Postural Stability Parameters Research Articles

Posture and vision: How different distances of viewing target affect postural stability and plantar pressure parameters in healthy population

BackgroundPostural stability is maintained by the Postural Control System (PCS), consisting of anatomical structures of Central Nervous System and peripheral receptors, interacting with each other, in order to keep whole-body balance by modulating the myofascial chains against gravity. The vision is one of the most important peripheral receptors for postural control. Previous studies analyzed the changes of body sway during viewing nearby (VNT) and distant (VDT) targets in healthy population without considering the feet adaptations related to the body weight distribution. Aim of this study was to investigate how different distances of viewing target affect the variability of postural stability and plantar pressure parameters in healthy subjects. Methods31 stabilometric and plantar pressure parameters were acquired in 20 young healthy subjects by baropodometry performed in bipedal standing during VNT and VDT (0.70 m and 3 m from the heels, respectively). Variability and statistical differences between VDT and VNT were implemented. ResultsResults showed the highest repeatability for plantar pressure parameters, a slightly high for CP speed and a lowest for CoPsa and Length Surface Function during both VNT and VDT. Moreover, a significant increase of load percentage on left-foot and right-Forefoot, of mean and maximum pressures on left-Forefoot, of CoPsa and CPspeed and a decrease of LSF were found during VDT. DiscussionThis study revealed how a greater distance of viewing target affects body-weight distribution and increases body oscillations. These findings highlighted the importance of visual target distance for the correct interpretation of postural stability and plantar pressure parameters, and the need to standardize target distance during stabilometric exam.

The impact of suboccipital muscle inhibition on postural stability in young individuals

Introduction. Postural stability is the result of cooperation between the musculoskeletal and nervous systems. The stability of standing posture ensures the spatial arrangement of the body, where the center of gravity falls within the center of the support base. FHT (Forward Head Posture) increases the extension in the occipito-cervical joint and upper cervical spine, deepening the flexion of the lower cervical segment, causing improper contraction of the suboccipital muscles. Disorders in the tone of the suboccipital muscles may affect the balance. Objective. The research hypothesis was made that a single 4-minute suboccipital muscle inhibition procedure influences the change in postural stability values with open and closed eyes in individuals with cranio vertebral angle (CVA) within the normal range and below. Materials and Methods. Healthy participants (10 women and 8 men) with an age of 22.7 ± 0.58. The participants took part in the study. They were classified into research groups based on the CVA angle assessment. Postural stability analysis used the Koordynacja stabilometric platform. Measurements were taken with open and closed eyes, before and immediately after suboccipital muscle inhibition. Results. The suboccipital muscle inhibition was observed to affect anterior-posterior (A-P) displacements in group A (CVA < 50) p-value = 0.0168, with no significant impact in group B (CVA ≥ 50), p-value = 0.3695. Conclusion. A single 4-minute suboccipital muscle inhibition procedure does not significantly influence postural stability parameters in the examined groups, except for A-P displacements with open eyes in the CVA < 50 group.

Effects of Proprioceptive Insoles and Specific Core Training on Postural Stability for Preventing Injuries in Tennis.

Tennis is a complex sport based on unpredictability that requires adequate physical and psychological preparation to prevent injuries. The aim of this study was to investigate the effects of 8-week specific core stability training on postural stability in competitive adolescent tennis players, aged between 14 and 19 years old. Sixty-one participants were randomly allocated into two groups: experimental (n = 32) and control (n = 29) groups. The first group wore proprioceptive insoles 8 h a day and performed a detailed training 3 times a week for 8 weeks; the second group only received proprioceptive insoles to wear 8 h a day for 8 weeks. The postural stability parameters (center-of-pressure length, center-of-pressure velocity, and 95% confidence ellipse sway area) included three assessment times: baseline (T0), intermediate test (T1), post-test (T2), and retention test (T3). Data analysis showed a significant improvement in the experimental group compared with the control group, indicating a large effect size in center-of-pressure length, ellipse sway area, and center-of-pressure velocity at T2 and T3 (p < 0.05). In conclusion, our results suggest that a specific and detailed core stability training plays a significant role in improving balance and postural stability in young tennis players, especially in terms of preventing the risk of injury.

