Static posturography across the EDSS scale in people with multiple sclerosis: a cross sectional study
|
|
- Owen Riley
- 6 years ago
- Views:
Transcription
1 Kalron et al. BMC Neurology (2016) 16:70 DOI /s RESEARCH ARTICLE Open Access Static posturography across the EDSS scale in people with multiple sclerosis: a cross sectional study Alon Kalron 1*, Dalia Nitzani 2 and Anat Achiron 2,3 Abstract Background: Posturography is considered the gold standard objective measure of standing postural control in people with multiple sclerosis (PwMS). This reliable tool provides quantitative data related to risk of falling and white and gray matter brain damage due to MS. Nevertheless, it remains unclear whether and to what extent, postural control declines throughout the disease process. We therefore examined the impact of disability on posturography measures in PwMS. Methods: In this cross-sectional study, the data pool was divided into seven levels of disability based on the Expanded Disability Status Scale (EDSS) score. The study group comprised 464 PwMS, mean disease duration was 6.2 (SD = 7.5) years and mean age 42.6 (SD = 14.1). Static postural control parameters were obtained from the Zebris FDM-T instrumented Treadmill (Medical GmbH, Germany). Results: A significant positive correlation between the EDSS and posturography parameters was found. Scores for the ellipse area, center of pressure (CoP) path length and sway rate with eyes open were Spearman s rho =0.512, 0.527, ; (P-value < 0.001), respectively. Non-significant differences were observed between the EDSS subgroups at the lower end of the spectrum (EDSS 0 2.5) in all posturography parameters. In contrast, MS patients with an EDSS score of demonstrated a significant increase in the ellipse area with eyes open (~108 %) and closed (~169 %), CoP path length with eyes open (~83 %) and closed (~88 %) and sway rate with eyes open (~39 %) and closed (~148 %), compared with those who scored within the range of in the EDSS. Non-significant differences were observed between MS patients with an EDSS score of MS patients with an EDSS score of were significantly poorer in 4 (out of 6) balance measures compared to other disability subgroups. Conclusions: Posturography CoP trajectories are appropriate outcome measures indicating disability deterioration in PwMS. Keywords: Multiple sclerosis, Balance, Postural control, EDSS, Disability, Neurological Background Balance disorders, common in people with multiple sclerosis (PwMS), is considered one of the most disabling symptoms of the disease. Balance deterioration negatively effects mobility and independence, leading to falls and injuries, adversely affecting the overall quality of life [1]. This deterioration appears in MS individuals with minimal or no clinically assessable impairments [2], * Correspondence: alkalron@gmail.com 1 Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel Full list of author information is available at the end of the article becoming more pronounced in those with significant disease progression [3]. Balance relies on integration of inputs from the visual, somatosensory and vestibular systems, which are frequently impaired in PwMS [4]. Based on several studies reporting on balance in PwMS, it appears that the primary mechanisms underlying the observed changes are slowed somatosensory conduction and impaired central integration [5]. Recently, Fling et al. found a strong relationship between poor postural control and reduced white matter integrity of the cortical proprioceptive tract in MS [6]. Moreover, muscle weakness and spasticity further compromise the 2016 Kalron et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
2 Kalron et al. BMC Neurology (2016) 16:70 Page 2 of 8 ability to balance by affecting the sequencing and force of muscle contraction [7]. Many objective and subjective measures aimed at assessing balance in the MS population have been described [8]. Compared to clinical balance scales, posturography measures have significant advantages such as objectivity, high sensitivity, absence of a ceiling effect and providing linear values [9]. This tool has been used to identify balance impairments in PwMS for over 30 years [10]. Since then its practice has dramatically increased, providing quantitative data frequently published in various clinical trials [9]. In a series of papers published by Prosperini et al., posturography scores of PwMS undergoing an MRI were found related to atrophy along the connections between the spinal cord, cerebellum and cerebral cortex. [11, 12]. Moreover, the same research group reported that the center of pressure(cop)pathmeasurementtakeninastaticpositionisa sensitive and accurate tool in identifying PwMS at risk of accidental falls [13]. This observation was reinforced by another report, indicating that MS fallers have a longer CoP trajectory line compared to non-fallers and is strongly correlated with the level of fear of falling [14]. Furthermore, in a longitudinal cohort study performed on 57 PwMS, static posturography scores were found associated with a decline in walk velocity over time [15]. These reports emphasize the exclusive contribution of posturography in the management of PwMS. However, there are still some reservations as to the use of posturography in PwMS, ie, most previous studies did not divide posturography scores according to the neurological impairment level which can ascertain whether and to what extent, postural control declines throughout the disease process. Moreover, is there a specific posturography parameter that can distinguish between disability levels? Does the presence or absence of vision have a similar effect on posturography scores on all disability levels? New information as to these queries can be beneficial to neurologists in terms of assessment and prognosis of disabilities in the MS population. Additionally, it may stimulate improved rehabilitation strategies aimed at improving postural control. Therefore, the objective of the current study was to examine posturography measures in a relatively large group of PwMS. The data pool was divided into seven levels of disability based on the Expanded Disability Status Scale (EDSS) score. Methods Study design and participants This was an observational cross-sectional study including 464 PwMS, 299 women and 165 men from the Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Inclusion criteria included: (1) a neurologistconfirmed diagnosis of definite MS according to the revised McDonald criteria [16]; (2) <7.0 on the EDSS [17], equivalent to walking at least 20 m without resting; (3) a static posturography test was performed between January 2012 and September 2015; and (4) the patient was relapse-free for at least 30 days prior to testing. Exclusion criteria included: (1) orthopedic disorders that could negatively affect balance; (2) pregnancy; (3) blurred vision; (4) cardiovascular disorders; (5) respiratory disorders; (6) or ingesting steroids. Retrospective data from 40 apparently healthy adults (27 women and 13 men), mean age of 32 (S.D. = 6.8) were collected. The study was approved by the Sheba Hospital Research Ethics Committee (Ethics Ref: / ). All participating subjects signed an informed consent form for use of their data in the research projects. Posturography Static postural control parameters were obtained from the Zebris FDM-T Treadmill (zebris Medical GmbH, Germany). The treadmill is fitted with an electronic mat embedded underneath the belt consisting of 10,240 miniature force sensors, each approximately cm. As the subject stands on the treadmill, the force exerted by his feet (the so-called reactive-normal force) is recorded by the sensors at a sampling rate of 120 Hz. Due to the high density of the sensors, the foot is mapped at a high resolution so that even subtle changes in force distribution and timing can be monitored. Dedicated software integrates the force signals and provides 2-D/3-D graphic representation of the center of pressure (CoP) trajectories during static stance. A set of outcome measures taken from the CoP data were: 1. the ellipse sway area (mm 2 ), defined as a 95 % confidence ellipse for the mean of the CoP anterior, posterior, medial and lateral coordinates. 2. the CoP path length (mm), defined as the absolute length of the CoP path movements throughout the testing period. 3. the sway rate (mm/s), defined as the mean speed of movement of the CoP throughout the testing period. Each subject completed a sequence of three consecutive postural control tests under two different task conditions with a 1-min break between tasks. Each task was repeated three times for 30-s, followed by a 30-s rest period with: 1. Eyes open: Subjects stood barefoot on the treadmill belt (a 10 cm gap between heels, in a 5 toe-out position), in an upright static position with arms resting at their sides. Participants were instructed to maintain their posture as steady as possible while visually focusing on a dot marked 1 m, located directly in front of them.
