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At least 1,027 records · Page 57Linked to original sources
PubMed2006

Immediate effects of plantar inputs on the upper half muscles and upright posture: a preliminary study.

This purpose of this study was to investigate the immediate effects of plantar inputs on both the upper half muscle activity (anterior temporal, masseter, digastric, sternocleidomastoid, upper and lower trapezius, cervical) and the body posture, by means of electromyography (EMG) and vertical force platform, respectively. Twenty four (24) healthy adults, between the ages of 24 and 31 years (25.3 +/- 1.9), with no history of craniomandibular disorder or systemic musculoskeletal dysfunction, were randomly divided into two groups: test group (fourteen subjects) and control group (ten subjects). A first recording session (TO) measured the baseline EMG and postural patterns of both groups. After this session, the test group wore test shoes with insoles that stimulated the plantar surfaces, while the control group wore placebo shoes. After one hour, a second set of measurements (T1) were performed. Significant differences between the groups at baseline were observed in the left anterior temporal, left cervical, and left upper trapezius, as well as at T1 in the left anterior temporal and right upper trapezius (p < 0.05). Within-test group analysis showed a significant increase of the right upper trapezius activity (p < 0.05), whereas no changes were found by within-control group analysis. Lower risk of asymmetric muscle patterns and postural blindness in the test group compared to the control group was observed. Further studies are warranted to investigate the short and long-term effects of this type of insole, in patients with both craniomandibular-cervical and lower extremity disorders.

Adult↗
PubMed2006

Leg orientation as a clinical sign for pusher syndrome.

BACKGROUND: Effective control of (upright) body posture requires a proper representation of body orientation. Stroke patients with pusher syndrome were shown to suffer from severely disturbed perception of own body orientation. They experience their body as oriented 'upright' when actually tilted by nearly 20 degrees to the ipsilesional side. Thus, it can be expected that postural control mechanisms are impaired accordingly in these patients. Our aim was to investigate pusher patients' spontaneous postural responses of the non-paretic leg and of the head during passive body tilt. METHODS: A sideways tilting motion was applied to the trunk of the subject in the roll plane. Stroke patients with pusher syndrome were compared to stroke patients not showing pushing behaviour, patients with acute unilateral vestibular loss, and non brain damaged subjects. RESULTS: Compared to all groups without pushing behaviour, the non-paretic leg of the pusher patients showed a constant ipsiversive tilt across the whole tilt range for an amount which was observed in the non-pusher subjects when they were tilted for about 15 degrees into the ipsiversive direction. CONCLUSION: The observation that patients with acute unilateral vestibular loss showed no alterations of leg posture indicates that disturbed vestibular afferences alone are not responsible for the disordered leg responses seen in pusher patients. Our results may suggest that in pusher patients a representation of body orientation is disturbed that drives both conscious perception of body orientation and spontaneous postural adjustment of the non-paretic leg in the roll plane. The investigation of the pusher patients' leg-to-trunk orientation thus could serve as an additional bedside tool to detect pusher syndrome in acute stroke patients.

Adult↗
PubMed2006

Development of a taxonomy to describe massage treatments for musculoskeletal pain.

BACKGROUND: One of the challenges in conducting research in the field of massage and bodywork is the lack of consistent terminology for describing the treatments given by massage therapists. The objective of this study was to develop a taxonomy to describe what massage therapists actually do when giving a massage to patients with musculoskeletal pain. METHODS: After conducting a review of the massage treatment literature for musculoskeletal pain, a list of candidate techniques was generated for possible inclusion in the taxonomy. This list was modified after discussions with a senior massage therapist educator and seven experienced massage therapists participating in a study of massage for neck pain. RESULTS: The taxonomy was conceptualized as a three level classification system, principal goals of treatment, styles, and techniques. Four categories described the principal goal of treatment (i.e., relaxation massage, clinical massage, movement re-education and energy work). Each principal goal of treatment could be met using a number of different styles, with each style consisting of a number of specific techniques. A total of 36 distinct techniques were identified and described, many of which could be included in multiple styles. CONCLUSION: A new classification system is presented whereby practitioners using different styles of massage can describe the techniques they employ using consistent terminology. This system could help facilitate standardized reporting of massage interventions.

Body Image↗
PubMed2002

The influence of preparedness on rapid stepping in young and older adults.

