Limits Of Stability Test Research Articles

The Relationships Among Proprioception, Balance, and Cognitive Perception of Body Awareness in College Students: A Pilot Study

Introduction: This pilot study examined the relationships among lower extremity proprioception, balance ability, and perception of body awareness. Researchers also evaluated the influence of sex, sport participation, leg dominance, and previous ankle injury. Methods: Eighteen participants (F = 11, M = 7) completed the initial testing, with eight (F = 4, M = 4) repeating the mLEPT one week later. Participant characteristics and mBARQ data were collected using an online survey. Measures included proprioception errors on the mLEPT, utilizing distances of 12 and 22 cm, and the Biodex Balance SystemÔ Limits of Stability Test. Results: For the mLEPT, good reliability was noted for the dominant leg 22 cm distance between trials 1 and 2 for all 18 participants (ICC = 0.83). Moderate test-retest reliability was observed when comparing the averages of day 1 to day 2 for the dominant leg 22 cm distance (ICC = 0.53), and for the overall error when collapsing across conditions (ICC = 0.63). Moderate reliability was also observed for the mBARQ (α = 0.76). Strong inverse relationships between proprioception error and directional control scores were observed, indicating an association between dynamic balance and lower extremity proprioception (r = -0.55-0.54, p = 0.02). Sex, sports participation, leg dominance, and previous ankle injury also influenced proprioception performance. Females displayed better lower extremity proprioception and balance control than males. In addition, participants without previous ankle injury scored higher on the mBARQ, and had better directional control and time to completion, indicating that those without ankle injury had a higher perception of body awareness and better dynamic balance. Conclusions: Both the mLEPT and mBARQ appear to have moderate reliability. mLEPT performance was strongly associated with dynamic balance measures. In addition, lower mBARQ scale scores in those with previous ankle injury were strongly associated with poorer proprioception. While preliminary findings are promising, a larger follow-up study is needed to determine if the mLEPT and mBARQ are potential quick and inexpensive tools to monitor changes in proprioception during rehabilitation post-injury.

Does multifactorial inspiratory muscle training improve postural stability and quality of life of patients with diabetes in Pakistan? A randomised controlled trial

ObjectiveTo determine the effects of multifactorial inspiratory muscle training (IMT) combined with Otago Exercise Programme (OEP) on balance and quality of life (QoL) in patients with diabetes.MethodsPretest–post-test randomised controlled trial.SettingRehabilitation...

The effects of gaze stability exercises on balance, gait ability, and fall efficacy in patients with chronic stroke: A 2-week follow-up from a randomized controlled trial.

This study aimed to examine the effect of gaze stability exercises on balance, gait ability, and fall efficacy in patients with chronic stroke, as well as to investigate whether any observed effects were maintained 2 weeks later. In this experiment, 30 chronic stroke patients were selected. The patients were randomly divided into 3 groups (10 patients in each group). All patients in the 3 groups performed basic neurodevelopmental treatment. Group 1 performed balance exercises accompanied by gaze stability exercises. Group 2 performed gaze stability exercises, and group 3 performed balance exercises. Each exercise program for 40 minutes 3 times a week for 4 weeks. After the intervention period, the patient's balance, gait ability, and fall efficacy were measured again. In order to know whether the training effect is maintained, a 2-week follow-up test was conducted after the training. The results of this study showed that there was a significant improve in balance (overall stability index, limit of stability test, and Berg Balance Scale), gait ability (gait velocity, cadence, step time and step length, Timed Up and Go [TUG] test), and fall efficacy over the different time within the 3 groups. The effect was observed to be maintained in follow-up tests after 2 weeks. In the comparison among 3 groups, the overall stability index, limit of stability test in the balance test and the gait velocity, cadence, step time, step length and Timed Up and Go test in the gait test all showed statistically significant differences, and the other items did not have significant differences. In most of the assessments, group 1 that used balance exercise combined with gaze stability exercise showed a better improvement than the other 2 groups. As a result, for stroke patients, gaze stability exercise is an effective arbitration method to improve balance and gait ability and fall efficacy. With balance exercise combined with gaze stability exercise, a greater effect can be seen than with gaze stability exercise or balance exercise alone. Thus, this combination exercise program can be recommended as effective.

Exploring Balance Impairment and Determinants in Chronic Obstructive Pulmonary Disease: A Comparative Study with Healthy Subjects.

