Purpose : The purpose of this study was to investigate the usefulness of clinical balance tests through the correlation of balance evaluation using by forceplate in elderly. Methods : Thirty nine healthy elderly subjects (14 males, 25 females) participated in the study. The subjects were evaluated with clinical balance tests [(Berg balance scale (BBS), Functional reach test (FRT), Tinetti's performance oriented mobility assessment (POMA), and one leg standing (OLS)]. Static balance evaluation was assessed by using forceplate. Center of pressure (COP) parameters were obtained using it as total path distance, total sway area, X mean frequency and Y mean frequency for 20 seconds in the following conditions: (1) comfortable standing with eyes opened and closed, (2) uncomfortable standing with eyes opened and closed. After static balance evaluation tested, dynamic balance evaluation was assessed. COP parameters were error distance and area during sine curve trace. COP parameters were movement time, error distance, and maintained time in the circle during COP movement task. Results : Clinical balance tests showed statistically significant correlation between static and dynamic balance evaluations. Among the clinical balance tests, the BBS, POMA, and OLS showed significant correlation with to assess the balance ability of elderly in clinical setting both evaluations. Conclusion : Clinical balance tests can be recommended in clinical setting because of low costs and simplicity.
Purpose : Patients with Parkionson's disease have a temporal and spatial restriction for their's exercise treatment. The aim of this study is to verify the effectiveness of e-exercise program on balance, gait, and endurance ability in people with Parkinson's disease. Methods : Eighteen participants, with Parkinson's disease that ranged from stage to on the Hoehn & Yahr scale, were assigned to two group. Two group were divided into on-line group that exercised in home by computer video, and off-line group that exercised in clinical center. Exercise program that included 3 sections (warm-up, main exercise, cool down)-5 parts(stretch, strength, balance, gait, stretch) was used to train for participants. We used the functional reach test for balance ability, timed up and go test for gait ability, 6 minute walking test for endurance ability. Wilkoxon sign lank tests were used to assess the difference of balance, gait, and endurance ability in pre-and post test each groups. Mann-whitney tests were used to assess the difference of balance, gait, and endurance ability between groups. Results : Wilkoxon sign lank tests revealed that both group were improved the balance, gait and endurance agility by e-exercise program intervention. Mann-whitney tests showed that there were no differences between groups in the variation of balance, gait, endurance ability. Conclusion : We believe that exercise program with on-line(e-exercise program) is an effective intervention for people with Parkinson's disease and is no different than off-line exercise group in the variation of balance, gait, endurance ability.
Purpose: The purpose of study was to measure stroke patients' ability to balance and their degrees of clinical function and to examine the effect of the aquatic exercise method using tasks related to these features. Methods: Twenty stroke patients were randomly assigned to an aquatic task exercise group and a land task exercise group. Both groups used the same exercise method for 60 minutes each session, three times a week for 12 weeks at the same time point and with the same amount of exercise. Results: Before and after the exercise, static balance was measured using balance measuring instruments locomotive faculties, muscular strength, and dynamic balance were assessed through the Berg balance and 10 m gait tests. Finally, gait abilities were measured, and the data obtained were analyzed to generate the results. Conclusion: Both groups showed significant improvement, but the aquatic exercise group showed slightly more significant results in static balance, Berg balance, and upright walking tests. It is thought that the improvement of stroke patients' balance and gait ability can be triggered through the application of aquatic exercise programs in the future.
Purpose: This study examined the difference in the static balance ability according to the visual cues and postural tasks in normal subjects. Methods: Thirty participants (12 male, 18 female; mean age $24.63\pm1.43$ years) stood barefoot on a force platform in a one-legged stance, tandem Romberg stance and tandem Romberg with neck extension stance with a visual cue open and closes. The static balance was assessed by the center of pressure (CoP), surface electromyography root mean square (RMS) of the leg muscles according to the stance position. Results: In the CoP tests, the difference in the unit path length and circumference area was affected by the visual cue according to the stance posture (p<0.01). In the RMS tests, the difference in the tibialis anterior and medial gastrocnemius muscle was affected by visual cue in accordance with the stance posture (p<0.01). Conclusion: The visual cue and postural task affect the balance ability in normal subjects. Therefore, this study provides clinical evidence that the balance and postural control can be improved. Therapeutic intervention, such as an obstacle course, and a lower leg muscle performance program with a change in the base of support can affect the balance and postural control.
