Correlation between balance, speed, and walking ability in individuals with chronic hemiparesis

Abstract Alterations in balance and gait are frequently present in patients with hemiparesis. This study aimed at determining whether there is a correlation between static and functional balance, gait speed and walking capacity. To that end, 17 individuals with chronic hemiparesis of both sexes (58.8% men and 42.25 women), mean age of 56.3 ± 9.73 years, took part in the study. Static balance was assessed by computerized baropodometry, under two different sensory conditions: eyes open (EO) and eyes closed (EC). Functional balance was evaluated by Berg Balance Scale and walking ability by the Functional Ambulation Classification. Gait speed was assessed by kinemetry. The Kolmogorov-Smirnov test was used to verify data distribution normality. Parametric variables were correlated by Pearson's test and their non-parametric parameters by Spearman's test. Functional balance showed a positive correlation with gait speed (p=0.005; r=0.64) and walking ability (p = 0.019; r = 0.56). Anteroposterior (AP) and mediolateral (ML) alterations with EO and EC exhibited negative correlations with gait speed (EO: AP amplitude (p = 0.0049 and r = -0.48); mean ML deviation (p = 0.019 and r =-0.56)/ EC: mean AP deviation (p = 0.018 and r = -0.56) and mean ML deviation (p = 0.032 and r = -0.52); AP amplitude (p = 0.014 and r = -0.57) and ML amplitude (p = 0.032 and r = -0.52); postural instability (p = 0.019 and r = -0.55)) and walking ability (EO: mean AP deviation (p = 0.05 and r = -0.47) and AP amplitude (p = 0.024 and r = -0.54)). The results suggest correlations between static and functional balance and gait speed and walking ability, and that balance training can be an important component of gait recovery protocols.

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The competition with a concurrent cognitive task affects posturographic measures in patients with Parkinson disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20150153 ◽

2015 ◽

Vol 73 (11) ◽

pp. 906-912 ◽

Cited By ~ 14

Author(s):

Alessandra Ferreira Barbosa ◽

Carolina de Oliveira Souza ◽

Janini Chen ◽

Débora Valente Francato ◽

Fátima Aparecida Caromano ◽

...

Keyword(s):

Parkinson Disease ◽

Dual Task ◽

Cognitive Task ◽

Berg Balance Scale ◽

Functional Balance ◽

Eyes Closed ◽

Static Posturography ◽

Eyes Open ◽

The Impact ◽

General Balance

ABSTRACTObjectives To estimate the impact of a sensory-motor- cognitive task on postural balance, in Parkinson disease patients (Hoehn and Yahr 2-3) and to investigate possible relationships between posturography and functional balance clinical scales.Method Parkinson disease patients (n = 40) and healthy controls (n = 27) were evaluated with fluency tests, Berg Balance scale, Mini Best test and static posturography on the conditions eyes open, eyes closed and dual-task (simultaneous balance and fluency tasks).Results Posturographic data showed that Parkinson disease patients performed worse than controls in all evaluations. In general, balance on dual-task was significantly poorer than balance with eyes closed. Posturographic data were weakly correlated to clinical balance scales.Conclusion In clinical practice, Parkinson disease patients are commonly assessed with eyes closed, to sensitize balance. Our study showed that adding a cognitive task is even more effective. Static posturographic data should be carefully overgeneralized to infer functional balance impairments.

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The Efficacy of Balance Training with Video Game-Based Therapy in Subacute Stroke Patients: A Randomized Controlled Trial

BioMed Research International ◽

10.1155/2014/580861 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 39

Author(s):

Giovanni Morone ◽

Marco Tramontano ◽

Marco Iosa ◽

Jacob Shofany ◽

Antonella Iemma ◽

...

Keyword(s):

Video Game ◽

Conventional Therapy ◽

Controlled Trial ◽

Balance Training ◽

Berg Balance Scale ◽

Walking Ability ◽

Stroke Patients ◽

Functional Balance ◽

Wii Fit ◽

Subacute Stroke

The video game-based therapy emerged as a potential valid tool in improving balance in several neurological conditions with controversial results, whereas little information is available regarding the use of this therapy in subacute stroke patients. The aim of this study was to investigate the efficacy of balance training using video game-based intervention on functional balance and disability in individuals with hemiparesis due to stroke in subacute phase. Fifty adult stroke patients participated to the study: 25 subjects were randomly assigned to balance training with Wii Fit, and the other 25 subjects were assigned to usual balance therapy. Both groups were also treated with conventional physical therapy (40 min 2 times/day). The main outcome was functional balance (Berg Balance Scale-BBS), and secondary outcomes were disability (Barthel Index-BI), walking ability (Functional Ambulation Category), and walking speed (10-meters walking test). Wii Fit training was more effective than usual balance therapy in improving balance (BBS: 53 versus 48,P=0.004) and independency in activity of daily living (BI: 98 versus 93,P=0.021). A balance training performed with a Wii Fit as an add on to the conventional therapy was found to be more effective than conventional therapy alone in improving balance and reducing disability in patients with subacute stroke.

