35 results on '"Posturographie"'
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2. Posturale Regulation und Stabilität unter akustischem Input bei Normalhörenden.
- Author
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Seiwerth, I., Jonen, J., Rahne, T., Lauenroth, A., Hullar, T. E., Plontke, S. K., and Schwesig, R.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2020
- Full Text
- View/download PDF
3. The influence of different visual stimuli on postural control
- Author
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Mayerhofer, Doris
- Subjects
Posturographie ,Balance ,Postural Control ,Gleichgewicht ,Center of Pressure ,Posturography ,Posturale Kontrolle ,Center of Gravity - Abstract
Die Mock-up Studie befasst sich mit der Fragestellung des Einflusses der visuellen Umgebung auf die Posturale Kontrolle. Durch das Untersuchen einer kleinen Proband*innen Gruppe soll ein Trend der Auswirkung verschiedener visuellen Gegebenheiten auf das Gleichgewicht festgestellt werden. Mit dem Grundkonzept kann weitere Gleichgewichtsforschung für Personen mit Störungen der Posturalen Kontrolle durchgeführt werden. Besonders das Krankheitsbild Morbus Parkinson ist hierbei von großem Interesse. Gemessen wurden sieben junge Erwachsene in drei Konditionen. Auf zwei Kraftmessplatten standen die Teilnehmer*innen im bipedalen Stand und sollten jeweils 40 Sekunden ruhig stehen. Die drei Messbedingungen waren geöffnete sowie geschlossene Augen, und der Blick auf ein bewegtes Animationsbild. Hierbei wurde die Schwankung des Center of Pressures sowie die Auslenkung des siebten Halswirbels im Raum vermessen und analysiert. In den Ergebnissen konnte der Trend einer maximalen Schwankung bei der Messung mit geschlossenen Augen festgestellt werden. Zwei Personen hatten allerdings die meiste Haltungsschwankung bei der Messung, in der sie ein bewegtes Bild beobachten sollten. Durch die geringe Anzahl an Proband*innen ist es nicht möglich eine allgemeine Aussage zu treffen. Bei der Studie wird jedoch verdeutlicht, dass sich bei allen Testpersonen ein Effekt der veränderten visuellen Umgebung zeigt. Für die physiotherapeutische Praxis bedeutet dies, dass das Berücksichtigen der gewählten Umgebung unerlässlich ist. Hier soll das Training so sicher wie möglich gestaltet sein und für sturzgefährdete Personen eine möglichst ruhige Umgebung geschaffen werden. Ein weiterer Aspekt, die Messergebnisse in die Therapie einfließen zu lassen, ist die Steigerungsmöglichkeit eines Gleichgewichtstrainings mit verändertem visuellen Input. Die Mock-up Studie und deren Ergebnisse sind somit eine Ausgangslage, welche für weiterführende Forschung herangezogen werden kann. The mock-up study addresses the question of the influence of the visual environment on postural control. By examining a small group of subjects, a trend of the effect of different visual conditions on balance will be detected. With the basic concept, further balance research can be conducted for individuals with disorders of postural control. Especially the clinical picture of Parkinson's disease is of great interest. Seven young adults were measured in three conditions. The participants stood on two force plates in bipedal stance and were asked to stand still for 40 seconds for each measurement. The three conditions were eyes open, and eyes closed, such as looking at a moving animation image. The fluctuation of the center of pressures and the deflection of the seventh cervical vertebra were measured and analysed. In the results, the trend of maximum sway was observed when measured with eyes closed. However, two subjects had the most postural sway in the measurement in which they were asked to observe a moving image. Due to the small number of subjects, it is not possible to make a general statement. However, it gets clear that all probands show an effect in postural control of the changed visual environment. For the physiotherapeutic practice this means that the consideration of the chosen environment is essential. Here, the training should be designed as safely as possible and an environment as steady as possible should be created for persons at risk of falling. Another aspect of incorporating the measurement results into therapy is the possibility of increasing balance training with altered visual input. The mock-up study and it´s outcome is thus a foundation that can be used for further research.
- Published
- 2022
4. Use of real-time feedback systems for balance training of ADLs in healthy elderly people
- Author
-
Weissensteiner, Thomas
- Subjects
Posturographie ,Gleichgewichtstraining ,Devices for movement improvement ,Posturography ,Quality of movement ,Activities of daily living ,Bewegungsqualität ,Aktivitäten des täglichen Lebens ,Geräte zur Bewegungsverbesserung ,Balance training - Abstract
Hintergrund: Mit zunehmendem Alter kann es ohne geeignetes Training zu einer Reduktion der Gleichgewichtsfähigkeit kommen. Oft ist diese Veränderung auch mit einer Verschlechterung der Bewegungsqualität bei der Ausführung von ADLs verbunden. Ein umfassendes Gleichgewichtstraining kann eingesetzt werden, um diese Qualität auch im fortgeschrittenen Alter zu erhalten. Hierfür wird bereits eine Vielzahl an Echtzeitfeedback-gestützten Geräten angeboten. Ziel: Diese Arbeit beschäftigt sich mit der Frage, welche gerätebasierten Möglichkeiten der Bewegungsverbesserung über eine reine Sturzprophylaxe hinaus für ältere Menschen bereits verfügbar sind. Da die gängigen Geräte nur eine Steigerung der Gleichgewichtsfähigkeit, nicht aber die von Bewegungsqualität zum Ziel haben, muss analysiert werden, ob auch Geräte verfügbar sind, mit deren Hilfe eine solche Qualitätssteigerung zu erreichen ist. Es soll erhoben werden, welche Systeme auf dem Markt sind, wie sie funktionieren, wieweit solche Geräte nur zur Diagnostik oder auch zur Therapie eingesetzt werden können. Weiters wird der Versuch unternommen, ein Konzept für ein ideales Gerät zur Bewegungsverbesserung bei älteren Menschen zu entwickeln. Methodik: Dafür wurde zunächst eine Literaturrecherche bezüglich verfügbarer Geräte durchgeführt und die Hersteller derselben angeschrieben, um weitere Informationen zu ihren Produkten zu erhalten. Anhand dieser Informationen wurden die Geräte analysiert, hinsichtlich ihrer Eignung für die Ziele Steigerung der Gleichgewichtsfähigkeit und Steigerung der Bewegungsqualität bewertet und in einer Übersichtstabelle vergleichend dargestellt. Anhand der Informationen zu den verschiedenen Systemen wurde dann ein Konzept für ein Gerät entworfen, welches fähig sein soll, diese beiden Ziele zu vereinen. Ergebnisse: Die üblicherweise erfassten Messwerte CoP und RoM stellten sich als ungeeignet dar, um die Qualität von Bewegungen, insbesondere die der oberen Extremitäten zu beurteilen. Hierfür scheinen Systeme am geeignetsten, die gezielt die Körperbewegungen über ein motion-capture System erfassen und diese anschließend über ein geeignetes Programm ihrer Qualität nach bewerten. Diskussion: Solchen Geräten wird wohl in Zukunft eine immer größere Bedeutung zukommen, insbesondere die Telerehabilitation eröffnet ein großes Einsatzgebiet. Background: Without a preventive training, increasing age leads to a reduction of body balance. This often leads to a decrease in the quality of movement when performing ADLs. Balance training can be used to maintain the quality even in older age. A large number of real-time feedback devices are already available for this purpose. Aim: This work deals with the question, which devices for improving movement quality, despite fall prevention are already available for elderly people. Since the current devices only aim to increase the body balance and not the quality of movement, it has to be analyzed whether some of these devices can also be used to achieve such an increase in quality. The aim is to find out which systems are on the market, how they work, and if such devices can only be used for diagnostics or also for therapy. Furthermore, a concept for an ideal device for improving movement in elderly people is developed. Methods: For this purpose, literature research about available devices was conducted and the manufacturers of the same were contacted and asked for further information on their products. Based on this information, the devices were analyzed and evaluated regarding their suitability for increasing balance and increasing the quality of movement. The results were shown in a comparative table. Based on the information about the different systems, a concept for a device that can combine both goals was developed. Main results: The usually recorded measurements of the CoP and the RoM turned out to be unsuitable for assessing the quality of movements, especially those of the upper extremities. For this purpose, systems which record the body movements via a motion-capture system and then evaluate their quality via a suitable software seem best. Discussion: Such devices will probably become more and more important, especially as telerehabilitation opens a large area of application.
- Published
- 2022
5. Interaction between postural asymmetry and visual feedback effects in undisturbed upright stance control in healthy adults.
- Author
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Rougier, Patrice R. and Boudrahem, Samir
- Subjects
- *
POSTURE disorders , *BODY weight , *CENTER of mass , *STANDING position , *NEUROPHYSIOLOGY - Abstract
Summary Objectives The technique of additional visual feedback has been shown to significantly decrease the center of pressure (CP) displacements of a standing subject. Body-weight asymmetry is known to increase postural instability due to difficulties in coordinating the reaction forces exerted under each foot and is often a cardinal feature of various neurological and traumatic diseases. To examine the possible interactions between additional visual feedback and body-weight asymmetry effects, healthy adults were recruited in a protocol with and without additional visual feedback, with different levels of body-weight asymmetry. Methods CP displacements under each foot were recorded and used to compute the resultant CP displacements (CP Res ) and to estimate vertically projected center of gravity (CG v ) and CP Res -CG v displacements. Overall, six conditions were randomly proposed combining two factors: asymmetry with three BW percentage distributions (50/50, 35/65 and 20/80; left/right leg) and feedback (with or without additional VFB). Results The additional visual feedback technique principally reduces CG v displacements, whereas asymmetry increases CP Res -CG v displacements along the mediolateral axis. Some effects on plantar CP displacements were also observed, but only under the unloaded foot. Interestingly, no interaction between additional visual feedback and body-weight asymmetry was reported. Discussion These results suggest that the various postural effects that ensue from manipulating additional visual feedback parameters, shown previously in healthy subjects in various studies, could also apply independently of the level of asymmetry. Conclusion Visual feedback effects could be observed in patients presenting weight-bearing asymmetries. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
6. Which biomechanical models are currently used in standing posture analysis?
- Author
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Crétual, A.
