Sway Range Research Articles

Can Foot Orthoses Prevent Falls? A Proposal for a New Evaluation Protocol

Foot pain represents one of the most common symptoms in lower limb issues, especially in elderly individuals. This condition, often associated with other pathologies, increases the risk of falling. To better understand the risk of falls, it is essential to assess patients’ postural stability. In this pilot study, we aimed to set a protocol to prevent the falling risk. We propose the use of inertial sensors (IMUs) to detect even minimal body oscillations in a non-invasive, rapid, and cost-effective way. We have analyzed a sample of 35 patients (age = 58 ± 14 years, female = 20/male = 15) to investigate the total range of body sway in the anteroposterior (AP) and mediolateral (ML) directions during static balance in relation to their age and BMI. The analysis of the collected parameters (sway area, sway pathAP, and sway pathML) has showed a lower stability at t1, at the time of orthosis application, with respect to the previous condition, implied by the necessary period of adaptation to the new plantar device. In fact, the postural parameters have visibly improved at 30 days (t2). Comparing the results obtained in the different postural exercises, we have obtained significant differences between the natural standing position with eyes open and the others. According to these results, we can suppose that using inertial sensors associated to postural exercise is the best way to assess a patient’s postural stability and that the progressive improvements may be more marked over a longer period, such as six months (t3).

Static Posture Instability as a Sensitive Biomarker for Motor Abnormalities in Pre-ataxic Spinocerebellar Ataxia Type 3 Patients.

Spinocerebellar ataxia type 3 (SCA3) is a neurodegenerative disorder, with balance instability as a feature of the disease. Balance instability often manifests before the onset of obvious ataxic symptoms in patients. However, current clinical scales exhibit limited sensitivity in characterizing changes in pre-ataxic patients. Our research aims to identify appropriate postural characteristics for tracking motor changes in pre-ataxic patients with SCA3 over time. The posturographic platform assessed 102 participants (34 pre-ataxic SCA3 patients, 34 ataxic patients with SCA3, and 34 healthy controls) to measure their postural balance. Multivariate comparative analyses assessed the differential postural characteristics across the three groups. The Taiwanese formula was employed to estimate the age of onset for pre-ataxic patients. A Spearman's rho test was employed to assess correlations between postural characteristics and the time manifestation for pre-ataxic patients. Compared to the healthy control group, we observed significant abnormalities in the static posture of pre-ataxic patients (P < 0.01). Compared to the pre-ataxic group, ataxic patients have significant abnormalities in all variables (P < 0.05). The sway range standard deviation (SD), total sway area, and limits of stability were positively correlated with the estimated time to onset. The total sway area is more closely associated with time to manifestation, whereas the sway range SD in the medial-lateral direction of the center of foot pressure is the most sensitive indicator of postural instability in pre-ataxic patients. Static posture instability is a sensitive diagnostic parameter that may assist in capturing disease progression in the pre-ataxic stage of SCA3. © 2025 International Parkinson and Movement Disorder Society.

Research on the Mechanism of Spinal Stability Under Body Load

In modern society, the prevalence of musculoskeletal disorders and spinal problems has become increasingly concerning, particularly among students and working professionals who regularly carry heavy loads. The growing awareness of health issues related to load carrying has sparked significant research interest in this field. This study investigated the mechanisms of spinal stability under various loading conditions among college students. While backpacks are essential in daily life, their impact on spinal biomechanics and potential injury risks remains a concern. Twenty university students (10 males, 10 females) participated in this research examining the effects of different load magnitudes (0%, 5%, 10%, 20%, and 30% body weight) and carrying durations on spinal stability. Using three-dimensional motion capture, force platform measurements, and surface electromyography, we analyzed participants&amp;apos; postural control and muscle activity during both static stance and dynamic walking conditions at various gradients (0°, 5°, 10°, 20°). Results showed that loads exceeding 20% body weight caused significant alterations in spinal alignment, with forward lean angles increasing by 7-8 degrees at 30% body weight loading. During inclined walking, the combination of slope and load had multiplicative effects, with 30% body weight load at 20° slope resulting in approximately 10-12 degrees more spine forward flexion compared to level ground. Prolonged loading (60 minutes) led to a 30-35% increase in center of pressure sway range, indicating deteriorated postural control. EMG analysis revealed significant muscle fatigue, with erector spinae and multifidus muscles showing primary roles in maintaining spinal stability. Recovery of spinal stability parameters required approximately 30 minutes following heavy load carrying. These findings provide important guidance for establishing evidence-based recommendations for load carrying among college students and emphasize the need for appropriate rest periods and carrying techniques to maintain spinal health.

