Detecting sitting posture abnormalities in wheelchair users enables early identification of changes in their functional status.To date,this detection has relied on in-person observation by medical specialists.However,...Detecting sitting posture abnormalities in wheelchair users enables early identification of changes in their functional status.To date,this detection has relied on in-person observation by medical specialists.However,given the challenges faced by health specialists to carry out continuous monitoring,the development of an intelligent anomaly detection system is proposed.Unlike other authors,where they use supervised techniques,this work proposes using unsupervised techniques due to the advantages they offer.These advantages include the lack of prior labeling of data,and the detection of anomalies previously not contemplated,among others.In the present work,an individualized methodology consisting of two phases is developed:characterizing the normal sitting pattern and determining abnormal samples.An analysis has been carried out between different unsupervised techniques to study which ones are more suitable for postural diagnosis.It can be concluded,among other aspects,that the utilization of dimensionality reduction techniques leads to improved results.Moreover,the normality characterization phase is deemed necessary for enhancing the system’s learning capabilities.Additionally,employing an individualized approach to the model aids in capturing the particularities of the various pathologies present among subjects.展开更多
Sensory conflict impacts postural control,yet its effect on cortico-muscular interaction remains underexplored.We aimed to investigate sensory conflict's influence on the cortico-muscular network and postural stab...Sensory conflict impacts postural control,yet its effect on cortico-muscular interaction remains underexplored.We aimed to investigate sensory conflict's influence on the cortico-muscular network and postural stability.We used a rotating platform and virtual reality to present subjects with congruent and incongruent sensory input,recorded EEG(electroencephalogram)and EMG(electromyogram)data,and constructed a directed connectivity network.The results suggest that,compared to sensory congruence,during sensory conflict:(1)connectivity among the sensorimotor,visual,and posterior parietal cortex generally decreases,(2)cortical control over the muscles is weakened,(3)feedback from muscles to the cortex is strengthened,and(4)the range of body sway increases and its complexity decreases.These results underline the intricate effects of sensory conflict on cortico-muscular networks.During the sensory conflict,the brain adaptively decreases the integration of conflicting information.Without this integrated information,cortical control over muscles may be lessened,whereas the muscle feedback may be enhanced in compensation.展开更多
Persistent postural-perceptual dizziness, defined in 2017, is a chronic functional vestibular disorder. Which is characterized by persistent dizziness, unsteadiness, and/or non-spinning vertigo. However, the exact mec...Persistent postural-perceptual dizziness, defined in 2017, is a chronic functional vestibular disorder. Which is characterized by persistent dizziness, unsteadiness, and/or non-spinning vertigo. However, the exact mechanisms remain unclear. In recent years, FMRI studies have provided key insights into the pathogenesis of PPPD. This review summarized functional imaging studies of persistent postural dizziness and its predecessors in recent years and found changes in the activity and functional connectivity of important areas of visual processing, multisensory vestibular and spatial cognition in patients with PPPD. In addition, factors such as stimulation mode, personality traits, mental comorbidities and external vestibular lesions have important effects on brain functional activities and connectivity patterns, and further stratified studies on these factors are needed in the future to further clarify and draw exact conclusions on the pathological mechanism of PPPD.展开更多
Postural tachycardia syndrome(POTS)is a chronic autonomic disorder characterized by excessive heart rate elevation upon standing or head-up tilt,in the absence of orthostatic hypotension.This debilitating condition af...Postural tachycardia syndrome(POTS)is a chronic autonomic disorder characterized by excessive heart rate elevation upon standing or head-up tilt,in the absence of orthostatic hypotension.This debilitating condition affects primarily young to middle-aged individuals,particularly women,and substantially influences quality of life.The main present-ing symptoms are lightheadedness,palpitations,exercise intolerance,and cognitive impairment.POTS is of particular importance to cardiologists,given its prominent cardiovascular symptoms.The diagnostic criteria for POTS include a sustained heart rate increase of more than 30 beats per minute upon standing or head-up tilt;symptoms of orthostatic intolerance lasting at least 3 months;and exclusion of other causes.The exact etiology of POTS is unknown,but mul-tiple possible etiologies leading to a similar clinical phenotype have been proposed.Early intervention and appropri-ate management can improve symptoms.Treatment strategies include lifestyle modifications,pharmacotherapy,and tailored conditioning programs.Non-pharmacologic options are the first line treatment.Prognosis varies widely:POTS can be a temporary condition for some individuals but a chronic and debilitating condition for others.Further research is necessary to elucidate the pathophysiology and optimize treatment strategies for this condition.展开更多
Vasovagal syncope(VVS) and postural tachycardia syndrome(POTS) are the main forms of orthostatic intolerance in pediatrics and both are underlying causes of neurally-mediated syncope.In recent years,increasing attenti...Vasovagal syncope(VVS) and postural tachycardia syndrome(POTS) are the main forms of orthostatic intolerance in pediatrics and both are underlying causes of neurally-mediated syncope.In recent years,increasing attention has been paid to the management of VVS and POTS in children and adolescents.A number of potential mechanisms are involved in their pathophysiology,but the leading cause of symptoms varies among patients.A few studies thus have focused on the individualized treatment of VVS or POTS based on selected hemodynamic parameters or biomarkers that can predict the therapeutic effect of certain therapies and improve their effectiveness.This review summarizes the latest developments in individualized treatment of VVS and POTS in children and indicates directions for further research in this field.展开更多
