Assessment Of Postural Stability Research Articles

Comparison Of Kinovea And Force Platforms For Postural Stability Assessment In Older Adults

Comparison Of Kinovea And Force Platforms For Postural Stability Assessment In Older Adults

Efficacy of scapulothoracic exercises on proprioception and postural stability in cranio-cervico-mandibular malalignment: A randomized, double-blind, controlled trial.

Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and temporomandibular joint (TMJ) disorders and affects masticatory muscles. This randomized, double-blind controlled trial aimed to compare the efficacy of scapula-thoracic (ST) exercises on temporomandibular and cervical joint position sense and postural stability in individuals with CCM malalignment. Fourty-nine participants with CCM malalignment were randomly assigned to the ST exercise group (STEG, n= 24) or the control group (CG, n= 25). STEG included progressive strengthening, proprioceptive, and stabilization exercises. All participants were assessed before treatment, at the end of the 8th week treatment period and at the 12th week post-treatment follow-up. Cranio-vertebral angle measurement, Fonseca's Questionnaire, Helkimo Clinical Dysfunction Index, TMJ position test, cervical joint position error test and postural stability assessment were used. The TMJ and cervical joint position sense, total sway degree, area gap percentage, sway velocity and antero-posterior body sway results showed significant improvement in the STEG compared to the CG (p< 0.05), however medio-lateral body sway did not differ between groups (p> 0.05). Postural stability, TMJ and cervical joint position sense appear to be affected in individuals with CCM malalignment. Our results showed that an exercise program including ST stabilization, proprioception and strengthening of the scapular muscles may be effective in the management of CCM malalignment and will allow clinicians to plan holistic treatment.

Assessment of postural stability of 14-year-old girls training volleyball

Introduction: Measurements of postural stability are carried out for the prevention of injuries and for rehabilitation of athletes who have sustained traumatic injuries. The aim of the study was to assess postural stability measured in static and dynamic conditions in 14-year-old girls, of whom some were training volleyball, and some were not. Materials and Methods: The study involved a group of 30 girls aged 14, attending volleyball classes. This group was compared with the control group (n = 30) of girls of the same age who regularly participated only in regular physical education (PE) classes. The tests were conducted twice. The first examination was conducted at the end of September 2021 and then repeated at the beginning of January 2022, at a primary school with an extended sport curriculum in Krakow. The Flamingo Balance Test was used to determine postural stability in static conditions, and the Y-Balance Test – to measure postural stability in dynamic conditions. Results: Statistically significant differences between the results obtained during the first and the second examination were found for four parameters: Y-ANT R (p = 0.025) and FBT L (p = 0.001) in the group of girls practicing volleyball and (FBT L (p = 0.002) and FBT R (p = 0.030) in the regular PE group. Conclusions: Neither examination showed any statistically significant differences in the intergroup YBT values. The largest difference of 4% was recorded for the Y-POST-MED R range in the second examination.

Trend change analysis of postural balance in Parkinson’s disease discriminates between medication state

BackgroundMaintaining static balance is relevant and common in everyday life and it depends on a correct intersegmental coordination. A change or reduction in postural capacity has been linked to increased risk of falls. People with Parkinson’s disease (pwPD) experience motor symptoms affecting the maintenance of a stable posture. The aim of the study is to understand the intersegmental changes in postural sway and to apply a trend change analysis to uncover different movement strategies between pwPD and healthy adults.MethodsIn total, 61 healthy participants, 40 young (YO), 21 old participants (OP), and 29 pwPD (13 during medication off, PDoff; 23 during medication on, PDon) were included. Participants stood quietly for 10 s as part of the Short Physical Performance Battery. Inertial measurement units (IMU) at the head, sternum, and lumbar region were used to extract postural parameters and a trend change analysis (TCA) was performed to compare between groups.ObjectiveThis study aims to explore the potential application of TCA for the assessment of postural stability using IMUs, and secondly, to employ this analysis within the context of neurological diseases, specifically Parkinson’s disease.ResultsComparison of sensors locations revealed significant differences between head, sternum and pelvis for almost all parameters and cohorts. When comparing PDon and PDoff, the TCA revealed differences that were not seen by any other parameter.ConclusionsWhile all parameters could differentiate between sensor locations, no group differences could be uncovered except for the TCA that allowed to distinguish between the PD on/off. The potential of the TCA to assess disease progression, response to treatment or even the prodromal PD phase should be explored in future studies.Trial registrationThe research procedure was approved by the ethical committee of the Medical Faculty of Kiel University (D438/18). The study is registered in the German Clinical Trials Register (DRKS00022998).

