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1.
Clin Interv Aging ; 19: 745-760, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38736563

RESUMEN

Purpose: The aim of this study is to investigate the effects of a preoperative combined with postoperative moderate-intensity progressive resistance training (PRT) of the operative side in patients with hip osteoarthritis (HOA) who are undergoing total hip arthroplasty (THA). The study seeks to evaluate the impact of this combined intervention on muscle strength, gait, balance, and hip joint function in a controlled, measurable, and objective manner. Additionally, the study aims to compare the outcomes of this combined intervention with those of preoperative or postoperative muscle strength training conducted in isolation. Methods: A total of 90 patients with HOA scheduled for unilateral primary THA were randomly assigned to three groups: Pre group (preoperative PRT), Post group (postoperative PRT), and Pre& Post group (preoperative combined with postoperative PRT) focusing on hip flexion, extension, adduction, and abduction of operated side. Muscle strength, gait parameters, balance, and hip function were assessed at specific time points during a 12-month follow-up period. Results: All three groups showed significant improvements in muscle strength, with the Pre& Post group demonstrating the most pronounced and sustained gains. Gait velocity and cadence were significantly improved in the Pre& Post group at 1-month and 3-month postoperative follow-ups compared to the other groups. Similarly, the Pre& Post group exhibited superior balance performance at 3-month and 12-month postoperative follow-ups. The Harris Hip Score also showed better outcomes in the Pre& Post group at all follow-up intervals. Conclusion: Preoperative combined with postoperative moderate-intensity PRT in HOA patients undergoing THA led to superior improvements in muscle strength, gait, balance, and hip joint function compared to preoperative or postoperative PRT alone. This intervention shows significant promise in optimizing postoperative rehabilitation and enhancing patient outcomes following THA.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Marcha , Fuerza Muscular , Osteoartritis de la Cadera , Equilibrio Postural , Entrenamiento de Fuerza , Humanos , Artroplastia de Reemplazo de Cadera/rehabilitación , Masculino , Femenino , Entrenamiento de Fuerza/métodos , Anciano , Persona de Mediana Edad , Osteoartritis de la Cadera/cirugía , Estudios Prospectivos , Rango del Movimiento Articular , Resultado del Tratamiento , Articulación de la Cadera/cirugía , Periodo Posoperatorio
2.
J Prev Med Hyg ; 65(1): E83-E92, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38706770

RESUMEN

Introduction: Falling is a serious problem for all ages. There are several tests to assess balance. Mini-BESTest and brief-BESTest are balance tests for which there are no normative values for Iranian people. We aimed to provide the normative values of mini-BESTest and brief-BESTest among healthy Iranian adults. Methods: A cross-sectional study was designed. Three hundred healthy adults (150 males and 150 females) in six age groups (18-29, 30-39, 40-49, 50-59, 60-69, +70 years) completed the tests using Persian mini-BESTest and brief-BESTest. Normative values were calculated for age groups. Results: Normative values of mini-BESTest and brief- BESTest decreased significantly with age (from 27 to 21.9 for mini-BESTest and from 22.9 to 15.4 for brief BESTest). There were no significant differences between genders except for females in 30-39 and 40-49 years age groups which scored better on brief-BESTest and mini-BESTest, respectively. Males had significantly scored better in brief- BESTest in 60-69 and ≥ 70 age groups. Conclusions: The normative values of the mini-BESTest and brief-BESTest provided for healthy Iranian adults can help clinicians when assessing subjects with balance dysfunction.


Asunto(s)
Equilibrio Postural , Humanos , Masculino , Femenino , Adulto , Irán , Persona de Mediana Edad , Estudios Transversales , Anciano , Adulto Joven , Adolescente , Valores de Referencia , Accidentes por Caídas/prevención & control , Factores de Edad
3.
PeerJ ; 12: e17313, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38708344

RESUMEN

Background: Humans continuously maintain and adjust posture during gait, standing, and sitting. The difficulty of postural control is reportedly increased during unstable stances, such as unipedal standing and with closed eyes. Although balance is slightly impaired in healthy young adults in such unstable stances, they rarely fall. The brain recognizes the change in sensory inputs and outputs motor commands to the musculoskeletal system. However, such changes in cortical activity associated with the maintenance of balance following periods of instability require further clarified. Methods: In this study, a total of 15 male participants performed two postural control tasks and the center of pressure displacement and electroencephalogram were simultaneously measured. In addition, the correlation between amplitude of center of pressure displacement and power spectral density of electroencephalogram was analyzed. Results: The movement of the center of pressure was larger in unipedal standing than in bipedal standing under both eye open and eye closed conditions. It was also larger under the eye closed condition compared with when the eyes were open in unipedal standing. The amplitude of high-frequency bandwidth (1-3 Hz) of the center of pressure displacement was larger during more difficult postural tasks than during easier ones, suggesting that the continuous maintenance of posture was required. The power spectral densities of the theta activity in the frontal area and the gamma activity in the parietal area were higher during more difficult postural tasks than during easier ones across two postural control tasks, and these correlate with the increase in amplitude of high-frequency bandwidth of the center of pressure displacement. Conclusions: Taken together, specific activation patterns of the neocortex are suggested to be important for the postural maintenance during unstable stances.


