scholarly journals The effect of the type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) on the accuracy in identifying older adults with fall history

2020 ◽  
Vol 40 (02) ◽  
pp. 133-143
Author(s):  
Rumpa Boonsinsukh ◽  
Bodin Khumnonchai ◽  
Vitoon Saengsirisuwan ◽  
Nithinun Chaikeeree
Keyword(s):  
Roc Analysis ◽  
Postural Sway ◽  
Characteristic Curve ◽  
Composite Score ◽  
Cutoff Score ◽  
Clinical Test ◽  
Large Area ◽  
Sensory Interaction ◽  
Accurate Identification ◽  
Eyes Closed

Background: The type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) influences the accuracy with which elderly fallers are identified. Two types of foam are commonly used in practice: Airex and Neurocom foam. Objective: The aim of this study was to assess the accuracy with which elderly fallers can be identified when the Airex foam and Neurocom foam are used in the mCTSIB. Methods: One hundred eighty-four elderly participants with a mean age of 69 years were classified into faller and nonfaller groups based on their 12-month fall history. Balance stability was measured under four conditions of the mCTSIB for 120 s each: standing on a floor or a foam pad with their eyes open or eyes closed. The time needed to maintain stability was measured by a stopwatch, and postural sway characteristics were measured using an acceleration-based system. Comparisons between groups were performed by two-way mixed ANOVA. The accuracy of differentiating elderly fallers from nonfallers with different foam types was evaluated using receiver operating characteristic curve (ROC) analysis. The time to maintain stability under four conditions of the mCTSIB (composite score) and under two conditions on the foam (foam score) were used for the ROC analysis. Results: The results showed that the nonfallers required more time to maintain stability and had a smaller sway area than the fallers ([Formula: see text]). The foam led to a larger difference between groups, suggesting the use of foam in examining the risk of falls. The Airex and the Neurocom foam pads led to a large area under the curve (0.93 to 0.95) in identifying elderly fallers and nonfallers when the composite and foam scores were used. A cutoff score of 447/480 s for the composite score and 223/240 s for the foam score yielded a posttest accuracy of 88% to 89%, with a sensitivity of 0.80–0.92 and specificity of 0.88–0.95. Conclusion: In conclusion, Airex and Neurocom foam can be used interchangeably with guidance in the mCTSIB, as they led to the accurate identification of elderly fallers among older persons who could walk and live independently in the community.

scholarly journals Investigation of Balance in Old People Residing in Nursing Homes Using Clinical Assessments

2020 ◽  
Vol 3 (1) ◽  
pp. 11-16
Author(s):  
Sogol Zeinali ◽  
◽  
Zahra Olyaei ◽  
Benyamin Kor ◽  
Maryam Binesh ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Postural Sway ◽  
Age Groups ◽  
Clinical Test ◽  
Old People ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Clinical Assessments ◽  
Eyes Closed ◽  
Eyes Open

Background and Objectives: Balance problems are the main cause of falls and fall-related complications in the elderly. The objective of this study was to investigate the balance in old people residing in nursing homes using clinical assessments. Methods: A total of 54 people participated in this cross-sectional study. Timed Up and Go (TUG) was used to assess balance regarding mobility impairments. The modified Clinical Test Of Sensory Interaction on Balance (CTSIB) was also used to assess balance regarding sensory problems. This test was used in 4 conditions: standing with eyes open on a firm surface, standing with eyes closed on a firm surface, standing with eyes open on a compliant foam, and standing with eyes closed on a compliant foam. Data analysis was done by SPSS V. 18 software. Results: The mean time for the completion of TUG was significantly higher than standard scores in all age groups (P<0.05). Postural sway during standing with eyes closed on the ground, eyes open and eyes closed on the foam was more than standing with eyes open on the ground (P<0.001). Postural sway in standing with eyes closed on the foam was more in comparison with standing with eyes closed on the ground and eyes open on the foam (P<0.001). Conclusion: Elderly people living in nursing homes had poorer motor skills to maintain balance. They also showed greater dependence on visual and sensory systems to maintain balance.

scholarly journals Influence of gender on static balance in healthy community dwelling elderly: a comparison using posturography

2020 ◽  
Vol 8 (8) ◽  
pp. 2950
Author(s):  
Atiya A. Shaikh ◽  
Rutuja D. Joshi
Keyword(s):  
Community Dwelling ◽  
P Value ◽  
Static Balance ◽  
Clinical Test ◽  
Sensory Interaction ◽  
Male And Female ◽  
Eyes Closed ◽  
Healthy Elderly ◽  
Significant Difference ◽  
Eyes Open