Investigating postural control as a predictor of low back and pelvic girdle pain during and after pregnancy

Falls are common during pregnancy, posing risks to maternal and fetal health. Pregnant individuals also commonly experience low back and/or pelvic girdle pain. Other populations with pain, such as older adults with back pain demonstrate increased fall risk. This study assessed the relationship between standing balance control characteristics during single leg stance and low back/pelvic girdle pain scores during and after pregnancy with eyes open and closed. We hypothesized that standing balance control characteristics of smaller sway and sway velocity would be related to greater low back/pelvic girdle pain during the third trimester. During the second trimester, third trimester, and postpartum nineteen individuals performed single leg stance on a force platform with eyes open and closed and completed the Quebec Back Pain Disability Scale. Stepwise multiple linear regressions were used to investigate the variance of Quebec Back Pain Disability Scale scores that could be explained by postural control variables for each time point and condition. During the third trimester, decreased total sway and anterior/posterior sway range with eyes closed were significantly associated with higher low back/pelvic girdle pain disability scores (P=0.005, R2=0.480). No significant relationships were found during the second trimester or postpartum nor for eyes open conditions. This study suggests a potential association between low back/pelvic girdle pain and postural control during pregnancy. Pregnant individuals with lumbopelvic pain may demonstrate postural stability deficits, particularly without visual input. Balance assessments and interventions should be considered during routine care for pregnant individuals, especially for those with pain.

Efficacy of shock wave therapy and ultrasound therapy in non-insertional Achilles tendinopathy: a randomised clinical trial.

Physiotherapists and physicians continue to seek effective conservative treatments for Achilles tendinopathy. This study aimed to subjectively and objectively determine the therapeutic efficacy of radial shock wave therapy (RSWT) and ultrasound therapy in non-insertional Achilles tendinopathy. Thirty-nine patients with non-insertional Achilles tendinopathy were randomly assigned to three experimental groups, i.e., RSWT (group A), ultrasound therapy (group B), and placebo ultrasound (group C) groups. Before the intervention and at weeks 1 and 6 after the treatment, the patients were assessed using the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire and posturographic measurements of step initiation performed on the force platforms under two different conditions (non-perturbed transit and perturbed transit). Six weeks after therapy, all groups exhibited significantly increased VISA-A scores against the measurement at week 1 after therapy. The post-therapy percentage changes in VISA-A scores were significantly greater in group A compared to group B. The three-way ANOVA demonstrated that treatment type affected sway range in the frontal plane and mean velocity of the centre of foot pressure displacements in the sagittal and frontal planes during quiet standing before step initiation. The Bonferroni post-hoc test showed that the means of all those variables were significantly smaller for group A than for group B patients. The three-way ANOVA revealed an effect of the platform arrangement on transit time and double-support period. The Bonferroni post-hoc test revealed statistically longer transit time for the perturbed vs. non-perturbed trials; a reverse relationship was observed for the double-support period. The VISA-A showed that RSWT was significantly more effective than sonotherapy for alleviation of pain intensity as well as function and activity improvement in patients with non-insertional Achilles tendinopathy. Therefore, RSWT therapy can be used in clinical practice by physiotherapists to alleviate the symptoms of non-insertional Achilles tendinopathy. Objective data registered by force platforms during quiet standing before and after step initiation did not prove useful for monitoring the progress of treatment applied to patients with non-insertional Achilles tendinopathy between consecutive therapy interventions.Clinical trial registration:https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617000860369, identifier (ACTRN12617000860369).