Background: Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy subjects. The secondary aim was to investigate the potential determinants of balance in patients with COPD. Methods: This comparative study recruited 23 patients with COPD and 23 age- and comorbidity-matched healthy subjects. Participants were assessed regarding demographic and clinical data, "Postural Stability Test" (PST), "Limits of Stability Test" (LOST), "Clinical Test of Sensory Integration of Balance" (CTSIB), pulmonary function, respiratory and peripheral muscle strength, functional capacity, and cognitive function. Results: There were significant differences in all outcome measures assessing balance, pulmonary function, respiratory muscle strength, peripheral muscle strength, and functional capacity, but not cognitive function, in the COPD group compared to the healthy group (p < 0.05). The PST had a significant and strong correlation with maximal inspiratory pressure (MIP) (r = -0.630, p = 0.001) and a significant and moderate correlation with m. quadriceps strength and 6 min walk test (6MWT) distance (r = -0.472, p = 0.023; r = -0.496, p = 0.016; respectively). MIP, m. quadriceps strength, and 6MWT distance were independent predictors to explain the PST with an R2 = 0.336 (p = 0.004). Conclusions: The present study revealed that balance is impaired in adults with COPD, even if compared with age- and comorbidity-matched healthy subjects. Assessing and improving balance and its determinants, inspiratory and peripheral muscle strength, and functional capacity may be important for fall prevention and disease management in patients with COPD.

Evaluating the Stability Limits Between Individuals with Mild and Moderate-to-Severe Grades of Forward Head Posture

Background: Forward head posture (FHP) leads to the anterior excursion of the center of gravity, which can affect a person's standing balance. Evaluating the balance in different degrees of severity of FHP can help design and plan appropriate balance exercises for people with FHP. Objectives: This study aimed to evaluate the changes in the limits of stability (LOS) in people with mild and moderate-to-severe grades of FHP. Methods: The participants in this study were 70 individuals suffering from FHP, aged between 17 - 45. They were divided into two groups based on their craniovertebral angle: Mild (&gt; 45.5 degrees) and moderate-to-severe (&lt; 45.5 degrees). The LOS test was performed using a posturography device (Neurocom, Equitest, USA). Five indices—movement reaction time (RCT), movement velocity (MVL), endpoint excursion (EPE), maximum excursion (MXE), and directional control (DCL)—were evaluated. Results: Based on the results of the LOS test, RCT, MVL, EPE, MXE, and DCL were significantly different between the mild and moderate-to-severe FHP groups in both anterior and posterior directions (P &lt; 0.05). However, in other directions, no significant difference was observed in these variables based on the LOS test (P &gt; 0.05). Conclusions: It can be concluded that individuals with moderate-to-severe FHP are more likely to have postural control deficits. Therefore, it is necessary to design appropriate targeted interventions to prevent falls in these individuals. Specifically, they should receive balance exercises in dynamic situations.

C-Mill Virtual Reality/Augmented Reality Treadmill Training for Reducing Risk of Fall in the Elderly: A Randomized Controlled Trial.

Objective: Falling is considered one of the major problems that may affect the elderly, leading to multiple health issues. Walking adaptability to environmental demands is essential for safe walking in the elderly. The aim of this study was to evaluate the efficacy of virtual reality (VR)/augmented reality (AR) treadmill training on balance performance and the risk of falls in the elderly. Materials and Methods: Sixty Saudi elderly individuals of both genders, aged between 60 and 70 years, participated in the study. The participants were categorized into two groups: the experimental and the control groups. Both groups received 1 hour of training: 30 minutes of conventional exercises and 30 minutes of gait training on the C-Mill VR/AR treadmill. The experimental group used the C-Mill treadmill with VR and AR games therapy. The control group had gait training on the C-Mill treadmill without VR and AR. The training for both groups was conducted for 6 successive weeks/three times a week. The changes in the scores of the following variables were recorded at baseline, after 6 weeks of training, and 4 weeks after the completion of training. These variables involved the time needed for completing the Timed Up and Go (TUG) test, overall stability indices of the Fall Risk (FR) test and Limit of Stability (LOS) test evaluated using the Biodex Balance System (BBS), and the time required for completing the LOS test. Results: Both groups demonstrated significant improvement in all measured variables immediately post-training, and this improvement persisted for 4 weeks after completing the training. The experimental group exhibited greater improvement in the recorded values of all measured variables compared with the control group following the training. Conclusions: This study concluded that C-Mill VR/AR treadmill training is effective in improving balance control and reducing the fall risk in the elderly.

