White matter fiber integrity and structural brain network topology: implications for balance function in postischemic stroke patients.

Previous studies have suggested that ischemic stroke can result in white matter fiber injury and modifications in the structural brain network. However, the relationship with balance function scores remains insufficiently explored. Therefore, this study aims to explore the alterations in the microstructural properties of brain white matter and the topological characteristics of the structural brain network in postischemic stroke patients and their potential correlations with balance function. We enrolled 21 postischemic stroke patients and 21 age, sex, and education-matched healthy controls (HC). All participants underwent balance function assessment and brain diffusion tensor imaging. Tract-based spatial statistics (TBSS) were used to compare the fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity of white matter fibers between the two groups. The white matter structural brain network was constructed based on the automated anatomical labeling atlas, and we conducted a graph theory-based analysis of its topological properties, including global network properties and local node properties. Additionally, the correlation between the significant structural differences and balance function score was analyzed. The TBSS results showed that in comparison to the HC, postischemic stroke patients exhibited extensive damage to their whole-brain white matter fiber tracts (P < 0.05). Graph theory analysis showed that in comparison to the HC, postischemic stroke patients exhibited statistically significant reductions in the values of global efficiency, local efficiency, and clustering coefficient, as well as an increase in characteristic path length (P < 0.05). In addition, the degree centrality and nodal efficiency of some nodes in postischemic stroke patients were significantly reduced (P < 0.05). The white matter fibers of the entire brain in postischemic stroke patients are extensively damaged, and the topological properties of the structural brain network are altered, which are closely related to balance function. This study is helpful in further understanding the neural mechanism of balance function after ischemic stroke from the white matter fiber and structural brain network topological properties.

The Impact of Bilateral Cerebellar Transcranial Direct Current Stimulation on Balance Control in Healthy Young Adults.

Cerebellar transcranial direct current stimulation (tDCS) has been shown to influence movement functions, but little is known about the specific effects of stimulation polarity on balance control. This study investigated the impact of bilateral cerebellar tDCS on balance functions as a function of stimulation polarity. In this randomized, controlled trial, thirty-nine healthy young adults were assigned to one of three groups: right anodal/left cathodal cerebellar stimulation (AC group), right cathodal/left anodal cerebellar stimulation (CA group), and a control sham group. Each participant underwent a daily 30-minute session of tDCS at 2 mA for one week. Balance function was assessed pre- and post-intervention and the data were analyzed using generalized estimating equations. The CA group exhibited a significant reduction in sway area when standing on the left leg and on both stable and unstable surfaces with eyes open, compared to both the AC and sham groups. However, there were no significant differences among the groups in terms of sway length, anteroposterior velocity, or mediolateral velocity. Our results indicate the polarity-dependent effects of bilateral cerebellar tDCS on balance functions, with enhanced stability observed only following cathodal tDCS over the right cerebellum paired with anodal tDCS over the left cerebellum. This polarity-specific modulation may have implications for developing cerebellar neuromodulation interventions for movement disorders.

Impact of whole-body vibration training on ankle joint proprioception and balance in stroke patients: a prospective cohort study.

BACKGROUND: Although whole-body vibration (WBV) training is acknowledged for its benefits in enhancing motor functions across several neurological disorders, its precise influence on ankle joint proprioception and balance in stroke patients is still not well understood. This research seeks to assess the impact of WBV training on ankle joint proprioception and balance in stroke patients, thereby filling this important research void. METHODS: In this prospective cohort study, thirty-five stroke patients were randomly assigned to either the WBV group (n = 17) or a control group (n = 18) using a random number table method. The control group received daily general rehabilitation for four weeks, while the WBV group received an additional 30 min of WBV training each day with the Trunsan S110 Vibration Training System. Blinded outcome assessments were conducted at baseline and post-treatment, utilizing the Berg balance scale (BBS), Functional reach test (FRT), Romberg test length (RTL) and area (RTA), and completion rates of ankle joint dorsiflexion-plantar flexion (DP) and inversion-eversion (IE) tests. Follow-up assessments were performed after four weeks of intervention, focusing on RTL, RTA, DP, and IE as primary outcomes. RESULTS: Analysis of intra-group changes from baseline to post-treatment revealed significant improvements across the BBS, FRT, RTL, RTA, and DP and IE assessments (p < 0.001). Notably, the WBV group showed significant enhancements compared to the control group in DP and IE (p < 0.001 and p < 0.05, respectively), with mean values increasing from 13.556 to 16.765 (23.7%) and from 5.944 to 8.118 (36.6%), respectively. However, WBV did not provide additional benefits over the control treatment for balance recovery parameters such as BBS, FRT, RTL, and RTA (p > 0.05). CONCLUSIONS: This study demonstrates that WBV therapy is equally effective as conventional methods in enhancing proprioception and balance in stroke patients, but it does not provide additional benefits for balance recovery. WBV significantly improves proprioceptive functions, particularly in DP and IE parameters. However, it does not surpass traditional rehabilitation methods in terms of balance recovery. These findings indicate that WBV should be incorporated into stroke rehabilitation primarily to enhance proprioception rather than to optimize balance recovery. TRIAL REGISTRATION: This study was retrospectively registered in the ISRCTN Registry on 29/07/2024 ( https://www.isrctn.com/ , ISRCTN64602845).