- Subjects
- *
BIOMECHANICS , *PHYSIOLOGY , *POSTURE , *CENTER of mass , *BIOENGINEERING , *MATHEMATICAL models - Abstract
Summary In 1995, David Winter concluded that postural analysis of upright stance was often restricted to studying the trajectory of the center of pressure (CoP). However, postural control means regulation of the center of mass (CoM) with respect to CoP. As CoM is only accessible by using a biomechanical model of the human body, the present article proposes to determine which models are actually used in postural analysis, twenty years after Winter's observation. To do so, a selection of 252 representative articles dealing with upright posture and published during the four last years has been checked. It appears that the CoP model largely remains the most common one (accounting for nearly two thirds of the selection). Other models, CoP/CoM and segmental models (with one, two or more segments) are much less used. The choice of the model does not appear to be guided by the population studied. Conversely, while some confusion remains between postural control and the associated concepts of stability or strategy, this choice is better justified for real methodological concerns when dealing with such high-level parameters. Finally, the computation of the CoM continues to be a limitation in achieving a more complete postural analysis. This unfortunately implies that the model is chosen for technological reasons in many cases (choice being a euphemism here). Some effort still has to be made so that bioengineering developments allow us to go beyond this limit. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
7. Der Einfluss einer VKB-Plastik auf die stabile Standfähigkeit.
- Author
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Palm, H.-G., Schlumpberger, S., Riesner, H.-J., Friemert, B., and Lang, P.
- Abstract
Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2015
- Full Text
- View/download PDF
8. The assessment and treatment of postural disorders in cerebellar ataxia: A systematic review.
- Author
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Marquer, A., Barbieri, G., and Pérennou, D.
- Subjects
- *
POSTURE disorders , *CEREBELLAR ataxia , *GAIT disorders , *MEDICAL rehabilitation , *SYSTEMATIC reviews , *RANDOMIZED controlled trials , *THERAPEUTICS - Abstract
Gait and balance disorders are often major causes of handicap in patients with cerebellar ataxia. Although it was thought that postural and balance disorders in cerebellar ataxia were not treatable, recent studies have demonstrated the beneficial effects of rehabilitation programs. This article is the first systematic review on the treatment of postural disorders in cerebellar ataxia. Nineteen articles were selected, of which three were randomized, controlled trials. Various aetiologies of cerebellar ataxia were studied: five studies assessed patients with multiple sclerosis, four assessed patients with degenerative ataxia, two assessed stroke patients and eight assessed patients with various aetiologies. Accurate assessment of postural disorders in cerebellar ataxia is very important in both clinical trials and clinical practice. The Scale for the Assessment and Rating of Ataxia (SARA) is a simple, validated measurement tool, for which 18 of the 40 points are related to postural disorders. This scale is useful for monitoring ataxic patients with postural disorders. There is now moderate level evidence that rehabilitation is efficient to improve postural capacities of patients with cerebellar ataxia – particularly in patients with degenerative ataxia or multiple sclerosis. Intensive rehabilitation programs with balance and coordination exercises are necessary. Although techniques such as virtual reality, biofeedback, treadmill exercises with supported bodyweight and torso weighting appear to be of value, their specific efficacy has to be further investigated. Drugs have only been studied in degenerative ataxia, and the level of evidence is low. There is now a need for large, randomized, controlled trials testing rehabilitation programs suited to postural and gait disorders of patients with cerebellar ataxia. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
9. Contributions et déterminants des indices de posturographie pour comprendre le comportement postural en station debout après un AVC
- Author
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Chauvin, Adèle, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), and Dominique Pérennou
- Subjects
Balance ,Posturographie ,Motor weakness ,Posturography ,Instability ,Postural control ,Négligence spatiale ,Weight bearing asymmetry ,Stroke ,Contrôle postural ,Faiblesse musculaire ,Accident vasculaire cérébral (AVC) ,Instabilité ,Asymétrie d’appui ,Equilibre ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Spatial neglect - Abstract
Objective. (1) To determine the posturographic indices needed to explain the standing behavior after a subacute stroke. (2) To analyze their clinical determinants and (3) their role in balance and gait disorders in daily life. Methods. Cohort study of 95 patients consecutively admitted to rehabilitation after a first hemispheric stroke. Position and instability posturographic indices were measured in medio-lateral (ML) and antero-posterior (AP) axes. Functional abilities were also assessed. Deficits were quantified at Day 30 or Day 60 post-stroke. Statistics comprised factorial analysis of principal component and, uni-and multivariate analyses. Results. One instability index and both position indices on each axis, with or without vision, were required to describe the post-stroke postural control. Instability was the first component and contained nearly half of the posturographic information. The primary indices were independently determined by spatial neglect (p=0.002) and motor weakness (p=0.005). These deficits explained ML instability (p
- Published
- 2020
10. Concomitant changes in clinical and posturographic data in elderly fallers during the course of an in-home anti-falling multimodal program – A preliminary investigation.
- Author
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Carette, P., Kemoun, G., Watelain, E., and Dugué, B.
- Subjects
- *
URINARY organ radiography , *HOME-based mental health services , *MULTIMODAL psychotherapy , *FEAR of falling , *PREVENTION of falls in old age , *EQUILIBRIUM testing , *MINI-Mental State Examination - Abstract
Summary: Aim of the study: The objective of this preliminary study was to evaluate the effectiveness, in terms of fall reduction, of an in-home strategy that we have developed for elderly fallers. We also aimed at finding links between the expected changes in the data obtained in static posturography and in clinical balance tests through our program. Patients and methods: Twelve elderly patients living at home who were diagnosed as fallers (5 males and 7 females; 77.9±4.1 years) participated in the study. Our multimodal intervention lasted 6 months. Before this period, and one year later, an evaluation was conducted using cognitive (MMSE), clinical balance tests (i.e. Berg Balance Scale, Balance One leg, Timed Up and Go, and Functional Reach tests) and static posturography (where the area of body sway, velocity and medio–lateral and antero–posterior amplitudes were recorded twice, first with eyes open and then with eyes closed). Results: Among the 12 patients who were diagnosed as fallers, eight became non-fallers. When comparing data obtained after the intervention with those obtained beforehand, we found significant changes in all of the clinical balance tests and in the posturographic-derived variables indicating improvements in the balance control in our group of subjects. We also found significant correlations between the changes in the Berg Balance Scale scores and the changes in the area of body sway data, in antero–posterior amplitude both with eyes open and with eyes closed, and also in the medio–lateral amplitude in the eyes closed condition. Conclusions: We prospectively demonstrated the relevance of our anti-falling intervention at home and of the use of posturography for clinical follow-up. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
11. Contribution du test de Dumas par vibrations crâniennes au dépistage des troubles de l'équilibre et de l'oreille interne chez l'enfant. Interprétation physiopathologique et applications cliniques
- Author
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Sinno, Solara, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Université de Lorraine, Philippe Perrin, Georges Dumas, and Kim Smith Abouchacra
- Subjects
Oculomotor Test ,Posturographie ,Enfants ,Cochlear Implant ,Skull vibration induced nystagmus test (SVINT) - Dumas’ test ,Posturography ,Test du nystagmus induit par les vibrations osseuses du crâne (TVO) - Test de Dumas ,Test oculomoteur ,Implant cochléaire ,Prothèses auditives ,Hearing-aids ,Children ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Introduction: Sensorineural hearing loss in children is often accompanied by vestibular dysfunction. The evaluation of the vestibular system in the pediatric population requires adapting techniques used in adults. Skull-Vibration-Induced-Nystagmus Test (SVINT), also known as Dumas’ Test, a non-invasive first-line examination test, stimulates both otolith and canal structures and shows instantaneously a vestibular asymmetry in adults. This study aimed to evaluate the use of this test in healthy children and further explore its clinical value in children with hearing loss (HL) amplified with hearing aids (HA) or cochlear implant (CI). Material and Methods: A case-control study compared the results of SVINT, oculomotor testing (saccade and smooth pursuit), caloric test (CaT) and video head-impulse-test (VHIT) and posturography (SOT) in 120 controls to 30 children with HA and 30 with CI, aged 5-17 years old. SVINT was recorded with videonystagmography after very high frequency (VHF 100 Hz) stimulation of mastoids and vertex. Result: SVINT was easy to perform in children and its’ result was not affected by age. However, saccade latency decreased, and smooth pursuit gain increases as age increased. Similarly, SOT data showed a significant age-associated improvement in performance and a gender difference. SVINT was easily performed by the tester and with a sensitivity of 86 % and a specificity of 96 % in detecting unilateral vestibular lesion (UVL). In the case of a bilateral deficit, the SVINT is non-discriminatory. In amplified participants, a UVL was equally detected whether using SVINT, CaT or VHIT. The comparisons between tests permitted to assume that SVINT stimulates the phasic cells (type I), which equip the apices of the ampullary crests and the vicinity of the striola of the utricular and saccular maculae. Conclusion: SVINT is a well-tolerated and useful test to screen vestibular asymmetry in children with HL when combined with other vestibular tests and shows its complementary at very high frequencies. It confirms its role as a “vestibular Weber” test.; Introduction : La perte auditive neurosensorielle chez l'enfant est souvent accompagnée d'un dysfonctionnement vestibulaire. L'évaluation du système vestibulaire dans la population pédiatrique nécessite d'adapter les techniques utilisées chez l'adulte. Le test du nystagmus induit par les vibrations osseuses du crâne (TVO) ou test de Dumas, test d’examen de première intention non invasif, stimule à la fois les structures otolithiques et canalaires et montre instantanément une asymétrie vestibulaire chez l’adulte. Cette étude a visé à évaluer l'utilisation de ce test chez des enfants sains et à explorer plus sa valeur clinique chez les enfants malentendants bénéficiant d’une amplification par prothèses auditives (PA) ou par implant cochléaire (IC). Matériel et méthodes : Une étude cas-témoins a comparé les résultats du TVO, des tests oculomoteurs (saccade et poursuite oculaires), du test calorique (TC), du test de Halmagyi (VHIT) et de la posturographie (TOS) chez 120 enfants sains (groupe témoin) à ceux de 30 enfants avec PA et à ceux de 30 enfants avec IC, âgés de 5 à 17 ans. Le TVO a été enregistré par vidéonystagmographie après stimulation à très haute fréquence (THF= 100 Hz) des mastoïdes et du vertex. Résultats : Le TVO s’est révélé facile à réaliser chez les enfants et son résultat n’était pas affecté par leur âge dans le protocole d’utilisation employé. Cependant, avec l’âge, la latence des saccades a diminué et les gains de poursuite oculaire ont augmenté. De même, les données du TOS ont montré une amélioration significative de la posture liée à l'âge et une différence entre les sexes. Le TVO s’est également révélé facile à réaliser pour l’examinateur, avec une sensibilité de 86 % et une spécificité de 96 % pour la détection des lésions vestibulaires unilatérales (LVU). En cas de déficit bilatéral, le TVO est inopérant. Chez les participants bénéficiant d’une amplification, une LVU a été également détectée, que ce soit avec TVO, TC ou VHIT. Les comparaisons entre les tests permettent de suggérer que le TVO stimule les cellules phasiques (type I), qui occupent les sommets des crêtes ampullaires et le voisinage de la striola des macules utriculaires et sacculaires. Conclusion : le TVO est un test bien toléré et utile pour le dépistage d’une asymétrie vestibulaire chez l’enfant avec des troubles d’audition associés à d’autres tests vestibulaires. Il montre sa complémentarité à très haute fréquence. Il confirme son rôle comme un "Weber vestibulaire".