Asunto(s)
Electroencefalografía , Equilibrio Postural , Humanos , Equilibrio Postural/fisiología , Masculino , Adulto Joven , Adulto , Postura/fisiología , Corteza Cerebral/fisiología , Posición de Pie
4.
J Pak Med Assoc ; 74(4): 773-777, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38751276

RESUMEN

The purpose of this study was to find the effects of motor imagery on balance and mobility of stroke patients.This was a single-blind randomised controlled trial which included a total of 30 patients. These patients were assigned into two group: experimental (n=15) and control (n=15) by sealed envelope method. Functional Reach Test (FRT), Time Up and Go Test (TUGT), Berg Balance Scale (BBS), and Movement Imagery Questionnaire (MIQ) were used as assessment tools. The overall mean age of the participants was 52.63 ±8.78 years. Between groups analysis showed non-statistically significant difference (p>0.05) in FRT but significant difference in TUGT, BBS, and MIQ-3 (p<0.009) after eight weeks of training. Within group analysis showed statistically significant difference (p<0.05) for all outcome measures. This study concluded that motor imagery is an effective treatment strategy for improving balance and mobility in stroke patients and brings better results as compared to conventional treatments.


Asunto(s)
Imágenes en Psicoterapia , Accidente Cerebrovascular Isquémico , Equilibrio Postural , Rehabilitación de Accidente Cerebrovascular , Humanos , Equilibrio Postural/fisiología , Método Simple Ciego , Rehabilitación de Accidente Cerebrovascular/métodos , Persona de Mediana Edad , Masculino , Femenino , Accidente Cerebrovascular Isquémico/terapia , Accidente Cerebrovascular Isquémico/fisiopatología , Accidente Cerebrovascular Isquémico/rehabilitación , Imágenes en Psicoterapia/métodos , Adulto , Terapia por Ejercicio/métodos
5.
BMC Geriatr ; 24(1): 403, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38714957

RESUMEN

BACKGROUND: Evidence on the effects of plantar intrinsic foot muscle exercise in older adults remains limited. This study aimed to evaluate the effect of an integrated intrinsic foot muscle exercise program with a novel three-dimensional printing foot core training device on balance and body composition in community-dwelling adults aged 60 and above. METHODS: A total of 40 participants aged ≥ 60 years were enrolled in this quasi-experimental, single-group, pretest-posttest design; participants were categorized into two groups, those with balance impairment and those without balance impairment. The participants performed a 4-week integrated intrinsic foot muscle exercise program with a three-dimensional printing foot core training device. The short physical performance battery (SPPB) and timed up and go test were employed to evaluate mobility and balance. A foot pressure distribution analysis was conducted to assess static postural control. The appendicular skeletal muscle mass index and fat mass were measured by a segmental body composition monitor with bioelectrical impedance analysis. The Wilcoxon signed rank test was used to determine the difference before and after the exercise program. RESULTS: Among the 40 enrolled participants (median age, 78.0 years; female, 80.0%; balance-impaired group, 27.5%), the 95% confidence ellipse area of the center of pressure under the eyes-closed condition was significantly decreased (median pretest: 217.3, interquartile range: 238.4; median posttest: 131.7, interquartile range: 199.5; P = 0.001) after the exercise. Female participants without balance impairment demonstrated a significant increase in appendicular skeletal muscle mass index and a decrease in fat mass. Participants in the balance-impaired group exhibited a significant increase in SPPB. CONCLUSIONS: Integrated intrinsic foot muscle exercise with a three-dimensional printing foot core training device may improve balance and body composition in adults aged 60 and above. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05750888 (retrospectively registered 02/03/2023).