Effect of a juggling-based physical activity on postural stability, reaction time, and attention focus in older adults: a randomized crossover study

BackgroundIn the aging society, more attention is paid to the promotion of forms of physical activity that can improve postural stability and cognitive functioning. In this context, the importance of combined exercises, requiring simultaneous physical and cognitive involvement, is emphasized. Juggling seems to be a form of activity that is both cognitively and physically demanding. The purpose of this study was to determine the effect of additional juggling exercise on postural stability and cognitive abilities in healthy, physically active older adults.MethodsTwenty-six healthy and physically active older adults (70.08±4.40 years old) were included in a randomized crossover study. The addition of juggling three times a week during four weeks was the main intervention (one period), while the control phase included four weeks with no addition of juggling (second period). Measurements of postural stability and cognitive abilities were performed before and after each period. For the purpose of postural stability assessment, a velocity of center of pressure with root mean square, area 95 percentile, medio-lateral and anterior-posterior range of motion were measured. Center of pressure signals were obtained using an AccuGait™ System force plate in three conditions: free standing, dual-task and limits of stability. The Vienna Test System was used for the assessment of selected cognitive abilities. A battery of reaction time tests and Cognitrone test were used for this purpose.ResultsA significant interaction effect of intervention and time was observed in the postural stability dual-task condition in the root mean square of the center of pressure velocity in the advantage of the juggling period (medio-lateral: F=14.83, p<.01, ƞp2=.37; anterior-posterior: F=26.30, p<.01, ƞp2=.51). Additionally, moderate effect sizes were observed in the velocity of the center of pressure and variability of simple reaction time measurements, but without statistical significance.ConclusionsThe results of this study indicate that the implementation of juggling activity in everyday life may have positive effects on cognitive abilities and postural stability in healthy, physically active older adults, but the true effect may be low to moderate.Trial registrationThe study was registered retrospectively (30.10.2023) at ClinicalTrials.gov (NCT06108713).

Virtual Reality-Induced Modification of Vestibulo-Ocular Reflex Gain in Posturography Tests.

Background: The aim of the study was to demonstrate the influence of virtual reality (VR) exposure on postural stability and determine the mechanism of this influence. Methods: Twenty-six male participants aged 21-23 years were included, who underwent postural stability assessment twice before and after a few minute of single VR exposure. The VR projection was a computer-generated simulation of the surrounding scenery. Postural stability was assessed using the Sensory Organization Test (SOT), using Computerized Dynamic Posturography (CDP). Results: The findings indicated that VR exposure affects the visual and vestibular systems. Significant differences (p < 0.05) in results before and after VR exposure were observed in tests on an unstable surface. It was confirmed that VR exposure has a positive influence on postural stability, attributed to an increase in the sensory weight of the vestibular system. Partial evidence suggested that the reduction in vestibulo-ocular reflex (VOR) reinforcement may result in an adaptive shift to the optokinetic reflex (OKR). Conclusions: By modifying the process of environmental perception through artificial sensory simulation, the influence of VR on postural stability has been demonstrated. The validity of this type of research is determined by the effectiveness of VR techniques in the field of vestibular rehabilitation.

Effect of pain on cranio-cervico-mandibular function and postural stability in people with temporomandibular joint disorders.

Neck and jaw pain is common and is associated with jaw functional limitations, postural stability, muscular endurance, and proprioception. This study aimed to investigate the effect of jaw and neck pain on craniocervico- mandibular functions and postural stability in patients with temporomandibular joint disorders (TMJDs). Fifty-two patients with TMJDs were included and assessed using Fonseca's Questionnaire and the Helkimo Clinical Dysfunction Index. An isometric strength test was performed for the TMJ depressor and cervical muscles. The TMJ position sense (TMJPS) test and cervical joint position error test (CJPET) were employed for proprioception. Total sway degree was obtained for the assessment of postural stability. Deep neck flexor endurance (DNFE) was assessed using the craniocervical flexion test. The mandibular function impairment questionnaire (MFIQ) was employed to assess mandibular function, and the craniovertebral angle (CVA) was measured for forward head posture. Jaw and neck pain negatively affected CVA (R2 = 0.130), TMJPS (R2 = 0.286), DNFE (R2 = 0.355), TMJ depressor (R2 = 0.145), cervical flexor (R2 = 0.144), and extensor (R2 = 0.148) muscle strength. Jaw and neck pain also positively affected CJPET for flexion (R2 = 0.116) and extension (R2 = 0.146), as well as total sway degree (R2 = 0.128) and MFIQ (R2 = 0.230). Patients with painful TMJDs, could have impaired muscle strength and proprioception of the TMJ and cervical region. The jaw and neck pain could also affect postural stability, and the endurance of deep neck flexors as well as mandibular functions in TMJDs.

