Stance Tasks Research Articles

Non-Gaussian center-of-pressure velocity distribution during quiet stance

In the present study, we investigate patterns in the postural sway that characterize the static balance in human beings. To measure the postural sway, sixteen healthy young subjects performed quiet stance tasks providing the center-of-pressure (COP) trajectories. From these trajectories, we obtained the COP velocities. We verified that the velocity distributions exhibit non-normal behavior and can be approximated by generalized Gaussians with fat tails. We also discuss possible implications of modeling COP velocity by using generalized Fokker-Planck equations related to Tsallis statistics and Richardson anomalous diffusion.

Constant bandwidth server revisited

The Constant Bandwidth Server (CBS) is an algorithm for providing temporal protection and real-time guarantees to real-time sporadic tasks. Recently, an implementation of this algorithim called SCHED_DEADLINE has been included in the Linux kernel. Therefore, the CBS algorithm is now used to serve more generic tasks than do not obey to the classical sporadic task model. One important type of tasks which was not considered by the original CBS algorithm is the so called "self-suspending task model", where a task instance can suspend itself waiting for an external event. Even if the original algorithm is adapted so that the temporal protection property continues to hold, it is difficult for developers to provide guarantees and to select the most appropriate server parameters for such tasks. This paper investigates the problem of using the CBS algorithm for serving self-suspending tasks, by analysing it from a theoretical point of view and showing how to select the server parameters (budget and periods) for self-suspending tasks. Finally, the effectiveness of these proposals is shown through both simulations and real experiments on Linux / SCHED_DEADLINE.

Utilization-based admission control for aperiodic tasks under EDF scheduling

Utilization-based admission control policies for processors executing aperiodic tasks are often favored due to their low overhead. This paper investigates utilization-based admission control for uniprocessor systems executing aperiodic tasks following the earliest deadline first priority assignment. We first propose a new constant time utilization-based admission control policy, CTAC. We prove that CTAC is safe and will admit any task instance that can be admitted by the best existing utilization-based admission control policy, ASL, given the same processor state. We also introduce an optimal utilization-based admission control policy, OPAC. It is proved that given the same processor state, a newly arriving task instance that can be admitted by any other safe utilization-based admission control policy can also be admitted by OPAC. We also show that OPAC cannot be implemented in constant time. Simulation results show that CTAC indeed outperforms ASL with constant time complexity and achieves performance close to OPAC in terms of various metrics.

Inter-joint coordination strategies during unilateral stance 6-months following first-time lateral ankle sprain

BackgroundLongitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants, 6-months after they sustained an acute, first-time lateral ankle sprain in comparison to a control group. MethodsSixty-nine participants with a 6-month history of first-time lateral ankle sprain and 20 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-dimensional kinematic data for similarity in the aim of establishing patterns of lower-limb inter-joint coordination. The fractal dimension of the stance limb centre of pressure path was also calculated. FindingsBetween-group analyses revealed significant differences in stance limb inter-joint coordination strategies for conditions 1 and 2, and in the fractal dimension of the centre-of-pressure path for condition 2 only. Injured participants displayed increases in ankle–hip linked coordination compared to controls in condition 1 (sagittal/frontal plane: 0.15 [0.14] vs 0.06 [0.04]; η2=.19; sagittal/transverse plane: 0.14 [0.11] vs 0.09 [0.05]; η2=0.14) and condition 2 (sagittal/frontal plane: 0.15 [0.12] vs 0.08 [0.06]; η2=0.23), with an associated decrease in the fractal dimension of the centre-of-pressure path (injured limb: 1.23 [0.13] vs 1.36 [0.13]; η2=0.20). InterpretationParticipants with a 6-month history of first-time lateral ankle sprain exhibit a hip-dominant coordination strategy for static unilateral stance compared to non-injured controls.

Power spectral analysis of postural sway during foam posturography in patients with peripheral vestibular dysfunction.

