scholarly journals Are Gait and Balance Problems in Neurological Patients Interdependent? Enhanced Analysis Using Gait Indices, Cyclograms, Balance Parameters and Entropy

Entropy ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 359
Author(s):  
Malgorzata Syczewska ◽  
Ewa Szczerbik ◽  
Malgorzata Kalinowska ◽  
Anna Swiecicka ◽  
Grazyna Graff
Keyword(s):  
Sensory Integration ◽  
Neurological Diseases ◽  
Force Plate ◽  
Balance Assessment ◽  
Complex Functions ◽  
Neurological Patients ◽  
Balance Deficits ◽  
Integration Problems ◽  
Analytical Tools ◽  
Balance Problems

Background: Balance and locomotion are two main complex functions, which require intact and efficient neuromuscular and sensory systems, and their proper integration. In many studies the assumption of their dependence is present, and some rehabilitation approaches are based on it. Other papers undermine this assumption. Therefore the aim of this study was to examine the possible dependence between gait and balance in patients with neurological or sensory integration problems, which affected their balance. Methods: 75 patients (52 with neurological diseases, 23 with sensory integration problems) participated in the study. They underwent balance assessment on Kistler force plate in two conditions, six tests on a Balance Biodex System and instrumented gait analysis with VICON. The gait and balances parameters and indices, together with entropy and cyclograms were used for the analysis. Spearman correlation, multiple regression, cluster analysis, and discriminant analysis were used as analytical tools. Results: The analysis divided patients into 2 groups with 100 % correctly classified cases. Some balance and gait measures are better in the first group, but some others in the second. Conclusions: This finding confirms the hypothesis that there is no direct link between gait and balance deficits.

scholarly journals The Balance Evaluation Systems Test (BESTest) to Differentiate Balance Deficits

2009 ◽  
Vol 89 (5) ◽  
pp. 484-498 ◽  
Author(s):  
Fay B Horak ◽  
Diane M Wrisley ◽  
James Frank
Keyword(s):  
Control Systems ◽  
Concurrent Validity ◽  
Interrater Reliability ◽  
Balance Control ◽  
Balance Assessment ◽  
Evaluation Systems ◽  
Balance Confidence ◽  
Balance Deficits ◽  
Abc Scale ◽  
Balance Problems

BackgroundCurrent clinical balance assessment tools do not aim to help therapists identify the underlying postural control systems responsible for poor functional balance. By identifying the disordered systems underlying balance control, therapists can direct specific types of intervention for different types of balance problems.ObjectiveThe goal of this study was to develop a clinical balance assessment tool that aims to target 6 different balance control systems so that specific rehabilitation approaches can be designed for different balance deficits. This article presents the theoretical framework, interrater reliability, and preliminary concurrent validity for this new instrument, the Balance Evaluation Systems Test (BESTest).DesignThe BESTest consists of 36 items, grouped into 6 systems: “Biomechanical Constraints,” “Stability Limits/Verticality,” “Anticipatory Postural Adjustments,” “Postural Responses,” “Sensory Orientation,” and “Stability in Gait.”MethodsIn 2 interrater trials, 22 subjects with and without balance disorders, ranging in age from 50 to 88 years, were rated concurrently on the BESTest by 19 therapists, students, and balance researchers. Concurrent validity was measured by correlation between the BESTest and balance confidence, as assessed with the Activities-specific Balance Confidence (ABC) Scale.ResultsConsistent with our theoretical framework, subjects with different diagnoses scored poorly on different sections of the BESTest. The intraclass correlation coefficient (ICC) for interrater reliability for the test as a whole was .91, with the 6 section ICCs ranging from .79 to .96. The Kendall coefficient of concordance among raters ranged from .46 to 1.00 for the 36 individual items. Concurrent validity of the correlation between the BESTest and the ABC Scale was r=.636, P<.01.LimitationsFurther testing is needed to determine whether: (1) the sections of the BESTest actually detect independent balance deficits, (2) other systems important for balance control should be added, and (3) a shorter version of the test is possible by eliminating redundant or insensitive items.ConclusionsThe BESTest is easy to learn to administer, with excellent reliability and very good validity. It is unique in allowing clinicians to determine the type of balance problems to direct specific treatments for their patients. By organizing clinical balance test items already in use, combined with new items not currently available, the BESTest is the most comprehensive clinical balance tool available and warrants further development.