Consistency in the assessment of postural balance using static stabilometry and scale techniques in older individuals: An observational study

BACKGROUND: In clinical practice, both clinical scales and instrumental methods are used in parallel to assess postural stability and the risk of falls. Literature data on the comparability of postural balance estimates obtained using scale techniques and stabilometry, particularly in older patients, are conflicting.&#x0D; AIM: to analyze the consistency in the assessment of postural balance by static stabilometry and scale techniques in older patients.&#x0D; MATERIALS AND METHODS: A pilot observational, nonrandomized, single-center study was conducted. The study participants were 39 women aged 60–75 years who did not have diseases or conditions that significantly affected the postural control system. Postural balance was assessed using clinical scales and tests (timed up and go test, classic and a double task; Berg balance scale; Mini-BESTest, balance evaluation systems test; performance-oriented mobility assessment; and falls efficacy scale) and basic spatial, spatiotemporal, and spectral parameters of static stabilometry. A stabilometric study was conducted at the posturological complex Biokinect. Correlation analysis of the data of the scale techniques and stabilometry was performed.&#x0D; RESULTS: The correlation analysis showed both the correlation between some parameters of stabilogram and scale techniques and the complete absence of a significant correlation between others. However, even in the presence of a statistically significant correlation, the relationship between the parameters did not exceed the moderate or average level (maximum value of the correlation coefficient, 0.685, p 0.01). The largest correlation was found between the stabilometric parameters and the timed up and go test (correlated with 11 out of 21 parameters) and the falls efficacy scale (10 parameters), and the smallest was found with the Mini-BESTest (5 parameters). The values of the stabilometric parameter (speed of movement of the center of pressure) demonstrated a statistically significant correlation with most of the clinical instruments (4 out of 6).&#x0D; CONCLUSION: This study showed low consistency between the basic parameters of static stabilometry and scale techniques in older people. The results of simpler scale techniques for the assessment of postural balance correlated better with stabilometry data than with more complex and multicomponent ones because the total indicator of the latter is a generalized assessment of postural stability and other elements of complex motor behavior associated with postural balance. Therefore, simple scale techniques and tasks should be preferred when assessing the basic postural stability and risk of falls in older people.

Effectiveness of Abdominal Activation on Motor Control in Diplegic Cerebral Palsy: A Randomized Control Trial

Background: Cerebral palsy (CP) is a disorder of the nervous system manifested in movement, posture, muscle tone, and functional activity. Poor postural control is the most common problem related to CP. Neuro-developmental techniques, or facilitation techniques, were used to activate muscles and improve trunk control. Aim: To determine the influence of the effects of abdominal activation for correcting posture in spastic diaplegic CP children. Methods: A quantitative, randomized clinical trial was conducted, allocating 26 CP patients randomly into two groups: the control group and the treatment group. Baseline treatment was given to the control group, which included lower-limb passive stretching exercises and interrupted direct current. However, baseline treatment with neuro-developmental techniques was given to the treatment group. The measuring tool used for assessment of postural correction and stability was the trunk control measurement scale. Results: The study recruited 26 CP patients, of who 10 belonged to the age groups 8–10 years and 11–13 years, respectively, while 6 children were from the age group 14–15 years. An independent sample t-test was used for between-group analysis, and the results showed a significant improvement in the TCMS score post-treatment, as the p-value was 0.012, while within-group analysis was done by applying a paired sample t-test. There was a significant improvement in the treatment group (p-value 0.000) where NTD was applied, compared to the control group (p-value 0.096), where only baseline treatment was given. Implication: Neurodevelopmental approaches can improve trunk control in children with cerebral palsy, enhancing mobility, independence, posture, and functional skills. This reduces the risk of musculoskeletal issues and facilitates activity participation. Conclusion: The study showed significant improvement in postural control with the use of Neuro-developmental techniques in CP children. Children with cerebral palsy (CP) can benefit from improved trunk control using neurodevelopmental approaches, which can increase their mobility, independence, posture, ability to participate in activities, and functional skills. Keywords: Cerebral palsy (CP), Neuro-developmental techniques (NDT), Interrupted direct current (IDC).

