Zbigniew Trzaskoma

A comparative analysis of static balance between patients with lumbar spinal canal stenosis and asymptomatic participants.

OBJECTIVE The aim of this study was to assess static balance in patients with lumbar spinal canal stenosis who qualified for surgical decompression of associated neural structures and compare them with asymptomatic participants. METHODS This case-controlled study evaluated a sample of 50 patients with spinal canal stenosis (stenosis group) and 48 participants with no history of clinical symptoms of back pain. Static balance was assessed by conducting quantitative analysis of balance reaction parameters in quiet standing with the eyes closed. RESULTS Higher values were observed in total length of center of pressure (COP) path, length of COP path in the anterior-posterior plane, mean amplitude of COP projection in the anterior-posterior plane, maximal amplitude between the 2 most distant points in the anterior-posterior plane, mean COP velocity, and sway area marked by the moving COP in the stenosis group compared with the asymptomatic group. CONCLUSIONS This study showed statistically significant differences in static balance parameters between patients with spinal canal stenosis compared with the asymptomatic group.

Assessment of postural stability in patients with lumbar spine chronic disc disease

PURPOSE The pain, motor and sensory deficits are common symptoms of the lumbar disc disorder, and they can significantly affect human postural control. The aim of this study was to assess postural stability in patients with severe symptoms of lumbar spine disc disease qualifying them for surgical treatment and to compare them with a control group. METHODS The study involved 103 subjects: 54 patients and 49 healthy subjects. Patients mean age was 46.4 ± 11.3 years, mean body height 172.2 ± 10.3 cm, mean body mass 83.1 ± 18.9 kg, and mean body mass index (BMI) was 27.9 ± 5.2 kg m-2. The mean time of their recent pain episode was 9.7 ± 8.5 months. RESULTS We found statistically significant differences between postural stability in patients with lumbar spine disc disease and the control group. The measurements taken with eyes closed, as compared with the clinical control group, revealed higher and statistically significant values of the mean amplitude of COP, mean amplitude of COP on sagittal plane, and maximal sway in sagittal plane parameters. The analysis of pressure value differences between the right and left lower limbs in both groups revealed statistical significance. In the study population the difference was significantly greater in comparison to the control group. The patients had significantly greater asymmetry of lower limb load. CONCLUSIONS 1. Patients with lumbar spine discogenic pain had decreased postural control. 2. The patients had significant asymmetry in foot pressure resulting from pain radiating to a lower limb.

The effect of unilateral osteoarthritis of the hip on postural balance disorders

Background Postural stability is of great importance because imbalances and muscle weakness are significant risk factors for falls experienced by the elderly. Hip arthrosis, which causes pain and gait disorders that affect balance control, is common in the ageing population. Aim The aim of this study was to assess postural stability in patients with unilateral hip arthrosis before total hip arthroplasty. Methods The study population consisted of 52 patients with hip arthrosis (study group) and 47 subjects with no history of clinical symptoms of hip pain. The groups did not differ statistically in terms of age and BMI. Static balance was assessed by conducting a quantitative analysis of balance reaction parameters in a quiet standing position with the eyes open and closed. Results Analysis of the collected data revealed numerous statistically significant differences between patients with unilateral hip arthrosis before total hip arthoplasty and the asymptomatic group for parameters tested with eyes closed (p<0.05). We observed higher values of total length of centre of pressure (COP), sway path (SP), length of COP path in the medial-lateral plane (SPML), maximal amplitude between the 2 most distant points in the medial-lateral plane (MaxML), mean COP velocity (MV), and mean COP velocity in medial-lateral (MVML) in the study group.

The foot deformity versus postural control in females aged over 65 years.

Purpose: Correct foot structure is important due to locomotion and postural stability. The aim of this study was to determine the relationships between morphological foot structure and balance indices in a quiet standing position in women over 65 years of age. Methods: The study included 116 women aged 65–90 years. The mean age was 70.6 ± 8.4 years and BMI 29.1 ± 3.4 m/kg 2 . The measured indices included postural control while standing on both feet and photogrammetric foot evaluation. An analysis was performed of the selected foot and balance indices. Results: There were no significant differences observed in the feet structure. Certain correlations between some foot indices and the indices of postural control were noted. The increased differences in the width indices between the right and the left foot lead to balance deterioration. Larger angles of valgity and varus deformity of toes and indices describing the longitudinal arch and transverse front arch of the foot have the greatest impact on the deterioration of balance in the medio-lateral axis. Conclusions: The differences between the indices and morphological indices for the right and the left foot are not significant, which indicates the proportionate formation of feet in the individual life. The increased differences in the width indices between the right and the left foot lead to balance deterioration. Larger angles of valgity and varus deformity of toes and indices describing the longitudinal arch and transverse front arch of the foot have the greatest impact on the deterioration of balance in the medio-lateral axis.

