Purpose
The purpose of this study was to examine the reliability and validity of the Index of Postural Stability for patients with neurological disease.
Methods
The Index of postural stability (IPS) is a logarithmic value of the ratio between the stability limit and the area of centre of pressure (COP) in standing position, and is based on a probabilistic idea. Subjects were 75 patients with neurological disease (mean age; 63±12 years, 47 with Parkinson's disease, 9 with multiple sclerosis, 8 with Parkinsonism and others 11). Balance ability of subjects were assessed using IPS, Berg balance scale (BBS), Timed Up and Go Test(TUG), Functional Reach Test(FR), and gait ability of subjects were assessed using Functional Gait Category(FAC). IPS was assessed twice at intervals of about 30 minutes. Reliability of IPS was examined using Intraclass correlation coefficient (ICC), Bland-Altman plot and minimal detectable change (MDC). Validity of IPS was examined using correlation coefficients with BBS, TUG, FRT, and FAC.
Results
IPS showed significant and moderate correlation with BBS (r = 0.54), FR (r = 0.36), TUG (r =-0.43). IPS and FAC showed strong correlation (rs= 0.64). ICC of 2 separate measurements was 0.96. From the results of Bland-Altman plot, IPS had no additional error or proportional error (95%CI:-0.048~0.034, r=-0.0088, p=0.94). The MDC of IPS was 0.34.
Discussion
Since IPS has high reproducibility and does not have additional errors or proportional errors, and is also significantly related to other evaluation indexes of balance ability, it is considered that IPS may be a useful evaluation index of balance ability for patients with neurological diseases.
Impairments resulting from stroke are wide ranging. In this article, I discuss the nature of motor palsy and spasticity, which are the main impairments of stroke patients, and the assessment of them. For the assessment of motor palsy, Brunnstrom's recovery stages and motor function tests in the Stroke Impairment Assessment Set (SIAS) are compared; and for the assessment of spasticity, the Modified Ashworth Scale and the Modified Tardieu Scale are compared. I also discuss the assessment of balance ability in patients with stroke. Key words: stroke, impairment, spasticity, balance ability, assessment -23-15(〒130-8575)
The purpose of this study was to measure the airway pressure of amyotrophic lateral sclerosis (ALS) patients at different bed-backrest angles. [Subjects] The subjects were 10 ALS patients under tracheostomy positive pressure ventilation (TPPV) management. [Methods] We measured the maximum airway pressure of ALS patient at 3 different bed-backrest angles (0°, 30°, 60°), using the airway pressure meter of the respirator. [Results] There were significant differences in maximum airway pressures, between 0°and 60°, and between 30° and 60°. [Conclusion] Maximum airway pressure of ALS patients under positive pressure ventilation increased as the bedbackrest angle was increased. It is necessary to pay attention to changes in airway pressure when elevating the head.
Here, we publish results of a questionnaire which was carried out to aid the development of a clinical measure of balance ability. [Subjects and Methods] We questioned 23 physical therapists who published about balance on journals. The questionnaire consisted of 7 major questions, such as definition of balance, key concepts for measuring balance ability, and requirements for measures of balance ability. [Results] There were some differences among physical therapists in the answers for the definition of balance and key concepts of balance ability. They regarded shorter measurement time, subjectivity of results and clinical usefulness of the results as important. We also recognized there were some issues in the measures of balance ability in practice. [Conclusion] We will develop a new clinically valid measure of balance ability on the basis of these results.
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