scholarly journals The Impact of Visual Input and Support Area Manipulation on Postural Control in Subjects after Osteoporotic Vertebral Fracture

Entropy ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 375
Author(s):  
Michalina Błażkiewicz ◽  
Justyna Kędziorek ◽  
Anna Hadamus
Keyword(s):  
Postural Control ◽  
Vertebral Fractures ◽  
Center Of Pressure ◽  
Health Concern ◽  
Eyes Closed ◽  
Osteoporotic Vertebral Fractures ◽  
Increased Risk ◽  
Support Area ◽  
Risk Factors For Falls ◽  
The Impact

Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that may result in fracture, injury, or even death. Identifying the risk factors for falls and assessing the complexity of postural control within this population is essential for developing effective regimes for fall prevention. The aim of this study was to assess postural control in individuals recovering from osteoporotic vertebral fractures while performing various stability tasks. Seventeen individuals with type II osteoporosis and 17 healthy subjects participated in this study. The study involved maintaining balance while standing barefoot on both feet for 20 s on an Advanced Mechanical Technology Inc. (AMTI) plate, with eyes open, eyes closed, and eyes closed in conjunction with a dual-task. Another three trials lasting 10 s each were undertaken during a single-leg stance under the same conditions. Fall risk was assessed using the Biodex Balance platform. Nonlinear measures were used to assess center of pressure (CoP) dynamics in all trials. Reducing the support area or elimination of the visual control led to increased sample entropy and fractal dimension. Results of the nonlinear measurements indicate that individuals recovering from osteoporotic vertebral fractures are characterized by decreased irregularity, mainly in the medio-lateral direction and reduced complexity.

scholarly journals Static postural control assessment during pregnancy

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Ana Silvia Moccellin ◽  
Fernanda G. S. A. Nora ◽  
Paula H. L. Costa ◽  
Patricia Driusso
Keyword(s):  
Postural Control ◽  
Pregnant Women ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Force Plate ◽  
Pubic Symphysis ◽  
Eyes Closed ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Eyes Open

The hormonal and anatomic changes during pregnancy affect the musculoskeletal system and may lead to instability of static postural control and increased risk of falls. The aim of this study was to analyze changes in static postural control during the three trimesters of pregnancy, using variables derived from the center of pressure. This is a descriptive study in which posturographic tests were applied in four still standing positions, for three trials, with a combination of different visual conditions (eyes open - EO/eyes closed - EC) and support base configurations on 20 non-pregnant women (C) and 13 pregnant women during the gestational period (G1, G2 and G3). For static postural control assessment, a force plate (Bertec®) was used, and the variables analyzed were statokinesigram area, displacement amplitude, displacement velocity and sway frequency. The results demonstrate that, early in pregnancy, the woman's body seems to already change postural control, probably due to increased mobility of the sacroiliac joint and pubic symphysis caused by hormonal factors, and during the trimesters there is a decrease in postural stability, observed as an increase in the elliptical areas, amplitudes of center of pressure displacement and velocity of center of pressure displacement.

scholarly journals Static postural control assessment during pregnancy

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Ana Silvia Moccellin ◽  
Fernanda G. S. A. Nora ◽  
Paula H. L. Costa ◽  
Patricia Driusso
Keyword(s):  
Postural Control ◽  
Pregnant Women ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Force Plate ◽  
Pubic Symphysis ◽  
Eyes Closed ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Eyes Open

<p>The hormonal and anatomic changes during pregnancy affect the musculoskeletal system and may lead to instability of static postural control and increased risk of falls. The aim of this study was to analyze changes in static postural control during the three trimesters of pregnancy, using variables derived from the center of pressure. This is a descriptive study in which posturographic tests were applied in four still standing positions, for three trials, with a combination of different visual conditions (eyes open - EO/eyes closed - EC) and support base configurations on 20 non-pregnant women (C) and 13 pregnant women during the gestational period (G1, G2 and G3). For static postural control assessment, a force plate (Bertec®) was used, and the variables analyzed were statokinesigram area, displacement amplitude, displacement velocity and sway frequency. The results demonstrate that, early in pregnancy, the woman's body seems to already change postural control, probably due to increased mobility of the sacroiliac joint and pubic symphysis caused by hormonal factors, and during the trimesters there is a decrease in postural stability, observed as an increase in the elliptical areas, amplitudes of center of pressure displacement and velocity of center of pressure displacement.</p>

scholarly journals Impaired Postural Control and Altered Sensory Organization During Quiet Stance Following Neurotoxic Chemotherapy: A Preliminary Study

