Parameterization and reliability of single-leg balance test assessed with inertial sensors in stroke survivors: a cross-sectional study

Background and purpose There are no published studies on the parameterisation and reliability of the single-leg stance (SLS) test with inertial sensors in stroke patients. Purpose: to analyse the reliability (intra-observer/inter-observer) and sensitivity of inertial sensors used for the SLS test in stroke patients. Secondary objective: to compare the records of the two inertial sensors (trunk and lumbar) to detect any significant differences in the kinematic data obtained in the SLS test. Methods Design: cross-sectional study. While performing the SLS test, two inertial sensors were placed at lumbar (L5-S1) and trunk regions (T7–T8). Setting: Laboratory of Biomechanics (Health Science Faculty - University of Málaga). Participants: Four chronic stroke survivors (over 65 yrs old). Measurement: displacement and velocity, Rotation (X-axis), Flexion/Extension (Y-axis), Inclination (Z-axis); Resultant displacement and velocity (V): RV=(Vx2+Vy2+Vz2)−−−−−−−−−−−−−−−−−√ Along with SLS kinematic variables, descriptive analyses, differences between sensors locations and intra-observer and inter-observer reliability were also calculated. Results Differences between the sensors were significant only for left inclination velocity (p = 0.036) and extension displacement in the non-affected leg with eyes open (p = 0.038). Intra-observer reliability of the trunk sensor ranged from 0.889-0.921 for the displacement and 0.849-0.892 for velocity. Intra-observer reliability of the lumbar sensor was between 0.896-0.949 for the displacement and 0.873-0.894 for velocity. Inter-observer reliability of the trunk sensor was between 0.878-0.917 for the displacement and 0.847-0.884 for velocity. Inter-observer reliability of the lumbar sensor ranged from 0.870-0.940 for the displacement and 0.863-0.884 for velocity. Conclusion There were no significant differences between the kinematic records made by an inertial sensor during the development of the SLS testing between two inertial sensors placed in the lumbar and thoracic regions. In addition, inertial sensors. Have the potential to be reliable, valid and sensitive instruments for kinematic measurements during SLS testing but further research is needed.

Comparison of dynamic balance in adolescent male soccer players from rwanda and the United States.

PURPOSE/BACKGROUND: Dynamic balance is an important component of motor skill development. Poor dynamic balance has previously been associated with sport related injury. However, the vast majority of dynamic balance studies as they relate to sport injury have occurred in developed North American or European countries. Thus, the purpose of this study was to compare dynamic balance in adolescent male soccer players from Rwanda to a matched group from the United States. METHODS: Twenty-six adolescent male soccer players from Rwanda and 26 age- and gender-matched control subjects from the United States were screened using the Lower Quarter Y Balance Test during their pre-participation physical. Reach asymmetry (cm) between limbs was examined for all reach directions. In addition, reach distance in each direction (normalized to limb length, %LL) and the composite reach score (also normalized to %LL) were examined. Dependent samples t-tests were performed with significant differences identified at p<0.05. RESULTS: Twenty-six male soccer players from Rwanda (R) were matched to twenty-six male soccer players from the United States (US). The Rwandan soccer players performed better in the anterior (R: 83.9 ± 3.2 %LL; US: 76.5 ± 6.6 %LL, p<0.01), posterolateral (R: 114.4 ± 8.3 %LL ; US: 106.5 ± 8.2 %LL, p<0.01) and composite (R: 105.6 ± 1.3 %LL; US: 97.8 ± 6.2 %LL, p<0.01) reach scores. No significant differences between groups were observed for reach asymmetry. CONCLUSIONS: Adolescent soccer players from Rwanda exhibit superior performance on a standardized dynamic balance test as comparison to similar athletes from the United States. The examination of movement abilities of athletes from countries of various origins may allow for a greater understanding of the range of true normative values for dynamic balance. LEVELS OF EVIDENCE: 3b.