Peripheral neuropathy(PN) is a multifarious disorder that is caused by damage to the peripheral nerves. Although the symptoms of PN vary with the etiology, most cases are characterized by impaired tactile and proprioc...Peripheral neuropathy(PN) is a multifarious disorder that is caused by damage to the peripheral nerves. Although the symptoms of PN vary with the etiology, most cases are characterized by impaired tactile and proprioceptive sensation that progresses in a distal to proximal manner. Balance also tends to deteriorate as the disorder becomes more severe, and those afflicted are substantially more likely to fall while walking compared with those who are healthy. Most patients with PN walk more cautiously and with greater stride variability than age-matched controls, but the majority of their falls occur when they must react to a perturbation such as a slippery or uneven surface. The purpose of this study was to first describe the role of somatosensory feedback in the control of posture and then discuss how that relationship is typically affected by the most common types of PN. A comprehensive review of the scientific literature was conducted using MEDLINE, and the relevant information was synthesized. The evidence indicates that the proprioceptive feedback that is conveyed primarily through larger type I afferents is important for postural control. However, the evidence indicates that the tactile feedback communicated through smaller type II afferents is particularly critical to the maintenance of balance. Many forms of PN often lead to chronic tactile desensitization in the soles of the feet and, although the central nervous system seems to adapt to this smaller type II afferent dysfunction by relying on more larger type I afferent reflex loops, the result is still decreased stability. We propose a model that is intended both to help explain the relationship between stability and the smaller type II afferent and the larger type I afferent feedback that may be impaired by PN and to assist in the development of pertinent rehabilitative interventions.展开更多
The control of balance is crucial for efficiently performing most of our daily motor tasks, such as those involving goal-directed arm movements or whole body displacement. The purpose of this article is twofold. First...The control of balance is crucial for efficiently performing most of our daily motor tasks, such as those involving goal-directed arm movements or whole body displacement. The purpose of this article is twofold. Firstly, it is to recall how balance can be maintained despite the different sources of postural perturbation arising during voluntary movement. The importance of the so-called "anticipatory postural adjustments"(APA), taken as a "line of defence" against the destabilizing effect induced by a predicted perturbation, is emphasized. Secondly, it is to report the results of recent studies that questioned the adaptability of APA to various constraints imposed on the postural system. The postural constraints envisaged here are classified into biomechanical(postural stability, superimposition of motor tasks),(neuro) physiological(fatigue), temporal(time pressure) and psychological(fear of falling, emotion). Overall, the results of these studies point out the capacity of the central nervous system(CNS) to adapt the spatio-temporal features of APA to each of theseconstraints. However, it seems that, depending on the constraint, the "priority" of the CNS was focused on postural stability maintenance, on body protection and/or on maintenance of focal movement performance.展开更多
Aircraft digital flexible assembly fixture and technologies are widely used in developed countries, while the traditional jig-based assembly mode is still used in China. The application study of aircraft digital flexi...Aircraft digital flexible assembly fixture and technologies are widely used in developed countries, while the traditional jig-based assembly mode is still used in China. The application study of aircraft digital flexible assembly system is just beginning in our country recently. To meet the requirements of automated posture alignment and join in digital assembly system for large aircraft components, a novel fitting fixture called 3-axis actuator is developed. On the basis of the actuators, three kinds of posture alignment system for large aircraft components are proposed, including the non-redundant system, the redundant actuating system, and the redundant leg system, and their constitutions and properties are introduced. Through deriving the feeding transmission stiffness model of single actuator and analyzing the inverse kinematics of these systems, the relationship between the external force and the changes of position and orientation of large aircraft component is obtained, and then the postural alignment stiffness models are established. With the method mentioned above, the postural alignment stiffness of three systems is computed by using the algebraic formulate, and the results show that redundant properties can increase system＇s postural alignment stiffness. As an example, a optimized layout of the assembly system for a given model of aircraft is developed, the results of application show that the layout has many advantages, such as high accuracy, stiffness, stability, reliability, efficiency and flexible, which can satisfy the requirement of aircraft digital assembly system well. The proposed study of postural alignment stiffness for different systems can supply the theoretic support for the optimization layout design of aircraft digital assembly system, and contribute to evaluate the system working performance of systems.展开更多
Postural orthostatic tachycardia syndrome （POTS） has been recognized since at least 1940.A review of the literature identifies differences in the definition for this condition and wide variations in treatment and ou...Postural orthostatic tachycardia syndrome （POTS） has been recognized since at least 1940.A review of the literature identifies differences in the definition for this condition and wide variations in treatment and outcomes.This syndrome appears to describe a group of conditions with differing pathophysiology,which requires treatment tailored to the true underlying disorder.Patients need to be fully evaluated to guide treatment.Further research is required to effectively classify the range of underlying pathophysioiogy that can produce this syndrome and to guide optimal management.展开更多
BACKGROUND Suspension training(SET)is a method of neuromuscular training that enables the body to carry out active training under unstable support through a suspension therapy system.However,there have been few report...BACKGROUND Suspension training(SET)is a method of neuromuscular training that enables the body to carry out active training under unstable support through a suspension therapy system.However,there have been few reports in the literature on the application of SET to anterior cruciate ligament reconstruction(ACLR)patients.It is not clear what aspects of the patient's function are improved after SET.AIM To investigate the effect of SET on the neuromuscular function,postural control,and knee kinematics of patients after ACLR surgery.METHODS Forty participants were randomized to an SET group or a control group.The SET group subjects participated in a SET protocol over 6 wk.The control group subjects participated in a traditional training protocol over 6 wk.Isokinetic muscle strength of the quadriceps and hamstrings,static and dynamic posture stability test,and relative translation of the injured knee were assessed before and after training.RESULTS The relative peak torque of the quadriceps and hamstrings in both groups increased significantly(P<0.001),and the SET group increased by a higher percentage than those in the control group(quadriceps:P=0.004;hamstrings:P=0.011).After training,both groups showed significant improvements in static and dynamic posture stability(P<0.01),and the SET group had a greater change than the control group(P<0.05).No significant improvement on the relative translation of the injured knee was observed after training in either group(P>0.05).CONCLUSION Our findings show that SET promotes great responses in quadriceps and hamstring muscle strength and balance function in ACLR patients.展开更多
