Postural Balance In Individuals Research Articles

Effect of Verbal Encouragement on Postural Balance in Individuals with Intellectual Disabilities.

This study investigated the effect of verbal encouragement (VE) on static and dynamic balance in individuals with intellectual disabilities (IDs). A total of 13 mild IDs and 12 moderate IDs participants underwent static balance tests (bipedal stance on firm surface, under open eyes (OEs) and closed eyes (CEs), and foam surface, unipedal stance on firm surface) and dynamic balance assessments (Y Balance Test (YBT) and Expanded Timed Up-and-Go Test (ETUGT)) under VE and no VE (NO/VE) conditions. VE significantly reduced center of pressure mean velocity (CoPVm) values for mild IDs in firm bipedal CEs conditions. The mild IDs group exhibited improved YBT scores and enhanced ETUGT performances for both groups under VE. Incorporating VE as a motivational strategy in balance training interventions can positively impact static and dynamic balance in individuals with mild IDs, especially in challenging conditions like unipedal stances on firm surfaces.

Inertial Sensor-Based Assessment of Static Balance in Athletes with Chronic Ankle Instability.

The Balance Error Scoring System (BESS), a subjective examiner-based assessment, is often employed to assess postural balance in individuals with chronic ankle instability (CAI); however, inertial sensors may enhance the detection of balance deficits. This study aimed to compare the BESS results between the CAI and healthy groups using conventional BESS scores and inertial sensor data. The BESS test (six conditions: double-leg, single-leg, and tandem stances on firm and foam surfaces, respectively) was performed for the CAI (n = 16) and healthy control (n = 16) groups with inertial sensors mounted on the sacrum and anterior shank. The BESS score was calculated visually by the examiner by counting postural sway as an error based on the recorded video. The root mean square for resultant acceleration (RMSacc) in the anteroposterior, mediolateral, and vertical directions was calculated from each inertial sensor affixed to the sacral and shank surfaces during the BESS test. The mixed-effects analysis of variance and unpaired t-test were used to assess the effects of group and condition on the BESS scores and RMSacc. No significant between-group differences were found in the RMSacc of the sacral and shank surfaces, and the BESS scores (P > 0.05), except for the total BESS score in the foam condition (CAI: 14.4 ± 3.7, control: 11.7 ± 3.4; P = 0.039). Significant main effects of the conditions were found with respect to the BESS scores and RMSacc for the sacral and anterior shank (P < 0.05). The BESS test with inertial sensors can detect differences in the BESS conditions for athletes with CAI. However, our method could not detect any differences between the CAI and healthy groups.

Effect of home-based virtual reality training and telerehabilitation on balance in individuals with Parkinson disease, multiple sclerosis, and stroke: a systematic review and meta-analysis.

ObjectiveIn the last decade, there is a growing interest in the use of virtual reality for rehabilitation in clinical and home settings. The aim of this systematic review is to do a summary of the current evidence on the effect of home-based virtual reality training and telerehabilitation on postural balance in individuals with central neurological disorders.MethodsLiterature was searched in PubMed, Web of Science, PEDro, ScienceDirect, and MEDLINE. Randomized controlled trials (RCTs) evaluating the effect of home-based virtual reality (VR) training and telerehabilitation (TR) on postural balance in patients with Parkinson's disease, Multiple sclerosis or stroke. Studies were imported to EndNote and Excel to perform two screening phases by four reviewers. Risk of bias was assessed using PEDro scale and Cochrane assessment tool for risk of bias. Synthesis of the data on comparative outcomes was performed using RevMan software.ResultsSeven RCTs were included, with all three pathologies represented. VR and TR consisted of a training device (e.g., Nintendo Wii or Xbox 360) and a monitoring device (e.g., Skype or Microsoft Kinect). Five studies used the Berg Balance Scale (BBS) for measuring postural balance. Across studies, there was an improvement in BBS scores over time in both experimental and control groups, and the effect remained at follow-up for both groups. However, there was no significant difference between groups post-intervention (MD = 0.74, p = 0.45).ConclusionHome-based VR and TR can be used as prolongation to conventional therapy.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10072-021-05855-2.

