Comparison of postural control between strabismic and non-strabismic children. / Comparativa del control postural entre niños estrábicos y no estrábicos.

OBJECTIVE: To compare the postural control of children with strabismus versus non-strabismus children. MATERIAL AND METHODS: Cross-sectional cohort study with a total of 171 children, including 73 children with esotropia, 24 with exotropia, and 74 controls. Postural control was determined using a dynamometric platform in a standing position in various conditions: eyes open and eyes closed, near and gaze fixation, and with and without foam pad. The studied variables were the area, the mean speed, and the lengths in the X and Y axis of the centre of pressure displacement. RESULTS: Children with esotropia and exotropia had significantly higher mean values (speed, lengths of X and Y) compared to controls. In the open-eye, far distance fixation, and on foam pad, as well as under exam conditions; with eyes open, without foam pad, and far distance fixation, the exotropia values were higher than those of endotropia and controls. With eyes closed, there were no differences between the 3 groups under the described examination conditions, but their values were worse compared to their respective ones with eyes open. CONCLUSIONS: The children with strabismus had a worse postural control than the non-strabismus ones. All of the them appeared to be more unstable with eyes closed than with eyes open, which demonstrates that vision plays an important relevant role in postural stability in both strabismus and non-strabismus children.

Límites de estabilidad en los distintos patrones posturográficos. Estudio de cohortes / Stability limits in different posturography patterns. Cohort study

Introducción y objetivo: El desarrollo de las plataformas dinamométricas computerizadas ha significado una evolución trascendental en la medición del equilibrio en bipedestación estática. El objetivo principal de nuestro estudio es determinar la relación entre los límites de estabilidad y el tipo de información que utilizan estos pacientes para mantener el equilibrio.Método: Estudio de cohortes retrospectivo de una muestra de 70 pacientes a partir del análisis de los resultados obtenidos en las posturografías dinámicas computerizadas (PDC) realizadas en la Unidad de Otoneurología del Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello del Complejo Asistencial Universitario de Salamanca.Resultados: No hay ningún tipo de déficit en 28 de los 70 pacientes a los que se realizó una PDC. La media de los límites de estabilidad en los pacientes con un valor compuesto patológico es menor que los pacientes con un compuesto normal, siendo esta relación estadísticamente significativa (p<0,05). Los pacientes con mayor afectación de los límites de estabilidad son aquellos que no hacen un buen uso de la información vestibular y visual.Discusión / Conclusiones: Es importante analizar si el paciente usa correctamente la información vestibular para mantener el equilibrio y de no ser así, promover estrategias de rehabilitación para reducir el riesgo de caídas. (AU)

[Rationale, design and methodology of physical attributes identification of the fear of falling syndrome (FISTAC study)]. / Razonamiento, diseño y metodología del estudio de identificación de los atributos físicos del síndrome de temor a caerse en ancianos (FISTAC).

INTRODUCTION: The aim of this study was to identify the physical determining factors of the Fear of Falling Syndrome (FoF) in older adults with a history of falls. METHODS: An observational study was conducted on 183 subjects older than 64 years with a fall in the previous year, with data collected from the geriatrics outpatient clinic of the Complejo Hospitalario Universitario from Albacete, Spain. Sociodemographic and anthropometric data, as well as comorbidity, drugs usually taken, functional status, physical function, frailty, cognitive and affective status were collected. Muscle mass was measured using bioimpedancy meter (BIA), and densitometry (DXA), strength with digital hand-held JAMAR dynamometer and with a Leg-press machine, muscle potency with a T-Force instrument, gait variability with the Gait-Rite instrument, and postural stability with the Neurocom Balance Master posturograph were also determined. An analysis was performed to determine if the FoF is associated with physical impairments adjusted for the study covariates. RESULTS: The study included 140 subjects with FoF, and 43 without it. The mean age was 78.4 years, and 147 were women. Posturography could be measured in 182 participants, DXA in 117, BIA in 165, and muscle potency in 146. FoF was associated with female sex, frailty, depressed mood, social risk, muscle strength and power, physical function, number of drugs used, and orthostatic hypotension in the overall sample. After adjusting for sex, only frailty, depressed mood, and number of drugs remained associated. CONCLUSIONS: Rationale, design, and methods of the FISTAC study are presented.

