An Assessment of Balance through Posturography in Healthy about Women: An Observational Study

The incidence of falls in adults constitutes a public health problem, and the alteration in balance is the most important factor. It is necessary to evaluate this through objective tools in order to quantify alterations and prevent falls. This study aims to determine the existence of alteration of balance and the influence of age in a population of healthy women. Static posturography was performed on 49 healthy adult women with no history of falls in four different situations using the Romberg test with the NedSVE/IBV® platform. The variables studied were the body sway area and the anteroposterior and mediolateral displacements. The situation of maximum instability occurred in RGC (p = 0.001), with a significant increase in anteroposterior oscillations regarding the ML (p < 0.001), with no correlation to age. Age alone does not influence the balance in the sample studied, other factors must come together to alter it. The joint cancellation of visual and somatosensory afferents could facilitate the appearance of falls, given that it is a situation of maximum instability. Proprioceptive training is interesting as a preventive strategy for falls.

Posturography with head movements in the assessment of balance in chronic unilateral vestibular lesions

The aim of our study was to validate the method of head-shake static posturography (HS-posturography) in healthy individuals and to establish the value of this novel method in the diagnostics of patients with unilateral vestibular lesion (UV). The study included 202 participants divided into two groups, one consisting of 133 patients with canal paresis CP > 19% and one of 69 healthy subjects. Participant was tested according to the standard protocol of static posturography (SP), and with head movements of 0.3 Hz (HS 40), 0.6 Hz (HS 70) in random order controlled by a metronome. HS-posturography revealed a similar repeatability and internal consistency as the standard posturography. In patients with UV, 4th condition revealed higher sensitivity (74%) and specificity (71%) in HS 40 than in the standard posturography (67%, 65% respectively) and HS 70 (54%, 70% respectively). Static posturography and HS- posturography revealed a high reliability of the testing method. The head movements added to static posturography improve the sensitivity and specificity of the method in group with vestibular impairment. The most important test for that purpose seems to be the one on unstable surface with the eyes closed, with low frequency of head movements.

Association of Static Posturography With Severity of White Matter Hyperintensities

Background: Impaired gait and balance are associated with severity of leukoaraiosis. Evaluation of balance is based on neurological examination using Romberg's test with bipedal standing, assessment scale, and posturographic parameters. The goal of this study was to determine the relationship between static equilibrium and grades of white matter hyperintensities (WMHs) using static posturography as a quantitative technical method.Method: One hundred and eighteen (118) patients with lacunar infarct were recruited and assessed on MRI with Fazekas's grading scale into four groups. On admission, age, gender, height, weight, Berg Balance Scale (BBS), mini-mental state examination (MMSE), and static posturography parameters were recorded, and their correlations with WMHs were determined.Results: Age was significantly and positively correlated with severity of WMHs (r = 0.39, p &lt; 0.05). WMH score was negatively correlated with BBS score (r = −0.65, p &lt; 0.05) and MMSE score (r = −0.79, p &lt; 0.05). There was a significant positive correlation between track length anteroposterior (AP, with eyes closed) and severity of WMHs (r = 0.70, p &lt; 0.05). Partial correlation analysis and multiple logistic regression analysis indicated that track length AP with eyes closed, was a predictor for the severity of WMHs (p&lt; 0.05).Conclusion: The severity of WHMs is associated with age, cognitive decline, and impairment in balance. Posturography parameter in track length in AP direction with eyes closed in relation to cognition and balance, may be a potential marker for disease progression in WMHs.

Analysis of Postural Control of Patients with Functional Impairment After Hospitalization for COVID-19