- Published
- 2019
12. Contribution of Dumas’ test via skull vibration in the screening of vestibular and inner ear disorders in children. Pathophysiological interpretation and clinical applications
- Author
-
Sinno, Solara, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Université de Lorraine, Philippe Perrin, Georges Dumas, and Kim Smith Abouchacra
- Subjects
Oculomotor Test ,Posturographie ,Enfants ,Cochlear Implant ,Skull vibration induced nystagmus test (SVINT) - Dumas’ test ,Posturography ,Test du nystagmus induit par les vibrations osseuses du crâne (TVO) - Test de Dumas ,Test oculomoteur ,Implant cochléaire ,Prothèses auditives ,Hearing-aids ,Children ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Introduction: Sensorineural hearing loss in children is often accompanied by vestibular dysfunction. The evaluation of the vestibular system in the pediatric population requires adapting techniques used in adults. Skull-Vibration-Induced-Nystagmus Test (SVINT), also known as Dumas’ Test, a non-invasive first-line examination test, stimulates both otolith and canal structures and shows instantaneously a vestibular asymmetry in adults. This study aimed to evaluate the use of this test in healthy children and further explore its clinical value in children with hearing loss (HL) amplified with hearing aids (HA) or cochlear implant (CI). Material and Methods: A case-control study compared the results of SVINT, oculomotor testing (saccade and smooth pursuit), caloric test (CaT) and video head-impulse-test (VHIT) and posturography (SOT) in 120 controls to 30 children with HA and 30 with CI, aged 5-17 years old. SVINT was recorded with videonystagmography after very high frequency (VHF 100 Hz) stimulation of mastoids and vertex. Result: SVINT was easy to perform in children and its’ result was not affected by age. However, saccade latency decreased, and smooth pursuit gain increases as age increased. Similarly, SOT data showed a significant age-associated improvement in performance and a gender difference. SVINT was easily performed by the tester and with a sensitivity of 86 % and a specificity of 96 % in detecting unilateral vestibular lesion (UVL). In the case of a bilateral deficit, the SVINT is non-discriminatory. In amplified participants, a UVL was equally detected whether using SVINT, CaT or VHIT. The comparisons between tests permitted to assume that SVINT stimulates the phasic cells (type I), which equip the apices of the ampullary crests and the vicinity of the striola of the utricular and saccular maculae. Conclusion: SVINT is a well-tolerated and useful test to screen vestibular asymmetry in children with HL when combined with other vestibular tests and shows its complementary at very high frequencies. It confirms its role as a “vestibular Weber” test.; Introduction : La perte auditive neurosensorielle chez l'enfant est souvent accompagnée d'un dysfonctionnement vestibulaire. L'évaluation du système vestibulaire dans la population pédiatrique nécessite d'adapter les techniques utilisées chez l'adulte. Le test du nystagmus induit par les vibrations osseuses du crâne (TVO) ou test de Dumas, test d’examen de première intention non invasif, stimule à la fois les structures otolithiques et canalaires et montre instantanément une asymétrie vestibulaire chez l’adulte. Cette étude a visé à évaluer l'utilisation de ce test chez des enfants sains et à explorer plus sa valeur clinique chez les enfants malentendants bénéficiant d’une amplification par prothèses auditives (PA) ou par implant cochléaire (IC). Matériel et méthodes : Une étude cas-témoins a comparé les résultats du TVO, des tests oculomoteurs (saccade et poursuite oculaires), du test calorique (TC), du test de Halmagyi (VHIT) et de la posturographie (TOS) chez 120 enfants sains (groupe témoin) à ceux de 30 enfants avec PA et à ceux de 30 enfants avec IC, âgés de 5 à 17 ans. Le TVO a été enregistré par vidéonystagmographie après stimulation à très haute fréquence (THF= 100 Hz) des mastoïdes et du vertex. Résultats : Le TVO s’est révélé facile à réaliser chez les enfants et son résultat n’était pas affecté par leur âge dans le protocole d’utilisation employé. Cependant, avec l’âge, la latence des saccades a diminué et les gains de poursuite oculaire ont augmenté. De même, les données du TOS ont montré une amélioration significative de la posture liée à l'âge et une différence entre les sexes. Le TVO s’est également révélé facile à réaliser pour l’examinateur, avec une sensibilité de 86 % et une spécificité de 96 % pour la détection des lésions vestibulaires unilatérales (LVU). En cas de déficit bilatéral, le TVO est inopérant. Chez les participants bénéficiant d’une amplification, une LVU a été également détectée, que ce soit avec TVO, TC ou VHIT. Les comparaisons entre les tests permettent de suggérer que le TVO stimule les cellules phasiques (type I), qui occupent les sommets des crêtes ampullaires et le voisinage de la striola des macules utriculaires et sacculaires. Conclusion : le TVO est un test bien toléré et utile pour le dépistage d’une asymétrie vestibulaire chez l’enfant avec des troubles d’audition associés à d’autres tests vestibulaires. Il montre sa complémentarité à très haute fréquence. Il confirme son rôle comme un "Weber vestibulaire".
- Published
- 2019
13. Schwindelerkrankungen.
- Author
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Lauenroth, A., Knipping, S., and Schwesig, R.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2012
- Full Text
- View/download PDF
14. Could home be an appropriate location for performing posturographic assessments in elderly subjects?
- Author
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Carette, P., Kemoun, G., Thibaud, M., Breque, C., and Dugué, B.
- Subjects
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URINARY organ radiography , *POSTURE , *PSYCHOLOGICAL stress , *ANXIETY , *MENTAL depression ,RISK factors of accidental falls in old age - Abstract
Summary: Introduction: Posturographic measurements are often performed in hospital in the context of assessing fall risks in elderly subjects. These hospital visits may generate different kinds of stimuli that could influence test outcomes. Study aim: The aim was to investigate whether posturographic measurements performed both at home and in hospital in a randomized order provide similar data. Methods: Thirty-five healthy elderly subjects (average age 72.5±3.7 years) were assigned to two postural evaluations performed in a random order: one at home and one at the hospital. Before the first evaluation, subject''s levels of anxiety, depression and stress were assessed. Then, the area of body sway, velocity and medial-lateral and antero-posterior amplitudes were recorded twice, first with the subject''s eyes opened and then with eyes closed. Results and discussion: The posturographic data obtained in hospital and at home were quite similar. However, when the group that was first evaluated in hospital was compared with the group first evaluated at home, the medio-lateral amplitude was observed to significantly decrease in the second evaluation compared with the data obtained in the first trial (P <0.05), and this decrease was significantly higher in the first group (P <0.05). For the eyes-opened condition, we found significant correlations between anxiety and the area of body sway, stress and the area of body sway, and anxiety and the medial-lateral amplitude. Conclusions: Psychological factors may influence some posturographic data, and carrying out posturographic evaluations at home for elderly subjects could be a reasonable strategy. [Copyright &y& Elsevier]
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- 2012
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15. Statische Posturographie bei ausgewählten Parkinson-Syndromen.
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Wolfsegger, T., Rotaru, I., Schneider, A.M., Schwameder, H., and Aichner, F.T.
