scholarly journals Force Plate Assessment of Quiet Standing Balance Control: Perspectives on Clinical Application within Stroke Rehabilitation

2015 ◽  
Vol 4 ◽  
pp. RPO.S20363 ◽  
Author(s):  
Avril Mansfield ◽  
Elizabeth L. Inness
Keyword(s):  
Stroke Rehabilitation ◽  
Center Of Pressure ◽  
Balance Control ◽  
Weight Bearing ◽  
Force Plate ◽  
Standing Balance ◽  
Assessment Tools ◽  
Quiet Standing ◽  
Patient Specific ◽  
Eyes Closed

Assessment of balance control is essential to guide physical rehabilitation poststroke. However, current observational assessment tools available to physiotherapists provide limited information about underlying dyscontrol. This paper describes a force plate-based assessment of quiet standing balance control that we have implemented for individuals attending inpatient stroke rehabilitation. The assessment uses two force plates to measure location of ground reaction forces to maintain stability in quiet standing in five conditions (eyes open, eyes closed, standing symmetrically, and maximal loading on the less-affected and more-affected limbs). Measures of interest are variability of the centers of pressure under each foot and both feet combined, weight-bearing asymmetry, and correlation of center of pressure fluctuations between limbs. We present representative values for the above-mentioned measures and case examples to illustrate how the assessment can reveal patient-specific balance control problems and direct treatment. We identify limitations to our current assessment and recommendations for future research.

scholarly journals Static Balance in Patients with Vestibular Impairments: A Preliminary Study

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
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.

IMMEDIATE EFFECT OF DIFFERENT FOREFOOT WEDGES ON STANDING STABILITY IN YOUNG ADULTS

2018 ◽  
Vol 30 (01) ◽  
pp. 1850014
Author(s):  
Chu-Fen Chang ◽  
Hui-Ji Fan ◽  
Hung-Bin Chen ◽  
Houu-Wooi Lim ◽  
Hsiao-Yuan Lee ◽  
...  
Keyword(s):  
Young Adults ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Balance Control ◽  
Random Sequence ◽  
Force Plate ◽  
Eyes Closed ◽  
Eyes Open ◽  
Arch Support ◽  
Forward Falls

The aim of this study was to investigate the immediate effect of wearing the functional insoles with different slopes of forefoot wedges on postural stability in young adults during quiet stance. In this study, the functional insole was composed of a forefoot wedge and a medial arch support. Twelve healthy young adults (six males and six females) participated. Each subject wore sneakers with and without functional insole and stood as still as possible on a force plate with feet together, arms by side and head facing ahead for 60[Formula: see text]s, while eyes open and eyes closed, respectively. The functional insole was applied in the random sequence of no insole, wearing insole with a medial arch and a four-degree forefoot wedge, as well as wearing insole with a medial arch and an eight-degree forefoot wedge. The sway areas as well as the maximal excursions of the center of pressure (COP) in anterior–posterior (AP) and medial–lateral (ML) directions were used to evaluate the static postural stability. During stance with feet together and eyes closed, the sway area and maximal excursion of the COP in the AP direction were significantly decreased when wearing an eight-degree forefoot wedge functional insole. Since the reduced displacements of the COP indicated better postural control, it was suggested that the functional insole with an eight-degree forefoot wedge and a medial arch support might be beneficial to improve the postural stability in patients with impaired balance control, especially for whom having high risk of forward falls.

Differential Effects of Perturbation Magnitude on Reactive Balance Control in Young Sedentary Adults

Motor Control ◽  
2021 ◽  
pp. 1-14
Author(s):  
Erika Zemková ◽  
Alena Cepková ◽  
José M. Muyor
Keyword(s):  
Body Mass ◽  
Center Of Pressure ◽  
Balance Control ◽  
Force Plate ◽  
Time To Peak ◽  
Eyes Closed ◽  
Postural Responses ◽  
Eyes Open ◽  
Load Release ◽  
Postural Perturbations

This study investigates postural responses to unexpected perturbations induced by a load release of different weights. Groups of 26 men (age 22.6 ± 2.4 years, height 178.0 ± 9.1 cm, and body mass 86.9 ± 11.5 kg) and 21 women (age 21.9 ± 2.7 years, height 168.8 ± 6.8 cm, and body mass 65.3 ± 8.7 kg) underwent load-triggered postural perturbations by 1 and 2 kg while standing on a force plate with either eyes open or eyes closed. Postural perturbations induced by a heavier load, representing about 2% and 3% of body weight in men and women, respectively, led to significantly higher peak anterior and peak posterior center of pressure displacements when compared with a lighter load (29.6% and 45.4%, respectively) both with eyes open (36.9%) and closed (42.1%). Their values were significantly lower in men than women only when a higher load was used (∼25%). However, there were no significant differences in time to peak anterior and posterior center of pressure displacements. These findings indicate that heavier load-induced postural perturbations are greater in women than men regardless of visual conditions. This underlines the importance of loading dose in the magnitude of postural responses to externally induced perturbations.

