Postural control deficits in people with fibromyalgia: a pilot study

PubMed Central

2011-01-01

Introduction Postural instability and falls are increasingly recognized problems in patients with fibromyalgia (FM). The purpose of this study was to determine whether FM patients, compared to age-matched healthy controls (HCs), have differences in dynamic posturography, including sensory, motor, and limits of stability. We further sought to determine whether postural instability is associated with strength, proprioception and lower-extremity myofascial trigger points (MTPs); FM symptoms and physical function; dyscognition; balance confidence; and medication use. Last, we evaluated self-reported of falls over the past six months. Methods In this cross-sectional study, we compared middle-aged FM patients and age-matched HCs who underwent computerized dynamic posturography testing and completed the Fibromyalgia Impact Questionnaire-Revised (FIQR) and balance and fall questionnaires. All subjects underwent a neurological and musculoskeletal examination. Descriptive statistics were used to characterize the sample and explore the relationships between variables. The relationships between subjective, clinical and objective variables were evaluated by correlation and regression analyses. Results Twenty-five FM patients and twenty-seven HCs (combined mean age ± standard deviation (SD): 48.6 ± 9.7 years) completed testing. FM patients scored statistically lower on composite sensory organization tests (primary outcome; P < 0.010), as well as with regard to vestibular, visual and somatosensory ratio scores on dynamic posturography. Balance confidence was significantly different between groups, with FM patients reporting less confidence than HCs (mean ± SD: 81.24 ± 19.52 vs. 98.52 ± 2.45; P < 0.001). Interestingly, 76% to 84% of FM patients had gastrocnemius and/or anterior tibialis MTPs. Postural stability was best predicted by dyscognition, FIQR score and body mass index. Regarding falls, 3 (11%) of 27 HCs had fallen only once during the past 6 months, whereas 18 (72%) of 25 FM patients had fallen at least once. Fifteen FM patients (60%) reported falling at least three times in the past six months. Conclusions In this study, we report that middle-aged FM patients have consistent objective sensory deficits on dynamic posturography, despite having a normal clinical neurological examination. Further study is needed to determine prospective fall rates and the significance of lower-extremity MTPs. The development of interventions to improve balance and reduce falls in FM patients may need to combine balance training with exercise and cognitive training. PMID:21810264

Effects of Learning on Performance When Computerized Dynamic Posturography Assessments Are Repeated

NASA Technical Reports Server (NTRS)

Taylor, Laura C.; Paloski, William H.; Wood, Scott J.

2008-01-01

Background: Computerized dynamic posturography is widely used to measure balance control performance. Clinically, performance is assessed by comparing individual data against standards obtained from a normative population. When performing repeated assessments to track performance changes, one must be concerned with the influence of learning effects. Subjects do not have the opportunity to practice before the first session, and often a second session is not performed prior to an experiment. Thus, the objective of this activity was to examine learning effects on balance control performance. We hypothesize that subjects will perform better on the second session when compared to the first, and that the difference will be greater for more difficult conditions. Methods: Data were collected from 204 subjects using the NeuroCom Equitest system during quiet stance with arms crossed at the chest on up to two sessions. All subjects performed standard sensory organization tests (SOTs) including 1) normal vision, fixed support; 2) absent vision, fixed support; 3) sway-referenced vision, fixed support; 4) normal vision, swayreferenced support; 5) absent vision, sway-referenced support; and 6) sway-referenced vision, sway-referenced support. 120 of these subjects performed modified sensory organization tests (mSOTs 2 and 5) which included static (20 back) and dynamic (20, 0.33Hz) head tilts. Median equilibrium scores (mEQ) were calculated from peak-to-peak anterior-posterior sway across trials. Data collected on the first session were then compared with the second to examine learning effect. Results: There were no differences in mEQ scores between the first and second sessions for SOTs 1, 2, and 4, while mEQ scores were higher for the second session when compared to the first for SOTs 3, 5, and 6 and for all mSOTs. Discussion: An additional familiarization session or practice trials prior to the first session may be necessary for more challenging SOT and mSOT conditions to minimize learning effect.

Balance as a measurement of fatigue in postcall residents.

PubMed

Cuthbertson, David W; Bershad, Eric M; Sangi-Haghpeykar, Haleh; Cohen, Helen S

2015-02-01

To determine the degree to which balance is impaired by fatigue in postcall medical residents and to assess the validity of posturography in quantifying that impairment. Prospective study. Medical residents underwent the following tests before and immediately after overnight call: 1) computerized dynamic posturography (CDP) using the Equitest force platform (Natus Medical Inc., Clackamas, OR); 2) Clinical Test of Sensory Interaction and Balance, in which the residents stood on a compliant foam mat with closed eyes and flexed and extended their necks; 3) a computerized reaction time test (available at www.humanbenchmark.com). All tests were performed before and after call at approximately the same time of day to exclude circadian rhythm influence on fatigue. The residents also completed questionnaires, including the Stanford Sleepiness Scale, describing their level of fatigue before and after call. A statistically significant difference was found between a resident's pre- and postcall test with regard to reaction time (P = .01), Stanford Sleepiness Scale score (P = .001), and preference for the visual system as measured by CDP (P = .05). Linear regression analysis showed a statistically significant relationship between sleep deprivation and multiple performance variables measured by CDP. With the growing attention paid to resident duty hours, there is an increasing need for research involving fatigue and practical ways to measure it. This study shows that residents who are measurably fatigued (both objectively and subjectively) may have difficulty utilizing vestibular input during quiet standing but can compensate by means of somatosensory and visual input. NA. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Head Tilt Posturography to Enhance Balance Control Assessment for Astronauts: A Case Study

NASA Technical Reports Server (NTRS)

Hwang, E. Y.; Paloski, W. H.

2006-01-01

For many years, we have used a standard clinical computerized dynamic posturography (CDP) protocol to assess recovery of integrated sensory-motor function in astronauts returning from space flight. The most reliable indications of postflight crew performance capabilities have been obtained from the sensory organization tests (SOTs) within the CDP protocol, particularly SOTs 5 (eyes closed, surface support sway referenced) and 6 (eyes open, surface support and visual surround sway referenced), which are sensitive to changes in availability and/or utilization of vestibular cues. We have observed, however, that some astronauts exhibiting visible signs of incomplete sensory-motor recovery are able to score within clinical norms on standard SOTs 5 and 6 trials, perhaps as a result of cognitive strategies driven by their naturally competitive natures. To improve the sensitivity of the CDP protocol for assessing recovery of integrated sensory-motor function and fitness to return to duties and/or activities of daily living, we have introduced pitch plane head tilt SOT trials to our protocol. In a preliminary study of 5 short duration (11day missions) astronauts, we showed that they were unable to maintain balance on landing day when performing dynamic head tilt trials, despite scoring within the clinically normal range on the standard SOT trials. The present case report illustrates the advantages of including head tilt trials for assessing sensory-motor recovery in long duration crewmembers.

Unraveling the mechanisms underlying postural instability in Parkinson's disease using dynamic posturography.

PubMed

Nonnekes, Jorik; de Kam, Digna; Geurts, Alexander C H; Weerdesteyn, Vivian; Bloem, Bastiaan R

2013-12-01

Postural instability, one of the cardinal symptoms of Parkinson's disease (PD), has devastating consequences for affected patients. Better strategies to prevent falls are needed, but this calls for an improved understanding of the complex mechanisms underlying postural instability. We must also improve our ability to timely identify patients at risk of falling. Dynamic posturography is a promising avenue to achieve these goals. The latest moveable platforms can deliver 'real-life' balance perturbations, permitting study of everyday fall circumstances. Dynamic posturography studies have shown that PD patients have fundamental problems in scaling their postural responses in accordance with the need of the actual balance task at hand. On-going studies evaluate the predictive ability of impaired posturography performance for daily life falls. We also review recent work aimed at exploring balance correcting steps in PD, and the presumed interaction between startle pathways and postural responses.

Characterizing effects of mild traumatic brain injury and posttraumatic stress disorder on balance impairments in blast-exposed servicemembers and Veterans using computerized posturography.

