Using Accelerometers to Record Postural Sway in Adolescents With Concussion: A Cross-Sectional Study

Objective To investigate the magnitude of postural sway induced by different balance tasks in adolescents with concussion and to examine the associations of postural sway with concussion symptoms. Design Cross-sectional study. Patients or Other Participants Fifty-six adolescents (20 girls, 36 boys) between 13 and 17 years of age who sustained a concussion within the past 44 days and were still symptomatic. Main Outcome Measure(s) Anterior-posterior postural sway was measured using an accelerometer attached to the participant's lower back while he or she performed 6 static-balance tasks that varied the visual input, type of surface, and foot stance. Participants self-reported symptoms that occurred at the time of the concussion (eg, dizziness, confusion, amnesia) as well as at the time of balance testing (eg, eye and head movement–induced dizziness). Results The normalized path length of postural sway during the different balance tasks was greater with the eyes closed (mean = 19.3 mG/s) compared with the eyes open (mean = 12.4 mG/s; P < .001). Furthermore, sway while standing with the feet together on a foam surface (mean = 17.9 mG/s) or while tandem standing on a firm surface (mean = 19.4 mG/s) was greater than sway while standing with the feet together on a firm surface (mean = 10.3 mG/s; P < .001). Greater sway was associated with dizziness and confusion reported at the time of injury (P < .05). Dizziness and headache symptoms at rest were positively correlated with sway (P < .05). Conclusions Using accelerometers to measure postural sway during different challenging balance conditions in adolescents with concussion may provide an objective means of quantifying balance impairments in clinical environments. Furthermore, the association of these measurements with symptoms suggests a need to account for symptom severity at the time of testing.

Download Full-text

DIFFERENCES IN HIP MUSCLE STRENGTH AND STATIC BALANCE IN PATIENTS WITH TRANSFEMORAL AMPUTATIONS CLASSIFIED AT DIFFERENT K-LEVELS: A PRELIMINARY CROSS-SECTIONAL STUDY

Canadian Prosthetics & Orthotics Journal ◽

10.33137/cpoj.v5i1.37456 ◽

2022 ◽

Vol 5 (1) ◽

Author(s):

Stefanie John ◽

Katja Orlowski ◽

Kai-Uwe Mrkor ◽

Jürgen Edelmann-Nusser ◽

Kerstin Witte

Keyword(s):

Muscle Strength ◽

Cross Sectional Study ◽

Static Balance ◽

Residual Limb ◽

Sectional Study ◽

Cross Sectional ◽

Hip Strength ◽

Eyes Closed ◽

Hip Muscle ◽

Eyes Open

BACKGROUND: Following amputation, patients with lower limb amputations (LLA) are classified into different functional mobility levels (K-levels) ranging from K0 (lowest) to K4 (highest). However, K-level classification is often based on subjective criteria. Objective measures that are able to differentiate between K-levels can help to enhance the objectivity of K-level classification. OBJECTIVE(S): The goal of this preliminary cross-sectional study was to investigate whether differences in hip muscle strength and balance parameters exist among patients with transfemoral amputations (TFA) assigned to different K-levels. METHODOLOGY: Twenty-two participants with unilateral TFA were recruited for this study, with four participants assigned to K1 or K2, six assigned to K3 and twelve assigned to K4. Maximum isometric hip strength of the residual limb was assessed in hip flexion, abduction, extension, and adduction using a custom-made diagnostic device. Static balance was investigated in the bipedal stance on a force plate in eyes open (EO) and eyes closed (EC) conditions. Kruskal-Wallis tests were used to evaluate differences between K-level groups. FINDINGS: Statistical analyses revealed no significant differences in the parameters between the three K-level groups (p>0.05). Descriptive analysis showed that all hip strength parameters differed among K-level groups showing an increase in maximum hip torque from K1/2-classified participants to those classified as K4. Group differences were also present in all balance parameters. Increased sway was observed in the K1/2 group compared to the K4 group, especially for the EC condition. CONCLUSION: Although not statistically significant, the magnitude of the differences indicates a distinction between K-level groups. These results suggest that residual limb strength and balance parameters may have the potential to be used as objective measures to assist K-level assignment for patients with TFA. This potential needs to be confirmed in future studies with a larger number of participants. Layman's Abstract Patients with lower limb amputation (LLA) are classified into different mobility levels, so-called K-levels, which are ranging from K0 (lowest) to K4 (highest). K-level classification is relevant for the patients as it determines the type of prosthetic components available. However, K-level can vary greatly based on the clinician or orthopedic technician individual assessment. Objective data from physical performance tests can help to improve K-level classification. Therefore, muscle strength tests of the amputation stump as well as balance tests were performed in this study to determine whether these parameters have the potential to support K-level classification. Twenty-two participants with a thigh amputation participated in the study (four K1/2-, six K3- and twelve K4-participants). Hip muscle strength on the amputation side was assessed as well as static balance in the double leg stance with eyes open and eyes closed. Analysis of the data showed that all hip strength parameters differed between the K-level groups, with maximum strength increasing from the K1/2 group to the K4 group. Group differences were also seen in the balance parameters with greater body sway for the K1/2 group when compared to the K4 group, especially when participants had their eyes closed. These results show that muscle strength tests of the residual limb and static balance tests may serve as additional measures to improve K-level assignment for patients with LLA. This was only an initial study and further studies with a larger number of participants are required to confirm these results. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37456/28905 How To Cite: John S, Orlowski K, Mrkor K.U, Edelmann-Nusser J, Witte K. Differences in hip muscle strength and static balance in patients with transfemoral amputations classified at different K-levels: A preliminary cross-sectional study. Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.5. https://doi.org/10.33137/cpoj.v5i1.37456 Corresponding Author: Stefanie John,Department of Sports Science, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany.E-Mail: [email protected] ID: https://orcid.org/0000-0001-6722-7195