2019 ◽  
Vol 18 ◽  
pp. 153473541982882 ◽  
Author(s):  
Scott M. Monfort ◽  
Xueliang Pan ◽  
Charles L. Loprinzi ◽  
Maryam B. Lustberg ◽  
Ajit M. W. Chaudhari
Keyword(s):  
Postural Control ◽  
Cancer Survivors ◽  
Center Of Pressure ◽  
Postural Instability ◽  
Eyes Closed ◽  
Sensory Organization ◽  
Increased Risk ◽  
Vestibular Information ◽  
Preliminary Study ◽  
Impaired Balance

Individuals diagnosed with chemotherapy-induced peripheral neuropathy (CIPN) demonstrate impaired balance and carry an increased risk of falling. However, prior investigations of postural instability have only compared these individuals against healthy controls, limiting the understanding of impairments associated with CIPN. Therefore, the purpose of this study was to better isolate postural control impairments that are associated with CIPN. Twenty cancer survivors previously diagnosed with breast or colorectal cancer participated. Participants were separated into 3 groups: no prior chemotherapy exposure (CON, n = 6), and recent treatment with taxane- or oxaliplatin-based chemotherapy with no/mild symptoms of CIPN (−CIPN, n = 8) or moderate/severe symptoms of CIPN (+CIPN, n = 6). Postural control was assessed by measuring center of pressure during standing balance conditions that systematically interfered with somatosensory, visual, and/or vestibular information. The presence of CIPN sensory symptoms was associated with impaired postural control, particularly during eyes-closed balance conditions ( P < .05). Additionally, medial-lateral postural instability was more pronounced in the +CIPN group compared with the −CIPN group and CON participants ( P < .05). Greater postural instability during eyes-closed balance in individuals with CIPN is consistent with impaired peripheral sensation. Balance impairments in cancer survivors with CIPN demonstrate the unique challenges in this population and motivate the need for targeted efforts to mitigate postural control deficits that have previously been associated with fall risk.

Surface height effects on postural control: A hypothesis for a stiffness strategy for stance*

1999 ◽  
Vol 9 (4) ◽  
pp. 277-286 ◽  
Author(s):  
Mark G. Carpenter ◽  
James S. Frank ◽  
Cathy P. Silcher
Keyword(s):  
Postural Control ◽  
Center Of Pressure ◽  
High Surface ◽  
Quiet Standing ◽  
Vestibular Input ◽  
Mean Power ◽  
Mean Power Frequency ◽  
Balance Confidence ◽  
Eyes Closed ◽  
Ankle Stiffness

One possible factor influencing the control of upright stance is the perceived threat to one's personal safety, i.e. balance confidence. We explored this factor by examining the control of stationary stance when standing on an elevated platform under various conditions of reduced visual and vestibular inputs. Twenty-eight adults (14 male and 14 female, mean age = 23.5 years) participated in the experiment. Postural control was examined by recording the amplitude variability (RMS) and mean power frequency (MPF) of center of pressure excursions (COP) over a 2-minute interval while participants stood in a normal stance on a low (0.19 m) and a high (0.81 m) platform with toes positioned either at or away from the edge of the platform. Vision was manipulated through eyes open and eyes closed trials. Vestibular input was reduced by tilting the head into extension [1]. Anterior-posterior RMS and MPF of COP were significantly influenced by an interaction between surface height and vision. When vision was available, a significant decrease in RMS was observed during quiet standing on a high surface compared to a low surface independent of step restriction. When vision was available MPF increased when subjects were raised from a low to a high surface. The mean position of the COP was significantly influenced by an interaction between height and step restriction. Differences in RMS and MPF responses to height manipulation were observed between genders in eyes closed conditions. Vestibular input influenced postural control at both low and high levels with significant increases in RMS when vestibular input was reduced. The reciprocal changes observed in RMS and MPF suggest modifications to postural control through changes in ankle stiffness. Vision appears to play a role in increasing ankle stiffness when balance confidence is compromised.