Asunto(s)
Composición Corporal , Pie , Vida Independiente , Músculo Esquelético , Equilibrio Postural , Humanos , Femenino , Anciano , Equilibrio Postural/fisiología , Masculino , Composición Corporal/fisiología , Pie/fisiología , Músculo Esquelético/fisiología , Persona de Mediana Edad , Terapia por Ejercicio/métodos , Terapia por Ejercicio/instrumentación , Anciano de 80 o más Años
6.
J Biomech ; 168: 112123, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38696984

RESUMEN

Motorized treadmills have been extensively used in investigating reactive balance control and developing perturbation-based interventions for fall prevention. However, the relationship between perturbation intensity and its outcome has not been quantified. The primary purpose of this study was to quantitatively analyze how the treadmill belt's peak velocity affects the perturbation outcome and other metrics related to the reactive balance in young adults while the total belt displacement is controlled at 0.36 m. Thirty-one healthy young adults were randomly assigned into three groups with different peak belt speeds: low (0.9 m/s), medium (1.2 m/s), and high (1.8 m/s). Protected by a safety harness, participants were exposed to a forward support surface translation while standing at an unexpected timing on an ActiveStep treadmill. The primary (perturbation outcome: fall vs. recovery) and secondary (dynamic stability, hip descent, belt distance at liftoff, and recovery step latency) outcome measures were compared among groups. Results revealed that a higher perturbation intensity is correlated with a greater faller rate (p < 0.001). Compared to the low- and medium-intensity groups, the high-intensity group was less stable (p < 0.001) with a larger hip descent (p < 0.001) and a longer belt distance (p < 0.001) at the recovery step liftoff. The results suggest that the increased perturbation intensity raises the risk of falling with larger instability and poorer reactive performance after a support surface translation-induced perturbation in healthy young adults. The findings could furnish preliminary guidance for us to design and select the optimal perturbation intensity that can maximize the effects of perturbation-based training protocols.


Asunto(s)
Accidentes por Caídas , Equilibrio Postural , Humanos , Equilibrio Postural/fisiología , Accidentes por Caídas/prevención & control , Masculino , Femenino , Adulto , Adulto Joven , Posición de Pie , Fenómenos Biomecánicos , Prueba de Esfuerzo/métodos
7.
J Biomech ; 168: 112122, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38703516

RESUMEN

As the recovery from gait perturbations is coordinatively complex and error-prone, people often adopt anticipatory strategies when the perturbation is expected. These anticipatory strategies act as a first line of defence against potential balance loss. Since age-related changes in the sensory and neuromotor systems could make the recovery from external perturbations more difficult, it is important to understand how older adults implement anticipatory strategies. Therefore, we exposed healthy young (N = 10, 22 ± 1.05 yrs.) and older adults (N = 10, 64.2 ± 6.07 yrs.) to simulated slips on a treadmill with consistent properties and assessed if the reliance on anticipatory control differed between groups. Results showed that for the unperturbed steps in between perturbations, step length decreased and the backward (BW) margin of stability (MOS) increased (i.e., enhanced dynamic stability against backward loss of balance) in the leg that triggered the slip, while step lengths increased and BW MOS decreased in the contralateral leg. This induced step length and BW MOS asymmetry was significantly larger for older adults. When exposed to a series of predictable slips, healthy older adults thus rely more heavily on anticipatory control to proactively accommodate the expected backward loss of balance.


Asunto(s)
Marcha , Equilibrio Postural , Humanos , Masculino , Femenino , Equilibrio Postural/fisiología , Persona de Mediana Edad , Anciano , Marcha/fisiología , Accidentes por Caídas/prevención & control , Adulto , Envejecimiento/fisiología , Anticipación Psicológica/fisiología , Fenómenos Biomecánicos , Adulto Joven , Caminata/fisiología
8.
J Neuroeng Rehabil ; 21(1): 73, 2024 May 05.
Artículo en Inglés | MEDLINE | ID: mdl-38705999

RESUMEN

BACKGROUND: Exoskeletons are increasingly applied during overground gait and balance rehabilitation following neurological impairment, although optimal parameters for specific indications are yet to be established. OBJECTIVE: This systematic review aimed to identify dose and dosage of exoskeleton-based therapy protocols for overground locomotor training in spinal cord injury/disease. METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items Systematic Reviews and Meta-Analyses guidelines. A literature search was performed using the CINAHL Complete, Embase, Emcare Nursing, Medline ALL, and Web of Science databases. Studies in adults with subacute and/or chronic spinal cord injury/disease were included if they reported (1) dose (e.g., single session duration and total number of sessions) and dosage (e.g., frequency of sessions/week and total duration of intervention) parameters, and (2) at least one gait and/or balance outcome measure. RESULTS: Of 2,108 studies identified, after removing duplicates and filtering for inclusion, 19 were selected and dose, dosage and efficacy were abstracted. Data revealed a great heterogeneity in dose, dosage, and indications, with overall recommendation of 60-min sessions delivered 3 times a week, for 9 weeks in 27 sessions. Specific protocols were also identified for functional restoration (60-min, 3 times a week, for 8 weeks/24 sessions) and cardiorespiratory rehabilitation (60-min, 3 times a week, for 12 weeks/36 sessions). CONCLUSION: This review provides evidence-based best practice recommendations for overground exoskeleton training among individuals with spinal cord injury/disease based on individual therapeutic goals - functional restoration or cardiorespiratory rehabilitation. There is a need for structured exoskeleton clinical translation studies based on standardized methods and common therapeutic outcomes.


