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1.
Rev. bras. med. esporte ; 28(6): 723-725, Nov.-Dec. 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1376769

RESUMO

ABSTRACT Introduction Surfing depends mainly on the driving force resulting from wave oscillations. Athletes need to paddle in the wave zone and complete the competition actions in the most robust section on the wave walls. This requires extreme balance skills, which can be strengthened with specific training. Among them, it is believed that core training could be beneficial. Objective To study the influence of training on a stable and unstable platform on the regulation of the surfer's orthostatic posture under balance disturbance. Methods Members of the Hainan National Surf Training Team were volunteers for the experiment; their physical training methods, memory training, and effects evaluation were analyzed. Results 90% of athletes manage to complete the balance control in a short-term autonomous position on the balance board in 1 week; their progress also depends on the training duration, times, and intervals; the progression rule lies according to the literary theory of sports training. Conclusion With the further extension of the balance board training cycle, it is believed that athletes' ability to control balance and real competition comprehensive capabilities will continue to increase, the overall technical level and stability of their performance will be even greater. Evidence level II; Therapeutic Studies - Investigating the results.


RESUMO Introdução O surfe depende principalmente da força motriz resultante das oscilações nas ondas. Os atletas precisam remar na zona de ondas e completar as ações da competição na seção mais forte nas paredes das ondas. Isso exige extrema habilidade de equilíbrio, que pode ser fortalecida com treinos específicos. Dentre eles, acredita-se que o treino de core poderia ser benéfico. Objetivo Estudar a influência do treino em plataforma estável e instável na regulação da postura ortostática do surfista sob perturbação do equilíbrio. Métodos Membros da Equipe Nacional de Treinamento de Surf de Hainan foram voluntários do experimento, foram analisados os seus métodos de treino físico, treino de memória e avaliação dos efeitos. Resultados 90% dos atletas conseguem completar o controle de equilíbrio em uma posição autônoma de curto prazo na prancha de equilíbrio em 1 semana, a velocidade de seu progresso também depende da duração do treino, tempos e intervalos, a regra da progressão encontra-se de acordo com a teoria literária do treino esportivo. Conclusão Com a extensão adicional do ciclo de treino da prancha de equilíbrio, acredita-se que a capacidade dos atletas no controle do equilíbrio e capacidades abrangentes de competição reais continuarão a aumentar, o nível técnico geral e a estabilidade de seu desempenho serão ainda mais aprimorados. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.


RESUMEN Introducción El surf depende principalmente de la fuerza motriz resultante de las oscilaciones de las olas. Los deportistas necesitan remar en la zona de la ola y completar las acciones de la competición en la sección más robusta de las paredes de la ola. Para ello, es necesario contar con habilidades de equilibrio extremas, que pueden reforzarse con un entrenamiento específico. Entre ellas, se cree que el entrenamiento del núcleo podría ser beneficioso. Objetivo Estudiar la influencia del entrenamiento en una plataforma estable e inestable sobre la regulación de la postura ortostática del surfista bajo una perturbación del equilibrio. Métodos Los miembros del Equipo Nacional de Entrenamiento de Surf de Hainan fueron voluntarios para el experimento; se analizaron sus métodos de entrenamiento físico, el entrenamiento de la memoria y la evaluación de los efectos. Resultados El 90% de los atletas consiguen completar el control del equilibrio en una posición autónoma a corto plazo en la tabla de equilibrio en 1 semana; su progreso también depende de la duración del entrenamiento, los tiempos y los intervalos; la regla de progresión se encuentra según la teoría literaria del entrenamiento deportivo. Conclusión Con la ampliación del ciclo de entrenamiento en la tabla de equilibrio, se cree que la capacidad de los atletas para controlar el equilibrio y las capacidades integrales de la competición real seguirán aumentando, el nivel técnico general y la estabilidad de su rendimiento serán aún mayores. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Equilíbrio Postural/fisiologia , Esportes Aquáticos/fisiologia , Posição Ortostática
2.
Medicine (Baltimore) ; 101(35): e30286, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36107516

