Unilateral Stance Test Research Articles

Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors.

Aim of the studyThere is little known about any change in postural balance caused by asymmetrical volume increase due to unilateral upper extremity lymphedema in patients who underwent breast surgery. The aim of this study was to determine whether there is a change in postural balance by measuring postural sway velocity (PSV), center of gravity (CoG) displacement and directional control (DCL) in patients with unilateral upper extremity lymphedema in breast cancer survivors.Material and methodsEighteen females 38–60 (M = 53) years old diagnosed with upper extremity lymphedema due to breast cancer surgery, and 18 healthy females with similar ages (M = 52.5) were assessed using the Balance Master system (Neuro Com, Clackamas, USA). Unilateral stance (US) and bilateral stance (BS) tests in eyes open and closed conditions and the limit of stability (LOS) test were applied to quantify postural sway velocity (PSV), CoG displacement, and directional control (DCL).ResultsThe lymphedema group showed a significant increase in PSV in the US test on the ipsilateral leg with eyes open (p = 0.02) and eyes closed (p = 0.005) as well as on the contralateral leg with eyes open (p = 0.004) and eyes closed (p = 0.0001). Average displacement and position of the CoG were 25% of LOS (p = 0.0001) towards the lymphedema side and 60.6 degrees respectively. DCL in the lymphedema group was significantly lower in forward (p = 0.0001), back (p = 0.003), ipsilateral (p = 0.002), and contralateral (p = 0.03) directions.ConclusionsThese findings suggest that unilateral upper extremity lymphedema may have challenging effects on postural balance.

Comparison of Balance Ability Between Patients With Type 2 Diabetes and With and Without Peripheral Neuropathy

(1) To examine the effects of peripheral neuropathy on balance stability in patients with type 2 diabetes, and (2) to assess static and dynamic balance and functional limitations. A cross-sectional study. Outpatient clinic. Subjects with type 2 diabetes and healthy subjects (n= 60) were divided into 3groups: subjects with diabetes and with established peripheral neuropathy (diabetic peripheral neuropathy [DPN] group) (n= 17), subjects with diabetes and without peripheral neuropathy (diabetic control group) (n= 25), and subjects without diabetes (nondiabetic control [NDC] group) (n= 18). Sensory impairment assessment, motor impairment assessment, and functional limitation assessment were assessed by using the Balance Master system. In motor impairment assessment, left-to-right directional control in the rhythmic weight shift was significantly poorer in the diabetic control group than in the NDC group during slow movement (P = .027). During fast movement, it was poorer in the DPN group than in theNDC group (P= .022). In the unilateral stance test of functional limitation assessment with both eyes open, the mean center of gravity sway velocity was significantly higher in the DPN group than in the NDC group (P= .011 for the left leg standing, P=.008 for the right leg standing) and higher in the DPN group than in the diabetic control group (P= .027 for the right leg standing). In the tandem walk test, walking speed was significantly lower in the DPN group than in the NDC group (P= .033), and end sway was significantly greater in the DPN group than in the NDC group (P= .020). Analysis of the results of this study suggest that functional limitations may occur more in the patients with diabetes and with peripheral neuropathy, and dynamic balance stability may decrease more with the patients with diabetes than with the subjects without diabetes. Further studies on balance rehabilitation that concern dynamic balance stabilities and exercise abilities are needed in patients with diabetes.

The effectiveness of a single session of Whole-Body Vibration in improving the balance and the strength in type 2 diabetic patients with mild to moderate degree of peripheral neuropathy: A pilot study

Peripheral neuropathy is a common complication of diabetes mellitus. Muscle strength and the balance deficits are seen in these patients. Whole-Body Vibration (WBV) is a time-efficient method which may be beneficial for them. The immediate effects of WBV on muscle strength and balance have not been studied yet. The aim of this study was to investigate the effects of one session of WBV on muscle strength and the balance of diabetic patients. Ten diabetic patients with peripheral neuropathy took part in this study. Outcome measurements were total strength, strength of tibialis anterior and quadriceps femoris muscles and the balance parameters including Unilateral Stance Test and Timed Up and Go Test. Tibialis anterior muscle strength and Timed Up and GO Test parameters showed significant differences post-exercise in comparison to baseline. A session of WBV had positive effects on muscle strength and the balance in patients with type-2 diabetes associated with neuropathy.