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PARKINSON'S disease , *ACCIDENTAL falls , *POSTURE disorders , *PATIENTS , *DIAGNOSIS - Abstract
Objectives: Idiopathic Parkinson's disease (IPD) is associated with postural disturbances and falls. The assessment of postural instability by the pull test may lead to inconclusive results. Static posturography measurements may give more reliable information regarding the differential diagnosis of Parkinson syndromes. Patients and methods: We compared results of the pull test and static posturography (sway area in eyes-open/eyes-closed conditions) in healthy controls (C) and patients with akinetic-rigid IPD ( n=18), atypical Parkinson syndromes (APS; n=18) and secondary Parkinson syndromes (SPS; n=17). Results: Static posturography and the pull test results did not differ significantly between controls and patients with akinetic-rigid IPD. APS patients had significantly greater postural sway areas when tested with eyes open compared to controls (APS: 16.89 vs C: 6.89 mm, p≤0.001) and IPD patients (APS: 16.89 vs IPD: 9.55 mm, p=0.005). The correlation in the APS group between the pull test and sway area in the eyes-open condition was significant ( r=0.526, p=0.025). With eyes closed, postural instability in APS patients was not significantly increased (+2%, p=.847). SPS patients were more unstable under the eyes-closed condition compared to controls (sway area SPS: 26.29 vs C: 8.79 mm, p≤0.001), IPD patients (sway area SPS: 26.29 vs IPD: 11.06 mm, p≤0.001) and APS patients (sway area SPS: 26.29 vs APS: 17.28 mm, p=0.027), without a significant correlation to the pull test. The sway area in the SPS patients increased significantly by 67% ( p=0.001) under the eyes-closed condition. Conclusion: Static posturography may be a helpful tool for the differentiation of Parkinson syndromes. [ABSTRACT FROM AUTHOR]
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- 2011
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16. Posturale Defizite und Sturzrisiko bei älteren Personen mit Verdacht auf Osteoporose.
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Schwesig, R., Becker, S., Lauenroth, A., Müller, K., Leuchte, S., Esperer, H.-D., and Kluttig, A.
- Abstract
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- 2010
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17. Beeinträchtigen Meniskusverletzungen den stabilen Stand?
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Palm, H.-G., Laufer, C., Von Lübken, F., Achatz, G., and Friemert, B.
- Abstract
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- 2010
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18. Posturographische Untersuchungen bei Kindern und jungen Erwachsenen mit und ohne Kreuzbiss.
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Ohlendorf, D., Büntemeyer, B., Filmann, N., Schwesig, R., and Kopp, S.
- Abstract
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- 2009
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19. Dreidimensionale Trainingstherapie bei Neuropathia vestibularis.
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Lauenroth, A., Pudszuhn, A., Bloching, M., Esperer, H.D., Hottenrott, K., Becker, S., Neumann, K., and Schwesig, R.
- Abstract
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- 2008
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20. Sensomotorisches Training bei Neuropathia vestibularis.
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Lauenroth, A., Schwesig, R., Pudszuhn, A., Bloching, M., and Hottenrott, K.
- Abstract
Copyright of Manuelle Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2008
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21. Place de la posturographie à domicile dans un concept de prévention de la chute de la personne âgée.
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Kemoun, G. and Carette, P.
- Abstract
Copyright of Lettre de Medecine Physique et de Readaptation is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2007
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22. Parametrisierung posturaler Subsysteme mit Posturografie.
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Schwesig, R., Lauenroth, A., Müller, A., Becker, S., and Hottenrott, K.
- Abstract
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- 2006
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23. Standstabilität im Kindes- und Jugendalter.
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Steindl, R., Ulmer, H., and Scholtz, A.
- Abstract
Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2004
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24. Mechanisms of postural ataxia after intake of alcohol.
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Diener, H., Dichgans, J., Bacher, M., Hülser, J., and Liebich, H.
- Abstract
Copyright of Zeitschrift für Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 1983
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25. Adaptation sensorimotrice aux troubles de la marche et de l’équilibre chez les patients présentant une neuropathie périphérique
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Gomes Paiva, Ana flávia, STAR, ABES, Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université Paris-Sud - Paris 11 (UP11)-Université d'Orléans (UO), Université Paris Saclay (COmUE), and Philippe Thoumie
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Balance ,Posturographie ,Neuropathie périphérique ,Peripheral neuropathy ,Marche ,Posturography ,[PHYS.MECA.BIOM] Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] ,[PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] ,Eye-Tracker ,Equilibre ,Gait - Abstract
The balance function is a complex function that involves interaction between the somatosensory, the vestibular and the visual systems, the latter ensuring the equilibrium function regulation. In pathology, the control of posture and balance can be impaired as in the case of peripheral neuropathies, characterized by the impairment of sensory and motor fibers of variable level. Predominantly sensory neuropathies are called ataxic neuropathies; they are characterized by proprioceptive impairment in the lower limbs that can lead to disorders of posture and balance in static or dynamic condition, or even during gait. This study reports three assessment methods developed under the three balance conditions to better characterize balance disorders concerning this population. Balance assessment under static condition on a force platform has enabled us to characterize the weight of the sensory and motor impairments in neuropathies, provided that by the inclusion of measuring the limits of equilibrium balance parameter, which separates the most these two components. Under dynamic conditions, the analysis of balance on the motorized force platform "IsiMove" allowed us to create a composed score that distinguishes balance disorders in a population of ataxic subjects, which is characterized by major instability in quasi-static conditions (low frequency instability) and a less marked instability in more dynamic conditions (high frequencies). During gait, the eye tracker glasses have proven to be a relevant tool for the analysis of visual compensation, both reproducible and sensitive to the pathology. This technology has helped us to quantitatively characterize the visual strategy implemented by ataxic patients during locomotion. The results of this thesis open different perspectives regarding the development of more specific rehabilitation programs for this population. It also opens different perspectives on the instrumental characterization of new profiles of balance disorders in patients with instability of neurological origin., La fonction d’équilibration est une fonction complexe qui implique une interaction entre les systèmes somatosensoriel, vestibulaire et visuelle qui en assurent la régulation. En pathologie, le contrôle de la posture et de l’équilibre peut être atteint comme dans le cas de neuropathies périphériques qui se caractérisent par une atteinte des fibres sensitives et motrices de niveau variable. Les neuropathies à prédominance sensitive sont dénommées neuropathies ataxiantes ; elles se caractérisent au niveau des membres inférieurs par l’atteinte proprioceptive qui peut entraîner des troubles de la posture et de l’équilibre en condition statique, dynamique ou encore lors de la marche. Ce travail rapporte trois méthodes d’évaluation élaborées dans les trois conditions d’équilibration afin de mieux caractériser les troubles de l’équilibre de cette population. L’évaluation de l’équilibre en condition statique sur une plateforme de force nous a permis de caractériser le poids des atteintes sensorielles et motrices dans les neuropathies à condition d’y inclure la mesure du paramètre de limite de l’équilibre qui dissocie le plus ces deux composantes. En condition dynamique, l’analyse de l’équilibre sur une plateforme de force motorisée « IsiMove » nous a permis de créer un score composé qui discrimine les troubles de l’équilibre d’une population de sujets ataxiques caractérisé par une instabilité majeure en conditions quasi statique (basse fréquence de déstabilisation) et une instabilité moins marquée en conditions plus dynamiques (hautes fréquences). Au cours de la marche, les lunettes eye-tracker se sont avérées constituer un outil pertinent pour l’analyse de la compensation visuelle, à la fois reproductible et sensible à la pathologie. Cette technologie nous a aidés à caractériser quantitativement une stratégie visuelle mise en place par les patients ataxiques lors de la locomotion. Les résultats de ce travail de thèse ouvrent différentes perspectives en ce qui concerne l’élaboration de programmes de rééducation plus spécifiques pour cette population, et la caractérisation instrumentale de nouveaux profils de troubles de l’équilibre des patients présentant une instabilité d’origine neurologique.
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- 2016
26. Les troubles de l’équilibre statique chez la personne âgée. Validation d’un dispositif permettant de quantifier le trouble de l’équilibre et de prédire le risque de chute à 6 mois chez la personne âgée de 70 ans et plus consultant aux urgences
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Thomas, Damien, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), École du Val de Grâce (EVDG), Service de Santé des Armées, and Damien Ricard
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MESH: Aged ,Posturographie ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,MESH: Emergencies ,Équilibre statique ,Posturography ,Urgences ,Personne âgée ,Chute ,MESH: Accidental Falls ,Static balance ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Wii Balance Board - Abstract
Fall is one of main reason for consultation of the elderly in the emergency room services. Fall risk factors, are, however, little explored by ER. A device, developed by the UMRMD Cognac-G, consisting of a Nintendo Wii Balance Board® and a Android® tablet as part of the SMARTSTAT-AG study could be a quick and easy way to evaluate the fall risk in the elderly. The two aims of our study are: to evaluate the feasibility and value of using this device in a emergency department, and confirm the device's capability to predict fall risk in the elderly emergency patients. Results: 534 over 70 years-old patients, have consulted in the ER during our study. 30% of them were coming for fall. Only 58 (10.86% of patients) were included in our study. The reasons for non inclusion were mainly related to a patient's unusual state of health: impossibility to stand up (41% of the excluded), cognitive disorders (8%). Over 15% of non included patients were for extra-medical reasons, including organizational dysfunction in the ER service. The device, which seems to be pertinent for the evaluation of outpatients, does not allow an assessment of the risk of falling within 6 months in the elderly presenting to the emergency. Discussion: Studying the elderly balance disorders in an ER service seems inadequate. Referral to a dedicated consultation away from any acute events seems to be recommended.; La chute devient un des principaux motifs de consultation des personnes âgées aux urgences. Les facteurs de risque de chute ne sont cependant que peu explorés par les médecins urgentistes. Un dispositif, développé par l'UMRMD Cognac-G, constitué d'une Nintendo Wii Balance Board® et d'une tablette Android® dans le cadre de l'étude SMARTSTAT-AG pourrait être un moyen simple et rapide d'évaluation du risque de chute de la personne âgée. Notre objectif est double : évaluer la faisabilité de l'utilisation de ce dispositif dans un service d'urgence, et valider la capacité du dispositif à prédire un risque de chute à 6 mois chez la personne âgée consultant aux urgences. Résultats : 534 patients de plus de 70 ans ont été recensé comme consultant aux urgences. 30% d'entre eux consultaient pour chute. Seuls 58 patients, soit 10,86% des patients ont pu être inclus. Les motifs de non inclusions étaient principalement lié à un état inhabituel du patient : impossibilité à l'orthostatisme (41% des exclus), troubles cognitifs (8%). Plus de 15% des patients n'ont pas pu être inclus pour des causes extra-médicales, notamment par manque de temps. Le dispositif testé, qui semble pourtant performant pour identifier les patients chuteurs de plus de 70 ans en consultation réglée, n'a pas fait preuve d'un bon taux de prédiction des chutes à 6 mois à partir de la mesure de l'équilibre statique réalisée aux urgences. Discussion : il nous semble inadapté d'évaluer les troubles de l'équilibre statique par un système nécessitant l'orthostatisme des personnes âgées dans un service d'urgences. L'orientation vers une consultation dédiée à distance de tout évènement aigu semble à recommander.
