Postural Stability In Individuals Research Articles

One spinal manipulation session reduces local pain sensitivity but does not affect postural stability in individuals with chronic low back pain: a randomised, placebo-controlled trial

BackgroundClinical practice guidelines recommend spinal manipulation for patients with low back pain. However, the effects of spinal manipulation have contradictory findings compared to placebo intervention. Therefore, this study investigated the immediate effects of lumbar spinal manipulation on pressure pain threshold (PPT) and postural stability in people with chronic low back pain (cLBP). Second, we investigated the immediate effect of lumbar spinal manipulation on pain intensity and the interference of the participant beliefs about which treatment was received in the PPT, postural stability, and pain intensity.MethodsA two-arm, randomised, placebo-controlled, double-blind trial was performed. Eighty participants with nonspecific cLPB and a minimum score of 3 on the Numeric Pain Rating Scale received one session of lumbar spinal manipulation (n = 40) or simulated lumbar spinal manipulation (n = 40). Primary outcomes were local and remote PPTs and postural stability. Secondary outcomes were pain intensity and participant’s perceived treatment allocation. Between-group mean differences and their 95% confidence intervals (CIs) estimated the treatment effect. One-way analysis of covariance (ANCOVA) was performed to assess whether beliefs about which treatment was received influenced the outcomes.ResultsParticipants had a mean (SD) age of 34.9 (10.5) years, and 50 (62.5%) were women. Right L5 [between-group mean difference = 0.55 (95%CI 0.19 to 0.90)], left L5 [between-group mean difference = 0.45 (95%CI 0.13 to 0.76)], right L1 [between-group mean difference = 0.41 (95%CI 0.05 to 0.78)], left L1 [between-group mean difference = 0.57 (95%CI 0.15 to 0.99)], left DT [between-group mean difference = 0.35 (95%CI 0.04 to 0.65)], and right LE [between-group mean difference = 0.34 (95%CI 0.08 to 0.60)] showed superior treatment effect in the spinal manipulation group than sham. Neither intervention altered postural stability. Self-reported pain intensity showed clinically significant decreases in both groups after the intervention. A higher proportion of participants in the spinal manipulation group achieved more than two points of pain relief (spinal manipulation = 90%; sham = 60%). The participants’ perceived treatment allocation did not affect the outcomes.ConclusionOne spinal manipulation session reduces lumbar pain sensitivity but does not affect postural stability compared to a sham session in individuals with cLPB. Self-reported pain intensity lowered in both groups and a higher proportion of participants in the spinal manipulation group reached clinically significant pain relief. The participant’s belief in receiving the manipulation did not appear to have influenced the outcomes since the adjusted model revealed similar findings.

Role of virtual reality in examining the effect of fear of falling (FOF) on postural stability in individuals without and with Parkinson’s disease in Egypt: a mixed-methods feasibility study protocol

BackgroundFalls are common in older people and individuals with neurological conditions. Parkinson’s disease (PD) is known for postural instability causing mobility disabilities, falls and reduced quality of life. The fear...

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.

Exploring the Nexus of lower extremity proprioception and postural stability in older adults with osteoporosis: a cross-sectional investigation.

