NeuroCom Balance Master Research Articles

Effect of Backward Walking on Treadmill with Inclination in Individuals with Forward Head Posture: A Comparative Study

Abstract Background: Forward head posture (FHP) is one of the most common postural abnormalities found in undergraduates (18–30 years), with a prevalence rate of 73%. If the cervical spine is held in a protracted position, such as hyperextension of the upper cervical spine (C1-C3) and flexion of the lower cervical spine (C4-C7), it can cause changes in head posture, eventually leading to FHP. Aims: This study aimed to determine the effect of backward walking (BW) on the surface and on treadmill with inclination in individuals with FHP. Objectives: The objective of this study was to compare the effect of surface BW and BW on treadmill with inclination on the craniovertebral angle (CVA) and gait outcomes in individuals with FHP. Materials and Methods: Sixty-two participants were recruited and randomly assigned to the surface BW group (n = 31) and BW on treadmill with inclination (n = 31). Participants fulfilled the pre- and postassessment with a 2 weeks (three times per week) intervention of BW in conjunction with conventional exercises. The CVA was measured using Markus Bader ruler software. Gait outcomes were assessed using Neurocom Balance Master, walk across component was selected. Results: The present study implemented statistical tests such as paired t-test and unpaired t-test for the recorded data. Conclusion: BW has shown a significant difference in the CVA and some components of gait outcomes in within the group analysis, whereas in between the group analysis, there is a significant difference in some gait outcomes.

The Convergent Validity of the SWAY Balance Application to Assess Postural Stability in Military Cadets Recovering from Concussion.

Concussions are often accompanied by balance disturbances. Clinically accurate evaluation systems are often expensive, large, and inaccessible to most clinicians. The Sway Balance Mobile Application (SWAY) is an accessible method to quantify balance changes. To determine the known groups and convergent validity of the SWAY to assess balance after a concussion. Case-Control Study. Twenty participants with acute concussion and twenty controls were recruited. At initial, one-week, and final return to activity (RTA) evaluations, all participants completed the Sports Concussion Assessment Tool (SCAT-5), and balance control measured by SWAY mBESS and NeuroCom Balance Master Sensory Organization Test (SOT). Mixed model ANOVAs were used to detect differences in SWAY mBESS and NeuroCom SOT scores with time (initial, one-week, final RTA) as the within-subjects factor and group (concussed, healthy) as the between-subjects factor. Spearman's Rho correlations explored the associations between NeuroCom SOT scores, SWAY scores, SCAT-5 symptom scores, and time in days to final RTA. The sampled population was predominantly male and age (20 ± 1), and BMI differences were insignificant between groups. The SWAY did not detect differences between healthy and concussed participants and did not detect change over time [F(2,40) = .114, p = 0.89; F(2,40)= .276, p =0.60]. When assessing the relationship between the SWAY and the SOT, no correlation was found at any time point (r = -0.317 to -0.062, p > 0.05). Time to RTA demonstrated a moderate correlation with both SCAT-5 symptom severity score (r = .693, p < 0.01) and SCAT-5 total symptom score (r = .611, p < 0.01) at the one-week follow-up. The SWAY mBESS does not appear to be a valid balance assessment for the concussed patient. The SWAY mBESS in patients with concussion failed to demonstrate convergent validity and did not demonstrate an ability to validate known groups. When assessing the time to final RTA, the one-week post-initial assessment SCAT-5 symptom severity and total scores may help determine the length of recovery in this population. Level 3.