OBJECTIVE: To investigate the influence of age and preparation level on postural muscle activation and step completion time during a rapid step task. DESIGN: Postural muscle onset times (EMG) and ground reaction forces were recorded from healthy young (n = 20, age 21 +/- 3 years) and older (n = 25, age 71 +/- 5 years) female adults during a choice reaction-time stepping paradigm. MAIN OUTCOME MEASURES: Onset times of six trunk and hip muscles, reaction time and components of the step (weight shift time, step time and task time) were recorded. RESULTS: Muscle activation was delayed and movement time was lengthened in both young and older adults when poorly prepared for a stepping task. While reduced preparation did not influence older adults to a greater extent than young adults, the slowest step response and completion time was evident in older adults when poorly prepared to move. CONCLUSIONS: A late postural response when poorly prepared to move may be a contributing factor to an increased risk of overbalancing in older adults. Future assessment of and intervention to improve postural stability in older adults should be expanded to incorporate tasks performed at various levels of preparation.

Adolescent↗
PubMed2005

The measurement properties and performance characteristics among older people of TURN180, a test of dynamic postural stability.

OBJECTIVES: To establish the measurement properties of TURN180, a test of dynamic postural stability. DESIGN: One physiotherapist conducted three trials of TURN 180, one of which was also observed by a second therapist. SETTING: A day unit for elderly people accepting both inpatients and outpatients. SUBJECTS: Sixty-six people (mean age 82.45 years), only six (9.1%) of whom could walk without using a walking aid. MAIN MEASUREMENT: The number of steps that a person takes to step around 180 degrees. A step is defined as any attempt on the subject's part to take a step, successful or not. RESULTS: Repeatability is good, intraclass correlation coefficient = 0.828; the minimal detectable change revealed that in order to be considered a real improvement the number of steps the person takes to complete the postintervention TURN180 must be 28-29% fewer than the preintervention count. As long as the protocol is followed carefully, between-observer agreement is good, with differences between two observers rarely exceeding one step. People who had fallen in the previous year took statistically significantly more steps than those who had not done so to complete TURN180. Requesting written as well as oral consent seems to reduce the likelihood of an elderly patient agreeing to participate in a study. CONCLUSION: TURN180 yields repeatable (retest reliable) and valid data about a person's dynamic postural stability, especially the minimal detectable change which allows clinicians to judge whether any change in their patient's performance is real.

Accidental Falls↗
PubMed2006

Evaluation of physical therapy in parkinsonian patients with freezing of gait: a pilot study.

OBJECTIVE: Freezing of gait is a frequently disabling symptom in Parkinson's disease, poorly responding to dopaminergic treatment. We investigated the short-term effectiveness of a rehabilitation protocol in parkinsonian patients with freezing of gait. DESIGN: Prospective, uncontrolled pilot study with open label design. SETTING: Outpatient service for rehabilitation of neurological disorders. SUBJECTS: Twelve patients (8 male, 4 female; aged 59-78 years; Hoehn-Yahr stage: 2-3; mean disease duration: 14.2 +/- SD 4.1 years). INTERVENTIONS: Patients attended three (45 min) sessions every week, over a six-week period, of physical therapy focused to improve balance, postural control and walking, and to learn new strategies for overcoming freezing of gait. MAIN OUTCOME MEASURES: Patients were evaluated before (T0), at the end (T1), and one month after (T2) rehabilitation by means of clinical rating scales (Unified Parkinson Disease Rating Scale--Motor Section; Freezing of Gait Questionnaire; Parkinson Disease Quality of Life Score) and gait parameters (number of strides, stride length and velocity) during a standardized walking test. RESULTS: The scores of Freezing of Gait Questionnaire and of Parkinson Disease Quality of Life Questionnaire (but not of the Unified Parkinson Disease Rating Scale--Motor Section) were significantly improved after treatment (T1). Gait parameters were significantly improved at T1 and T2. CONCLUSIONS: We showed the potential short-term efficacy of a rehabilitative approach to freezing of gait in Parkinson's disease. The positive outcome was documented by clinical rating scales and objective gait evaluation. The rapid reversibility of the clinical benefit suggests that further studies are needed to better define the optimal frequency and duration of treatment.

Aged↗
PubMed2004

Underdevelopment of the postural control system in autism.

