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

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.

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Differences in Static- and Dynamic-Balance Task Performance After 4 Weeks of Intrinsic-Foot-Muscle Training: The Short-Foot Exercise Versus the Towel-Curl Exercise

Journal of Sport Rehabilitation ◽

10.1123/jsr.21.4.327 ◽

2012 ◽

Vol 21 (4) ◽

pp. 327-333 ◽

Cited By ~ 50

Author(s):

Scott K. Lynn ◽

Ricardo A. Padilla ◽

Kavin K.W. Tsang

Keyword(s):

Task Performance ◽

Outcome Measures ◽

Repeated Measures ◽

Mixed Model ◽

Center Of Pressure ◽

Dynamic Balance ◽

Weight Bearing ◽

Static Balance ◽

Balance Test ◽

Balance Task

Context:Proper functioning of the intrinsic foot musculature (IFM) is essential in maintaining the integrity of the medial longitudinal arch (MLA). Improper functioning of the IFM leads to excessive pronation of the foot, which has been linked to various pathologies. Therefore, training the IFM to avoid excessive pronation may help prevent some of these pathologies; however, it is not clear how to train these muscles optimally.Objective:To investigate the effects of 2 different types of IFM training on the height of the MLA and static- and dynamic-balance task performance.Design:Randomized controlled trial, repeated-measures mixed-model design.Setting:University biomechanics laboratory for testing and a home-based training program.Participants:24 healthy, university-age volunteers (3 groups of 8) with no history of major lower limb pathology or balance impairment.Interventions:One experimental group performed 4 wk of the short-foot exercise (SFE) and the other performed 4 wk of the towel-curl exercise (TCE). Participants were asked to perform 100 repetitions of their exercise per day.Main Outcome Measures:Navicular height during weight bearing, the total range of movement of the center of pressure (COP) in the mediolateral (ML) direction for a static-balance test and a dynamic-balance test.Results:There were no differences in the navicular height or static-balance tests. For the dynamic-balance test, all groups decreased the ML COP movement on the dominant limb by a small amount (~5 mm); however, the SFE group was able to decrease COP movement much more than the TCE group in the nondominant limb.Conclusions:The SFE appeared to train the IFM more effectively than the TCE; however, there were differing results between the dominant and nondominant legs. These imbalances need to be taken into consideration by clinicians.

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Static Balance in Patients with Vestibular Impairments: A Preliminary Study

Scientifica ◽

10.1155/2016/6539858 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 3

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.

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An observational study of balance and proprioception function in patients with spinocerebellar ataxias type 3

10.21203/rs.3.rs-58116/v1 ◽

2020 ◽

Author(s):

Xia-Hua Liu ◽

Ying Li ◽

Hao-Ling Xu ◽

Arif Sikandar ◽

Wei-Hong Lin ◽

...

Keyword(s):

Postural Control ◽

Dynamic Balance ◽

Body Sway ◽

Static Balance ◽

Clinical Test ◽

Spinocerebellar Ataxias ◽

Balance Test ◽

Eyes Closed ◽

Eyes Open ◽

Type 3

Abstract BackgroundPostural instability is one of the most disabling features of spinocerebellar ataxias type 3 (SCA3) and often leads to falls that reduce mobility and functional capacity. This study aimed to quantitatively analyse static and dynamic balance and proprioception function on postural control in patients with SCA3 using the Pro-kin system and optimise rehabilitation programmes for them.MethodsEight-one clinically diagnosed SCA3 patients (38 women, 43 men; aged 39.00 ± 9.66) and 62 healthy controls were studied and evaluated using the Pro-kin system (PK254P, Tecnobody S.r.l, Dalmine, Italy). The measurements included (1) a static balance test in two visual feedback conditions: eyes open (EO) and eyes closed (EC); (2) a dynamic balance test measuring limits of stability (LOS); and (3) a proprioception function test to obtain proprioceptive measurements on a multiaxial balance evaluator for both right and left lower limbs.ResultsCompared to controls, SCA3 patients showed significantly higher values of all static balance outcome variables with eyes open and eyes closed, implying postural instability. SCA3 patients showed significantly higher values in the standard deviation of body sway along the medio-lateral (ML) axis and in the velocity of body sway along the anterior-posterior (AP) axis. The overall scores and the scores for all eight LOS components were significantly lower in the SCA3 patients than in the controls. The mean values of AP index (API), ML index (MLI), Stability index (SI) and average trace error (ATE) were significantly greater in SCA3 patients compared to HC subjects, while API showed a trend toward higher values.ConclusionsSCA3 patients have a significant postural control disorder, and are likely to fall on the AP plane and prefer performing postural adjustments in the ML direction; a decreased proprioception function in the knee and ankle is also evident. Visual cues and proprioception should be emphasized in balance rehabilitation training. Attention should also be paid to improve muscle strength and range of motion.Trial registrationThe Chinese clinical test registration center. ChiCTR1800020133. Registered 15 december 2018 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=33950

