Postural Impairment Research Articles

User-Centered Design Methodologies for the Prototype Development of a Smart Harness and Related System to Provide Haptic Cues to Persons with Parkinson's Disease.

This paper describes the second part of the PASSO (Parkinson smart sensory cues for older users) project, which designs and tests an innovative haptic biofeedback system based on a wireless body sensor network using a smartphone and different smartwatches specifically designed to rehabilitate postural disturbances in persons with Parkinson's disease. According to the scientific literature on the use of smart devices to transmit sensory cues, vibrotactile feedback (particularly on the trunk) seems promising for improving people's gait and posture performance; they have been used in different environments and are well accepted by users. In the PASSO project, we designed and developed a wearable device and a related system to transmit vibrations to a person's body to improve posture and combat impairments like Pisa syndrome and camptocormia. Specifically, this paper describes the methodologies and strategies used to design, develop, and test wearable prototypes and the mHealth system. The results allowed a multidisciplinary comparison among the solutions, which led to prototypes with a high degree of usability, wearability, accessibility, and effectiveness. This mHealth system is now being used in pilot trials with subjects with Parkinson's disease to verify its feasibility among patients.

Body Function and Structure, Activity, and Participation Limitations of Lung Transplant Recipients Within the Scope of the International Classification of Functioning, Disability, and Health.

There is no study in the literature that specifically evaluates lung transplant recipients in the long-term under the framework of the International Classification of Functioning, Disability, and Health. The aim of this study was to evaluate the relationships between lung transplant recipient age, age at transplant, and comorbidity levels and the body structure and functions and the activity and participation levels of patients within the scope of the International Classification of Functioning, Disability, and Health. We evaluated 27 lung transplant recipients according to the International Classification of Functioning, Disability, and Health items in domain b (body functions), domain s (body structures), and domain d (activities and participation). For domain b, sleep functions, psychosocial status, respiratory functions, and upper and lower extremity exercise capacity were evaluated. Posture was evaluated for the s domain. Balance, arm functional capacity, health-related quality of life, and physical activity were evaluated for domain d. As the age of lung transplant recipients and the age at transplant increase, their sleep quality and respiratory functions decreased, and postural impairment increased. There was a negative correlation between age at transplant and functional exercise capacity (P < .05). As the comorbidity level of the recipient increases, the upper and lower extremity exercise capacity, physical activity level, and quality of life declined. There was a moderately positive correlation between the level of comorbidity and balance disorder (P < .05). We found the International Classification of Functioning, Disability, and Health framework to be useful for the evaluation and for planning pulmonary rehabilitation for lung transplant recipients; it can bring a new perspective to physiotherapists specialized in cardiopulmonary rehabilitation.

A pilot study combining noninvasive spinal neuromodulation and activity-based neurorehabilitation therapy in children with cerebral palsy

Cerebral Palsy (CP) is the most common pediatric motor disability with multiple symptoms and etiologies. CP is exhibited through sensorimotor delays, impaired posture resulting in limited activities and participation. Our recently concluded, single arm, unblinded, pilot study (NCT04882592) explored whether an intervention combining non-invasive spinal neuromodulation during an activity-based neurorehabilitation therapy (ABNT) can improve voluntary sensory-motor function captured via the Gross Motor Function Measure (GMFM-88) scores (primary outcome). Sixteen children diagnosed with CP with Gross Motor Function Classification Scale levels I-V were recruited and received the same intervention (2x/week for 8 weeks) to correct the dysfunctional connectivity between supraspinal and spinal networks using the normally developed proprioception. We demonstrate that the intervention was associated with clinically and statistically significant improvement in GMFM-88 scores in all children, thus meeting the prespecified primary endpoint. However, the improvement with ABNT alone needs further exploration. No serious adverse events were observed (safety endpoint).

Balance control impairments in Fabry disease.