Asymmetries in Postural Stability and Balance Parameters during Specific Elements in Sub-Elite Rhythmic Gymnasts

Purpose: This study aims to investigate the level of lower-limb functional asymmetries in sub-elite rhythmic gymnasts while performing sport-specific elements, including passe and side passe balance stance. Methods: The analysis focuses on postural stability and balance parameters, measured using Gyko, a 3-axis accelerometer, gyroscope, and magnetometer device. The task was to execute a passe balance and maintain the position for 30 seconds, which was the duration of the test, and then perform the same task with the other leg. The test was repeated for both legs in a side passe balance stance. Sixteen active female sub-elite rhythmic gymnasts participated in the study. Results: The results reveal significant differences in the mean travel velocity in all anatomical planes during the passe elements, indicating asymmetry in postural stability in favor of the non-dominant leg (P≤ .01). Similarly, in the side passe balance test, significant differences were observed in the mediolateral (in favor of the dominant leg) and anteroposterior (in favor of the non-dominant leg) total distances, indicating asymmetry in postural stability (P= .03). However, no significant differences were found in other postural stability parameters, the ellipse (EA) and the total length of the trajectory (Len(D)). Conclusions: Evident asymmetries in movement speed during the passe element and imbalances in weight distribution during the side passe balance test do not appear to compromise overall postural stability considering that asymmetry was not proven in several variables, such as the ellipse or the total length of the trajectory. These findings shed light on the potential impact of asymmetries on performance and injury risk in rhythmic gymnastics, emphasizing the importance of considering sport-specific balance tests.

Evaluation of postural stability under single and dual task conditions in individuals with and without intellectual disability

Background: The aim was to investigate how varying levels of intellectual disability (ID) impact postural stability parameters and response reaction time (RRT). Method: Fifty-nine individuals with low and moderate levels of ID and 55 sex- and age-matched peers without ID performed a bipedal standing postural control task while having their (I) eyes open [OE], (II) eyes closed [CE], and (III) while performing a secondary cognitive task- pressing a trigger button while maintaining still stance (dual task, DT). Seven postural control parameters (total, mediolateral and anteroposterior displacement, sway area, sway mean velocity, mediolateral dispersion, and anteroposterior dispersion) during each experimental condition as well as the RRT during the DT were recorded. Results: The results revealed that (I) CE and DT partially affected postural control parameters when compared to OE condition (in 13 and in 3 out of 21 pairwise comparisons, respectively), (II) individuals with ID had poorer postural control than peers without ID during the OE and DT conditions (p ≤ 0.05), but not during the CE condition (except for the larger total displacement observed in participants with moderate disability compared to participants without ID, p ≤ 0.05), (III) RRT was longer in individuals with ID compared to the group without ID (p ≤ 0.001), and (IV) no postural control parameter (p ≥ 0.05) nor RRT (p = 0.138) revealed differences between the participants with low and moderate levels of ID. Conclusions: These findings suggest that individuals with ID present reduced performance in the postural control parameters especially when they need to respond to DT compared to individuals without ID.

Effects of protective step training on proactive and reactive motor adaptations in Parkinson's disease patients.