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Concussion History and Balance Performance in Adolescent Rugby Union Players

The American Journal of Sports Medicine ◽

10.1177/0363546521998709 ◽

2021 ◽

pp. 036354652199870

Author(s):

Mark Matthews ◽

William Johnston ◽

Chris M. Bleakley ◽

Richard J. Davies ◽

Alan T. Rankin ◽

...

Keyword(s):

Dual Task ◽

Inertial Sensor ◽

Dynamic Balance ◽

Rugby Union ◽

Static Balance ◽

Balance Performance ◽

Eyes Closed ◽

History Of ◽

Concussion History ◽

Rugby Players

Background: Sports-related concussion is a worldwide problem. There is a concern that an initial concussion can cause prolonged subclinical disturbances to sensorimotor function that increase the risk of subsequent injury. The primary aim of this study was to examine whether a history of sports-related concussion has effects on static and dynamic balance performance in adolescent rugby players. Hypothesis: Dynamic balance would be worse in players with a history of concussion compared with those with no history of concussion. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Male adolescent rugby players aged 14 to 18 years from 5 schools were recruited before the start of the 2018-2019 playing season. Participants completed questionnaires and physical tests, including dynamic Y balance and single-leg static balance (eyes closed) tests, while performing single and dual tasks. Dynamic balance was assessed using inertial sensor instrumentation. Dependent variables were normalized reach distance and the sample entropy (SEn) of the 3 axes ( x, y, and z). Results: Of the 195 participants, 100 reported a history of concussion. Those with a history of concussion demonstrated higher SEn in all directions, with highest values during anterior (standardized mean difference [SMD], 0.4; 95% CI, 0.0-0.7; P = .027) and posteromedial (SMD, 0.5; 95% CI, 0.2-0.9; P = .004) reach directions compared with those with no history. There was no difference between groups (concussion history vs control) in traditional Y balance reach distances in the anterior or posteromedial directions or single-leg static balance during both single- ( P = .47) and dual-task ( P = .67) conditions. Conclusion: Adolescent rugby union athletes with a history of concussion had poorer dynamic balance during performance tasks compared with healthy controls. Static single-leg balance tests, either single or dual task, may not be sensitive enough to detect sensorimotor deficits in those with a history of concussion.

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Test–Retest Reliability of the Mini-BESTest in People With Mild to Moderate Multiple Sclerosis

Physical Therapy ◽

10.1093/ptj/pzab045 ◽

2021 ◽

Author(s):

A Wallin ◽

M Kierkegaard ◽

E Franzén ◽

S Johansson

Keyword(s):