To assess the frequency-domain characteristics of postural instability caused by peripheral vestibular dysfunction by performing a power spectral analysis of the center of pressure (COP) sway during foam posturography. Data were obtained from 78 patients and 163 controls. Two-legged stance tasks were performed in 4 conditions: eyes open with and without foam rubber, and eyes closed with and without foam rubber. We estimated the power spectrum of the acceleration signal using the maximum entropy method. The areas under the curve (AUCs) of power spectral density of the COP were calculated across low-frequency (0.02 to 0.1 Hz, LF-AUC), middle-frequency (0.1 to 1Hz, MF-AUC), and high-frequency (1 to 10 Hz, HF-AUC) ranges. We performed binomial logistic regression analyses to see whether the AUCs of selected bandwidths of COP have a stronger association with the presence of peripheral vestibular dysfunction in comparison with the velocity and area in the eyes closed/foam rubber condition. In both the controls and patients, the MF-AUC was significantly larger than the LF-AUC or HF-AUC in the eyes closed/foam rubber condition. In this condition, the presence of peripheral vestibular dysfunction had a significantly positive relationship with MF-AUC and HF-AUC (p < 0.05) and the MF-AUC of the anterior-posterior axis showed a stronger association with the presence of peripheral vestibular dysfunction than area. An increase in activity at middle frequency movements could be characteristic of peripheral vestibular dysfunction when standing on foam rubber with the eyes closed.

The effect of aging on the center-of-pressure power spectrum in foam posturography

To assess age-related frequency-domain characteristics of the sway of center of pressure (COP) in foam posturography, two-legged stance tasks were performed by 163 controls in 4 conditions: eyes open with and without foam rubber, and eyes closed with and without foam rubber. The areas under the curve (AUCs) of power spectral density of the COP were calculated across low frequency (≥0.02Hz and <0.1Hz, LF-AUC), middle frequency (≥0.1Hz and <1Hz, MF-AUC) and high frequency (≥1Hz and <10Hz, HF-AUC) ranges. We categorized the controls into 7 age groups and analyzed each AUC in the 4 conditions. MF- and HF-AUCs tended to show a difference between younger and older age-groups in all 4 conditions. Comparing the number of pairs in which a significant difference was shown, the condition with foam rubber, especially with eyes open, tended to highlight age-related changes. In the medial-lateral axis in the eyes open/foam rubber condition, the MF-AUC of the ≥ 75 years group was significantly larger than that of the 65–74 years group, and the MF-AUC of the 65–74 years group was significantly higher than that of the 55–64 years group, although there were no significant differences of MF-AUC among age groups under 54 years. In this condition, although HF-AUC did not change in groups over 35 years old, HF-AUC of each age group over 35 years old was significantly larger than that of the group under 24 years old. This result suggests that, in the medial-lateral axis in the eyes open/foam rubber condition, MF-AUC is specifically affected by age in late-middle-aged (ages 55–64) and older subjects, while HF-AUC is specifically affected by age in early-middle-aged (ages 35–44) subjects.

Assessment of postural stability in patients with cerebellar disease using gyroscope data

This study examines a relatively new method of studying and quantifying human postural stability in patients with degenerative cerebellar disease. Trunk sway and feet sway were measured during quiet stance. To test the method, ten patients and eleven healthy subjects performed two different stance tasks: standing with eyes open on a firm surface and standing with eyes closed on a foam support surface. Data were recorded using three body-worn gyroscopes (Xsens Technologies B.V.) to measure roll and pitch angular movements of the lower trunk, and left and right foot. The pitch versus roll plots of the trunk and feet were created, and the areas of the convex hull shapes were calculated. It was found that the area of the convex hull of the pitch versus roll plots is suitable for the identification of postural instability disorders caused by degenerative cerebellar disease.

Instance-Privacy Preserving Crowdsourcing

Crowdsourcing is a technique to outsource tasks to a number of workers. Although crowdsourcing has many advantages, it gives rise to the risk that sensitive information may be leaked, which has limited the spread of its popularity. Task instances (data workers receive to process tasks) often contain sensitive information, which can be extracted by workers. For example, in an audio transcription task, an audio file corresponds to an instance, and the content of the audio (e.g., the abstract of a meeting) can be sensitive information. In this paper, we propose a quantitative analysis framework for the instance privacy problem. The proposed framework supplies us performance measures of instance privacy preserving protocols. As a case study, we apply the proposed framework to an instance clipping protocol and analyze the properties of the protocol. The protocol preserves privacy by clipping instances to limit the amount of information workers obtain. The results show that the protocol can balance task performance and instance privacy preservation. They also show that the proposed measure is consistent with standard measures, which validates the proposed measure.

