Search Results (26)

Musculoskeletal diseases of the knee joint affect a large percentage of the population, particularly athletes at the competitive level where stress on the joints is higher. These conditions can be diagnosed and monitored using various imaging techniques, such as radiography, computed tomography, and magnetic resonance imaging. Additionally, digital infrared thermal imaging is gaining popularity for screening, diagnosis, and disease progression monitoring. This method measures the heat radiating from the superficial dermal microcirculation located 1–2 mm below the epidermal surface. Numerous pathological processes, such as inflammatory, metabolic, and toxic conditions, manifest as local changes in heat production, making infrared thermal imaging a valuable clinical tool. In the present study, the temperature of the knee area in 22 participants was monitored using an infrared camera while performing sit-to-stand cycles. The change in temperature correlated with weight distribution between the legs during exercise, measured using a Wii Balance Board. The results of this new trial protocol are promising and suggest that further investigations should be conducted with more patients. Infrared thermal imaging demonstrated consistency in repeated knee measurements and showed potential for evaluating the relationship between regional knee temperatures and pathological conditions. Its strengths lie in its simplicity, accuracy, non-invasive nature, radiation-free nature, and patient specificity, which can improve clinical management. In combination with other diagnostic techniques, thermography provides a comprehensive overview of patients’ clinical conditions. Full article

Cerebral palsy (CP) is a neuromotor disorder affecting movement, muscle tone, and posture, leading to difficulties in motor coordination, balance, and strength. Virtual reality (VR) games offer an interactive method to engage children in a non-real environment, potentially improving balance and motor function. This study aimed to explore the impact of a VR-based balance system on gross motor function and balance in children with CP. Four participants (two boys and two girls, mean age 9.75 ± 3.41) were assessed at three time points: pre-treatment, six weeks post-initial assessment, and two weeks after intervention. Using tools like the Gross Motor Function Measure Scale (GMFMS), Pediatric Balance Scale (PBS), and Gross Motor Performance Measure (GMPM), the study found significant improvements in gross motor skills, balance, and motor performance with the use of the Nintendo Wii Balance Board within conventional physiotherapy. Further research is recommended to refine intervention parameters, incorporate additional outcome measures, and assess broader applicability, including for children with conditions like ADHD. Full article

Patellofemoral pain syndrome (PFPS) ranks among the most prevalent factors causing anterior knee pain. Quadriceps exercises such as forward lunges are important to treat PFPS. Aim: We investigated whether there is a difference in muscle activity between the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles and the center of pressure (CoP) among three hip positions, namely, hip adduction forward lunge (HADF), hip neutral forward lunge (HNEF), and hip abduction forward lunge (HABF), in healthy subjects. Method: This was a randomized controlled pilot study that included twenty healthy (age: 23.7 ± 2.51) volunteers. The CoP was measured using a “Wii Balance Board” from Nintendo, and VMO and VL muscle activity were measured via wireless surface electromyography. Results: The CoP outcomes showed significant differences among the three positions in terms of position (p < 0.001), sum distance (p < 0.001), range (p < 0.001), and max distance (p < 0.001). VMO (p < 0.000), and VL (p < 0.005) muscle activity and the ratio of VMO/VL (p < 0.000) significantly differed among the three positions. Conclusions: Although VMO and VL muscle activity increased in the HADF and HABF, excessive changes in the CoP occurred in the two positions. The change in the CoP during the HADF and HABF may result in valgus, varus, and loading of the knee joint, which may worsen PFPS. The HNEF is recommended for quadriceps strengthening in healthy subjects and PFPS patients. Full article

The knee is one of the joints most vulnerable to disease and injury, particularly in athletes and older adults. Surface temperature monitoring provides insights into the health of the analysed area, supporting early diagnosis and monitoring of conditions such as osteoarthritis and tendon injuries. This study presents an innovative approach that combines infrared thermography techniques with a Resnet 152 (DeepLabCut based) to detect and monitor temperature variations across specific knee regions during repeated sit-to-stand exercises. Thermal profiles are then analysed in relation to weight distribution data collected using a Wii Balance Board during the exercise. DeepLabCut was used to automate the selection of the region of interest (ROI) for temperature assessments, improving data accuracy compared to traditional time-consuming semi-automatic methods. This integrative approach enables precise and marker-free measurements, offering clinically relevant data that can aid in the diagnosis of knee pathologies, evaluation of the rehabilitation progress, and assessment of treatment effectiveness. The results emphasize the potential of combining thermography with DeepLabCut-driven data analysis to develop accessible, non-invasive tools for joint health monitoring or preventive diagnostics of pathologies. Full article

