Stabilometric Platform Research Articles

Comparison of upright balance in stroke, Parkinson and multiple sclerosis.

Multiple sclerosis (MS), Parkinson's disease (PD) and stroke (ST) subjects show balance impairments due to damage of the balance control system. The objective of the study was to assess the impact of MS, PD and ST on upright posture in eyes open condition and when visual and/or proprioceptive inputs are altered. A total of 188 subjects with MS (n = 80), PD (n = 58) and ST (n = 50), mean age (SD), 57.9 (14.6) years, and 32 healthy subjects (HS) aged 53.7 (15.7) years were assessed by a stabilometric platform in a cross-sectional study. Compared to HS, MS showed large deviations from normal performances with respect to magnitude (P < 0.001) and regularity (P < 0.05) of body sway irrespective of the altered sensory information. Similarly to MS, PD showed large and abnormal levels of body sway (P < 0.001) and postural tremor (P < 0.05), while ST was the least impaired except for an asymmetrical distribution of body weight between legs (P < 0.001). Finally, the MS group compared to PD and ST showed the largest body instability after eye closure (P < 0.05) and when visual and proprioceptive inputs were removed (P < 0.05). PD showed instability mainly after the alteration of proprioceptive inputs (P < 0.05), while ST showed the smallest increase of body instability when sensory inputs were reduced. Objective assessment revealed pathology-specific balance disorders and showed the differential impact of MS, PD and ST on the ability to use sensory information for balance control.

Trajectory length of pitch vs. roll: Technique for assessment of postural stability

Background: Patients with disorders of nervous or musculoskeletal system often show instability of the body segments during the stance tasks. Traditionally, stabilometric platforms are used to measure body sway. However, these devices are expensive and do not allow the evaluation of the individual movements of body segments. At present, accelerometers or gyroscopes are used to measure the movements of the body segments. For these new motion capture (MoCap) systems, methods for quantitative evaluation of a body segment movement are being developed. Objective: The main objective of this paper is to describe a new method which would be suitable for quantifying postural stability and identifying differences in balance control using data recorded by an inexpensive 2-DoF gyroscope. Methods: Method based on total length of trajectory (TL) in a 2-D plot of angles was proposed for quantitative evaluation of the trunk and feet sway. The sway was measured during quiet stance of ten middle-aged patients (Pts) with degenerative cerebellar disorder and eleven young healthy subjects (HS) standing with eyes open (EO) on a firm surface (FiS) and eyes closed (EC) on a foam surface (FoS). Data were obtained using three gyroscopes (Xsens) to measure roll and pitch angular movements of the trunk, and left and right foot. The pitch versus roll plots of the trunk and feet were created and the trajectory lengths of the pitch vs. roll angle were calculated. Results: Although the results vary while measuring different segments of the body, the method showed significant differences between the two different groups. Significant differences between the HS and Pts were found in EO standing on a FiS for TLs of the trunk (p = .02) and TLs of the feet (p < .01). Similarly in EC standing on a FoS significant differences (p < .01) between groups were found for TLs of both the trunk and the feet (p < .01). Conclusions: It was found that the TL of pitch vs. roll is suitable for quantifying postural sway and identifying differences in balance control. The technique, based on the length of the pitch angle vs. roll angle trajectory can be used even where MoCap systems can only measure two sway angles which could extend the clinical information of the body sway.

CROSS-EFFECTS OF ADAPTATION TO STRESS SITUATIONS

To counteract the stress it is necessary to study its effect on the internal condition of the body. The level of achievements in various sports and employments is determined by the exhaust motor programs that are improved in the process of trainings, ensuring the achievement of high results and reducing the mental and energy losses. Adaptation to short-term impacts of the stressor naturally leads to increased physiological capacity of the sympathetic-adrenal regulation. The recruitment of this regulatory system is an essential and absolute link of adaptation to the effects of environmental factors. It can be affirmed that adaptation to extreme situations increases the resistance not only to separate factors but to all factors affecting the body. Thus, adaptation has a positive cross-effect. We believe it is important to assess the possible impacts of the elaborated methodology on the development of the vestibular apparatus that includes cross-effects of adaptation to stress situations on the readiness of athletes. The article presents conclusions about the possibilities to improve the coordination abilities of athletes through targeted effect on their special preparedness by the original methods which intensify the effects of adaptation to stress situations. The changes were assessed based on the data obtained using a stabilometric platform.