OBJECTIVE: To determine if abnormalities exist in postural control in autism and if they are related to age. METHODS: Dynamic posturography was performed in 79 autistic individuals without mental retardation and 61 healthy volunteers between ages 5 and 52 years. Both the sensory organization and the movement coordination portions of the test were performed. RESULTS: The autistic subjects had reduced postural stability (p = 0.002). Examination of age effects revealed that the development of postural stability was delayed in the autistic subjects (p < 0.001) and failed to achieve adult levels (p = 0.004). Postural stability was reduced under all conditions but was clinically significant only when somatosensory input was disrupted alone or in combination with other sensory challenges (mean reduction in stability of 2.6 +/- 1.0 for the first three conditions without somatosensory disruption vs 6.7 +/- 2.7 for the last three conditions with somatosensory disruption), indicating problems with multimodality sensory integration. CONCLUSIONS: The evidence from this and studies of the motor system suggests more general involvement of neural circuitry beyond the neural systems for social behavior, communication, and reasoning, all of which share a high demand on neural integration of information.

Adolescent↗
PubMed2005

Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo.

The authors assessed the natural course of benign paroxysmal positional vertigo (BPPV) in 108 patients who were not treated with canalith repositioning procedure. The average number of days from onset to remission of positional vertigo in patients with posterior canal BPPV (P-BPPV) (39 days) was longer than in those with horizontal canal BPPV (H-BPPV) (16 days). The ratio of patients with H-BPPV to those with BPPV was 33%.

Adult↗
PubMed1982

Vestibular dysfunction in Parkinson disease.

Symptoms and signs of postural instability are often present in patients with Parkinson disease (PD). Because vestibular dysfunction might contribute to the postural instability, we carried out bithermal caloric tests and electronystagmography in 36 patients with PD and 316 controls. Significantly more PD patients had reduced and absent vestibular responses than controls. Decreased or absent vestibular responses in patients with PD were associated with postural instability and increasing severity of other symptoms. Vestibular dysfunction may contribute to the postural instability of PD.

Aged↗
PubMed2004

Evaluation of the pull test technique in assessing postural instability in Parkinson's disease.

Variability in pull test (PT) performance can lead to inadequate evaluation of postural instability in patients with Parkinson's disease (PD). Assessing 66 PTs by 25 examiners, at least two of four raters agreed that specific items were performed incorrectly for stance in 27.3%, for strength and briskness of the pull in 84.9%, for examiner's response in 36.4%, and for technique issues in 9.1%. Examiners were consistent in their errors, and only 9% of examinations were error-free.

Diagnostic Techniques, Neurological↗
PubMed2004

Vestibular compensation in lampreys: restoration of symmetry in reticulospinal commands.

Removal of a vestibular organ (unilateral labyrinthectomy, UL) in the lamprey results in a loss of equilibrium, so that the animal rolls (rotates around its longitudinal axis) when swimming. Owing to vestibular compensation, UL animals gradually restore postural equilibrium and, in a few weeks, swim without rolling. Important elements of the postural network in the lamprey are the reticulospinal (RS) neurons, which are driven by vestibular input and transmit commands for postural corrections to the spinal cord. As shown previously, a loss of equilibrium after UL is associated with disappearance of vestibular responses in the contralateral group of RS neurons. Are these responses restored in animals after compensation? To answer this question, we recorded vestibular responses in RS neurons (elicited by rotation of the compensated animal in the roll plane) by means of chronically implanted electrodes. We found that the responses re-appeared in the compensated animals. This result supports the hypothesis that the loss of equilibrium after UL was caused by asymmetry in supraspinal motor commands, and the recovery of postural control in compensated animals was due to a restoration of symmetry.

Action Potentials↗
PubMed2005

Detection of dynamic stability deficits in subjects with functional ankle instability.

PURPOSE: To determine which combination of landing protocol and analysis technique would be the most effective at detecting differences in dynamic stability between healthy subjects and subjects with functional ankle instability (FAI). METHODS: Fifty-eight subjects participated in this investigation: 29 healthy individuals and 29 individuals with FAI. Subjects were assessed during a single test session for time to stabilization (TTS) in the anterior/posterior, medial/lateral, and vertical directions from two protocols: a step down and jump protocol. The step down protocol started with each subject atop a 20-cm-high platform, and the jump protocol started with subjects in a standing position 70 cm from the center of a force plate and required each subject to jump off both legs and touch a designated marker placed at a position equivalent to 50% of the subject's maximum vertical leap. TTS scores in the anterior/posterior, medial/lateral, and vertical direction were compared between group, protocol, and type of analysis. RESULTS: A significant protocol by analysis by group interaction (F(1,56) = 6.9, P = 0.011) was observed for anterior/posterior TTS. Likewise, protocol by group (F(1,56) = 4.4, P = 0.042) and protocol by analysis (F(1,56) = 14.1, P < 0.001) interactions were also noted in anterior/posterior TTS. The jump protocol (2381.7 +/- 36.5 ms) produced significantly greater TTS scores in the vertical direction than the step protocol (1533.5 +/- 71.8 ms), whereas the unbounded third order polynomial (UTOP) method (2554.4 +/- 68.7 ms) produced significant greater TTS scores as compared with the sequential estimation (SE) method (1360.8 +/- 52.1 ms). CONCLUSIONS: The jump protocol and UTOP method of analysis are the most effective TTS combination in detecting differences between healthy and FAI groups.