Ab. No. 70 Efficacy of Perturbation Training on Balance and Function in Older Individuals- An Experimental Study

Introduction: Aging involves decline in visual, vestibular and proprioceptive acuity associated with functional limitations and reduced motor function, disturbing balance and increasing risk of fall. The study evaluates the effect of perturbation training in older individuals with mild to moderate risk of fall and its effect on postural stability and balance. Perturbation training has been advocated as an effective intervention for re-educating proprioception and restoring normal neuromuscular coordination. Older adults can quickly adapt to large postural perturbations, altering their biomechanics and preventing falls. Methods: An experimental trial recruited 30 older individuals (65-85 years) with mild to moderate fall risk through purposive sampling. Participants underwent Perturbation Training with tilt-board and conventional balance exercises thrice weekly for four weeks (12 sessions). Modified-CTSIB test on NeuroCom Balance Master® and Timed Up and Go (TUG) Test were taken at baseline and post-completion. Homogeneity of samples was assessed using Shapiro-Wilk’s Test of Normality. Dependent sample t-tests were employed to analyze group data, with means and standard deviations indicating statistical differences in pre and post outcome measures at 95% confidence interval. Results: Pre and post measures on TUG test and M-CTSIB test on NeuroCom Balance Master® shows statistically significant improvement in TUG values(p&lt;0.0001*) and COG sway velocity in all conditions except on Firm surface with eyes open, with FIEO(p&lt;0.1208), FIEC(p&lt;0.0011*), FOEO(P&lt;0.0013*), FOEC(p&lt;0.0001*) and Composite COG sway velocity(p&lt;0.0001*). Conclusion: Perturbation training coupled with conventional balance exercises, showed to be effective intervention to improve balance and postural control in older individuals. The study lacked follow-up, leaving room for future studies into continuity of exercises and retention of its effects. Implications: Given the effectiveness, the study suggests integrating perturbation training in geriatric rehabilitation protocol to enhance physical function, diminish fear of falling, and boost fall-related self-efficacy.

Postural balance and functional mobility in relation to BMI and body composition among female students at a College of Applied Medical Sciences: A cross-sectional study

IntroductionThis study aimed to compare different Body Mass Index (BMI) categories, body composition parameters, postural balance, and functional mobility among female students at a College of Applied Medical Sciences; and examine the relationship between BMI and body composition with postural balance and functional mobility among female students at the college of applied medical sciences. Materials and methodsFemale students, aged 18‒25 years old. They were subdivided into four groups according to their BMI category: underweight, normal, overweight, or obese, with n = 20 participants in each group. A Bioelectrical Impedance Human Body Analyzer (BIA) was used to assess the following body composition parameters: Fat Percentage (FATP), fat mass, muscle mass, and Total Body Water (TBW). A NeuroCom Balance Master was used to assess postural balance and functional mobility. A Timed Up and Go (TUG) test was employed to assess functional mobility. All data were analyzed using SPSS. ResultsParticipants’ ages and heights were matched (p > 0.05). However, there were variables that were statistically significantly higher in terms of weight, BMI and body composition, including FATP, fat mass, muscle mass, and TBW (p = 0.000), among the obese group. Moreover, postural balance was lower among the obese group. There was a significant relationship between BMI and body composition variables in respect of postural balance but not in relation to functional mobility. ConclusionPostural instability but not functional mobility was related to higher BMI and body composition values among the study groups.

The stepping test, and infrared depth sensor, provide reliable measures of balance in community-dwelling older adults.

[Purpose] The purpose was to examine relationships between variables characterizing the 20-second stepping test movement pattern, assessed with an infrared depth sensor (KinectTM), and measurements of dynamic and static balance. [Participants and Methods] A total of 27 independent-living, older adults (7 males and 20 females) participated in this study. For each participant, the stepping test total movement distance, movement displacement, knee movement distance, and step number were calculated from Kinect closed joint-point coordinate data. Dynamic and static balance were assessed using a NeuroCom Balance Master Platform system. [Results] The stepping test total movement distance had a moderate negative correlation with endpoint excursion (r=-0.469) and a moderate positive correlation with total movement distance, corrected for knee movement distance (r=0.557). Step numbers had a moderate negative correlation with stepping test total movement distance (r=-0.667) and total movement distance, corrected for knee movement distance (r=-0.531). Division into high and low-balance sub-groups (based on endpoint excursion or sway velocity scores) revealed that stepping test total movement distances and movement displacements were greater, and step numbers were fewer, in low balance groups. [Conclusion] The stepping test, combined with a KinectTM-assessed movement pattern provides a simple, objective, reliable means for assessing balance in community-dwelling, independent-living older adults.