PubMed

Wares, Joanna R; Hoke, Kathy W; Walker, William; Franke, Laura Manning; Cifu, David X; Carne, William; Ford-Smith, Cheryl

2015-01-01

The high rate of blast exposures experienced by U.S. servicemembers (SMs) during the recent conflicts in Iraq and Afghanistan has resulted in frequent combat-related mild traumatic brain injuries (mTBIs). Dizziness and postural instability can persist after mTBI as a component of postconcussion syndrome, but also occur among the somatic complaints of posttraumatic stress disorder (PTSD). The goals of this study were to examine the use of computerized posturography (CPT) to objectively characterize chronic balance deficits after mTBI and to explore the utility of CPT in distinguishing between combat and blast-exposed participants with and without mTBI and PTSD. Data were analyzed from a subject pool of 166 combat-exposed SMs and Veterans who had a blast experience within the past 2 yr while deployed. Using nonparametric tests and measures of impairment, we found that balance was deficient in participants diagnosed with mTBI with posttraumatic amnesia (PTA) or PTSD versus those with neither and that deficits were amplified for participants with both diagnoses. In addition, unique deficiencies were found using CPT for individuals having isolated mTBI with PTA and isolated PTSD. Computerized balance assessment offers an objective technique to examine the physiologic effects and provide differentiation between participants with combat-associated mTBI and PTSD.

A link-segment model of upright human posture for analysis of head-trunk coordination

NASA Technical Reports Server (NTRS)

Nicholas, S. C.; Doxey-Gasway, D. D.; Paloski, W. H.

1998-01-01

Sensory-motor control of upright human posture may be organized in a top-down fashion such that certain head-trunk coordination strategies are employed to optimize visual and/or vestibular sensory inputs. Previous quantitative models of the biomechanics of human posture control have examined the simple case of ankle sway strategy, in which an inverted pendulum model is used, and the somewhat more complicated case of hip sway strategy, in which multisegment, articulated models are used. While these models can be used to quantify the gross dynamics of posture control, they are not sufficiently detailed to analyze head-trunk coordination strategies that may be crucial to understanding its underlying mechanisms. In this paper, we present a biomechanical model of upright human posture that extends an existing four mass, sagittal plane, link-segment model to a five mass model including an independent head link. The new model was developed to analyze segmental body movements during dynamic posturography experiments in order to study head-trunk coordination strategies and their influence on sensory inputs to balance control. It was designed specifically to analyze data collected on the EquiTest (NeuroCom International, Clackamas, OR) computerized dynamic posturography system, where the task of maintaining postural equilibrium may be challenged under conditions in which the visual surround, support surface, or both are in motion. The performance of the model was tested by comparing its estimated ground reaction forces to those measured directly by support surface force transducers. We conclude that this model will be a valuable analytical tool in the search for mechanisms of balance control.

Recovery of postural equilibrium control following space flight

NASA Technical Reports Server (NTRS)

Paloski, William H.; Reschke, Millard F.; Black, F. Owen; Dow, R. S.

1999-01-01

DSO 605 represents the first large study of balance control following spaceflight. Data collected during DSO 605 confirm the theory that postural ataxia following short duration spaceflight is of vestibular origin. We used the computerized dynamic posturography technique developed by Nashner et al. to study the role of the vestibular system in balance control in astronauts during quiet stance before and after spaceflight. Our results demonstrate unequivocally that balance control is disrupted in all astronauts immediately after return from space. The most severely affected returning crew members performed in the same way as vestibular deficient patients exposed to this test battery. We conclude that otolith mediated spatial reference provided by the terrestrial gravitational force vector is not used by the astronauts balance control systems immediately after spaceflight. Because the postflight ataxia appears to be mediated primarily by CNS adaptation to the altered vestibular inputs caused by loss of gravitational stimulation, we believe that intermittent periods of exposure to artificial gravity may provide an effective in-flight countermeasure. Specifically, we propose that in-flight centrifugation will allow crew members to retain their terrestrial sensory-motor adapted states while simultaneously developing microgravity adapted states. The dual-adapted astronaut should be able to make the transition from microgravity to unit gravity with minimal sensory-motor effects. We have begun a ground based program aimed at developing short arm centrifuge prescriptions designed to optimize adaptation to altered gravitational environments. Results from these experiments are expected to lead directly to in-flight evaluation of the proposed centrifuge countermeasure. Because our computerized dynamic posturography system was able to (1) quantify the postflight postural ataxia reported by crew members and observed by flight surgeons and scientists, (2) track the recovery of normal (preflight) balance control, (3) differentiate between rookie and veteran subjects, and (4) provide normative and clinical databases for comparison, and because our study successfully characterized postflight balance control recovery in a large cross-section of Shuttle crew members, we recommend that this system and protocol be adopted as a standard dependent measure for evaluating the efficacy of countermeasures and/or evaluating the postflight effects of changing mission durations or activities.

Recovery of dynamic balance after general anesthesia with sevoflurane in short-duration oral surgery.

PubMed

Fujisawa, Toshiaki; Miyamoto, Eriko; Takuma, Shigeru; Shibuya, Makiko; Kurozumi, Akihiro; Kimura, Yukifumi; Kamekura, Nobuhito; Fukushima, Kazuaki

2009-01-01

Recovery of dynamic balance, involving adjustment of the center of gravity, is essential for safe discharge on foot after ambulatory anesthesia. The purpose of this study was to assess the recovery of dynamic balance after general anesthesia with sevoflurane, using two computerized dynamic posturographies. Nine hospitalized patients undergoing oral surgery of less than 2 h duration under general anesthesia (air-oxygensevoflurane) were studied. A dynamic balance test, assessing the ability of postural control against unpredictable perturbation stimuli (Stability System; Biodex Medical), a walking analysis test using sheets with foot pressure sensors (Walk Way-MG1000; Anima), and two simple psychomotor function tests were performed before anesthesia (baseline), and 150 and 210 min after the emergence from anesthesia. Only the double-stance phase in the walking analysis test showed a significant difference between baseline and results at 150 min. None of the other variables showed any differences among results at baseline and at 150 and 210 min. The recovery times for dynamic balance and psychomotor function seem to be within 150 min after emergence from general anesthesia with sevoflurane in patients undergoing oral surgery of less than 2-h duration.

Mandibular position influence on pilots' postural balance analyzed under dynamic conditions.

PubMed

Baldini, Alberto; Nota, Alessandro; Cioffi, Clementina; Ballanti, Fabiana; Tecco, Simona

2017-11-01

The aim of this study is to evaluate the influence of the mandibular position on the postural stability in a sample of civilian and military pilots. Twenty military pilots (males, mean age 35.15 ± 3.14 years) and 17 civilian pilots (males, mean 34.91 ± 2.15 years) were enrolled in this study and underwent a Sensory Organization Test (SOT) using the EquiTest® (NeuroCom International Inc., Clackamas, OR, USA) computerized dynamic posturography. The composite parameter was recorded and analyzed. The equilibrium score (ES) recorded in centric occlusion is slightly higher than the ES recorded in mandibular rest position; civilian pilots showed ESs slightly higher than military pilots. The two-way ANOVA analysis shows these differences are not statistically significant. The findings of this study seem to suggest that the composite parameter of the SOT is not sensitive in analyzing the influence of the stomatognathic system on the postural balance of civilian and military pilots.

Postural stabilizing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) compared with calcium carbonate assessed by computerized posturography.