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- 2015
27. Schwindelerkrankungen: Auswirkungen eines sensomotorischen Trainings auf Haltungsregulation und Kompensationsverlauf
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Lauenroth, A., Knipping, S., and Schwesig, R.
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- 2012
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28. Which biomechanical models are currently used in standing posture analysis?
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Armel Crétual, Analysis-Synthesis Approach for Virtual Human Simulation (MIMETIC), Université de Rennes 2 (UR2)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-MEDIA ET INTERACTIONS (IRISA-D6), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Laboratoire Mouvement Sport Santé (M2S), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Inria Rennes – Bretagne Atlantique, CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de Recherche en Informatique et en Automatique (Inria)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UNIV-RENNES)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-CentraleSupélec-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Université de Rennes (UNIV-RENNES)-CentraleSupélec-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-CentraleSupélec, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Université de Rennes 2 (UR2), and Université de Rennes (UNIV-RENNES)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
- Subjects
Posturographie ,medicine.medical_specialty ,Computer science ,[SDV]Life Sciences [q-bio] ,Posture ,Population ,Les modèles segmentaires ,Models, Biological ,Center of mass ,Biomechanical Phenomena ,Postural control ,Segmental models ,03 medical and health sciences ,0302 clinical medicine ,Le contrôle postural ,Center of pressure (terrestrial locomotion) ,Physiology (medical) ,medicine ,Postural Balance ,Humans ,education ,Confusion ,education.field_of_study ,Posturography ,030229 sport sciences ,General Medicine ,Surgery ,Center of pressure ,Centre de masse ,Neurology ,Centre de pression ,Postural controlés ,Biomechanical model ,Neurology (clinical) ,medicine.symptom ,030217 neurology & neurosurgery ,Cognitive psychology - Abstract
International audience; In 1995, David Winter concluded that postural analysis of upright stance was often restricted to studying the trajectory of the center of pressure (CoP). However, postural control means regulation of the center of mass (CoM) with respect to CoP. As CoM is only accessible by using a biomechanical model of the human body, the present article proposes to determine which models are actually used in postural analysis, twenty years after Winter's observation. To do so, a selection of 252 representative articles dealing with upright posture and published during the four last years has been checked. It appears that the CoP model largely remains the most common one (accounting for nearly two thirds of the selection). Other models, CoP/CoM and segmental models (with one, two or more segments) are much less used. The choice of the model does not appear to be guided by the population studied. Conversely, while some confusion remains between postural control and the associated concepts of stability or strategy, this choice is better justified for real methodological concerns when dealing with such high-level parameters. Finally, the computation of the CoM continues to be a limitation in achieving a more complete postural analysis. This unfortunately implies that the model is chosen for technological reasons in many cases (choice being a euphemism here). Some effort still has to be made so that bioengineering developments allow us to go beyond this limit
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- 2015
29. Postural control in knee osteoarthritis: chronobiological variations and effects of different rehabilitation programs
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Zhang, Zheng, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Université de Lorraine, Philippe Perrin, and Jean Paysant
- Subjects
Posturographie ,Posturography ,Gonarthrose ,Hydrothérapie ,Variation diurne ,Diurnal variation ,Troubles de la posture ,Contrôle d’équilibre ,Balance control ,Personnes âgées ,Knee osteoarthritis ,Elderly patient ,Patient âgé ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Hydrotherapy - Abstract
Background and Objective – Increasing evidence supports balance control impairment in elderly patients with knee osteoarthritis (OA). Current guidelines recommend non-pharmacologic methods as first-line options in the management of OA. Hydrotherapy is a beneficial training medium for rehabilitation in elderly knee OA patients. However, few indications at present are available concerning the effect of hydrotherapy combining with targeted individual rehabilitation programs to improve balance control. Meanwhile, there is limited data on diurnal variation of balance control in these patients. This study aimed to investigate postural stability in elderly patients with symptomatic knee OA during different periods in a daytime before the spa therapy, then to study the results obtained before and after hydrotherapy to compare the improvement of balance control in these patients in two different water-based rehabilitation programs. Materials and Methods – Two-hundred and eighty-four knee OA patients were enrolled in this study. Static posturography using a vertical force platform was performed one week before spa therapy in simple (eyes open, firm support) and conflicting sensory (vision altered or unavailable, proprioception altered) conditions. To assess diurnal postural variations, patients were randomized to four testing sessions in a daytime defined as follows: 8-10am, 10-12am, 1pm-3pm, 3pm-5pm. Influence of sex, age, height, weight, and body mass index on postural stability was evaluated. Knee pain was also assessed in four testing sessions. Patients were then randomized to two different rehabilitated groups to receive spa therapies. Classic treatment group as a control received the efficacy proven spa water therapy, and active treatment group received spa water therapy combining with targeted individual rehabilitation programs. Static posturographies were carried out respectively in 21 days, 42 days and 90 days after the beginning of hydrotherapy. Results – Posturographic tests were completed for 241 patients (mean age: 64.8 + 8.7 years; 82 males). Balance control was more efficient in the afternoon than in the morning both in simple (p = 0.012) and conflicting sensory conditions (p = 0.047), especially in early afternoon when vision and proprioception were available (p = 0.026) or disturbed (p = 0.019). Patients’ knee pain was more pronounced in the morning than in the afternoon (p < 0.001). Diurnal variation of balance control was more noticeable in older, heavier, and male patients under different testing conditions (p < 0.05). Both the water-based therapies had considerable curative effect on balance control restoration. Better postural sway precision were found in active group than classic group 42 days after the beginning of hydrotherapy (p = .020), especially when proprioception was interfered with (p = .028) or without (p = .025) an available vision. Both of the groups have been observed a comparable postural stability in a three-month term. Conclusions – This study showed that better postural stability was observed in patients with knee OA in early afternoon than in late morning in simple and conflicting sensory situations. These variations appeared also to be related to age, sex, and weight and could be explained by fluctuant joint pain in a daytime. As feasible and recommended non-pharmacologic treatment, hydrotherapy is beneficial to the improvement of postural stability in elderly patients with knee OA, especially combining with targeted individual rehabilitation programs. These findings are important for future studies aiming at enhancing postural stability in knee OA patients and should be taken into account in the management of knee OA to generate applicative approaches to prevent the occurrence of adverse events in patient’s daily life.; Contexte et objectif – Les patients âgés gonarthrosiques présentent une dégradation du contrôle postural. Les méthodes non pharmacologiques sont aujourdhui recommandées comme option de première intention dans la gestion de l’arthrose. L’hydrothérapie fait partie des moyens de rééducation à disposition des patients âgés atteints d’arthrose du genou pour ses effets antalgiques et musculaires. Cependant, peu d’études sont actuellement disponibles concernant l’effet de l’hydrothérapie sur le contrôle postural, associée ou non à des programmes de rééducation individuels ciblés. Par ailleurs, le contrôle postural est susceptible de variations diurnes. Cette étude a eu pour objet de décrire le contrôle postural des personnes gonarthrosiques à quatre périodes de la journée, puis de comparer l’amélioration du contrôle postural au cours de deux programmes de rééducation différents recourant à l’hydrothérapie. Matériel et méthodes - Deux-cent-quatre-vingt quatre patients souffrant d’arthrose du genou ont été inclus dans cette étude. Le bilan posturographique a été réalisé une semaine avant la cure thermale en condition simple (yeux ouverts, support stable) et en conditions sensorielles contradictoires (vision faussée ou indisponible, proprioception perturbée). Pour évaluer les variations diurnes de la stabilité posturale, les patients ont été randomisés à quatre périodes d’essai dans la journée définies comme suit : 8h-10h, 10h-12h, 13h-15h, 15h-17h. L’influence du sexe, de l’âge, de la taille, du poids et de l’indice de masse corporelle sur la stabilité posturale a été évaluée. La gonalgie a également été évaluée à quatre périodes d’essai. Par la suite, les patients ont été randomisés en deux groupes de rééducation différents pour recevoir des traitements aquatiques : groupe cure classique (hydrothérapie efficace prouvée, c’est-à-dire groupe témoin) et groupe cure active (hydrothérapie combinant des programmes de réhabilitation individuels ciblés). Les bilans de posturographie statique ont été réalisés respectivement à 21 jours, 42 jours et 90 jours après le début de l’hydrothérapie. Résultats –Les tests posturographiques ont été réalisés chez 241 patients (âge moyen : 64,8 + 8,7 ans ; 82 hommes). Le contrôle de l’équilibre était plus efficace l’après-midi que le matin à la fois dans les conditions simple (p = 0,012) et sensorielle contradictoire (p = 0,047), en particulier en début d’après-midi lorsque la vision et la proprioception étaient disponibles (p = 0,026) ou perturbées (p = 0,019). La gonalgie a été plus prononcée le matin que l’après-midi (p < 0,001). La variation diurne du contrôle postural était plus marquée chez les patients plus âgés, de poids plus élevé, de sexe masculin, dans les conditions d’essais différentes (p < 0,05). Les deux cures d’hydrothérapie ont eu des effets curatifs considérables sur la restauration du contrôle de l’équilibre. Une meilleure précision des oscillations posturales a été constatée dans le groupe cure active par rapport au groupe cure classique, 42 jours après le début de l’hydrothérapie (p = 0,020), en particulier lorsque la proprioception a été perturbée avec (p = 0,028) ou sans (p = 0,025) vision disponible. Dans les deux groupes a été observée une stabilité posturale comparable dans un délai de trois mois. Conclusions - Cette étude a montré une meilleure stabilité posturale chez les patients atteints d’arthrose du genou, en début d’après-midi par rapport à la fin de matinée dans les situations sensorielles simples ou contradictoires. Il a été constaté que ces variations étaient également liées à l’âge, au sexe, au poids et pourraient être expliquées par la douleur articulaire fluctuante dans la journée. Considérée comme un traitement non pharmacologique applicable et recommandé, l’hydrothérapie est bénéfique à l’amélioration de la stabilité posturale chez les patients âgés atteints d’arthrose du genou, en particulier combinant un programme de réhabilitation individuel ciblé. Ces résultats sont importants pour de futures études visant à améliorer la stabilité posturale chez les patients atteints de gonarthrose et devraient être également pris en compte dans la gestion de la gonarthrose afin de générer des stratégies applicatives pour prévenir la survenue d’événements indésirables dans la vie quotidienne.
