scholarly journals Rethinking the neurological examination II: dynamic balance assessment

2011 ◽  
Vol 69 (6) ◽  
pp. 959-963 ◽  
Author(s):  
Péricles A. Maranhão-Filho ◽  
Eliana Teixeira Maranhão ◽  
Marco Antônio Lima ◽  
Marcos Martins da Silva
Keyword(s):  
Neurological Examination ◽  
Older Patients ◽  
Dynamic Balance ◽  
Balance Assessment ◽  
Balance Test ◽  
Sit To Stand ◽  
Neurological Exam ◽  
Bedside Tests ◽  
Dynamic Gait Index ◽  
Dynamic Gait

The authors propose that the neurological exam needs reevaluation with respect to the dynamic balance test (walking). Validated tests such as: preferred and maximum gait speed, dynamic gait index, five-times-sit-to-stand test, timed up & go cognitive and manual, should be part of the neurological examination routine. In the neurological exam of older patients, these same bedside tests bring the plus of evaluation the risk of occasional falling.

scholarly journals Clinical Measurement of Sit-to-Stand Performance in People With Balance Disorders: Validity of Data for the Five-Times-Sit-to-Stand Test

2005 ◽  
Vol 85 (10) ◽  
pp. 1034-1045 ◽  
Author(s):  
Susan L Whitney ◽  
Diane M Wrisley ◽  
Gregory F Marchetti ◽  
Michael A Gee ◽  
Mark S Redfern ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Balance Disorders ◽  
Stand Test ◽  
Balance Confidence ◽  
Sit To Stand ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Confidence Scale ◽  
Better Than

Abstract Background and Purpose. People with balance disorders are characterized as having difficulty with transitional movements, such as the sit-to-stand movement. A valid and feasible tool is needed to help clinicians quantify the ability of people with balance disorders to perform transitional movements. The purpose of this study was to describe the concurrent and discriminative validity of data obtained with the Five-Times-Sit-to-Stand Test (FTSST). The FTSST was compared with the Activities-specific Balance Confidence Scale (ABC) and the Dynamic Gait Index (DGI). Subjects and Methods. Eighty-one subjects without balance disorders and 93 subjects with balance disorders were recruited for the study. Each subject was asked to stand from a 43-cm-high chair 5 times as quickly as possible. The ABC and DGI scores were recorded. Results. Subjects with balance disorders performed the FTSST more slowly than subjects without balance disorders. Discriminant analysis demonstrated that the FTSST correctly identified 65% of subjects with balance dysfunction, the ABC identified 80%, and the DGI identified 78%. The ability of the FTSST to identify subjects with balance dysfunction was better for subjects younger than 60 years of age (81%). Discussion and Conclusion. The FTSST displays discriminative and concurrent validity properties that make this test potentially useful in clinical decision making, although overall the ABC and the DGI are better than the FTSST at discriminating between subjects with and subjects without balance disorders.

scholarly journals Intrarater and Interrater Reliability of Dynamic Gait Index in Post Stroke Patients With Eye Movement Disorders

2021 ◽  
Author(s):  
Sana Batool ◽  
Hamayun Zafar ◽  
Syed Amir Gilani ◽  
Ashfaq Ahmad ◽  
Asif Hanif
Keyword(s):  
Acute Stroke ◽  
Eye Movement ◽  
Movement Disorders ◽  
Dynamic Balance ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Eye Movement Disorders ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

Abstract Background: The Dynamic Gait Index is a useful scale that has been evaluated for its reliability in patients with vestibular disorder, elderly people and, in chronic stroke population but its reliability has not been evaluated yet in sub-acute stroke patients with eye movement disorders. So the purpose of this study was to evaluate the intra-rater and inter-rater reliability of the Dynamic gait index to measure the dynamic balance, gait and risk of fall in sub-acute stroke population with eye movement disorders.Methods: A total of 30 (18 male, 12 females) stroke patients in the sub-acute phase suffering from eye movement disorders were recruited for this reliability study. Two experienced Physical therapists assessed the intra-rater and inter-rater reliability of the Dynamic gait index in two testing sessions three days apart. In the later session, two raters assessed the patients’ performance simultaneously on the Dynamic gait index. Data analysis was done at 95% confidence interval using the intra-class correlation coefficient (ICC2, 1). A significance level was set at P-value <0.05.Results: Mean tests scores by rater 1 in the first and second assessment were 17.4±2.04 and 18.0±2.05. Mean tests score by rater 2 in the second assessment were 18.6±2.06. Intra-rater (ICC=0.86, CI=0.73-0.93) and inter-rater (ICC=0.91, CI=0.83-0.96) reliability of total DGI scores was found good to excellent while intra-rater (ICC=0.73-0.91) and inter-rater (ICC=0.73-0.93) reliability of individual items of DGI scores were ranged from moderate to good. Item 8 (steps) showed lowest reliability (ICC=0.73). The significant difference was seen in total and individual scores (P<0.001) of DGI scale in both intra-rater and inter-rater reliability.Conclusions: The Dynamic gait index is found clinically a reliable tool to objectively measure dynamic balance, gait and risk of fall in sub-acute stroke individuals with eye movement disorders. The intra-rater and inter-rater reliability of the total DGI scores was found good to excellent; whereas intra-rater and inter-rater reliability for individual items of DGI were varied from moderate to good.

