Search Results (58)

Background: Peripheral neuropathy (PN) refers to a spectrum of symptoms resulting from dysfunctions of the peripheral sensory, motor, and autonomic neurons. PN is associated with significant balance impairments and an increased risk of falls, contributing to reduced functional independence and quality of life. Although diabetic PN has been extensively investigated, there remains a lack of synthesized evidence regarding rehabilitation approaches for individuals with non-diabetic PN. This systematic review aims to evaluate the effectiveness of stabilometric platforms incorporating virtual reality (VR) and feedback (FB) in improving balance and related outcomes in patients with PN of various etiologies. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the protocol registered in PROSPERO (CRD420251086625). Seven major databases (PubMed, Scopus, ScienceDirect, Cochrane, Web of Science, Springer, and Wiley) were searched from inception to April 2025. Studies including adult patients with non-diabetic PN undergoing balance rehabilitation using stabilometric platforms with VR and FB were considered. The methodological quality of the included studies was assessed using the PEDro scale, RoB2, and ROBINS-I V2 tools. Results: A total of six studies met the inclusion criteria, encompassing 133 participants with non-diabetic PN. Interventions involving specialized balance training platforms incorporating VR and FB demonstrated significant improvements in both static and dynamic balance and postural control, as well as a reduction in the risk of falling. These systems also showed favorable adherence rates to rehabilitation programs. However, variability in intervention protocols and outcome measures limited the ability to perform direct comparisons across studies. Conclusions: The use of stabilometric platforms appears to be a promising approach for balance rehabilitation in patients with non-diabetic PN. Despite the limited number of included studies, the results support their integration into rehabilitation programs for this patient population. Further large-scale, high-quality studies are needed to establish standardized protocols and confirm long-term efficacy. Full article

This study examined the efficacy of a 12-week school-based program combining proprioceptive and plyometric training to enhance static and dynamic balance in children and adolescents with visual impairment. A total of 33 students were randomly assigned to either an experimental group (EG; n = 18), receiving a one-weekly session of integrative training alongside regular physical education, or a control group (CG; n = 15), following only the standard curriculum. Balance outcomes were assessed at baseline (T0) and post intervention (T1) using stabilometric measures under visual deprivation (eyes closed) and BOT-2 (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition) balance subtests. The EG demonstrated statistically significant reductions in ellipse surface area (p = 0.002, d = −1.29), center of pressure displacement (p < 0.001, d = −1.67), and sway velocity (p = 0.015, d = −1.06), indicating improved postural stability when vision was unavailable. BOT-2 Test 4 showed significant intra-group improvement (p = 0.006, d = 1.37), while BOT-2 Test 3 and between-group comparisons revealed medium-to-large effect sizes, though not always statistically significant. These findings suggest that augmenting somatosensory input through proprioceptive and plyometric training may partially compensate for visual deficits and improve postural control in individuals with visual impairments. This improvement likely reflects the activation of compensatory mechanisms that enhance proprioceptive and vestibular contributions to balance maintenance. Importantly, meaningful improvements occurred with just one weekly session, making this an accessible and scalable intervention for inclusive school settings. Full article

Background/Objectives: This study investigated postural stability in male inmates of a semi-open correctional facility, with a specific focus on comparing individuals with and without a history of substance dependence. The aim was to identify how addiction-related neurophysiological changes impact postural control under varying sensory and biomechanical demands. Methods: A total of 47 adult male prisoners (mean age: 24.3 years) participated in this study. Nineteen inmates had a documented history of alcohol or drug dependence (addicted group), while twenty-eight had no such history (non-addicted group). All participants were physically able and free of neurological disorders. Postural control was assessed using a stabilometric platform and wireless IMU across six 30 s standing tasks of varying difficulty (bipedal/unipedal stance and eyes open/closed). Linear (center of pressure path and ellipse area) and nonlinear (sample entropy, fractal dimension, and the Lyapunov exponent) sway metrics were analyzed, along with trunk kinematics from IMU data. This study received institutional ethical approval; trial registration was not required. Results: The addicted group showed greater instability, especially in the eyes-closed and single-leg tasks, with increased sway and irregularity in the anterior–posterior direction. IMU data indicated altered trunk motion, suggesting impaired neuromuscular control. In contrast, non-addicted individuals demonstrated more efficient, targeted postural strategies, while addicted participants relied on broader, less selective movements, possibly reflecting compensatory or neuroadaptive changes from substance use. Conclusions: Substance dependence is associated with compromised postural stability in incarcerated men. Balance assessments may be valuable for detecting functional impairments and guiding rehabilitation within prison healthcare systems. Full article