The effect of a segmental, localized lower limb cooling protocol on muscular strength and balance

The human neuromuscular system is susceptible to changes within the thermal environment. Cold extrinsic temperatures can significantly reduce muscle and nervous system function and communication, which can have consequences for motor performance. A repeated measures design protocol exposed participants to a 12°C cold water immersion (CWI) up to the ankle, knee, and hip to determine the effect that reduced skin and muscle temperature had on balance and strength task execution. Although a linear reduction in the ability to perform balance tasks was seen from the control condition through to the hip CWI, results from the study indicated a significant reduction in dynamic balance (Star Excursion Balance Test reach distance) performance from only the hip CWI (P<0.05). This reduced performance could have been due to an increase in joint stiffness, increased agonist-antagonist co-contraction, and/or reduced isokinetic muscular strength. Reduced physical performance due to cold temperature could negatively impact outdoor recreational athletics.

Genetic and environmental influences on variation in balance performance among female twin pairs aged 21-82 years

Genetic and environmental influences on variation in balance performance were measured in 93 monozygous and 83 dizygous female twin pairs aged 21–82 years (mean age, 50.5 years) in Melbourne, Australia, between 1999 and 2003. The authors administered clinical (Lord's Balance Test and Step Test) and laboratory tests of static and dynamic balance from the Chattecx Balance System with and without distractor tasks. The authors conducted factor analysis and estimated genetic and environmental variance components and heritability (defined as additive genetic variance as a proportion of all variance, after adjustment for age) using a multivariate normal model with the statistical package FISHER. Three factors were identified and adjusted for age. Heritability was 46% (standard error (SE), 9) for the "sensory balance tests" factor and 30% (SE, 9) for the "static and dynamic perturbations" factor. For both factors, the remaining variance was attributed to unique environmental effects. There was no evidence that genetic factors influenced variation in the "dynamic weight shift tests" factor, with environmental effects shared by twins accounting for 38% (SE, 7) of variance. Neither genetic nor environmental proportions of variance differed significantly between twin subgroups by age (≤50/>50 years). An age-related decline in performance measures was found across the whole sample. These results imply that balance impairments may have a heritable element.

Postural control and functional balance in individuals with diabetic peripheral neuropathy

A Neuropatia diabética periférica (NDP) cursa com redução somatossensitiva que pode levar a alterações no controle postural. O objetivo do estudo foi avaliar o controle postural na postura ereta, em diferentes condições, e o equilíbrio funcional em indivíduos com NDP, correlacionar os resultados obtidos na avaliação do controle postural com os valores do teste do equilíbrio funcional e comparar os resultados obtidos no grupo neuropata com o grupo controle, verificando as possíveis diferenças entre as condições de avaliação em ambos os grupos. Participaram do estudo 13 mulheres com NDP (GN) e 17 mulheres não diabéticas (GC). A avaliação do controle postural foi realizada por cinemetria nas condições: olhos abertos (OA), olhos fechados (OF) e semi tandem (ST). Após processamento no MATLAB, foram geradas as variáveis: amplitude média de oscilação (AMO) na direção ântero-posterior (AP) e médio-lateral (ML); e velocidade média de oscilação (VMO) na direção AP e ML. O equilíbrio funcional foi avaliado pelo Timed Up and Go Test. Houve diferença significante entre os grupos (p<0,005) na AMO-AP OA e OF, AMO-ML of e ST e VMO-ML ST. Houve diferença entre as condições OA e ST (p<0,005) e of e ST (p<0,005) para as variáveis AMO-ML e VMO-ML, com maior prejuízo para o GN, que também apresentou um menor equilíbrio funcional (p=0,001). A instabilidade ML foi correlacionada positivamente com o desequilíbrio funcional. Os resultados nos mostram uma alteração no sistema de controle postural na NDP, o que pode levar estes indivíduos a um maior risco a quedas e prejuízos funcionais.

The influence of anthropometric factors on postural balance: the relationship between body composition and posturographic measurements in young adults

