Posturography

Question 1

Aspects of Balance

Answer 1

• Sensory reception and integration
  – Visual, Somatosensory and Vestibular
  – Ex: Berg. TUG, Tinetti
• Volitional (Anticipatory) postural control
  – Limits of stability/BOS
• Non-volitional (Reactionary/Non voluntary) postural control
  – Unexpected pertibations (Stepping strategy)
• Musculoskeletal Integrity
  – Ankle, knee and hip strength and ROM clinical exam

Question 2

Posturography

Answer 2

Strian guagues within a force platform + Computer Software = Objective and Precise Data for Postural Sway

Question 3

Posturography measurements are taken based on…

Answer 3

Center of Pressure

ML, AP

Question 4

COP excursion is typically ____ than COM excursion and has more ____

Answer 4

• larger
• oscillations

Question 5

COP is at the feet, COM is located more over the ____

Answer 5

torso.

COP has much more force/movement than COM.

Question 6

In order to keep natural stability humans need postural stability. Neurological dependence would be too taxing. What strategies do we use?

Answer 6

• Stances
• Rely on muscles and bones
• Direct our force above the COM NOT through it

Question 7

Why do taller people have more stability?

Inverted Pendulum

Answer 7

• Taller people fall slower due to inertia and therefore have more time to correct and counter the angular inertia through more strategies.

Question 8

How can spinning your arms help in prevention from falling?

Answer 8

Spinning the arms adds angular momentum in the proper direction to prevent falling by opposing the angular inertia.

Question 9

Measures commonly reported for posturography

Answer 9

• Area outline by the COP Path; Ex: 95% ellipse (green)
• Path Length: total distance traveled
• Maximal Excursion (width of trace in both ML and AP) (Blue)
• Variability (Ex: SD)
• Velocity (how fast someone is moving) (Red)
• Time to contact (before falling off balance)

Question 10

COP can be measured with one or two platforms looking at…

Answer 10

the pressure of each foot or the global pressure (both combined)

Can allow to see if one foot has more weight than the other.

Question 11

____ is often built for standing. You need to compare ____ to COP to normalize data.

Answer 11

• Piezioelectric
• BOS from foot measurements

Question 12

Someone who has sensory detrement can be tested by a ____ Test.

Answer 12

Sensory Organization

Question 13

NeuroCom Balance Master

Answer 13

• Most research support
• Static postural tasks

Question 14

Bertec Balance Advantage CDP

Answer 14

• Allows more interactive, live tasks to be performed with changing conditions
• Bottom foot plate can move and slide
• Can perform a sensort deprevation test on it
• Can be used for interventions

Question 15

Biodex Balance System

Answer 15

• Similar to Bertec
• Base platform moves a little bit
• Has games

Question 16

Motek Medical

Answer 16

• Static and dynamic balance assessment and training
• 0.5-1.0 Million Dollars
• Machine can do pertibations
• Games

Question 17

Indications for Posturography

Answer 17

Who:
* Pts with dizziness or imbalance complaints
* Pts with known or non-specific Dx of sensory-motor impairments
* Pts suspected of exaggerating Sx

Why
- Help Dx
- Guide prescription and monitor results
- Quanitify balance objectively
- Customized balance training and outcome assessment

Question 18

How do you determine what you are going to measure?

Answer 18

• Relative to the pts condition and the type of question you are asking
• Look in the literature for variables!

Question 19

Standardization

Answer 19

• Number of platforms
• Foot Placement
• Conditions (Eyes O/C; Surface: H/S)
• Dual task (Cognitive, Sensorimotor)

Question 20

Data Processing

Answer 20

• Sampling frequency (50-100 Hz good for standing tasks)
• Duration of recording (Generally 10-30 seconds)
• Decision of Filtering Noise
• Normalize Data (Height, Foot size, etc.)

Question 21

Alternative methods for balance training/assessment

Answer 21

• Wii balance board
• Smart phone accelerometer (measures angular sway from inverted pendulum model)