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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: Postural Balance/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: Postural Balance/physiology*
The effect of feet position on standing balance in patients with diabetes

Mehdikhani M, Khalaj N, Chung TY, Mazlan M

Proc Inst Mech Eng H, 2014 Aug;228(8):819-23.
PMID: 25205748 DOI: 10.1177/0954411914547714

Feet displacement is recognized to be an important element in standing and is also linked to postural instability in elderly people with diabetes. This study investigates standing balance in diabetic patients in four asymmetric feet displacements. Quiet standing balance was investigated using the Biodex Balance System in 18 diabetic patients and compared with 18 control elderly subjects. The four standing conditions, namely, comfortable feet position, preferred feet position with a stance width of 17 cm and 15° angle between the medial borders, feet side by side, and heel side by side with a 30° angle between medial edges of feet were evaluated (i.e. eyes opened, eyes closed). The overall stability was calculated by measuring anterior-posterior and medial-lateral indices in standing conditions. Differences among feet positions were compared using an analysis of variance and the independent t-test. The diabetic patients were unstable in the medial-lateral direction when standing with feet side by side versus heel side by side with a 30° angle between medial edges of feet (p = 0.012 and 0.011, respectively), while in controls the anterior-posterior stability scores between standing in preferred foot position with stance width of 17 cm and 15° angle between the medial borders versus feet side by side, and heel side by side with a 30° angle between medial edges of feet versus preferred foot position with stance width of 17 cm and 15° angle between the medial borders had significant difference (p

Matched MeSH terms: Postural Balance/physiology*
Fulltext The effect on human balance of standing with toe-extension

Ku PX, Abu Osman NA, Yusof A, Wan Abas WA

PLoS One, 2012;7(7):e41539.
PMID: 22848523 DOI: 10.1371/journal.pone.0041539

Postural balance is vital for safely carrying out many daily activities, such as locomotion. The purpose of this study was to determine how changes in normal standing (NS) and standing with toe-extension (SWT) impact postural control during quiet standing. Furthermore, the research aimed to examine the extent to which the effect of these factors differed between genders.

Matched MeSH terms: Postural Balance/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: Postural Balance/physiology*
The effects of toe-out and toe-in postures on static & dynamic balance, risk of fall and TUG score in healthy adults

Khan SJ, Khan SS, Usman J

Foot (Edinb), 2019 Jun;39:122-128.
PMID: 30580888 DOI: 10.1016/j.foot.2018.06.002

BACKGROUND: Toe-in and toe-out foot positions have not yet been tested for dynamic balance and risk of fall. The aim of this study was to investigate the effects of these two modifications on static and dynamic postural stability and risk of fall through instrumental (Biodex Balance System®) and functional (timed up and go-TUG test) tools.
METHODOLOGY: Twenty healthy adults (8 males, 12 females, age: 29±4.10years, BMI: 21.56±2.36kg/m2) participated in this study. Static and dynamic (levels 8 and 2) balance with single stance and double stance and dynamic (level 8 and levels 6-2) for risk of fall with double stance were tested with the Biodex Balance System with three self-selected feet positions: straight (13.8°), toe-out (35.6°) and toe-in (-11.9°) for each test condition. Additionally, TUG test was performed with toe-out and toe-in gait.
RESULTS: The results of repeated measures ANOVA showed significant differences (p<0.05) between straight and modified toe angles in balance at dynamic level 2 with both double and single stance conditions. Significant differences (p<0.001) were also found in TUG scores for the test conditions.
CONCLUSION: Toe-in and toe-out gait modifications have significant effects on balance at higher levels of platform tilt and functional balance. Further investigations with knee osteoarthritis patients and electromyography may provide insight in balancing strategies adopted by the body in toe-out and toe-in gait.

Matched MeSH terms: Postural Balance/physiology*
Fulltext The impact of a submaximal level of exercise on balance performance in older persons

Alias HA, Justine M

ScientificWorldJournal, 2014;2014:986252.
PMID: 25383386 DOI: 10.1155/2014/986252

The purpose of this study was to determine the impact of a submaximal level of exercise on balance performance under a variety of conditions.

Matched MeSH terms: Postural Balance/physiology*
The limits of stability and muscle activity in middle-aged adults during static and dynamic stance

Ku PX, Abu Osman NA, Wan Abas WAB

J Biomech, 2016 Dec 08;49(16):3943-3948.
PMID: 27865478 DOI: 10.1016/j.jbiomech.2016.11.006

Balance control plays an important role in maintaining daily activity. However, studies on postural control among middle-aged adults are scarce. This study aims (i) to examine directional control (DCL) and electromyography activity (EMG) for different stability levels, and (ii) to determine left-right asymmetry for DCL and muscle activity among sedentary middle-aged adults. Twenty healthy, middle-aged adults (10 males, 10 females; age=50.0±7.5yrs; body height: 1.61±0.10m; body mass: 70.0±14.5kg) participated in the study. EMG for left and right side of rectus femoris (RF), biceps femoris (BF), and medial gastrocnemius (MG) were recorded. Two-way repeated measures analysis of variance was used to assess the effect of dynamic level on DCL and EMG, whereas independent sample t-test was conducted to analyse the asymmetries of DCL and EMG for the left and right leg. When the dynamic tilt surface increased, DCL scores significantly decreased (except forward, forward-rightward, and backward-leftward direction) and only RF muscle indicated significant differences. Left-right asymmetry was found in BF and MG muscles. No significant gender difference was observed in DCL and EMG. These data demonstrated that increased dynamic tilt surface may increase the displacement of center of pressure of certain directions, and stimulate RF activity in dynamic stance among sedentary middle-aged adults. Further studies should be conducted to examine the dynamic stance and muscle activity of the lower limb in age-matched patient groups with balance abnormalities.

Matched MeSH terms: Postural Balance/physiology
Unexpected-Disturbance Program for Rehabilitation of High-Performance Athletes

Teichmann J, Suwarganda EK, Lendewig C, Wilson BD, Yeo WK, Aziz RA, et al.

J Sport Rehabil, 2016 May;25(2):126-32.
PMID: 25658597 DOI: 10-1123/jsr.2014-0280

CONTEXT: The Unexpected-Disturbance Program (UDP) promotes exercises in response to so-called involuntary short- to midlatency disturbances.
OBJECTIVE: This study investigated the effectiveness of the UDP in the last 6 wk of rehabilitation.
DESIGN: Pre-post study with 2-tailed paired t tests for limited a priori comparisons to examine differences.
SETTING: National Sports Institute of Malaysia.
PARTICIPANTS: 24 Malaysian national athletes.
INTERVENTIONS: 7 sessions/wk of 90 min with 3 sessions allocated for 5 or 6 UDP exercises.
MAIN OUTCOMES: Significant improvements for men and women were noted. Tests included 20-m sprint, 1-repetition-maximum single-leg press, standing long jump, single-leg sway, and a psychological questionnaire.
RESULTS: For men and women, respectively, average strength improvements of 22% (d = 0.96) and 29% (d = 1.05), sprint time of 3% (d = 1.06) and 4% (d = 0.58), and distance jumped of 4% (d = 0.59) and 6% (d = 0.47) were noted. In addition, athletes reported improved perceived confidence in their abilities. All athletes improved in each functional test except for long jump in 2 of the athletes. Mediolateral sway decreased in 18 of the 22 athletes for the injured limb.
CONCLUSION: The prevention training with UDP resulted in improved conditioning and seems to decrease mediolateral sway.

Matched MeSH terms: Postural Balance/physiology