RESUMO

BACKGROUND: This randomized controlled trial aimed to investigate the effects of dance therapy using telerehabilitation on trunk control and balance training in patients with stroke and compare them with the effects of conventional treatment. METHODS: We enrolled 17 patients with subacute or chronic stroke who were randomly assigned to either an experimental or a control group. In addition to conventional physical therapy, the experimental group (n = 9) participated in 40-minute, non-face-to-face, dance-therapy sessions and the control group (n = 8) received conventional physical therapy. The primary outcome measures were the Trunk Impairment Scale (TIS) scores to assess trunk control and balance function between the 2 groups as a measure of change from baseline to after the intervention. RESULTS: We found that the TIS scores of the patients in the experimental group significantly improved (P = .017). The TIS results indicated non-inferiority within a predefined margin for dance therapy using telerehabilitation (difference = -0.86, 95% confidence interval [CI] = -2.21 to 0.50). CONCLUSION: Dance therapy using telerehabilitation significantly improved the TIS scores in the experimental group and was not inferior to conventional rehabilitation treatment when compared in a non-inferiority test. The remote dance program may therefore have similar effects to those of conventional treatment regarding trunk-control improvement in patients with stroke.


Assuntos
Dançaterapia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Telerreabilitação , Terapia por Exercício/métodos , Estudos de Viabilidade , Humanos , Projetos Piloto , Equilíbrio Postural , Reabilitação do Acidente Vascular Cerebral/métodos
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 4354-4357, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086233

RESUMO

In the field of rehabilitation, there is a great demand for an automatic and quantitative evaluation system. The balance ability is an essential factor for motor function evaluation related to posture control. Although balance ability is assessed using various indices in current clinical situations, most of previous studies developing an automatic evaluation system have used only a single particular index for balance evaluation. In this study, we developed a system that evaluates whole-body motor function using multiple indices based on the trajectory of the center of mass (CoM) and the motion smoothness. The system is inexpensive and little physical burden because the evaluation indices are calculated from the skeleton tracked by Kinect in a game environment. We attempt to capture the differences in individual motor functions which are difficult to be detected by qualitative visual observation.


Assuntos
Movimento , Equilíbrio Postural , Movimento (Física) , Modalidades de Fisioterapia
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 5144-5147, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086254

RESUMO

Balance Dysfunction (BDF) is a severe conse-quence of Traumatic Brain Injury (TBI) that significantly increases the falls risk. However, the neuromuscular mecha-nisms of the BDF are not adequately researched. Therefore, in this study, our objective was to investigate the effects of a Computerized Biofeedback-based Balance Intervention (CBBI) on the muscle coactivation patterns in a group of TBI participants. This study presents the findings from 13 TBI individuals randomized into the Intervention group (TBI - INT, N=6) and Control group (TBI-CTL, N=7). Using a computerized posturography platform (Neurocom Balance Master) during baseline and follow-up assessment visits, the participant's pos-tural response to anterior-posterior balance perturbations were recorded in a multimodal setup including electroencephalogra-phy (EEG), electromyography (EMG), and the platform sway in terms of center of pressure (COP). The muscle responses were recorded from lower-limb muscles, including tibialis an-terior (TA) and gastrocnemius (GAST), whose coactivation was computed using a metric called Co-Contraction Index (CCI). Clinical outcome measures such as Berg Balance Scale (BBS), 10 Meter Walk Test (10MWT), and Timed Up-and-Go (TUG) tests were used to evaluate functional balance and mobility. The comparison of CCI values across time points (baseline and follow-up) revealed a significant decrease (p<0.01) in the TBI-INT group but not TBI-CTL. The intervention-related changes in CCI correlated with the changes in BBS score (from baseline to follow-up). These preliminary findings demonstrate that the CBBI training may help postural stability by facilitating the coactivation between muscles involved in postural control. Clinical relevance- The current knowledge of changes in the neuromuscular response to balance perturbation in TBI is limited. Our study opens the possibility of using the muscle CCI metric to evaluate the muscle response in individuals with impaired balance.