Postural Balance in Individuals With Knee Osteoarthritis During Stand-to-Sit Task.

Objective: Stand-to-sit task is an important daily function, but there is a lack of research evidence on whether knee osteoarthritis (knee OA) affects the postural balance during the task. This study aimed to compare individuals with knee OA and asymptomatic controls in postural balance and identify kinematic and lower extremity muscle activity characteristics in individuals with knee OA during the stand-to-sit task.Methods: In total, 30 individuals with knee OA and 30 age-matched asymptomatic controls performed the 30-s Chair Stand Test (30sCST) at self-selected speeds. Motion analysis data and surface electromyography (sEMG) were collected while participants performed the 30sCST. To quantify postural balance, the displacement of the center of mass (CoM) and the peak instantaneous velocity of the CoM were calculated. The kinematic data included forward lean angles of the trunk and pelvic, range of motion (RoM) of the hip, knee, and ankle joints in the sagittal plane. The averaged activation levels of gluteus maximus, vastus lateralis, vastus medialis, rectus femoris, biceps femoris (BF), tibialis anterior (TA), and medial head of gastrocnemius muscles were indicated by the normalized root mean square amplitudes.Results: Compared with the asymptomatic control group, the knee OA group prolonged the duration of the stand-to-sit task, demonstrated significantly larger CoM displacement and peak instantaneous CoM velocity in the anterior-posterior direction, reduced ankle dorsiflexion RoM, greater anterior pelvic tilt RoM, and lower quadriceps femoris and muscles activation level coupled with higher BF muscle activation level during the stand-to-sit task.Conclusion: This study indicates that individuals with knee OA adopt greater pelvic forward lean RoM and higher BF muscle activation level during the stand-to-sit task. However, these individuals exist greater CoM excursion in the anterior-posterior direction and take more time to complete the task. This daily functional activity should be added to the rehabilitation goals for individuals with knee OA. The knee OA group performs reduced ankle dorsiflexion RoM, quadriceps femoris, and TA activation deficit. In the future, the rehabilitation programs targeting these impairments could be beneficial for restoring the functional transfer in individuals with knee OA.

Co-contraction of ankle muscle activity during quiet standing in individuals with incomplete spinal cord injury is associated with postural instability

Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), soleus and medial gastrocnemius were collected bilaterally. The iSCI-group exhibited more co-contractions than the AB-group (EO: 0.208% vs. 75.163%, p = 0.004; EC: 1.767% vs. 92.373%, p = 0.016). Furthermore, postural sway was larger during co-contractions than during no co-contraction in the iSCI-group (EO: 1.405 cm/s2 vs. 0.867 cm/s2, p = 0.023; EC: 1.831 cm/s2 vs. 1.179 cm/s2, p = 0.030), but no differences were found for the AB-group (EO: 0.393 cm/s2 vs. 0.499 cm/s2, p = 1.00; EC: 0.686 cm/s2 vs. 0.654 cm/s2, p = 1.00). To investigate the mechanism, we performed a computational simulation study using an inverted pendulum model and linear controllers. An increase of mechanical stiffness in the simulated iSCI-group resulted in increased postural sway (EO: 2.520 cm/s2 vs. 1.174 cm/s2, p < 0.001; EC: 4.226 cm/s2 vs. 1.836 cm/s2, p < 0.001), but not for the simulated AB-group (EO: 0.658 cm/s2 vs. 0.658 cm/s2, p = 1.00; EC: 0.943 cm/s2 vs. 0.926 cm/s2, p = 0.190). Thus, we demonstrated that co-contractions may be a compensatory strategy for individuals with iSCI to accommodate for decreased motor function, but co-contractions may result in increased ankle mechanical joint stiffness and consequently postural sway.