CROSS-EFFECTS OF ADAPTATION TO STRESS SITUATIONS

To counteract the stress it is necessary to study its effect on the internal condition of the body. The level of achievements in various sports and employments is determined by the exhaust motor programs that are improved in the process of trainings, ensuring the achievement of high results and reducing the mental and energy losses. Adaptation to short-term impacts of the stressor naturally leads to increased physiological capacity of the sympathetic-adrenal regulation. The recruitment of this regulatory system is an essential and absolute link of adaptation to the effects of environmental factors. It can be affirmed that adaptation to extreme situations increases the resistance not only to separate factors but to all factors affecting the body. Thus, adaptation has a positive cross-effect. We believe it is important to assess the possible impacts of the elaborated methodology on the development of the vestibular apparatus that includes cross-effects of adaptation to stress situations on the readiness of athletes. The article presents conclusions about the possibilities to improve the coordination abilities of athletes through targeted effect on their special preparedness by the original methods which intensify the effects of adaptation to stress situations. The changes were assessed based on the data obtained using a stabilometric platform.

CROSS-EFFECTS OF ADAPTATION TO STRESS SITUATIONS

To counteract the stress it is necessary to study its effect on the internal condition of the body. The level of achievements in various sports and employments is determined by the exhaust motor programs that are improved in the process of trainings, ensuring the achievement of high results and reducing the mental and energy losses. Adaptation to short-term impacts of the stressor naturally leads to increased physiological capacity of the sympathetic-adrenal regulation. The recruitment of this regulatory system is an essential and absolute link of adaptation to the effects of environmental factors. It can be affirmed that adaptation to extreme situations increases the resistance not only to separate factors but to all factors affecting the body. Thus, adaptation has a positive cross-effect. We believe it is important to assess the possible impacts of the elaborated methodology on the development of the vestibular apparatus that includes cross-effects of adaptation to stress situations on the readiness of athletes. The article presents conclusions about the possibilities to improve the coordination abilities of athletes through targeted effect on their special preparedness by the original methods which intensify the effects of adaptation to stress situations. The changes were assessed based on the data obtained using a stabilometric platform.

ANALYSIS AFTER STABILOMETRIC PROPRIOCEPTIVE EXERCISES: A RANDOMIZED CONTROLLED CLINICAL STUDY

Objective: identify stabilometric changes before and after a program of proprioceptive training. Methods : a randomized controlled clinical trial was conducted with 18 subjects, mean age 20.6 ± 2.1 years of age, of both sexes, with a mean body mass index 23.3 ± 5.4 kg/m² that were evaluated in stabilometric platform before and after a program of proprioceptive training using the equipment and proprioceptive hard rocker, and divided into proprioception (n = 10) and control group (n = 8) group. The proprioceptive training consisted of 10 measures with one foot, knee in semiflexion for 30 seconds twice a week for five weeks using the rocker apparatus and proprioceptive disc. Results : D’Agostinotests were performed to test the normality, to which it was noted that the study sample was obtained normal behavior for both groups: proprioception and control, was used the Student t-test for observation the significance of p value (<0.05). At the end of the intervention subjects were reassessed at stabilometric platform on which it was observed that the proprioception group there was a significant reduction in body sway in relation to the control group (p = 0.002). Conclusion : the short time, with oneleg proprioceptive training has been shown to be effective for improving balance by reducing body sway.