Multiple Sclerosis ◽

Measurement Errors ◽

Balance Control ◽

Intraclass Correlation ◽

Repeated Measurements ◽

Minimal Detectable Change ◽

Detectable Change ◽

Limits Of Agreement ◽

Retest Reliability ◽

Test Retest Reliability

Abstract Objective The mini-BESTest is a balance measure for assessment of the underlying physiological systems for balance control in adults. Evaluations of test–retest reliability of the mini-BESTest in larger samples of people with multiple sclerosis (MS) are lacking. The purpose of this study was to investigate test–retest reliability of the mini-BESTest total and section sum scores and individual items in people with mild to moderate overall MS disability. Methods This study used a test–retest design in a movement laboratory setting. Fifty-four people with mild to moderate overall MS disability according to the Expanded Disability Status scale (EDSS) were included, with 28 in the mild subgroup (EDSS 2.0–3.5) and 26 in the moderate subgroup (EDSS 4.0–5.5). Test–retest reliability of the mini-BESTest was evaluated by repeated measurements taken 1 week apart. Reliability and measurement error were analyzed. Results Test–retest reliability for the total scores were considered good to excellent, with intraclass correlation coefficients of .88 for the whole sample, .83 for the mild MS subgroup, and .80 for the moderate MS subgroup. Measurement errors were small, with standard error of measurement and minimal detectable change of 1.3 and 3.5, respectively, in mild MS, and 1.7 and 4.7, respectively, in moderate MS. The limits of agreement were − 3.4 and 4.6. Test–retest reliability for the section scores were fair to good or excellent; weighted kappa values ranged from .62 to .83. All items but 1 showed fair to good or excellent test–retest reliability, and percentage agreement ranged from 61% to 100%. Conclusions The mini-BESTest demonstrated good to excellent test–retest reliability and small measurement errors and is recommended for use in people with mild to moderate MS. Impact Knowledge of limits of agreement and minimal detectable change contribute to interpretability of the mini-BESTest total score. The findings of this study enhance the clinical usefulness of the test for evaluation of balance control and for designing individually customized balance training with high precision and accuracy in people with MS.

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Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review

Reviews in Endocrine and Metabolic Disorders ◽

10.1007/s11154-020-09619-9 ◽

2021 ◽

Author(s):

Koen Andre Horstink ◽

Lucas Henricus Vincentius van der Woude ◽

Juha Markus Hijmans

Keyword(s):

Systematic Review ◽

Peripheral Neuropathy ◽

Plantar Pressure ◽

Diabetic Peripheral Neuropathy ◽

Balance Control ◽

Dynamic Balance ◽

Movement Control ◽

Future Research ◽

Static Balance ◽

Somatosensory Information

AbstractPatients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance. Offloading devices are used to reduce peak plantar pressure and prevent diabetic foot ulcers. However, offloading devices can unfortunately have negative effects on static and dynamic balance. It is important to investigate these unwanted effects, since patient with DPN already are at high risk of falling and offloading devices could potentially increase this risk. The aim of this systematic review is to investigate the effects of plantar offloading devices used for ulcer prevention on their role in static and dynamic balance control in patients with DPN. PubMed and Embase were systematically searched using relevant search terms. After title selection, abstract selection, and full-text selection only five articles could be included for further analysis. Two articles included static balance measurements, two articles included dynamic balance measurements, and one article included both. Results suggested that static balance control is reduced when rocker bottom shoes and different insole configurations are used, however, toe-only rockers showed less evidence for reduced static balance control. There was no evidence for reduced dynamic balance control in combination with offloading devices. However, these results should be interpreted with care, since the number of studies was very small and the quality of the studies was moderate. Future research should evaluate balance in combination with different offloading devices, so that clinicians subscribing them are more aware of their potential unwanted consequences.

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Investigation of the Effect of Acute Muscular Fatigue on Static and Dynamic Balance Performances in Elite Wrestlers

Journal of Education and Learning ◽

10.5539/jel.v8n5p179 ◽

2019 ◽

Vol 8 (5) ◽

pp. 179

Author(s):

Ömer Özer

Keyword(s):

Aerobic Power ◽

Dynamic Balance ◽

Muscular Fatigue ◽

Static Balance ◽

Muscular Endurance ◽

Maximal Strength ◽

Balance Test ◽

Balance Exercise ◽

Fatigue Exercise ◽

Before And After

Maximal strength, muscular endurance, maximal aerobic power, and anaerobic capabilities, power are needed to have victory for wrestlers in a wrestling competition.The aim of the study is to investigate the effect of acute muscular fatigue on static and dynamic balance performances in elite wrestlers. Ten elite male wrestlers (25 ± 2.3 years, 181 ± 6.5 cm, 84 ± 4.2 kg) participated in the study voluntarily. Participants were undertaken dynamic and static balance test before fatigue exercise (in Cybex) and immediately after fatigue exercise, theywere undertaken dynamic and static balance test again. SPSS packet program was used to evaluate the data. There were no statistically significant differences in static and dynamic balance before and after fatigue. The results show that wrestlers’ balance is not affected by muscular fatigue, so there is no need for balance exercise after fatigue at least according to this study.