3 Kalron et al. BMC Neurology (2016) 16:70 Page 3 of 8 2. Eyes closed: Identical conditions to eyes open but with eyes closed. Static posturography was performed at the Center of Advanced Technologies in Rehabilitation, Sheba Medical Center. Measurements were taken by an experienced physical therapist specialized in neurological rehabilitation. Expanded Disability Status Scale (EDSS) The EDSS, an accepted method of quantifying disability in MS consists of an eight-function system scale monitoring motor, sensory, cerebellar, brain stem, visual, bowel and bladder, pyramidal and other functions. Each domain is graded from 0 = no disability to 5 or 6 = maximal disability. 17 According to the score achieved from each functional system, an integrated score between 0 = normal examination and 10 = death from MS is derived. A score ranging from 1.0 to 4.5 denotes patients who are fully ambulatory without an aid; a score from 5.0 to 7.5 reveals moderate to severe impairment in ambulation. An EDSS level of 6.0 is primarily defined by the need of a unilateral aid for walking at least 100 m; an EDSS level of 6.5 is defined by the need of a bilateral walking aid; and a score from 8.0 to 9.5 refers to PwMS essentially restricted to bed. PwMS were divided into seven levels of disability groups based on their EDSS score. As the half step on the EDSS scale at EDSS levels does not represent a significant difference in disability, we assigned participants to groups encompassing different EDSS scores: an EDSS score under 1.0, EDSS scores of , , , and (using a walking aid). Statistical analysis Descriptive statistics determined the demographic and clinical characteristics of the study participants according to their level of neurological impairment. Posturography data were normally distributed according to the Kolmogorov- Smirnov test. Outliers were determined for each outcome using box plots. Differences in posturography parameters between PwMS subgroups were determined using the analysis of variance (ANOVA) test. A post-hoc Bonferonni adjustment enabled multiple comparisons between EDSS subgroups. Additionally, we present Spearman s rank correlation coefficient between EDSS scores and posturography outcomes. All analyses were performed using SPSS software (Version 23.0 for Windows, SPSS Inc. Chicago, IL, USA). All reported P-values were two-tailed. The level of significance was set at P <0.05. Results The mean EDSS for the entire study group was 2.8 (SD = 1.8), median score of 2.5, mean disease duration was 6.2 (SD = 7.5) years and mean age 42.6 (SD = 14.1). In terms of EDSS categories, the scores of the pyramidal, cerebellar and sensory divisions were 1.7 (SD = 1.2), 0.9 (SD = 1.1) and 0.9 (SD = 1.0), respectively. Median scores for all EDSS subcategories was zero. No differences were observed between the MS patient subgroups in terms of height (P-value = 0.474), body mass (P-value =0.397) and gender ratio (P-value =0.736). As expected, age and disease duration was increased in the high disability groups compared to patients in the lower disability level groups (P-value < 0.001). The individuals characteristics and neurological assessment scores are summarized in Table 1. Posturography scores of the healthy subjects for the ellipse area (mm 2 ), CoP length (mm) and sway rate (mm/s) with eyes open were 43.5 (SD = 32.9), 97.3 (SD = 46.8) and 5.1 (SD = 3.4), respectively. Parallel measures performed with eyes closed were 79.7 (SD = 63.6), (SD = 72.9), Table 1 Demographic and clinical characteristics of the study group EDSS (n = 464) <1.0 (n = 57) (n = 78) (n = 118) (n = 45) (n = 93) (n = 26) (n = 47) Age (years) 35.5 (13.4) 34.5 (13.2) 42.1 (14.0) 47.1 (13.2) 48.0 (11.8) 48.3 (9.1) 49.5 (13.0) Female Male Disease duration (years) 0.4 (1.1) 4.3 (6.0) 5.6 (7.5) 6.5 (6.2) 7.8 (8.3) 8.8 (6.0) 9.4 (8.4) Height (cm) (8.9) (8.8) (9.4) (8.4) (9.2) (22.7) (8.6) Weight (kg) 66.4 (17.7) 66.9 (14.1) 69.1 (15.8) 66.6 (11.7) 70.7 (15.8) 75.3 (25.1) 71.5 (14.9) EDSS (score) 0.2 (0.1) 1.2 (0.2) 2.2 (0.2) 3.2 (0.3) 4.2 (0.2) 5.2 (0.3) 6.1 (0.2) Pyramidal 0.2 (0.1) 0.7 (0.6) 1.3 (0.8) 2.3 (0.8) 2.6 (0.8) 2.7 (0.9) 3.3 (0.6) Cerebellar 0.1 (0.1) 0.2 (0.5) 0.5 (0.8) 1.2 (1.1) 1.8 (1.0) 2.0 (0.9) 1.7 (1.3) Sensory 0.1 (0.1) 0.3 (0.5) 0.9 (1.0) 1.2 (1.1) 1.3 (1.1) 1.2 (1.1) 1.6 (1.1) Scores are presented as mean (SD)
4 Kalron et al. BMC Neurology (2016) 16:70 Page 4 of (SD = 3.7). Posturography scores for the MS sample pool are provided in Table 2 and presented graphically infigs.1,2and3.scoresofthetotalmssamplefor the ellipse area (mm 2 ), CoP length (mm) and sway rate (mm/s) with eyes open were (SD = 189.3), (SD = 169.1) and 12.5 (SD = 17.5), respectively. Parallel measures performed with eyes closed were (SD = 556.8), (SD = 460.3), 21.0 (SD = 18.8). A significant positive correlation between the EDSS and all six posturography parameters was found. Scores for the ellipse area, CoP path length and sway rate with eyes open were Spearman s rho= 0.512, 0.527, 0.528; (P-value < 0.001), respectively. Parallel measures performed with eyes closed were 0.540, 0.535, 0.555; (P-value < 0.001). Table 3 describes the Bonferoni post-hoc analysis results. Non-significant differences were observed between the EDSS subgroups at the lower end of the spectrum (EDSS 0 2.5) in all posturography parameters. In contrast, MS patients with an EDSS score of demonstrated a significant increase in the ellipse area with eyes open (~108 %) and closed (~169 %), CoP path length with eyes open (~83 %) and closed (~88 %), and sway rate with eyes open (~39 %) and closed (~148 %) compared with those who scored in the EDSS range. Non-significant differences were observed between MS patients with an EDSS score of With the exception of the ellipse area during eyes open, MS patients with an EDSS score of were significantly poorer in all balance measures compared to other disability subgroups. Discussion The primary aim of the present study was to determine posturography measures in PwMS according to the level of neurological disability. Numerous studies have shown that elevated posturography measures are associated with brain damage and clinically relevant syndromes in PwMS, such as falling and ambulation [10 15]. This background information encouraged us to expand the current base of knowledge of posturography scores in PwMS. Auniqueaspectofourstudystemsfromtherelatively large data pool (n = 464). The substantial amount of subjects facilitated distribution of the posturography records into seven, relatively large, disability subgroups. Consequently, the present study provides an insight into the development of postural control throughout the disease course. Several novel findings were highlighted in our study such as the nonsignificant difference in CoP trajectories between patients in the lower disability