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PubMedDate not supplied

Proprioceptive function in children with adolescent idiopathic scoliosis.

Recent studies in Japan and in Sweden have suggested that a disturbance of postural equilibrium exists in idiopathic scoliosis. Proprioceptive function is one of the factors involved, and therefore a study of proprioception in patients with adolescent idiopathic scoliosis (AIS) was carried out. No difference was noted in joint position sense and in fine motor control between 24 scoliotics and matched controls taken from a group of 70 normal children of the same age group. Blindfold weight discrimination, a test of muscle spindle and tendon stretch receptor function, also showed no abnormality in scoliotic children. The Charpentier test, thought to be a test of control of muscle spindle function, showed a tendency to an infantile response in patients with adolescent idiopathic scoliosis, while the control subjects showed a normal size-weight response.l This suggests that the muscle spindle system may be at fault in AIS and supports the suggestion that postural equilibrium reactions may be abnormal in this disease.

Adolescent↗

PubMed1988

Sway of the center of gravity in patients with spinal canal stenosis.

In this study the sway of the center of gravity was observed in patients with spinal canal stenosis, in order to observe the movement of the center of the gravity after the onset of claudication. In normal subjects the sway of the center of gravity was restricted to a small area, but in patients with spinal stenosis, the center of gravity was diverted to the left or right side. With claudication, the center of gravity moved forward. Following several rest periods, the center of gravity returned to the initial area. The time required to return to the initial area was longer than for a patient's subjective recovery from the symptoms.

Adult↗

PubMed1994

A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.

STUDY DESIGN: A computerized technique, employing a motion analysis system and a force platform, was developed to analyze lateral bending behavior of subjects with normal and painful spines. METHODS: Lateral bending was quantified using motion (angle and speed of rotation), force (ground reaction kinetics), and biomechanical behavior ("compliance" and "transfer mobility") characteristics of four discrete spinal segments measured during standing, range of bending, and bending at normal and maximum speeds. RESULTS: For subjects with pain, there were reductions in the range of lateral bend (43%) and speed of rotation (39%). Ground reaction moment about the medial-lateral axis was greater (58%), whereas that about the anterior-posterior axis was less (28%). "Compliance" was less (25%), whereas "transfer mobility" was greater (24%). CONCLUSIONS: The findings suggest that the characteristics of lateral bending, rather than range of motion, is most affected in subjects with pain.

Adult↗

PubMed1998

The measurement of lumbar proprioception in individuals with and without low back pain.

STUDY DESIGN: A clinical trial comparing a back pain group with a pain-free group. OBJECTIVES: To investigate whether proprioceptive deficits existed in a group of individuals reporting low back pain. SUMMARY OF BACKGROUND DATA: Little work has so far been conducted on the measurement of proprioception in the spine. Those studies that have been carried out, however, have failed to identify proprioceptive deficits in individuals with back pain. Previous work on peripheral joints has revealed that proprioception is affected with muscular or joint injury or degeneration. METHODS: Forty individuals took part in the study, 20 with back pain and 20 with no pain. Participants were required to reproduce a predetermined target position, in standing and four-point kneeling, 10 times in 30 seconds. A computer screen was used to provide visual feedback on position. A mean deviation from the target position was obtained for each individual. A measurement of left elbow position sense was conducted in five individuals from each group to establish differences in short-term motor memory between the groups. RESULTS: There were no differences between the subject groups in terms of short-term motor memory (P > 0.05). A two-way analysis of variance between subject groups and position to identify differences in accuracy (deviation from the target) found that there were differences between subject groups in either position (P < 0.05). There was no significant difference in accuracy between the positions used (P > 0.05). CONCLUSIONS: Differences in proprioception do exist between individuals with back pain and those free from back pain. Further research needs to be undertaken on proprioceptive exercise programs and their effect on back pain.

Adult↗

PubMed2002

Human muscular and postural responses in unstable load lifting.

