This paper presents quantitative analysis of a training system based on an unstable platform and a visual interactive system for improving sense of equilibrium. The training system consists of an unstable platform, a force plate, a safety harness, a monitoring device, and a personal-computer. To confirm the effects of the training system, fifteen young volunteers and five elderly volunteers went through a series of balance training using the system. During the training, we measured relevant parameters such as the time a subject maintain his or her center of pressure on a target, the time a subject moves his or her center of pressure to the target, and the mean absolute deviation of the trace before and after training with this system and training programs to evaluate the effects of the training. The results showed that the training system can successfully assess the gradual improvement of the postural control capability of the subject in the system and showed a possibility of improving balance of the subject. Moreover, the significant improvement in the postural capability of the elderly subject suggests that elderly subjects can benefit more from the training using the system for the improvement of sense of equilibrium.
We performed experimental studies on the muscle activities in the lower limbs for the different movement patterns on an unstable platform. A training system for postural control using an unstable platform that we previously developed was applied for the experiments. This unstable platform provides 360 degrees of movement allowing for training of posture in various directions and provides simultaneous excitations to visual sensory, somatic sensation and vestibular organs. Compare with the stable platform, keeping body balance on the unstable platform requests more effective sensation from vision, vestibular sense and somatic sense. Especially, the somatosensory inputs from the muscle proprioceptors and muscle force are crucial. To study the muscle activities for the different movement patterns and find the best training method for improving the ability of postural control through training and improving the lower extremity muscular strength, fifteen young healthy participants went through trainings and experiments. The participants were instructed to move the center of pressure following the appointed movement pattern while standing on the unstable platform. The electromyographies of the muscles in the lower limbs were recorded and analyzed in the time and the frequency domain. Our experimental results showed the significant differences in muscle activities for the different movement patterns. Especially, the spectral energy of electromyography signals in muscle for the movement pattern in anterior-posterior direction was significantly higher than those occurred in the other patterns. The muscles in the lower leg, especially tibialis anterior and gastrocnemius were more activated compared to the others for controlling the balance of body on the unstable platform. The experimental results suggest that, through the choice of different movement pattern, the training for lower extremity strength could be performed on specific muscles in different intensity. And, the ability of postural control could be improved by the training for lower extremity strength.
Kim, Jong-Gun;Kim, Jin-Hong;Do, Kwang-Sun;Yim, Jongeun
Physical Therapy Rehabilitation Science
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v.5
no.3
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pp.138-142
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2016
Objective: The purpose of this study was to investigate how light touch with a finger affects balance ability when a posture is maintained in the condition of visual information blockage and to provide a fundamental material for developing balance ability in the process of rehabilitation treatment. Design: Cross-sectional study. Methods: The study subjects were 17 healthy men and women in their twenties and thirties who were studying at S University in Seoul. The system was comprised of an equilateral triangular force platform. Subjects were asked to step on the foot position of the force platform (Good Balance, Finland) barefooted for 30 seconds, with eyes closed, hands hanging down loosely, and feet comfortably apart. It was connected to a laptop by using Bluetooth technology. An experiment was conducted in the following three circumstances: 1) no-touch trial, 2) light touch to the back (T7 area), and 3) light touch to the middle finger of the left hand. Each subject was given a 10-minute break between consecutive measurements. The experimental circumstances were performed randomly. Anteroposterior sway (APSV), mediolateral sway velocity (MLSV), and velocity moment (VM) were measured. Results: The APSVs (mm/s) were $9.32{\pm}3.37$ and $5.45{\pm}2.98$; the MLSVs (mm/s), $6.39{\pm}3.35$ and $3.31{\pm}2.48$; and VM ($mm^2/s$), $17.13{\pm}11.75$ and $6.76{\pm}8.31$ in the first and second experimental circumstances, respectively. APSV, MLSV, and VM values were significantly improved with the 1) no-touch trial and 2) light touch to the back trail conditions compared with the 3) light touch to the middle finger of the left hand condition (p<0.05). Conclusions: This study revealed that the balance ability for maintaining a body posture was influenced more by light touch to the back (T7) than by light touch with the sensitive fingertip and body sway diminished after visual information was blocked.