Background: The aim of this study was a qualitative assessment and quantitative assessment, i.e., the assessment of time to stability (TTS) before and after fatigue test, of landing in patients with chronic ankle instability, referred to as “copers”, in comparison to a control group of healthy persons. The indirect aim of the study was to develop a new method to assess more time precise measurement of TTS. Methods: The study involved 60 physically young active individuals aged 18 to 35 years. They were divided into three groups: the study population of 29 copers was divided into: I—14 persons with chronic one side ankle instability, study population II—15 persons with chronic bilateral ankle instability, and the control group included 31 persons without ankle instability. The study involved quantitative assessment of time to stability (TTS) after single-leg landing onto the HUR stabilometric platform from a 30 cm high platform before and after fatigue tests based on a modified Short-Term Fatigue Protocol. To conduct qualitative assessment of landing and to verify time to stability with video imaging, a video analysis was conducted. We used three cameras and two markers: on the malleolus lateralis of the fibula and on the malleolus medialis of the tibia. Each landing was subjectively assessed by a physiotherapist on a four-degree scale. A further biomechanic analysis was conducted only for the trials with a correct landing. The trials were repeated after a fatigue test. Results: There were significant differences before and after the fatigue test in qualitative landing analysis (p < 0.001) only for one jump for the right leg. In groups with unilateral and bilateral ankle instability, there was a higher percentage of landings with a considerable shift or unstable landings. The conducted dynamic test (TTS assessment) did not reveal significant differences between groups or after the fatigue test. Conclusions: Copers develop effective mechanisms of compensation, allowing them to participate in physical activities without symptoms of joint instability. Determining biomechanical differences between athletes who return to their sport and patients who develop chronic instability is important in the context of introducing adequate physiotherapy. Full article

Background: Accurate differentiation of Parkinson’s disease (PD) from healthy aging is crucial for timely intervention and effective management. Postural sway abnormalities are prominent motor features of PD. Quantitative stabilometry and machine learning (ML) offer a promising avenue for developing objective markers to support the diagnostic process. This study aimed to develop and validate high-performance ML models to classify individuals with PD and age-matched healthy older adults (HOAs) using a comprehensive set of stabilometric parameters. Methods: Thirty-seven HOAs (mean age 70 ± 6.8 years) and 26 individuals with idiopathic PD (Hoehn and Yahr stages 2–3, on medication; mean age 66 years ± 2.9 years), all aged 60–80 years, participated. Stabilometric data were collected using a force platform during quiet stance under eyes-open (EO) and eyes-closed (EC) conditions, from which 34 parameters reflecting the time- and frequency-domain characteristics of center-of-pressure (COP) sway were extracted. After data preprocessing, including mean imputation for missing values and feature scaling, three ML classifiers (Random Forest, Gradient Boosting, and Support Vector Machine) were hyperparameter-tuned using GridSearchCV with three-fold cross-validation. An ensemble voting classifier (soft voting) was constructed from these tuned models. Model performance was rigorously evaluated using 15 iterations of stratified train–test splits (70% train and 30% test) and an additional bootstrap procedure of 1000 iterations to derive reliable 95% confidence intervals (CIs). Results: Our optimized ensemble voting classifier achieved excellent discriminative power, distinguishing PD from HOAs with a mean accuracy of 0.91 (95% CI: 0.81–1.00) and a mean Area Under the ROC Curve (AUC ROC) of 0.97 (95% CI: 0.92–1.00). Importantly, feature analysis revealed that anteroposterior sway velocity with eyes open (V-AP) and total sway path with eyes closed (TOD_EC, calculated using COP displacement vectors from its mean position) are the most robust and non-invasive biomarkers for differentiating the groups. Conclusions: An ensemble ML approach leveraging stabilometric features provides a highly accurate, non-invasive method to distinguish PD from healthy aging and may augment clinical assessment and monitoring. Full article

(1) Background: This study aimed to assess whether older adults exhibit greater discrepancies between intended and actual motor unit recruitment, which could affect the quality of muscle activation and potentially increase the risk of falls. (2) Methods: Forty-eight physically active older women were assessed (65 ± 6 years, 164 ± 6 cm, and 76 ± 7 kg). The bioelectrical activity (EMG) of the vastus lateralis oblique (VLO) and vastus medialis oblique (VMO) muscles were assessed during isometric testing with the knee joint bent to 75 degrees. The participants were instructed to press against a stable bar for 5 s at a specific percentage of their perceived force level (at 15%, 30%, and 60% of MVC) when the EMG activity was recorded. Balance was assessed using a stabilometric platform in a standing position. (3) Results: In all three thresholds, the bioelectrical activity of the VLO and VMO muscles significantly deviated from what was expected under the assumption of a nearly linear relationship between muscle force and bioelectrical activity. In each of the three thresholds, it did not exceed 10% MVC and significantly differed only between the 15% and 60% MVC thresholds. No significant differences were found between the dominant and non-dominant sides. A significant relationship was observed between the sway area (Area 95%) and the activity of the non-dominant limb VLO muscle. (4) Conclusions: Our results suggest that older adults experience deficits in muscle activation perception, leading to discrepancies between intended and actual muscle engagement, which may affect functional task performance and potentially increase fall risk. Full article

