scholarly journals Auditory feedback alters postural control and functional ability in patients with chronic stroke

2020 ◽  
Author(s):  
Hee Sung Lim ◽  
Jiseon Ryu ◽  
Sihyun Ryu
Keyword(s):  
White Noise ◽  
Inclination Angle ◽  
Auditory Feedback ◽  
Exercise Intervention ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Effective Means ◽  
Center Of Mass ◽  
Chronic Stroke ◽  
Post Intervention

Abstract Background: This study aimed to investigate the effect of white noise on dynamic balance in patients with stroke and the pre- and post-intervention changes in dynamic balance during walking by analyzing the anterior-posterior (A-P) and medial-lateral (M-L) center of pressure (CoP) range and velocity, center of mass (CoM), and A-P/M-L inclination angle using CoM-CoP and to establish the basis for using auditory feedback as an effective means of exercise intervention by bringing changes in dynamic balance abilities of patients with chronic stroke and retain the necessary abilities for maintaining independent and functional daily living.Methods: Nineteen patients with chronic stroke (age: 61.2±9.8 years, height: 164.4±7.4 cm, weight: 61.1±9.4 kg, paretic side (R/L): 11/8, duration: 11.6±4.9 years) were included as study participants. Auditory feedback used white noise, and all participants listened for 20 minutes mixing six types of natural sounds with random sounds. The dynamic balancing ability was evaluated during the walking, and the variables were the center of pressure (CoP), the center of mass (CoM), CoP-CoM inclined angle.Results: There is a significant increase in the A-P CoP range, A-P inclination angle, and gait speed on the paretic and non-paretic sides following white noise intervention (p<.05). In addition, the changes in CoP velocity on the paretic and non-paretic sides increased in both the A-P and M-L directions but not significantly.Conclusion: Our findings confirmed the positive effect of using white noise as auditory feedback through a more objective and quantitative assessment using CoP-CoM inclination angle as an evaluation indicator for assessing dynamic balance in patients with chronic stroke. The A-P and M-L inclination angle can be employed as a useful indicator for evaluating other exercise programs and intervention methods for functional enhancement of patients with chronic stroke in terms of their effects on dynamic balance and effectiveness.

scholarly journals Feasibility and effect of interactive telerehabilitation on balance in individuals with chronic stroke: a pilot study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Shih-Ching Chen ◽  
Chueh-Ho Lin ◽  
Sheng-Wen Su ◽  
Yu-Tai Chang ◽  
Chien-Hung Lai
Keyword(s):  
Pilot Study ◽  
Effect Size ◽  
Exercise Intervention ◽  
Chronic Stroke ◽  
Control Group ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Timed Up And Go ◽  
Kinect Camera ◽  
Experimental Group

Abstract Background Stroke survivors need continuing exercise intervention to maintain functional status. This study assessed the feasibility and efficacy of an interactive telerehabilitation exergaming system to improve balance in individuals with chronic stroke, compared to conventional one-on-one rehabilitation. Methods In this prospective case–control pilot study, 30 Taiwanese individuals with chronic stroke were enrolled and randomly allocated to an experimental group and a control group. All participants received intervention 3 times per week for 4 weeks in the study hospital. The experiment group underwent telerehabilitation using a Kinect camera-based interactive telerehabilitation system in an independent room to simulate home environment. In contrast, the control group received conventional one-on-one physiotherapy in a dedicated rehabilitation area. The effectiveness of interactive telerehabilitation in improving balance in stroke survivors was evaluated by comparing outcomes between the two groups. The primary outcome was Berg Balance Scale (BBS) scores. Secondary outcomes were performance of the Timed Up and Go (TUG) test, Modified Falls Efficacy Scale, Motricity Index, and Functional Ambulation Category. Results Comparison of outcomes between experimental and control groups revealed no significant differences between groups at baseline and post-intervention for all outcome measures. However, BBS scores improved significantly in both groups (control group: p = 0.01, effect size = 0.49; experimental group: p = 0.01, effect size = 0.70). Completion times of TUG tests also improved significantly in the experimental group (p = 0.005, effect size = 0.70). Conclusion The Kinect camera-based interactive telerehabilitation system demonstrates superior or equal efficacy compared to conventional one-on-one physiotherapy for improving balance in individuals with chronic stroke. Trial registration ClinicalTrials.gov. NCT03698357. Registered October 4, 2018, retrospectively registered.