This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants（20 stroke patients, 20 age-...This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants（20 stroke patients, 20 age-matched healthy participants） were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait. Changes in postural control parameters anteroposterior sway speed and total center of pressure distance differed significantly between the stroke and control groups. In addition, changes in gait kinematic parameters knee and ankle angles of initial contact differed significantly between stroke（paretic and non-paretic） and control groups. Muscle fatigue in the unaffected knee and ankle impaired postural control and debilitates kinematic movement of ipsilateral and contralateral lower limbs, and may place the fatigued stroke patients at greater risk for falls.展开更多
Clinical disorders often are characterized by a breakdown in dynamical processes that contribute to the control of upright standing.Disruption to a large number of physiological processes operating at different time s...Clinical disorders often are characterized by a breakdown in dynamical processes that contribute to the control of upright standing.Disruption to a large number of physiological processes operating at different time scales can lead to alterations in postural center of pressure(Co P)fluctuations.Multiscale entropy(MSE) has been used to identify differences in fluctuations of postural Co P time series between groups with and without known physiological impairments at multiple time scales.The purpose of this paper is to:1) review basic elements and current developments in entropy techniques used to assess physiological complexity;and 2) identify how MSE can provide insights into the complexity of physiological systems operating at multiple time scales that underlie the control of posture.We review and synthesize evidence from the literature providing support for MSE as a valuable tool to evaluate the breakdown in the physiological processes that accompany changes due to aging and disease in postural control.This evidence emerges from observed lower MSE values in individuals with multiple sclerosis,idiopathic scoliosis,and in older individuals with sensory impairments.Finally,we suggest some future applications of MSE that will allow for further insight into how physiological deficits impact the complexity of postural fluctuations;this information may improve the development and evaluation of new therapeutic interventions.展开更多
Background: Heavy backpacks are often used by soldiers and firefighters. Weight carrying could reduce the speed and efficiency in task completion by altering the foot sole sensitivity and postural control.Methods: In ...Background: Heavy backpacks are often used by soldiers and firefighters. Weight carrying could reduce the speed and efficiency in task completion by altering the foot sole sensitivity and postural control.Methods: In fifteen healthy subjects, we measured the changes in sensitivity to vibrations applied to the foot sole when standing upright or walking after load carrying(30% body weight). The participants were asked to judge different vibration amplitudes applied on the 2 nd or 5 th metatarsal head and the heel at two frequencies(25 and 150 Hz) to determine the vibration threshold and the global perceptual representation(Ψ)of the vibration amplitude(Φ)given by the Stevens power function(Ψ=k×Φ~n). Any increase in negative k value indicated a reduction in sensitivity to the lowest loads. Pedobarographic measurements, with computation of the center of pressure(COP) and its deviations, were performed during weight carrying.Results: The 25-Hz vibration threshold significantly increased after weight carrying when standing upright or walking.After standing with the added loads, the absolute negative k value increased for the 25 Hz frequency. After walking with the added loads, the k coefficient increased for the two vibration frequencies. Weight carrying significantly increased both the CoP surface and CoP lateral deviation.Conclusions: Our data show that weight carrying reduces the sensory pathways from the foot sole and accentuates the center of pressure deviations.展开更多
There are data about the positive effect of rehabilitation with postural training in traumatic brain injury (TBI) patients. Brain mechanisms of functional recovery have been investigated insufficiently. In this study,...There are data about the positive effect of rehabilitation with postural training in traumatic brain injury (TBI) patients. Brain mechanisms of functional recovery have been investigated insufficiently. In this study, functional recovery was examined in TBI patients with primary motor (20 patients) or higher mental impairment (10 patients)—post-traumatic Korsakov syndrome compared to healthy volunteers (n = 20). Integral clinical, stabilographic, and EEG approach was used as a tool for estimation of functional deficit in TBI patients before and after rehabilitation course. Specific alterations of stabilographic and EEG parameters were observed in TBI patients with primary motor or mental deficit before rehabilitation. Rehabilitation course with postural training improved recovery of all functions in both patient groups. To understand brain mechanisms of rehabilitation, we examined EEG findings during standing and postural task performance in healthy volunteers (n = 10). EEG coherence increase was marked for different spectral bands predominantly in the right hemisphere and more in alpha-2 and beta bands during postural task performance. These EEG findings were discussed in relation to rehabilitation effect on TBI patients and proved that postural training with visual feedback may provoke primary activation of the right hemisphere and can serve as a trigger for integration of cortical and subcortical structures and for recovery of motor and higher mental function in TBI patients.展开更多
BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventio...BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.展开更多
Concussion,or mild traumatic brain injury,incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom.The purpose of this review is to provide an overview of the linear and non-lin...Concussion,or mild traumatic brain injury,incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom.The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control.The current acute evaluation for concussion utilizes the subjective balance error scoring system(BESS) to assess postural control.While the sensitivity of the overall test battery is high,the sensitivity of the BESS is unacceptably low and,with repeat administration,is unable to accurately identify recovery.Sophisticated measures of postural control,utilizing traditional linear assessments,have identified impairments in postural control well beyond BESS recovery.Both assessments of quiet stance and gait have identified lingering impairments for at least 1 month post-concussion.Recently,the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy(Ap En).Ap En,most commonly in the medial-lateral plane,has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values;unfortunately these studies have not gone beyond the acute phase of recovery.One study has identified lingering deficits in postural control,utilizing Shannon and Renyi entropy metrics,which persist at least through clinical recovery and return to participation.Finally,limited evidence from two studies suggest that individuals with a previous history of a single concussion,even months or years prior,may display altered Ap En metrics.Overall,non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.展开更多
