Postural Symmetry Research Articles

Modified Constraint Induced Movement Therapy enhanced by a Neuro-Development Treatment-based therapeutic handling protocol: Two case studies

Modified Constraint Induced Movement Therapy (CIMT) and Neuro-Developmental Treatment (NDT) are both intervention strategies that focus on active practice to optimize function. CIMT involves constraint of the less involved upper extremity during function and NDT includes facilitation of optimal postural control and symmetry to enhance the ability to complete a given motor function. The purpose of this article is to describe an intervention protocol for children with hemiplegia that integrates key NDT and CIMT principles. Two children participated in a modified CIMT (mCIMT)/NDT program 2 hours a day for two months. The children wore a constraint on the less involved arm and participated in guided play with early intervention members and parents. Play was individualized to developmental level and incorporated principles of NDT. Function was measured pre- and post-intervention using the PDMS-2, QUEST, ACQUIRE Therapy Motor Patterns, and ACQUIRE Functional Activities. Both children demonstrated motor skill acquisition, improved quality of functional use, and increased frequency of bilateral hand use. Parents found the protocol challenging but manageable in their daily routines. The inclusion of NDT principles within a mCIMT protocol may be an effective intervention to maximize functional motor skill acquisition in children with hemiplegia. Additional research is warranted to support this intervention.

Analysis of body posture between young football players and their untrained peers

PurposeThe aim of this study was to analyze the body posture of young football players and their untrained peers.MethodsA group of 73 football players and 78 untrained boys, all aged between 11 and 14 years, were studied by measuring body posture indices with computer posturography (the MORIE technique). Spinal angles and curvatures in the sagittal plane and body posture asymmetry in the frontal and transversal plane were measured. Body height and mass and BMI were also determined.ResultsCompared to the untrained boys, the group of football players had lower BMI. The position of pelvis in the frontal plane was more symmetrical (<i>p</i> < 0.001) in football players, but the alignment of the remaining measured parameters was similar between the two groups except for the horizontal symmetry of the waist triangles (a higher incidence of symmetry in some ages groups of football players) and the horizontal symmetry of the shoulder blades (a higher incidence of asymmetry in some ages groups of football players). A postural symmetry index that was created for this study did not find any differentiation among the studied groups. The spinal alignment of the football players featured a more flattened lumbar lordosis.ConclusionsPreviously conducted studies on the body posture of young athletes are still not ample and complete, while the results do not clearly indicate the development of posture when subjected to sports training.

Unilateral Shoulder Bags: Can They Be Worn in a Way to Reduce Postural Asymmetry?

Purpose: To investigate whether there is a way to wear a unilateral strap shoulder bag that will allow more symmetrical postural alignment, preventing potentially harmful musculoskeletal effects. Subjects: Sixty-five college student volunteers.Methods: Each participant donned a unilateral strap shoulder bag two different ways on the dominant and non-dominant shoulder while standing on a Postural Scale Analyzer to measure lower extremity weight distribution. Results: A significant improvement (p < 0.05) in lower extremity weight distribution was found in right hand dominant subjects (n = 63) when wearing a shoulder bag draped across the left shoulder to right hip. Discussion: When individuals who are right hand dominant wear a shoulder bag draped across the left shoulder (non-dominant shoulder), the weight distribution through the person’s lower extremities becomes more equal indicating improved postural symmetry in static standing.Conclusion: It is possible that individual prescription of a unilateral bag on the non-dominant shoulder draped across the body can be utilized to create a reduction in postural asymmetry demonstrated by more evenly distributed lower extremity loading. Recommendations: Health care providers, parents, students, and educators should be educated to carry an across-the-body unilateral strap shoulder bag that reduces postural asymmetry and the risk of future development of biomechanical problems and back pain in adulthood.