Effect of participating in fitness classes on postural stability of young women

Summary Study aim: the aim of the study was to compare the postural stability and ability to control balance in active women who attend fitness classes versus inactive women. Material and methods: the study included 41 women who exercise regularly (mean age 28.64±5.26 years). The control group consisted of 42 women not engaged in regular physical activity (mean age 28.55±5.05 years). In each subject, postural stability testing was performed using the Stabilometric Platform CQStab2P (the 2-platform version). Authors analysed the mean, median and standard deviation for each parameter of the stabilogram and statokinesiogram. Results: for most of the studied parameters, the statistical analysis showed a positive effect of exercising on the level of fitness compared to the control group, for both the test with eyes open and the test with eyes closed. Conclusions: attending fitness classes significantly affects postural stability and balance control in young women, and leads to lesser dependence on sight to maintain it.

Influence of passive stiffness of hamstrings on postural stability.

The aim of the study was to explore whether passive stiffness of the hamstrings influences the strategy of maintaining postural stability. A sample of 50 subjects was selected; the final analyses were based on data of 41 individuals (33 men, 8 women) aged 21 to 29 (mean = 23.3, SD = 1.1) years. A quasi- experimental ex post facto design with repeated measures was used. Categories of independent variables were obtained directly prior to the measurement of the dependent variables. In stage one of the study, passive knee extension was measured in the supine position to assess hamstring stiffness. In stage two, the magnitude of postural sway in antero-posterior direction was measured, while varying the body position on a stabilometric platform, both with and without visual control. The margin of safety was used as a measure of postural control. The magnitude of the margin of safety increased significantly between the open-eye and closed-eye trials. However, although we registered a visible tendency for a larger increase of the margin of safety associated with lower levels of passive hamstrings stiffness, no significant differences were found. Therefore, this study demonstrated that hamstring stiffness did not influence the strategy used to maintain postural stability.

Clinical and stabilometric measures predicting falls in Parkinson disease/parkinsonisms.

Clinical predictors of falls in patients with Parkinson disease (PD) are fairly inaccurate. Stabilometric measures appear useful in investigating the relationship between balance, sensory disturbance, and falls. The aim of the study was to identify the best combination of clinical and stabilometric tests to predict falls prospectively. Fifty-three consecutive subjects with PD or parkinsonisms at risk of falls were included and followed for 6 months. Clinical variables were used as fall predictors: the Unified Parkinson Disease's Rating Scale (motor section) and the Longitudinal Aging study Amsterdam Physical Activity Questionnaire (LAPAQ). Variables from stabilometric platform underwent a principal component analysis. Multivariate logistic models were used to predict fallers using fall status (fallers: 1 + falls; recurrent fallers: 2 + falls) as dependent variable. Seven patients were lost to follow up, leaving 46 evaluable subjects. Of these, 32 (70%) were fallers and 22 (48%) were recurrent fallers. The only variable predicting fallers was the LAPAQ (odd ratio [OR] 0.99 (95% confidence interval [CI] 0.98-1.00); accuracy 71.7%; sensitivity 87.5%; specificity 35.7%). For recurrent fallers, Factor 2 (body sway velocity) (OR 2.37; 95% CI 1.01-5.58) and, in part, LAPAQ (OR 0.99; 95% CI 0.98-1.00) retained significance in the multivariate model, showing an accuracy of 76.9%, a sensitivity of 77.8%, and a specificity of 76.2%. A combination of clinical and instrumental tools is useful to identify fallers in PD or parkinsonisms. Body sway velocity and ability to perform the activities of daily living are the best predictors of recurrent falls.

Crossover versus Stabilometric Platform for the Treatment of Balance Dysfunction in Parkinson's Disease: A Randomized Study.

Balance dysfunctions are a major challenge in the treatment of Parkinson's disease (PD). Previous studies have shown that rehabilitation can play a role in their treatment. In this study, we have compared the efficacy of two different devices for balance training: stabilometric platform and crossover. We have enrolled 60 PD patients randomly assigned to two groups. The first one (stabilometric group) performed a 4-week cycle of balance training, using the stabilometric platform, whereas the second one (crossover group) performed a 4-week cycle of balance training, using the crossover. The outcome measures used were Unified Parkinson's Disease Rating Scale (UPDRS) part II, Berg Balance Scale (BBS), Timed Up and Go (TUG), and Six Minutes Walking Test (6MWT). Results showed that TUG, BBS, and UPDRS II improved in both groups. There was not difference in the efficacy of the two balance treatments. Patients in both groups improved also the meters walked in the 6MWT at the end of rehabilitation, but the improvement was better for patients performing crossover training. Our results show that the crossover and the stabilometric platform have the same effect on balance dysfunction of Parkinsonian patients, while crossover gets better results on the walking capacity.