Asunto(s)
Terapia por Ejercicio , Dispositivo Exoesqueleto , Equilibrio Postural , Traumatismos de la Médula Espinal , Traumatismos de la Médula Espinal/rehabilitación , Humanos , Equilibrio Postural/fisiología , Terapia por Ejercicio/métodos , Terapia por Ejercicio/instrumentación , Marcha/fisiología , Trastornos Neurológicos de la Marcha/rehabilitación , Trastornos Neurológicos de la Marcha/etiología
9.
BMC Pediatr ; 24(1): 295, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38724964

RESUMEN

BACKGROUND: Balance is crucial for physical development in preschool children. Exploring the relationship between different types of balance can help understand early physical development in children. Currently, research is mostly focused on the relationship between different types of balance in the adult population and lacks exploration of the preschool population. The aim of this study explored the relationship between static and dynamic balance in preschool children aged 4 to 5 years. METHODS: A total of 128 preschool children between the ages of 4 to 5 years were selected. The following tests were conducted as they wore inertial sensors detecting their centers of mass (COM): T1, standing with eyes open; T2, standing with eyes closed; T3, standing with eyes open on foam; T4, standing with eyes closed on foam; and T5, walking on the balance beam. Static balance was measured by the angular velocity modulus (ω-T1-ω-T4) of the shaking COM, as well as the pitch angle (θ-T1-θ-T4) and roll angle (φ-T1-φ-T4) indicators in T1-T4 testing. Dynamic balance was measured by the time (t) and angular velocity modulus (ω-T5), as well as the pitch angle (θ-T5) and roll angle (φ-T5) indicators in the T5 test. The Pearson product-moment correlation coefficient was used to test the correlation between static and dynamic balance indicators. RESULTS: There is no correlation between ω-T1-ω-T4 and t (P > 0.05), while ω-T1-ω-T4 and ω-T5 (r = 0.19-0.27, P < 0.05) and ω-T1-ω-T4 and θ-T5, φ-T5 (r = 0.18-0.33, P < 0.05) were weakly correlated. There is no correlation between θ-T1-θ-T4, φ-T1-φ-T4 and t (P > 0.05), while θ-T1-θ-T4, φ-T1-φ-T4, and θ-T5, φ-T5 were weakly correlated (r = 0.01-0.28, P < 0.05). CONCLUSIONS: The relationship between static and dynamic balance in preschool children aged 4-5 years is weak. Static and dynamic balance in children needs to be intervened separately for the development of children.


Asunto(s)
Equilibrio Postural , Humanos , Equilibrio Postural/fisiología , Preescolar , Estudios Transversales , Femenino , Masculino , Desarrollo Infantil/fisiología
10.
J Neuroeng Rehabil ; 21(1): 74, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38724981

RESUMEN

BACKGROUND: Degenerative lumbar spine disease (DLD) is a prevalent condition in middle-aged and elderly individuals. DLD frequently results in pain, muscle weakness, and motor impairment, which affect postural stability and functional performance in daily activities. Simulated skateboarding training could enable patients with DLD to engage in exercise with less pain and focus on single-leg weight-bearing. The purpose of this study was to investigate the effects of virtual reality (VR) skateboarding training on balance and functional performance in patients with DLD. METHODS: Fourteen patients with DLD and 21 age-matched healthy individuals completed a 6-week program of VR skateboarding training. The motion capture and force platform systems were synchronized to collect data during a single-leg stance test (SLST). Musculoskeletal simulation was utilized to calculate muscle force based on the data. Four functional performance tests were conducted to evaluate the improvement after the training. A Visual Analogue Scale (VAS) was also employed for pain assessment. RESULTS: After the training, pain intensity significantly decreased in patients with DLD (p = 0.024). Before the training, patients with DLD took longer than healthy individuals on the five times sit-to-stand test (p = 0.024). After the training, no significant between-group differences were observed in any of the functional performance tests (p > 0.05). In balance, patients with DLD were similar to healthy individuals after the training, except that the mean frequency (p = 0.014) was higher. Patients with DLD initially had higher biceps femoris force demands (p = 0.028) but shifted to increased gluteus maximus demand after the training (p = 0.037). Gluteus medius strength significantly improved in patients with DLD (p = 0.039), while healthy individuals showed consistent muscle force (p > 0.05). CONCLUSION: This is the first study to apply the novel VR skateboarding training to patients with DLD. VR skateboarding training enabled patients with DLD to achieve the training effects in a posture that relieves lumbar spine pressure. The results also emphasized the significant benefits to patients with DLD, such as reduced pain, enhanced balance, and improved muscle performance.