Caracterización de resultados de posturografía en adolescentes con pérdida auditiva severa a profunda / Characterization of posturography results in adolescents with severe to profound hearing loss

Contexto: Las pérdidas auditivas en adolescentes se acompañan de desórdenes vestibulares desapercibidos que impactan el desarrollo motor e influyen en el aprendizaje. La identificación temprana y el conocimiento sobre la neuromaduración vestibular arroja alternativas para mejorar el rendimiento académico. Objetivos: caracterizar los resultados de la posturografía en adolescentes con pérdida auditiva severa a profunda. Método: estudio cuantitativo, con técnica descriptiva, buscando relaciones entre variables estudiadas. Población: 38 adolescentes con pérdida auditiva neurosensorial severa a profunda, en grupos de 12 ­ 15 y 16 - 19 años. Resultados: los adolescentes mayores presentaron un menor movimiento oscilatorio. Con antecedentes del desarrollo evidenciaron desempeño inferior en la posturografía y mayores dificultades en pensamiento cuantitativo, lenguaje y comunicación. Discusión: Los antecedentes neuromadurativos son importantes para el desarrollo del balance y el equilibrio. No se registraron relaciones directas entre la posturografía con bajo rendimiento académico, sin embargo, fue de utilidad clínica aportando datos del desempeño sensorial, motor y vestibular, para la intervención. Conclusiones: Los resultados sugieren efecto indirecto sobre el rendimiento académico verbal. La integración de los sistemas sensoriomotor, visual, vestibular y cognitivo, es clave para el desarrollo de habilidades de aprendizaje. La maduración es un proceso activo en el paso de la adolescencia a la edad adulta. La relación entre el déficit vestibular y los antecedentes del desarrollo, como nacimiento prematuro o edad de inicio de marcha, amerita identificar factores de riesgo del sistema vestibular en la primera infancia. El entorno socioafectivo, la familia y la convivencia con compañeros son importantes para el desempeño académico.

Context: Hearing loss in adolescents is accompanied by unnoticed vestibular disorders that impact motor development and influence learning. Early identification and knowledge about vestibular neuromaturation provides alternatives to improve academic performance. Objectives: to characterize the results of posturography in adolescents with severe to profound hearing loss. Method: quantitative study, with descriptive technique, searching for relationships between studied variables. Population: 38 adolescents with severe to profound sensorineural hearing loss, in groups of 12 - 15 and 16 - 19 years old. Results: older adolescents presented less oscillatory movement. With a developmental history, they showed lower performance in posturography and greater difficulties in quantitative thinking, language and communication. Discussion: neuromadurative antecedents are important for the development of balance and equilibrium. No direct relationships were recorded between posturography with low academic performance, however, it was clinically useful providing sensory, motor and vestibular performance data, for intervention. Conclusions: The results suggest indirect effect on verbal academic performance. The integration of the sensorimotor, visual, vestibular and cognitive systems is key to the development of learning skills. Maturation is an active process in the transition from adolescence to adulthood. The relationship between vestibular deficit and developmental history, such as premature birth or age of onset of walking, merits identifying risk factors of the vestibular system in early childhood. The socio-affective environment, the family and living with peers are important for academic performance.

Hearing performance as a predictor of postural recovery in cochlear implant users.

OBJECTIVE: This study aimed to evaluate if hearing performance is a predictor of postural control in cochlear implant (CI) users at least six months after surgery. METHODS: Cross-sectional study including (CI) recipients with post-lingual deafness and controls who were divided into the following groups: nine CI users with good hearing performance (G+), five CI users with poor hearing performance (G-), and seven controls (CG). For each patient, computerized dynamic posturography (CDP) tests, a sensory organization test (SOT), and an adaptation test (ADT) were applied as dual task performance, with first test (FT) and re-test (RT) on the same day, including a 40-60min interval between them to evaluate the short-term learning ability on postural recovery strategies. The results of the groups were compared. RESULTS: Comparing the dual task performance on CDP and the weighted average between all test conditions, the G+ group showed better performance on RT in SOT4, SOT5, SOT6, and CS, which was not observed for G- and CG. The G- group had significantly lower levels of short-term learning ability than the other two groups in SOT5 (p=0.021), SOT6 (p=0.025), and CS (p=0.031). CONCLUSION: The CI users with good hearing performance had a higher index of postural recovery when compared to CI users with poor hearing performance.

Efectos posturográficos de la maniobra de Epley en pacientes con vértigo posicional paroxístico del canal posterior / Posturographic effects of the Epley maneuver on patients with benign paroxysmal positional vertigo of the posterior canal

Resumen Introducción: El vértigo posicional paroxístico benigno (VPPB) es la afección periférica más común en las enfermedades otoneurológicas. Con el reposicionamiento de partículas se busca eliminar el vértigo y sus síntomas asociados como lo son el mareo residual y la inestabilidad. Objetivo: Determinar si la maniobra de reposicionamiento de Epley (MRE) produce una modificación significativa del control postural (CP) en aquellos pacientes con VPPB de canal semicircular posterior (VPPB-CSC-P). Material y Método: Se realizó un estudio descriptivo prospectivo en una muestra de 21 pacientes con diagnóstico de VPPB-CSC-P. Comparamos el desplazamiento, la velocidad y el área del centro de presión (CoP) antes y después de la MRE. Resultados: La velocidad y el área de la CoP estudiada por posturografía computarizada muestra una disminución significativa en sus valores después de la MRE, mientras que el desplazamiento de la CoP se mantuvo sin cambios. Conclusión: La MRE ejecutada en pacientes con VPPB-CSC-P produce una modulación en el control de la CoP, demostrada por la disminución de la velocidad y el área de desplazamiento de la CoP. El éxito de la MRE produce modulación del CP.