- Published
- 2014
30. Contrôle postural dans la gonarthrose : variations chronobiologiques et effets de différents protocoles de rééducation
- Author
-
Zhang, Zheng, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Université de Lorraine, Philippe Perrin, and Jean Paysant
- Subjects
Posturographie ,Posturography ,Gonarthrose ,Hydrothérapie ,Variation diurne ,Diurnal variation ,Troubles de la posture ,Contrôle d’équilibre ,Balance control ,Personnes âgées ,Knee osteoarthritis ,Elderly patient ,Patient âgé ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Hydrotherapy - Abstract
Background and Objective – Increasing evidence supports balance control impairment in elderly patients with knee osteoarthritis (OA). Current guidelines recommend non-pharmacologic methods as first-line options in the management of OA. Hydrotherapy is a beneficial training medium for rehabilitation in elderly knee OA patients. However, few indications at present are available concerning the effect of hydrotherapy combining with targeted individual rehabilitation programs to improve balance control. Meanwhile, there is limited data on diurnal variation of balance control in these patients. This study aimed to investigate postural stability in elderly patients with symptomatic knee OA during different periods in a daytime before the spa therapy, then to study the results obtained before and after hydrotherapy to compare the improvement of balance control in these patients in two different water-based rehabilitation programs. Materials and Methods – Two-hundred and eighty-four knee OA patients were enrolled in this study. Static posturography using a vertical force platform was performed one week before spa therapy in simple (eyes open, firm support) and conflicting sensory (vision altered or unavailable, proprioception altered) conditions. To assess diurnal postural variations, patients were randomized to four testing sessions in a daytime defined as follows: 8-10am, 10-12am, 1pm-3pm, 3pm-5pm. Influence of sex, age, height, weight, and body mass index on postural stability was evaluated. Knee pain was also assessed in four testing sessions. Patients were then randomized to two different rehabilitated groups to receive spa therapies. Classic treatment group as a control received the efficacy proven spa water therapy, and active treatment group received spa water therapy combining with targeted individual rehabilitation programs. Static posturographies were carried out respectively in 21 days, 42 days and 90 days after the beginning of hydrotherapy. Results – Posturographic tests were completed for 241 patients (mean age: 64.8 + 8.7 years; 82 males). Balance control was more efficient in the afternoon than in the morning both in simple (p = 0.012) and conflicting sensory conditions (p = 0.047), especially in early afternoon when vision and proprioception were available (p = 0.026) or disturbed (p = 0.019). Patients’ knee pain was more pronounced in the morning than in the afternoon (p < 0.001). Diurnal variation of balance control was more noticeable in older, heavier, and male patients under different testing conditions (p < 0.05). Both the water-based therapies had considerable curative effect on balance control restoration. Better postural sway precision were found in active group than classic group 42 days after the beginning of hydrotherapy (p = .020), especially when proprioception was interfered with (p = .028) or without (p = .025) an available vision. Both of the groups have been observed a comparable postural stability in a three-month term. Conclusions – This study showed that better postural stability was observed in patients with knee OA in early afternoon than in late morning in simple and conflicting sensory situations. These variations appeared also to be related to age, sex, and weight and could be explained by fluctuant joint pain in a daytime. As feasible and recommended non-pharmacologic treatment, hydrotherapy is beneficial to the improvement of postural stability in elderly patients with knee OA, especially combining with targeted individual rehabilitation programs. These findings are important for future studies aiming at enhancing postural stability in knee OA patients and should be taken into account in the management of knee OA to generate applicative approaches to prevent the occurrence of adverse events in patient’s daily life.; Contexte et objectif – Les patients âgés gonarthrosiques présentent une dégradation du contrôle postural. Les méthodes non pharmacologiques sont aujourdhui recommandées comme option de première intention dans la gestion de l’arthrose. L’hydrothérapie fait partie des moyens de rééducation à disposition des patients âgés atteints d’arthrose du genou pour ses effets antalgiques et musculaires. Cependant, peu d’études sont actuellement disponibles concernant l’effet de l’hydrothérapie sur le contrôle postural, associée ou non à des programmes de rééducation individuels ciblés. Par ailleurs, le contrôle postural est susceptible de variations diurnes. Cette étude a eu pour objet de décrire le contrôle postural des personnes gonarthrosiques à quatre périodes de la journée, puis de comparer l’amélioration du contrôle postural au cours de deux programmes de rééducation différents recourant à l’hydrothérapie. Matériel et méthodes - Deux-cent-quatre-vingt quatre patients souffrant d’arthrose du genou ont été inclus dans cette étude. Le bilan posturographique a été réalisé une semaine avant la cure thermale en condition simple (yeux ouverts, support stable) et en conditions sensorielles contradictoires (vision faussée ou indisponible, proprioception perturbée). Pour évaluer les variations diurnes de la stabilité posturale, les patients ont été randomisés à quatre périodes d’essai dans la journée définies comme suit : 8h-10h, 10h-12h, 13h-15h, 15h-17h. L’influence du sexe, de l’âge, de la taille, du poids et de l’indice de masse corporelle sur la stabilité posturale a été évaluée. La gonalgie a également été évaluée à quatre périodes d’essai. Par la suite, les patients ont été randomisés en deux groupes de rééducation différents pour recevoir des traitements aquatiques : groupe cure classique (hydrothérapie efficace prouvée, c’est-à-dire groupe témoin) et groupe cure active (hydrothérapie combinant des programmes de réhabilitation individuels ciblés). Les bilans de posturographie statique ont été réalisés respectivement à 21 jours, 42 jours et 90 jours après le début de l’hydrothérapie. Résultats –Les tests posturographiques ont été réalisés chez 241 patients (âge moyen : 64,8 + 8,7 ans ; 82 hommes). Le contrôle de l’équilibre était plus efficace l’après-midi que le matin à la fois dans les conditions simple (p = 0,012) et sensorielle contradictoire (p = 0,047), en particulier en début d’après-midi lorsque la vision et la proprioception étaient disponibles (p = 0,026) ou perturbées (p = 0,019). La gonalgie a été plus prononcée le matin que l’après-midi (p < 0,001). La variation diurne du contrôle postural était plus marquée chez les patients plus âgés, de poids plus élevé, de sexe masculin, dans les conditions d’essais différentes (p < 0,05). Les deux cures d’hydrothérapie ont eu des effets curatifs considérables sur la restauration du contrôle de l’équilibre. Une meilleure précision des oscillations posturales a été constatée dans le groupe cure active par rapport au groupe cure classique, 42 jours après le début de l’hydrothérapie (p = 0,020), en particulier lorsque la proprioception a été perturbée avec (p = 0,028) ou sans (p = 0,025) vision disponible. Dans les deux groupes a été observée une stabilité posturale comparable dans un délai de trois mois. Conclusions - Cette étude a montré une meilleure stabilité posturale chez les patients atteints d’arthrose du genou, en début d’après-midi par rapport à la fin de matinée dans les situations sensorielles simples ou contradictoires. Il a été constaté que ces variations étaient également liées à l’âge, au sexe, au poids et pourraient être expliquées par la douleur articulaire fluctuante dans la journée. Considérée comme un traitement non pharmacologique applicable et recommandé, l’hydrothérapie est bénéfique à l’amélioration de la stabilité posturale chez les patients âgés atteints d’arthrose du genou, en particulier combinant un programme de réhabilitation individuel ciblé. Ces résultats sont importants pour de futures études visant à améliorer la stabilité posturale chez les patients atteints de gonarthrose et devraient être également pris en compte dans la gestion de la gonarthrose afin de générer des stratégies applicatives pour prévenir la survenue d’événements indésirables dans la vie quotidienne.
