Quantifying Postural Control in Premanifest and Manifest Huntington Disease Using Wearable Sensors

Background. Impairments in postural control in Huntington disease (HD) have important consequences for daily functioning. This observational study systematically examined baseline postural control and the effect of sensory attenuation and sensory enhancement on postural control across the spectrum of HD. Methods. Participants (n = 39) included healthy controls and individuals in premanifest (pHD) and manifest stages (mHD) of HD. Using wearable sensors, postural control was assessed according to (1) postural set (sit vs stand), (2) sensory attenuation using clinical test of sensory integration, and (3) sensory enhancement with gaze fixation. Outcomes included sway smoothness, amplitude, and frequency. Results. Based on postural set, pHD reduced postural sway in sitting relative to standing, whereas mHD had pronounced sway in standing and sitting, highlighting a baseline postural deficit. During sensory attenuation, postural control in pHD deteriorated relative to controls when proprioceptive demands were high (eyes closed on foam), whereas mHD had significant deterioration of postural control when proprioception was attenuated (eyes open and closed on foam). Finally, gaze fixation improved sway smoothness, amplitude, and frequency in pHD; however, no benefit was observed in mHD. Conclusions. Systematic examination of postural control revealed a fundamental postural deficit in mHD, which further deteriorates when proprioception is challenged. Meanwhile, postural deficits in pHD are detectable when proprioceptive challenge is high. Sensory enhancing strategies using gaze fixation to benefit posture may be useful when introduced well before motor diagnosis. These findings encourage further examination of wearable sensors as part of routine clinical assessments in HD.

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Influence of gender and physical exercise on balance of healthy young adults

Fisioterapia em Movimento ◽

10.1590/0103-5150.027.003.ao10 ◽

2014 ◽

Vol 27 (3) ◽

pp. 399-406 ◽

Cited By ~ 3

Author(s):

Sarina Francescato Torres ◽

Júlia Guimarães Reis ◽

Daniela Cristina Carvalho de Abreu

Keyword(s):

Physical Activity ◽

Energy Expenditure ◽

Postural Control ◽

Postural Sway ◽

Short Form ◽

Quiet Standing ◽

Moderate Activity ◽

Men And Women ◽

Eyes Closed ◽

Sedentary Women

Objective To verify the effects of gender and physical activity on postural sway. Method A cross-sectional study was conducted to analyze upright balance of young men and women between the ages of 20-30, both active and sedentary. Study participants were 60 individuals, who were divided into: active women (n = 15), sedentary women (n = 15), active men (n = 15) and sedentary men (n = 15). The International Physical Activity Questionnaire (IPAQ) short form, was used to evaluate each participant’s level of physical activity. According to the questionnaire, active individuals are those who carry out moderate activity, with an energy expenditure between 3.5 and 6 METs (1 MET: 3.5 ml/kg/min), or vigorous activity, with an energy expenditure above 6 METs, at least three days a week for 20 minutes. To assess control of postural sway, we measured the amplitude and velocity of anteroposterior (AP) and mediolateral (ML) sway in standing position, with their eyes open and closed, with and without foam, on a force platform. Results Comparison between genders revealed that, when compared to sedentary women, sedentary men displayed poorer performance in velocity and amplitude of AP postural control sway with their eyes closed, with and without foam. There were no differences in the amplitude and velocity of ML sway, both with open and closed eyes among groups (p < 0.05). There were no differences when comparing physically active men and women either. Conclusion Sedentary men seem to rely more on vision for maintaining postural control in quiet standing situations with respect to women.

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Investigation of Balance in Old People Residing in Nursing Homes Using Clinical Assessments

Function and Disability Journal ◽

10.32598/fdj.3.137.1 ◽

2020 ◽

Vol 3 (1) ◽

pp. 11-16

Author(s):

Sogol Zeinali ◽

◽

Zahra Olyaei ◽

Benyamin Kor ◽

Maryam Binesh ◽

...

