The Effects Of Biofeedback System On Dynamic Balance During Walking

*John Guido and Sherry Werner make a point that “The stride leg functions to dynamically stabilize the hip and knee joints in a single leg stance to maintain standing posture for

Exercises and physical activity have been associated with numerous health benefits including reducing incidences of falls and injuries among the elderly and the geriatric population. Appropriately exercise programs and cardiovascular fitness in older people improve strength and balance. The interventions included strengthening, endurance, balance, flexibility exercises, Tai Chi, stand up/step down procedure and walking exercises. In the first research, the findings were that program targeting balance, leg strength, and freezing gait were only effective in people with milder illnesses, as opposed to more serious disorders like Parkinson’s disease. The study was done for a period of 2 years. In the second research, the findings showed that a multi-component enhanced physical performance of the community indwelling adults but did not translate to psychological outcomes or reduced rates of falling.

The study will be a single-centered, crossover, randomized control trial which will aim to determine which foot condition, barefoot or shod, allows for best performance of the SEBT. The dependent variable is reach distance. The independent variable is the differing foot conditions, barefoot versus shod. The SEBT will produce continuous, ratio data measured in centimeters. A quantitative primary research approach will be used as quantitative measurements allow for statistical comparison between variables, which will allow the hypothesis to be accepted or rejected (Barker et al., 2016). 1:1 block randomization will be used in this study, with participant being randomly assigned to either barefoot or shod first groups of equal sizes using the crossover design. Randomization

Falls are a common and complex geriatric syndrome that cause considerable mortality, morbidity, reduced functioning, and premature nursing home admissions. Falls have multiple precipitating causes and predisposing risk factors, which make their diagnosis, treatment, and prevention a difficult clinical challenge. Identifying effective interventions to prevent falls and fall-related injuries among older adults is a major area of research and policy development in geriatrics. Several published clinical guidelines review the evidence for fall prevention strategies and provide recommendations for assessment and intervention (Rubenstein & Josephson, 2006).

Olama, K.A., & Thabit, N.S. (2010) performed a randomized controlled trial to determine the efficacy of whole body vibration (WBV) and a designed physical therapy program versus suspension therapy and the same designed physical therapy intervention in balance control in children with hemiparetic CP. Criteria for inclusion for the study were children with hemiparesis cerebral palsy from both sexes ages 8 to 10 years old, able to understand commands given to them, able to stand and walk independently with frequent falling, and balance problems ( as confirmed by the Tilt Board Balance Test). The exclusion criteria consisted of presence of any medical condition such as vision and hearing loss, cardiac abnormalities, and musculoskeletal disorders. Children who met the criteria (n=30) were recruited from the outpatient clinic, College of Physical Therapy, Cairo University The randomization was done according to the Gross Motor Function Classification System (GMFCS). Treatment allocations were done by the selection of a closed envelope randomly selected. Parents and children were informed of the treatment allocation after the selection, procedures were explained to both of them and signed assent and consent were obtained.

The evidence included in this summary is from Franco, J. R., Jacobs, K., Inzerillo, C., & Kluzik, J. (2012). The effect of the Nintendo Wii Fit and exercise in improving balance and quality of life in community dwelling elders. Technology & Health Care, 20(2), 95-115. The study addressed whether or not improving balance through exercise decreased the risk of falls. The study compared two types of exercise programs for improving balance; the Nintendo Wii Fit and the Matter of Balance program. The methodology included dividing residents of an independent living senior facility into three groups. The Wii Fit group and the Matter of Balance group consisted of 11 participants and the third group, the Control group, consisted of 10 participants. Results were determined based on one-way ANOVAS in which variation within each sample was compared to the variation between the samples to test whether there is greater variation between the groups. Assessments from the outcome measurements were not statistically significant according to the study. The Berg Balance Scale tool measured the pre and post balance of the participants resulting in little change with the strength of this assessment evidenced by (p=0.837). The Tinetti Gait and Balance Assessment of mobility, balance, gait, and fall risk of participants registered minimal pre and post change with the

