Stabilometric Data Research Articles

Breathing, postural stability, and psychological health: a study to explore triangular links.

This study aims to test the hypothesis that breathing can be directly linked to postural stability and psychological health. A protocol enabling the simultaneous analysis of breathing, posture, and emotional levels in university students is presented. This aims to verify the possibility of defining a triangular link and to test the adequacy of various measurement techniques. Twenty-three subjects (9 females and 14 males), aged between 18 and 23years, were recruited. The experiment consisted of four conditions, each lasting 3minutes: Standard quiet standing with open eyes 1), with closed eyes 2), and relaxed quiet standing while attempting deep abdominal breathing with open eyes 3) and with closed eyes 4). These latter two acquisitions were performed after subjects were instructed to maintain a relaxed state. All subjects underwent postural and stability analysis in a motion capture laboratory. The presented protocol enabled the extraction of 4 sets of variables: Stabilometric data, based on the displacement of the center of pressure and acceleration, derived respectively from force plate and wearable sensors. Postural variables: angles of each joint of the body were measured using a stereophotogrammetric system, implementing the Helen Hayes protocol. Breathing compartment: optoelectronic plethysmography allowed the measurement of the percentage of use of each chest compartment. Emotional state was evaluated using both psychometric data and physiological signals. A multivariate analysis was proposed. A holistic protocol was presented and tested. Emotional levels were found to be related to posture and the varied use of breathing compartments. Abdominal breathing proved to be a challenging task for most subjects, especially females, who were unable to control their breathing patterns. In males, the abdominal breathing pattern was associated with increased stability and reduced anxiety. In conclusion, difficulties in performing deep abdominal breathing were associated with elevated anxiety scores and decreased stability. This depicts a circular self-sustaining relationship that may reduce the quality of life, undermine learning, and contribute to muscular co-contraction and the development of musculoskeletal disorders. The presented protocol can be utilized to quantitatively and holistically assess the healthy and/or pathological condition of subjects.

Using a spherical inverted pendulum and statokinesigram for modeling and evaluating quiet standing posture

This paper proposes a new approach to model and analyze erect posture, based on a spherical inverted pendulum which is used to mimic the body posture. The pendulum oscillates in two directions, [Formula: see text] and [Formula: see text], from which the mathematical model was derived and two torque components in oscillation directions were introduced. They are estimated using stabilometric data acquired by a foot pressure mapping system. The model was quantitatively investigated using data from 19 participants, who were first were classified into three groups, according to the foot arch-index. Stabilometric data were then collected and fed into the model to estimate the torque’s components. The components were statistically processed, and the results revealed that the components in direction [Formula: see text] are able to reject intrinsic perturbation. The frequency spectrum of the components in direction [Formula: see text] was processed using fast Fourier transform, and the results showed the feasibility of the component in segregating foot deformities. In addition, high-arched foot cases tended to be more stable than other cases because the exerted torque is less. The torque profiles estimated by our model were compared with the profiles derived from a classical inverted pendulum. In most cases, our results showed a significant change ( t-test p < 0.05).

Fallers after stroke: a retrospective study to investigate the combination of postural sway measures and clinical information in faller's identification.

Falls can have devastating effects on quality of life. No clear relationships have been identified between clinical and stabilometric postural measures and falling in persons after stroke. This cross-sectional study investigates the value of including stabilometric measures of sway with clinical measures of balance in models for identification of faller chronic stroke survivors, and the relations between variables. Clinical and stabilometric data were collected from a convenience sample of 49 persons with stroke in hospital care. They were categorized as fallers (N = 21) or non-fallers (N = 28) based on the occurrence of falls in the previous 6 months. Logistic regression (model 1) was performed with clinical measures, including the Berg Balance scale (BBS), Barthel Index (BI), and Dynamic Gait Index (DGI). A second model (model 2) was run with stabilometric measures, including mediolateral (SwayML) and anterior-posterior sway (SwayAP), velocity of antero-posterior (VelAP) and medio-lateral sway (VelML), and absolute position of center of pressure (CopX abs). A third stepwise regression model was run including all variables, resulting in a model with SwayML, BBS, and BI (model 3). Finally, correlations between independent variables were analyzed. The area under the curve (AUC) for model 1 was 0.68 (95%CI: 0.53-0.83, sensitivity = 95%, specificity = 39%) with prediction accuracy of 63.3%. Model 2 resulted in an AUC of 0.68 (95%CI: 0.53-0.84, sensitivity = 76%, specificity = 57%) with prediction accuracy of 65.3%. The AUC of stepwise model 3 was 0.74 (95%CI: 0.60-0.88, sensitivity = 57%, specificity = 81%) with prediction accuracy of 67.4%. Finally, statistically significant correlations were found between clinical variables (p < 0.05), only velocity parameters were correlated with balance performance (p < 0.05). A model combining BBS, BI, and SwayML was best at identifying faller status in persons in the chronic phase post stroke. When balance performance is poor, a high SwayML may be part of a strategy protecting from falls.

