Imbalance: Objective measures versus subjective self-report in clinical practice

Chiarovano, Elodie; Wang, Wei; Reynolds, Pam; MacDougall, Hamish G.

doi:10.1016/j.gaitpost.2017.10.019

Cited by 15 publications

(16 citation statements)

References 30 publications

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“…Compared to the commonly used eyes-open or eyes-closed conditions, immersive VR applications can decouple the visual and vestibular systems in a more fine-grained manner by providing a wide range of visual perturbations. This feature allows for sensitive measures of balance to be calculated, such as determining the exact thresholds of visual perturbation required to induce falls 16,72,73 . Such systems can be low cost, for example by combining the commercially available Wii balance board (Nintendo) with an immersive VR HMD system, which has been validated against the (more expensive) gold standard Equitest dynamic posturography machine (Neurocom Inc) 74 .…”

Section: [H3] Non-immersive Vr Via Visual Augmentationmentioning

confidence: 99%

“…Such systems can be low cost, for example by combining the commercially available Wii balance board (Nintendo) with an immersive VR HMD system, which has been validated against the (more expensive) gold standard Equitest dynamic posturography machine (Neurocom Inc) 74 . Cheap and widely available VRbased balance assessments might prove useful for identifying those people with PD at high risk of falls owing to balance impairment and those who would benefit most from balance training 72 . These systems also allow balance to be assessed in all planes, thereby enabling therapists to better personalize their interventions to the individual's balance deficit 74 .…”

Section: [H3] Non-immersive Vr Via Visual Augmentationmentioning

confidence: 99%

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Virtual reality in research and rehabilitation of gait and balance in Parkinson disease

et al. 2020

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Virtual reality (VR) technology has emerged as a promising tool for studying and rehabilitating gait and balance impairments in people with Parkinson disease (PD) as it allows users to be engaged in an enriched and highly individualized complex environment. This Review examines the rationale and evidence for using VR in the assessment and rehabilitation of people with PD, makes recommendations for future research and discusses the use of VR in the clinic. In the assessment of people with PD, VR has been used to manipulate environments to enhance study of the behavioural and neural underpinnings of gait and balance, improving understanding of the motor-cognitive neural circuitry involved. Despite suggestions that VR can provide rehabilitation that is more effective and less labour intensive than non-VR rehabilitation, little evidence exists to date to support these claims. Nevertheless, much unrealised potential exists for the use of VR to provide personalized assessment and rehabilitation that optimises motor learning both in the clinic and home environments, and adapts to change in individuals over time. Design of such systems will require collaboration between all stakeholders to maximise useability, engagement, safety and effectiveness. [H1] INTRODUCTIONParkinson disease (PD) is a complex, progressive multi-system neurodegenerative disorder associated with motor and non-motor impairments 1 . The hallmark motor symptoms include bradykinesia, rigidity, tremor and postural instability,

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Section: [H3] Non-immersive Vr Via Visual Augmentationmentioning

confidence: 99%

Section: [H3] Non-immersive Vr Via Visual Augmentationmentioning

confidence: 99%

Virtual reality in research and rehabilitation of gait and balance in Parkinson disease

et al. 2020

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“…5 However, as also seen in other medical fields, objective functionality does not necessarily correspond to subjective quality-of-life outcomes for patients. [22][23][24] These studies concluded that combining measurements of objective functioning and subjective functioning (in this study the MAT and MFIQ) are complementary to each other, should strengthen each other and lead to treatment in a way that meets the needs of patients. 24 Mandibular condylar fractures often go along with disc displacement of the temporomandibular joint.…”

Section: Discussionmentioning

confidence: 91%

“…[22][23][24] These studies concluded that combining measurements of objective functioning and subjective functioning (in this study the MAT and MFIQ) are complementary to each other, should strengthen each other and lead to treatment in a way that meets the needs of patients. 24 Mandibular condylar fractures often go along with disc displacement of the temporomandibular joint. 15 Disruption in the anatomy of this joint interferes with its physiology and therefore affects the maximum mouth opening.…”

Section: Discussionmentioning

confidence: 91%

Reproducibility and construct validity of the utrecht mixing ability Test to obtain masticatory performance outcome in patients with condylar mandibular fractures