Download Full-text

Altering Visual Feedback Conditions Impacts Postural Sway Performance in Children After Controlling for Body Mass Index and Habitual Physical Activity

Journal of Motor Learning and Development ◽

10.1123/jmld.2016-0039 ◽

2017 ◽

Vol 5 (2) ◽

pp. 267-279 ◽

Cited By ~ 1

Author(s):

Michael Duncan ◽

Elizabeth Bryant ◽

Mike Price ◽

Samuel Oxford ◽

Emma Eyre ◽

...

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Body Mass ◽

Visual Feedback ◽

Postural Sway ◽

Habitual Physical Activity ◽

Eyes Closed ◽

Computerized Posturography ◽

Eyes Open ◽

Anterior Posterior

This study examined postural sway in children in eyes open (EO) and eyes closed (EC) conditions, controlling for body mass index (BMI) and physical activity (PA). Sixty two children (aged 8–11years) underwent sway assessment using computerized posturography from which 95% ellipse sway area, anterior/posterior (AP) sway, medial/lateral (ML) sway displacement and sway velocity were assessed. Six trials were performed alternatively in EO and EC. BMI (kg/m2) was determined from height and mass. PA was determined using sealed pedometry. AP amplitude (p = .038), ML amplitude (p = .001), 95% ellipse (p = .0001), and sway velocity (p = .012) were higher in EC compared with EO conditions. BMI and PA were not significant as covariates. None of the sway variables were significantly related to PA. However, sway velocity during EO (p = .0001) and EC (p = .0001) was significantly related to BMI. These results indicate that sway is poorer when vision is removed, that BMI influences sway velocity, but that pedometer-assessed PA was not associated with postural sway.

Download Full-text

Does Dual Motor Tasks Provokes Posture Adaptations in Healthy Young Adults? A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49048.15374 ◽

2021 ◽

Author(s):

Carley Bowman ◽

Aleena Jose ◽

Martin G Rosario

Keyword(s):