BackgroundFabry disease (FD) is a rare inherited lysosomal storage disorder caused by the deficiency of the enzyme alpha-galactosidase A. This deficiency leads to an accumulation of glycosphingolipids leading to progressive and multisystemic disease, including renal, cardiac, and neurological damages. FD may also have neuro-otological and visual impairments, which can generate postural control alterations, inner ear, and vision being involved in this function. This study aimed to evaluate the impact of FD on postural control.MethodsIn total, fourteen adult patients (8 men/6 women, mean age = 37.6 ± 11.4 years) and two children (mean age = 11 years) with FD and 19 healthy adults (12 men/7 women, mean age = 36.5 ± 16.9 years) and two healthy children (mean age = 10.5 years) took part in this study. Postural control was evaluated by a sensory organization test combining three visual situations (eyes open, eyes closed, and sway referenced visual surround motion) with two platform situations (stable platform and sway referenced platform motion), aiming to calculate a composite equilibrium score (CES), a high score being representative of good postural control. Somatosensory (RSOM), visual (RVIS), and vestibular (RVEST) contributions to postural control were calculated, a low score reflecting a poor use of the indicated sensory input.ResultsThe CES was lower in adult patients with FD compared with the healthy subjects (p < 0.001). RVIS (p = 0.001) and RVEST (p = 0.003) were lower in patients with FD compared with the control group, whereas no difference in RSOM was observed.ConclusionInner ear and visual pathologies associated with the central nervous system impairments are factors of postural control impairments. Physical activities, which can also be rehabilitative, by maintaining or increasing the weight of proprioception, may help diminish dependency on altered sensorial inputs.

Impairment and characteristics of postural control sub-components in people with COPD: a scoping review

Purpose Impairment of postural control is common in people with COPD. However, the precise characteristics of this alteration are not clearly known. The “Systems Framework for Postural Control” which define postural control sub-components, represents an interesting tool to explore this field. The main aim of this review was to identify which postural control sub-components are impaired in people with COPD and to summarise characteristics for each sub-component. A secondary aim was to precise the relation between postural control and activities of daily living (ADL). Materials and methods A scoping review was conducted, according to the JBI methodology. Medline, Cochrane Library, Scielo, Google Scholar, OpenGrey, and HAL were searched from inception to May 2022. The search was performed in English and French. Results Eighty-nine articles were included. There was evidence of a potential impairment for most of the postural control sub-components. Characteristics of every sub-component alteration were heterogeneous. Reduced postural control could be associated with difficulties in ADL. Conclusions People with COPD may have impairment in a wide range of postural control sub-components. Further research is needed to clarify if a common pattern of modification exits for this alteration and to precise the link with ADL. Implications for rehabilitation Impairment of postural control is a common extra-respiratory manifestation in people with COPD and so clinicians must include it in their clinical reasoning. Numerous postural control sub-components could be altered in people with COPD, suggesting that postural control assessment must be holistic. This scoping review shows that characteristics of postural control impairment are varied and that there may be no common pattern at the COPD population level. The relationship between impaired postural control and activities of daily living remains unclear, but clinicians should be alert to potential negative interactions between these two areas.

Cumulative additional information does not improve the neuromuscular control during postural responses to perturbations in postural instability/gait disorders subtype of Parkinson's disease.

Postural response impairments in postural instability and gait disorders (PIGD) subtype patients may be attributed to Parkinson's disease (PD)-deterioration in central-set (programing/modulating of central outputs during motor responses). Although additional information improves some PD motor impairments, an unanswered question is whether additional information can benefit postural response in PIGD subtype. To analyze the effect of cumulative additional information on postural responses after perturbation in PIGD and neurologically healthy older adults (CG). Perturbations were applied in 16 PIGD and 19 CG by the support-base translation. Participants performed 3 blocks of 5 trials without additional information (B1-B3, Day 1) and 5 trials of each cumulative additional information (C1-C4, Day 2): information about perturbation (C1), visual (C2), verbal (C3), and somatosensory information (C4). Electromyography and center of pressure (CoP) parameters were analyzed by ANOVAs with Group (PIGD×CG) and Block (B1×B2×B3) and with Group (PIGD×CG) and Condition (B3×C1×C2×C3×C4). PIGD decreased the range of CoP in B3 while CG decreased both range of CoP and the integral of antagonist's muscle activity (iEMG) in B2. Also, PIGD decreased the recovery time in C4 while CG increased the iEMG of agonist's muscle in C2 and antagonist's muscle in all conditions except C2. Additional information provided before postural control assessment influences the postural response in PIGD and CG differently. PIGD demonstrated inflexibility of central-set in modulating the neuromuscular control regardless of additional information. CG presents a flexible system evidenced by the increase of agonist muscle iEMG when provided visual information.