Differential Postural Control and Sensory Organization in Young Tennis Players and Taekwondo Practitioners

This study compared the sensory organization and standing balance of adolescent tennis players, taekwondo (TKD) practitioners, and healthy control participants. Sixty participants including 12 tennis players, 21 TKD practitioners, and 27 healthy control participants were tested. All of the participants underwent the Sensory Organization Test (SOT) and the Unilateral Stance Test (UST) on a Smart Equitest system. Results revealed that tennis players had higher SOT visual ratios than the control participants (p = .005), and TKD practitioners swayed more slowly in the UST than the control participants (p = .039). No differences (p > .05) were found in the composite score, somatosensory ratio, or vestibular ratio between the groups. Tennis players swayed less when they relied more on visual input to maintain balance, whereas TKD practitioners were more stable when standing on one leg. Parents may consider these sports as recreational activities for their children to develop specific balance abilities.

Static and dynamic postural control in low-vision and normal-vision adults

OBJECTIVE:This study aimed to evaluate the influence of reduced visual information on postural control by comparing low-vision and normal-vision adults in static and dynamic conditions.METHODS:Twenty-five low-vision subjects and twenty-five normal sighted adults were evaluated for static and dynamic balance using four protocols: 1) the Modified Clinical Test of Sensory Interaction on Balance on firm and foam surfaces with eyes opened and closed; 2) Unilateral Stance with eyes opened and closed; 3) Tandem Walk; and 4) Step Up/Over.RESULTS:The results showed that the low-vision group presented greater body sway compared with the normal vision during balance on a foam surface (p≤0.001), the Unilateral Stance test for both limbs (p≤0.001), and the Tandem Walk test. The low-vision group showed greater step width (p≤0.001) and slower gait speed (p≤0.004). In the Step Up/Over task, low-vision participants were more cautious in stepping up (right p≤0.005 and left p≤0.009) and in executing the movement (p≤0.001).CONCLUSION:These findings suggest that visual feedback is crucial for determining balance, especially for dynamic tasks and on foam surfaces. Low-vision individuals had worse postural stability than normal-vision adults in terms of dynamic tests and balance on foam surfaces.

Differential effect of Taekwondo training on knee muscle strength and reactive and static balance control in children with developmental coordination disorder: A randomized controlled trial

This randomized controlled trial aimed to investigate the effect of short-term intensive TKD training on the isokinetic knee muscle strength and reactive and static balance control of children with developmental coordination disorder (DCD). Among the 44 children with DCD (mean age: 7.6 ± 1.3 years) recruited, 21 were randomly assigned to undergo daily TKD training for 1h over three consecutive months, with the remaining 23 children being assigned to the DCD control group. Eighteen typically developing children (mean age: 7.2 ± 1.0 years) received no training as normal controls. Knee extensor and flexor muscle strength and reactive and static balance control were assessed using an isokinetic machine (with low, moderate and high movement velocities), a motor control test (MCT) and a unilateral stance test (UST), respectively. A repeated measures MANCOVA revealed a significant group through time interaction effect in isokinetic outcomes at 180°/s and in the UST outcome. Post hoc analysis demonstrated that DCD-TKD children's isokinetic knee muscle strength, specifically at 180°/s, was as high as that of the normal control children (p>0.0083) after TKD training. Moreover, UST body sway velocity was slower in the DCD-TKD group than in the DCD control group (p<0.001), and was comparable to that of the normal control group (p>0.05) after TKD training. However, no such improvement in balance was observed in the MCT (p>0.025). The results show that children with DCD who undergo a 3-month program of intensive TKD training experience improvements in isokinetic knee muscle strength at 180°/s and static single-leg standing balance control, but do not benefit from improved reactive balance control.

