Search Results (1,364)

This pilot study examines the relationship between pain intensity and trunk sitting postural control in 10 office workers with chronic spinal pain, using field-based real-time inertial sensors. Pain intensity was assessed with the Numeric Pain Rating Scale (NPRS) before and after work across three non-consecutive workdays, while postural control was evaluated through estimated center of pressure (COP) displacements. Linear and nonlinear metrics, including sway range, velocity, the Hurst exponent, and sample entropy, were derived from the estimated COP time series. Pearson correlation coefficients (r) and corresponding p-values were used to analyze the relationship between pain intensity and postural control. Significant correlations, though limited to specific metrics, were found (r = −0.860 to 0.855; p < 0.05), suggesting that higher pain intensity may be correlated with reduced postural variability. These findings provide preliminary insights into the potential link between pain intensity and postural control. Understanding trunk posture dynamics could inform the development of targeted ergonomic interventions to reduce musculoskeletal stress and improve sitting comfort in office environments. Full article

Background/Objectives: Traditional fusion leads to a loss of spine mobility across the fused vertebrae. Vertebral body tethering (VBT) was developed with the goal of increasing flexibility and maintaining some spinal mobility. However, it is not known if the additional mobility leads to significant functional improvement. This prospective motion analysis study evaluates functional outcomes, specifically gait stability, in pre-operative, post-fusion, and post-VBT patients by using postural perturbations on a treadmill. Methods: Overall, 79 subjects underwent a computer-controlled treadmill study with postural perturbations, which simulated trips and slips. The subjects were harnessed for safety. Overall, 21 subjects were healthy controls, 18 patients were at least one-year post-VBT, 15 patients were at least one-year post-fusion, and 25 were pre-operative scoliosis patients. Subject weight, height, and treadmill acceleration were recorded and used to determine anteroposterior single (ASSTs, PSSTs) and multiple (AMSTs, PMSTs) stepping thresholds to describe the maximum torque a patient could withstand before failing to recover from the simulated trip. Independent t-tests were run to compare groups under the advice of a master statistician with expertise in orthopedic surgery. Results: Pre-operative scoliosis patients had lower PSSTs than healthy controls (uncorrected p = 0.036). No significant differences were observed between pre-operative and post-operative groups for both fusion and VBT. There was no significant difference in ASST, AMST, or PMST between any of the groups. Conclusions: The lower PSST in pre-operative scoliosis patients compared to healthy controls may reflect impaired reactive balance and potentially increased fall risk. Interestingly, there was no significant difference in reactive balance measures between pre-operative and post-operative scoliosis patients or between post-fusion and post-VBT patients. Full article

Focal limb dystonias (FLDs) are abnormal postures and muscle contractions in an arm or leg that can occur in the setting of specific activities or without any stimulus. This pathology can have a profound impact on quality of life and potentially limit work in those whose dystonias are brought on by activities related to their occupations. Botulinum toxin (BoNT) is approved for use in the United States by the Food and Drug Administration for several indications, including cervical dystonia and blepharospasm, but not for FLD. Despite this limitation, BoNT is frequently used clinically for FLD, generally with individualized dosing based on patient need and clinician expertise. Various methods exist for targeting treatment to the specific affected muscles and assessing the benefit of treatment. Small clinical trials have demonstrated the efficacy of BoNT, but larger controlled studies are needed. Full article

As the end-effector of a humanoid robot, the dexterous hand plays a crucial role in the process of robot execution. However, due to the complicated and delicate structure of the human hand, it is difficult to replicate human hand functionality, balancing structural complexity, and cost. To address the problem, the article introduces the design and development of a multi-finger synergistic adaptive humanoid dexterous hand with underactuation flexible articulated fingers and integrated pressure sensors. The proposed hand achieves force feedback control, minimizes actuator use while enabling diverse grasping postures, and demonstrates the capability to handle everyday objects. It combines advanced bionics with innovative design to optimize flexibility, ease of manufacturing, and cost-effectiveness. Full article