Abstract Introduction: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral condition in otoneurologic diseases. With the repositioning of particles, the aim is to eliminate vertigo and its associated symptoms, such as residual dizziness and instability. Aim: To determine if the Epley repositioning maneuver (ERM) produces a significant modification of postural control (PC) in those patients with posterior semicircular canal BPPV (BPPV-CSC-P). Material and Method: A prospective descriptive study was carried out in a sample of 21 patients diagnosed with BPPV-CSC-P. We compared the displacement, velocity, and area of the center of pressure (CoP) before and after the Epley repositioning maneuver. Results: The velocity and the area of the CoP studied by computed posturography show a significant decrease in its values after the MRE, while the CoP shift remained unchanged. Conclusion: ERM performed in patients with BPPV-CSC-P produces an improvement in the control of the CoP, demonstrated by the decrease in the speed and the area of movement of the CoP. The success of the MRE produces modulation of the PC.

Postural control at posturography with virtual reality in the intercritical period of vestibular migraine / Controle postural à posturografia com realidade virtual no período intercrítico da migrânea vestibular

Abstract Introduction: Vestibular migraine is a condition that associates headache and vestibular symptoms. Objective: To evaluate body-balance with virtual reality posturography in vestibular migraine. Methods: A total of 26 patients in the intercritical period of vestibular migraine were compared by means of the Balance Rehabilitation UnitMT (Medical/Interacoustics) posturography with 30 controls, paired for age and gender. Results: There was no significant statistical difference (p = 0.121) in the limit of stability area (cm2) between the experimental group and the control group values. There were significant differences (p < 0.05) in the values of sway velocity (cm/s) in nine of ten evaluated sensory conditions and in the pressure center displacement area (cm2) values in eight of those ten sensory conditions in the comparison between the control group and the experimental group. Conclusion: Posturography with virtual reality can identify changes in the sway velocity and the pressure center displacement area, characterizing the inability to maintain postural control with and without visual deprivation in situations of visual conflict and vestibulovisual interaction,in the intercritical period of the vestibular migraine.

Resumo Introdução: A migrânea vestibular é um quadro clínico que associa cefaleia migranosa e sintomas vestibulares. Objetivo: Avaliar o controle postural à posturografia com realidade virtual no período intercrítico da migrânea vestibular. Método: Um total de 26 pacientes com migrânea vestibular no período intercrítico da afecção foram comparados comparados à posturografia do Balance Rehabilitation UnitTM (Medical/Interacoustics) a um grupo controle com 30 indivíduos hígidos pareados por idade e sexo. Resultados: Não houve diferença estatisticamente significante (p = 0,102) entre os valores da área do limite de estabilidade (cm2) entre o grupo experimental e o controle. Houve diferença significante (p < 0,05) nos valores da velocidade de oscilação (cm/s) em nove de dez condições sensoriais avaliadas e nos valores da área de deslocamento do centro de pressão (cm2) em oito destas dez condições sensoriais em comparação entre os grupos controle e experimental. Conclusão: A posturografia com realidade virtual pode identificar alterações da velocidade de oscilação e da área de deslocamento do centro de pressão, o que caracteriza a inabilidade para manter o controle postural com e sem privação da visão, em situações de conflito visual e interação vestibulovisual, no período intercrítico da migrânea vestibular.

Is it possible to shorten examination time in posture control studies?

INTRODUCTION AND OBJECTIVES: The sensory organization test (SOT) is the gold-standard test for the study of postural control with posturographic platforms. Three registers of Conditions 3, 4, 5 and 6 are conducted to find an arithmetic mean of the 3, with the time that this entails. The aim of this study was to determine whether a single record for each SOT condition would give us the same information as the arithmetic mean of the 3 recordings used until now. MATERIALS AND METHODS: 100 healthy individuals who performed a sensory organisation test in the Smart Balance Master(®) Neurocom platform. For the statistical analysis we used the Wilcoxon test for nonparametric variables and dependent t-student for paired samples for parametric variables (P<.05). RESULTS: When comparing the scores on the first record with the average of the 3 records, we found statistically significant differences for the 4 conditions (P<0.05). Comparing the first record to the second record also yielded statistically significant differences in the 4 conditions (P<.05). Upon comparing the second record with the third, however, we found differences in only Condition 5, with the significance being borderline (P=.04). Finally, comparing the average of the first and second record with the average of the 3 records, we also found statistically significant differences for the 4 conditions (P<.05). CONCLUSION: Using only 1 or 2 records from each of the conditions on the SOT does not give us the same information as the arithmetic average of the 3 records used until now.