Does Nordic walking improves the postural control and gait parameters of women between the age 65 and 74: a randomized trial.

[Purpose] To assess the effect of 12-weeks Nordic walking training on gait parameters and some elements of postural control. [Subjects and Methods] Sixty-seven women aged 65 to 74 years were enrolled in this study. The subjects were divided into a Nordic Walking group (12 weeks of Nordic walking training, 3 times a week for 75 minutes) and a control group. In both study groups, a set of functional tests were conducted at the beginning and at the end of the study: the Forward Reach Test (FRT) and the Upward Reach Test (URT) on a stabilometric platform, and the analysis of gait parameters on a treadmill. [Results] The NW group showed improvements in: the range of reach in the FRT test and the URT test in compared to the control group. The length of the gait cycle and gait cycle frequency also showed changes in the NW group compared to the control group. [Conclusion] A 12-week NW training program had a positive impact on selected gait parameters and may improve the postural control of women aged over 65 according to the results selected functional tests.

Do visually impaired people have a static balance as effective as sighted people?

Neuroplastic compensations are reported to improve static balance in visually impaired people (VIP). To compare the static balance of VIP with control sighted subjects in different conditions of proprioceptive disturbance. Thanks to a stabilometric platform, static balance was determined by measuring (1) the speed of displacement of the center of pressure of the subjects and (2) its total surface. Recordings on surfaces with (foam) or without (hard) proprioceptive disturbance were taken with both open and closed eyes. We compared 38 VIP to 36 control subjects. On hard surface, the speed of displacement was always higher in VIP than in control. On the foam surface, the speed was higher in VIP with open eyes while no difference was seen with closed eyes. The total surface of displacement was larger in VIP on the foam surface with open eyes while there was no difference either with closed eyes or on hard surface between VIP and control. Static balance with open eyes is more precarious in VIP than in control. Nevertheless, VIP subjects do as well as control sighted subjects with closed eyes as shown by similar total surface of displacement irrespective with the type of surface.

Original Rehabilitation Programme after Anatomical ACL Reconstruction Based on MRI Evaluated Graft Remodelling

Objectives:This study was carried out to design a rehabilitation program allowing for complete functional post-surgical recovery of the limb, that would not affect the remodelling process of the transplanted graft evaluated on MRI imaging. The main reason for changing the rehabilitation protocol was the 14 months of observation of the MRI images (a series of 9 MRIs performed over a two year period) among the patients after ACL reconstruction, in whom the adverse characteristics in remodelling of the graft were observed in line with the implementation of the traditional rehabilitation program.Methods:A 23 years old patient, a professional hi-rank skateboarder, took part in this pilot study. He had a torsion injury of the left knee joint. The main concepts of the rehabilitation program were: functional training in CKC that would involve muscles of the entire kinetic chain of the operated limb; the co-contraction training under the axial load, active extension training, the avoidance of static flexor stretching for at least 24 weeks after the surgery, no passive movements while exercising, the use of posterior translation of the tibia while doing the exercises, and no knee joint extensor strengthening activities in OKC for at least six months after the surgery. In order to evaluate the remodelling of the graft, seven oblique axial MR images (DOA) were taken, on which the graft’s cross-sectional area was measured. The MRI's were performed in the second, sixth, and twelfth week; then in the fourth, sixth, and ninth month, and, finally a year after the surgery. The angle of the graft and PCL was also measured. Additionally, the quality of tendon signal was assessed. For the functional evaluation, isokinetic and isometric tests of the knee extensor and the flexor muscles, along with the tibial rotator functions were performed using Humac Norm device. Postural stability based on COP parameter was established, as well, using the stabilometric platform HUR. For the dynamic stabilography assessment Biodex Balance System device was used. In order to indicate the subjective functional evaluation by the patient, the Lyshom scale and IKDC questionnaires were used.Results:The MRI 12 months after the surgery showed good tendon signal, and no significant changes characteristic for the anterior subluxation of the tibia were observed. In the functional evaluation, very good values of flexor and extensor muscle strength were recorded. These values were comparable to those achieved by the opposing limb. The strength of the left knee rotator muscles was comparable to that of the opposite limb. Additionally, very good stability index was recorded in both static and dynamic conditions. The results the two limbs were comparable. Patient’s subjective evaluation was also assessed to be on a very good level (the results of the IKDC questionnaires were 98,85 and 100/100 on the Lysholm’s scale).Conclusion:The original rehabilitation program in CMC seems to be a valuable protocol conditioning the return to sport activities without disrupting the the remodelling process of the graft. The case described is a part of a bigger project which includes the total of over 30 patients.