Assuntos
Lesões Encefálicas Traumáticas , Equilíbrio Postural , Biorretroalimentação Psicológica , Eletromiografia , Humanos , Músculo Esquelético/fisiologia , Equilíbrio Postural/fisiologia
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1792-1796, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086275

RESUMO

A key problem in human balance recovery lies in understanding the mechanism of balance behavior with redundant bio-mechanical motors. Motor synergy has been known as an efficient tool to analyze characteristics of motion behavior and reconstruct control command. In this paper, motor synergy analysis for different control strategies is proposed to analyze different balance motion coordination for various levels of pushing force, and understand the coordination of human multiple joints regarding balance recovery. The spatial synergy of specific joint angles for different pushing force levels exerted on the subject's back is computed with the principal component analysis (PCA) to evaluate the adaptive balance motion response patterns and illustrate the improvement of balance robustness through the switch of joint coordination. Therefore, the switch of postural coordination over multiple joints in balance recovery movements was analyzed to better understand the mechanism of balance strategy generation in this study.


Assuntos
Movimento , Equilíbrio Postural , Fenômenos Biomecânicos/fisiologia , Humanos , Movimento (Física) , Movimento/fisiologia , Equilíbrio Postural/fisiologia , Análise de Componente Principal
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2878-2881, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086349

RESUMO

Humans are intrinsically unstable in quiet stance from a rigid body system viewpoint; however, they maintain balance thanks to neuro-muscular sensory properties whilst still exhibiting postural sway characteristics. This work intro-duces a one-degree-of-freedom supernumerary tail for balance augmentation in the sagittal plane to negate anterior-posterior postural sway. Simulations showed that the tail could success-fully balance a human with impaired ankle stiffness and neural control. Insights into tail design and control were made; namely, to minimise muscular load the tail must have a significant component in the direction of the muscle, mounting location of the tail is significant in maximising inertial properties for balance augmentation and that adaptive control of the tail will be best suited for different loads held by a wearer.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Humanos , Equilíbrio Postural/fisiologia , Postura/fisiologia
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2390-2394, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086546

RESUMO

One of the consequences of aging is the increased risk of falls, especially when someone walks in unknown or uncontrolled environments. Usually, gait is evaluated through observation and clinical assessment scales to identify the state and deterioration of the patient's postural control. Lately, technological systems for bio-mechanical analysis have been used to determine abnormal gait states being expensive, difficult to use, and impossible to apply in real conditions. In this article, we explore the ability of a system based on a single inertial measurement unit located in the lower back to estimate spatio-temporal gait parameters by analyzing the signals available in the Physionet repository "Long Term Movement Monitoring Database" which, together with automatic classification algorithms, allow predicting the risk of falls in the elderly population. Different classification algorithms were trained and evaluated, being the Support Vector Machine classifier with a third-degree polynomial kernel, cost function C = 2 with the best performance, with an Accuracy = 59%, Recall = 91%, and F1- score = 71%, providing promising results regarding a proposal for the quantitative, online and realistic evaluation of gait during activities of daily living, which is where falls actually occur in the target population. Clinical Relevance - This work proposes an early risk of falls detection tool, essential to start preventive treatment strategies to maintain the independence of the elderly through a non-invasive, simple, and low-cost alternative.


Assuntos
Acidentes por Quedas , Atividades Cotidianas , Acidentes por Quedas/prevenção & controle , Idoso , Marcha , Humanos , Equilíbrio Postural , Caminhada
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1489-1492, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086556

RESUMO

Balance refers to the dynamics of body posture to prevent falls. For years, researchers have tried to find out which tasks and measures provide optimal detection of balance disorders, so that they can be quantified. This paper proposes the use of an accelerometer sensor located in the lower back to measure the center of mass accelerations and to characterize the subject's static balance. For characterizing the static balance objectively, we propose using normality circles, a centroid, and a dispersion circle during the modified Clinical Test of Sensory Interaction in Balance (mCTSIB) test. The proposed methodology was tested using two groups of subjects (10 healthy and 3 unhealthy). Our methodology for the static balance was compared to the Berg Balance Scale score. The results shown that a subject with lower BBS score obtain lower dispersion circle and is outside the normality circle. Also, our method outperforms a new option since it characterizes the static balance in an objective, portable, simple, and low-cost way. Clinical Relevance- Our proposed methodology to characterize the static balance can help to simplify objectify and reduce the cost of the clinical practice for balance evaluation.


