SISTEMA ETHEL PARA EXAMES DE POSTUROGRAFIA UTILIZANDO WII BALANCE BOARD

A posturografia tem sido usada, por profissionais da saúde, para avaliar a oscilação corporal e mudanças na postura de indivíduos. Entretanto o seu uso é limitado devido ao alto custo dos sistemas utilizados na sua implementação. Equipada com sensores de pressão, a plataforma de jogos Wii Balance Board ™ (WBB) pode ser usada como uma plataforma de força de baixo custo para sistemas de posturografia. No entanto, os sistemas para a implementação desta técnica usando WBB são bastante limitados. Neste artigo apresentamos o sistema Ethel, que nos permite capturar e processar sinais de WBB e calcular parâmetros quantitativos usados na posturografia. Técnicas de aquisição e processamento de sinais foram implementadas no sistema e incorporadas com interface gráfica amigável, além de um sistema de banco de dados que foi projetado para armazenar os resultados dos exames médicos. Uma metodologia de calibração e validação da plataforma também foi implementada e os resultados preliminares obtidos com esta solução são apresentados. O Ethel se apresenta como uma alternativa viável, de baixo custo e acessível por ser implementada como uma solução baseada em software livre.

The Effects of Sit-to-Stand Training Combined with Real-Time Visual Feedback on Strength, Balance, Gait Ability, and Quality of Life in Patients with Stroke: A Randomized Controlled Trial

This study aimed to investigate the effects of lower limbs muscles’ strength, balance, walking, and quality of life through sit-to-stand training combined with real-time visual feedback (RVF-STS group) in patients with stroke and to compare the effects of classic sit-to-stand training (C-STS group). Thirty patients with stroke were randomly divided into two groups. The RVF-STS group received sit-to-stand training combined with real-time visual feedback using a Wii Balance Board (n = 15), and the C-STS group received classic sit-to-stand training (n = 15). All participants received training for 20 min once a day, 5 days a week for 6 weeks, and both groups underwent general physical therapy for 30 min before training. Before and after the training, the muscle strength of the hip flexor, abductor, and knee extensor were measured, and the Wii Balance Board was used to perform the center of pressure test and Berg Balance Scale to evaluate static and dynamic balance. Additionally, the 10 m walking test and the Timed Up and Go test were performed to evaluate gait function. The Stroke-Specific Quality of Life was used to measure the quality of life. The results showed that the lower extremity muscle strength, balance ability, walking ability, and quality of life of the RVF-STS group significantly improved in comparison of the pre- and post-differences (p < 0.05), and it also showed significant differences between groups (p < 0.05). This study showed that sit-to-stand training combined with real-time visual feedback was effective at improving the muscle strength of the lower extremities, balance, gait, and quality of life in patients with stroke. Therefore, repeating sit-to-stand training combined with real-time visual feedback could be used as an effective treatment method for patients with stroke.

AVALIAÇÃO DO EQUILÍBRIO ESTÁTICO EM JOVENS COM SÍNDROME DE DOWN PELO NINTENDO® WII BALANCE BOARD™

O presente estudo teve como objetivo avaliar o equilíbrio estático em 160 participantes, entre 7 e 14 anos, sendo 80 com Síndrome de Down (GSD) e 80 no grupo controle (GC), em condições olhos abertos (OA) e olhos fechados (OF). Os dados foram coletados com uso do Balance Board™ (BB) do Nintendo® Wii Fit pelo software LabView e processados para cálculo do deslocamento do centro de pressão. Verificou-se o GSD apresentou maior amplitude e velocidade de oscilação que o GC, tanto nas condições OA quanto OF. Notou-se que o BB foi eficiente para avaliação do equilíbrio, reforçando os achados da literatura sobre as características na população estudada e que novos estudos devem ser feitos com equipamentos de baixo custo para avaliação do equilíbrio postural.