scholarly journals Added body mass alters plantar shear stresses, postural control, and gait kinetics: Implications for obesity

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246605
Author(s):  
Hwigeum Jeong ◽  
A. Wayne Johnson ◽  
J. Brent Feland ◽  
Spencer R. Petersen ◽  
Jared M. Staten ◽  
...  
Keyword(s):  
Postural Control ◽  
Body Mass ◽  
Mass Distribution ◽  
Repeated Measures ◽  
Center Of Pressure ◽  
Health Concern ◽  
Shear Stresses ◽  
Clinical Role ◽  
Body Distribution ◽  
Weighted Vest

Context Obesity is a growing global health concern. The increased body mass and altered mass distribution associated with obesity may be related to increases in plantar shear that putatively leads to physical functional deficits. Therefore, measurement of plantar shear may provide unique insights on the effects of body mass and body distribution on physical function or performance. Purpose 1) To investigate the effects of body mass and distribution on plantar shear. 2) To examine how altered plantar shear influences postural control and gait kinetics. Hypothesis 1) a weighted vest forward distributed (FV) would shift the center of pressure (CoP) location forward during standing compared with a weighted vest evenly distributed (EV), 2) FV would increase plantar shear spreading forces more than EV during standing, 3) FV would increase postural sway during standing while EV would not, and 4) FV would elicit greater compensatory changes during walking than EV. Methods Twenty healthy young males participated in four different tests: 1) static test (for measuring plantar shear and CoP location without acceleration, 2) bilateral-foot standing postural control test, 3) single-foot standing postural test, and 4) walking test. All tests were executed in three different weight conditions: 1) unweighted (NV), 2) EV with 20% added body mass, and 3) FV, also with 20% added body mass. Plantar shear stresses were measured using a pressure/shear device, and several shear and postural control metrics were extracted. Repeated measures ANOVAs with Holms post hoc test were used to compare each metric among the three conditions (α = 0.05). Results FV and EV increased both AP and ML plantar shear forces compared to NV. FV shifted CoP forward in single-foot trials. FV and EV showed decreased CoP range and velocity and increased Time-to-Boundary (TTB) during postural control compared to NV. EV and FV showed increased breaking impulse and propulsive impulse compared to NV. In addition, EV showed even greater impulses than FV. While EV increased ML plantar shear spreading force, FV increased AP plantar shear spreading force during walking. Conclusion Added body mass increases plantar shear spreading forces. Body mass distribution had greater effects during dynamic tasks. In addition, healthy young individuals seem to quickly adapt to external stimuli to control postural stability. However, as this is a first step study, follow-up studies are necessary to further support the clinical role of plantar shear in other populations such as elderly and individuals with obesity or diabetes.

scholarly journals Maximal stability limits in adolescents with Tourette syndrome

2021 ◽  
Vol 4 (1) ◽  
pp. 013-022
Author(s):  
Blanchet Mariève ◽  
Prince François ◽  
Lemay Martin ◽  
Chouinard Sylvain ◽  
Messier Julie
Keyword(s):  
Postural Control ◽  
Tourette Syndrome ◽  
Center Of Pressure ◽  
Phase 1 ◽  
Sensory Information ◽  
Control Group ◽  
Eyes Closed ◽  
Highly Sensitive ◽  
Eyes Open ◽  
Stability Limits