Asunto(s)
Vértebras Lumbares , Equilibrio Postural , Realidad Virtual , Humanos , Equilibrio Postural/fisiología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Rendimiento Físico Funcional , Terapia por Ejercicio/métodos , Enfermedades de la Columna Vertebral/rehabilitación , Enfermedades de la Columna Vertebral/fisiopatología
11.
PeerJ ; 12: e17256, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38699182

RESUMEN

Background: Humans have a remarkable capability to maintain balance while walking. There is, however, a lack of publicly available research data on reactive responses to destabilizing perturbations during gait. Methods: Here, we share a comprehensive dataset collected from 10 participants who experienced random perturbations while walking on an instrumented treadmill. Each participant performed six 5-min walking trials at a rate of 1.2 m/s, during which rapid belt speed perturbations could occur during the participant's stance phase. Each gait cycle had a 17% probability of being perturbed. The perturbations consisted of an increase of belt speed by 0.75 m/s, delivered with equal probability at 10%, 20%, 30%, 40%, 50%, 60%, 70%, or 80% of the stance phase. Data were recorded using motion capture with 25 markers, eight inertial measurement units (IMUs), and electromyography (EMG) from the tibialis anterior (TA), soleus (SOL), lateral gastrocnemius (LG), rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and gluteus maximus (GM). The full protocol is described in detail. Results: We provide marker trajectories, force plate data, EMG data, and belt speed information for all trials and participants. IMU data is provided for most participants. This data can be useful for identifying neural feedback control in human gait, biologically inspired control systems for robots, and the development of clinical applications.


Asunto(s)
Electromiografía , Marcha , Caminata , Humanos , Fenómenos Biomecánicos/fisiología , Caminata/fisiología , Masculino , Adulto , Femenino , Marcha/fisiología , Equilibrio Postural/fisiología , Músculo Esquelético/fisiología , Adulto Joven , Prueba de Esfuerzo/métodos
12.
Eur Rev Med Pharmacol Sci ; 28(8): 3154-3164, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38708474

RESUMEN

OBJECTIVE: Previous studies' results on the impact of preoperative balance training on postoperative functional recovery after total knee arthroplasty (TKA) appeared to be ambiguous. Thus, this systematic review and meta-analysis were performed to investigate the effects of preoperative balance training on walking ability, balance-specific performance, and other functional indicators in elderly patients post-TKA. MATERIALS AND METHODS: Patient data were obtained from databases including PubMed, Physiotherapy Evidence Database (PEDro), CINAHL, SPORTDiscus, and Scopus. The inclusion criteria followed the Population-Intervention-Comparison-Outcome (PICO) principle. The assessment process involved meticulous screening, judicious data extraction, and rigorous evaluation of trial method quality, conducted by two independent researchers. Based on standardized mean differences and 95% confidence intervals, meta-analysis was performed employing a random-effects model or fixed-effects model. RESULTS: Preoperative balance training appears to be a potentially effective intervention for enhancing the knee osteoarthritis (KOA) patients' knee joint function (RR = 1.16, 95% CI: -2.58, 4.91), isometric knee flexion (RR = 2.49, 95% CI: -2.53, 7.50), knee extension (RR = -0.13, 95% CI: -0.45, 0.18), knee society score (KSS) (RR = 2.18, 95% CI: -1.51, 5.88), stair test (RR = -0.73, 95% CI: -1.84, 0.37), and timed up and go (RR = -1.18, 95% CI: -1.60, -0.76). CONCLUSIONS: Compared to interventions with less emphasis on balance training, rehabilitation programs highly emphasizing balance training significantly enhance the walking ability, balance specificity, and functional indicators of elderly patients post-TKA. This includes rehabilitation programs for senior TKA patients, with a focus on activities meant to improve the sensory system, balance in particular.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Equilibrio Postural , Recuperación de la Función , Humanos , Artroplastia de Reemplazo de Rodilla/rehabilitación , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/rehabilitación
13.
Sci Rep ; 14(1): 10518, 2024 05 08.
Artículo en Inglés | MEDLINE | ID: mdl-38714827

RESUMEN

Previous work assessing the effect of additive noise on the postural control system has found a positive effect of additive white noise on postural dynamics. This study covers two separate experiments that were run sequentially to better understand how the structure of the additive noise signal affects postural dynamics, while also furthering our knowledge of how the intensity of auditory stimulation of noise may elicit this phenomenon. Across the two experiments, we introduced three auditory noise stimulations of varying structure (white, pink, and brown noise). Experiment 1 presented the stimuli at 35 dB while Experiment 2 was presented at 75 dB. Our findings demonstrate a decrease in variability of the postural control system regardless of the structure of the noise signal presented, but only for high intensity auditory stimulation.