Surface height effects on postural control: A hypothesis for a stiffness strategy for stance*

1999 ◽  
Vol 9 (4) ◽  
pp. 277-286 ◽  
Author(s):  
Mark G. Carpenter ◽  
James S. Frank ◽  
Cathy P. Silcher
Keyword(s):  
Postural Control ◽  
Center Of Pressure ◽  
High Surface ◽  
Quiet Standing ◽  
Vestibular Input ◽  
Mean Power ◽  
Mean Power Frequency ◽  
Balance Confidence ◽  
Eyes Closed ◽  
Ankle Stiffness

One possible factor influencing the control of upright stance is the perceived threat to one's personal safety, i.e. balance confidence. We explored this factor by examining the control of stationary stance when standing on an elevated platform under various conditions of reduced visual and vestibular inputs. Twenty-eight adults (14 male and 14 female, mean age = 23.5 years) participated in the experiment. Postural control was examined by recording the amplitude variability (RMS) and mean power frequency (MPF) of center of pressure excursions (COP) over a 2-minute interval while participants stood in a normal stance on a low (0.19 m) and a high (0.81 m) platform with toes positioned either at or away from the edge of the platform. Vision was manipulated through eyes open and eyes closed trials. Vestibular input was reduced by tilting the head into extension [1]. Anterior-posterior RMS and MPF of COP were significantly influenced by an interaction between surface height and vision. When vision was available, a significant decrease in RMS was observed during quiet standing on a high surface compared to a low surface independent of step restriction. When vision was available MPF increased when subjects were raised from a low to a high surface. The mean position of the COP was significantly influenced by an interaction between height and step restriction. Differences in RMS and MPF responses to height manipulation were observed between genders in eyes closed conditions. Vestibular input influenced postural control at both low and high levels with significant increases in RMS when vestibular input was reduced. The reciprocal changes observed in RMS and MPF suggest modifications to postural control through changes in ankle stiffness. Vision appears to play a role in increasing ankle stiffness when balance confidence is compromised.

scholarly journals The Effects of Active Self-Correction on Postural Control in Girls with Adolescent Idiopathic Scoliosis: The Role of an Additional Mental Task

2020 ◽  
Vol 17 (5) ◽  
pp. 1640 ◽  
Author(s):  
Elżbieta Piątek ◽  
Michał Kuczyński ◽  
Bożena Ostrowska
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Postural Control ◽  
Repeated Measures ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Force Plate ◽  
Stroop Test ◽  
Quiet Standing ◽  
Mental Task

Due to balance deficits that accompany adolescent idiopathic scoliosis (AIS), the potential interaction between activities of daily living and active self-correction movements (ASC) on postural control deserves particular attention. Our purpose was to assess the effects of ASC movements with or without a secondary mental task on postural control in twenty-five girls with AIS. It is a quasi-experimental within-subject design with repeated measures ANOVA. They were measured in four 20-s quiet standing trials on a force plate: no task, ASC, Stroop test, and both. Based on the center-of-pressure (COP) recordings, the COP parameters were computed. The ASC alone had no effect on any of the postural sway measures. Stroop test alone decreased COP speed and increased COP entropy. Performing the ASC movements and Stroop test together increased the COP speed and decreased COP entropy as compared to the baseline data. In conclusion, our results indicate that AIS did not interfere with postural control. The effects of the Stroop test accounted for good capacity of subjects with AIS to take advantage of distracting attentional resources from the posture. However, performing both tasks together exhibited some deficits in postural control, which may suggest the need for therapeutic consultation while engaging in more demanding activities.

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

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 402 ◽  
Author(s):  
Juan De la Torre ◽  
Javier Marin ◽  
Marco Polo ◽  
José J. Marín
Keyword(s):  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Static Balance ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Balance Test ◽  
Balance Disorders ◽  
Eyes Closed ◽  
Specialist Physician

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.