scholarly journals EFEITO DA TERAPIA COM REALIDADE VIRTUAL NO EQUILÍBRIO DINÂMICO DE INDIVÍDUOS PÓS-ACIDENTE VASCULAR ENCEFÁLICO

2019 ◽  
Vol 11 (3) ◽  
pp. 99-105
Author(s):  
Alice Haniuda Moliterno ◽  
Isabela Bortolim Frasson ◽  
Silas de Oliveira Damasceno ◽  
Caroline Nunes Gonzaga ◽  
Isabella Cristina Leoci ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Dynamic Balance ◽  
Balance Training ◽  
Moderate Correlation ◽  
Nintendo Wii ◽  
Significant Difference ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Therapy Sessions

The aim of this study was to analyze the effect of virtual reality-based (VR) therapy on balance training of patients after stroke. 10 hemiparetic participants received twelve individual physical therapy sessions using the VR therapeutic, through Nintendo Wii® Fit Plus and Wii Sports Resort™. The analysis revealed that the Dynamic Gait Index (DGI) instrument, responsible for evaluating the dynamic balance, obtained significant difference (p=0.0085) between the basal (17.30±3.59) and final (20.30±2.94) evaluation. The Penguin Slide game had no significance between the scores (p=0.918), but there was a moderate correlation between the DGI instrument (r=0.662; p=0.037). This study obtained favorable results related to dynamic balance and also suggests that VR therapy as in general influenced the improvement of dynamic balance in individuals with hemiparesis after stroke.

scholarly journals Effects of application of texture insoles on the balance of subjects with Multiple Sclerosis

2017 ◽  
Vol 16 (1) ◽  
pp. 9-16
Author(s):  
Wildja De Lima Gomes ◽  
Thais Botossi Scalha ◽  
Lucas Brino Mota ◽  
Viviane Almeida Kuroda ◽  
Juliana Cintra Garrafa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dynamic Balance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Measuring Instruments ◽  
Balance Scale ◽  
Functional Gait ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

Objective: The aim of this study was to evaluate the effects on static and dynamic balance after the use of textured insoles. Method: Fifteen subjects with multiple sclerosis were evaluated before using the insoles, after using them for 1 month, and after 2 months without using, them using the following measuring instruments: the Berg Balance Scale, Dynamic Gait Index, and 10-meter Walk Test, a means of functional gait assessment. Results: Improvement was observed in the Berg Balance Scale and Dynamic Gait Index scores, walking time, number of steps and step length after using the insoles for 1 month. The improvement in Berg Balance Scale score remained after two months without the insoles and there were no changes in gait speed. Conclusion: The use of textured insoles was effective as an intervention to improve static and dynamic balance in patients with multiple sclerosis.

scholarly journals Comparing the Convergent and Concurrent Validity of the Dynamic Gait Index with the Berg Balance Scale in People with Multiple Sclerosis

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 27 ◽  
Author(s):  
Tapan Mehta ◽  
Hui-Ju Young ◽  
Byron Lai ◽  
Fuchenchu Wang ◽  
Yumi Kim ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Extremity ◽  
Physical Functioning ◽  
Concurrent Validity ◽  
Convergent Validity ◽  
Dynamic Balance ◽  
Berg Balance Scale ◽  
Sf 36 ◽  
Dynamic Gait Index ◽  
Dynamic Gait