PubMed

Fujita, Takuo; Nakamura, Shoji; Ohue, Mutsumi; Fujii, Yoshio; Miyauchi, Akimitsu; Takagi, Yasuyuki; Tsugeno, Hirofumi

2007-01-01

Sway and postural instability have drawn attention as a risk factor for osteoporotic fracture, in addition to low bone mineral density (BMD) and poor bone quality. In view of the fracture-reducing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) not readily explained by rather mild increases of BMD, attempts were made to evaluate postural stabilizing effect of alfacalcidol, AAA Ca, and calcium carbonate (CaCO(3)) by computerized posturography. Track of the gravity center was analyzed to calculate parameters related to tract length, track range, and track density to express the degree of sway before and after supplementation in 126 subjects ranging in age between 20 and 81 years randomly divided into four groups. Supplementation with AAA Ca containing 900 mg elemental Ca (group A), no calcium (group B), CaCO(3) also containing 900 mg elemental Ca (group C), or alfacalcidol (group D) continued daily for 12 months. For each parameter, the ratio closed eye value/open eye value (Romberg ratio) was calculated to detect aggravation of sway by eye closure. Age, parameters of Ca and P, and proportions of subjects with fracture and those with low BMD showed no marked deviation among the groups. With eyes open, significant decreases of a track range parameter (REC) from group B was noted in groups A (P = 0.0397) and D (P = 0.0296), but not in group C according to multiple comparison by Scheffe, indicating superior postural stabilizing effect of A and D over C. In the first 2 months, a significant fall was already evident in REC from group B in group D (P = 0.0120) with eyes open. Paired comparison of sway parameters before and after supplementation revealed a significant increase of track density parameter (LNGA), indicating sway control efficiency and a significant decrease of REC in groups A and D compared to group B with eyes open. With eyes closed, only group A showed a significant improvement from group B (P = 0.0456; Fig. 1), with a significant shortening on paired After/Before comparison (P = 0.0142; Fig. 2). Computerized posturography appears to be useful in analyzing sway phenomena especially as to the effects of vitamin D and various Ca preparations.

Posturography and locomotor tests of dynamic balance after long-duration spaceflight.

PubMed

Cohen, Helen S; Kimball, Kay T; Mulavara, Ajitkumar P; Bloomberg, Jacob J; Paloski, William H

2012-01-01

The currently approved objective clinical measure of standing balance in astronauts after space flight is the Sensory Organization Test battery of computerized dynamic posturography. No tests of walking balance are currently approved for standard clinical testing of astronauts. This study determined the sensitivity and specificity of standing and walking balance tests for astronauts before and after long-duration space flight. Astronauts were tested on an obstacle avoidance test known as the Functional Mobility Test (FMT) and on the Sensory Organization Test using sway-referenced support surface motion with eyes closed (SOT 5) before and six months after (n=15) space flight on the International Space Station. They were tested two to seven days after landing. Scores on SOT tests decreased and scores on FMT increased significantly from pre- to post-flight. In other words, post-flight scores were worse than pre-flight scores. SOT and FMT scores were not significantly related. ROC analyses indicated supra-clinical cut-points for SOT 5 and for FMT. The standard clinical cut-point for SOT 5 had low sensitivity to post-flight astronauts. Higher cut-points increased sensitivity to post-flight astronauts but decreased specificity to pre-flight astronauts. Using an FMT cut-point that was moderately highly sensitive and highly specific plus SOT 5 at the standard clinical cut-point was no more sensitive than SOT 5, alone. FMT plus SOT 5 at higher cut-points was more specific and more sensitive. The total correctly classified was highest for FMT, alone, and for FMT plus SOT 5 at the highest cut-point. These findings indicate that standard clinical comparisons are not useful for identifying problems. Testing both standing and walking balance will be more likely to identify balance deficits.

Creative Dance Practice Improves Postural Control in a Child With Cerebral Palsy.

PubMed

Stribling, Kate; Christy, Jennifer

2017-10-01

To investigate the effect of creative dance instruction on postural control and balance in an 11-year-old with spastic triplegic cerebral palsy, Gross Motor Function Classification Scale level II. We conducted 1-hour dance interventions twice weekly for 8 weeks, with a focus on somatosensory awareness and movement in all planes of motion. Computerized dynamic posturography using the SMART Balance Master/EquiTest (NeuroCom) was used to assess postural control and balance reactions before the first class and following the final class. Gains in standing stability, balance recovery, directional control, and endpoint excursion of movement were found. Participation in creative dance lessons appears to improve somatosensory effectiveness and postural control in a child with cerebral palsy. Dance is a fun way to improve balance and coordination. These interventions could be easily implemented into programs for children with cerebral palsy.

Balance Evaluation Systems

NASA Technical Reports Server (NTRS)

1996-01-01

NeuroCom's Balance Master is a system to assess and then retrain patients with balance and mobility problems and is used in several medical centers. NeuroCom received assistance in research and funding from NASA, and incorporated technology from testing mechanisms for astronauts after shuttle flights. The EquiTest and Balance Master Systems are computerized posturography machines that measure patient responses to movement of a platform on which the subject is standing or sitting, then provide assessments of the patient's postural alignment and stability.

Functional near-infrared spectroscopy (fNIRS) brain imaging of multi-sensory integration during computerized dynamic posturography in middle-aged and older adults.

PubMed

Lin, Chia-Cheng; Barker, Jeffrey W; Sparto, Patrick J; Furman, Joseph M; Huppert, Theodore J

2017-04-01

Studies suggest that aging affects the sensory re-weighting process, but the neuroimaging evidence is minimal. Functional Near-Infrared Spectroscopy (fNIRS) is a novel neuroimaging tool that can detect brain activities during dynamic movement condition. In this study, fNIRS was used to investigate the hemodynamic changes in the frontal-lateral, temporal-parietal, and occipital regions of interest (ROIs) during four sensory integration conditions that manipulated visual and somatosensory feedback in 15 middle-aged and 15 older adults. The results showed that the temporal-parietal ROI was activated more when somatosensory and visual information were absent in both groups, which indicated the sole use of vestibular input for maintaining balance. While both older adults and middle-aged adults had greater activity in most brain ROIs during changes in the sensory conditions, the older adults had greater increases in the occipital ROI and frontal-lateral ROIs. These findings suggest a cortical component to sensory re-weighting that is more distributed and requires greater attention in older adults.

Balance and mobility dysfunction and falls risk in older people with mild to moderate Alzheimer disease.

PubMed

Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Logiudice, Dina; Lautenschlager, Nicola T; Dodd, Karen J

2012-01-01

This study aimed to identify the magnitude and type of balance and mobility impairments in people with Alzheimer disease by comparing their performance with that of older people without cognitive impairment. Twenty-five community-dwelling people with mild to moderate Alzheimer disease and a comparison group of 25 cognitively intact age- and sex-matched people completed a comprehensive balance and mobility assessment. This included computerized posturography measures of static and dynamic balance under various conditions, clinical balance, and mobility measures, and measures of falls and falls risk. The level of falls risk was higher in people with Alzheimer disease. Standing balance in people with Alzheimer disease was significantly impaired across a range of static and dynamic balance conditions. Activity level, gait, and mobility measures were also impaired, particularly turning and dual tasks. The findings of the study highlight the value of including balance screening as a routine component of early dementia assessment. This would allow for the early detection of balance dysfunction and the introduction of balance retraining before impairments progress to more advanced levels.

Longitudinal relationships among posturography and gait measures in multiple sclerosis.

PubMed

Fritz, Nora E; Newsome, Scott D; Eloyan, Ani; Marasigan, Rhul Evans R; Calabresi, Peter A; Zackowski, Kathleen M

2015-05-19

Gait and balance dysfunction frequently occurs early in the multiple sclerosis (MS) disease course. Hence, we sought to determine the longitudinal relationships among quantitative measures of gait and balance in individuals with MS. Fifty-seven ambulatory individuals with MS (28 relapsing-remitting, 29 progressive) were evaluated using posturography, quantitative sensorimotor and gait measures, and overall MS disability with the Expanded Disability Status Scale at each session. Our cohort's age was 45.8 ± 10.4 years (mean ± SD), follow-up time 32.8 ± 15.4 months, median Expanded Disability Status Scale score 3.5, and 56% were women. Poorer performance on balance measures was related to slower walking velocity. Two posturography measures, the anterior-posterior sway and sway during static eyes open, feet apart conditions, were significant contributors to walk velocity over time (approximate R(2) = 0.95), such that poorer performance on the posturography measures was related to slower walking velocity. Similarly, the anterior-posterior sway and sway during static eyes closed, feet together conditions were also significant contributors to the Timed 25-Foot Walk performance over time (approximate R(2) = 0.83). This longitudinal cohort study establishes a strong relationship between clinical gait measures and posturography. The data show that increases in static posturography and reductions in dynamic posturography are associated with a decline in walk velocity and Timed 25-Foot Walk performance over time. Furthermore, longitudinal balance measures predict future walking performance. Quantitative walking and balance measures are important additions to clinical testing to explore longitudinal change and understand fall risk in this progressive disease population. © 2015 American Academy of Neurology.

One-year vestibular and balance outcomes of Oklahoma City bombing survivors.