We explored if adolescents with Gilles de la Tourette syndrome (GTS) had functional postural control impairments and how these deficits are linked to a disturbance in the processing and integration of sensory information. We evaluated the displacements of the center of pressure (COP) during maximal leaning in four directions (forward, backward, rightward, leftward) and under three sensory conditions (eyes open, eyes closed, eyes closed standing on foam). GTS adolescents showed deficits in postural stability and in lateral postural adjustments but they had similar maximal COP excursion than the control group. The postural performance of the GTS group was poorer in the eyes open condition (time to phase 1 onset, max-mean COP). Moreover, they displayed a poorer ability to maintain the maximum leaning position under the eyes open condition during mediolateral leaning tasks. By contrast, during forward leaning, they showed larger min-max ranges than control subjects while standing on the foam with the eyes closed. Together, these findings support the idea that GTS produces subclinical postural control deficits. Importantly, our results suggest that postural control disorders in GTS are highly sensitive to voluntary postural leaning tasks which have high demand for multimodal sensory integration.

The Impact of Hurricane Maria on Individuals Living with Non-Communicable Disease in Puerto Rico: The experience of 10 communities

2021 ◽  
Author(s):  
Elizabeth L. Andrade ◽  
Amalis Cordova Mustafa ◽  
Courtney Riggle-vanSchagen ◽  
Megan Jula ◽  
Carlos E. Rodriguez-Diaz ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Natural Hazards ◽  
Structural Damage ◽  
Communicable Disease ◽  
Community Level ◽  
Morbidity And Mortality ◽  
Health Concern ◽  
Increased Risk ◽  
The Impact ◽  
Non Communicable Disease

Abstract Background Coinciding with the rising non-communicable disease (NCD) prevalence worldwide is the increasing frequency and severity of natural hazards. Protecting populations with NCDs against natural hazards is ever more pressing given their increased risk of morbidity and mortality in disaster contexts. Methods This investigation examined Hurricane Maria’s impact across 10 communities in Puerto Rico to determine whether and how disaster impact and community attributes affected NCD management. We conducted 40 qualitative interviews with mayors, first responders, faith leaders, community leaders, and municipal employees, with 4 interviews per selected municipality. Using QSR NVivo software, we coded interview transcripts and created categorical community-level impact variables based on participant responses. We undertook thematic analysis to characterize community-level impact and consequences for NCD management, and to identify convergent and divergent themes. Using a matrix coding query, we compared NCD management experiences across communities by impact variables and community attributes. Results The delivery of healthcare, pharmacy, and dialysis services was compromised due to facility structural damage and ineffective contingencies for electrical power and water supply. The challenges resulting from power outages were immediate, and individuals who were reliant on life-sustaining medical equipment, dialysis, or the refrigeration of medications were most vulnerable. Inaccessible roadways and the need to travel greater distances to locate operational health services were major impediments to transporting patients in need of NCD care, with those requiring dialysis and living in remote, mountainous communities at highest risk due to landslides and lengthy roadway obstruction. These barriers were compounded by limited communication to locate services and coordinate care. Two weeks post-hurricane, emerging challenges to NCD management included widespread diesel fuel shortages for generators, and shortages in medications, oxygen, and medical supplies. In the weeks to months post-hurricane, the emergence or exacerbation of mental health disorders was characterized as a pressing health concern. Conclusions Study findings identify contributors to morbidity and mortality among individuals with NCDs following Hurricane Maria. The degree to which these impacts were experienced across communities with different characteristics is discussed, offering important lessons regarding the impact of catastrophic disasters on NCD management for improve community disaster resilience.

BalanCI: Head-Referenced Cochlear Implant Stimulation Improves Balance in Children with Bilateral Cochleovestibular Loss

2019 ◽  
Vol 25 (Suppl. 1-2) ◽  
pp. 60-71 ◽  
Author(s):  
Nikolaus E. Wolter ◽  
Karen A. Gordon ◽  
Jennifer L. Campos ◽  
Luis D. Vilchez Madrigal ◽  
David D. Pothier ◽  
...  
Keyword(s):  
Postural Control ◽  
Cochlear Implant ◽  
Virtual Environment ◽  
Clinical Setting ◽  
Spatial Information ◽  
Center Of Pressure ◽  
Effective Means ◽  
Sensory Information ◽  
Clinical Test ◽  
The Impact