Background/Objectives: As a representative anatomic ankle ligament repair technique, the Broström procedure continues to be modified to reach better clinical outcomes, superior mechanical stability, early rehabilitation, and minimal risk of recurrent instability. This study aimed to evaluate the intermediate-term clinical outcomes after the modified Broström procedure (MBP) with suture-tape augmentation for chronic lateral ankle instability. Methods: Ninety-four patients with chronic lateral ankle instability were followed for ≥3 years after MBP augmented with suture tape. The patient-reported clinical outcomes were evaluated with the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM). The changes in mechanical ankle stability were evaluated with physical examination and periodic stress radiography. The changes in static and dynamic postural control ability were assessed with the single-leg stance test and Biodex posturography. Results: FAOS and FAAM scores significantly improved from preoperative means of 52.6 and 54.2 points to 91.8 and 90.5 points at final follow-up, respectively (p < 0.001). Talar tilt angle and anterior talar translation significantly improved from preoperative means of 15.4° and 14.3 mm to 2.7° and 4.5 mm at final follow-up, respectively (p < 0.001). Two patients (2.1%) complained of a recurrence of mechanical and functional instability. One patient (1.1%) showed non-specific inflammation related to a suture tape. Balance retention time significantly improved from a preoperative mean of 3.7 to 6.4 s at final follow-up (p < 0.001), with a non-significant side-to-side difference. The overall stability index significantly improved from a preoperative mean of 3.7 to 1.9 at final follow-up (p < 0.001), with a significant side-to-side difference. Conclusions: The MBP augmented with suture tape appears to be an effective surgical technique for chronic lateral ankle instability. Through anatomic repair of attenuated ankle ligaments and suture-tape augmentation, this modified procedure can provide reliable stability and minimal risk of recurrent instability. In addition, static and dynamic postural control ability may be improved through continuous proprioceptive-oriented rehabilitation following surgery. Full article

Active patient participation in the rehabilitation process after stroke has been shown to accelerate neural remodeling. The control framework of rehabilitation robots should provide appropriate assistive forces to users. An assist-as-needed (AAN) control method is proposed to help users to move upper limbs in the workspace freely, and to control the exoskeleton to provide assistance. The method is based on zero moment control (ZMC), helping the user achieve robotic traction with minimal interaction force. Based on the posture of the upper arm and forearm, an AAN controller can modify assistive forces at two human–robot-interaction (HRI) points along the direction opposite to gravity. A shoulder motion prediction model is proposed to enable the exoskeleton to mimic the user’s upper limb natural movements. In order to improve the transparency during rehabilitation training, a nonlinear numerical friction model based on the Stribeck friction model is developed. A healthy adult male was recruited to perform various activities of daily living (ADL) tests to assess the effectiveness of the controllers. The experimental results show that the proposed ZMC controller has high HRI transparency and can control the exoskeleton to complete a wide range of upper limb movements, and the maximum interaction force and torque can be captured within −7.76 N and 4.58 Nm, respectively. The AAN controller can provide appropriate assistance in the desired direction, and the exoskeleton maintains kinematic synchronization with the user’s shoulder during shoulder girdle movement. Full article

