Postural performance assessment in aging people with diabetes and diabetic peripheral neuropathy using a Wii balance board.

PURPOSE: To determine the effect of sensory perturbations on static postural control in older people with type 2 diabetes mellitus by comparing postural outcomes of people with and without diabetic neuropathy using a Wii Balance Board (WBB). MATERIALS AND METHODS: Static postural balance assessments were performed in 31 participants: nine with type 2 diabetes mellitus; 12 with diabetic neuropathy; and 10 non-diabetic controls. Participants stood on the WBB under sensory perturbations (visual and proprioceptive). Body balance was analysed using centre of pressure ellipse area, mean velocity, and sample entropy. The effects of within-participant factors, sensory perturbations and the between-participants factor 'group' on outcomes were analysed using a multivariate analysis of variance model. RESULTS: Type 2 diabetes mellitus participants with and without neuropathy showed altered postural performance under sensory perturbations compared to non-diabetic participants. Moreover, participants with diabetic neuropathy showed impaired postural performance when one perceptual system was disturbed. Finally, participants with type 2 diabetes mellitus without neuropathy decreased their postural performance when both sensory disturbances were present. CONCLUSIONS: The Wii Balance Board can be a useful alternative for balance impairment screening related to diabetic neuropathy and contribute as an affordable source of insight in early interventions in integral diabetes care.Implications to rehabilitationOlder people with diabetic peripheral neuropathy depend on visual and somatosensory cues to keep their static postural balance.Static balance assessment using the Wii Balance Board allows the identification of alterations in postural performance in participants with diabetes.This low-cost method used can be considered as a complement to integral diabetes care.

Variability in Normalization Methods of Surface Electromyography Signals in Eccentric Hamstring Contraction.

CONTEXT: In human movement analysis, normalization of a surface electromyography signal is a crucial step; therefore, parameter selection for this procedure must be adequately justified. The aim of this research was to determine the variability of electromyography signals in eccentric hamstring contraction under different normalization parameters. DESIGN: Cross-sectional study. METHODS: Nine university rugby players (age 21.50 [3.61] y; body mass index 21.50 [4.95]) and no history of recent hamstring injury. Values from maximum voluntary isometric contraction protocol and task related (ie, Nordic hamstring exercise) were used for surface electromyography signal normalization. Intersubject and intrasubject variation coefficients were used for normalization method variability and for signal reproducibility, respectively. RESULTS: Intrasubject variation coefficient value indicates acceptable reproducibility of surface electromyography (less than 12%) for all normalization procedures. Lower values of intersubject variation coefficient value were achieved for normalization procedures using task-related values. CONCLUSION: Parameters extracted from task execution provided less variability for surface electromyography amplitude normalization in eccentric hamstring muscle contractions.

Inter-rater reliability of scapular dyskinesis classification in overhead athletes by entry-level physical therapy students.

BACKGROUND: Scapular dyskinesis (SD) is a dysfunction associated with shoulder pathologies in overhead athletes and its classification is highly complex, especially in entry-level physical therapy students. OBJECTIVE: This research aimed to determine the effect of a video training method on inter-rater reliability of physical therapy entry-level students with no clinical experience while performing SD ratings under 4-type, severity, and 'yes or no' criteria in overhead athletes. METHODS: A total of 49 overhead athletes were evaluated by video recordings in posterior view of lifting tasks. Two entry-level students without clinical experience performed SD classifications according to previously mentioned criteria on both scapula in two separate sessions, with 1 week of difference. Data analysis was conducted based on the kappa coefficient (k) and its confidence intervals (CI). RESULTS: The 'yes or no' criteria present better results than the 4-type and severity criteria. In addition, a better inter-rater agreement is evidenced in the second measurement compared to the first one. Furthermore, the k coefficients reach values like those achieved by experienced evaluators. CONCLUSION: Video training settings for scapular dyskinesis rating in entry-level physical therapist students with no clinical experience allows better inter-rater reliability values.