Effect of a 10-Week Traditional Dance Program on Static and Dynamic Balance Control in Elderly Adults

2009 ◽  
Vol 17 (2) ◽  
pp. 167-180 ◽  
Author(s):  
Giorgos Sofianidis ◽  
Vassilia Hatzitaki ◽  
Stella Douka ◽  
Giorgos Grouios
Keyword(s):  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Effective Means ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Elderly Adults ◽  
Healthy Elderly ◽  
Traditional Dance

This preliminary study examined the effect of a 10-wk traditional Greek dance program on static and dynamic balance indices in healthy elderly adults. Twenty-six community-dwelling older adults were randomly assigned to either an intervention group who took supervised Greek traditional dance classes for 10 wk (1 hr, 2 sessions/week,n= 14), or a control group (n= 12). Balance was assessed pre- and postintervention by recording the center-of-pressure (COP) variations and trunk kinematics during performance of the Sharpened-Romberg test, 1-leg (OL) stance, and dynamic weight shifting (WS). After practice, the dance group significantly decreased COP displacement and trunk sway in OL stance. A significant increase in the range of trunk rotation was noted during performance of dynamic WS in the sagittal and frontal planes. These findings support the use of traditional dance as an effective means of physical activity for improving static and dynamic balance control in the elderly.

Strategies for maintaining dynamic balance in persons with neurological disorders during overground walking

2021 ◽  
pp. 095441192110236
Author(s):  
Tiziana Lencioni ◽  
Denise Anastasi ◽  
Ilaria Carpinella ◽  
Anna Castagna ◽  
Alessandro Crippa ◽  
...  
Keyword(s):  
Neurological Disorder ◽  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Objective Assessment ◽  
Center Of Mass ◽  
Frontal Plane ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Lateral Direction

Maintaining a stable gait requires a dynamic balance control, that can be altered in persons with Multiple Sclerosis (MS), Stroke (ST), and Parkinson’s disease (PD). The understanding of the strategy for Center of Mass (CoM) positioning adopted by patients during walking is important to be able to program treatments aimed at improving gait control and preventing falls. Forty-four persons with a mild-to-moderate neurological disorder (20 with MS, 14 with ST, 10 with PD) underwent clinical examination and gait analysis. Ten Healthy Subjects (HS) walking at matched speed provided the normative data. Dynamic balance was assessed using the margin of stability (MoS). It was calculated as the distance between the extrapolated Center of Pressure and the extrapolated CoM at mid-stance. The MoS values for lower limbs were calculated in patients and compared with speed-matched values of HS. Persons with neurological disorder showed increased MoS in the medio-lateral direction with respect to HS. Within-group comparison analysis showed a symmetry between lower limbs in HS (Mean (95%CI) [mm], dominant vs non-dominant limb, 43.3 (31.9–54.6) vs 42.9 (28.8–56.9)) and PD (less affected vs more affected limb, 71.1 (59.8–82.5) vs 72.5 (58.5–86.6)), while a significant asymmetry was found in MS (54.4 (46.4–62.4) vs 81.1 (71.2–91.1)) and ST (52.1 (42.6–61.7) vs 74.7 (62.8–86.6)) participants. The history of falls was comparable among PD, MS, and ST groups, and the MoS in the frontal plane showed a strong correlation with these records. Objective assessment of MoS revealed pathology-specific strategies showing different impacts in MS, ST, and PD on the ability to control CoM information to manage the balance between limbs during gait. MoS evaluation will provide useful information to address a tailored rehabilitation program and to monitor disease progression.