Objective: The Star Excursion Balance Test (SEBT) and Y-Balance Test (YBT) have been commonly applied to measure dynamic postural stability ability. These two tests are utilized interchangeably in various settings. However, they could in fact require different movements to assess dynamic postural stability, as one uses a platform and different measuring techniques than the other. The purpose of this study was to determine if there was a significant difference in the kinematic patterns in physically active population while performing the SEBT and the YBT. Method: Seventy participants performed in the Anterior (AN), Posteromedial (PM), and Posterolateral (PL) directions of the SEBT and the YBT. The kinematics of hip, knee, and ankle in sagittal plane was calculated and analyzed. Paired-sample t-tests were performed to compare joint angular displacement in the ankle, knee, and hip between the SEBT and the YBT. Results: Significant differences in angular displacement at the hip, knee, and ankle joints in the sagittal plane between performance on the SEBT and on the YBT were observed. Conclusion: Clinicians and researchers should not apply these dynamic postural control tasks interchangeably from one task to another. There appear to be kinematic pattern differences between tests in healthy physical active population.
Purpose: This study examined the inter-rater reliability of cervical proprioception, dynamic balance ability, and ankle dorsiflexion range of motion using STARmat®, which is a practical clinical tool that can provide practitioners and patients with quantitative and qualitative results. Methods: Thirty healthy young subjects were enrolled in this study, and two well-trained physical therapists participated as a tester. Two testers measured the cervical joint position error at the starting position after neck flexion, extension, side bending, and rotation; three dynamic balance tests, including anterior excursion, anterior reaching with single leg balance, and posterior diagonal excursion; and ankle dorsiflexion range of motion using STARmat®. The intra-class correlation coefficient (ICC) was used to determine the inter-rater reliability of the tests. Results: The inter-rater reliability for the cervical proprioception ranged from moderate to good (0.66 to 0.83), particularly for flexion (0.82), extension (0.70), right side bending (0.73), left side bending (0.71), right rotation (0.83), and left rotation (0.66). For the dynamic balance, the inter-rater reliability ranged from good to excellent (0.87 to 0.91), particularly for anterior excursion (0.86), posterior diagonal excursion (0.87 to 0.89), and anterior reaching with a single leg balance (0.90 to 0.91). In addition, for the ankle dorsiflexion range of motion, the ICC for the inter-rater reliability ranged from 0.95 to 0.96. Conclusion: STARmat® is a reliable tool for measuring cervical proprioception, dynamic balance tests, and ankle dorsiflexion range of motion in healthy young adults.
Purpose: This study examined the effects of upper- and lower-limb coordinated exercise with proprioceptive neuromuscular facilitation (PNF) on stroke patients' recovery of their balancing and walking abilities. Methods: This study was conducted with 30 patients aged at least 60 years and diagnosed with stroke. The patients were randomly assigned to either a PNF upper- and lower-limb coordinated exercise group of 15 patients or an aero-step balance exercise group of 15 patients. To test the subjects' balancing and walking abilities, balancing ability tests and 10-m walking speed tests were conducted before and after the interventions. The patients performed their respective exercises for 30 minutes per session, three times per week for four weeks. The PNF exercise group performed six stages of exercise consisting of a combination of PNF patterns such as sprinting, skating, and striking. The six stages (right striking, right skating, right sprinting, left striking, left skating, and left sprinting) were performed continuously with a rest period of 1 min. after training for 4 min. The exercises for the aero-step balance group consisted of balancing in a two-leg standing position, weight shifting in a two-leg standing position, one-leg standing, squat exercises, marching in place, and squatting on an aero step. Results: The PNF exercise group showed significant improvements in their balancing ability evaluations compared to the aero-step balance group and also showed significant improvements in their 10-m walking speed tests. Conclusion: Based on the results of this study, PNF upper- and lower-limb coordinated exercise resulted in clinical improvements of stroke patients' balancing and walking abilities. Therefore, this type of exercise is recommended as a clinical intervention for the recovery of stroke patients' lower-limb function. Future studies should be conducted with longer intervention periods and more subjects to generalize the study results.
