Rehabilitation and Therapy Commons^™

Approximate Entropy And Velocity Of Center Of Pressure To Determine Postural Stability: A Pilot Study, Natalie Tipton, Gordon Alderink, Samhita Rhodes

Open Access Publishing Support Funded Articles

The body’s postural control system is responsible for responding to perturbations of balance and keeping the body upright. During quiet standing, the center of pressure oscillates about the center of mass, counteracting imbalances. These oscillations can be analyzed to determine the degree of stability, which could be helpful in quantifying the effects of brain injuries. In this research, the center of pressure was recorded for stances with feet together and feet tandem, with eyes opened and eyes closed, in neurotypical participants. These signals were analyzed using indices of approximate entropy and velocity to determine how sensitive the measures were in …

Effects Of A 12-Week Remote Exercise Program On Balance In Adults With Down Syndrome, Kayla Kotake, Sherwin Cadiao, Nicole Kaes, Jayston Prudencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals …

Spatial Characteristics Of Reactive Stepping Among People Living With Chronic Incomplete Spinal Cord Injury, Matthew G Heffernan, Jae Woung Lee, Katherine Chan, Janelle Unger, Susan Marzolini, Timothy N Welsh, Kei Masani, Kristin E Musselman

Physical Therapy Publications

Objective: Compare the spatial characteristics of reactive stepping between individuals with chronic motor incomplete spinal cord injuries (iSCI) and able-bodied (AB) individuals.

Design: Cross sectional.

Setting: Lyndhurst Centre.

Participants: Twelve individuals with iSCI (3 males, 53.6 ± 15.2 years old) and 11 age- and sex-matched AB individuals (3 males, 54.8 ± 14.0 years old).

Interventions: The Lean-and-Release test was used to elicit reactive stepping. A horizontal cable, attached at waist height, was released when 8-12% body weight was supported in a forward lean position. Participants underwent up to 10 Lean-and-Release trials in a session. Kinematic and …

Using The Instrumented Sway System (Isway) To Identify And Compare Balance Domain Deficits In People With Multiple Sclerosis, Patrick G. Monaghan, Andrew S. Monaghan, Andrew Hooyman, Brett W. Fling, Jessie M. Huisinga, Daniel S. Peterson

Physical Therapy Faculty Articles and Research

Objective
To develop a multiple sclerosis (MS)-specific model of balance and examine differences between (1) MS and neurotypical controls and (2) people with MS (PwMS) with (MS-F) and without a fall history (MS-NF).

Design and Setting
A cross-sectional study was conducted at the Gait and Balance Laboratory at the University of Kansas Medical Center. Balance was measured from the instrumented sway system (ISway) assessment.

Participants
In total, 118 people with relapsing-remitting MS (MS-F=39; MS-NF=79) and 46 age-matched neurotypical controls.

Intervention
Not applicable.

Outcome Measures
A total of 22 sway measures obtained from the ISway were entered into an exploratory factor …

Safestride Dog Leash: Designing For Occupational Participation, Ghadah Alharthi, Ots, Emilee Blonder, Ids, Andrew Maitski, Ots, Kristine Nguyen, Ots

Program of Industrial Design Posters

Poster is of the "SafeStride Dog Leash" that is a dog leash designed to promote stability by reducing the force exerted by the dog's sudden lurching movements.

Does Acute Fatigue Affect Lumbar Proprioception And Balance?, Ozde Depreli, Ender Angin

Internet Journal of Allied Health Sciences and Practice

Purpose: To investigate the acute effects of trunk extensor, abdominal, and calf muscle fatigue on lumbar proprioception and balance. Method: Seventy healthy individuals, aged between 18-25, without pain in the low back and lower extremities, with right dominant lower extremities, were included in the study. Dynamic balance with the Y-balance Test, lumbar proprioception sense with the application of the IOS software, and fatigue level with the 6-20 Borg Scale were evaluated before and immediately after the back extensor, abdominal, and calf muscle fatigue protocols were applied to the individuals at 72-hour intervals. Results: After all fatigue protocols, proprioception sense at …

What’S All The Racket? Comparing Physical Health Outcomes Between Pickleball And Tennis In Older Athletes, Megan Doneen Wilson Spt, Ashley Nicole Meldrum Spt, Austin Jeffrey Buchholz Spt, Andrew David Taverna Spt, Michael John Olson Spt

Physical Therapy Student Research Projects

Background: Pickleball is rising in popularity, especially among older adults. Pickleball boasts psychological and physical benefits to aging athletes. Singles pickleball has been found to approximate brisk walking in metabolic equivalents (METs) at 4.1, while the METs level for singles tennis is 7.0-8.0. The physical health benefits of tennis are known to be positive while those of pickleball are still being explored. With objective differences in MET level it may be surmised that health outcomes might vary between the two sports.