Effect of Using Wii Balance Board on Functional Balance of Children With Ataxic Cerebral Palsy

Objective: Ataxic cerebral palsy accounts for 5%-10% of the population with cerebral palsy. This palsy is characterized by poor balance and coordination, clumsiness, and involuntary tremor. As a result, balance training is one of the essential parts of the rehabilitation programs for children with ataxic cerebral palsy. Wii Balance Board (WBB) is an efficient tool for balance training in children with different physical problems, including cerebral palsy. This study aims to assess the effect of WBB-based balance training on functional balance and the persistence of its effect two months after the intervention in children with ataxic cerebral palsy. Materials & Methods: This is a single-case study with a pre-test, post-test and follow-up design conducted on 3 children (2 girls and 1 boy) with ataxic cerebral palsy (Mean±SD age=10.56±1.09 years). They were classified at levels I and II of the gross motor function classification system. They received conventional occupational therapy three sessions per week, each for 45 minutes in the baseline and follow-up phases. In the intervention phase, each session consisted of 25 minutes of routine rehabilitation followed by 20 minutes of WBB-based balance training for 3 months (12 hours). The changes were evaluated by the Pediatric Balance Scale (PBS) and Timed Up And Go (TUG) test, three times in the baseline phase, three times in the intervention phase (at the end of 12th, 24th, and 36th sessions), and two times in the follow-up phase (one and two months after the intervention). Assessments were done by a pediatric occupational therapist who was unaware of the study process. Finally, the results were analyzed using the Percentage of Nonoverlapping Data (PND), 2 Standard Deviations (2SD), Hedges’s g, and the visual analysis method. Results: The results of the PBS and TUG test showed the improvement of functional balance in all children in the intervention phase and maintained in the follow-up phase. The PND of PBS and TUG test results was 100% for all children, indicating that balance training by the WBB improved functional balance in the intervention and follow-up phases compared to the baseline. Hedeges’ g value for all participants was more than 0.8, indicating a significant difference between the baseline and follow-up phases. The 2SD results showed a significant increase in the PBS score and a significant reduction in the TUG test duration in all children. Furthermore, the visual analysis revealed a significant improvement in the functional balance of all children in the intervention phase and the stability of these changes in the follow-up phase. Conclusion: Balance training by the WBB is an effective method for improving the functional balance of children with ataxic cerebral palsy. Further studies are needed using a larger sample size to confirm its effectiveness.

Dual task interference in children from 8 to 12 years old (Interferencia de las dobles tareas en niños de 8 a 12 años)

The main aim of this manuscript was to analyze the effect of dual task and their difficulty on the motor and cognitive performance using a postural control and a memory tasks in middle childhood group ages children, establishing the differences between the effect of the tasks in the different age groups. The study sample was composed by one hundred and sixteen children, between 8 and 12 years old. The participants completed three single tasks and two dual-tasks. The postural single task (EO) consisted in maintain the balance in the bipedal stance position and two cognitive single tasks performed were the Backward Digit Span Test with 3-Digits sequences length and the Backward Digit Span Test 5-Digits sequences length. The dual-tasks were the combination of the postural task and the cognitive tasks. Regarding the postural control measurement, CoP signals were acquired with a Wii Balance Board. The analysis performed showed that the younger groups (8-9 years old) had worse punctuations in postural control variables in dual-task conditions than the older age groups (11-12 years old), especially than the 12 years old group. Regarding the effect of dual task in postural control, in all groups between 9 to 12 years old, higher postural control and stability were observed during the execution of the 5D dual-task than during the 3D task. Finally, no differences were found in the number of correct answers in the cognitive task when performing a single or dual-task, in any age group. Resumen. El objetivo principal de este manuscrito fue analizar el efecto de la doble tarea y su dificultad sobre el rendimiento motor y cognitivo mediante una tarea de control postural y otra de memoria en niños, estableciendo las diferencias entre el efecto de las tareas en los distintos grupos de edad. La muestra del estudio estuvo compuesta por ciento dieciséis niños, de entre 8 y 12 años de edad. Los participantes completaron tres tareas simples y dos tareas dobles. La tarea individual postural (EO) consistió en mantener el equilibrio en posición de bipedestación y las dos tareas individuales cognitivas realizadas fueron el Backward Digit Span Test con secuencias de 3 dígitos y el Backward Digit Span Test con secuencias de 5 dígitos. Las dobles tareas fueron la combinación de la tarea postural y las tareas cognitivas. En cuanto a la medición del control postural, las señales del CoP se adquirieron mediante una Wii Balance Board. El análisis realizado mostró que los grupos más jóvenes (8-9 años) obtuvieron peores puntuaciones en las variables de control postural en condiciones de doble tarea que los grupos de mayor edad (11-12 años), especialmente que el grupo de 12 años. En cuanto al efecto de la doble tarea sobre el control postural, en todos los grupos de 9 a 12 años se observó un mayor control postural y estabilidad durante la ejecución de la doble tarea 5D que durante la tarea 3D. Por último, no se encontraron diferencias en el número de respuestas correctas en la tarea cognitiva al realizar una tarea simple o dual, en ningún grupo de edad.