- Published
- 2014
31. The assessment and treatment of postural disorders in cerebellar ataxia: a systematic review
- Author
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A. Marquer, Dominic Pérennou, and G. Barbieri
- Subjects
Posturographie ,medicine.medical_specialty ,Ataxia ,Cerebellar Ataxia ,Ataxie cérébelleuse posturale ,medicine.medical_treatment ,Rééducation ,Biofeedback ,Physical medicine and rehabilitation ,medicine ,Humans ,Orthopedics and Sports Medicine ,Postural Balance ,Balance (ability) ,Rehabilitation ,Cerebellar ataxia ,Posturography ,Gait ,Exercise Therapy ,Clinical trial ,Sensation Disorders ,Physical therapy ,medicine.symptom ,Psychology ,Postural and balance disorders - Abstract
Gait and balance disorders are often major causes of handicap in patients with cerebellar ataxia. Although it was thought that postural and balance disorders in cerebellar ataxia were not treatable, recent studies have demonstrated the beneficial effects of rehabilitation programs. This article is the first systematic review on the treatment of postural disorders in cerebellar ataxia. Nineteen articles were selected, of which three were randomized, controlled trials. Various aetiologies of cerebellar ataxia were studied: five studies assessed patients with multiple sclerosis, four assessed patients with degenerative ataxia, two assessed stroke patients and eight assessed patients with various aetiologies. Accurate assessment of postural disorders in cerebellar ataxia is very important in both clinical trials and clinical practice. The Scale for the Assessment and Rating of Ataxia (SARA) is a simple, validated measurement tool, for which 18 of the 40 points are related to postural disorders. This scale is useful for monitoring ataxic patients with postural disorders. There is now moderate level evidence that rehabilitation is efficient to improve postural capacities of patients with cerebellar ataxia – particularly in patients with degenerative ataxia or multiple sclerosis. Intensive rehabilitation programs with balance and coordination exercises are necessary. Although techniques such as virtual reality, biofeedback, treadmill exercises with supported bodyweight and torso weighting appear to be of value, their specific efficacy has to be further investigated. Drugs have only been studied in degenerative ataxia, and the level of evidence is low. There is now a need for large, randomized, controlled trials testing rehabilitation programs suited to postural and gait disorders of patients with cerebellar ataxia.
- Published
- 2013
32. Concomitant changes in clinical and posturographic data in elderly fallers during the course of an in-home anti-falling multimodal program--a preliminary investigation
- Author
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G. Kemoun, Benoit Dugué, P. Carette, Eric Watelain, Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) (MOVE), Université de Poitiers, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Laboratoire de Biomodélisation et Ingénierie des Handicaps - EA 4322 (HANDIBIO), Université de Toulon (UTLN), Laboratoire d'Automatique, de Mécanique et d'Informatique industrielles et Humaines - UMR 8201 (LAMIH), and Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Centre National de la Recherche Scientifique (CNRS)-INSA Institut National des Sciences Appliquées Hauts-de-France (INSA Hauts-De-France)
- Subjects
Posturographie ,Male ,medicine.medical_specialty ,Aging ,Poison control ,Tests cliniques d’équilibre ,Vieillissement ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Physiology (medical) ,Injury prevention ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Programme de prévention des chutes ,Postural Balance ,Balance (ability) ,Aged ,Fall prevention program ,business.industry ,Posturography ,Cognition ,Clinical balance tests ,General Medicine ,Neurology ,Posturographyés ,Berg Balance Scale ,Concomitant ,Physical therapy ,Accidental Falls ,Female ,Neurology (clinical) ,sense organs ,Falling (sensation) ,business ,030217 neurology & neurosurgery ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; SummaryAim of the study The objective of this preliminary study was to evaluate the effectiveness, in terms of fall reduction, of an in-home strategy that we have developed for elderly fallers. We also aimed at finding links between the expected changes in the data obtained in static posturography and in clinical balance tests through our program. Patients and methods Twelve elderly patients living at home who were diagnosed as fallers (5 males and 7 females; 77.9 ± 4.1 years) participated in the study. Our multimodal intervention lasted 6 months. Before this period, and one year later, an evaluation was conducted using cognitive (MMSE), clinical balance tests (i.e. Berg Balance Scale, Balance One leg, Timed Up and Go, and Functional Reach tests) and static posturography (where the area of body sway, velocity and medio–lateral and antero–posterior amplitudes were recorded twice, first with eyes open and then with eyes closed). Results Among the 12 patients who were diagnosed as fallers, eight became non-fallers. When comparing data obtained after the intervention with those obtained beforehand, we found significant changes in all of the clinical balance tests and in the posturographic-derived variables indicating improvements in the balance control in our group of subjects. We also found significant correlations between the changes in the Berg Balance Scale scores and the changes in the area of body sway data, in antero–posterior amplitude both with eyes open and with eyes closed, and also in the medio–lateral amplitude in the eyes closed condition. Conclusions We prospectively demonstrated the relevance of our anti-falling intervention at home and of the use of posturography for clinical follow-up.
- Published
- 2012
33. Modifications des stratégies sensori-motrices de l'équilibration en fonction du type d'exercice et de perturbations de l'homéostasie
- Author
-
Lion, Alexis, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université Henri Poincaré - Nancy 1, and Philippe Perrin
- Subjects
Posturographie ,Sensory organisation ,Dehydration ,Équilibre (physiologie) ,Homéostasie ,[SHS.EDU]Humanities and Social Sciences/Education ,Posturography ,Cycling ,Exercice ,Vertiges ,Cyclisme ,Exercice -- Aspect physiologique ,Cyclisme-Effets physiologiques ,Vertigo ,Organisation sensorielle ,Déshydratation ,Troubles de l' ,Exercise ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Exercise leads to the acquisition and the integration of new motor skills specific for the type of practiced activity. Exercise is also a risk factor for injuries and seems to transiently alter the balance function. Nevertheless, physiological and pathophysiological mechanisms and their consequences on balance function still remain unclear. This work, which used cycling as a neurosensory model, aimed to evaluate the possible changes of physiological and compensatory balance-related sensory-motor strategies in function of the type of exercise and homeostatic perturbations. Road cyclists? (RCs) and mountain bikers? (MTBs) sensory-motor strategies were evaluated by posturography as well as the effects of exercise-related dehydration. Moreover, the prevalence of vertigo after competitions or training sessions was investigated by a questionnaire in RCs and downhill mountain bikers (MTBsDh).Balance-related visual information was better used by RCs and MTBs, who mainly practised road cycling. Somesthetic information was better used in MTB, who mainly practiced mountain biking. Exercise-related dehydration transiently altered postural control. The more severe the dehydration, the lower was the use of vestibular information. Vertigo commonly occurred after the practice of cycling, particularly in downhill mountain biking. Exhaustion was reported as a crucial factor for vertigo by RCs, whereas for MTBs it was sudden accelerations-decelerations and falls.The difference in sensory organisation between MTB and RC could be explained by adaptive processes elaborated from environmental stimulations and technical specificities of these disciplines. Even though muscular fatigue could explain the exercise-induced alterations of postural performances, vestibular fluid modifications may also be involved by their influence on intralabyrinthine homeostasis, lowering thus the contribution of vestibular information on balance control. The pathophysiological mechanisms generating vertigo might be an effort-related disturbance of homeostasis in RCs. In MTBsDh, the accelerations-decelerations (including falls), to which the head is subjected, might generate dysfunction of peripheral vestibular structures, particularly the otolith organs; L'exercice permet l'acquisition et l'intégration de nouvelles habiletés motrices propres à la nature de l'activité considérée. L'exercice est également un facteur de risque de lésions et semble altérer temporairement la fonction d'équilibration. Cependant, les mécanismes physiologiques et physiopathologiques et leurs conséquences sur la fonction d'équilibration sont encore mal connus. Ce travail, pour lequel le cyclisme a été utilisé comme modèle neurosensoriel, visait à évaluer les éventuelles modifications des stratégies sensori-motrices physiologiques et compensatoires de la fonction d'équilibration en fonction du type d'exercice et de perturbations de l'homéostasie.Les stratégies sensori-motrices de routiers et de vététistes et celles des effets d'une déshydratation induite par un exercice ont été évaluées par posturographie. De plus, la prévalence de vertiges après compétitions ou entraînements a été évaluée par questionnaire chez des routiers et des descendeurs (spécialistes du vélo tout terrain descente). Pour assurer la fonction d'équilibration, les vététistes, qui pratiquaient le plus de VTT, utilisaient principalement les informations proprioceptives. Les routiers et les vététistes, qui pratiquaient le plus le cyclisme sur route, utilisaient davantage les informations visuelles. La déshydratation induite par l'exercice altérait temporairement le contrôle postural. Plus la déshydratation était importante, moins les informations vestibulaires étaient requises. Les vertiges survenaient couramment après la pratique du cyclisme et, en particulier, en VTT descente. L'épuisement a été rapporté comme un déterminant important des vertiges en cyclisme sur route alors que les accélérations-décélérations brusques et les chutes ont été rapportées comme déterminants des vertiges en VTT descente.La différence d'organisation sensorielle entre les vététistes et les routiers peut être expliquée par des processus adaptatifs élaborés à partir des stimulations environnementales et des spécificités techniques de ces disciplines. Bien que la fatigue musculaire puisse expliquer les altérations posturales à la suite d'un exercice, les modifications de l'homéostasie des liquides vestibulaires peuvent également diminuer le poids de l'information vestibulaire dans la régulation de l'équilibration. Les mécanismes physiopathologiques générant des vertiges peuvent être liés à des modifications homéostatiques induites par l'effort en cyclisme sur route. En VTT descente, les accélérations-décélérations (incluant les chutes), auxquelles la tête est soumise, peuvent générer des dysfonctionnements des structures vestibulaires, en particulier des organes otolithiques