scholarly journals Review of the Upright Balance Assessment Based on the Force Plate

2021 ◽  
Vol 18 (5) ◽  
pp. 2696
Author(s):  
Baoliang Chen ◽  
Peng Liu ◽  
Feiyun Xiao ◽  
Zhengshi Liu ◽  
Yong Wang
Keyword(s):  
Postural Balance ◽  
Force Plate ◽  
Assessment Method ◽  
Balance Assessment ◽  
Experimental Conditions ◽  
Methodological Research ◽  
Assessment Tests ◽  
Wide Range ◽  
Foot Posture ◽  
Plate System

Quantitative assessment is crucial for the evaluation of human postural balance. The force plate system is the key quantitative balance assessment method. The purpose of this study is to review the important concepts in balance assessment and analyze the experimental conditions, parameter variables, and application scope based on force plate technology. As there is a wide range of balance assessment tests and a variety of commercial force plate systems to choose from, there is room for further improvement of the test details and evaluation variables of the balance assessment. The recommendations presented in this article are the foundation and key part of the postural balance assessment; these recommendations focus on the type of force plate, the subject’s foot posture, and the choice of assessment variables, which further enriches the content of posturography. In order to promote a more reasonable balance assessment method based on force plates, further methodological research and a stronger consensus are still needed.

scholarly journals Frequency of myelin oligodendrocyte glycoprotein antibodies in a large cohort of neurological patients

2021 ◽  
Vol 7 (2) ◽  
pp. 205521732110227
Author(s):  
Friederike Held ◽  
Sudhakar Reddy Kalluri ◽  
Achim Berthele ◽  
Ana-Katharina Klein ◽  
Markus Reindl ◽  
...  
Keyword(s):  
Time Course ◽  
Neurological Diseases ◽  
External Validation ◽  
Diagnostic Value ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Large Cohort ◽  
Wide Range ◽  
Neurological Patients ◽  
A Cell ◽  
Nosological Entity

Background Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOG-AD) is recognized as a distinct nosological entity. IgG antibodies against MOG (MOG-Ab) overlap with neuromyelitis optica spectrum disorders (NMOSD) phenotype in adults. However, an increasing number of clinical phenotypes have been reported to be associated with MOG-Ab. Objective To investigate the seroprevalence of MOG-Ab under consideration of demographics, disease entities and time course in a large cohort of unselected neurological patients. Methods Blood samples of 2.107 consecutive adult neurologic patients admitted to our department between 2016-2017 were tested for MOG-Ab using a cell-based assay. MOG-Ab persistence was analyzed in follow-up samples. External validation was performed in two independent laboratories. Results We found MOG-Ab in 25 of 2.107 (1.2%) patients. High antibody ratios were mostly associated with NMOSD and MOG-AD phenotype (5/25). Low ratios occurred in a wide range of neurological diseases, predominantly in other demyelinating CNS diseases (5/25) and stroke (6/25). MOG-Ab persistence over time was not confined to NMOSD and MOG-AD phenotype. Conclusion The present study demonstrates the occurrence of MOG-Ab in a wide range of neurological diseases. Only high MOG-Ab ratios were associated with a defined clinical phenotype, but low MOG-Ab ratios were not. The diagnostic value of low MOG-Ab is thus highly limited.