Análisis de la marcha y el equilibrio mediante el uso de sensores inerciales: estudio prospectivo, longitudinal, no aleatorio / Gait and balance analysis through the use of inertial sensors. Prospective, longitudinal, non-randomized study

Antecedentes: la población mundial envejece de manera acelerada. Una tercera parte de los mayores de 65 años se cae por lo menos una vez al año, y esta prevalencia se incrementan a la mitad cuando se superan los 69 años. Objetivo: establecer la sensibilidad del uso de sensores inerciales para determinar la marcha y las rotaciones del tronco en un grupo de individuos sanos. Materiales: utilizamos tres sensores inerciales de nueve ejes, junto a un mismo número de microcontroladores, los cuales enviaron la información vía bluetooth al ordenador, el procesamiento de los datos fue realizado mediante un programa de análisis desarrollado en MATLAB. Para analizar la sensibilidad de los sensores utilizamos el protocolo de Akram et al.,5 modificado, el cual consta de cinco actividades. Resultados: en nuestro estudio participaron seis voluntarios, con una media de edad de 29 años, con un rango de edad de 25 a 33 años. Los sensores fueron capaces de detectar múltiples variables, entre ellas la elevación máxima y mínima de las piernas, número de pasos, el grado de inclinación del tronco, giro, velocidad y cadencia. Conclusión: los resultados hasta ahora obtenidos son prometedores y consideramos que el uso de múltiples sensores inerciales para valorar la marcha y el equilibrio podrían resultar en una nueva herramienta para el diagnóstico y seguimiento de personas con trastorno de la marcha y equilibrio

Introduction: The world population is aging rapidly. A third of those over 65 years of age falls at least once a year, and this prevalence increases by half when they exceed 69 years. Objective: To determine the sensitivity of the use of inertial sensors to determine the gait and rotations of the trunk in a group of healthy individuals. Materials: We use 3 inertial sensors of 9-axis together with the same number of microcontrollers, that sent the information via bluetooth to the computer, the data processing was carried out through an analysis program developed in MATLAB. To analyze the sensitivity of the sensors we use the protocol of Akram et al,5 modified, which consists of 5 activities. Results: In our study 6 volunteers participated, with an average age of 29 years, with an age range 25 to 33 years. The sensors were able to detect multiple variables, including the maximum and minimum elevation of the legs, number of steps, the degree of inclination of the trunk, rotation, speed and cadence. Conclusion: The results obtained are promising and we believe that the use of multiple inertial sensors to assess gait and balance could result in a new tool for the diagnosis and monitoring of people with gait and balance disorder.

Hearing performance as a predictor of postural recovery in cochlear implant users / Desempenho auditivo como preditor de recuperação postural em usuários de implante coclear

Abstract Objective This study aimed to evaluate if hearing performance is a predictor of postural control in cochlear implant (CI) users at least six months after surgery. Methods Cross-sectional study including (CI) recipients with post-lingual deafness and controls who were divided into the following groups: nine CI users with good hearing performance (G+), five CI users with poor hearing performance (G−), and seven controls (CG). For each patient, computerized dynamic posturography (CDP) tests, a sensory organization test (SOT), and an adaptation test (ADT) were applied as dual task performance, with first test (FT) and re-test (RT) on the same day, including a 40–60 min interval between them to evaluate the short-term learning ability on postural recovery strategies. The results of the groups were compared. Results Comparing the dual task performance on CDP and the weighted average between all test conditions, the G+ group showed better performance on RT in SOT4, SOT5, SOT6, and CS, which was not observed for G− and CG. The G− group had significantly lower levels of short-term learning ability than the other two groups in SOT5 (p = 0.021), SOT6 (p = 0.025), and CS (p = 0.031). Conclusion The CI users with good hearing performance had a higher index of postural recovery when compared to CI users with poor hearing performance.

