Balance Rehabilitation Unit (BRU TM) posturography in relapsing-remitting multiple sclerosis

Kessler, Natália; Ganança, Maurício Malavasi; Ganança, Cristina Freitas; Ganança, Fernando Freitas; Lopes, Sabrina Chiogna; Serra, Ana Paula; Caovilla, Heloísa Helena

doi:10.1590/s0004-282x2011000400015

Cited by 13 publications

(10 citation statements)

References 11 publications

(11 reference statements)

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“…46 The MS group had significantly greater COP Area and Velocity from the control group in all conditions and the BRU was able to discriminate between the MS group and the control group. 46 …”

Section: Discussionmentioning

confidence: 82%

Estimating Postural Control With the Balance Rehabilitation Unit: Measurement Consistency, Accuracy, Validity, and Comparison With Dynamic Posturography

Alahmari

Marchetti

Sparto

et al. 2014

Archives of Physical Medicine and Rehabilitation

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OBJECTIVE To examine the psychometric properties (test-retest reliability, concurrent validity, construct validity) of the Balance Rehabilitation Unit (BRU) during testing of sensory integration processes in healthy adults and individuals with vestibular disorders. DESIGN Experimental cross-sectional design. SETTING Vestibular disorders clinic. PARTICIPANTS Participants (N= 90); 30 subjects with vestibular disorders (18 to 85 years); 30 young healthy adults (18 to 50 years); and 30 older healthy adults (60 to 85 years). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES: Participants were tested twice with the BRU and once with the Smart Equitest Sensory Organization Test (SOT) The Center of Pressure (COP) was recorded in the anteroposterior (COPap) and mediolateral (COPml) directions. The COPap and COPml time series were used to estimate the COP area andvelocity. RESULTS The intra-class correlation coefficient (ICC) of the BRU COP area and velocity measures for all subjects were at least 0.76 in all sensory organization conditions (p<.001). Significant correlations were found between the BRU and SOT, ranging from 0.64 to 0.81 for COP area and from 0.44 to 0.76 for COP velocity. The older control group had significantly greater COP area and velocity compared with the younger controls for BRU and SOT. COP (area, velocity) was significantly higher for the younger vestibular group compared with the younger controls. CONCLUSIONS The reliability and validity of COP measurements obtained during testing of sensory integration processes were demonstrated using the BRU. Future work should examine the responsiveness of these measures when individuals with balance disorders participate in rehabilitation.

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Section: Discussionmentioning

confidence: 82%

Estimating Postural Control With the Balance Rehabilitation Unit: Measurement Consistency, Accuracy, Validity, and Comparison With Dynamic Posturography

Alahmari

Marchetti

Sparto

et al. 2014

Archives of Physical Medicine and Rehabilitation

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“…Several instrumented balance tests have therefore been proposed to study equilibrium control in healthy subjects [5, 6], to assess the severity of balance disorders in patients with neurological diseases [7, 8], and to verify the effectiveness of the selected clinical treatments [9, 10]. Balance tests can be grouped depending on the absence or presence of movements of the support base on which the subjects stand during the posture test; the first condition is generally addressed to Not-perturbed Test (NPT) and the latter one as Perturbed Test (PT).…”

Section: Introductionmentioning

confidence: 99%

Quantification of postural stability in minimally disabled multiple sclerosis patients by means of dynamic posturography: an observational study

Grassi

Rossi

Studer

et al. 2017

J NeuroEngineering Rehabil

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BackgroundMultiple Sclerosis (MS) is a widespread progressive neurologic disease with consequent impairments in daily activities. Disorders of balance are frequent and equilibrium tests are potentially useful to quantify disability and to verify treatment effectiveness. The fair sensitivity of the widely used not-perturbed tests to detect balance disturbances in MS patients have prompted the development of mechatronic systems capable to impose known equilibrium perturbations, in order to challenge the balance control and, consequently, to better assess the level of impairment. We sought to clarify whether the proposed perturbed-test is capable to discriminate healthy subjects from patients with MS, even in mild or in the absence of clinically evident balance disturbances.MethodsWe assessed balance performances of 17 adults with MS and 13 age-matched healthy controls (HC) using both perturbed (PT) and not-perturbed (NPT) postural tests by means of a 3 Degree Of Freedom (DOF) rotational mechatronic platform. Participants stood barefoot on the platform in standing position and their center of pressure (CoP) was gathered by using a pressure matrix. Each trial lasted 30 s and was carried out with and without visual stimuli. Several postural indices were computed for each trial. Correlations between postural indices and clinical scales were analyzed.ResultsNo significant differences were found between groups for all indices when subjects performed NPTs. Conversely, significant differences in postural indices between MS and HC emerged during PTs. Additionally, PTs revealed significant differences between patients without any cerebellar impairment (cerebellar EDSS subscore equal to 0) and HC. The discrimination capability of PTs was confirmed by the ROC analysis. No significant change of the selected metrics occurred in HC when NPTs were performed with eyes closed, while indices presented a significant worsening in MS subjects.ConclusionsNot-perturbed tests showed lower sensitivity than perturbed ones in the identification of equilibrium impairments in minimally disabled MS patients. However, not-perturbed tests allow to better evaluate the influence of visual flow disturbances on balance control in MS. In conclusion, our findings proved that the use of the novel tests based on a 3DOF mechatronic device represents an effective tool to investigate early balance disturbances in MS.

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“…Moreover, computerised postural sway measures have been reported as correlated with disability and functional scales [24, 35, 65, 83]. Table 2 summarizes pros and cons pros of force platform measures, contrasted with those of clinical measures.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Relevance of Force Platform Measures in Multiple Sclerosis: A Review

Prosperini

Pozzilli

2013

Multiple Sclerosis International

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Balance impairment and falls are frequent in patients with multiple sclerosis (PwMS), and they may occur even at the earliest stage of the disease and in minimally impaired patients. The introduction of computer-based force platform measures (i.e., static and dynamic posturography) has provided an objective and sensitive tool to document both deficits and improvements in balance. By using more challenging test conditions, force platform measures can also reveal subtle balance disorders undetectable by common clinical scales. Furthermore, posturographic techniques may also allow to reliably identify PwMS who are at risk of accidental falls. Although force platform measures offer several theoretical advantages, only few studies extensively investigated their role in better managing PwMS. Standardised procedures, as well as clinical relevance of changes detected by static or dynamic posturography, are still lacking. In this review, we summarized studies which investigated balance deficit by means of force platform measures, focusing on their ability in detecting patients at high risk of falls and in estimating rehabilitation-induced changes, highlighting the pros and the cons with respect to clinical scales.

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Balance Rehabilitation Unit (BRU TM) posturography in relapsing-remitting multiple sclerosis

Cited by 13 publications

References 11 publications

Estimating Postural Control With the Balance Rehabilitation Unit: Measurement Consistency, Accuracy, Validity, and Comparison With Dynamic Posturography

Estimating Postural Control With the Balance Rehabilitation Unit: Measurement Consistency, Accuracy, Validity, and Comparison With Dynamic Posturography

Quantification of postural stability in minimally disabled multiple sclerosis patients by means of dynamic posturography: an observational study

The Clinical Relevance of Force Platform Measures in Multiple Sclerosis: A Review

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