Trend of Hospital Admission and Outcome Study of Patients Admitted in a Neurology Unit at a Tertiary Care Neuroscience Hospital in Bangladesh

2018 ◽  
Vol 4 (2) ◽  
pp. 69-74
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Choudhury ◽  
KM Ahasan Ahmed ◽  
Mohammad Sadekur Rahman Sarkar ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Total Death ◽  
Neurological Patients ◽  
Study Population ◽  
The Mean ◽  
Day By Day

Background: Neurological disorders is becoming a growing concern both for developed and developing countries. Magnitude of the problem is increasing day by day. Among all neurological disorders, stroke is the leading cause of morbidity and mortality globally.Objectives: The purpose of the study was to see the trend of admission of patients with neurological diseases and to study the outcome of patients at referral neurology hospital in Bangladesh.Methodology: This retrospective chart review was conducted in the blue unit of the Department of Neurology at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from 1st January to 31st December 2016 for a period of one (01) year. All the admitted patients with both sexes were selected as study population. The outcome was observed among the study population.Result: A total number of 1044 patients were admitted during the study period. Majority of the patients were in the age group of the 41 to 50 years which was 417(39.9%) cases. Both male and female were in highest number in the month of May which was 63 and 48 cases respectively. The total death of the study population was 146(14.0%) cases. The mean length of hospital stay was 8.4±2.31 days.Conclusion: Middle aged male is the main bulk of the neurological patients, admitted in a referral neurology hospital in Bangladesh. Highest admission and mortality was observed in stroke patients.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 69-74

scholarly journals Plasmapheresis in neurological disorders: six years experience from University Clinical center Tuzla

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1234 ◽  
Author(s):  
Osman Sinanović ◽  
Sanela Zukić ◽  
Adnan Burina ◽  
Nermina Pirić ◽  
Renata Hodžić ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Response ◽  
Plasma Exchange ◽  
Neurological Diseases ◽  
Therapeutic Plasma Exchange ◽  
Motor Neuropathy ◽  
Extracorporeal Blood Purification ◽  
Clinical Center ◽  
Plasma Factor ◽  
Neurological Patients

Background: Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique that is designed to remove substances with a large molecular weight. The TPE procedure includes removal of antibodies, alloantibodies, immune complexes, monoclonal protein, toxins or cytokines, and involves the replenishment of a specific plasma factor. The aim of the study was to describe the clinical response to TPE in various neurological patients, and to assess the clinical response to this therapy. Methods: The study was retrospective. We analyzed the medical records of 77 patients who were treated at the Department of Neurology, University Clinical Center (UCC) Tuzla from 2011 to 2016.   Results: 83 therapeutic plasma exchanges were performed in the 77 patients. There was a slight predominance of male patients (54.5%), with an average age of 51±15.9 years. The most common underlying neurological diseases were Guillain–Barré syndrome (GBS) (37.7%), then chronic inflammatory demyelinating polyneuropathy (CIDP) (23.4%), multiple sclerosis (MS) (11.7%) and myasthenia gravis (10.4%). Less frequent neurological diseases that were encountered were paraneoplastic polyneuropathies (5.2%), neuromyelitis optica (also known as Devic’s disease) (3.9%), motor neuron disease (3.9%), polymyositis (2.6%) and multifocal motor neuropathy (1.2%). Conclusions: Six years experience of therapeutic plasma exchange in neurological patients in our department have shown that, following evidence-based guidelines for plasmapheresis, the procedure was most effective in patients with GBS, CIDP and myasthenia gravis.