The aim of this study was to investigate to what extent PD affects the ability to walk, respond to balance perturbations in a single training session, and produce acute short-term effects to improve compensatory reactions and control of unperturbed walking stability. Understanding the mechanism of compensation and neuroplasticity to unexpected step perturbation training during walking and static stance can inform treatment of PD by helping to design effective training regimens that remediate fall risk. Current rehabilitation therapies are inadequate at reducing falls in people with Parkinson's disease (PD). While pharmacologic and surgical treatments have proved largely ineffective in treating postural instability and gait dysfunction in people with PD, studies have demonstrated that therapy specifically focusing on posture, gait, and balance may significantly improve these factors and reduce falls. The primary goal of this study was to assess the effectiveness of a novel and promising intervention therapy (protective step training - i.e., PST) to improve balance and reduce falls in people with PD. A secondary goal was to understand the effects of PST on proactive and reactive feedback responses during stance and gait tasks. Multiple-baseline, repeated measures analyses were performed on the multitude of proactive and reactive performance measures to assess the effects of PST on gait and postural stability parameters. In general, the results indicate that participants with PD were able to use experiences with perturbation training to integrate and adapt feedforward and feedback behaviors to reduce falls. The ability of the participants with PD to adapt to changes in task demands suggests that individuals with PD could benefit from the protective step training to facilitate balance control during rehabilitation.

Postural stability and plantar pressure parameters in healthy subjects: variability, correlation analysis and differences under open and closed eye conditions.

Introduction: The "postural control system" acts through biomechanical strategies and functional neuromuscular adaptations to maintain body balance under static and dynamic conditions. Postural stability and body weight distribution can be affected by external sensory inputs, such as different visual stimuli. Little information is available about the influence of visual receptors on stabilometric and plantar pressure parameters. The aim of this study was to analyze variability, correlations, and changes in these parameters under open- (OE) and closed-eye (CE) conditions. Methods: A total of 31 stabilometric and plantar pressure parameters were acquired in 20 young and healthy adults during baropodometric examination performed in bipedal standing under both visual conditions. Variability of parameters was evaluated via the coefficient of variation, correlation analysis via Pearson's R2, and statistical differences via the Wilcoxon test. Results: High intra-subject repeatability was found for all plantar pressure parameters and CoP-speed (CV < 40%) under OE and CE conditions, while CoP-sway area (CoPsa) and length surface function (LSF) showed larger variability (CV > 50%). Mean and peak pressures at midfoot and total foot loads showed the least number of significant correlations with other parameters under both visual conditions, whereas the arch-index and rearfoot loads showed the largest number of significant correlations. The limb side significantly affected most plantar pressure parameters. A trend of larger LSF and lower CoPsa and mean and peak pressures at the right forefoot was found under the CE condition. Discussion: The present study provides a deeper insight into the associations between postural stability and foot load. Interesting postural adaptations, particularly with respect to different visual stimuli, the effect of the dominant side, and the specific role of the midfoot in balance control were highlighted.

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.

Which is superior for postural stability: contact lens or spectacles?

ABSTRACT Clinical relevance The visual system plays an important role in providing postural balance. Visual input must have good quality to ensure proper balance. Background The aim of this work is to compare the use of soft contact lenses and spectacles in terms of postural stability. Methods Patients who wore both soft spherical or toric contact lenses and spectacles were examined between February and July, 2021. A detailed ophthalmic examination, including contact lens evaluation, was performed. The aim was to fully correct the refractive error and to prescribe the most appropriate spectacle and contact lens correction. After 1 month of use, patients were subjected to the balance test. The balance tests were repeated using the Biodex Balance System (Biodex Inc. Shirley, New York, USA), first with contact lenses and then with spectacles, 15 minutes later. Static and dynamic postural stability indices were compared. Results Thirty patients were included in the study. The mean age of the study group was 31.33 ± 4.54 (26–40) years. All patients had myopic refractive errors (20 patients with myopia and 10 patients with myopia and astigmatism). The mean spherical equivalent was −2.95 ± 1.81 (−4.50–(−0.50)) D. Static stability index score was found to be statistically significantly better in tests with contact lenses (p = 0.004). Among the dynamic postural stability parameters, overall stability index and antero-posterior stability index (APSI) scores with contact lenses were better than with spectacles, but the difference was not statistically significant (p > 0.05 for both). Medio-lateral stability index (MLSI) score was better in tests with contact lenses (p < 0.001). Conclusion Contact lenses may provide better static and dynamic postural balance than spectacles in young patients with myopic refractive errors.

A gender based comparison and correlation of spatiotemporal gait parameters and postural stability.