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control.

Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease.

A Discussion of Communication Schemes for Process Execution Histories to Enforce Entailment Constraints in Process-Driven SOAs

A distributed business process is executed in a distributed computing environment. In this context, the service-oriented architecture (SOA) paradigm provides a mature and well-understood framework for the integration of software services. Entailment constraints, such as mutual exclusion or binding constraints, are an important means to specify and enforce business processes in a SOA. Process engines control the process flow and are responsible for the coordination of the services that participate in a distributed business process. Since the enforcement of entailment constraints requires knowledge of the subjects and roles who executed particular task instances, we need to communicate the execution history of the respective tasks and processes between the services and the process engines. However, the inherent concurrency of a distributed system may lead to omission failures. Such failures may impair the enforcement of entailment constraints in a process-driven SOA. In particular, the impact of these failures as well as the corresponding countermeasures depend on the architecture of the respective process engine. In this paper, we discuss communication schemes for (distributed) process execution histories in a SOA. In particular, we provide generic procedures for different communication schemes and examine the efficiency of these schemes as well as their characteristics if omission failures occur. In this context, we especially consider if the respective process engine acts as an orchestration engine or as a choreography engine.

Efficiency Achievements From a User-Developed Real-Time Modifiable Clinical Information System

This investigation was initiated after the introduction of a new information system into the Nepean Hospital Emergency Department. A retrospective study determined that the problems introduced by the new system led to reduced efficiency of the clinical staff, demonstrated by deterioration in the emergency department's (ED's) performance. This article is an investigation of methods to improve the design and implementation of clinical information systems for an ED by using a process of clinical team-led design and a technology built on a radically new philosophy denoted as emergent clinical information systems. The specific objectives were to construct a system, the Nepean Emergency Department Information Management System (NEDIMS), using a combination of new design methods; determine whether it provided any reduction in time and click burden on the user in comparison to an enterprise proprietary system, Cerner FirstNet; and design and evaluate a model of the effect that any reduction had on patient throughput in the department. The methodology for conducting a direct comparison between the 2 systems used the 6 activity centers in the ED of clerking, triage, nursing assessments, fast track, acute care, and nurse unit manager. A quantitative study involved the 2 systems being measured for their efficiency on 17 tasks taken from the activity centers. A total of 332 task instances were measured for duration and number of mouse clicks in live usage on Cerner FirstNet and in reproduction of the same Cerner FirstNet work on NEDIMS as an off-line system. The results showed that NEDIMS is at least 41% more efficient than Cerner FirstNet (95% confidence interval 21.6% to 59.8%). In some cases, the NEDIMS tasks were remodeled to demonstrate the value of feedback to create improvements and the speed and economy of design revision in the emergent clinical information systems approach. The cost of the effort in remodeling the designs showed that the time spent on remodeling is recovered within a few days in time savings to clinicians. An analysis of the differences between Cerner FirstNet and NEDIMS for sequences of patient journeys showed an average difference of 127 seconds and 15.2 clicks. A simulation model of workflows for typical patient journeys for a normal daily attendance of 165 patients showed that NEDIMS saved 23.9 hours of staff time per day compared with Cerner FirstNet. The results of this investigation show that information systems that are designed by a clinical team using a technology that enables real-time adaptation provides much greater efficiency for the ED. Staff consider that a point-and-click user interface constantly interrupts their train of thought in a way that does not happen when writing on paper. This is partially overcome by the reduction of cognitive load that arises from minimizing the number of clicks to complete a task in the context of global versus local workflow optimization.