Background: Covid-19 associated with hospitalization results in damage to structures and body functions. Objective: Analyze the postural control of patients with functional loss after hospitalization by COVID-19. Design and setting: Prospective cohort study that evaluated patients after 1 month of discharge from Clinical Hospital - FMUSP, São Paulo, Brazil. Methodology: Functionality before and after hospitalization (Barthel Index), balance (Brief BalanceEvaluation Systems Test- BriefBESTest) and postural control (Static Posturography - Horus®Platform) were evaluated and divided into two groups: functional impairment (FI) and without functional impairment (WFI). Independent T test and Mann- Whitney were applicated for groups comparison (p=0.05). Result: 67 patients were evaluated. FI had 30 patients (44.7%) with a mean age of 62.8 (±10.7), 19 (63.3%) female and 11 (36.6%) male. WFI had 37 patients (55.2%) around average age of 57.7 (±11.6), 13 (35.1 %) female and 24 (64,8 %) male. There was a difference between groups in BriefBESTest (p=0.005) and the measurements of: trust ellipse (EC)-mm² and EC/Stability limit (LM) -% in Open eyes stable surface (OASE) (p=0.042 ; p=0.017), Open eyes unstable surface (OASI) (p=0.018; p=0.004) and Eyes closed unstable surface (OFSI) (p=0.004; p=0.002); Midlateral velocity (ML) in OASI (p=0.008); Functional residual balance in OASI (p=0.018) and OFSI (p=0.002); ML displacement and the anteroposterior of the maximum LM to the left (p=0.048; p=0.028). Conclusion: There is a difference between the FI and WFI groups regarding balance and postural control. It is suggested to include evaluations and targeted interventions for balance improvement and postural control after hospitalization by COVID-19.

Slackline Training in Children with Spastic Cerebral Palsy: A Randomized Clinical Trial

Objective: To assess whether a slackline intervention program improves postural control in children/adolescents with spastic cerebral palsy (CP). Design: Randomized controlled trial. Setting: Patients’ association. Participants: Twenty-seven children/adolescents with spastic CP (9–16 years) were randomly assigned to a slackline intervention (n = 14, 13 ± 3 years) or control group (n = 13, 12 ± 2 years). Intervention: Three slackline sessions per week (30 min/session) for 6 weeks. Main outcome measures: The primary outcome was static posturography (center of pressure—CoP—parameters). The secondary outcomes were surface myoelectrical activity of the lower-limb muscles during the posturography test and jump performance (countermovement jump test and Abalakov test). Overall (RPE, >6–20 scale) rating of perceived exertion was recorded at the end of each intervention session. Results: The intervention was perceived as “very light” (RPE = 7.6 ± 0.6). The intervention yielded significant benefits on static posturography (a significant group by time interaction on Xspeed, p = 0.006) and jump performance (a significant group by time interaction on Abalakov test, p = 0.015). Conclusions: Slackline training improved static postural control and motor skills and was perceived as non-fatiguing in children/adolescents with spastic CP.

Visual Feedback and Postural Control in Multiple Sclerosis

As people with multiple sclerosis (pwMS) manifest heterogeneous demyelinating lesions that could affect somatosensory or vestibular ways, visual stimulus as feedback could be especially relevant to achieve postural control. This has clinical importance for the development of preventive measures and rehabilitation therapies in order to avoid falls and accidents in this group. In our study, we objectively evaluated the influence of visual feedback on the stabilization of balance in pwMS versus healthy controls (HC) and its potential utility in clinical evaluation. Static posturography tests were performed in 99 pwMS and 30 HC. Subjects stood on a force platform with open and closed eyes. During this procedure, three balance parameters were obtained for both vision conditions: average sway, average speed, and average speed of sway. Neurostatus-Expanded Disease Disability Score (EDSS) and Multiple Sclerosis Functional Composite (MSFC) were performed in parallel as well. A two-way mixed repeated measures ANCOVA, controlling for sex and age, was performed to evaluate the effect of vision, MS diagnosis, and the interaction of both in static posturography parameters. The difference between both closed and open eyes conditions was calculated for each parameter and further analyzed according to MS-relevant clinical variables. The magnitude of the vision effect differed between pwMS and HC as a significant interaction between the vision and the MS diagnosis in the delineated area (p < 0.001) and average speed of sway (p = 0.001) was seen. These parameters had a greater increase in pwMS than in HC after closing eyes. For the average sway, a significant main effect of vision was present (p = 0.047). Additionally, the differences obtained between open and closed eyes conditions assessed with the delineated area and average speed of sway were moderately correlated to the assessed clinical tests EDSS (r = 0.405 and r = 0.329, respectively) and the MSFC (r = −0.385 and r = −0.259, respectively). In our study, pwMS were more dependent of visual feedback than HC to maintain postural control. This easy and short evaluation by static posturography could support the development of targeted preventive measures and interventions in pwMS.