Background:Athletes have been shown to exhibit better balance compared to non-athletes(NON).However,few studies have investigated how the surface on which athletes train affects the strategies adopted to maintain bala...Background:Athletes have been shown to exhibit better balance compared to non-athletes(NON).However,few studies have investigated how the surface on which athletes train affects the strategies adopted to maintain balance.Two distinct athlete groups who experience different types of sport-specific balance training are stable surface athletes(SSA) such as basketball players and those who train on unstable surfaces(USA) such as surfers.The purpose of this study was to investigate the effects of training surface on dynamic balance in athletes compared to NON.Methods:Eight NON,eight SSA,and eight USA performed five 20-s trials in each of five experimental conditions including a static condition and four dynamic conditions in which the support surface translated in the anteroposterior(AP) or mediolateral(ML) planes using positive or negative feedback paradigms.Approximate entropy(Ap En) and root mean square distance(RMS) of the center of pressure(Co P) were calculated for the AP and ML directions.Four 3 × 5(group × condition) repeated measures ANOVAs were used to determine significant effects of group and condition on variables of interest.Results:USA exhibited smaller Ap En values than SSA in the AP signals while no significant differences were observed in the ML Co P signals.Generally,the negative feedback conditions were associated with significantly greater RMS values than the positive feedback conditions.Conclusion:USA exhibit unique postural strategies compared to SSA.These unique strategies seemingly exhibit a direction-specific attribute and may be associated with divergent motor control strategies.展开更多
Postural orthostatic tachycardia syndrome(POTS) is a relatively rare syndrome recognised since 1940. It is a heterogenous condition with orthostatic intolerance due to dysautonomia and is characterised by rise in hear...Postural orthostatic tachycardia syndrome(POTS) is a relatively rare syndrome recognised since 1940. It is a heterogenous condition with orthostatic intolerance due to dysautonomia and is characterised by rise in heart rate above 30 bpm from base line or to more than 120 bpm within 5-10 min of standing with or without change in blood pressure which returns to base line on resuming supine position. This condition present with various disabling symptoms such as light headedness, near syncope, fatigue, nausea, vomiting, tremor, palpitations and mental clouding, etc. However there are no identifiable signs on clinical examination and patients are often diagnosed to have anxiety disorder. The condition predominantly affects young female between the ages of 15-50 but is rarely described in older people. We describe an older patient who developed POTS which recovered over 12 mo. Recognising this condition is important as there are treatment options available to alleviate the disabling symptoms.展开更多
The purpose of this study was to investigate neuronal mechanisms active during the percep-tion of forward postural limits in a standing po-sition and to specify fall-related brain activity using optical functional nea...The purpose of this study was to investigate neuronal mechanisms active during the percep-tion of forward postural limits in a standing po-sition and to specify fall-related brain activity using optical functional near-infrared spectros-copy. The study group included six right-handed, healthy female volunteers (range: 19, 20 years). The optical imaging device comprised 16 opto-des designed to provide 24-channel recording of changes in hemoglobin oxygenation. We meas-ured the changes of oxygenated hemoglobin levels in the frontal region when subjects per-ceived reachability in a standing position. Com- pared with those in other regions, the oxygen-ated hemoglobin levels in the right frontal region compatible with the right prefrontal cortex sig-nificantly increased. This result suggests that brain activities in the right prefrontal cortex are related to perception of reachability. Overesti-mation of postural limits has been reported as one of the risk factor for falling. This overesti-mation might be induced by dysfunction in the prefrontal cortex, resulting in a failure to inhibit a motor program that would have caused a loss of balance in reaching. Activation of the right prefrontal cortex may be a key factor for pre-venting accidental falls in the elderly and in pa-tients with neurological disorders.展开更多
Aim and Objective: To study musculoskeletal problems like musculoskeletal pain, postural deformity and nerve radiculopathy in women engaged in Papad making by clinical assessment. Methodology: A cross-sectional observ...Aim and Objective: To study musculoskeletal problems like musculoskeletal pain, postural deformity and nerve radiculopathy in women engaged in Papad making by clinical assessment. Methodology: A cross-sectional observational survey carried out at Shri. Mahila Gruh Udyog Lijjat Papad, Nandanvan, Nagpur (2014). 50 female subjects were selected for the study. After taking permission from factory in-charge, the survey was conducted at the factory site and subjects were explained about the study in details in language they can understand. Consent form was obtained by subjects to participate. Data were collected by interview and clinical examination of women engaged in this occupation, As per proforma of musculoskeletal examination. Result: Almost 37 subjects out of 50 complaints about low back pain as a chief complaint followed by neck pain in 34, thoracic kyphosis was more profound postural deviation seen in 10 subjects. Paraspinal and calf muscle spasm is more common. Radiating pain and numbness more in dominant hand suggestive of involvement of median nerve were confirmed by Upper Limb Traction Test [ULTT]. Discussion: Socioeconomic status greatly influences the working needs of women. Shri. Mahila Gruh Udyog Lijjat Papad factory provides a platform for Women Empowerment. Faulty posture adoption for longer duration during work gives rise to various musculoskeletal problems. Conclusion: 74% of the study population has low back pain as a chief musculoskeletal problem. 34% present with postural deviation and 82% belong to poor socioeconomic scale.展开更多
基金FEDER/Ministry of Science and Innovation-State Research Agency/Project PID2020-112667RB-I00 funded by MCIN/AEI/10.13039/501100011033the Basque Government,IT1726-22+2 种基金by the predoctoral contracts PRE_2022_2_0022 and EP_2023_1_0015 of the Basque Governmentpartially supported by the Italian MIUR,PRIN 2020 Project“COMMON-WEARS”,N.2020HCWWLP,CUP:H23C22000230005co-funding from Next Generation EU,in the context of the National Recovery and Resilience Plan,through the Italian MUR,PRIN 2022 Project”COCOWEARS”(A framework for COntinuum COmputing WEARable Systems),N.2022T2XNJE,CUP:H53D23003640006.