Quantification and reliability of center of pressure movement during balance tasks of varying difficulty

Postural control is often assessed by quantifying the magnitude of the center of pressure (COP) movement. However, these measures usually focus on the gross amount of movement and ignore the temporal structure of the COP signal. A novel non-linear analysis technique was recently developed to characterize the temporal structure of the COP signal with an output termed the entropic half-life [E(1/2)]. The E(1/2) reflects how much of the previous postural position is used to determine the current postural control strategy (memory effect). The purpose of this study was to quantify the E(1/2) and four COP movement magnitude measurements (medio-lateral and anterior–posterior excursion, path length, 95% ellipse area) for balance tasks increasing in sensory difficulty, as well as the test–retest reliability of each measure. Twenty-seven healthy young adults completed single limb stance tasks varying in sensory difficulty (rigid surface eyes open, rigid surface eyes closed, foam surface eyes open) on two separate occasions. Relative reliability was assessed using an intraclass correlation coefficient (ICC3,3). Absolute reliability was assessed using the standard error of the measurement (SEM) and the sensitivity of the measurement to true changes was assessed using the minimal detectable change (MDC95). The E(1/2) was found to have excellent reliability for all tasks tested (ICC range 0.82–0.91, SEM range 3.5–14.1mm, MCD95 range 9.7–39.2mm). The high reliability of the E(1/2) was comparable to that of movement magnitude measurements. This may be used in order to better understand the underlying motor control system.

Postural control strategies during single limb stance following acute lateral ankle sprain

BackgroundSingle-limb stance is maintained via the integration of visual, vestibular and somatosensory afferents. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. This investigation supplements kinetic analysis of eyes-open and eyes-closed single-limb stance tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain group to assess the adaptive capacity of the sensorimotor system to injury. MethodsSixty-six participants with first-time acute lateral ankle sprain completed a 20second eyes-open single-limb stance task on their injured and non-injured limbs (task 1). Twenty-three of these participants successfully completed the same 20second single-limb stance task with their eyes closed (task 2). A non-injured control group of 19 participants completed task 1, with 16 completing task 2. 3-dimensional kinematics of the hip, knee and ankle joints, as well as associated fractal dimension of the center-of-pressure path were determined for each limb during these tasks. FindingsBetween trial analyses revealed significant differences in stance limb kinematics and fractal dimension of the center-of-pressure path for task 2 only. The control group bilaterally assumed a position of greater hip flexion compared to injured participants on their side-matched “involved”(7.41 [6.1°] vs 1.44 [4.8]°; η2=.34) and “uninvolved” (9.59 [8.5°] vs 2.16 [5.6°]; η2=.31) limbs, with a greater fractal dimension of the center-of-pressure path (involved limb=1.39 [0.16°] vs 1.25 [0.14°]; uninvolved limb=1.37 [0.21°] vs 1.23 [0.14°]). InterpretationBilateral impairment in postural control strategies present following a first time acute lateral ankle sprain.

Neuromuscular fatigue alters postural control and sagittal plane hip biomechanics in active females with anterior cruciate ligament reconstruction.

Background:Females with history of anterior cruciate ligament (ACL) injury and subsequent ligament reconstruction are at high risk for future ACL injury. Fatigue may influence the increased risk of future injury in females by altering lower extremity biomechanics and postural control.Hypothesis:Fatigue will promote lower extremity biomechanics and postural control deficits associated with ACL injury.Study Design:Descriptive laboratory study.Methods:Fourteen physically active females with ACL reconstruction (mean age, 19.64 ± 1.5 years; mean height, 163.52 ± 6.18 cm; mean mass, 62.6 ± 13.97 kg) volunteered for this study. Postural control and lower extremity biomechanics were assessed in the surgical limb during single-leg balance and jump-landing tasks before and after a fatigue protocol. Main outcome measures were 3-dimensional hip and knee joint angles at initial contact, peak angles, joint angular displacements and peak net joint moments, anterior tibial shear force, and vertical ground reaction force during the first 50% of the loading phase of the jump-landing task. During the single-leg stance task, the main outcome measure was center of pressure sway speed.Results:Initial contact hip flexion angle decreased (t = −2.82, P = 0.01; prefatigue, 40.98° ± 9.79°; postfatigue, 36.75° ± 8.61°) from pre- to postfatigue. Hip flexion displacement (t = 2.23, P = 0.04; prefatigue, 45.19° ± 14.1°; postfatigue, 47.48° ± 14.21°) and center of pressure sway speed (t = 3.95, P < 0.05; prefatigue, 5.18 ± 0.96 cm/s; postfatigue, 6.20 ± 1.72 cm/s) increased from pre- to postfatigue. There was a trending increase in hip flexion moment (t = 2.14, P = 0.05; prefatigue, 1.66 ± 0.68 Nm/kg/m; postfatigue, 1.91 ± 0.62 Nm/kg/m) from pre- to postfatigue.Conclusion:Fatigue may induce lower extremity biomechanics and postural control deficits that may be associated with ACL injury in physically active females with ACL reconstruction.Clinical Relevance:Rehabilitation and maintenance programs should incorporate activities that aim to improve muscular endurance and improve the neuromuscular system’s tolerance to fatiguing exercise in efforts to maintain stability and safe landing technique during subsequent physical activity.

