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Real-time stability measurement system for postural control

Gopalai AA, Senanayake SM, Kiong LC, Gouwanda D

J Bodyw Mov Ther, 2011 Oct;15(4):453-64.
PMID: 21943619 DOI: 10.1016/j.jbmt.2010.10.005

A method for assessing balance, which was sensitive to changes in the postural control system is presented. This paper describes the implementation of a force-sensing platform, with force sensing resistors as the sensing element. The platform is capable of measuring destabilized postural perturbations in dynamic and static postural conditions. Besides providing real-time qualitative assessment, the platform quantifies the postural control of the subjects. This is done by evaluating the weighted center of applied pressure distribution over time. The objective of this research was to establish the feasibility of using the force-sensing platform to test and gauge the postural control of individuals. Tests were conducted in Eye Open and Eye Close states on Flat Ground (static condition) and the balance trainer (dynamic condition). It was observed that the designed platform was able to gauge the sway experienced by the body when subject's states and conditions changed.

Matched MeSH terms: Proprioception/physiology
The largest Lyapunov exponent of gait in young and elderly individuals: A systematic review

Mehdizadeh S

Gait Posture, 2018 Feb;60:241-250.
PMID: 29304432 DOI: 10.1016/j.gaitpost.2017.12.016

The largest Lyapunov exponent (LyE) is an accepted method to quantify gait stability in young and old adults. However, a range of LyE values has been reported in the literature for healthy young and elderly adults in normal walking. Therefore, it has been impractical to use the LyE as a clinical measure of gait stability. The aims of this systematic review were to summarize different methodological approaches of quantifying LyE, as well as to classify LyE values of different body segments and joints in young and elderly individuals during normal walking. The Pubmed, Ovid Medline, Scopus and ISI Web of Knowledge databases were searched using keywords related to gait, stability, variability, and LyE. Only English language articles using the Lyapunov exponent to quantify the stability of healthy normal young and old subjects walking on a level surface were considered. 102 papers were included for full-text review and data extraction. Data associated with the walking surface, data recording method, sampling rate, walking speed, body segments and joints, number of strides/steps, variable type, filtering, time-normalizing, state space dimension, time delay, LyE algorithm, and the LyE values were extracted. The disparity in implementation and calculation of the LyE was from, (i) experiment design, (ii) data pre-processing, and (iii) LyE calculation method. For practical implementation of LyE as a measure of gait stability in clinical settings, a standard and universally accepted approach of calculating LyE is required. Therefore, future studies should look for a standard and generalized procedure to apply and calculate LyE.

Matched MeSH terms: Proprioception/physiology*
Determining level of postural control in young adults using force-sensing resistors

Gopalai AA, Senanayake SM, Gouwanda D

IEEE Trans Inf Technol Biomed, 2011 Jul;15(4):608-14.
PMID: 21478080 DOI: 10.1109/TITB.2011.2140378

A force-sensing platform (FSP), sensitive to changes of the postural control system was designed. The platform measured effects of postural perturbations in static and dynamic conditions. This paper describes the implementation of an FSP using force-sensing resistors as sensing elements. Real-time qualitative assessment utilized a rainbow color scale to identify areas with high force concentration. Postprocessing of the logged data provided end-users with quantitative measures of postural control. The objective of this research was to establish the feasibility of using an FSP to test and gauge human postural control. Tests were conducted in eye open and eye close states. Readings obtained were tested for repeatability using a one-way analysis of variance test. The platform gauged postural sway by measuring the area of distribution for the weighted center of applied pressure at the foot. A fuzzy clustering algorithm was applied to identify regions of the foot with repetitive pressure concentration. Potential application of the platform in a clinical setting includes monitoring rehabilitation progress of stability dysfunction. The platform functions as a qualitative tool for initial, on-the-spot assessment, and quantitative measure for postacquisition assessment on balance abilities.

Matched MeSH terms: Proprioception/physiology*
Fulltext The effects of comprehensive warm-up programs on proprioception, static and dynamic balance on male soccer players

Daneshjoo A, Mokhtar AH, Rahnama N, Yusof A

PLoS One, 2012;7(12):e51568.
PMID: 23251579 DOI: 10.1371/journal.pone.0051568

The study investigated the effects of FIFA 11+ and HarmoKnee, both being popular warm-up programs, on proprioception, and on the static and dynamic balance of professional male soccer players.