Posture Symmetry based Motion Capture System for Analysis of Lower -limbs Rehabilitation Training

This paper presents a motion capture based rehabilitation training system for a lower-limb paretic patient. The system evaluates the rehabilitation status of the patient by using the bend posture of the knees and the weight balance of the body. The posture of both legs is captured with a single camera using the planar mirror. The weight distribution is obtained by the Wii Balance Board. Self-occlusion problem in the tracking of the legs is resolved by using k-nearest neighbor based clustering with body symmetry and local-linearity of the posture data. To do this, we present data normalization and its symmetric property in the normalized vector space.

The effect of school bag design and load on spinal posture during stair use by children

Thirteen male children ascending and descending stairs with loads that equalled 0%, 10%, 15% and 20% of their body weight were the subject of our research: the boys were wearing an asymmetrical single-strap athletic bag or a symmetrical double-strap backpack during our experiments with them. The maximum spinal tilt to the loading side and to the support side, and the range of spinal motions, were obtained by using a motion analysis system. Our results showed that symmetry of spinal posture was observed both when they ascended staircase with all loads and descended in a backpack. When carrying an athletic bag with 15% and 20% of their body weight while ascending the staircase, the lateral spinal tilt to the supporting side was significantly increased. We concluded that a symmetrical backpack with a load not exceeding 20% or an asymmetrical single-strap athletic bag with a load not exceeding 10% should be recommended for school children in order to promote safer staircase use. Statement of Relevance: Children carrying heavy school bags may develop spinal problems. This study suggested that when they are using stairs, a symmetrical backpack with a load within 20% body weight is acceptable for them. When they are carrying an asymmetrical single-strap athletic bag, the bag's weight should not exceed 10% of the body weight in order to avoid excessive spinal tilt.

Postural asymmetries in transfemoral amputees

Postural asymmetries are thought to lead to impairment of body structure and function such as muscle imbalance, gait asymmetry and possible chronic conditions, which result in limitation of mobility and restriction of daily activity for transfemoral amputees (TFAs). Despite the potential clinical impact, postural asymmetries have not been confirmed or quantified in TFAs. To identify the presence of postural asymmetries in TFAs utilizing clinical evaluation measures. An observational cross-sectional study in which participants were evaluated at a single time point without intervention or follow-up. Forty-seven unilateral TFAs were measured for standing limb length, pelvic innominate inclination (PII), lateral trunk flexion and hip extension. Limb length discrepancy was present in 66% of participants and 57% had a short prosthetic limb. PII was greater than has been reported in the literature, and the shorter the prosthetic lower limb, the greater the PII on the amputated side (r = -0.422, p = 0.004). Limb length discrepancy and decreased lateral trunk flexion accounted for 26% of the variance in amputated side PII. Three postural measurements, namely leg length, pelvic innominate inclination and hip extension, were found to differ between the intact and amputated limb in this study sample. Clinicians should include postural assessment as part of their routine evaluation of TFAs in an effort to achieve postural symmetry and reduce the risk of chronic conditions associated with impairment of body structure and function.

The JCM Moonlite Sleep System: Assisting in the provision of 24-hour postural support

Children and adults with mobility problems often suffer with contraction of unused muscles, which can consequently pose a risk to joint stability. Both contraction and joint instability can be extremely painful, leading to among other issues, poor quality of sleep. Although seating provision attempts to maintain appropriate posture during the day, suitable equipment provision must also be considered for the night. Sleep systems aim to provide appropriate support, promote postural symmetry and increase quality of sleep. This article discusses the Moonlite Sleep System, manufactured by JCM. It describes the features and benefits of the system and summarizes client feedback to date.

Relationships Between Standing Balance and Symmetry Measurements in Patients Following Recent Strokes (≤3 Weeks) or Older Strokes (≥6 Months)