Adult↗
PubMed1995

[Subclinical neuro-psychobehavioral effects in occupational, environmental and community health: methodology and recent findings].

Evoked potentials (short-latency somatosensory, visual and brainstem auditory evoked potentials), event-related potential (P300), electrocardiographic R-R interval variability, peripheral nerve conduction velocity, distribution of nerve conduction velocities, postural balance, neurobehavioral test batteries, and questionnaires and psychiatric interview methods appear to be promising techniques for assessment of subclinical neuro-psychobehavioral effects in occupational, environmental and community health. In this paper, an overview of recent methodology and findings is provided. The available data indicate that these techniques are valid, reliable and standardized, and are easily applied in field studies.

Clinical Trials as Topic↗
PubMed2004

Usefulness of posturography after epidural block.

After a nerve block, observation of the course of effects is necessary until discharge of patients. Particularly epidural block in the lumbar region markedly affects ambulation and postural stability. Although there are few methods of objective evaluation of the postural stability, safe and early discharge is desired. We evaluated the influences of epidural block with 5 ml of 1% lidocaine on equilibrium before as well as 30, 60 and 90 minutes after epidural block. Computerized posturography allows the objective evaluation and quantitative assessment of impairment of receptors and the central nervous system involved in the maintenance of postural stability by analyzing of results. Locus length per unit area with the eyes open and that with the eyes closed 30 minutes after epidural block (27.339 +/- 11.761 cm and 25.804 +/- 10.561 cm, respectively) were significantly (P = 0.0067 and 0.0175, respectively) higher than baseline values (19.528 +/- 8.240 cm and 19.496 +/- 7.450 cm, respectively). Sway area with the eyes open 30 minutes after epidural block (3.923 +/- 2.494 cm2) was significantly (P = 0.0190) larger than the baseline value (2.533 +/- 1.309 cm2). These results suggest that marked effect remain after epidural block even when standing appears to be stable, and the observation of the course of effects after epidural block is still necessary for the safety of patients. We considered that locus length per unit area is a useful parameter for the assessment of an early discharge.

Adult↗
PubMed1991

Clinical assessment of postural stability following vestibular nerve section.

Little is known about the recovery of postural control in patients following acute vestibular loss. This paper reports on the results of moving-platform posturography to assess the recovery of postural stability in 24 patients following vestibular nerve section. Posturography was abnormal prior to surgery in 17% of the patients. Seven days following surgery, 44% of the patients demonstrated vestibular deficit patterns, while 56% of the patients had normal posturography. Posturography was normal in all patients 1 month following surgery. Abnormal posturography was subsequently noted in 21% of the patients between 3 and 20 months following surgery. Each of the patients with abnormal preoperative posturography subsequently demonstrated abnormal late postoperative posturography. These results suggest that perioperative posturography may be useful in the evaluation and counseling of patients considering ablative vestibular surgery.

Adult↗
PubMed1992

Patterns of vestibular function following vestibular nerve section.

Bithermal caloric irrigations, low-frequency rotational chair stimulation, and posturography were performed on 20 patients before and after vestibular nerve section. Twelve patients demonstrated acute postoperative spontaneous nystagmus and rotational vestibulo-ocular reflex (VOR) asymmetry. Eight patients demonstrated minimal acute postoperative spontaneous nystagmus and VOR asymmetry. Four patients had suppression of all vestibular function characterized by an absent contralateral caloric response, low VOR gain, and falls on posturography when required to rely solely on vestibular input to maintain posture. Four patients had a severe preoperative vestibular loss and no acute change in vestibular function following surgery. Over time, 5 patients continued to manifest elevated spontaneous nystagmus, 2 patients manifested a persistent rotational VOR asymmetry, and 5 patients exhibited a return of caloric function in the operated ear. It is suggested that multiple clinical factors contributed to the variable vestibular responses demonstrated in this study.

Adult↗