Static and dynamic postural control of postpartum women of different delivery methods

ObjectiveThe aim of this study was to determine whether there is a difference in postural control between nulligravida women and women who have given birth by vaginal or cesarean section.MethodsWomen who had only vaginal delivery in the previous 1–3 years were included in the vaginal delivery group (n = 27), those who had only cesarean delivery in the previous 1–3 years were included in the cesarean section group (n = 28), and those who had never given birth were included in the control group (n = 32). Evaluations were administered 6–8 days after the ovulation phase. Postural control of the participants was evaluated with the computerized dynamic posturography device.ResultsA total of 87 women with a mean age of 29.4 ± 4 years and a mean body mass index of 24.1 ± 3.1 kg/m² were included in the study. Antero-posterior somatosensory organization test values of the vaginal delivery group were lower than the control group (p = 0.0016). The cesarean delivery group had statistically lower antero-posterior somatosensory (p < 0.001 and p = 0.0013) and medio-lateral somatosensory (p = 0.002 and p = 0.017, respectively) test scores compared to the control group and the vaginal delivery group.ConclusionsIt was observed that women who birthed with vaginal or cesarean delivery had impaired somatosensory postural control. There is definitely a need for further studies with a long-term follow-up examining the effects of postural control during pregnancy and the postpartum period.     

Influence of footwear on postural sway: A systematic review and meta-analysis on barefoot and shod bipedal static posturography in patients and healthy subjects

BackgroundBipedal static posturography is widely used to assess postural control. However, standardized methods and evidence on the influence of footwear on balance in comparison to barefoot stance is sparse.Research questionsIs bipedal static posturography applied in a standardized way with respect to demographics and the experimental set-up (systematic review)? Does habitual footwear influence postural control in comparison to barefoot condition during bipedal static posturography in adult patients and healthy subjects (meta-analysis)?MethodsFor this systematic review and meta-analysis, a comprehensive follow-up literature search was conducted from March 2009 until January 2020 according to the PRISMA guidelines. Original, research articles reporting on bipedal, unsupported, static posturography in adults (≥18 years) were included according to inclusion criteria (age, sex, height, weight, duration, repetitions, visual/foot condition, sampling frequency). Studies comparing habitual footwear with barefoot condition during bipedal static posturography were included for the meta-analysis. Center of pressure parameters (sway velocity, range, root mean square, paths lengths) with subjects having eyes closed (EC) or open (EO) were analyzed using random effects models.ResultsFor this systematic review and meta-analysis, 207 and eight out of 5189 studies with 12'341 and 156 subjects, respectively, were eligible. Most studies (89%) reported barefoot, 5% shod, and 6% barefoot and shod measurements. Less than half of studies (44%) included patients of which the minority (13%) suffered from neurological disease. Sway velocity in the anterior-posterior direction was higher in habitual shoes compared to barefoot with EC (SMD: 1.08; 95% CI: 0.68–1.48; p < 0.01; I² = 0%), with EO (SMD: 0.68; 95% CI: 0.11–1.26; p = 0.02; I² = 1%), and in the medio-lateral direction with EC (SMD: 1.30; 95% CI: 0.76–1.85, p < 0.01; I² = 37%).SignificanceMethodical heterogeneity of bipedal static posturography hampers studies’ comparability. Thus, we provide a standardized approach to increase knowledge whether habitual footwear decrease postural control in comparison to barefoot stance.     

Do malocclusion and Helkimo Index ≥5 correlate with body posture?

Summary Whether there are correlations between the stomatognathic system and body posture remains controversial. Here, we have investigated whether malocclusal traits and having a Helkimo Index ≥5 show detectable correlations with body‐posture alterations in children and young adults. A total of 1178 11‐ to 19‐year‐old subjects were divided into four groups: (i) controls; (ii) malocclusion; (iii) Helkimo Index ≥5 and (iv) malocclusion + Helkimo Index ≥5. Dental occlusion assessment included the following: overbite, overjet, posterior crossbite, scissorbite, mandibular crowding and dental class. Subsequently, body‐posture assessments were performed through static analyses of body inclination and trunk asymmetry, and according to the dynamic Fukuda stepping test. Univariate and multivariate statistical analyses were performed. Although at the univariate level both the trunk asymmetry and Fukuda stepping test showed significant differences among the groups, the multivariate level revealed that age and gender were mostly responsible for this. The only significant correlation that was seen was for the malocclusion + Helkimo Index ≥5 group: these subjects had a positive (worse) trunk asymmetry and a negative (better) Fukuda stepping test performance. At the further multivariate analyses of each single malocclusal trait/Helkimo Index ≥5 (irrespective of the groups), only an increased overbite showed a statistically significant association with a slightly better Fukuda stepping test performance. Given the small number of significant associations seen and their limited entities, this study does not support the existence of clinically relevant correlations for malocclusal traits and Helkimo Index ≥5 with body posture in children and young adults.     