Investigation of postural sensory organization in women with and without primary dysmenorrhea in three phases of the menstrual cycle

BackgroundThe effects of the menstrual cycle in women with and without primary dysmenorrhea on phase-related postural sensory organization are controversial. Research questionThis study was carried out to examine postural sensory organization in three phases of the menstrual cycle in women with and without primary dysmenorrhea and to evaluate whether there is a difference between women with/without primary dysmenorrhea in this regard. MethodsWomen aged 18–30 years were divided into two groups as primary dysmenorrhea group (PDG, n = 14) and control group (CG, n = 15). Computerized dynamic posturography were applied to the participants on the follicular, ovulation, and luteal phases of the menstrual cycle. Outcome measures were antero-posterior and medio-lateral Sensory Organization Test (SOT–somatosensory, vestibular and visual scores) and Limits of Stability test (LoS). The findings obtained were analyzed with the two-factor ANOVA, paired samples t test, and independent samples t test. ResultsIn the PDG, follicular phase antero-posterior somatosensory scores were lower compared to luteal phase (p = 0.002). Follicular phase antero-posterior and medio-lateral vestibular scores were lower than ovulation (p = 0.003, p = 0.004, respectively) and luteal (p = 0.005, p = 0.001, respectively) phases. Follicular phase LoS scores were lower than ovulation (p = 0.001) and luteal (p = 0.002) phases. In the CG, ovulation phase antero-posterior somatosensory scores were lower than follicular phase (p = 0.003). Follicular phase LoS scores were lower than ovulation phase (p = 0.002). The PDG had lower follicular phase antero-posterior somatosensory (p = 0.019), vestibular (p = 0.031), and medio-lateral somatosensory (p = 0.019) scores than those of the CG. The PDG had lower luteal phase antero-posterior somatosensory scores than those of the CG (p = 0.029). The PDG showed lower follicular phase LoS scores than those of the CG (p = 0.009). SignificanceThis study revealed that primary dysmenorrhea impairs postural sensory organization. Decreased sensory organization may predispose women to injury. The risk of injury should be investigated and necessary precautions should be taken.

Oblique, forward, and lateral directions reach test distances in young adults, and concurrent validity of these tests with the center of pressure excursion in assessing the limits of stability

BackgroundLimits of stability is required to perform functional activities and other advanced tasks of life without losing balance, and assessment of limits of stability is essential in clinical practice. Forward, Lateral, and Oblique direction reach tests are clinical balance tests that assess limits of stability, and these reach distances in various directions may be symmetrical or asymmetrical. The aim was to establish the symmetry between various reach distances on three reach tests and to establish the concurrent validity of oblique, forward, and lateral direction reach test distances with limits of stability measured by the Iso Free machine of TecnoBody company. Methods: The measurements of oblique, forward, and lateral reach tests and limits of stability excursions of center of pressure were taken in eight directions on Iso Free machine of Techno Body in fifty typical college-going young adults who were recruited through convenience sampling. Pearson correlation test was used to find the relationship between forward, lateral, and oblique direction reaches and limits of stability in forward, lateral, and oblique directions. Regression analysis was used to find the factors influencing the forward, lateral, and oblique reach tests. Results: The reach distances were symmetrical, and out of the three tests, the lateral and oblique direction reach tests have a moderate positive correlation with limits of stability test in lateral and oblique directions with an r-value of 0.569 (p < 0.001) and 0.50 (p < 0.001) respectively. A Significant standardized beta value of 0.49 (p < 0.05) for the oblique direction reach test with total stability limits. Conclusions: The oblique and lateral direction reach tests are correlated with their respective center of pressure excursion. However, the oblique direction reach test moderately correlated with the total limits of stability scores. Forward reach distances were more in number followed by oblique and lateral reach distances among young Saudi adults.