Background: Background and need of study- Influence of gender on balance is still controversial. Previous researchers have done studies using traditional methods. These methods may fail to detect subtle changes in balance difference. A tool like posturography which is highly specific may help to for accurate assessment and hence precise conclusion. Aim was to compare balance scores of male and female elderly using modified Clinical Test of Sensory Interaction on Balance (CTSIB).Methods: There were 56 healthy elderly ambulating without an assistive device and free from any neurological and orthopedic problems were assessed for their balance abilities using mCTSIB of balance master(standing on firm surface with eyes open, with eyes closed, standing on foam surface with eyes open and with eyes closed). Sway velocity was assessed using Unpaired t test.Results: There was a no significant difference in scores of modified CTSIB between male and female elderly ( p value>0.005).Conclusions: Gender has no effect on static balance abilities between male and female elderly while performing modified clinical test of sensory interaction on balance.

scholarly journals Screening for Vestibular Disorders Using the Modified Clinical Test of Sensory Interaction and Balance and Tandem Walking With Eyes Closed

2019 ◽  
Vol 40 (5) ◽  
pp. 658-665 ◽  
Author(s):  
Helen S. Cohen ◽  
Ajitkumar P. Mulavara ◽  
Jasmine Stitz ◽  
Haleh Sangi-Haghpeykar ◽  
Susan P. Williams ◽  
...  
Keyword(s):  
Clinical Test ◽  
Vestibular Disorders ◽  
Sensory Interaction ◽  
Eyes Closed

scholarly journals Quantifying Postural Control in Premanifest and Manifest Huntington Disease Using Wearable Sensors

2020 ◽  
Vol 34 (9) ◽  
pp. 771-783
Author(s):  
Franchino Porciuncula ◽  
Paula Wasserman ◽  
Karen S. Marder ◽  
Ashwini K. Rao
Keyword(s):  
Postural Control ◽  
Huntington Disease ◽  
Postural Sway ◽  
Wearable Sensors ◽  
Clinical Test ◽  
Significant Deterioration ◽  
Gaze Fixation ◽  
Eyes Closed ◽  
Sensory Attenuation ◽  
Sensory Enhancement

Background. Impairments in postural control in Huntington disease (HD) have important consequences for daily functioning. This observational study systematically examined baseline postural control and the effect of sensory attenuation and sensory enhancement on postural control across the spectrum of HD. Methods. Participants (n = 39) included healthy controls and individuals in premanifest (pHD) and manifest stages (mHD) of HD. Using wearable sensors, postural control was assessed according to (1) postural set (sit vs stand), (2) sensory attenuation using clinical test of sensory integration, and (3) sensory enhancement with gaze fixation. Outcomes included sway smoothness, amplitude, and frequency. Results. Based on postural set, pHD reduced postural sway in sitting relative to standing, whereas mHD had pronounced sway in standing and sitting, highlighting a baseline postural deficit. During sensory attenuation, postural control in pHD deteriorated relative to controls when proprioceptive demands were high (eyes closed on foam), whereas mHD had significant deterioration of postural control when proprioception was attenuated (eyes open and closed on foam). Finally, gaze fixation improved sway smoothness, amplitude, and frequency in pHD; however, no benefit was observed in mHD. Conclusions. Systematic examination of postural control revealed a fundamental postural deficit in mHD, which further deteriorates when proprioception is challenged. Meanwhile, postural deficits in pHD are detectable when proprioceptive challenge is high. Sensory enhancing strategies using gaze fixation to benefit posture may be useful when introduced well before motor diagnosis. These findings encourage further examination of wearable sensors as part of routine clinical assessments in HD.

scholarly journals Quantitative Assessment of the Echogenicity of a Breast Tumor Predicts the Response to Neoadjuvant Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3546
Author(s):  
Katarzyna Sylwia Dobruch-Sobczak ◽  
Hanna Piotrzkowska-Wróblewska ◽  
Piotr Karwat ◽  
Ziemowit Klimonda ◽  
Ewa Markiewicz-Grodzicka ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Treatment Response ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Quantitative Measure ◽  
Malignant Cell ◽  
Breast Cancer Patients ◽  
The Third ◽  
Leibler Divergence

The aim of the study was to improve monitoring the treatment response in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). The IRB approved this prospective study. Ultrasound examinations were performed prior to treatment and 7 days after four consecutive NAC cycles. Residual malignant cell (RMC) measurement at surgery was the standard of reference. Alteration in B-mode ultrasound (tumor echogenicity and volume) and the Kullback-Leibler divergence (kld), as a quantitative measure of amplitude difference, were used. Correlations of these parameters with RMC were assessed and Receiver Operating Characteristic curve (ROC) analysis was performed. Thirty-nine patients (mean age 57 y.) with 50 tumors were included. There was a significant correlation between RMC and changes in quantitative parameters (KLD) after the second, third and fourth course of NAC, and alteration in echogenicity after the third and fourth course. Multivariate analysis of the echogenicity and KLD after the third NAC course revealed a sensitivity of 91%, specificity of 92%, PPV = 77%, NPV = 97%, accuracy = 91%, and AUC of 0.92 for non-responding tumors (RMC ≥ 70%). In conclusion, monitoring the echogenicity and KLD parameters made it possible to accurately predict the treatment response from the second course of NAC.

