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.
Journal of The Korean Society of Integrative Medicine
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v.4
no.3
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pp.61-68
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2016
Purpose : The purpose of this study was to examine the differences in sit-to-stand movement and static standing balance between young adults and older adults Methods : Thirty young adults and thirty older adults participated in this study. The Good Balance System was used to assess participants' sit-to-stand movement and static standing balance. The sit-to-stand movement was measured as mediolateral and anterioposterior displacement of the centre of pressure (mm/s) while sit-to-stand on a force platform, and time required to complete a sit-to-stand movement on a force platform. The static standing balance was measured as mediolateral and anterioposterior displacement of the center of pressure (mm/s) and velocity moment (mm2/s) while standing on a force platform with opened eyes and with closed eyes. Result : A significant difference was found in the mediolateral and anterioposterior center of pressure displacement and the time required to complete a sit-to-stand movement of the two groups (p<.05). A significant difference between the groups was found as to mediolateral centre of pressure displacement and the velocity moment when standing with opened eyes and with closed eyes (p<.05). Conclusion : In conclusion, older adults showed decreased sit-to-stand movement and static standing balance ability compared to the young adult. Clinicians should consider sit-to-stand and balance training for older adult.
Purpose: The purpose of the study was to comparison of trunk muscle activity during static standing position and standing position on therapeutic climbing wall of adult. Methods: Study subject is arbitrarily classified into 10 of experimental group and 10 control group among 20 of adult. Trunk activity measured as rectus abdominalis, external oblique, internal oblique, erector spinae. Control group maintains that center of gravity of trunk pass the front of shoulder, pelvis, knee and ankle on stable surface with putting legs apart more than shoulder width. Experimental group had static exercise on 4 by 3 meter, 90 degree of Therapeutic climbing wall. Starting position is that putting arms and legs apart more than shoulder width. In order to compare the effect of it between the groups, independent t-test was used. Results: According to the test result, significant difference between among rectus abdominalis, erector spinae the experimental groups. And external oblique, internal oblique muscle atvity is no significant difference experimental groups between among the control groups was observed. Conclusion: Trunk muscle activation is activated to standing position on the Therapeutic Climbing Wall more than static standing position.
The purpose of this study was to investigate the effect of functional strengthening exercise on static and dynamic standing balance in a child with cerebral palsy. The subject was a 7 year old boy with diplegia whose Gross Motor Function Measure (GMFM) score was 80% along with G1 of the lower extremities in Modified Ashworth Scale. The subject was ambulatory with some degree of limitation and demonstrated muscle weakness and strength asymmetry in the lower extremities. A changing criterion design for a single-subject research was used for this study. The functional strengthening exercise consisted of lower extremity ergometer exercise and knee exercise with grading movement in standing position, each for 20 minutes, which lasted 18 sessions for 6 weeks. A knee extensor strength test on both extremities and standing balance test were conducted after each functional strengthening exercise. Two types of standing balance were tested: one leg stance test and functional reach test. One leg stance test was to evaluate static standing balance, and functional reach test was to evaluate dynamic standing balance. The results showed that the functional strengthening exercise had some positive effects on improvement of both static and dynamic standing balance, and there was a positive correlation between the knee strength and standing balance.
Purpose: The purpose of this study was to examine test-retest reliability and criterion-related validity of a trunk stability robot when measuring the weight-bearing symmetry static sitting and standing in stroke patients. Methods: For 27 stroke patients, weight-bearing symmetry was assessed twice, 7 days apart. The intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC) were used to examine the level of agreement between test and retest. The criterion-related validity of weight -bearing symmetry was demonstrated by Spearman correlation of modified Barthel index (MBI), the sit to stand test (STS), the timed up & go Test (TUG), and the function in sitting test (FIST). Results: the test-retest agreements were excellent for the weight-bearing symmetry of static sitting (ICC2,1: 0.90) and standing (ICC2,1: 0.89). It all showed that the acceptable MDC for the weight-bearing symmetry of static sitting and standing was 0.11 and 0.16, respectively (highest possible score<20 %), indicating that the measures had a small and acceptable degree of measurement error. The weight-bearing symmetry of static sitting was significantly correlated with the TUG(r=-0.45) and FIST(r=0.46)(p<0.05); the weight-bearing symmetry of static standing was also significantly correlated with MBI (r=0.65), TUG (r=-0.67), FIST (r=0.61)(p<0.01), and STS (r=-0.47)(p<0.05). Conclusion: The weight-bearing symmetry of static sitting and standing assessed by the trunk stability robot showed highly sufficient test-retest agreement and mild-to-moderate validity. It could also be useful for clinicians and researchers to evaluate balance performance and monitor functional change in stroke patients.
The purposes of this study were to determine wether knee muscular fatigue affects on one-leg static standing balance. Sixty four healthy subjects were used for this study : 44 men and 20 women, with an average age of 19.52. One leg static standing balance was measured at pre-fatigue and post-fatigue by an instrumented balance assessment system(kinesthetic ability training balance platform) which is commercially available for testing or training balance. Isokinetic exercises were used to evoke muscle fatigue at 180 degree/see by Cybex 1200. One leg static standing balance ability was significantly decreased after knee muscular fatigue. Although these phenomenons were not clearly understood, these results have important implications for rehabilitation in fatigable patients. These results suggest that the excessive fatiguing during rehabilitation in patients with fatigable disease may increase risk of reinjury and falling injury due to balance disturbance. Further studies are required to determine the physiological mechanisms of muscle fatigue that can play in decreasing one-leg static standing balance ability.