Influence of age on postural sway during different dual-task conditions.

Dual-task performance assessments of competing parallel tasks and postural outcomes are growing in importance for geriatricians, as it is associated with predicting fall risk in older adults. This study aims to evaluate the postural stability during different dual-task conditions including visual (SMBT), verbal (CBAT) and cognitive (MAT) tasks in comparison with the standard Romberg's open eyes position (OE). Furthermore, these conditions were investigated in a sample of young adults and a group of older healthy subjects to examine a potential interaction between type of secondary task and age status. To compare these groups across the four conditions, a within-between mixed model ANOVA was applied. Thus, a stabilometric platform has been used to measure center of pressure velocity (CoPV), sway area (SA), antero-posterior (AP) and medio-lateral (ML) oscillations as extents of postural sway. Tests of within-subjects effects indicated that different four conditions influenced the static balance for CoPV (p < 0.001), SA (p < 0.001). Post-hoc analyses indicated that CBAT task induced the worst balance condition on CoPV and resulted in significantly worse scores than OE (−11.4%; p < 0.05), SMBT (−17.8%; p < 0.01) and MAT (−17.8%; p < 0.01) conditions; the largest SA was found in OE, and it was statistically larger than SMBT (−27.0%; p < 0.01) and MAT (−23.1%; p < 0.01). The between-subjects analysis indicated a general lower balance control in the group of elderly subjects (CoPV p < 0.001, SA p < 0.002), while, the mixed model ANOVA did not detect any interaction effect between types of secondary task and groups in any parameters (CoPV p = 0.154, SA p = 0.125). Postural sway during dual-task assessments was also found to decrease with advancing age, however, no interactions between aging and types of secondary tasks were found. Overall, these results indicated that the secondary task which most influenced the length of sway path, as measured by postural stability was a simple verbal assignment.

Effect of muscle weakness distribution on balance in neuromuscular disease.

To assess balance and identify the effects of muscle weakness distribution on balance in children with different neuromuscular diseases. Forty ambulant, pediatric patients with neuromuscular disease were enrolled in the study. Patients were separated into two groups according to muscle weakness distribution as group 1 (proximal) and group 2 (distal). Demographic data were recorded. Functional level (Brooke lower extremity functional classification), muscular strength (manual muscle testing), balance (pediatric functional reach test [PFRT], timed up-and-go test [TUGT], stabilometric platform) and functional performance (6 min walk test [6MWT]) were assessed. Group 1 consisted of 20 Duchenne muscular dystrophy patients, and group 2, of 20 neuropathy patients. The total lower, upper limbs and trunk muscles muscle strength (P < 0.05); forward and right side reach subsections of the sitting position, and PFRT total score (P < 0.01) were significantly different between the groups. TUGT results were 7.79 ± 1.54 s and 10.13 ± 2.63 s, respectively, in group 1 and 2 (z = -2950; P < 0.01). No statistically significant difference between groups in any performance parameters of the 6MWT was found (P ≥ 0.05). Anterior body balance was found to be dominant in group 1, while posterior body balance was dominant in group 2 (P ≤ 0.05) measured by stabilometric platform. The distal group was particularly affected regarding dynamic balance, and the proximal group regarding static balance. Muscle strength was important for providing dynamic stability in the distal group, and for maintaining proximal stabilization during dynamic activities in the proximal group.