Purpose: The purpose of this study was to use the Senior Athlete Fitness Exam (SAFE) to quantify and compare …

Effectiveness Of Nintendo Ring Fit In Improving Balance Deficits After Recovery From Acl Reconstruction, Emma Lord

Mahurin Honors College Capstone Experience/Thesis Projects

PURPOSE: This study aimed to assess the effectiveness of a gaming system in improving balance and strength after recovery from an anterior cruciate ligament reconstruction (ACLR). Existing bilateral deficits in strength and balance were also assessed among patients. METHODS: Four participants between the ages of 18-24 were recruited for this case-control study. Participants must have had ACL reconstruction surgery in the last 2 years, been discharged from formal physical therapy, and have a continued history of participating in physical activity at least three times a week. Participants were assigned to either the experimental or control groups using counterbalancing. The two …

Advancing The Assessment And Treatment Of Signs And Symptoms Of Parkinson Disease, David Scott May

WUSM Theses and Dissertations – All Programs

People with PD often report signs and symptoms that negatively impact quality of life. Among these are balance difficulties, impaired gait, and FOG. New treatment and assessment strategies for these signs and symptoms are needed, as current techniques are limited. While new treatment and assessment strategies continue to emerge, gaps in knowledge persist. Deep brain stimulation (DBS) has been utilized in many people with PD throughout the 21st century, but it is unknown specifically how subthalamic nucleus deep brain stimulation (STN-DBS) affects balance. Alternative treatment strategies, such as a dental mouthpiece, have also been proposed. While dental mouthpieces have shown …

Effects Of Neuromuscular Interventions Utilizing External Biofeedback Apparatuses On The Risk And Incidence Of Second Anterior Cruciate Ligament Injuries: A Systematic Review., Marisa Olmo, Rebecca Sharp

DPT Capstones

STUDY DESIGN: Systematic review.

BACKGROUND: Anterior cruciate ligament (ACL) injury is a common orthopedic condition with an estimated rate of 20,000 to 600,000 injuries in the US per year, with higher incidences in athletic and female populations. The rate of re-injury following surgical ACL repair (ACLR)ranges between 13.8-33.3%. Current clinical practice guidelines for ACLR rehabilitation cite inconclusive evidence for definitive outcome measures that accurately determine successful return to sport (RTS). There is a need to establish more effective avenues of rehabilitation interventions to decrease the rate of reinjury, particularly in female athletes. Recent evidence suggests interventions utilizing external biofeedback apparatuses …

Degenerative Cervical Myelopathy Delays Responses To Lateral Balance Perturbations Regardless Of Predictability, T. F. Boerger, L. Mcginn, M. C. Wang, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The aim of this study was to quantify balance impairments in standing in people with degenerative cervical myelopathy (PwDCM) in response to external perturbations. PwDCM have damage to their spinal cord due to degeneration of the cervical vertebral column, but little is known about balance. Balance was quantified by capturing kinetics, kinematic, and electromyographic data during standing in response to lateral waist pulls. Participants received pulls during predictable and unpredictable contexts in three stance widths at two magnitudes. In response to lateral waist pulls, PwDCM had larger center of mass excursion (P < 0.001) and delayed gluteus medius electromyography onset (P < 0.001) and peak (P < 0.001) timing. These main effects of history of myelopathy were consistent across predictability, stance width, and magnitude. A multilinear regression determined that gluteus medius peak timing + tibialis anterior peak timing most strongly predicted center of mass excursion (R2 = 0.50, P < 0.001). These data suggest that PwDCM have delays in generating voluntary and reactive motor commands, contributing to balance impairments. Future rehabilitation strategies should focus on generating rapid muscular contractions. Additionally, frontal plane postural control is regulated by the gluteus medius and the tibialis anterior, whereas other muscles (e.g. gluteus minimus, ankle invertors/evertors) not studied here may also contribute.