The Functional Standing Balance (FSB) Scale was designed to obtain measurements of standing balance and to identify the problems typically faced by people with stroke. The purpose of this study was to investigate the validity of measurements obtained with the FSB Scale for use in the acute and chronic phases of stroke by comparing the measurements obtained with the FSB Scale with those obtained for postural sway and lateral symmetry by use of a force platform. Measurements were obtained for 26 people with recent strokes (ie, strokes within 3 weeks of data collection) and for 28 people with long-standing strokes (ie, strokes of 6 months' duration or older). The FSB Scale consists of 3 components: weight distribution, balance without movement, and balance with movement. Measurements of balance performance were compared with measurements of anteroposterior and lateral sway velocity obtained on a force platform. The weight distribution on 2 digital scales was compared with the lateral symmetry measured on the force platform. The highest correlations were found between the FSB Scale balance measurements and the measurements of anteroposterior sway velocity obtained on the force platform with feet apart and eyes open. The correlations (r) were -.68 and -.67 for the group with recent strokes and -.74 and -.91 for the group with long-standing strokes. The correlations (r) between weight distribution measured on the digital scales and lateral symmetry measured on the force platform were.44 for the group with recent strokes and.52 for the group with long-standing strokes. The subjects whose results on the FSB Scale were poor had higher sway velocities on the force platform than the subjects whose results on the FSB Scale were good. The results of this study suggest that the FSB Scale provides the same kind of information as that obtained for sway velocity and lateral symmetry as measured with the use of force platforms in both patients with recent strokes and patients with long-standing strokes.

Does weight-shifting exercise improve postural symmetry in sitting in people with hemiplegia?

Background : Weight-shifting exercise was empirically practised in correcting the biased posture of people with stroke-induced hemiplegia. Objectives : (1) Evaluate the loading symmetry at the buttock-seat interface as a reflection of a postural defect in sitting. (2) Investigate if weight-shifting exercises could correct the postural problem of people with hemiplegia. Design : Control group design Participants : 16 subjects with hemiplegia after stroke and 14 healthy individuals. Procedures : Subjects were assessed for buttock-seat interface loading while in erect sitting using a seat pressure mapping system. Subjects with stroke then practised one session of weight-shifting exercise followed by a reassessment. Results : The subjects with hemiplegia, particularly those with right hemisphere lesion, had more load borne at the buttock ipsilateral to the side of stroke lesion. The weight-shifting exercise did not produce an immediate improvement on the loading asymmetry. Conclusion : The exercise would require further investigation to clarify its benefits in treating postural problems after stroke.

Training symmetry of weight distribution after stroke: a randomized controlled pilot study comparing task-related reach, Bo bath and feedback training approaches

To determine (1) the most effective of three treatment approaches to retrain seated weight distribution long-term after stroke and (2) whether improvements could be generalized to weight distribution in standing. Inpatient rehabilitation unit. Forty asymmetrical acute stroke subjects were randomly allocated to one of four groups in this pilot study. Changes in weight distribution were compared between the 10 subjects of each of three treatment groups (task-specific reach, Bobath, or Balance Performance Monitor [BPM] feedback training) and a no specific treatment control group. One week of measurement only was followed by two weeks of daily training sessions with the treatment to which the subject was randomly allocated. Measurements were performed using the BPM daily before treatment sessions, two weeks after cessation of treatment and 12 weeks post study. Weight distribution was calculated in terms of mean balance (percentage of total body weight) or the mean of 300 balance points over a 30-s data run. In the short term, the Bobath approach was the most effective treatment for retraining sitting symmetry after stroke (p = 0.004). Training with the BPM and no training were also significant (p = 0.038 and p = 0.035 respectively) and task-specific reach training failed to reach significance (p = 0.26). At 12 weeks post study 83% of the BPM training group, 38% of the task-specific reach group, 29% of the Bobath group and 0% of the untrained group were found to be distributing their weight to both sides. Some generalization of symmetry training in sitting to standing was noted in the BPM training group which appeared to persist long term. Results should be treated with caution due to the small group sizes. However, these preliminary findings suggest that it might be possible to restore postural symmetry in sitting in the early stages of rehabilitation with therapy that focuses on creating an awareness of body position.

Frontal cephalometric analysis in the evaluation of facial asymmetry in torticollis, and outcomes of bipolar release in patients over 6 years of age.

The aim of this study was to investigate the mid-term results of bipolar release in congenital muscular torticollis patients over 6 years of age, and the efficacy of frontal cephalometric analysis in the determination and follow-up of facial asymmetry. Twelve patients (9 boys, 3 girls) from 7 to 12 years of age were included in the study. Bipolar release was performed, followed by 5-7 days of traction and 3 months of physiotherapy. Posteroanterior cephalometric radiography was performed at the beginning of and after therapy. The postural symmetry angle (PSA) was used to determine the presence and severity of facial asymmetry. A modified version of Lee et al.'s system was used in evaluating the results. The average follow-up period was 3 years and 5 months. According to the congenital muscular torticollis evaluation system, the outcome was excellent in 2 of the patients, good in 6, fair in 2 and poor in 2. Asymmetry was not severe in all patients at the beginning of therapy according to PSA values, being insignificant in 2, mild in 6, and severe in 4. The PSA results of the last examination indicated that severe facial asymmetry persisted in 3 patients. In 2 of them, PSA values remained within the limits of severe asymmetry despite a slight angular correction. Congenital muscular torticollis patients can benefit from surgical treatment over the age of 6 years. Bipolar release is an adequate and complication-free method. Moreover, PSA may be used as an objective method in the determination and follow-up of facial asymmetry in torticollis patients.

Anterior ankle-foot orthosis effects on postural stability in hemiplegic patients

Objectives: To evaluate the effects of an anterior ankle-foot orthosis (AFO) on static and dynamic postural stability in hemiplegic patients. Design: A cross sectional assessment of hemiplegic subjects with and without an AFO. Setting: Outpatient department of a rehabilitation hospital. Patients: A convenience sample of 24 subjects who had been prescribed an anterior AFO. Outcome Measures: Postural sway index and postural symmetry (body weight distribution through the affected leg) when standing were measured as static postural stability. Maximal balance range in anterior-posterior and lateral directions and the affected leg's weight bearing after weight shift to affected side were measured as dynamic postural stability. Results: When wearing the anterior AFO, there was no significant difference and small effect size ( r < 0.3) in postural sway index ( p = .35), postural symmetry ( p = .21), and maximal balance range in anterior-posterior direction ( p = .46). There was a significant improvement and large effect size ( r > 0.5) in lateral weight shifting ( p < .01) and weight bearing through the affected leg after weight shifted to the affected side ( p < .01). Conclusions: The significant effects of the anterior AFO in long-term hemiplegic patients were on lateral weight shifting and weight bearing through affected leg after weight shifted to the affected side. Postural sway, postural symmetry, and anterior-posterior weight shifting were not significantly affected.

EFFECT OF BALANCE EXERCISE ON POSTURAL CONTROL AND SOMATOSENSORY EVOKED POTENTIAL IN C.N.S DISORDERS

956 The purpose of this study was to analyze the effect of balance exercise at force platform on postural control and somatosensory pathway in adults with central nervous system disorders. The twenty people who have central nervous system disorders were studied: experimental group(n=10), comparative group(n=10). The experimental group has done balance exercise at force platform for 12 weeks. Postural control was measured by Dynamic Balance System(Chattanooga, Inc., UAS) at stable, liner and toes up-down for somatosensory pathway was measured as somatosensory evoked potential by Neurotec(Viking 4P, USA). This study analyzed center of balance X(COBx). center of balance Y(COBY), anterior to posterior sway distance, left to right sway distance and latency of N9, N13 and N20. All of the subjects were tested for 3 times: pre, mid, post. COBX and COBY at stable platform and at linear, toes up-down platform, during balance exercise in both group showed that they didn't influence on recover postural symmetry about postural control when COB moves to the center. But anterior to posterior(A-P) and left to right(L-R) sway distance at stable platform, decreased significantly(p<.05) after 8 weeks exercise in the experimental group and sway distance of the experimental group decreased significantly(p<.05, p<.01) after exercise either for 8 or 12 weeks compared with that of control group. And those of linear, toes up-down platform showed same results(p<.05, p<.01). In the latency of somatosensory evoked potential(SEP), N9 and N13 were not changed significantly in both groups and both sides, but N20 increased significantly(p<.05) and then showed normal latency in experimental group after 8 weeks exercise in both sides. In addition, increasing the latency of scalp(N20) meant neural restoration of the sensory function of C.N.S. And it expects the improvement of motor function because N20 influences on the sensory-motor integration of C.N.S.

