Enhancing sensory acuity and balance function using near-sensory biofeedback-based perturbation intervention for individuals with traumatic brain injury

BACGROUND: Interventions addressing balance dysfunction after traumatic brain injury (TBI) only target compensatory aspects and do not investigate perceptual mechanisms such as sensory acuity. OBJECTIVE: To evaluate the efficacy of a novel intervention that integrates sensory acuity with a perturbation-based approach for improving the perception and functional balance after TBI. METHODS: A two-group design was implemented to evaluate the effect of a novel, perturbation-based balance intervention. The intervention group (n = 5) performed the intervention with the sinusoidal (0.33, 0.5, and 1 Hz) perturbations to the base of support with amplitudes derived using our novel outcome of sensory acuity - perturbation perception threshold (PPT). The efficacy is evaluated using changes in PPT and functional outcomes (Berg Balance Scale (BBS), Timed-up and Go (TUG), 5-meter walk test (5MWT), and 10-meter walk test (10MWT)). RESULTS: There was a significant post-intervention change in PPT for 0.33 Hz (p = 0.021). Additionally, clinically and statistically significant improvements in TUG (p = 0.03), 5MWT (p = 0.05), and 10MWT (p = 0.04) were observed. CONCLUSIONS: This study provides preliminary efficacy of a novel, near-sensory balance intervention for individuals with TBI. The use of PPT is suggested for a comprehensive understanding and treatment of balance dysfunction. The promising results support the investigation in a larger cohort.

Wobble-Board Balance Intervention to Decrease Symptoms and Prevent Reinjury in Athletes With Chronic Ankle Instability: An Exploration Case Series

Controlled research has shown that a single-exercise wobble-board intervention is effective at reducing symptoms and increasing function in patients with chronic ankle instability. However, the effectiveness of this protocol has not been documented in a realistic intercollegiate athletics environment. Eight intercollegiate athletes with chronic ankle instability participated in an 8-week (3 sessions/wk) wobble-board intervention. In a realistic environment, this simple intervention was feasible to implement and resulted in meaningful improvements in patient-reported stability for more than half of the patients (5 of 8) but only improved the global rating of function and pain for a minority of the patients (2 of 8 and 3 of 8, respectively). Not all patients experienced equal symptom reduction; however, no new ankle sprains occurred during the intervention.

Effects of a 6-month balance intervention on postural control of preschoolers born with biological risk factors

Study aim: To investigate the effects of 6-month sensorimotor training on postural control of 5-6-year-old preschool children born with ‘biological risk factors’ (BRF). Material and methods: Sixty-four Hungarian preschoolers participated in this study, and were assigned to an experimental group (n = 17), control group 1 (n = 23) and control group 2 (n = 24). The experimental group (born with BRF) attended a 6-month balance intervention based on Ayres’ therapy, while control group 1 (born with BRF) and control group 2 (born with no BRF) fol­lowed the regular preschool schedule. Birth weight, gestational age at birth, Apgar score and other abnormalities during pregnancy and birth were considered to be BRF. A moveable platform (stabilometer) was used to examine the distance of center of pressure movements of all participants prior to the start and after the end of the intervention. The testing procedure was performed with four enjoyable tests in the same sequence (‘Mouse in the hole’, ‘Center’, ‘Christmas tree’, ‘Square painting’). Results: The balance intervention program resulted in significant improvements in postural control of the experimental group. In three of six variables the balance index scores of the intervention group approached the scores of their peers born without BRF, and they even had better performance in three of six variables. Conclusions: Balance training with instability training devices could help children born with BRF attain a higher level of inte­gration through the stimulation of tactile and balancing senses.

Effects of Combined exergame and conventional exercise to reduce and prevent fall risk among elderly people: A Hypothesis

Background: Falling among old individuals has provoked ceaseless discussion among gerontologists and physical therapists and it is still one of the greatest issues among this population. Loss of the balance and functional mobility is the main reason of falling. There have been numerous studies conducting the effect of the conventional balance exercise and exergame independently on balance and functional mobility of elderly. Previous studies lacked dealing with the effect of combined exergame and conventional exercise on the balance and functional mobility. Combined exercises are enjoyable and may have more effective to improve balance and performance to reduce risk of fall among elderly people. This package would be preferable for older people. Objective: We hypothesize that while conventional balance exercise and exergame improve balance and functional mobility, combined both types of exercise would superior improvements in elderly performance. Conclusion: Ultimately we expect that this hypothesis will provide a useful framework for facilitating combined exergame and conventional balance intervention in older people.