Nonlinear integration of multispectral information: Human colour vision analogues to sensory integration in rattlesnake

2012 ◽  
Vol 25 (0) ◽  
pp. 179
Author(s):  
Vincent A. Billock ◽  
Brian H. Tsou
Keyword(s):  
Spectral Sensitivity ◽  
Information Integration ◽  
Sensory Integration ◽  
Colour Vision ◽  
Neural Model ◽  
Neural Firing ◽  
Visual Responses ◽  
Neural Synchronization ◽  
Synchronization Mechanism ◽  
Integration Problems

Information integration occurs at every sensory scale and although distinctions are made for integration between and within senses, integration at intermediate scales may exploit familiar mechanisms. Here, we explore this idea by applying a sensory integration mechanism to some poorly understood multispectral integration problems in human colour vision. Billock and Tsou (IMRF, 2011) used a binding-like neural synchronization mechanism to model intensity-dependent (inverse) enhancement of visual responses by auditory stimulation in cat. The same model also applies to mutual enhancement of visual and infrared responses in rattlesnake, suggesting that a similar mechanism could model integration of spectral information in human colour vision. For example, chromatic brightness is thought to be a vector-like nonlinear combination of luminance and chromatic channels; its neural correlate is unknown. We model its spectral sensitivity by pairwise excitatory synchronization between luminance (broadband) neurons and cortically rectified L+M- and S+M-L- LGN neurons. Similarly, the yellow lobe of the yellow-blue opponent channel is known to be a nonlinearly enhanced combination of long- and medium-wavelength-sensitive inputs, but no sensible neural model for this interaction has been advanced. We model the spectral sensitivity of ‘yellowness’ using excitatory synchronization between cortically rectified L+M+S- and M+L- LGN units. The inputs for both simulations were macaque neural firing rate data (DeValois et al., 1966). Fascinatingly, in both cases, multispectral integration in human colour vision was well modeled using the rattlesnake/cat neural synchronization equations without any use of fitting parameters. This is the first application of sensory integration concepts to human colour vision transformations.

scholarly journals Rethinking the neurological examination I: static balance assessment

2011 ◽  
Vol 69 (6) ◽  
pp. 954-958 ◽  
Author(s):  
Péricles A. Maranhão-Filho ◽  
Eliana Teixeira Maranhão ◽  
Marcos Martins da Silva ◽  
Marco Antônio Lima
Keyword(s):  
Elderly Patients ◽  
Neurological Examination ◽  
Sensory Integration ◽  
Static Equilibrium ◽  
Static Balance ◽  
Clinical Test ◽  
Balance Assessment ◽  
Risk Of Falling ◽  
Functional Reach ◽  
Functional Reach Test

The authors advocate a modernization of the neurologic exam with regard to the evaluation of static equilibrium through the application of some easily performed and interpreted bedside maneuvers like the Clinical Test of Sensory Integration and Balance - modified and the Functional Reach Test. The authors also believe that these and other assessments, such as that of the risk of falling for elderly patients, should be incorporated into the routine neurological examination.

Effects of Fatigue on the BTrackS Balance Test for Concussion Management

2017 ◽  
Vol 22 (4) ◽  
pp. 23-28 ◽  
Author(s):  
Scott E. Benedict ◽  
Jeffrey W. Hinshaw ◽  
Ryan Byron-Fields ◽  
Harsimran S. Baweja ◽  
Daniel J. Goble
Keyword(s):  
Scoring System ◽  
Tracking System ◽  
Low Cost ◽  
Force Plate ◽  
Balance Assessment ◽  
Balance Test ◽  
Concussion Management ◽  
Fatigue Protocol ◽  
Balance Testing ◽  
Balance Error

Fatigue has been shown to adversely affect balance results, as measured by the Balance Error Scoring System (BESS). The present study aimed to determine whether a new low-cost force plate for concussion balance assessment, the Balance Tracking System (BTrackS), is subject to similar fatigue effects. Significant fatigue effects were only evident immediately following a fatigue protocol (p > .05), and were fully resolved within 5 min postfatigue. These results suggest that the BTrackS Balance Test (BBT) is more fatigue resistant than the BESS, and support use of the BBT as a potentially more reliable alternative to the BESS during immediate sideline balance testing.

scholarly journals Hippotherapy—An Intervention to Habilitate Balance Deficits in Children With Movement Disorders: A Clinical Trial

