Objective:We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological&Balance Center patients.Design:This is a retrospective descriptive study.Partic...Objective:We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological&Balance Center patients.Design:This is a retrospective descriptive study.Participants included Seventy-three adults with diagnoses of acute,episodic,or chronic vestibular syndromes.They were classified into the following two groups:group 1 included 46 individuals treated with ISIT plus VRT,and group 2 included 27 individuals treated only with ISIT.Results:The Sensory Organization Test(SOT)for both groups showed a statistical significance for all three sensory inputs;visual systems(G1:p=0.0003;G2:p=0.0337),vestibular system(G1:p<0.0001;G2:p=0.0003),and balance as demonstrated by compound balance score(G1:p<0.0001;G2:p=0.0035),and balance percentage deficit(G1:p<0.0001;G2:p=0.0078).Conclusions:The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions,and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.展开更多
The postural balance is a important aspect of assessment in vestibular rehabilitation therapy.As the computerized dynamic posturography,the foam posturo-graphy performed by using foam in posturography is a useful meas...The postural balance is a important aspect of assessment in vestibular rehabilitation therapy.As the computerized dynamic posturography,the foam posturo-graphy performed by using foam in posturography is a useful measurement tool for postural balance.Then,the reliability of foam posturography is critical in clinic.To our knowledge,there is no report about the test-retest reliability of foam posturography in the patients with ver-tigo in China.The foam posturography was taken on the patients with vertigo in stable state and repeated in 3 to 5 days.In the two assessments of test and retest,all subjects stood under 4 sensory conditions,such as firm surface with eyes open(T1),firm surface with eyes closed(T2),foam surface with eyes open(T3)and foam surface with eyes closed(T4)for 30 seconds respectively.The average sway velocity(SV)of center of pressure(COP)under feet of upright standing was recorded as research parameter.The results of patients with vertigo were compared with those of normal subjects.It demonstrated that all normal subjects did not fall in the two assessments.There were 10 of 34 patients with vertigo at least fell one time during the two assessments,and the SVs of these subjects did not taken the analysis of test-retest reliability.The results showed that:(1)The interclass correlation coefficients(ICC)of all 49 subjects including normal subjects and patients without falling were 0.887–0.973 according to the T1–T4 between two assessment.(2)The SVs between the normal subjects and patients were significantly differ-ent in the T2(t 52.018,P 50.049)and T4(t 53.905,P,0.001)in the first assessment and in the T4(t 53.715,P 50.001)in the second.And(3)the cases of falling between two assessments were not significant different(x250.073,P 50.787)in the patients with vertigo.It is concluded from this study that the foam posturography has high test-retest reliability to assess the postural bal-ance in the patients with vertigo in stable state,indicating the foam posturography can be used as the valid means to assess the improvement of postural balance for patients with vertigo in the vestibular rehabilitation therapy.展开更多
Although the typical clinical signs of Parkinson disease (PD) are tremor, rigidity, bradykinesia, and postural instability, PD is preceded by a preclinical phase during which neuronal degeneration develops without typ...Although the typical clinical signs of Parkinson disease (PD) are tremor, rigidity, bradykinesia, and postural instability, PD is preceded by a preclinical phase during which neuronal degeneration develops without typical symptoms. More general nonspecific symptoms including dizziness have also been described to predate the typical PD signs for several years. All subjects were selected among patients in the Willis Hospital (Pusan, South of Korea), with complaints of diz-ziness from September 2009 to September 2010 and the baseline neurological screening and clinical ENT examination, to which the results were within the normal range. At baseline, 113 participants underwent neurological screening and provided information on dizziness. Of those participants, 103 were enrolled including 63 subjects in the control group. We used posturography. It allows quantitative assessment of vestibular-spinal component of body balance. The parame-ter of average speed of pressure center displacement to the lateral plan (VMX) and antero-posterior plan (VMY), which presented statistically significant differences between the groups except VMX with closed eyes. (p = 0.008 and p = 0.012, with closed eyes). With open eyes, only VMY showed significant difference between the groups (p = 0.010). In this study, the patients with dizziness and subjective complaints related to typical clinical signs of PD complaints presented higher instability in the orthostatic position than the control group of patients with dizziness and without such complaint. It could suggest that dizziness may be one symptom of preclinical PD and progress to overt postural instability. It is believed that a stepwise approach with a simple and inexpensive initial screening test of preclinical PD is required.展开更多