Purpose: The aim of the present study was to measure the standing balance symmetry of stroke patients using a force-plate with computer system, and to investigate the correlation between the standing balance symmetry and that of the walking function in stroke patients. Methods: 48 patients with stroke (34 men, 14 women, $56.8{\pm}11.72$ years old) participated in this study. Static standing balance was evaluated by the weight distribution on the affected and the nonaffected lower limbs, sway path, sway velocity, and sway frequency, which reflected the characteristic of body sway in quiet standing. Dynamic standing balance was evaluated by anteroposterior and mediolateral sway angle, which revealed the limit of stability during voluntary weight displacement. Symmetry index of static standing balance, (SI-SSB) calculated by the ratio of the affected weight distribution for the nonaffected weight distribution, and symmetric index of dynamic standing balance (SI-SDB) by the ratio of the affected sway angle for the nonaffected sway angle. Functional balance assessed by a Berg balance scale (BBS), and the functional walking by 10m walking velocity, as well as the modified motor assessment scale (mMAS). Results: Static balance scales and SI-SSB was the only correlation with BBS (p<0.05). Dynamic balance scales and SI-DSB, not only was correlated with BBS, but also with 10m walking velocity and mMAS (p<0.01). Additionally, there was a significant difference between SI-SSB and that of SI-DSB (p<0.01). Conclusion: The balance and the walking function relate to real life in the stroke showed strong relationships with the dynamic standing balance symmetry in the frontal plane and the ability of anterior voluntary weight displacement in sagittal plane.
Background: South Korea is one of fastest aging countries in the world. Poor balance and falls of the elderly are main health issues. Objects: The goal of this study was to understand the association between the socioeconomical factors and the standing balance of elderly living in the rural and urban area. Methods: One hundred sixty-six elderly participants who were older than 65 and were able to walk without an assistive device were recruited in the city of Gwangju and in the rural area of Jeonnam, South Korea. All participants performed the static and dynamic standing balance tests. Static standing balance was measured with chronometer in seconds while standing on one leg. Dynamic balance was tested with the timed up and go test (TUG), measured in seconds while getting up from a chair and walking 3 meters and back to sit. The static and dynamic standing balance was analyzed using analysis of variance and the Fisher's Least Significant Difference post hoc test. Results: Male participants from both areas had no difference in one leg standing and TUG. The female elderly living in rural area took shorter in TUG than females living in urban area. Age decreased the one leg standing time in both areas while did not affect the TUG significantly. As the monthly income increased, both of one leg standing and TUG increased in urban area, while the medium monthly income showed best performance (it was not statistically significant) in both of one leg standing and TUG in rural area. Conclusion: Socioeconomical factors affects differently the standing balance of the elderly living in rural and urban South Korea. Female living alone in urban area with low monthly income demonstrated worst standing balance in this study.
Park, Je-Sang;Choi, Houng-Sik;Kim, Tack-Hoon;Roh, Jung-Suk
Physical Therapy Korea
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v.8
no.2
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pp.73-85
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2001
The purpose of this study was to investigate whether the standing balance could be influenced by the different foot positions. Seventeen patients with hemiplegia were tested for the static and dynamic balance under the different foot positions. In the balance test, subject stood by bearing weight on one foot, and the other foot was positioned in three different positions (symmetric, $45^{\circ}$ anterolateral, and anterior position). This study used the Kinesthetic ability trainer (KAT2000) to measure the standing balance. The results were as follows: 1) There were significant differences in the static standing balance in different foot positions with both weight-bearing on the paretic limb and on the nonparetic limb (p<.05). 2) There were also significant differences in the dynamic standing balance in different foot positions with both weight-bearing on the paretic limb and on the nonparetic limb (p<.05). 3) There was a significant difference when the paretic weight-bearing and the nonparetic weight-bearing were compared (p<.01). 4) when the paretic weight-bearing and the nonparetic weight-bearing were compared, anterior foot position showed a significant difference in the dynamic standing balance (p<.05), but $45^{\circ}$ anterolateral foot position did not show a significant difference (p>.05). In this study, the standing balance showed a significant difference according to different foot positions in hemiparetic patients, and standing balance was better when they stood by bearing weight on the nonparetic limb. These results indicate that it is a necessary to consider both weight-bearing limb and foot position not only in the rehabilitation program but also in achieving the stability in the independent life.
Multi-sensory systems, including the visual, somatosensory, and vestibular ones, are involved in maintaining standing balance. The organization of these sensory systems is as important as the efficiency of each individual system in maintaining optimal balance. The purpose of the present experiment was to investigate the developmental changes in static standing balance and sensory organization under altered sensory conditions. This study involved 64 children (from 4 to 15 years of age) and 17 young adults. The children were divided into four age groups: 4~6, 7~9, 10~12, and 13~15 years. Static standing balance was assessed with the one-leg standing test under four different sensory conditions: the children stood on a firm surface with (1) eyes open or (2) closed, and they stood on a foam surface with eyes (3) open or (4) closed. In balancing ability, the age groups exhibited significant differences. The function of sensory organization for balance control was poorer for the children than for the young adults. The functional efficiency of the somatosensory system of the children aged 7~9 years was at the young adults' level, and the visual function of the children aged 10~12 years had also reached the young adults' level. However, the functional efficiency of the vestibular system of children was significantly lower than that of the young adults, even at the age of 15 years. This may indicate that sensory organization and standing balance are still developing after the age of 15 years.
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