THE RELIABILITY AND VALIDITY OF THE BALANCE MAT

BACKGROUND Reliable and accurate postural sway assessment tools are important for monitoring the postural stability of individuals so that interventions can be evaluated, and balance ability is better assessed. The Balance Mat (PSI, ACT, Australia) is a new postural sway assessment device that is relatively cheap and highly portable, but it is yet to be scientifically validated and its reliability tested. Therefore, the aims of this project were to assess the test-retest reliability and validity of the Balance Mat (BM). METHODS Seventeen participants (age range 18 – 67) were recruited, and they performed nine balance tests. The reference method for obtaining balance measurements was the AMTI AccuSway-Optimized force platform (Advanced Mechanical Technology, Inc., MA, USA), which was placed below the BM so that force plate and BM data were collected simultaneously. Each participant performed two trials for each test, which were 20 seconds in duration each. From the BM software, the sway variance, mean sway distance, sway range, sway velocity, and sway path were obtained for each trial. From the force platform, the following centre of pressure (COP) measurements were obtained: standard deviation of the radial displacement of the COP; mean radial displacement of the COP; 95% confidence ellipse area; average velocity of the COP; and COP path length. Spearman’s rank-order correlation coefficient was used to test the validity and reliability of the BM. RESULTS For the comparison between BM and force plate data, correlation coefficients ranged from 0.63 to 0.79 (p&amp;lt;0.001). For the test-retest reliability analyses, correlation coefficients ranged from 0.77 to 0.85 (p&amp;lt;0.001) among the nine tests. CONCLUSIONS The strong to very strong positive correlations suggest that the BM is a valid and reliable tool for assessing postural sway.

Postural control and trunk stability on sway parameters in adults with and without chronic low back pain

BackgroundPostural sway changes often reflect functional impairments in adults with chronic low back pain (LBP). However, there is a gap in understanding how these individuals adapt their postural strategies to maintain stability.PurposeThis study investigated postural sway distance and velocity, utilizing the center of pressure (COP) and center of gravity (COG), between adults with and without LBP during repeated unilateral standing trials.MethodsTwenty-six subjects with LBP and 39 control subjects participated in the study. Postural sway ranges, COP/COG sways, and sway velocities (computed by dividing path length by time in anteroposterior (AP) and mediolateral (ML) directions over 10 s) were analyzed across three unilateral standing trials.ResultsA significant group interaction in sway range difference was observed following repeated trials (F = 5.90, p = 0.02). For COG sway range, significant group interactions were demonstrated in both directions (F = 4.28, p = 0.04) and repeated trials (F = 5.79, p = 0.02). The LBP group demonstrated reduced ML sway velocities in the first (5.21 ± 2.43 for the control group, 4.16 ± 2.33 for the LBP group; t = 1.72, p = 0.04) and second (4.87 ± 2.62 for the control group, 3.79 ± 2.22 for the LBP group; t = 1.73, p = 0.04) trials.ConclusionThe LBP group demonstrated decreased ML sway velocities to enhance trunk stability in the initial two trials. The COG results emphasized the potential use of trunk strategies in augmenting postural stability and optimizing neuromuscular control during unilateral standing.

Characteristics of static balance performance in 4-stage balance test in the healthy older adults

Background The 4-Stage Balance test is one of the most commonly used tests to assess balance for older adults. Although it is generally accepted that the four positions (including side-by-side (SBSS), semi-tandem (STS), tandem (TS), and single-leg stance (SLS)) in this test are progressively more difficult, there are no studies comparing the balance parameters of the four positions in older adults to prove this result. The purpose of this study is to determine the difficulty of 4 positions in the 4-Stage Balance test and the effect of the dominant and non-dominant lower extremities on static balance among healthy older adults. Methods A total of 115 community-dwelling healthy older adults were included. The postural parameters (including sway range standard deviation (SR), velocity of body sway (V), total sway area (TSA) and sway perimeter (TSP) of the center of pressure) were measured during 8 static postures (including SBSS, left STS, right STS, left TS, right TS, left SLS, right SLS and comfortable stance (CS)). Repeated measures ANOVA was used to analyze the postural parameters in 8 static postures. Results The static balance stability of the five stances in older adults can be ranked in the following sequence: CS > SBSS/STS > TS > SLS. Moreover, changing foot placement in STS, TS and SLS tasks has no influence on stability. This study has been registered in China Clinical Trial Registry (ChiCTR2200065803). Conclusions Our findings suggest that it is feasible to simplify the 4-Stage Balance test to a 3-Stage Balance test in the older adults.