scholarly journals Sensorimotor Strategies in Individuals With Poststroke Hemiparesis When Standing Up Without Vision

Motor Control ◽  
2020 ◽  
Vol 24 (1) ◽  
pp. 150-167
Author(s):  
Yuko Kuramatsu ◽  
Yuji Yamamoto ◽  
Shin-Ichi Izumi
Keyword(s):  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Center Of Mass ◽  
Healthy Controls ◽  
Orthogonal Direction ◽  
Standing Up ◽  
Lift Off ◽  
Task Accomplishment ◽  
Asymmetrical Balance

This study investigated the sensorimotor strategies for dynamic balance control in individuals with stroke by restricting sensory input that might influence task accomplishment. Sit-to-stand movements were performed with restricted vision by participants with hemiparesis and healthy controls. The authors evaluated the variability in the position of participants’ center of mass and velocity, and the center-of-pressure position, in each orthogonal direction at the lift-off point. When vision was restricted, the variability in the mediolateral center-of-pressure position decreased significantly in individuals with hemiparesis, but not in healthy controls. Participants with hemiparesis adopted strategies that explicitly differed from those used by healthy individuals. Variability may be decreased in the direction that most requires accuracy. Individuals with hemiparesis have been reported to have asymmetrical balance deficits, and that meant they had to prioritize mediolateral motion control to prevent falling. This study suggests that individuals with hemiparesis adopt strategies appropriate to their characteristics.

scholarly journals Does Exercise-Based Conventional Training Improve Reactive Balance Control among People with Chronic Stroke?

2020 ◽  
Vol 11 (1) ◽  
pp. 2
Author(s):  
Lakshmi Kannan ◽  
Jinal Vora ◽  
Gonzalo Varas-Diaz ◽  
Tanvi Bhatt ◽  
Susan Hughes
Keyword(s):  
Balance Control ◽  
Center Of Mass ◽  
Behavioral Outcomes ◽  
Chronic Stroke ◽  
Post Intervention ◽  
Movement Velocity ◽  
Limits Of Stability ◽  
Task Specificity ◽  
Component Training ◽  
Reactive Balance

Background: Exercise-based conventional training has predominantly benefited fall-associated volitional balance control domain; however, the effect on reactive balance control is under-examined. Therefore, the purpose of this study was to examine the effect of exercise-based conventional training on reactive balance control. Methods: Eleven people with chronic stroke (PwCS) underwent multi-component training for six weeks (20 sessions) in a tapering manner. Training focused on four constructs-stretching, functional strengthening, balance, and endurance. Volitional balance was measured via movement velocity on the Limits of Stability (LOS) test and reactive balance via center of mass (COM) state stability on the Stance Perturbation Test (SPT). Additionally, behavioral outcomes (fall incidence and/or number of steps taken) were recorded. Results: Movement velocity significantly increased on the LOS test (p < 0.05) post-intervention with a significant decrease in fall incidence (p < 0.05). However, no significant changes were observed in the COM state stability, fall incidence and number of recovery steps on the SPT post-intervention. Conclusion: Although volitional and reactive balance control may share some neurophysiological and biomechanical components, training based on volitional movements might not significantly improve reactive balance control for recovery from large-magnitude perturbations due to its task-specificity.

Tai Chi Intervention Improves Dynamic Postural Control During Gait Initiation in Older Adults: A Pilot Study

2014 ◽  
Vol 30 (6) ◽  
pp. 697-706 ◽  
Author(s):  
Srikant Vallabhajosula ◽  
Beverly L. Roberts ◽  
Chris J. Hass
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Tai Chi ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Separation Distance ◽  
Gait Initiation ◽  
Mobility Disability ◽  
Post Intervention ◽  
Movement Characteristics