Osteoporosis, characterized by reduced bone mass and micro-architectural deterioration, poses a significant public health concern due to increased fracture susceptibility. Beyond bone health, this cross-sectional study aimed to assess and compare lower extremity proprioception and postural stability in individuals with and without osteoporosis and to explore their correlation within the osteoporosis group. In this prospective cross-sectional study, 80 participants were divided into two groups: osteoporosis (n = 40) and control (n = 40). The demographic characteristics and clinical parameters of the participants were as follows: Age (years) - Osteoporosis group: 65.04 ± 4.33, Control group: 65.24 ± 4.63; Sex (%) - Osteoporosis group: Male 30%, Female 70%; Control group: Male 30%, Female 70%; Body mass index (kg/m2) - Osteoporosis group: 23.7 ± 3.2, Control group: 24.5 ± 4.6; T-score (Lumbar) - Osteoporosis group: -2.86 ± 1.23, Control group: 0.27 ± 0.58; T-score (hip) - Osteoporosis group: -2.28 ± 0.79, Control group: 0.68 ± 0.86. Joint Position Sense (JPS) at the hip, knee, and ankle was assessed using a digital inclinometer, and postural stability was measured using computerized force platforms. Osteoporosis participants exhibited higher errors in hip (5.63° vs. 2.36°), knee (4.86° vs. 1.98°), and ankle (4.46° vs. 2.02°) JPS compared to controls. Postural stability measures showed increased anterior-posterior sway (10.86 mm vs. 3.98 mm), medial-lateral sway (8.67 mm vs. 2.89 mm), and ellipse area (966.88 mm2 vs. 446.19 mm2) in osteoporosis participants. Furthermore, correlation analyses within the osteoporosis group unveiled significant positive associations between lower extremity proprioception and postural stability. Specifically, hip JPS exhibited a strong positive correlation with anterior-posterior sway (r = 0.493, p = 0.003), medial-lateral sway (r = 0.485, p = 0.003), and ellipse area (r = 0.496, p < 0.001). Knee JPS displayed a moderate positive correlation with anterior-posterior sway (r = 0.397, p = 0.012), medial-lateral sway (r = 0.337, p = 0.032), and ellipse area (r = 0.378, p < 0.001). Similarly, ankle JPS showed a moderate positive correlation with anterior-posterior sway (r = 0.373, p = 0.023), medial-lateral sway (r = 0.308, p = 0.045), and ellipse area (r = 0.368, p = 0.021). These findings underscore the interplay between proprioceptive deficits, compromised postural stability, and osteoporosis, emphasizing the need for targeted interventions to improve fall prevention strategies and enhance the quality of life for individuals with osteoporosis.

Quadriceps Strength, Postural Stability, and Pain Mediation in Bilateral Knee Osteoarthritis: A Comparative Analysis with Healthy Controls.

Bilateral knee osteoarthritis (OA) poses significant challenges to individuals' functional abilities, including quadriceps strength, postural stability, and pain perception. Understanding the complex relationships among these factors is crucial for enhancing knee OA management strategies. The primary objective of this research is to evaluate and draw comparisons between the strength of the quadriceps and the level of postural stability in two distinct groups: individuals afflicted with bilateral knee OA and those who are healthy. Furthermore, the study seeks to examine the potential correlation between the strength of the quadriceps and the level of postural stability in individuals with knee OA. In addition to this, an investigation into the potential mediating effect of pain on the relationship between these physiological factors will also be conducted. A total of 95 participants with bilateral knee OA and 95 healthy controls were recruited. Quadriceps strength was assessed using dynamometry and postural stability was evaluated through anterior-posterior and medial-lateral sway measurements along with the ellipse area using a force plate. Pain levels were measured using the Visual Analog Scale (VAS). Mediation analysis was employed to explore the role of pain in mediating the relationship between quadriceps strength and postural stability. Statistical analyses included t-tests, Pearson correlation coefficients, and mediation analysis. Knee OA participants exhibited significantly lower quadriceps strength (1.08 Nm/kg ± 0.54) compared to controls (1.54 Nm/kg ± 0.57, p < 0.001). They also demonstrated compromised postural stability with increased anterior-posterior sway (9.86 mm ± 3.017 vs. 2.98 mm ± 1.12, p < 0.001), medial-lateral sway (7.87 mm ± 2.23 vs. 3.12 mm ± 1.34, p < 0.001), and larger ellipse area (935.75 mm2 ± 172.56 vs. 436.19 mm2 ± 135.48, p < 0.001). Negative correlations were observed between quadriceps strength and postural stability variables (r = from -0.43 to -0.51, p < 0.001). Pain significantly mediated the relationship between quadriceps strength and postural stability variables (p < 0.05). This study highlights the associations between quadriceps strength, postural stability, and pain mediation in individuals with bilateral knee OA. Our findings emphasize the need for targeted interventions addressing quadriceps weakness and compromised postural stability. Additionally, the mediation effect of pain underscores the complexity of these relationships, offering insights for more effective management strategies.