Background: Mild traumatic brain injury (mTBI) in the pediatric population is a significant public health concern, often associated with persistent post-concussion symptoms, including postural instability. Current tools for assessing postural control, such as the Balance Error Scoring System (BESS), lack integration with objective metrics. Incorporating force plate sensors into BESS assessments may enhance diagnostic accuracy and support return-to-play or sports decisions. This study evaluates postural performance in children with mTBI compared to controls using an instrumented BESS and examines recovery trajectories after mTBI. Methods: This prospective, longitudinal study included 31 children with mTBI (12.01 ± 3.28 years, 20 females) and 31 controls (12.31 ± 3.27 years, 18 females). Postural control was assessed using an instrumented BESS protocol during standing on a ground reaction force plate at three timepoints: within 72 h post injury (T1), at two weeks (T2), and three months after trauma (T3). Posturographic parameters derived from the displacement of the center of pressure included the ellipse area, path length, and mean velocity in the anterior–posterior and medio–lateral directions. Symptom burden was monitored using the Post-Concussion Symptom Inventory (PCSI). Results: The BESS total scores did not differ significantly between the groups at any timepoint. A significant reduction in BESS errors over time was observed exclusively in the two-legged stance on a soft surface (p = 0.047). The instrumented BESS revealed higher body swaying in the mTBI group compared to controls, particularly under demanding conditions. Significant between-group differences were most frequently observed in single-leg soft surface (38% of comparisons) and two-legged soft surface stances (29%). In those cases, path length and mean velocity differed between groups, respectively. Ellipse area did not show significant differences across conditions. Conclusions: An instrumented BESS has the potential to enhance the detection of subtle postural deficits in pediatric mTBI patients. Specifically, more demanding conditions with altered sensory-proprioceptive input and path length as an outcome measure should be focused on. This study underscores the need for tailored and age-appropriate objective and quantitative balance assessments to improve diagnostic precision in pediatric mTBI populations. Full article

Traditional assessments of balance and postural control often face challenges related to accessibility, cost, subjectivity, and inter-rater reliability. With advancements in technology, smartphones equipped with inertial measurement units (IMUs) are emerging as a promising tool for assessing postural control, measuring both static and dynamic motion. This study aimed to develop and validate a novel smartphone application by comparing it with research-grade posturography instruments, including motion capture and force plate systems to establish construct- and criterion-related validity. Twenty-two participants completed the quiet stance under varying visual (eyes open—EO; eyes closed—EC) and surface (Firm vs. Foam) conditions, with data collected from the smartphone, force plate, and motion capture systems. Intraclass correlation coefficients (ICCs) and Pearson correlation coefficients assessed the reliability and validity for all outcome measures (sway area and sway velocity). The results demonstrated reliability, with strong validity between the devices. A repeated-measures ANOVA found no significant differences between the devices. Postural outcomes revealed the significant main effects of both the visual (EO vs. EC) and surface (Firm vs. Foam) conditions. In conclusion, the study demonstrated the validity, sensitivity, and accuracy of the custom-designed smartphone app, offering the potential for bridging the gap between at-home and clinical balance assessments. Full article

Background and objectives: Idiopathic scoliosis is a three-dimensional spinal deformity characterized by a lateral curvature exceeding 10 degrees in the frontal plane accompanied by vertebral rotation in the transverse plane. Despite extensive research on genetic and neurological factors, its etiology is uncertain. This prospective observational study aims to investigate the relation between the primitive reflexes, specifically, the asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and spinal Galant reflex (SGR), which play key roles in early motor development and postural control and the severity of idiopathic scoliosis (measured via the Cobb angle and the Nash–Moe rotational quota. Additionally, the study evaluated whether the retention of primitive reflexes correlates with increased progression risk over 12 months of conservative treatment. Materials and Methods: Our study cohort included 162 patients, aged 7–19 years, diagnosed with idiopathic scoliosis, who underwent clinical examination and assessment of retained primitive reflexes using standardized grading systems. Results: A total of 162 patients (95 girls, 67 boys; mean age: 12.73 ± 2.74 years) met the inclusion criteria. In 73.5% of the cases, scoliosis was detected, with the majority occurring in the dorsal region (40.1%). The mean initial Cobb angle was 13.49° ± 7.14°, with no significant change after 12 months of conservative treatment (p = 0.584). Nash–Moe rotation scores were 1 in 52.5% and 2 in 22% of the cases. Retention of the following primitive reflexes were identified at baseline: Moro (19.1%), ATNR (38.3%), STNR (44.4%), and GSR (27.8%). GSR retention significantly correlated with the Cobb angle (p = 0.011; R = 0.233). All the reflex scores decreased significantly after 12 months, but no correlation existed between the retained reflexes and scoliosis progression. Patients with a history of quadrupedal locomotion had significantly lower ATNR (p = 0.002), STNR (p < 0.001), and GSR (p = 0.017) retention. Conclusions: These findings suggest that primitive reflex testing could serve as an early screening tool in scoliosis risk stratification, being a cost-effective, non-invasive instrument for identifying at-risk children before clinically significant deformity develops. Full article