Tai Chi intervention has been shown to be beneficial for balance improvement. The current study examined the effectiveness of Tai Chi to improve the dynamic postural control among older adults with mobility disability. Six sedentary older adults with mobility disability participated in a 16-week Tai Chi intervention consisting of one hour sessions three times a week. Dynamic postural control was assessed pre- and post intervention as participants initiated gait in four stepping conditions: forward; 45° medially, with the stepping leg crossing over the other leg; 45° and 90° laterally. The center of pressure (CoP) displacement, velocity, and its maximum separation distance from the center of mass in the anteroposterior, mediolateral, and resultant directions were analyzed. Results showed that in the postural phase, Tai Chi increased the CoP mediolateral excursions in the medial (13%) and forward (28%) conditions, and resultant CoP center of mass distance in the medial (9%) and forward (19%) conditions. In the locomotion phase, the CoP mediolateral displacement and velocity significantly increased after the Tai Chi intervention (both by > 100% in the two lateral conditions). These results suggest that through alteration in CoP movement characteristics, Tai Chi intervention might improve the dynamic postural control during gait initiation among older adults.

scholarly journals State-Space Characterization of Balance Capabilities in Biped Systems with Segmented Feet

2021 ◽  
Vol 8 ◽  
Author(s):  
Carlotta Mummolo ◽  
Kubra Akbas ◽  
Giuseppe Carbone
Keyword(s):  
State Space ◽  
Trajectory Optimization ◽  
Sagittal Plane ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Center Of Mass ◽  
Whole Body ◽  
Stability Criteria ◽  
Reduced Order

The human ability of keeping balance during various locomotion tasks is attributed to our capability of withstanding complex interactions with the environment and coordinating whole-body movements. Despite this, several stability analysis methods are limited by the use of overly simplified biped and foot structures and corresponding contact models. As a result, existing stability criteria tend to be overly restrictive and do not represent the full balance capabilities of complex biped systems. The proposed methodology allows for the characterization of the balance capabilities of general biped models (ranging from reduced-order to whole-body) with segmented feet. Limits of dynamic balance are evaluated by the Boundary of Balance (BoB) and the associated novel balance indicators, both formulated in the Center of Mass (COM) state space. Intermittent heel, flat, and toe contacts are enabled by a contact model that maps discrete contact modes into corresponding center of pressure constraints. For demonstration purposes, the BoB and balance indicators are evaluated for a whole-body biped model with segmented feet representative of the human-like standing posture in the sagittal plane. The BoB is numerically constructed as the set of maximum allowable COM perturbations that the biped can sustain along a prescribed direction. For each point of the BoB, a constrained trajectory optimization algorithm generates the biped’s whole-body trajectory as it recovers from extreme COM velocity perturbations in the anterior–posterior direction. Balance capabilities for the cases of flat and segmented feet are compared, demonstrating the functional role the foot model plays in the limits of postural balance. The state-space evaluation of the BoB and balance indicators allows for a direct comparison between the proposed balance benchmark and existing stability criteria based on reduced-order models [e.g., Linear Inverted Pendulum (LIP)] and their associated stability metrics [e.g., Margin of Stability (MOS)]. The proposed characterization of balance capabilities provides an important benchmarking framework for the stability of general biped/foot systems.

scholarly journals Effects of white Gaussian noise on dynamic balance in healthy young adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ziyou Zhou ◽  
Can Wu ◽  
Zhen Hu ◽  
Yujuan Chai ◽  
Kai Chen ◽  
...  
Keyword(s):  
Young Adults ◽  
Gaussian Noise ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
White Gaussian Noise ◽  
Fluctuation Analysis ◽  
Balance Performance ◽  
Short Term ◽  
Crossover Point ◽  
Short Time