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Effect of Exercises in Water and Land on Balance and Cognitive Functions in Elderly and Old Persons

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v1i18.746 ◽

2019 ◽

Vol 1 (18) ◽

Author(s):

Remigija Dekaminavičiūtė ◽

Vilma Dudonienė

Keyword(s):

Cognitive Functions ◽

Elderly Women ◽

Dynamic Balance ◽

Exercise Program ◽

Static Balance ◽

Trail Making Test ◽

Exercise Programs ◽

Balance Test ◽

Trail Making ◽

Better Than

Research background. Aging constantly manifests itself not only in physiological changes, but also in cognitive ones. Exercise programs for elderly have been created aiming at avoiding risk of falling, but there is little known about changes in cognitive functions under the eﬀect of exercise. The aim was to evaluate the eﬀect of water-based and land-based exercises on balance and cognitive functions in elderly women and men. Methods. The dynamic balance of study participants (n = 32) was evaluated using Timed Up & Go Test, the static balance was evaluated with a 4-position Static Balance Test and the cognitive functions were evaluated with Six-Item Cognitive Impairment Test, the Cognitive Failures Questionnaire and the Trail Making Test. The participants were randomly divided in two groups: water exercise and land-based exercise. Results. After 8 weeks of exercise in water and on land, static and dynamic balance and cognitive functions improved in both groups (p < 0.05), no statistically signifcant diﬀerence was found between the groups except for the trail making test, which was performed more quickly by subjects who attended exercise in water. After the exercise program, the men’s dynamic and static balance (while standing in the tandem position) were better than women’s, but women’s standing on one leg position was better than that of men’s (p < 0.05). Conclusion. There were no statistically signifcant diﬀerences in cognitive function between men and women after intervention. After both exercise programs, dynamic and static balance (in the tandem position) in men were better (p < 0.05) than those in women, standing on one leg but women’s position was statistically signifcantly better than that of men’s.Keywords: exercise program in water and land-based, static and dynamic balance, cognitive functions.

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Age-related neuromuscular function and dynamic balance control during slow and fast balance perturbations

Journal of Neurophysiology ◽

10.1152/jn.00476.2013 ◽

2013 ◽

Vol 110 (11) ◽

pp. 2557-2562 ◽

Cited By ~ 3

Author(s):

Jarmo M. Piirainen ◽

Vesa Linnamo ◽

Neil J. Cronin ◽

Janne Avela

Keyword(s):

Sensory Feedback ◽

Center Of Pressure ◽

Balance Control ◽

Dynamic Balance ◽

Neuromuscular Function ◽

Plantar Flexor ◽

Fast Recovery ◽

M Wave ◽

Age Related ◽

Wave Latency

This study investigated age-related differences in dynamic balance control and its connection to reflexes and explosive isometric plantar flexor torque in 19 males (9 Young aged 20–33 yr, 10 Elderly aged 61–72 yr). Dynamic balance was measured during Slow (15 cm/s) and Fast (25 cm/s) anterior and posterior perturbations. H/M-ratio was measured at 20% of maximal M-wave (H/M20%) 10, 30, and 90 ms after perturbations. Stretch reflexes were measured from tibialis anterior and soleus during anterior and posterior perturbations, respectively. In Slow, Elderly exhibited larger peak center-of-pressure (COP) displacement (15%; P < 0.05) during anterior perturbations. In Fast, Young showed a trend for faster recovery (37%; P = 0.086) after anterior perturbations. M-wave latency was similar between groups (6.2 ± 0.7 vs. 6.9 ± 1.2 ms), whereas Elderly showed a longer H-reflex latency (33.7 ± 2.3 vs. 36.4 ± 1.7 ms; P < 0.01). H/M20% was higher in Young 30 ms after Fast anterior (50%; P < 0.05) and posterior (51%; P < 0.05) perturbations. Plantar flexor rapid torque was also higher in Young (26%; P < 0.05). After combining both groups' data, H/M20% correlated negatively with Slow peak COP displacement ( r = −0.510, P < 0.05) and positively with Fast recovery time ( r = 0.580, P < 0.05) for anterior perturbations. Age-related differences in balance control seem to be more evident in anterior than posterior perturbations, and rapid sensory feedback is generally important for balance perturbation recovery.

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

Romanian Journal of Rhinology ◽

10.1515/rjr-2017-0010 ◽

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.

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