A Theoretical Framework For Addressing Fear Of Falling Avoidance Behavior In Parkinson’S Disease, Merrill R. Landers, Maria H. Nilsson

Physical Therapy Faculty Research

Postural instability in Parkinson’s disease (PD) is associated with several downstream consequences that ultimately lead to a greater risk of falling. Among the prominent downstream consequences is fear of falling (FOF), which is both common and problematic in PD. It can lead to a vicious cycle of FOF avoidance behavior that results in more sedentary behavior, physical deconditioning, and weakening of already impaired balance systems. This, in turn, may make the person with PD more susceptible to a future fall even with benign daily tasks. While FOF activity avoidance can be adaptive (appropriate), it can also be maladaptive (inappropriate or …

Subthreshold Vibration Influences Standing Balance But Has Unclear Impact On Somatosensation In Persons With Transtibial Amputations, Zachary S. Meade, Aaron D. Likens, Jenny A. Kent, Kota Z. Takahashi, Shane R. Wurdeman, Adam L. Jacobsen, Manuel E. Hernandez, Nick Stergiou

Physical Therapy Faculty Research

Stochastic resonance has been successfully used to improve human movement when using subthreshold vibration. Recent work has shown promise in improving mobility in individuals with unilateral lower limb amputations. Furthering this work, we present an investigation of two different signal structures in the use of stochastic resonance to improve mobility in individuals with unilateral lower limb amputations. Cutaneous somatosensation and standing balance measures using spatial and temporal analysis were assessed. There were no differences in the somatosensation measures, but differences in the temporal characteristics of the standing measures were seen with the various vibration structures when compared to no vibration, …

Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla

Journal of Transformative Touch

Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …

Case Comparison Protocol: The Effects Of Therapeutic Horseback Riding For Improving Balance, Core Strength, And Endurance In Children With Prader-Willi Syndrome., Olivia Noone, Giana Russo, Hannah Kepple, Maureen Rinehimer

Student Research Poster Presentations 2022

No abstract provided.

Footwear Characteristics: Effects On Dynamic Balance In The Young And Elderly, Joseph Wallace

Theses and Dissertations (Comprehensive)

Older adults suffer from an increased risk of falling, and falls make up a substantial percentage of injuries and mortality rates in elderly populations. Falls also burden health and long-term care infrastructure and can limit individual independence and overall functioning due to fear of falling. Footwear and orthotic interventions have previously been shown to affect balance in both young and older adult populations and may provide a potential avenue for improving balance and combatting fall rates. Footwear and orthotic interventions are relatively easily implemented, however there is a lack of consistency among current footwear and orthotic literature as well as …

Effect Of Balance In Home Program Training With Head And Neck Stability Device For Teenagers With Cerebral Palsy-A Preliminary Report, Shao-Chih Hsu, Yin-Chou Lin, Chia-Ying Chung, Kuo-Kuang Yeh, Wen-Yu Liu, Shu-Tin Chang, Alice Mk Wong, Chih-Kuang Chen

Rehabilitation Practice and Science

Background and aims: Cerebral palsy (CP) is impaired development in movement and postural control due to brain damage during the fetal or early infancy stage of life. Poor control of the neck muscle affects the peripheral sensory input and central nervous signal output, inhibiting the pre-action feedback response and expected postural regulation, which might result in impaired postural stability of the head and trunk. Therefore, the main purpose of this study is to conduct head and neck vertical stabilization training for teenage students with cerebral palsy, and to examine its balance effect. Methods: In addition to maintaining regular rehabilitation training, …

The Effect Of Exercise Intervention Held In A Community Care Center On Physical Function In Elders With Dementia: A Pilot Study, Jui-Chi Hsu, Jung-Cheng Yang, Yu-Ying Chu, Yi-Chun Chein, Yi-Chen Tsai, Hsiao-Ting Tsai, Ching-Fei Lo, Yen-Ting Lai

Rehabilitation Practice and Science

The care-issue for dementia is becoming more important as the elderly dementia population rapidly increases in Taiwan. Although many studies show exercise intervention is effective in slowing the disease progression of people with dementia living in institutions, there is insufficient evidence regarding individuals with dementia living in the community. Therefore, the purpose of this study is to assess if a once a week group exercise session along with four home exercise sessions per week is effective in improving the balance, mobility, muscle strength and aerobic endurance in community dwelling elders with dementia. This study recruited 18 elders above 65 years …

No Evidence Of Stochastic Resonance In Postural Sway Response To Noisy Galvanic Vestibular Stimulation In Healthy Young Adults, Dominique Rice

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

The transcutaneous application of a sub-sensory electrical stimulation to the vestibular afferents, known as noisy galvanic vestibular stimulation (nGVS), is thought to cause a reduction in postural sway at optimal amplitude intensities due to a mechanism known as stochastic resonance (SR). SR is a phenomenon whereby the addition of low amplitude noise to a non-linear system can be beneficial rather than detrimental. In humans, behavioral markers of SR in postural sway have been inconsistent, potentially due to insufficient power or false positives. Therefore, the main purpose of this study was to determine whether the frequency of observing SR-like effects improves …

