Original study. The clinical value of foam posturography in assessing patients with peripheral vestibular dysfunction – our experience

2017 ◽  
Vol 7 (26) ◽  
pp. 93-101
Author(s):  
Raluca Enache ◽  
Dorin Sarafoleanu ◽  
Codrut Sarafoleanu
Keyword(s):  
Center Of Pressure ◽  
Balance Control ◽  
Vestibular Dysfunction ◽  
Control Group ◽  
Vestibular Disorders ◽  
Clinical Value ◽  
Dynamic Posturography ◽  
Eyes Closed ◽  
Peripheral Vestibulopathy ◽  
Romberg Test

Abstract BACKGROUND. Computerized dynamic posturography is the most important battery test designed to assess the ability to use visual, vestibular and proprioceptive cues in the maintenance of posture. Foam posturography reduces the availability of proprioceptive inputs, which makes more difficult the balance control. OBJECTIVE. The objective of the study was to assess the clinical use of foam posturography in evaluating peripheral vestibular dysfunction. MATERIAL AND METHODS. We evaluated 41 patients with vestibular disorders and 41 normal patients by using the sensory organization test in eyes opened, eyes closed and mislead vision conditions with and without the foam. We measured several parameters: the position of the center of pressure, the displacement in the center of pressure in anteroposterior and mediolateral planes and Romberg’s ratio on static and foam rubber. RESULTS. The values of all parameters were significantly higher in patients with peripheral vestibular disorders than in the control group (p<0.05). Also. comparing the Romberg test results, the foam surface used by the patient was larger than the static one. CONCLUSION. Foam posturography can be a reliable test in assessing patients with peripheral vestibulopathy, being also able to identify the visual and proprioceptive dependence levels.

scholarly journals Severe Dizziness Related to Postural Instability, Changes in Gait and Cognitive Skills in Patients with Chronic Peripheral Vestibulopathy

2019 ◽  
Vol 24 (01) ◽  
pp. e99-e106 ◽  
Author(s):  
Almir Resende Coelho ◽  
Júlia Licursi Lambertti Perobelli ◽  
Lilian Shizuka Sonobe ◽  
Renato Moraes ◽  
Camila Giacomo de Carneiro Barros ◽  
...  
Keyword(s):  
Cognitive Skills ◽  
Elderly Women ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Step Length ◽  
Control Group ◽  
Vestibular Disorders ◽  
Cognitive Assessments ◽  
Cognitive Balance ◽  
Peripheral Vestibulopathy

Abstract Introduction Peripheral vestibular disorders can lead to cognitive deficits and are more common in elderly patients. Objective To evaluate and correlate cognitive, balance and gait aspects in elderly women with chronic peripheral vestibular dizziness, and to compare them with elderly women without vestibular disorders. Methods Twenty-two women presenting peripheral vestibular dizziness episodes for at least six months participated in the study. The individuals were categorized by dizziness severity level: moderate (n = 11) or severe (n = 11). The control group (n = 11) included women showing no vestibulopathy, light-headedness or dizziness. Cognitive assessments and semi-static and dynamic balance assessments were performed with the Balance Master (Neurocom International, Inc., Clackamas, OR), while the Dizziness Handicap Inventory provided a score for the severity of the symptoms. The groups were submitted to statistics of inference and correlation between cognitive, balance and stability variables. Results The group with severe dizziness showed higher sway speed of the center of pressure in the anteroposterior direction, smaller step length, and slower gait than the control group. Regarding the cognitive variables, the group with severe dizziness symptoms presented significant correlations with stability and gait variables. Conclusion The relationship between cognitive aspects, balance and gait was stronger in women with severe dizziness than in those with no vestibulopathy.

scholarly journals Greater exposure to repetitive subconcussive head impacts is associated with vestibular dysfunction and balance impairments during walking

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S27.2-S27
Author(s):  
Fernando Santos ◽  
Jaclyn B Caccese ◽  
Mariana Gongora ◽  
Ian Sotnek ◽  
Elizabeth Kaye ◽  
...  
Keyword(s):  
Center Of Pressure ◽  
Balance Control ◽  
Center Of Mass ◽  
Vestibular Stimulation ◽  
Vestibular Dysfunction ◽  
Foot Placement ◽  
Head Impacts ◽  
Eyes Closed ◽  
Balance Deficits ◽  
Soccer Heading

