Posturography stands or quantitative assessment of body postural stability analysis. The present study developed a balance plate system to monitor patient's center of pressure (COP) movement and to analyze its stability. An equilateral triangular shaped plate was made of duralumin and forces were measured on the three vertices of the plate using industrial load cells. Specially designed electronic circuit picked up force signals ed into data acquisition system to calculate the cartesian coordinates of COP. COP calculation error was less than 2%. The force signals enabled to compute stability measures, which consisted of a variety of clinical parameters related to postural stability. Clinical experiments were carefully designed and performed on 40 normal subjects. The results were that 1) postural stability decreased with age and 2) the best parameters were those of posture deviation measures. A customized PC-based software package was developed to apply the present technique with a great convenience to monitoring and analyzing postural stability in an accurate and quantitative way.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.23
no.1
/
pp.63-72
/
2017
Background: The purpose of this case study was to investigate into the effect of complex exercise program on the postural change, gait and balance ability in elementary school students with forward head posture. Methods: Four patients with forward head posture were recruited. They were evaluated pre-treatment, and after 6weeks, using neck disability index (NDI), numeric pain rating scale (NPRS), balance ability, foot pressure (fore foot/rear foot peak pressure ratio, F/R ratio), gait ability (cadence, toe out angle, stance phase). Results: First, the angle of forward head posture (craniovertebral angle; CVA and cranialrotation angle; CRA) was decreased in all subjects. The NPRS and NDI were decreased in all subjects. Also, The cadence, toe out angle and F/R ratio were increased in all subjects. The stance phase of gait cycle was positively change in all subjects. Lastly, the static balance ability improved in all subjects. Conclusion: According to the results above, the complex exercise program for students with forward head posture can help improve the postural change, gait and balance ability. Also, the complex exercise program was able to select interventions depending on the patient's condition and the desired goal.
Objective: The purpose of this study was determine the effect of Balance Trainer training with Transcutaneous Electrical Nerve Stimulation (TENS) on spasticity and balance in persons with chronic stroke. Design: Randomized controlled trial. Methods: A total of 30 subjects with hemiparetic stroke were recruited and randomly divided into the Balance Trainer training with TENS group (n=15) and Balance Trainer training with placebo TENS group (n=15). The Balance Trainer training with TENS group practiced additional Balance Trainer training with TENS for 30 minutes a day, 5 days per a week during 4 weeks and the Balance Trainer training with placebo TENS group practiced additional Balance Trainer training with placebo TENS for the same period. Spasticity and balance were assessed by ability (static balance, dynamic balance) and were measured before and after the 4-week programs. Results: The result of spasticity and dynamic balance were improved significantly in both groups (p<0.05). The Balance Trainer training with TENS group showed significantly greater improvement in spasticity of the gastrocnemius & dynamic balance, compared to the Balance Trainer training with placebo TENS group (p<0.05). The Balance trainer training with TENS group showed a significant improvement in static balance, especially during the eye-closed condition (p<0.05). Conclusions: The Balance Trainer training with TENS was effective in improving spasticity and balance in subjects with chronic stroke. Based on these results, it is suggested that Balance Trainer training with TENS could clinically be used more actively in conjunction with conventional physical therapy.
The purpose of this study was to investigate the effect of foot orthotic on postural sway. Subjects were 15 patients(7 men and 8 women) who prescribed foot orthotic at B hospital and L rehabilitation medicine clinic in Seoul. Postural sway during a single limb stance was measured using the CMS 10 Measuring System when subjects positioned on the balance trainer under two treatment conditions(orthotic and nonorthotic). RCSP(resting calcaneal stance position) while subjects were standing on the glass plate was measured using the angle finder after subjects were positioned in prone to divide equally lower leg and calcaneus using the goniometer. The result was as follows. There were significant difference between postural sway of orthotic and nonorthotic conditions(t=4.888, 4.589, p<0.001), and the leg of the small RCSP within a subject has the small postural sway index($x^2=26.000$, p<0.001). In conclusion, foot orthotics provide structural support for detecting and controlling postural sway in patients prescribed foot orthotics.