Using Biofeedback To Reduce Spatiotemporal Asymmetry Impairs Dynamic Balance In People Post-Stroke, Sungwoo Park, Chang Liu, Natalia Sánchez, Julie K. Tilson, Sara J. Mulroy, James M. Finley

Physical Therapy Faculty Articles and Research

Background. People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective. We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods. We performed clinical balance assessments and measured wholebody angular momentum during walking using a full-body marker set in a sample of 36 people with …

Gait And Balance Changes With Investigational Peripheral Nerve Cell Therapy During Deep Brain Stimulation In People With Parkinson’S Disease, Geetanjali Gera, Zain Guduru, Tritia R. Yamasaki, Julie A. Gurwell, Monica Chau, Anna Krotinger, Frederick A. Schmitt, John T. Slevin, Greg A. Gerhardt, Craig G. Van Horne, Jorge E. Quintero

Physical Therapy Faculty Publications

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess the …

The Effect Of Perturbation-Based Balance Training And Conventional Intensive Balance Training On Reactive Stepping Ability In Individuals With Incomplete Spinal Cord Injury Or Disease: A Randomized Clinical Trial, Janelle Unger, Katherine Chan, Jae W Lee, B Catharine Craven, Avril Mansfield, Mohammad Alavinia, Kei Masani, Kristin E Musselman

Physical Therapy Publications

Introduction: Impaired balance leads to falls in individuals with motor incomplete spinal cord injury or disease (iSCI/D). Reactive stepping is a strategy used to prevent falls and Perturbation-based Balance Training (PBT) can improve this ability.

Objective: The objective of this study was to determine if PBT results in greater improvements in reactive stepping ability than frequency-matched Conventional Intensive Balance Training (CIBT) in adults with iSCI/D.

Design: Randomized clinical trial.

Setting: Tertiary SCI/D rehabilitation center.

Participants: Twenty-one adults with chronic (>1 year) iSCI/D were randomized. Due to one drop out 20 participants completed the study.

Methods: Participants were randomly allocated …

Effects Of An Anterior Ankle-Foot Orthosis On Static Standing Balance Control In Patients With Chronic Stroke Wearing The Orthosis For A Long Time, Min-Yuan Yu, Yu-Hsuan Tseng, Po-Chih Chen, Jen-Wen Hung

Rehabilitation Practice and Science

Aims: To investigate the effects of anterior ankle-foot orthosis (A-AFO) on static standing postural control in patients with chronic stroke wearing the A-AFO for a long time. Methods: We recruited patients with chronic stroke wearing an A-AFO for at least 5 months. Static standing balance control was evaluated using the Tetrax Balance System in eight positions: (1) eyes open on a solid surface [NO];(2) eyes closed on a solid surface [NC];(3) eyes open on a foam surface [PO];(4) eyes closed on a foam surface [PC];and head turned at 30° to (5) right [HR], (6) left [HL], (7) up [HB], and …

A Consensus Guide To Using Functional Near-Infrared Spectroscopy In Posture And Gait Research, Jasmine C. Menant, Inbal Maidan, Lisa Alcock, Emad Al-Yahya, Antonio Cerasa, David J. Clark, Eling D. De Bruin, Sarah Fraser, Vera Gramigna, Dennis Hamacher, Fabian Herold, Roee Holtzer, Meltem Izzetoglu, Shannon Lim, Annette Pantall, Paulo Pelicioni, Sue Peters, Andrea L. Rosso, Rebecca St George, Samuel Stuart, Roberta Vasta, Rodrigo Vitorio, Anat Mirelman

Physical Therapy Publications

Background: Functional near-infrared spectroscopy (fNIRS) is increasingly used in the field of posture and gait to investigate patterns of cortical brain activation while people move freely. fNIRS methods, analysis and reporting of data vary greatly across studies which in turn can limit the replication of research, interpretation of findings and comparison across works.

Research question and methods: Considering these issues, we propose a set of practical recommendations for the conduct and reporting of fNIRS studies in posture and gait, acknowledging specific challenges related to clinical groups with posture and gait disorders.

