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At least 127 records · Page 7Linked to original sources

PubMed2005

Reliability of the seated postural control measure for adult wheelchair users.

PURPOSE: To evaluate the test-retest and interrater reliability of the Seated Postural Control Measure for Adults 1.0 (SPCMA 1.0). METHOD: The participants were evaluated first by two raters and then, 3 weeks later, by one rater. Section 1 (one item, seven-point scale) evaluates the adult's overall ability to control its posture in a sitting position. Sections 2 and 3 (22 items each, scored on a seven-point scale), evaluate the adult's postural alignment in a static position and the changes in postural alignment induced by a dynamic activity. RESULTS: For the test-retest reliability, the intraclass correlation coefficient (ICC) of section 1 was excellent (0.95) and moderate to good for sections 2 and 3 (0.60 - 0.62) and their subsections (0.47 - 0.78). For interrater reliability, the three sections had good to excellent ICCs (0.68 - 0.93) and their subsections had moderate to good ICCs (0.41 - 0.69). A large range was observed in Kappa coefficients (test-retest and interrater reliability) for the item analysis of the sections 2 and 3, due to a lack of variability in some items. CONCLUSIONS: The results confirm that the SPCMA is reliable as a whole. Suitable information has been obtained for the development of the SPCMA 2.0 and, although further psychometric testing is needed, the latter should improve clinical evaluation of seated postural control in adult wheelchair users.

Activities of Daily Living↗

PubMed2006

Age-related differences in the effect of a perceived threat to stability on postural control.

BACKGROUND: Studies indicate that the strategy for postural control may be affected by psychological factors, and that young adults respond to perceived threat to stability by increasing their ankle stiffness. The objective of this study was to compare the postural control strategy adopted by young and old adults when faced with postural threat induced by manipulating surface height. METHODS: Sixty elderly (mean age 77.5+/-4.4 years) and 20 young volunteers (mean age 21.5+/-3.7 years) participated in the study. Movement of the center of pressure (COP) was recorded for 60 seconds with a portable force-plate, as participants stood with eyes open and closed, both at ground level and 85 cm above ground level. Analysis of variance and Tukey-Kramer tests were conducted to determine the effects of age, postural threat, and vision on mean power frequency (MPF), on amplitude variability both in the anterior-posterior (AP) and medio-lateral (ML) directions, and on mean COP sway velocity, with the significance level set at p=.05. RESULTS: Postural threat did not affect COP measures for the young adults, whereas it induced greater changes in MPF in the AP and ML directions in the elderly participants. A similar trend was observed in the elderly group for amplitude variability in the ML direction and for mean COP sway velocity. CONCLUSIONS: In comparison with young adults, elderly adults tend to have an exaggerated postural response to conditions that are perceived as threatening to stability. This response involves primarily increases in MPF, with limited compensatory decreases in amplitude variability observed only in the ML direction.

Accidental Falls↗

PubMed2002

Role of visual input in nonlinear postural control system.

Stabilometry signals involve irregular and unpredictable components. The purpose of the present study was to investigate these signals with a nonlinear technique to examine how the complexity of the postural control system breaks down under altered visual conditions. We evaluated the dynamical similarities of the postural control system when the eyes were open or closed, or when there was optokinetic stimulation (OKS). A similarity index was calculated by the cross-correlation integral between the two dynamics: eyes open and eyes closed, or eyes open with OKS. Using this technique, dynamical changes were not observed between eyes-open and eyes-closed conditions. This result suggests that the nonvision condition does not produce any striking effect on the postural control system; instead, the eyes-open condition causes a decrease in the stochastic activity of the postural control system, which may originate mainly from the stiffness of the musculoskeletal systems. In contrast, the visual input of OKS affected the dynamics of the postural control system in nearly half of the subjects (group 2) despite showing no significant differences between the eyes-open condition and the other conditions for area as the conventional parameter. However, the other half of the subjects (group 1) did not experience any influence of OKS on their postural dynamics, despite showing significant differences between eyes-open and the other conditions for all traditional parameters. From the results for group 2, we hypothesize that OKS may induce the striking effect on dynamics properties of the multilink network system involving visual and vestibular cortex related to self-motion perception, which acts to decrease the stochastic activity in order to correct disturbed posture.

