Citations
To demonstrate the efficacy of the balance control trainer (BCT), developed for training patients with balance problems, as a balance assessment tool in subacute stroke patients.
A prospective cross-sectional study was carried out on 38 subacute stroke patients in their first episode of a stroke, and having the ability to maintain a standing position without aid for at least 5 minutes. Patients were assessed using the BCT (BalPro) 43.7±35.7 days after stroke. The balance was assessed using the Berg Balance Scale (BBS), the Timed Up and Go Test (TUG), a 10-meter walking test (10mWT), a 6-minute walking test (6MWT), and the Korean version of the Modified Barthel Index. The correlation and validity between the BCT and various balance assessments were analyzed.
Statistically significant linear correlations were observed between the BCT score and the BBS (r=0.698, p<0.001). A moderate to excellent correlation was seen between the BCT score and 11 of the 14 BBS items. The BCT scores and other secondary outcome parameters (6MWT r=0.392, p=0.048; TUG r=–0.471, p=0.006; 10mWT r=–0.437, p=0.012) had a moderate correlation.
Balance control training using the BCT (BalPro) showed significant statistical correlation with the BBS, and could therefore be a useful additional balance assessment tool in subacute stroke patients.
Citations
To evaluate quiet standing balance of patients with Wallenberg syndrome before and after rehabilitation.
Six patients with Wallenberg syndrome were enrolled within one month after being affected by an infarct of the lateral medulla. Quiet standing balance was assessed using posturography with eyes open and closed. The assessment was repeated after the patients had undergone rehabilitation treatment for three to nine months, and the results of the two assessments were compared.
The quiet standing balance evaluation was performed by measurement of center of pressure (CoP) movement. In the initial test, the mean scores of mediolateral and anteroposterior speed, velocity movement, mediolateral and anteroposterior extent of CoP were all high, indicating impairments of quiet standing balance in the patients. After rehabilitation treatment, the anteroposterior speed and extent, the mediolateral speed and extent, and velocity moment of CoP showed statistically significant reductions in the eyes open condition (p<0.05), and the anteroposterior speed and extent and velocity moment of CoP had decreased in the eyes closed condition (p<0.05). Mediolateral speed and extent of CoP in the eyes closed condition had also decreased, but the reduction was not statistically significant.
This study demonstrated improvements of quiet standing balance, especially anteroposterior balance, in patients with Wallenberg syndrome following rehabilitation. We suggest that balance training is important in the rehabilitation of Wallenberg syndrome and that, as an objective measure of balance status, posturography is useful in the assessment of quiet standing balance.
Citations
To investigate balance control according to the severity of knee osteoarthritis (OA) using clinical tests and Tetra-ataxiometric posturography (Tetrax®).
A total 80 patients with primary knee OA classified according to American College of Rheumatology criteria, and 40 age-matched controls were enrolled in this study. Of those with OA, 39 patients had mild OA (Kellgren-Lawrence [KL] grade 1, 2) and the other 41 had moderate to severe OA (KL grade 3, 4). The postural control capabilities of the subjects were assessed using the timed up and go test (TUG), Berg balance scale (BBS), and Tetrax®, which utilizes two paired force plates to measure vertical pressure fluctuations over both heels and forefeet. The subjects were checked for their stability index (ST), Fourier index, weight distribution index (WDI), and synchronization index (SI) in eight positions using Tetrax®.
Patients with moderate to severe OA exhibited significantly higher stability indices in all positions than patients with mild OA. The Fourier index was also higher in patients with moderate to severe OA than in patients with mild OA. However, the weight distribution index and synchronization of both heels and forefeet were not significantly different in the three groups.
These findings suggest that patients with moderate to severe OA have more deficits in balance control than those with mild disease. Therefore, evaluation of balance control and education aimed at preventing falls would be useful to patients with knee OA.
