scholarly journals Effectiveness and Limitations of Unsupervised Home-Based Balance Rehabilitation with Nintendo Wii in People with Multiple Sclerosis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Massimiliano Pau ◽  
Giancarlo Coghe ◽  
Federica Corona ◽  
Bruno Leban ◽  
Maria Giovanna Marrosu ◽  
...  

Balance training represents a critical part of the rehabilitation process of individuals living with multiple sclerosis (MS) since impaired postural control is a distinctive symptom of the disease. In recent years, the use of the Nintendo Wii system has become widespread among rehabilitation specialists for this purpose, but few studies have verified the effectiveness of such an approach using quantitative measures of balance. In this study, we analyzed the postural sway features of a cohort of twenty-seven individuals with MS before and after 5 weeks of unsupervised home-based balance training with the Wii system. Center of pressure (COP) time-series were recorded using a pressure platform and processed to calculate sway area, COP path length, displacements, and velocities in mediolateral (ML) and anteroposterior (AP) directions. Although the results show a significant reduction in sway area, COP displacements, and velocity, such improvements are essentially restricted to the ML direction, as the Wii platform appears to properly stimulate the postural control system in the frontal plane but not in the sagittal one. Available Wii games, although somewhat beneficial, appear not fully suitable for rehabilitation in MS owing to scarce flexibility and adaptability to MS needs and thus specific software should be developed.

2002 ◽  
Vol 11 (1) ◽  
pp. 51-66 ◽  
Author(s):  
Riann M. Palmieri ◽  
Christopher D. Ingersoll ◽  
Marcus B. Stone ◽  
B. Andrew Krause

Objective:To define the numerous center-of-pressure derivatives used in the assessment of postural control and discuss what value each might provide in the assessment of balance.Data Sources:MEDLINE and SPORTDiscus were searched with the termsbalance, postural control, postural sway,andcenter of pressure. The remaining citations were collected from references of similar papers. A total of 67 references were studied.Conclusions:Understanding what is represented by each parameter used to assess postural control is crucial. At the present time the literature has failed to demonstrate how the variables reflect changes made by the postural-control system. Until it can be shown that the center of pressure and its derivatives actually reveal changes in the postural-control system, the value of using these measures to assess deficits in postural control is minimized.


2019 ◽  
Vol 9 (11) ◽  
pp. 113 ◽  
Author(s):  
Harish Chander ◽  
Sachini N. K. Kodithuwakku Arachchige ◽  
Christopher M. Hill ◽  
Alana J. Turner ◽  
Shuchisnigdha Deb ◽  
...  

Background: Virtual reality (VR) is becoming a widespread tool in rehabilitation, especially for postural stability. However, the impact of using VR in a “moving wall paradigm” (visual perturbation), specifically without and with anticipation of the perturbation, is unknown. Methods: Nineteen healthy subjects performed three trials of static balance testing on a force plate under three different conditions: baseline (no perturbation), unexpected VR perturbation, and expected VR perturbation. The statistical analysis consisted of a 1 × 3 repeated-measures ANOVA to test for differences in the center of pressure (COP) displacement, 95% ellipsoid area, and COP sway velocity. Results: The expected perturbation rendered significantly lower (p < 0.05) COP displacements and 95% ellipsoid area compared to the unexpected condition. A significantly higher (p < 0.05) sway velocity was also observed in the expected condition compared to the unexpected condition. Conclusions: Postural stability was lowered during unexpected visual perturbations compared to both during baseline and during expected visual perturbations, suggesting that conflicting visual feedback induced postural instability due to compensatory postural responses. However, during expected visual perturbations, significantly lowered postural sway displacement and area were achieved by increasing the sway velocity, suggesting the occurrence of postural behavior due to anticipatory postural responses. Finally, the study also concluded that VR could be used to induce different postural responses by providing visual perturbations to the postural control system, which can subsequently be used as an effective and low-cost tool for postural stability training and rehabilitation.


