Sitting balance: Its relation to function in individuals with hemiparesis

Nichols, Deborah S.; Miller, Laura C.; Colby, Lynn Allen; Pease, William S.

doi:10.1016/s0003-9993(96)90271-3

Cited by 101 publications

(50 citation statements)

References 14 publications

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“…Another study has suggested some relationship between the degree to which seated individuals can lean and their functional capabilities. 22 The results show that all of the SCI participants could have bene®ted from some type of lateral support. Of course, use of the arms would have improved stabilization for some of the subjects, but in practice this interferes with task performance or places the joints of the arm in potentially injurious postures in a dynamic environment.…”

Section: Discussionmentioning

confidence: 85%

Preliminary investigation of the lateral postural stability of spinal cord-injured individuals subjected to dynamic perturbations

et al. 1999

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Study Design: A study of the impact of spinal cord injury (SCI) on seated balance was conducted by comparing the results obtained from experiments with able-bodied and SCI subjects. Objectives: The purpose of this preliminary study was to examine the lateral postural stability of seated individuals with SCI in a dynamic environment. Setting: Experiments were conducted at the Cleveland Clinic Foundation in Cleveland, Ohio. Methods: Controlled perturbations were applied to each subject, seated in a wheelchair, through the use of a servo-controlled tilt platform. The platform was rotated so as to create disturbances similar in nature to those experienced in the frontal plane during left turns in a vehicle. Four quadriplegic, four paraplegic, and ®ve able-bodied subjects participated in this study. Kinematic information and center of pressure (COP) movement were recorded. Results: None of the spinal cord-injured subjects was able to maintain his stability when exposed to the stronger perturbations, while all of the able-bodied subjects stayed upright for all of the trials. On an individual basis, injury level was not always indicative of balance. However, regression results suggest a correlation between ability to perform static leaning and dynamic balance (P50.001). Conclusions: SCI subjects lost stability under dynamic conditions even though they were stable in the static situation. Initial results also raise some questions about where and when external support may be needed. Information of this nature could help to guide the design of new lateral supports with improved client acceptance.

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Section: Discussionmentioning

confidence: 85%

Preliminary investigation of the lateral postural stability of spinal cord-injured individuals subjected to dynamic perturbations

et al. 1999

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“…Balance is also an important predictor of sensory-motor and functional rehabilitation results poststroke 25 . Functional improvement may be attributed to the "true" physiological recovery derived from "normal" balance responses and compensatory strategies mainly related to the non-impaired half body or a combination of both 12 .…”

Section: Discussionmentioning

confidence: 99%

Post-stroke motor and functional evaluations: a clinical correlation using Fugl-Meyer assessment scale, Berg balance scale and Barthel index

Oliveira

Cacho

Borges

2006

Arq. Neuro-Psiquiatr.

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-Stroke is one of the major causes of morbidity and mortality. Sequels deriving from this event may lead to motor disability and from mild to severe deficits. In order to better classify sensory-motor dysfunction, balance and ability to perform activities of daily living, quantitative and qualitative evaluation scales have been used. Objective: To correlate the scales Fugl-Meyer assessment scale, Berg balance scale and Barthel index. Twenty subjects with sequel after a single, unilateral stroke in chronic phase (>6 months post ictus) were evaluated for about one hour. Results: Barthel scale was statistically related to the total motor score of Fugl-Meyer assessment (r=0.597, p=0.005). The lower limb section at Fugl-Meyer had positive correlation with Berg scale (r=0.653, p=0.002) and with the balance section of Fugl-Meyer own scale (r=0.449, p=0.047). Both balance scales were correlated one with other (r=0.555, p=0.011). Statistical divergence appeared when Barthel's Index was correlated with Berg's Scale (r=0.425, p=0.062), and it is not statistically significant. Conclusion: The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general clinical performance of the patient, especially when positively related joint evaluations are applied.KEY WORDS: Fugl-Meyer assessment scale, Berg balance scale, Barthel index, stroke. Avaliações motoras e funcionais pós-AVC: correlação clínica usando a escala de desempenho físico de Fugl-Meyer, a escala de equilíbrio de Berg e o índice de BarthelRESUMO -O acidente vascular cerebral (AVC) é reconhecido como uma das maiores causas de morbidade e mortalidade. Seqüelas decorrentes deste evento podem levar a inabilidade motora e déficits leves a graves. Para classificar melhor a disfunção sensitivo-motora, o equilíbrio e as habilidades para as atividades de vida diária, escalas de avaliações quantitativas e qualitativas estão sendo utilizadas. Objetivo: Correlacionar a escala de desempenho físico de Fugl-Meyer, a escala de equilíbrio de Berg e o índice de Barthel. Método: Foram selecionados 20 sujeitos com sequela de um único e unilateral AVC em fase crônica (>6 meses pós ictal), que passaram pelas avaliações por cerca de uma hora. Resultados: A escala de Barthel correlacionou-se com a pontuação motora total 597, p=0,005). A seção para membros inferiores de Fugl-Meyer teve correlação positiva com a de Berg (r=0,653, p=0,002) e com a seção de equilíbrio da própria escala 449, p=0,047). Ambas as escalas de equilíbrio tiveram correlação entre si (r=0555, p=0,011). A divergência estatística apareceu quando se correlacionou a Escala de Barthel com o Índice de Berg (r=0,425, p=0,062), não sendo estatisticamente significativo. Conclusão: O uso de escalas quantitativas e qualitativas mostrou ser um bom instrumento de medida para a classificação do quadro físico geral do paciente, ainda mais quando são aplicadas avaliações em conjunto que se relacionam positivamente.

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“…Previous studies have demonstrated that the postural stability of the trunk affects sitting balance and upper-limb function [22,23]. Although balancing in the sitting position is not, in itself a functional activity as balancing in the standing position is, proper seated posture is required for basic daily activities, such as eating and dressing [24,25]. Therefore, achieving a symmetrical sitting posture would be beneficial for hemiparesis patients.…”

Section: Introductionmentioning

confidence: 99%

Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

Ukita¹,

Abe²,

Nikaido³

et al. 2017

Biomed Res Clin Prac

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We have previously reported the effect of wheelchair with a unique backrest shape with pelvic and thoracic support (P-WC) on healthy individuals. However, the actual effect of P-WC on real users is still unclear. Therefore, the purpose of this study was to investigate the effect of different backrest shapes on asymmetric seated posture and pressure points in patients with hemiplegia. We compared a typical wheelchair with a flat backrest (T-WC) to P-WC. Ten subjects with hemiparesis were analyzed. Outcome measures were body alignment angles and pressure distributions of the supporting surfaces. The total seat pressure decreased (p<0.01) and total back pressure increased (p<0.05), in P-WC compared with T-WC. The head-neck was more upright (p<0.05) in P-WC than in T-WC. Moreover, the center of pressure was located in the middle of both the seat and backrest (p<0.05), and the high unilateral pressure around the ischial tuberosity was dispersed (p<0.05) in P-WC. In conclusion, the backrest shape of the P-WC contributes to reducing postural asymmetry. These results highlight the importance of the shape of the wheelchair backrest for patients with hemiparesis.

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Sitting balance: Its relation to function in individuals with hemiparesis

Cited by 101 publications

References 14 publications

Preliminary investigation of the lateral postural stability of spinal cord-injured individuals subjected to dynamic perturbations

Preliminary investigation of the lateral postural stability of spinal cord-injured individuals subjected to dynamic perturbations

Post-stroke motor and functional evaluations: a clinical correlation using Fugl-Meyer assessment scale, Berg balance scale and Barthel index

Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

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