- Published
- 2010
34. Changes in sensory-motor strategies of balance in function of the type of exercise and homeostasic perturbations
- Author
-
Lion, Alexis, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université Henri Poincaré - Nancy 1, Philippe Perrin, and UL, Thèses
- Subjects
Posturographie ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Sensory organisation ,Dehydration ,Équilibre (physiologie) ,Homéostasie ,[SHS.EDU]Humanities and Social Sciences/Education ,Posturography ,[SHS.EDU] Humanities and Social Sciences/Education ,Cycling ,Exercice ,Vertiges ,Cyclisme ,Exercice -- Aspect physiologique ,Cyclisme-Effets physiologiques ,Vertigo ,Organisation sensorielle ,Déshydratation ,Troubles de l' ,Exercise ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Exercise leads to the acquisition and the integration of new motor skills specific for the type of practiced activity. Exercise is also a risk factor for injuries and seems to transiently alter the balance function. Nevertheless, physiological and pathophysiological mechanisms and their consequences on balance function still remain unclear. This work, which used cycling as a neurosensory model, aimed to evaluate the possible changes of physiological and compensatory balance-related sensory-motor strategies in function of the type of exercise and homeostatic perturbations. Road cyclists? (RCs) and mountain bikers? (MTBs) sensory-motor strategies were evaluated by posturography as well as the effects of exercise-related dehydration. Moreover, the prevalence of vertigo after competitions or training sessions was investigated by a questionnaire in RCs and downhill mountain bikers (MTBsDh).Balance-related visual information was better used by RCs and MTBs, who mainly practised road cycling. Somesthetic information was better used in MTB, who mainly practiced mountain biking. Exercise-related dehydration transiently altered postural control. The more severe the dehydration, the lower was the use of vestibular information. Vertigo commonly occurred after the practice of cycling, particularly in downhill mountain biking. Exhaustion was reported as a crucial factor for vertigo by RCs, whereas for MTBs it was sudden accelerations-decelerations and falls.The difference in sensory organisation between MTB and RC could be explained by adaptive processes elaborated from environmental stimulations and technical specificities of these disciplines. Even though muscular fatigue could explain the exercise-induced alterations of postural performances, vestibular fluid modifications may also be involved by their influence on intralabyrinthine homeostasis, lowering thus the contribution of vestibular information on balance control. The pathophysiological mechanisms generating vertigo might be an effort-related disturbance of homeostasis in RCs. In MTBsDh, the accelerations-decelerations (including falls), to which the head is subjected, might generate dysfunction of peripheral vestibular structures, particularly the otolith organs, L'exercice permet l'acquisition et l'intégration de nouvelles habiletés motrices propres à la nature de l'activité considérée. L'exercice est également un facteur de risque de lésions et semble altérer temporairement la fonction d'équilibration. Cependant, les mécanismes physiologiques et physiopathologiques et leurs conséquences sur la fonction d'équilibration sont encore mal connus. Ce travail, pour lequel le cyclisme a été utilisé comme modèle neurosensoriel, visait à évaluer les éventuelles modifications des stratégies sensori-motrices physiologiques et compensatoires de la fonction d'équilibration en fonction du type d'exercice et de perturbations de l'homéostasie.Les stratégies sensori-motrices de routiers et de vététistes et celles des effets d'une déshydratation induite par un exercice ont été évaluées par posturographie. De plus, la prévalence de vertiges après compétitions ou entraînements a été évaluée par questionnaire chez des routiers et des descendeurs (spécialistes du vélo tout terrain descente). Pour assurer la fonction d'équilibration, les vététistes, qui pratiquaient le plus de VTT, utilisaient principalement les informations proprioceptives. Les routiers et les vététistes, qui pratiquaient le plus le cyclisme sur route, utilisaient davantage les informations visuelles. La déshydratation induite par l'exercice altérait temporairement le contrôle postural. Plus la déshydratation était importante, moins les informations vestibulaires étaient requises. Les vertiges survenaient couramment après la pratique du cyclisme et, en particulier, en VTT descente. L'épuisement a été rapporté comme un déterminant important des vertiges en cyclisme sur route alors que les accélérations-décélérations brusques et les chutes ont été rapportées comme déterminants des vertiges en VTT descente.La différence d'organisation sensorielle entre les vététistes et les routiers peut être expliquée par des processus adaptatifs élaborés à partir des stimulations environnementales et des spécificités techniques de ces disciplines. Bien que la fatigue musculaire puisse expliquer les altérations posturales à la suite d'un exercice, les modifications de l'homéostasie des liquides vestibulaires peuvent également diminuer le poids de l'information vestibulaire dans la régulation de l'équilibration. Les mécanismes physiopathologiques générant des vertiges peuvent être liés à des modifications homéostatiques induites par l'effort en cyclisme sur route. En VTT descente, les accélérations-décélérations (incluant les chutes), auxquelles la tête est soumise, peuvent générer des dysfonctionnements des structures vestibulaires, en particulier des organes otolithiques
- Published
- 2010
35. Ganganalytische Besonderheiten bei Patienten mit diabetischer Neuropathie am Ganganalysesystem GangAS
- Author
-
Surminski, Oleg, Swoboda, B., Zacher, J., and Böhm, P.
- Subjects
Posturographie ,Ganganalyse ,NLG ,610 Medizin ,YC 7000 ,Goniometer ,Walking ,Osteoarthropathie ,Gang ,goniometr ,Diabetes mellitus ,ddc:610 ,gait-analysis-system GangAS ,Laufband ,osteoarthropathy ,posturography ,diabetische Neuropathie ,conveyor ,diabetic neuropathy ,Polyneuropathie ,Ganganalysesystem GangAS ,nerve conduction velocity ,gait analysis ,polyneuropathy ,33 Medizin - Abstract
Diabetiker entwickeln nach durchschnittlich 10 Jahren Folgeschäden. Die Polyneuropathie mit nachfolgender Osteoarthropathie des Fußes ist eine meist zu spät erkannte und suboptimal versorgte Komplikation. Nicht rechtzeitig erkannte Schäden führen zu Ulcera, sekundären Infektionen, Osteomyelitiden und Amputationen. Fragestellung: Ist eine Ganganalyse incl. Posturographie in der Lage, eine evtl. bestehende Polyneuropathie zu verifizieren, um eine frühzeitige orthopädische Schuhversorgung vornehmen zu können? Material und Methoden: Es wurden Diabetiker (n = 73) mit (mittels Messung der Nervenleitgeschwindigkeit NLG) nachgewiesener Neuropathie und eine gesunde Vergleichsgruppe (n = 38) ohne Neuropathie am Ganganalysesystem GANGAS untersucht. Ergebnisse: Die Allgemeinparameter relative Geschwindigkeit, Schrittlänge und Kadenz, sowie die Belastungsparameter Fersen-, Mittelfuß-, Vorfußbelastung und Belastung beim Auftritt und Abstoß zeigten keine wesentlich signifikanten Unterschiede im Gruppenvergleich. Dagegen zeigte die Posturographie (apparative Untersuchung der Schwankung des Druckschwerpunktes beim Romberg-Test, welche durch die Länge und Geschwindigkeit beschrieben wurde) signifikante Unterschiede zwischen beiden Patientengruppen. So lag z.B. der Median der Weglänge des Druckschwerpunktes beim Test mit geschlossenen Augen bei den Diabetikern bei 21,27 cm und in der Vergleichsgruppe bei 15,4 cm (p = 0,007). Die Bewegungsgeschwindigkeit des Druckschwerpunktes beim Test mit geschlossenen Augen betrug im Median 1,33 cm/sec bei den Diabetikern und 0,96 cm/sec in der gesunden Vergleichsgruppe (p = 0,006). Beim Test mit offenen Augen ergab sich kein signifikanter Unterschied im Gruppenvergleich. Klinische Relevanz: Eine Instabilität des Ganges der Patienten mit diabetischer Neuropathie und entsprechenden Folgeschäden des Fußes läßt sich durch die Ganganalyse mit Standardparametern nach vorliegendem Datenmaterial nicht nachweisen. Die Posturographie ist eine einfache, zeitlich mit geringem Aufwand verbundene Methode, die mit statistischer Signifikanz die subjektiven Kriterien der klinisch-orthopädischen Frühdiagnostik sinnvoll ergänzen und damit die Verdachtsdiagnose eine diabetischen Fußes objektiv nachweisen kann, bevor bleibende Schäden am Fuß entstanden sind., Every diabetic patient after about ten years develops secondary changes in different tissues. Polyneuropathy with consecutive osteoarthropathy of the foot often is recognized too late and suboptimal treated. Diabetic disorders recognized too late may lead to ulcera, secondery infections and even amputations. Question: Is standard gait analysis including posturography able to verify diabetic neuropathy in order to supply the patient with adapted orthopadic shoeware in time? Materials and methods: A group of diabetics (n=73) with proved neuropathy by measuring nerve conduction velocity and a healthy control group (n=38) without neuropathy were examined by the gait-analysis-system GANGAS. Results: The general parameters: relative speed, length of step and cadence as well as the loading parameters of the heel, middle foot and forefoot during treading and repulsion show no significant differences between both groups. Posturography however (apparative examination of the elongation of focal point of pressure (FPP) according to the Romberg test, described by length and speed) shows significant differences between both groups. For diabetics making the test with closed eyes the mean value of walking length of the FPP was 21,27 cm, for the healthy control persons it was only 15,4 cm (p = 0,007). Asimulary results were found for the speed of movement of FPP during the test with closed eyes: mean value in diabetics 1,33 cm/s and for the healthy control persons 0,96 cm/s (p = 0,006). During this test with open eyes there was no significant difference between both groups. Clinical Relevance: Walking instability of patients with diabetic neuropathy and corresponding sequential damage of the foot could not be proved by the current data with standard parameters. Posturography however is able to give additional information with statistical significance to the subjective criteria of the clinical-orthopedic early diagnosis and verify the diagnosis of a beginning diabetic foot before severe disorders have occured.
- Published
- 2003
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