level groups (EDSS 0 2.5). This statement refers to posturography measures collected with and without vision. Nevertheless, we did observe a significant increase in CoP trajectories when PwMS reached the mild-moderate disability level, represented by EDSS scores of 3 and 4. Interestingly, PwMS, classified in the EDSS 3 4 range are normally considered fully ambulatory, indicating that static postural control deterioration is preliminary to a reduction in maximum walking distance, the main factor shifting patients within the EDSS range of 4 through [7]. However, this finding is not altogether new. Previous studies have shown that minimally impaired PwMS and even clinically isolated syndrome patients demonstrate poorer postural control and altered spatio-temporal characteristics of gait [18, 19]. Generally, our observations are in line with previous reports exploring posturography in PwMS [20 22], confirming that there is a positive relationship between posturography data to level of disability. Worth noting, Cao et al s study cohort investigated MS patients up to level 4.5 [20, 21] while Boes et al. divided the MS participants into only two disability levels, EDSS and [22]. We therefore, believe that the current study is more encouraging compared to the previous reports. We provided statistics from a wider range of disability levels together with data from precise disability levels. Moreover, the current database may serve as a reference for future research studies and clinical trials monitoring posturographic data in the MS community. Table 2 Posturography measurements of the study group Posturographic parameter EDSS (n = 464) <1.0 (n = 57) (n = 78) (n = 118) (n = 45) (n = 93) (n = 26) (n = 47) Eyes open Ellipse area (mm 2 ) 41.3 (44.7) 82.9 (124.7) (154.2) (199.3) (171.0) (184.4) (227.2) CoP path length (mm) 97.1 (58.9) (112.8) (150.2) (177.7) (145.2) (155.8) (232.8) Sway rate (mm/s) 5.8 (6.2) 9.0 (14.5) 11.3 (22.8) 13.1 (18.8) 15.4 (17.9) 16.5 (7.9) 18.9 (11.8) Eyes closed Ellipse area (mm 2 ) 74.5 (74.0) (271.3) (328.7) (660.3) (578.0) (568.3) (641.5) CoP path length (mm) (88.1) (229.5) (213.4) (342.0) (324.9) (421.9) (672.8) Sway rate (mm/s) 9.7 (10.8) 14.0 (13.3) 15.4 (12.5) 24.0 (17.6) 27.1 (15.9) 26.9 (22.9) 39.5 (23.6)
5 Kalron et al. BMC Neurology (2016) 16:70 Page 5 of 8 Fig. 1 Ellipse area measures according to EDSS subgroups Fig. 2 CoP path length measures according to EDSS subgroups
6 Kalron et al. BMC Neurology (2016) 16:70 Page 6 of 8 Fig. 3 Sway rate measures according to EDSS subgroups Interestingly, we report that MS individuals with mobility aids (EDSS score of 6 6.5) are unique in terms of posturography measures. Individuals in this group scored significantly higher in 4 (out of 6) CoP trajectory scores compared to other subgroups, including the EDSS group. All participants, including those with mobility aids, performed the postural control tests standing still with no upper limb support. Previous trials have examined posturography measurements in PwMS with mobility aids [3, 11 13, 15]. However, the data of MS mobility aid users were combined with scores of MS participants without mobility aids. Since PwMS with mobility aids suffer from significantly worse postural control compared to other MS patients, we strongly suggest separately analyzing posturographic outcomes of MS mobility aid users. Furthermore, our data may positively affect the decision-making process as to whether a walking aid (e.g. cane) is necessary. Our study cannot explain the cause-effect relationship between impaired postural control and usage of canes in MS. The question whether poor postural control will lead to PwMS adapting to a walking aid or does ambulating with a walking aid worsen postural control, remains open. However, we believe that interventions aimed at improving postural control are essential and can help maintain the disability level of a PwMS. Therefore, in light of the present findings, we propose implementing such interventions prior to the point when the maximum walking distance begins to lessen, namely before PwMS reach level EDSS 4. A recent systematic review confirms that interventions to improve balance are effective in adults with MS [23]. Another contribution of this study relates to the conditions under which posturography scores were collected. In the present report, scores of CoP trajectories collected with closed eyes had an advantage in differentiating between the EDSS subgroups compared to identical values collected under open eyes. As is known, proper balance control is based on the vision, vestibular and somatosensory systems. When one system becomes neutralized, the others must compensate. Since, PwMS measured under closed eyes had to rely more on the somato-sensory and vestibular systems; we speculate that one or both of these components deteriorate at the EDSS range of in a manner that impairs postural control. These statements are in line with previous reports investigating balance capabilities with and without vision in PwMS [11, 24]. This assumption is also reinforced by Prosperini s et al. recent publication which examined the relationship between posturography measures and brain damage in 50 PwMS. They reported that the extent of the CoP path length under eyes open indicated different patterns of damage in the cerebellum and spinal cord compared to the CoP path length under eyes closed [11]. A limitation of this study is its cross-sectional design. Additionally, poor postural control may be due to the
7 Kalron et al. BMC Neurology (2016) 16:70 Page 7 of 8 Table 3 P-value for posturography parameters according to disability level sum of multiple impairments. Potential risk factors previously investigated include vestibular dysfunction, spasticity, fatigue, cognitive deficits and reduced lower limb strength [25]. In this context, we did not take into account all potential risk factors. Nevertheless, the exact contribution of these factors related to the risk of falling in MS patients, is controversial. Finally, compared to previous reports, the current study s CoP sampling duration was relatively short, consisting of only 3 consecutive repetitions of 30 s. Although evaluation of CoP excursions is a commonly used method for measuring postural stability in various pathological conditions, no standardization exists. While some studies suggest that reliable data may be obtained from sample durations of 10s [26], others propose intervals of up to 120 s [27]. Moreover, the majority of these studies base their recommendations on data collected solely from healthy subjects. To date, optimal sampling duration necessary for static postural control evaluation in PwMS is questionable. Despite these statements, we believe that the static posturography measure represents the multifactorial nature of balance in MS.