2014 ◽  
Vol 49 (4) ◽  
pp. 454-461 ◽  
Author(s):  
Massimiliano Pau ◽  
Gianfranco Ibba ◽  
Giuseppe Attene

Context: Although balance is generally recognized to be an important feature in ensuring good performance in soccer, its link with functional performance remains mostly unexplored, especially in young athletes. Objective: To investigate changes in balance induced by fatigue for unipedal and bipedal static stances in young soccer players. Design: Crossover study. Setting: Biomechanics laboratory and outdoor soccer field. Patients or Other Participants: Twenty-one male soccer players (age = 14.5 ± 0.2 years, height = 164.5 ± 5.6 cm, mass = 56.8 ± 6.8 kg). Intervention(s): Static balance was assessed with postural-sway analysis in unipedal and bipedal upright stance before and after a fatigue protocol consisting of a repeated sprint ability (RSA) test (2 × 15-m shuttle sprint interspersed with 20 seconds of passive recovery, repeated 6 times). Main Outcome Measure(s): On the basis of the center-of-pressure (COP) time series acquired during the experimental tests, we measured sway area, COP path length, and COP maximum displacement and velocity in the anteroposterior and mediolateral directions. Results: Fatigue increased all sway values in bipedal stance and all values except COP velocity in the mediolateral direction in unipedal stance. Fatigue index (calculated on the basis of RSA performance) was positively correlated with fatigue/rest sway ratio for COP path length and COP velocity in the anteroposterior and mediolateral directions for nondominant single-legged stance. Conclusions: Fatigued players exhibited reduced performance of the postural-control system. Participants with better performance in the RSA test appeared less affected by balance impairment, especially in single-legged stance.


Author(s):  
Frédéric Noé ◽  
Xavier García-Massó ◽  
Damien Ledez ◽  
Thierry Paillard

Objective: This study was undertaken in order to provide new insight into sensorimotor control of posture when wearing high-shaft (HS) boots as ski boots. Background: Previous studies into the effects of HS boots on postural control have produced controversial results. Some studies reported postural control impairments with ski boots in bipedal postural tasks due to ankle movement restrictions without quantifying the actual restrictive effect of these boots and specifying the adaptations of the postural control system. Method: Eighteen young healthy subjects took part in the experiment. Bilateral postural control was assessed on stable and unstable surfaces, while standing barefoot or wearing ski boots. Center of pressure (COP) parameters, ankle, knee, and hip joints movements were calculated and EMG activity from main postural muscles was recorded. Results: Ski boots did not restrict the amplitude of ankle angular movements and largely impacted COP parameters and EMG activity on stable ground. In conditions of mediolateral instability, COP data illustrated an enhanced postural control in the frontal plane when wearing ski boots. Conclusions: Ski boots do not affect bipedal postural balance by restricting the ankle angular motions but induce complex adaptations of the postural control system which combine factors of a mechanical, motor, and sensorial nature. They impede postural control mainly when standing on stable ground without producing similar deleterious effects on unstable surfaces. Application: Our results show that HS boots as ski boots can improve lateral balance on unstable surfaces, which can contribute to prevent fall risk and ankle sprain.


2021 ◽  
pp. 135245852110122
Author(s):  
Feray Güngör ◽  
Ela Tarakci ◽  
Zeynep Özdemir-Acar ◽  
Aysun Soysal

Background: Pilates-based core stability training (PBCST) is a controlled form of exercise that may improve the transmission of torque from the upper extremities and trunk to the lower extremities by enabling the core muscles to activate effectively. Objectives: The aim of this study was to investigate the effects of PBCST given as supervised or home-based on lower extremity strength and postural control in multiple sclerosis. Methods: Fifty individuals were enrolled and randomly allocated into two groups. Primary outcome measures were knee muscle strength and postural sway in different conditions. The supervised group received PBCST 2 days per week for 8 weeks at the clinic, and the other group performed PBCST at home. Exercises were progressed every 2 weeks in both groups. Results: Between groups, the supervised group was mostly superior to the home group ( p < 0.05). A significant improvement was noted in all parameters in both groups, except some sub-parameters of postural sway in home PBCST ( p < 0.05). Conclusions: Supervised PBCST was determined to be more effective than home PBCST in improving strength, postural control, core stability, physical capacity, and fatigue. Although supervised training is the primary choice, home training can be recommended to patients who have limitations attending supervised sessions.