PubMed

Van Campen, L E; Dennis, J M; King, S B; Hanlin, R C; Velderman, A M

1999-10-01

This multisite investigation assessed subjective, behavioral, and objective balance function in 30 blast survivors. Subjects with vertigo, dizziness, or imbalance were screened (n = 6) or evaluated (n = 27) during 1 year. Tests included a questionnaire, electronystagmography (ENG), and computerized dynamic posturography (CDP). Ninety-seven percent of subjects were located inside a building during the blast, and 63 percent of subjects experienced dysequilibrium within 48 hours. Forty-three percent of symptoms could not be attributed to head injury. Sixty percent of subjects had abnormal ENG and/or CDP; ENG abnormalities mostly were peripheral or nonlocalizing, whereas CDP patterns were "vestibular," "surface dependent," and "physiologically inconsistent." At 1-year postblast, 55 percent of initially abnormal CDP results were normal, and 72 percent of subjects said symptoms were unchanged or occurred intermittently. A serial, test battery approach is recommended to assess symptoms. Blast-related dysequilibrium had clinically significant manifestations and should be considered a valid component of aural blast injury.

Tetra-ataxiometric Posturography in Patients with Migrainous Vertigo.

PubMed

Ongun, Nedim; Atalay, Nilgun S; Degirmenci, Eylem; Sahin, Fusun; Bir, Levent Sinan

2016-01-01

Migraine is a common disorder characterized by headache attacks frequently accompanied by vestibular symptoms like dizziness, vertigo, and balance disorders. Clinical studies support a strong link between migraine and vertigo rather than between other headache types and vertigo or nonvertiginous dizziness. There is a lack of consensus regarding the pathophysiology of migrainous vertigo. Activation of central vestibular processing during migraine attacks and vasospasm-induced ischemia of the labyrinth are reported as the probable responsible mechanisms. Because vestibular examination alone does not provide enough information for diagnosis of migrainous vertigo, posturography systems which provide objective assessment of somatosensory, vestibular, and visual information would be very helpful to show concomitant involvement of the vestibular and somato-sensorial systems. There are few posturographic studies on patients with migraine but it seems that how balance is affected in patients with migraine and/or migrainous vertigo is still not clear. We want to investigate balance function in migraineurs with and without vertigo with a tetra-ataxiometric posturography system and our study is the first study in which tetra-ataxiometric static posturography was used to evaluate postural abnormalities in a well-defined population of patients with migrainous vertigo. To investigate balance functions in migraineurs with and without vertigo with a tetra-ataxiometric posturography system. Prospective, nonrandomized, controlled study. Pamukkale University Hospital, Neurology and Physical Therapy and Rehabilitation outpatient clinics. Sixteen patients with migrainous vertigo, 16 patients with migraine without aura and no vestibular symptoms, and 16 controls were included in the study. Computerized static posturography system was performed and statistical analyses of fall, Fourier, Stability, and Weight distribution indexes were performed. The tetra-ataxiometric posturography device measures vertical pressure fluctuations on 4 independent stable platforms, each placed beneath 2 heels and toe parts of the patient; inputs from these platforms are integrated and processed by a computer digitally. Four separate plates are used and perpendicular pressures of the anterior and posterior feet are measured. Pressure of each force plate is measured and data was analyzed by the software program. A very small, non-randomized, and controlled study with the inability to find an answer to the mechanism of involvement of the somatosensorial system and vestibular system in migrainous headaches. The distribution of patients with posturographical abnormalities in the migrainous vertigo group was significantly different than the control group. Distribution of the patients with posturographical abnormalities in the high frequencies of the head-right position was significantly different in the migrainous vertigo group than in the control group and distribution of the patients with posturographical abnormalities in high frequencies of the head-right position was significantly different in the migraine group than in the controls groups. The stability index of the migrainous vertigo group was significantly higher than in the control group when tested on in the neutral-head position with open eyes. In this first study of tetra-ataxiometric static posturography evaluating postural abnormalities in a well-defined population of patients with migrainous vertigo, the central part of the vestibular apparatus would be responsible of postural abnormalities in patients with migraine and migrainous vertigo.

Static and dynamic posturography in patients with asymptomatic HIV-1 infection and AIDS

PubMed Central

Dellepiane, M; Medicina, MC; Mora, R; Salami, A

2005-01-01

Summary Alterations of the vestibulo-ocular reflex, optokinetic nystagmus, and visuo-vestibular-ocular reflex, have already been described in patients with AIDS and HIV-1 positive asymptomatic subjects. The introduction to the clinical practice of posturographic techniques allows us to study, with precision, postural perturbation that may be present when performing Romberg’s test and to study the vestibulo-spinal reflex as a component of the vestibular system. The relative lack of studies on posturography and AIDS, encouraged us to continue our research on the vestibular system both in asymptomatic HIV-1 seropositive patients and in patients with AIDS (IV stage according to the classification proposed by the Centre for Disease Control). Recordings were made in group 1 (control group, 55 normal subjects), in group 2 (15 asymptomatic HIV-positive subjects), and in group 3 (15 patients with AIDS stage IV). Static and dynamic posturography were carried out using Tonnies platform system (Tonnies GmbH & Co., Wurzburg, Germany) and the data were analysed with Tonnies Posturographic Tübingen (TPOST) software vers. 5.19. In asymptomatic HIV+ subjects, we observed an increase in RW, RA and M3 reflex latency. AIDS patients (stage IV) exhibited significant alterations in almost all the posturographic parameters and the electromyographic potentials. Our results validate static and dynamic posturography as a method for otoneurological investigation and appear to confirm that the entire vestibular system is involved since the earliest stages of the HIV infection. In the HIV+ subjects, a variable dysfunction in the reflex control to long latency was observed, which is correlated with the alteration of the central dopaminergic system; in AIDS patients, the central nervous system damage appears more important, globally distributed and correlated also with immunosuppression. PMID:16749603

The Vestibular Effects of Repeated Low-Level Blasts.

PubMed

Littlefield, Philip D; Pinto, Robin L; Burrows, Holly L; Brungart, Douglas S

2016-01-01

The objective of this study was to use a prospective cohort of United States Marine Corps (USMC) instructors to identify any acute or long-term vestibular dysfunction following repeated blast exposures during explosive breaching training. They were assessed in clinic and on location during training at the USMC Methods of Entry School, Quantico, VA. Subjects received comprehensive baseline vestibular assessments and these were repeated in order to identify longitudinal changes. They also received shorter assessments immediately following blast exposure in order to identify acute findings. The main outcome measures were the Neurobehavioral Symptom Inventory, vestibular Visual Analog Scale (VAS) of subjective vestibular function, videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP), rotary chair (including the unilateral centrifugation test), computerized dynamic posturography, and computerized dynamic visual acuity. A total of 11 breachers and 4 engineers were followed for up to 17 months. No acute effects or longitudinal deteriorations were identified, but there were some interesting baseline group differences. Upbeat positional nystagmus was common, and correlated (p<0.005) with a history of mild traumatic brain injury (mTBI). Several instructors had abnormally short low-frequency phase leads on rotary chair testing. This study evaluated breaching instructors over a longer test period than any other study, and the results suggest that this population appears to be safe from a vestibular standpoint at the current exposure levels. Upbeat positional nystagmus correlated with a history of mTBI in this population, and this has not been described elsewhere. The data trends also suggest that this nystagmus could be an acute blast effect. However, the reasons for the abnormally short phase leads seen in rotary chair testing are unclear at this time. Further investigation seems warranted.

Cervicocephalic kinesthetic sensibility and postural balance in patients with nontraumatic chronic neck pain--a pilot study.