Exposure to repetitive subconcussive head impacts (RSHI), specifically soccer heading, is associated with white matter microstructural changes and cognitive performance impairments. However, the effect of soccer heading exposure on vestibular processing and balance control during walking has not been studied. Galvanic vestibular stimulation (GVS) is a tool that can be used to probe the vestibular system during standing and walking. The purpose of this study was to investigate the association of soccer heading with subclinical balance deficits during walking. Twenty adult amateur soccer players (10 males and 10 females, 22.3 ± 4.5 years, 170.5 ± 9.8 cm, 70.0 ± 10.5 kg) walked along a foam walkway with the eyes closed under 2 conditions: with GVS (∼40 trials) and without GVS (∼40 trials). Outcome measures included mediolateral center-of-mass (COM), center-of-pressure (COP) separation, foot placement, mediolateral ankle modulation, hip adduction, and ankle push off. For each balance mechanism, a GVS response was calculated (GVS, mean [without GVS]). In addition, participants completed a questionnaire, reporting soccer heading exposure over the past year. A linear regression model was used to determine if vestibular processing and balance during walking were related to RSHI exposure. Both foot placement (R2 = 0.324, p = 0.009) and hip adduction (R2 = 0.183, p = 0.50) were predicted by RSHI; whereby, greater exposure to RSHI was associated with greater foot placement and hip adduction responses. However, COM-COP separation (R2 < 0.001, p = 0.927), ankle modulation (R2 = 0.037, p = 0.417), and push off (R2 < 0.001, p = 0.968) were not related to RSHI exposure. Individuals who were exposed to greater RSHI were more perturbed by vestibular stimulation during walking, suggesting that there may be vestibular dysfunction and balance impairments with frequent heading; specifically, individuals with greater exposure to RSHI responded with larger foot placement and hip adduction responses to GVS.

scholarly journals Maximal stability limits in adolescents with Tourette syndrome

2021 ◽  
Vol 4 (1) ◽  
pp. 013-022
Author(s):  
Blanchet Mariève ◽  
Prince François ◽  
Lemay Martin ◽  
Chouinard Sylvain ◽  
Messier Julie
Keyword(s):  
Postural Control ◽  
Tourette Syndrome ◽  
Center Of Pressure ◽  
Phase 1 ◽  
Sensory Information ◽  
Control Group ◽  
Eyes Closed ◽  
Highly Sensitive ◽  
Eyes Open ◽  
Stability Limits

We explored if adolescents with Gilles de la Tourette syndrome (GTS) had functional postural control impairments and how these deficits are linked to a disturbance in the processing and integration of sensory information. We evaluated the displacements of the center of pressure (COP) during maximal leaning in four directions (forward, backward, rightward, leftward) and under three sensory conditions (eyes open, eyes closed, eyes closed standing on foam). GTS adolescents showed deficits in postural stability and in lateral postural adjustments but they had similar maximal COP excursion than the control group. The postural performance of the GTS group was poorer in the eyes open condition (time to phase 1 onset, max-mean COP). Moreover, they displayed a poorer ability to maintain the maximum leaning position under the eyes open condition during mediolateral leaning tasks. By contrast, during forward leaning, they showed larger min-max ranges than control subjects while standing on the foam with the eyes closed. Together, these findings support the idea that GTS produces subclinical postural control deficits. Importantly, our results suggest that postural control disorders in GTS are highly sensitive to voluntary postural leaning tasks which have high demand for multimodal sensory integration.

scholarly journals Applying the Minimal Detectable Change of a Static and Dynamic Balance Test Using a Portable Stabilometric Platform to Individually Assess Patients with Balance Disorders

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 402 ◽  
Author(s):  
Juan De la Torre ◽  
Javier Marin ◽  
Marco Polo ◽  
José J. Marín
Keyword(s):  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Static Balance ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Balance Test ◽  
Balance Disorders ◽  
Eyes Closed ◽  
Specialist Physician