STUDY DESIGN: Most studies of manual material handling have focused on stable (fixed) loads. The muscular response during unstable load handling deserves more investigative attention. OBJECTIVES: To investigate muscular and postural responses during unstable load lifting, and to quantify the threat posed by such loads in the workplace. SUMMARY OF BACKGROUND DATA: Accurate assessment of load weight is important for lifters. Unfortunately, this information is not always available to individuals handling containers of liquids or shifting loads, or those encountering impact loading or a sudden unexpected load. METHODS: In this study, 12 subjects were subjected to time-variant loads, in which a box weighing 18 kg was used to generate a sudden 12 (kg. m)/second load impact internally during the lifting process. Responses were investigated as a function of different load-shift conditions (anterior-to-posterior and posterior-to-anterior rolling loads and stable load), two foot placements (wide and narrow stance), and two lifting techniques (stoop and squat). Normalized electromyography signals, joint angles, and total linear length for center of pressure (COP-length) were investigated. RESULTS: Lifting an unstable load significantly increases total lifting time, COP-length, and muscular contraction levels. When responding to impact momentum, subjects attempted to lift with greater elbow extension and shoulder and trunk flexion. A more flexed knee joint (approximately an additional 5 degrees ) was observed during preparation for load impact in the anterior-to-posterior rolling task, allowing the formation of a more stable platform to compensate for the load variation. The largest erector spinae contraction for unstable lifting was approximately 12% to 25% greater maximal voluntary contraction than for the stable analog. CONCLUSIONS: The normalized electromyography data demonstrate that the central nervous system detects and responds to the need to stabilize the joints closest to the location of load-shift perturbation.

Acceleration↗

PubMedDate not supplied

Tai Chi as an adjunct to cardiac rehabilitation exercise training.

Heart disease is a chronic condition needing lifetime secondary prevention measures to decrease morbidity and mortality, and to improve quality of life. Cardiac rehabilitation exercise training, one aspect of cardiac recovery, traditionally includes some form of aerobic fitness and, more recently, muscle strength training to improve exercise tolerance. Tai chi, widely practiced in China for centuries, is a popular form of exercise among older Chinese persons associated with enhanced well-being and health among traditional Chinese practitioners. Recent research has reported improvement in cardiorespiratory function, balance and postural stability, fall prevention, and stress reduction. A review of the literature suggests potential benefits from tai chi exercise performed as an adjunct to cardiac rehabilitation exercise training. Tai chi is cost-effective and facilitates a lifestyle of health-related behavior practices.

Accidental Falls↗

PubMed1998

Effects of marijuana on equilibrium, psychomotor performance, and simulated driving.

Delta-9-tetrahydrocannabinol (THC) is frequently found in the blood of drivers involved in automobile accidents, and marijuana use has been associated with impaired field sobriety test performance. The present study used a within-subject design to compare the effects of marijuana (0, 1.77, or 3.95% THC) on equilibrium and simulated driving. Ten marijuana users (seven men, three women) smoked one marijuana cigarette at the beginning of each session. Then 2 min later, they began a 60-min test battery that included subjective effects scales, a computerized test of body sway, a rapid judgment task and brake latency measurement in a driving simulator, critical flicker fusion (CFF), and a choice reaction time task (CRT). Self-report ratings of 'high' and 'drug potency' increased comparably following both active doses. The high, but not the low, dose significantly increased body sway. The high dose also marginally increased brake latency by a mean of 55 ms (P < 0.10), which is comparable to an increase in stopping distance of nearly 5 feet at 60 mph Judgment, CFF, and CRT scores did not differ across dose conditions. The equilibrium and brake latency data with 3.95% THC are similar to prior results in our laboratory in participants with breath alcohol concentrations near 0.05%.

Adult↗

PubMed2006

The effect of 6 weeks of custom-molded foot orthosis intervention on postural stability in participants with >or=7 degrees of forefoot varus.