文摘Detecting sitting posture abnormalities in wheelchair users enables early identification of changes in their functional status.To date,this detection has relied on in-person observation by medical specialists.However,given the challenges faced by health specialists to carry out continuous monitoring,the development of an intelligent anomaly detection system is proposed.Unlike other authors,where they use supervised techniques,this work proposes using unsupervised techniques due to the advantages they offer.These advantages include the lack of prior labeling of data,and the detection of anomalies previously not contemplated,among others.In the present work,an individualized methodology consisting of two phases is developed:characterizing the normal sitting pattern and determining abnormal samples.An analysis has been carried out between different unsupervised techniques to study which ones are more suitable for postural diagnosis.It can be concluded,among other aspects,that the utilization of dimensionality reduction techniques leads to improved results.Moreover,the normality characterization phase is deemed necessary for enhancing the system’s learning capabilities.Additionally,employing an individualized approach to the model aids in capturing the particularities of the various pathologies present among subjects.
基金supported by the National Defense Foundation Strengthening Program Technology Field Fund Project of China(2021-JCJQ-JJ-1029)the Science Technology Plan Project of Zhejiang Province(2023C03159)+1 种基金the Science Foundation of National Health and Family Planning Commission-Medical Health Science and Technology Project of Zhejiang Provincial Health(WKJ-ZJ-2334)the key projects of major health science and technology plan of Zhejiang Province(WKJ-ZJ-2129).
文摘Sensory conflict impacts postural control,yet its effect on cortico-muscular interaction remains underexplored.We aimed to investigate sensory conflict's influence on the cortico-muscular network and postural stability.We used a rotating platform and virtual reality to present subjects with congruent and incongruent sensory input,recorded EEG(electroencephalogram)and EMG(electromyogram)data,and constructed a directed connectivity network.The results suggest that,compared to sensory congruence,during sensory conflict:(1)connectivity among the sensorimotor,visual,and posterior parietal cortex generally decreases,(2)cortical control over the muscles is weakened,(3)feedback from muscles to the cortex is strengthened,and(4)the range of body sway increases and its complexity decreases.These results underline the intricate effects of sensory conflict on cortico-muscular networks.During the sensory conflict,the brain adaptively decreases the integration of conflicting information.Without this integrated information,cortical control over muscles may be lessened,whereas the muscle feedback may be enhanced in compensation.
文摘Persistent postural-perceptual dizziness, defined in 2017, is a chronic functional vestibular disorder. Which is characterized by persistent dizziness, unsteadiness, and/or non-spinning vertigo. However, the exact mechanisms remain unclear. In recent years, FMRI studies have provided key insights into the pathogenesis of PPPD. This review summarized functional imaging studies of persistent postural dizziness and its predecessors in recent years and found changes in the activity and functional connectivity of important areas of visual processing, multisensory vestibular and spatial cognition in patients with PPPD. In addition, factors such as stimulation mode, personality traits, mental comorbidities and external vestibular lesions have important effects on brain functional activities and connectivity patterns, and further stratified studies on these factors are needed in the future to further clarify and draw exact conclusions on the pathological mechanism of PPPD.
文摘Postural tachycardia syndrome(POTS)is a chronic autonomic disorder characterized by excessive heart rate elevation upon standing or head-up tilt,in the absence of orthostatic hypotension.This debilitating condition affects primarily young to middle-aged individuals,particularly women,and substantially influences quality of life.The main present-ing symptoms are lightheadedness,palpitations,exercise intolerance,and cognitive impairment.POTS is of particular importance to cardiologists,given its prominent cardiovascular symptoms.The diagnostic criteria for POTS include a sustained heart rate increase of more than 30 beats per minute upon standing or head-up tilt;symptoms of orthostatic intolerance lasting at least 3 months;and exclusion of other causes.The exact etiology of POTS is unknown,but mul-tiple possible etiologies leading to a similar clinical phenotype have been proposed.Early intervention and appropri-ate management can improve symptoms.Treatment strategies include lifestyle modifications,pharmacotherapy,and tailored conditioning programs.Non-pharmacologic options are the first line treatment.Prognosis varies widely:POTS can be a temporary condition for some individuals but a chronic and debilitating condition for others.Further research is necessary to elucidate the pathophysiology and optimize treatment strategies for this condition.