Purpose: The purpose of this study was to examine the influence of a handrail (presence and position) on treadmill gait and balance in stroke patients during gait training. Methods: 39 patients with stroke (male 31, female 8) participated in this study. The training groups were classified into a no-handrail group (NHG), front handrail group (FHG), and bilateral handrail group (BHG). Each group comprised 13 subjects. The subjects were trained to walk in a straight path 30 minutes per day for 8 weeks. The Good Balance System was used to measure static balance and dynamic balance. To measure walking ability, timed up and go (TUG) was also assessed. Results: The NHG showed no significant differences in static balance, dynamic balance, and TUG. The FHG was significantly different in their medial-lateral speed of static balance, dynamic balance, and TUG. The BHG was significantly different in their static balance, dynamic balance, and TUG. Conclusion: These findings consider the effects of holding handrails concomitantly with changes in postural stability. We conclude that for training stroke patients, treadmill walking while holding handrails improves balance and gait more than treadmill walking without holding handrails. The resulting changes in muscle activity patterns may facilitate the transfer to a gait pattern. The results of this study suggest methods for training treadmill walking in stroke patients.
In the patients with hemiplegia caused by stroke and TBI. postural sway is increased and open displaced laterally over the non-affected leg, reflecting asymmetry in weight bearing on lower extremities during standing balance. Recovery of symmetric weight bearing and postural stability is an important aim in physical therapy. Plastic AFO has been used for hemiplegic patients in order to help their abnormal walking patterns. Past studies have mainly focused on the AFO influences on hemiplegic walking patterns without balance function approaches. The purpose of this study was to identify the immediate effects of plastic AFO and shoes on the static balance in hemiplegic patients. The scale for static balance were weight bearing on affected leg(%), sway area(mm2), sway path(mm), maximal sway velocity(mm/s), anteroposterior sway angle($^{\circ}$ ), and lateral angle($^{\circ}$ ). Seventeen hemiplegic patients participated in this study: 13 men and 4 women, with an average age of 50.18 years. Static balance was measured using BPM(balance performance monitor; dataprint software version 5.3) under four standing condition namely bare-foot standing. standing in shoes, standing with AFO, and standing in shoes with AFO. In order to assure the statistical significance of the results, an one-way ANOVA, the independent t-test. and a pearson's correlation were applied at the .05 level of significant. The results of this study were as follows: 1) There were statistically significant differences in weight bearing(%) on the static balance between affected leg and non-affected leg(p<.01). 2) There were statistically significant differences in sway reverse frequence(Hz) in standing with AFO between affected leg and non-affected leg(p<.05). 3) Sway area(mm2) on standing in shoes with AFO was lower than bare-foot standing(p<.05), Lateral sway angle($^{\circ}$ ) on standing in shoes with AFO was lower than bare-foot standing and standing in shoes(p<.05). 4) Weight bearing in affected leg was not significantly correlated with postural sway.
This study was designed to investigate the effects of an ankle foot orthosis(AFO) with variable ankle joint angles on balance performance in healthy adults. Eighteen healthy adults were recruited in this repeated measures design with subjects as their own controls. An AFO with four kinds of ankle joint angles(-5, 0, 5, and 10 degree) were used and balance performance was measured during single limb standing. Three trials were obtained and then averaged for data analysis. Foot pressure was measured using an F-scan system and muscle activity was measured using an MP150 system. There were significant differences in balance performance with ankle joint angles. An AFO with -5 degrees was associated with significant increases in postural sway(anterior-posterior), and in muscle activity for the medial gastrocnemius and tibialis anterior compared with other degrees of angle. Findings of this study show that angles of an AFO are related to balance performance and a joint angle of 10 degree is effective for promoting joint stability and postural control. This information can be used by clinicians to prescribe AFOs.