2012 ◽  
Vol 92 (5) ◽  
pp. 707-717 ◽  
Author(s):  
Debbie J. Silkwood-Sherer ◽  
Clyde B. Killian ◽  
Toby M. Long ◽  
Kathy S. Martin
Keyword(s):  
Movement Disorders ◽  
Repeated Measures ◽  
Control Group ◽  
Friedman Analysis ◽  
Repeated Measures Design ◽  
Clinical Observations ◽  
Balance Deficits ◽  
And Function ◽  
Post Hoc ◽  
Balance Problems

Background Clinical observations have suggested that hippotherapy may be an effective strategy for habilitating balance deficits in children with movement disorders. However, there is limited research to support this notion. Objective The purposes of this study were to assess the effectiveness of hippotherapy for the management of postural instability in children with mild to moderate balance problems and to determine whether there is a correlation between balance and function. Design A repeated-measures design for a cohort of children with documented balance deficits was used. Methods Sixteen children (9 boys and 7 girls) who were 5 to 16 years of age and had documented balance problems participated in this study. Intervention consisted of 45-minute hippotherapy sessions twice per week for 6 weeks. Two baseline assessments and 1 postintervention assessment of balance, as measured with the Pediatric Balance Scale (PBS), and of function, as measured with the Activities Scale for Kids—Performance (ASKp), were performed. Results With the Friedman analysis of variance, the PBS and the ASKp were found to be statistically significant across all measurements (P<.0001 for both measures). Post hoc analysis revealed a statistical difference between baseline and postintervention measures (P≤.017). This degree of difference resulted in large effect sizes for PBS (d=1.59) and ASKp (d=1.51) scores after hippotherapy. A Spearman rho correlation of .700 indicated a statistical association between PBS and ASKp postintervention scores (P=.003). There was no correlation between the change in PBS scores and the change in ASKp scores (rs=.13, P>.05). Limitations Lack of a control group and the short duration between baseline assessments are study limitations. Conclusions The findings suggest that hippotherapy may be a viable strategy for reducing balance deficits and improving the performance of daily life skills in children with mild to moderate balance problems.

scholarly journals A comparison of head movements tests in force plate and accelerometer based posturography in patients with balance problems due to vestibular dysfunction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Magdalena Janc ◽  
Mariola Sliwinska-Kowalska ◽  
Magdalena Jozefowicz-Korczynska ◽  
Pawel Marciniak ◽  
Oskar Rosiak ◽  
...  
Keyword(s):  
Inertial Sensors ◽  
Force Plate ◽  
Vestibular Dysfunction ◽  
Force Platform ◽  
Head Movements ◽  
Lower Sensitivity ◽  
Surface Parameter ◽  
Eyes Open ◽  
Vestibular Pathology ◽  
Balance Problems

AbstractThis study compares HS posturography on inertial sensors (MediPost) with force platform posturography in patients with unilateral vestibular dysfunction. The study group included 38 patients (age 50.6; SD 11.6) with unilateral vestibular weakness (UV) and 65 healthy volunteers (48.7; SD 11.5). HS tests were performed simultaneously on the force plate and with MediPost sensor attached at L4. Four conditions applied: eyes open/closed, firm/foam. The tests were performed twice, with the head moving at the frequency of 0.3 Hz (HS 0.3) and 0.6 Hz (HS 0.6). Mean sway velocity was significantly lower for MediPost than force plate in 4th condition both in UV and healthy group. For HS 0.3 the differences between devices were marginal; the highest sensitivity (87%) and specificity (95%) were in 4th condition. For HS 0.6 MediPost revealed lower sensitivity than force plate although the surface parameter improved results. MediPost IMU device and force platform posturography revealed a similar ability to differentiate between patients with balance problems in course of vestibular pathology and healthy participants, despite the differences observed between measuring methods. In some tests surface parameter may be more appropriate than sway velocity in improving MediPost sensitivity.

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