Adult↗

PubMed1998

Effects of hypobaric hypoxia on postural control.

BACKGROUND: While the effects of accelerative forces on the vestibular system have been thoroughly investigated, the effects of hypobaric conditions on the postural system have attracted less attention. The purpose of the study was to investigate if postural control is affected by hypobaric hypoxia. HYPOTHESIS: Moderate hypobaric hypoxia may reduce postural control. METHODS: Subjective and multiple objective measurements of postural control with open and closed eyes were made in 16 military aircrew standing on a static balance platform before, during, and after exposure to an altitude chamber training profile with a maximum altitude of 25,000 ft. RESULTS: No subjective dizziness and no clinical unsteadiness were noted. However, significant changes in body sway were found at the balance platform during hypobaric exposure at 18,000, 14,000 and 8000 ft compared with the baseline registrations. The relative increase in sway movements was greater in the eyes open condition compared with the eyes closed condition, and significant for movements in the anteroposterior plane but not in the lateral plane. Most sway parameters returned to pre-exposure values on return to ground level. CONCLUSIONS: Acute hypobaric hypoxia, corresponding to the tested altitudes, influenced postural control primarily in the anteroposterior plane with eyes open. This is in agreement with other studies showing that vision is the first of the special senses to be altered by lack of oxygen.

Adult↗

PubMed2003

The relationship between postural control and fine manual dexterity.

The influence of the development of postural control of the trunk and center of the body on the development of fine manual dexterity ability is a common assumption. The objectives of this study were: (1) to examine the relationship between the adult version of the Nine-Hole Peg Test and the "children's version" in order to establish construct validity for the latter, and (2) to investigate the relationship between postural control and fine motor performance of children developing typically aged five to six. The study sample included 47 children, 25 males and 22 females, with a mean age of 5 years and 8 months and a standard deviation of 3.8 months. Two tests were administered: (1) The balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP; Bruininks, 1978); and (2) the Nine-Hole Peg Test (NHPT; Kellor, Frost, Silberg Iversen & Cumming, 1971), as well as the "children's version" of rotation and translation tasks (Case-Smith, 1993, 1995). The adult version of the NHPT revealed significant moderate correlations with most of the BOTMP tasks for both hands. Secondary results of the study support the concurrent validity of the two "children's version" tasks. Results show low to moderate correlations between performance on the NHPT subtests and the BOTMP subtest tasks, with significant correlations ranging from -.31 to -.47. Given the negative and low correlations obtained in this study, it is suggested that more extensive longitudinal research examine the relationship between postural control and fine motor manual dexterity performance.

Child, Preschool↗

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↗

PubMed2006

Age-dependent differences in the time course of postural control during sensory perturbations.

BACKGROUND AND AIMS: With research demonstrating that older adults are more likely to sustain a loss of balance than younger adults, the need for an account of age-related differences in postural control is apparent. Several measures of balance reported in the literature have assessed balance using an average or summative measure over the course of a trial, typically lasting several seconds. One limitation related to these measures is the inability to assess the time-course of postural control occurring throughout the trial. To this end, the current investigation assessed the temporal changes in balance both as a function of age and sensory environment. METHODS: Postural control was assessed from 10 older adults (69.3+/-4.7 years) and 10 younger adults (22.1+/-1.7 years) over the course of fifteen seconds in three different sensory environments. The sensory manipulations involved sway-referenced rotation of the floor and/or the visual surround. RESULTS: Significant differences (p=0.001) in overall postural stability were observed between the two groups on all three sensory conditions. Additionally, time-course changes were observed between the two groups when the environment did not cause sensory conflict (sway-referenced floor or room only). However, when the environment created a situation of sensory conflict (sway-referenced floor and room) both groups followed the same time-course of postural changes. CONCLUSIONS: Interestingly, the time course of postural control for the older adults on the easiest condition was mimicked by the younger adults on a more challenging condition. However, when faced with sensory conflict there were no group differences in the time course of postural control. The findings suggest an age-related decline in the temporal control of posture in altered sensory environments.

Accidental Falls↗

PubMedDate not supplied

Physical activity and postural control in the elderly: coupling between visual information and body sway.