Background: Recent clinical guidelines for adults with neurological disabilities suggest the need to assess measures of static and dynamic balance using the Berg Balance Scale (BBS) and Dynamic Gait Index (DGI) as core outcome measures. Given that the BBS measures both static and dynamic balance, it was unclear as to whether either of these instruments was superior in terms of its convergent and concurrent validity, and whether there was value in complementing the BBS with the DGI. Objective: The objective was to evaluate the concurrent and convergent validity of the BBS and DGI by comparing the performance of these two functional balance tests in people with multiple sclerosis (MS). Methods: Baseline cross-sectional data on 75 people with MS were collected for use in this study from 14 physical therapy clinics participating in a large pragmatic cluster-randomized trial. Convergent validity estimates between the DGI and BBS were examined by comparing the partial Spearman correlations of each test to objective lower extremity functional measures (Timed Up and Go (TUG), Six-Minute Walk Test (6MWT), Timed 25-Foot Walk (T25FW) test) and the self-reported outcomes of physical functioning and general health using the 36-Item Short Form Health Survey (SF-36). Concurrent validity was assessed by applying logistic regression with gait disability as the binary outcome (Patient Determined Disease Steps (PDDS) as the criterion measure). The predictive ability of two models, a reduced/parsimonious model including the BBS only and a second model including both the BBS and DGI, were compared using the adjusted coefficient of determinations. Results: Both the DGI and BBS were strongly correlated with lower extremity measures overall as well as across the two PDSS strata with correlations. In PDDS ≤ 2, the difference in the convergence of BBS with TUG and DGI with TUG was −0.123 (95% CI: −0.280, −0.012). While this finding was statistically significant at a type 1 error rate of 0.05, it was not significant (Hommel’s adjusted p-value = 0.465) after accounting for multiple testing corrections to control for the family-wise error rate. The BBS–SF-36 physical functioning correlation was at least moderate and significant overall and across both PDDS strata. However, the DGI–physical functioning score did not have a statistically significant correlation within PDDS ≤ 2. None of the differences in convergent and concurrent validity between the BBS and DGI were significant. The additional variation in 6MWT explained by the DGI when added to a model with the BBS was 7.78% (95% CI: 0.6%, 15%). Conclusions: These exploratory analyses on data collected in pragmatic real-world settings suggest that neither of these measures of balance is profoundly superior to the other in terms of its concurrent and convergent validity. The DGI may not have any utility for people with PDDS ≤ 2, especially if the focus is on mobility, but may be useful if the goal is to provide insight on lower extremity endurance. Further research leveraging longitudinal data from pragmatic trials and quasi-experimental designs may provide more information about the clinical usefulness of the DGI in terms of its predictive validity when compared to the BBS.

scholarly journals A VARIANT OF EXPERT ASSESSMENT OF BALANCE AND GAIT FUNCTIONS IN PATIENTS AFTER STROKE

2017 ◽  
Vol 20 (4) ◽  
pp. 176-180
Author(s):  
S. V Prokopenko ◽  
Mariya V. Abros’kina ◽  
V. S Ondar ◽  
S. A Kaygorodtseva
Keyword(s):  
Dynamic Balance ◽  
Dynamic Assessment ◽  
Objective Evaluation ◽  
Berg Balance Scale ◽  
Expert Assessment ◽  
Kinematic Parameters ◽  
Neurological Patients ◽  
Risk Of Falls ◽  
Dynamic Gait Index ◽  
Dynamic Gait

The article presents the results of approbation of the complex of objective evaluation of equilibrium and walking functions, including such functional scales as Berg Balance Scale, Dynamic Gait Index, hardware methods of computer stabilometry and laser analyzer of kinematic parameters of walking in groups of patients with poststroke vestibulo-atactic syndrome and hemiparesis syndrome. The proposed complex allows objectively and informatively to assess the state of static and dynamic balance, the risk of falls during walking, changes in the walking pattern in neurological patients. The complex is recommended for the dynamic assessment of patients’ condition during neurorehabilitation.

scholarly journals Effect of Aerobic and Anaerobic Exercise on Static and Dynamic Balance in Physiotherapy Students

2019 ◽  
pp. 495-501
Author(s):  
Bhakti Panchal ◽  
Urvashi Sharma ◽  
Tushar Palekar
Keyword(s):  
Aerobic Exercise ◽  
Dynamic Balance ◽  
Anaerobic Exercise ◽  
Balance Assessment ◽  
Balance Test ◽  
Post Exercise ◽  
Group A ◽  
Group B ◽  
Physiotherapy Students ◽  
Aerobic And Anaerobic

The aim of the study is to evaluate and compare the effects of aerobic and anaerobic exercise on static and dynamic balance in healthy physiotherapy students. 30 subjects were selected and were divided into two groups (n= 15). Their pre balance assessment was done by stork standing balance test and modified BASS test for static and dynamic balance. After completion of the initial balance measurement, group-A subjects were given aerobic exercise which included 15 minutes of Modified Bruce protocol and group-B subjects were given 3 forms of aerobic exercises for 2 weeks alternate days. Post exercise balance assessment was done on day 15 which showed significant changes in the pre and post exercise balance scores. Thus, this study concludes that both aerobic and anaerobic exercise showed statistically significant improvement in the static and dynamic balance.