Studies in the Falls Efficacy Scale-International for patients with cervical compressive myelopathy: Reliability, validity, and minimum clinically important difference

Context Patients with cervical compressive myelopathy (CCM) often complain of body balance problems, such as fear of falling and bodily unsteadiness. However, no accepted patient-reported outcome measures (PROMs) for this symptomatology exist. The Falls Efficacy Scale-International (FES-I) is one of the most widely used PROMs for evaluating impaired body balance in various clinical fields. Objective To examine reliability, validity, and minimum clinically important difference (MCID) of the FES-I for the evaluation of impaired body balance in patients with CCM. Methods Patients who underwent surgery for CCM were retrospectively reviewed. The FES-I was administered preoperatively and at 1 year postoperatively. Further, cJOA-LE score (subscore for lower extremities in the Japanese Orthopaedic Association score for cervical myelopathy) and stabilometric data, obtained at the same time points of the FES-I administration, were analyzed. Reliability was examined through internal consistency with Cronbach’s alpha. Convergent validity was studied using correlation analysis. The MCID was estimated using anchor- and distribution-based methods. Results Overall, 151 patients were included for analysis. Cronbach’s alpha coefficient was the acceptable value of 0.97 at both baseline and 1 year postoperatively. As for convergent validity, the FES-I had significant correlations with the cJOA-LE score and stabilometric parameters both at baseline and 1 year postoperatively. The MCID calculated using anchor- and distribution-based methods was 5.5 and 10, respectively. Conclusion FES-I is a reliable and valid PROM to evaluate body balance problems for the CCM population. The established thresholds of MCID can help clinicians recognize the clinical significance of changes in patient status.

Identification of pathobiomechanical markers of statokinesiograms on the example of neural network identification of a post-stroke state

The purpose of this study is neural network modeling and determination of the parameters of statokinesiograms, which are carriers of useful information about the features of postural regulation, which determined the obtained trajectory of movements of the human center of mass. A technique for obtaining informative markers by identifying clustering centroids based on self-organizing Kohonen neural networks with the Euclidean metric has been developed. Kohonen networks trained without a teacher (that is, without the use of a priori diagnostic information about the state of the subjects) are a powerful and informative method that allows you to obtain not only graphic, but also mathematical markers of health disorders in subjects, to explore the biomechanics of micromovements of the center of pressure based on a flexible mathematical apparatus – neural network cluster analysis. On the example of the identification of the post-stroke state, a neural network analysis of stabilometric data was carried out and a method for identifying pathobiomechanical markers of statokinesiograms was shown, which made it possible to standardize the type affiliation of the groups of subjects. With the help of neural networks, it was possible to identify clusters that are amenable to biomedical interpretation with a reliability of up to 95.9 %, which determines the theoretical significance of the results obtained. Decision trees and a supervised multilayer neural network were also considered. A multilayer neural net-work made it possible to identify markers of health disorders with a probability of 71.9 %.