Exoskeleton rehabilitation robot training for balance and lower limb function in sub-acute stroke patients: a pilot, randomized controlled trial.

PURPOSE: This pilot study aimed to investigate the effects of REX exoskeleton rehabilitation robot training on the balance and lower limb function in patients with sub-acute stroke. METHODS: This was a pilot, single-blind, randomized controlled trial. Twenty-four patients with sub-acute stroke (with the course of disease ranging from 3 weeks to 3 months) were randomized into two groups, including a robot group and a control group. Patients in control group received upright bed rehabilitation (n = 12) and those in robot group received exoskeleton rehabilitation robot training (n = 12). The frequency of training in both groups was once a day (60 min each) for 5 days a week for a total of 4 weeks. Besides, the two groups were evaluated before, 2 weeks after and 4 weeks after the intervention, respectively. The primary assessment index was the Berg Balance Scale (BBS), whereas the secondary assessment indexes included the Fugl-Meyer Lower Extremity Motor Function Scale (FMA-LE), the Posture Assessment Scale for Stroke Patients (PASS), the Activities of Daily Living Scale (Modified Barthel Index, MBI), the Tecnobody Balance Tester, and lower extremity muscle surface electromyography (sEMG). RESULTS: The robot group showed significant improvements (P < 0.05) in the primary efficacy index BBS, as well as the secondary efficacy indexes PASS, FMA-LE, MBI, Tecnobody Balance Tester, and sEMG of the lower limb muscles. Besides, there were a significant differences in BBS, PASS, static eye-opening area or dynamic stability limit evaluation indexes between the robotic and control groups (P < 0.05). CONCLUSIONS: This is the first study to investigate the effectiveness of the REX exoskeleton rehabilitation robot in the rehabilitation of patients with stroke. According to our results, the REX exoskeleton rehabilitation robot demonstrated superior potential efficacy in promoting the early recovery of balance and motor functions in patients with sub-acute stroke. Future large-scale randomized controlled studies and follow-up assessments are needed to validate the current findings. CLINICAL TRIALS REGISTRATION: URL: https://www.chictr.org.cn/index.html.Unique identifier: ChiCTR2300068398.

Short Physical Performance Battery and Cardio-Ankle Vascular Index Association in Older Patients with Heart Failure.

Balance dysfunction in older patients compromises independence and increases the risk of falls and disability. Arterial stiffness, an important parameter of atherosclerosis, can affect peripheral organs, including the brain, causing balance disorders. The cardio-ankle vascular index (CAVI), measured independently of blood pressure, has attracted attention as an indicator of arterial stiffness. However, the association between balance dysfunction and CAVI in patients with heart failure remains unclear. We investigated the association between the Short Physical Performance Battery (SPPB) score and CAVI in older patients with heart failure.We investigated heart failure patients from our cardiac rehabilitation database between 2017 and 2022. Physical function, body composition, and CAVI were measured the day before discharge. Body composition was assessed using bioelectrical impedance analysis. Physical function was determined by assessing handgrip strength, 6-minute walk distance, and SPPB. Sarcopenia was classified according to the Asian Working Group for Sarcopenia 2019 guidelines, defining sarcopenia as an SPPB total score ≤ 9.Among the 205 consecutive hospitalized patients aged ≥ 65 years (mean, 77.0 years; male, 140; female, 65), 45.0% had sarcopenia. CAVI was significantly higher in patients with sarcopenia than in those without (10.4 [9.5, 11.4] versus 9.8 [8.9, 10.8], respectively). Age, 6-minute walk distance, SPPB tandem time, 4-m walk time, 5 repetition sit-to-stand time, and SPPB score were significantly associated with CAVI, with tandem being an independent CAVI determinant (ß = -0.142, P = 0.047).These results suggest an association between arterial stiffness and SPPB score in older patients with heart failure.

Effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury. / ä¸ç¨³å®šè¡¨é¢èº¯å¹²è®­ç»ƒå¯¹ä¸å®Œå ¨æ€§è„Šé«“æŸä¼¤æ‚£è€ ä¸‹è‚¢è¿åŠ¨åŠŸèƒ½çš„å½±å“.

OBJECTIVES: To investigate the effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury. METHODS: A total of 80 patients with incomplete spinal cord injury caused by thoracolumbar fracture admitted in Ningbo Yinzhou No.2 Hospital from April 2020 to December 2021 were randomly divided into control group and study group, with 40 cases in each group. In addition to routine training, the control group received torso training on stable surface and the study group received torso training on unstable surface. The gait, lower limb muscle strength, balance function, lower limb function, mobility and nerve function of the two groups were compared. RESULTS: After treatment, the stride length, stride frequency and comfortable walking speed improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05). The muscle strength of quadriceps femoris, gluteus maximus, hamstring, anterior tibialis and gastrocnemius were improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05); the total trajectories of static eye opening and static eye closing gravity center movement in the two groups were significantly shorter (all P<0.05), and the improvements in the study group were more significant (all P<0.05). The dynamic stability limit range and the American Spinal Injury Association (ASIA) lower extremity motor score, Berg balance scale, modified Barthel index scale in the two groups were significantly higher (all P<0.05), and these scores in study group were significantly higher than those in the control group (all P<0.05). Both groups showed a significant improvement in ASIA grade (all P<0.05), and the improvement in the study group was significantly better (P<0.05). CONCLUSIONS: Torso training on unstable surface can effectively improve the gait and lower limb muscle strength of patients with incomplete spinal cord injury and improve the lower limb motor function.

Frequency of neuropathic pain and its effects on rehabilitation outcomes, balance function and quality of life among people with traumatic spinal cord injury.

Background & Objectives: Traumatic Spinal cord injury (SCI) is a devastating condition that results in life long disability. Impairments associated with traumatic SCI such as sensory, motor, and autonomic dysfunctions lead to an array of secondary SCI-specific complications. Neuropathic pain is one of the most common medical complications of traumatic SCI which significantly affects motor function and activities of daily living (ADL) in people with traumatic SCI. Neuropathic pain is one of the main factors for dependency, decreased quality of life (QOL), poor rehabilitation outcomes, and depression in traumatic SCI individuals. The main aim of the current study was to determine the frequency of neuropathic pain and its effects on rehabilitation outcomes, balance function, and QOL in people with traumatic SCI. Methods: A cross-sectional survey was carried out at PCP from March to August 2020. Overall, 123 participants were added to the study using a non-probability convenience sampling technique. Information was collected using an adapted, validated questionnaire. Both male and female traumatic SCI patients with age between 18-60 years who received at least two weeks of rehabilitation, 42 days after diagnosis of traumatic SCI were included in current study while patients with Acute SCI, SCI patients with any other condition which can affect neuropathic pain such as traumatic brain injury, diabetic neuropathy, amputation, etc. and progressive neurological diseases such as multiple sclerosis and Guillain barre syndromes were excluded. Patients who have received at least two weeks of rehabilitation, 42 days after diagnosis of traumatic SCI. Patients with traumatic SCI. Results: Overall, 123 traumatic SCI patients were included in the study. The majority of the (n=101, 82%) participants were male and 83 (67.5%) were from urban areas. Eighty-Seven (70.73%) participants had neuropathic pain. Neuropathic pain was significantly associated (P-value <0.005) with rehabilitation outcomes, balance function, and quality of life. Conclusion: It can be concluded that more than two-third of SCI patients suffer from neuropathic pain. Moreover, neuropathic pain is significantly associated with rehabilitation outcomes, balance function, and quality of life.

High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis.