Taekwondo training improves sensory organization and balance control in children with developmental coordination disorder: A randomized controlled trial

Children with developmental coordination disorder (DCD) have poorer postural control and are more susceptible to falls and injuries than their healthy counterparts. Sports training may improve sensory organization and balance ability in this population. This study aimed to evaluate the effects of three months of Taekwondo (TKD) training on the sensory organization and standing balance of children with DCD. It is a randomized controlled trial. Forty-four children with DCD (mean age: 7.6±1.3 years) and 18 typically developing children (mean age: 7.2±1.0 years) participated in the study. Twenty-one children with DCD were randomly selected to undergo daily TKD training for three months (1 h per day). Twenty-three children with DCD and 18 typically developing children received no training as controls. Sensory organization and standing balance were evaluated using a sensory organization test (SOT) and unilateral stance test (UST), respectively. Repeated measures MANCOVA showed a significant group by time interaction effect. Post hoc analysis demonstrated that improvements in the vestibular ratio (p=0.003) and UST sway velocity (p=0.007) were significantly greater in the DCD-TKD group than in the DCD-control group. There was no significant difference in the average vestibular ratio or UST sway velocity between the DCD-TKD and normal-control group after three months of TKD training (p>0.05). No change was found in the somatosensory ratio after TKD training (p>0.05). Significant improvements in visual ratios, vestibular ratios, SOT composite scores and UST sway velocities were also observed in the DCD-TKD group after training (p≤0.01). Three months of daily TKD training can improve sensory organization and standing balance for children with DCD. Clinicians can suggest TKD as a therapeutic leisure activity for this population.

Postural stability decreases in elite young soccer players after a competitive soccer match

ObjectiveTo investigate the effects of an official soccer match on postural stability in youth elite soccer players. DesignSingle-group pre-post design. SettingCompetitive soccer match. ParticipantsTwenty elite U-19 male soccer players (mean age: 17.7 ± 1.0 years) of which 11 completed the full experimental set-up. Main outcome measuresPostural stability evaluated by unilateral stance tests for dominant and non-dominant lower limbs on a force plate under two visual conditions: eyes opened (EO) and eyes closed (EC). ResultsAfter the match, the centre of gravity (CoG) sway velocity with EO increased on the dominant and non-dominant limbs (median [interquartile range], 0.90°/s [0.60–1.10] vs. 1.10°/s [0.60–1.60]; and 0.70°/s [0.50–0.90] vs 1.00°/s [0.70–1.30]; respectively; p < 0.05). The CoG sway velocity with eyes closed did not change pre- to post-match. ConclusionsThe soccer match decreased the postural stability only when the assessment was conducted with eyes open.

Neck pain and postural balance among workers with high postural demands - a cross-sectional study

BackgroundNeck pain is related to impaired postural balance among patients and is highly prevalent among workers with high postural demands, for example, cleaners. We therefore hypothesised, that cleaners with neck pain suffer from postural dysfunction. This cross-sectional study tested if cleaners with neck pain have an impaired postural balance compared with cleaners without neck pain.MethodsPostural balance of 194 cleaners with (n = 85) and without (N = 109) neck pain was studied using three different tests. Success or failure to maintain the standing position for 30 s in unilateral stance was recorded. Participants were asked to stand on a force platform for 30 s in the Romberg position with eyes open and closed. The centre of pressure of the sway was calculated, and separated into a slow (rambling) and fast (trembling) component. Subsequently, the 95% confidence ellipse area (CEA) was calculated. Furthermore a perturbation test was performed.ResultsMore cleaners with neck pain (81%) failed the unilateral stance compared with cleaners without neck pain (61%) (p < 0.01). However, the risk of failure in unilateral stance was statistically elevated in cleaners with concurrent neck/low back pain compared to cleaners without neck/low back pain (p < 0.01), whereas pain at only neck or only low back did not increase the risk. Impaired postural balance, measured as CEA (p < 0.01), rambling (p < 0.05) and trembling (p < 0.05) was observed among cleaners with neck pain in comparison with cleaners without neck pain in the Romberg position with eyes closed, but not with eyes open.ConclusionsPostural balance is impaired among cleaners with neck pain and the current study suggests a particular role of the slow component of postural sway. Furthermore, the unilateral stance test is a simple test to illustrate functional impairment among cleaners with concurrent neck and low back pain.Trial registrationISRCTN96241850