Time of day and athlete status effects on the modified clinical test of sensory integration and balance (mCTSIB) and stability evaluation test (SET)

BackgroundConcussions or musculoskeletal injuries may impair postural control, which is one diagnostic to help determine return-to-activity decisions. Postural control may be affected by diurnal rhythm. Research questionDoes time of day influence postural control as measured by two Neurocom Balance Master diagnostic protocols, the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) and the Stability Evaluation Test (SET)? MethodsFollowing Institutional Review Board (IRB) approval, consented participants completed the SET and mCTSIB twice: between 0700 and 1000; and between 1600 and 1900. We randomized and balanced testing order. Familiarization trials were completed for the mCTSIB and SET. Assessments were completed in a controlled laboratory environment. We instructed participants to get a normal night’s sleep prior to testing and refrain from caffeine use and exhaustive exercise on the day of testing. Sixty-nine participants (48 female, 21 male: age = 21.42±2.56 years, height = 168.20±7.53 cm, mass = 72.05±16.60 kg) completed the study. Thirty-one of the participants were National Association of Intercollegiate Athletes (NAIA) student-athletes from the sports of baseball, soccer and softball. Average postural sway velocity was measured and compared by time of day for each of the balance conditions in the mCTSIB and SET protocols. ResultsAccording to repeated measures ANOVA, there were no significant postural sway velocity main effects by time of day for any of the balance conditions. We found significant postural sway main effects by foam, stance and eyes. We also noted significant ANOVA between participants’ differences for athlete status, but not for sex. SignificanceThese results inform practitioners about the importance of controlling time-of-day between baseline and post-injury testing, which may allow for more flexible, accurate and reliable diagnosis and return-to-activity decisions. Athletes displayed better static postural control, possibly warranting different normative values for diagnostic comparison.

Combined treatment of muscle tension dysphonia: voice therapy with instrumental postural rehabilitation.

This investigation aimed to propose a new rehabilitation technique that combines voice exercises and instrumental postural rehabilitation for patients with muscle tension dysphonia (MTD). We enrolled nine dysphonic patients (8 women and 1 man, aged 22-55 years). Voice assessment included strobovideolaryngoscopy, Maximum Phonation Time (MPT), perceptual evaluation by GRBAS scale and patient's self-rating by Italian version of the Voice Handicap Index (VHI). Vestibular function was evaluated by the Bed Side Examination and Video Head Impulse test (VHIT). Postural control was evaluated by Dynamic Posturography (DP) using the Sensory Organization Test (SOT) and analysing the Equilibrium Score (ES) and balance subsystems (somatosensorial, visual, vestibular). All cases underwent different types of voice exercises combined with balance training based on NeuroCom Balance Master Protocols, once a week for six 35-minutes sessions. After therapy, an improvement in MPT, VHI, GRBAS scores and endoscopic laryngeal features was obtained. DP results at baseline were normal and after therapy we showed a slight improvement of ES (somatosensorial and visual components). A combined rehabilitation technique for MTD, by improving the attention to postural control, allows for significant improvement in vocal symptoms.

Comparing the Effect of Flat and High-Heel Footwears on Tandem Walk and Step-up/Over Test in Females by Using a Neurocom Balance Master

Abstract Aims: Footwear plays an important role in day-to-day life; their utilitarian purpose has been undermined by fashion. Furthermore, fashion has frequently dictated numerous design details, such as whether shoes have high heels or flat heels. The aim of this study is to compare female users who wear flat footwear vs. high heels using a dynamic weight-bearing activity test with a Neurocom Balance Master. Materials and Methods: Fifty-three females were screened, out of which 30 females participated in this study, 15 each divided into two groups. According to the inclusion criteria, 5 cm heel height and 0 cm flat heel users on a daily basis were included. Group A included high-heel footwear users and Group B included flat footwear users; they performed the tandem walk test and step-up/over test to measure their balance in dynamic activities on the Neurocom Balance Master. Results: Data normality was assessed using the Shapiro–Wilkinson test. The independent t test was used to find out the difference between the groups. Experimental results showed that compared with flat footwear users, high-heel footwear users show imbalance in the tandem walk test. Conclusion: According to the findings of this study, there is a significant difference between high-heel female users and flat footwear female users in the tandem walk test, but no significant difference between high-heel female users and flat footwear female users in the step-up/over test.