Effects of Ankle Orthoses, Taping, and Insoles on Postural Stability of Individuals with Chronic Ankle Instability: A Systematic Review.

Chronic ankle instability (CAI) is a prevalent condition characterized by recurring instances of the ankle giving way and persistent symptoms, including pain and diminished function. Foot and ankle external supports are commonly used in clinical practice and research for treating CAI. This systematic review aimed to assess the effects of foot and ankle external supports on the postural stability of individuals with CAI to guide clinical practice and inform future research. A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Google Scholar databases from 1 January 2012 to 1 November 2022. Eighteen studies involving individuals with CAI were chosen in this systematic review. The quality of the included studies and risk of bias were assessed using Cochrane Collaboration's tool for randomized controlled trials, the Newcastle-Ottawa Scale for case-control studies, and the DELPHl-list for crossover trial studies. The external supports included in this review were ankle orthoses (elastic, semi-rigid, and active orthoses), taping (kinesiotaping and fibular reposition taping), and insoles (textured and supportive insoles). The outcome measures included static and dynamic postural stability tests, such as the single-leg stance test, star excursion balance test, Y-balance test, single-leg landing test, lateral jump test, walking test, and running test. The results showed that elastic orthoses, Kinesiotaping, and textured insoles demonstrated potential benefits in improving postural stability in individuals with CAI. Elastic orthoses decreased ankle joint motion variability, kinesiotaping facilitated cutaneous receptors and proprioceptive feedback, while textured insoles increased tactile stimulation and foot position awareness. However, the effects of semi-rigid orthoses, fibular reposition taping, and arch support insoles were inconsistent across studies. Future research should explore the long-term effects of these external supports, analyze the effects of different characteristics and combinations of supports, and employ standardized outcome measures and testing protocols for assessing postural stability.

Effects of a 12-week online Tai Chi intervention on gait and postural stability in individuals with Parkinson's disease.

Parkinson's disease (PD) affects gait and postural stability. Tai Chi (TC) is recommended for PD for management of the condition, however biomechanical understanding to its effects on gait and postural stability is limited. This study aimed to examine the effects of an online 12-week biomechanical-based TC intervention on gait and posture in people with PD. Fifteen individuals in early-stage PD were recruited (Hoehn & Yahr stages 1-2). The TC intervention program was 60​min session, three times weekly for 12 weeks. The pre- and post-intervention test in obstacle crossing, timed-up-and-go (TUG) test, and single leg standing (SLS) with eyes open (EO) and closed (EC) were conducted. Gait speed, crossing stride length, clearance height of the heel and toe, anterior-posterior (AP) and medial-lateral (ML) displacement and velocity of the center of mass (COM) and separation of the COM-center of pressure (COP) were analyzed. The participants significantly improved their pre-vs. post-TC intervention performance on TUG test (p​=​0.002). During obstacle crossing, the participants significantly increased crossing stride length of the trailing foot, increased AP COM displacement and decreased ML COM-COP separation (p​<​0.05); the maximal dorsiflexion angle of the leading limb significantly increased and maximal plantarflexion angle of the trailing limb significantly decreased (p​<​0.05). A 12-week biomechanical-based online TC training was effective towards improvement of gait and postural stability among people in the early-stage of PD. The TC program and online training could be applied for management of PD.

Proprioceptive Focal Stimulation (Equistasi®) for gait and postural balance rehabilitation in patients with Parkinson's disease: A systematic review.

Gait and postural deficits are the most common impairments in patients with Parkinson's Disease (PD). These impairments often reduce patients' quality of life. Equistasi® is a wearable proprioceptive stabilizer that converts body thermic energy into mechanical vibration. No systematic reviews have been published investigating the influences of Equistasi® on gait and postural control in patients with PD. This review aimed to examine the effects of proprioceptive focal stimulation (Equistasi®) on gait deficits and postural instability in patients with PD. 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 studies met the eligibility criteria. The scores on the PEDro scale ranged from 3 to 8, with a median score of 8. The results showed evidence for the benefits of the proprioceptive focal stimulation (Equistasi®) on gait and postural stability in individuals with PD. Proprioceptive focal stimulation (Equistasi®) appears to be safe and well-tolerated in patients with PD. Proprioceptive focal stimulation (Equistasi®) may improve gait ability and postural stability in patients with PD. Further high-quality studies with long-term follow-ups are strongly needed to clarify the long-term effects of proprioceptive focal stimulation (Equistasi®) in patients with PD.