Reliability of Force-Platform Measures of Postural Sway and Expertise-Related Differences

2011 ◽  
Vol 20 (4) ◽  
pp. 442-456 ◽  
Author(s):  
Zohreh Meshkati ◽  
Mehdi Namazizadeh ◽  
Mahyar Salavati ◽  
Masood Mazaheri
Keyword(s):  
Outcome Measures ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Intraclass Correlation ◽  
Specific Property ◽  
Force Platform ◽  
Quiet Standing ◽  
Eyes Closed ◽  
Before And After ◽  
Eyes Open

Context:Although reliability is a population-specific property, few studies have investigated the measurement error associated with force-platform parameters in athletic populations.Objective:To investigate the skill-related differences between athletes and nonathletes in reliability of center-of-pressure (COP) summary measures under eyes-open (EO) and eyes-closed (EC) conditions.Design:Test–retest reliability study.Setting:COP was recorded during double-leg quiet standing on a Kistler force platform before and after a fatiguing treadmill exercise, with EO and EC.Participants:31 male participants including 15 athletes practiced in karate and 16 nonathletes.Main Outcome Measures:Standard deviation (SD) of amplitude, phase-plane portrait, SD of velocity, mean total velocity, and area were calculated from 30-s COP data. Intraclass correlation coefficient (ICC), standard error of measurement, and coefficient of variation (CV) were used as estimates of reliability and precision.Results:Higher ICCs were found for COP measures in the athlete (compared with the nonathlete) group, postfatigued (compared with prefatigued) condition, and EC (compared with EO) tests. CVs smaller than 15% were obtained for most of the COP measures. SD of velocity in the anteroposterior direction showed the highest reliability in most conditions.Conclusions:Tests with EC and to a lesser extent tests performed in the athlete group and in the postfatigued condition showed better reliability.

THE EFFECTS OF DRESS SHOES ON STABILITY DURING QUIET STANDING AND ENERGY CONSUMPTION WHILE WALKING

2012 ◽  
Vol 12 (05) ◽  
pp. 1250029
Author(s):  
SAED MOHSEN MIRBOD ◽  
MOHAMMAD TAGHI KARIMI ◽  
A. ESHRAGHI
Keyword(s):  
Energy Consumption ◽  
Center Of Pressure ◽  
Force Plate ◽  
Normal Subjects ◽  
Quiet Standing ◽  
P Value ◽  
Cost Index ◽  
Mean Values ◽  
Physiological Cost ◽  
The Stability

Footwear is an extremely important clothing item worn by all individuals. Currently, there is insufficient research regarding the influence of dress shoes on standing stability and energy consumption while walking. Therefore, the aim of this study was to evaluate the influence of dress shoes on the performance of normal subjects based on stability and energy consumption analysis. Fifteen normal subjects were recruited in this research study to stand and walk with and without shoes. The stability of the subjects in quiet standing was measured by the use of a force plate based on center of pressure (COP) sway. The energy consumption was evaluated by a heart rate monitoring system (Polar Electro) based on the physiological cost index (PCI). The mean values of PCI while walking with and without shoes were 0.29 ± 0.117 and 0.265 ± 0.112 beats/m, respectively (p-value > 0.05). The amplitudes of COP sways in the mediolateral and anteroposterior directions were 10.4 ± 3.5 and 25 ± 6.92 mm while standing with shoes and 9.3 ± 2.84 and 22.5 ± 5.25 mm in barefoot standing, respectively (p-value > 0.05). It can be concluded that wearing dress shoes does not influence the performance of subjects while standing or walking.

scholarly journals Postural Stability in Obese Preoperative Bariatric Patients Using Static and Dynamic Evaluation

Obesity Facts ◽  
2020 ◽  
Vol 13 (5) ◽  
pp. 499-513
Author(s):  
Gabriel M. Pagnotti ◽  
Amna Haider ◽  
Ariel Yang ◽  
Kathryn E. Cottell ◽  
Catherine M. Tuppo ◽  
...  
Keyword(s):  
Postural Stability ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Postural Instability ◽  
Patient Specific ◽  
Morbidly Obese ◽  
Tissue Quality ◽  
Eyes Closed ◽  
Obese Subjects ◽  
The Impact