Video-game System for Improving the Balance of Ageing Adults with Intellectual Disability in Sheltered Workshop

Objective: To explore the feasibility of using video game system for training to improve clinical measures of balance in ageing adults with mild to moderate intellectual disability (ID). Subjects and Methods: 16 adults diagnosed with mild to moderate ID, aged 40 or above and attending workshop were recruited to receive 21 sessions of 20 minutes video game training using HUR Balance Trainer BT4. Pre- and post-score of participants’ balance ability by Romberg test and limit of stability test were obtained. Wilcoxon’s test of SPSS was adopted to analyse the data of pre-and post-test to compare the differences. Results: Significant results were found in the pre-and post-data of “static balance score” and “leftward limit of stability”. Conclusion: The results revealed that video games could improve some aspects of the balance ability in ageing adults with mild to moderate ID. More in-depth research is needed.

Effect of dance movement therapy on balance in adults with Down Syndrome. A pilot study.

Systematic participation in dance therapy may improve balance and reduce risk of falls. The aim of this study was to assess the effect of dance therapy on balance and risk of falls in adults with Down syndrome. Study participants comprised 23 persons with Down syndrome aged 26- 49 years who underwent dance therapy. Before and after the therapy, all participants were measured on a BioSway balance platform using three tests: postural stability, limits of stability, and M-CTSIB fall risk. Mean result was lower following intervention (2.40 ± 1.81 vs. 1.65 ± 1.32; p = .006) in the postural stability test. The limits of stability test found a statistically significant difference (26.30 ± 8.99 vs. 37.90 ± 12.54; p < .001). The results of this study only partially supported the hypothesis that dance therapy improves balancing skills in adults with Down Syndrome.

Predictors of static and dynamic balance control in kidney transplant recipients.

We aimed to evaluate balance control and lower extremity muscle strength in kidney transplant recipients (KTRs) including acomparison to ahealthy control group and determine the predictors of static and dynamic balance control after kidney transplantation. In this study 40 KTRs and 40healthy controls were included. Balance control was assessed using the Biodex balance system. The static postural stability test (SPST) and clinical test of sensory integration and balance (CTSIB) were used to assess static balance control whereas the dynamic postural stability test (DPST) and limits of stability test (LOST) were used for dynamic balance control. Lower extremity muscle strength was measured with ahand-held dynamometer. Renal functions and laboratory findings of KTRs were recorded. All the stability index scores of SPST and sway index in CTSIB were significantly higher in KTRs compared to healthy controls. The right anteroposterior stability index score in DPST and the reaction time in LOST were significantly higher whereas overall score in LOST and lower extremity muscle strength were significantly lower in KTRs. The linear regression analysis revealed that hemoglobin was the predictor of static balance control accounting for 11% of the variance and body weight was the predictor of dynamic balance control accounting for 34% of the variance. Balance control, both static and dynamic, are impaired in KTRs as well as lower extremity muscle strength. Hemoglobin level is apredictor of static balance control whereas body weight is apredictor of dynamic balance control after kidney transplantation.

Diaphragmatic breathing combined with abdominal drawing-in maneuver for walking function in post-stroke patients: a randomized controlled study protocol

BackgroundPatients with stroke frequently experience walking dysfunction. Core training can help improve balance and walking function in patients with stroke. However, core training movements in clinical practice are numerous and differently targeted. Therefore, this study will investigate the improvement of walking function in patients with combined diaphragmatic breathing maneuver (DBM) and draw-in breathing technique (ADIM) training.MethodsThis single-blind, randomized controlled preliminary will analyze the viability of DBM combined ADIM training versus routine rehabilitation therapy in patients with stroke with early to mid-stroke. Patients will be randomly assigned to either the DBM and ADIM training or the routine rehabilitation training. We will recruit 42 stroke inpatients from the Second Rehabilitation Hospital of Shanghai who meet the trial criteria and measure the balance and walking functions and improvement of that after 4 weeks of intervention. The primary outcome is the 10 m maximum walking test (10MWT). The secondary outcomes indices include the limits of stability test (LOS), Berg balance scale test (BBS), Functional Ambulation Categories test (FAC), Timed Up and Go test (TUG), trunk impairment scale test (TIS), ultrasound indicators of the diaphragm and transversus abdominis (UI), rhythmic weight shift test (RWS), walk across test (WA), Fugl-Meyer assessment of lower extremity (FMA-LE), and Barthel index of ADL test.DiscussionThe primary objective of this project was to investigate the effects of DBM combined with ADIM on balance capacity and walking function for patients with early to mid-stroke. The outcomes of this study will hold significant implications for future clinical applications in rehabilitation.Trial registrationChinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2100054897. Registered on 28 December 2021.