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.

Immediate effects of spinal manipulation on painful sensitivity and postural stability in patients with chronic nonspecific low back pain: study protocol for a controlled randomised clinical trial

BackgroundLow back pain is one of the main public health concerns. Chronic low back pain (cLBP) reduces functional capacity and affects postural stability. Although health professionals widely use spinal manipulation, its immediate effect on painful sensitivity and postural stability is lacking. This study aims to verify the immediate effects of lumbar spinal manipulation on the pressure pain threshold and postural stability in individuals with cLBP.MethodsA two-arm, placebo-controlled clinical trial with parallel groups and examiner-blinded will be conducted with 80 participants with cLBP from an outpatient physical therapy department, randomly allocated at a 1:1 distribution. The experimental group will receive a lumbar spinal manipulation technique, and the placebo group will receive a simulated lumbar spinal manipulation. Both groups will receive one session of treatment and will be evaluated before and immediately after the intervention. The primary outcomes will be the pressure pain threshold and postural stability. Pain intensity and patient’s expectation will be assessed as a secondary outcome. The pressure pain threshold will be assessed using a pressure algometer in 6 different anatomical regions. The evaluation of postural stability will be performed in a baropodometry exam by displacing the centre of pressure. The pain intensity will be measured using the Numeric Pain Rating Scale. A Likert scale will be used for the patient’s expectation about the treatment. A two-way analysis of variance will compare the effect of the interventions between groups.DiscussionThis study will provide insights regarding the immediate effects of spinal manipulation in patients with cLBP against a simulated spinal manipulation using objective outcomes and considering patients’ expectations regarding the treatment.Trial registrationBrazilian Registry of Clinical Trials RBR-3ksq2c. Registered on 13 July 2020

Postural Control in Diabetic Peripheral Neuropathy: A Narrative Review

Diabetes mellitus is a metabolic disease of chronic hyperglycaemia which leads to neurological complications such as Diabetic Peripheral Neuropathy (DPN). When compared to healthy persons, those with DPN are more likely to fall, especially in geriatric population. Present review aims to provide an insight to the pathophysiology, outcome measures, and physiotherapy treatment of impaired postural control in DPN. Searches for relevant articles were conducted using Google Scholar, PubMed, Ovid, Springerlink, Science Direct (SD), Seniorcare Ageing Growth Engine (SAGE), Elton B. Stephens Company (EBSCO) Discovery Service and Web of Science. Keywords used were diabetes, DPN, diabetic foot, postural control, balance, postural sway, physiotherapy intervention. Irrespective of their year of publication, studies and reports published in English, that provide data of postural control in individuals with DPN and its physiotherapy management were included in the study. The included publications were reviewed and a narrative review was formulated. A total of 35 studies were included in this review. All studies suggest that there is postural instability in people with DPN which increases with age and duration of diabetes. Multidirectional postural sway was observed in most of the studies with medio-lateral instability encountered in more cases. Significant improvement in timed up and go test, single leg stance test, Berg balance scale, and other outcome measures post physiotherapy intervention were reported. Literature suggests that multidirectional postural instability is present in DPN patients. Physiotherapy, offloading devices and diabetic foot care education improve postural stability in individuals with DPN.