Effect Of Ice Hockey Repetitive Head Impacts On Dual Task Tandem Gait Performance

Repetitive head impacts (RHI) may adversely affect neurophysiological health, but their effect of functional tasks remain to be further elucidated. PURPOSE: To determine the effect of RHI on single task (ST) and dual task (DT) tandem gait performance in collegiate ice hockey players. METHODS: 36 male collegiate ice hockey players (age: 19.7 + 1.2 y.o., ht: 1.80 + 0.06 m, wt: 80.9 + 6.8 kg, concussion history: 48.6% (17/36), 0.8 + 0.9 concussions) were assessed over the course of a club collegiate ice hockey season between 2016 and 2019. Head impact monitoring occurred during each practice and home game using the Smart Impact Monitor (SIM-G) through visual and/or video review. Participants performed five trials each of ST and DT Tandem Gait (TG) at pre-season, mid-season, and post-season. The DT challenges were working memory tasks which included subtraction, spelling, and reciting the months of the year backwards as the participant walked heel-to-toe down a 3-meter line, turned around, and returned. To assess changes over the course of the season, a repeated measures mixed model ANOVA was performed for ST and DT tandem gait total time with pairwise post-hoc on significant findings. RESULTS: There was a significant main effect for time for both ST tandem gait (p = 0.001, partial eta = 0.217) and DT tandem gait (p < 0.001, partial eta = 0.305). There was a significant improvement in ST tandem gait from Pre-season to Post-season (pre; 10.3 + 1.8 sec, post; 9.2 + 1.8 sec, p < 0.001, d = 0.61), but not Mid-Season (mid; 9.7 + 1.8 sec, p = 0.067). There was a significant main effect for time in DT tandem gait from pre-season to both mid-season (pre; 13.8 + 4.7 sec, mid; 12.2 + 3.3 sec, p = 0.001, d = 0.39) and Post-Season (post; 11.9 + 3.9 sec, p < 0.001, d = 0.43). CONCLUSION: Contrary to our hypothesis that repetitive head impacts experienced over the course of an ice hockey season would result in reduced/worsened tandem gait performance, the participants herein showed significant improvements over time with medium to large effects sizes. While prior studies have shown modest improvements in tandem gait performance with repeat administration, these results suggest that participation in collegiate club ice hockey season are not associated with postural control impairments as measured by either ST or DT tandem gait.

Apathy exacerbates postural control impairments in stroke survivors: The potential effects of cognitive dual-task for improving postural control

Apathy is a stressor and debilitating common condition for both stroke survivors and their caregivers. However, its effects on the postural control of these patients have not yet been investigated. Improved postural stability through withdrawing attention from postural control by concurrent cognitive task (i.e. dual-task condition) has been reported previously, but the effect of apathy, as a confounding factor, remains unknown. This study aimed to examine the effects of apathy and dual-task condition on postural control of chronic stroke survivors from biomechanical and neurophysiological perspectives. Twenty non-apathetic stroke survivors, 20 apathetic stroke survivors, and 20 sex-, age-, weight-, and height-matched healthy subjects were assessed using different postural sway measures and electromyography activity of ankle and hip muscles while quietly standing on rigid and foam surfaces under single-task, easy dual-task, and difficult dual-task conditions. The results showed postural instability and neuromuscular stiffening of stroke survivors, particularly apathetic stroke survivors, compared with healthy controls as evidenced by significantly greater postural sway measures and increased co-contraction of ankle muscles as well as hip muscles. Notably, concurrently performing a cognitive task significantly reduced postural instability and neuromuscular stiffening in chronic stroke survivors even in those with apathy. In conclusion, apathy exacerbates postural control impairments in chronic stroke survivors promoting an inefficient conscious mode of postural control. It is recommended that distracting the attention away from postural control by performing a concurrent cognitive task can be considered an effective strategy while designing interventions for improving postural control in apathetic stroke survivors.