Keyword(s):

Nursing Homes ◽

Postural Sway ◽

Age Groups ◽

Clinical Test ◽

Old People ◽

Timed Up And Go ◽

Cross Sectional ◽

Clinical Assessments ◽

Eyes Closed ◽

Eyes Open

Background and Objectives: Balance problems are the main cause of falls and fall-related complications in the elderly. The objective of this study was to investigate the balance in old people residing in nursing homes using clinical assessments. Methods: A total of 54 people participated in this cross-sectional study. Timed Up and Go (TUG) was used to assess balance regarding mobility impairments. The modified Clinical Test Of Sensory Interaction on Balance (CTSIB) was also used to assess balance regarding sensory problems. This test was used in 4 conditions: standing with eyes open on a firm surface, standing with eyes closed on a firm surface, standing with eyes open on a compliant foam, and standing with eyes closed on a compliant foam. Data analysis was done by SPSS V. 18 software. Results: The mean time for the completion of TUG was significantly higher than standard scores in all age groups (P<0.05). Postural sway during standing with eyes closed on the ground, eyes open and eyes closed on the foam was more than standing with eyes open on the ground (P<0.001). Postural sway in standing with eyes closed on the foam was more in comparison with standing with eyes closed on the ground and eyes open on the foam (P<0.001). Conclusion: Elderly people living in nursing homes had poorer motor skills to maintain balance. They also showed greater dependence on visual and sensory systems to maintain balance.

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The effect of the type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) on the accuracy in identifying older adults with fall history

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702520500134 ◽

2020 ◽

Vol 40 (02) ◽

pp. 133-143

Author(s):

Rumpa Boonsinsukh ◽

Bodin Khumnonchai ◽

Vitoon Saengsirisuwan ◽

Nithinun Chaikeeree

Keyword(s):

Roc Analysis ◽

Postural Sway ◽

Characteristic Curve ◽

Composite Score ◽

Cutoff Score ◽

Clinical Test ◽

Large Area ◽

Sensory Interaction ◽

Accurate Identification ◽

Eyes Closed

Background: The type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) influences the accuracy with which elderly fallers are identified. Two types of foam are commonly used in practice: Airex and Neurocom foam. Objective: The aim of this study was to assess the accuracy with which elderly fallers can be identified when the Airex foam and Neurocom foam are used in the mCTSIB. Methods: One hundred eighty-four elderly participants with a mean age of 69 years were classified into faller and nonfaller groups based on their 12-month fall history. Balance stability was measured under four conditions of the mCTSIB for 120 s each: standing on a floor or a foam pad with their eyes open or eyes closed. The time needed to maintain stability was measured by a stopwatch, and postural sway characteristics were measured using an acceleration-based system. Comparisons between groups were performed by two-way mixed ANOVA. The accuracy of differentiating elderly fallers from nonfallers with different foam types was evaluated using receiver operating characteristic curve (ROC) analysis. The time to maintain stability under four conditions of the mCTSIB (composite score) and under two conditions on the foam (foam score) were used for the ROC analysis. Results: The results showed that the nonfallers required more time to maintain stability and had a smaller sway area than the fallers ([Formula: see text]). The foam led to a larger difference between groups, suggesting the use of foam in examining the risk of falls. The Airex and the Neurocom foam pads led to a large area under the curve (0.93 to 0.95) in identifying elderly fallers and nonfallers when the composite and foam scores were used. A cutoff score of 447/480 s for the composite score and 223/240 s for the foam score yielded a posttest accuracy of 88% to 89%, with a sensitivity of 0.80–0.92 and specificity of 0.88–0.95. Conclusion: In conclusion, Airex and Neurocom foam can be used interchangeably with guidance in the mCTSIB, as they led to the accurate identification of elderly fallers among older persons who could walk and live independently in the community.

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Effect of Head Orientation on Human Postural Stability Following Unilateral Vestibular Ablation

Journal of Vestibular Research ◽

10.3233/ves-1991-1206 ◽

1991 ◽

Vol 1 (2) ◽

pp. 153-160

Author(s):

Charles R. Fox ◽

Gary D. Paige

Keyword(s):

Postural Control ◽

Postural Stability ◽

Postural Sway ◽

Normal Subjects ◽

Head Orientation ◽

Support Surface ◽

Eyes Closed ◽

Vestibular Information ◽

Postural Equilibrium ◽

Vestibular Pathology

Effective interpretation of vestibular inputs to postural control requires that orientation of head on body is known. Postural stability might deteriorate when vestibular information and neck information are not properly coupled, as might occur with vestibular pathology. Postural sway was assessed in unilateral vestibulopathic patients before and acutely, 1,4, and 18+ months after unilateral vestibular ablation (UVA) as well as in normal subjects. Postural equilibrium with eyes closed was quantified as scaled pk-pk sway during 20 s trials in which the support surface was modulated proportionally with sway. Subjects were tested with the head upright and facing forward, turned 45∘ right, and 45∘ left. Equilibrium was uninfluenced by head orientation in normal subjects. In contrast, patients after UV A showed both a general reduction in stability and a right/left head orientation-dependent asymmetry. These abnormalities adaptively recovered with time. It is concluded that vestibular inputs to postural control are interpreted within a sensory-motor context of head-on-body orientation.