PubMed

Palmgren, Per J; Andreasson, Daniel; Eriksson, Magnus; Hägglund, Andreas

2009-06-30

Although cervical pain is widespread, most victims are only mildly and occasionally affected. A minority, however, suffer chronic pain and/or functional impairments. Although there is abundant literature regarding nontraumatic neck pain, little focuses on diagnostic criteria. During the last decade, research on neck pain has been designed to evaluate underlying pathophysiological mechanisms, without noteworthy success. Independent researchers have investigated postural balance and cervicocephalic kinesthetic sensibility among patients with chronic neck pain, and have (in most cases) concluded the source of the problem is a reduced ability in the neck's proprioceptive system. Here, we investigated cervicocephalic kinesthetic sensibility and postural balance among patients with nontraumatic chronic neck pain. Ours was a two-group, observational pilot study of patients with complaints of continuous neck pain during the 3 months prior to recruitment. Thirteen patients with chronic neck pain of nontraumatic origin were recruited from an institutional outpatient clinic. Sixteen healthy persons were recruited as a control group. Cervicocephalic kinesthetic sensibility was assessed by exploring head repositioning accuracy and postural balance was measured with computerized static posturography. Parameters of cervicocephalic kinesthetic sensibility were not reduced. However, in one of six test movements (flexion), global repositioning errors were significantly larger in the experimental group than in the control group (p < .05). Measurements did not demonstrate any general impaired postural balance, and varied substantially among participants in both groups. In patients with nontraumatic chronic neck pain, we found statistically significant global repositioning errors in only one of six test movements. In this cohort, we found no evidence of impaired postural balance.Head repositioning accuracy and computerized static posturography are imperfect measures of functional proprioceptive impairments. Validity of (and procedures for using) these instruments demand further investigation. Current Controlled Trials ISRCTN96873990.

Devices and tasks involved in the objective assessment of standing dynamic balancing - A systematic literature review.

PubMed

Petró, Bálint; Papachatzopoulou, Alexandra; Kiss, Rita M

2017-01-01

Static balancing assessment is often complemented with dynamic balancing tasks. Numerous dynamic balancing assessment methods have been developed in recent decades with their corresponding balancing devices and tasks. The aim of this systematic literature review is to identify and categorize existing objective methods of standing dynamic balancing ability assessment with an emphasis on the balancing devices and tasks being used. Three major scientific literature databases (Science Direct, Web of Science, PLoS ONE) and additional sources were used. Studies had to use a dynamic balancing device and a task described in detail. Evaluation had to be based on objectively measureable parameters. Functional tests without instrumentation evaluated exclusively by a clinician were excluded. A total of 63 articles were included. The data extracted during full-text assessment were: author and date; the balancing device with the balancing task and the measured parameters; the health conditions, size, age and sex of participant groups; and follow-up measurements. A variety of dynamic balancing assessment devices were identified and categorized as 1) Solid ground, 2) Balance board, 3) Rotating platform, 4) Horizontal translational platform, 5) Treadmill, 6) Computerized Dynamic Posturography, and 7) Other devices. The group discrimination ability of the methods was explored and the conclusions of the studies were briefly summarized. Due to the wide scope of this search, it provides an overview of balancing devices and do not represent the state-of-the-art of any single method. The identified dynamic balancing assessment methods are offered as a catalogue of candidate methods to complement static assessments used in studies involving postural control.

Static posturography with dynamic tests. Usefulness of biomechanical parameters in assessing vestibular patients.

PubMed

Balaguer García, Ramón; Pitarch Corresa, Salvador; Baydal Bertomeu, José María; Morales Suárez-Varela, María M

2012-01-01

Posturography allows evaluating postural control. This study showed the posturographic parameters that were useful for assessing the functional ability to maintain balance in our sample of vestibular patients. Of a total of 89 patients, 59 were healthy subjects and 30 had a peripheral vestibular disorder. The subjects were studied using the posturographic NedSVE/IBV system, combining static (Romberg) and dynamic (stability limits and rhythmic weight shifts) tests. We then compared the measurements found in the groups. Normal subjects showed significantly lower oscillations than our patients in all of the posturographic parameters studied (except the displacement angle). In testing the limits of stability, although normal subjects achieved maximum displacements greater than the subjects with the disorder, the differences found were not significant. In rhythmic weight shift tests, normal subjects showed more favourable results than did the vestibular patients, with significant differences in 3 of the 4 parameters studied: 1) anteroposterior ability, 2) mediolateral ability, and 3) anteroposterior control and efficiency. Rhythmic weight shift tests and the static posturography test parameters used were useful in discriminating among the normal and pathological subjects in this study. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Postflight balance control recovery in an elderly astronaut: a case report

NASA Technical Reports Server (NTRS)

Paloski, William H.; Black, F. Owen; Metter, E. Jeffrey

2004-01-01

OBJECTIVE: To examine the sensorimotor adaptive response of a 77-year-old man exposed to the gravito-inertial challenges of orbital space flight. STUDY DESIGN: Prospective case study with retrospective comparisons. SETTING: NASA Neurosciences Laboratory (Johnson Space Center) and Baseline Data Collection Facility (Kennedy Space Center). PRIMARY PARTICIPANT: One 77-year-old male shuttle astronaut. INTERVENTION: Insertion into low Earth orbit was used to remove gravitational stimuli and thereby trigger sensorimotor adaptation to the microgravity environment. Graviceptor stimulation was reintroduced at landing, and sensorimotor readaptation to the terrestrial environment was tracked to completion. MAIN OUTCOME MEASURES: Computerized dynamic posturography tests were administered before and after orbital flight to determine the magnitude and time course of recovery. RESULTS: The elderly astronaut exhibited balance control performance decrements on landing day; however, there were no significant differences between his performance and that of younger astronauts tested on the same shuttle mission or on previous shuttle missions of similar duration. CONCLUSIONS: These results demonstrate that the physiological changes attributed to aging do not necessarily impair adaptive sensorimotor control processes.

Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial.

PubMed

Bogaerts, An; Verschueren, Sabine; Delecluse, Christophe; Claessens, Albrecht L; Boonen, Steven

2007-07-01

This randomized controlled trial investigated the effects of a 12 month whole body vibration training program on postural control in healthy older adults. Two hundred and twenty people were randomly assigned to a whole body vibration group (n=94), a fitness group (n=60) or a control group (n=66). The whole body vibration and fitness groups trained three times a week for 1 year. The vibration group performed exercises on a vibration platform and the fitness group performed cardiovascular, strength, balance and stretching exercises. Balance was measured using dynamic computerized posturography at baseline and after 6 and 12 months. Whole body vibration training was associated with reduced falls frequency on a moving platform when vision was disturbed and improvements in the response to toes down rotations at the ankle induced by the moving platform. The fitness group showed reduced falls frequency on the moving surface when vision was disturbed. Thus, whole body vibration training may improve some aspects of postural control in community dwelling older individuals.

[Functional assessment of patients with vertigo and dizziness in occupational medicine].

PubMed

Zamysłowska-Szmytke, Ewa; Szostek-Rogula, Sylwia; Śliwińska-Kowalska, Mariola

2018-03-09

Balance assessment relies on symptoms, clinical examination and functional assessment and their verification in objective tests. Our study was aimed at calculating the assessment compatibility between questionnaires, functional scales and objective vestibular and balance examinations. A group of 131 patients (including 101 women; mean age: 59±14 years) of the audiology outpatient clinic was examined. Benign paroxysmal positional vertigo, phobic vertigo and central dizziness were the most common diseases observed in the study group. Patients' symptoms were tested using the questionnaire on Cawthworne-Cooksey exercises (CC), Dizziness Handicap Inventory (DHI) and Duke Anxiety-Depression Scale. Berg Balance Scale (BBS), Dynamic Gait Index (DGI), the Tinetti test, Timed Up and Go test (TUG), and Dynamic Visual Acuity (DVA) were used for the functional balance assessment. Objective evaluation included: videonystagmography caloric test and static posturography. The study results revealed statistically significant but moderate compatibility between functional tests BBS, DGI, TUG, DVA and caloric results (Kendall's W = 0.29) and higher for posturography (W = 0.33). The agreement between questionnaires and objective tests were very low (W = 0.08-0.11).The positive predictive values of BBS were 42% for caloric and 62% for posturography tests, of DGI - 46% and 57%, respectively. The results of functional tests (BBS, DGI, TUG, DVA) revealed statistically significant correlations with objective balance tests but low predictive values did not allow to use these tests in vestibular damage screening. Only half of the patients with functional disturbances revealed abnormal caloric or posturography tests. The qualification to work based on objective tests ignore functional state of the worker, which may influence the ability to work. Med Pr 2018;69(2):179-189. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Acupuncture treatment of whiplash injury.