Resumo Objetivo O presente estudo teve por objetivo avaliar se o desempenho auditivo é preditor de controle postural em usuários de IC pelo menos seis meses após a cirurgia. Método Estudo transversal que consistiu em recipientes de implante coclear (IC) com surdez pós-lingual e controles, que foram divididos nos seguintes grupos: nove usuários de IC com bom desempenho auditivo (G+), cinco usuários de usuários de IC com desempenho auditivo insatisfatório (G-) e sete controles (GC). Aplicamos os testes de posturografia dinâmica computadorizada (PDC), de organização sensitiva (TOS) e de adaptação (TAd) como desempenho de dupla tarefa, primeiro teste (PT) e reteste (RT) no mesmo dia, com intervalo de 40-60 minutos entre testes, com o objetivo de avaliar a capacidade de aprendizado em curto prazo nas estratégias de recuperação postural. Comparamos os resultados dos testes. Resultados Na comparação do desempenho de dupla tarefa no teste PDC e a média ponderal entre todas as condições de teste, o grupo G+ demonstrou melhor desempenho no RT nos TOS4, TOS5, TOS6 e EC, o que não foi observado para os grupos G- e GC. O grupo G- obteve níveis significantemente mais baixos de capacidade de aprendizado em curto prazo vs. outros dois grupos no TOS5 (p = 0,021), TOS6 (p = 0,025) e EC (p = 0,031). Conclusão Usuários de IC com bom desempenho auditivo tiveram índice melhor de recuperação postural, quando comparados com usuários de IC com desempenho auditivo insatisfatório.

Comparação entre testes de equilíbrio de campo e plataforma de força / Comparison between field balance tests and force platform

Vários testes de equilíbrio têm sido utilizados para identificar o controle postural e o risco de quedas em idosos. Entretanto, não se sabe quais testes refletem mais efetivamente a capacidade em manter o equilíbrio. O objetivo deste estudo foi comparar um conjunto de testes de campo de equilíbrio (TC) com os testes de posturografia em plataforma de força (PF) e verificar se esses testes são capazes de discriminar diferenças no equilíbrio entre jovens e idosos. Participaram do estudo 21 jovens (21,7 ± 2,0 anos) e 18 idosos (69,3 ± 7,0 anos) de ambos os gêneros. Os TC foram: escala de equilíbrio de Berg (BBS), escala de equilíbrio orientado pelo desempenho, (POMA), alcance funcional (AF) e levantar e caminhar cronometrado (TUGT). As variáveis analisadas na PF foram: amplitude de deslocamento nas direções anteroposterior (AMP-AP) e médio-lateral (AMP-ML) e trajetória do centro de pressão (TRAJ-CP). Os sujeitos foram avaliados em cinco condições durante 60s cada. Uma ANOVA one-way foi aplicada para determinar diferenças nos testes de equilíbrio entre grupos (jovens x idosos). Além disso, o teste de correlação de Spearman foi aplicado para identificar a associação entre os TC e PF. Os TC foram capazes de diferenciar jovens de idosos (p < 0,05). Os testes na PF também diferenciaram os grupos, exceto na AMP-AP em duas condições. As correlações indicaram que os testes BBS (r = - 0,43 ± 0,04) e TUGT (r = 0,45 ± 0,10) se correlacionaram com maior número de variáveis da PF (p < 0,05) e devem ser preferidos quando a avaliação do equilíbrio for determinada. Outros testes são questionados quanto à sua capacidade de determinar adequadamente o equilíbrio.

Several balance tests have been used to identify postural control and the risk of falls in the elderly. However, it is not known which tests better reflect effectively the ability to maintain balance. The objective of this study was to compare a number of field tests (FT) designed to determine balance with stabilometric tests using force platforms (FP) to determine whether these tests are able to discriminate differences in balance between young and older adults. Twenty-one young (21.7±2.0 years) and 18 older adults (69.3±7.0 years) of both genders volunteered to participate in the study. The field tests were: Berg Balance Scale (BBS), Performance Oriented Mobility Assessment (POMA), Functional Reach (FR) and Timed Up and Go Test (TUGT). The variables analyzed in the FP were: center of pressure displacement in the antero-posterior (AMP-AP) and medio-lateral direction (AMP-ML) and total sway of the center of pressure (TRAJ-CP). The subjects were evaluated in five conditions of 60s each. One-way ANOVA was applied to determine differences in balance tests between groups (young x elderly). In addition, the Spearman correlation test was used to identify the correlation between FT and FP. The FTs were able to discriminate young from elderly (p < 0.05). The FP tests also discriminated groups, except for AMP-AP in two experimental conditions. The correlation coefficients indicated that the tests BBS (r =- 0:43 ± 0.04) and TUGT (r = 0.45 ± 0.10) showed the largest correlation with the FP tests (p < 0.05). Thus, these field tests should be preferred among the other balance tests. The results of the other tests are questionable since they seemed unable to discriminate the balance performance between young and elderly subjects.

Revisão sobre Posturografia Dinâmica: Uma ferramenta para avaliação do equilíbrio de idosos / Review of Dynamic Posturography: A tool for assessing the balance of elderly

O processo do envelhecimento pode levar a importantes alterações no equilíbrio dos indivíduos, em consequência à degeneração dos sistemas visual, auditivo e proprioceptivo. A avaliação da contribuição desses sistemas para o equilíbrio corporal é de grande importância. Diante disso, o presente estudo busca, através de uma revisão, apresentar um instrumento que pode ser usado para avaliação do equilíbrio postural, bem como quantificar a contribuição de cada sistema para o equilíbrio do idoso...