Introduction: To determine the impact of a head-referenced cochlear implant (CI) stimulation system, BalanCI, on balance and postural control in children with bilateral cochleovestibular loss (BCVL) who use bilateral CI. Methods: Prospective, blinded case-control study. Balance and postural control testing occurred in two settings: (1) quiet clinical setting and (2) immersive realistic virtual environment (Challenging Environment Assessment Laboratory [CEAL], Toronto Rehabilitation Institute). Postural control was assessed in 16 and balance in 10 children with BCVL who use bilateral CI, along with 10 typically developing children. Children with neuromotor, cognitive, or visual deficits that would prevent them from performing the tests were excluded. Children wore the BalanCI, which is a head-mounted device that couples with their CIs through the audio port and provides head-referenced spatial information delivered via the intracochlear electrode array. Postural control was measured by center of pressure (COP) and time to fall using the WiiTM (Nintendo, WA, USA) Balance Board for feet and the BalanCI for head, during the administration of the Modified Clinical Test of Sensory Interaction in Balance (CTSIB-M). The COP of the head and feet were assessed for change by deviation, measured as root mean square around the COP (COP-RMS), rate of deviation (COP-RMS/duration), and rate of path length change from center (COP-velocity). Balance was assessed by the Bruininks-Oseretsky Test of Motor Proficiency 2, balance subtest (BOT-2), specifically, BOT-2 score as well as time to fall/fault. Results: In the virtual environment, children demonstrated more stable balance when using BalanCI as measured by an improvement in BOT-2 scores. In a quiet clinical setting, the use of BalanCI led to improved postural control as demonstrated by significant reductions in COP-RMS and COP-velocity. With the use of BalanCI, the number of falls/faults was significantly reduced and time to fall increased. Conclusions: BalanCI is a simple and effective means of improving postural control and balance in children with BCVL who use bilateral CI. BalanCI could potentially improve the safety of these children, reduce the effort they expend maintaining balance and allow them to take part in more complex balance tasks where sensory information may be limited and/or noisy.

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.

Vestibular function modulates the impact of nGVS on postural control in older adults

2020 ◽  
Author(s):  
Mujda Nooristani ◽  
Charlotte Bigras ◽  
Louise Lafontaine ◽  
Benoit-Antoine Bacon ◽  
Maxime Maheu ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Path Length ◽  
Vestibular Function ◽  
Vestibular Stimulation ◽  
Sham Stimulation ◽  
Important Relationship ◽  
Increased Risk ◽  
Risk Of Falls ◽  
The Impact

Previous studies have reported an important relationship between increasing age, vestibular impairment and increased risk of falls. Recently, noisy galvanic vestibular stimulation (nGVS) has been shown to improve postural control in older adults. However, this effect of nGVS in older adults has not been examined in interaction with the integrity of the vestibular function. We aimed at determining the effect of nGVS on postural control in older adults with and without vestibular impairment and ii) at examining the sustained effect of nGVS as compared to a sham stimulation. 36 older adults were randomly assigned to the nGVS group [n=24] or the sham group [n=12]. In the nGVS group, 12 participants had normal vestibular function and 12 had vestibular impairment. Static postural control was assessed prior to stimulation, during stimulation and immediately following 30 minutes of nGVS. Results showed that nGVS induced a significant improvement in sway velocity (p<0.001) and path length (p<0.001) compared to sham stimulation. In the nGVS group, participants with vestibular impairment showed a significant decrease of sway velocity (p<0.05) and path length (p<0.05) as compared to those with normal vestibular function. Improvements in sway velocity (p<0.001) and path length (p<0.001) induced by nGVS were sustained immediately following stimulation. These findings suggest that nGVS improves postural control in older adults, and that the effect of nGVS varies depending on the integrity of the vestibular function. Results also show that nGVS effect on postural control, compared to a sham stimulation, can be sustained after the end of stimulation.

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