Normalized stability time analysis within the boundaries between adults with and without fear of falling

BackgroundThe unilateral stance test, measured by the center of pressure (COP), has been widely used to identify balance deficits. However, there is a critical gap in understanding the specific COP thresholds on postural stability in adults with a fear of falling (FOF).AimsTo investigate the normalized stability time, which was defined as the ratio of time spent within stability boundaries to the total test duration, under different visual conditions and specific thresholds between adults with and without FOF.MethodsTwenty-one older adults with FOF and 22 control subjects completed the unilateral limb standing test in eyes-open and eyes-closed conditions. Normalized stability times were computed based on five pre-determined COP sway range thresholds: 10 mm, 15 mm, 20 mm, 25 mm, and 30 mm.ResultsReceiver operating characteristic analysis determined the diagnostic accuracy of FOF. There were significant differences in the effects of both visual conditions (F = 46.88, p = 0.001) and threshold settings (F = 119.38, p = 0.001) on stability time between groups. The FOF group significantly reduced normalized stability time at the 10 mm COP threshold under eyes-closed conditions (t = – 1.95, p = 0.03).DiscussionThe findings highlight the heightened sensitivity of the 10 mm COP threshold in identifying group variances in postural stability when eyes are closed. Moreover, the FOF group displayed a marked reduction in stability duration based on visual scenarios and normalized thresholds.ConclusionThe study highlights the need to account for both COP boundaries and visual conditions in adults with FOF. When assessing postural control during unilateral stances, clinicians must also give attention to non-visual cues.

C-STIM: Protocol for a randomized, single-blind, crossover study of cerebellar repetitive transcranial magnetic stimulation (rTMS) for postural instability in people with progressive supranuclear palsy (PSP)

Methods for modulating the cerebellum with transcranial magnetic stimulation (TMS) are well established, and preliminary data from our group and others has shown evidence of transient improvements in balance after cerebellar repetitive transcranial magnetic stimulation (rTMS) in progressive suprancuclear palsy (PSP). This study examines extensive posturography measures before and after 10 sessions of cerebellar rTMS and sham TMS in PSP. Thirty subjects with PSP and postural instability will undergo cerebellar active and sham rTMS in a single-blind, crossover design with a randomized order of a 10-day intervention. Primary outcomes will be changes in sway area and medio-lateral range of sway with eyes open while standing on a stationary force-plate, and safety, tolerability, and blindedness. Secondary outcomes will include posturography and gait analysis with body-worn, triaxial inertial sensors, clinical balance scales and questionnaires, and a bedside test of vestibular function. Exploratory outcomes are changes in functional near infrared spectroscopy (fNIRS) signal over the prefrontal, supplementary motor, and primary motor cortices while standing and walking, and speech samples for future analysis. The C-STIM crossover intervention study adds a longer duration of stimulation and extensive posturography measures to more finely measure the improvements in balance and exploratory functional near-infrared spectroscopy (fNIRS) over the prefronal, supplementary motor, and primary motor cortices during balance assessments before and after 10 sessions of cerebellar rTMS and 10 sessions of sham cerebellar TMS. This project will improve our understanding of the importance of the cerebellum for control of postural stability in PSP.

The relationship between cervical spine range of motion and postural sway in mechanical neck pain: A cross-sectional study.

Impairments in postural sway have been identified in people with mechanical neck pain. The influence of cervical spine range of motion (ROM) on postural sway is unclear in mechanical neck pain (MNP). This study investigated the relationship between cervical spine range of motion (ROM) and postural sway in MNP. The cervical ROM was measured using the Cervical Range of Motion (CROM) device. Standing postural sway characterised by mean centre of pressure (COP) measurements in the anterior posterior (AP) and medio-lateral direction with eyes closed and feet together condition was recorded on a posturography platform. Pearson product moment correlation coefficient was used to identify the relationship between cervical ROM and postural sway. Seventy-two MNP individuals (Mean age: ) of either sex (Male: ) were recruited. Overall, no statistically significant correlations were identified between cervical spine ROM in sagittal and frontal plane and postural sway (r values ranging from 0.00 to ; p-values ). However, a weak negative correlation was present between the cervical rotation and AP (r-; p-) and mediolateral (r-; p-) COP excursion. The cervical spine ROM was found to have a weak relationship with postural sway in individuals with MNP. This suggests the investigation of other mechanisms especially muscle tension which might be responsible for altered postural sway in MNP.

Postural balance ability and vertical jumping performance in female veteran volleyball athletes and non-athletes.

