1,721,098 research outputs found
Development of a Sensory Integration Test for Locomotion: A Study Protocol
No full textBackground & Aim: As falls are common during gait in older adults, investigating the factors contributing to stable gait has gained growing interest. In this context, the contribution of visual, somatosensory, and vestibular systems (i.e., sensory integration) to gait has been studied for years, albeit primarily as individual systems. Although an earlier attempt was made to develop a test to comprehensively assess the sensory integration during gait, this effort encountered certain limitations that impacted its overall effectiveness. Thus, this study aims to develop a new test to evaluate sensory integration during gait, called the "Sensory Integration in Walking (SensIWalk) Test" and assess its validity and reliability in both young and older adults. Methods: This study is planned as an observational study. Younger (n=24, 18-35 years old) and older adults (n=24, >= 65 years old) will be invited to participate, and all measurements will be performed at the Computer Assisted Rehabilitation Environment (CAREN, Motek Medical BV, Amsterdam, The Netherlands). SensIWalk, adapted from the framework of the Clinical Test of Sensory Interaction and Balance (CTSIB) with the same six conditions, will be modified to accommodate locomotion. The conditions of SensIWalk will be as follows: 1) Walking at preferred speed on a firm surface (i.e., on the treadmill) with eyes open, 2) Walking at preferred speed on a firm surface in the dark (1.3 lux), 3) Walking at preferred speed on a firm surface with sways of the virtual reality (VR) environment (i.e., visual conflict), 4) Walking at preferred speed with foam insoles (2 cm thick) with eyes open, 5) Walking at preferred speed with foam insoles in the dark, 6) Walking at preferred speed with foam insoles with sways of the VR environment. Discussion: This study will allow delving into the underlying sensory mechanisms explaining suboptimal balance during walking by assessing the effects of sensory strategies on movement patterns. This may provide a deeper insight into the underlying mechanisms of falls in older adults, which could foster novel training or rehabilitation paradigms to decrease the risk of falls in older adults. (c) 2025 AGBM. Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.This work has been supported by: This research is funded by the Special Research Fund (BOF) of Hasselt University (BOF23OWB38)
Validity of Deep Learning-Based Motion Capture Using DeepLabCut to Assess Proprioception in Children
No full textProprioceptive deficits can lead to impaired motor performance. Therefore, accurately measuring proprioceptive function in order to identify deficits as soon as possible is important. Techniques based on deep learning to track body landmarks in simple video recordings are promising to assess proprioception (joint position sense) during joint position reproduction (JPR) tests in clinical settings, outside the laboratory and without the need to attach markers. Fifteen typically developing children participated in 90 knee JPR trials and 21 typically developing children participated in 126 hip JPR trials. Concurrent validity of two-dimensional deep-learning-based motion capture (DeepLabCut) to measure the Joint Reproduction Error (JRE) with respect to laboratory-based optoelectronic three-dimensional motion capture (Vicon motion capture system, gold standard) was assessed. There was no significant difference in the hip and knee JRE measured with DeepLabCut and Vicon. Two-dimensional deep-learning-based motion capture (DeepLabCut) is valid to assess proprioception with respect to the gold standard in typically developing children. Tools based on deep learning, such as DeepLabCut, make it possible to accurately measure joint angles in order to assess proprioception without the need of a laboratory and to attach markers, with a high level of automatization.Funding: NJ and this work were supported by the Research Foundation—Flanders (FWO)
(grant.number: 92836, 2021) and the Special Research Fund (BOF) for Small Research Project—Hasselt
University (BOF19KP08), respectively.
Acknowledgments: The authors would like to thank all children and parents who volunteered and
participated in this study and the school and master’s students who collaborated and assisted with
the recruitment of the children
The Effect of Exercise on Muscle Strength, Mobility and Balance in Prefrail Older Adults: a Systematic Review and Meta-analysis.