基金supported by Peking University Clinical Scientist Program (BMU2019LCKXJ001,Beijing)Fundamental Research Funds for the Central Universities of China.
文摘Vasovagal syncope(VVS) and postural tachycardia syndrome(POTS) are the main forms of orthostatic intolerance in pediatrics and both are underlying causes of neurally-mediated syncope.In recent years,increasing attention has been paid to the management of VVS and POTS in children and adolescents.A number of potential mechanisms are involved in their pathophysiology,but the leading cause of symptoms varies among patients.A few studies thus have focused on the individualized treatment of VVS or POTS based on selected hemodynamic parameters or biomarkers that can predict the therapeutic effect of certain therapies and improve their effectiveness.This review summarizes the latest developments in individualized treatment of VVS and POTS in children and indicates directions for further research in this field.
文摘Peripheral neuropathy(PN) is a multifarious disorder that is caused by damage to the peripheral nerves. Although the symptoms of PN vary with the etiology, most cases are characterized by impaired tactile and proprioceptive sensation that progresses in a distal to proximal manner. Balance also tends to deteriorate as the disorder becomes more severe, and those afflicted are substantially more likely to fall while walking compared with those who are healthy. Most patients with PN walk more cautiously and with greater stride variability than age-matched controls, but the majority of their falls occur when they must react to a perturbation such as a slippery or uneven surface. The purpose of this study was to first describe the role of somatosensory feedback in the control of posture and then discuss how that relationship is typically affected by the most common types of PN. A comprehensive review of the scientific literature was conducted using MEDLINE, and the relevant information was synthesized. The evidence indicates that the proprioceptive feedback that is conveyed primarily through larger type I afferents is important for postural control. However, the evidence indicates that the tactile feedback communicated through smaller type II afferents is particularly critical to the maintenance of balance. Many forms of PN often lead to chronic tactile desensitization in the soles of the feet and, although the central nervous system seems to adapt to this smaller type II afferent dysfunction by relying on more larger type I afferent reflex loops, the result is still decreased stability. We propose a model that is intended both to help explain the relationship between stability and the smaller type II afferent and the larger type I afferent feedback that may be impaired by PN and to assist in the development of pertinent rehabilitative interventions.
基金Supported by UFR STAPS of the University of Paris 11,France
文摘The control of balance is crucial for efficiently performing most of our daily motor tasks, such as those involving goal-directed arm movements or whole body displacement. The purpose of this article is twofold. Firstly, it is to recall how balance can be maintained despite the different sources of postural perturbation arising during voluntary movement. The importance of the so-called "anticipatory postural adjustments"(APA), taken as a "line of defence" against the destabilizing effect induced by a predicted perturbation, is emphasized. Secondly, it is to report the results of recent studies that questioned the adaptability of APA to various constraints imposed on the postural system. The postural constraints envisaged here are classified into biomechanical(postural stability, superimposition of motor tasks),(neuro) physiological(fatigue), temporal(time pressure) and psychological(fear of falling, emotion). Overall, the results of these studies point out the capacity of the central nervous system(CNS) to adapt the spatio-temporal features of APA to each of theseconstraints. However, it seems that, depending on the constraint, the "priority" of the CNS was focused on postural stability maintenance, on body protection and/or on maintenance of focal movement performance.
文摘Aircraft digital flexible assembly fixture and technologies are widely used in developed countries, while the traditional jig-based assembly mode is still used in China. The application study of aircraft digital flexible assembly system is just beginning in our country recently. To meet the requirements of automated posture alignment and join in digital assembly system for large aircraft components, a novel fitting fixture called 3-axis actuator is developed. On the basis of the actuators, three kinds of posture alignment system for large aircraft components are proposed, including the non-redundant system, the redundant actuating system, and the redundant leg system, and their constitutions and properties are introduced. Through deriving the feeding transmission stiffness model of single actuator and analyzing the inverse kinematics of these systems, the relationship between the external force and the changes of position and orientation of large aircraft component is obtained, and then the postural alignment stiffness models are established. With the method mentioned above, the postural alignment stiffness of three systems is computed by using the algebraic formulate, and the results show that redundant properties can increase system＇s postural alignment stiffness. As an example, a optimized layout of the assembly system for a given model of aircraft is developed, the results of application show that the layout has many advantages, such as high accuracy, stiffness, stability, reliability, efficiency and flexible, which can satisfy the requirement of aircraft digital assembly system well. The proposed study of postural alignment stiffness for different systems can supply the theoretic support for the optimization layout design of aircraft digital assembly system, and contribute to evaluate the system working performance of systems.
文摘Postural orthostatic tachycardia syndrome （POTS） has been recognized since at least 1940.A review of the literature identifies differences in the definition for this condition and wide variations in treatment and outcomes.This syndrome appears to describe a group of conditions with differing pathophysiology,which requires treatment tailored to the true underlying disorder.Patients need to be fully evaluated to guide treatment.Further research is required to effectively classify the range of underlying pathophysioiogy that can produce this syndrome and to guide optimal management.