Results: Our paper is organized around three main sections: …

Mediolateral Damping Of An Overhead Body Weight Support System Assists Stability During Treadmill Walking, M. Bannwart, S. L. Bayer, Niklas König Ignasiak, M. Bolliger, G. Rauter, C. A. Easthope

Physical Therapy Faculty Articles and Research

Background

Body weight support systems with three or more degrees of freedom (3-DoF) are permissive and safe environments that provide unloading and allow unrestricted movement in any direction. This enables training of walking and balance control at an early stage in rehabilitation. Transparent systems generate a support force vector that is near vertical at all positions in the workspace to only minimally interfere with natural movement patterns. Patients with impaired balance, however, may benefit from additional mediolateral support that can be adjusted according to their capacity. An elegant solution for providing balance support might be by rendering viscous damping along …

The Effects Of Dual-Tasking On Fall Risks In Adults With Brain Injury, Kaley Campbell, Anayston Casey, Madison Culpepper, Elizabeth Denton, Katie Morgan

Master of Occupational Therapy Student Critically Appraised Topics

Clinical Scenario: Dual-tasking combines both physical and cognitive components into one therapeutic intervention. There has been limited research on the benefits of dual tasking in relation to fall risks in adults with brain injury. Currently, it is common for various therapy interventions to spend the majority of time targeting physical or cognitive components, but not both at once. After appraisal, a total of five articles were used. These included two level I studies involving a high-quality randomized control trial and a meta-analysis, two level II studies that were both small-scale randomized control trials, and one level IV study that was …

The Effectiveness Of Lsvt-Big And Pwr! Programs On A Patient With Parkinson’S Disease: A Case Report, Naureen Imam, Jennifer Dannenbring

San Marcos, Spring 2020

Background: The prevalence of Parkinson’s Disease (PD) drives the search for effective interventions. While LSVT-BIG and high-intensity training improve gait speed and balance deficits, only limited research exists on the impact of the Parkinson's Wellness Recovery (PWR!) program on PD symptoms. Thus, LSVT-BIG and PWR! should be explored in tandem as standardized treatment for patients with PD.

Purpose: The primary purpose of this case report is to determine the effects of LSVT-BIG and PWR! programs on gait impairments, balance deficits, and participation restrictions in a patient with PD.

Case Description: A 74-year old male with PD attended PT …

Distality Of Attentional Focus And Its Role In Postural Balance Control, Christian Kupper, Karen Roemer, Elizabeth Jusko, Karen Zentgraf

All Faculty Scholarship for the College of Education and Professional Studies

The role of attentional focusing in motor tasks has been highlighted frequently. The “internal–external” dimension has emerged, but also the spatial distance between body and attended location. In two experiments, an extended attentional focus paradigm was introduced to investigate distality effects of attentional foci on balance performance. First, the distality of the coordinates of the point of focus was varied between a proximal and distal position on an artificial tool attached to the body. Second, the distance of the displayed effect on the wall was varied between a 2.5 and 5 m condition. Subjects were instructed to focus on controlling …

Cardiorespiratory Fitness, Balance And Walking Improvements In An Adolescent With Cerebral Palsy (Gmfcs Ii) And Autism After Motor-Assisted Elliptical Training, Guilherme Manna Cesar, Thad W. Buster, Judith M. Burnfield

Department of Mechanical and Materials Engineering: Faculty Publications

Purpose: To quantify the impact of motor-assisted elliptical (ICARE) training on cardiorespiratory fitness, balance and walking function of an adolescent with walking limitations due to cerebral palsy.

Materials and methods: A thirteen-year-old boy with hemiplegic cerebral palsy (Gross Motor Function Classification System II) and autism participated. Peak oxygen consumption (peak VO₂, primary outcome measure), oxygen cost of walking, Pediatric Balance Scale (PBS), modified Timed Up and Go (mTUG), 2-Minute Walk Test (2MWT), and gait characteristics (speed, cadence, step length, single support time) were assessed prior to and after completion of 24 sessions of moderate- to vigorous- intensity ICARE …

Resilient Aging: Maximizing Functional Abilities Of Aging Adults, Casey M. Perkins

MOT Student Capstones

The Resilient Aging program aims to educate fitness trainers and other movement professionals who work with community-dwelling older adults in order to help them provide the best exercise programs for overall wellness. Training from the program includes education regarding a variety of restorative movements, stretching, positional transitions. proprioceptive training, balance, and strengthening exercise in multiple planes with a variety of loads to maximize the functional abilities, and resilience of the elderly participants, with outcomes aimed at improving the movement professionals" understanding of these topics. The program promotes the client participation in occupations by providing education to movement professionals regarding not …