With the process of aging, movement, gait, flexibility and reflexes are altered. Reduced stability and gait is an increasing risk factor in older adults that are at risk for falls. Research studies compare the mobility of older adults that have fallen and compared to non-fallers and have determined that once an older adult falls, there is an increase in hesitance when it comes to mobility. Since the older adult then reduces their mobility as a result of fear of falls, they will ultimately decreased their functional capacity and result in gait unsteadiness. This will consequently increase the risk of falls in the older adult since they are more apprehensive to walking independently and performing activities of daily living on their own (Sapir,

In 2015, researchers conducted a study on 79 adults (mean age 68.7) to determine the validity of the BESTest, Mini-BESTest and Brief BESTest. Activities-Specific Balance Confidence Scale, The Physical Activity Scale for the Elderly, The Timed Up and GO Test, and The Single Leg Stance test were used to assess the

A group of student collaborated in a study for patient with Multiple Sclerosis that presented with a balance deficit. The purpose of the study was to compare Berg Balance Scale and Mini-BESTest and the ability of both balance measures to detect falls. The study was fulfilled in 8 weeks of physical rehabilitation on people who suffer from Multiple Sclerosis. Multiple Sclerosis is the most common chronic progressive disorder of the CNS that commonly affects young people. Balance deficit is one of the many symptoms associated with MS, this can cause impairment that progressively increases as the disease progresses.

Six standing trials include 1) single dominant leg stance on a firm surface (SDFS), 2) single non-dominant leg stance on a firm surface (SNDFS), 3) double leg stance on a firm surface (DFS), 4) single dominant leg stance on a wobble board (SDWB), 5) single non-dominant leg stance on a wobble board (SNDWB), and 6) double leg stance on a wobble board (DWB). The order of the standing trials will be randomized. A two minute testing period will be recorded for each standing condition. During testing, participants will be instructed to position barefoot with the hands akimbo for as still as possible for both a firm surface and a wobble board conditions. During all one leg stance trials, participants will be instructed to flex the knee of the contralateral

TA muscle, a crucial muscle for foot lift during gait, and major player in maintaining balance and stability, demonstrated no significant differences during IDS, SS, and TDS on the affected side with the RE as compared to without the RE (P= 0.52780, P= 0.73530, P= 0.07592 respectively), but showed a significant difference during swing as stated above. In the TA muscle, there was no significant differences between the affected and unaffected limbs with RE (P>0.05). While there was no significant differences in EMG activation of the TA muscle without the RE during TDS and Swing, conversely there was a significant difference in IDS, and SS when comparing the affected and unaffected limbs (IDS: P=0.02631, SS: P=0.04539, TDS: P=0.06174, SW: P=0.09960). There was no significant

The control group was researched for balance, limits of stability, and gait of patients with AD, FTD’s. The balance was measured using dynamic posturography, in single and dual tasks and gait with Biodex Gait Trainer. In

Biofeedback is sometimes a very confusing topic. It refers to the use of electronic, medical devices to give more auditory, verbal, and visual information back to the body about how it is working. For example, during biofeedback when a person tries to relax his muscles, he can hear a sound telling the degree of relaxation. Or if a person is to slow his pulse, he can hear or see his pulses more easily than by just feeling the pulse. By hearing the pulse, it is easier to try to manipulate it with his conscious control. This is also done with temperature control. When people are nervous, their hands might get colder or sweaty and warmer.

During walking, there was significant decreases in the values of VL duration between subjects, speed and incline. Within running gait, there was a cogent interaction between VL EMG duration and speed and incline (Fig. 3C). In each treatment, EMG duration of the BF varied significantly between subjects and there were interactions between subject and speed or gait in during walking or between gaits, respectively (Table 1,3).

To work on the athlete balance stabilization, a few exercises can be implemented into their training program. Some exercises consist of single-leg balance progression, single-leg balance reach progression, and single-leg balance with dynamic movement progression. These exercises can help assist in the sensitization of muscles spindles leading to improvements in neuromuscular efficiency (Clark, pg. 216).