Assuntos
Equilíbrio Postural , Postura , Humanos
9.
Sensors (Basel) ; 22(17)2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36080897

RESUMO

For individuals with altered sensory cues, vibrotactile feedback improves their balance control. However, should vibrotactile feedback be provided every time balance control is compromised, or only one-third of the time their balance is compromised? We hypothesized that vibrotactile feedback would improve balance control more when provided every time their balance is compromised. Healthy young adults were randomly assigned to two groups: group 33% feedback (6 males and 6 females) and group 100% feedback (6 males and 6 females). Vibrotactile feedbacks related to the body's sway angle amplitude and direction were provided, while participants stood upright on a foam surface with their eyes closed. Then, we assessed if balance control improvement lasted when the vibrotactile feedback was removed (i.e., post-vibration condition). Finally, we verified whether or not vibrotactile feedback unrelated to the body's sway angle and direction (sham condition) altered balance control. The results revealed no significant group difference in balance control improvement during vibrotactile feedback. Immediately following vibrotactile feedback, both groups reduced their balance control commands; body sway velocity and the ground reaction forces variability decreased. For both groups, unrelated vibrotactile feedback worsened balance control. These results confirmed that participants processed and implemented vibrotactile feedback to control their body sways. Less vibrotactile feedback was effective in improving balance control.


Assuntos
Sinais (Psicologia) , Equilíbrio Postural , Retroalimentação , Feminino , Humanos , Masculino , Modalidades de Fisioterapia , Vibração , Adulto Jovem
10.
PLoS One ; 17(9): e0274348, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36121792

RESUMO

BACKGROUND: Patients with multiple sclerosis have low levels of physical activity. This is of concern because low activity levels are related to cardiovascular disease, poor walking ability, and reduced quality of life. The aim of this study was to evaluate the impact of rehabilitation on daily physical activity and walking capacity in patients with multiple sclerosis who have moderate to severe walking disability. METHODS: This exploratory, observational study of 24 patients with multiple sclerosis examined daily physical activity, walking capacity and fatigue before and after 3 weeks of inpatient rehabilitation. Inpatient rehabilitation included physiotherapy (30-60 min, 5 times/week), strength and endurance training (30-45 min, 3-5 times/week), occupational therapy (30 min, 2-3 times/week), and neuropsychological training (30 min, 2 times/week). There were no specific interventions to target daily levels of physical activity. RESULTS: Daily physical activity did not change after rehabilitation (physical activity: effect size = -0.23, 95% confidence interval (95% CI) 0.02‒0.62). There were significant improvements in walking capacity (Two-Minute Walk Test: effect size = 0.74, 95% CI 0.31‒1.16, +17 m, 20.2%) and mobility (Timed Up and Go Test: effect size = 0.65, 95% CI 0.22‒1.07, ‒2.1 s, 14.9%). Motor and cognitive fatigue (Fatigue Scale for Motor: effect size = 0.56, 95% CI 0.14‒0.99 and Cognitive Functions: effect size = 0.44, 95% CI 0.01‒0.86) improved significantly after rehabilitation. CONCLUSION: Three weeks of rehabilitation improved walking capacity, but not daily physical activity, in patients with multiple sclerosis with moderate to severe walking disability. To increase physical activity, it may be necessary to add specific behavioural interventions to the rehabilitation programme. The intervention plan should include strategies to overcome personal and environmental barriers.