No full textExpanding the walking fatigability definition in people with multiple sclerosis: An exploratory study
No full textObjective: To investigate the relationship of the 6MWT and walking fatigability with different domains of physical activity in pwMS with WF (MS-WF), non-WF (MS-NWF) and healthy controls (HC). Methods: Twenty-two MS-WF (EDSS 4.7±1.1; 15F/7M), 21 NWF-MS (EDSS: 4.9±1.2; 15F/6M) and 21 HC (18F/3M) responded to the international physical activity questionnaire (IPAQ-long version) and performed the 6MWT. IPAQ was calculated in metabolic equivalent of task for moderate, vigorous and total physical activities domains. Total and minute-by-minute distances were recorded in the 6MWT, and the distance walked index from the last minute (DWI 6-1) was calculated for WF. Spearman's rank correlation, separately per group, was used to examine the correlation between IPAQ and total distance on 6MWT and DWI 6-1. Results: Moderate and total physical activities were significantly moderately associated with the 6MWT (MSWF: rho = 0.598, p<0.003 and rho = 0.608, p<0.003, respectively; NWFMS: rho = 0.564, p<0.008 and rho = 0.628, p<0.002 respectively) and the DWI 6-1 (MSWF: rho = 0.524, p<0.012 and rho = 0.461, p<0.031 respectively; NWFMS: rho = 0.441, p<0.045-moderate). No significant association was observed between moderate and total (HC) and vigorous activities (MS-WF, NWF-MS and HC) with the 6MWT and DWI 6-1. Conclusion: Our results indicate that physical activity is similarly associated with walking capacity and WF. The lower levels of physical activity, normally observed among studies in pwMS, could be related to lower walking capacity (i.e., lower performance on 6MWT) and lower capacity to sustain walking performance over prolonged periods (i.e., lower values on DWI 6-1). Improving walking capacity and fatigability may consequently improve physical activity in pwMS and other factors associated as fatigue, quality of life and disability levels
The Effect of Exercise on Muscle Strength, Mobility and Balance in Prefrail Older Adults: a Systematic Review and Meta-analysis.
No full textExpanding the walking fatigability definition in people with multiple sclerosis: An exploratory study
No full textObjective: To investigate the relationship of the 6MWT and walking fatigability with different domains of physical activity in pwMS with WF (MS-WF), non-WF (MS-NWF) and healthy controls (HC). Methods: Twenty-two MS-WF (EDSS 4.7±1.1; 15F/7M), 21 NWF-MS (EDSS: 4.9±1.2; 15F/6M) and 21 HC (18F/3M) responded to the international physical activity questionnaire (IPAQ-long version) and performed the 6MWT. IPAQ was calculated in metabolic equivalent of task for moderate, vigorous and total physical activities domains. Total and minute-by-minute distances were recorded in the 6MWT, and the distance walked index from the last minute (DWI 6-1) was calculated for WF. Spearman's rank correlation, separately per group, was used to examine the correlation between IPAQ and total distance on 6MWT and DWI 6-1. Results: Moderate and total physical activities were significantly moderately associated with the 6MWT (MSWF: rho = 0.598, p<0.003 and rho = 0.608, p<0.003, respectively; NWFMS: rho = 0.564, p<0.008 and rho = 0.628, p<0.002 respectively) and the DWI 6-1 (MSWF: rho = 0.524, p<0.012 and rho = 0.461, p<0.031 respectively; NWFMS: rho = 0.441, p<0.045-moderate). No significant association was observed between moderate and total (HC) and vigorous activities (MS-WF, NWF-MS and HC) with the 6MWT and DWI 6-1. Conclusion: Our results indicate that physical activity is similarly associated with walking capacity and WF. The lower levels of physical activity, normally observed among studies in pwMS, could be related to lower walking capacity (i.e., lower performance on 6MWT) and lower capacity to sustain walking performance over prolonged periods (i.e., lower values on DWI 6-1). Improving walking capacity and fatigability may consequently improve physical activity in pwMS and other factors associated as fatigue, quality of life and disability levels
A continuum of balance performance between children with developmental coordination disorder, spastic cerebral palsy, and typical development