The influence of jump-landing direction on dynamic postural stability following anterior cruciate ligament reconstruction

BackgroundTraditional testing prior to return to sport following anterior cruciate ligament reconstruction typically involves jump-landing tasks in the forward direction. As injury is most likely the result of multiplanar neuromuscular control deficits, assessment of dynamic postural stability using landing tasks that require multiplanar stabilization may be more appropriate. The purpose of this study was to examine how dynamic postural stability is affected when performing jump-landing tasks in three different directions. MethodsFifteen athletes [11 females (18.0 ± 3.0 years) and 4 males (18.5 ± 3.1 years)] following anterior cruciate ligament reconstruction performed a series of single-limb jump-landing tasks in 3 directions. Individual directional stability indices and a composite dynamic postural stability index were calculated using ground reaction force data and were compared using separate one-way repeated measures ANOVAs. FindingsAll directional stability indices demonstrated a significant main effect for jump-landing direction (medial-lateral P < 0.001, η2p = 0.95; anterior-posterior P < 0.001, η2p = 0.97; vertical P = 0.021, η2p = 0.24). The diagonal jump-landing direction produced increased medial-lateral stability and vertical stability scores, while the forward and diagonal jump-landing directions produced increased anterior-posterior stability scores. There was no significant effect for the composite dynamic stability index score. InterpretationJump-landing direction affects dynamic postural stability in all 3 planes of movement in athletes following anterior cruciate ligament reconstruction. Results indicate the potential need to incorporate multiple jump-landing directions to better assess dynamic postural stability prior to return to sport.

Noninstrumented Clinical Assessment of Static Postural Stability in Chronic Ankle Instability: A Systematic Review and Meta-Analysis.

Several clinical tests are available to assess static postural stability in individuals with chronic ankle instability (CAI); however, it is unclear which test should be used. To determine which noninstrumented clinical tests should be used to detect static postural stability deficits in individuals with CAI. We searched 4 databases from their inception to February 2023, and included studies comparing static postural stability in individuals with CAI and healthy controls using noninstrumented assessments. Two reviewers independently extracted study characteristics, participant information, static postural stability assessment methods, and results. We calculated the pooled standardized mean difference (SMD) and 95% confidence interval using a random effects meta-analysis and assessed the certainty of the evidence. Fourteen cross-sectional studies (293 participants with CAI and 284 healthy controls) were included. The meta-analysis showed no significant differences between the CAI and healthy groups in the double-leg stance condition of the Balance Error Scoring System (BESS) (SMD, -0.03; low-certainty evidence). Significant group differences were found in the BESS single-leg stance (SLS) on firm and foam surfaces (SLS firm: SMD, 0.47, very low-certainty evidence; SLS foam: SMD, 0.80, very low-certainty evidence), the tandem stance (TS) on firm and foam surfaces (TS firm: SMD, 0.39, low-certainty evidence; TS foam: SMD, 0.76, low-certainty evidence), and the total BESS in the foam conditions (SMD, 1.12, very low certainty evidence). Significant differences were also found between the CAI and healthy groups in the foot-lift (SMD, 1.24; very low certainty evidence) and time-in-balance tests (SMD, -0.94; very low certainty evidence). Due to the large magnitude of the differences, the SLS foam, TS foam, and the total BESS in the foam conditions, as well as the foot-lift test or time-in-balance test, may be the most appropriate to clinically identify static postural stability impairment in individuals with CAI.

Postural stability assessment in expert versus amateur basketball players during optic flow stimulation

We evaluated the role of visual stimulation on postural muscles and the changes in the center of pressure (CoP) during standing posture in expert and amateur basketball players. Participants were instructed to look at a fixation point presented on a screen during foveal, peripheral, and full field optic flow stimuli. Postural mechanisms and motor strategies were assessed by simultaneous recordings of stabilometric, oculomotor, and electromyographic data during visual stimulation. We found significant differences between experts and amateurs in the orientation of visual attention. Experts oriented attention to the right of their visual field, while amateurs to the bottom-right. The displacement in the CoP mediolateral direction showed that experts had a greater postural sway of the right leg, while amateurs on the left leg. The entropy-based data analysis of the CoP mediolateral direction exhibited a greater value in amateurs than in experts. The root-mean-square and the coactivation index analysis showed that experts activated mainly the right leg while amateurs the left leg. In conclusion, playing sports for years seems to have induced some strong differences in the standing posture between the right and left sides. Even during non-ecological visual stimulation, athletes maintain postural adaptations to counteract the body oscillation.

