Inaoka PT1, Asai H1, Nakaizumi D2, Endo S3
1Kanazawa University, Physical Therapy, Kanazawa, Japan, 2Kanazawa Red Cross Hospital, Rehabilitation, Kanazawa, Japan, 3Kanazawa Disabled Children's Hospital, Rehabilitation, Kanazawa, Japan
Background: Objective balance measurement is important for evidence-based practice when aiming to improve balance ability and prevent falls. However, assessment of standing balance using an accurate equipment usually requires the ability of patients to stand independently without aid. We developed a stabilometer with an attached sensored-handrail to provide standing balance assessment for people who require hand support to maintain the standing position.
Purpose: This study aimed to assess the standing stability in healthy elderlies and in patients with stroke and examine the effects of the use of handrail on their balance control.
Methods: Healthy elderlies (Control group, n=16) and chronic stroke (hemiparetic) patients (Stroke group, n=20) capable of standing on one-leg using a handrail volunteered for this study. The stroke patients were further divided into walking aid-dependent (S1 group, n=10) and aid-independent (S2 group, n=10) groups. The forces applied to the handrail (XYZ directions) and the sway based on central of foot pressure were recorded and analyzed (sampling: 20Hz). The Berg Balance Scale (BBS) and Timed up and go test (TUG) were also measured to compare with the stabilometer data. All subjects performed twice (30 sec duration) each of the following conditions: two-leg-stance + eyes open (A), two-leg-stance + eyes closed (B), handrail + two-leg-stance +eyes open (C), handrail + two-leg-stance + eyes closed (D), handrail + ipsilateral one-leg-stance + eyes open (E), and handrail + contralateral one-leg-stance + eyes open (F). Participants held the handrail using the dominant side (Control group) or non-paretic side (Stroke group). Non-parametric tests were performed for statistical analyses.
Results: The total sway length was significantly larger in the Stroke Group's than in Control group under the D (46.7±26.6cm > 30.8±10.3cm), E (81.3±33.8cm > 58.6±22.4cm) and F (88.5±43.5cm > 41.9±13.4cm) conditions. The total force on the handrail (X+Y+Z) was significantly higher in the Stroke group than in Control group during F condition. In addition, there was a strong correlation between handrail total forces with BBS (p 0.05, r = -0.50), and with TUG (p 0.01, r=0.62) during E condition. Although there were no significant differences between S1 group and S2 on the sway length in any condition, the handrail total force was higher in S1 compared to S2 group during E condition.
Conclusion(s): The stabilometer test did not detect major differences during regular test conditions (A, B), however in D, E, F conditions (handrail using conditions) differences were found between the Control and Stroke groups. The handrail total forces in E condition also detected differences in walking ability between S1 and S2 groups. The equipment described here may be a valuable tool for assessing changes in balance parameters in longitudinal long-term studies.
Implications: The results of this study support the use of the stabilometer with attached sensored-handrail to assess objectively the standing balance in patients who need aid to maintain the standing position or during walking. This equipment would be useful to set up objective criteria for determining walking assistance or aid dependence level for patients with balance impairments.
Keywords: Standing balance, Sensored-handrail, Stroke
Funding acknowledgements: This work was supported by JSPS KAKENHI Grant Number 16K12952.
Purpose: This study aimed to assess the standing stability in healthy elderlies and in patients with stroke and examine the effects of the use of handrail on their balance control.
Methods: Healthy elderlies (Control group, n=16) and chronic stroke (hemiparetic) patients (Stroke group, n=20) capable of standing on one-leg using a handrail volunteered for this study. The stroke patients were further divided into walking aid-dependent (S1 group, n=10) and aid-independent (S2 group, n=10) groups. The forces applied to the handrail (XYZ directions) and the sway based on central of foot pressure were recorded and analyzed (sampling: 20Hz). The Berg Balance Scale (BBS) and Timed up and go test (TUG) were also measured to compare with the stabilometer data. All subjects performed twice (30 sec duration) each of the following conditions: two-leg-stance + eyes open (A), two-leg-stance + eyes closed (B), handrail + two-leg-stance +eyes open (C), handrail + two-leg-stance + eyes closed (D), handrail + ipsilateral one-leg-stance + eyes open (E), and handrail + contralateral one-leg-stance + eyes open (F). Participants held the handrail using the dominant side (Control group) or non-paretic side (Stroke group). Non-parametric tests were performed for statistical analyses.
Results: The total sway length was significantly larger in the Stroke Group's than in Control group under the D (46.7±26.6cm > 30.8±10.3cm), E (81.3±33.8cm > 58.6±22.4cm) and F (88.5±43.5cm > 41.9±13.4cm) conditions. The total force on the handrail (X+Y+Z) was significantly higher in the Stroke group than in Control group during F condition. In addition, there was a strong correlation between handrail total forces with BBS (p 0.05, r = -0.50), and with TUG (p 0.01, r=0.62) during E condition. Although there were no significant differences between S1 group and S2 on the sway length in any condition, the handrail total force was higher in S1 compared to S2 group during E condition.
Conclusion(s): The stabilometer test did not detect major differences during regular test conditions (A, B), however in D, E, F conditions (handrail using conditions) differences were found between the Control and Stroke groups. The handrail total forces in E condition also detected differences in walking ability between S1 and S2 groups. The equipment described here may be a valuable tool for assessing changes in balance parameters in longitudinal long-term studies.
Implications: The results of this study support the use of the stabilometer with attached sensored-handrail to assess objectively the standing balance in patients who need aid to maintain the standing position or during walking. This equipment would be useful to set up objective criteria for determining walking assistance or aid dependence level for patients with balance impairments.
Keywords: Standing balance, Sensored-handrail, Stroke
Funding acknowledgements: This work was supported by JSPS KAKENHI Grant Number 16K12952.
Topic: Human movement analysis; Neurology: stroke; Outcome measurement
Ethics approval required: Yes
Institution: Kanazawa University
Ethics committee: Ethics committee of Kanazawa University
Ethics number: 806-1
All authors, affiliations and abstracts have been published as submitted.