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A systematic review and meta-analysis on efficacy of exercise on posture and balance in patients suffering from Diabetic Neuropathy

Current Diabetes Reviews ◽

10.2174/1573399816666200703190437 ◽

2020 ◽

Vol 16 ◽

Author(s):

Neerja Thukral ◽

Jaspreet Kaur ◽

Manoj Malik

Keyword(s):

Diabetes Mellitus ◽

Diabetic Neuropathy ◽

Meta Analysis ◽

Berg Balance Scale ◽

Risk Of Bias ◽

Core Stability ◽

Balance Scale ◽

Eyes Closed ◽

Significant Difference ◽

Eyes Open

Background: Peripheral neuropathy is a major and chronic complication of diabetes mellitus affecting more than 50% of patients suffering from diabetes. There is involvement of both large and small diameter nerve fibres leading to altered somatosensory and motor sensations, thereby causing impaired balance and postural instability. Objective: To assess the effects of exercises on posture and balance in patients suffering from diabetes mellitus. Method: Mean changes in Timed Up and Go test(TUGT), Berg Balance Scale and Postural Sway with eyes open and eyes closed on Balance System were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Eighteen randomized controlled trials met the selection criteria and were included in the study. All the studies ranked high on PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias. Included studies had low risk of bias. Sixteen RCT’s were included for the meta-analysis. Result: Results of meta-analysis showed that there was statistically significant improvement in TUGT with p≤ 0.05 and substantial heterogeneity (I 2 = 84%, p < 0.00001) in experimental group as compared to control group. There was statistically significant difference in Berg Balance Scale scores and heterogeneity of I 2 = 62%, p < 0.00001 and significant changes in postural stability (eyes open heterogeneity of I 2 = 100%, p =0.01 and eyes closed, heteogeneity I 2 = 0%, p =0.01). Sensitivity analysis causes change in heterogeneity. Conclusion: It can be concluded that various exercises like balance training, core stability, Tai-Chi, proprioceptive training etc. have a significant effect in improving balance and posture in diabetic neuropathy.

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The measurable parameters of balance trainings in case of young healthy adults: Improved balance confidence or better postural stability? A pilot study

Developments in Health Sciences ◽

10.1556/2066.2021.00037 ◽

2021 ◽

Author(s):

G. Posa ◽

D. Farkasinszky ◽

T. Margithazi ◽

E. Nagy

Keyword(s):

Pilot Study ◽

Postural Sway ◽

Force Plate ◽

Balance Training ◽

Balance Confidence ◽

Eyes Closed ◽

Healthy Female ◽

Eyes Open ◽

Support Surfaces ◽

Base Of Support

AbstractPurposeThe objective of this pilot study was to compare the effects of two parallel balance trainings on postural sway and balance confidence. The study was performed in different contexts with stable vs. unstable base of support and balance confidence was measured with a scale modified for young adults with higher functional level.Materials/methodsTwenty healthy female physiotherapist students volunteered for the study and took part in a six-week balance training intervention. They were randomly assigned to two groups training on different support surfaces. Postural sway was recorded under various conditions: on different surfaces (firm, foam) and with different visual conditions (eyes open (EO), eyes closed (EC)). Modified Activities-specific Balance Confidence (mABC) scale was self-evaluated.ResultsBoth types of training caused a significant improvement in the mABC scores. The sway path increased after the training in the less challenging balance situations. We found a tendency of decreasing sway path only in the more challenging balance situations, that is standing on foam mounted on force plate with EC.ConclusionsConsidering the improved balance confidence in the case of both groups, we suggest that an increase in sway path after balance training may be the behavioural sign of the higher confidence in the less challenging balance situations.