Foot position affects postural stability during upright standing; however, conflicting indications have been reported for the ideal foot placement during stabilometric exams. The aims of this study were to evaluate (1) the correlation between anthropometric measurements (AMs) and between-feet measurements (BFMs) in self-selected comfortable foot position (SCFP) and (2) the effect of comfortable and standardized foot position (SFP) on plantar pressure and stabilometric parameters. Stabilometry was conducted on twenty healthy subjects in terms of SCFP and SFP. Correlation between AMs and BFMs in SCFP was investigated via Pearson’s analysis. Data variability was assessed using the coefficient of variation, and statistical differences between SCFP and SFP were evaluated via the Wilcoxon test. No correlation was found between AMs and BFMs. Subjects placed their feet nearly parallel in SCFP with a wider inter-heel distance. The variability of plantar pressure parameters was greater in SFP. A lower foot contact area on the right side and higher plantar pressures in the left midfoot region (p-value < 0.05) were found in SFP as compensatory foot adaptations. According to the present study, a comfortable foot position allows for the reduction in postural stability and plantar pressure parameter variability. This position may help improve statistical power when investigating statistical differences between conditions in stabilometry. Full article

Background: Postural changes are considered a public health issue and have gathered significant interest in both research and clinical practice. Aims: To evaluate the effectiveness of Global Postural Reeducation (GPR) in improving postural changes and postural stability in healthy young adults. Additionally, this study aims to identify the main postural changes in the sample population. Methods: A longitudinal study was conducted with a sample of students (n = 38) from the 2nd and 3rd years of undergraduate programs at Coimbra Health School, divided into an experimental group (EG) with 20 subjects and a control group (CG) with 18 subjects. The EG underwent a GPR intervention, while the CG received no intervention. Postural changes were assessed using a 3D motion analysis system (Qualisys), and stabilometry was evaluated using a Bertec force platform. Results: At baseline (T0), the groups were homogeneous regarding sample characterization variables, as well as postural and stabilometric variables (p > 0.05). After four weeks of the intervention (T1), no significant differences were observed between the EG and CG for any of the variables studied (p > 0.05). However, within-group analysis for the experimental group revealed a significant difference (p = 0.04) in anterior-posterior velocity, indicating a reduction in this parameter from T0 to T1. In the control group, a significant difference was observed (p = 0.03) in the left knee valgus, indicating a reduction in valgus alignment. Conclusions: GPR does not appear to be effective in improving postural changes or center of pressure displacement in healthy young students. Full article

Background/Objectives: The main aim of our study was to analyze the stabilometric parameters in relation to hip and knee muscle force in children with unilateral slipped capital femoral epiphysis (SCFE) who had undergone surgical treatment. Another objective was to compare the stabilometry in three testing situations (eyes open, eyes closed, and head retroflexed). Methods: In total, 26 patients with unilateral right SCFE treated via in situ fixation with one percutaneous screw performed stabilometry assessments under three different situations (with their eyes open, with their eyes closed, and with their head retroflexed) and isometric muscle force assessment of the bilateral hip flexors, extensors, abductors and adductors and bilateral knee flexors and extensors. Results: No significant differences between the right side (affected hip) and left side (non-affected hip) were recorded for all of the tested muscle groups. We found significant negative correlations between the 90% confidence ellipse area (eyes open condition) and left knee extensors (p = 0.028), right knee flexors (p = 0.041), and left knee flexors (p = 0.02), respectively. When performing the comparison between the eyes open and eyes closed situations, there were significant differences in CoP path length (p < 0.0001) and maximum CoP speed (p = 0.048); the parameters increased in the eyes closed situation. Conclusions: Better postural stability is acquired when assessed with eyes open or with the head retroflexed in contrast with eyes closed testing. Full article

