Wobble Board Exercise Group Study

My Bachelor’s in Exercise Science has equipped knowledge of the human anatomy and physiology, and exercise testing and prescription for people of different ages and health conditions. During my attendance at the University of Texas at Arlington, I joined the Little Mavs Movement Academy directed by Dr. Priscilla Cacola. I volunteered for a year in this program; while in the program I had the opportunity to learn about developmental coordination disorder (DCD) and how it interferes with activities of daily living and learning of

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

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.

Patients will report to physical therapists with a multitude of impairments throughout the progression of the disease. The most prominent impairments will present during cerebellar testing. Patients will show signs of dysmetria, dysphasia, dysdiadochokinesia, and ataxia primarily as a result of the atrophy and damage to the cerebellum. Instability and lack of postural control will be demonstrated during the Romberg's test. Additionally, cranial nerve testing will have positive results for many cranial nerve palsies such as CN III, V, VII, IX, and XII. Patients show weakness in their trunk and extremities during the manual muscle testing. Vestibular testing will result in abnormal VOR, saccades, smooth pursuits and nystagmus. As a result of these impairments, patients experience functional limitations. Primarily, these patients are considered to be “high fall risks,” which ultimately decreases their independence due to weakness, instability and decreased postural control. These patients will feel uncomfortable in many situations and be unable to function independently in the community. This creates an increased risk for further injury. Due to the dysmetria and weakness, patients will also experience difficulty with their daily living skills, such as maintaining proper hygiene; They will have trouble bathing themselves and brushing their teeth without assistive equipment. PT interventions can help minimize and control these limitations. The implementation of balance training and assistive devices will be imperative interventions for an individual to modify and adapt to their gait

I directed Henderson to place her right foot in front of her left and keep her hand by her side while I demonstrate. Henderson was unable to keep balance without swaying. Henderson was then asked to stop before she hurt herelf. I demonstrated five times how to do the test and Henderson still had difficulties following instructions. Henderson also started the test without being promt to do so.

However, client demonstrate deficit in narrow BOS balance and tandem standing balance with closed eyes and slight resistance. In addition, client was concerned about her balance during one leg rising with opposite hand raising gym exercise. Client will attend occupational therapy services 3x per week and will be able to stand on balance board for 1 minute with wider BOS while holding side bar to improve her balance. For long term goal, client will attend occupational therapy services 3x per week and will be able to stand independently on balance board for 1 minute with narrow BOS to improve her endurance, strength and balance while standing. Client will get education from an occupational therapist for increasing her BOS while standing, and to hold side rail while walking/exercising to avoid future fall accident. It is also recommended that client will attend outpatient physical therapy service to address her balance

Because the administration of the BESTest takes from 45 to 60 minutes, which may not be practical in all clinical settings, a condensed shorter version of the BESTest (Mini-BESTest) was created. Through the basis of rash analysis, unnecessary items and 2 sections of the BESTest, biomechanical constrains and stability limits/vertically, were removed to yield the assessment of dynamic balance. The Mini-BESTest contains 14 items of the original 36 items from the BESTest. The items on the Mini-BESTest are scored on a 3 point scale ranging from (0) to (2). A score of (0) indicates the lowest level of function and a score of (2) indicates the highest level of function, leading to a possible total score of 28 points (Yingyongyudha et al., 2015).

MS is a disease that involves that demyelination of the neuromuscular system (cite). This autoimmune disease is characterized by extreme fatigue and limited mobility; this in turn affects his or her balance. In this study done by Dr. Jeffrey Herbert and company, thirty-eight subjects underwent a fourteen-week single-blinded, randomized controlled trial aimed to combat vestibular deficiency using a VR program and exercise protocol for endurance training. The subjects were then randomly allocated into three separate groups: experimental intervention (12), exercise intervention (13), and control (13). Additionally, the following weeks were organized into three phases: 1. Measuring the patient’s baselines (Week 1-4) 2. Performing the interventions in a human performance laboratory (Week 5-10) and 3. Measuring the outcomes (Week 11-14). The experimental group worked on a VR program that has clinical and literature based evidence that includes upright postural control and eye movement exercises (cite). A firm surface, foam cushion, and tiltboard were all used to change the base of support (BOS) during upright postural control, in addition, the investigators also challenged the subjects by closing/opening their eyes, tossing objects for them to catch, and changing their feet placement (shoulder width, heels together, partial heel to toe, and tandem). The eye movement exercises for the protocol