BACKGROUND: Aging is characterized by a decline in the postural control performance, which is based on a coherent and stable coupling between sensory information and motor action. Therefore, changes in postural control in elderlies can be related to changes in this coupling. In addition, it has been observed that physical activity seems to improve postural control performance in elderlies. These improvements can be due to changes in the coupling between sensory information and motor action related to postural control. OBJECTIVE: The purpose of this study was to verify the coupling between visual information and body sway in active and sedentary elderlies. METHODS: Sixteen sedentary elderlies (SE), 16 active elderlies (AE) and 16 young adults (YA) were asked to stand upright inside a moving room in two experimental conditions: (1) discrete movement and (2) continuous movement of the room. RESULTS: In the continuous condition, the results showed that the coupling between the movement of the room and body sway was stronger and more stable for SE and AE compared to YA. In the discrete condition, SE showed larger body displacement compared to AE and YA. CONCLUSIONS: SE have more difficulty to discriminate and to integrate sensory information than AE and YA indicating that physical activity may improve sensory integration.

Adult↗

PubMed2005

Effects of immersion in virtual reality on postural control.

In the present study, we examined the effects of the time lag between visual scene and the head movement in the virtual reality (VR) world on motion sickness and postural control in healthy volunteers. After immersion in VR with additional time lags (from 0 to 0.8 s) to the inherent delay (about 250 ms), the visual-vestibular conflict induced a slight motion sickness in experimental subjects, but no change was noticed in the body sway path with eyes open and closed. However, Romberg ratio of body sway path with eyes closed divided by that with eyes open after immersion in VR was significantly decreased in comparison with that before immersion in VR. Since Romberg ratio is an index of visual dependency on postural control, this finding indicates that the immersion in VR decreases the visual dependency on postural control. It is suggested that adaptation to visual-vestibular conflict in VR immersion increases the contribution of vestibular and somatosensory inputs to postural control by ignoring the conflicting delayed visual input in the VR world. VR may be a promising treatment for visual vertigo in vestibular patients with unsuccessful compensation by its ability to induce vestibular and somatosensory reweighing for postural control.

Adult↗

PubMed2005

How attentional focus on body sway affects postural control during quiet standing.

The purpose of this study was to investigate how attentional focus on body sway affects postural control during quiet standing. To address this issue, sixteen young healthy adults were asked to stand upright as immobile as possible on a force platform in both Control and Attention conditions. In the latter condition, participants were instructed to deliberately focus their attention on their body sways and to increase their active intervention into postural control. The critical analysis was focused on elementary motions computed from the centre of pressure (CoP) trajectories: (1) the vertical projection of the centre of gravity (CoG(v)) and (2) the difference between CoP and CoG(v) (CoP-CoG(v)). The former is recognised as an index of performance in this postural task, whilst the latter constitutes a fair expression of the ankle joint stiffness and is linked to the level of neuromuscular activity of the lower limb muscles required for controlling posture. A frequency-domain analysis showed increased amplitudes and frequencies of CoP-CoG(v) motions in the Attention relative to the Control condition, whereas non-significant changes were observed for the CoG(v) motions. Altogether, the present findings suggest that attentional focus on body sway, induced by the instructions, promoted the use of less automatic control process and hampered the efficiency for controlling posture during quiet standing.

Adult↗

PubMed1989

Organization of posture controls: an analysis of sensory and mechanical constraints.

We analyse two components of posture control in standing human subjects: (1) the mechanical properties which constrain the body's ability to execute stabilizing postural movements and (2) the mechanical and neural properties which constrain the ability of the vestibular system to sense changes in body orientation. Rules are then proposed to describe the central organization of posture controls within the sensory and mechanical constraints. The organizational rules and knowledge of constraints are combined to predict the effects of selective semicircular canal and utricular otolith lesions on postural stability and the patterns of body and head movements used to maintain balance. Our analysis leads to the prediction that semicircular canal and otolith deficits destabilize patients at different frequencies, and force them to use different patterns of body and head movements. These predictions are compared to posture controls observed in patients with different types of vestibular deficits. The additional steps required to prove or disprove the theory are discussed.

Humans↗

PubMed1997

Active posture control during experimental motion sickness in guinea-pigs.