scholarly journals Serum Extracellular Vesicle-Derived circHIPK3 and circSMARCA5 Are Two Novel Diagnostic Biomarkers for Glioblastoma Multiforme

2021 ◽  
Vol 14 (7) ◽  
pp. 618
Author(s):  
Michele Stella ◽  
Luca Falzone ◽  
Angela Caponnetto ◽  
Giuseppe Gattuso ◽  
Cristina Barbagallo ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Roc Analysis ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Digital Pcr ◽  
Extracellular Vesicle ◽  
Size Exclusion ◽  
Circular Rnas ◽  
Diagnostic Biomarkers ◽  
Exclusion Chromatography

Glioblastoma multiforme (GBM) is the most frequent and deadly human brain cancer. Early diagnosis through non-invasive biomarkers may render GBM more easily treatable, improving the prognosis of this currently incurable disease. We suggest the use of serum extracellular vesicle (sEV)-derived circular RNAs (circRNAs) as highly stable minimally invasive diagnostic biomarkers for GBM diagnosis. EVs were isolated by size exclusion chromatography from sera of 23 GBM and 5 grade 3 glioma (GIII) patients, and 10 unaffected controls (UC). The expression of two candidate circRNAs (circSMARCA5 and circHIPK3) was assayed by droplet digital PCR. CircSMARCA5 and circHIPK3 were significantly less abundant in sEVs from GBM patients with respect to UC (fold-change (FC) of −2.15 and −1.92, respectively) and GIII (FC of −1.75 and −1.4, respectively). Receiver operating characteristic curve (ROC) analysis, based on the expression of sEV-derived circSMARCA5 and circHIPK3, allowed us to distinguish GBM from UC (area under the curve (AUC) 0.823 (0.667–0.979) and 0.855 (0.704 to 1.000), with a 95% confidence interval (CI), respectively). Multivariable ROC analysis, performed by combining the expression of sEV-derived circSMARCA5 and circHIPK3 with preoperative neutrophil to lymphocyte (NLR), platelet to lymphocyte (PLR) and lymphocyte to monocyte (LMR) ratios, three known diagnostic and prognostic GBM markers, allowed an improvement in the GBM diagnostic accuracy (AUC 0.901 (0.7912 to 1.000), 95% CI). Our data suggest sEV-derived circSMARCA5 and circHIPK3 as good diagnostic biomarkers for GBM, especially when associated with preoperative NLR, PLR and LMR.

scholarly journals Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Niklas Sörlén ◽  
Andreas Hult ◽  
Peter Nordström ◽  
Anna Nordström ◽  
Jonas Johansson
Keyword(s):  
Older Adults ◽  
Postural Sway ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Eyes Closed ◽  
Balance Exercise

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.

Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

2020 ◽  
Vol 49 (6) ◽  
pp. 611-616
Author(s):  
Tarik Qassem ◽  
Mohamed S. Khater ◽  
Tamer Emara ◽  
Doha Rasheedy ◽  
Heba M. Tawfik ◽  
...  
Keyword(s):  
Screening Tool ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Receiver Operator Characteristic Curve ◽  
Cutoff Score ◽  
Arabic Speakers ◽  
Dementia Patients ◽  
Significant Difference ◽  
Sensitivity Specificity ◽  
Addenbrooke’S Cognitive Examination

<b><i>Background:</i></b> The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that assesses 5 subdomains of cognition (attention, memory, verbal fluency, visuospatial abilities, and memory recall). It is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. <b><i>Objectives:</i></b> We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. <b><i>Methods:</i></b> We included 37 patients with dementia (Alzheimer’s disease [<i>n</i> = 25], vascular dementia [<i>n</i> = 8], and dementia with Lewy body [<i>n</i> = 4]) and 43 controls. <b><i>Results:</i></b> There was a statistically significant difference (<i>p</i> &#x3c; 0.001) on the total m-ACE score between dementia patients (mean 10.54 and standard deviation [SD] 5.83) and controls (mean 24.02 and SD 2.75). There was also a statistically significant difference between dementia patients and controls on all sub-score domains of the m-ACE (<i>p</i> &#x3c; 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cutoff score for dementia on the m-ACE total score was found to be 18 (92% sensitivity, 95% specificity, and 94% accuracy). <b><i>Conclusions:</i></b> We adapted the m-ACE in Arabic speakers in Egypt and provided objective validation of it as a screening tool for dementia, with high sensitivity, specificity, and accuracy.

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