On environment difficulty and discriminating power

This paper presents a way to estimate the difficulty and discriminating power of any task instance. We focus on a very general setting for tasks: interactive (possibly multi-agent) environments where an agent acts upon observations and rewards. Instead of analysing the complexity of the environment, the state space or the actions that are performed by the agent, we analyse the performance of a population of agent policies against the task, leading to a distribution that is examined in terms of policy complexity. This distribution is then sliced by the algorithmic complexity of the policy and analysed through several diagrams and indicators. The notion of environment response curve is also introduced, by inverting the performance results into an ability scale. We apply all these concepts, diagrams and indicators to two illustrative problems: a class of agent-populated elementary cellular automata, showing how the difficulty and discriminating power may vary for several environments, and a multi-agent system, where agents can become predators or preys, and may need to coordinate. Finally, we discuss how these tools can be applied to characterise (interactive) tasks and (multi-agent) environments. These characterisations can then be used to get more insight about agent performance and to facilitate the development of adaptive tests for the evaluation of agent abilities.

Noisy vestibular stimulation improves body balance in bilateral vestibulopathy

To examine the effect of an imperceptible level of galvanic vestibular stimulation (GVS), delivered as zero-mean current noise (noisy GVS), on postural performance in healthy subjects as well as in patients with bilateral peripheral vestibular dysfunction. White noise GVS with an amplitude ranging from 0 to 1,000 μA was applied in 21 healthy subjects and 11 patients with bilateral vestibular dysfunction. Two-legged stance tasks were performed with the eyes closed during a 60-second period, which consisted of a baseline period without stimulation and a stimulation period with GVS. We examined 3 parameters: the velocity, the envelopment area, and the root mean square (RMS) of the center of pressure. White noise GVS improved all 3 parameters in 76% of healthy subjects. The amplitude of the optimal stimulus was 281 ± 40 μA, and it improved the velocity, area, and RMS by 18.4% ± 2%, 37.9% ± 3.5%, and 20.4% ± 2.2%, respectively (p < 0.01). The GVS improved all 3 parameters in 91% of patients. The amplitude of the optimal stimulus was 456 ± 82 μA, and it improved the velocity, area, and RMS by 29.4% ± 4.9%, 45.6% ± 4.7%, and 22% ± 3.3%, respectively (p < 0.01). Noisy GVS is effective in improving postural stability in healthy subjects as well as in patients with bilateral vestibular dysfunction. This study provides Class IV evidence that in patients with bilateral vestibular dysfunction, an imperceptible level of noisy GVS may improve postural stability.

A computational analysis of motor synergies by dynamic response decomposition

Analyses of experimental data acquired from humans and other vertebrates have suggested that motor commands may emerge from the combination of a limited set of modules. While many studies have focused on physiological aspects of this modularity, in this paper we propose an investigation of its theoretical foundations. We consider the problem of controlling a planar kinematic chain, and we restrict the admissible actuations to linear combinations of a small set of torque profiles (i.e., motor synergies). This scheme is equivalent to the time-varying synergy model, and it is formalized by means of the dynamic response decomposition (DRD). DRD is a general method to generate open-loop controllers for a dynamical system to solve desired tasks, and it can also be used to synthesize effective motor synergies. We show that a control architecture based on synergies can greatly reduce the dimensionality of the control problem, while keeping a good performance level. Our results suggest that in order to realize an effective and low-dimensional controller, synergies should embed features of both the desired tasks and the system dynamics. These characteristics can be achieved by defining synergies as solutions to a representative set of task instances. The required number of synergies increases with the complexity of the desired tasks. However, a possible strategy to keep the number of synergies low is to construct solutions to complex tasks by concatenating synergy-based actuations associated to simple point-to-point movements, with a limited loss of performance. Ultimately, this work supports the feasibility of controlling a non-linear dynamical systems by linear combinations of basic actuations, and illustrates the fundamental relationship between synergies, desired tasks and system dynamics.