Combining return to sport, psychological readiness, body mass, hamstring strength symmetry, and hamstring/quadriceps ratio increases the risk of a second anterior cruciate ligament injury.

To investigate the combinations of variables that comprise the biopsychosocial model domains to identify clinical profiles of risk and protection of second anterior cruciate ligament injury. One hundred and forty-five patients for return-to-sport testing after anterior cruciate ligament (ACL) reconstruction (ACLR) were contacted, and 97 were deemed eligible. All were evaluated between 6 and 24months and followed up for 2years. Participants answered the International Knee Documentation Committee (IKDC) and Anterior Cruciate Ligament-Return to Sport after Injury Scale (ACL-RSI), performed the postural stability assessment using the Biodex Balance System, and assessed muscle strength at 60° and 300°/s on the isokinetic dynamometer. Personal factors (age, gender, body mass index), body structures (graft type and concomitant injuries), and environmental factors (time between surgery and evaluation) were also collected. The participants were asked about the occurrence of a second ACL injury and return to sport after 2years of follow-up. Classification and regression tree (CART) analysis was used to determine predictors of a second ACL injury. The receiver operating characteristic (ROC) curve was performed to verify the accuracy of the CART analysis, in addition to the sensitivity, specificity, and relative risk (RR) of the model. Of the initial 97 participants, 88 (89.8%) responded to follow-up and 14 (15.9%) had a second ACL injury (11 graft ruptures and three contralateral ACL). CART analysis identified the following variables as predictors of second ACL injury: return to sport, hamstring strength symmetry at 300°/s, ACL-RSI score, hamstrings/quadriceps ratio at 60°/s, and body mass index (BMI). CART correctly identified 9 (64.3%) of the 14 participants who were reinjured and 71 (95.9%) of the 74 participants who were not. The total correct classification was 90.9%. The area under the ROC curve was 0.88 (95% CI 0.72-0.99; p < 0.001), and the model showed a sensitivity of 75% (95% CI 42.8-94.5), specificity of 93.4% (95% CI 85.3-97.8), and RR of 15.9 (95% CI 4.9-51.4; p < 0.0001). The combination of hamstring strength symmetry, hamstring/quadriceps ratio (body functions); return to sport (activity and participation); psychological readiness; and BMI (personal factors) could identify three clinical risk profiles for a second ACL injury with good accuracy. IV.

Proprioceptive reliance on trunk muscles for maintaining postural stability decreases in older patients with sagittal imbalance

BackgroundControl of postural adjustments requires tight regulation of the spinal alignments. Sagittal imbalance may cause balance impairment and proprioceptive decline in older adults. However, the evidence on the proprioceptive mechanisms is limited, although it is known that poor proprioceptive inputs may induce spinal deformities. Thus, this study aimed to measure proprioceptive control quantifiers in older adults with sagittal imbalance to clarify the characteristic postural adjustments during proprioceptive inputs. Research questionWhat are the specific proprioceptive postural adjustments required to maintain balance in older adult patients with lumbar spondylosis? MethodsThis was a cross-sectional, observational study. The participants were classified according to the sagittal vertical axis (SVA) lengths with 50 mm as the cut-off value. The pressure displacement center was determined in 36 patients without sagittal imbalance and 68 patients with sagittal imbalance during an upright stance on a balance board with eyes closed. Vibratory stimulations of 27–272 Hz were applied to the gastrocnemius (GS) and lumbar multifidus (LM) muscles to measure the relative contributions and center of pressures of different relative proprioceptive weighting ratios (RPWs) used on postural adjustments. ResultsThe RPWs of older adults with sagittal imbalance were higher than that in those without sagittal imbalance (56–100 Hz; p = 0.013). Logistic regression analysis showed that older patients with sagittal imbalance had a significant ankle proprioception control of advantage (odds ratio: 1.1, 95% confidence interval: 1.01−1.1, p = 0.012). SignificanceIn older patients with sagittal imbalance, the reliance on hip strategy during balance control (RPW 56–100 Hz) decreases. A quantitative assessment of postural stability during proprioceptive inputs is crucial to identify dependence on proprioception signals, including postural strategy, in older patients with sagittal imbalance. Interventions to improve proprioception can improve the postural stability and strategy of older patients with sagittal imbalance.