2010 ◽  
Vol 109 (6) ◽  
pp. 1786-1791 ◽  
Author(s):  
Brad Manor ◽  
Madalena D. Costa ◽  
Kun Hu ◽  
Elizabeth Newton ◽  
Olga Starobinets ◽  
...  

The degree of multiscale complexity in human behavioral regulation, such as that required for postural control, appears to decrease with advanced aging or disease. To help delineate causes and functional consequences of complexity loss, we examined the effects of visual and somatosensory impairment on the complexity of postural sway during quiet standing and its relationship to postural adaptation to cognitive dual tasking. Participants of the MOBILIZE Boston Study were classified into mutually exclusive groups: controls [intact vision and foot somatosensation, n = 299, 76 ± 5 (SD) yr old], visual impairment only (<20/40 vision, n = 81, 77 ± 4 yr old), somatosensory impairment only (inability to perceive 5.07 monofilament on plantar halluxes, n = 48, 80 ± 5 yr old), and combined impairments ( n = 25, 80 ± 4 yr old). Postural sway (i.e., center-of-pressure) dynamics were assessed during quiet standing and cognitive dual tasking, and a complexity index was quantified using multiscale entropy analysis. Postural sway speed and area, which did not correlate with complexity, were also computed. During quiet standing, the complexity index (mean ± SD) was highest in controls (9.5 ± 1.2) and successively lower in the visual (9.1 ± 1.1), somatosensory (8.6 ± 1.6), and combined (7.8 ± 1.3) impairment groups ( P = 0.001). Dual tasking resulted in increased sway speed and area but reduced complexity ( P < 0.01). Lower complexity during quiet standing correlated with greater absolute ( R = −0.34, P = 0.002) and percent ( R = −0.45, P < 0.001) increases in postural sway speed from quiet standing to dual-tasking conditions. Sensory impairments contributed to decreased postural sway complexity, which reflected reduced adaptive capacity of the postural control system. Relatively low baseline complexity may, therefore, indicate control systems that are more vulnerable to cognitive and other stressors.


2012 ◽  
Vol 7 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Rafał Stemplewski ◽  
Janusz Maciaszek ◽  
Maciej Tomczak ◽  
Robert Szeklicki ◽  
Dorota Sadowska ◽  
...  

The aim of the study was to compare the effect of exercise on postural control (PC) among the elderly with lower or higher level of habitual physical activity (HPA). The study involved 17 elderly men (mean age 72.9 ± 4.79 years). Mean velocity of the center of pressure (COP) displacements was measured using a force plate both before and after cycle ergometer exercise. A significantly higher increase in mean velocity of COP displacements and its component in the sagittal plane were observed in the group with lower level of HPA in comparison with the group with higher HPA level. Simultaneously, a relatively similar reaction to the exercise in the frontal plane was observed in both groups, possibly connected to the specific type of used exercise, which mainly activated the sagittal muscles.


