scholarly journals Functional Task Constraints Foster Enhanced Postural Control in Children With Cerebral Palsy

2016 ◽  
Vol 96 (3) ◽  
pp. 348-354 ◽  
Author(s):  
Jennifer M. Schmit ◽  
Michael Riley ◽  
Sarah Cummins-Sebree ◽  
Laura Schmitt ◽  
Kevin Shockley
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Postural Stability ◽  
Postural Sway ◽  
Postural Instability ◽  
Apparent Difference ◽  
Typical Development ◽  
Postural Control System ◽  
Study Objective ◽  
Functional Play

BackgroundPostural instability is a classical characteristic of cerebral palsy (CP), but it has not been examined during functional play activity. Recent work has demonstrated that when motor tasks are made functionally more relevant, performance improves, even in children with movement pathology. It is possible that in a disease state, the underlying control mechanisms that are associated with healthy physiology must be elicited.ObjectiveThe study objective was to explore the utility of the functional play task methodology as a more rich and interpretable approach to the quantification of postural instability in children with CP.DesignPostural stability measures obtained from a cross-sectional cohort of children with CP (n=30) were compared with stability measures taken from children with typical development (n=30) during a single measurement period.MethodsPostural stability data were obtained with a portable force platform system. Postural sway was quantified during a precision manual functional play task. A baseline condition (no task) also was included. Postural sway variability and postural sway regularity were analyzed with analyses of variance.ResultsThere was an apparent difference in postural control (greater irregularity, greater sway variability) during quiet stance between children with CP and peers with typical development; this difference was mitigated during the performance of the precision functional play task.LimitationsA small and nonprobability sample of convenience may limit the findings of this study.ConclusionsThe findings illustrate flexibility and adaptability in the postural control system despite the pathological features associated with CP.

scholarly journals Virtual-Reality-Induced Visual Perturbations Impact Postural Control System Behavior

2019 ◽  
Vol 9 (11) ◽  
pp. 113 ◽  
Author(s):  
Harish Chander ◽  
Sachini N. K. Kodithuwakku Arachchige ◽  
Christopher M. Hill ◽  
Alana J. Turner ◽  
Shuchisnigdha Deb ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Control System ◽  
Postural Control ◽  
Repeated Measures ◽  
Postural Stability ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Postural Control System ◽  
Postural Responses ◽  
The Impact

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.

Impact of Virtual Reality–Generated Construction Environments at Different Heights on Postural Stability and Fall Risk

2020 ◽  
Vol 69 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Harish Chander ◽  
Alireza Shojaei ◽  
Shuchisnigdha Deb ◽  
Sachini N. K. Kodithuwakku Arachchige ◽  
Christopher Hudson ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Repeated Measures ◽  
Postural Stability ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Postural Instability ◽  
Postural Control System ◽  
Environment Exposure ◽  
Acute And Chronic Exposure ◽  
The Impact

Background Falls due to postural instability are common in construction environments especially from a height. The purpose of the study was to investigate the impact of virtual reality (VR)-generated environments at different virtual heights on postural stability. Methods Nineteen adults were analyzed for postural stability, tested in real (No VR) environment and in three VR environments, randomly assigned, at virtual heights of 0 ft. (VR0), 40 ft. (VR40), and 120 ft. (VR120). Postural stability was quantified using center of pressure postural sway variables and analyzed using a repeated measures analysis of variance (ANOVA). Participants also completed a simulation sickness questionnaire (SSQ) before and after VR exposure and a presence questionnaire (PQ) after VR exposure. Findings Significant postural instability ( p < .05) was identified between VR and No VR, in which increased postural instability was evident in all VR conditions compared with No VR. Scores from SSQ were within a pre–post score difference of five and the PQ score was (104.21 ± 14.03). Conclusion/Application to Practice Findings suggest that VR environments, regardless of virtual height, induced increased postural instability, which can be attributed to visual sensory conflicts to the postural control system created by VR exposure. Participants’ subjective responses on SSQ and PQ confirmed the feasibility of using VR to represent realistic immersions in virtual heights. However, objectively, VR could potentially lead to postural instability, stressing caution. VR can be a potential tool for providing virtual high-altitude environment exposure for fall prevention training, however, more research is needed on postural adaptation with acute and chronic exposure to VR.