Detection and assessment of Parkinson's disease based on gait analysis: A survey.

Neurological disorders represent one of the leading causes of disability and mortality in the world. Parkinson's Disease (PD), for example, affecting millions of people worldwide is often manifested as impaired posture and gait. These impairments have been used as a clinical sign for the early detection of PD, as well as an objective index for pervasive monitoring of the PD patients in daily life. This review presents the evidence that demonstrates the relationship between human gait and PD, and illustrates the role of different gait analysis systems based on vision or wearable sensors. It also provides a comprehensive overview of the available automatic recognition systems for the detection and management of PD. The intervening measures for improving gait performance are summarized, in which the smart devices for gait intervention are emphasized. Finally, this review highlights some of the new opportunities in detecting, monitoring, and treating of PD based on gait, which could facilitate the development of objective gait-based biomarkers for personalized support and treatment of PD.

Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes?

A variety of rehabilitation programmes can be offered to Long COVID patients, specifically physical training. Indeed 90% of these patients reports impairments of verticalization, stability and spatial orientation, making difficult exercise in the gym. The aim of our study was to assess the effectiveness and safety of aquatic exercise techniques as part of a comprehensive rehabilitation program for patients with Long COVID. The first of a two-stage program involved development of aquatic exercises technique, which was evaluated in 12 patients with impaired upright posture control before and after exercising by "Habilect" video gait analysis system. During the second phase, effectiveness and safety of aqua exercises were tested in water pool as part of a comprehensive rehabilitation programme conducted in 23 patients with Long COVID outcomes. Physical examination, 6-minute step test, Euro-QL-5D questionnaire, Borg scale, laser Doppler flowmetry, cardiointervalography, and spirometry were performed before and after the aquatic exercises program. After the training with aquatic exercises, indices of deviations of the main body axes of the head and the body mass centre ameliorated, as well as direction of body movement vector decreased (p<0.05). This study demonstrated a statistically significant improvement in exercise tolerance in both groups, as measured by the 6-minute step test after rehabilitation. The comparison group averaged 236.7 metres [126; 380] (T=8, p=0.047) after the rehabilitation course and the intervention group averaged 233.71 metres [150; 320] (T=8.0, p=0.047). When tested with the Euro-QL-5D questionnaire, a post-treatment improvement was noted in the comparison group on the anxiety/depression subscale (3 [3;3] (T=0, p=0.043)). In the intervention group, laser Doppler flowmetry revealed a statistically significant increase in microcirculation (6.36 standard units after rehabilitation) [5.54; 8.17] (T=7.0, p=0.004), and a decrease of oxidative metabolism index of 6.89 standard units. [4.76; 6.96] (T=4.0, p=0.03). No serious adverse events were reported. In conclusion, the developed aquatic exercises technique seems to contribute to recovery of impaired upright posture and motor function, normalizing the walking pattern.

Resting state functional networks predict different aspects of postural control in Parkinson’s disease