Purpose : This study was to compare the difference Trunk Control Test(TCT), Postural Assessment Scale for Stroke(PASS-TC), and Trunk Impairment Scale(TIS) and its subscales in relation to the difference MBI(Modified Barthel Index), BBS(Berg Balance Scale), and to establish the association between MBI, BBS, Fugl Meyer-motor function(FM-M), and to predict MBI-subscales from the variables. Methods : 58 stroke patients, attending a rehabilitation programme, participated in the study. Trunk control was measured with the use of the TCT, PASS-TC, TIS, and the performance of Activities daily living was obtained by MBI, and dynamic balance ability(by BBS). Trunk control scores from the difference MBI, BBS were compared using the 1-way ANOVA(Mann Whitney U test) and the data were analyzed using Pearson product correlation. Multiple stepwise regression analyses were performed to identify prognostic factors for ADL subscale. Results : Trunk control scores showed significant differences between MBI(F=2.139~13.737, p<.05~.001), BBS(t=3.491~7.705, p<.01~.001). It was significantly related with value of the MBI(r=.25~.50), BBS(r=.38~.68), FMM( r=.31~.48). Stepwise linear regression analysis showed an additional, significant contribution of the TCT, in addition to the PASS-TC, dynamic sitting balance subscale of the TIS for measures of MBI subscales. Conclusion : Measures of trunk control were significantly related with values of MBI, BBS score, so the management of trunk rehabilitation after stroke should be emphasized. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of the stroke patients. Further study about trunk control is needed using a longitudinal study design.
Objective: Attentional focus is one of the critical factors that has consistently been demonstrated to enhance motor performance and motor skill. Focusing attention on the inside of the body while engaging in a particular exercise is called internal focus (IF) and focus on the external environment is called external focus (EF). The purpose of this study was to identify effects of IF and EF of attention on postural balance in healthy school-aged children. Design: Cross-sectional study. Methods: Twenty-four healthy school-aged children participated in this study. School-aged children was defined as children ages 8-12 years old. They performed the one-legged standing with EF (focusing on the marker at the level of participants' chest and 150 cm away), IF (focusing the supporting feet), and control (no instruction) respectively. The order of the focus condition was randomly selected. The center of pressure (COP) range, distance, and velocity was measured to compare the effects of applying different attentional focuses in the three conditions. Results: The results of our study show that differences in COP range, distance, and velocity among groups were not significant between the different attentional focuses, although all variables of EF were smaller than IF. It is postulated that the reason for this may be that school school-aged children between 8-12 years old go through a transitional phase from IF to EF in effective motor learning. Conclusions: These findings reveal that the type of attentional focus did not have any effect on postural balance in healthy school-aged children.
Objective: This study aimed to investigate the impact of a 12-week combined cognitive and physical exercise program on cognitive and physical functions in older adults diagnosed with mild cognitive impairment (MCI). Design: A one-group pretest-posttest study. Methods: Twelve participants with MCI engaged in a weekly 60-minute session of combined cognitive and physical exercise program. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while physical function was evaluated through measures of muscle strength, postural balance, and walking capabilities. Muscle strength assessments included the arm curl test, handgrip strength, and the 5 sit-to-stand test. Postural balance was evaluated using the one-leg stance test, timed up-and-go test, functional reach test, and four square step test. Walking function was analyzed through a gait analysis device. Pre- and post-intervention measurements were compared to determine the effects of the exercise program. Results: The results demonstrated significant improvements in MoCA, arm curl test, timed up-and-go test, walking speed, and cadence following the 12-week intervention (p<0.05). MoCA scores revealed enhanced cognitive performance, while measures of muscle strength, including the arm curl test, exhibited significant changes. Improvements in timed up-and-go test scores indicated enhanced mobility, accompanied by increased walking speed and cadence, as evidenced by gait analysis. Conclusions: This study suggests that a structured 12-week program incorporating both cognitive and physical exercises can lead to meaningful improvements in cognitive and physical functions among older adults with MCI.
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