Balance disorders have a high prevalence among elderly people in developed countries, and falls resulting from balance disorders involve high healthcare costs. Therefore, tools and indicators are necessary to assess the response to treatments. Therefore, the aim of this study is to detect relevant changes through minimal detectable change (MDC) values in patients with balance disorders, specifically with vertigo. A test-retest of a static and dynamic balance test was conducted on 34 healthy young volunteer subjects using a portable stabilometric platform. Afterwards, in order to show the MDC applicability, eight patients diagnosed with balance disorders characterized by vertigo of vestibular origin performed the balance test before and after a treatment, contrasting the results with the assessment by a specialist physician. The balance test consisted of four tasks from the Romberg test for static balance control, assessing dynamic postural balance through the limits of stability (LOS). The results obtained in the test-retest show the reproducibility of the system as being similar to or better than those found in the literature. Regarding the static balance variables with the lowest MDC value, we highlight the average velocity of the center of pressure (COP) in all tasks and the root mean square (RMS), the area, and the mediolateral displacement in soft surface, with eyes closed. In LOS, all COP limits and the average speed of the COP and RMS were highlighted. Of the eight patients assessed, an agreement between the specialist physician and the balance test results exists in six of them, and for two of the patients, the specialist physician reported no progression, whereas the balance test showed worsening. Patients showed changes that exceeded the MDC values, and these changes were correlated with the results reported by the specialist physician. We conclude that (at least for these eight patients) certain variables were sufficiently sensitive to detect changes linked to balance progression. This is intended to improve decision making and individualized patient monitoring.

The D+R Balance application: a novel method of assessing postural sway

2015 ◽  
Vol 129 (8) ◽  
pp. 773-778 ◽  
Author(s):  
C Yvon ◽  
A Najuko-Mafemera ◽  
R Kanegaonkar
Keyword(s):  
Healthy Volunteers ◽  
Feasibility Study ◽  
Postural Sway ◽  
Dynamic Posturography ◽  
Eyes Closed ◽  
Novel Method ◽  
Iphone Application ◽  
Romberg Test ◽  
Potential Use ◽  
Hard Floor

AbstractBackground:Postural sway can be assessed clinically using the Romberg test, or quantified using dynamic posturography. We assessed the potential use of a novel iPhone application as a method of quantifying sway.Methods:Fifty healthy volunteers performed the Romberg and tandem Romberg tests on a hard floor and on foam in soundproofed and normal clinic rooms. Postural sway was recorded using the D+R Balance application and data were compared using pairedt-tests.Results:Significantly more postural sway was noted in participants when standing with their eyes closed and feet in the ‘tandem’ positionvsfeet together; standing with their eyes closed on foamvson the floor; and standing with their eyes closed on foam with feet in the tandem positionvson the floor with feet together.Conclusion:This feasibility study suggests that the iPhone D+R Balance application deserves further investigation as a means of assessing postural sway and may provide an alternative to current dynamic posturography systems.

scholarly journals Static Balance in Patients with Vestibular Impairments: A Preliminary Study

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Hossein Talebi ◽  
Mohammad Taghi Karimi ◽  
Seyed Hamid Reza Abtahi ◽  
Niloofar Fereshtenejad
Keyword(s):  
Path Length ◽  
Center Of Pressure ◽  
Balance Control ◽  
Force Plate ◽  
Static Balance ◽  
Eyes Closed ◽  
Significant Difference ◽  
Eyes Open ◽  
Age Limits ◽  
The Difference

Aims. Vestibular system is indicated as one of the most important sensors responsible for static and dynamic postural control. In this study, we evaluated static balance in patients with unilateral vestibular impairments.Materials and Methods. We compared static balance control using Kistler force plate platform between 10 patients with unilateral vestibular impairments and 20 normal counterparts in the same sex ratio and age limits (50±7). We evaluated excursion and velocity of center of pressure (COP) and path length in anteroposterior (AP) and mediolateral (ML) planes with eyes open and with eyes closed.Results. There was no significant difference between COP excursions in ML and AP planes between both groups with eyes open and eyes closed (pvalue > 0.05). In contrast, the difference between velocity and path length of COP in the mentioned planes was significant between both groups with eyes open and eyes closed (pvalue < 0.05).Conclusions. The present study showed the static instability and balance of patients with vestibular impairments indicated by the abnormal characteristics of body balance.