文摘BACKGROUND Suspension training(SET)is a method of neuromuscular training that enables the body to carry out active training under unstable support through a suspension therapy system.However,there have been few reports in the literature on the application of SET to anterior cruciate ligament reconstruction(ACLR)patients.It is not clear what aspects of the patient's function are improved after SET.AIM To investigate the effect of SET on the neuromuscular function,postural control,and knee kinematics of patients after ACLR surgery.METHODS Forty participants were randomized to an SET group or a control group.The SET group subjects participated in a SET protocol over 6 wk.The control group subjects participated in a traditional training protocol over 6 wk.Isokinetic muscle strength of the quadriceps and hamstrings,static and dynamic posture stability test,and relative translation of the injured knee were assessed before and after training.RESULTS The relative peak torque of the quadriceps and hamstrings in both groups increased significantly(P<0.001),and the SET group increased by a higher percentage than those in the control group(quadriceps:P=0.004;hamstrings:P=0.011).After training,both groups showed significant improvements in static and dynamic posture stability(P<0.01),and the SET group had a greater change than the control group(P<0.05).No significant improvement on the relative translation of the injured knee was observed after training in either group(P>0.05).CONCLUSION Our findings show that SET promotes great responses in quadriceps and hamstring muscle strength and balance function in ACLR patients.
文摘This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants（20 stroke patients, 20 age-matched healthy participants） were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait. Changes in postural control parameters anteroposterior sway speed and total center of pressure distance differed significantly between the stroke and control groups. In addition, changes in gait kinematic parameters knee and ankle angles of initial contact differed significantly between stroke（paretic and non-paretic） and control groups. Muscle fatigue in the unaffected knee and ankle impaired postural control and debilitates kinematic movement of ipsilateral and contralateral lower limbs, and may place the fatigued stroke patients at greater risk for falls.
文摘Clinical disorders often are characterized by a breakdown in dynamical processes that contribute to the control of upright standing.Disruption to a large number of physiological processes operating at different time scales can lead to alterations in postural center of pressure(Co P)fluctuations.Multiscale entropy(MSE) has been used to identify differences in fluctuations of postural Co P time series between groups with and without known physiological impairments at multiple time scales.The purpose of this paper is to:1) review basic elements and current developments in entropy techniques used to assess physiological complexity;and 2) identify how MSE can provide insights into the complexity of physiological systems operating at multiple time scales that underlie the control of posture.We review and synthesize evidence from the literature providing support for MSE as a valuable tool to evaluate the breakdown in the physiological processes that accompany changes due to aging and disease in postural control.This evidence emerges from observed lower MSE values in individuals with multiple sclerosis,idiopathic scoliosis,and in older individuals with sensory impairments.Finally,we suggest some future applications of MSE that will allow for further insight into how physiological deficits impact the complexity of postural fluctuations;this information may improve the development and evaluation of new therapeutic interventions.
基金supported by the School of Podiatry of Marseille
文摘Background: Heavy backpacks are often used by soldiers and firefighters. Weight carrying could reduce the speed and efficiency in task completion by altering the foot sole sensitivity and postural control.Methods: In fifteen healthy subjects, we measured the changes in sensitivity to vibrations applied to the foot sole when standing upright or walking after load carrying(30% body weight). The participants were asked to judge different vibration amplitudes applied on the 2 nd or 5 th metatarsal head and the heel at two frequencies(25 and 150 Hz) to determine the vibration threshold and the global perceptual representation(Ψ)of the vibration amplitude(Φ)given by the Stevens power function(Ψ=k×Φ~n). Any increase in negative k value indicated a reduction in sensitivity to the lowest loads. Pedobarographic measurements, with computation of the center of pressure(COP) and its deviations, were performed during weight carrying.Results: The 25-Hz vibration threshold significantly increased after weight carrying when standing upright or walking.After standing with the added loads, the absolute negative k value increased for the 25 Hz frequency. After walking with the added loads, the k coefficient increased for the two vibration frequencies. Weight carrying significantly increased both the CoP surface and CoP lateral deviation.Conclusions: Our data show that weight carrying reduces the sensory pathways from the foot sole and accentuates the center of pressure deviations.
文摘There are data about the positive effect of rehabilitation with postural training in traumatic brain injury (TBI) patients. Brain mechanisms of functional recovery have been investigated insufficiently. In this study, functional recovery was examined in TBI patients with primary motor (20 patients) or higher mental impairment (10 patients)—post-traumatic Korsakov syndrome compared to healthy volunteers (n = 20). Integral clinical, stabilographic, and EEG approach was used as a tool for estimation of functional deficit in TBI patients before and after rehabilitation course. Specific alterations of stabilographic and EEG parameters were observed in TBI patients with primary motor or mental deficit before rehabilitation. Rehabilitation course with postural training improved recovery of all functions in both patient groups. To understand brain mechanisms of rehabilitation, we examined EEG findings during standing and postural task performance in healthy volunteers (n = 10). EEG coherence increase was marked for different spectral bands predominantly in the right hemisphere and more in alpha-2 and beta bands during postural task performance. These EEG findings were discussed in relation to rehabilitation effect on TBI patients and proved that postural training with visual feedback may provoke primary activation of the right hemisphere and can serve as a trigger for integration of cortical and subcortical structures and for recovery of motor and higher mental function in TBI patients.
文摘BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.