Assuntos
Esclerose Múltipla , Exercício Físico , Humanos , Limitação da Mobilidade , Esclerose Múltipla/reabilitação , Equilíbrio Postural , Qualidade de Vida , Estudos de Tempo e Movimento , Caminhada
11.
Hum Mov Sci ; 85: 102996, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36049269

RESUMO

People frequently experience perturbations while standing or walking in crowded areas or when interacting with external objects. Balance maintenance in response to a perturbation is affected by the predictability of the magnitude of a body disturbance. The aim of this quasi-experimental study was to investigate the role of aging in maintenance of standing balance in response to perturbations of varying magnitudes. Twelve older adults and twelve young adults received a series of frontal perturbations of small or large magnitudes induced to their upper body by a pendulum impact while standing. The perturbation sequence included 10 trials of small, 15 trials of large, and 10 more trials of small magnitudes. The participants were exposed to either repetitive perturbations of known (predictable) magnitude or perturbations of unknown (unpredictable) magnitude as they were not told which of the perturbation magnitude (small, large) to expect. Electromyographic activity of six leg and trunk muscles and displacements of the center of pressure were recorded and analyzed during anticipatory (APAs) and compensatory (CPAs) phases of postural control. When exposed to both, repetitive perturbations of known magnitude and perturbations of unpredictable magnitude, older adults, compared to young adults, demonstrated delayed and smaller anticipatory and compensatory postural adaptations. Older adults also required more trials to modify postural adjustments, as compared to young adults. The findings imply that the ability to predict magnitudes of frontal perturbations is declined in older adults.


Assuntos
Músculo Esquelético , Equilíbrio Postural , Adaptação Fisiológica , Idoso , Envelhecimento/fisiologia , Eletromiografia , Humanos , Músculo Esquelético/fisiologia , Equilíbrio Postural/fisiologia , Adulto Jovem
12.
Neurosurg Rev ; 45(5): 3417-3426, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36064875

RESUMO

Instrumented stabilization with intersomatic fusion can be achieved by open (O-TLIF) or minimally invasive (MIS-TLIF) transforaminal surgical access. While less invasive techniques have been associated with reduced postoperative pain and disability, increased manipulation and insufficient decompression may contradict MIS techniques. In order to detect differences between both techniques in the short-term, a prospective, controlled study was conducted. Thirty-eight patients with isthmic or degenerative spondylolisthesis or degenerative disk disease were included in this prospective, controlled study (15 MIS-TLIF group vs. 23 O-TLIF group) after failed conservative treatment. Patients were examined preoperatively, on the first, third, and sixth postoperative day as well as after 2, 4, and 12 weeks postoperatively. Outcome parameters included blood loss, duration of surgery, pre- and postoperative pain (numeric rating scale [NRS], visual analog scale [VAS]), functionality (Timed Up and Go test [TUG]), disability (Oswestry Disability index [ODI]), and quality of life (EQ-5D). Intraoperative blood loss (IBL) as well as postoperative blood loss (PBL) was significantly higher in the O-TLIF group ([IBL O-TLIF 528 ml vs. MIS-TLIF 213 ml, p = 0.001], [PBL O-TLIF 322 ml vs. MIS-TLIF 30 ml, p = 0.004]). The O-TLIF cohort showed significantly less leg pain postoperatively compared to the MIS-TLIF group ([NRS leg 3rd postoperative day, p = 0.027], [VAS leg 12 weeks post-op, p = 0.02]). The MIS group showed a significantly better improvement in the overall ODI (40.8 ± 13 vs. 56.0 ± 16; p = 0.05). After 3 months in the short-term follow-up, the MIS procedure tends to have better results in terms of patient-reported quality of life. MIS-TLIF offers perioperative advantages but may carry the risk of increased nerve root manipulation with consecutive higher radicular pain, which may be related to the learning curve of the procedure.


Assuntos
Fusão Vertebral , Espondilolistese , Perda Sanguínea Cirúrgica , Humanos , Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Dor Pós-Operatória , Equilíbrio Postural , Estudos Prospectivos , Qualidade de Vida , Estudos Retrospectivos , Fusão Vertebral/métodos , Espondilolistese/cirurgia , Estudos de Tempo e Movimento , Resultado do Tratamento
13.
BMJ Open ; 12(9): e061267, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127099