Asunto(s)
Estimulación Acústica , Ruido , Humanos , Femenino , Masculino , Adulto , Adulto Joven , Equilibrio Postural/fisiología , Color , Postura/fisiología , Posición de Pie
14.
Sci Rep ; 14(1): 10465, 2024 05 07.
Artículo en Inglés | MEDLINE | ID: mdl-38714823

RESUMEN

Balance impairment is associated gait dysfunction with several quantitative spatiotemporal gait parameters in patients with stroke. However, the link between balance impairments and joint kinematics during walking remains unclear. Clinical assessments and gait measurements using motion analysis system was conducted in 44 stroke patients. This study utilised principal component analysis to identify key joint kinematics characteristics of patients with stroke during walking using average joint angles of pelvis and bilateral lower limbs in every gait-cycle percentile related to balance impairments. Reconstructed kinematics showed the differences in joint kinematics in both paretic and nonparetic lower limbs that can be distinguished by balance impairment, particularly in the sagittal planes during swing phase. The impaired balance group exhibited greater joint variability in both the paretic and nonparetic limbs in the sagittal plane during entire gait phase and during terminal swing phase respectively compared with those with high balance scores. This study provides a more comprehensive understanding of stroke hemiparesis gait patterns and suggests considering both nonparetic and paretic limb function, as well as bilateral coordination in clinical practice. Principal component analysis can be a useful assessment tool to distinguish differences in balance impairment and dynamic symmetry during gait in patients with stroke.


Asunto(s)
Marcha , Equilibrio Postural , Análisis de Componente Principal , Accidente Cerebrovascular , Caminata , Humanos , Masculino , Femenino , Equilibrio Postural/fisiología , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/complicaciones , Persona de Mediana Edad , Caminata/fisiología , Anciano , Fenómenos Biomecánicos , Marcha/fisiología , Trastornos Neurológicos de la Marcha/fisiopatología , Trastornos Neurológicos de la Marcha/diagnóstico , Trastornos Neurológicos de la Marcha/etiología , Adulto
15.
Environ Health Perspect ; 132(5): 57010, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38780454

RESUMEN

BACKGROUND: Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance. OBJECTIVES: This study investigated the associations between childhood and adolescent Mn biomarkers and adolescent postural balance in participants from the longitudinal Marietta Communities Actively Researching Exposures Study (CARES) cohort. METHODS: Participants were recruited into CARES when they were 7-9 y old, and reenrolled at 13-18 years of age. At both time points, participants provided samples of blood, hair, and toenails that were analyzed for blood Mn and lead (Pb), serum cotinine, hair Mn, and toenail Mn. In adolescence, participants completed a postural balance assessment. Greater sway indicates postural instability (harmful effect), whereas lesser sway indicates postural stability (beneficial effect). Multivariable linear regression models were conducted to investigate the associations between childhood and adolescent Mn biomarkers and adolescent postural balance adjusted for age, sex, height-weight ratio, parent/caregiver intelligence quotient, socioeconomic status, blood Pb, and serum cotinine. RESULTS: CARES participants who completed the adolescent postural balance assessment (n=123) were 98% White and 54% female and had a mean age of 16 y (range: 13-18 y). In both childhood and adolescence, higher Mn biomarker concentrations were significantly associated with greater adolescent sway measures. Supplemental analyses revealed sex-specific associations; higher childhood Mn biomarker concentrations were significantly associated with greater sway in females compared with males. DISCUSSION: This study found childhood and adolescent Mn biomarkers were associated with subclinical neuromotor effects in adolescence. This study demonstrates postural balance as a sensitive measure to assess the association between Mn biomarkers and neuromotor function. https://doi.org/10.1289/EHP13381.


Asunto(s)
Biomarcadores , Cabello , Manganeso , Uñas , Equilibrio Postural , Humanos , Adolescente , Biomarcadores/sangre , Manganeso/sangre , Manganeso/análisis , Femenino , Masculino , Niño , Equilibrio Postural/fisiología , Cabello/química , Uñas/química , Estudios de Cohortes , Exposición a Riesgos Ambientales/estadística & datos numéricos , Plomo/sangre , Estudios Longitudinales , Cotinina/sangre , Contaminantes Ambientales/sangre
16.
Sci Rep ; 14(1): 11757, 2024 05 23.
Artículo en Inglés | MEDLINE | ID: mdl-38783000