Visual reweighting using stroboscopic vision in healthy individuals

Testing how individuals use visual information to maintain balance has been traditionally limited to two extreme conditions: eyes closed and eyes open. Stroboscopic glasses allow clinicians to control the amount of visual information that influences balance, varying between eyes open and closed. Seventeen uninjured participants completed the sensory organization test (SOT) under three visual conditions: full occlusion, high occlusion (i.e., 100ms transparent, 400ms opaque), and low occlusion (i.e., 100ms transparent, 100ms opaque). Equilibrium scores were calculated from the Neurocom Balance Master system during double-limb stance and the three-trial average from each condition and SOT was used for analysis. A two-way repeated measures ANOVA was used to evaluate the interaction between and within factors of vision (i.e., full occlusion, high occlusion, low occlusion, and no occlusion) and support surface (i.e., firm and sway). Increased visual occlusion negatively impacts balance on a firm surface and is amplified when somatosensory cues are unreliable. These findings highlight the importance of somatosensory cues as a guiding sensory modality for balance, especially when vision is occluded.

Effects of Computerized Biofeedback-based Balance Intervention on the Muscle Coactivation Patterns during Dynamic Postural Control in Traumatic Brain Injury.

Balance Dysfunction (BDF) is a severe conse-quence of Traumatic Brain Injury (TBI) that significantly increases the falls risk. However, the neuromuscular mecha-nisms of the BDF are not adequately researched. Therefore, in this study, our objective was to investigate the effects of a Computerized Biofeedback-based Balance Intervention (CBBI) on the muscle coactivation patterns in a group of TBI participants. This study presents the findings from 13 TBI individuals randomized into the Intervention group (TBI - INT, N=6) and Control group (TBI-CTL, N=7). Using a computerized posturography platform (Neurocom Balance Master) during baseline and follow-up assessment visits, the participant's pos-tural response to anterior-posterior balance perturbations were recorded in a multimodal setup including electroencephalogra-phy (EEG), electromyography (EMG), and the platform sway in terms of center of pressure (COP). The muscle responses were recorded from lower-limb muscles, including tibialis an-terior (TA) and gastrocnemius (GAST), whose coactivation was computed using a metric called Co-Contraction Index (CCI). Clinical outcome measures such as Berg Balance Scale (BBS), 10 Meter Walk Test (10MWT), and Timed Up-and-Go (TUG) tests were used to evaluate functional balance and mobility. The comparison of CCI values across time points (baseline and follow-up) revealed a significant decrease (p<0.01) in the TBI-INT group but not TBI-CTL. The intervention-related changes in CCI correlated with the changes in BBS score (from baseline to follow-up). These preliminary findings demonstrate that the CBBI training may help postural stability by facilitating the coactivation between muscles involved in postural control. Clinical relevance- The current knowledge of changes in the neuromuscular response to balance perturbation in TBI is limited. Our study opens the possibility of using the muscle CCI metric to evaluate the muscle response in individuals with impaired balance.

Effect of optokinetic virtual reality scenes on a sitting-to-stand movement.