Citations
Method: Thirty-two patients whose BAEP test showed normal latency were included after patients whose somatosensory ratio and visual ratio from posturography showed abnormality were excluded. Ten healthy participants were set up as control group. We made comparison between P13 latency in VEMP and vestibular ratio posturography among these participants. Results: Among the participants 47% showed normal P13 latency, and 53% showed abnormal P13 latency. In normal P13 latency group, 86.7% of patients showed normal vestibular ratio, and in abnormal P13 latency group, 70.6% of patients showed abnormal vestibular ratio. Conclusioin: VEMP showed high correlation between vestibular ratio of posturography. VEMP can be used in screening test and clinically complementary diagnostic method of vestibular function test for patients with vertigo. (J Korean Acad Rehab Med 2008; 32: 211-215)
Objective: To examine the correlation between Berg balance scale (BBS) which is tool for assessing the clinical balance function and sensory organization test (SOT) of computerized dynamic posturography (CDP) in brain injured patients.
Method: Thirty patients with brain injury were assessed on the BBS and SOT of CDP. BBS consists of 14 items and each item is graded on a five point ordinal scale (0∼4), yielding a total of 56 points. According to its characteristics, each item was divided 3 groups, which were sitting, standing and position change. Six equilibrium scores (EQ) were determined by SOT of CDP (EquiTest SystemⰒ, Version 5.08) under 6 conditions, and somatosensory, visual, vestibular ratios were analyzed by 6 EQ scores.
Results: EQ 5 was correlated with reaching forward item (r=0.513), turning 360 degrees item (r=0.537), stool stepping item (r=0.529) of BBS (p＜0.01). EQ 6 was correlated with turning 360 degrees item (r=0.498) of BBS (p＜0.01). Sum of standing item group scores was correlated with EQ 5 (r=0.478), EQ 6 (r=0.464), and sum of position change item scores was correlated with EQ 5 (r=0.622), EQ 6 (r=0.514)(p＜0.01). Vestibular ratio was correlated with BBS total score (r=0.552, p＜0.01).
Conclusion: We concluded that vestibular ratio of SOT was correlated with BBS, especially position change item group. Therefore BBS is a good tool for evaluating vestibular function in brain injured patients.
Objective: To investigate the deficit of static and dynamic postural control in patients with chronic ankle sprain using dynamic posturography.
Method: Twenty patients with unilateral recurrent ankle sprain and functional instability were assessed by Samsung medical center ankle injury score and by computerized dynamic posturography (EquiTestⰒ system, NeurocomⰒ, international, INC; USA).
The posturography test was performed 3 times at 6 different simulated conditions such as fixed of force platform/open eyes/fixed of screen (condition 1), fixed/closed/fixed (condition 2), fixed/open/movement (condition 3), sway/open/fixed (condition 4), sway/closed/fixed (condition 5), sway/open/movement (condition 6). We evaluated anteroposterior sway of center of gravity of the patients and calculated equilibrium scores. We compared the equilibrium scores of patient group and normal data reported previously. We also compared the equilibrium scores of two subgroups of the patients according to severity of ankle injury.
Results: Patients showed significantly low equilibrium scores than normal one at the condition 4, 5 and 6 (p＜0.05). The group B with severe ankle injury revealed low equilibrium scores at the condition 4, 5 and 6. Especially the group B showed statistically significance at condition 5 (p＜0.05).
Conclusion: Patients with chronic ankle sprain showed the deficit of dynamic postural control due to the proprioceptive dysfunction of injured ankle than normal person.
Objective: To determine the posturographic characteristics of the stroke patients due to various brain lesions.
Method: Stroke patients capable of standing without assistive devices were included. Patients were divided into three groups according to the lesion distribution: cerebral; brain stem; cerebellar. Quantitative computerized posturographic studies were performed to determine the subject's response to sensory (sensory organization test, SOT) and motor translations (motor control test, MCT).
Results: Equilibrium scores of 4th (EQ4), 5th (EQ5) and 6th (EQ6) conditions and visual (VIS) and vestibular (VEST) ratio of SOT were significantly lower in brainstem and cerebellar lesion groups in comparison with normal population. In addition, prolonged latencies for medium and large backward and forward translations were noticed in the brainstem lesion group. However, there was no significant difference between cerebral lesion group and normal population. According to the lesion distribution, cerebellar group showed increased incidence of abnormalities of EQ4 score. Brainstem group showed increased incidence of abnormalities in EQ5, EQ6 score, VEST ratio and prolonged latency for large forward translation.
Conclusion: We found that posturography revealed characteristic appearances according to the various brain lesions, especially in cerebellum and brainstem stroke patients.
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