Acta Gymnica, 2015 (vol. 45), issue 2

Acta Gymnica 2015, 45(2):85-92 | DOI: 10.5507/ag.2015.008

Trajectory length of pitch vs. roll: Technique for assessment of postural stability

Patrik Kutílek1, Vladimír Socha1, Ondřej Čakrt1,2, Jakub Schlenker1, Lucia Bizovská3
1 Faculty of Biomedical Engineering, Czech Technical University, Prague, Czech Republic
2 University Hospital Motol - 2nd Faculty of Medicine, Charles University, Prague, Czech Republic;
3 Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic

Background: Patients with disorders of nervous or musculoskeletal system often show instability of the body segments during the stance tasks. Traditionally, stabilometric platforms are used to measure body sway. However, these devices are expensive and do not allow the evaluation of the individual movements of body segments. At present, accelerometers or gyroscopes are used to measure the movements of the body segments. For these new motion capture (MoCap) systems, methods for quantitative evaluation of a body segment movement are being developed.

Objective: The main objective of this paper is to describe a new method which would be suitable for quantifying postural stability and identifying differences in balance control using data recorded by an inexpensive 2-DoF gyroscope.

Methods: Method based on total length of trajectory (TL) in a 2-D plot of angles was proposed for quantitative evaluation of the trunk and feet sway. The sway was measured during quiet stance of ten middle-aged patients (Pts) with degenerative cerebellar disorder and eleven young healthy subjects (HS) standing with eyes open (EO) on a firm surface (FiS) and eyes closed (EC) on a foam surface (FoS). Data were obtained using three gyroscopes (Xsens) to measure roll and pitch angular movements of the trunk, and left and right foot. The pitch versus roll plots of the trunk and feet were created and the trajectory lengths of the pitch vs. roll angle were calculated.

Results: Although the results vary while measuring different segments of the body, the method showed significant differences between the two different groups. Significant differences between the HS and Pts were found in EO standing on a FiS for TLs of the trunk (p = .02) and TLs of the feet (p < .01). Similarly in EC standing on a FoS significant differences (p < .01) between groups were found for TLs of both the trunk and the feet (p < .01).

Conclusions: It was found that the TL of pitch vs. roll is suitable for quantifying postural sway and identifying differences in balance control. The technique, based on the length of the pitch angle vs. roll angle trajectory can be used even where MoCap systems can only measure two sway angles which could extend the clinical information of the body sway.

Keywords: trunk sway, feet sway, postural stability, length of trajectory, pitch vs. roll, cerebellar disorder

Accepted: May 26, 2015; Prepublished online: June 26, 2015; Published: June 30, 2015