Postural disorders in patients with vibration disease

2019 ◽  
pp. 314-318
Author(s):  
Larisa S. Vasileva ◽  
Natalya V. Slivnitsyna ◽  
Oleg L. Lakhman
Keyword(s):  
Center Of Pressure ◽  
Statistical Significance ◽  
Statistical Processing ◽  
Control Group ◽  
Combined Effects ◽  
Local Vibration ◽  
Vibration Disease ◽  
Eyes Closed ◽  
Significant Difference ◽  
Postural Disorders

Introduction. Vibration disease (VD) is one of the leading occupational diseases. One of the manifestations of this disease when exposed to general vibration may be a violation of balance.The aim of the study is to identify the imbalance and the causes of their occurrence in patients with vibration disease.Materials and methods. 3 groups of patients were examined. The first group consisted of 50 patients diagnosed with VD associated with combined exposure to local and general vibration (age 48.7±3.1 years); the second group consisted of 50 patients diagnosed with VD associated with exposure to local vibration (age 48.9+2.8 years); the control group consisted of 50 relatively healthy men not in contact with vibration (age 49.1+2.5 years). Survey on electronic stabilometer ST–150 (Biomera, Russia). Patients performed the Romberg test standing barefoot vertically on a stabilometric platform with a “European” stop position. Statistical processing of the results was carried out using the software package “Statistica 10.0” (StatSof, USA, 2011). Methods of descriptive statistics included estimation of median, lower and upper quartiles. The statistical significance of the differences was determined using the nonparametric Wilkinson method. Differences were considered statistically significant at p<0.05.Results. In the analysis of the obtained stabilometric parameters found that in the first group of patients marked imbalance.Moreover, in comparison with the second group and the control group in the phase with eyes closed, patients are more difficult to maintain a given posture, which increases the length of statokinesigram (p=0.02 and p=0.005), increasing the speed of movement of the center of pressure (p=0.03 and p=0.004) and the square of the deviation of the center of pressure (p=0.03 and p=0.004). When closing the eyes, patients put more effort to maintain balance, which affects the rate of mechanical work (p=0.001 and p=0.001). When comparing the second group with the control group, no statistically significant difference was found in the main stabilometric indicators.Conclusions: In the group of patients with VD associated with the combined effects of local and general vibration, marked (64%) and moderate (36%) postural disorders, especially in the phase of closed eyes. In the group of patients with VS associated with local vibration exposure and in the control group, imbalance was detected in 10% and 6%, respectively. The leading role in the occurrence of postural disorders in patients with VD, associated with the combined effects of local and general vibration, plays the formation of a focus of stagnant excitation in the centers of vibration sensitivity. In the future, the pulse can spread to nearby centers of pain, temperature sensitivity and proprioception, which contributes to the emergence of lower limb polyneuropathy and impaired stability in patients with vibration disease.

scholarly journals Balance Markers in Adolescents at 1 Month Postconcussion

2017 ◽  
Vol 5 (3) ◽  
pp. 232596711769550 ◽  
Author(s):  
Coralie Rochefort ◽  
Coren Walters-Stewart ◽  
Mary Aglipay ◽  
Nick Barrowman ◽  
Roger Zemek ◽  
...  
Keyword(s):  
Center Of Pressure ◽  
Age Distribution ◽  
Control Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Group ◽  
Dual Task Condition ◽  
Eyes Closed ◽  
Eyes Open ◽  
Balance Deficits

Background: The Balance Error Scoring System (BESS) shows that balance tends to recover within days after a concussion, whereas measures of the movement of the center of pressure (COP) show that balance deficits can persist up to 1 month after concussion. While approximately 30% of adolescents suffering concussion have functional consequences including balance deficits, evidence of the use of different balance assessments for concussion is limited within this population. Purpose: To compare performance on a series of balance assessments between adolescents with a diagnosed concussion at 1 month postinjury and noninjured control participants within the same age distribution. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Thirty-three adolescents 1 month postconcussion and 33 control participants completed the BESS followed by two, 2-minute trials standing on a Nintendo Wii Balance Board (WBB), during which the COP under their feet was recorded using 2 testing protocols: (1) double-leg stance, eyes open (EO) and (2) double-leg stance, eyes closed (EC). Participants then completed a dual-task condition (DT) with eyes open combining a double-leg stance and a Stroop color and word test while standing on the WBB. Three commonly used COP variables, anterior-posterior (A/P) and mediolateral (M/L) velocity and 95% ellipse, were computed for each condition performed on the WBB. Results: Participants postconcussion swayed over a significantly larger ellipse area compared with the control group in the EO ( P = .008), EC ( P = .002), and DT ( P = .003) conditions and also performed the DT condition with faster COP velocity in the M/L direction ( P = .007). No significant group difference was identified for BESS total score. Conclusion: At 1 month postconcussion, participants continued to demonstrate balance deficits in COP control despite scoring similar to controls on the BESS. Simple COP measures of balance may identify subtle impairments not captured by the BESS.