Pilates therapy improves core muscle function and axial stability but its effects on balance in idiopathic Parkinson’s disease (IPD) have not been evaluated. The objective of this study was to evaluate the effects of...Pilates therapy improves core muscle function and axial stability but its effects on balance in idiopathic Parkinson’s disease (IPD) have not been evaluated. The objective of this study was to evaluate the effects of a Pilates exercise program on postural stability and balance confidence in people with IPD. Ten IPD patients (Hoehn & Yahr Stage 1-3) with a history of falls or nearfalls had the following assessments before and after completion of a 6-week supervised Pilates exercise program: Activities-Specific Balance Confidence Scale (ABC);Berg Balance Scale (BBS);Schwab and England Scale (SES);Unified Parkinson’s Disease Rating Scale (UPDRS);pull-test;timed-up-and-go (TUG);5-metre walk;static and dynamic posturography. There were significant improvements in BBS score, 5-metre walk time and TUG after the training program, as well as improvement trends in some posturographic measures. Participants also reported improved balance confidence with Activities of Daily Living (ADLs). Our findings suggest that Pilates therapy can be beneficial in IPD and warrants further evaluation in a larger study.展开更多
Mild traumatic brain injury (mTBI) causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, l...Mild traumatic brain injury (mTBI) causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, little is known regarding the normal pattern of postural control in young children. This study was therefore conducted as an effort to fill this knowledge gap. Eight normal school-aged children participated. Posture assessment was conducted before (7-8 a.m. in the morning) and after (4-7 p.m. in the after-noon) school on regular school days using the Balance Master? evaluation system composed of 3 static tests and 2 dynamic balance tests. A significant difference in the weight-bearing squats was detected between morning hours and afternoon hours (P < 0.05). By end of afternoon, the body weight was borne mainly on the left side with the knee fully extended and at various degrees of knee flexion. A significantly better directional control of the lateral rhythmic weight shifts was observed at the end of the afternoon than at morning hours (P < 0.05). In summary, most of our findings are inconsistent with results from previous studies in adults, sug-gesting age-related differences in posture control in humans. On a regular school day, the capacity of postural control and laterality or medio-lateral balance in children varies between morning and afternoon hours. We suggest that posturographic assessment in children, either in normal (e.g., physical education and sports training) or in abnormal conditions (e.g., mTBI-associated balance disorders), be better performed late in the afternoon.展开更多
文摘Objective:We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological&Balance Center patients.Design:This is a retrospective descriptive study.Participants included Seventy-three adults with diagnoses of acute,episodic,or chronic vestibular syndromes.They were classified into the following two groups:group 1 included 46 individuals treated with ISIT plus VRT,and group 2 included 27 individuals treated only with ISIT.Results:The Sensory Organization Test(SOT)for both groups showed a statistical significance for all three sensory inputs;visual systems(G1:p=0.0003;G2:p=0.0337),vestibular system(G1:p<0.0001;G2:p=0.0003),and balance as demonstrated by compound balance score(G1:p<0.0001;G2:p=0.0035),and balance percentage deficit(G1:p<0.0001;G2:p=0.0078).Conclusions:The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions,and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.
基金supported by grants from the National Outstanding Youth Science Foundation of China(No.39925035)the National Natural Science Foundation of China(Grant No.30371525)+1 种基金the National Tenth Five-year Project for Scientific and Technological Development of China(No.2004BA720A18-02)the Key Clinical Subject Foundation of the Ministry of Health of China(No.2004486)。
文摘The postural balance is a important aspect of assessment in vestibular rehabilitation therapy.As the computerized dynamic posturography,the foam posturo-graphy performed by using foam in posturography is a useful measurement tool for postural balance.Then,the reliability of foam posturography is critical in clinic.To our knowledge,there is no report about the test-retest reliability of foam posturography in the patients with ver-tigo in China.The foam posturography was taken on the patients with vertigo in stable state and repeated in 3 to 5 days.In the two assessments of test and retest,all subjects stood under 4 sensory conditions,such as firm surface with eyes open(T1),firm surface with eyes closed(T2),foam surface with eyes open(T3)and foam surface with eyes closed(T4)for 30 seconds respectively.The average sway velocity(SV)of center of pressure(COP)under feet of upright standing was recorded as research parameter.The results of patients with vertigo were compared with those of normal subjects.It demonstrated that all normal subjects did not fall in the two assessments.There were 10 of 34 patients with vertigo at least fell one time during the two assessments,and the SVs of these subjects did not taken the analysis of test-retest reliability.The results showed that:(1)The interclass correlation coefficients(ICC)of all 49 subjects including normal subjects and patients without falling were 0.887–0.973 according to the T1–T4 between two assessment.(2)The SVs between the normal subjects and patients were significantly differ-ent in the T2(t 52.018,P 50.049)and T4(t 53.905,P,0.001)in the first assessment and in the T4(t 53.715,P 50.001)in the second.And(3)the cases of falling between two assessments were not significant different(x250.073,P 50.787)in the patients with vertigo.It is concluded from this study that the foam posturography has high test-retest reliability to assess the postural bal-ance in the patients with vertigo in stable state,indicating the foam posturography can be used as the valid means to assess the improvement of postural balance for patients with vertigo in the vestibular rehabilitation therapy.
