To compare the effects of balance training with and without Gaze Stabilization exercises on clinical outcomes in elderly patient with chronic dizziness.
Total 64 participants after referral from ...neurologist at Lahore General Hospital were recruited in this study. These participants were randomly assigned into two groups i.e. Group A (Gaze group) and Group B (control group) with 32 participants in each group by sealed envelope method. Gaze group performed balance exercises with gaze stability exercise whereas, group B performed balance exercises with saccade eye exercises. Berg Balance Scale, Disability Handicapped Inventory, and Activity Specific Balance Confidence Scale were used to measure outcome variables.
Demographic variables were represented by mean, standard deviation and frequency distribution. Results showed that there was no baseline difference between gaze and control group (p > 0.05). Both groups showed improved results with the gaze group showing significantly more improvement as compare to the control group on balance (p < 0.05, Mean Group A = 44.1, Mean group B = 40.91), perceived disability (p < 0.05, Mean Group A = 52.84, Group B = 56.09), and risk of fall (p < 0.05, Mean Group A = 53.84, Mean Group B = 50.72) respectively.
This study concluded that gaze stability exercises with balance training are effective in improving balance, level of perceived disability, and risk of fall prevention among elderly patients with chronic dizziness.
•The BBS and PBS are valid and reliable functional balance tests and can differentiate functional balance ability among levels of GMFCS-E&R I to IV for adolescents with cerebral palsy.•PBS would be ...an easier test for examining static functional balance than the BBS in adolescents with moderate cerebral palsy.•BBS could be an appropriate functional test for adolescents with mild cerebral palsy.
The Berg balance scale (BBS) and the paediatric balance scale (PBS) are reliable tools for measuring balance ability. However, reports of BBS and PBS scores in adolescent cerebral palsy have been limited. The objectives of this study were to investigate functional balance capacities, as tested with the BBS and PBS in adolescents with cerebral palsy, to compare the total PBS and BBS scores between Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) levels and to compare the static balance PBS and BBS scores within each GMFCS-E&R level. Fifty-eight school-aged adolescents with cerebral palsy between the ages of 12 and 18 years with GMFCS-E&R levels of I to IV were recruited. The Kruskal–Wallis test was utilized to compare the median scores for the PBS and BBS between the different GMFCS-E&R levels. Wilcoxon signed-rank tests were performed to examine the differences in the static balance scores between the PBS and the BBS within the same GMFCS-E&R levels. The results reveal that there were differences in the BBS and PBS scores among the four GMFCS-E&R levels. A significant difference was found between the BBS and PBS scores only among the patients with cerebral palsy and level III GMFCS-E&R. The BBS and PBS are valid and reliable tools for clinical examination and for distinguishing between levels of functional balance in adolescents with cerebral palsy.
Falls are a major cause of morbidity and long-term hospitalization among growing older population. An automated and accurate fall-risk assessment system is vital to identify high fall-risk population ...and to prevent falls by early intervention. Therefore, this paper provides an objective, cost-effective, and unsupervised method to obtain functional balance and mobility assessment-based fall-risk of community-dwelling older adults. More specifically, waist-mounted triaxial accelerometer signals acquired from directed routine (supervised control movements) are used to estimate the well-known clinical assessment scoreBerg balance scale (BBS). The trunk acceleration signals are used to extract features and to find the optimal subset of features for each training data during repeated tenfold cross validation of the BBS estimation model. The average of two BBS estimates based on test and retest yielded a strong correlation p = 0.86 with the standard BBS score. Also, high correlation (p = 0.90) and low root-mean-square error (1.66) was observed between the two estimates of each subject. The proposed method is well suited for the assessment of balance impairment and prescreening of quantitative fall-risk in an unsupervised setting. It has the potential to act as a surrogate of the standard clinical assessment-BBS.
Introduction
Breast cancer is the most common cancer disease of women in industrialized countries. Neurotoxic chemotherapy drugs are known to harm peripheral nerves and cause a chemotherapy-induced ...peripheral neuropathy (CIPN). CIPN is one of the most common adverse events associated with Paclitaxel chemotherapy and may remain present long after the termination of chemotherapy. Thus, it reduces the patients’ quality of life (QoL) both during chemotherapy and onwards, and can impose a danger on breast cancer survivors due to an increased risk of falling and fall-related injuries.
Methods
The aim of this randomized-controlled trial (RCT) (
n
= 36) (IG: intervention group,
n
= 17) (CG: control group,
n
= 19) was to determine whether sensorimotor exercises have a positive effect on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy (Paclitaxel).
Results
As a result, we were able to show significant improvements in postural stability in monopedal stance left leg 16.17 ± 3.67 vs. 21.55 ± 5.33 (
p
< 0.001) and right leg 15.14 ± 2.30 vs. 20.85 ± 5.05 (
p
< 0.001) and in bipedal stance T1 vs. T0, − 0.49 (IG) vs. + 1.14 (CG)
p
= 0.039.
Discussion
These results in posturography correlate with the clinical presentation with intervention group patients scoring significantly better on the Fullerton Advanced Balance Scale 37.71 ± 2.73 vs. 34.47 ± 3.98 (
p
= 0.004). Moderate strength training successfully prevented a strength loss in the IG that was remarkable in the CG (− 1.60 vs. 0.60,
p
= 0.029). Concerning the psychological parameters assessed via EORTC- and MFI-questionnaires, no significant improvements were found.