Instrumental assessment of dynamic postural stability in patients with unilateral vestibular hypofunction during straight, curved, and blindfolded gait.

To characterise dynamic postural stability of gait in patients with vestibular hypofunction (PwVH) using a sensor-based assessment while performing dynamic tasks and to correlate the results of this evaluation with clinical scales. This cross-sectional study involved 22 adults between 18 and 70years old from a healthcare hospital centre. Eleven patients suffering from chronic vestibular hypofunction (PwVH) and eleven healthy controls (HC) were evaluated through a combined inertial sensor-based and clinical scale assessment. Participants were equipped with five synchronised inertial measurement units (IMUs) (128Hz, Opal, APDM, Portland, OR, USA): three IMUs were located on the occipital cranium bone, near the lambdoid suture of the head, at the centre of the sternum, and at L4/L5 level, just above the pelvis, and were used to quantify gait quality parameters, while the other two were located slightly above lateral malleoli and used to perform stride and step segmentation. Three different motor tasks were performed in a randomized order: the 10-m Walk Test (10mWT), the Figure of Eight Walk Test (Fo8WT) and the Fukuda Stepping Test (FST). A set of gait quality parameters related to stability, symmetry and smoothness of gait were extracted from IMU data and correlated with the clinical scale scores. PwVH and HC results were compared to test for significant between-group differences. Significant differences were found for the three motor tasks (10mWT, Fo8WT and FST) when comparing PwVH and HC groups. For the 10mWT and the Fo8WT, significant differences between the PwVH and HC groups were found for the stability indexes. Considering the FST, significant differences between the PwVH and HC groups were also found in the stability and symmetry of gait. A significant correlation was found between the Dizziness Handicap Inventory and gait indices during the Fo8WT. In this study, we characterized the dynamic postural stability alterations during linear, curved, and blindfolded walking/stepping in PwVH combining an instrumental IMU-based with traditional clinical scales approach. Combining instrumental and clinical evaluation for dynamic stability of gait alterations in PwVH is useful in thoroughly evaluating the effects of unilateral vestibular hypofunction.

Effect of a Balance Adjustment System on Postural Control in Patients with Chronic Ankle Instability.

This study aimed to evaluate how a two-week program using the in-phase mode of a balance adjustment system (the BASYS) affected postural control in participants with chronic ankle instability (CAI). It was hypothesized that the in-phase mode on the BASYS would lead to improved postural control compared with training on a balance disc. Randomized control trial. Twenty participants with CAI were recruited. The participants were divided into two intervention groups: the BASYS (n = 10) and Balance Disc (BD; cushion type, n = 10). All participants underwent six supervised training sessions over a two-week period. Static postural control during single leg standing with closed eyes was assessed for the CAI limb. We collected COP data while participants balanced on the BASYS. The test was performed for 30 sec, and the total trajectory length and 95% ellipse area were calculated. In the assessment of dynamic postural stability, Y-Balance tests-anterior, posteromedial, and posterolateral directions were measured on the CAI limb for all participants and normalized to the individual's leg length. Participants were recorded at three instances: pretraining (Pre), post-training 1 (Post1: after the first training), and post-training 2 (Post2: after the last training). There was an effect on time in the COP total trajectory length of the BASYS group, which was significantly decreased for Post 1 and Post 2 than for the Pre (p = 0.001, 0.0001). Group differences and time-by-group interactions were not observed for either of the Y-balance test reach distances. The study's primary finding was that two weeks of intervention in the in-phase mode on the BASYS improved static postural control in participants with CAI. Level Ⅰ, randomized control trial.

At-home assessment of postural stability in parkinson’s disease: a vision-based approach

Postural instability is one of the most disabling symptoms of Parkinson’s Disease, with important impacts on people safety and quality of life since it increases the risk of falls and injuries. Home monitoring of changes in postural stability, as a consequence of therapies and disease progression, is highly desirable for the safety of the patient and better disease management. In this context, we present a system for the automatic evaluation of postural stability that is suitable for self-managing by people with motor impairment directly at home. The system is based on an optical RGB-Depth device, which tracks the body movements both for system’s interaction, thanks to a gesture-based human-machine interface, and the automated assessment of postural stability. A set of tasks, based on standard clinical scales, has been designed for the assessment. The user controls the delivery of the tasks through the system interface. A machine learning approach is adopted, and some kinematic parameters that characterize the user’s performance during each task execution are estimated and used by supervised classifiers for the automatic assessment. Data collected during experimental clinical trials were used to train the classifiers. This approach supports the compliance of the classifier assessments with respect to the clinical ones. The system prototype and the preliminary results on its accuracy in the assessment of postural stability are presented and discussed.