Young Adults ◽

Postural Stability ◽

Cross Sectional Study ◽

P Value ◽

Motor Tasks ◽

Anova Analysis ◽

Dual Tasks ◽

Cross Sectional ◽

Eyes Closed ◽

Eyes Open

Introduction: Most studies on postural deviations during single and dual tasks have been extensively studied in neuromuscular and older adult populations. Nevertheless, further research is warranted to identify whether such tasks can impose postural adaptations in young, healthy adults without sensory impairments. Aim: To assess postural stability modifications in young adults during single tasks and dual motor tasks (holding a cup filled with water) while concomitantly challenging the sensory systems. Materials and Methods: This was the cross-sectional study on 82 young adults (18-45 years old) from Texas Woman’s University (TWU) Health Science Center in Dallas, Texas, and surrounding areas. Standing postural control was measured by collecting total sway, direction of sway and velocity in the Anterior-Posterior (AP) and Medial-Lateral (ML) directions during different balance tasks. For single and dual tasks, the tests were performed with a bipedal stance on foam involving challenging the sensory input via Eyes Open (EO), Eyes Closed (EC), and head movements with eyes open (EO HUD) and closed (EC HUD). The dual motor tasks were similar to the single tasks with the addition of holding a cup full of water to split attention. Data were placed into the Statistical Package for Social Sciences (SPSS) Data Analysis 25.0 system and were analysed for repeated measures Analysis of Variance (ANOVA) analysis. Results: Eighty-two healthy young adults participated in this study (mean age of 24.6±2.7 years, 13 males and 69 females). An ANOVA analysis revealed that postural stability was considerably altered during motor tasks. Sway in the Antero-Posterior (AP) direction, and velocity of sway increased as the complexity of the tasks intensified. A substantial difference in total sway during single tasks when eyes were closed compared to eyes open (p-value <0.01) was noted. There was a significant difference in total sway (AP and ML) during eyes open (EOM) to eyes closed (ECM) and during eyes open with head moving up and down (EOM HUD) (p-value 0.001). There were significant differences in mean AP velocity during EO (0.11±0.12) compared to EC HUD (0.19±0.15), and when comparing EOM (0.07±0.04) to ECM HUD (0.13±0.08) (p=0.01) Conclusion: This study identified postural changes when comparing single and dual tasks in healthy young adults, and the outcomes of this study showed definite distinctions in postural responses during single and dual motor tasks.

Download Full-text

Upper Extremity Pain Is Associated with Lower Back Pain among Young Basketball Players: A Cross-Sectional Study

The Tohoku Journal of Experimental Medicine ◽

10.1620/tjem.250.79 ◽

2020 ◽

Vol 250 (2) ◽

pp. 79-85 ◽

Cited By ~ 1

Author(s):

Yoshihiro Hagiwara ◽

Yutaka Yabe ◽

Takuya Sekiguchi ◽

Haruki Momma ◽

Masahiro Tsuchiya ◽

...

Keyword(s):

Back Pain ◽

Upper Extremity ◽

Lower Back Pain ◽

Cross Sectional Study ◽

Sectional Study ◽

Basketball Players ◽

Cross Sectional ◽

Lower Back

Download Full-text

Work-related musculoskeletal disorders among Saudi orthopedic surgeons: a cross-sectional study

Bone & Joint Open ◽

10.1302/2046-3758.14.bjo-2020-0005 ◽

2020 ◽

Vol 1 (4) ◽

pp. 47-54

Author(s):

Omar A. Al-Mohrej ◽

Amani K. Elshaer ◽

Sahar S. Al-Dakhil ◽

AlBraa I. Sayed ◽

Seham Aljohar ◽

...

Keyword(s):

Statistical Significance ◽

Daily Practice ◽

Cross Sectional Study ◽

Musculoskeletal Symptoms ◽

Sectional Study ◽

Contributing Factors ◽

Cross Sectional ◽

Orthopaedic Surgeons ◽

Work Related ◽

Lower Back

Introduction Studies have addressed the issue of increasing prevalence of work-related musculoskeletal (MSK) pain among different occupations. However, contributing factors to MSK pain have not been fully investigated among orthopaedic surgeons. Thus, this study aimed to approximate the prevalence and predictors of MSK pain among Saudi orthopaedic surgeons working in Riyadh, Saudi Arabia. Methods A cross-sectional study using an electronic survey was conducted in Riyadh. The questionnaire was distributed through email among orthopaedic surgeons in Riyadh hospitals. Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms were used. Descriptive measures for categorical and numerical variables were presented. Student’s t-test and Pearson’s χ2 test were used. The level of statistical significance was set at p ≤ 0.05. Results The response rate was 80.3%, with a total number of 179 of Saudi orthopaedic surgeons (173 males and six females). Of our sample, 67.0% of the respondents complained of having MSK pain. The most commonly reported MSK pain was lower back (74.0%), followed by neck (58.2%). Age and body mass index were implicated in the development of more than one type of MSK pain. Increased years of experience (≥ 6 years) was linked to shoulder/elbow, lower back, and hip/thigh pain. Smoking is widely associated with lower back pain development, whereas physicians who do not smoke and exercise regularly reported fewer pain incidences. Excessive bending and twisting during daily practice have been correlated with increased neck pain. Conclusion MSK pain was found to be common among Saudi orthopaedic surgeons. Further extensive research should be conducted to understand and analyze the risk factors involved and search for possible improvements to avoid further complications. However, ergonomics education during surgical training could be effective at modifying behaviors and reducing MSK pain manifestations.