No full textBACKGROUND: Balance deficits are one of the most common impairments in developmental coordination disorder (DCD) and cerebral palsy (CP), with shared characteristics between both groups. However, balance deficits in DCD are very heterogeneous, but unlike in CP, they are poorly understood. AIM: To unravel the heterogeneity of balance performance in children with DCD by comparing them with CP and typical development (TD). DESIGN: Cross-sectional case-control study. SETTING: Different outpatient settings and the community. POPULATION: Children aged 5-10.9 years with TD (N.=64, boys: 34, mean [SD] age: 8.1 [1.6]), DCD (N.=39, boys: 32, mean [SD] age: 8.1 [1.5], formal diagnosis [N.=27]), and CP (N.=24, boys: 14, mean [SD] age: 7.5 [1.4], GMFCS level I [N.=14]/II [N.=10], unilateral [N.=13]/bilateral [N.=11]). METHODS: We evaluated balance performance with the extended version of the Kids-Balance Evaluation Systems Test (Kids-BESTest). Between-group differences in domain and total scores (%) were assessed via ANCOVA (covariate: age), with Tukey post-hoc analyses (P RESULTS: Children with DCD and CP performed poorer than TD children on total and domain scores with large effects (domains: eta(2)=0.25-0.66 [P CONCLUSIONS: There is a continuum of balance performance between children with TD, DCD and CP, but with great inter- and intra-individual heterogeneity in DCD and CP. DCD and CP children have difficulties with tasks requiring anticipatory postural adjustments, fast reactive responses, and with tasks that require complex sensory integration, suggesting an internal modeling deficit in both groups. This implies that these children must rely on slow conscious feedback-based control rather than fast feedforward control and fast automatic feedback. The performance of both DCD and CP children on their stability limits/verticality is similarly poor which further emphasizes a potential deficit in their sensory input and/or integration. Future research must focus on unraveling the control mechanisms, to further understand the heterogeneity of these balance deficits. CLINICAL REHABILITATION IMPACT: The heterogeneous balance performances in both children with DCD and CP underscore the importance of comprehensively evaluating balance deficits in both groups. This comprehensive assessment contributes to a better understanding of individual balance deficits, thereby facilitating more tailored treatment programs.We would like to thank all the children and parents who volunteered and the schools and therapists who collaborated and helped with the recruitment of the children and patients. a special thank you to the cerebral palsy referral center antwerp (cepra) for the recruitment of children with cerebral palsy and colleagues silke Velghe and Mieke Goetschalckx for the recruitment of children with developmental coordination disorder. thank you to all master students at both hasselt university and university of antwerp for the help during the test sessions. thank you, Erik fransen, for the statistical support
Feasibility of fNIRS in Children with Developmental Coordination Disorder
No full textINTRODUCTION: Balance deficits are heterogeneous among children with Developmental Coordination Disorder (DCD). Balance performance depends on different balance domains, each associated with specific underlying neurological systems. In DCD, any of these domains can be affected, but the control mechanisms are poorly understood. The mirror neuron system (MNS) seems to play a key-role in DCD-related deficits. To understand the role of MNS as a control mechanism underlying the balance deficits, simultaneous registration of cortical MNS activity while performing balance tasks is imperative. Therefore, a protocol for combining real-time registration of cortical MNS activity during functional balance tasks in children with DCD, CP and TD is introduced. Methods: Children with DCD, CP and TD (n=108) aged 5-10yr perform preselected tasks of the Kids-BESTest, representing specific balance domains (mixed design): leaning with eyes closed (stability limits/verticality), single-leg-stance, alternate stair touching (anticipatory balance), in-place response, compensatory stepping backward (reactive balance) and walking over obstacles (gait stability). Simultaneously, functional Near-Infrared Spectroscopy (fNIRS) monitors cortical activity involving the MNS: premotor, inferior and superior parietal cortex and supplementary motor area. An 8-8-optode bundle, making 22 channels, targets this region of interest. Outcome measures are: (de)oxygenated hemoglobin concentration changes per task per channel. Results: In this ongoing research, the protocol was already feasible in 19 children (7.52±1.19). Conclusion: Simultaneous registration of cortical MNS activity (fNIRS) and Kids-BESTest scores will help increase the understanding of the control mechanisms underlying the heterogeneous balance problems in DCD. Consequently, first steps are made to confirm whether DCD shows deviant or delayed development. DISCLOSURE: No significant relationships