scholarly journals Postural control in top-level female volleyball players

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Dorota Borzucka ◽  
Krzysztof Kręcisz ◽  
Zbigniew Rektor ◽  
Michał Kuczyński
Keyword(s):  
Postural Control ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Balance Control ◽  
Sampling Rate ◽  
Force Plate ◽  
Peak Frequency ◽  
Control Group ◽  
Mean Velocity ◽  
Volleyball Players

Abstract Background The aim of this study was to compare the postural control of the Poland national women’s volleyball team players with a control group of non-training young women. It was hypothesized that volleyball players use a specific balance control strategy due to the high motor requirements of their team sport. Methods Static postural sway variables were measured in 31 athletes and 31 non-training women. Participants were standing on a force plate with eyes open, and their center of pressure signals were recorded for the 20s with the sampling rate of 20 Hz in the medial-lateral (ML) and anterior-posterior (AP) planes. Results In both AP and ML planes, athletes had lower range and higher fractal dimension of the COP. They had also higher peak frequency than control group in the ML plane only. The remaining COP indices including variability, mean velocity and mean frequency did not display any intergroup differences. Conclusion It can be assumed that due to the high motor requirements of their sport discipline Polish female volleyball players have developed a unique posture control. On the court they have to distribute their sensory resources optimally between balance control and actions resulting from the specifics of the volleyball game. There are no clearly defined criteria for optimal postural strategies for elite athletes, but they rather vary depending on a given sport. The results of our research confirm this claim. Trial registration The tests were previously approved by the Bioethical Commission of the Chamber of Physicians in Opole. (Resolution No. 151/13.12.2007). This study adheres to the CONSORT guidelines.

scholarly journals Single-Legged Hop and Single-Legged Squat Balance Performance in Recreational Athletes With a History of Concussion

2020 ◽  
Vol 55 (5) ◽  
pp. 488-493 ◽  
Author(s):  
Robert C. Lynall ◽  
Kody R. Campbell ◽  
Timothy C. Mauntel ◽  
J. Troy Blackburn ◽  
Jason P. Mihalik
Keyword(s):  
Injury Risk ◽  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Reaction Force ◽  
Force Plate ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Time To Stabilization ◽  
History Of

Context Researchers have suggested that balance deficiencies may linger during functional activities after concussion recovery. Objective To determine whether participants with a history of concussion demonstrated dynamic balance deficits as compared with control participants during single-legged hops and single-legged squats. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants A total of 15 previously concussed participants (6 men, 9 women; age = 19.7 ± 0.9 years, height = 169.2 ± 9.4 cm, mass = 66.0 ± 12.8 kg, median time since concussion = 126 days [range = 28–432 days]) were matched with 15 control participants (6 men, 9 women; age = 19.7 ± 1.6 years, height = 172.3 ± 10.8 cm, mass = 71.0 ± 10.4 kg). Intervention(s) During single-legged hops, participants jumped off a 30-cm box placed at 50% of their height behind a force plate, landed on a single limb, and attempted to achieve a stable position as quickly as possible. Participants performed single-legged squats while standing on a force plate. Main Outcome Measure(s) Time to stabilization (TTS; time for the normalized ground reaction force to stabilize after landing) was calculated during the single-legged hop, and center-of-pressure path and speed were calculated during single-legged squats. Groups were compared using analysis of covariance, controlling for average days since concussion. Results The concussion group demonstrated a longer TTS than the control group during the single-legged hop on the nondominant leg (mean difference = 0.35 seconds [95% confidence interval = 0.04, 0.64]; F2,27 = 5.69, P = .02). No TTS differences were observed for the dominant leg (F2,27 = 0.64, P = .43). No group differences were present for the single-legged squat on either leg (P ≥ .11). Conclusions Dynamic balance-control deficits after concussion may contribute to an increased musculoskeletal injury risk. Given our findings, we suggest that neuromuscular deficits currently not assessed after concussion may linger. Time to stabilization is a clinically applicable measure that has been used to distinguish patients with various pathologic conditions, such as chronic ankle instability and anterior cruciate ligament reconstruction, from healthy control participants. Whereas the single-legged squat may not sufficiently challenge balance control, future study of the more dynamic single-legged hop is needed to determine its potential diagnostic and prognostic value after concussion.

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