OBJECTIVE: Postural stability (PS) was assessed in a group of participants with >or=7 degrees of forefoot varus (FV) after 6 weeks of custom-molded functional foot orthosis (FO) intervention to investigate the effect of FO intervention in a population that may have decreased PS due to their foot structure. DESIGN: A force platform was used to assess right and left single-limb stance position and eyes open and eyes closed condition PS. SETTING: PS was assessed in a biomechanics research laboratory. PARTICIPANTS: Twelve participants with >or=7 degrees of FV (MFV) and 5 participants with <7 degrees of FV (LFV) participated in the study. INTERVENTIONS: PS of the MFV group was assessed initially when FOs were received and after 6 weeks of FO intervention. The LFV group PS was assessed during initial and 6-week testing sessions. MAIN OUTCOME MEASURES: The root mean square of the center of pressure velocity was used to quantify single-limb stance PS during no FO and FO conditions. RESULTS: LFV group PS did not change significantly (P=0.829) over the 6-week time period. Significant improvement was, however, reported in the MFV group anteroposterior (P=0.003) and mediolateral (P=0.032) PS at the 6-week assessment versus the initial assessment during both the noFO and FO conditions. CONCLUSIONS: Six weeks of FO intervention may significantly improve PS in participants with >or=7 degrees of FV both when wearing FOs and when not wearing FOs.

Adult↗

PubMed1996

Postural stability assessment in sewer workers.

In this study, postural stability was measured with a microcomputer-based force platform as an indirect assessment of central nervous system effect in 28 sewer workers (age range 23.4 to 64.5 years, standard deviation of 8.7 years). All workers performed four 30-second postural sway tests. The organic-solvent exposure was measured by a photo-ionization detector. The photo-ionization detector was calibrated to measure volatile organic solvents in total benzene equivalence, and concentrations were measured in various parts of the plant. The mean exposure was .32 parts per million (ppm) benzene equivalent (range of .02 to .95 ppm, standard deviation .19 ppm). Based on a covariate adjusted linear multiple-regression model, a statistically significant (p < .05) positive correlation was demonstrated between postural sway and organic-solvent exposure. These workers also had increased postural sway compared with a nonexposed population. The statistically significant correlation between postural sway determinations and organic-solvent exposure was surprising given the very low exposures measured. It is possible that the organic-solvent exposure might not be the causative agent, but rather that the solvents themselves correlate with some other causative exposure, ie, total volatile organics as implicated in the cause of sick-building syndrome.

Adult↗

PubMed1989

The Auto-Tilt Test in patients with positional vertigo and Menière's disease.

As a new method of testing the righting reflex, which has been considered to be closely related to the otolith function, we used the Auto-Tilt Test (ATT) on 24 patients with positional vertigo, on 5 patients with Meniere's disease before and after cochlearendolymphatic shunt, and on 10 normal subjects. The subject is required to stand on an electrically driven tilt board with an autoregulating switch in hand, and to perform bilateral tilt swings of 5 degrees and 10 degrees wearing a helmet with a Head Inclinometer or tilt sensor. The result of this test in patients with positional vertigo revealed the patients had an abnormal labyrinthine reflex and significantly excessive tilt in the return swing from the side of the lesion. In addition, we consistently observed an inaccurate righting reflex, coupled with a diminished sensation of tilt, on the side of the lesion. The results in Meniere's disease patients, followed up before and after surgery, showed that the depressed righting reflex toward the affected side and the tendency to list to the healthy side before surgery, improved after surgery.

Adult↗

PubMed2006

Adaptive task prioritization in aging: selective resource allocation to postural control is preserved in Alzheimer disease.