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Postural control and executive functioning in patients with schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2132 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S195-S195

Author(s):

M. Yildirim ◽

A. Elvan ◽

G. Ercegil ◽

I.E. Simsek ◽

S. Savci ◽

...

Keyword(s):

Executive Functioning ◽

Postural Control ◽

Verbal Fluency ◽

Postural Sway ◽

Cognitive Task ◽

Motor Task ◽

Executive Dysfunction ◽

Proprioceptive Information ◽

Healthy Controls ◽

Eyes Closed

IntroductionPatients with schizophrenia commonly show deficits in executive functioning that allow a person to make plans, solve problems, do many tasks simultaneously and adapt to unexpected conditions. Executive dysfunction is associated with very simple and automatic activities, such as walking in schizophrenia patients. However, no study exists about its relation to postural control in these patients.AimTo investigate the effect of executive functioning on postural control using dual task paradigms.MethodsFifteen clinically stable schizophrenia outpatients and 15 healthy controls were enrolled in the study. Postural control was assessed with bilateral stance test using the Balance Master system under three different conditions with eyes open and eyes closed (EC): without a task, during a cognitive task (verbal fluency) and during a motor task (holding a cup of water).ResultsStanding on a foam surface with EC resulted in higher postural sway velocities in schizophrenia patients under all conditions (P = 0.009, P = 0.032, P = 0.013). During a cognitive task, both schizophrenia patients and healthy controls showed higher velocities on firm surface with EC in comparison to the condition without a task (P = 0.023). Both schizophrenia patients and healthy controls did not show higher postural sway velocities during the motor task.ConclusionThe effect of verbal fluency on postural sway shows the relationship between executive functioning and postural control in schizophrenia patients. Foam surface also higher postural sway velocities in schizophrenia patients in EC condition suggesting the difficulties in integrating the proprioceptive information in the absence of visual input.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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43 State Mental Energy Influences Posture During Vision-Occluded States

Age and Ageing ◽

10.1093/ageing/afz164.43 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv9-iv12

Author(s):

Ali Boolani ◽

Chelsea Yager ◽

Matthew Lee Smith ◽

Sumona Mondal ◽

Thevasha Sathiyakumar ◽

...

Keyword(s):

Postural Control ◽

Significant Risk ◽

Significant Risk Factor ◽

Mood States ◽

Clinical Test ◽

Eyes Closed ◽

Physical Energy ◽

Clinical Recommendation ◽

Increased Risk ◽

State Mental

Abstract Background Fatigue has been postulated to influence postural control, which may lead to an increased risk for falling among older adults.1 Mental and physical energy and fatigue have recently been reported to be four distinct mood states.2,3 Thus, to test Grobe’s1 theory of the influence of fatigue on postural control, we must examine all four mood states. Objective This study examined the influence of mental and physical energy and fatigue on postural control. Methods Adults (N=133, Males=50, Females=83, Age=25.8±7.96, BMI=24.8±3.8) aged 18-69 years were recruited from the community and asked to complete a series of surveys that measured their current mental and physical energy and fatigue states. After the completion of the surveys, subjects were instructed to complete the modified Clinical Test of Sensory Interaction in Balance (mCTSIB) using the APDM mobility monitors. Necessary assumptions were verified, and four multivariate multiple regression models were developed. Results Analyses yielded a significant association between posture and state mental energy (p=.048), but only when subjects were standing with their eyes closed while on a foam surface. Increased feelings of mental energy were associated with decreased total frequency dispersion (b=-358.62) and increased jerk in the coronal plane (b=11.78). No other associations were found. Discussion Results of our study suggest that as mental energy decreases there is a concomitant decrease in postural control when subjects are placed in conditions where they are unable to rely on visual feedback on unstable surfaces to maintain balance. Progressive increases in postural instability lead to increased risks of falls, most commonly in the elderly population. Falls are a significant risk factor for mortality. This study supports the clinical recommendation either to: (1) improve integration of vestibular and somatosensory input into postural control; or (2) train compensatory strategies for low lighting environments during episodes of decreased mental energy.