Postural stability during gait is a crucial factor that reduces the risk of falls. Researchers determine the most effective way to assist patients whose postural stability deficit predominantly related to gait parameters. The aim of this study was to investigate the comparison and relationship between spatiotemporal gait parameters and postural stability in young male and female. 96 participants (male, and female) with age range from 18-40 years were selected to conduct this cross-sectional correlation study. Any participants with cardiovascular, neuromuscular diseases, musculoskeletal injury, vision, and hearing problem were excluded from the study. To measure spatiotemporal data, the Physilog application by Gaitup was used. Stabilometer was used to assess unipedal dynamic postural stability. Statistical analysis of data was performed by using SPSS software. Mann Whitney U test, Kruskall Wallis H test, and Spearman rank correlation coefficient tests were used to statistical analysis. The results of this study revealed that anteroposterior stability for left leg was significant (p=.002) between male and female. The gait parameters as stride length (Left Leg, p=.050), (Right leg, p=.001); gait speed (Left Leg, p=.006), (Right leg, p=.009); and maximal heel clearance (Left Leg, p=.001), (Right leg, p=.001) were significant between genders. No significant relationship was found among the dynamic postural stability and spatiotemporal parameters of gait. In summary, this research illustrates the putative mechanisms of gait parameters and postural dynamic stability parameters differences in male and female participants and also relationship among them.

Exploring effects of Egoscue versus lumbar stabilisation exercises for lower crossed syndrome on postural stability and hyperlordotic posture correction

Abstract The aim of the study was to evaluate the comparative effectiveness of Egoscue exercises and lumbar stabilisation exercises in individuals with the lower crossed syndrome in terms of hyperlordotic posture correction, postural stability, and patient satisfaction towards treatment. The study was a randomised controlled trial. Through randomisation, 30 participants were allocated into 2 study groups, the Egoscue Exercise (EE) group (n=15) and the lumbar stabilisation exercise (LSE) group (n=15). The outcome measures were the degree of lumbar lordosis, functional disability, and postural stability parameters (risk of fall, stability index, weight distribution, anterior-posterior sway, and lateral sway) and patient satisfaction with treatment assessed at baseline and post-10th session of the intervention. Within group analysis showed significant improvement in the outcome measures, such as Index of Lumbar Lordosis, functional disability, postural stability, and patient satisfaction towards treatment with the groups (P&lt;0.05). Between groups analysis showed that EE group and LSE groups were equally effective in improving lumbar hyperlordosis (P=0.458), functional disability (P=0.545), postural stability (risk of fall P=0.781; stability index P=0.964; weight distribution index P=0.718; anterior-posterior sway P=0.402; lateral sway P=0.212) and patient satisfaction towards treatment (P=0.999). Egoscue exercises and lumbar stabilisation exercises are equally effective in correcting lumbar hyper lordotic posture, postural stability, pain, and functional disability in low back pain individuals with the lower crossed syndrome. Clinical Trials Registry – India (CTRI): CTRI/2021/09/036733

Investigation of the Effect of Conventional Treatment on Postural Stability and Balance in Individuals with Shoulder Pain

Background: The stability provided by the trunk is needed for normal shoulder function. This is also related to balance. Objectives: To examine the postural stability and balance status of individuals with shoulder pain and the relations of these parameters to each other. In addition, to investigate the effects of conventional shoulder pain treatment on postural instability and balance parameters. Methods: Twenty patients with shoulder pain and twenty healthy individuals included in the study were assigned to the treatment (n = 20) and control group (n = 20). A conventional physiotherapy program was applied 3 times a week to individuals with shoulder pain in the treatment group for 8 weeks (24 sessions). Pain, shoulder range of motion, and balance were evaluated at the end of the program. Results: A statistically significant improvement was observed in the pre-and post-treatment values of pain and range of motion in the treatment group at the end of 8 weeks (P = 0.00; P = 0.02). In addition, statistically significant differences were found in all values in the results of the balance assessment between the groups, except for the dynamic balance scores of the medial-lateral balance (P = 0.014; P = 0.016). Conclusions: Postural stability and balance status of individuals with shoulder pain were evaluated, and no statistically significant difference was found between them and healthy individuals. It was observed that therapeutic agents applied in addition to exercise in individuals with shoulder pain prove to be a safe method that can be implemented to improve the parameters of pain, mobility, balance, and postural stability.

