Vestibular dysfunction resulting from peripheral vestibular disorders, head trauma, and other central nervous system disorders can lead to imbalance and falls. [1][2][3] Balance impairment can have a significant impact on an individual's ability to perform activities of daily living or participate in work and leisure activities. A thorough assessment of balance includes examination of the sensory systems that contribute to postural control. The Clinical Test of Sensory Interaction on Balance (CTSIB) was developed to assess the contribution of the visual, somatosensory, and vestibular systems to postural control. 4 The original test evaluates static postural stability in 6 distinct standing conditions with eyes open, with eyes closed, and with the use of a dome to alter visual input on both firm and foam surfaces. This test has been modified to include eyes open and eyes closed on both firm and foam surfaces, given the finding that altered visual inputs from the dome were not different from those in the eyes closed condition. 5 This test can be administered in less than 15 minutes with minimal equipment (stopwatch and foam pad). The CTSIB and modified CTSIB have excellent reliability and validity in adults with vestibular disorders and can be easily administered in all clinical settings. This Rehabilitation Measures Database summary provides a review of the psychometric properties of the CTSIB and modified CTSIB in adults with vestibular dysfunction. A full review of the CTSIB and modified CTSIB as well as reviews of more than 100 other instruments can be found at www.rehabmeasures.org.
Background Repetitive task practice reduces mean upper extremity motor impairment in populations of patients with chronic stroke, but individual response is highly variable. A method to predict meaningful reduction in impairment in response to training based on biomarkers and other data collected prior to an intervention is needed to establish realistic rehabilitation goals and to effectively allocate resources. Objectives To identify prognostic factors and better understand the biological substrate for reductions in arm impairment in response to repetitive task practice among patients with chronic (≥6 months) post-stroke hemiparesis. Methods The intervention is a form of repetitive task practice using a combination of robot-assisted therapy and functional arm use in real-world tasks. Baseline measures include the Fugl-Meyer Assessment, Wolf Motor Function Test, Action Research Arm Test, Stroke Impact Scale, questionnaires on pain and expectancy, MRI, transcranial magnetic stimulation, kinematics, accelerometry, and genomic testing. Results Mean increase in FM-UE was 4.6 ± 1.0 SE, median 2.5. Approximately one-third of participants had a clinically meaningful response to the intervention, defined as an increase in FM ≥ 5. The selected logistic regression model had a receiver operating curve with AUC = .988 (Std Error = .011, 95% Wald confidence limits: .967–1) showed little evidence of overfitting. Six variables that predicted response represented impairment, functional, and genomic measures. Conclusion A simple weighted sum of 6 baseline factors can accurately predict clinically meaningful impairment reduction after outpatient intensive practice intervention in chronic stroke. Reduction of impairment may be a critical first step to functional improvement. Further validation and generalization of this model will increase its utility in clinical decision-making.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.