Effects of Aquatic Physical Exercise on Motor Risk Factors for Falls in Older People During the COVID-19 Pandemic: A Randomized Controlled Trial

ObjectiveThe aim of this study was to assess the effects of aquatic training on motor risk factors for falls in older people during the COVID-19 pandemic. MethodsA randomized controlled trial was carried out with older people, divided into an aquatic training group (ATG) (n = 24) and a control group (CG) (n = 25). Muscle strength was assessed by the 5-Times Sit-to-Stand Test, mobility by the simple and dual-task Timed Up and Go Test, and postural stability through stabilometric data (force platform). The CG received monthly calls to monitor general health. The ATG carried out training lasting 16 weeks, with two 1-hour sessions per week. ResultsBoth groups improved muscular strength and cognitive-motor tasks, and they performed a dual task with fewer errors in the secondary task after 16 weeks regardless of the pandemic and COVID-19 diagnosis. There was a significant decrease in the area of center of pressure displacement in the tandem posture with eyes closed in the CG. When analyzing participants who adhered at least 50% to the intervention, the ATG significantly reduced the number of steps on the Timed Up and Go Test performance. Both groups improved muscular strength and cognitive-motor tasks and increased the cognitive task cost. In the CG, there was a significant decrease in the mean amplitude of the anteroposterior center of pressure displacement in the feet together with eyes open. ConclusionWe found that aquatic physical exercise presented positive effects on some potentially modifiable motor risk factors for falls (mobility and muscle strength) regardless of the COVID-19 pandemic and COVID-19 diagnosis, especially among people who adhered to the intervention.

Energy estimates from force plate data

In this paper, we discuss a possibility of evaluating a part of the energy cost for maintaining a vertical posture by a person. We use the stabilometric data (center of pressure (CoP) postural sway measurements) only. The application of an inverted pendulum model for calculating the components of the mechanical work of particular groups of leg muscles is described. We use integral of the modulus of the power of total torques developed by the antagonists. For the sagittal direction, the mechanical work of muscles of the ankle is make an estimate mainly, and for the frontal direction – of the pelvic muscles. The possibility of using approximate estimates of energy indicators for the slow components of human movement is discussed. To analyze the correlations of various indicators, the results of postural stability tests were used. During these tests the subjects stood with their eyes open in an upright posture. Moreover, in several tests, they were presented with various visual illusions. It was causing a change in postural characteristics and, accordingly, stabilometric parameters. The correlations between the introduced energetical indicators and indicators traditionally used in stabilometry are analyzed. The next indicators: CoP trajectory range of oscillations along the frontal and sagittal, the average CoP velocity and its projection on the frontal and sagittal axes, as well as an indicator called the "total energy density of statokinesiogram" and its components for the frontal and sagittal directions were considered. A correlation between the used indicator of mechanical work and the stabilogram range was developed. It is shown that the change in a part of the energy corresponding to an indicator called the “total energy density of statokinesiogram” is small and, apparently, does not adequately characterize the change in mechanical energy.

Is Any Feature of the Stabilometric Evaluation Clinically Relevant in Patients with Temporomandibular Disorders? A Cross-Sectional Study

Current neuroanatomical evidence showed the anatomical relationship between the temporomandibular joint innervation with the vestibular system. However, there is no clear evidence regarding if temporomandibular disorders are associated with balance impairments. Therefore, the aims of this study were to assess the clinical relevance of stabilometric features in populations with temporomandibular disorders and to analyze the influence of the mandibular position and visual afference in the balance scores in both healthy and clinical populations. This observational study was conducted in one sample of healthy controls and one sample with temporomandibular disorders. Sociodemographic data (age, gender, height, weight, body mass index, and foot size), clinical data (presence or absence of temporomandibular disorders) and stabilometric data under six different conditions were collected. Sixty-nine subjects (43.5% male; 36.2% patients) were assessed. No differences between Temporomandibular disorders and healthy groups were found in any stabilometric outcomes, unlike oscillation area with closed eyes and medium interscuspidal position (p &lt; 0.01). Although visual feedback showed to be relevant (p &lt; 0.0001), mandibular position produced no differences in any stabilometric measurement (p &gt; 0.05). This study found that healthy subjects and patients with temporomandibular disorders showed no balance differences in the stabilometric outcomes assessed. Although visual input played an important role in the balance, mandibular position seems to be irrelevant.