OBJECTIVE: With age, the performance of multiple tasks decreases, a pattern exaggerated in Alzheimer disease (AD). At the same time, recent research, based on adaptive theories of healthy aging, indicates a preference of older adults to allocate resources toward tasks of higher immediate value (e.g., postural control). This study investigated whether such models also hold for pathologic cognitive aging. METHOD: Using a dual-task paradigm, the authors combined a working memory with a postural control task under easy and difficult conditions in patients with AD, older adults, older adults low on performance on a cognitive marker test, and young adults (N = 40). Participants repeatedly performed a cognitive and a postural control task both simultaneously and in isolation over the course of eight sessions. RESULTS: Consistent with earlier studies on divided attention in age and AD, the authors found large dual-task performance decrements with age and more so in AD. When not challenged, patients with AD showed large performance decrements under dual-task conditions in both postural control and working memory. With increasing difficulty in the postural control task, however, older adults, and more so patients with AD, maintained a high level of functioning in postural control, as compared with working memory. CONCLUSION: The findings indicate that the theory of selective optimization with compensation extends to pathologic aging and have broad implications for models of dual-task performance and executive control in aging and AD.

Adult↗

PubMed2005

A new set of criteria for evaluating malingering in work-related vestibular injury.

OBJECTIVE: To develop and use a set of criteria using computerized dynamic posturography results to detect aphysiologic behavior in patients with complaints of imbalance, and to compare the efficacy of this system with present quantitative techniques and with subjective methods of evaluating malingerers. STUDY DESIGN: Prospective study of two groups of sequentially referred patients complaining of dizziness and/or imbalance. SETTING: A tertiary and quaternary care ambulatory referral center. PATIENTS: Two groups of patients were studied. One was a group of patients who had suffered work-related head trauma and had subsequent complaints of dizziness and/or imbalance. The other was a group of patients referred for dizziness and/or imbalance who had no history of head trauma, work-related injury, or litigation procedures. INTERVENTIONS: Standard vestibular assessment including computerized dynamic posturography was carried out on all patients. MAIN OUTCOME MEASURES: All patients in both groups were scored for aphysiologic behavior using a quantified formula that has been used to detect malingerers, an analysis criterion using different aspects of computerized dynamic posturography performance that has been used for some time, and our newly developed nine-point scoring method. Results of all three methods were compared to determine the effectiveness of each one in detecting malingering behavior. RESULTS: Our nine-point protocol was effective in assessing patients in a consistent manner. Assessment using the quantitative formula in the literature raised suspicions of malingering in many patients with no known ulterior motives, some of whom had documented vestibular disease. Our criteria also evaluate other aspects of performance not evaluated by the presently used techniques. CONCLUSION: Our newly developed criteria are effective at evaluating the medicolegal patients from both the quantitative and qualitative viewpoints, and provide a more thorough assessment than has previously been available.

Adult↗

PubMed2006

Self-initiated gait increases susceptibility to the moving platform after-effect.

Walking onto a stationary platform previously experienced as moving results in a large forward sway, despite awareness of the changing context. This after-effect demonstrates aberrant motor prediction. Here, we compared after-effect magnitude when gait initiation was either externally triggered or self-initiated. Both participant groups adapted their walking speed similarly when walking onto the moving platform. When it was kept stationary however, after-effect magnitude was more than doubled in the self-initiated group. We attribute this to a stronger association made between the action (gait initiation) and its consequence (platform movement) when the action is initiated by oneself. This increased sense of agency reduces the ability to switch off the acquired motor response when it is no longer appropriate.

Adult↗

PubMed1984

A study of postural equilibrium in idiopathic scoliosis.

The relationship between upright static and dynamic equilibrium function and idiopathic scoliosis was investigated using a seven-part postural equilibrium test battery. Twenty-three normal subjects and 31 subjects with differing degrees of idiopathic scoliosis participated in the study. No significant difference was found among any of the subtest scores of the normal and scoliotic groups. Subtest scores were not significantly correlated with curve measurements. Curve measurements and subjects' ages proved to have some effect on subtest scores, but other unknown factors accounted for a greater percentage of score variance. The existence of a clinically measurable deficit in upright static and dynamic equilibrium in idiopathic scoliosis could not be proven. Further investigation is suggested to identify the factors that affect equilibrium scores. If these factors could be identified, the test battery might serve as a tool for the examination of female patients with idiopathic scoliosis.

