The effect of weight-bearing asymmetry on dynamic postural stability in people with chronic stroke

Kam, Digna de; Kamphuis, Jip. F.; Weerdesteyn, Vivian; Geurts, Alexander C. H.

doi:10.1016/j.gaitpost.2016.12.019

Cited by 15 publications

(9 citation statements)

References 21 publications

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“…Sudden horizontal translation perturbation with controlled stop : The participant is standing quietly on a horizontal rigid platform when a sudden translational perturbation is delivered ( Fig 7A ). The platform can have built-in force plates to track COP excursion and the time to stabilization [ 45 , 46 ]. The motion of the platform can be more complex, i.e.…”

Section: Resultsmentioning

confidence: 99%

“…A platform actuated with sudden horizontal translation perturbation with controlled stop [ 45 – 49 ] was able to significantly discriminate between low back pain and healthy control groups [ 48 ]. This method also provides a well-defined motion trajectory which can be adjusted to fit populations with impaired functions as demonstrated on post-stroke patients [ 45 , 46 ]. The controlled motion of the platform makes it a suitable candidate for sensitive neurological measurements to be carried out during balancing, such as monitoring cortical activity using near-infrared spectroscopy [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

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Devices and tasks involved in the objective assessment of standing dynamic balancing – A systematic literature review

2017

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BackgroundStatic balancing assessment is often complemented with dynamic balancing tasks. Numerous dynamic balancing assessment methods have been developed in recent decades with their corresponding balancing devices and tasks.ObjectiveThe aim of this systematic literature review is to identify and categorize existing objective methods of standing dynamic balancing ability assessment with an emphasis on the balancing devices and tasks being used.Data SourcesThree major scientific literature databases (Science Direct, Web of Science, PLoS ONE) and additional sources were used.Study selectionStudies had to use a dynamic balancing device and a task described in detail. Evaluation had to be based on objectively measureable parameters. Functional tests without instrumentation evaluated exclusively by a clinician were excluded. A total of 63 articles were included.Data extractionThe data extracted during full-text assessment were: author and date; the balancing device with the balancing task and the measured parameters; the health conditions, size, age and sex of participant groups; and follow-up measurements.Data synthesisA variety of dynamic balancing assessment devices were identified and categorized as 1) Solid ground, 2) Balance board, 3) Rotating platform, 4) Horizontal translational platform, 5) Treadmill, 6) Computerized Dynamic Posturography, and 7) Other devices. The group discrimination ability of the methods was explored and the conclusions of the studies were briefly summarized.LimitationsDue to the wide scope of this search, it provides an overview of balancing devices and do not represent the state-of-the-art of any single method.ConclusionsThe identified dynamic balancing assessment methods are offered as a catalogue of candidate methods to complement static assessments used in studies involving postural control.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Devices and tasks involved in the objective assessment of standing dynamic balancing – A systematic literature review

2017

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“…de Kam et al (2017) reported that postural control was impaired in patients with hemiparesis and suggested an increased risk of falling toward the paretic side. Weight-bearing is typically transferred to the unaffected side in participants with hemiparesis when the body mass is raised from sitting to the less stable standing position during STS movement.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, prioritizing mediolateral dynamic balance control might have different implications for individuals with hemiparesis compared with healthy individuals. Previous studies on dynamic balance control demonstrated that the paretic side had a weaker response to perturbations (de Kam, Kamphuis, Weerdesteyn, & Geurts, 2017), and that mediolateral gait instability was greater (Kao, Dingwell, Higginson, & Binder-Macleod, 2014) in poststroke people compared with healthy individuals. Other studies have investigated correlations between clinical scores and laboratory-based measures, including marginof-stability (Vistamehr, Kautz, Bowden, & Neptune, 2016) and whole-body angular momentum (Nott, Neptune, & Kautz, 2014), and examined the effect of visual feedback on gait in individuals with chronic stroke (Walker, Hyngstrom, & Schmit, 2016).…”

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confidence: 95%

Sensorimotor Strategies in Individuals With Poststroke Hemiparesis When Standing Up Without Vision

2020

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This study investigated the sensorimotor strategies for dynamic balance control in individuals with stroke by restricting sensory input that might influence task accomplishment. Sit-to-stand movements were performed with restricted vision by participants with hemiparesis and healthy controls. The authors evaluated the variability in the position of participants’ center of mass and velocity, and the center-of-pressure position, in each orthogonal direction at the lift-off point. When vision was restricted, the variability in the mediolateral center-of-pressure position decreased significantly in individuals with hemiparesis, but not in healthy controls. Participants with hemiparesis adopted strategies that explicitly differed from those used by healthy individuals. Variability may be decreased in the direction that most requires accuracy. Individuals with hemiparesis have been reported to have asymmetrical balance deficits, and that meant they had to prioritize mediolateral motion control to prevent falling. This study suggests that individuals with hemiparesis adopt strategies appropriate to their characteristics.

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“…There is a strong need for more sensitive and reliable measures to be able to quantify subtle changes in standing balance performance and disentangle postural control mechanisms ( 48 ). Despite several promising methods to quantify postural control, a golden standard is still lacking ( 49 , 50 ). We used the CoP comp-score as a sensitive comprehensive outcome parameter, combining information from five parameters of standing balance performance ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Short-Term Effects of Cerebellar tDCS on Standing Balance Performance in Patients with Chronic Stroke and Healthy Age-Matched Elderly

et al. 2018

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Transcranial direct current stimulation (tDCS) may serve as an adjunct approach in stroke rehabilitation. The cerebellum could be a target during standing balance training due to its role in motor adaptation. We tested whether cerebellar tDCS can lead to short-term effects on standing balance performance in patients with chronic stroke. Fifteen patients with a chronic stroke were stimulated with anodal stimulation on the contra-lesional cerebellar hemisphere, ipsi-lesional cerebellar hemisphere, or sham stimulation, for 20 min with 1.5 mA in three sessions in randomized order. Ten healthy controls participated in two sessions with cerebellar stimulation ipsi-lateral to their dominant leg or sham stimulation. During stimulation, subjects performed a medio-lateral postural tracking task on a force platform. Standing balance performance was measured directly before and after each training session in several standing positions. Outcomes were center of pressure (CoP) amplitude and its standard deviation, and velocity and its standard deviation and range, subsequently combined into a CoP composite score (comp-score) as a qualitative outcome parameter. In the patient group, a decrease in comp-score in the tandem position was found after contra-lesional tDCS: β = − 0.25, CI = − 0.48 to − 0.03, p = 0.03. No significant differences in demographics and clinical characteristics were found between patients who responded (N = 10) and patients who did not respond (N = 5) to the stimulation. Contra-lesional cerebellar tDCS shows promise for improving standing balance performance. Exploration of optimal timing, dose, and the relation between qualitative parameters and clinical improvements are needed to establish whether tDCS can augment standing balance performance after stroke.

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The effect of weight-bearing asymmetry on dynamic postural stability in people with chronic stroke

Cited by 15 publications

References 21 publications

Devices and tasks involved in the objective assessment of standing dynamic balancing – A systematic literature review

Devices and tasks involved in the objective assessment of standing dynamic balancing – A systematic literature review

Sensorimotor Strategies in Individuals With Poststroke Hemiparesis When Standing Up Without Vision

Short-Term Effects of Cerebellar tDCS on Standing Balance Performance in Patients with Chronic Stroke and Healthy Age-Matched Elderly

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