Practicing physical activities or sports that involve frequent jumping and landing can strain the muscles and joints of the lower limbs, especially in those who do not have adequate physical preparation. The objective of this study was to (a) determine the correlation between ankle range of motion (ROM) and landing stability following jumps; (b) assess the association between the jump height in a counter-movement jump (CMJ) test and ankle ROM; and (c) examine the connection between stabilometry during specific jumps movements present in many sports and in ankle stabilization. Sixty-two healthy amateur volleyball players participated in the study (age: thirty-seven females and twenty-five males; age (years): 16.5 ± 4.25; height (cm): 166 ± 11.4; weight (Kg): 61.6 ± 13.7). Participants were recruited for the study in collaboration with student sports associations. The evaluations encompassed the measurement of ankle joint mobility for both lower limbs using an inertial sensor, a static baropodometric and stabilometric analysis using a pressure platform, and the CMJ test using the Microgate system. After the assessments, participants performed a “specific jump landing task”. Significant correlations were found between foot range of motion (ROM) and counter-movement jump (CMJ) performance. Specifically, the ROM of the right foot had a strong correlation with the CMJ (r = 0.81, p < 0.001), while the left foot ROM showed a moderate correlation (r = 0.46, p < 0.001). The specific jump task revealed substantial changes in stabilometry parameters, particularly during forward hops compared to lateral jumps. Dorsiflexion ROM significantly impacts jumping ability. Evaluating landing patterns and stabilometry during targeted activities can help optimize training, improve dynamic balance, and reduce ankle injury risk. Full article

Patients with end stage renal disease (ESRD) display many cognitive and physiological alterations resulting from renal failure and physical inactivity. Caffeine intake has been reported to improve cognitive/physical performance in several studies. However, whether the benefits of caffeine intake apply to patients with ESRD remains unknown. The aim of the present study was to explore the effect of caffeine intake on postural balance, cognitive function and functional capacity in patients with ESRD. In a randomized order, 12 patients with ESRD (age: 33.85 ± 8.57 years; Female: 45.5%) performed a battery of tests after either caffeine (CF) (400 mg) or placebo (PLA) ingestion. Postural balance was evaluated using a stabilometric platform. Functional capacity was assessed with the sit-to-stand and up-and-go tests, and for cognitive performances, reaction time test and a vigilance test were used. Results showed a significant improvement in up-and-go test (p = 0.01) and sit-to-stand test performances with CF compared to PLA (p < 0.01). Time of reaction test and vigilance test (p < 0.01) performances were significantly higher with CF. No significant difference was observed in postural balance between CF and PLA. The results of this study suggest that acute caffeine ingestion positively enhances cognitive function and functional capacity in patients with ESRD. Full article

Degenerative joint disease is a dynamic pathological process characterised by a destabilisation of the degradation and synthesis processes of articular cartilage and subchondral bone layer. Studies suggest that individuals with gonarthrosis experience deficits in proprioception, in addition to changes within their joints, which directly affects their ability to maintain posture and increases their risk of falling. Objectives: The aim of this study was to assess the functional status of patients with gonarthrosis through a posturographic examination conducted on a stabilometric platform (force plate) and a functional clinical examination. Methods: Participants were divided into two groups—a control group (n = 125) and a study group (n = 125). During the qualification process, subjective and objective examinations were conducted, including a functional assessment by means of such tests as the “Up and Go” Test, Functional Reach Test, Five Time Sit to Stand Test, and the Step Test. Subsequently, an assessment was conducted on the force plate by means of a posturographic test—the Romberg test performed with open and closed eyes in a standing position—and balance was evaluated using the Berg Balance Scale. The obtained data were analysed with the use of the IBM SPSS Statistics software version 27.0, by means of the Mann–Whitney test, and correlations were determined by means of Spearman’s test. A significance level of p = 0.05 was adopted. Results: Statistically significant differences were observed among the assessed groups as a result of both functional and posturographic examinations, along with positive correlations for disease duration, age, and BMI index. Conclusions: Patients with gonarthrosis exhibited disturbances in balance, functionality, and posture compared to healthy individuals in the control group. Full article

Background: Osteoarthritis is one of the most frequent joint disorders in the world. The specialists in the field strongly support the role of physical exercise as a key component in the holistic management of arthrosis. The aim of the current study was to identify and assess the functional deficit of these patients and to identify means to alleviate it through pre-surgery physiotherapy programs. Methods: The study was conducted on two samples of patients: a witness sample, encompassing 126 subjects without pathologies at the level of their lower limbs, and a study sample, formed of 116 subjects diagnosed with severe gonarthrosis with total knee arthroplasty indication. The assessment protocol was accomplished with the GPS 400 stabilometric platform. Results: The barycenter differences within the support polygon, recorded for the two samples within sagittal deviation, emphasize that the barycenter shifting mainly towards the healthy lower limb will demand, from the individual, more intense rebalancing postural reactions that will place the center-of-gravity projection in the sagittal plane, closer to the central area of the support polygon. Conclusions: In the case of gonarthrosis and other joint disorders, the use of functional testing to assess body weight distribution and center-of-gravity imbalances represents a promising direction in the research on and management of these disorders, providing essential information for functional diagnosing and thus enabling the elaboration and monitoring of individualized functional rehabilitation plans. Full article