The Effects of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions, and Postural Control in Children With Hearing Loss: A Randomized Controlled Trial.

To evaluate the effects of core stabilization training on respiratory muscle strength, respiratory functions, and postural control in children with hearing loss. We conducted a randomized controlled trial at Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation. Thirty children with hearing loss who were diagnosed with prelingual sensorineural hearing loss were randomly allocated to the study (n = 15, 12.20 ± 1.69 years) and control (n = 15, 11.87 ± 2.20 years) groups. Core stabilization training protocol was performed by the study group for 8 weeks, 5 days/week, whereas the control group received no training. The primary outcome measure was respiratory muscle strength. The secondary outcome measures were: spirometry, postural control tests on Biodex Balance System, and Balance Error Scoring System (BESS). Exercise adherence was recorded via a diary for home sessions. Outcomes were assessed at baseline and the end of the 8 weeks. In the study group, a significant improvement was observed in force vital capacity, peak expiratory flow of the spirometry test, maximum inspiratory pressure/expiratory pressure (MEP) of the respiratory muscle strength test; postural stability test except "anterior/posterior stability index", limits of stability test except "backward" and "forward/right", all parameters of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) test except "eyes closed firm surface" of the Biodex Balance System, and total score of BESS. Group × time interaction was found in MEP, "overall" stability index in postural stability test, "overall," "left," and "backward left" of limits of stability test, all parameters of the mCTSIB, and BESS total. Core stabilization exercises were effective in improving respiratory muscle strength, spirometry, and postural control in children with hearing loss.

Quantitative analysis of balance function characteristics in older patients with mild to moderate cognitive impairment

BackgroundCognitive decline in older adults may affect balance function, but the relationship between the two is not fully understood, especially in the early stages of cognitive impairment. Mild to moderate cognitive impairment can be assessed with the Montreal Cognitive Assessment (MOCA). AimThis study quantitatively analyzed balance function in older adults with mild to moderate cognitive impairment using computerized dynamic posturography (CDP) testing. Methods248 older patients were divided into a cognitive impaired group (MOCA <26, n = 126) and a normal group (MOCA ≥26, n = 122) based on the Montreal Cognitive Assessment (MOCA) Beijing Version. Patients underwent CDP testing, which included the sensory organization test (SOT) and the limits of stability test (LOS). ResultsThe cognitive impaired group had significantly lower SOT composite and visual scores, as well as reaction time (RT), movement velocity (MVL), endpoint excursion (EPE), maximum excursion (MXE), and directional control (DCL) of the LOS test. Binary logistic regression analysis revealed that RT and MXE were independent factors significantly associated with MOCA, even after adjustment for age and sex. ConclusionsOlder patients with mild to moderate cognitive impairment may have reduced sensory integration and balance stability limits, mainly manifested as prolonged motor reaction time and shortened maximum movement distance.

Reliability and validity of the supine-to-stand test in people with stroke.

To investigate the psychometric properties of the supine-to-stand test in people with stroke. Cross-sectional design. Fifty-two people with stroke (mean (standard deviation) age 63.13 (6.09) years; time post-stroke 93.13 (61.36) months) and 49 healthy older adults (61.90 (7.29) months). Subjects with stroke were recruited from the community dwelling in Hong Kong and assessed with the supineto- stand test, Fugl-Meyer Motor Assessment, ankle muscle strength test, Berg Balance Scale, limit of stability test, Timed Up-and-Go Test, Six-Minute Walk Test, Chinese version of Activities-specific Balance Confidence scale, Community Integration Measure (CIM-C), and 12-item Short-Form Health Survey (SF-12) in a university-based rehabilitation laboratory. The supine-to-stand test completion time demonstrated excellent intra-rater, inter-rater and test-retest reliability (intraclass correlation coefficient 0.946-1.000) for the people with stroke. The completion time was significantly negatively correlated with Berg Balance Scale, Six-Minute Walk Test, limit of stability - maximal excursion, and limit of stability - endpoint excursion results (r = -0.391 to -0.507), whereas it was positively correlated with the Timed Up-and-Go test results (r = 0.461). The optimal cut-off supine-to-stand test completion time of 5.25 s is feasible for a clinical measure to distinguish the performance of people with stroke from healthy older adults (area under the curve = 0.852, sensitivity = 81.1%, specificity = 84.0%). The supine-to-stand test is a reliable, sensitive, specific and easy-to-administer clinical test for assessing the supine-to-stand ability of people with stroke.