Conclusion
Future studies should focus on the correlation of clinical and posturometry findings and subjective QOL such as the long-term-development of CIPN.
Background:
Evidence-based complementary treatment options for multiple sclerosis (MS) are limited.
Objective:
To investigate the effect of hippotherapy plus standard care versus standard care alone ...in MS patients.
Methods:
A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity.
Results:
Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54).
Conclusion:
Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.
Introduction
The purpose of this study was to evaluate balance function before and after total knee arthroplasty (TKA) using Berg balance scale (BBS). The study also aimed to identify factors ...associated with balance impairment.
Materials and methods
Ninety-three knees in 90 patients were prospectively evaluated using their BBS scores, passive knee extension/flexion angles, Visual analogue scale for pain scores, hip–knee–ankle angles, and knee extensor/flexor muscle strengths before and after TKA. A total BBS score of less than 45 indicates an enhanced risk of multiple falls. Multivariate logistic regression models were performed to elucidate factors associated with post-operative BBS score.
Results
A significant difference in mean pre- and post-operative BBS scores were noted (49.3 ± 6.4 vs. 52.2 ± 4.7) (
p
< 0.05). The percentage of pre- and post-operative BBS scores less than 45 were 20% and 10% (
p
< 0.05). Rheumatoid Arthritis (RA), lower pre-operative BBS score, and larger post-operative knee flexion contracture were significantly associated with lower post-operative BBS score (
p
< 0.01). The post-operative knee flexion contracture greater than 10° was significantly associated with substantially high odds of post-operative BBS scores less than 45 (Odds ratio 7.6; 95% confidential interval 1.69–34.17).
Conclusions
While TKA significantly improved BBS scores, 10% of the patients remained at a risk for multiple falls. RA, lower pre-operative BBS score, and post-operative knee flexion contracture greater than 10° retained balance impairment even after TKA.
Automating fall risk assessment, in an efficient, non-invasive manner, specifically in the elderly population, serves as an efficient means for implementing wide screening of individuals for fall ...risk and determining their need for participation in fall prevention programs. We present an automated and efficient system for fall risk assessment based on a multi-depth camera human motion tracking system, which captures patients performing the well-known and validated Berg Balance Scale (BBS). Trained machine learning classifiers predict the patient's 14 scores of the BBS by extracting spatio-temporal features from the captured human motion records. Additionally, we used machine learning tools to develop fall risk predictors that enable reducing the number of BBS tasks required to assess fall risk, from 14 to 4-6 tasks, without compromising the quality and accuracy of the BBS assessment. The reduced battery, termed Efficient-BBS (E-BBS), can be performed by physiotherapists in a traditional setting or deployed using our automated system, allowing an efficient and effective BBS evaluation. We report on a pilot study, run in a major hospital, including accuracy and statistical evaluations. We show the accuracy and confidence levels of the E-BBS, as well as the average number of BBS tasks required to reach the accuracy thresholds. The trained E-BBS system was shown to reduce the number of tasks in the BBS test by approximately 50% while maintaining 97% accuracy. The presented approach enables a wide screening of individuals for fall risk in a manner that does not require significant time or resources from the medical community. Furthermore, the technology and machine learning algorithms can be implemented on other batteries of medical tests and evaluations.
INTRODUCTIONInspiratory muscle training (IMT) has been widely used in both healthy and diseased populations especially in older adults, and its effects have been proven not only on inspiratory muscle ...strength but also on dyspnea, exercise capacity, quality of life, and other health parameters. AIMThis study aims to review the effects of IMT on balance and functional ability of healthy and diseased populations. METHODSA systematic literature search was conducted on MEDLINE, EMBASE, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized control trials having participants > 18 years of age and having balance and functional mobility as primary or secondary outcomes were included. Two independent reviewers screened studies against the eligibility criteria, extracted the data, and assessed the quality of evidence. The protocol was prospectively registered on PROSPERO: CRD42021261652. RESULTSTen studies were included in the review out of which eight had balance and six had functional mobility as an outcome measure. There was a significant improvement in balance of the participants after treatment with IMT, however the effect on functional mobility was inconclusive. CONCLUSIONThe review provided evidence of improvement in balance and functional mobility following inspiratory muscle training in both healthy and diseased adults. Future studies should be conducted to determine the optimal protocol and dosage of treatment.
Introduction
The Berg Balance Scale, possibly the most widely used balance-related measure, has gained popularity in clinical trials. It provides information about patients’ balance-related abilities ...and can be used to assess improvement or worsening after rehabilitation. The aim of this study is to determine the cut-off value of the Berg Balance Scale for the fall risk in patients with multiple sclerosis (MS).
Methods
This study was designed as a prospective descriptive trial, and 186 patients with MS were included. Fall history was recorded by interview; balance was assessed using the Berg Balance Scale (BBS).
Results
The mean ages of 96 patients with a fall history within the previous month and 90 patients without a fall history were 35.98 ± 8.58 and 35.71 ± 9.33 years, respectively. The mean value of the BBS score of the faller group was 49.44 ± 5.43 while 52.36 ± 3.53 in non-faller group. The cut-off value of the BBS for fall risk in patients with MS was determined as 50.50 points.
Conclusions
For patient safety and the success of rehabilitation, it is crucial to evaluate the risk of falling in patients with MS, one of the neurological patient groups where complaints about falling are most prevalent. The results showed that BBS is a sensitive and specific measure for identifying in patients with MS at risk of falling.
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