BackgroundParkinson’s disease (PD) is a neurodegenerative disorder causing postural control impairments. Postural control involves multiple domains, such as control of postural sway in stance, automatic postural responses (APRs) and anticipatory postural adjustments (APAs). We hypothesize that impairments in each postural domain is associated with resting-state functional connectivity (rsFC), accounted by predictive modeling and that cortical and cerebellar networks would predict postural control in people with PD (PwPD). ObjectiveTo determine whether rsFC can predict three domains of postural control independently in PwPD and older adults (OA) based on predictive accuracy of models. MethodsThe cohort consisted of 65 PwPD (67.7 +8.1 age) tested in their OFF-state and 42 OA (69.7 +8.2 age). Six body-worn, inertial sensors measured postural sway area while standing on foam, step length of APRs to a backward push-and-release perturbation, and magnitude of lateral APAs prior to voluntary gait initiation. Resting state-fMRI data was reported on 384 regions of interest that were grouped into 13 functional brain networks. Associations between rsFC and postural metrics were characterized using predictive modeling, with an independent training (n = 67) and validation (n = 40) dataset. Models were trained in the training sample and performance of the best model was validated in the independent test dataset. ResultsrsFC of different brain networks predicted each domain of postural control in PD: Frontoparietal and Ventral Attention rsFC for APAs; Cerebellar-Subcortical and Visual rsFC and Auditory and Cerebellar-Subcortical rsFC for APRs; Ventral Attention and Ventral Multimodal rsFC for postural sway. In OA, CinguloOpercular and Somatomotor rsFC predicted APAs. ConclusionsOur findings suggest that cortical networks predict postural control in PD and there is little overlap in brain network connectivities that predict different domains of postural control, given the rsFC methodology used. PwPD use different cortical networks for APAs compared to OA.

Comparing the effects of cognitive dual tasking on balance and gait motor performance in people with mild multiple sclerosis and healthy individuals

Background/Aims People with multiple sclerosis show both cognitive and postural impairment, and various static and dynamic postural activities may be affected under conditions of cognitive distraction. The aim of this study was to determine the effects of cognitive dual tasking on the balance and gait motor performance of people with mild multiple sclerosis (Expanded Disability Status Scale score of 2.0 ± 1.3) and healthy people and to compare these two groups in terms of performing single and dual tasks. Methods People with mild multiple sclerosis (n=39) and healthy individuals (n=33) performed static balance tests (Romberg's Test, tandem stance test, single-legged stance test) and dynamic balance tests (Functional Reach Test, Four Square Step Test, Timed Up and Go Test, 10-Metre Walk Test), with and without a word list generation test (single and dual tasks). Independent t-tests were used to evaluate differences between the two groups, and paired t-tests were used for single or dual tasks for all static and dynamic tests. The magnitude of differences in tasks between measures was expressed as Cohen's d. Results Dual task effects were more evident during dynamic balance tests in participants with multiple sclerosis and healthy participants (specifically the Timed Up and Go Test and 10-Metre Walk Test) (P&lt;0.001). There was a significant difference between both groups only in terms of static balance (P&lt;0.001). Conclusions Dynamic balance and gait were shown to be more affected when performing the dual cognitive task than static balance in people with multiple sclerosis. Dual tasks should be included in diagnoses.

Аssociation between incidence of caries of temporary teeth and pathology of the musculoskeletal system in preschool children, considering biochemical markers of connective tissue metabolism

