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At least 163 records · Page 9Linked to original sources

PubMed2006

Improvements in muscle-tendon properties are beneficial to balance in multiple sclerosis.

A 63-year-old male was diagnosed with multiple sclerosis (MS) two years prior to this investigation. We hypothesized that compromised postural balance in MS can be improved by training-induced alterations in muscle-tendon properties. Sixteen weeks of strength and balance training induced an increase in quadriceps and gastrocnemius muscle size, strength, central activation, muscle recruitment and tendon stiffness. Concomitantly, the ability to maintain postural stances was increased in both eyes-open and eyes-closed conditions. We concluded that improvements in muscle-tendon properties were accompanied by improved balance and a general feeling of well-being after training.

Humans↗

PubMed2005

A mechanism for balancing the human body on the hips.

A mechanism for the postural balance of the human torso over the hip joints is reported that does not appear to have been fully recognised. The centre of gravity of the torso is usually considered poised above the hips. This is in a state of unstable equilibrium. Here, we propose that body weight acting through the sacrum is counter-balanced by tension in the ilio-femoral ligament; the hips acting as the fulcrum. This places the torso in stable equilibrium and means that balance may be maintained with minimal muscular forces. The joint reaction force due to this mechanism in a two-legged stance is then of the order of the body-weight on each hip. An implication is that capsular ligaments are important and consideration should be given to retaining or restoring them as much as possible in hip arthroplasty.

Biomechanical Phenomena↗

PubMed2002

Prognosis of contraversive pushing.

Stroke patients with 'pusher syndrome' actively push away from the non-hemiparetic side leading to a loss of postural balance and falling towards the paralysed side. The behaviour is due to an altered perception of the body's orientation in relation to gravity. Here, we studied the prognosis of the disorder. Twelve pusher patients first investigated immediately after the stroke were re-examined 6 months later. Pusher symptoms had nearly completely recovered. The aim for physiotherapy of patients with contraversive pushing thus is to shorten the period of necessary treatment and enable earlier discharge from residential care.

Adult↗

PubMed1978

Muscle stretch receptor hypersensitization in spasticity. Inapproprioception, Part III.

The author's concept of Inapproprioception, which accounts for athetoid movements in terms of defective proprioceptive feedback (i.e., distortion of afferent signals representing limb position) is extended here to explain spasticity in cerebral palsy was well. Descending activation of gamma efferents supplying hypertonic muscles may be excessive, leading to hypersensitization of stretch receptors in those muscles (the exact distribution of muscles affected varying with the individual). The result is exaggerated reflex activation of alpha motoneurons in response to the slightest muscle stretch. Even passive tension due to gravitational forces, which is inescapable, results in excessive impulse discharge from sensitized stretch afferents and thus leads to reflex contractions simply in response to shifts in body position. The affected muscles shorten to a length corresponding to the elevated level of reflexly originating motoneuron discharge, manifesting excessive tone even in the contracted state. The distribution of hypertonicity thus induced usually follows a predictable pattern and can be modified using slow passive stretch of hypertonic muscles to relax them, followed by facilitated voluntary contraction to strengthen weak antagonists, and progressing to functional reciprocal usage of agonists and antagonists to achieve proper muscle balance. Application of this procedure leads to improved posture, balance and ambulation in subjects with spastic cerebral palsy.

Adolescent↗

PubMed2006

The biomechanics of restricted movement in adult obesity.

In spite of significant advances in the knowledge and understanding of the multi-factorial nature of obesity, many questions regarding the specific consequences of the disease remain unanswered. In particular, there is a relative dearth of information pertaining to the functional limitations imposed by overweight and obesity. The limited number of studies to date have mainly focused on the effect of obesity on the temporospatial characteristics of walking, plantar foot pressures, muscular strength and, to a lesser extent, postural balance. Collectively, these studies have implied that the functional limitations imposed by the additional loading of the locomotor system in obesity result in aberrant mechanics and the potential for musculoskeletal injury. Despite the greater prevalence of musculoskeletal disorders in the obese, there has been surprisingly little empirical investigation pertaining to the biomechanics of activities of daily living or into the mechanical and neuromuscular factors that may predispose the obese to injury. A better appreciation of the implications of increased levels of body adiposity on the movement capabilities of the obese would afford a greater opportunity to provide meaningful support in preventing, treating and managing the condition and its sequelae. Moreover, there is an urgent need to establish the physical consequences of continued repetitive loading of major structures of the body, particularly of the lower limbs in the obese, during the diverse range of activities of daily living.

Activities of Daily Living↗

PubMed1994

Factors associated with falling in elderly hospital patients.

Forty-four patients aged 65 years and over who fell whilst in an acute hospital and 44 patients who did not fall during their hospital stay underwent structured medical examinations to identify factors associated with falling. The control subjects were matched for age (+/- 3 years), sex, patient type, and primary diagnosis. The examination was based on established assessments of posture, balance and gait, the musculoskeletal system, vision, cardiovascular status, and neurological function. Bivariate analyses revealed seven assessment measures that were significantly associated with falls: cognitive impairment, particularly impaired orientation; evidence of previous cerebrovascular accident; incoordination as measured clinically; inability to perform the 'Get-up-and-go' test, especially an inability to turn around after a 5-metre walk, and the use of psycho-active medications. Of these variables, impaired orientation, psycho-active drug use, evidence of stroke, and impaired performance in the 'Get-up-and-go' test were included in a stepwise logistic regression which correctly classified 80% of the patients into faller and non-faller groups. Falling was also related to the number of these identified risk factors. These findings suggest that a simple screening protocol, taking about 5 min to complete, can assist in the identification of patients at risk of falls whilst in hospital.

Accidental Falls↗

PubMed2001

Comparison of unilateral and bilateral intrastriatal 6-hydroxydopamine-induced axon terminal lesions: evidence for interhemispheric functional coupling of the two nigrostriatal pathways.

Partial lesions of the nigrostriatal dopamine system can be induced reliably by the intrastriatal injection of 6-hydroxydopamine (6-OHDA) and are considered to be analogous to the early stages of human Parkinson's disease. Previous studies have established a clear correlation between different doses and placements of the 6-OHDA toxin and the degree of neurodegenerative changes and behavioral impairments. In the present study, the influence of the interdependence between the two nigrostriatal systems in both hemispheres on the effects on sensorimotor behavioral performances after terminal 6-OHDA lesions was investigated. The behavioral effects were correlated to the extent of nigral dopamine neuron cell and striatal tyrosine-hydroxylase (TH)-positive fiber loss. Sprague-Dawley rats receiving unilateral intrastriatal 6-OHDA injections (4 x 5 microg) exhibited a 30-70% reduction in striatal TH-positive fiber density along an anterior-posterior gradient, an 80% loss of nigral dopamine neurons and a mild degree of behavioral impairments as revealed by amphetamine-induced rotational asymmetry, and a reduced performance in the stepping and postural balance tests. When the same amount of toxin was injected twice into both hemispheres (2 x 4 x 5 microg), additional behavioral deficits were observed, consisting of a significant, but temporary, weight loss, a stable reduction in general locomotor activity and explorational behavior, and a long-term deficit in skilled forelimb use. This is interesting in light of the morphological findings, in which uni- and bilaterally lesioned animals did not differ significantly in the extent of TH-immunoreactive fiber and dopamine neuron loss within the nigrostriatal system in each lesioned hemisphere. These results indicate that the interdependent regulation of the two nigrostriatal systems may provide some compensatory support for the function and behavioral performance of the lesioned side via the normal unlesioned side, which is lost in animals with bilateral lesions of the nigrostriatal system. Therefore, this model of uni- and bilateral partial lesions of the nigrostriatal system, as characterized in the present study, may foster further exploration of compensatory functional mechanisms active in the early stages of Parkinson's disease and promote development of novel neuroprotective and restorative strategies.

Adrenergic Agents↗

PubMed2006

Generalizability of center of pressure measures of quiet standing.

Center of pressure (COP) measures are commonly used as indicators of balance and postural control. At present, there are no universally accepted standards in research investigating fluctuations in the COP with regard to the number of trials or the length of a given trial. The purpose of this study was to use the tools of Generalizability Theory (G-Theory) to investigate the reliability of COP measures of quiet standing and to establish an optimal measurement protocol. G-Theory provides a tool that allows us to break down the sources of variation, or facets, in a measurement procedure and ultimately design a protocol that provides optimal reliability. Fifteen participants completed 10 90-s trials with eyes open and closed. COP measures of anterior-posterior standard deviation (SD(AP)), medial-lateral SD (SD(ML)), average velocity (Vel), and 95% confidence ellipse area (Area) were calculated using the first 30, 60, and 90s of each trial. A G-study and follow-up D-studies were performed to estimate reliability coefficients (G-coefficients). The results of the G-Theory analysis suggest that these COP measures reached acceptable levels of reliability (G>or=0.70) with at least five 60s trials.

Adult↗

PubMed2004

The usefulness of computerized dynamic posturography for the study of equilibrium in patients with Meniere's disease: correlation with clinical and audiologic data.

The use of computerized dynamic posturogaphy (CDP) in the evaluation of patients with balance alterations not only allows quantification of the subject's capacity to maintain a stable centre of gravity, but also analysis of the degree to which the subject is able to use different types of sensory information. The present study investigated the possible use of CDP for clinical staging of vestibular diseases, specifically Meniere's disease (MD). We applied CDP sensory organization tests to 75 patients with definitive MD (AAO-HNS 1995 criteria). A total of 98 CDP sessions were included in the analysis, which focused on four CDP parameters specifically related to vestibular function (condition-5 score, condition-6 score, overall balance score, and VEST, a measure of the relative importance of vestibular information for maintenance of balance). We found a statistically significant relationship between audiometric hearing threshold and CDP scores, especially in patients with audiometrically advanced disease. In addition, CDP scores showed statistically significant variation with time elapsed since the last typical vertigo attack, suggesting that patients can be usefully grouped into three MD activity-level categories: recent post-attack (less than 1 week since last vertigo attack), late post-attack (1 week - 60 days since last attack), and inactive MD (more than 60 days since last attack). On the basis of these results, we propose expected ranges for each of the four CDP parameters in each of the three MD activity-level categories, allowing staging in terms of balance and posture. This staging system complements existing staging systems (based on audiometric criteria, and on subjective assessment of the severity of vertigo attacks and their implications for quality of life).

Adult↗

PubMed2003

[A comparative study of the perceptual and motor performance at school age of preterm and full term children].

The objective of this study was to compare the perceptualmotor performance in school age children who were born preterm and full term. Two groups of children, ages 5 to 7, participated in this study. Group I had 35 children, from low-income families, born up to the 34 week of gestation and/or weight bellow 1500 g. Group II had 35 full-term children, matched by age, gender and socioeconomic status to the children in Group I. Children were tested on the Bender gestalt, the motor accuracy test and on balance and postural responses measures. The preterm group obtained significantly lower scores in the majority of the tests. These besides reinforcing the importance of the follow-up of preterm children up to school age, also indicate the need to stimulate the fine motor and postural control Devment, even among preterm children who do not show evidence of neurological impairment.

Child↗

PubMedDate not supplied

Effects of foot orthoses on patients with chronic ankle instability.

Chronic instability of the ankle can be the result of mechanical and functional deficits. An acute ankle sprain can cause mechanical and functional instability, which may or may not respond to standard rehabilitation programs. Chronic instability results when there is persistent joint laxity of the ankle or when one or more components of neuromuscular control of the ankle are compromised. A loss of balance or postural control seems to be the most consistent finding among athletes with chronic instability of the ankle. Recent research in patients with acute and chronic ankle instability has revealed positive effects of foot orthoses on postural control. This article reviews the current research relevant to the use of foot orthoses in patients with chronic ankle instability and clarifies the suggested benefits and the shortcomings of these investigations.

Ankle Joint↗

PubMed2006

Is fall prevention by vitamin D mediated by a change in postural or dynamic balance?

INTRODUCTION: The objectives were:(1) to validate a quantitative balance assessment method for fall risk prediction; (2) to investigate whether the effect of vitamin D and calcium on the risk of falling is mediated through postural or dynamic balance, as assessed by this method. MATERIALS AND METHODS: A secondary analysis of a double blind randomized controlled trial was employed, which included 64 institutionalized elderly women with complete balance assessment (age range: 65-97; mean 25-hydroxyvitamin D levels: 16.4 ng/ml (SD +/-9.9). Participants received 1,200 mg calcium plus 800 IU cholecalciferol (n=33) or 1,200 mg calcium (n=31) per day over a 3-month treatment period. Using an electronic device attached to the lower back of the participant, balance was assessed as the degree of trunk angular displacement and angular velocity during a postural task (standing on two legs, eyes open, for 20 s) and a dynamic task (get up from a standard height chair with arm rests, sit down and then stand up again and remain standing). RESULTS: It was found that both postural and dynamic balance independently and significantly predicted the rate of falling within the 3-month follow-up. Vitamin D plus calcium reduced the rate of falls by 60% [relative risk (RR)=0.40; 95% CI: 0.17, 0.94] if compared with calcium alone. Once postural and dynamic balance were added to the regression analysis, they both attenuated the effect of vitamin D plus calcium on the rate of falls. For postural balance, the RR changed by 22% from 0.40 to 0.62 if angular displacement was added to the model, and by 9% from 0.40 to 0.49 if angular velocity was added. For dynamic balance, it changed by 1% from 0.40 to 0.41 if angular displacement was added, and by 14% from 0.40 to 0.54 if angular velocity was added. DISCUSSION: Thus, balance assessment using trunk angular displacement is a valid method for the prediction of falls in older women. Of the observed 60% reduction in the rate of falls by vitamin D plus calcium supplementation compared with calcium alone, up to 22% of the treatment effect was explained by a change in postural balance and up to 14% by dynamic balance.

Accidental Falls↗

PubMed1996

Long-term effects of antidepressants on balance, equilibrium, and postural reflexes.

To assess the long-term effects of antidepressant medication on balance, equilibrium, and postural reflexes, we studied 30 patients, ages 20-76 years, who had a diagnosis of depressive disorder (as defined by DSM-III-R criteria) and had been treated with tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) for > or = 1 year. They were assessed by a Balance Master System. The assessment included three tasks: static balance, rhythmic weight shift, and limits of stability. When compared with 30 nonhospitalized healthy controls (of comparable age and the same sex), patients who took TCAs showed impaired balance function in all main indices. The results suggest that the impairment of balance function includes motor coordination, fine-motor control, postural reflexes, maintaining equilibrium, and reaction time. No obvious impairment of balance function was observed in patients who took SSRIs.

Adult↗

PubMedDate not supplied

Factors predicting dynamic balance and quality of life in home-dwelling elderly women.

BACKGROUND: Proper balance seems to be a critical factor in terms of fall prevention among the elderly. OBJECTIVE: The purpose of this cross-sectional study was to examine factors that are associated with dynamic balance and health-related quality of life in home-dwelling elderly women. METHODS: One hundred and fifty-three healthy postmenopausal women (mean age: 72 years, height: 159 cm, weight: 72 kg) were examined. General health and physical activity were assessed by a questionnaire. Quality of life was measured using a health-related quality of life questionnaire (Rand 36-Item Health Survey 1.0). Dynamic balance (agility) was tested by a figure-of-eight running test. Static balance (postural sway) was tested on an unstable platform. Maximal isometric strength of the leg extensors was measured with a leg press dynamometer. Dynamic muscle strength of lower limbs was tested by measuring ground reaction forces with a force platform during common daily activities (sit-to-stand and step-on-a-stair tests). RESULTS: Concerning physical activity, 33% of the subjects reported brisk exercise (walking, Nordic walking, cross-country skiing, swimming and aquatic exercises) at least twice a week, and 22% some kind of brisk activity once a week in addition to lighter physical exercise. The remaining 45% did not exercise regularly and were classified as sedentary. The correlations of step-on-a-stair and sit-to-stand ground reaction forces, and leg extensor strength to dynamic balance were from -0.32 to -0.43 (the better the strength, the better the balance). In the regression analysis with backward elimination, step-on-a-stair and sit-to-stand ground reaction forces, and leg extensor strength, age, brisk physical activity, number of diseases and dynamic postural stability explained 42% of the variance in the dynamic balance. Similarly, dynamic balance (figure-of-eight running time), number of diseases and walking more than 3 km per day explained 14% of the variance in the quality of life score. Of these, figure-of-eight running time was the strongest predictor of the quality of life score, explaining 9% of its variance. CONCLUSION: This study emphasizes the concept that in home-dwelling elderly women good muscle strength in lower limbs is crucial for proper body balance and that dynamic balance is an independent predictor of a standardized quality of life estimate. The results provide important and useful information when planning meaningful contents for studies related to fall prevention and quality of life and interventions in elderly women.

Accidental Falls↗

PubMed1997

Postural sway and stepping response among working population: reproducibility, long-term stability, and associations with symptoms of the low back.

OBJECTIVE: To investigate the day-to-day reproducibility and long-term (9 months) stability of variables of postural control, and the associations of these variables with low-back and lower-extremity pain in a working population. DESIGN: Test-retest measurements of 18 healthy subjects. Cross-sectional study of 165 working women and 343 men. BACKGROUND: Sudden loss of postural balance may result in microtraumas of back structures. Therefore workers with decreased postural control may run an increased risk of low-back pain. There are few reports describing the reproducibility of force-plate-based posturography. METHODS: Amplitude and velocity of postural sway were measured with a force-plate in a two-feet stance with eyes open and closed, and in a one-foot stance with eyes open. A stepping response test was developed to measure the dynamic components of balance. RESULTS: The mean differences between the repeated measurements were generally 5-10% and the standard deviations of these differences were up to a quarter or one third of the mean measurement values. Sway velocity showed the best overall reproducibility. Men had a larger sway than women independent of age and anthropometry. The group of non-symptomatic subjects showed wide variation and a slightly lower sway than the groups with low-back or lower-extremity pain. CONCLUSIONS: Postural sway has moderate stability, wide variation, and slight associations with low-back symptoms in a working population.

Journal Article↗

PubMed1999

Postural set for balance control is normal in Alzheimer's but not in Parkinson's disease.

BACKGROUND: It has been suggested that patients with dementia of the Alzheimer type have abnormalities in the basal ganglia, and thus, may have similar sensorimotor problems as patients with basal ganglia degeneration from Parkinson's disease. Whether the similarity extends to balance control is unknown. One distinguishing feature of balance disorder in Parkinson's disease is difficulty with changing postural set in terms of adapting the amplitude of leg muscle activity as a function of support condition. We, therefore, tested whether patients with Alzheimer's disease without extrapyramidal signs would show a similar problem in changing postural set as patients with Parkinson's disease. METHODS: The ability to quickly change postural set was measured by comparing leg muscle activity under two conditions of support (free stance, versus grasping a frame, or sitting) during backward surface translations, during toes up surface rotations, and during voluntary rise to toes. Results were compared among 12 healthy adults, 8 nondemented Parkinson's patients on their usual dose of medication, and 11 Alzheimer patients without extrapyramidal signs. RESULTS: Subjects with Alzheimer's, but not Parkinson's, disease performed similarly to the healthy control subjects. They changed postural set immediately, by suppressing leg muscle activity to low levels when supported. Parkinson subjects did not change postural set immediately. They did not suppress the tibialis anterior in voluntary rise to toes when holding, nor the soleus in perturbed sitting as much as the healthy control and Alzheimer subjects in the first trial. Instead, the Parkinson subjects changed set more slowly, over repeated and consecutive trials in both protocols. The onset latencies of soleus responses to backward surface translations and perturbed sitting, as well as tibialis anterior responses to toes up rotations, were the same for all three groups. CONCLUSION: Alzheimer patients without extrapyramidal signs, unlike nondemented Parkinson's disease patients, have no difficulty in quickly changing postural set in response to altered support conditions. Our results, therefore, do not support the hypothesis that Parkinson's and uncomplicated Alzheimer's diseases share common postural set problems that may contribute to disordered balance control.

Adaptation, Physiological↗

PubMed2000

Balance control and posture differences in the anxious BALB/cByJ mice compared to the non anxious C57BL/6J mice.

A relation between anxiety disorders and balance control dysfunctions has been observed in many studies in humans. A mismatch in the integration of sensory inputs could trigger these disturbances. Very few experimental animal procedures have been designed to study the functional link between anxiety and balance control. A task was therefore developed, challenging the visual, vestibular and somesthesic sensory systems in mice. The test, called the 'rotating beam', gave an accurate assessment of balance control and the posture, using sensitive measures (number of falls and imbalances, position of tail and trunk). Striking differences were observed between the two inbred strains of mice known to have radically different anxiety-related behaviour. The highly anxious strain, BALB/cByJ, performed poorly compared to the non anxious strain, C57BL/6J. Balance control and postural abilities of anxious mice were improved by acute anxiolytic diazepam treatment. Lower behavioural performance level was registered in non anxious mice given anxiogenic beta-CCM treatment. The findings account for a strong relationship between anxiety and balance control in mice. Finally, the highly sensitive procedure proved to be well suited to the study of functional links between anxiety and sensorimotor processes.

Animals↗

PubMed1996

Bilateral vestibulopathy revisited.

Bilateral vestibular failure (BVF) is an often undetected disorder of the peripheral labyrinths or the eighth nerves. Key symptoms are oscillopsia during locomotion or head movements and unsteadiness, particularly in the dark. Diagnosis is made by a bedside test for defective vestibulo-ocular reflex and the absence of nystagmic reaction to both caloric and rotatory pendular testing. Most frequent etiologies include ototoxicity, cerebellar degeneration, meningitis, neuropathies, sequential vestibular neuritis, autoimmune disorders, tumors, and miscellaneous otological diseases. Idiopathic BVF is found in more than twenty percent of the patients. Recovery is possible but mostly incomplete. Somatosensory and visual input largely substitute the vestibular deficit for spatial orientation, postural balance and ocular motor control.

Diagnosis, Differential↗