RESUMEN

Chronic imbalance is a frequent and limiting symptom of patients with chronic unilateral and bilateral vestibulopathy. A full-body kinematic analysis of the movement of patients with vestibulopathy would provide a better understanding of the impact of the pathology on dynamic tasks such as walking. Therefore, this study aimed to investigate the global body movement during walking, its variability (assessed with the GaitSD), and the strategies to stabilise the head (assessed with the head Anchoring Index). The full-body motion capture data of 10 patients with bilateral vestibulopathy (BV), 10 patients with unilateral vestibulopathy (UV), and 10 healthy subjects (HS) walking at several speeds (slow, comfortable, and fast) were analysed in this prospective cohort study. We observed only a few significant differences between groups in parts of the gait cycle (shoulder abduction-adduction, pelvis rotation, and hip flexion-extension) during the analysis of kinematic curves. Only BV patients had significantly higher gait variability (GaitSD) for all three walking speeds. Head stabilisation strategies depended on the plan of motion and walking speed condition, but BV and UV patients tended to stabilise their head in relation to the trunk and HS tended to stabilise their head in space. These results suggest that GaitSD could be a relevant biomarker of chronic instability in BV and that the head Anchoring Index tends to confirm clinical observations of abnormal head-trunk dynamics in patients with vestibulopathy while walking.


Asunto(s)
Vestibulopatía Bilateral , Marcha , Cabeza , Caminata , Humanos , Masculino , Fenómenos Biomecánicos , Femenino , Persona de Mediana Edad , Caminata/fisiología , Cabeza/fisiopatología , Vestibulopatía Bilateral/fisiopatología , Marcha/fisiología , Adulto , Estudios Prospectivos , Anciano , Equilibrio Postural/fisiología , Enfermedad Crónica
17.
Sci Rep ; 14(1): 11817, 2024 05 23.
Artículo en Inglés | MEDLINE | ID: mdl-38783047

RESUMEN

We assessed lifespan development of multitasking in a sample of 187 individuals aged 8-82 years. Participants performed a visuo-spatial working memory (VSWM) task together with either postural control or reaction time (RT) tasks. Using criterion-referenced testing we individually adjusted difficulty levels for the VSWM task to control for single-task differences. Age-differences in single-task performances followed U-shaped patterns with young adults outperforming children and older adults. Multitasking manipulations yielded robust performance decrements in VSWM, postural control and RT tasks. Presumably due to our adjustment of VSWM challenges, costs in this task were small and similar across age groups suggesting that age-differential costs found in earlier studies largely reflected differences already present during single-task performance. Age-differences in multitasking costs for concurrent tasks depended on specific combinations. For VSWM and RT task combinations increases in RT were the smallest for children but pronounced in adults highlighting the role of cognitive control processes. Stabilogram diffusion analysis of postural control demonstrated that long-term control mechanisms were affected by concurrent VSWM demands. This interference was pronounced in older adults supporting concepts of compensation or increased cognitive involvement in sensorimotor processes at older age. Our study demonstrates how a lifespan approach can delineate the explanatory scope of models of human multitasking.


Asunto(s)
Memoria a Corto Plazo , Tiempo de Reacción , Humanos , Anciano , Adulto , Adolescente , Niño , Femenino , Masculino , Anciano de 80 o más Años , Tiempo de Reacción/fisiología , Persona de Mediana Edad , Adulto Joven , Memoria a Corto Plazo/fisiología , Equilibrio Postural/fisiología , Desempeño Psicomotor/fisiología , Comportamiento Multifuncional/fisiología , Análisis y Desempeño de Tareas , Envejecimiento/fisiología , Longevidad/fisiología , Cognición/fisiología
18.
Brain Behav ; 14(5): e3542, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38783598

RESUMEN

INTRODUCTION: A previous study has shown an association between executive dysfunction (ED) and balance function in patients with stroke. However, it is unclear what factors mediate the association between ED and balance function. Therefore, the aim of this study was to investigate the association between ED and balance function and to identify mediating factors using mediation analysis. METHODS: This study had a cross-sectional design. The study included 107 patients with stroke. This study was divided into two groups (ED and non-ED) using trail making test (TMT) part B. Two groups were compared for balance function (timed up and go test [TUGT] and Berg balance scale [BBS]) and other variables using paired test. In addition, partial correlation analysis with age, cognitive function as a control factor, and mediation analysis were also performed. RESULTS: The ED group (N = 55) had significantly lower TUGT and BBS scores than the non-ED group (N = 52). TMT part B correlated with TUGT (ρ = 0.41), BBS (ρ = -0.33), and Brunnstrom recovery stage (BRS) lower limb (ρ = -0.22). The TUGT model of mediation analysis showed a significant indirect effect as a result of mediation of the BRS lower limb between TMT part B and TUGT. The BBS model showed a significant indirect effect as a result of mediation of the activities of daily living (ADL) motor function between TMT part B and BBS. CONCLUSIONS: ED and balance function were associated, and the degree of paralysis and ADL motor function were associated with them in patients with stroke.