文摘Although the typical clinical signs of Parkinson disease (PD) are tremor, rigidity, bradykinesia, and postural instability, PD is preceded by a preclinical phase during which neuronal degeneration develops without typical symptoms. More general nonspecific symptoms including dizziness have also been described to predate the typical PD signs for several years. All subjects were selected among patients in the Willis Hospital (Pusan, South of Korea), with complaints of diz-ziness from September 2009 to September 2010 and the baseline neurological screening and clinical ENT examination, to which the results were within the normal range. At baseline, 113 participants underwent neurological screening and provided information on dizziness. Of those participants, 103 were enrolled including 63 subjects in the control group. We used posturography. It allows quantitative assessment of vestibular-spinal component of body balance. The parame-ter of average speed of pressure center displacement to the lateral plan (VMX) and antero-posterior plan (VMY), which presented statistically significant differences between the groups except VMX with closed eyes. (p = 0.008 and p = 0.012, with closed eyes). With open eyes, only VMY showed significant difference between the groups (p = 0.010). In this study, the patients with dizziness and subjective complaints related to typical clinical signs of PD complaints presented higher instability in the orthostatic position than the control group of patients with dizziness and without such complaint. It could suggest that dizziness may be one symptom of preclinical PD and progress to overt postural instability. It is believed that a stepwise approach with a simple and inexpensive initial screening test of preclinical PD is required.
文摘Pilates therapy improves core muscle function and axial stability but its effects on balance in idiopathic Parkinson’s disease (IPD) have not been evaluated. The objective of this study was to evaluate the effects of a Pilates exercise program on postural stability and balance confidence in people with IPD. Ten IPD patients (Hoehn & Yahr Stage 1-3) with a history of falls or nearfalls had the following assessments before and after completion of a 6-week supervised Pilates exercise program: Activities-Specific Balance Confidence Scale (ABC);Berg Balance Scale (BBS);Schwab and England Scale (SES);Unified Parkinson’s Disease Rating Scale (UPDRS);pull-test;timed-up-and-go (TUG);5-metre walk;static and dynamic posturography. There were significant improvements in BBS score, 5-metre walk time and TUG after the training program, as well as improvement trends in some posturographic measures. Participants also reported improved balance confidence with Activities of Daily Living (ADLs). Our findings suggest that Pilates therapy can be beneficial in IPD and warrants further evaluation in a larger study.
文摘Mild traumatic brain injury (mTBI) causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, little is known regarding the normal pattern of postural control in young children. This study was therefore conducted as an effort to fill this knowledge gap. Eight normal school-aged children participated. Posture assessment was conducted before (7-8 a.m. in the morning) and after (4-7 p.m. in the after-noon) school on regular school days using the Balance Master? evaluation system composed of 3 static tests and 2 dynamic balance tests. A significant difference in the weight-bearing squats was detected between morning hours and afternoon hours (P < 0.05). By end of afternoon, the body weight was borne mainly on the left side with the knee fully extended and at various degrees of knee flexion. A significantly better directional control of the lateral rhythmic weight shifts was observed at the end of the afternoon than at morning hours (P < 0.05). In summary, most of our findings are inconsistent with results from previous studies in adults, sug-gesting age-related differences in posture control in humans. On a regular school day, the capacity of postural control and laterality or medio-lateral balance in children varies between morning and afternoon hours. We suggest that posturographic assessment in children, either in normal (e.g., physical education and sports training) or in abnormal conditions (e.g., mTBI-associated balance disorders), be better performed late in the afternoon.
