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Get a perfect balance assessment

Total Balance PRO

We created a new approach to balance assessment: Total Balance Pro

1- The motive behind

As we explained before in one of our articles, balance is the ability to maintain the body’s center of mass over its base of support. Balance is achieved and maintained by a complex set of sensorimotor control systems that include sensory input from vision (sight), proprioception (touch), and the vestibular system (motion, equilibrium, spatial orientation); integration of that sensory input; and motor output to the eye and body muscles.

There are different protocols/tests to measure different aspects of the balance system, such as the well-known Clinical Test of Sensory Interaction in Balance, the Limits of Stability, or the One Leg Standing test.

Although these protocols allow to gather important information about the patient’s sway, postural stability, or movement control, we felt it was important to create a new feature that could present all the parameters at once in one chart, so as to quickly analyze several characteristics of the balance. Thus, we combine three protocols – the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), the Limits of Stability (LOS) and the Sit-to-Stand (STS), to analyze the patient balance through six categories:

proprioception,

vestibular & visual input,

postural stability,

lower limb strength,

reflexes & reaction time

motor control.

We named this combination Total Balance Pro. This new protocol can be done in about seven minutes!

Why those protocols?

The mCTSIB protocol is a postural sway test to measure the influence of sensory input in balance. It has four conditions: (1) stand on firm surface with eyes open; (2) stand on firm surface with eyes closed; (3) stand on unstable surface (foam) with eyes open; and (4) stand on unstable surface (foam) with eyes closed. This test indicates if the patient has difficulty incorporating visual, somatosensory or vestibular information in balance control, depending on the condition(s) with higher values of sway velocity.

The LOS protocol quantifies the patent ability to intentionally displace its centre of gravity (CoG), without losing balance, to eight directions: front, front/right, right, back/right, back, back/left, left and front/left. This allows the measure of reaction time, movement velocity, first distance reached (endpoint excursion), maximum excursion and directional control. Those parameters are important as limited capacity for CoG displacement can be correlated with lower extremities strength, range of motion, or other musculoskeletal impairments. Moreover, poor directional control is an indicator of motor control abnormalities.

At last, the STS protocol measures the ability of the patient to lift from a sitting position to a standing position as quickly as possible on three 15-seconds trials. Rising from a seated to a standing position is influenced by a number of musculoskeletal, movement control, and balance factors. The rising maneuver also depends on adequate lower extremity and trunk strength, and range of motion. Thus, the percentage of body weight used (rising index), weight time transfer and left/right symmetry are measured during this movement.

In this way it is possible to analyze the different parameters of the three protocols, compare them with their age normative values and combine them in one radar chart with the six categories mentioned.

Results

After performing the three protocols, a radar chart is displayed with the six categories – proprioception, vestibular & visual input, postural stability, lower limb strength, reflexes & reaction time and motor control. The value of each category corresponds to the weighted average of the parameters results in relation to their normative values. In which a value of 100% indicates that all the parameter results in this category are within the normative values. The scale of the chart is inverted (100% in middle) so as to quickly present the categories that need intervention.

In addition, the software has the option to export the radar chart and a detailed result section with all the parameters calculated to a clinical report, in which a description of each category and some clinical considerations are presented for the health professional.

This protocol is available in the new version of PhysioSensing Balance 21 with the pressure plate. Ask us for a quotation!

Details

  • Coimbra, Portugal
  • Claudia Tonelo