8 Kalron et al. BMC Neurology (2016) 16:70 Page 8 of 8 Conclusions Results of the current study illustrate that posturography measures change during the disease. While CoP trajectories tend to perform steadily in lower levels of disability, a significant increase occurs once patients reach an EDSS score of 3. Furthermore, MS mobility aid users showed worse postural control than all other disability groups. From a clinical standpoint, the present information can benefit all those involved in the management of PwMS, especially in centers using posturography devices. We encourage clinicians to follow CoP trajectories outcomes as it appears to indicate disability deterioration in PwMS. Hopefully, addressing this phenomenon before it is expected to rise, can preserve the mobility abilities of these individuals. Nevertheless, additional research is still needed in order to attain a clearer perspective as to the mechanisms involved in impaired postural control in the MS community. Abbreviations ANOVA: analysis of variance test; COP: center of pressure; EDSS: expanded disability status scale; PwMS: people with multiple sclerosis. Funding None. Availability of data and materials Written consent to publish was not obtained from all participants. Therefore the data will not be made available in order to protect the participants identity. Authors contributions AK, DN, AA contributed to the design of the study concept, in analysis and interpretation of results and in drafting/revising the manuscript for content. AK performed the acquisition of data and statistical analysis, DN active role in performing and collecting the posturography measures and AA supervised and helped draft the manuscript. All authors have read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Declarations The study was approved by the Sheba Hospital Research Ethics Committee (Ethics Ref: /141210). All participating subjects signed an informed consent form for use of their data in the research projects. Author details 1 Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. 2 Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel. 3 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Received: 17 January 2016 Accepted: 16 May 2016 References 1. Matsuda PN, Shumway-Cook A, Ciol MA, Bombardier CH, Kartin DA. Understanding falls in multiple sclerosis: association of mobility status, concerns about falling, and accumulated impairments. Phys Ther. 2012;92: Kalron A, Achiron A, Dvir Z. Effect of a cognitive task on postural control in patients with a clinically isolated syndrome suggestive of multiple sclerosis. Eur J Phys Rehabil Med. 2011;47: Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Pula JH, Suh Y, et al. Mobility, balance and falls in persons with multiple sclerosis. PLoS One. 2011;6: e Cattaneo D, Jonsdottir J. Sensory impairments in quiet standing in subjects with multiple sclerosis. Mult Scler. 2009;15: Cameron MH, Horak FB, Herndon RR, Bourdette D. Imbalance in multiple sclerosis: a result of slowed spinal somatosensory conduction. Somatosens Mot Res. 2008;25: Fling BW, Dutta GG, Schlueter H, Cameron MH, Horak FB. Associations between proprioceptive neural pathway structural connectivity and balance in people with multiple sclerosis. Front Hum Neurosci. 2014;8: Sosnoff JJ, Gappmaier E, Frame A, Motl RW. Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther. 2011;35: Cattaneo D, Jonsdottir J, Repetti S. Reliability of four scales on balance disorders in persons with multiple sclerosis. Disabil Rehabil. 2007;29: Prosperini L, Pozzilli C. The clinical relevance of force platform measures in multiple sclerosis: a review. Mult Scler Int. 2013;2013: Daley ML, Swank RL. Quantitative posturography: use in multiple sclerosis. IEEE Trans Biomed Eng. 1981;28: Prosperini L, Petsas N, Raz E, Sbardella E, Tona F, Mancinelli CR, et al. Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis. Mult Scler. 2014;20: Prosperini L, Sbardella E, Raz E, Cercignani M, Tona F, Bozzali M, et al. Multiple sclerosis: white and gray matter damage associated with balance deficit detected at static posturography. Radiology. 2013;268: Prosperini L, Fortuna D, Giannì C, Leonardi L, Pozzilli C. The diagnostic accuracy of static posturography in predicting accidental falls in people with multiple sclerosis. Neurorehabil Neural Repair. 2013;27: Kalron A, Achiron A. Postural control, falls and fear of falling in people with multiple sclerosis without mobility aids. J Neurol Sci. 2013;335: Fritz NE, Newsome SD, Eloyan A, Marasigan RE, Calabresi PA, Zackowski KM. Longitudinal relationships among posturography and gait measures in multiple sclerosis. Neurology. 2015;84: Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69: Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS). Neurology. 1983;33: Martin CL, Phillips BA, Kilpatrick TJ, Butzkueven H, Tubridy N, McDonald E, et al. Gait and balance impairment in early multiple sclerosis in the absence of clinical disability. Mult Scler. 2006;12: Kalron A, Achiron A. Postural control, falls and fear of falling in people with multiple sclerosis without mobility aids. J Neurol Sci. 2013;335: Cao H, Peyrodie L, Agnani O, Cavillon F, Hautecoeur P, Donzé C. Evaluation of an Expanded Disability Status Scale (EDSS) modeling strategy in multiple sclerosis. Med Biol Eng Comput. 2015;53: CaoH,PeyrodieL,BoudetS,CavillonF,AgnaniO,HautecoeurP,etal.Expanded Disability Status Scale (EDSS) estimation in multiple sclerosis from posturographic data. Gait Posture. 2013;37: Boes MK, Sosnoff JJ, Socie MJ, Sandroff BM, Pula JH, Motl RW. Postural control in multiple sclerosis: effects of disability status and dual task. J Neurol Phys Ther. 2012;315: Gunn H, Markevics S, Haas B, Marsden J, Freeman J. Systematic review: The effectiveness of interventions to reduce falls and improve balance in adults with multiple sclerosis. Arch Phys Med Rehabil. 2015;296: Denommé LT, Mandalfino P, Cinelli ME. Understanding balance differences in individuals with multiple sclerosis with mild disability: an investigation of differences in sensory feedback on postural control during a Romberg task. Exp Brain Res. 2014;232: Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of risk factors for falls in multiple sclerosis: a systematic review and meta-analysis. Phys Ther. 2013;93: Riley PO, Benda BJ, Gill-Body KM, Krebs DE. Phase plane analysis of stability in quiet standing. J Rehabil Res Dev. 1995;32: Carpenter MG, Frank JS, Winter DA, Peysar GW. Sampling duration effects on center of pressure summary measures. Gait Posture. 2001;13:35 40.
Somatosensory Impairment and Balance Dysfunction in Multiple Sclerosis
University of Massachusetts Medical School escholarship@umms UMass Center for Clinical and Translational Science Research Retreat 2014 UMass Center for Clinical and Translational Science Research Retreat
Agings and the parameters in static postural way
Proceeding 8th INSHS International Christmas Sport Scientific Conference, 5-7 December 2013. International Network of Sport and Health Science. Szombathely, Hungary Agings and the parameters in static
Mellen Center Approaches Exercise in MS
Mellen Center Approaches Exercise in MS Framework: Physical exercise is generally recommended to promote fitness and wellness in individuals with or without chronic health conditions. Implementing and
Physical exercise in MS / Tallinn Anders Romberg, PhD, Physical Therapist Neuro Society / Masku Neurological Rehabilitation Centre
Physical exercise in MS 20.3.2015 / Tallinn Anders Romberg, PhD, Physical Therapist Neuro Society / Masku Neurological Rehabilitation Centre 2 Finnish Neuro Society Content; 5 perspectives 1) Historical
Cleveland Clinic Mellen Center for Multiple Sclerosis. Mellen Center Approaches: Falls and Fall Prevention in MS. Q: What is a fall?
Mellen Center Approaches: Falls and Fall Prevention in MS Q: What is a fall? A: A fall can be defined as an unplanned change in position resulting in the individual resting on the ground or a lower level.