The effect of dual-task functional exercises on postural balance in adolescents with intellectual disability – a preliminary report

Purpose: The study aimed to assess the effectiveness of an original intervention programme of unstable surface dual-task functional exercises on postural stability in adolescents with intellectual disability (ID). Methods: A total of 34 adolescents with ID, aged 14–16 years, were engaged in our study. A 17-person experimental group (E) took part in a 12-week intervention programme which consisted of unstable surface functional exercises, designed after activities of daily living (ADLs). Another group of 17 youngsters constituted a control group (C). Within a span of 12 weeks, the postural stability assessment was conducted twice in both groups, employing a stabilometric platform ALFA AC International East. Results: After taking part in the intervention programme, the experimental group (E) improved all their scores (p < 0.05). The path length of the COG and the time in which the dynamic test was performed were shorter in the experimental group (E), while the control group (C) scored worse in comparison with their initial results. Conclusions: A distinctly positive effect of unstable-surface dual-task functional exercises on postural stability in individuals with ID was also revealed in our tests.Implications for RehabilitationRehabilitation of intellectually disabled persons should be carried out individually and contain ADL-based exercises.The use of unstable surfaces, making the above training more difficult, naturally stimulates the trainee to focus more closely on the task being performed.Implementation of dual-task exercises, consisting in compiling functional tasks with balance training, in the intervention programme for adolescents with ID is likely to improve efficiency of their everyday living and the quality of their lives.

A low-cost real time virtual system for postural stability assessment at home

Background and objectiveThe degeneration of the balance control system in the elderly and in many pathologies requires measuring the equilibrium conditions very often. In clinical practice, equilibrium control is commonly evaluated by using a force platform (stabilometric platform) in a clinical environment.In this paper, we demonstrate how a simple movement analysis system, based on a 3D video camera and a 3D real time model reconstruction of the human body, can be used to collect information usually recorded by a physical stabilometric platform. MethodsThe algorithm used to reconstruct the human body model as a set of spheres is described and discussed. Moreover, experimental measurements and comparisons with data collected by a physical stabilometric platform are also reported. The measurements were collected on a set of 6 healthy subjects to whom a change in equilibrium condition was stimulated by performing an equilibrium task. ResultsThe experimental results showed that more than 95% of data collected by the proposed method were not significantly different from those collected by the classic platform, thus confirming the usefulness of the proposed system. ConclusionsThe proposed virtual balance assessment system can be implemented at low cost (about 500$) and, for this reason, can be considered a home use medical device. On the contrary, astabilometric platform has a cost of about 10,000$ and requires periodical calibration. The proposed system does not require periodical calibration, as is necessary for stabilometric force platforms, and it is easy to use. In future, the proposed system with little integration can be used, besides being an emulator of a stabilometric platform, also to recognize and track, in real time, head, legs, arms and trunk, that is to collect information actually obtained by sophisticated optoelectronic systems.

Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: a randomized controlled pilot study

Objective: Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson’s disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy. Design: A randomized single-blind controlled trial. Setting: Outpatients. Subjects: Thirty-four patients with Parkinson’s disease in Hoehn-Yahr stage 2.5–3. Intervention: Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months). Main measures: The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson’s Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson’s Disease Questionnaire-39. Results: Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change: 45.4 SD64.9 vs. 6.9 SD45.3, p = 0.05), Berg Balance Scale (51.2 SD3.1 vs. 6.0 SD3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD10.6 vs. 4.1 SD5.4, p = 0.0001), Falls Efficacy Scale (−5.9 SD4.8 vs. −1.9 SD1.4, p = 0.003), Parkinson’s Disease Quetionnaire-39 (−18.4 SD12.9 vs. −8.0 SD7.0, p = 0.006) and falls diary (−2.4 SD2.2 vs. −0.4 SD0.5, p = 0.001). Conclusion: Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease.