AbstractIt has been known that short-time auditory stimulation can contribute to the improvement of the balancing ability of the human body. The present study aims to explore the effects of white Gaussian noise (WGN) of different intensities and frequencies on dynamic balance performance in healthy young adults. A total of 20 healthy young participants were asked to stand at a dynamic balance force platform, which swung along the x-axis with an amplitude of ± 4° and frequency of 1 Hz. Their center of pressure (COP) trajectories were recorded when they were stimulated by WGN of different intensities (block 1) and different frequencies (block 2). A traditional method and detrended fluctuation analysis (DFA) were used for data preprocessing. The authors found that only with 75–85 dB WGN, the COP parameters improved. WGN frequency did not affect the dynamic balance performance of all the participants. The DFA results indicated stimulation with 75 dB WGN enhanced the short-term index and reduced the crossover point. Stimulation with 500 Hz and 2500 Hz WGN significantly enhanced the short-term index. These results suggest that 75 dB WGN and 500 Hz and 2500 Hz WGN improved the participants’ dynamic balance performance. The results of this study indicate that a certain intensity of WGN is indispensable to achieve a remarkable improvement in dynamic balance. The DFA results suggest that WGN only affected the short-term persistence, indicating the potential of WGN being considered as an adjuvant therapy in low-speed rehabilitation training.

scholarly journals Transfer and generalization of learned manipulation between unimanual and bimanual tasks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Trevor Lee-Miller ◽  
Marco Santello ◽  
Andrew M. Gordon
Keyword(s):  
Learning Transfer ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Pressure Point ◽  
Torque Generation ◽  
Before And After ◽  
Object Center ◽  
High Level ◽  
Bimanual Grasping ◽  
Partial Learning

AbstractSuccessful object manipulation, such as preventing object roll, relies on the modulation of forces and centers of pressure (point of application of digits on each grasp surface) prior to lift onset to generate a compensatory torque. Whether or not generalization of learned manipulation can occur after adding or removing effectors is not known. We examined this by recruiting participants to perform lifts in unimanual and bimanual grasps and analyzed results before and after transfer. Our results show partial generalization of learned manipulation occurred when switching from a (1) unimanual to bimanual grasp regardless of object center of mass, and (2) bimanual to unimanual grasp when the center of mass was on the thumb side. Partial generalization was driven by the modulation of effectors’ center of pressure, in the appropriate direction but of insufficient magnitude, while load forces did not contribute to torque generation after transfer. In addition, we show that the combination of effector forces and centers of pressure in the generation of compensatory torque differ between unimanual and bimanual grasping. These findings highlight that (1) high-level representations of learned manipulation enable only partial learning transfer when adding or removing effectors, and (2) such partial generalization is mainly driven by modulation of effectors’ center of pressure.

scholarly journals Adherence to a Lifestyle Exercise and Nutrition Intervention in University Employees during the COVID-19 Pandemic: A Randomized Controlled Trial

2021 ◽  
Vol 18 (14) ◽  
pp. 7510
Author(s):  
Guillermo García Pérez de Sevilla ◽  
Olga Barceló Guido ◽  
María de la Paz De la Cruz ◽  
Ascensión Blanco Fernández ◽  
Lidia B. Alejo ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Effect Size ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Nutrition Intervention ◽  
Sitting Time ◽  
Post Intervention ◽  
University Employees ◽  
Randomized Controlled

Healthy lifestyles should be encouraged in the workplace through the occupational health teams of the companies. The objective of the present study was to evaluate the adherence to a lifestyle intervention carried out in university employees during the COVID-19 pandemic and its impact on health-related quality of life (HrQoL). A randomized controlled trial following the CONSORT guidelines was performed, consisting of three supervised interventions lasting for 18 weeks: an educational intervention on healthy habits, a nutritional intervention, and a telematic aerobic and strength exercise intervention. Lifestyle and HrQoL were analyzed six months post-intervention to assess adherence. Twenty-three middle-aged participants completed the study. The intervention group significantly improved their lifestyle according to the Health Promoting Lifestyle Profile II questionnaire, especially in the categories of Health Responsibility, Physical Activity, and Nutrition, with a large effect size. Sitting time was reduced by 2.5 h per day, with a moderate effect size. Regarding HrQoL, the intervention group showed a clinically significant improvement in the Physical Component Summary. Despite the lockdown and the mobility restrictions caused by the COVID-19 pandemic, this intervention performed on university employees achieved adherence to a healthier lifestyle and improved their HrQoL, which is of great clinical relevance.

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