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Interactive Sensor-Based Balance Training in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial

Gerontology ◽

10.1159/000442253 ◽

2015 ◽

Vol 62 (5) ◽

pp. 553-563 ◽

Cited By ~ 42

Author(s):

Michael Schwenk ◽

Gurtej S. Grewal ◽

Dustin Holloway ◽

Amy Muchna ◽

Linda Garland ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Postural Control ◽

Cancer Patients ◽

Fear Of Falling ◽

Wearable Sensors ◽

Balance Training ◽

Joint Movement ◽

Eyes Closed ◽

Closed Position ◽

Older Cancer Patients

Background: Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have deficits in sensory and motor skills leading to inappropriate proprioceptive feedback, impaired postural control, and fall risk. Balance training programs specifically developed for CIPN patients are lacking. Objective: This pilot study investigated the effect of an interactive motor adaptation balance training program based on wearable sensors for improving balance in older cancer patients with CIPN. Methods: Twenty-two patients (age: 70.3 ± 8.7 years) with objectively confirmed CIPN [vibration perception threshold (VPT) >25 V] were randomized to either an intervention (IG) or a control (CG) group. The IG received interactive game-based balance training including repetitive weight shifting and virtual obstacle crossing tasks. Wearable sensors provided real-time visual/auditory feedback from the lower limb trajectory and allowed the perception of motor errors during each motor action. The CG received no exercise intervention and continued their normal activity. Outcome measures were changes in sway of ankle, hip, and center of mass (CoM) in both mediolateral and anteroposterior (AP) directions during 30-second balance tests with increasing task difficulty [i.e. standing in feet-closed position with eyes open (EO) and eyes closed (EC), and in semi-tandem position with EO] at baseline and after the intervention. Additionally, gait performance (speed, variability) and fear of falling [Falls Efficacy Scale-International (FES-I)] were measured. Results: Training was safe despite the participants' impaired health status, great severity of CIPN (VPT 49.6 ± 26.7 V), and great fear of falling (FES-I score 31.37 ± 11.20). After the intervention, sway of hip, ankle, and CoM was significantly reduced in the IG compared to the CG while standing in feet-closed position with EO (p = 0.010-0.022, except AP CoM sway) and in semi-tandem position (p = 0.008-0.035, except ankle sway). No significant effects were found for balance with EC, gait speed, and FES-I score (p > 0.05). Conclusions: This proof-of-concept study demonstrates that older cancer patients with CIPN can significantly improve their postural balance with specifically tailored, sensor-based exercise training. The training approach has potential as a therapy for improving CIPN-related postural control deficits. However, future studies comparing the proposed technology-based training with traditional balance training are required to evaluate the benefit of the interactive joint movement feedback.

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Correlation between body weight and postural control in healthy individuals using sway meter

Obesity and metabolism ◽

10.14341/omet10110 ◽

2019 ◽

Vol 16 (2) ◽

pp. 36-41

Author(s):

Tharani G ◽

Vedha Varshini M G ◽

Senthil Nathan C V ◽

Mohan Kumar G ◽

Kamatchi K

Keyword(s):

Body Weight ◽

Postural Control ◽

Body Mass ◽

Strong Correlation ◽

Daily Living ◽

Postural Sway ◽

The Body ◽

Healthy Individuals ◽

Eyes Closed ◽

Anterior Posterior

BACKGROUND: Postural control is critical for ensuring a safety activity of daily living. Individuals with poor stability are more prone to fall while doing activities of daily living. A certain level of sway is essentially present due to small perturbation within the body during shifting body weight from one to other foot, breathing, etc. The purpose of this study was to analyze the correlation between body mass and postural control in normal, lean and obese individual. AIMS: to analyze the correlation between body mass and postural control in healthy individuals using sway meter. MATERIALS AND METHODS: This is an observational study done with 75 participants. Both male and female healthy individuals between 18-23 years were included in this study. Individuals with any musculoskeletal injuries, neurological conditions, peripheral artery disease and pregnant women were excluded from the study. BMI of each participant was calculated and assigned into three groups. Group A-lean, group B-normal and group C-obese. Postural control was analyzed for each group by using sway meter; level of postural sway was compared between groups A, B C. RESULTS: On comparing mean values of groups A, B and C there was a positive association and strong correlation between body mass index and postural control with eye open and eye closed in anterior, posterior and postural sway towards left between the groups at (P 0.05). However, there was a negative association and weak correlation between BMI and postural control with eye open eye closed in postural sway towards right between the groups at (P 0.05). CONCLUSIONS: This study reveals that there is strong correlation between BMI and postural control. Subjects in eyes closed and eyes opened conditions showed sway in anterior, posterior and left directions but there was less sway towards right side direction.