The aging process can lead to major changes in the individuals balance, due to degeneration of the visual, auditory and proprioceptive systems. Assessing these systems is very importance for body balance contribution. Thus, the present study attempts, through a revision, provide an instrument that can be used to evaluate the postural balance and quantify the contribution of each system to the balance in elderly...

Avaliação do controle postural em adultos jovens através da posturografia dinâmica Foam-laser e plataforma de força / Evaluation of the postural control in young adults by use of foam-laser dynamic posturography and power plataform

Uma das tarefas mais importantes do sistema do controle postural humano é a manutenção do equilíbrio do corpo sobre a base de apoio fornecida pelos pés. Como um sensor de gravidade, o sistema vestibular é uma das ferramentas mais importantes do sistema nervoso no controle da postura. Quando há um desequilíbrio neste sistema o indivíduo passa a apresentar um conjunto de sintomas no qual a vertigem geralmente é preponderante. Objetivou-se no presente estudo avaliar e correlacionar o controle postural de adultos jovens através da posturografia dinâmica Foam-Laser (FLP) e plataforma de força. Para a realização do estudo participaram 31 voluntários (19 homens e 11 mulheres) sendo submetidos à avaliação do controle postural através da posturografia dinâmica Foam-Laser e plataforma de força simultaneamente. Para análise dos dados registrados na plataforma de força, utilizou-se o programa MATLAB® 7.4. Os resultados da FLP foram obtidos através da fórmula matemática para cálculos de ângulos de oscilações apresentados. Os resultados revelaram que houve forte correlação entre os valores obtidos nos testes de organização sensorial (SOT) e a área de deslocamento do centro de pressão (CP) registrada pela plataforma de força em todos os SOT. Nos SOT III, V e VI, respectivamente, observou-se forte correlação entre os resultados dos exames da FLP e plataforma de força, com r = -0,78, r = -0,70 e r = -0,80. Conclui-se que a FLP é um método eficaz para avaliação do equilíbrio, e seus resultados demonstraram forte correlação com a área de deslocamento do centro de pressão.

One of the most important tasks of the human postural control system is to keep the body balanced on the base of support provided by the feet. As a gravity sensor, the vestibular system is one of the most important tools of the nervous system in the control of the posture. When there is a malfunction in this system the individual starts to present a group of symptoms in which the vertigo generally is preponderant. The present study had as objective to correlate the results of the postural control evaluation in young peolple obtained through the Dynamic Posturography Foam-laser (FLP) and platform force. For the accomplishment of the study were invited 31 volunteers (19 men and 11 women) that were submitted to the evaluation of the postural control through the Dynamic Posturography Foam-laser and power platform simultaneously. The results reveled that there was strong correlation among the values obteined in the tests of sensorial organization (TOS) and area displacement pressure center (PC) at power platform in all TOS. In TOS III, V e VI respectively, correlation was observed strong enters the results of the examinations in FPL and power platform, with r = - 0,79, r = 0,70 and r = - 0,80. This study concludes that the FLP is a very useful method for evaluation of the balance, and this results show strong correlation with pressure center displacement area.

Revisão sobre posturografia baseada em plataforma de força para avaliação do equilíbrio / Revision of posturography based on force plate for balance evaluation

CONTEXTUALIZAÇÃO: A manutenção do equilíbrio e da orientação corporal em humanos é garantida pelo adequado funcionamento do sistema de controle postural. A investigação desse controle tem despertado interesse em profissionais de diversas áreas, tais como, Fisioterapia, Educação Física, Engenharia, Física, Medicina, Psicologia, entre outras. OBJETIVOS: Revisar os métodos de análise experimental de dados utilizados para investigação do controle postural em seres humanos e demonstrar o cálculo e rotinas de programação das principais medidas utilizadas na avaliação desse controle. CONCLUSÃO: Os procedimentos experimentais e as medidas utilizadas na avaliação do controle postural apresentados nesta revisão poderão auxiliar na padronização da investigação do controle postural.

BACKGROUND: The maintenance of balance and body orientation in humans is guaranteed by the adequate functioning of the postural control system. The investigation of this control has awakened the interest of professionals from several fields such as Physical Therapy, Physical Education, Engineering, Physics, Medicine, Psychology, and others. OBJECTIVES: The purposes of this study are to revise the methods of data analysis used to investigate the postural control in human beings and to demonstrate the computational algorithms of the main measures used in the postural control evaluation. CONCLUSION: The experimental procedures and measures used in postural control evaluation presented in this review can help in the standardization of postural control investigation.