Fatigue plays a critical role in sports science, significantly affecting recovery, training effectiveness, and overall athletic performance. Understanding and predicting fatigue is essential to optimize training, prevent overtraining, and minimize the risk of injuries. The aim of this study is to leverage Human Activity Recognition (HAR) through deep learning methods for dimensionality reduction. The use of Adversarial AutoEncoders (AAEs) is explored to assess and visualize fatigue in a two-dimensional latent space, focusing on both semi-supervised and conditional approaches. By transforming complex time-series data into this latent space, the objective is to evaluate motor changes associated with fatigue within the participants’ motor control by analyzing shifts in the distribution of data points and providing a visual representation of these effects. It is hypothesized that increased fatigue will cause significant changes in point distribution, which will be analyzed using clustering techniques to identify fatigue-related patterns. The data were collected using a Wii Balance Board and three Inertial Measurement Units, which were placed on the hip and both forearms (distal part, close to the wrist) to capture dynamic and kinematic information. The participants followed a fatigue-inducing protocol that involved repeating sets of 10 repetitions of four different exercises (Squat, Right Lunge, Left Lunge, and Plank Jump) until exhaustion. Our findings indicate that the AAE models are effective in reducing data dimensionality, allowing for the visualization of fatigue’s impact within a 2D latent space. The latent space representation provides insights into motor control variations, revealing patterns that can be used to monitor fatigue levels and optimize training or rehabilitation programs. Full article

Falls are considered a significant cause of disability, pain, and premature deaths in older adults, often due to sedentary lifestyles and various risk factors. Combining immersive virtual reality (IVR) with physical exercise, or exergames, enhances motivation and personalizes training, effectively preventing falls by improving strength and balance in older people. IVR technology may increase the ecological validity of the assessments. The main goal of our study was to assess the feasibility of using a KAVE-based VR platform combining simulations of Levadas and a cable car to perform a balanced assessment and profiling of the older adult population for high risk of falls and the related user experience. A VR-based platform using a Wii balance board and a CAVE was developed to assess balance and physical fitness. Validated by the Biodex Balance System (BBS), 25 older adults participated in this study. The usability and presence were measured through the System Usability Scale and ITC-SOPI questionnaires, respectively. The IVR system showed a high presence and a good usability score of 75. Significant effects were found in the maximum excursion of the centre of pressure (COP) on the anterior–posterior axis during the cable car simulation (CCS), correlating with BBS metrics. Multiple discriminative analysis models and the support vector machine classified fall risk with moderate to high accuracy, precision, and recall. The system accurately identified all high-risk participants using the leave-one-out method. This study suggests that an IVR-based platform based on simulations with high ecological validity can be used to assess physical fitness and identify individuals at a higher risk of falls. Full article

Background: Stroke is a leading cause of disability, especially due to an increased fall risk and postural instability. The objective of this study was to analyze the impact of motor impairment in the hemiparetic UE on static balance in standing, in subject with chronic stroke. Methods: Seventy adults with chronic stroke, capable of independent standing and walking, participated in this cross-sectional study. The exclusion criteria included vestibular, cerebellar, or posterior cord lesions. The participants were classified based on their UE impairment using the Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA-UE). A posturographic evaluation (mCTSIB) was performed in the standing position to analyze the center of pressure (COP) displacement in the mediolateral (ML) and anteroposterior (AP) axes and its mean speed with eyes open (OE) and closed (EC) on stable and unstable surfaces. Results: A strong and significant correlation (r = −0.53; p < 0.001) was observed between the mediolateral (ML) center of pressure (COP) oscillation and the FMA-UE, which was particularly strong with eyes closed [r(EO) = 0.5; r(EC) = 0.54]. The results of the multiple linear regression analysis indicated that the ML oscillation is influenced significantly by the FMA-Motor, and specifically by the sections on UE, wrist, coordination/speed, and sensation. Conclusions: The hemiparetic UE motor capacity is strongly related to the ML COP oscillation during standing in individuals with chronic stroke, with a lower motor capacity associated with a greater instability. Understanding these relationships underpins the interventions to improve balance and reduce falls in people who have had a stroke. Full article