Transcutaneous spinal cord stimulation improves postural stability in individuals with multiple sclerosis

BackgroundWidespread demyelination in the central nervous system can lead to progressive sensorimotor impairments following multiple sclerosis, with compromised postural stability during standing being a common consequence. As such, clinical strategies are needed to improve postural stability following multiple sclerosis. The objective of this study was therefore to investigate the effect of non-invasive transcutaneous spinal stimulation on postural stability during upright standing in individuals with multiple sclerosis. MethodsCenter of pressure displacement and electromyograms from the soleus and tibialis anterior were recorded in seven individuals with multiple sclerosis during standing without and with transcutaneous spinal stimulation. Center of pressure and muscle activity measures were calculated and compared between no stimulation and transcutaneous spinal stimulation conditions. The relationship between the center of pressure displacement and electromyograms was quantified using cross-correlation analysis. ResultsFor transcutaneous spinal stimulation, postural stability was significantly improved during standing with eyes closed: the time- and frequency-domain measures obtained from the anterior-posterior center of pressure fluctuation decreased and increased, respectively, and the tibialis anterior activity was lower compared to no stimulation. Conversely, no differences were found between no stimulation and transcutaneous spinal stimulation when standing with eyes open. ConclusionFollowing multiple sclerosis, transcutaneous spinal stimulation improved postural stability during standing with eyes closed, presumably by catalyzing proprioceptive function. Future work should confirm underlying mechanisms and explore the clinical value of transcutaneous spinal stimulation for individuals with multiple sclerosis.

The influence of proximal strength on postural stability in individuals with subacute ankle sprain: An observational case control study

Aim. To explore whether the eccentric muscle strength of both hip abductors and external rotators differ in participants with subacute lateral ankle sprain and healthy population, and to compare the Biodex balance measures as well. Material and methods. Thirty males diagnosed as a second degree ankle sprain enrolled in this study, while twenty-nine healthy volunteers considered as controls. The study measured both the peak eccentric torque for both hip abductors and external rotators using Biodex isokinetic dynamometer. All participants examined for bilateral and unilateral balance ability using Biodex balance system from erect position to determine total stability index (SI), anteroposterior index (API), and mediolateral index (MLI). Results. A detected significant negative correlation was obvious between peak eccentric isokinetic testing for hip external rotators torque; and total SI, API, and MLI of all the Biodex balance system measures for bilateral stance and API in unilateral stance. While, a moderate significant positive correlation found for peak eccentric isokinetic torques between both hip external rotators and abductors. Conclusion. Decreased hip muscle strength can increase the vulnerability of ankle ligaments via minimizing the postural control during weight-bearing activities, which, in turn, stimulates the compensatory neuromuscular mechanisms.

Postural Stability in Individuals with and without Sacroiliac Joint Dysfunction Before and After Pelvic Belt Application

Background: Sacroiliac Joint Dysfunction (SIJD) is considered an origin of low-back pain. It can change the motor control strategy and postural control (PC). Objectives: We aimed to find any probable differences in PC between subjects with and without SIJD and determine the effects of the pelvic belt (PB) on PC. Methods: Thirty-eight subjects were assigned into two equal groups with and without SIJD. They started to walk from the place marked on a force plate for 10 seconds after hearing an auditory signal and performed three attempts for each foot. They repeated six more ones with PB. Raw data were imported to an excel software (version 2007) spreadsheet to calculate the reaction time (RT) and anticipatory postural adjustment (APA) as the components of PC. Results: Our results showed a significant difference in RT between the SIJD-affected and non-affected sides (P = 0.035), but there was no significant difference in APA (P = 0.057). There were significant differences in RT and APAs between the control and SIJD-affected side groups (P = 0.001 and P = 0.010, respectively). The PB application showed a significant difference in RT and APAs of the SIJD-affected side (P = 0.001 and P = 0.047, respectively). Conclusions: It seems pain could lead to the postural sway into instability and change the motor control strategy. The proprioception signals from the neuromuscular system of SIJ improved after PB. Therefore, PB, as a feasible tool, can be recommended for PC improvement.

Acute Effect of Kinesiology Taping on Postural Stability in Individuals With Unilateral Chronic Ankle Instability.