Objective: Mental fatigue (MF) induced by prolonged cognitive tasks poses significant risks to postural stability, yet its effects on multi-sensory integration remain poorly understood. Method: This study investigated how MF alters sensory reweighting and postural control in 27 healthy young males. A 45 min incongruent Stroop task was employed to induce MF, validated via subjective Visual Analog Scale (VAS) scores and psychomotor vigilance tests. Postural stability was assessed under four sensory perturbation conditions (O-H: no interference; C-H: visual occlusion; O-S: proprioceptive perturbation; C-S: combined perturbations) using a Kistler force platform. Center of pressure (COP) signals were analyzed through time-domain metrics, sample entropy (SampEn), and Discrete Wavelet Transform (DWT) to quantify energy distributions across sensory-related frequency bands (visual: 0–0.1 Hz; vestibular: 0.1–0.39 Hz; cerebellar: 0.39–1.56 Hz; proprioceptive: 1.56–6.25 Hz). Results: MF significantly reduced proprioceptive energy contributions (p < 0.05) while increasing vestibular reliance under O-S conditions (p < 0.05). Time-domain metrics showed no significant changes in COP velocity or displacement, but SampEn decreased under closed-eye conditions (p < 0.001), indicating reduced postural adaptability. DWT analysis highlighted MF’s interaction with visual occlusion, altering cerebellar and proprioceptive energy dynamics (p < 0.01). Conclusion: These findings demonstrate that MF disrupts proprioceptive integration, prompting compensatory shifts toward vestibular and cerebellar inputs. The integration of nonlinear entropy and frequency-domain analyses advances methodological frameworks for fatigue research, offering insights into real-time sensor-based fatigue monitoring and balance rehabilitation strategies. This study underscores the hierarchical interplay of sensory systems under cognitive load and provides empirical evidence for optimizing interventions in high-risk occupational and clinical settings. Full article

Daily activities require balance and control posture. A severe Acquired Brain Injury (sABI) disrupts movement organization, control and execution, affecting trunk control and balance. Trunk control therapy for difficult patients requires known and novel methods. This study analyzes how hunova^® robotic platform therapy affects sABI patients’ sitting balance and trunk control. Twenty-six sABI patients were randomized into the experimental group (HuG) that employed hunova^® for trunk control in addition to traditional therapy and the control group (CoG) that received only conventional rehabilitation. Clinical assessments were performed for trunk, balance, cognitive and motor performance, disability, autonomy, quality of life, and fatigue. Both static and dynamic sitting balance and trunk control were assessed with hunova^®. HuG and CoG were significant in intragroup analysis. Intergroup comparisons showed substantial differences in trunk control, affected side motor function, autonomy, quality of life, and fatigue. Only patients with HuG improved statistically in the instrumental assessment of trunk control and sitting balance. Between-group analysis showed that a statistically significant difference emerged in COP path and trunk movement. The study found effectiveness and adaptability of hunova^® for trunk control rehabilitation, showing improvement in static and dynamic trunk control, motor function, autonomy, quality of life and fatigue in sABI patients. Registration: NCT05280587. Full article

This study examines how the use of postural and mobility devices evolves in home environments for children with GMFCS IV cerebral palsy, focusing on parents’ perspectives on benefits, outcomes, and challenges. As children grow, changes in muscle strength, motor function, and daily activity demands necessitate adjustments in assistive devices to maintain mobility and postural support. Data from 10 parents, collected through descriptive statistics and qualitative interviews, covered device types, usage patterns, and family impacts across developmental stages from preschool to adulthood. Device needs shift significantly with growth, transitioning from early gait trainers and postural support devices to advanced mobility devices, such as power wheelchairs, which become essential in adulthood. Parents reported positive outcomes, including improved emotional well-being, social participation, and independent mobility, alongside reduced caregiving burdens. However, challenges persist, including financial constraints, frequent device replacements, and limited training for users and caregivers. These insights highlight the need for more adaptable device designs and enhanced family-centered support programs to better assist caregivers in managing device transitions. This study addresses a gap by exploring the real-world outcomes of home-based device use, providing data and parental insights to inform device design, clinical practices, and family-centered support programs. Future research should focus on enhancing device functionality, customization, and accessibility to improve quality of life and promote greater independence for individuals with cerebral palsy. Full article