An initial set of reference values for the Balance Tracking System (BTrackS) Limits of Stability protocol

BackgroundThe Balance Tracking System (BTrackS) Limits of Stability (LOS) protocol is a relatively new means of evaluating unconstrained dynamic postural control ability. While the reliability of this protocol has previously been established, reference data is currently unavailable to assist in the interpretation of results. Research QuestionWhat are typical reference values for the BTrackS LOS protocol with respect to sex, height, and BMI? MethodsA cross= -section of 800 healthy, young adults (aged 18–29 years; 368 men, 432 women) were administered the BTrackS LOS protocol. Sex, height and weight variables were also captured for the participants. ResultsResults of a stepwise linear regression showed that the outcome measure for BTrackS LOS testing (i.e. LOS Area) was larger in taller individuals and in men. Based on these findings, four percentile ranking categories were established and associated look-up tables created. SignificanceThe reference values provided by this study offer much needed guidance to clinicians and researchers for the determination of dynamic balance abnormalities based on BTrackS LOS testing.

Difference in the recruitment of intrinsic foot muscles in the elderly under static and dynamic postural conditions.

The effect of foot, especially intrinsic muscles, on postural control and its related mechanisms remain unclear due to the complex structure. Therefore, this study aims to investigate the activation of intrinsic foot muscles in the elderly under static and dynamic postural tasks. Twenty-one elderly participants were included to perform different postural tests (sensory organization test (SOT), motor control test (MCT), limit of stability test (LOS), and unilateral stance test) by a NeuroCom Balance Manager System. The participants were instructed to maintain postural stability under conditions with combined different sensory inputs (vision, vestibular, and proprioception) in SOT as well as conditions with translation disturbance in MCT, and to perform an active weight-shifting tasks in LOS. During these tasks, muscle activation were simultaneously acquired from intrinsic foot muscles (abductor halluces (AbH) and flexor digitorum brevis (FDB)) and ankle muscles (anterior tibialis, medial head of gastrocnemius, lateral head of gastrocnemius, and peroneus longus). The root-mean-square amplitude of these muscles in postural tasks was calculated and normalized with the EMG activity in unilateral stance task. The activation of intrinsic foot muscles significantly differed among different SOT tasks (p<0.001). Post-hoc tests showed that compared with that under normal condition 1 without sensory interference, EMGs increased significantly under sensory disturbance (conditions 2-6). By contrast, compared with that under the single-sensory disturbed conditions (conditions 2-4; 2 for disturbed vision, 3 for disturbed vestibular sensation, 4 for disturbed proprioception), activation was significantly greater under the dual-sensory disturbed postural tasks (conditions 5 and 6; 5 for disturbed vision and proprioception, 6 for disturbed vestibular sensation and proprioception). In MCT, EMGs of foot muscles increased significantly under different translation speeds (p<0.001). In LOS, moderate and significant correlations were found between muscle activations and postural stability parameters (AbH, r = 0. 355-0.636, p<0.05; FDB, r = 0.336-0.622, p<0.05). Intrinsic foot muscles play a complementary role to regulate postural stability when disturbances occur. In addition, the recruitment magnitude of intrinsic foot muscles is positively correlated with the limit of stability, indicating their contribution to increasing the limits of stability in the elderly.

Testing the validity and reliability of a new android application-based accelerometer balance assessment tool for community-dwelling older adults