BackgroundChronic ankle instability (CAI), which is characterized by deficient postural control, could be improved through kinesiology taping (KT). However, the effect of KT on postural control in CAI individuals is controversial. Therefore, this study aimed to investigate the acute effect of KT on postural control through computerized dynamic posturography (CDP) and self-perceived sensation in CAI individuals.MethodsParticipants with CAI received four different ankle treatments randomly, including KT, athletic taping (AT), sham taping (ST), and no taping (NT). A series of postural stability measurements was performed using CDP subsequently. The measurements included sensory organization test (SOT), unilateral stance (US), limit of stability (LOS), motor control test (MCT), and adaption test (ADT). In addition, self-perceived sensation was measured through visual analog scaling. Repeated measures analysis of variance was conducted to determine whether the difference among KT, AT, ST, and NT was significant; Bonferroni test was used for post hoc analysis.ResultsNo significant difference was observed for parameters in SOT, US, and LOS in four different taping treatments. In MCT, the amplitude scaling scores of KT were 35.87% significantly lower than that of NT [p < 0.001, 95% confidence interval (CI) = 0.548–1.795] in forward-small slip and 21.58% significantly lower than that of ST (p = 0.035, 95% CI = 0.089–3.683) in backward-large slip. In ADT, sway energy scores were 7.59% significantly greater in ST than in AT (p = 0.028, 95% CI = −8.343 to −0.320). For perceived stability, KT was significantly greater than ST (p < 0.001, 95% CI = 0.552–1.899) and NT (p < 0.001, 95% CI = 0.797–2.534), and AT was significantly greater than ST (p = 0.001, 95% CI = 0.423–2.246) and NT (p < 0.001, 95% CI = 0.696–2.852). For perceived comfort, KT was significantly greater than AT (p = 0.001, 95% CI = 0.666–3.196) and NT (p = 0.031, 95% CI = 0.074–2.332), and ST was significantly greater than AT (p = 0.007, 95% CI = 0.349–2.931).ConclusionKT and AT have limited effect to facilitate postural control for CAI individuals during SOT, US, and LOS. However, KT and AT could provide effective support to cope with sudden perturbation in MCT and ADT. Moreover, KT provided excellent perceived stability and comfort, whereas AT provided excellent perceived stability but least comfort.

The Relationship between Core Muscles Dysfunction and Chronic Ankle Instability: A Review

Objective The aim of this study is investigate the core muscles dysfunctions and their consequences in patients with chronic ankle instability. Methods In this review study, search was conducted in three online databases of PubMed, Scopus, and Google scholar based on Patient, Intervention, Comparison, Outcome (PICO) strategy, and using keywords related to the role and function of core muscles, their electromyography, kinematic patterns of proximal segments, and postural stability in individuals with chronic ankle instability. Results Seven studies were finally selected for the review based on the inclusion and exclusion criteria. The results indicated that individuals with chronic ankle instability in comparison with healthy peers have different electromyography and kinematic patterns of proximal segments (trunk, abdomen and pelvis). Conclusion Muscle activity and kinematic patterns of proximal segments in individuals with chronic ankle instability are different to those of healthy ones. These differences are compensatory strategies for postural stability. These strategies may not provide the body’s need to maintain and control the poster in new environments or during complex activities. Further studies are needed to investigate effects of the correction of core muscle function on the postural control in individuals with chronic ankle instability.

THE EFFECT OF NOVEL ANKLE-REALIGNING SOCKS ON DYNAMIC POSTURAL STABILITY IN INDIVIDUALS WITH CHRONIC ANKLE INSTABILITY

A dynamic postural stability deficit has been suggested to be present in individuals with chronic ankle instability (CAI). Interventions to improve postural control in individuals with CAI have been reported, but they required a long period of and compliance with interventions. To examine the effect of novel ankle-realigning socks on dynamic postural stability in individuals with CAI using the star excursion balance test (SEBT). Case-control study. Twenty-eight control and 22 subjects with CAI (who were tested in both barefoot and with socks) were enrolled. The weight-bearing ankle dorsiflexion range of motion (DF-ROM) and SEBT were measured in the control group, the barefoot CAI group, and the CAI with socks group. In addition, subjective ankle instability during SEBT was measured using a visual analog scale (0 - 100). DF-ROM was 48.3 ± 7.4 º in the control group, 43.3 ± 8.0 º in the barefoot CAI group, and 45.7 ± 6.8 º in the CAI with socks group. DF-ROM was significantly less in the barefoot CAI group than in the control group. The SEBT scores were significantly less in the barefoot CAI group than in the control group in all directions. The SEBT score was significantly larger in the CAI with socks group than in the barefoot CAI group in the posteromedial, posterior, and posterolateral directions. In addition, there were no significant differences between the control group and the CAI with socks group in six directions. Wearing the novel ankle-realigning socks immediately improved dynamic postural stability as measured by the SEBT and subjective ankle instability in individuals with CAI. Level 3b.