Neuroclusterization method of stabilometric data

Stabilometry is a modern method for assessing the functional state of a person by the ability to maintain a stable balance of an upright posture. Technically, the implementation of the stabilometry method consists in measuring, with the help of specialized devices, the values that make up the support reaction, with the subsequent determination, according to these measurements, of the coordinates of the center of body pressure on the support. The nature of the migrations of the center of pressure during the stabilometric study is a source of information about the features of the processes of postural regulation. At the same time, up to the present time, there is a problem of the correct interpretation of the results of stabilometry. The adequacy of the conclusions is largely determined by the human factor, i.e. qualification of a specialist analyzing stabilometry data. Thus, in our opinion, the task of objectifying the assessment of stabilometry results is urgent. The aim of this work is to study the possibility of applying the neurocluster method using self-organizing neural networks to objectify the analysis of stabilometry data. The authors proposed a technique for analyzing the structure of individual and group stabilometric data by clustering them using selforganizing Kohonen neural maps with Euclidean metrics. Neuroclusterization of stabilometric data allows in automatic mode (without human intervention) to identify the type of group of subjects corresponding to the norm or pathology, various types of pathologies, as well as individual biometric characteristics of the subjects. The subsequent analysis of the individual characteristics of the data of the subjects, grouped in this way, makes it possible to detect deviations indicating the presence of abnormalities or the formation of various pathological conditions, which can be useful for the early diagnosis of diseases.

Do Grade II Ankle Sprains Have Chronic Effects on the Functional Ability of Ballet Dancers Performing Single-Leg Flat-Foot Stance? An Observational Cross-Sectional Study

Ballet dancers have a higher risk than the general population of ankle sprains. Ankle proprioception is of the utmost importance for executing static and dynamic positions typical of ballet dancing. Ankle sprains can create changes in functional ability that may affect ballet performance. The aim of this cross-sectional observational study is to evaluate if non-professional ballet dancers that were previously injured with a grade II ankle sprain carry a long-term stability deficit in ballet specific positions (passé, arabesque) and in single-leg flat-foot stance, thereby affecting ballet performance. We enrolled 22 amateur female ballet dancers, 11 who previously had a grade II ankle injury and 11 who had no history of ankle injury. Stabilometric data (Center of Pressure Speed and Elipse Area) were assessed with the postural electronic multisensory baropodometer in normal, arabesque, and passè positions with both open and closed eyes. Using an unpaired t-test, we compared healthy and pathological feet of the ankle injury group for a standard monopodalic position and two ballet-specific positions. No difference between pathological and healthy feet of non-professional ballet dancers who suffered grade II ankle injury was detected. According to the parameters considered in this study, grade II ankle sprains seem to have a favorable prognosis in the sample that we evaluated.

Analysis of the Results of Stabiolmetric Tests with a Stepwise Input Action in the Context of the Mechanics of Controlled Systems

Abstract—Problems of optimal control were analyzed for a human motion model for stabilometric tests where the posture changes under a stepwise input action. The presence of a prominent “swing” and an “overshoot” are characteristic of the center-of-pressure trajectories recorded in the test. A one-dimensional inverted pendulum model was used in the study. The solution of the optimal control for the inverted pendulum motion controlled by coupling torque was put in correspondence with the test results. The problems of optimal speed-of-response control and linear–quadratic regulator were considered. The solution of these optimum problems was compared with the stabilometric test results. A modified algorithm was proposed for stabilometric data processing. This motion was shown to reach a stable motor pattern. The swing and overshoot were found to correspond to the acceleration and deceleration stages, respectively.