OBJECTIVE: This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia. METHODS: In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer's program. RESULTS: We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer's program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31-0.83). Hauer's program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none. CONCLUSIONS: High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.

Comparison of vestibular rehabilitation on balance function in cochlear implant recipients.

Cochlear Implantation (CI) is an effective surgical approach to rehabilitate the deaf patients. However, the insertion of an electrode into the cochlea may have an adverse effect on vestibular receptors, resulting in vertigo or dizziness. The present study is aimed to investigate the impacts of vestibular rehabilitation therapy (VRT) exercises on dizziness symptoms of patients who underwent CIlimb.

Investigating the Effects of Vestibular Rehabilitation on Balance Function in Cochlear Implant Recipients.

BACKGROUND: Cochlear Implantation (CI) is an effective surgical approach to rehabilitate the severe to profound hearing-impaired patients. However, the insertion of CI electrodes into the cochlea may adversely affect vestibular receptors, resulting in vertigo or dizziness. The present study aimed to investigate the impacts of Vestibular Rehabilitation Therapy (VRT) exercises on dizziness symptoms of patients who underwent CI. METHODS: A total of 21 consecutive patients (age range: 28 to 61 years) with profound sensorineural hearing loss undergoing CI operation participated. The VRT therapy plan consisted of a habituation and adaptation exercises in combination with gait and balance exercises. The handicapping influences of dizziness was measured using a Dizziness Handicap Inventory (DHI) scale to measure the level of respondent's performance on physical, emotional, and functional dimensions. Visual Analogue Scale (VAS) was also conducted to assess the severity of dizziness symptoms. The DHI and VAS scales were conducted before VRT and at "oneweek", "two-week", and "four-week" following the last rehabilitation session. RESULTS: A repeated-measure analysis of variance demonstrated a significant decrement and a consequent improvement in DHI scores after vestibular exercises in all emotional, physical and functional domains (p < 0.001). We also found that the influence of implanted ear (p=0.076) and gender (p=0.094) variables on DHI scores were not statistically significant. The mean VAS score was 5.87 ± 2.27 at baseline stage and it reduced significantly during the course of the therapy (second week, 2.02 ±1.75, p < 0.001; and forth week, 1.51 ± 1.29, p < 0.001). CONCLUSION: The findings of this study showed that vestibular rehabilitation therapy has a positive impact on the symptoms of the patients who underwent CI surgery. These exercises lead to an improvement in balance and postural stability, and a reduction in the self-report measure of handicaps. These findings provide the basis for better pre-operative counseling and postoperative vestibular rehabilitation to CI recipients.

Effects of rehabilitation training of core muscle stability on stroke patients with hemiplegia.

OBJECTIVE: To evaluate the effects of rehabilitation training of core muscle stability on stroke patients with hemiplegia. METHODS: A total of 180 stroke patients who were hospitalized from December 2017 to December 2018 were enrolled. They were randomly divided into an observation group and a control group (n=90) that both received conventional hemiplegia rehabilitation therapy. On this basis, the observation group was subjected to training for core muscle stability, five times a week for a total of eight weeks. The balance functions before and after training were assessed using the Berg Balance Scale (BBS). The functions of hemiplegic lower limbs were evaluated by Brunnstrom staging and the Fugl-Meyer motor assessment (FMA) scale. The walking speed was estimated using the 10 m walking test. Musculoskeletal ultrasonography was performed to measure the thicknesses of three abdominal muscles of the paralytic side, i.e. transverse abdominis, internal oblique and external oblique muscles. RESULTS: After treatment, the BBS scores of the two groups were significantly higher than those before treatment, with significant differences (P<0.05). The BBS score of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the Brunnstrom stage and FMA scale score, and standing and stepping scores were significantly higher than those before treatment (P<0.05). The Brunnstrom stage, FMA scale score, stepping score and walking speed of the observation group significantly exceeded those of the control group (P<0.05). After treatment, the thicknesses all increased compared with those before treatment, but the thicknesses of internal oblique and external oblique muscles were not significantly different (P>0.05). The thickness of transverse abdominis muscle of the observation group significantly surpassed that before treatment (P<0.05), whereas the thicknesses of the control group were similar (P>0.05). The thickness of transverse abdominis muscle of the observation group was significantly higher than that of the control group (P<0.05). CONCLUSION: Rehabilitation training of core muscle stability can effectively improve the balance function and walking speed of stroke patients, probably by increasing the thickness of transverse abdominis muscle.

Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of falling.

BACKGROUND: Impairments in dynamic balance have a detrimental effect in older adults at risk of falls (OARF). Gait initiation (GI) is a challenging transitional movement. Centre of pressure (COP) excursions using force plates have been used to measure GI performance. The Nintendo Wii Balance Board (WBB) offers an alternative to a standard force plate for the measurement of CoP excursion. AIMS: To determine the reliability of COP excursions using the WBB, and its feasibility within a 4-week strength and balance intervention (SBI) treating OARF. METHODS: Ten OARF subjects attending SBI and ten young healthy adults, each performed three GI trials after 10 s of quiet stance from a standardised foot position (shoulder width) before walking forward 3 m to pick up an object. Averaged COP mediolateral (ML) and anteroposterior (AP) excursions (distance) and path-length time (GI-onset to first toe-off) were analysed. RESULTS: WBB ML (0.866) and AP COP excursion (0.895) reliability (ICC3,1) was excellent, and COP path-length reliability was fair (0.517). Compared to OARF, healthy subjects presented with larger COP excursion in both directions and shorter COP path length. OARF subjects meaningfully improved their timed-up-and-go and ML COP excursion between weeks 1-4, while AP COP excursions, path length, and confidence-in-balance remained stable. DISCUSSION: COP path length and excursion directions probably measure different GI postural control attributes. Limitations in WBB accuracy and precision in transition tasks needs to be established before it can be used clinically to measure postural aspects of GI viably. CONCLUSIONS: The WBB could provide valuable clinical evaluation of balance function in OARF.

Immediate effects of lumbar spine patterns after neuromuscular joint facilitation on balance in stroke patients.

[Purpose] The present study investigated changes in the balance function of stroke patients after neuromuscular joint facilitation treatment. [Participants and Methods] Fourteen stroke patients were randomly subjected to neuromuscular joint facilitation intervention (neuromuscular joint facilitation intervention group) and no intervention (control group), with a 1-day interval between treatments. The interventions were performed consecutively. The order of interventions was completely randomized. Before and after one neuromuscular joint facilitation and control intervention, the functional reach test, and body sway were measured. [Results] Functional reach test values were significantly increased and peripheral area was significantly reduced in the neuromuscular joint facilitation intervention group than in the control group. [Conclusion] These results suggest that neuromuscular joint facilitation of the trunk has an immediate effect on balance and function in stroke patients.

Effects of visual fatigue caused by smartphones on balance function in healthy adults.

[Purpose] The purpose of this study was to determine the effects of visual fatigue caused by smartphone use on balance function. [Subjects and Methods] The participants consisted of 22 healthy male and female adults. Their postural stability, limit of stability, and limit of stability running time were evaluated using a computerized posturography apparatus before and after inducing visual fatigue. Postural stability and the limit of stability were divided into static and dynamic conditions. [Results] There were significant differences between the dynamic postural stability, the static and dynamic limit of stability, and both the static and dynamic limit of stability running times after the induction of visual fatigue. [Conclusion] The results showed that visual fatigue caused by smartphone use has a negative effect on balance function. Therefore, reducing visual fatigue through proper rest is necessary.

Simple Indicator to Judge the Independence Level Required in Dressing in a Hospital Ward for Patients with Stroke.

BACKGROUND: This study aimed to create a simple and objective indicator for use by inexperienced nurses and family members of patients to judge the assistance level required for dressing in a hospital, while encouraging independence in activities of daily living among inpatients with stroke using the Berg balance scale. METHODS: We retrospectively analyzed the data of 108 hospitalized patients with first stroke in a rehabilitation hospital ward. Receiver operating characteristic curves were used to identify the Berg balance scale item with the highest discriminatory power against independence level in dressing. RESULTS: For comparisons between the independence and supervision or less level groups, the area under the curve of the sum score of "Retrieving object from floor" and "Standing with one foot in front" was .954, and the calculated cutoff value was 6/5 (sensitivity, 86%; specificity, 94%). For comparisons between the supervision or higher level and dependence groups, the area under the curve of the score of "Retrieving object from floor" was .930, and the calculated cutoff value was 2/1 (sensitivity, 93%; specificity, 81%). CONCLUSIONS: Our results suggested that Berg balance scale items are individually and in combination simple and useful indicators to judge independence level in dressing in a hospital ward for patients with stroke. These indices appear to be appropriate for individuals who are unfamiliar with Berg balance scale, such as inexperienced nurses and family members of patients.