The Effectiveness of Inertial Sensors to Assess Static Postural Stability in Individuals With Concussion: A Systematic Review

The Effectiveness of Inertial Sensors to Assess Static Postural Stability in Individuals With Concussion: A Systematic Review

The Effect of Heel Lifts on Postural Stability in Individuals with Parkinson’s Disease

Our purpose was to investigate if accommodating plantar flexion contractures will improve postural alignment, patient perceived stability, and balance in individuals with Parkinson’s disease (PD), and the correlation of plantarflexion (PF) contractures and the Falls Efficacy scale (FES). This was a single session pretest posttest study with subject as their own control. We recruited a convenience sample of 32 participants with PD who could independently ambulate 20 feet without assistive devices. The Institutional Review Board approved the study, and informed consent was obtained from all participants prior to their participation. The outcome measures included: sagittal plane posture photo, verbal numeric rating of perceived stability, 1-minute recording of double leg stance on an interface pressure map, functional reach test (FRT) and the Falls Efficacy Scale (FES). The intervention was the use of bilateral Adjust-a-Lift heel lifts worn inside the participants’ shoe. Assigned heel lift thickness was based on PF contracture severity, determined via passive talocrural dorsiflexion measurement. Photographic posture analysis was completed with free image measurement software. Sway measurements were taken of center of gravity tracing with Tekscan software. Statistical analysis included Paired t-tests for outcome measures and Pearson product correlation between the FES and PF contracture data. We found significant changes (p<.05) in increase in height (mean 1.00 cm), an anterior translation of the pelvis (mean 2.3cm), a more upright trunk angle (mean 1.37 degrees) and a more upright head angle (mean 2.61 degrees). Perceived stability significantly increased (mean 0.75) and functional reach significantly decreased (mean 2.22cm). Significant correlations (r=0.36–0.50) were found between the degree of PF contracture and the total scale score as well as reported fear of falling for questions that required walking on the FES. This study showed accommodating PF contractures with heel lift intervention significantly improved postural alignment and perceived stability, but decreased participants’ functional reach.

THE APPLICATIONS OF SMART MOBILE DEVICE FOR DETECTING BALANCE DYSFUNCTION IN INDIVIDUALS WITH DOWN SYNDROME

Falls are a major health concern leading cause of fatal and non-fatal injuries for neurological disorders. Balance dysfunction is one of the common factors to determine fall risk in neurological patients. Preventative measures may help to reduce the incidence and severity of falls for detecting balance function and fall risk factors. However, the objective measures for balance require expensive equipment with the assessment of clinical expertise. A main gap remains in the evaluation method to objectively characterize the balance functions in individuals with high risk of falling. With the development of wearable and mobile devices, recent advances in smart mobile devices may provide a potential opportunity to manage the gap in the detailed quantification of balance impairments. The purpose of this study is to identify whether the biomechanical data measured by the mobile device is reliable to characterize the posture stability in various balance test conditions. A total of 39 children with Down syndrome completed four balance-testing tasks under altered base of support and vision. Simultaneous biomechanical measurements were gathered from the iPod and force plate analysis system during functional balance testing. The force plate and mobile system provided similar patterns of stability across groups. Correlation ([Formula: see text] between two systems for path length, 95% ellipse area, peak-to-peak, standard deviation and mean ranged from 0.60 to 0.99. We expect that the smart mobile device can provide reliable and accurate information to quantify the postural stability in individuals with elderly people or neurological disorders. The objectivity, portability and easy use of such mobile device make it ideal to apply in clinical environments for detecting balance functions and reducing the risk of falls in Down syndrome or other neurological patients.