PubMed

Fattori, Bruno; Ursino, Francesco; Cingolani, Cristina; Bruschini, Luca; Dallan, Iacopo; Nacci, Andrea

2004-01-01

We evaluated by computerized static posturography the postural changes after acupuncture treatment in a group of 27 patients (12 men and 15 women; mean age, 35.7+/-6.8 SD) having balance disorders caused by cervical torsion due to whiplash injury. Acupuncture was performed by piercing deeply and bilaterally acupuncture points bladder 10 and gall bladder 20 with steel needles that were twirled manually for 20 seconds. All patients underwent posturographic evaluations before and just after each session of acupuncture. The posturography was performed with open eyes (OE), closed eyes (CE), and closed eyes with retroflexed head (CER). The control group consisted of 25 patients complaining of the same symptoms as those recorded by the study group due to whiplash injury but treated with nonsteroidal anti-inflammatory drugs and myorelaxation or with physiotherapy only. The data presented in this study revealed a considerable difference between the two groups as regards the reduction of the CE and CER length of the statokinesigram just before each session of acupuncture; the frequency oscillation on the sagittal plane in CER was reduced in the study group, whereas we noticed a progressive increase of its values in the control group. The high percentage of positive results in whiplash injury patients leads us to advocate acupuncture for balance disorders due to cervical pathology.

Central adaptation to repeated galvanic vestibular stimulation: implications for pre-flight astronaut training.

PubMed

Dilda, Valentina; Morris, Tiffany R; Yungher, Don A; MacDougall, Hamish G; Moore, Steven T

2014-01-01

Healthy subjects (N = 10) were exposed to 10-min cumulative pseudorandom bilateral bipolar Galvanic vestibular stimulation (GVS) on a weekly basis for 12 weeks (120 min total exposure). During each trial subjects performed computerized dynamic posturography and eye movements were measured using digital video-oculography. Follow up tests were conducted 6 weeks and 6 months after the 12-week adaptation period. Postural performance was significantly impaired during GVS at first exposure, but recovered to baseline over a period of 7-8 weeks (70-80 min GVS exposure). This postural recovery was maintained 6 months after adaptation. In contrast, the roll vestibulo-ocular reflex response to GVS was not attenuated by repeated exposure. This suggests that GVS adaptation did not occur at the vestibular end-organs or involve changes in low-level (brainstem-mediated) vestibulo-ocular or vestibulo-spinal reflexes. Faced with unreliable vestibular input, the cerebellum reweighted sensory input to emphasize veridical extra-vestibular information, such as somatosensation, vision and visceral stretch receptors, to regain postural function. After a period of recovery subjects exhibited dual adaption and the ability to rapidly switch between the perturbed (GVS) and natural vestibular state for up to 6 months.

Cervicocephalic kinesthetic sensibility and postural balance in patients with nontraumatic chronic neck pain – a pilot study

PubMed Central

Palmgren, Per J; Andreasson, Daniel; Eriksson, Magnus; Hägglund, Andreas

2009-01-01

Background Although cervical pain is widespread, most victims are only mildly and occasionally affected. A minority, however, suffer chronic pain and/or functional impairments. Although there is abundant literature regarding nontraumatic neck pain, little focuses on diagnostic criteria. During the last decade, research on neck pain has been designed to evaluate underlying pathophysiological mechanisms, without noteworthy success. Independent researchers have investigated postural balance and cervicocephalic kinesthetic sensibility among patients with chronic neck pain, and have (in most cases) concluded the source of the problem is a reduced ability in the neck's proprioceptive system. Here, we investigated cervicocephalic kinesthetic sensibility and postural balance among patients with nontraumatic chronic neck pain. Methods Ours was a two-group, observational pilot study of patients with complaints of continuous neck pain during the 3 months prior to recruitment. Thirteen patients with chronic neck pain of nontraumatic origin were recruited from an institutional outpatient clinic. Sixteen healthy persons were recruited as a control group. Cervicocephalic kinesthetic sensibility was assessed by exploring head repositioning accuracy and postural balance was measured with computerized static posturography. Results Parameters of cervicocephalic kinesthetic sensibility were not reduced. However, in one of six test movements (flexion), global repositioning errors were significantly larger in the experimental group than in the control group (p < .05). Measurements did not demonstrate any general impaired postural balance, and varied substantially among participants in both groups. Conclusion In patients with nontraumatic chronic neck pain, we found statistically significant global repositioning errors in only one of six test movements. In this cohort, we found no evidence of impaired postural balance. Head repositioning accuracy and computerized static posturography are imperfect measures of functional proprioceptive impairments. Validity of (and procedures for using) these instruments demand further investigation. Trial registration Current Controlled Trials ISRCTN96873990 PMID:19566929

Changes in Balancing Ability of Athletes With Chronic Ankle Instability After Foot Orthotics Application and Rehabilitation Exercises

PubMed Central

Lee, Hong-Jae; Lim, Kil-Byung; Jung, Tae-Ho; Kim, Dug-Young

2013-01-01

Objective To compare the effect of foot orthotics and rehabilitation exercises by assessing balancing ability and joint proprioception in athletes who have chronic ankle instability. Methods Forty-one athletes who visited hospitals due to chronic ankle instability were randomly assigned to two groups. One group had ankle rehabilitation exercises while the other group had the same rehabilitation exercises as well as foot orthotics. Joint position sense of the ankle joint was examined by using an isokinetic exercise machine. Balancing abilities categorized into static, dynamic and functional balance abilities were evaluated by using computerized posturography. We tested the subjects before and after the four-week rehabilitation program. Results After the four-week treatment, for joint reposition sense evaluation, external 75% angle evaluation was done, revealing that the group with the application of foot orthotics improved by -1.07±1.64 on average, showing no significant difference between the two groups (p>0.05). Static, dynamic and functional balancing abilities using balance masters were evaluated, revealing that the two groups improved in some items, but showing no significant difference between them (p>0.05). Conclusion This study found that athletes with chronic ankle instability who had foot orthotics applied for four weeks improved their proprioceptive and balancing abilities, but did not show additional treatment effects compared with rehabilitation exercise treatment. PMID:24020033

Changes in balancing ability of athletes with chronic ankle instability after foot orthotics application and rehabilitation exercises.

PubMed

Lee, Hong-Jae; Lim, Kil-Byung; Jung, Tae-Ho; Kim, Dug-Young; Park, Kyung-Rok

2013-08-01

To compare the effect of foot orthotics and rehabilitation exercises by assessing balancing ability and joint proprioception in athletes who have chronic ankle instability. Forty-one athletes who visited hospitals due to chronic ankle instability were randomly assigned to two groups. One group had ankle rehabilitation exercises while the other group had the same rehabilitation exercises as well as foot orthotics. Joint position sense of the ankle joint was examined by using an isokinetic exercise machine. Balancing abilities categorized into static, dynamic and functional balance abilities were evaluated by using computerized posturography. We tested the subjects before and after the four-week rehabilitation program. After the four-week treatment, for joint reposition sense evaluation, external 75% angle evaluation was done, revealing that the group with the application of foot orthotics improved by -1.07±1.64 on average, showing no significant difference between the two groups (p>0.05). Static, dynamic and functional balancing abilities using balance masters were evaluated, revealing that the two groups improved in some items, but showing no significant difference between them (p>0.05). This study found that athletes with chronic ankle instability who had foot orthotics applied for four weeks improved their proprioceptive and balancing abilities, but did not show additional treatment effects compared with rehabilitation exercise treatment.

Predictors of vertigo in patients with untreated vestibular schwannoma.