BackgroundPostural instability is a risk factor for falls in older adults. It is possible to detect postural stability using an integrated accelerometer (ACC) sensor in a smartphone. Therefore, a novel ACC-based smartphone application running on the Android operating system called BalanceLab was created and tested. PurposeThis study aimed to determine the validity and reliability of a novel ACC-based Android smartphone application for assessing balance in older adults. MethodsUsing BalanceLab, 20 older adults completed three balance assessments: the Modified Clinical Test of Sensory Interaction in Balance (MCTSIB), a single-leg stance test (SLST), and a limit of stability test (LOS). The validity of this mobile application was investigated using a three-dimensional (3D) motion analysis system and the Fullerton Advanced Balance (FAB) scale. The test-retest reliability of this mobile application was determined on two separate occasions within one day, at least two hours apart. ResultsThe two static balance assessments (the MCTSIB and SLST) demonstrated moderate to excellent correlation with the 3D motion analysis system (r = 0.70–0.91) and the FAB scale (r = 0.67–0.80). However, the majority of the dynamic balance tests (the LOS tests) did not demonstrate any correlation with the 3D motion analysis system or the FAB scale. This novel ACC-based application demonstrated good to excellent test-retest reliability (ICC = 0.76–0.91). ConclusionA static, but not dynamic, balance assessment tool that uses a novel ACC-based application for Android can be used to measure balance in older adults. This application has moderate to excellent validity and test-retest reliability.

The Effect of Vestibular Rehabilitation on Balance and Quality of Life in Patients with Bilateral Vestibular Hypofunction.

This study aims to investigate the effectiveness of vestibular rehabilitation on balance, dynamic visual acuity, and quality of life in patients with bilateral vestibular hypofunction (BVH). 20 patients diagnosed by videonystagmography were included in the study. Balance tests, Visual Analogue Scale (VAS), testing of Dynamic Visual Acuity (DVA), Dizziness Handicap Inventory (DHI), Computer-modified Clinical Test of Sensory Interaction in Balance (m-CTSIB), and Limits of Stability Test were applied before and 3 and 6months after the treatment. Physiotherapy sessions were given at two-week intervals. According to the development of the patients, they were asked to perform a home exercise program with 10 repetitions 3 times a day. After 6months of vestibular rehabilitation, improvements in balance and quality of life parameters were observed in the patients. VAS, DVA, DHI, all static balance parameters except Romberg, Semi-tandem eyes open were significant (p < 0.005). In computerized M-CTSIB, while no significant results were obtained on the hard surface with the eyes open (p = 0.126), statistically significant improvement was observed on the hard surface with the eyes closed and on a foam surface with eyes open and close. LOS results showed significant improvement in velocity, reaching the endpoint, and maximal deviation in all directions except the right posterior. While significant results were found in the right, posterior, left anterior, and left posterior directions in the reaction time section, there was no statistical significance in any of the direct control sections (p < 0.005). Trial registration number:NCT05231109, Date of registration:27/01/2022 (Retrospectively registered).

Postural control among individuals with and without chronic obstructive pulmonary disease: A cross-sectional study of motor and sensory systems.

Chronic obstructive pulmonary disease (COPD) is considered a heterogenic syndrome with systemic effects, including muscle dysfunction. There is evidence of postural control impairments among individuals with COPD, partly related to muscle weakness. However, research is scarce regarding the other underlying systems of postural control, such as the visual, somatosensory and vestibular system. The aim was to compare postural control, as well as the motor and sensory systems, between individuals with and without COPD. Twenty-two participants with COPD (mean age 74.0 ±6.2 years) and 34 non-obstructive references (mean age 74.9 ±4.9 years) participated in this cross-sectional study. Postural control was assessed with center of pressure trajectory of postural sway in quiet as well as a limits of stability test, calculating mediolateral and anteroposterior amplitudes for each test. Assessment of function in the motor system included maximum hand grip strength, as well as maximum strength in muscles around the hip, knee and ankle joints. Visual acuity, pressure sensibility, proprioception, vestibular screening, and reaction time were also included. Data was compared between groups, and significant differences in postural control were further analyzed with an orthogonal projection of latent structures regression model. There was a significantly increased sway amplitude in the mediolateral direction in quiet stance on soft surface with eyes open (p = 0.014) as well as a smaller anteroposterior amplitude in the limits of stability test (p = 0.019) in the COPD group. Regression models revealed that the mediolateral amplitude was related to visual acuity and the burden of tobacco smoking assessed as pack-years. Further, muscle strength associated with anteroposterior amplitude in limits of stability test in the COPD group, and with age and ankle dorsal flexion strength among the referents. Besides for lower ankle plantar flexion strength in the COPD group, there were however no significant differences in muscle strength. Individuals with COPD had a decreased postural control and several factors were associated with the impairments. The findings imply that the burden of tobacco smoking and reduced visual acuity relate to increased postural sway in quiet stance, and that muscle weakness is related to decreased limits of stability, among individuals with COPD.