The aim is study biochemical markers of connective tissue metabolism in children with musculoskeletal disorders and their association with dental caries of temporary teeth. There were examined 232 children at the age of 5 (202 children with musculoskeletal disorders and 30 conditionally healthy children without somatic pathology). Among children with musculoskeletal disorders 68 (33.66%) had flat feet, 59 (29.21%) – postural impairment and 75 (37.13%) – combined pathology of the musculoskeletal sestem. For further research, the children were divided into three groups, 30 people in each. Group І included children with pathology of the musculoskeletal system, dental caries, without oxyproline in urine; group ІІ – with pathology of the musculoskeletal system, dental caries and oxyproline in urine; group ІІІ – with dental caries and without oxyproline in urine. Urinary excretion of glycosaminoglycans using a nephelometric test with cetylpyridinium chloride was determined. The concentration of creatinine in urine was measured in units of weight in the formation of a chromogenic complex of a solution of picric acid with creatinine in an alkaline medium. Dental status was assessed in terms of caries prevalence, deft index and severity of dental caries. The prevalence of caries of temporary teeth in 5-years old children with musculoskeletal disorders was on average 90.6±2.05%, deft index ─ 6.62±0.20, being significantly higher than in children without somatic pathology (respectively 70.83±4.45% and 5.15±0.34, р&lt;0.001). Oxyprolin was detected only in the urine of children with combined pathology of musculoskeletal system (on average 3.53±0.11 units). The excretion rates of glycosaminoglycans in children with pathology of the musculoskeletal system, dental caries and oxyproline in urine (gr.ІІ) were two times higher than the reference range (415.37±15,09 CPCh units / 1 g creatinine, р&lt;0.001). In the absence of oxyproline in urine, both in somatically healthy children (gr. ІІІ) and in children with pathology of the musculoskeletal system (gr. І), the levels of excretion of glycosoaminoglycans were within the reference range (respectively 198.83±10.71 and 203.87±12.52 CPCh units / 1 g creatinine. The levels of daily excretion of creatinine were within the normal range in children of gr. ІІІ (1.17±0.13 g/day; in children of gr. І they were 2.85 times lower (0.41±0.05 g/day, p&lt;0.001); in children of gr. ІІ – 6.5 times lower (0.18±0.02 g/day р&lt;0.001). In children of gr. ІІ, a negative correlation was found between the levels of creatinine and oxyproline (τ= -0.68, p&lt;0.05). The absence of oxyproline in the urine of children of gr. І and ІІІ indicates the absence of collagen decay in their bodies. In children with pathology of the musculoskeletal system against the background of undifferentiated connective tissue dysplasia (gr. ІІ), a strong, positive correlation was found between the deft index and levels of urinary excretion of oxyproline (τ= +0.77, p&lt;0.05) and glycosaminoglycans (τ= +0.90, p&lt;0.05), which indicates that the development of dental caries depends on the severity of the pathology of the musculoskeletal system.

Effects of Right Sidelying Respiratory Left Adductor Pull Back Exercise on Improving Hip Biomechanics in Participants With a Tendency to Stand on Right Side

Objectives: A helpful functional exercise that tends to correct postural unevenness and attempts to re-establish lumbopelvic mechanics is beneficial for patients with postural impairment. This study evaluates the effects of right sidelying respiratory left adductor pull back exercise on improving hip biomechanics in participants with a tendency to stand on the right side. Methods: A total of 30 subjects (6 females and 24 males) with a Mean±SD age of 28.53±2.62 years, Mean±SD weight of 63.83±3.89 kg, and Mean±SD height of 165.8±3.97 cm were screened based on eligible criteria. Subjects had been randomly allocated into identical groups (Group I: n=15, Group II: n=15). Pre- and post-intervention, active and passive measurements of right and left hip internal rotation, external rotation, abduction, as well as active right and left hip shift were recorded. The intervention was provided to both groups twice a day for 3 weeks. Group I (experimental group) received stretching, strengthening, postural re-education, and right sidelying respiratory left adductor pull back exercise, whereas group II (control group) received only stretching, strengthening, and posture re-education. Results: Statistically significant differences were reported in both groups in the active and passive right and left hip lateral and medial rotation, and abduction range of motion (P&lt;0.05), with right and left hip shift (P&lt;0.05) following the intervention. However, the experimental group showed better improvement compared to the control group. Discussion: The results suggest that right sidelying respiratory left adductor pull back exercise is effective in improving hip biomechanics in participants with a tendency to stand on the right side.

Thirty-Second Single-Leg Stance Identifies Impaired Postural Control in Children After Concussion: A Preliminary Report.

Objective and expedient assessments of standing postural control incorporating static and dynamic tasks are necessary for identifying subtle motor deficits and clearing children to return to high-risk activities after concussion. The Revised Physical and Neurological Examination for Subtle Signs (PANESS) gaits and stations tasks evaluate both static and dynamic aspects of postural control. While the PANESS gaits and stations subscale is sensitive to concussion in youth, the benefit of each specific task for this purpose is unknown. This study evaluated whether specific PANESS tasks identify postural impairments after youth concussion. Cross-sectional study. Academicallyaffiliated research laboratory. Sixty youth, ages 10-17years, comprised 3 groups: (1)youth symptomatic from concussion (4-14d postinjury [n = 18]), (2)clinically-recovered youth (27-122d postinjury [n = 15]), and (3)age- and gender-matched never-concussed controls (n = 27). PANESS gaits and stations tasks (6 dynamic and 3 static) at the time of the initial research visit. Kruskal-Wallis statistic identified a significant main effect of group on standing on one foot (a 30-s task). Both symptomatic and clinically-recovered youth showed deficits on standing on one foot relative to controls. Single-leg tasks of longer duration may maximize the ability to detect residual postural deficits after concussion and can be readily incorporated in targeted sport rehabilitation protocols.