Background: Several exercise methods with virtual reality devices have been used in treatments for older adults and patients with neurodegenerative diseases, although the mechanisms continue to be elucidated. The aim of this study is to establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural balance in older adults. It also seeks to compare low-cost virtual reality under two delivery modalities, telerehabilitation (TR) in elderly centres and face-to-face (FtF) in rehabilitation centres. Methods: The study is set up as a non-inferiority two-arm parallel triple-blind randomised controlled clinical trial. Sixteen persons aged 65 to 75-years-old will be included. Eighteen Wii therapy sessions (25–30 min) will be provided through both FtF (control group, n = 8) and TR (exposure group, n = 8), both with a Nintendo Wii balance board. Data will be collected at baseline (week 0), during the Wii therapy sessions (weeks 2, 4, and 6), and during the follow-up (weeks 8 and 10). The primary outcome will be the area of centre-of-pressure (CoP) sway; secondary outcomes will be medial–lateral and anterior–posterior velocity and standard deviation of CoP; and tertiary outcomes will be clinical measures: single-leg stand, timed up-and-go tests, Barthel Index, and Tinetti’s scale. Statistical analyses will be performed using SPSS 20.00 for Windows. The trial adheres to the Declaration of Helsinki and the Chilean laws of rights and duties of the patient and research in humans. Ethical approval was obtained from the Ethics Committee of the University of Talca. Written informed consent will be obtained from participants. Discussion: In this trial, older adults from a Chilean city with a large rural and underserved population share will be included to test the feasibility and effectiveness of a rehabilitation programme using low-cost VR aimed at improving postural balance to generate evidence to support decision makers generating public health policy. Trial registration: Australian New Zeeland Clinical Trials Registration (ACTRN12621001380886). Full article

Background: The stability index estimation algorithm was derived and applied to develop and implement a balance ability diagnosis system that can be used in daily life. Methods: The system integrated an approach based on sensory function interaction, called the clinical test of sensory interaction with balance. A capacitance and resistance sensing type force mat was fabricated, and a stability index prediction algorithm was developed and applied using the center of pressure variables. The stability index prediction algorithm derived a center of pressure variable for 103 elderly people by Nintendo Wii Balance Board to predict the stability index of the balance system (Biodex SD), and the accuracy of this approach was confirmed. Results: As a result of testing with the test set, the linear regression model confirmed that the r-value ranged between 0.943 and 0.983. To confirm the similarity between the WBB and the flexible force mat, each measured center of pressure value was inputted and calculated in the developed regression model, and the result of the correlation coefficient validation confirmed an r-value of 0.96. Conclusion: The system developed in this study will be applicable to daily life in the home in the form of a floor mat. Full article

Background: Parkinson’s disease is characterised by the loss of balance and the presence of walking difficulties. The inclusion of rehabilitation therapies to complement pharmacological therapy allows for comprehensive management of the disease. In recent years, virtual reality has been gaining importance in the treatment of neurological diseases and their associated symptoms. Therefore, the objective of this systematic review was to analyse the effectiveness of virtual reality on balance and gait in patients with Parkinson’s disease. Methods: This study is a systematic review conducted following PRISMA’s statements. An electronic search of the literature was carried out in the following databases: PubMed, Cochrane, Dialnet, Scopus, Web of Science, PsycINFO and Science Direct PEDro. The inclusion criteria were controlled and non-controlled clinical trials published in the last 12 years in English or Spanish, in which virtual reality was applied to treat balance and gait impairments in patients with Parkinson’s disease. Results: 20 studies were finally included in this review. A total of 480 patients participated in the included studies. All patients were diagnosed with Parkinson’s disease. Most of the investigations used the Nintendo Wii + Balance Board or the Microsoft Kinect TM combined with the Kinect Adventures games as a virtual reality device. Conclusions: According to the results of this literature review, virtual reality-based interventions achieve good adherence to treatment, bring innovation and motivation to rehabilitation, and provide feedback as well as cognitive and sensory stimulation in patients with Parkinson’s disease. Therefore, virtual reality can be considered an alternative for personalised rehabilitation and for home treatment. Full article

Standing up from a chair is a mechanically demanding daily motion, and its biomechanics represent motor performance. In older adults with locomotive syndrome (LS), sit-to-stand (STS) movement with adequate postural control is essential to prevent falls. This study evaluated the characteristics of dynamic balance during STS movement on older adults with LS. A total of 116 participants aged ≥65 years were divided into Non-LS, LS stage 1, and LS stage 2 groups using the LS risk test. The participants were instructed to stand on the Nintendo Wii Balance Board as quickly as possible, and the STS movement was quantified using the vertical ground reaction force (VGRF) and center of pressure (CoP). The STS score, which represented dynamic balance, was significantly different among the groups (p < 0.001). The rate of VGRF development was significantly lower in the LS stages 1 and 2 than in the Non-LS group (p < 0.001). On the other hand, the total distance of the CoP path did not differ among the groups (p = 0.211). These findings indicated a reduction of postural control in older adults with LS. The STS score emphasized the importance of balance training to prevent falls in older adults with LS. Full article