<b><i>Introduction:</i></b> Globally, 300 million adults have clinical obesity. Heightened adiposity and inadequate musculature secondary to obesity alter bipedal stance and gait, diminish musculoskeletal tissue quality, and compromise neuromuscular feedback; these physiological changes alter stability and increase injury risk from falls. Studies in the field focus on obese patients across a broad range of body mass indices (BMI &#x3e;30 kg/m<sup>2</sup>) but without isolating the most morbidly obese subset (BMI ≥40 kg/m<sup>2</sup>). We investigated the impact of obesity in perturbing postural stability in morbidly obese subjects elected for bariatric intervention, harboring a higher-spectrum BMI. <b><i>Subjects and Methods:</i></b> Traditional force plate measurements and stabilograms are gold standards employed when measuring center of pressure (COP) and postural sway. To quantify the extent of postural instability in subjects with obesity before bariatric surgery, we assessed 17 obese subjects with an average BMI of 40 kg/m<sup>2</sup> in contrast to 13 nonobese subjects with an average BMI of 30 kg/m<sup>2</sup>. COP and postural sway were measured from static and dynamic tasks. Involuntary movements were measured when patients performed static stances, with eyes either opened or closed. Two additional voluntary movements were measured when subjects performed dynamic, upper torso tasks with eyes opened. <b><i>Results:</i></b> Mean body weight was 85% (<i>p</i> &#x3c; 0.001) greater in obese than nonobese subjects. Following static balance assessments, we observed greater sway displacement in the anteroposterior (AP) direction in obese subjects with eyes open (87%, <i>p</i> &#x3c; 0.002) and eyes closed (76%, <i>p</i> = 0.04) versus nonobese subjects. Obese subjects also exhibited a higher COP velocity in static tests when subjects’ eyes were open (47%, <i>p</i> = 0.04). Dynamic tests demonstrated no differences between groups in sway displacement in either direction; however, COP velocity in the mediolateral (ML) direction was reduced (31%, <i>p</i> &#x3c; 0.02) in obese subjects while voluntarily swaying in the AP direction, but increased in the same cohort when swaying in the ML direction (40%, <i>p</i> &#x3c; 0.04). <b><i>Discussion and Conclusion:</i></b> Importantly, these data highlight obesity’s contribution towards increased postural instability. Obese subjects exhibited greater COP displacement at higher AP velocities versus nonobese subjects, suggesting that clinically obese individuals show greater instability than nonobese subjects. Identifying factors contributory to instability could encourage patient-specific physical therapies and presurgical measures to mitigate instability and monitor postsurgical balance improvements.

scholarly journals Impact of Spasticity on Balance Control during Quiet Standing in Persons after Stroke

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Reza Rahimzadeh Khiabani ◽  
George Mochizuki ◽  
Farooq Ismail ◽  
Chris Boulias ◽  
Chetan P. Phadke ◽  
...  
Keyword(s):  
Balance Control ◽  
Frontal Plane ◽  
Control Measures ◽  
Quiet Standing ◽  
Measurement Unit ◽  
Mean Power ◽  
Mean Power Frequency ◽  
Cross Sectional ◽  
Eyes Closed ◽  
Roll Velocity

Background. Balance impairments, falls, and spasticity are common after stroke, but the effect of spasticity on balance control after stroke is not well understood.Methods. In this cross-sectional study, twenty-seven participants with stroke were divided into two groups, based on ankle plantar flexor spasticity level. Fifteen individuals with high spasticity (Modified Ashworth Scale (MAS) score of ≥2) and 12 individuals with low spasticity (MAS score <2) completed quiet standing trials with eyes open and closed conditions. Balance control measures included centre of pressure (COP) root mean square (RMS), COP velocity, and COP mean power frequency (MPF) in anterior-posterior and mediolateral (ML) directions. Trunk sway was estimated using a wearable inertial measurement unit to measure trunk angle, trunk velocity, and trunk velocity frequency amplitude in pitch and roll directions.Results. The high spasticity group demonstrated greater ML COP velocity, trunk roll velocity, trunk roll velocity frequency amplitude at 3.7 Hz, and trunk roll velocity frequency amplitude at 4.9 Hz, particularly in the eyes closed condition (spasticitybyvisioninteraction). ML COP MPF was greater in the high spasticity group.Conclusion. Individuals with high spasticity after stroke demonstrated greater impairment of balance control in the frontal plane, which was exacerbated when vision was removed.

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