Lifetime participation in sports is associated with improved components of physical conditioning. The main purpose was to cross-sectionally investigate postural balance and vertical jumping performance in athletes with different histories of sports participation and secondarily to examine the restriction of vision on balance ability. A final aim was to investigate possible associations between balance and jumping performance. We hypothesized higher balance and jumping performance in active veteran volleyball athletes compared to retired athletes and non-athletes, suggesting a positive effect of continuous systematic training in active veteran athletes. We also hypothesized greater negative effect of vision removal on balance in the veteran compared to non-athletes due to athletes' stronger reliance on visual information. Eighty-one healthy middle-aged women (mean (standard deviation) 50 (5) years) were assigned to three experimental groups, a retired (n = 39, recreationally active former athletes), an active (n = 27, training 2days/week x 1.5 h/session) veteran volleyball athletes' and a control group (n = 15, sedentary participants). Participants completed an assessment of single-legged quiet stance trials with either left or right leg with eyes open while standing barefoot on a force plate and two-legged trials with both eyes open or closed. They also executed a protocol of countermovement jumps. Statistical analyses included univariate and full factorial ANOVAs with group and vision as fixed and repeated-measures factors and simple linear regression analysis. In the single-legged balance task, solely the mediolateral sway range was greater for the active (p < 0.001) and retired athletes (p < 0.001) compared to non-athletes, whereas in the two-legged stance, no differences among groups were found (p > 0.05). Restriction of vision deteriorated balance performance similarly in the three groups as a significant vision effect was found for path length (p < 0.001), anteroposterior (p < 0.001) and mediolateral sway (p < 0.05). The active and retired athletes had significantly (p < 0.001) greater height, mean and maximal power in countermovement jump compared to non-athletes. Results showed weak associations (average R2 = 9.5%) of balance with jumping performance only in the veteran volleyball athletes' group. Overall, the findings showed that retired volleyball athletes exhibited similar balance ability and vertical jumping performance as the active ones, suggesting a positive impact of prior experience in systematic training.

Characterization of Balance Control and Postural Stability in Patients With Alzheimer Disease.

Balance in Alzheimer disease (AD) patients is not rigorously understood. In this study, we characterize balance using qualitative [Berg Balance Scale (BBS)] and quantitative measures (posturography) and assess relationships between qualitative and quantitative balance measures in AD. Patients with mild-moderate AD (n=48) were recruited. BBS scores and posturography metrics, including medial-lateral sway range, anterior-posterior sway range, sway area, and sway velocity, were assessed in eyes-open and eyes-closed conditions. Adjusted linear regressions were used to assess relationships between posturography and BBS score. Mean BBS score was 50.4±5.3. In eyes-open conditions, posturography and BBS score were not significantly associated. In eyes-closed conditions, better BBS score was significantly associated with lower sway area (β=-0.91; P =0.006). Better scores of BBS items involving turning and reduced base of support were associated with greater eyes-closed sway area. Posturography in the more challenging eyes-closed condition may predict functional balance deficits in AD patients.

Immediate Effect of an Intervention Using a Head-mounted Display with a Modified Pitch Angle on Spatial Awareness and Standing Balance in Stroke Hemiparesis

This study aimed to clarify the effect of an intervention using a head-mounted display with a web camera set at a modified pitch angle on spatial awareness, sit-to-stand movement, and standing balance in patients with left and right hemisphere damage. The participants were 12 patients with right hemisphere damage and 12 patients with left hemisphere damage. The line bisection test, a sit-to-stand movement, and balance assessment were performed before and after the intervention. The intervention task involved pointing at targets 48 times in an upward bias condition. Significant upward deviation on the line bisection test was noted in patients with right hemisphere damage. The load on the forefoot during the sit-to-stand movement was significantly increased. The range of anterior-posterior sway during forward movement in the balance assessment was reduced. An adaptation task performed in an upward bias condition may produce an immediate effect on upward localization, sit-to-stand movement, and balance performance in patients with right hemisphere stroke.

Comparative Assessment of Gait and Balance in Patients with Parkinson's Disease and Normal Pressure Hydrocephalus.