The effect of various jaw motor tasks on body sway

Alterations of body sway caused by isometric contractions of the jaw muscles have been reported previously. The objective of this study was to test if motor tasks of the masticatory system with different control demands affect body posture differently during quiet stance. Position and sway displacements of the center of foot pressure (COP) were measured for 20 healthy subjects who either kept the mandible at rest or performed unilateral and bilateral maximum voluntary teeth clenching, feedback-controlled biting tasks at submaximum bite forces, or unilateral chewing. Two weeks later the measurements were repeated. Compared with quiet stance, the COP results revealed significant changes during the feedback-controlled biting tasks. Robust sway reduction and anterior displacement of the COP were observed under these conditions. Body oscillations were not significantly affected by maximum bites or by unilateral chewing. For most of the variables investigated there were no significant differences between unilateral and bilateral biting. Robust sway reduction during feedback-controlled biting tasks in healthy subjects involved a stiffening phenomenon that was attributed to the common physiological repertoire of posture control, and might optimize the stability of posture under these conditions.     

Sinusoidal Transcranial Direct Current Versus Galvanic Vestibular Stimulation for Treatment of Lateropulsion Poststroke

Objective

To compare the effects of Transcranial Direct Current Stimulation (tDCS) versus Galvanic Vestibular Stimulation (GVS) on Lateropulsion following stroke.

Age-based normative data for a computerized dynamic posturography system that uses a virtual visual surround environment

Background: Computerized dynamic posturography (CDP) is the gold standard to differentiate between sensory, motor, and central adaptive impairments to postural control.

Objective: To obtain normative values in healthy adults age 20–69 for a CDP system that uses a full-field dynamic visual surround. This is in contrast to the mechanically movable visual surround used in traditional CDP systems.

Methods: Fifty healthy adults divided into five age groups were tested during the three test protocols for CDP: sensory organization test (SOT), motor control test (MCT), and adaptation test (ADT). Outcomes were compared across age groups and to published normative CDP values. Repeatability was assessed in five different subjects (23–30 years old) on 2 days, 1 week apart.

Results: Most outcomes were comparable to published norms with notable differences in SOT condition 4 and ADT. SOT composite and conditions 4–6, all MCT translations, and ADT toes up showed moderate to good repeatability (r?=?0.60 to 0.99). Age group and gender differences were not substantial.

Conclusions: Some but not all CDP outcomes with a virtual visual environment were comparable to published norms. The differences are likely related to the virtual surround having a more compelling effect on balance even in conditions with a stationary surround.     

Posturographic limits of stability can predict the increased risk of falls in elderly patients with instability?

Conclusions: There was a difference in average score of the sensory organization test (SOT) of the case group (elderly instability) compared to the control group (healthy subjects). Cases had worse scores on the limits of stability (LOS) than controls, but were only able to confirm statistically significant differences in the movement velocity.

Objective: To study the LOS of elderly patients with instability vs healthy subjects of the same age to try to explain the increased risk of falls in elderly patients with instability.

Methods: Fifty individuals ≥65 years, 30 cases (at least one of the next inclusion criteria: ≥1 fall in the last 12 months, >15?s or some support in the timed up and go test, composite <68 in SOT, ≥1 fall during production of the SOT) compared to 20 controls. Postural study: SOT and LOS, Smart Equitest Neurocom^® platform. Statistical analysis: t-Student test (p?Result: Mean value of overall balance: patients with instability =56% vs controls =77.1% (p p?=?0.029). The reaction time (cases =1217?s vs controls =1.077?s), excursion (56.95% vs 59.35%) and directional control (56.95% vs 59.35%) differences were not statistically significant.     

人体平衡功能检测系列研究(2):正常人静态平衡的正常参考值范围及相关因素

目的 探讨正常人群的静态平衡正常范围及相关的影响因素。方法 采用PH-A型平衡功能检测训练系统测定445名正常人的坐位、睁眼和闭眼双脚站位、左右单脚站位的平衡数据，并计算出各检测指标的正常参考值范围。结果 通过计算得出正常人群、男性、女性以及各年龄组人群的平衡功能指标正常参考值范围。结论 静态姿势平衡检测能客观、定量、准确地评价人体的平衡功能，其正常参考值范围的确定有助于平衡障碍的评估和相关疾病的诊断。