The Journal of Korean Academy of Sensory Integration
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v.17
no.1
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pp.9-18
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2019
Objective : This study investigated the effect of intensive weight shift training (IWST) on the ability to balance in a sitting posture of children with spastic cerebral palsy (SCP). Methods : One child with spastic diplegia participated in this study for a total of 8 weeks using the ABA experimental design. For the pre-intervention period (A1), general physical therapy (GPT) for children with SCP was performed. The intervention period (B1 and B2), GPT and IWST were conducted for children with SCP, and GPT was conducted again for the post-intervention period (A'1 and A'2). Trunk control capacity was measured using the Korean Trunk Control Measurement Scale (TCMS-K) and Biorescue (RM Ingenierie, France). Results : All TCMS-K variables increased from A1 to B2, and decreased from B2 to A'2. The total area with limit of stability (LOS) increased from A1 to B2, and decreased from B2 to A'2. The ratio of the left/right (Lt/Rt) and anterior/posterior (Ant/Post) LOS area was closer to 1, meaning symmetry, in B2 than in A1. The ratio of the Lt/Rt LOS area decreased further from 1 in A'2 than in B2. The ratio of the Ant/Post LOS area was closer to 1 in A'2 than in B2. Conclusion : IWST had a positive effect on the improvement of balance in the sitting posture of a child with SCP. The results suggest that IWST might help to improve the balance abilities of children with SCP for independent sitting, postural control, and activities of daily living.
Clinical measures that Quantify falling risk factors are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the test-retest and interrater reliability of the dynamic gait index (DGI) for persons with Parkinson's disease (PD). A total of 22 idiopathic PD patients were recruited from rehabilitation hospital, Korea in this study. The DGI was assessed in two sessions that were, three days apart. We also measured Berg balance test (BBT) and geriatric depression scale (GDS) for concurrent validity with DGI. Intrarater and interrater reliability (.96 and .98 respectively) for DGI were high. indicating good agreement. The DGI was showed a good positive correlation with the BBS (r=.852). but not GDS (r=-.462). Intrarater and interrater reliability of DGI were high in people with PD. The DGI could be a reliable measure to evaluate functional postural control during gait activities in the PD population, and the ability of DGI to detect real change is acceptable in research and clinical settings.
A 'pusher syndrome' encompassing postural imbalance and hemi-neglect is believed to aggravate the prognosis of stroke patients. The patients with pusher syndrome show a particular posture that pushing away from the unaffected side of the body. The objective of this study was to investigate associated proprioception, associated neuro-psychological symptoms and characteristics of functional outcome with and without pusher syndrome. The subjects of this study were 58 acute stroke patients who been rehabilitated at two university hospitals in Seoul and Buchun. Data were collected using proprioception test and line bisection test. The ability of ADL was assessed by the Modified Barthel Index, transfer by the Functional Independence Measure, and balance by the Modified Motor Assessment Scale. The results were that significant difference was found in the presence of proprioception, in the incidence of hemineglect and anosognosia, and in the score of ADL, transfer and balance between patients with and without pusher syndrome. Patients without pusher syndrome gained more motor score than patients with pusher syndrome. From improvement of view, patients with pusher syndrome gained the lowest score in ability of transfer. The finding suggest that the patients with pusher syndrome is a poorer functional outcome, be related to proprioception, hemineglect and anosognosia.
Journal of the Korean Society of Physical Medicine
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v.11
no.4
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pp.105-114
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2016
PURPOSE: This study is to investigate the therapeutic effect of Tetrax on balance dysfunction caused by ataxia in cerebellar stroke. METHODS: A total of thirty subjects with cerebellar stroke were recruited. The participants was divided into two groups, the experimental (n=15) and the control group (n=15). Tetrax training and conventional physical therapy (CPT) were performed in experimental group, whereas the patients in the control group were treated with CPT twice a day. Each session of the Tetrax and CPT was carried out for 30 minutes, 5 times per week for 4 weeks. Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) was the primary outcome measure, and the secondary outcomes covered Berg balance scale (BBS), falling index (FI), Timed up and go (TUG), and modified Barthel index of Korean version (K-MBI). All outcome measures were evaluated before and after 4 weeks. RESULTS: K-SARA was decreased significantly after 4 weeks intervention in both the experimental (p<.05) and the control group (p<.05). Furthermore, the experimental group produced significantly better outcomes in K-SARA, BBS, FI, and TUG compared with the control group (p=.012, p=.027, p=.008, and p=.048). There were significant correlations between K-SARA and BBS, FI, TUG, and K-MBI (p<.001, p<.001, p=.004, and p<.001). CONCLUSION: The restoration of ataxia was related with the improvement of the balance, falling risk, mobility, and activity of daily living. Tetrax training was effectively aided recovery of ataxia after cerebellar stroke.