We aim to compare balance and gait parameters in patients diagnosed with Parkinson's disease (PD) and normal pressure hydrocephalus (NPH). A total of 13 patients with NPH, 20 with PD, and 13 healthy controls (HC) recruited in the study. Three IMU sensors (Ambulatory PD Monitoring Inc., OR, USA) were placed on the lumbar area and the feet of the participants. The balance evaluations comprised eight successive standing tasks; the modified clinical test of sensory interaction on balance test. These tasks involved standing with feet apart and eyes open as well as eyes closed on a firm and foam surface, standing with feet together and eyes open as well as eyes closed, and tandem stance with the right foot front and the left foot front. Functional evaluations of gait were conducted using the 10-M Walk Test (10 MWT), the 2 min-Walk Test (2 MWT), and the timed-up and go (TUG). Parameters of the gait and balance were analyzed and then compared. NPH patients displayed a notable decrease in both stride length and gait speed as compared with both PD patients and healthy participants. The balance tests revealed that the NPH group demonstrated significantly poorer performance, specifically in the feet-apart eyes-closed foam-surface test, and the tandem stance test. During the tasks while eyes were open on firm and foam surfaces, PD and NPH groups showed an increase in root mean square sway, range, and mean velocity (p<0.05) of sway in the anteroposterior plane. In addition, during the TUG test, the NPH group exhibited a significant prolongation in the time needed to complete the task and a decline in turning velocity as compared to PD, but no notable difference was seen in comparison to the HC group. Our study indicated that the patients with NPH exhibited notably worse gait and balance measurements in comparison to both the PD patients and HC groups. These findings emphasize the significance of monitoring and managing gait and balance impairments in NPH patients. Sensor-based technologies may offer objective parameters for a more precise and efficient follow-up of these patients in terms of gait and balance.

Effect of virtual reality training on standing balance in individuals with incomplete spinal cord injury

Recovery of balance ability during standing is one of the primary and essential aims of rehabilitative programs in individuals with incomplete spinal cord injury (iSCI). A sample of ten participants (mean age: 35.7 years, range: 25-63 years) with traumatic or non-traumatic iSCI (AIS grade C or D) and were able to stand with or without the support of an assistive device for a minimum of 2 min were recruited from the rehabilitation department of the Indian Spinal Injuries Centre, New Delhi, India. The participants received Virtual Reality (VR) based balance training for one hour, three times a week for four weeks on the Nintendo Wii gaming console. Participants were assessed three times: pre-intervention, post-intervention and follow-up assessment for the total ellipse area (TEA), total sway perimeter (TSP), sway range (anterior-posterior/medio-lateral (AP/ML)) and limits of stability (LOS). At post-intervention assessment, significant increases in comparison with pre-intervention scores was found in LOS (P=0.00), TEA with eyes open (EO) (P=0.00) and eyes closed (EC) (P=0.00), TSP with EO (P=0.00) and EC (P=0.00), sway range in AP direction (SD-AP) with EO (P=0.01) and EC (P=0.02) and sway range in ML direction (SD-ML) with EO (P=0.02) and EC (P=0.01). At follow-up assessment, a significant improvement in comparison to post intervention scores was found in TEA measured both in EO (P=0.01) and EC conditions (P=0.02), TSP measured with EO (P=0.01) and SD-ML both with EO (P=0.04) and EC (P=0.01). No significant changes were found in LOS (P=0.89), TSP measured with EC (P=0.38) and SD-AP both with EO (P=0.50) and EC (P=1). However, significant improvement was seen on comparing follow-up assessment scores with pre-intervention scores for all variables, such as LOS (P=0.00), TEA in EO (P=0.00) and EC (P=0.00), TSP with EO (P=0.00) and EC (P=0.00), SD-AP with EO (P=0.01) and EC (P=0.02) and SD-ML with EO (P=0.01) and EC (P=0.00). VR-based balance training intervention was able to elicit improvements in balance ability and maintain it during follow-up despite a small training dosage suggesting that it is a promising intervention for standing balance rehabilitation among individuals with iSCI. The VR-based balance training challenges elements of balance, which physical therapists may want to consider when designing a comprehensive rehabilitation program. Clinical Trials Registry-India: CTRI/2018/12/016814.

Risk of falling in patients with unilateral discogenic sciatica

Background: Unilateral Discogenic Sciatica is low back pain radiating into one limb, in addition to one or more positive neurological signs. This pain may cause loss of function and reduce quality of life and working capability. Objective: This study was performed to assess the risk of falling in patients with unilateral discogenic sciatica. Methods: Sixty subjects participated in the study (30 patients with unilateral discogenic sciatica and 30 healthy controls). All participants undergone balance assessment using PROKIN system to evaluate static and dynamic balance. The risk of falling was evaluated via Berg Balance Scale (BBS). Results: There was significant improvement in static balance variable (sway range forward backward and mediolateral) and significant decrease in dynamic balance variable (limit of stability LOS) in the study group in comparison with the control group (P &lt;0.05). There was substantial positive correlation between BBS score and dynamic balance (LOS) in patients with unilateral discogenic sciatica, whereas, the correlation between BBS score and static balance (sway range forward backward and mediolateral) was non-significant. Conclusion: Sciatica affects both static as well as dynamic balance and so increases the risk of falling in patients with unilateral discogenic sciatica.