Examining the test-retest reliability and construct validity of the Six-Spot Step Test in older adults with self-reported balance problems

2021 ◽  
pp. 026921552110102
Author(s):  
John Brincks ◽  
Jacob Callesen
Keyword(s):  
Older Adults ◽  
Construct Validity ◽  
Correlation Coefficient ◽  
Step Test ◽  
Timed Up And Go ◽  
Balance Test ◽  
Test Retest Reliability ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Balance Problems

Objective: To evaluate the test-retest reliability and construct validity of the Six-Spot Step Test in older adults. Design: Cross-sectional study. Setting: Outpatient clinics. Subjects: Sixty-six adults aged ⩾65 years with self-reported balance problems. Main measure: The Six-Spot Step Test was completed twice on day 1. Three days later, the Six-Spot Step Test, the Timed “Up and Go” test, Dynamic Gait Index, the Mini-BESTest, and standing balance test were conducted. Reliability and validity were estimated using Bland-Altman statistics, minimal detectable change, Intraclass Correlation Coefficient (ICC), and Spearman’s rank correlation coefficient (ρ). Results: Participants had a mean (SD) age of 75.5 (6.6) years, a median ( Q1– Q3) Montreal Cognitive Assessment test score of 26 (24–27), and a median ( Q1– Q3) Falls Efficacy Scale International score of 22 (20–26). The study found within-day and between-day limits of agreements of ±15.7% and ±18.1%, respectively. The minimal detectable changes at the 95% level of confidence for within-day and between-day were 17.5% and 21.6%, and the ICCs were 0.96 (CI: 0.92–0.98) and 0.94 (CI: 0.86–0.97), respectively. A learning effect was observed between the first and second Six-Spot Step Test. Moderate to strong correlations were found between the Six-Spot Step Test and Mini-BESTest (ρ = −0.62), Dynamic Gait Index (ρ = −0.55), and the Timed “Up and Go” test (ρ = 0.79). Weak correlations were identified between the Six-Spot Step Test and static standing balance test (ρ < 0.38). Conclusion: The Six-Spot Step Test shows excellent relative consistency and moderate to high construct validity in older adults. A change of 21.6% is a true change in outcome.

scholarly journals Proposta de um protocolo para reabilitação vestibular em vestibulopatias periféricas

2010 ◽  
Vol 23 (1) ◽  
pp. 83-91 ◽  
Author(s):  
Adriana Roberta Degressi Rogatto ◽  
Laira Pedroso ◽  
Sara Regina Meira Almeida ◽  
Telma Dagmar Oberg
Keyword(s):  
Dizziness Handicap Inventory ◽  
Sit To Stand ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

INTRODUÇÃO: A reabilitação vestibular tem sido reconhecida como tratamento de escolha para pacientes com persistência da vertigem, por causa da disfunção vestibular periférica, proporcionando acentuada melhora na qualidade de vida. Dentre os tratamentos indicados, tem-se os exercícios de Cawthorne e Cooksey, integração sensorial e plataformas com movimentação corpórea. OBJETIVO: O objetivo da pesquisa foi criar um protocolo de exercícios em um balanço, associando os exercícios de Cawthorne e Cooksey à Integração Sensorial. METODOLOGIA: Foi desenvolvido um relato de caso para avaliar uma paciente por meio das seguintes escalas: Escala de Equilíbrio de Berg e Dynamic Gait Índex (DGI) para verificar o equilíbrio; Five Times Sit-to-Stand (FTSTS) para avaliar a atividade de sentar e levantar; Dizziness Handicap Inventory (DHI) para verificar sintomas de vertigem; Escala de Sintomas após Tratamento Fisioterapêutico (ESATF), que gradua a sintomatologia após exercícios. Foi desenvolvido um protocolo associando as duas técnicas, nas quais os exercícios oculares, cefálicos e de tronco eram associados ao balanço. Foram realizadas 10 das 20 sessões previstas, por causa da frequência irregular do paciente às sessões. RESULTADOS: O paciente melhorou de 19 para 22 pontos na DGI, manteve a pontuação na Berg e melhorou de 74 para 67 pontos na DHI. Na escala FTSTS, diminuiu o tempo de 15 para 14 segundos para realizar atividade de sentar e levantar. Na ESATF, houve oscilação da pontuação. CONCLUSÕES: Após o tratamento, a paciente manteve e obteve melhora no equilíbrio e na capacidade funcional e diminuiu o tempo gasto para realizar a atividade de sentar e levantar cinco vezes de uma cadeira com os membros superiores cruzados. Estudos adicionais com o protocolo proposto devem ser realizados, com um número maior de pacientes e maior assiduidade para haver habituação e reabilitação mais precoce.

Sign in / Sign up

Export Citation Format

Share Document