Kim, Jin-seong;Choi, Moon-young;Kong, Doo-hwan;Chung, Kyu-sung;Hwang, Ui-jae;Kwon, Oh-yun
Physical Therapy Korea
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v.27
no.4
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pp.286-291
/
2020
Background: Anterior cruciate ligament reconstruction (ACLR) causes a reduction in the balance of the lower extremities. Static and dynamic balance were evaluated separately to confirm the decrease in balance in patients underwent ACLR. The commonly used methods include the Biodex Balance System (BBS) for static balance and the Y balance test (YBT) for dynamic balance. No study has evaluated whether the static and dynamic balance of the involved side recovers as much as the uninvolved side one year after ACLR. Objects: The purpose of this study was to investigate the recovery of static and dynamic balance between the involved and the uninvolved sides. Methods: The BBS (overall, anteroposterior index, and mediolateral index) and YBT (anterior, posterolateral, and posteromedial) of 58 patients underwent ACLR were measured one year postoperation. Both sides of the BBS and the YBT were compared using the paired t-test. Results: All the index of the BBS showed no difference between the involved and the uninvolved sides, while all the scores of the YBT showed a significant difference in both sides. The YBT anterior result was 54.64 ± 5.62 cm in the involved side and 56.90 ± 5.41 cm in the uninvolved side (p = 0.001). The YBT posterolateral results were 90.12 ± 10.51 cm and 92.34 ± 9.85 cm (p = 0.013). The YBT posteromedial results were 93.72 ± 8.84 cm and 96.14 ± 9.37 cm (p = 0.002). Conclusion: A year after ACLR, the static balance showed no difference, while the dynamic balance showed a significant difference in the involved and the uninvolved sides. The static balance of the involved side recovered as much as the uninvolved side, but the dynamic balance did not. Therefore, dynamic balance training should be considered in the rehabilitation program for patients underwent ACLR.
The purpose of this study is to assess the ability of balance control in virtual moving surround stimulation using head mount display (HMD) device and force platform in patients with brain injury. Fifteen patients with stroke (mean age 54.47 yrs) and fifteen healthy normal persons participated. COP parameters were obtained total path distance, frequency of anterior-posterior and medial-lateral component by FFT analysis, weight-spectrum analysis in the two different conditions; (1) during comfortable standing with opened or closed eyes, (2) during virtual moving surround stimulation delivered using HMD with four different moving pattern. Moving patterns consisted of close-far, superior-inferior lilting (pitch) , right-left tilting (roll) and horizontal rotation (yaw) movement. In all parameters, the test-retest reliability was high. Also, the construct validity of virtual moving surround stimulation was excellent (p<0.05). A posturographic balance assessment system equiped with virtual moving surround stimulation using HMD is considered clinically useful in evaluation of balance control in patients with brain injury.
Objective: Children with spastic diplegic cerebral palsy show weakness especially in the lower-extremity rather than upper-extremity muscles and display characteristics such as asymmetric alignment, deficits in postural control or balance ability, and slow walking speed. Various therapeutic interventions are applied to children with cerebral palsy, of which taping is widely used in the field of rehabilitation, however, there are few studies of the effects of kinesio taping on gait patterns of children with cerebral palsy. The present study investigated the effects of kinesio taping on gait parameters of children with cerebral palsy. Design: Cross-sectional study. Methods: Four children with spastic diplegia participated in this study. The participants' gait parameters while walking 10 m with and without kinesio taping (tibialis anterior, quadriceps femoris, and gluteus maximus) were recorded. Gait parameters including gait velocity, cadence, step length, stride length, single support time, and double support time were evaluated using the GAITRite. Mean values were obtained after having the subjects walk three times in each condition with a 5-minute rest period between each condition. The order of each condition was assigned randomly. Results: There were significant improvements in gait velocity, step length, stride length, and single support time of the right leg with kinesio taping condition compared to the without kinesio taping condition taping (p<0.05). However, there were no significant differences in cadence, single support time of the left leg, or double support time. Conclusions: The results show that kinesio taping may have a positive effect for improving gait parameters of children with spastic diplegia. However, its usefulness in the rehabilitation of children with cerebral palsy needs to be further investigated.
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