PubMed

Andersen, Jan Fredrik; Nilsen, Kathrin Skorpa; Vassbotn, Flemming Slinning; Møller, Per; Myrseth, Erling; Lund-Johansen, Morten; Goplen, Frederik Kragerud

2015-04-01

Previous studies have shown that vertigo is the most powerful negative predictor of quality of life in patients with vestibular schwannomas, but the variability in vertigo symptom severity is still poorly understood. We wanted to find out whether vertigo could be related to objective parameters such as tumor size, location, vestibular nerve function, hearing, and postural stability in patients with untreated vestibular schwannomas. Baseline data from prospective cohort study. Tertiary referral center. Four hundred thirty-four consecutive patients with unilateral VS diagnosed on MRI. Mean age 56 years (range 16-84 yr). Fifty-three percent women. Diagnostic, with a medical history, otolaryngological examination, pure-tone and speech audiometry, MRI, posturography, and videonystagmography with bithermal caloric tests. Dizziness measured on a 100-mm visual analog scale (VAS). Secondary outcome measures were canal paresis and postural imbalance (static and dynamic posturography). Three hundred three patients (70%) completed the VAS. Severe dizziness, defined as VAS 75 or greater, was reported by 9% of the patients. Larger tumors were associated with higher risk of postural instability and canal paresis. Moderate to severe dizziness was associated with postural imbalance and canal paresis, and possibly with small to medium-sized tumors. Postural instability was related to tumor size and canal paresis when measured by dynamic, but not with static, posturography. A minority of VS patients experience severe vestibular symptoms related to canal paresis and postural instability. A curvilinear relationship is hypothesized between tumor size and dizziness.

Influence of Sensory Dependence on Postural Control

NASA Technical Reports Server (NTRS)

Santana, Patricia A.; Mulavara, Ajitkumar P.; Fiedler, Matthew J.

2011-01-01

The current project is part of an NSBRI funded project, "Development of Countermeasures to Aid Functional Egress from the Crew Exploration Vehicle Following Long-Duration Spaceflight." The development of this countermeasure is based on the use of imperceptible levels of electrical stimulation to the balance organs of the inner ear to assist and enhance the response of a person s sensorimotor function. These countermeasures could be used to increase an astronaut s re-adaptation rate to Earth s gravity following long-duration space flight. The focus of my project is to evaluate and examine the correlation of sensory preferences for vision and vestibular systems. Disruption of the sensorimotor functions following space flight affects posture, locomotion and spatial orientation tasks in astronauts. The Group Embedded Figures Test (GEFT), the Rod and Frame Test (RFT) and the Computerized Dynamic Posturography Test (CDP) are measurements used to examine subjects visual and vestibular sensory preferences. The analysis of data from these tasks will assist in relating the visual dependence measures recognized in the GEFT and RFT with vestibular dependence measures recognized in the stability measures obtained during CDP. Studying the impact of sensory dependence on the performance in varied tasks will help in the development of targeted countermeasures to help astronauts readapt to gravitational changes after long duration space flight.

A vestibular phenotype for Waardenburg syndrome?

NASA Technical Reports Server (NTRS)

Black, F. O.; Pesznecker, S. C.; Allen, K.; Gianna, C.

2001-01-01

OBJECTIVE: To investigate vestibular abnormalities in subjects with Waardenburg syndrome. STUDY DESIGN: Retrospective record review. SETTING: Tertiary referral neurotology clinic. SUBJECTS: Twenty-two adult white subjects with clinical diagnosis of Waardenburg syndrome (10 type I and 12 type II). INTERVENTIONS: Evaluation for Waardenburg phenotype, history of vestibular and auditory symptoms, tests of vestibular and auditory function. MAIN OUTCOME MEASURES: Results of phenotyping, results of vestibular and auditory symptom review (history), results of vestibular and auditory function testing. RESULTS: Seventeen subjects were women, and 5 were men. Their ages ranged from 21 to 58 years (mean, 38 years). Sixteen of the 22 subjects sought treatment for vertigo, dizziness, or imbalance. For subjects with vestibular symptoms, the results of vestibuloocular tests (calorics, vestibular autorotation, and/or pseudorandom rotation) were abnormal in 77%, and the results of vestibulospinal function tests (computerized dynamic posturography, EquiTest) were abnormal in 57%, but there were no specific patterns of abnormality. Six had objective sensorineural hearing loss. Thirteen had an elevated summating/action potential (>0.40) on electrocochleography. All subjects except those with severe hearing loss (n = 3) had normal auditory brainstem response results. CONCLUSION: Patients with Waardenburg syndrome may experience primarily vestibular symptoms without hearing loss. Electrocochleography and vestibular function tests appear to be the most sensitive measures of otologic abnormalities in such patients.

[Cataract surgery and its impact on balance and autonomy in elderly].

PubMed

Raynal, M; Aupy, B; Jahidi, A; Ettien, D; Le Page, P; Briche, T; Kossowski, M; Pailllaud, E

2009-01-01

Cataract is a major cause of visual impairment among elderly. Cataract surgery improves visual afferencies and can have an impact on balance. The present study assessed the impact of cataract surgery upon balance and autonomy in elderly. We realized clinical examinations and objective tests the day before surgery and 2-months later. The initial cohort consisted of 66 patients that had to undergo a cataract surgery. Their mean age was 79 +/- 0.5. For logistic reasons, only 33 patients have been completely evaluated before and after surgery. Each patient underwent a history and examination that have assessed autonomy, walking, visual and then cochleo-vestibular functions including bone vibratory test and dynamic computerized posturography (Equitest). After 2 months, cataract surgery had no incidence on balance. The fear of falling has stayed the same whereas the number of falls has been noticeably reduced by surgery. The overall score of Equitest has shown an increase in visual dependence after surgery. Although cataract surgery has no incidence on autonomy, it may improve the quality of life among older people by leisure activities recovery. An early physical rehabilitation facilitated by visual improvement after surgery can also prevent visual dependence and autonomy loss. We recommend vestibular rehabilitation in elderly with major visual dependence.

The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus.

PubMed

Abram, Katrin; Bohne, Silvia; Bublak, Peter; Karvouniari, Panagiota; Klingner, Carsten M; Witte, Otto W; Guntinas-Lichius, Orlando; Axer, Hubertus

2016-01-01

Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients. Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic posturography (CDP), and neuropsychological assessment. Examinations were done before and after spinal tap test. The gait score showed a significant improvement 24 h after spinal tap test in all subtests and in the sum score (p < 0.003), while neuropsychological assessment did not reveal significant differences 72 h after spinal tap test. CDP showed significant improvements after spinal tap test in the Sensory Organization Tests 2 (p = 0.017), 4 (p = 0.001), and 5 (p = 0.009) and the composite score (p = 0.01). Patients showed best performance in somatosensory and worst performance in vestibular dominated tests. Vestibular dominated tests did not improve significantly after spinal tap test, while somatosensory and visual dominated tests did. Postural stability in NPH is predominantly affected by deficient vestibular functions, which did not improve after spinal tap test. Conditions which improved best were mainly independent from visual control and are based on proprioceptive functions.

One-shot, low-dosage intratympanic gentamicin for Ménière's disease: Clinical, posturographic and vestibular test findings.

PubMed

Daneshi, Ahmad; Jahandideh, Hesam; Pousti, Seyed Behzad; Mohammadi, Shabahang

2014-01-01

Ménière's disease has been remained as a difficult therapeutic challenge. The present study aimed to determine the effects of one-shot low-dosage intratympanic gentamicin on vertigo control, auditory outcomes and findings of computerized dynamic posturography and vestibular evoked myogenic potentials in patients with unilateral Ménière's disease. In a prospective clinical study, 30 patients with unilateral Ménière's disease were treated with one-shot intratympanic injection of 20 milligrams gentamicin. Main outcome measures included clinical, audiometric, postural and vestibular outcomes evaluated 1 and 9 months after the treatment. Mean vertigo attacks frequency, pure tone average threshold and functional level scale significantly decreased after the treatment (P < 0.05). Effective vertigo control (class A and B) obtained in 95.8% of the patients. In total, 75% of patients reported decrease in both aural fullness and tinnitus. Vestibular evoked myogenic potentials became absent in all the patients but four of them. Posturographic scores were improved after the treatment. One-shot low-dosage gentamicin was effective in controlling vertigo attacks in Ménière's disease and has useful effects on aural fullness and tinnitus of patients as well. Postural and vestibular tests only have adjunctive role for monitoring therapeutic responses in intratympanic gentamicin-therapy.

A prospective study of posturography in normal older people.