The effect of prosthetic feedback on the strategies and synergies used by vestibular loss subjects to control stance

BackgroundThis study investigated changes in stance movement strategies and muscle synergies when bilateral peripheral vestibular loss (BVL) subjects are provided feedback of pelvis sway angle.MethodsSix BVL (all male) and 7 age-matched male healthy control (HC) subjects performed 3 stance tasks: standing feet hip width apart, eyes closed, on a firm and foam surface, and eyes open on foam. Pelvis and upper trunk movements were recorded in the roll and pitch planes. Surface EMG was recorded from pairs of antagonistic muscles at the lower leg, trunk and upper arm. Subjects were first assessed without feedback. Then, they received training with vibrotactile, auditory, and fall-warning visual feedback during stance tasks before being reassessed with feedback.ResultsFeedback reduced pelvis sway angle displacements to values of HCs for all tasks. Movement strategies were reduced in amplitude but not otherwise changed by feedback. These strategies were not different from those of HCs before or after use of feedback. Low frequency motion was in-phase and high frequency motion anti-phasic. Feedback reduced amplitudes of EMG, activity ratios (synergies) of antagonistic muscle pairs and slightly reduced baseline muscle activity.ConclusionsThis is the first study demonstrating how vestibular loss subjects achieve a reduction of sway during stance with prosthetic feedback. Unchanged movement strategies with reduced amplitudes are achieved with improved antagonistic muscle synergies. This study suggests that both body movement and muscle measures could be explored when choosing feedback variables, feedback location, and patient groups for prosthetic devices which reduce sway of those with a tendency to fall.

Idiopathic latent vestibulopathy: a clinical entity as a cause of chronic postural instability

The objective of this study is to describe a new clinical entity of idiopathic latent vestibulopathy (ILV), in which patients have unilateral or bilateral vestibulopathy combined with unsteadiness but without episodic vertigo, auditory disturbance, or a medical history suggesting the presence of vestibulopathy. A retrospective study of 1,233 consecutive new outpatients was conducted. Two-legged stance tasks were performed by 11 patients identified as having ILV in four conditions: eyes open with and without foam rubber, and eyes closed with and without foam rubber. We examined six parameters: the velocity of movement of the center of pressure (COP) with eyes closed/foam rubber, the envelopment area traced by the movement of the COP with eyes closed/foam rubber, Romberg's ratio of velocity and area with foam rubber, and the foam ratios of velocity and area with eyes closed. Multiple regression analyses were performed in order to explore the relationship between the presence of ILV and the six parameters recorded during foam posturography, while adjusting for the subjects' gender and age. The presence of ILV had a significantly positive relationship with the values of 4 of the 6 parameters. Even though six patients showed only unilateral vestibulopathy, their median value in all 6 parameters was greater than that of healthy controls. ILV could be a clinical entity accountable for postural instability.

The Impact of Vibrotactile Biofeedback on the Excessive Walking Sway and the Postural Control in Elderly.

Gait and postural control are important aspects of human movement and balance. Normal movement control in human is subject to change with aging. With aging, the nervous system comprising, somatosensory, visual senses, spatial orientation senses, and neuromuscular control degrade. As a result, the body movement control such as the lateral sway while walking is affected which has been shown to be a significant cause of falling among the elderly. Biofeedback has been investigated to assist elderly improve their body movement and postural ability, by supplementing the feedback to the nervous system. In this paper, we propose a wearable low-power sensor system capable of characterizing lateral sway and gait parameters. Then, it can provide corrective feedback to reduce excessive sway in real-time via vibratory feedback modules. Real-time and low-power characteristics along with wearability of our proposed system allow long-term continuous subjects' sway monitoring while giving direct feedback to enhance walking sway and prevent falling. It can also be used in the clinics as a tool for evaluating the risks of falls, and training users to better maintain their balance. The effectiveness of the biofeedback system was evaluated on 12 older adults as they performed gait and stance tasks with and without biofeedback. Significant improvement (p-value < 0.1) in sway angle in variance of the sway angle, variance of gait phases, and in postural control while on perturbed surface was detected when the proposed Sway Error Feedback System was used.