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Increased static postural sway after energy drink consumption: A randomized trial

F1000Research ◽

10.12688/f1000research.12565.1 ◽

2017 ◽

Vol 6 ◽

pp. 2036

Author(s):

Martin G. Rosario ◽

Henry Collazo ◽

Milagros Mateo ◽

Maryví Gonzalez-Sola ◽

Flavia Bayron

Keyword(s):

Postural Control ◽

Postural Sway ◽

Center Of Pressure ◽

Energy Drinks ◽

Energy Drink ◽

The United States ◽

General Tendency ◽

Postural Perturbation ◽

Eyes Closed ◽

The Central Nervous System

Background: Energy drinks consumption continues to grow since its appearance in the United States in 1997. Available evidence indicates that caffeine, their main ingredient, can alter the central nervous system (CNS). However, it is unknown how energy drinks alter the CNS postural control mechanism. The purpose of this study was to investigate how energy drinks can affect postural control after sensory perturbations during stance. Methods: 20 healthy adults, (11 males; 9 females) averaging 26.1 years of age, stood on a MatScan™ pressure mat, which measured center of pressure (CoP), anteroposterior (AP) and mediolateral (ML) postural sways during eight different balance tests (BALT’s). BALT's were designed to alter or cancel the systems involved in postural control: visual, vestibular and somatosensory. Subjects were randomly assigned to a caffeine group and an energy drink group. MANOVA analysis was performed for all variables of interest. Results: In the caffeine group, the AP sway of the Eyes Closed test on a stable surface was statistically significant. In the energy drinks group, we observed a general tendency of participants to increase CoP slightly, AP and ML sway in most of the BALT’s after the consumption of an energy drink. However, this increase was not statistically significant. These results suggest that in healthy young adults, the sensory re-weighting mechanism can overcome postural perturbation and maintain overall postural control. Conclusions: We observed an overall tendency to increase postural instability after the ingestion of energy drinks.

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The contribution of hearing to normal balance

The Journal of Laryngology & Otology ◽

10.1017/s002221511200179x ◽

2012 ◽

Vol 126 (10) ◽

pp. 984-988 ◽

Cited By ~ 34

Author(s):

R G Kanegaonkar ◽

K Amin ◽

M Clarke

Keyword(s):

Postural Control ◽

Significant Influence ◽

Postural Sway ◽

Normal Subjects ◽

Nintendo Wii ◽

Sensory Inputs ◽

Eyes Closed ◽

Ambient Sound ◽

Eyes Open ◽

Balance Board

AbstractIntroduction:Normal balance relies on three sensory inputs: vision, proprioception and the peripheral vestibular system. This study assessed hearing change and postural control in normal subjects.Materials and methods:Postural control in 20 normal volunteers was assessed using a Nintendo Wii gaming console and balance board. Each subject was tested standing upright for 30 seconds in a clinic room and a soundproof room with their eyes open, eyes closed, whilst standing on and off foam, and with and without ear defenders.Results:There was significantly more postural sway in the following subjects: those standing with their eyes closed vs those with eyes open (normal room, p = 0.0002; soundproof room, p = 0.0164); those standing on foam with eyes open vs those standing normally with eyes open (in both rooms; p < 0.05); those standing with eyes open in a soundproof room vs a normal room (p = 0.0164); and those standing on foam in a soundproof room with eyes open and wearing ear defenders vs those in the same circumstances but without ear defenders.Conclusion:Our results suggest that this method provides a simple, inexpensive tool for assessing static postural control. Whilst it is recognised that visual input and proprioception play a central role in maintaining posture, our findings suggest that ambient sound and hearing may also have a significant influence.

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