The aim of the study was to evaluate whether the static stabilometric parameters among elite fencers, were affected by prolonged, asymmetric training regimen. A sample of 26 elite fencers of both genders, aged 19.15 ± 2.24 years, practising one of the three disciplines foil, épée, or sabre, was recruited for the study. Anthropometric measurements including thigh and calf circumferences and postural assessment based on the weight distribution on a stabilimeter platform were performed. Postural tone, as indicated by measures such as sway length and sway area ratio was calculated.. No notable anthropometric asymmetries were detected within the examined group The weight distribution patterns on the support quadrants in static stabilometric measurements did not suggest clinically significant issues. There were no significant differences among subgroups based on gender and lower limb dominance for both anthropometric and stabilimeter variables. However, 30.8% of participants showed anomalies in postural tone (hypertonic and hypotonic condition). Five out of eight athletes found with abnormal postural tone were foil fencers, suggesting a potential discipline-specific effect. Individual adjustments were found in foil fencers. These findings provide insights into the potential effects of fencing training on postural parameters among elite athletes. Full article

Background: The Balance Error Scoring System (BESS) is a commonly used method for clinically evaluating balance after traumatic brain injury. The utilization of force plates, characterized by their cost-effectiveness and portability, facilitates the integration of instrumentation into the BESS protocol. Despite the enhanced precision associated with instrumented measures, there remains a need to determine the clinical significance and feasibility of such measures within pediatric cohorts. Objective: To report a comprehensive set of posturographic measures obtained during instrumented BESS and to examine the concurrent validity, reliability, and feasibility of instrumented BESS in the pediatric point of care setting. Methods: Thirty-seven participants (18 female; aged 13.32 ± 3.31 years) performed BESS while standing on a force plate to simultaneously compute stabilometric measures (instrumented BESS). Ellipse area (EA), path length (PL), and sway velocity (VM) were obtained for each of the six BESS positions and compared with the respective BESS scores. Additionally, the effects of sex and age were explored. A second BESS repetition was performed to evaluate the test–retest reliability. Feedback questionnaires were handed out after testing to evaluate the feasibility of the proposed protocol. Results: The BESS total score was 20.81 ± 6.28. While there was no statistically significant age or sex dependency in the BESS results, instrumented posturography demonstrated an age dependency in EA, VM, and PL. The one-leg stance on a soft surface resulted in the highest BESS score (8.38 ± 1.76), EA (218.78 cm² ± 168.65), PL (4386.91 mm ± 1859.00), and VM (21.93 mm/s ± 9.29). The Spearman’s coefficient displayed moderate to high correlations between the EA (rs = 0.429–0.770, p = 0.001–0.009), PL (rs = 0.451–0.809, p = 0.001–0.006), and VM (rs = 0.451–0.809, p = 0.001–0.006) when compared with the BESS scores for all testing positions, except for the one-leg stance on a soft surface. The BESS total score significantly correlated during the first and second repetition (rs = 0.734, p ≤ 0.001), as did errors during the different testing positions (rs = 0.489–0.799, p ≤ 0.001–0.002), except during the two-legged stance on a soft surface. VM and PL correlated significantly in all testing positions (rs = 0.465–0.675, p ≤ 0.001–0.004; (rs = 0.465–0.675, p ≤ 0.001–0.004), as did EA for all positions except for the two-legged stance on a soft surface (rs = 0.392–0.581, p ≤ 0.001–0.016). A total of 92% of participants stated that the instructions for the testing procedure were very well-explained, while 78% of participants enjoyed the balance testing, and 61% of participants could not decide whether the testing was easy or hard to perform. Conclusions: Instrumented posturography may complement clinical assessment in investigating postural control in children and adolescents. While the BESS score only allows for the consideration of a total score approximating postural control, instrumented posturography offers several parameters representing the responsiveness and magnitude of body sway as well as a more differentiated analysis of movement trajectory. Concise instrumented posturography protocols should be developed to augment neuropediatric assessments in cases where a deficiency in postural control is suspected, potentially stemming from disruptions in the processing of visual, proprioceptive, and/or vestibular information. Full article