Evaluation of Dynamic Posturography in Anterior Cruciate Ligament Injury Patients

Background: The incidence of the anterior cruciate ligament is high in the general population. Aim: To identify quantitative postural sway assessed by unilateral stance test using computerized dynamic posturography in unilateral anterior cruciate ligament injury patients and healthy individuals. Subjects and Methods: We studied 30 knees in 30 male patients suffering from chronic ACL injury and twenty five healthy individuals. There were selected from Al-Razi Orthopedics Hospital and Physical Medicine and Rehabilitation Hospital, Ministry of Health, Kuwait. All subjects were evaluated clinically and submitted to computerized dynamic posturography for the unilateral stance test. Mean COG (centre of gravity) sway velocity which displays COG stability was computerized assessed. Results: A significantly increase of means (± SD) of COG sway velocity on left or right leg standing with eyes open and eye closed in ACL group as compared to control group. Also, there was a significantly increase of means (± SD) of the percentage difference score of COG sway velocity during standing on left and right foot with eyes open and eyes closed in ACL group as compared to control group. Conclusion: The patients with chronic ACL injury had impairment in postural control and balance which can be quantitatively evaluated by using computerized dynamic posturegraphy.

Balance And Strength Changes Following Injury Prevention Protocol In Female Soccer Players

The prevention of sports injuries is characterised by a wide spectrum of approaches with multimodal programs most often advocated, evaluated based on epidemiology but typically failing to clarify which aspect of the intervention program contributed to the reduction in injury incidence. PURPOSE: To quantify the affects of a multimodal injury prevention program previously shown to reduce injury incidence. METHODS: Female collegiate soccer players (n=9) completed the F-MARC 11 injury prevention program in addition to their soccer training over a duration of 6 weeks, whilst an age and training-age matched control group (n=9) completed an equivalent amount of soccer training. Pre- and post-intervention, all players were assessed for isokinetic strength of the knee flexors and extensors in both concentric and eccentric mode at speeds of 1.05, 3.14 and 5.23 rad·s-1, and dynamic posturography using sensory organisation and unilateral sway tests. Between group comparisons were made using repeated measures ANOVA, with significance accepted at p≤0.05. RESULTS: Post-intervention, the F11 group displayed a significant increase in the somatosensory and vestibular contributions to balance during the sensory organisation test. The F11 group also displayed a significant post-intervention decrease in sway velocity during a unilateral stance test, for both eyes open and eyes closed conditions. No changes were observed for the control group. There was no change in peak concentric or eccentric torque for either knee flexors or extensors post-intervention, irrespective of movement speed. There was however a significant change in the angle of peak torque for eccentric knee flexors at the slowest test speed. The control group showed no changes in isokinetic parameters. CONCLUSION: The F11 injury prevention program created a change in the relative contributions to dynamic balance, with an increase in both the somatosensory and vestibular ratios, and no change in the visual ratio. Whilst peak torque was unaffected, there was evidence of a shift in the angle of peak eccentric hamstring torque at the slowest test speed post-intervention. Injury reduction might therefore be attributed to those exercises involving dynamic single-legged balance, enhancing movement control rather than maximal strength.

The Effect of Stretching on Muscle Responses and Postural Sway Responses During Computerized Dynamic Posturography in Women and Men

Lewis NL, Brismée JM, James CR, Sizer PS, Sawyer SF. The effect of stretching on muscle responses and postural sway responses during computerized dynamic posturography in women and men. Objective To evaluate the effect of stretching on the parameters of postural sway and on the kinematic variables associated with balance control in women and men. Design Mixed repeated measures design with 2 levels. Setting Research laboratory. Participants Fifteen women and fifteen men (mean age 23.4±2.2). Intervention Two separate sessions of (1) lower extremity stretching and (2) no-stretching, immediately prior to balance testing with simultaneous surface electromyographic (EMG) recordings of muscle responses. Main Outcome Measures EMG latencies and average amplitudes for 4 lower extremity muscles for the preferred stance limb during computerized dynamic posturography (CDP) tests, specifically the Postural Evoked Response Test, Adaptation Test, Motor Control Test, Sensory Organization Test, and Unilateral Stance Test. Results Analyses of variance indicated no significant main effect for stretching and 2 significant main effects for gender for the Motor Control Test ( P=.021) and latency of tibialis anterior ( P=.009). Analyses of covariance with covariants of height and active knee extension revealed no significant main effect of stretching or of gender on muscles responses or CDP performance. Conclusions In both women and men, lower extremity stretching did not significantly affect muscle responses or performance during CDP.