A scoping review on recent trends in wearable sensors to analyze gait in people with stroke: From sensor placement to validation against gold-standard equipment.

The purpose of the review is to evaluate wearable sensor placement, their impact and validation of wearable sensors on analyzing gait, primarily the postural instability in people with stroke. Databases, namely PubMed, Cochrane, SpringerLink, and IEEE Xplore were searched to identify related articles published since January 2005. The authors have selected the articles by considering patient characteristics, intervention details, and outcome measurements by following the priorly set inclusion and exclusion criteria. From a total of 1077 articles, 142 were included in this study and classified into functional fields, namely postural stability (PS) assessments, physical activity monitoring (PA), gait pattern classification (GPC), and foot drop correction (FDC). The review covers the types of wearable sensors, their placement, and their performance in terms of reliability and validity. When employing a single wearable sensor, the pelvis and foot were the most used locations for detecting gait asymmetry and kinetic parameters, respectively. Multiple Inertial Measurement Units placed at different body parts were effectively used to estimate postural stability and gait pattern. This review article has compared results of placement of sensors at different locations helping researchers and clinicians to identify the best possible placement for sensors to measure specific kinematic and kinetic parameters in persons with stroke.

Evaluation of the Functional Status of the Posture Control System in Children with Detected Disorders in Body Posture.

Screening tests for body posture defects and abnormalities conducted over the past several decades have revealed a significant and constantly increasing problem of health risks in children. A sedentary lifestyle, which is considered to be the primary cause, can result in proprioceptive disorders leading to postural instability. The aim of the study was to find the correlation between the level of proprioceptive control and the number of postural disorders. The study involved a representative group of 1090 children aged 8-10 years, from randomly selected primary schools. Subjects who scored from 1 to 5 points in a prior postural screening test were qualified for the examination of the postural control system. The examination of the postural control system was carried out using an electronic station enabling assessment of postural stability and proprioception. A single leg stance test showed that the number of postural disorders does not significantly impact proprioceptive control. Proprioceptive control was found to significantly increase with the age of the children, and girls presented significantly better proprioceptive control in relation to the boys in each age group.

Test-Retest reliability and preliminary reliable change estimates for Sway Balance tests administered remotely in community-dwelling adults.

Impaired balance and postural stability can occur with advanced age, following traumatic brain injury, in association with neurological disorders and diseases, and as the result of acute or chronic orthopedic problems. The remote assessment of balance and postural stability could be of value in clinical practice and research. We examined the test-retest reliability and reliable change estimates for Sway Balance Mobile Application tests (Sway Medical, Tulsa OK, USA) administered remotely from the participant's home. Primarily young, healthy community-dwelling adults completed Sway Balance Mobile Application tests remotely on their personal mobile devices once per week for three consecutive weeks while being supervised with a video-based virtual connection. Sway Balance tests include five stances (i.e., feet together, tandem right foot forward, tandem left foot forward, single leg right foot, single leg left foot), which are averaged to compute a Sway Balance composite score from 0 to 100, with higher scores indicating better postural stability. We examined test-retest reliability (measured with intraclass correlation coefficients, ICCs) and preliminary reliable change estimates for 70%, 80%, and 90% confidence intervals. Participants included 55 healthy adults (ages = 26.7 ± 9.9 years, interquartile range = 20-30, range = 18-58; 38 [69%] women). Test-retest reliability for the Sway Balance composite score across three weeks was.88. Test-retest reliability for individual stances ranged from 62 to 83 (all ps < 0.001). At the 80% confidence interval, preliminary reliable changes estimates were 9 points for the Sway Balance composite score. For a remote administration, test-retest reliability was moderate-to-good for all Sway Balance stances, as well as for the Sway Balance composite score. Reliable change estimates may allow clinicians to determine whether an improvement or decline in performance is greater than the expected improvement or decline due to measurement error in young adults.