care projects.