RESUMO

INTRODUCTION: Studies have indicated that gait intervention programmes with minimalist shoes are effective for reducing pain, improving functionality and reducing knee joint overload in older women with knee osteoarthritis (OA). Other clinical trials with knee and foot muscle strength training and/or dynamic balance training have also shown clinical and functional effectiveness. Despite promising strategies, there is no evidence of the combination of shoes with gait intervention programmes. Thus, the objective of this randomised clinical trial is to investigate the effects of therapeutic programme of muscular resistance, balance and gait exercises with and without the use of low-cost, flexible shoes on the clinical, functional and biomechanical aspects of older women with medial knee OA. METHODS AND ANALYSIS: This randomised controlled trial with blinded evaluators will involve 36 older women. Twenty-four older women with knee OA (medial compartment) will be randomised to the intervention groups with minimalist shoes (GIC; n=12) or in a barefoot condition (GID; n=12), and 12 older women to the control group (n=12). The intervention protocol will consist of knee-foot muscle resistance and static balance training, reactive and proactive dynamic balance training, and gait training with visual feedback. The intervention will have a duration of two consecutive months, twice a week, totalling 16 sessions. The primary outcomes will be walking pain measured by Visual Analogue Scale and questionnaires: Western Ontario McMaster Universities Osteoarthritis Index and Lequesne Algofunctional. The secondary outcomes will be: 6-min walk test, Falls Risk Awareness Questionnaire, Timed Up and Go Test, and distribution of plantar load during gait and balance by pressure platform. Data will be analysed according to an intention-to-treat approach. ETHICS AND DISSEMINATION: This study involves human participants and was approved by the ethics committee of the Universidade Santo Amaro, School Medicine, São Paulo/SP, Brazil (N°4.091.006). Participants gave informed consent to participate in the study before taking part. Investigators will communicate trial results to participants and healthcare professionals through scientific databases, social media, publications and conferences. TRIAL REGISTRATION NUMBER: RBR-10j4bw25 in Brazilian Clinical Trial Registry.


Assuntos
Osteoartrite do Joelho , Idoso , Brasil , Feminino , Marcha , Humanos , Dor/complicações , Equilíbrio Postural , Ensaios Clínicos Controlados Aleatórios como Assunto , Sapatos , Estudos de Tempo e Movimento , Resultado do Tratamento
14.
J Aging Phys Act ; 30(5): 745-746, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36049742
15.
Sensors (Basel) ; 22(18)2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36146092

RESUMO

One of the pillars which underpins active aging is found in the performance of physical activity. While adherence to physical activity programs has traditionally been low in older people, immersive virtual reality (IVR) could provide an alternative and complementary training mode. A randomized clinical trial was conducted to explore the feasibility and effects of a 10-week IVR exergame program on physical functions of 24 institutionalized older adults who were allocated to an experimental group (EG n = 13; 85.08 ± 8.48 years) and control group (CG n = 11; 84.82 ± 8.10 years). The IVR intervention was feasible, with no adverse effects being reported (no Simulator Sickness Questionnaire symptoms; low negative experience scores on the Game Experience Questionnaire < 0.34/4), no dropouts, high adherence, and good post-gaming usability (System Usability Scale > 73.96%). The EG showed significant improvements: Tinetti scores for balance (1.84 ± 1.06; p < 0.001), gait (1.00 ± 1.08; p < 0.001), total score (2.84 ± 1.67; p < 0.001), and handgrip (4.96 ± 4.22; p < 0.001) (pre-post assessment). The CG showed significantly worsened compared to the EG: Five times sit-to-stand test, Tinetti scores for balance, gait, and total score, and the Timed Up and Go test total score (post-assessment). The findings show that the IVR intervention is a feasible method to approach a personalized exercise program and an effective way by which to improve physical function in the target population.


Assuntos
Equilíbrio Postural , Realidade Virtual , Idoso , Terapia por Exercício/métodos , Jogos Eletrônicos de Movimento , Estudos de Viabilidade , Força da Mão , Humanos , Estudos de Tempo e Movimento
16.
Sensors (Basel) ; 22(18)2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-36146348