Download citation

References

  1. Abrahámová, D., & Hlavačka, F. (2008). Age-related changes of human balance during quiet stance. Physiological Research, 57, 957-964. Go to PubMed...
  2. Adkin, A. L., Bloem, B. R., & Allum, J. H. J. (2001). Trunk sway measurements during stance and gait tasks in Parkinson's disease. Gait & Posture, 22, 240-249. Go to original source...
  3. Allum, J. H. J., Adkin, A. L., Carpenter, M. G., Held-Ziolkowska, M., Honegger, F., & Pierchala, K. (2001). Trunk sway measures of postural stability during clinical balance tests: Effects of a unilateral vestibular deficit. Gait & Posture, 14, 227-237. Go to original source...
  4. Aoki, H., Demura, S., Kawabata, H., Sugiura, H., Uchida, Y., Xu, N., & Murase, H. (2012). Evaluating the effects of open/closed eyes and age-related differences on center of foot pressure sway during stepping at a set tempo. Advances in Aging Research, 1, 72-77. Go to original source...
  5. Blackburn, J. T., Riemann, B. L., Myers, J. B., & Lephart, S. M. (2003). Kinematic analysis of the hip and trunk during bilateral stance on firm, foam, and multiaxial support surfaces. Clinical Biomechanics, 18, 655-661. Go to original source... Go to PubMed...
  6. Čakrt, O., Vyhnálek, M., Slabý, K., Funda, T., Vuillerme, N., Kolář, P., & Jeřábek, J. (2012). Balance rehabilitation therapy by tongue electrotactile biofeedback in patientswith degenerative cerebellar disease. NeuroRehabilitation, 31, 429-434. Go to PubMed...
  7. Choy, N. L., Brauer, S., & Nitz, J. (2003). Changes in postural stability in women aged 20 to 80 years. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 58, M525-M530. Go to original source...
  8. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.
  9. Coolican, H. (2009). Research methods and statistics in psychology. London: Hodder & Stoughton Publisher.
  10. Cutti, A. G., Ferrari, A., Garofalo, P., Raggi, M., Cappello, A., & Ferrari, A. (2010). 'Outwalk': A protocol for clinical gait analysis based on inertial and magnetic sensors. Medical & Biological Engineering & Computing, 48, 17-25. Go to original source... Go to PubMed...
  11. Deza, M. M., & Deza, E. (2013). Encyclopedia of distances. Berlin: Springer-Verlag. Go to original source...
  12. Diener, H. C., Dichgans, J., Bacher, M., & Gompf, B. (1984). Quantification of postural sway in normals and patients with cerebellar diseases. Electroencephalography and Clinical Neurophysiology, 57, 134-142. Go to original source... Go to PubMed...
  13. Donath, L., Roth, R., Zahner, L., & Faude, O. (2012). Testing single and double limb standing balance performance: Comparison of CoP path length evaluation between two devices. Gait & Posture, 36, 439-443. Go to original source...
  14. Duclos, C., Nadeau, S., & Lecours, J. (2008). Lateral trunk displacement and stability during sit-to-stand transfer in relation to foot placement in patients with hemiparesis. Neurorehabilitation and Neural Repair, 6, 715-722. Go to original source... Go to PubMed...
  15. Findling, O., Sellner, J., Meier, N., Allum, J. H. J., Vibert, D., Lienert, C., & Mattle, H. P. (2011). Trunk sway in mildly disabled multiple sclerosis patients with and without balance impairment. Experimental Brain Research, 213, 363-370. Go to original source... Go to PubMed...
  16. Fritz, C. O., Morris, P. E., & Richler, J. J. (2012). Effect size estimates: Current use, calculations, and interpretation. Journal of Experimental Psychology: General, 141, 2-18. Go to original source... Go to PubMed...
  17. Gill, J., Allum, J. H., Carpenter, M. G., Held-Ziolkowska, M., Adkin, A. L., Honegger, F., & Pierchala, K. (2001). Trunk sway measures of postural stability during clinical balance tests: Effects of age. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56, M438-M447. Go to original source...
  18. Harbourne, R. T., Willett, S., Kyvelidou, A., Deffeyes, J., & Stergiou, N. (2010). A comparison of interventions for children with cerebral palsy to improve sitting postural control: A clinical trial. Physical Therapy, 90, 1881-1898. Go to original source... Go to PubMed...
  19. Honegger, F., Hillebrandt, I., Elzen, N., Tang, K., & Allum, J. H. J. (2013). The effect of prosthetic feedback on the strategies and synergies used by vestibular loss subjects to control stance. Journal of NeuroEngineering and Rehabilitation, 115, 1-11. Go to original source... Go to PubMed...