ВЛИЯНИЕ ПОСТУРАЛЬНОГО БАЛАНСА НА ИЗМЕНЕНИЕ ЭЛЕКТРОКАРДИОГРАФИЧЕСКИХ ПОКАЗАТЕЛЕЙ ЕДИНОБОРЦЕВ

Aim. The article deals with forecasting electrocardiogram changes (ECG) in athletes using stabilometric parameters. Materials and methods. 77 elite athletes aged 16–18 participated in the study (Candidate for Master of Sport, Master of sport: judo, taekwondo). To reveal cardiac conductivity disturbances and heart rhythm disorders, we used veloergometry. To assess postural balance, we used stabilometric equipment. Results. We registered incomplete right bundle branch block (IRBBB) in 5 athletes (22.72 %), extrasystoles – in 10 athletes (45.45 %), early repolarization syndrome (ERS) – in 3 athletes (13.63 %), sinoatrial block (SB) – in 2 athletes (9.09 %), pacemaker migration – in 2 athletes (9.09 %). The standard deviation of center of pressure (CoP) in the frontal plane in athletes with ECG changes in the natural standing position exceeded values of athletes without ECG changes by 94.93 % with the eyes opened; by 121.09 % with the head turned to the left; by 71.05 % with the head turned to the left and the eyes closed; by 61.98 % with the head turned to the right. We built a mathematical model. Conclusion. We studied the peculiarities of ECG changes in athletes. The parameters of stabilometry in athletes both with and without ECG changes were statistically significant (p &lt; 0.05). With the help of stabilometric data, we created Random Forest model for forecasting possible ECG changes such as cardiac conductivity disturbances and heart rhythm disorders.

Neuromuscular recovery in ACL reconstruction with Bone-Tendon-Patellar-Bone and Semitendinosus-Gracilis autograft.

Several different types of grafts have been used in ACL rupture. The purpose of the study was to compare the recovery of lower limbs muscle strength and proprioception in athletes, who underwent ACL reconstruction with Bone-Patellar-Tendon-Bone (BPTB) versus semitendinosus and gracilis(HS) autografts. We enrolled 30 male amateur athletes. Each patient was evaluated by isokinetic test, triaxial accelerometer test and balance test with stabilometric platform. Isokinetic test evaluated quadriceps and hamstrings Peak Torque. Accelerometer test evaluated squat jump test (SJT) and stiffness test (ST). The recording on the balance platform was performed with open and closed eyes and evaluated medio-lateral and anterior-posterior pathways. 30 patients were selected (15 in group BPTB and 15 in group HS). In SJT we noticed a statistically significant difference in height of jump in the involved side in favour of Group BPTB (p=0.037) and not significant difference in the other parameters. In the ST, we did not observe significant statistical differences in the parameters of the test. The stabilometric platform data and isokinetic peak torque parameters did not show a significant difference. Little high quality researches are available to help determine when patients can safely return to full activity and sport. Included evaluation criteria were a combination of factors regarding knee motion, muscles strength and neuromuscular function. In our study, despite a not full recovery of explosive strength in HS group , the balance and the other parameters after one year are comparable between the two graft. In our findings there isn't clinical difference between the two grafts. We suggest that the evaluation of explosive strength and proprioception are the priority parameters in neuromuscular recovery after ACL reconstruction.

A longitudinal assessment of myoelectric activity, postural sway, and low-back pain during pregnancy.

The present study aimed at investigating the control of upright quiet standing in pregnant women throughout pregnancy, and whether low-back pain exerts influence on this motor task. Myoelectric signals from postural muscles and stabilometric data were collected from 15 non-pregnant and 15 pregnant women during upright quiet standing. Electromyogram envelopes and center of pressure metrics were evaluated in the control group, as well as in pregnant women in their first and third trimester of pregnancy. A correlation analysis was performed between the measured variables and a low-back pain disability index. Pregnant women exhibited a decreased maximum voluntary isometric activity for all postural muscles evaluated. Additionally, the activity of lumbar muscles during the postural task was significantly higher in the pregnant women in comparison to the non-pregnant controls. The soleus muscle maintained its activity at the same level as the gestation progressed. Higher postural oscillations were observed in the anteroposterior direction while mediolateral sway was reduced in the third trimester of pregnancy. No correlation was detected between the lowback pain disability index and neuromechanical variables. This study provides additional data regarding the functioning and adaptations of the postural control system during pregnancy. Also, we provide further evidence that postural control during quiet standing cannot be used to predict the occurrence of low-back pain. We hypothesize that the modifications in the neural drive to the muscles, as well as in postural sway may be related to changes in the biomechanics and hormonal levels experienced by the pregnant women.