Acute effect of kinesio tape on postural control in individuals with functional ankle instability following ankle muscle fatigue.

Background: Kinesio taping (KT) is one of the therapeutic interventions in sports medicine practice. The study aims to assess the acute effect of different KT methods on postural control in individuals with functional ankle instability (FAI) after ankle muscle fatigue. Methods: Twenty-eight participants with FAI were recruited to complete maximum voluntary isometric contraction (MVIC) and proprioception of ankle using isokinetic dynamometer, dynamic postural control using Y-balance test and static postural control using a force platform after a fatigue protocol in four taping conditions: facilitatory KT (FKT), ankle balance taping (ABT), sham taping (ST) and no taping (NT). Results: No significant difference was observed for the data MVIC and proprioception after ankle muscle fatigue amongst the four taping treatments. A significant difference in Y-Balance Test was observed amongst the four taping treatments at posterolateral direction (p < 0.001) and posteromedial direction (p < 0.001), suggesting that KT may significantly improve dynamic postural control following ankle muscle fatigue. For Center of pressure (COP) measurements, the mediolateral COP sway range of NT was significantly larger than that of FKT (p = 0.003) and ST (p < 0.001), suggesting that the placebo effect of KT was inevitable. Conclusion: The effect of KT seems increased dynamic postural control in individuals with FAI after ankle muscle fatigue, and this effect is not strongly related to the taping methods. By preventing fatigue-related impairments of postural control, KT may help reduce the risk of injury in individuals with FAI.

39. Preliminary assessment of lumbar discectomy patient balance recovery: Is a force plate necessary or will a yard stick suffice?

<h3>BACKGROUND CONTEXT</h3> Lumbar disc herniations (LDH) cause significant deficits in health-related quality of life and can greatly impact physical activity level. Considering that balance ability has been shown to be negatively impacted by LDH, balance testing provides meaningful assessment of preoperative functional deficits and postoperative recovery. Objective assessment of balance can be done using both simple clinical tests or sophisticated equipment like force plates. Guidance is needed on whether force plate analysis is necessary to adequately assess LDH patient balance before and after treatment or if simpler tests suffice. <h3>PURPOSE</h3> Determine if the Y-Balance test (YBT) provides comparable assessment of LDH patient balance recovery to force plate analysis following lumbar discectomy. <h3>STUDY DESIGN/SETTING</h3> Preliminary analysis of a prospective, concurrent-cohort study at a single institution. <h3>PATIENT SAMPLE</h3> LDH patients undergoing lumbar discectomy and healthy (H) controls. <h3>OUTCOME MEASURES</h3> PROMs: VAS pain, ODI; Force plate center of pressure (COP) measures: sagittal (s) and coronal (c) range of sway (ROS) normalized to base of support, 95% sway ellipse area (SE), average sway velocity (AV); YBT reach distances. <h3>METHODS</h3> LDH patients were evaluated 4 times: before (P0), 2 weeks after (P2w), 6 weeks after (P6w) and 3 months after (P3m) surgery. Subjects completed patient-reported outcome measures (PROMs), a 60s standing balance test, and YBT. Standing balance measures included force plate COP measures. YBT measures forward (F), back-lateral (BL), and back-medial (BM) leg reach distances of the dominant leg normalized by leg length. <h3>RESULTS</h3> A total of 51 LDH (12F/39M, 45±12yr, 95±22kg, 1.8±0.1m, 30±7kg/m2) and 10 H (8F/2M, 34±18yr, 70±10kg, 1.7±0.1m, 25±3kg/m2) subjects were included. PROMs showed significant improvements (all p 0.05). LDH AVc (5.6±5.7m/s, p=0.998) and AVs (8.7±4.0m/s, p=0.612) were not significantly different than H (AVc=5.6±2.6m/s; AVs=8.0±3.6m/s) at P0 and remained so across all follow-ups (all p >0.05). All P0 LDH YBT distances (F=56.1±10.3%; BL=76.0±12.5%; BM=55.4±14.9%, all p <0.001) were shorter than H (F=71.5±11.2%; BL=95.1±9.6%; BM=87.0±7.7%). After surgery, all LDH YBT reach distances showed significant improvements at P2w (F=61.4±8.9%, p=0.027; BL=83.3±11.2%, p=0.013; BM=64.1±14.5%, p=0.015) and P6w (F=65.1±8.8%, p=0.001; BL=83.4±12.3%, p=0.032; BM=64.9±18.4%, p=0.032) relative to P0. All directions remained significantly shorter than H (all p <0.05) at all follow-ups, except F at P6w which normalized (p=0.069). <h3>CONCLUSIONS</h3> COP and YBT both found immediate improvements in balance following LDH surgery. YBT provides a comparable assessment of LDH patient balance recovery to force plate analysis and should be considered a viable alternative. Objective functional measures for LDH surgery provide important indicators of postoperative recovery and treatment outcome. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