Asunto(s)
Función Ejecutiva , Equilibrio Postural , Accidente Cerebrovascular , Humanos , Equilibrio Postural/fisiología , Masculino , Femenino , Función Ejecutiva/fisiología , Estudios Transversales , Persona de Mediana Edad , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/complicaciones , Anciano , Análisis de Mediación
19.
BMC Neurol ; 24(1): 161, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38745275

RESUMEN

INTRODUCTION: Postural balance impairment can affect the quality of life of patients with Parkinson's disease. Previous studies have described connections of the vestibular system with postural functions, suggesting a potential participation of the basal ganglia in receiving vestibular stimuli. This systematic review aims to summarize the evidence on the effectiveness of vestibular rehabilitation on postural balance in patients with Parkinson's disease. METHODS: A systematic review was conducted using the electronic databases: PubMed, Embase, Scopus and PEDro. The study selection was independently conducted by two reviewers, and disagreements were evaluated by a third reviewer. The included studies had no restrictions on publication dates or languages and the last update occurred in July 2023. RESULTS: From the 485 studies found in the searches, only 3 studies were deemed eligible for the systematic review involving a total of 130 participants. The Berg Balance Scale was described as the tool for evaluation of postural balance in all studies. The meta-analysis showed statistically significant results in favor of vestibular rehabilitation (MD = 5.35; 95% CI = 2.39, 8.31; P < 0.001), regardless of the stage of Parkinson's disease. Although the effect size was suggested as a useful functional gain, the analysis was done with caution, as it only included 3 randomized controlled trials. The risk of bias using the RoB-2 was considered as being of "some concern" in all studies. Furthermore, the quality of the evidence based on the Grading of Recommendations Assessment Development and Evaluation system, produced by pooling the included studies was considered very low. CONCLUSION: Compared to other interventions, vestibular rehabilitation has potential to assist the postural balance of patients with Parkinson's disease. However, the very low quality of the evidence demonstrates uncertainty about the impact of this clinical practice. More robust studies are needed to confirm the benefits of this therapy in patients with Parkinson's disease. This study was prospectively registered in PROSPERO: CRD42020210185.


Asunto(s)
Enfermedad de Parkinson , Equilibrio Postural , Ensayos Clínicos Controlados Aleatorios como Asunto , Equilibrio Postural/fisiología , Humanos , Enfermedad de Parkinson/rehabilitación , Enfermedad de Parkinson/fisiopatología , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Enfermedades Vestibulares/rehabilitación , Enfermedades Vestibulares/fisiopatología , Resultado del Tratamiento , Vestíbulo del Laberinto/fisiopatología , Rehabilitación Neurológica/métodos
20.
Clinics (Sao Paulo) ; 79: 100382, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38759438

RESUMEN

INTRODUCTION: An accurate assessment of balance problems is critical for decreasing the risk of falling in patients with Parkinson's Disease (PD). Reliable diagnostic tools such as Computerized Dynamic Posturography (CDP) are not feasible for the clinical setting. Therefore, the present study's aim was to assess the correlation between the clinical Balance Evaluation Systems Test (BESTest) and CDP. METHODS: 20 male older adults with Parkinson's Disease (PD) were included in this study. Participants first executed the Sit-To-Stand (STS), Step/Quick turn (SQT), and Step Up and Over (SUO) tests on a Balance Master® force platform, followed by a clinical balance evaluation using the BESTest. RESULTS: Four outcomes of the CDP were negatively correlated with one or more BESTest domains or total BESTest score: STS sway velocity was negatively correlated with the anticipatory postural adjustment (p = 0.02) and sensory orientation (p = 0.01) domains. SQT turn time was negatively correlated with biomechanical restriction (for turns to the left, p = 0.01, and right, p = 0.03, respectively), postural response (p = 0.01, p = 0.01), dynamic balance during gait (p = 0.007, p = 0.001), and total score (p = 0.02, p = 0.01). Step over time to the right in SUP was negatively correlated with the limits of the stability domain (p = 0.002) and total BESTest score (p = 0.020). SUO impact index was negatively correlated with the anticipatory postural adjustment domain (p = 0.01). CONCLUSION: This study shows that several BESTest domains are significantly correlated with CDP outcomes, demonstrating that the BESTest can be used as a more clinically feasible alternative for computerized posturography, without loss of information.


Asunto(s)
Enfermedad de Parkinson , Equilibrio Postural , Humanos , Equilibrio Postural/fisiología , Masculino , Enfermedad de Parkinson/fisiopatología , Anciano , Persona de Mediana Edad , Accidentes por Caídas/prevención & control , Valores de Referencia , Estadísticas no Paramétricas
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