OBJECTIVE: The aim of the present study was to evaluate the influence of anthropometric characteristics and gender on postural balance in adults. One hundred individuals were examined (50 males, 50 females; age range 20-40 years). METHODS: The following body composition measurements were collected (using bone densitometry measurements): fat percentage (% fat), tissue (g), fat (g), lean mass (g), bone mineral content (g), and bone mineral density (g/cm(2)). In addition, the following anthropometric measurements were collected: body mass (kg), height (cm), length of the trunk-cephalic region (cm), length of the lower limbs (cm) and length of the upper limbs (cm). The following indices were calculated: body mass index (kg/m(2)), waist-hip ratio and the support base (cm 2). Also, a postural balance test was performed using posturography variables with open and closed eyes. RESULTS: The analysis revealed poor correlations between postural balance and the anthropometric variables. A multiple linear regression analysis demonstrated that the whole group (female and male) height explained 12% of the medial-lateral displacement, 10% of the speed of oscillation, and 11% of the displacement area. The length of the trunk-cephalic length explained 6% of the displacement in the anteroposterior direction. With eyes closed, the support base and height explained 18% of the medial displacement, and the lateral height explained 10% of the displacement speed and 5% of the scroll area. CONCLUSION: Measured using posturography, the postural balance was only slightly influenced by the anthropometric variables, both with open and closed eyes. Height was the anthropometric variable that most influenced postural balance, both in the whole group and separately for each gender. Postural balance was more influenced by anthropometric factors in males than females.

The combination of plyometric and balance training improves sprint and shuttle run performances more often than plyometric-only training with children

Because balance is not fully developed in children and studies have shown functional improvements with balance only training studies, a combination of plyometric and balance activities might enhance static balance, dynamic balance, and power. The objective of this study was to compare the effectiveness of plyometric only (PLYO) with balance and plyometric (COMBINED) training on balance and power measures in children. Before and after an 8-week training period, testing assessed lower-body strength (1 repetition maximum leg press), power (horizontal and vertical jumps, triple hop for distance, reactive strength, and leg stiffness), running speed (10-m and 30-m sprint), static and dynamic balance (Standing Stork Test and Star Excursion Balance Test), and agility (shuttle run). Subjects were randomly divided into 2 training groups (PLYO [n = 14] and COMBINED [n = 14]) and a control group (n = 12). Results based on magnitude-based inferences and precision of estimation indicated that the COMBINED training group was considered likely to be superior to the PLYO group in leg stiffness (d = 0.69, 91% likely), 10-m sprint (d = 0.57, 84% likely), and shuttle run (d = 0.52, 80% likely). The difference between the groups was unclear in 8 of the 11 dependent variables. COMBINED training enhanced activities such as 10-m sprints and shuttle runs to a greater degree. COMBINED training could be an important consideration for reducing the high velocity impacts of PLYO training. This reduction in stretch-shortening cycle stress on neuromuscular system with the replacement of balance and landing exercises might help to alleviate the overtraining effects of excessive repetitive high load activities.

Balance ability of 7 and 10 year old children in the population:results from a large UK birth cohort study

OBJECTIVE: The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. METHODS: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. RESULTS: Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. CONCLUSIONS: This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic.

Improving posture and decreasing pain with novel shoe insoles

A single subject longevity study is presented as a case study for the Medical Device Partnering Program (MDPP). The MDPP supports the development of cutting-edge medical devices and assistive technologies, through unique collaborations between researchers, industry, clinical end-users and government. The study aimed to identify what effect the innersole has on specific muscles that may influence stability and whether the innersole had any influence on gait. Three tests were conducted; a standard gait test, dynamic balance test and a standing balance test. Results from the kinematic analysis showed reduced variability in post testing results when compared to pre testing results. Reductions in muscle activation levels were also found across all tests. Further testing with a larger sample size is required to determine if these effects are due to the innersole.

Reliability and validity of physical fitness field tests for adults aged 55 to 70 years

The aim of this study was to examine the reliability and validity of field tests for assessing physical function in mid-aged and young-old people (55-70 y). Tests were selected that required minimal space and equipment and could be implemented in multiple field settings such as a general practitioner's office. Nineteen participants completed 2 field and I laboratory testing sessions. Intra-class correlations showed good reliability for the tests of upper body strength (lift and reach, R=.66), lower body strength (sit to stand, R=.80) and functional capacity (Canadian Step Test, R=.92), but not for leg power (single timed chair rise, R=.28). There was also good reliability for the balance test during 3 stances: parallel (94.7% agreement), semi-tandem (73.7%), and tandem (52.6%). Comparison of field test results with objective laboratory measures found good validity for the sit to stand (cf 1RM leg press, Pearson r=.68, p <.05), and for the step test (cf PWC140, r = -.60, p <.001), but not for the lift and reach (cf 1RM bench press, r=.43, p >.05), balance (r=-.13, -.18, .23) and rate of force development tests (r=-.28). It was concluded that the lower body strength and cardiovascular function tests were appropriate for use in field settings with mid-aged and young-old adults.

