Physiotherapy - Research Publications
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ItemLow-cost evaluation and real-time feedback of static and dynamic weight bearing asymmetry in patients undergoing in-patient physiotherapy rehabilitation for neurological conditions(BMC, 2013-07-12)BACKGROUND: Weight bearing asymmetry is common in patients with neurological conditions, and recent advances in gaming technology have produced force platforms that are suitable for use in a clinical setting. The aim of this research is to determine whether commercially-available Wii Balance Boards with customized software providing real-time feedback could be used in a clinical setting to evaluate and improve weight-bearing asymmetry in people with various neurological conditions. METHODS: Twenty participants (age = 43.25 ± 19.37 years) receiving physiotherapy as a result of a neurological condition performed three trials each of two tasks (static standing and sit-to-stand) with and without visual feedback. Vertical forces were measured using available Wii Balance Boards coupled with customized software that displayed visual feedback in real-time. Primary outcome measures included weight-bearing asymmetry as a percentage of body mass, peak force symmetry index, and a visual analogue scale score rating self-perceived level of asymmetry. RESULTS: Weight-bearing asymmetry during the static balance task was significantly reduced (Z = -2.912, p = 0.004, ES = 0.65) with visual feedback. There was no significant difference (Z = -0.336, p = 0.737) with visual feedback for the dynamic task, however subgroup analysis indicated that those with higher weight-bearing asymmetry responded the most to feedback. Correlation analysis revealed little or no relationship between participant perception of weight-bearing asymmetry and the results for the static or dynamic balance task (Spearman's rho: ρ = 0.138, p = 0.561 and ρ = 0.018, ρ =0.940 respectively). CONCLUSIONS: These findings suggest that weight-bearing asymmetry can be reduced during static tasks in patients with neurological conditions using inexpensive commercially-available Wii Balance Boards coupled with customized visual feedback software. Further research is needed to determine whether real-time visual feedback is appropriate for reducing dynamic weight-bearing asymmetry, whether improvements result in improved physical function, and how cognitive and physical impairments influence the patient's ability to respond to treatment.
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ItemA pilot investigation using global positioning systems into the outdoor activity of people with severe traumatic brain injury(BMC, 2014-03-19)BACKGROUND: Little is known about the post-discharge outdoor activities of people who have incurred severe traumatic brain injury (TBI). This study used a body-worn global positioning system (GPS) device to determine the outdoor activity per day performed by this population. Additionally, this study examined the association that mobility, time since injury and injury severity had with levels of outdoor physical activity. FINDINGS: Seventeen people with TBI and 15 control subjects wore a GPS device for between 3-7 days to monitor their outdoor activity. Based on the individual's location and speed of movement the outdoor physical activity in minutes per day was derived. Assessments of duration of outdoor activity between groups, and the relationship that duration of outdoor activity had with results on the high-level mobility assessment tool, length of post-traumatic amnesia, and time since injury were performed. No significant (p = 0.153, effect size = 0.26) difference in time spent in outdoor physical activity was observed between the TBI (median[IQR] = 19[3-43]mins) and control (median[IQR] = 50[18-65]mins) group. Interestingly, 35% of TBI subjects performed <10 mins of outdoor activity per day compared to 13% of the control group. The TBI group also recorded three of the four highest values for outdoor physical activity. Higher levels of mobility were associated with more outdoor activity (Spearman's rho = 0.443, p = 0.038). No other significant associations were observed. CONCLUSIONS: While preliminary, our results indicate that a sub-group of people with TBI exists who restrict their outdoor activities. GPS has potential as an activity tracking tool, with implications for rehabilitation and exercise prescription.