Identification of a voluntary overcontrol of postural sway from static stabilometric assessment

When subjects present medically unexplained postural instability, a voluntary overcontrol of postural sway is often suspected. Aphysiologic postural imbalance may be detected in dynamic conditions on a servo-controlled platform (Equitest), but it remains difficult to objectify from static stabilometric evaluation. Our objective was to identify the key stabilometric parameters that allow to discriminate subjects with voluntary postural instability, control subjects and neurological patients with organic postural instability. Stabilometric data from 41 control subjects, 21 voluntarily simulating postural instability, were compared with those from 173 neurological patients with postural instability (stroke, spinal cord injury, Parkinson's disease, cerebellar syndrome) and with data from 3 patients suspected to simulate postural instability. Data were obtained in static condition of bipodal support, with open and closed eyes. The studied parameters were: velocity of center of pressure (velocity-CP), area of the 90% confidence ellipse of statokinesigram (area-SKG) and number of peaks greater than 0.2 (NP2) on the curve of cross-correlations between anteroposterior and mediolateral displacements of CP. Eyes open, high values of the velocity-CP (72.3 ± 36.3 mm·s −1 ), NP2 (4.9 ± 2.4) and area-SKG (13 015 ± 10 667 mm 2 ) were observed in controls simulating instability, comparable to those of 3 patients suspected to simulate postural instability (velocity-CP: 15–131 mm·s −1 , NP2: 3–9, area-SKG: 1117–6675 mm 2 ) and higher than those of neurological patients (velocity-CP: 16.8 ± 10.1 mm·s −1 , NP2: 1.3 ± 1.1, surface-SKG: 385.7 ± 436.9 mm 2 ; P < 0.05). Similar results were obtained with eyes closed. Several stabilometric parameters obtained in static conditions seem relevant to identify aphysiologic postural instability related to a voluntary overcontrol of postural sway, while allowing to distinguish such subjects from patients with postural instability of neurological origin.

Static and Dynamic Postural Changes after a Mountain Ultra-Marathon of 80 km and 5500 D.

The study aimed to investigate the effect of fatigue on static and dynamic postural stability after completing a mountain ultra-marathon. Twelve male athletes participated in the study. Postural stability was assessed before and immediately after the race. Static postural stability was evaluated on a dynamometric platform with eyes opened (OE) and closed (CE). Dynamic postural stability was assessed with OE on an instrumented plate which allowed medio-lateral oscillations. Stabilometric data were affected by fatigue in the OE condition, concerning sway path velocity (p = 0.0006), sway area velocity (p = 0.0006), area of the confidence ellipse (p = 0.0016), maximal anterior-posterior (AP) (p = 0.0017) and medio-lateral (ML) (p = 0.0039) oscillations. In the CE condition the sway path velocity (p = 0.0334), the maximal ML oscillations (p = 0.0161) and the area of the confident ellipse (p = 0.0180) were also negatively influenced. Stabilogram diffusion analysis showed in the OE condition an increase of short-term diffusion coefficients considering the anterior-posterior direction (Dfys; p = 0.0023) and the combination of the two (Dfr2s; p = 0.0032). Equally, long term diffusion coefficients increased considering the anterior-posterior direction (Dfyl; p = 0.0093) and the combination of the two (Dfr2l; p = 0.0086). In CE condition greater values were detected for medio-lateral direction (Dfxl; p = 0.033), anterior-posterior direction (Dfyl; p = 0.0459) and the combination of the two (Dfr2l; p = 0.0048). The dynamic postural stability test showed an increase of the time spent with the edges of the plate on the floor (p = 0.0152). Our results showed that mountain ultra-marathon altered static stability more than dynamic stability. An involvement of cognitive resources to monitor postural stability after fatiguing could be the explanation of the worsening in the automatic task (quiet standing) and of the positive compensation in the less automatic task (dynamic standing on the instrumented plate).

Craniomandibular System and Postural Balance after 3-Day Dry Immersion.