32. An introductory investigation of postural balance strategy reliance using a novel force plate analysis technique among common degenerative spinal pathologies

<h3>BACKGROUND CONTEXT</h3> There has been growing interest in functional outcomes following surgical treatments for degenerative spinal pathologies (DSP). Objective functional measures provide unbiased metrics for assessing both patient's individual baseline functional deficits and postoperative recovery. Balance is a key component to assessment of spine treatment outcomes and has been objectively shown to improve postoperatively among many common DSP. There has, however, been a fundamental lack of understanding of exactly how DSP affects standing postural control and whether it is also impacted by surgical treatments. A novel technique was recently developed using a single force plate which provides direct assessment of balance control and quantifies balance strategy reliance but has yet to be applied to DSP. <h3>PURPOSE</h3> To provide preliminary data on balance strategy reliance among DSP using a novel force plate analysis and to compare to health (H) controls. <h3>STUDY DESIGN/SETTING</h3> Retrospective review at a single institution. <h3>PATIENT SAMPLE</h3> DSP patients 122 adult spinal deformity (ASD, 85F/36M, 61yr, 1.6m, 77kg), 81 degenerative lumbar spondylolisthesis (DLS, 51F/31M, 60yr, 1.7m, 81kg), 140 lumbar spinal stenosis (LSS, 40F/100M, 54yr, 1.7m, 92kg), 106 cervical spondylotic myelopathy (CSM, 58F/48M, 62yr, 1.7m, 82kg), and 61 H (37F/24M, 40yr, 1.7m, 72kg). <h3>OUTCOME MEASURES</h3> PROMs VAS pain, ODI/NDI; balance strategy reliance data. <h3>METHODS</h3> Subjects completed 60-second quiescent standing tests with eyes open and arms at their sides while on a force plate. Center of pressure (COP) range of sway (ROS) was used to assess baseline balance deficits. Balance strategy reliance was assessed using force intersection point (FIP) analysis which quantifies degree of balance activation by sway frequency ∼1.75Hz relates to knee and hip involvement at smaller amplitudes. FIP amplitude is reported as % height of the center of mass. <h3>RESULTS</h3> PROMs indicated DSP patients had severe VAS pain (Neck (CSM) 4.8, Back >6.0, Leg >4.0) and disability (ODI/NDI >40). DSP patients all exhibited significantly elevated ROS (mean coronal=31mm, mean sagittal=45mm) compared to H (18mm and 32mm respectively). ASD had significantly lower FIP at 3.5Hz (23%, p=0.003) and 4.0Hz (17%, p=0.029) compared to H (32% and 24%). DLS had significantly lower FIP at 3.0Hz (33%, p=0.036) than H (38%). LSS had significantly lower FIP in 3.5Hz (25%, 0.018), 4.0Hz (18%, p=0.030), and 4.5Hz (14%, p=0.005) than H (32%, 24%, 22% respectively). CSM had significantly lower FIP at 2.5Hz (49%, p=0.027), 3.0Hz (33%, p=0.011), and 4.5Hz (14%, p=0.003) than H (53%, 38%, and 22% respectively). Averages in low frequency FIPs tended to be greater than H and averages in high frequency FIPs tended to be less than H. <h3>CONCLUSIONS</h3> FIP provides novel insight into balance deficits among DSP patients which no method has previously quantified and negates issues associated with voluntary shifts in sway by providing simulatenous data across a range of relevant frequencies. Symptomatic DSP patients exhibited differences in balance strategy reliance compared to H with a general increase in low frequency, ankle-based reliance and a decrease in higher frequency, knee- and hip-based reliance. FIP analysis data is simple to implement clinically with a single force plate and may serve as a future screening tool for DSP screenings. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.