Visual perception plays a role in balance control while performing a sit-to-stand movement (STS). The dynamic virtual environment could reduce effective neuromuscular regulation and instability. Nevertheless, virtual reality (VR) on the STS movement was not explored in any research. This study's aim was to investigate the effect of the VR of an optokinetic drum on the STS movement by using optokinetic drum VR scenes. This study used a repeated measurement research design. Ninety healthy subjects aged 18-23years with no experience in virtual reality were recruited. Each participant was asked to stand as quickly as possible from a height-adjustable chair three times under five conditions: with eyes-open (EO), eyes-closed (EC), and three VR scenes: a limited field view of an optokinetic scene, a black and white striped scene, moving in horizontal direction (VRhori), vertical direction (VRvert), and roll (VRroll). VR scenes were generated using a mobile phone in a head-mounted display. The rising index (the upward force produced by the legs as a proportion of body weight), sway velocity, and weight transfer time were measured using a NeuroCom Balance Master. Only VRvert condition significantly reduced weight transfer time as compared to EO and the other two VR conditions. All three VR scenes significantly reduced the rising index as compared to EO. VRvert condition significantly increased sway velocity as compared to all conditions. These findings suggest that optokinetic environment scenes in virtual reality could be used as an alternative method to increase the challenge of maintaining the balance during STS.

Assessment of the relationship between rectus femoris cross-sectional area and knee extension strength in the prosthesis users with transtibial amputation: A case-control study.

Objectives This study aims to investigate cross-sectional area of the amputated-limb rectus femoris compared to the intact-limb and controls and to determine its correlation with functional strength and walking tests in prosthesis users with transtibial amputation. Patients and methods Between October 2018 and April 2019, a total of 14 prosthesis users (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) who met the inclusion criteria, and 14 age-, sex-, and dominancy-matched able-bodied controls (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) were included in this case-control study. Cross-sectional area of rectus femoris (CSA-RF) was evaluated bilaterally by two independent examiners. Knee extension strength was measured bilaterally by using a handheld dynamometer. Functional strength and walking were assessed by Step-Up-Over and Walk-Across tests of the NeuroCom Balance Master® device. Results The CSA-RF was found to be reduced in amputated-limb compared to the intact-limb and able-bodied controls (p<0.01). In the prosthesis users, the cross-sectional area difference between both limbs rectus femoris muscles was shown to be correlated with actual and functional knee extension strength, step length, and walking speed (p<0.05). Intra- and inter-observer reliability of CSA-RF on both sides were found to be good to excellent (intraclass correlation coefficient: 0.856-0.936). Conclusion Ultrasonographic measurement of CSA-RF is a valid and reliable tool to assess the functional strength and walking in the prosthesis users with unilateral transtibial amputation.

Assessing gait, balance, and muscle strength among breast cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN): study protocol for a randomized controlled clinical trial

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is a common and understudied consequence of taxane chemotherapy for breast cancer treatment. CIPN symptoms include numbness combined with tingling sensations, persistent shooting, stabbing, or burning pain even in the absence of painful stimuli, lower extremity muscle weakness, and impaired balance. CIPN symptoms often persist for a long time after completion of chemotherapy, causing significant loss of functional abilities and increased risk of falls. Persistent CIPN caused by taxanes represents a therapeutic challenge due to the limited treatment options. Resistance exercise has shown promising results; however, the effect of exercise on CIPN remains understudied. This study aims to assess the effects of exercise on gait, balance, and lower extremity muscle strength after a 16-week home-based exercise program compared to an educational attention control condition.MethodsA sample of 312 women who completed taxane-based chemotherapy for breast cancer and have symptomatic neuropathy is recruited from a community-dwelling sample. Participants are randomized to either a 16-week Home-Based Physical Activity Intervention or an Educational Attention control group. The home-based intervention protocol consists of targeted lower extremity stretches, followed by 10 min each of gait/balance and 10 min of resistive training accessed by hyperlink or DVD. An Exercise Diary records quantitative exercise data. The gait assessment includes temporospatial parameters and lower extremity joint angles using APDM motion sensors. Participants’ balance is assessed using the Sensory Organization Test (SOT) performed using a NeuroCom Balance Master. Isometric strength of hip, knee, and ankle flexor and extensor muscles is assessed using an isokinetic dynamometer, Biodex BX Advantage. In addition, we assess neuropathy symptoms using the FACT-Taxane Additional Concerns Subscale and nerve conduction velocity of the sural and peroneal nerve action potentials. Outcomes are assessed at baseline (prior to randomization) and 16 weeks.DiscussionThere are currently no evidence-based interventions that address the functional declines associated with CIPN. If successful, this program is simple and easy to implement in the standard of care for individuals with CIPN. Gait and balance training have the potential to reduce physical dysfunction associated with CIPN and reduce the burden of disease in cancer survivors.Trial registrationClinicalTrials.gov NCT04621721. Registered on August 3, 2020. ClincialTrials.gov is a primary registry of the World Health Organization International Clinical Trials Registry Platform (WHO ICTEP) network and includes all items from the WHO Trial Registration data set in Trial registration.