Somatosensory inputs by application of KinesioTaping: effects on spasticity, balance, and gait in chronic spinal cord injury.

Introduction: Leg paralysis, spasticity, reduced interlimb coordination, and impaired balance are the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI). In recent years, the application of KinesioTaping (KT) has been proposed to enhance sensory inputs, decreasing spasticity by proprioception feedback and relieving abnormal muscle tension. Because no studies have examined KT-based techniques in SCI subjects, our goal was to analyze the effects of ankle joint KT on spasticity, balance, and gait.Materials and Methods: A randomized crossover case control design was used to compare the effects of KT and conventional nonelastic silk tape (ST) in 11 chronic SCI subjects, AIS level D, with soleus/gastrocnemius (S/G) muscle spasticity and balance and gait impairments. Treatment: 48 h of treatment with KT or ST was followed by 48 h with the other technique after 1 week. A single Y-strip of Cure© tape (KT) and ST was to the S and G muscles with 0% stretch. Before and 48 h after of application of KT and ST, clinical data on the range of motion (ROM), spasticity, clonus, pain, balance, and gait were collected. Stabilometric platform assessment of center of pressure (COP) movements; bidimensional gait analysis; and recording of electromyographic (EMG) activity of the S, G, and tibialis anterior and extensor hallucis lungus muscles were also performed.Results: Only KT had significant effects on spasticity (p < 0.05), clonus (p < 0.001) and COP movements (p < 0.05), kinematic gait parameters (p < 0.001), and EMG activity (p < 0.001). Comparison between ST and KT improvements pointed out significant differences as concerns ROM (p < 0.001), spasticity (p < 0.001), clonus (p < 0.001), pain (p < 0.001), COP parameters (p < 0.05), and most kinematic gait data (p < 0.05).Discussion: Short-term application of KT reduces spasticity and pain and improves balance and gait in chronic SCI subjects. Although these data are promising, they require confirmation in a larger cohort of patients.

Reliability, validity, and effectiveness of center of pressure parameters in assessing stabilometric platform in subjects with incomplete spinal cord injury: a serial cross-sectional study

BackgroundSpinal cord injury (SCI) can damage long tracts, affecting postural stability. Impairments in balance have recently been proposed to be highly predictive of functional recovery in patients with SCI and thus merit evaluation. In addition to common observational clinical scales, more objective evaluation methods of balance can be implemented by analyzing center of pressure (COP) parameters using stabilometric platforms (SPs). COP analysis has been used in various pathologies, but the COP parameters with regard to measurement vary, depending on the features of the target population, and have only been assessed in healthy subjects. Specifically, concerning subjects with SCI, few studies have reported COP parameters, and none has addressed the reliability, validity, or responsiveness of this measure. The objective of this serial cross-sectional study was to analyze the reliability, validity, and responsiveness of COP parameters under various conditions in incomplete SCI subjects to assess balance.MethodsTwenty-three patients with incomplete SCI were examined 111 times for 1 year. Each session comprised administration of the Berg Balance scale, Tinetti scale, and WISCI scale and evaluation of stabilometric platform use. Stabilometry was performed under various sensory conditions (OF: open feet; CF: closed feet; OE: open eyes; CE: closed eyes), wherein several COP parameters were analyzed (L: COP path length; V: mean COP velocity, VAP: anteroposterior COP velocity; VLL: laterolateral COP velocity, A: COP ellipse area, SA1: x-axis of COP ellipse area; SA2: y-axis of COP ellipse area). The reliability, validity, and responsiveness of COP parameters that were associated with visual/support area conditions were analyzed.ResultsOf the COP parameters, V and arithmetically related measures had the highest reliability, validity, and effectiveness scores. Of all test conditions, OE-OF was the most valid, whereas CE-OF was the most responsive.ConclusionThe assessment of balance in SCI subjects can be reliable, valid, and effective in acquiring V data, based on OF-OE and OF-CE conditions and heel distance values.