Improving Balance and Mobility in People with Multiple Sclerosis
University of Massachusetts Medical School escholarship@umms UMass Center for Clinical and Translational Science Research Retreat 2014 UMass Center for Clinical and Translational Science Research Retreat
Alon Kalron 1*, Ilia Fonkatz 2, Lior Frid 2, Hani Baransi 3 and Anat Achiron 2,4
Kalron et al. Journal of NeuroEngineering and Rehabilitation (2016) 13:13 DOI 10.1186/s12984-016-0124-y RESEARCH Open Access The effect of balance training on postural control in people with multiple sclerosis
University of Groningen. Maintaining balance in elderly fallers Swanenburg, Jaap
University of Groningen Maintaining balance in elderly fallers Swanenburg, Jaap IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please
Whom to Target for Falls-Prevention Trials
Whom to Target for Falls-Prevention Trials Recommendations from the International MS Falls Prevention Research Network Michelle Cameron, MD, PT, MCR; Susan Coote, PhD, PT; Jacob J. Sosnoff, PhD Effective
Mary Fitzpatrick, ANP, MSCN Michelle Cameron, MD, PT
Mary Fitzpatrick, ANP, MSCN Michelle Cameron, MD, PT This continuing education activity is managed and accredited by Professional Education Service Group. The material presented in this activity represents
ScienceDirect. The impact of the severity of knee osteoarthritis on the postural stability
Available online at www.sciencedirect.com ScienceDirect Materials Today: Proceedings 3 (2016 ) 1069 1073 DAS 2015 The impact of the severity of knee osteoarthritis on the postural stability G. Nagymate
Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis
490546MSJ20110.1177/1352458513490546Multiple Sclerosis JournalProsperini et al. 2013 Research Paper MULTIPLE SCLEROSIS JOURNAL MSJ Balance deficit with opened or closed eyes reveals involvement of different
ORIGINAL CONTRIBUTION. Multiple Sclerosis That Is Progressive From the Time of Onset
ORIGINAL CONTRIBUTION Multiple Sclerosis That Is Progressive From the Time of Onset Clinical Characteristics and Progression of Disability P. B. Andersson, MBChB, DPhil; E. Waubant, MD; L. Gee, MPH; D.
Institute of Neurobiology Bulgarian Academy of Sciences. Postural and Motor Coordination during Sensory Conflict across the Life Span
Institute of Neurobiology Bulgarian Academy of Sciences Postural and Motor Coordination during Sensory Conflict across the Life Span Katerina Kirilova PhD student Scientific Supervisor: Assoc. Prof. Plamen
CURRICULUM VITAE Brian M. Sandroff
CURRICULUM VITAE Brian M. Sandroff Institutional Address Brian M. Sandroff, Ph.D. Assistant Professor, Department of Physical Therapy School of Health Professions The University of Alabama at Birmingham
Falls and Multiple Sclerosis (MS)
6/9/14 Balance Based Torso Weighting Results in Fall Reduction during Sensory Organization Test for People with Multiple Sclerosis Kristin Horn BS, Cynthia Gibson Horn PT, Diane D Allen PhD, PT, Gail L
Fall risk in people with MS: A Physiological Profile Assessment study.
University of Plymouth PEARL Faculty of Health and Human Sciences https://pearl.plymouth.ac.uk School of Health Professions 2016-01 Fall risk in people with MS: A Physiological Profile Assessment study.
Simplifying Treatment Dilemmas: Comparing Two Patients
A CASE STUDY Simplifying Treatment Dilemmas: Comparing Two Patients Impairments Drive Specialized Treatment Plan Patients A and B are elderly individuals referred from family practice presenting with mild
Supplementary Online Content
Supplementary Online Content Schlaeger R, Papinutto N, Zhu AH, et al. Association between thoracic spinal cord gray matter atrophy and disability in multiple sclerosis. JAMA Neurol. Published online June
Overview The BBS is a widely-used, clinician-rated scale used to assess sitting and standing, static and dynamic balance.
Core Measure: Berg Balance Scale (BBS) Overview The BBS is a widely-used, clinician-rated scale used to assess sitting and standing, static and dynamic balance. Number of Test Items The BBS consists of
MEDIA BACKGROUNDER. Multiple Sclerosis: A serious and unpredictable neurological disease
MEDIA BACKGROUNDER Multiple Sclerosis: A serious and unpredictable neurological disease Multiple sclerosis (MS) is a complex chronic inflammatory disease of the central nervous system (CNS) that still
Multiple Sclerosis and Falls An Evolving Tale
Multiple Sclerosis and Falls An Evolving Tale Jacob J Sosnoff, 1 Robert W Motl 1 and Steven Morrison 2 1. Associate Professor, Department of Kinesiology and Community Health, College of Applied Health
CORE MEASURE: CORE MEASURE: BERG BALANCE SCALE (BBS)
OVERVIEW NUMBER OF TEST ITEMS SCORING EQUIPMENT TIME (NEW CLINICIAN) TIME (EXPERIENCED CLINICIAN) COST o The BBS is a widely-used, clinician-rated scale used to assess sitting and standing, static and
System for Evaluation of the Static Posturography Based on Wii Balance Board
System for Evaluation of the Static Posturography Based on Wii Balance Board PIVNICKOVA L., DOLINAY V., VASEK V. Faculty of Applied Informatics Tomas Bata University in Zlin nam. T.G.Masaryka 5555, 760
Natus Medical Incorporated is the sole designer, manufacturer, and seller of the following systems:
Natus Medical Incorporated 9570 SE Lawnfield Road Clackamas, OR 97015 Phone: (800) 767-6744 www.onbalance.com SOLE SOURCE NeuroCom Balance Manager systems consist of hardware and software that provide
Multiple sclerosis (MS) impairs cognition, Community Delivery of a Comprehensive Fall-Prevention Program in People with Multiple Sclerosis
Community Delivery of a Comprehensive Fall-Prevention Program in People with Multiple Sclerosis A Retrospective Observational Study Cinda L. Hugos, MS, PT; Debra Frankel, MS, OT; Sara A. Tompkins, PhD;
World's largest Science, Technology & Medicine Open Access book publisher
PUBLISHED BY World's largest Science, Technology & Medicine Open Access book publisher 3,000+ OPEN ACCESS BOOKS BOOKS DELIVERED TO 151 COUNTRIES 101,000+ INTERNATIONAL AUTHORS AND EDITORS AUTHORS AMONG
Kathryn D. Mitchell, PT, DPT, NCS, MSCS; Han Chen, MD, MPH; Sheri P. Silfies, PT, PhD
Test-Retest Reliability, Validity, and Minimal Detectable Change of the Balance Evaluation Systems Test to Assess Balance in Persons with Multiple Sclerosis Kathryn D. Mitchell, PT, DPT, NCS, MSCS; Han
Why Train Your Calf Muscles
Why Train Your Calf Muscles 1 Why Train Your Calf Muscles The muscles of the calf are often considered genetic muscles among fitness enthusiasts, suggesting that one is born with sizable and well developed
FES Standing: The Effect of Arm Support on Stability and Fatigue During Sit-to-Stand Manoeuvres in SCI Individuals
FES Standing: The Effect of Arm Support on Stability and Fatigue During Sit-to-Stand Manoeuvres in SCI Individuals Musfirah Abd Aziz and Nur Azah Hamzaid Abstract Functional Electrical Stimulation (FES)
Will Vestibulo-Ocular Reflex and Balance Rehabilitation Reduce Visual Deficits & Improve Stability of a Patient with Multiple Sclerosis?