Balance function and sensory integration after mild traumatic brain injury.

OBJECTIVE: This study examined the disparities in balance functions and sensory integration in patients with mild traumatic brain injuries (mTBIs) and healthy controls. PARTICIPANTS: One hundred and seven patients with mTBI and 107 age- and sex-matched controls were recruaited for this study. PRIMARY MEASURES: Symptoms of dizziness, balance functions and the ability to perform daily activities were assessed using the dizziness handicap inventory (DHI). This study also performed the postural-stability test and a modified clinical test of sensory integration by using the Biodex Stability System (BBS). RESULTS: DHI scores (functional, emotional, physical and total self-reported scores) were substantially increased in patients following an mTBI compared with the scores of the controls (p < 0.000). The postural-stability test indices (anterior-posterior) (p = 0.045) and the sensory-integration test index (eyes-open-firm-surface index) (p = 0.006) were substantially lower in patients with mTBI than in the controls. However, indices of two other postural-stability test indices (overall and medial-lateral) and three other sensory-integration tests indices (eyes-closed-firm-surface, eyes-open-foam-surface and eyes-closed-foam-surface) measured for the mTBI group did not differ from those of the control group. CONCLUSION: Activities of daily living, balance in postural stability and sensory integration were strongly impaired in patients with mTBI.

Usefulness of the tri-axial accelerometer for assessing balance function in children.

BACKGROUND: The aim of this study was to verify whether the tri-axial accelerometer can be used for quantitatively evaluating balance function in children. METHODS: In total, 198 participants, including 172 healthy children aged 3-11 years (87 boys, 85 girls) and 26 young adults aged 21-24 years (seven men, 19 women), were enrolled in this study. The participants undertook three types of balance tasks: quiet standing with eyes open and closed, one-leg standing on the dominant leg and non-dominant leg, and walking on the floor and a balance beam. We derived the root mean square from participants' accelerations measured by the tri-axial accelerometer. RESULTS: We found that for quiet standing, one-leg standing, and walking tasks, postural sway decreased with age. Girls controlled their posture better than boys of the same age on all tasks. There was a significant sex difference in quiet standing for children aged 8-9 years. Furthermore, sex differences existed in one-leg standing for children aged 5-11 years. A mild positive correlation was observed between static and dynamic balance. CONCLUSIONS: The tri-axial accelerometer is a useful quantitative tool for evaluating both static and dynamic balance function in children. Thus, it has the potential to be used clinically for diagnosis and rehabilitation.

Effect of robot-assisted gait training on motor dysfunction in Parkinson's patients:A systematic review and meta-analysis.

BACKGROUND: Robot-assisted gait training (RAGT) has been reported to treat motor dysfunction in patients with Parkinson's disease (PD) in the last few years. However, the benefits of RAGT for treating motor dysfunction in PD are still unclear. OBJECTIVES: To investigate the efficacy of RAGT for motor dysfunction in PD patients. METHODS: We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, Chinese Biomedical Literature Database (CBM), and Chinese VIP Database for randomized controlled trials investigating RAGT to improve motor dysfunction in PD from the databases' inception dates until September 1, 2022. The following outcome indexes were employed to evaluate motor dysfunction: the Berg Balance Scale (BBS), Activities-specific Balance Confidence Scale (ABC), 10-Meter Walk Test gait speed (10-MWT), gait speed, stride length, cadence Unified Parkinson Disease Rating Scale Part III (UPDRS III), 6-Minute Walk Test (6MWT), and the Timed Up and Go test (TUG). The meta-analysis was performed using the proper randomeffect model or fixed-effect model to evaluate the difference in efficacy between the RAGT and the control groups. The Cochrane Risk of Bias Tool was used for the included studies and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to interpret the certainty of the results. RESULTS: The results consisted of 17 studies comprising a total of 670 participants. Six hundred and seven PD patients with motor dysfunction were included: 335 in the RAGT group and 335 in the control group. This meta-analysis results established that when compared with the control group, robot-assisted gait training improved the BBS results of PD patients (MD: 2.80, 95%CI: 2.11-3.49, P< 0.00001), ABC score (MD: 7.30, 95%CI: 5.08-9.52, P< 0.00001), 10-MWT (MD: 0.06, 95%CI: 0.03-0.10, P= 0.0009), gait speed (MD: 3.67, 95%CI: 2.58-4.76, P< 0.00001), stride length (MD: 5.53, 95%CI: 3.64-7.42, P< 0.00001), cadence (MD: 4.52, 95%CI: 0.94-8.10, P= 0.01), UPDRS III (MD: -2.16, 95%CI: -2.48--1.83, P< 0.00001), 6MWT (MD: 13.87, 95%CI: 11.92-15.82, P< 0.00001). However, RAGT did not significantly improve the TUG test result of patients with PD (MD =-0.56, 95% CI: -1.12-0.00, P= 0.05). No safety concerns or adverse reactions among robot-assisted gait training patients were observed. CONCLUSION: Even though RAGT can improve balance function, walking function, and gait performance and has demonstrated positive results in several studies, there is currently insufficient compelling evidence to suggest that it can improve all aspects of lower motor function.