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

The purpose of this experiment was to identify which flexibility measurement tests correlate with the sit-and-reach and modified sit-and-reach tests. In more recent studies, statistics have shown that both hip flexion test results and shoulder extension test results were directly correlated to modified sit-and-reach test results (Mayorga-Vega, Merino-Marban, and Viciana, 2014). The data gathered for the sample

This is especially important because individuals with balance related disorders can have ADL impairments, resulting in loss of independence (Meli, 2006). When designing a training program, data from the assessments can be used to: (a) set goals, (b) determine safety parameters/identifying exercise contraindications, (c) modify exercises, and (d) track progress. One method of obtaining assessment information is through collaboration with the individual’s physical therapist (PT). Having access to an evaluation conducted by a PT is a major asset because it will can provide detailed information about positional limitations, previous rehab programing, and other screening information. Research shows that vestibular rehabilitation programs conducted by physical therapists can improve balance and other coordination-based abilities (Nyabenda, Briart et al. 2003; Gottshall, Hoffer et al. 2005). When dealing with a client who has undergone vestibular rehabilitation, it is important to have the original program to help determine exercise progressions and/or regression. If an individual with Meniere’s hasn’t previously conducted a vestibular rehabilitation program, a referral might be necessary. In addition to the data from the PT, trainers may incorporate self-report instruments such as the Dizziness

These studies found that these alternative methods did help to improve strength and function of these patients, but none of the studies had significant data to definitively prove this. While the data from these studies are not significant, it does not mean that they are entirely unimportant. Most of the researchers from these studies sent out follow up questionnaires about the enjoyment of the rehabilitation styles. All of the studies that did these questionnaires found that the participants had much greater levels of enjoyment and motivation while completing their from of rehab. This shows that while these alternative methods of hemiplegia rehabilitation might not be entirely effective on their own, they can serve a purpose when combined with traditional physical therapy methods. Physical therapist can utilize video games like the Wii or virtual reality software for patients that do not respond to or do not have proper motivation for traditional rehabilitation methods. This can help the physical therapist tremendously so they will have a tool at their disposal to help increase the motivation of the harder to work with patients. While the studies were performed well, they did have a number of limitations that hindered the research. Many of the studies, all besides one, had less than 50 participants, which leaves very little room for participant or conductor error. These small sample sizes also allow for outliers to throw off the data tremendously, as compared to if the study had a larger sample size. Another limitation that most of these studies had was that there were often a greater number of males to females. While this may not seem detrimental to these studies, it does provide doubt about the accuracy because of the differences between males and females, which may have skewed the data in a

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).

According to Pozzi et al., patients with CAI present with decreased balance deficits while performing the Star Excursion Balance Test (SEBT).3 The SEBT consists of eight lines placed on the floor that forms a circle with 45-degree arcs to resemble a star pattern.3 To perform this test, the patient is instructed to balance on the involved leg while the opposite leg reaches out in each direction.3 When the test was performed with individuals who had CAI, the excursions were shorter in distance when compared to the uninvolved leg.3 Additionally, there is an increased reliance on proximal joints, indicating decreased balance deficits.3 In any ankle rehabilitation program, static and dynamic balance exercises should be addressed.13 According to Cain et al., balance training should be used to decrease symptoms and reoccurrence of injury of CAI.13 For instance, static balance exercises performed on a Biomechanical Ankle Platform System (BAPS) has been proven to be beneficial in the rehabilitation of CAI, and has shown improvements with the SEBT for dynamic balance after four weeks.13 It is essential to begin a balance program by beginning with static balance exercises, progressing to dynamic exercises and concluding with sport specific activities.14 Balance rehabilitation programs that are performed on unstable surfaces have proven to increase ankle stability and neuromuscular control compared to stable surfaces.14 Utilizing unstable surfaces is an effective way to challenge

We will be investigating if exercising the Vestibulo Ocular Reflex increases and improves balance in adults and children.