B. Durward

What is balance

Balance is a term frequently used by health professionals working in a wide variety of clinical specialities. There is no universally accepted definition of human balance, or related terms. This article identifies mechanical definitions of balance and introduces clinical definitions of balance and postural control. Postural control is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. Postural control strategies may be either predictive or reactive, and may involve either a fixed-support or a change-in-support response. Clinical tests of balance assess different components of balance ability. Health professionals should select clinical assessments based on a sound knowledge and understanding of the classification of balance and postural control strategies.

The effect of independent practice of motor tasks by stroke patients: a pilot randomized controlled trial:

Objective: To investigate the effect of independent practice of sitting balance as an addition to standard physiotherapy treatment for patients with stroke. Design: Randomized controlled trial, using blocked randomization procedure with 2:1 ratio. Subjects: Inpatients with diagnosis of stroke, having achieved one minute of independent sitting balance but not yet achieved 10 independent steps, and with no known previous disabilities, pathology or neurological de”cit affecting mobility prior to stroke. Intervention: A four-week regime of independent practice aimed at improving aspects of balance, as an addition to standard physiotherapy treatment based on the Bobath Approach. Main outcome measure: Proportion of patients achieving ‘normal’ symmetry of weight distribution during sitting, standing, rising to stand, sitting down, and reaching. Results: Nineteen subjects were randomized to the control group; nine to the intervention group. There were no clinically signi”cant differences in measured outcome between the groups. Conclusions: The regime of independent practice had no measured bene”cial effect on the balance ability of patients with recently acquired stroke.

A new system for the measurement of displacements of the human body with widespread applications in human movement studies

This paper reports the development, construction and use of a new system for the measurement of linear kinematics in one, two or three dimensions. The system uses a series of rotary shaft encoders and inelastic tensioned strings to measure the linear displacement of key anatomical points in space. The system is simple, inexpensive, portable, accurate and flexible. It is therefore suitable for inclusion in a variety of motion analysis studies. Details of the construction, calibration and interfacing of the device to an IBM PC computer are given as is a full mathematical description of the appropriate measurement theory for one, two and three dimensions. Examples of the results obtained from the device during gait, running, rising to stand, sitting down and pointing with the upper limb are given. Finally it is proposed that, provided the constraints of the system are considered, this method has the potential to measure a variety of functional human movements simply and inexpensively and may therefore be a valuable addition to the methods available to the motion scientist.

Symmetry of Weight Distribution During Sitting in Subjects with Recently Acquired Stroke

Following stroke, asymmetry of posture and movement in sitting is recognised as a common problem. A clinical measurement system capable of the objective measurement of vertical forces through the seat, feet and arms during sitting has been developed at Queen Margaret College, Edinburgh (Durward, 1994). This system comprises a standard upright chair mounted on a low platform; there are a total of ten force-sensitive measurement sections incorporated within the seat of the chair, the platform and the armrests. Each of these sections can independently measure the application of a vertical force, sampling a t 50 Hz. The data are collected and processed via a computer.

Measurement of Rising to Stand, Standing and Gait Using a New Quantified Functional Outcome Measure to Evaluate Physiotherapy in Stroke

This paper aims to look at the measurement of rising to stand, standing and gait using a new quantified functional outcome measure.

Age-specific Profiles for the Forces Measured beneath the Hands and Feet during Rising to Stand in Normal Subjects

The elderly population often experiences considerable difficulties in the safe and effective execution of the functional movement of rising to stand. An inability to complete the rising to stand movement may predispose elderly people to falls or admission to hospital. Despite this recognised difficulty the movement has received little attention and there is a paucity of age-specific data for the elderly population. The aim of this investigation was to identify the age-specific changes in the force characteristics measured beneath the hands and feet during the movement of rising to stand in a sample of normal subjects.