Changes of the body posture parameters in the standing versus relaxed sitting and corrected sitting position

BACKGROUND Decrease of physiological curvatures of the spine can lead to back pain. OBJECTIVE The aim of this study was to compare the curvatures of the spine and body posture parameters in three positions: relaxed standing, relaxed sitting, corrected sitting. METHODS The study included 40 healthy persons aged 18-32 years (mean 24.7 ± 2.3), with body height 152-195 cm (mean 171.8 ± 9.3), weight 47-115 kg (mean 66.4 ± 13.7), BMI 17.9-32.5 kg/m2 (mean 22.3 ± 3.0). The study was performed using the photogrammetric method. RESULTS After changing the position from relaxed standing to relaxed sitting, significant decrease of the inclination of the thoracolumbar region, the thoracic kyphosis depth and the lumbar lordosis depth were observed. Lumbar lordosis angle increased significantly. After the sitting position correction, the inclination of the upper thoracic and thoracolumbar region decreased, and the depth of thoracic kyphosis and lumbar lordosis increased. CONCLUSIONS - In the relaxed sitting position, the lumbar lordosis was significantly smaller than in the standing position. - A change from the standing to the sitting position results in flattening of thoracic kyphosis. - The corrected sitting position does not adequately correct the spinal curvatures.

Evaluation of Functional Outcomes in Individuals 10 Years after Posterior Lumbar Interbody Fusion with Corundum Implants and Decompression: A Comparison of 2 Surgical Techniques

Background The purpose of this study was to evaluate lumbar spine-related functional disability in individuals 10 years after lumbar decompression and lumbar decompression with posterior lumbar interbody fusion (PLIF) with corundum implants surgery for degenerative stenosis and to compare the long-term outcome of these 2 surgical techniques. Material/Methods From 1998 to 2002, 100 patients with single-level lumbar stenosis were surgically treated. The patients were randomly divided into 2 groups that did not differ in terms of clinical or neurological symptoms. Group A consisted of 50 patients who were treated with PLIF and the use of porous ceramic corundum implants; the mean age was 57.74 and BMI was 27.34. Group B consisted of 50 patients treated with decompression by fenestration; mean age was 51.28 and the mean BMI was 28.84. Results There was no statistical significance regarding age, BMI, and sex. Both treatments revealed significant improvements. In group A, ODI decreased from 41.01% to 14.3% at 1 year and 16.3 at 10 years. In group B, ODI decreased from 63.8% to 18.36% at 1 year and 22.36% at 10 years. The difference between groups was statistically significant. There were no differences between the groups regarding the Rolland-Morris disability questionnaire and VAS at 1 and 10 years after surgery. Conclusions Long-term results evaluated according to the ODI, the Rolland-Morris disability questionnaire, and the VAS showed that the both methods significantly reduce patient disability, and this was maintained during next 10 years. The less invasive fenestration procedure was only slightly less favorable than surgical treatment of stenosis by both PLIF with corundum implants and decompression.

Is static balance affected by using shoes of different height

Summary Study aim: to investigate the impact of heels of different height on static balance of teenagers and young women not accustomed to high heels. Material and methods: The study involved 71 young women aged 21.09 ± 2.91 years. We used a stabilometric platform to take measurements barefoot and with heels: of 4 cm and of 10 cm. Two types of measurements were taken: with eyes open and with eyes closed. Results: Statistical analysis revealed a significant increase in values of the measured stabilographic parameters with 4 cm and 10 cm heels, in comparison to measurements taken with bare feet. Measurements with eyes closed revealed significantly greater distortions to static balance than measurements with eyes open. A comparison of measurements – both with eyes open and with eyes closed – barefoot, with 4 cm heels and with 10 cm heels revealed statistically significant differences. Conclusions: High heels in the population of young women significantly worsen static balance. Heel height and the exclusion of visual control are important factors diminishing static balance.

Static balance after surgical decompression of lumbar spinal canal stenosis

BACKGROUND AND OBJECTIVES Spinal canal stenosis is the most common reason for spinal surgeries in patients over 65 years of age. The aim of the study was to assess static balance in patients prior to and after surgical decompression of lumbar spinal canal stenosis. MATERIAL AND METHODS The study population consisted of 30 patients suffering from spinal canal stenosis. Their static balance was measured, i.e. quantitative analysis of balance reaction parameters in quiet standing was performed. RESULTS The analysis of the collected data did not reveal any statistically significant differences between parameters measured prior to and after the surgery (for p< 0.05). A tendency for a decrease of measured parameters was observed. The regularity of changes was determined; in addition, for this analysis, the Spearmans rank correlation coefficient was used. CONCLUSIONS The analysis of the collected data did not reveal any statistically significant improvement of balance reactions after spinal canal stenosis surgery. In spite of pain reduction, there was no improvement in balance reactions, as behavioural patterns for balance reactions had been fossilised before surgery.