Fiabilidad de diferentes pruebas que se utilizan para evaluar el riesgo de lesión del miembro inferior en mujeres deportistas

233 p. : il. + anexo (247 p.)

Numerical modelling and validation of Marangoni and surface tension phenomena using the finite volume method

Surface tension induced flow is implemented into a numerical modelling framework and validated for a number of test cases. Finite volume unstructured mesh techniques are used to discretize the mass, momentum and energy conservation equations in three dimensions. An explicit approach is used to include the effect of surface tension forces on the flow profile and final shape of a liquid domain. Validation of this approach is made against both analytical and experimental data. Finally, the method is used to model the wetting balance test for solder alloy material, where model predictions are used to gain a greater insight into this process. Copyright © 2000 John Wiley & Sons, Ltd.

Wetting and Reaction of Sn-2.8Ag-0.5Cu-1.0Bi Solder with Cu and Ni Substrates

The wettability of newly developed Sn-2.8Ag-0.5Cu-1.0Bi lead-free solder on Cu and Ni substrates was assessed through the wetting balance tests. The wettability assessment parameters such as contact angle (ϑc) and maximum wetting force (Fw) were documented for three solder bath temperatures with three commercial fluxes, namely, no-clean (NC), nonactivated (R), and water-soluble organic acid flux (WS). It was found that the lead-free Sn-2.8Ag-0.5Cu-1.0Bi solder exhibited less wetting force, i.e., poorer wettability, than the conventional Sn-37Pb solder for all flux types and solder bath temperatures. The wettability of Sn-2.8Ag-0.5Cu-1.0Bi lead-free solder on Cu substrate was much higher than that on Ni substrate. Nonwetting for Sn-2.8Ag-0.5Cu-1.0Bi and Sn-Pb solders on Ni substrate occurred when R-type flux was used. A model was built and simulations were performed for the wetting balance test. The simulation results were found very close to the experimental results. It was also observed that larger values of immersion depth resulted in a decrease of the wetting force and corresponding meniscus height, whereas the increase in substrate perimeter enhanced the wettability. The wetting reactions between the solder and Cu/Ni substrates were also investigated, and it was found that Cu atoms diffused into the solder through the intermetallic compounds (IMCs) much faster than did the Ni atoms. Rapid formation of IMCs inhibited the wettability of Sn-2.8Ag-0.5Cu-1.0Bi solder compared to the Sn-Pb solder.

Comparative wetting behavior of Sn-0.7Cu and Sn-0.7Cu-0.3Ni solders on Cu and Ni substrates

Electronic packaging industries are now in great challenge to find a suitable lead-free solder as an interconnection material to replace the conventional SnPb solders. Many solders such as SnCu, SnAg, SnAgCu, SnZn, SnBi have already been proposed as the replacement but none of them has reached the physical and metallurgical properties similar to the SnPb solder. However, wetting is one of the basic problems that make the lead-free solder inferior as compared to the SnPb solder. Therefore, alloying with the help of third, fourth or fifth element is the researchers' interest to improve the wetting behavior of lead-free solders. This paper describes the comparative wetting behavior of Sn-0.7Cu and Sn-0.7Cu-0.3Ni solders on Cu and Ni substrates. Wetting balance tests were performed to assess the wetting behaviors. Three different commercial fluxes namely no-clean (NC), non-activated (R) and water soluble organic acid (WS)fluxes were used to assess the wettability for three solder bath temperatures. It was found that Sn0.7Cu-03Ni solder exhibits better wettability on Cu substrate for NC and WS fluxes whereas reverse results were found for R-type flux. In the case of Ni substrate, Sn-0.7Cu-0.3Ni solder showed better wetting behavior compared to the well-known Sn-0.7Cu solder. Among the three fluxes, R-type flux showed the worst performance. Very large contact angles were documented for both solders with this flux. Higher solder bath temperature lowered the contact angles, increased the wetting forces and enhanced the wettability. Computer modeling of wetting balance test revealed that both the wetting force and meniscus height are inversely proportional to the contact angles. Modeling results also reveal that increase in solder bath depths and radiuses do not affect significantly on the wetting behavior.