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A 9-Week Nordic and Free Walking Improve Postural Balance in Parkinson’s Disease

Sports Medicine International Open ◽

10.1055/s-0043-124757 ◽

2018 ◽

Vol 02 (02) ◽

pp. E28-E34 ◽

Cited By ~ 8

Author(s):

Leandro Franzoni ◽

Elren Monteiro ◽

Henrique Oliveira ◽

Rodrigo da Rosa ◽

Rochelle Costa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Center Of Pressure ◽

Neuroprotective Effect ◽

Functional Mobility ◽

Nordic Walking ◽

Promising Alternative ◽

Functional Balance ◽

Eyes Closed ◽

Eyes Open

AbstractAerobic training has a neuroprotective effect in people with Parkinson’s disease. Recent evidence indicates that Nordic walking seems a promising alternative due to positive outcomes in functional mobility. However, the effects of Nordic walking compared to free walking on static and functional balance parameters are still unknown. The aim of this study was to evaluate the effects of nine weeks of Nordic and free walking training on static and functional balance. The sample size was 33 individuals with eight dropouts, leaving 25 individuals in the final sample (Nordic Walking, n=14, Free Walking, n=11). The participants underwent two evaluations in the present randomized clinical trial, pre- and post-training, to determine average velocity and root-mean-square values from center of pressure with eyes open and eyes closed. The functional balance showed approximately 5% improvement for the two groups (p=0.04). The results indicate that nine weeks of Nordic and free walking training were enough to induce improvements in the proprioceptive system and functional balance.

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Improvements in muscle-tendon properties are beneficial to balance in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458506070715 ◽

2006 ◽

Vol 12 (5) ◽

pp. 666-669 ◽

Cited By ~ 8

Author(s):

G LN Onambélé ◽

H Degens

Keyword(s):

Multiple Sclerosis ◽

Gastrocnemius Muscle ◽

Balance Training ◽

Well Being ◽

Muscle Size ◽

Tendon Stiffness ◽

Eyes Closed ◽

General Feeling ◽

Eyes Open ◽

Tendon Properties

A 63-year-old male was diagnosed with multiple sclerosis (MS) two years prior to this investigation. We hypothesized that compromised postural balance in MS can be improved by training-induced alterations in muscle-tendon properties. Sixteen weeks of strength and balance training induced an increase in quadriceps and gastrocnemius muscle size, strength, central activation, muscle recruitment and tendon stiffness. Concomitantly, the ability to maintain postural stances was increased in both eyes-open and eyes-closed conditions. We concluded that improvements in muscle-tendon properties were accompanied by improved balance and a general feeling of well-being after training.

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Multiple game based rehabilitation platform instead of intensified conventional balance training in patients with stroke: pilot study

10.21203/rs.2.9581/v1 ◽

2019 ◽

Author(s):

Imre Cikajlo ◽

Marko Rudolf ◽

Renato Mainetti ◽

Nunzio Alberto Borghese

Keyword(s):

Pilot Study ◽

Center Of Pressure ◽

Statistical Tests ◽

Balance Training ◽

Functional Restoration ◽

Step Test ◽

Clinical Test ◽

Modern Approach ◽

Functional Balance ◽

Eyes Closed

Abstract Background: People who survive a stroke usually suffer for moderate to severe movement disorders such as uncontrollable movements of the limb, posture and balance disorders. An intensive and repetitive physiotherapy and balance training are often a key to functional restoration of movements. Recently modern rehabilitation centers have offered virtual reality supported balance training with exergames in addition to the conventional therapy. However, the choice of the appropriate exergame is still not straightforward. Methods: We designed a randomized pilot study investigating how different types of balance training in addition to the physiotherapy program influence on functional outcomes. 20 eligible participants were randomized into 2 groups; exergaming vs conventional balance training. Multiple-game platform with exergames supporting single leg exercises, weight shifting, balancing and standing up and equivalent conventional physiotherapy exercises were used. Center of pressure was monitored during exergaming and clinical impact was evaluated with the Four Square Step Test (FSST), Timed Up & Go, 10m Walk Test (10MWT), Romberg, Sharpened Romberg, Clinical Test for Sensory Interaction in Balance in both groups. Statistical tests were used to find statistically significant (p < 0.05) differences and Cohen’s U3 test to examine the effect sizes. Results: Participants of both groups demonstrated substantively and statistically significant improvements of functional balance, in particular the exergaming group (FSST p = 0.009, U3 = 0.9 and 10MWT p = 0.008, U3 = 0.9). . However, significant differences between the groups were found only in tests with eyes closed, Sharpened Romberg test (p = 0.05) and standing on the right leg (p = 0.035). We found a decrease of center of pressure area for up to 20% in the exergaming group. Conclusions: In the exergaming group the participants achieved improved functional balance that could be well targeted by the selection of games and objectively evaluated. The modern approach had a great potential by choosing the appropriate game to target the exercise, but the low statistical power may hinder the equivalence of both additional balance training methods. However, the exergaming provided independent balance training, also feasible without physiotherapist’s strenuous work that may be crucial for future home or telerehabilitation services.