Effects of Dance Music on Motor Skills and Balance in Children: An Observational Cohort Study.

BACKGROUND/OBJECTIVES: During the COVID-19 pandemic, children in Japan were restricted from sports and outdoor activities. Regular physical activity is essential for healthy growth and development in children, with recommendations advocating for activities such as strength training. However, the long-term effects of the restrictions have not been fully investigated. This study aimed to evaluate the effectiveness of an "exercise class", specifically a dance program, designed to improve motor function in elementary school children affected by the coronavirus disease 2019 (COVID-19) pandemic, which may have compromised their motor function. METHODS: The dance program was developed by a sports science teacher, a professional dancer, and a physical therapist, and it was evaluated in a community-based participatory study. Trained dance instructors conducted one-hour dance sessions in a medical center, held once a week for two months from June to August 2023. A physical therapist and dance instructors led the elementary school children. Outcome measures included grip strength, lower extremity muscle strength, back muscle strength, dynamic balance function during movement, physical activity time, and body fat percentages. Descriptive statistics were used for analysis. RESULTS: Twenty-four children aged 6-9 years participated in the exercise class over a two-month period. Improvement was observed in grip strength, lower extremity muscle strength, and dynamic balance function during movement. However, physical activity time, body fat percentages, and back muscle strength did not change. CONCLUSIONS: The results indicated a significant improvement in motor skills. Dance is an inexpensive program that elementary school children can enjoy while improving their motor skills.

Amelioration of gait and balance disorders by rosuvastatin is associated with changes in cerebrovascular reactivity in older patients with hypertensive treatment.

To investigate the effect of rosuvastatin on gait and balance disorder progression and elucidate the role of cerebrovascular reactivity (CVR) on this effect. From April 2008 to November 2010, 943 hypertensive patients aged ≥60 years were enrolled from the Shandong area of China. Patients were randomized into rosuvastatin and placebo groups. Gait, balance, CVR, fall and stroke were assessed. During an average 72 months of follow-up, the decreasing trends for step length, step speed, and Berg balance scale scores and the increasing trends for step width and chair rising test were slower in the rosuvastatin group when compared to the placebo group. The hazard ratio of incident balance impairment and falls was 0.542 [95% confidence interval (CI) 0.442-0.663] and 0.532 (95% CI 0.408-0.694), respectively, in the rosuvastatin group compared with placebo group. For CVR progression, the cerebrovascular reserve capacity and breath-holding index were increased and the pulsatility index decreased in the rosuvastatin group, while the cerebrovascular reserve capacity and breath-holding index were decreased, and pulsatility index increased in the placebo group. The changes in gait stability and balance function were independently associated with the changes in the CVR. The odds risks of balance impairment and falls were 2.178 (95% CI: 1.491-3.181) and 3.227 (95% CI: 1.634-6.373), respectively, in the patients with CVR impairment and patients without CVR impairment. Rosuvastatin ameliorated gait and balance disorder progression in older patients with hypertension. This effect might result from the improvement in the CVR. This double-blind clinical trial recruited 943 hypertensive patients aged ≥60 years who were randomly administered rosuvastatin and placebo interventions. The data indicates that rosuvastatin significantly ameliorated the progressions of gait and balance disorders in older hypertensive patients. The cerebrovascular reactivity might play an important mediating role in this amelioration.