Adolescent↗

PubMed1996

Neurodevelopmental treatment: application to nursing and effects on the hemiplegic stroke patient.

Nursing care of the hemiplegic stroke patient is based on a traditional approach, using compensatory rehabilitative principles. However, during recent years, the neurodevelopmental treatment (NDT) approach, based on the noncompensatory rehabilitative principles and focused on activating the affected side of the hemiplegic stroke patient, is increasingly begin applied to neuroscience nursing. Until recently, little evidence existed to support the superiority of the NDT approach. The NDT approach requires considerable investment in education and training. Therefore, benefit of the NDT approach in comparison to the traditional approach must be assessed and interventions applied accordingly.

Activities of Daily Living↗

PubMed2001

Prediction of stable walking for a toy that cannot stand.

Previous experiments [M. J. Coleman and A. Ruina, Phys. Rev. Lett. 80, 3658 (1998)] showed that a gravity-powered toy with no control and that has no statically stable near-standing configurations can walk stably. We show here that a simple rigid-body statically unstable mathematical model based loosely on the physical toy can predict stable limit-cycle walking motions. These calculations add to the repertoire of rigid-body mechanism behaviors as well as further implicating passive dynamics as a possible contributor to stability of animal motions.

Animals↗

PubMed2001

Simulations of foot stability during gait characteristic of ankle dorsiflexor weakness in the elderly.

Falls are common among the elderly and often cause injuries. They most frequently occut during walking and are associated with the chronic deterioration in neuromuscular and sensory systems, as well as with ankle dorsiflexor muscular weakness and lowered endurance of these muscles to fatigue. In the present study, a three-dimensional (3-D) finite element model of the structure of the foot was utilized to determine the effects of ankle dorsiflexor muscle weakness on the structural stability of the foot and, consequently, on the risk of falls during gait. The medial-lateral tendency of instability of the foot during gait in such conditions of weakness was analyzed by means of this model to identify the most important muscles used in controlling foot stability in affected individuals. The values of the eccentricity of the center of pressure under the heel during foot placement were used to indicate the degree of foot stability. The computational analysis indicated that it is the tibialis anterior muscle's weakness that dramatically decreases foot stability. Clinical investigation is now needed to correlate the significance of tibialis anterior muscle weakness with other known risk factors affecting the tendency to falls among the elderly, e.g., deterioration of sensory abilities. Rehabilitation practitioners and physical therapists may apply the present analytic approach to evaluate the stability of a foot before treatment and compare the predicted with the actual therapeutic results in terms of optimization of foot-ground pressure.

Accidental Falls↗

PubMed2001

Spectral characteristics of visually induced postural sway in healthy elderly and healthy young subjects.

Spectral analysis and time-frequency analysis were applied to anterior-posterior (A-P) center-of-pressure (COP) data collected during quiet stance and sinusoidal (0.25 Hz) moving visual scene perturbations from sixteen healthy elderly subjects and thirteen healthy young subjects. While the total energy of COP was larger in the elderly subjects than in the young subjects, energy-normalized spectra of the entire COP time series were similar between the two populations. Further time-dependent analysis of the spectral characteristics showed that the time-varying spectra were also similar, as revealed by time-frequency analysis, although some differences were observed. Specifically, time-dependent mean frequency and bandwidth responses to the stimulus showed similar increases in both young and elderly subjects with the introduction of the stimulus. Furthermore, time-frequency analysis showed that both groups exhibited an initial increase in sway at the stimulus frequency that then declined as the sinusoidal scene movement progressed. This reduction in sway during visual stimulation may indicate an "adaptation" to constant frequency visual perturbation that is invariant with age. This finding is in contrast to results reported recently for patients with vestibular impairments, who appear to lack such adaptation.

Adaptation, Physiological↗