Sacred Heart University Scholar Volume 1 Number 1 Article 5 Fall 2017 Will Vestibulo-Ocular Reflex and Balance Rehabilitation Reduce Visual Deficits & Improve Stability of a Patient with Multiple Sclerosis?
SMART EquiTest. Physical Dimensions. Electrical Characteristics. Components. Performance Characteristics. Accessories Included
Balance Manager Systems Technical Specifications SMART EquiTest Physical Dimensions (W x D x H) in cm Assembled dimensions 53 x 61* x 94 135 x 155* x 239 Base 53 x 61 x 6 135 x 155 x 15 System cart 25
C-MILL PRE-TRAINING MATERIAL
4 C-MILL PRE-TRAINING MATERIAL 1 Background information The ability to adjust gait to the requirements of the environment is related to fall risk. Someone must be able to avoid a doorstep, puddle of water
Fall Incidence as the Primary Outcome in Multiple Sclerosis Falls-Prevention Trials
Fall Incidence as the Primary Outcome in Multiple Sclerosis Falls-Prevention Trials Recommendation from the International MS Falls Prevention Research Network Susan Coote, PhD, PT; Jacob J. Sosnoff, PhD;
Nintendo Wii virtual reality game improves short term balance capabilities in multiple sclerosis patients: a pilot quasi-experimental study
Nintendo Wii virtual reality game improves short term balance capabilities in multiple sclerosis patients: a pilot quasi-experimental study Alon Kalron MSc, PT a *, Lior Frid BPE a. INTRODUCTION Multiple
Physical activity effects on postural adjustments: a review
Proceeding 10th INSHS International Christmas Sport Scientific Conference, 4-5 December 2015. International Network of Sport and Health Science. Szombathely, Hungary Physical activity effects on postural
Human Postural Responses to Different Frequency Vibrations of Lower Leg Muscles
Physiol. Res. 50: 405-410, 2001 Human Postural Responses to Different Frequency Vibrations of Lower Leg Muscles A. POLÓNYOVÁ, F. HLAVAČKA Institute of Normal and Pathological Physiology, Slovak Academy
Endpoints in a treatment trial in NMO: Clinician s view. Anu Jacob Consultant Neurologist The Walton Centre, Liverpool,UK
Endpoints in a treatment trial in NMO: Clinician s view Anu Jacob Consultant Neurologist The Walton Centre, Liverpool,UK 1 The greatest challenge to any thinker is stating the problem in a way that will
The Effects of Upper -Body and Lower -Body Fatigue on Standing Balance
The Effects of Upper -Body and Lower -Body Fatigue on Standing Balance F. Cogswell 1, B. Dietze 1, F. Huang 1 1 School of Kinesiology, The University of Western Ontario No conflicts of interest declared.
What goes wrong with balance in Parkinson s Disease? Fay B Horak, PhD, PT Professor of Neurology Oregon Health and Science. CoM
What goes wrong with balance in Parkinson s Disease? Fay B Horak, PhD, PT Professor of Neurology Oregon Health and Science CoM CoM Course Objectives Understand different types of balance systems affected
lntertester and lntratester Reliability of a Dynamic Balance Protocol Using the Biodex Stability System
Journal of Sport Rehabilitation, 1998, 7, 95-101 0 1998 Human Kinetics Publishers, Inc. lntertester and lntratester Reliability of a Dynamic Balance Protocol Using the Biodex Stability System Randy Schmitz
Balance function control on the background of vestibular stimulation in athletes
ORIGINAL ARTICLE Balance function control on the background of vestibular stimulation in athletes Rina S. Kamahina 1, Andrey S. Nazarenko 2, Ehlmira Shamilevna Shamsuvaleeva 2, Chulpan I. Nizamova 1 1
COMPARING MACHINE LEARNING APPROACHES FOR FALL RISK ASSESSMENT
BIOSIGNALS 2017 COMPARING MACHINE LEARNING APPROACHES FOR FALL RISK ASSESSMENT Joana Silva, João Madureira, Cláudia Tonelo, Daniela Baltazar, Catarina Silva, Anabela Martins, Carlos Alcobia and Inês Sousa
Objectives_ Series II
Interaction Between the Development of Posture Control and Executive Function of Attention (Reilly et. al 2008) Journal of Motor Behavior, Vol. 40, No. 2, 90 102 Objectives_ Series II Gain an understanding
Corporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: dynamic_posturography 9/1990 2/2018 2/2019 2/2018 Description of Procedure or Service Dynamic posturography
Comparison. Dynamic Gait Index (DGI)Results with. Patients with vestibular Hypofunction Youssef Koaik MPT
Comparison of Dynamic Gait Index (DGI)Results with Static ti Stabilometry t (SATEL) on Patients with vestibular Hypofunction Youssef Koaik MPT Balance Postural Control In order ode to possess normal postural
Effect of Weight Shift Training with Electrical Sensory Stimulation Feedback on Standing Balance in Stroke patients
J Korean Soc Phys Med, 2015; 10(3): 257-263 http://dx.doi.org/10.13066/kspm.2015.10.3.257 Online ISSN: 2287-7215 Print ISSN: 1975-311X Research Article Open Access Effect of Weight Shift Training with
Balance Matters. Dan Mathers, MSPT. Balance Program Coordinator St. Vincent Rehabilitation.
Balance Matters Dan Mathers, MSPT Balance Program Coordinator St. Vincent Rehabilitation dpmather@stvincent.org Who I am Dan Mathers, MSPT Graduated with Master of Science in Physical Therapy in 1999 from
Significance of Walking Speed. Maggie Benson Virginia Commonwealth University Department of Physical Therapy
Significance of Walking Speed Maggie Benson Virginia Commonwealth University Department of Physical Therapy The 6 th Vital Sign Walking speed is considered the 6 th vital sign A valid and reliable measure
ii. Reduction of tone in upper limb Lycra arm splints improve movement fluency in children with cerebral palsy.
Guidelines for the Provision of Dynamic Compression for people diagnosed with Multiple Sclerosis The use of Lycra garments in patients with the diagnosis of Multiple Sclerosis has been initiated with very
Update on Falls Prevention Research
Update on Falls Prevention Research Professor Stephen Lord Coffs Harbour Falls Prevention Network Rural Forum 28 th February 2014 Acknowledgments: Dr Jasmine Menant, Mr. Daniel Schoene Recent falls risk
Neuroimaging and Other Biomarkers. MRI for Diagnosis, Prognosis and Treatment Decisions in MS
Neuroimaging and Other Biomarkers MRI for Diagnosis, Prognosis and Treatment Decisions in MS Eric Klawiter, MD MSc Massachusetts General Hospital May 30, 2014 Disclosures and Funding Disclosures: Consulting
functiestoornissen van het evenwichtssysteem: een wereld van onbegrip
functiestoornissen van het evenwichtssysteem: een wereld van onbegrip Herman Kingma, department of ORL, Maastricht University Medical Centre Maastricht Research Institute Mental Health and Neuroscience
914. Application of accelerometry in the research of human body balance
914. Application of accelerometry in the research of human body balance A. Kilikevičius 1, D. Malaiškaitė 2, P. Tamošauskas 3, V. Morkūnienė 4, D. Višinskienė 5, R. Kuktaitė 6 1 Vilnius Gediminas Technical
Are randomised controlled trials telling us what rehabilitation interventions work?