scholarly journals Effects of Task Constraints on Kinematic Characteristics of Body Segments in Children with Cerebral Palsy and Children with Typical Development during Hand-Reaching

2021 ◽  
Vol 11 (23) ◽  
pp. 11140
Author(s):  
Yun-Huei Ju ◽  
Rong-Ju Cherng
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Task Demands ◽  
Typical Development ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Cross Sectional ◽  
Postural Alignment ◽  
Reaching Tasks ◽  
Children With Cerebral Palsy

Background: Children with cerebral palsy (CP) have difficulty in managing postural control during functional reaching tasks, although children with different postural control ability are able to come up with different motor solutions to cope with different task demands. This study examined the effect of task constraint on postural control performance in children with cerebral palsy and typical development (TD) in terms of different postural control abilities. Methods: A cross-sectional research design was used. Twelve children with spastic diplegic cerebral palsy (mean age: 107.8 months) and 16 typically developing children (mean age: 110.9 months) participated in this study. Individually, all subjects were seated in a height-adjusted chair and were requested to reach for target(s) located at three different directions (medial, anterior, and lateral). A six-camera Qualisys Motion Capture System was used to capture motion data. Kinematic data in terms of body alignment and angular changes were analyzed. Results: Children with cerebral palsy demonstrated different postural control strategies to complete different reaching tasks compared to typically developing children by preparing postural alignment in advance, coordinating different body orientation movements during reaching after showing difficulty in managing reach medially. Conclusions: Children with cerebral palsy perceive their insufficient ability and prepare their alignment in advance to adapt to the task demanded and decrease the postural challenges of the task. Even though children with cerebral palsy self-generate different motor solutions to reach without falling, these alternative strategies might not be the most efficient adaptation.

scholarly journals Characteristics of Standing Postural Control in Women under Additional Load

2020 ◽  
Vol 17 (2) ◽  
pp. 490
Author(s):  
Bożena Wojciechowska-Maszkowska ◽  
Dorota Borzucka
Keyword(s):  
Postural Control ◽  
Postural Stability ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Stability Control ◽  
Standing Posture ◽  
Additional Load ◽  
Eyes Open ◽  
Heavy Loads ◽  
Load Conditions

The aim of this study was to evaluate the effect of additional load on postural-stability control in young women. To evaluate postural control in the 34 women in this study (mean age, 20.8 years), we measured postural sway (center of pressure, COP) in a neutral stance (with eyes open) in three trials of 30 s each. Three load conditions were used in the study: 0, 14, and 30 kg. In analysis, we used three COP parameters, variability (linear), mean sway velocity (linear), and entropy (nonlinear). Results suggested that a considerable load on a young woman’s body (approximately 48% of body weight) had significant influence on stability. Specifically, heavy loads triggered random movements, increased the dynamics of postural-stability control, and required more attention to control standing posture. The results of our study indicate that inferior postural control mainly results from insufficient experience in lifting such a load.

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.

Clinical Assessment of Postural Stability

2003 ◽  
Vol 03 (02) ◽  
pp. 135-144 ◽  
Author(s):  
Janusz W. Blaszczyk ◽  
Bogdan Bacik ◽  
Grzegorz Juras
Keyword(s):  
Fractal Dimension ◽  
Postural Stability ◽  
Complex Analysis ◽  
Postural Sway ◽  
Force Plate ◽  
Diagnostic Value ◽  
Postural Instability ◽  
Foot Pressure ◽  
Clinical Method

One of the most important applications of postural sway analysis is the detection of such impairments to the motor system that would allow us to predict risk of falling. Force plate posturography is a commonly used clinical method for the evaluation of postural instability. The diagnostic value of postural sway represented here by oscillations of the center-of-foot pressure (COFP) is being questioned very often. These diagnostic problems result from the lack of an adequate and reliable method of sway analysis — a method that would present a clear connection between stability and quality of postural control. To gain better insight into this problem, the following experiments were done and some effective methods of sway analysis typically applied in conventional mechanics and electrical engineering are presented here. Quality of the postural stability was assessed using, in addition to standard parameters, spatial histograms, body transfer function, contour plots as well as the COFP fractal dimension. Such complex analysis allowed us to extract significant sway parameters that are relevant to postural instability. Analysis of the data revealed that spatial histogram has clear peak which maximum was sensitive to sensory conditions. Changes in the postural sway distributions have been confirmed by the increase of the COFP fractal dimension.