The objective of the study was to determine the influence of simulated microgravity by exposure to dry immersion on the craniomandibular system. Twelve healthy male volunteers participated in a 3-day dry immersion study. Before and immediately after exposure we measured maximal bite force using piezoresistive sensors. The mechanical properties of the jaw and cervical muscles were evaluated before, during, and after dry immersion using MyotonPRO. Because recent studies reported the effects of jaw motor activity on the postural stability of humans, stabilometric measurements of center of pressure were performed before and after dry immersion in two mandibular positions: rest position without jaw clenching, and intercuspidal position during voluntary teeth clenching. Results revealed no significant changes of maximal bite force after dry immersion. All postural parameters were significantly altered by dry immersion. There were however no significant differences in stabilometric data according to mandibular position. Moreover the masseter tonicity increased immediately after the end of dry immersion period. Dry immersion could be used as a valid model for studying the effects of microgravity on human subjects. However, 3 days appear insufficient in duration to evaluate the effects of weightlessness on maximal bite force. Our research suggests a link between postural disturbance after dry immersion and masseter tonicity.

Comparative Study Using Functional and Stabilometric Evaluation of Balance in Elderly Submitted to Conventional Physiotherapy and Wii-rehabilitation

Objective: To analyze and compare the benefits and advantages of using the Nintendo® WII console software and conventional physiotherapy for improving the balance in the elderly. Materials and methods: Sixteen elders, divided in 2 groups according to the received treatment (conventional physiotherapy or Wii-based rehabilitation), had their balance evaluated by 4 methods, by using the Berg balance scale, the functional reach, the “time up and go” test, and stabilometry. Results: Berg balance scale scores improved for the Wii-based rehabilitation group. Larger body displacement towards the frontal region was observed in the functional reach test for the participants treated with Wii-based rehabilitation. Decreased time for completing the “time up and go” test was observed for Wii-based rehabilitation. Stabilometric data revealed no significant differences between the two groups or between the different evaluations. Conclusions: We conclude that the Wii-based rehabilitation treatment was more effective in improving balance functional parameters than a more traditional physiotherapy protocol for older adults.

Immediate Effect of Bilateral Talocrural Joint Manipulation on Postural Balance in Healthy Subjects

The aim of this study was to assess the immediate effect of bilateral talocrural joint manipulation on the postural balance of healthy subjects. Ninety healthy subjects (21 males and 69 females) were included in this study. The mean age, height and body weight of the subjects were 22.21 years, 165.1 cm and 62.58 Kg, respectively. Following collection of anthropometric data, the subjects were allocated randomly into an experimental group (receiving real talocrural joint manipulation), a placebo group and a control group. Before and after manipulation, the subjects performed two postural balance tasks, inquiet standing position (eyes open and eyes closed) on a force platform. The stabilometric data were recorded for 60 seconds in each condition. Sway area, medio-lateral (ML) and anteroposterior (AP) velocities and median frequency were calculated from the center of pressure (COP) displacements. The results showed that in the experimental group the COP sway velocity decreased in both directions of movement (AP and ML) and in both visual tasks (eyes open and eyes closed). In general, the placebo and control groups had similar postural balance across balance parameterss. Significant effect of the bilateral talocrural joint manipulation was found on main balance parameter like COP velocity in the anteroposterior and mediolateral directions. These results have some much implications for manual therapy rehabilitation of individuals with ankle instability.

RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprain

Recent studies reveal the role of the ankle retinacula in proprioception and functional stability of the ankle, but there is no clear evidence of their role in the outcomes of ankle sprain. 25 patients with outcomes of ankle sprain were evaluated by MRI to analyze possible damage to the ankle retinacula. Patients with damage were subdivided into two groups: group A comprised cases with ankle retinacula damage only, and group B those also with anterior talofibular ligament rupture or bone marrow edema. Both groups were examined by VAS, CRTA and static posturography and underwent three treatments of deep connective tissue massage (Fascial Manipulation technique). All evaluations were repeated after the end of treatment and at 1, 3 and 6 months. At MRI, alteration of at least one of the ankle retinacula was evident in 21 subjects, and a further lesion was also identified in 7 subjects. After treatment, VAS and CRTA evaluations showed a statistically significant decrease in values with respect to those before treatment (p < 0.0001). There were also significant improvements (p < 0.05) in stabilometric platform results. No significant difference was found between groups A and B. The initial benefit was generally maintained at follow-up. The alteration of retinacula at MRI clearly corresponds to the proprioceptive damage revealed by static posturography and clinical examination. Treatment focused on the retinacula may improve clinical outcomes and stabilometric data.