Does Kinesio taping of tibialis posterior or peroneus longus have an immediate effect on improving foot posture, dynamic balance, and biomechanical variables in young women with flexible flatfoot?

BackgroundFlexible flatfoot is common in young adults. One of its causes is the failure of dynamic stabilizers, which play an important role in the medial longitudinal arch support, and their appropriate function is necessary for the integrity of the lower extremity and the spine. ObjectiveThe study aimed to determine Kinesio taping on which extrinsic foot muscle provides greater benefit regarding enhancement of foot posture, dynamic balance, and biomechanical parameters in functional tasks immediately. MethodsThirty women were recruited for the study. They were randomly divided into groups (A = 15, B = 15). In group A, Kinesio taping was applied on the tibialis posterior (TP), and in group B, Kinesio taping was applied on the peroneus longus (PL) and remained for 30 min. Outcome measures were the navicular drop test (NDT), foot posture index (FPI), Y-balance test, and biomechanical parameters in functional tasks. Before/After within-group and between-group comparisons of outcome measures were performed. ResultsNDT and FPI decreased in both groups (p < 0.05) with no significant difference between groups. In group A, maximum total force of the stance phase (MaxTFSP) during running increased, and some temporal parameters were changed. (p < 0.05). In group B, Y-balance test improved in all directions, and the width of the gait line during walking increased. There were no significant differences in the postural stability parameters in the within-group comparison, except for mean center of pressure displacement in group B (p = 0.04). ConclusionKinesio taping of both muscles could improve foot posture. TP Kinesio taping can increase the MaxTFSP during running and alter some temporal parameters during walking and running tasks. PL Kinesio taping could lead to better dynamic stability and coordination during dynamic tasks. Each muscle can be considered a therapeutic target for a specific purpose.

Improvement of postural stability and gait velocity after cervical decompression surgery in patients with cervical spondylotic myelopathy.

Cervical spondylotic myelopathy (CSM) is a progressive degenerative condition that can lead to significant neurological deficits, including gait instability. Biomechanical alterations of gait and its various components are poorly understood. The goal of the current study was to determine how spatiotemporal gait parameters, as well as postural and dynamic stability, change after surgery in CSM patients. A total of 47 subjects were included, with 23 test subjects and 24 controls. Baseline measurements were made for both cohorts. In the CSM cohort, repeat measurements were made at 3 and 6 months postoperatively. To record spatiotemporal and dynamic stability parameters, subjects performed walking trials over force plates on a 15-m runway. To assess postural stability, standing balance trials were conducted on a floor-mounted force plate. Three-dimensional motion analysis cameras and gait modeling software were used to quantify and visually represent results. Statistical analysis was completed using repeated-measures ANOVA and paired t-tests. Significance was set at p < 0.05. CSM patients had significantly increased gait velocity at the 6-month follow-up (mean 0.948 ± 0.248 m/sec/leg length) versus baseline (mean 0.852 ± 0.257 m/sec/leg length) (p = 0.039). The tilted ellipse area was significantly decreased at the 6-month follow-up compared with baseline (mean 979.8 ± 856.7 mm2 vs 598.0 ± 391.1 mm2, p = 0.018). Angular momentum excursion was not significantly different between baseline and the 3- and 6-month follow-ups. CSM patients displayed significant improvement in gait velocity and postural stability parameters after decompressive surgery. Dynamic stability parameters did not change significantly during the study period.