Arm lift strength in work space

This study was conducted to determine arm strength values for isometric and isokinetic efforts around the human trunk. Thirty-eight normal young adults (20 male and 18 female) performed a total of 19 tasks. These consisted of one self-selected optimum posture with upright stance and elbows bent at 90°, designated as standard posture for isometric test. In addition, isometric testing was done sagittally symmetrical 30° and 60° lateral planes at half-, three-quarters- and full-reach distances at knuckle height. The isokinetic tests were done between knuckle height and shoulder height in postures identical to isometric tests. The sequence of these tasks was randomised. The peak strength in standard posture was invariably lower than the peak strength at half-reach in isometric condition in all three planes for both sexes with the exception of one condition among females (60° lateral plane, half-reach isometric). Peak and average arm lift strengths of males were significantly higher than those of females ( p < 0·01) and ranged between 44% and 71%. For both sexes isometric strength was significantly higher than isokinetic strength ( p < 0·01). The peak and average strengths in the sagittal plane were invariably higher than those of asymmetric postures, with one exception among females. With increasing reach distance the strength declined significantly for all conditions among both genders ( p < 0·01). The ANOVA showed that the gender, mode of lifting, postural symmetry and reach of lifting, in addition to affecting the peak and average strength individually ( p < 0·01), had significant 2-way and 3-way interactions ( p < 0·01). All strength values were inter-correlated ( p < 0·01). The regressions predicting peak and average strengths from anthropometric characteristics and sagittal plane strengths accounted for 63% to 89% of all variance and were highly significant ( p < 0·01).

Head turning induced by unilateral intracaudate thyrotropin-releasing hormone (TRH) injection in the cat

Unilateral intracaudate injection of TRH in cats (10 μg) induced head turning responses similar to the responses produced by dopamine (DA) (10 μg). Contralateral head turning responses were observed after injections in the central part of the caudate body, whereas, injections placed more laterally induced ipsilateral responses. While haloperidol (3 mg/kg i.m.) suppressed the DA-induced response, it appeared to potentiate the effects of TRH. Cyproheptadine (10 mg/kg i.p.) did not alter the TRH-induced responses. These results suggest that, although TRH induces DA-like effects on postural symmetry, the mediation of TRH effects bypasses striatal dopaminergic and serotonergic receptors. While intracaudate TRH and DA induced head turning, they did not alter the level of head motility as measured by the number of head movements. Haloperidol, but not cyproheptadine pretreatment, decreased the level of head motility providing evidence that postural symmetry is modulated within the striatum, whereas head motility is regulated by extrastriatal dopaminergic mechanisms.

Compensation Des Déficits Posturaux Et Cinétiques Après Neurectomie Vestibulaire Unilatérale Chez Le Chat: Rôle de l'activité sensorimotrice

The role of sensorimotor activity in compensating deficits following unilateral vestibular neurectomy was studied in four adult cats using behavioral tests. Disturbances in posture and equilibrium were quantified and their subsequent compensation was described in both sensorimotor restrained and unrestrained cats. Sensorimotor restriction (S.M.R.) lasted 7 days and was performed in different postoperative periods. In the unrestrained animal, postural asymmetry compensation followed a 3-phase time course leading to preoperative criteria after about 40 days. Recovery of equilibrium developed by steps and was achieved after about 50 postoperative days. A first week applied S.M.R. was most effective in stopping postural symmetry recovery, while a later S.M.R. had no effect on the recovery time course and did not produce decompensation. On the contrary, S.M.R. (1st week or 3rd week) prevented and delayed equilibrium recovery, the earlier S.M.R. producing maximal effects. These observations suggest a CNS "sensitive period" to vicariant inputs.