This study evaluated active posture control in guinea-pigs under motion sickness stimulation. Twelve guinea-pigs, which received training to stay on a moving perch, were divided into two groups: a motion sickness stimulation group and a control group. The motion sickness group was given a combined stimulation of turntable rotation and optokinetic drum rotation, and the control group was given turntable stimulation alone. Motion sickness was evaluated by conditioned taste aversion to saccharin solution. Active posture control was evaluated by the angle of nose tip displacement and the staying duration (length of time that guinea-pigs stayed on the turntable). The consumption of saccharin solution increased in the control group but did not increase in the motion sickness group. The motion sickness group showed a significant increase in the mean angle of nose tip displacement and a significant decrease in the staying duration on the turntable. These results indicate that active posture control was disturbed by motion sickness stimulation.

Animals↗

PubMed2002

The effect of predictable and unpredictable motor tasks on postural control after traumatic brain injury.

This study examined the effects of environmental predictability on postural control during functional reaching while seated in healthy individuals and patients with traumatic brain injury (TBI). The postural perturbation used required reaching to the left versus reaching to the right, while seated, under predictable versus unpredictable conditions. Indexes of postural control--trajectory stability and response reach times--were measured using an electromechanical system in ten patients with TBI and ten healthy subjects. In the TBI group, greater trajectory stability and shorter response reach time were recorded under unpredictable conditions when reaching to both the right and left (d-index 0.57-2.3). In the control group, greater trajectory stability and shorter response time were recorded under predictable and unpredictable environments compared with the TBI group (d-index 0.46-0.95). This study refutes the hierarchical, predictable-to-unpredictable-environment model of postural control evaluation and treatment. The relationship between information processing demands and postural skill appears more complex than a simple linear association. Predictable and unpredictable conditions may be used concurrently, not sequentially, in TBI rehabilitation.

Adult↗

PubMed1997

Selection of spatial frame of reference and postural control variability.

The present paper addresses the question of the possible links between perceptive visual field dependence-independence and the visual contribution to postural control. In our differential approach, visual field dependent (FD) and independent (FI) subjects were selected on the basis of their score in the Rod and Frame Test (subjective vertical). The hypothesis that we have tested is that the FD subjects use mainly visual cues for estimating not only their subjective vertical but also their body orientation and stability. Moreover, we have postulated that these subjects use mainly dynamic visual cues to control their postural stability. In the postural test, the selected subjects were instructed to stand in the sharpened Romberg position in darkness and under normal or stroboscopic illumination, in front of either a vertical or a tilted frame. Lateral head and body orientation and stability were measured. We found that: (1) all subjects leaned slightly towards the tilted frame (postural frame effect), and this was obtained on the basis of the static visual cues alone; (2) FD subjects were less stable than FI subjects, and their stability required the use of dynamic visual cues, mainly extracted from the vertical frame. In FI subjects, static visual cues may act as a complementary regulation, enhancing stability even with a strobe tilted frame. We thus demonstrate that visual field dependence interacts with the visual contribution to postural control.

Adult↗

PubMed2006

Postural control deficits in participants with functional ankle instability as measured by the balance error scoring system.

OBJECTIVE: To determine if postural control deficits are present in participants with functional ankle instability (FAI) as measured by the Balance Error Scoring System (BESS). DESIGN AND SETTING: We used a between-groups design to assess postural control. All testing was conducted in a university athletic training facility. PARTICIPANTS: Sixty collegiate Division I athletes were included in this study. Thirty participants had functional ankle instability and thirty participants had no history of ankle injuries. MAIN OUTCOME MEASUREMENTS: Postural control was measured using the BESS. The BESS test battery requires participants to stand unsupported on two different surfaces (firm and foam) in three different stances (double, single, and in tandem). Each condition lasted 20 seconds. The number of errors were calculated for each individual condition and then summed to produce a total BESS score. RESULTS: We found a significant group by condition interaction (F5,290 = 5.12, P < 0.001) and significant main effects for group (F1,58 = 16.01, P < 0.001) and condition (F5,290 = 228.88, P < 0.001). Post hoc analyses revealed that subjects with functional ankle instability scored more errors (poorer balance) on the single stancefirm condition (2.9 +/- 2.1 versus 1.6 +/- 1.3 errors), tandem stancefoam condition (4.3 +/- 2.4 versus 2.7 +/- 1.6 errors), single stancefoam condition (7.0+/-1.6 versus 5.6 +/- 1.8 errors), and total BESS score (15.7 +/- 6.0 versus 10.7 +/- 3.2). CONCLUSIONS: Postural control deficits were identified in participants with functional ankle instability using the BESS. These deficits could be a contributing factor to the repeated episodes of instability and giving way that often occurs following an inversion ankle sprain. These results suggest the BESS, traditionally used for monitoring recovery from mild head injury, may also be useful in screening athletes for postural deficits following lower extremity injury.