Matched MeSH terms: Proprioception/physiology*
Multisensory distortions of the hand have differential effects on tactile perception

Treshi-marie Perera A, Newport R, McKenzie KJ

Exp Brain Res, 2015 Nov;233(11):3153-61.
PMID: 26195170 DOI: 10.1007/s00221-015-4384-8

Research has suggested that altering the perceived shape and size of the body image significantly affects perception of somatic events. The current study investigated how multisensory illusions applied to the body altered tactile perception using the somatic signal detection task. Thirty-one healthy volunteers were asked to report the presence or absence of near-threshold tactile stimuli delivered to the index finger under three multisensory illusion conditions: stretched finger, shrunken finger and detached finger, as well as a veridical baseline condition. Both stretching and shrinking the stimulated finger enhanced correct touch detections; however, the mechanisms underlying this increase were found to be different. In contrast, the detached appearance reduced false touch reports-possibly due to reduced tactile noise, as a result of attention being directed to the tip of the finger only. These findings suggest that distorted representations of the body could have different modulatory effects on attention to touch and provide a link between perceived body representation and somatosensory decision-making.

Matched MeSH terms: Proprioception/physiology*
The effect of exergaming on knee proprioception in older men: A randomized controlled trial

Sadeghi H, Hakim MN, Hamid TA, Amri SB, Razeghi M, Farazdaghi M, et al.

Arch Gerontol Geriatr, 2017 Mar-Apr;69:144-150.
PMID: 27923177 DOI: 10.1016/j.archger.2016.11.009

BACKGROUND: Proprioception is the ability to sense the body position, muscle sense, joint stability and posture. As balance decreases during the process of aging, knee proprioception has a critical role in body balance and daily activities. Exergaming has shown to be a potentially effective and more enjoyable form of exercise delivery.

OBJECTIVE: The purpose of this study was to determine the effect of an 8-week Xbox Kinect exercise program on knee proprioception in healthy older adults.

METHODOLOGY: Thirty-two elderly men who were 65 years of age or older were randomly allocated to either a control or experimental group (allocation ratio 1:1). The experimental group received an exergame intervention that included Xbox Kinect with games focusing on movements of the knee joint for 8 weeks (three times per week and 40min per sessions). A Biodex Isokinetic Dynamometer was used to measure knee joint position sense before and after the exercise program.

RESULTS: After eight weeks of training, knee proprioception significantly improved in the intervention group for several knee joint angles: 30° (3.5±1.1), 45° (3.1±0.9), and 60° (3.0±0.6) compared to the control group 30° (5.2±0.8), 45° (5.2±0.8), and 60° (6.2±0.9) (dominant leg F1, 28=23.469, p=0.001. ƞ2=0.456; non-dominant leg F1, 28=23.076, p=0.001. ƞ2=0.452).

CONCLUSION: The results from this study indicate that exergame intervention can enhance knee proprioception in elderly men.

Matched MeSH terms: Proprioception/physiology*
Fulltext Rubber hands in space: the role of distance and relative position in the rubber hand illusion

Kalckert A, Perera AT, Ganesan Y, Tan E

Exp Brain Res, 2019 Jul;237(7):1821-1832.
PMID: 31079236 DOI: 10.1007/s00221-019-05539-6

The rubber hand illusion (RHI) is a perceptual phenomenon in which participants experience ownership over a fake model hand through synchronous visuotactile stimulation. Several studies have shown that the illusion occurs only when both hands are in close proximity to each other. In the present study, we systematically examined the role of relative position (lateral, distal) and distance (13-75 cm) of the model hand (with respect to participants' real hand) on illusion experience across both lateral and distal positions. Furthermore, we also compared different facets of the subjective illusion experience; the experience of the model hand being part of one's body (i.e., ownership) and the perceptual fusion of vision and touch (i.e., referral of touch). In two experiments we observed indications for a stronger illusion experiences in distal compared to lateral positions of identical distances, indicating that the illusory effects may vary as a function of the relative position of the hand. Our results also showed that manipulations of distance differently modulated both facets of the illusion. While ownership was restricted to near distances, referral of touch sensations remained stable at farther distances. These results are interpreted in relation to variations in sensory weighting across different planes.