Effectiveness of Vestibular Stimulation on Balance Using Swing Therapy in Children with Hypotonic Cerebral Palsy

Background: Hypotonic cerebral palsy is the non-progressive neurodevelopmental disorder of the immature brain that covers a board spectrum of syndromes which is related to motor and postural impairment, and balance problems during both gross and fine motor activities.Objective: To assess the effectiveness of vestibular stimulation on balance using swing therapy in children with hypotonic cerebral palsy. Methods: A single-blinded randomized clinical trial was conducted on sample of 52 patients with level-II motor functions on gross motor function classification system (GMFCS). All other types of cerebral palsy like Spastic, Athetoid and Ataxic were excluded from the study. Simple random sampling technique was used, data was collected from subjects visiting to Pediatric Physical Therapy Department, and randomly allocated into two groups; comprising 26 patients in each via lottery method. The Group A was treated with vestibular stimulation for balance by swing therapy and conventional methods of rehabilitation including; walking on parallel bars, proper positioning and stretching exercises and while in group B only conventional techniques was used. Swing therapy was given for total 8 weeks on alternate days for 15 minutes and post intervention effect was recorded on pediatric balance scale. Results: The mean age of patients was 5.83±1.92 years. For Group A and B, pre-treatment mean on pediatric balance scale was 3.07±1.24 and 3.03±1.31 and post-treatment mean was 1.51±1.72 and 2.69±1.61. The measured value of “t” score was (-3.76) and “P” value was (0.001) showing significant change, as this was less than the reference value 0.05. Conclusion: The current study concluded that swing therapy when integrated with other conventional methods of rehabilitation proved to be effective in improving balance in children with hypotonic cerebral palsy.

Treatment of severe planovalgus foot deformity in a child

Planovalgus foot deformity is one of the most common orthopedic conditions detected in childhood. According to the literature, it is present in 70% of children under 11 years with various degree of severity. Without timely correction, the common complications of this deformity are: arthrosis of the talonavicular joint, valgus deformity of the knee joints, impaired posture and functional scoliosis, pain syndrome, impaired function of the lower extremities, which is an indication for surgical treatment of this pathology.&#x0D; The article presents a clinical case report of surgical treatment of a patient with severe planovalgus foot deformity. The main stages of surgical correction were tendon-muscle plasty, subtalar arthroeresis and Cotton osteotomy (wedging osteotomy of the medial sphenoid bone).&#x0D; Relying on the results of surgical treatment of the patient, we conclude that the use of the combination of methods is valid for the treatment of patients with severe planovalgus foot deformity.

Postural control and gait measures derived from wearable inertial measurement unit devices in Huntington's disease: Recommendations for clinical outcomes

BackgroundPostural control impairments begin early in Huntington's disease yet measures most sensitive to progression have not been identified. The aims of this study were to: 1) evaluate postural control and gait in people with and without Huntington's disease using wearable sensors; and 2) identify measures related to diagnosis and clinical severity. Methods43 individuals with Huntington's disease and 15 age-matched peers performed standing with feet together and feet apart, sitting, and walking with wearable inertial sensors. One-way analysis of variance determined differences in measures of postural control and gait between early and mid-disease stage, and non-Huntington's disease peers. A random forest analysis identified feature importance for Huntington's disease diagnosis. Stepwise and ordinal regressions were used to determine predictors of clinical chorea and tandem walking scores respectively. FindingsThere was a significant main effect for all postural control and gait measures comparing early stage, mid stage and non-Huntington's disease peers, except for gait cycle duration and step duration. Total sway, root mean square and mean velocity during sitting, as well as gait speed had the greatest importance in classifying disease status. Stepwise regression showed that root mean square during standing with feet apart significantly predicted clinical measure of chorea, and ordinal regression model showed that root mean square and total sway standing feet together significantly predicted clinical measure of tandem walking. InterpretationsRoot mean square measures obtained in sitting and standing using wearable sensors have the potential to serve as biomarkers of postural control impairments in Huntington's disease.