Effects of mobile phone texting on postural control and gait parameters in college students

Background: Mobile phone has become a part of everyday life. Mobile phone texting is one of the major causes of road traffic accidents, falls and injuries in young adults. Dual-task activities while using mobile phone increases the risk of falls. Objectives: To find out the changes in postural control and gait parameters while using mobile phone in young college students. Materials and Methods: A total of 100 college students of age 18–25 years participated in the study. NeuroCom Balance Master was used and the subjects were tested with and without phone. The participants had to maintain balance on firm surface and foam surfaces with and without phone. For walking, participants had to walk without phone followed by walking with phone. Outcome measures used were Modified Clinical test for Sensory Interaction on balance and Walk Across for balance and gait respectively. Results: The study showed statistically significant changes in postural control on firm and foam surfaces. Furthermore, the gait parameters such as step length, speed and step length symmetry were altered significantly, except step width while using the mobile phone. Conclusion: Subjects showed increased postural sway, step length and step length symmetry while the step width and speed decreased on using the mobile phone.

The Effects of Exergaming on Sensory Reweighting and Mediolateral Stability of Women Aged Over 60: Usability Study.

BackgroundOlder adults tend to experience difficulties in switching quickly between various reliable sensory inputs, which ultimately may contribute to an increased risk of falls and injuries. Sideward falls are the most frequent cause of hip fractures among older adults. Recently, exergame programs have been confirmed as beneficial tools for enhancing postural control, which can reduce the risk of falls. However, studies to explore more precisely which mechanism of exergaming directly influences older women’s ability to balance are still needed.ObjectiveOur aim was to evaluate, in a single-group pretest/posttest/follow-up usability study, whether Kinect exergame balance training might have a beneficial impact on the sensory reweighting in women aged over 60.MethodsA total of 14 healthy women (mean age 69.57 [SD 4.66] years, mean body mass index 26.21 [SD 2.6] kg/m2) participated in the study. The volunteers trained with the commercially available games of Kinect for Xbox 360 console 3 times (30 minutes/session) a week over a 6-week period (total of 18 visits). Participants’ postural sway in both the anteroposterior (AP) and mediolateral (ML) directions was recorded with NeuroCom Balance Master 6.0. To assess and measure postural sensory reweighting, the Modified Clinical Test of Sensory Interaction in Balance was used, where volunteers were exposed to various changes in visual (eyes open or eyes closed) and surface conditions (firm or foam surface).ResultsIn the ML direction, the Kinect exergame training caused a significant decrease in the sway path on the firm surface with the eyes open (P<.001) and eyes closed (P=.001), and on the foam surface with the eyes open (P=.001) and eyes closed (P<.001) conditions compared with baseline data. The follow-up measurements when compared with the baseline data showed a significant change in the sway path on the firm surface with the eyes open (P<.001) and eyes closed (P<.001) conditions, as well as on the foam surface with the eyes open (P=.003) and eyes closed (P<.001) conditions. Besides, on the firm surface, there were no significant differences in sway path values in the AP direction between the baseline and the posttraining measurements (eyes open: P=.49; eyes closed: P=.18). Likewise, on the foam surface, there were no significant differences in sway path values in the AP direction under both eyes open (P=.24) and eyes closed (P=.84) conditions.ConclusionsThe improved posturography measurements of the sway path in the ML direction might suggest that the Kinect exergame balance training may have effects on sensory reweighting, and thus on the balance of women aged over 60. Based on these results, Kinect exergaming may provide a safe and potentially useful tool for improving postural stability in the crucial ML direction, and thus it may help reduce the risk of falling.