Avaliação da influência do sistema vestibular no equilíbrio de adultos jovens através de posturografia dinâmica foam-laser e plataforma de força de Cascavel-PR / Evaluation of the influence of vestibular system in the young adults balance through dynamic posturografy foam-laser and platform of power

Uma das tarefas mais importantes do sistema do controle postural humano é o equilíbrio do corpo sobre a pequena base de apoio fornecida pelos pés. Como um sensor de gravidade, o sistema vestibular é uma das ferramentas mais importantes do sistema nervoso no controle da postura. O presente estudo teve como objetivo estudar a influencia do sistema vestibular no equilíbrio de adultos jovens, por meio da Posturografia Dinâmica Foam-laser (FLP). Para a realização do estudo, foram convidados 30 voluntários adultos jovens, acadêmicos do curso de educação física da UFSM, que foram submetidos à avaliação do controle postural através de FLP e plataforma de força simultaneamente, durante o Teste de Organização Sensorial (TOS) I e V. Os resultados revelaram que houve moderado e forte índice de correlação entre os valores obtidos nos TOS I e V e a área de deslocamento do centro de pressão (CP) registrada pela plataforma de força. Conclui-se que a FLP é um método muito útil para avaliação do equilíbrio, e seus resultados demonstraram boa correlação com a área de deslocamento do CP.

One of the most important tasks for the human postural control system is to maintain body balance ona small support base provided by the feet. As a gravity sensor, the vestibular system is one of the mostimportant nervous system tools in posture control . The objective of this work was to study the influenceof the vestibular system on the young adults’ balance control through Dynamic Posturografy Foam-laser(FLS). Participated in the study 30 young adults from the UFSM’s physical education undergraduatecourse, who volunteered to go under postural control evaluation through the FLP and platform of power,simultaneously, during the Sensorial Organization Test (TOS) I and V. Results showed that there was a

Effects of sensory stimuli on postural control: a tetraplegic case report

During sessions of physical therapy, a tetraplegic patient with incomplete spinal cord section at C5 level was found to have changes in the posture post intervention. The therapy consisted of tactile stimulation in specific points of his body to generate reflex patterns of muscle activation (Vojta therapy principies). To quantify these postural changes in the subject, the center of pressure displacement in sitting posture was measured. An analysis of the changes observed in postural control through fourteen months of follow-up is presented and discussed in the report bellow.

Durante las sesiones de terapia física, en un paciente tetrapléjico con sección incompleta de la médula espinal a nivel C5, se encontró que hubo cambios en la postura, posterior a la intervención. La terapia consistió en estimulación táctil en puntos específicos del cuerpo para generar patrones reflejos de activación muscular (principios de la terapia Vojta). Para cuantificar estos cambios de postura en el sujeto, se midió el desplazamiento del centro de gravedad en la posición sentada. Un análisis de las variaciones observadas en el control postural, a través de catorce meses de seguimiento, se presentan y discuten en el siguiente informe.

Eficácia da dieta fracionada e restritiva de carboidratos em pacientes portadores de distúrbios do equilíbrio corporal associados a alterações do metabolismo da glicose por meio da posturografia dinâmica computadorizada, disability índex e escala análogo visual / Effectiveness of the glucose restrictive and fractionated diet in patients with corporal imbalance and disorders of glucose metabolism by computerized dynamic posturography, disability index and visual analog scale

O consumo mundial de açúcar triplicou nos últimos 50 anos e a sua ingesta abusiva é responsável pela resistência periférica à insulina, que origina a síndrome metabólica - obesidade, diabetes melito, hipertensão arterial e doenças coronarianas . Motivados pelo elevado número de pacientes que nos procuram com queixas vestibulares associadas aos distúrbios de metabolismo da glicose (DMG) resolvemos avaliar de forma objetiva, a influência dos DMG nas disfunções labirínticas e o efeito da dieta restritiva de carboidratos como forma de tratamento. OBJETIVO: Observar o impacto da dieta fracionada e restritiva de carboidratos na qualidade de vida dos pacientes portadores de distúrbios do equilíbrio corporal e DMG por meio da posturografia dinâmica computadorizada (PDC), do disability index (DI) e da escala análogo-visual (EAV). CASUÍSTICA E METODOLOGIA: Este estudo foi desenhado como um ensaio clínico prospectivo controlado randomizado realizado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A amostra foi constituída de 51 pacientes divididos em dois grupos: Grupo Dieta (GD): indivíduos tratados com comprimidos de placebo e dieta fracionada com restrição de glicose, Grupo Controle (GC): receberam apenas placebo. Os pacientes realizaram PDC, DI e EAV no primeiro e trigésimo dias do estudo. RESULTADOS: A amostra mostrou-se homogêna quando comparados os grupos e observou-se melhora, estatísticamente comprovada nas condições posturográficas avaliadas quando comparados GD e GC. Observou-se ainda melhora clínica do GD na análise da EAV. CONCLUSÃO: A dieta fracionada e restritiva de carboidratos mostrou-se eficaz no tratamento da nossa amostra de pacientes portadores de disfunções vestibulares associadas a DMG.