  20. Hong, S. L., Manor B., & Li, L. (2007). Stance and sensory feedback influence on postural dynamics. Neuroscience Letters, 423, 104-108. Go to original source... Go to PubMed...
  21. Horak, F. B., & Hlavacka, F. (2001). Somatosensory loss increases vestibulospinal sensitivity. Journal of Neurophysiology, 86, 575-585. Go to PubMed...
  22. Horlings, C. G. C., Carpenter, M. G., Honegger, F., & Allum, J. H. J. (2009). Vestibular and proprioceptive contributions to human balance corrections: Aiding these with prosthetic feedback. Annals of the New York Academy of Sciences, 1164, 1-12. Go to original source... Go to PubMed...
  23. Horlings, C. G. C., Küng, U. M., Bloem, B. R., Honegger, F., Van Alfen, N., Van Engelen, B. G. M., & Allum, J. H. J. (2008). Identifying deficits in balance control following vestibular or proprioceptive loss using posturographic analysis of stance tasks. Clinical Neurophysiology, 119, 2338-2346. Go to original source... Go to PubMed...
  24. Hwang, I. S., Huang, C. T., Cherng, R. J., & Huang, C. C. (2006). Postural fluctuations during pointing from a unilateral or bilateral stance. Human Movement Science, 25, 275-291. Go to original source... Go to PubMed...
  25. Kalman, R. E. (1960). A new approach to linear filtering and prediction problems. Journal of Basic Engineering, 82, 35-45. Go to original source...
  26. Kammermeier, S., Kleine, J. F., Eggert, T., Krafczyk, S., & Büttner, U. (2013). Disturbed vestibular-neck interaction in cerebellar disease. Journal of Neurology, 260, 794-804. Go to original source... Go to PubMed...
  27. Kim, G., Ferdjallah, M., & Harris, G. F. (2009). Fast computational analysis of sway area using center of pressure data in normal children and children with cerebral palsy. American Journal of Biomedical Sciences, 1, 364-372. Go to original source...
  28. Lucy, S. D., & Hayes, K. C. (1985). Postural sway profiles, normal subjects and subjects with cerebellar ataxia. Physiotherapy Canada, 37, 140-148.
  29. Luinge, H. J. (2002). Inertial sensing of human movement. Enschede, Netherlands: Twente University Press.
  30. Morris, M. E. (2000). Movement disorders in people with Parkinson disease: A model for physical therapy. Physical Therapy, 80, 578-597. Go to PubMed...
  31. Ochi, F., Abe, K., Ishigami, S., Orsu, K., & Tomita, H. (1997). Trunk motion analysis in walking using gyro sensors. In R. J. Jaeger (Ed.), Proceedings of the 19th Annual International Conference of the IEEE: Engineering in Medicine and Biology Society (pp. 1824-1825). Chicago, IL: IEEE.
  32. Oliveira, L. F., Simpson, D. M., & Nadal, J. (1996). Calculation of area of stabilometric signals using principal component analysis. Physiological Measurement, 17, 305-312. Go to original source... Go to PubMed...
  33. Patel, M., Fransson, P. A., Lush, D., & Gomez, S. (2008). The effect of foam surface properties on postural stability assessment while standing. Gait & Posture, 28, 649-656. Go to original source...
  34. Raymakers, J. A., Samson, M. M., & Verhaar, H. J. J. (2005). The assessment of body sway and the choice of the stability parameter(s). Gait & Posture, 21, 48-58. Go to original source...
  35. Rossi-Izquierdo, M., Ernst, A., Soto-Varela, A., Santos-Pérez, S., Faraldo-García, A., Sesar-Ignacio, A., & Basta, D. (2013). Vibrotactile neurofeedback balance training in patients with Parkinson's disease: Reducing the number of falls. Gait & Posture, 37, 195-200. Go to original source...
  36. Stins, J. F., Ledebt, A., Emck, C., Dokkum, E. H., & Beek, P. J. (2009). Patterns of postural sway in high anxious children. Behavioral and Brain Functions, 5, 42. Go to original source... Go to PubMed...
  37. Teranishi, T., Kondo, I., Sonoda, S., Wada, Y., Miyasaka, H., Tanino, G., … Saitoh, E. (2011). Validity study of the standing test for imbalance and disequilibrium (SIDE): Is the amount of body sway in adopted postures consistent with item order? Gait & Posture, 34, 295-299. Go to original source...
  38. Tia, T., Saimpont, A., Paizis, C., Mourey, F., Fadiga, L., & Pozzo, T. (2011). Does observation of postural imbalance induce a postural reaction? PLoS One, 6, Article ID e17799.
  39. Vaz Garcia, F. (2009). Disequilibrium and its management in elderly patients. International Tinnitus Journal, 15, 83-90. Go to PubMed...
  40. Warrenburg, B. P. C., Bakker, M., Kremer, B. P. H., Bloem, B. R., & Allum, J. H. J. (2005). Trunk sway in patients with spinocerebellar ataxia. Movement Disorders, 20, 1006-1013. Go to original source... Go to PubMed...