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Effects of Typical Athletic Shoes on Postural Balance According to Foot Type

Journal of the American Podiatric Medical Association ◽

10.7547/17-178 ◽

2021 ◽

Vol 111 (3) ◽

Author(s):

Tae Im Yi ◽

Kee Hoon Kim ◽

Yeo Reum Choe ◽

Sung Heon Kim ◽

Joo Sup Kim ◽

...

Keyword(s):

Postural Balance ◽

Dynamic Balance ◽

Balance Training ◽

Random Order ◽

Medial Longitudinal Arch ◽

Balance Test ◽

Eyes Closed ◽

Foot Posture ◽

Eyes Open ◽

Athletic Shoes

Background The effects of shoes and foot type on balance are unclear. We aimed to investigate the differences between static and dynamic balance among three foot types and the changes in postural balance while wearing typical athletic shoes. Methods Based on the Foot Posture Index, the feet of 39 participants were classified as pronated, neutral, or supinated by a physiatrist. Static and dynamic balance function were assessed by center of gravity (COG) sway velocity with eyes open and eyes closed and a modified Star Excursion Balance Test in a random order with participants either barefoot or wearing shoes. Results The COG sway velocity was significantly higher in the supinated foot group than in the neutral foot group (barefoot: eyes open, P = .004, eyes closed, P = .001). Normalized composite reach distance (NCRD) was significantly lower in the pronated and supinated foot groups (barefoot: P = .039, P = .008; shoes: P = .018, P = .018). In all three foot type groups, COG sway velocity was significantly decreased (P < .05) and NCRD was significantly increased (P < .05) while wearing typical athletic shoes. Conclusions The medial longitudinal arch of the foot affects postural balance. Typical athletic shoes improve postural balance regardless of foot type. However, the pronated and supinated foot groups still had lower dynamic postural balance compared with the neutral foot group, even when wearing athletic shoes. People with pronated and supinated feet may need additional interventions, such as foot orthoses or balance training.

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Postural Stability During Standing Balance and Sit-to-Stand in Master Athlete Runners Compared With Nonathletic Old and Young Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2016-0074 ◽

2017 ◽

Vol 25 (3) ◽

pp. 345-350 ◽

Cited By ~ 7

Author(s):

Daniel Leightley ◽

Moi Hoon Yap ◽

Jessica Coulson ◽

Mathew Piasecki ◽

James Cameron ◽

...

Keyword(s):

Postural Stability ◽

Postural Sway ◽

Balance Training ◽

Microsoft Kinect ◽

Master Athletes ◽

Young Athletes ◽

Master Athlete ◽

Eyes Closed ◽

Sit To Stand ◽

Eyes Open

The aim of this study was to compare postural sway during a series of static balancing tasks and during five chair rises between healthy young (mean [SEM], age 26 [1] years), healthy old (age 67 [1] years) and master athlete runners (age 67 [1] years; competing and training for the previous 51 [5] years) using the Microsoft Kinect One. The healthy old had more sway than the healthy young in all balance tasks. The master athletes had similar sway to young athletes during two-leg balancing and one-leg standing with eyes open. When balancing on one leg with eyes closed, both the healthy old and the master athletes had around 17-fold more sway than the young athletes. The healthy old and master athletes also had less anterio-posterior movement during chair rising compared with young athletes. These results suggest that masters runners are not spared from the age-associated decline in postural stability and may benefit from specific balance training.

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Effects of Balance Training on Postural Stability

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/154193120204601349 ◽

2002 ◽

Vol 46 (13) ◽

pp. 1237-1240

Author(s):

Jennifer M. Schmit ◽

Deanna I. Rejacques ◽

Michael A. Riley

Keyword(s):

Postural Control ◽

Postural Sway ◽

Balance Training ◽

Control Group ◽

Significant Group ◽

Eyes Closed ◽

Eyes Open ◽

Group 2 ◽

Main Effects ◽

The Relationship

The present study is designed to address the relationship between postural sway and balance training. We compared postural sway in a group of trained dancers to a group of physically fit, untrained participants (control group) in order to assess enhanced postural control with balance training, particularly under challenging balance conditions. We varied the difficulty of postural control by using two surface conditions (rigid surface, foam surface) and two visual conditions (eyes open, eyes closed), factorially combined. The data were evaluated using 1-between (group) × 2-within (vision and surface) analyses of variance (ANOVA). The three dependent variables were the standard deviation of the COP time series in the anterior-posterior (AP) and medial-lateral (ML) axes, and the COP path length. Significant main effects were found for surface and vision and the surface*vision interaction in all conditions. Significant group differences were found in the AP and ML axes. The results of this study indicate that balance training enhances the control of posture. Thus, it may be useful to provide balance training to workers who must operate under conditions that threaten balance.

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