Effects of Posterior Spinal Correction and Fusion on Postural Stability in Patients with Adolescent Idiopathic Scoliosis

The present study aimed to assess the effects of posterior spinal correction and fusion on postural stability in patients with adolescent idiopathic scoliosis (AIS). The study included 41 female patients with AIS at our institution. All patients performed three 10 s single-leg standing trials on a force plate. The center of pressure (COP) was measured preoperatively, and at 1 week and 6 months postoperatively. The postural stability parameters were absolute minimum time-to-boundary (TTB), mean of the minimum TTB, mean COP velocity, standard deviation, range, and 95% confidence ellipse area. One-way repeated analysis of variance or Friedman test was applied to the postural stability parameters. Multiple comparisons were performed using the Bonferroni correction. The absolute minimum TTB and the mean minimum TTB showed a significant increase 6 months post-operation as compared to preoperatively and 1 week postoperatively. The COP velocity significantly decreased at 6 months post-operation compared to preoperatively and 1 week postoperatively. These changes in postural stability indicate that spinal correction and fusion can be considered to improve postural stability during single-leg standing tests in the postoperative period.

Auditory Stimulation Improves Gait and Posture in Cerebral Palsy: A Systematic Review with Between- and Within-Group Meta-Analysis.

The past decade has seen an increased interest in the implementation of auditory stimulation (AStim) for managing gait and postural deficits in people with cerebral palsy. Although existing reviews report beneficial effects of AStim on the spatiotemporal and kinematic parameters of gait, there are still numerous limitations that need to be addressed to correctly interpret these results. For instance, existing reviews have failed to characterize the effects of AStim by conducting separate between and within-group meta-analyses, these reviews have not evaluated the influence of AStim on postural outcomes, and nor have included several high-quality existing trials. In this study, we conducted between- and within-group meta-analyses to establish a state of evidence for the influence of AStim on gait and postural outcomes in people with cerebral palsy. We searched the literature according to PRISMA-P guidelines across 10 databases. Of 1414 records, 14 studies, including a total of 325 people with cerebral palsy, met the inclusion criterion. We report a significant enhancement in gait speed, stride length, cadence, and gross motor function (standing and walking) outcomes with AStim compared to conventional physiotherapy. The findings from this analysis reveal the beneficial influence of AStim on the spatiotemporal and kinematic parameters of gait and postural stability in people with cerebral palsy. Furthermore, we discuss the futurized implementation of smart wearables that can deliver person-centred AStim rehabilitation in people with cerebral palsy.

Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: Asystematic review.

Gait deficits and postural instability are common impairments among patients with neurological disorders. These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the nervous system. No systematic review has been published examining the influence of FMV on gait ability and postural stability in individuals with neurological disorders. This study aimed to investigate the effects of FMV on gait and postural stability parameters in individuals with neurological disorders. PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Five randomized controlled trials (RCTs) met the eligibility criteria. The scores on the PEDro scale ranged from seven to nine, with a median score of eight. The results showed evidence for the benefits and non-benefits of the FMV intervention on gait and postural stability in individuals with neurological disorders. The FMV intervention is safe and well-tolerated in individuals with neurological disorders. The evidence for the effects of FMV on individuals with neurological disorders was limited. Further high-quality studies with long-term follow-up are strongly needed.

Variability of Postural Stability and Plantar Pressure Parameters in Healthy Subjects Evaluated by a Novel Pressure Plate.

Background: Postural stability and plantar pressure parameters can be assessed by baropodometry; nevertheless, they are often affected by low repeatability. The aim of the study was to test the accuracy and repeatability of a novel resistive sensor pressure plate and to establish the most reliable baropodometric parameters. Methods: Accuracy and repeatability of the FM12050 BTS-Bioengineering plate measurements were assessed by using different weights in static conditions across three sessions. Subsequently, 20 healthy subjects were assessed by 30-s stabilometric analysis in bipedal standing with open eyes across four trials in two sessions, morning and afternoon. Results: Pressure plate repeatability in measuring the static weights was very high, and plate measurements were correlated to the scale measurements (Pearson’s coefficient = 0.99). Percentage of load distribution between left and right foot and in rearfoot and forefoot regions showed the largest repeatability (coefficient of variation < 5%) across trials. Eventually, median and percentiles (25–75%) were reported for each parameter. Conclusions: This study helped to assess the accuracy and repeatability of a novel pressure plate in static conditions and to define the most reliable parameters for the assessment of postural stability and foot morphology. The present healthy-subject stabilometric dataset may be used as reference data in the evaluation of pathological populations.