文摘Concussion,or mild traumatic brain injury,incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom.The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control.The current acute evaluation for concussion utilizes the subjective balance error scoring system(BESS) to assess postural control.While the sensitivity of the overall test battery is high,the sensitivity of the BESS is unacceptably low and,with repeat administration,is unable to accurately identify recovery.Sophisticated measures of postural control,utilizing traditional linear assessments,have identified impairments in postural control well beyond BESS recovery.Both assessments of quiet stance and gait have identified lingering impairments for at least 1 month post-concussion.Recently,the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy(Ap En).Ap En,most commonly in the medial-lateral plane,has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values;unfortunately these studies have not gone beyond the acute phase of recovery.One study has identified lingering deficits in postural control,utilizing Shannon and Renyi entropy metrics,which persist at least through clinical recovery and return to participation.Finally,limited evidence from two studies suggest that individuals with a previous history of a single concussion,even months or years prior,may display altered Ap En metrics.Overall,non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.
文摘Background:Athletes have been shown to exhibit better balance compared to non-athletes(NON).However,few studies have investigated how the surface on which athletes train affects the strategies adopted to maintain balance.Two distinct athlete groups who experience different types of sport-specific balance training are stable surface athletes(SSA) such as basketball players and those who train on unstable surfaces(USA) such as surfers.The purpose of this study was to investigate the effects of training surface on dynamic balance in athletes compared to NON.Methods:Eight NON,eight SSA,and eight USA performed five 20-s trials in each of five experimental conditions including a static condition and four dynamic conditions in which the support surface translated in the anteroposterior(AP) or mediolateral(ML) planes using positive or negative feedback paradigms.Approximate entropy(Ap En) and root mean square distance(RMS) of the center of pressure(Co P) were calculated for the AP and ML directions.Four 3 × 5(group × condition) repeated measures ANOVAs were used to determine significant effects of group and condition on variables of interest.Results:USA exhibited smaller Ap En values than SSA in the AP signals while no significant differences were observed in the ML Co P signals.Generally,the negative feedback conditions were associated with significantly greater RMS values than the positive feedback conditions.Conclusion:USA exhibit unique postural strategies compared to SSA.These unique strategies seemingly exhibit a direction-specific attribute and may be associated with divergent motor control strategies.
文摘Postural orthostatic tachycardia syndrome(POTS) is a relatively rare syndrome recognised since 1940. It is a heterogenous condition with orthostatic intolerance due to dysautonomia and is characterised by rise in heart rate above 30 bpm from base line or to more than 120 bpm within 5-10 min of standing with or without change in blood pressure which returns to base line on resuming supine position. This condition present with various disabling symptoms such as light headedness, near syncope, fatigue, nausea, vomiting, tremor, palpitations and mental clouding, etc. However there are no identifiable signs on clinical examination and patients are often diagnosed to have anxiety disorder. The condition predominantly affects young female between the ages of 15-50 but is rarely described in older people. We describe an older patient who developed POTS which recovered over 12 mo. Recognising this condition is important as there are treatment options available to alleviate the disabling symptoms.
文摘The purpose of this study was to investigate neuronal mechanisms active during the percep-tion of forward postural limits in a standing po-sition and to specify fall-related brain activity using optical functional near-infrared spectros-copy. The study group included six right-handed, healthy female volunteers (range: 19, 20 years). The optical imaging device comprised 16 opto-des designed to provide 24-channel recording of changes in hemoglobin oxygenation. We meas-ured the changes of oxygenated hemoglobin levels in the frontal region when subjects per-ceived reachability in a standing position. Com- pared with those in other regions, the oxygen-ated hemoglobin levels in the right frontal region compatible with the right prefrontal cortex sig-nificantly increased. This result suggests that brain activities in the right prefrontal cortex are related to perception of reachability. Overesti-mation of postural limits has been reported as one of the risk factor for falling. This overesti-mation might be induced by dysfunction in the prefrontal cortex, resulting in a failure to inhibit a motor program that would have caused a loss of balance in reaching. Activation of the right prefrontal cortex may be a key factor for pre-venting accidental falls in the elderly and in pa-tients with neurological disorders.
文摘Aim and Objective: To study musculoskeletal problems like musculoskeletal pain, postural deformity and nerve radiculopathy in women engaged in Papad making by clinical assessment. Methodology: A cross-sectional observational survey carried out at Shri. Mahila Gruh Udyog Lijjat Papad, Nandanvan, Nagpur (2014). 50 female subjects were selected for the study. After taking permission from factory in-charge, the survey was conducted at the factory site and subjects were explained about the study in details in language they can understand. Consent form was obtained by subjects to participate. Data were collected by interview and clinical examination of women engaged in this occupation, As per proforma of musculoskeletal examination. Result: Almost 37 subjects out of 50 complaints about low back pain as a chief complaint followed by neck pain in 34, thoracic kyphosis was more profound postural deviation seen in 10 subjects. Paraspinal and calf muscle spasm is more common. Radiating pain and numbness more in dominant hand suggestive of involvement of median nerve were confirmed by Upper Limb Traction Test [ULTT]. Discussion: Socioeconomic status greatly influences the working needs of women. Shri. Mahila Gruh Udyog Lijjat Papad factory provides a platform for Women Empowerment. Faulty posture adoption for longer duration during work gives rise to various musculoskeletal problems. Conclusion: 74% of the study population has low back pain as a chief musculoskeletal problem. 34% present with postural deviation and 82% belong to poor socioeconomic scale.