The Importance of Frailty in Older Adults With Benign Paroxysmal Positioning Vertigo
No full textBackground and Purpose: Even though Benign Paroxysmal Positioning Vertigo (BPPV) is one of the most reported vestibular disorders, its interaction with frailty and postural control in older adults is hardly or not investigated. Methods: Thirty-seven older adults (≥65 years) with a diagnosis of BPPV (oaBPPV) (mean age 73.13 (4.8)) were compared to 22 age-, weight-, and height-matched controls (mean age 73.5 (4.5)). Modified Fried criteria were used to assess frailty. Postural control was assessed with the timed chair stand test, mini Balance Systems Evaluation test (mini-BESTest), a Clinical Test of Sensory Interaction on Balance (CTSIB), and 10-m walk test. Falls were inquired. The Dizziness Handicap Inventory, Falls Efficacy Scale, and 15-item Geriatric Depression Scale assessed dizziness-related handicap, fear of falling, and feelings of depression, respectively. To assess the importance of frailty, all variables were also compared between frail oaBPPV, robust oaBPPV, and robust controls in a sub-analysis. The significance level was set at α = 0.05. Results: oaBPPV reported significantly more multiple falls (P = 0.05) and difficulties to remain standing with increasing task difficulty of the CTSIB (P = 0.004). They were significantly more (pre-)frail compared to controls (P < 0.001). Moreover, frail oaBPPV had a significantly decreased reactive postural control (P < 0.001) and dynamic gait (P < 0.001). Their fear of falling (P < 0.001) and dizziness-related handicap (P < 0.001) were significantly higher compared to robust oaBPPV. Discussion and Conclusions: oaBPPV were less healthy and more (pre-)frail compared to controls, impacting their daily functioning. Future research should investigate whether frailty and postural control were already decreased before the BPPV onset and if this recovers after treatment with repositioning maneuvers or if additional rehabilitation is necessary. Impact Statement: Older adults with Benign Paroxysmal Positional Vertigo (BPPV) can present with an impaired sensory orientation, declined cognition, significantly more multiple falls, and (pre-) frailty compared to controls. Moreover, frail older adults with BPPV also had a significantly decreased reactive postural control and dynamic gait, and an increased odds of falling compared to robust controls. BPPV and frailty appear to be linked with each other, which cannot be ignored in future research and clinicians treating older adults with BPPV.</p
Does Sensory Integration Influence Gait Parameters in Healthy Older Adults? Insights from a Systematic Review with Meta-Analysis
No full textBackground/Objective: Sensory integration (SI) involves the central processing of visual, vestibular, and somatosensory inputs. It plays a key role in regulating movements such as gait. However, aging may impair these systems and SI, altering the gait. Therefore, this systematic review and meta-analysis aim to examine the relationship between gait parameters and SI during standing in healthy older adults. Methods: A systematic literature search was conducted in the Web of Science, PubMed, MEDLINE, and PEDro databases. Correlation coefficients between gait speed, sway (area and/or velocity) while standing under different SI conditions, and quotients were extracted. The Romberg Quotient (RQ) and Proprioception Quotient (PQ) were used to assess reliance on visual and somatosensory systems, respectively. The studies were grouped by condition, quotient, and outcome measures for the meta-analysis. Results: Thirteen studies (n = 719, mean age 72.5 years) were included. There were significant associations between gait speed and sway area during standing with eyes open on a stable surface (r: -0.235, p 0.486 for all), except for the ECS (r: -0.149, p: 0.01). Conclusions: This study indicated a partial link between gait speed and SI in older adults. Future research should focus on dynamic SI evaluation to better understand this association.This research was funded by the Special Research Fund (BOF) of Hasselt University (BOF23OWB38 and 22DOCUM13B)
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