Star Excursion Balance Test as an Exercise to Improve Static and Dynamic Balance in Community-Dwelling Persons with Unilateral Osteoarthritis of Knee

Knee joint stability is important for postural stability.Abnormal weight distribution is common in individualswith unilateral osteoarthritis of knee (OA knee) as compensatory mechanism for pain and joint malalignments.Various forms of conventional physiotherapy interventions have been used to prevent further degenerativeprocess. Star excursion balance test (SEBT) has been invented to assess dynamic postural stability. Thispresent study was aimed to investigate effects of SEBT as a postural control exercise training tool(SEBTx)in persons with unilateral OA knee. Fourteen participants were randomly assigned to control group (n = 7)and SEBTx group (n = 7). The control group received weekly routine physiotherapy interventions (jointmobilization, ultrasound therapy, transcutaneous electrical nerve stimulation, and taping). In addition tothe routine interventions, the SEBTxgroup was instructed to perform SEBTxfor 30 min/session, 3 sessions/week, for 4 weeks. Primary outcome (weight distributionon posturography in 8 directions – anterior, Rt.anterolateral, Rt.lateral, Rt. posterolateral, posterior, Lt. posterolateral, Lt. lateral, Lt. anterolateral)wasmeasured at baseline and4 weeks post-intervention. Secondary outcomes numeric pain rating scale (NPRS)and Timed Up and Go test (TUG) were used to assess pain and dynamic balance, respectively. Resultsshowed thatweight distribution inSEBTx group significantly improved in the Lt. posterolateral and posteriordirections post-intervention. Moreover, NPRS in SEBTx group significantly reduced from 47.9±7.4 to33.3±6.0. Lastly, TUG significantly reduced from 13.5±0.9 to 11.5±0.7 s in SEBTx group. In conclusion,the SEBTx should be applied to improve postural balance in individuals with unilateral (OA knee).

Effects of land- and water-based exercise programmes on postural balance in individuals with COPD: additional results from a randomised clinical trial

ObjectiveTo investigate the effects of water-based exercise training on postural balance in individuals with chronic obstructive pulmonary disease (COPD), and compare the effects of two similar protocols of land- and water-based exercise programmes on postural balance in this population. DesignRandomised clinical trial. SettingUniversity-based, outpatient, physical therapy clinic. SubjectsFifty individuals with COPD. InterventionsParticipants were assigned at random to the land group (LG; n=27) or the water group (WG; n=23), and underwent high-intensity endurance and strength training three times per week for 3months. Main outcome measuresFunctional balance was assessed by the timed up and go test (TUG), and static balance was assessed with a force platform in the following conditions: standing with feet hip-width apart and eyes open; standing with feet hip-width apart and eyes closed; standing on a short base; and one-legged stance. ResultsSeventeen subjects completed the intervention in the LG {nine males, mean age 64 [standard deviation (SD) 8] years, mean forced expiratory volume in 1 second (FEV1) 48 (SD 17) %predicted} compared with 14 subjects in the WG [nine males, mean age 65 (SD 8) years, FEV1 51 (SD 15) %predicted]. Water-based exercise training had a positive effect on functional balance [TUG: mean difference −1.17 (−1.93 to −0.41 95% confidence interval) seconds; P=0.006], whereas static balance remained unaltered for both groups. There was no between-group difference in postural balance after exercise training; however, a higher proportion of participants who had a clinically relevant improvement in the TUG were in the WG (LG 35%, WG 64%; P<0.001). ConclusionFunctional balance improved after 3months of high-intensity exercise training performed in water. Despite the environment, non-specific training seems to be insufficient to improve static balance. Clinical trial registration numberclinicalTrials.gov NCT01691131.