Adolescent↗

PubMed2001

Serial Testing of Postural Control After Acute Lateral Ankle Sprain.

OBJECTIVE: To identify subjects' changes in postural control during single-leg stance in the 4 weeks after acute lateral ankle sprain. DESIGN AND SETTING: We used a 2 x 2 x 3 (side-by-plane-by-session) within-subjects design with repeated measures on all 3 factors. All tests were performed in a university laboratory. SUBJECTS: Seventeen young adults (9 men, 8 women; age, 21.8 +/- 5.9 years; mass, 74.9 +/- 10.5 kg; height, 176.9 +/- 7.1 cm) who had sustained unilateral acute mild or moderate lateral ankle sprains. MEASUREMENTS: Measures of center-of-pressure excursion length, root mean square velocity of center-of-pressure excursions (VEL), and range of center-of-pressure excursions (RANGE) were calculated separately in the frontal and sagittal planes during 5-second trials of static single-leg stance. RESULTS: We noted significant side-by-plane-by-session interactions for magnitude of center-of-pressure excursions in a given trial (PSL) (P =.004), VEL (P =.011), and RANGE (P =.009). Both PSL and VEL in the frontal plane were greater in the injured limbs compared with the uninjured limbs on day 1 and during week 2 but not during week 4, whereas sagittal-plane differences existed during all 3 testing sessions. Injured-limb, frontal-plane RANGE scores were greater than uninjured values at day 1 but not during weeks 2 or 4. No significant differences in sagittal-plane RANGE scores were seen. CONCLUSIONS: Postural control was significantly impaired in the injured limbs at day 1 and during week 2 after lateral ankle sprain but not during week 4. Consistent improvement in postural control measures on both injured and uninjured limbs was seen throughout the 4 weeks after ankle sprain.

Journal Article↗

PubMed2006

Preoperative postural control of patients with vestibular schwannoma assessed by visual feedback posturography.

BACKGROUND: The need for an objective method to describe the functional postural control of patients with vestibular schwannoma in agreement with their subjective sensation of balance. OBJECTIVES: The objective was to compare the postural control of 49 patients with unilateral vestibular schwannoma (VS) with that of healthy subjects by using visual feedback posturography (VFP). We aimed to find out if preoperative postural control of the patients correlates with their subjective sensation of balance. METHODS: In the VFP, while standing on the platform, patients were instructed to move their center of gravity (COG) marker to the targets as fast and accurately as possible. Hit delay (HD) to the targets, hold percentage (HP) within the targets, COG marker velocity (CMV) to the targets, and balance index (BI) were calculated. We rated intensity of balance disturbance using a 5-point qualitative scale. RESULTS: Twenty-two (45%) patients had at least one abnormal VFP parameter, and 49% of patients were simultaneously symptomatic. Mean hit delay (HD), hold percentage (HP), and balance index (BI) were significantly worsened in patients with VS (p < 0.05). Increased HD and BI correlated significantly with subjective sensation of imbalance (p = 0.02). CONCLUSIONS: The overall deficit in preoperative postural control of the VS patients was not severe, and this finding agreed well with their subjective sensations.

Adult↗

PubMed1991

Postural control in Huntington's disease (HD).

We studied postural control, using quantitative moving-platform posturography, in 20 patients with Huntington's Disease (HD) and in 20 age-matched controls. HD patients showed considerably more anterior-posterior sway than normals, even when a correction for chorea was attempted. This increase in sway was especially true when, by eliminating visual and by attenuating proprioceptive cues, patients were forced to rely primarily on vestibular cues for balance. HD patients also showed increased latencies (30-50 ms) but normal amplitude, in response to translational perturbations of the platform. HD patients showed increased amplitude of responses to rotational perturbations of the platform but a normal decrease in response on successive trials. Thus, patients with HD show a consistent pattern of abnormality on posturography suggesting a role for the basal ganglia in a number of aspects of postural control.

Cognition↗