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"Postural sway"

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"Postural sway"

Original Articles
The Effects of Transcutaneous Electrical Nerve Stimulation for Standing Balance in Patients with Hemiplegia.
Kim, Sang Hyun , Seok, Hyun , Lee, Hyuck , Lee, Hyuk Jin , Suh, Jung Woo
J Korean Acad Rehabil Med 2009;33(2):159-164.
Objective
To evaluate the effects of transcutaneous elec-trical nerve stimulation (TENS) applied at lower extre-mity for standing balance in patients with hemiplegia. Method: Twenty-two hemiplegic patients were tested while standing on balance trainer under eight stimulation modes (No TENS, bilateral TENS, hemiplegic TENS, and una-ffected TENS. These four conditions were applied both with and without vision). All patients were able to stand inde-pendently more than five minutes. TENS was applied with pulse width 200µs, frequency of 100 Hz, amplitude set at the sensory detection threshold of each patients. TENS was applied thirty seconds for each stimulation modes, and res-ting period was 10 minutes. Postural sway was determined during the testing period by the sum of anterior-posterior (AP) center of pressure (COP) sway, medio-lateral (ML) COP sway, and total sum of COP sway. Also postural sway was determined by proportion of time of COP in three circles, which semidiameters are 10 mm, 20 mm, 30 mm each. Results: When patients were applied with TENS eyes closed at the unaffected lower extremity, AP, ML, and total sum of COP sway decreased significantly. Conclusion: In hemiplegic patients with independent standing, TENS application at the unaffected leg over five minutes can be helpful standing balance enhancement. (J Korean Acad Rehab Med 2009; 33: 159-164)
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The Effect of Laterally Wedged Insoles on Standing Balance of Patients with Osteoarthritis in the Medial Compartment of Knees.
Yang, Myoung Seok , Kim, Young Gene , Oh, Ki Young , Lee, Kyu Hoon , Choi, Ki Seob , Kim, Mi Jung
J Korean Acad Rehabil Med 2007;31(3):324-328.
Objective
To investigate the effect of laterally wedged insole on static balance of patients with degenerative osteoarthritic knees. Method: Eighteen female patients were diagnosed with medial compartment knee degenerative osteoarthritis (OA) based on symptoms and simple X-rays. Patients were studied while they stood wearing shoes with the 5 degrees or 10 degrees lateral wedged insoles compared with a bare foot. Patients chose a comfortable stance with feet spread apart, slightly turned outwards, and were asked to look straight ahead at a fixed point in a quiet room. Postural sway and weight load asymmetry were recorded while the patients were standing on two adjacent force platforms during a 30 second trial. Results: Postural sway and weight load asymmetry for 30 seconds were not significantly changed by wearing laterally wedged insoles with varying elevations (p>0.05). Conclusion: The degree of the postural sway and weight load asymmetry for 30 seconds with the insole were not affected by the tilt of the lateral wedge. (J Korean Acad Rehab Med 2007; 31: 324-328)
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Postural Sway and Limb Load Asymmetry in the Rural Inhabitants in Korea.
Shin, Joon Ho , Lee, Kyu Hoon , Han, Seung Hoon , Choi, Bo Youl , Park, Si Bog
J Korean Acad Rehabil Med 2006;30(5):502-507.
Objective
To evaluate the effects of age, height, weight, body mass index (BMI), diabetes mellitus, osteoporosis, smoking and alcohol on postural sway (PS) and limb load asymmetry (LLA) in the rural inhabitants in Korea Method: Nine hundred and sixty inhabitants were included in this study. PS and LLA were recorded while the subjects were standing on two adjacent force platforms (Mediance; Human-Tech Inc, Korea) in a comfortable stance for 30 seconds. Bone mineral density was measured in the right calcaneus by ultrasonography (Sahara; Hologic Inc, USA). History of diabetes and smoking were taken through interview. Results: PS and LLA were correlated with age (p<0.01). There were significant decreases in PS and LLA in the young age-group (p<0.01). There was no significant difference in PS and LLA in terms of sex, osteoporosis, height, weight, BMI and smoking. There was a significant difference in LLA (p<0.05) but no difference in PS between diabetic and normal groups. Conclusion: PS and LLA may be related with ageing. Diabetic group may have higher LLA than normal group. However, sex, osteoporosis, height, weight, BMI, and smoking may not affect on PS and LLA. (J Korean Acad Rehab Med 2006; 30: 502-507)
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Quantitative Assessment of Static and Dynamic Postural Sway Using COBETS in Patients with Balance Problem.
Kim, Yun Hee , Kim, Nam Kyun , Cha, Eun Jong , Kim, Hyoung Ihl , Seo, Jeong Hwan , Shin, Yong Il , Lee, Kyoung Moo
J Korean Acad Rehabil Med 1997;21(1):45-54.

Ability to control postural balance is a prerequisite for standing and gait training during the period of rehabilitation in patients with balance disorder. Precise and quantitative assessment of balance deficit as well as development of effective training methods are the important areas of research in this field.

The purposes of this study are ⸁ to assess the test- retest reliability and clinical feasibility of Computerized Balance Evaluation and Training System(COBETS) developed by Department of Medical Engineering and Department of Rehabilitation Medicine at Chonbuk National University and ⸂ to quantitatively assess the static and dynamic postural control ability of the patients with balance disorders due to various causes using COBETS and compare them with the results of normal control subjects.

The subjects consist of 21 patients with brain damage by stroke, head injury, or surgical procedure to control intractable epilepsy, 5 patients with lower extremity amputation, 6 patients with unilateral total hip replacement, and 50 normal control subjects. Fifteen out of 50 normal control subjects performed subsequent two trials to evaluate the test- retest reliability of the COBETS. There was no statistically significant difference between the results of first and second trials in static and dynamic postural sway measured by COBETS. Therefore, the COBETS is considered to have sufficient test- retest reliability. In the patients with brain damage, amputation, and hip joint replacement, static postural sways during comfortable, narrow, and affected one- leg stance were significantly increased than normal control subjects. Abnormal results in somatosensory evoked potential study and presence of motor weakness were negatively influenced to the results of static postural sway. In all the patients groups, the movement time, path error, and peripheral sway were markedly increased in forward and affected lateral directions compared with normal subjects. Abnormal sensory and motor findings also negatively influenced to some parameters of dynamic postural control. However, there was no difference in the postural sway among the patients groups divided by the causes of balance disorder.

The COBETS is considered as a reliable and clinically useful tool for quantitative assessment of static and dynamic postural control in the patients with balance disorders. Its usefulness for the training of balance control is subject to be defined in future.

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