Are randomised controlled trials telling us what rehabilitation interventions work? Focus on stroke Jane Burridge March 6 th 2014 Neurorehabilitation: facts, fears and the future Overview Stroke recovery
Curriculum Vitae. Anat Lubetzky-Vilnai. RESEARCH INTERESTS: Motor Control and Learning, Biomechanics, Postural Control, Balance Training
Curriculum Vitae Anat Lubetzky-Vilnai RESEARCH INTERESTS: Motor Control and Learning, Biomechanics, Postural Control, Balance Training APPOINTMENTS: Sep 2014 Present Visiting Assistant Professor, New York
The Effect of Task-oriented Training on Mobility Function, Postural Stability in Children with Cerebral Palsy
J Korean Soc Phys Med, 2017; 12(3): 79-84 http://dx.doi.org/10.13066/kspm.2017.12.3.79 Online ISSN: 2287-7215 Print ISSN: 1975-311X Research Article Open Access The Effect of Task-oriented Training on
(Table 1),,. Cane, Cru. Age (yrs)
: 1 2 1998 1). 1,2), (visual input) 3), (proprioceptive deficit) 4), (respiration) ), (knee flexion contracture) 6), (leg length discrepancy) 7), (foot position) 8) 9).. Cane, Cru tch, Walker Bar and Rail
Nico Arie van der Maas
van der Maas BMC Neurology (2017) 17:50 DOI 10.1186/s12883-017-0834-1 RESEARCH ARTICLE Open Access Patient-reported questionnaires in MS rehabilitation: responsiveness and minimal important difference
Online Journal Club-Article Review
Online Journal Club-Article Review Article Citation Study Objective/Purpose (hypothesis) Brief Background (why issue is important; summary of previous literature) Study Design (type of trial, randomization,
IJPMR 12, April 2001; 25-30
IJPMR 12, April 2001; 25-30 An Objective Approach for Assessment of Balance Disorders and Role of Visual Biofeedback Training in the Treatment of Balance Disorders : A Preliminary Study Dr. Rajendra Sharma,
A Study of relationship between frailty and physical performance in elderly women
Original Article Journal of Exercise Rehabilitation 2015;11(4):215-219 A Study of relationship between frailty and physical performance in elderly women Bog Ja Jeoung 1, *, Yang Chool Lee 2 1 Department
Assessing Muscle Function and Balance Problems at Home, in the Clinic, and in Research 25 th IOA Colloquium on Aging September 17, 2013
Assessing Muscle Function and Balance Problems at Home, in the Clinic, and in Research 25 th IOA Colloquium on Aging September 17, 2013 Bjoern Buehring, M.D. University of Wisconsin School of Medicine
Eligibility The NCSF online quizzes are open to any currently certified fitness professional, 18 years or older.
Eligibility The NCSF online quizzes are open to any currently certified fitness professional, 18 years or older. Deadlines Course completion deadlines correspond with the NCSF Certified Professionals certification
Validation of the 2-Minute Walk Test with the 6-Minute Walk Test and Other Functional. Measures in Persons with Multiple Sclerosis.
Validation of the 2-Minute Walk Test with the 6-Minute Walk Test and Other Functional Measures in Persons with Multiple Sclerosis David A. Scalzitti, PhD; Kenneth J. Harwood, PhD; Joyce R. Maring, EdD;
Changes in Postural Control Parameters after Vestibular Rehabilitation in Patients with Central Vestibular Disorders
Acta Otolaryngol 2003; 123: 143 147 Changes in Postural Control Parameters after Vestibular Rehabilitation in Patients with Central Vestibular Disorders H. SUAREZ 1, M. AROCENA 2, A. SUAREZ 1, T. A. DE
Investigation of the Feasibility of an Intervention to Manage Fall Risk in Wheeled Mobility Device Users with Multiple Sclerosis
Investigation of the Feasibility of an Intervention to Manage Fall Risk in Wheeled Mobility Device Users with Multiple Sclerosis Laura A. Rice, PhD, MPT, ATP; Zadok Isaacs, MS; Cherita Ousley, MS; Jacob
Berg Balance Scale. CVA, Parkinson Disease, Pediatrics
CVA, Parkinson Disease, Pediatrics CVA Highly recommended for inpatient and outpatient rehabilitation Recommended for acute care Parkinson s Disease Recommended for H and Y stages 2 and 3 G code-changing
17 th WORKSHOP ON NEUROOTOLOGY. Dementia & Imbalance. DR. ATRI CHATTERJEE Assistant Professor. Neurology VMMC & SafdarJung Hospital New Delhi
17 th WORKSHOP ON NEUROOTOLOGY Dementia & Imbalance DR. ATRI CHATTERJEE Assistant Professor. Neurology VMMC & SafdarJung Hospital New Delhi ?Association Dementia Imbalance?Causation balance: An even distribution
Analysis of prognostic significance of clinical and paraclinical indices in case of different types of acute disseminated encephalomyelitis course.
1 2 Analysis of prognostic significance of clinical and paraclinical indices in case of different types of acute disseminated encephalomyelitis course. 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Fall Prevention for Community Dwelling Older Adults: An Update on Assessment and Intervention Strategies
Fall Prevention for Community Dwelling Older Adults: An Update on Assessment and Intervention Strategies Erica A. Pitsch, PT, MPT, DPT, NCS UCSF/SFSU Graduate Program in Physical Therapy Objectives Be
Multiple sclerosis (MS) presents in individual. Validity and Reliability of Four Clinical Gait Measures in Patients with Multiple Sclerosis
Validity and Reliability of Four Clinical Gait Measures in Patients with Multiple Sclerosis Susan E. Bennett, PT, DPT, EdD, NCS, MSCS; Lacey E. Bromley, PT, DPT, NCS, MSCS; Nadine M. Fisher, EdD; Machiko
Impaired balance and fall risk in people with multiple sclerosis
Impaired balance and fall risk in people with multiple sclerosis Balance is beautiful Örebro Studies in Medical Sciences 184 ANNA CARLING Impaired balance and fall risk in people with multiple sclerosis
Human Paleoneurology and the Evolution of the Parietal Cortex
PARIETAL LOBE The Parietal Lobes develop at about the age of 5 years. They function to give the individual perspective and to help them understand space, touch, and volume. The location of the parietal
Cerebellum. Steven McLoon Department of Neuroscience University of Minnesota
Cerebellum Steven McLoon Department of Neuroscience University of Minnesota 1 Anatomy of the Cerebellum The cerebellum has approximately half of all the neurons in the central nervous system. The cerebellum
KINE 4500 Neural Control of Movement. Lecture #1:Introduction to the Neural Control of Movement. Neural control of movement
KINE 4500 Neural Control of Movement Lecture #1:Introduction to the Neural Control of Movement Neural control of movement Kinesiology: study of movement Here we re looking at the control system, and what
The Ability of Clinical Balance Measures to Identify Falls Risk in Multiple Sclerosis: A
Title- The Ability of Clinical Balance Measures to Identify Falls Risk in Multiple A Systematic Review and Meta-Analysis Authors- Gillian Quinn, BSc Physio, PhD candidate, email contact: Gillian.Quinn@ul.ie
EFFECT OF POSTURAL SWAY SCALE AS A PROGNOSTIC TOOL IN LOW BACK PAIN MANAGEMENT.