RESUMO

Wearable sensors facilitate the evaluation of gait and balance impairment in the free-living environment, often with observation periods spanning weeks, months, and even years. Data supporting the minimal duration of sensor wear, which is necessary to capture representative variability in impairment measures, are needed to balance patient burden, data quality, and study cost. Prior investigations have examined the duration required for resolving a variety of movement variables (e.g., gait speed, sit-to-stand tests), but these studies use differing methodologies and have only examined a small subset of potential measures of gait and balance impairment. Notably, postural sway measures have not yet been considered in these analyses. Here, we propose a three-level framework for examining this problem. Difference testing and intra-class correlations (ICC) are used to examine the agreement in features computed from potential wear durations (levels one and two). The association between features and established patient reported outcomes at each wear duration is also considered (level three) for determining the necessary wear duration. Utilizing wearable accelerometer data continuously collected from 22 persons with multiple sclerosis (PwMS) for 6 weeks, this framework suggests that 2 to 3 days of monitoring may be sufficient to capture most of the variability in gait and sway; however, longer periods (e.g., 3 to 6 days) may be needed to establish strong correlations to patient-reported clinical measures. Regression analysis indicates that the required wear duration depends on both the observation frequency and variability of the measure being considered. This approach provides a framework for evaluating wear duration as one aspect of the comprehensive assessment, which is necessary to ensure that wearable sensor-based methods for capturing gait and balance impairment in the free-living environment are fit for purpose.


Assuntos
Esclerose Múltipla , Dispositivos Eletrônicos Vestíveis , Marcha , Humanos , Equilíbrio Postural , Velocidade de Caminhada
17.
PLoS One ; 17(9): e0269145, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36137124

RESUMO

OBJECTIVE: Cathodal transcranial direct current stimulation (C-tDCS) is generally assumed to inhibit cortical excitability. The parietal cortex contributes to multisensory information processing in the postural control system, and this processing is proposed to be different between the right and left hemispheres and sensory modality. However, previous studies did not clarify whether the effects of unilateral C-tDCS of the parietal cortex on the postural control system differ depending on the hemisphere. We investigated the changes in static postural stability after unilateral C-tDCS of the parietal cortex. METHODS: Ten healthy right-handed participants were recruited for right- and left-hemisphere tDCS and sham stimulation, respectively. The cathodal electrode was placed on either the right or left parietal area, whereas the anodal electrode was placed over the contralateral orbit. tDCS was applied at 1.5 mA for 15 min. We evaluated static standing balance by measuring the sway path length (SPL), mediolateral sway path length (ML-SPL), anteroposterior sway path length (AP-SPL), sway area, and the SPL per unit area (L/A) after 15-minute C-tDCS under eyes open (EO) and closed (EC) conditions. To evaluate the effects of C-tDCS on pre- and post-offline trials, each parameter was compared using two-way repeated-measures analysis of variance (ANOVA) with factors of intervention and time. A post-hoc evaluation was performed using a paired t-test. The effect sizes were evaluated according to standardized size-effect indices of partial eta-squared (ηp2) and Cohen's d. The power analysis was calculated (1-ß). RESULTS: A significant interaction was observed between intervention and time for SPL (F (2, 27) = 4.740, p = 0.017, ηp2 = 0.260), ML-SPL (F (2, 27) = 4.926, p = 0.015, ηp2 = 0.267), and sway area (F (2, 27) = 9.624, p = 0.001, ηp2 = 0.416) in the EO condition. C-tDCS over the right hemisphere significantly increased the SPL (p < 0.01, d = 0.51), ML-SPL (p < 0.01, d = 0.52), and sway area (p < 0.05, d = 0.83) in the EO condition. In contrast, C-tDCS over the left hemisphere significantly increased the L/A in both the EC and EO condition (EO; p < 0.05, d = 0.67, EC; p < 0.05, d = 0.57). CONCLUSION: These results suggest that the right parietal region contributes to static standing balance through chiefly visual information processing during the EO condition. On the other hand, L/A increase during EC and EO by tDCS over the left parietal region depends more on somatosensory information to maintain static standing balance during the EC condition.