Download Full-text

Musculoskeletal Complaints in Occupational Therapists Compared to the General Population: A Cross-Sectional Study in Germany

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17144916 ◽

2020 ◽

Vol 17 (14) ◽

pp. 4916

Author(s):

Ronny Zenker ◽

Maria Girbig ◽

Janice Hegewald ◽

Irina Gilewitsch ◽

Mandy Wagner ◽

...

Keyword(s):

Musculoskeletal Disorders ◽

Occupational Therapists ◽

Cross Sectional Study ◽

Physical Factors ◽

Musculoskeletal Complaints ◽

Sectional Study ◽

Cross Sectional ◽

Lower Back ◽

Increased Risk ◽

The Impact

Occupational therapists (OTs) are exposed to physical factors at work, which can lead to an increased risk of musculoskeletal disorders. Most studies examining musculoskeletal complaints in OT report that the neck, shoulders, and lower back are most often afflicted. The aim of the present study was to examine the impact of work as an OT (focusing on specific work tasks) on specific musculoskeletal complaints compared to the general working population. A cross-sectional study involving a self-administered standardized questionnaire was conducted from January until October 2015 in Germany. In OT and the comparison group, the highest 12-month prevalence of musculoskeletal disorders were observed for the lower back, the neck, and the shoulders. In contrast, elevated prevalence ratios (PR) were found for OT in the thumbs (PR = 2.7; 95% CI = 1.9–3.8), the wrists (PR = 1.4; 95% CI = 1.1–1.8), and the elbows (PR = 1.5; 95% CI = 1.0–2.2). OTs were particularly exposed to high exertion hand activity and several stressful postures at work. In conclusion, OTs seem to be at risk of developing work-related musculoskeletal complaints in the thumbs, wrists, and elbows. Preventive measures should help to reduce the exposures caused by highly repetitive and forceful hand activities.

Download Full-text

Investigation of Balance in Old People Residing in Nursing Homes Using Clinical Assessments

Function and Disability Journal ◽

10.32598/fdj.3.137.1 ◽

2020 ◽

Vol 3 (1) ◽

pp. 11-16

Author(s):

Sogol Zeinali ◽

◽

Zahra Olyaei ◽

Benyamin Kor ◽

Maryam Binesh ◽

...

Keyword(s):

Nursing Homes ◽

Postural Sway ◽

Age Groups ◽

Clinical Test ◽

Old People ◽

Timed Up And Go ◽

Cross Sectional ◽

Clinical Assessments ◽

Eyes Closed ◽

Eyes Open

Background and Objectives: Balance problems are the main cause of falls and fall-related complications in the elderly. The objective of this study was to investigate the balance in old people residing in nursing homes using clinical assessments. Methods: A total of 54 people participated in this cross-sectional study. Timed Up and Go (TUG) was used to assess balance regarding mobility impairments. The modified Clinical Test Of Sensory Interaction on Balance (CTSIB) was also used to assess balance regarding sensory problems. This test was used in 4 conditions: standing with eyes open on a firm surface, standing with eyes closed on a firm surface, standing with eyes open on a compliant foam, and standing with eyes closed on a compliant foam. Data analysis was done by SPSS V. 18 software. Results: The mean time for the completion of TUG was significantly higher than standard scores in all age groups (P<0.05). Postural sway during standing with eyes closed on the ground, eyes open and eyes closed on the foam was more than standing with eyes open on the ground (P<0.001). Postural sway in standing with eyes closed on the foam was more in comparison with standing with eyes closed on the ground and eyes open on the foam (P<0.001). Conclusion: Elderly people living in nursing homes had poorer motor skills to maintain balance. They also showed greater dependence on visual and sensory systems to maintain balance.

Download Full-text