Avaliação do equilíbrio postural em idosas com baixa densidade mineral óssea: caidoras e não caidoras.

Aging is associated with the decline of physiological functions. In this process, the human skeleton is especially affected by time: bone loss begins as early as the third decade of life. Performance in postural balance tests was evaluated in elderly women who were fallers and non-fallers with low bone mineral density and, secondarily, those afraid of falling had lower performance in balance tests. Sixty-two elderly women aged ≥ 60 years were evaluated, divided into two groups: fallers and non-fallers. The volunteers were evaluated using two postural balance tests: the miniBESTest (test with 14 tasks that assesses balance according to postural responses to external disturbances and verticality); and the NeuroCom Balance Master force platform, in the protocols of the Going Up and Going Down Steps and Sit and Stand Tests. There were no differences in the miniBESTest or in the NeuroCom Balance Master tests between groups. In addition, there were no differences between elderly women with and without fear of falls, in the same variables studied. Elderly people, regardless of being fallers, did not differ in the performance of the postural balance tests, nor in terms of the presence or absence of fear of falling. Keywords : Elderly; Osteoporosis; Falls; Postural balance.

The Effect of Sub-Concussive Impacts during a Rugby Tackling Drill on Brain Function.

Concussion is known to detrimentally affect brain health. Rugby tackles commonly occur with high collision force between tackler and ball carrier, and low impact head contact is not uncommon. Cognitive deficits following a bout of soccer ball heading has been attributed to the impact and termed sub-concussion. Although soccer ball heading studies provide evidence for acute effects of sub-concussion, it is unknown whether this phenomenon occurs following rugby tackles. This study investigates the acute effects of rugby tackles on brain function and balance in rugby players. Twenty-six volunteers were assigned to either the ball carrier (9), tackler (9) or control (8) group. Controls performed running without the tackle. Outcome measures included corticomotor function using transcranial magnetic brain stimulation (TMS) and balance was assessed by a series of tasks performed on a NeuroCom Balance Master before and immediately after a tackle training drill. Following the tackling bout, the cortical silent period (cSP) increased for the tacklers with no change for ball carrier and control groups, and no differences between groups for balance measures were observed. Lengthening of cSP observed in the tacklers following the bout has been reported in studies of concussion and may indicate long term detrimental effects.

Hamstrings muscle tightness, posterior pelvic tilt and sitting balance in children with cerebral palsy spastic diplegia

Background: School going children in the age group of 7-12 years have to spend long hours in sitting, and maintain adequate balance in order to use their upper limbs efficiently and functionally during play and in the performance of Activities of Daily Living (ADLs). Studies that have examined trunk control and the effect of underlying muscle tightness and spasticity that cause biomechanical constraints in children with Cerebral Palsy (CP) is scarce. Aim: This study aims to assess the effect of Hamstring muscle tightness on Sitting Balance in children with CP spastic diplegia. Materials and Methods: Thirty (30) children with CP spastic diplegia (n=30) belonging to GMFCS Levels I, II, and III, in the age group of 7-12 years, and thirty (30) age and sex-matched typically developing(TD) children were recruited for this study. Hamstring tightness was assessed by calculating the R2 angle using the modified tardieu scale. Pelvic tilt was measured in sitting using the pelvic inclinometer and sitting balance by Paediatric reach test & Trunk control measurement scale (TCMS). Centre of pressure excursion in forwarding direction was measured using the limits of stability protocol in sitting on the neurocom balance Master. Results: Children with CP spastic diplegia sat with a greater posterior pelvic tilt compared to TD children (p tilt in both groups of children (r value=0.6, p hamstrings spasticity with reach in forward as well as lateral directions (r value= 0.5, p tilt with reach in forward and lateral directions (r value = 0.6, p TCMS scores showed a moderate negative correlation with hamstrings tightness and posterior pelvic tilt (rho = 0.6). The maximum excursion of limits of stability showed a moderate negative correlation with hamstrings tightness and posterior pelvic tilt in the forward directions. Conclusion: Greater tightness of the hamstring muscles was associated with a posterior pelvic tilt and reduced sitting balance. Therapeutic interventions that manage hamstr