Weinberg

Vermaire

Forouzanfar

et al. 2019

J of Oral Rehabilitation

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Objective This study assessed the test‐retest reproducibility of the Utrecht mixing ability test (MAT) and the construct validity of the MAT in relation to the Mandibular Function Impairment Questionnaire (MFIQ) in patients with mandibular condylar fractures. Material and methods Twenty‐six patients treated for a mandibular condylar fracture participated in this clinimetric study; all patients performed the MAT twice. Simultaneously the MFIQ was conducted. Test‐retest reliability and construct validity were assessed using the intra‐class correlation coefficient (ICC) and Spearman correlation, respectively. Results The ICC of the MAT was 0.906 (95% CI: 0.801‐0.957), which indicates an excellent reliability. A weak correlation of 0.386 (P = .052) between the first MAT and the overall outcome of the MFIQ was found. A significant moderate correlation of 0.401 (P = .042) was found between the retest of the MAT and the overall outcome of the MFIQ. One question on the MFIQ (about yawning) showed a moderate positive correlation of 0.569 (P = .002) and 0.416 (P = .034) for the MAT test and retest, respectively. Conclusion The MAT is an easy test to use in follow‐up of patients. The test‐retest reliability of this test is excellent in condylar trauma patients. As the validity of the MAT and the MFIQ could not be confirmed, the MFIQ may be an addition to patient's feedback about the rehabilitation process of their mandibular functioning.

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“…1 The traditional four-square step test sequence: a participant is asked to walk as fast as possible clockwise (broken arrows) and counterclockwise (dotted arrows) over four walking canes arranged in a cross-shaped form, while looking forward. The participant should step through using both feet, as the starting and ending point are similar (square 1) in individuals with dizziness and balance impairments [23][24][25][26]. In the current study, we used a head-mounted display (HMD) that projects semi-realistic immersive visual experiences (HTC Vive; [27]) and was shown to be a valid and reliable tool for measuring postural tasks [28].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test

Aharoni

Lubetzky

Arie

et al. 2021

J NeuroEngineering Rehabil

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Background Persistent postural-perceptual dizziness (PPPD) is a condition characterized by chronic subjective dizziness and exacerbated by visual stimuli or upright movement. Typical balance tests do not replicate the environments known to increase symptoms in people with PPPD—crowded places with moving objects. Using a virtual reality system, we quantified dynamic balance in people with PPPD and healthy controls in diverse visual conditions. Methods Twenty-two individuals with PPPD and 29 controls performed a square-shaped fast walking task (Four-Square Step Test Virtual Reality—FSST-VR) using a head-mounted-display (HTC Vive) under 3 visual conditions (empty train platform; people moving; people and trains moving). Head kinematics was used to measure task duration, movement smoothness and anterior–posterior (AP) and medio-lateral (ML) ranges of movement (ROM). Heart rate (HR) was monitored using a chest-band. Participants also completed a functional mobility test (Timed-Up-and-Go; TUG) and questionnaires measuring anxiety (State-Trait Anxiety Inventory; STAI), balance confidence (Activities-Specific Balance Confidence; ABC), perceived disability (Dizziness Handicap Inventory) and simulator sickness (Simulator Sickness Questionnaire). Main effects of visual load and group and associations between performance, functional and self-reported outcomes were examined. Results State anxiety and simulator sickness did not increase following testing. AP-ROM and HR increased with high visual load in both groups (p < 0.05). There were no significant between-group differences in head kinematics. In the high visual load conditions, high trait anxiety and longer TUG duration were moderately associated with reduced AP and ML-ROM in the PPPD group and low ABC and high perceived disability were associated with reduced AP-ROM (|r| = 0.47 to 0.53; p < 0.05). In contrast, in controls high STAI-trait, low ABC and longer TUG duration were associated with increased AP-ROM (|r| = 0.38 to 0.46; p < 0.05) and longer TUG duration was associated with increased ML-ROM (r = 0.53, p < 0.01). Conclusions FSST-VR may shed light on movement strategies in PPPD beyond task duration. While no main effect of group was observed, the distinct associations with self-reported and functional outcomes, identified using spatial head kinematics, suggest that some people with PPPD reduce head degrees of freedom when performing a dynamic balance task. This supports a potential link between spatial perception and PPPD symptomatology.

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Imbalance: Objective measures versus subjective self-report in clinical practice

Cited by 15 publications

References 30 publications

Virtual reality in research and rehabilitation of gait and balance in Parkinson disease

Virtual reality in research and rehabilitation of gait and balance in Parkinson disease

Reproducibility and construct validity of the utrecht mixing ability Test to obtain masticatory performance outcome in patients with condylar mandibular fractures

Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test

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