Matched MeSH terms: Proprioception/physiology*
The evidence-base for elevated vacuum in lower limb prosthetics: Literature review and professional feedback

Gholizadeh H, Lemaire ED, Eshraghi A

Clin Biomech (Bristol, Avon), 2016 08;37:108-116.
PMID: 27423025 DOI: 10.1016/j.clinbiomech.2016.06.005

BACKGROUND: An optimal suspension system can improve comfort and quality of life in people with limb loss. To guide practice on prosthetic vacuum suspension systems, assessment of the current evidence and professional opinion are required.
METHODS: PubMed, Web of Science, and Google Scholar databases were explored to find related articles. Search terms were amputees, artificial limb, prosthetic suspension, prosthetic liner, vacuum, and prosthesis. The results were refined by vacuum socket or vacuum assisted suspension or sub-atmospheric suspension. Study design, research instrument, sample size, and outcome measures were reviewed. An online questionnaire was also designed and distributed worldwide among professionals and prosthetists (www.ispoint.org, OANDP-L, LinkedIn, personal email).
FINDINGS: 26 articles were published from 2001 to March 2016. The number of participants averaged 7 (SD=4) for transtibial and 6 (SD=6) for transfemoral amputees. Most studies evaluated the short-term effects of vacuum systems by measuring stump volume changes, gait parameters, pistoning, interface pressures, satisfaction, balance, and wound healing. 155 professionals replied to the questionnaire and supported results from the literature. Elevated vacuum systems may have some advantages over the other suspension systems, but may not be appropriate for all people with limb loss.
INTERPRETATION: Elevated vacuum suspension could improve comfort and quality of life for people with limb loss. However, future investigations with larger sample sizes are needed to provide strong statistical conclusions and to evaluate long-term effects of these systems.

Matched MeSH terms: Proprioception/physiology
Sharpening the Sharpened Romberg

Lee CT

SPUMS J, 1998 Sep;28(3):125-32.
PMID: 11542272

The Sharpened Romberg Test (SRT) is a test of balance commonly used in Diving Medicine. Interpretation of an abnormal test can be confounded by several factors. This study was conducted to further evaluate the usefulness of the SRT. In the first part of the study, naval and civilian volunteers in a Naval Base were recruited as subjects. The SRT scores were recorded in two separate trials; once in the morning (4 attempts) and once in the evening (4 attempts) to evaluate the effect of practice on the SRT. In the second part of the study immediate pre- and post-dive scores in a group of divers were measured to evaluate: (1) the effect of decompression; (2) the effect of the normal post-dive fatigue; and (3) the vestibular effect of swaying after a boat ride. Comparisons were also made between the distributions of the SRTs of the normal subjects and those of a retrospective group of DCI patients treated at the Slark Hyperbaric Unit, Royal New Zealand Navy Hospital (RNZNH), Auckland. The SRT was found to have an early learning effect. Second attempts were significantly better than the first (p<0.001) within the same trial. However this learning effect plateaued by the third and fourth attempts. No difference was found between trials (morning and evening). There was a post-dive decline in the scores of the first attempts only (p<0.05). Subsequent second to fourth attempts were not affected by diving. The practice effect is only evident between the first and second attempts within the same trial but not between trials. The pre- and post-dive data showed that the SRT was not affected by decompression, post-dive fatigue or the vestibular sensation of swaying that is commonly experienced after a boat ride. Comparison of the distributions between controls and DCI patients showed a bimodal pattern. Fifty-four percent (54%) of the DCI patients had 'normal' scores (60 seconds), while 14% had scores between 16-35 seconds and 32% scored less than 15 seconds. In contrast, 95% of the control groups had 'normal' scores while 5% scored between 16-35 seconds. Therefore, accepting a score of less than 40 seconds as being "abnormal" will give the SRT a sensitivity of 46%, specificity of 95% and predictive value of 82%.

Matched MeSH terms: Proprioception/physiology*