Validity and Reliability of a Smartphone App for Gait and Balance Assessment.

Advances in technology provide an opportunity to enhance the accuracy of gait and balance assessment, improving the diagnosis and rehabilitation processes for people with acute or chronic health conditions. This study investigated the validity and reliability of a smartphone-based application to measure postural stability and spatiotemporal aspects of gait during four static balance and two gait tasks. Thirty healthy participants (aged 20–69 years) performed the following tasks: (1) standing on a firm surface with eyes opened, (2) standing on a firm surface with eyes closed, (3) standing on a compliant surface with eyes open, (4) standing on a compliant surface with eyes closed, (5) walking in a straight line, and (6) walking in a straight line while turning their head from side to side. During these tasks, the app quantified the participants’ postural stability and spatiotemporal gait parameters. The concurrent validity of the smartphone app with respect to a 3D motion capture system was evaluated using partial Pearson’s correlations (rp) and limits of the agreement (LoA%). The within-session test–retest reliability over three repeated measures was assessed with the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM). One-way repeated measures analyses of variance (ANOVAs) were used to evaluate responsiveness to differences across tasks and repetitions. Periodicity index, step length, step time, and walking speed during the gait tasks and postural stability outcomes during the static tasks showed moderate-to-excellent validity (0.55 ≤ rp ≤ 0.98; 3% ≤ LoA% ≤ 12%) and reliability scores (0.52 ≤ ICC ≤ 0.92; 1% ≤ SEM% ≤ 6%) when the repetition effect was removed. Conversely, step variability and asymmetry parameters during both gait tasks generally showed poor validity and reliability except step length asymmetry, which showed moderate reliability (0.53 ≤ ICC ≤ 0.62) in both tasks when the repetition effect was removed. Postural stability and spatiotemporal gait parameters were found responsive (p < 0.05) to differences across tasks and test repetitions. Along with sound clinical judgement, the app can potentially be used in clinical practice to detect gait and balance impairments and track the effectiveness of rehabilitation programs. Further evaluation and refinement of the app in people with significant gait and balance deficits is needed.

Quantitative assessment of postural balance in patients with chronic anterior cruciate ligament injury- A controlled study

PurposeEvaluation of single and double limb support postural balance in patients with Anterior cruciate ligament (ACL)injury and comparison of the postural strategy adopted after ACL injury/deficiency(ACLD) with that of an age-matched healthy individual. MethodsThe study group that included 33 subjects confirming inclusion criteria had undergone postural balance assessment using the HUMAC Balance system. The parameters of the center of pressure excursion were recorded on a force plate and compared with age, BMI matched 66 healthy volunteers of control group. The center of pressure excursions was monitored using dependable variables such as sway path length(cm), the average velocity of sway(cm/sec), and the mean COP stability score(%). The mobility component was recorded as the percentage (%) of time spent on each target. ResultA decrease in postural balance in the injury group was evidenced by a statistically significant decrease of stability score(p = 0.015), increase in path length(p = 0.002) and decrease on time on target mean score (p= <0.001),. Although, the stability score path length and average sway velocity scores in the sound limb of the ACLD group showed impaired balance, the differences were not statistically significant (p = 0.180, p = 0.561, and p = 0.639 respectively) when compared with the dominant limb of the control group. ConclusionHUMAC balance system is an effective and simplified measure for quantifying postural balance. Although overall postural stability in ACL injury is impaired, static postural balance is maintained by the compensatory of strategy of sound limb. However, the quantitative parameters of postural stability for the sound limb, despite of a lower mean value, did not show statistically significant differences from the dominant limb of the controlled group.