Purpose: To investigate the rater reliability of a Pediatric Balance Scale (PBS) for children with cerebral palsy, and to investigate possible differences among raters according to their clinical work experience and testing experience. Methods: Study participants included 18 children with spastic cerebral palsy who could walk. They were instructed by pediatric physical therapists, two of whom had ten years of clinical work experience and two who had less than one year of experience. The children's ability to achieve physical balance was videotaped for PBS items. The raters watched the tapes and evaluated each child twice. Rater reliability was analyzed using the intraclass correlation coefficient (ICC). Differences between experienced and novice raters were analyzed using a paired t-test. The statistical significance level was set to 0.05. Results: The total PBS scores averaged 45.78~48.00 and 45.72~47.67 for first and second tests. Intra-rater reliability was very high (ICC=0.89~0.99), and the repeated measurement coincidence was high (p>0.05). Inter-rater reliability was high (ICC=0.83~0.84), but there was a bit of a difference in the coincidence (p<0.05). The experienced raters' reliability and coincidence were higher than those of the novices, and there were differences in reliance and coincidence between experienced and novice raters (p<0.05). Conclusion: Inter-rater and intra-rater reliability is very high. However, rater reliability showed defferences depending on clinical work experience and testing experience. When testing pediatric patients with the PBS, the rater's clinical experience and test experience may affect the test results.
Background: The range of motion (ROM) and balance ability of the ankle joint affect the stability of the ankle and prevent injuries or hurts from falling. In the clinical tests conducted recently, the floss band is widely used to enhance the range of joint motion and exercise performance, and there are many studies that have applied it to ankle joint increasing dorsi flexion (DF) angle. Objects: This study compared the effects on the range of ankle motion and static/dynamic balance ability of the ankle through three conditions (before floss band intervention, after floss band intervention, and after active exercise intervention) for adults. Methods: One intervention between floss band and active exercise was applied randomly and another intervention was applied the next day. After each intervention, the ROM of the ankle joints and the static balance was checked by measuring conducting one leg test. And the dynamic balance was checked by conducting a Y-balance test. Results: In the case of DF, the range of joint motion showed a significant increase after floss band intervention compared to before floss band intervention (p < 0.05). Static balance ability showed a significant increase after the intervention of floss band and active exercise compared to before the intervention of floss band (p < 0.05). The dynamic balance ability showed a significant increase after the intervention of the floss band compared to before intervention of the floss band and after active exercise intervention (p < 0.05). Conclusion: Based on these results, it was confirmed that the application of floss band to the ankle joint increases DF and improves the static and dynamic balance ability. Based on this fact, we propose the application of a floss band as an intervention method to improve the ROM of the ankle joint and improve the stability of the ankle in clinical field.
The use of a gym ball is becoming more popular for dynamic balance exercises. However, little is known about the effects of the dynamic ball exercises in the elderly. The purpose of this study was to compare balance and functional mobility after dynamic balance exercises using a gym ball to reduce the risk factorfor falls. All of the 15 subjects were women between the ages of 68 and 91 (mean age=79.9 yrs, SD=5.87) at anursing home in Wonju. Seven of fifteen subjects were placed in the experimental group and the others in the control group. Three clinical tests were used to determine the degree of balance and functional mobility before beginning the exercise program, after 4 weeks of gym ball exercise, and after 8 weeks of gym ball exercise. These three tests included Timed Up & Go (TUG), Berg Balance Scale (BBS) and the Functional Independence Measure (FIM). Dynamic ball exercises training for 8 weeks (5 days per week) included side stretching, prone walking, bridging, marching and opposite arm and leg lifting. There were significant differences found before the gym ball exercise program began and after 4 weeks and then 8 weeks in the experimental group (p<.05). Significant differences between the groups were shown for TUG and BBS (p<.05). No significant difference was noted between the groups for FIM. Therefore, gym ball exercises can improve dynamic balance and may be recommended to include in a therapeutic program to help the elderly reduce their risk of a fall.
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