PubMed

Baloh, R W; Corona, S; Jacobson, K M; Enrietto, J A; Bell, T

1998-04-01

To follow posturographic measurements over time in a group of normal older subjects to see if sway increases with aging and if sway is greater in those with deteriorating balance and falls. Seventy-two community-dwelling older people (age range 79-91 years), who initially had normal neurological evaluations, were followed with three yearly follow-up examinations. Amplitude and velocity of sway on static and dynamic posturography, Tinetti gait and balance score, reports of falls. Velocity of sway on dynamic tests increased significantly during the 3 years of follow-up. The percentage increase in sway was about the same in the anterior-posterior and medial-lateral directions and with eyes open and eyes closed. Subjects with low Tinetti scores had higher sway amplitude and velocity, particularly on dynamic tests, but no measure of sway was significantly different in those who reported falls compared with those who did not report falls. Sway increases in normal subjects over time, and sway is greater in older subjects with deteriorating balance compared with those with normal balance. Sway was not greater in those who fell compared with those who did not fall, probably because falls are highly dependent on individual behavior.

Identification of key outcome measures when using the instrumented timed up and go and/or posturography for fall screening.

PubMed

Sample, Renee Beach; Kinney, Allison L; Jackson, Kurt; Diestelkamp, Wiebke; Bigelow, Kimberly Edginton

2017-09-01

The Timed Up and Go (TUG) has been commonly used for fall risk assessment. The instrumented Timed Up and Go (iTUG) adds wearable sensors to capture sub-movements and may be more sensitive. Posturography assessments have also been used for determining fall risk. This study used stepwise logistic regression models to identify key outcome measures for the iTUG and posturography protocols. The effectiveness of the models containing these measures in differentiating fallers from non-fallers were then compared for each: iTUG total time duration only, iTUG, posturography, and combined iTUG and posturography assessments. One hundred and fifty older adults participated in this study. The iTUG measures were calculated utilizing APDM Inc.'s Mobility Lab software. Traditional and non-linear posturography measures were calculated from center of pressure during quiet-standing. The key outcome measures incorporated in the iTUG assessment model (sit-to-stand lean angle and height) resulted in a model sensitivity of 48.1% and max re-scaled R 2 value of 0.19. This was a higher sensitivity, indicating better differentiation, compared to the model only including total time duration (outcome of the traditional TUG), which had a sensitivity of 18.2%. When the key outcome measures of the iTUG and the posturography assessments were combined into a single model, the sensitivity was approximately the same as the iTUG model alone. Overall the findings of this study support that the iTUG demonstrates greater sensitivity than the total time duration, but that carrying out both iTUG and posturography does not greatly improve sensitivity when used as a fall risk screening tool. Copyright © 2017 Elsevier B.V. All rights reserved.

The Clinical Relevance of Force Platform Measures in Multiple Sclerosis: A Review

PubMed Central

Prosperini, Luca; Pozzilli, Carlo

2013-01-01

Balance impairment and falls are frequent in patients with multiple sclerosis (PwMS), and they may occur even at the earliest stage of the disease and in minimally impaired patients. The introduction of computer-based force platform measures (i.e., static and dynamic posturography) has provided an objective and sensitive tool to document both deficits and improvements in balance. By using more challenging test conditions, force platform measures can also reveal subtle balance disorders undetectable by common clinical scales. Furthermore, posturographic techniques may also allow to reliably identify PwMS who are at risk of accidental falls. Although force platform measures offer several theoretical advantages, only few studies extensively investigated their role in better managing PwMS. Standardised procedures, as well as clinical relevance of changes detected by static or dynamic posturography, are still lacking. In this review, we summarized studies which investigated balance deficit by means of force platform measures, focusing on their ability in detecting patients at high risk of falls and in estimating rehabilitation-induced changes, highlighting the pros and the cons with respect to clinical scales. PMID:23766910

Muscle quality, aerobic fitness and fat mass predict lower-extremity physical function in community-dwelling older adults.

PubMed

Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

2007-01-01

Muscle mass, strength and fitness play a role in lower-extremity physical function (LEPF) in older adults; however, the relationships remain inadequately characterized. This study aimed to examine the relationships between leg mineral free lean mass (MFLM(LEG)), leg muscle quality (leg strength normalized for MFLM(LEG)), adiposity, aerobic fitness and LEPF in community-dwelling healthy elderly subjects. Fifty-five older adults (69.3 +/- 5.5 years, 36 females, 19 males) were assessed for leg strength using an isokinetic dynamometer, body composition by dual energy X-ray absorptiometry and aerobic fitness via a treadmill maximal oxygen consumption test. LEPF was assessed using computerized dynamic posturography and stair ascent/descent, a timed up-and-go task and a 7-meter walk with and without an obstacle. Muscle strength, muscle quality and aerobic fitness were similarly correlated with static LEPF tests (r range 0.27-0.40, p < 0.05); however, the strength of the independent predictors was not robust with explained variance ranging from 9 to 16%. Muscle quality was the strongest correlate of all dynamic LEPF tests (r range 0.54-0.65, p < 0.001). Using stepwise linear regression analysis, muscle quality was the strongest independent predictor of dynamic physical function explaining 29-42% of the variance (p < 0.001), whereas aerobic fitness or body fat mass explained 5-6% of the variance (p < 0.05) depending on performance measure. Muscle quality is the most important predictor, and aerobic fitness and fat mass are secondary predictors of LEPF in community-dwelling older adults. These findings support the importance of exercise, especially strength training, for optimal body composition, and maintenance of strength and physical function in older adults.

Digital Posturography Games Correlate with Gross Motor Function in Children with Cerebral Palsy.

PubMed

Bingham, Peter M; Calhoun, Barbara

2015-04-01

This pilot study aimed to assess whether performance on posturography games correlates with the Gross Motor Function Measure (GMFM) in children with cerebral palsy. Simple games using static posturography technology allowed subjects to control screen events via postural sway. Game performance was compared with GMFMs using correlation analysis in a convenience sample of nine girls and six boys with cerebral palsy. Likert scales were used to obtain subjective responses to the balance games. GMFM scores correlated with game performance, especially measures emphasizing rhythmic sway. Twelve of the 15 subjects enjoyed the game and asserted an interest in playing again. Digital posturography games engage children with cerebral palsy in balance tasks, provide visual feedback in a balance control task, and have the potential to increase autonomy in balance control training among pediatric patients with cerebral palsy. This approach can support the relationship between child and therapist. The potential for interactive posturography to complement the assessment and treatment of balance in cerebral palsy bears continuing study.

Posturography using the Wii Balance Board™: A feasibility study with healthy adults and adults post-stroke.

PubMed

Llorens, Roberto; Latorre, Jorge; Noé, Enrique; Keshner, Emily A

2016-01-01

Posturography systems that incorporate force platforms are considered to assess balance and postural control with greater sensitivity and objectivity than conventional clinical tests. The Wii Balance Board (WBB) system has been shown to have similar performance characteristics as other force platforms, but with lower cost and size. To determine the validity and reliability of a freely available WBB-based posturography system that combined the WBB with several traditional balance assessments, and to assess the performance of a cohort of stroke individuals with respect to healthy individuals. Healthy subjects and individuals with stroke were recruited. Both groups were assessed using the WBB-based posturography system. Individuals with stroke were also assessed using a laboratory grade posturography system and a battery of clinical tests to determine the concurrent validity of the system. A group of subjects were assessed twice with the WBB-based system to determine its reliability. A total of 144 healthy individuals and 53 individuals with stroke participated in the study. Concurrent validity with another posturography system was moderate to high. Correlations with clinical scales were consistent with previous research. The reliability of the system was excellent in almost all measures. In addition, the system successfully characterized individuals with stroke with respect to the healthy population. The WBB-based posturography system exhibited excellent psychometric properties and sensitivity for identifying balance performance of individuals with stroke in comparison with healthy subjects, which supports feasibility of the system as a clinical tool. Copyright © 2015 Elsevier B.V. All rights reserved.

Tailored balance exercises on people with multiple sclerosis: A pilot randomized, controlled study.

PubMed

Brichetto, Giampaolo; Piccardo, Elisa; Pedullà, Ludovico; Battaglia, Mario Alberto; Tacchino, Andrea

2015-07-01

Altered integration of signals from visual (VIS), somatosensory (PROP) and vestibular system (VEST) lead to balance control impairments affecting the daily living activities of patients with multiple sclerosis (PwMS). As a consequence, tailored interventions could be crucial in improving efficacy of balance rehabilitation treatments. The objective of this paper is to assess the efficacy of tailored rehabilitation treatments for balance disorders based on visual, somatosensory and vestibular deficits versus traditional rehabilitation exercises. