Evaluation of Balance
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
The rationale behind clinical posturography is that it tests postural control as a whole, with the various sensory inputs interacting in physiological ways and mimicking potential real-life challenges to upright balance. This is its strength and its weakness at the same time, the latter because of its lack of topographic specificity. The findings of a meta-analysis of posturography indicates that its overall sensitivity and specificity is of the order of 50%.131 As expected, the diagnostic power was enhanced if patients with CNS lesions were included in the studies surveyed, but this is of little consolation since there are much better ways of diagnosing CNS disease than posturography. It is often said that posturography can be useful for rehabilitation, and indeed posturography has been instrumental in proving the value of vestibular rehabilitation.132,133 However, the daily problem in neuro-otology is the patient who is not objectively unsteady, but still reports off-balance sensations and dizziness. Whether posturography has anything to add to simple questionnaire assessment of symptoms remains an open question.
Organic Chemicals
William J. Rea, Kalpana D. Patel in Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
Thermography was performed on 39 patients (Table 5.17). Head points were rigid in 39 of 39 patients. All patients could not stand on their toes or walk a straight line with their eyes open or closed. Therefore, accomplished posturography examination was performed (balance test—Table 5.19). Heart rate variability was also performed as another autonomic NS test. Table 5.20 shows the changes. N = 52. All patients had neuropsychological consultation. Twelve patients underwent inhaled challenges after depollution in a less polluted environment. Chemical inhalant challenge and intradermal chemical skin test provoking the patient's symptoms and signs. Testing was performed in a controlled less polluted environment and the patients were residing in a less polluted environment. N = 46.
Exercise testing in older adults
R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms in Sport and Exercise Physiology Testing Guidelines: Volume II – Exercise and Clinical Testing, 2022
Balance control can be subdivided into four categories (Table 5.9.2): static steady-state balance (i.e., maintaining a steady position while standing), dynamic steady-state balance (i.e., maintaining a steady position while walking), proactive balance (i.e., anticipation of a predicted postural disturbance, such as leaning or reaching) and reactive balance (i.e., compensation of an unpredicted postural disturbance) (Shumway-Cook and Woollacott, 2007). Balance performance is often viewed as a ‘general ability’, suggesting that the various types of balance are interlinked. Contrary to this view, these components represent very different subsets of our balance repertoire (Kiss et al., 2018). The ideal balance screening measurement should be quick and simple to administer, provide easily interpretable results and be adequately sensitive to reveal emerging deterioration in balance control. Functional assessments of balance are easy to use, do not require expensive equipment, are usually quick to administer and are predictive of falls. However, these assessments are typically subjective, show ceiling and/or floor effects, are somewhat rudimentary and usually lack the ability to capture balance impairment at its early phase. In a laboratory setting, researchers explore postural stability using objective measures of posturography. Advantages of this approach over functional assessments include the avoidance of subjective scoring systems and a greater sensitivity to small changes. However, assessment of quiet stance using posturography lacks ecological validity, often demonstrates substantial inter- and intra-participant variability, requires expensive equipment and may not adequately stress an individual’s postural control system. Thus, this test represents a relatively small subset of our balance repertoire.
Influence of foot position on static and dynamic standing balance in healthy young adults
Published in Hearing, Balance and Communication, 2018
Carmen Krewer, Jeannine Bergmann, Pablo C. Gräfrath, Klaus Jahn
The profound medical and social impact of postural instability has led to a great deal of research in this field and to the development of several clinical and laboratory methods to explore the extent of balance dysfunction [1]. Clinicians have a limited number of tests available to quantify balance. These include seconds standing on one leg, performance on multiple observable tasks, and posturography. The latter has become an important tool for assessing balance in clinical settings [2]. Posturography is a common technique aimed at quantifying the body sway of subjects, mainly in a standing position. The specific characteristic of the body sway, however, is influenced by several factors such as visual, vestibular and proprioceptive input. Influencing also is the type of insoles [3] or shoes [4] the tested person is wearing. Being aware of all influencing factors is important to systematically modify them or to set standards that make measurements more comparable allowing clinicians to build up accurate diagnoses. Several efforts have been made to develop standards for performing posturography, especially for static standing. Recently, the International Society of Posture and Gait Research appointed a specific committee with the task of providing guidelines and standards for posturography in clinical practice [5]. In the framework of the process, the effect of foot position, i.e. the base of support, was also analyzed, but no final conclusion has been found yet [5,6].
Effectiveness and recovery action of a perturbation balance test – a comparison of single-leg and bipedal stances
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Bálint Petró, Judit T Nagy, Rita M Kiss
Besides static posturography, the sudden perturbation test is becoming prevalent (Müller et al. 2004; Petró et al. 2017). Evaluation measures include performance measures such as the balance index (Müller et al. 2004), the time of balancing (Giboin et al. 2015) and Lehr’s damping ratio (Kiss 2011). The directional ratio characterises platform motion trajectory (Petró and Kiss 2017) and thus the recovery action itself. Clinicians opt to perform these tests with participants adopting either a single-leg or a bipedal stance. However, to our knowledge, no study had been carried out to compare the performance and recovery action execution simultaneously between the two stances. Thus, the objective of the present study was to determine whether balance recovery performance levels, as measured by Lehr’s damping ratio, and platform motion trajectory, as characterised by the directional ratio, differ between dominant single-leg and bipedal balance recoveries for the young, healthy population. In essence, our study found that platform trajectories differ while reaching similar performance levels.
Longitudinal effects of evidence-based physical education in Maltese children
Published in Child and Adolescent Obesity, 2021
Amanda Fenech, N. Chockalingam, C. Formosa, A. Gatt
Posturography or balance parameters were included in this study in view of the numerous research linking balance with excess weight and the importance of balance in sports (Cimolin et al. 2020). Statokinesiograms and stabilograms are graphical representations of the center of pressure in the four directions and the center of pressure along time, respectively (Figure 4). Through these, comparisons at baseline and follow-up were made to establish any improvements in core balance. Although the study’s posturography results compare well to the public data set provided by Santos and Duarte (2016) and Kegel et al. (2011), so far there was no study investigating posturography as an outcome measure in association with school-based PA interventions. All posturography parameters, except for RMS AP direction, showed significant improvement in the intervention group, implying that adequate MVPA improves one’s balance creating a stronger core. Moreover, it was noted that weight status had affected some balance parameters, namely centre of pressure mean velocity, range in mediolateral direction, RMS in mediolateral direction and total displacement, significantly indicating the relationship of poor balance with excess body weight. The study’s findings are in agreement with those found by de David and Barbacena (2013).
Related Knowledge Centers
- Balance Disorder
- Central Nervous System
- Force Platform
- NON-Invasive Procedure
- Sensory Nervous System
- Motor System
- Physical Education
- Medical Diagnosis
- Physical Therapy
- Protocol