The Wii balance board (WBB) is a simplified force plate system used to evaluate the balancing ability of the elderly via a sensory interaction task to confirm a significant standing balance index. The accuracy of this system has been verified in previous studies. In this study, an instrumented and modified clinical test of sensory interaction on balance (i-mCTSIB) was performed on 84 elderly subjects, and the variables for center of pressure (CoP) were calculated using WBB for each task condition. The results indicate that the visual condition has a significant effect on the sway proprioceptive sensory variables with a foam condition as their complexity increases. In addition, the correlation between the variable and Berg Balance Scale was not confirmed since CTSIB is a sensory interaction on balance ability. Therefore, WBB can be used to evaluate balancing ability based on sensory interactions consisting of the surface condition. Full article

This paper analyzes the reliability and usability of a portable electronic instrument that measures balance and balance impairment in older adults. The center of pressure (CoP) metrics are measured with a modified Wii Balance Board (mWBB) platform. In the intra- and inter-rater testing, 16 and 43 volunteers (mean 75.66 and standard deviation (SD) of 7.86 years and 72.61 (SD 7.86) years, respectively) collaborated. Five volunteer raters (5.1 (SD 3.69) years of experience) answered the System Usability Scale (SUS). The most reliable CoP index in the intra-examiner tests was the 95% power frequency in the medial-lateral displacement of the CoP with closed-eyes. It had excellent reliability with an intraclass correlation coefficient ICC = 0.948 (C.I. 0.862–0.982) and a Pearson’s correlation coefficient PCC = 0.966 (p < 0.001). The best index for the inter-rater reliability was the centroidal frequency in the anterior-posterior direction closed-eyes, which had an ICC (2,1) = 0.825. The mWBB also obtained a high usability score. These results support the mWBB as a reliable complementary tool for measuring balance in older adults. Additionally, it does not have the limitations of laboratory-grade systems and clinical screening instruments. Full article

The interaction between oral and/or mental cognitive tasks and postural control and mobility remains unclear. The aim of this study was to analyse the influence of speech production and cognitive load levels on static balance and timed up and go (TUG) during dual-task activities. Thirty healthy young subjects (25 ± 4 years old, 17 women) participated in this study. A control situation and two different cognitive arithmetic tasks were tested: counting backward in increments of 3 and 7 under oral (O) and mental (M) conditions during static balance and the TUG. We evaluated the dual-task cost (DTC) and the effect of speech production (SP) and the level of cognitive load (CL) on these variables. There was a significant increase in the centre of pressure oscillation velocity in static balance when the dual task was performed orally compared to the control situation The DTC was more pronounced for the O than for the M. The SP, but not the CL, had a significant effect on oscillation velocity. There was an increase in TUG associated with the cognitive load, but the mental or oral aspect did not seem to have an influence. Mobility is more affected by SP when the cognitive task is complex. This may be particularly important for the choice of the test and understanding postural control disorders. Full article

Homebalance Stability medical device, based on audio-visual feedback and Nintendo Wii Balance Board, is a suitable tool for telerehabilitation of balance issues in patients with brain damage. The main goal was to expand the system by energy expenditure measurements and to verify the usability of the telemetric mobile device FlexiGuard. We used the FlexiGuard system (developed at our institute) and Oxycon (JAEGER^® Oxycon Mobile, Germany) to measure the energy expenditure. We performed measurements on eight probands. Each proband underwent six activities for a total length of 90 min. During these activities, we measured energy expenditure using Oxycon and heart rate using the FlexiGuard system, from which we calculated the energy expenditure. By comparing the energy expenditure from measuring the heart rate with the FlexiGuard system with that from the Oxycon reference device, we verified the applicability of the FlexiGuard system for estimation energy expenditure. The average deviation from the reference instrument was under 30%. The conventional method, such as Oxycon, cannot be used during home therapy. Therefore, we upgraded the platform of our telemetry system (FlexiGuard), which can measure the heart rate and calculate the energy expenditure. Full article