Sitting Postural Control in Infants With Typical Development, Motor Delay, or Cerebral Palsy

2013 ◽  
Vol 25 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Anastasia Kyvelidou ◽  
Regina T. Harbourne ◽  
Sandra L. Willett ◽  
Nicholas Stergiou
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Typical Development ◽  
Motor Delay

Center-of-Pressure Parameters Used in the Assessment of Postural Control

2002 ◽  
Vol 11 (1) ◽  
pp. 51-66 ◽  
Author(s):  
Riann M. Palmieri ◽  
Christopher D. Ingersoll ◽  
Marcus B. Stone ◽  
B. Andrew Krause
Keyword(s):  
Control System ◽  
Postural Control ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Data Sources ◽  
Postural Control System ◽  
Type Data

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.

scholarly journals Center of pressure-based postural sway differences on parallel and single leg stance in Olympic deaf basketball and volleyball players

2021 ◽  
Vol 17 (6) ◽  
pp. 418-427
Author(s):  
Yücel Makaracı ◽  
Recep Soslu ◽  
Ömer Özer ◽  
Abdullah Uysal
Keyword(s):  
Postural Control ◽  
Postural Stability ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Force Plate ◽  
Basketball Players ◽  
Male Athletes ◽  
Significant Difference ◽  
Single Leg Stance ◽  
Volleyball Players

In sports such as basketball and volleyball, loss of balance due to the inability to maintain body stability and lack of postural control adversely affect athletic performance. Deaf athletes appear to struggle with balance and postural stability problems. The purpose of this study was to examine postural sway values in parallel and single leg stance of Olympic deaf basketball and volleyball players and reveal differences between the branches. Twenty-three male athletes from the Turkish national deaf basketball (n= 11) and volleyball (n= 12) teams participated in the study. After anthropometric measurements, the subjects completed postural sway (PS) tests in parallel/single leg stances with open eyes and closed eyes on a force plate. PS parameters (sway path, velocity, and area) obtained from the device software were used for the statistical analysis. The Mann-Whitney U-test was used to compare differences in PS parameters between basketball and volleyball players, and the alpha value was accepted as 0.05. Volleyball players had significantly better results in parallel stance and dominant leg PS values than basketball players (P<0.05). There was no significant difference between the groups in nondominant leg PS values (P>0.05). We think that proprioceptive and vestibular system enhancing training practices to be performed with stability exercises will be beneficial in terms of both promoting functional stability and interlimb coordination. Trainers and strength coaches should be aware of differences in the postural control mechanism of deaf athletes.

Disruption of postural readaptation by inertial stimuli following space flight*

1999 ◽  
Vol 9 (5) ◽  
pp. 369-378 ◽  
Author(s):  
F. Owen Black ◽  
William H. Paloski ◽  
Millard F. Reschke ◽  
Makoto Igarashi ◽  
Fred Guedry ◽  
...  
Keyword(s):  
Postural Control ◽  
Postural Stability ◽  
Linear Acceleration ◽  
Postural Instability ◽  
Otolith Organs ◽  
Plane Rotation ◽  
Rotation Test ◽  
Normal Limits ◽  
Before And After ◽  
Recovery Trajectory

Postural instability (relative to pre-flight) has been observed in all shuttle astronauts studied upon return from orbital missions. Postural stability was more closely examined in four shuttle astronaut subjects before and after an 8 day orbital mission. Results of the pre- and post- flight postural stability studies were compared with a larger ( n = 34) study of astronauts returning from shuttle missions of similar duration. Results from both studies indicated that inadequate vestibular feedback was the most significant sensory deficit contributing to the postural instability observed post flight. For two of the four IML-1 astronauts, post-flight postural instability and rate of recovery toward their earth-normal performance matched the performance of the larger sample. However, post-flight postural control in one returning astronaut was substantially below mean performance. This individual, who was within normal limits with respect to postural control before the mission, indicated that recovery to pre-flight postural stability was also interrupted by a post-flight pitch plane rotation test. A similar, though less extreme departure from the mean recovery trajectory was present in another astronaut following the same post-flight rotation test. The pitch plane rotation stimuli included otolith stimuli in the form of both transient tangential and constant centripetal linear acceleration components. We inferred from these findings that adaptation on orbit and re-adaptation on earth involved a change in sensorimotor integration of vestibular signals most likely from the otolith organs.

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