INTRODUCTION: World sugar consumption has tripled in the last 50 years and its abusive ingestion is responsible for peripheral insulin resistance, which leads to metabolic syndrome - obesity, diabetes mellitus, hypertension and coronary heart disease. Because of the high number of patients with vestibular complaints and with glucose metabolism disorders (GMD) we decided to objectively evaluate the effect of glucose restrictive and fractionated diet as a option of treatment in these patients. OBJECTIVE: To evaluate the impact of the glucose restrictive and fractionated diet on the Computerized Dynamic Posturography (CDP), disability index (DI) and the visual analogue scale (VAS) in patients with balance disorders and disorders of glucose metabolism. SAMPLES AND METHODOLOGY: Randomized controlled trial. Sample of 51 patients divided into two groups: Diet Group (DG) treated with placebo pills and glucose restrictive and fractionated diet and Control Group (CG) with only placebo. The individuals performed CDP, DI and VAS at first and thirtieth days of study. RESULTS: The sample groups were homogeneous before the study. There were significant improvement of DG on CDP conditions 4, 5, 6 and composite score. There was, also, significant improvement of VAS analysis on DG after intervention. CONCLUSION: The glucose restrictive and fractionated diet was effective in the treatment of patients with vestibular dysfunction associated with glucose metabolism disorders...

Integração sensorial, limite de estabilidade corporal e melhora clínica em idosos vestibulopatas submetidos a dois programas de reabitação vestibular / Sensory organization, limits of postural stability and clinical improvement in elderly with vestibulopathy submitted to two vestibular rehabilitation programs

Forma de estudo: Ensaio clínico randomizado cego. Objetivo: Comparar a variação dos limites de estabilidade corporal, integração sensorial e melhora clínica dos pacientes após terapia de Reabilitação Vestibular (RV), segundo dois métodos distintos: a reabilitação vestibular clássica com treinamento global do sistema de equilíbrio (RVC) e a adaptação do Reflexo Vestíbulo-ocular (RVO). Casuística e Método: 39 pacientes, acima de 65 anos, com distúrbio de equilíbrio e indicação de tratamento pela RV foram selecionados e alocados aleatoriamente em dois grupos: Protocolo de Cawthorne e Cooksey modificado (Grupo RVC), e adaptação do RVO (Grupo RVO). Os pacientes foram avaliados antes e após o tratamento pelos protocolos de Integração Sensorial e Limite de Estabilidade da Posturografia Dinâmica Computadorizada (PDC), pela escala clínica Disability Index (DI) e por auto-avaliação fundamentada na porcentagem referida de melhora. Resultados: Dentre os 39 pacientes alocados, completaram adequadamente o estudo 16 indivíduos do Grupo RVC e 16 do Grupo RVO. Os grupos mostraram-se homogêneos quanto à faixa etária, sexo e alterações de equilíbrio observadas. Após o tratamento, ambos os grupos apresentaram variações semelhantes dos parâmetros posturográficos e da escala clínica adotada, bem como da auto-avaliação. Conclusão: Os dois protocolos foram semelhantes quanto a sua eficácia para o restabelecimento do equilíbrio corporal dos pacientes.

Study design: Blind randomized clinical trial. Objective: To compare the variation of the sensory organization, limits of postural stability and clinical improvement in elderly patients after Vestibular Rehabilitation (VR) therapy using two different methods: classical vestibular rehabilitation (CVR) with global training of balance system and adaptation of vestibulo-ocular reflex (VOR). Material and Method: Thirty-nine patients aged over 65 years with balance disorders and indication of VR therapy were selected and randomly allocated into two groups: Cawthorne-Cooksey modified protocol (CVR Group) and adaptation of VOR protocol (VOR Group). Patients were assessed before and after treatment with Sensory Organization Test (SOT) and Limits of Stability (LOS) by Computerized Dynamic Posturography (CDP), using clinical scale Disability Index (DI) and self-assessment based on reported percentage of improvement. Results: The study comprised 16 subjects in the CVR group and 16 in the VOR group who fully complied with the treatment. The groups showed similar age range, gender and balance abnormalities. After treatment, both groups presented similar variations of CDP tests and similar results in the clinical scale and in the self-assessment. Conclusion: Both VR protocols showed similar results in effective expansion of limits of stability, scores of sensory organization test and subjective clinical improvement of patients.