Assuntos
Estimulação Transcraniana por Corrente Contínua , Análise de Variância , Eletrodos , Humanos , Lobo Parietal/fisiologia , Equilíbrio Postural/fisiologia
18.
Medicina (Kaunas) ; 58(9)2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36143889

RESUMO

Background and Objectives: Falls are a common and serious threat to the health and independence of older adults. The decrease in functional capacity during aging means an increased risk of falls. To date, it is not known whether there is a relationship between balance and functional tests. The aim of the study was to evaluate the correlation between eyes-open and eyes-closed static balance with different functional tests. Materials and Methods: A correlation study was designed with 52 healthy subjects over 65 years of age. Results: Regarding the open eyes stabilometric parameters, significant correlations observed between the surface and the functional tests were weak in all cases. The correlations observed between length and the functional tests performed were moderate, except for that of the Timed Up and Go test (TUG) which was weak. No significant correlation between TUG and surface was found. Regarding the closed eyes stabilometric parameters, statistically significant moderate correlations were found between the surface and the Short Physical Performance Battery (SPPB) and the Five Times Sit to Stand test (5XSST). In the case of the length with eyes closed, a statistically significant moderate correlation (rho = 0.40-0.69) was found with the SPPB and 5XSST variables, and weak correlations with the 4 m Walk Speed test (4WS) and TUG variables. Conclusions: There is a mild to moderate correlation between some functional tests and stabilometric parameters in adults over 65 years old.


Assuntos
Avaliação Geriátrica , Equilíbrio Postural , Acidentes por Quedas/prevenção & controle , Idoso , Humanos , Desempenho Físico Funcional , Estudos de Tempo e Movimento
19.
J Biomech ; 143: 111269, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36049385

RESUMO

We aimed to verify whether the computational approaches previously proposed to analyze stability after a single-leg drop-jump (SLDJ) could be applied to a population of middle-aged adults. Fifteen middle-aged (56.4 ± 4.6 years) and 15 young adults (26.7 ± 3.9 years) performed five SLDJs. Stabilization measurements included (1) time to stabilization (TTS) based on vertical ground reaction force (GRF) (TTSv) and a fixed stabilization threshold; (2) TTS based on medio-lateral GRF (TTSml) using five different methods to preprocess the signal and stabilization threshold; (3) early medio-lateral stabilization- the averaged absolute values of the GRF in 0.2-1.4 s post-landing; (4) late medio-lateral stabilization - the averaged absolute values of the GRF at 1 s-5 s after landing. TTSv showed longer TTS values in middle-aged participants. In addition, middle-aged adults showed greater sway in late stabilization. However, TTSml values varied considerably between calculation methods, and early stabilization showed no significant differences between groups except in the first 0.2 s after landing. The results of the current study suggest that TTS calculations are sensitive to signal and threshold selection, and to the processing method. Calculations based on a fixed threshold are more appropriate for studying dynamic postural stability in middle age. With appropriate method selection, a decreased stabilizing performance can be demonstrated in middle-aged adults compared to young adults.


Assuntos
Perna (Membro) , Equilíbrio Postural , Humanos , Fenômenos Mecânicos , Pessoa de Meia-Idade , Adulto Jovem
20.
Motor Control ; 26(4): 729-747, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36068072

RESUMO

This study aimed to investigate the relationship of sit-to-stand and walking performance with leg muscle strength and core muscle endurance in people with multiple sclerosis (PwMS) with mild disabilities. In this study, 49 PwMS (Expanded Disability Status Scale score = 1.59 ± 0.79) and 26 healthy controls were enrolled. The functional performances, including sit-to-stand and walking performances, were evaluated with the five-repetition sit-to-stand test, timed up and go test, and 6-min walking test. The PwMS finished significantly slower five-repetition sit-to-stand, timed up and go, and 6-min walking test than the healthy controls. In addition, the significant contributors were the weakest trunk lateral flexor endurance for five-repetition sit-to-stand; the Expanded Disability Status Scale score, and the weakest hip adductor muscle for timed up and go; the weakest hip extensor muscles strength for 6-min walking test. The functional performances in PwMS, even with mild disabilities, were lower compared with healthy controls. Decreases in both leg muscle strength and core muscle endurance are associated with lower functional performance in PwMS.


Assuntos
Perna (Membro) , Esclerose Múltipla , Estudos Transversais , Humanos , Força Muscular/fisiologia , Músculo Esquelético , Desempenho Físico Funcional , Equilíbrio Postural/fisiologia , Estudos de Tempo e Movimento , Caminhada/fisiologia
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