Physical activity in patients with Parkinson’s disease: A holistic approach based on the ICF model

ObjectivesThe International Classification of Functioning, Disability and Health (ICF) is a framework providing information on disability and health. Physical activity’s behavior is complex and affected by various factors. We aimed to examine the ICF domains in Parkinson’s disease (PD) patients; to compare them in sedentary and non-sedentary PD patients and their association with activity level. Patients and MethodsSixty PD patients (25 sedentary PD group, 35 non-sedentary PD group) were included in this retrospective study. Functional disability was evaluated using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale. The physical activity level was measured by the SenseWear Arm Band activity monitor. Patients’ cognitive function, severity of depression and anxiety, the functional impact of fatigue, balance performance (NeuroCom Balance Master System), functional mobility (Timed Up and Go Test, TUG), walking capacity (Six-Minute Walk Test, 6MWT), fear of falling, health-related quality of life are also analyzed. ResultsSedentary PD patients had worse scores in NeuroCom Balance Master System parameters, TUG score, and 6MWT distance in activities domains of the ICF model as a guide than non-sedentary group (p < 0.05). No statistically significant differences were found in the body structures and function, participation, personal and environmental domains of the ICF model between sedentary and non-sedentary PD groups (p > 0.05). There was no correlation between steps taken per day and NeuroCom Balance Master System parameters, TUG score, and 6MWT distance in both groups (p > 0.05). ConclusionPatients with sedentary lifestyle had worse scores in postural control/balance, sit-to-stand and walking performance. However, deteriorated dynamic balance may not lead to sedentary lifestyle. Physiotherapy programs should be including the behavior change interventions and motivational strategies to promote activity level in PD.

Comparison Of Age, Gender, And Sport On Performance Of Stability Test In Senior Participants

PURPOSE: The purpose of this study was threefold: to observe the differences in performance variables of the Modified Clinical Test of Sensory Interaction in Balance in active elderly participants and to compare results by age (50-59, 60-69, 70-79, 80+), sports (aerobic, basketball, golf, tennis, volleyball, and none), and gender. METHODS: Anlayses were based on a sample of 525 World Senior Games attendees who were age 50 and over. Data were obtained from voluntary participation in balance and mobility screening as part of the health fair offered to all participants at the annual Hunstman World Senior Games. Of the 525 participants tested, 383 were participants in at least one sporting event at the games and 142 were non-participants. All modified CTSIB were performed on the NeuroCom Balance Master. The measured variables (center of gravity sway (degrees/sec)) were; firm surface with eyes open, firm surface with eyes closed, foam surface with eyes open, and foam surface with eyes closed. RESUTS: All data were analysed using SAS, version 9.4. An initial analysis of gender and age category was performed. A final model was run with the significant variables from the initial analysis plus sports category. Post hoc Tukey pairwise comparisons were also performed. A significant difference ∗(p<0.0001) was found between stratified age groups in all balance test variables. No significant differences were found between gender nor sports categories for the 4 balance variables.CONCLUSION: While balance sway significantly increases with age in all 4 variables, they remain similar when comparing between gender and sports. This test may not be sensitive enough to detect differences between sports in our participants. Also, our participants are probably too active to detect differences in the variables tested regardless of sports category. Further research is needed to better differentiate between active and non-active individuals and performance on the modified CTSIB.