The management of Parkinson’s disease (PD) has increasingly focused on innovative technologies, particularly virtual reality (VR), which has emerged as a significant tool for addressing neurological disorders. This bibliometric analysis summarizes current research trends and hotspots regarding VR applications in PD management. A comprehensive search of the Science Citation Index Expanded (SCIE) within the Web of Science Core Collection (WoSCC) identified 475 publications from 2000 to 2024. Key findings indicate a substantial increase in publication output, especially after 2013, driven by technological advancements and investments from major IT companies. Prominent research institutions and scholars from Australia, Israel, Italy, and Spain have led this field, exploring various VR applications for PD patients. The focus of VR therapy research has evolved from primarily addressing freezing of gait (FOG) to a broader range of functional impairments, including balance, postural control, upper limb motor, and cognitive function. This study provides valuable insights into the evolving landscape of clinical research on VR in PD management, highlighting global trends and potential areas for future investigation and application of VR therapies. Full article

Background: Whole-body vibration is a modality of exercise that uses high-frequency mechanical stimuli to enhance motor functions. Previous studies have demonstrated benefits of whole-body vibration in older adults. However, prolonged use of this modality of exercise may be detrimental to certain conditions. Objectives: to verify the acute effects of a single whole-body vibration session on mobility and postural control in community-dwelling older adults. Methods: In this two-arm, single-blind clinical trial, fifty-two participants were randomly allocated to either the experimental (subject to a single whole-body vibration session with a vibration amplitude of 2 mm and a frequency of 40 Hz) or placebo group. The exercise sessions were conducted using a tri-planar vibration platform. The tri-plane plates were adjusted to vibrate up and down, side to side, and front to back. The assessments included mobility and postural control tests. Repeated-measures analyses of variance were performed to examine the main effect of group (experimental vs. placebo), time (baseline vs. after the intervention), and group × time interaction effect. Significance was set at 5%. Results: Compared with the placebo group, participants who underwent whole-body vibration showed positive outcomes in terms of mobility (p = 0.014, effect size: 0.115). Contrastingly, no significant differences were observed between the groups in terms of postural control (p > 0.05). Conclusions: Benefits of a single whole-body vibration session were observed on mobility. Using whole-body vibration to improve postural control may require additional sessions. Contraindications typical of aging should be taken into account. Full article

As operational scenarios become more complex and task demands intensify, the requirements for the intelligence and automation of manipulators in industry are increasing. This work investigates the challenge of posture tracking control for hydraulic flexible manipulators by proposing a discrete-time integral terminal sliding mode predictive control (DITSMPC) method. First, the proposed method develops a second-order dynamic model of the manipulator using the Lagrangian dynamic strategy. Second, a discrete-time sliding mode control (SMC) law based on an adaptive switching term is designed to achieve high-precision tracking control of the system. Finally, to weaken the influence of SMC buffeting on the manipulator system, the predictive time domain function is integrated into the proposed SMC law, and the delay estimation of the unknown term in the manipulator system is carried out. The DITSMPC scheme is derived and its convergence is proven. Simulation experiments comparing the DITSMPC scheme with the classical discrete-time SMC method demonstrate that the proposed scheme results in smooth torque changes in each joint of the manipulator, with the integral of torque variations being $5.22\times {10}^3$. The trajectory tracking errors for each joint remain within ±0.0025 rad, all of which are smaller than those of the classical scheme. Full article