1999 ◽  
Vol 9 (2) ◽  
pp. 103-109
Author(s):  
Reginald L. Reginella ◽  
Mark S. Redfern ◽  
Joseph M. Furman

Sensory information from lightly touching a reference with the hand is known to influence postural sway in young adults. The primary aim of this study was to compare the influence of finger contact (FC) with an earth-fixed reference to the influence of FC with a body-fixed reference. A second goal of this study was to determine if FC is used differently by older adults compared to younger adults. Using a force plate, center of pressure at the feet was recorded from blindfolded young and older subjects during several conditions. Subjects either did or did not lightly touch a force-sensitive plate that was either earth-fixed or moved forward and backward in synchrony with body sway (that is, sway-referenced). In addition, support surface conditions were also varied, including a fixed floor and a sway-referenced floor using an EquitestTM. Results showed that the type of FC, floor condition, and age each had an effect on postural sway. Touching an earth-fixed plate decreased postural sway as compared to no touching, while touching a sway-referenced plate incresased sway. This influence of FC was enhanced when the floor was sway-referenced. Although older subjects swayed more than young subjects overall, no age-FC interactions occurred, indicating that FC was not utilized differently between the age groups. This study suggests that FC cannot be disregarded as erroneous, especially when proprioceptive information from the legs is distorted. Further, FC is integrated with other sensory information by the postural control system similarly in young and older persons.


2020 ◽  
Author(s):  
I-Lin Wang ◽  
Li-I Wang ◽  
Yang Liu ◽  
Shi-Jie Xue ◽  
Rui Hu ◽  
...  

Abstract Background: Visual feedback from the center of pressure (COP) on the benefits of standing quietly remains controversial. The study was to investigate the adaptive effect of COP real-time visual feedback training provided by smart wearable devices on standing in silence. Methods: Thirty healthy female college students were randomly divided into three groups (visual feedback balance training group (VFT), non-visual feedback balance training group (NVFT) and control group (CG)) .Two force plates were used to calculate the coordinates of COP anteroposterior (COPAP) and COP mediolateral (COPML).The motion analysis system is used to calculate the coordinates of the center of mass in two directions. Enhanced visual feedback on the screen in the form of fluctuating in different directions, VFT received real-time visual feedback from Podoon APP for training, the NVFT only performs open eye balance without receiving real-time visual feedback. The CG group did not receive any visual feedback. The training lasted 4 weeks, the training lasts 30 minutes at an interval of 1 days. Results: After four weeks of balance training, the results showed that visual feedback training can improve the stability of human posture control by one leg stance and tandem stance static balance training on VFT intelligent App. The parameters of COPML/AP max displacement, COPML/AP velocity and COP radius and COP area in the VFT were significantly increased (p<0.05).Conclusion: The conclusion shows that COP real-time visual feedback training provided by smart wearable devices can reduce postural sway better and improve body balance ability than general training when standing quietly.


2020 ◽  
Author(s):  
Zahra Rahmati ◽  
Saeed Behzadipour ◽  
Alfred C. Schouten ◽  
Ghorban Taghizadeh ◽  
Keikhosrow Firoozbakhsh

Abstract Background: Balance training improves postural control in Parkinson’s disease (PD). However, a systematic approach for the development of individualized, optimal training programs is still lacking, as the learning dynamics of the postural control in PD, over a training program are poorly understood. Objectives: We investigated the learning dynamics of the postural control in PD, during a balance-training program, in terms of the clinical, posturographic, and novel model-based measures. Methods: Twenty patients with PD participated in a balance-training program, 3 days a week, for 6 weeks. Clinical tests assessed functional balance and mobility pre-training, mid-training, and post-training. Center-of-pressure (COP) was recorded at four time-points during the training (pre-, week 2, week 4, and post-training). COP was used to calculate the sway measures and to identify the parameters of a patient-specific postural control model, at each time-point. The posturographic and model-based measures constituted the two sets of stability- and flexibility-related measures. Results: Mobility- and flexibility-related measures showed a continuous improvement during the balance-training program. In particular, mobility improved at mid-training and continued to improve to the end of the training, whereas flexibility-related measures reached significance only at the end. The progression in the balance- and stability-related measures was characterized by early improvements over the first three to four weeks of training, and reached a plateau for the rest of the training. Conclusions: The progression in balance and postural stability is achieved earlier and susceptible to plateau out, while mobility and flexibility continues to improve during the balance training.


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