Evaluation of postural stability in patients wit unilateral vestibular hypofunction: effect of feet orientation

ObjectiveTo investigate effect of feet orientation on the evaluation of the postural stability in patients with unilateral vestibular hypofunction (UVH) by timed standing tests and static posturography (SPG). Methods65 subjects with UVH and 92 healthy subjects regarded as control group took the postural stability tests in four different stances including(1) standard Romberg test, (2) feet–apart stance test, (3) tandem and (4) unilateral standing tests. In each stance, the postural stability was measured in both eyes open (EO) and eyes closed (EC) conditions. The average time that subjects kept balance before falling in each test conditions was recorded by stopwatch as the timed result. In addition, the sway velocity (SV) of center of foot pressure in the upright stance during standard Romberg test and feet apart stance, regarded as postural stability, was also recorded as SPG. Results(1) The balance–maintaining time of the UVH group in tandem and unilateral standing with EO and EC was decreased(P<0.001) compared with the control group. (2) The SVs during standard Romberg test and foot–apart stance with EO were not different between the UVH group and control group (P = 0.118 and 0.110 respectively), but significant with EC condition (P < 0.001). (3) For both groups, the SV during foot–apart standing was shorter than standard Romberg test both with EO and EC(P<0.05 and P < 0.001). (4) There was no correlation between the balance time and SV for either groups (P >0.05). ConclusionsThe results suggest that the tandem and unilateral stance tests may provide additional information about the upright stance to the SPG measurement in patients with UVH. The effect of feet orientation on SPG measurements should be considered.

Comparison of postural control in unilateral stance between healthy controls and lumbar discectomy patients with and without pain

Previous studies have demonstrated that sciatica patients have poorer postural control than healthy controls and that postural control remains unchanged 3 months after lumbar discectomy in sciatica patients. The aims of the current study were to investigate whether static balance control recovers in pain-free discectomy patients long-term after lumbar discectomy. Next is to determine whether static balance responses of asymptomatic and symptomatic lumbar discectomy patients differed from each other and from healthy controls. In addition, the influence of the extent of disc resection (unilateral/bilateral removal) and the side of operation on static balance control were investigated. Fifteen pain-free lumbar discectomy patients, 23 lumbar discectomy patients with residual pain and 72 controls performed unilateral stance tasks with eyes open and eyes closed on a force plate were taken up for the investigation. Three repetitions of a 10 s unilateral stance test were performed on each leg. Postural sway was determined. Patients were divided into three age groups. In the eyes open condition, there was no significant difference between postural sway of pain-free lumbar discectomy patients and controls (P=0.68), whereas balance of patients with pain was significantly worse than in controls (P=0.003). In the eyes closed condition, the sway in both groups of lumbar discectomy patients was significantly worse than in controls (pain-free P=0.009/painful P<0.001). No significant differences were found in postural sway between patients with unilateral and bilateral disc resection. In unilateral stance on the leg of the operated side, centre of gravity sway was not significantly different in the eyes open condition compared to the eyes closed condition, whereas in stance on the leg of the non-operated side, postural sway was significantly lower in the eyes open condition compared to the eyes closed condition. In both conditions, postural sway in the age group of 50-65 years was significantly higher than in the age groups of 30-39 years (eyes open P=0.005; eyes closed P<0.001) and 40-49 years (eyes open P=0.002; eyes closed P=0.006). There was no significant difference between the age group of 30-39 years and the age group of 40-49 years (P=0.51). As for long-term following lumbar discectomy, there is no complete recovery of postural control. Patients seem to develop visual compensation mechanisms for underlying sensory-motor deficits, which are, however, sufficient in case of pain relief only. Further study is needed to determine the cause of the balance disturbances in lumbar discectomy patients.