Métodos fisioterapêuticos utilizados na reabilitação do equilíbrio postural em indivíduos com osteoartrite: uma revisão sistemática

A osteoartrite é uma doença que pode interferir no equilíbrio postural por meio de alterações neuromusculares diversas e a fisioterapia possui meios que buscam a manutenção ou reabilitação deste problema. O objetivo desta revisão foi identificar, na literatura, meios reabilitativos sobre o equilíbrio postural de indivíduos com osteoartrite. Realizou-se uma revisão sistemática nas bases de dados SciELO, Medline e LILACS, entre os meses de janeiro à março de 2016, a partir do descritor primário “Osteoartrite” (Osteoarthritis) em cruzamento com os descritores secundários “Equilíbrio Postural” (Postural Balance), “Fisioterapia” (Physical Therapy Specialty) e “Reabilitação” (Rehabilitation), nas línguas portuguesa e inglesa. Inicialmente encontraram-se 275, dos quais 29 foram recrutados para uma análise qualitativa criteriosa. Ao fim, quatro artigos foram eleitos mediante os critérios estabelecidos pela revisão: um artigo abordou a cinesioterapia em solo, dois a hidrocinesioterapia e um a prática de exercícios domiciliares. Conclui-se que a manutenção ou reabilitação do equilíbrio postural, tanto estático quanto dinâmico, constitui um fenômeno de grande complexidade nos indivíduos acometidos pela osteoartrite. As técnicas fisioterapêuticas abordadas (cinesioterapia em solo, hidrocinesioterapia e a prática de exercícios físicos domiciliares) demonstraram efeitos positivos no manejo do equilíbrio postural em indivíduos com osteoartrite de quadril ou de joelho.

Use of the wii balance board to assess changes in postural balance across athletic season

ObjectiveThe purpose of this study was to investigate potential utility of a customised Wii Balance Board (WBB) program to assess postural balance in an athletic population. Researchers hypothesised that WBB measures would be strongly correlated to the Balance Error Scoring System (BESS) used in concussion assessments.DesignCross-sectional time series. Static and dynamic balance was assessed using the WBB and BESS at three time points of an athletic season: 1) pre-season, 2) mid-season, and 3) post-season.SettingUniversity research laboratorySubjectsInterventionOutcome measures1) BESS, 2) WBB dynamic recovery time, and 3) WBB static Centre of Pressure (COP).ResultsWBB COP data were found to be strongly correlated with BESS scores across all time points [pre-season (r=0.689, p&lt;0.05), mid-season (r=0.767, p&lt;0.01), and post-season (r=0.780, p&lt;0.01)]. There were significant differences in recovery time (p&lt;0.005) and COPx variance for the single-leg BESS condition across all time points (p&lt;0.005). No significant differences were observed in raw BESS scores across time points.ConclusionsStudy results support the use of a WBB as an objective tool in measuring variance in static and dynamic postural balance. This program has potential utility for clinicians when assessing balance deficits related to concussion. Planned work will examine the use of the WBB program in measuring variance in postural balance in individuals with sport-related concussion.Competing interestsNone.

Postural balance in Alzheimer's disease patients undergoing sensory pitfalls

Despite consensus regarding the interference of cognitive processes on the human balance, the impact that different sensory stimuli have on the stabilometric measures remains unclear. Here, we investigated changes in the postural balance of individuals with Alzheimer's disease (AD) and in healthy controls undergoing different proprioceptive and somesthetic pitfalls. We included 17 subjects submitted to eight sensorimotor dynamics with differences in the support bases, contact surfaces, and visual clues. The measurements used to assess participants balance were as follows: position of the body in space, range of instability, area of the support base, and velocity of postural control. From a total of 56 cross-sectional analyses, 21.42% pointed out differences between groups. Longitudinal analyses showed that tasks with proprioceptive and somesthetic pitfalls similarly impact imbalance in both groups. The current results suggest that AD subjects and healthy controls had different patterns submitted to balance, but suffered similar interference when undergoing proprioceptive and somesthetic challenges.

Proprioceptive Changes Impair Balance Control in Individuals with Chronic Obstructive Pulmonary Disease

IntroductionBalance deficits are identified as important risk factors for falling in individuals with chronic obstructive pulmonary disease (COPD). However, the specific use of proprioception, which is of primary importance during balance control, has not been studied in individuals with COPD. The objective was to determine the specific proprioceptive control strategy during postural balance in individuals with COPD and healthy controls, and to assess whether this was related to inspiratory muscle weakness.MethodsCenter of pressure displacement was determined in 20 individuals with COPD and 20 age/gender-matched controls during upright stance on an unstable support surface without vision. Ankle and back muscle vibration were applied to evaluate the relative contribution of different proprioceptive signals used in postural control.ResultsIndividuals with COPD showed an increased anterior-posterior body sway during upright stance (p = 0.037). Compared to controls, individuals with COPD showed an increased posterior body sway during ankle muscle vibration (p = 0.047), decreased anterior body sway during back muscle vibration (p = 0.025), and increased posterior body sway during simultaneous ankle-muscle vibration (p = 0.002). Individuals with COPD with the weakest inspiratory muscles showed the greatest reliance on ankle muscle input when compared to the stronger individuals with COPD (p = 0.037).ConclusionsIndividuals with COPD, especially those with inspiratory muscle weakness, increased their reliance on ankle muscle proprioceptive signals and decreased their reliance on back muscle proprioceptive signals during balance control, resulting in a decreased postural stability compared to healthy controls. These proprioceptive changes may be due to an impaired postural contribution of the inspiratory muscles to trunk stability. Further research is required to determine whether interventions such as proprioceptive training and inspiratory muscle training improve postural balance and reduce the fall risk in individuals with COPD.

Avaliação da manobra de reposicionamento de Epley em indivíduos com vertigem posicional paroxística benigna

OBJETIVO: avaliar os parâmetros estabilométricos após a manobra de reposicionamento de Epley em indivíduos com Vertigem Posicional Paroxística Benigna (VPPB) previamente confirmada através da manobra de Dix-Hallpike. MÉTODOS: estudo experimental que incluiu pacientes que apresentaram VPPB com nistagmo de posicionamento à prova de Dix-Hallpike, avaliados no ano de 2008, no Ambulatório Multidisciplinar de Vertigem, e que foram submetidos à manobra de reposicionamento de Epley e avaliados quanto ao equilíbrio postural pelo exame de Estabilometria, antes e após a citada manobra. RESULTADOS: os 13 indivíduos do gênero feminino com idade variando de 15 a 78 anos com VPPB, previamente confirmados e selecionados para a pesquisa, apresentaram melhora estatisticamente significante em parâmetros estabilométricos verificados da primeira para a segunda avaliação, confirmando melhora do equilíbrio postural, após a manobra de Epley. CONCLUSÃO: nesta pesquisa a manobra de reposicionamento de Epley mostrou-se como um procedimento de intervenção importante para a melhora das respostas do equilíbrio postural em indivíduos com VPPB avaliados pela estabilometria.

Efeito de informação sensorial adicional na propriocepção e equilíbrio de indivíduos com lesão do LCA

OBJETIVO: Investigar o efeito da utilização de informação sensorial adicional na propriocepção e no equilíbrio de indivíduos com lesão do Ligamento Cruzado Anterior (LCA). MÉTODOS: Participaram deste estudo 28 indivíduos com lesão unilateral do LCA e 28 indivíduos com joelhos sadios. A propriocepção foi avaliada por meio do limiar para detecção de movimento passivo da articulação do joelho nas posições de 15 e 45 graus, para as direções de flexão e de extensão. O equilíbrio foi avaliado em posição unipodal sem visão, sobre uma plataforma de força e investigado por meio da amplitude e da velocidade média de oscilação do centro de pressão. As condições de informação sensorial utilizadas foram: informação normal, bandagem infra-patelar e faixa infra-patelar. RESULTADOS: Indivíduos com lesão do LCA apresentam um prejuízo na propriocepção e no equilíbrio quando comparados a indivíduos com joelhos sadios (p&lt;0,05). Entretanto, com adição de informação sensorial, tanto a capacidade proprioceptiva quanto o equilíbrio de indivíduos com lesão do LCA é melhorado (p&lt;0,05). Indivíduos com joelhos sadios não apresentam benefício na utilização de informação sensorial adicional (p&gt;0,05). CONCLUSÃO: A lesão do LCA acarreta um prejuízo da propriocepção e do equilíbrio, porém estes efeitos são minimizados com utilização de informação sensorial adicional.