Longitudinal associations between sport participation and fat mass with body posture in children: A 5-year follow-up from the Czech ELSPAC study

The main purpose of the study was to examine longitudinal associations between sport participation and fat mass with body posture in children. We used data from children recruited in the Czech European Longitudinal Study of Pregnancy and Childhood (CELSPAC) at the ages of 11 y (n = 1065), 13 y (n = 811) and 15 y (n = 974). Information on body posture, practicing sport in a club and at a competitive level, and skinfold thicknesses (biceps, triceps, subscapula, suprailiaca and thigh) from pediatrician’s medical records were collected. Body posture was inspected by a pediatrician. The sum of 5 skinfolds was used as a proxy of fat mass. The 85th and 95th percentiles defined ‘overfat’ and ‘obese’children. Practicing sport in a club and at a competitive level were included as ‘yes/no’ answers. General linear mixed models with risk ratios (RR) and 95% confidence intervals (95% CI) were calculated. Overall, 35.6% of children and adolescents had impaired body posture; the prevalence of ’incorrect’ body posture increased by age (from 41.0% to 28.0%, p<0.001). Practicing sport in a club and at a competitive level decreased by follow-up (p<0.001), while the level of ‘overfat’ and ‘obese’ children increased (p<0.01). In separate models, ’incorrect’ body posture was associated with non-practicing sport in clubs (RR = 1.68; 95% CI 1.43–1.97, p<0.001) or at competitive level (RR = 1.61; 95% CI 1.37–1.88, p<0.001) and with being ’overfat’ (RR = 2.05; 95% CI 1.52–2.75, p<0.001) and ’obese’ (RR = 2.15; 95% CI 1.68–2.75, p<0.001). When all variables were put simultaneously into the model additionally adjusted for sex, self-rated health and baseline body posture, similar associations remained. This study shows, that not participating in sport and being overfat/obese are longitudinally associated with ‘incorrect’ body posture. Therefore, the detection of these risk factors in childhood, through the development of school- and community-based interventions, should be advocated.

Correlation between Postural Impairment and Lymphedema in Breast Cancer Survivors

The major complication of breast cancer is secondary lymphedema seen within few days to months after the surgery. Lymphedema has a debilitating effect on posture. The significance of this study is to show the effect of lymphedema on posture. These all have a huge impact on the quality of life of patients, within her family as well as working places. This study provides a platform to assess the spinal posture which may be at risk due to lymphedema in breast cancer survivors. Hence, the study is to find out correlation between spinal postural impairment and lymphedema in breast cancer survivors and to assess the correlation between demographic variables and lymphedema in breast cancer survivors. The aim of the study was to study and find out the correlation between postural impairment and lymphedema in breast cancer survivors. This was an observational study with the total of 116 breast cancer survivor women’s who had undergone radiotherapy and surgery were selected from Krishna Institute of Medical Sciences, Karad. Their age ranged from 35 to 60 years old. The outcome measures which were included are postural examination chart in the anterior, posterior, lateral views by plumb line, muscle length test, muscle strength test, pain assessment using visual analog scale, and lymphedema measurement using inch tape. The obtained results showed statistically high significant increase in the forward head posture, rounded shoulders, thoracic kyphosis and scoliosis, scapular dyskinesis, and increased volume of affected arm. There were high significant correlation between spinal postural impairments and lymphedema in breast cancer survivors and also correlation between demographic variables and lymphedema in breast cancer survivors.