Original Research Article Allied Science International Journal of Pharma and Bio Sciences ISSN 0975-6299 EFFECT OF POSTURAL SWAY SCALE AS A PROGNOSTIC TOOL IN LOW BACK PAIN MANAGEMENT. 1 MANJULADEVI.NB.P.T,
Kegelmeyer 2018 OPTA Spring Conference 1
Slide 1 Technology for Mobility and Balance in Neurologic Populations Dr. Deb Kegelmeyer The Ohio State University Slide 2 Download the CoreX equine app on your iphone If you are able and willing please
Mechanisms of postural threat: the Achilles heel of postural control?
Mechanisms of postural threat: the Achilles heel of postural control? Doumas, M. (2017). Mechanisms of postural threat: the Achilles heel of postural control? Journal of Physiology, 1-2. https://doi.org/10.1113/jp274367
Incorporating Balance, Resistance, and Aerobic Training into Therapy Sessions with a Patient who has MS: A Case Report
Doctor of Physical Therapy Program Case Reports 2017 Incorporating Balance, Resistance, and Aerobic Training into Therapy Sessions with a Patient who has MS: A Case Report Eric Callahan University of Iowa
Int J Physiother.Vol1 (2), 40-45, June (2014) ISSN:
Int J Physiother.Vol1 (2), 40-45, June (2014) ISSN: 2348-8336 Sandesh Rayamajhi 1 Dipika Khanal 2 Mallikarjunaiah H S 3 ABSTRACT Background: Stroke has been considered to be the most common cause of neurological
Building Better Balance
Building Better Balance The Effects of MS on Balance Individuals with MS experience a decline in their balance due to various MS related impairments. Some of these impairments can be improved with exercise
quantified neurological examination and assessment of Kurtzke s Functional Systems and Expanded Disability Status Scale in Multiple Sclerosis Exposé
Electronic Scoring Tools data for capture a standardised management neurological system examination for a standardized and quantified neurological examination and assessment of Kurtzke s Functional Systems
Gait Assessment & Implications in Geriatric Rehabilitation
Gait Assessment & Implications in Geriatric Rehabilitation Therapy Network Seminars, Inc. Nicole Dawson, PT, PhD, GCS Learning Objectives Following completion of this webinar, participants will be able
Configure for Diverse
Configure for Diverse Clinical Needs Foot Drop Lower Cuff Foot Drop & Knee Instability Lower & Thigh Cuffs Pediatric Foot Drop Small Lower Cuff Foot Sensor: required for gait Knee Instability & Thigh Weakness
PEOPLE WITH STROKE often have difficulties changing
2156 ORIGINAL ARTICLE The Four Square Step Test is a Feasible and Valid Clinical Test of Dynamic Standing Balance for Use in Ambulant People Poststroke Jannette M. Blennerhassett, PhD, Victoria M. Jayalath,
Functional Ability Screening Tools for the Clinic
Functional Ability Screening Tools for the Clinic Shelley Hockensmith,, P.T., NCS Objectives Review screening tools for physical or functional ability including Five Times Sit to Stand, Walking Speed,
Autologous Hematopoietic Stem Cell Transplantation for the Treatment of Neuromyelitis Optica in Singapore
Case Reports 26 Autologous Hematopoietic Stem Cell Transplantation for the Treatment of Neuromyelitis Optica in Singapore Koh Yeow Hoay, Pavanni Ratnagopal Abstract Introduction: Neuromyelitis optica (NMO)
How to Do the EDSS. Stephen S. Kamin, MD New Jersey Medical School
How to Do the EDSS Stephen S. Kamin, MD New Jersey Medical School John F. Kurtzke, MD 1926-2015 EDSS Expanded Disability Status Scale Devised by John Kurtzke in the 1960s and modified in the 1980s EDSS
28 th Annual Meeting CMSC Dallas Texas - USA 28 th and 31 th May 2014
28 th Annual Meeting CMSC Dallas Texas - USA 28 th and 31 th May 2014 Assessing Short and Graphically Mobility in MS and Other Neurological Diseases with the new Iphone App SaGAS 10 C.Vaney 1, N.Forkel
Movement Science Lab. Computerized Dynamic Posturography (CDP) a. Sensory Organization Test (SOT)
Computerized Dynamic Posturography (CDP) a. Sensory Organization Test (SOT) The SOT determines the ability to use the three sensory systems that contribute to postural control: somatosensory, visual and
Balance and Falls in PD: Effective Interventions and Assistive Devices
Balance and Falls in PD: Effective Interventions and Assistive Devices Hanan Khalil, PhD Department of Rehabilitation Sciences Jordan University of Science and Technology Irbid, Jordan hwkhalil8@just.edu.jo
Quality of life defined
Psychometric Properties of Quality of Life and Health Related Quality of Life Assessments in People with Multiple Sclerosis Learmonth, Y. C., Hubbard, E. A., McAuley, E. Motl, R. W. Department of Kinesiology
A Measurement of Lower Limb Angles Using Wireless Inertial Sensors during FES Assisted Foot Drop Correction with and without Voluntary Effort
A Measurement of Lower Limb Angles Using Wireless Inertial Sensors during FES Assisted Foot Drop Correction with and without Voluntary Effort Takashi Watanabe, Shun Endo, Katsunori Murakami, Yoshimi Kumagai,
Neurological Assessment for Multiple Sclerosis and Extended Disability Scale Score
Neurological Assessment for Multiple Sclerosis and Extended Disability Scale Score This section should only be completed by a neurologist or MD / ROD (Medical Doctor / Resident on Duty) involved in the
Fall Risk Reduction in the Elderly. Disequilibrium of Aging. CDP results that identified impairments and provided focused patient management.
A CASE STUDY Fall Risk Reduction in the Elderly NeuroCom International, Inc. A 70 year-old woman is referred to physical therapy by her primary care physician. She reports a seven month history of dizziness
Mind-body Balance Training for Special Populations
ACE Pro Source Mind-body Balance Training for Special Populations By Elizabeth Kovar Individuals who are balance challenged, such as those with Parkinson's disease or multiple sclerosis, require a method
Exercise for people with MS
Research Explored Exercise for people with MS Susan Coote, PhD, MISCP @susancoote susan.coote@ul.ie www.msresearch.ie Outline of presentation Brief history of exercise and MS Physical Activity levels Bridging
The Effects of Carpal Tunnel Syndrome on the Kinematics of Reach-to-Pinch Function
The Effects of Carpal Tunnel Syndrome on the Kinematics of Reach-to-Pinch Function Raviraj Nataraj, Peter J. Evans, MD, PhD, William H. Seitz, MD, Zong-Ming Li. Cleveland Clinic, Cleveland, OH, USA. Disclosures: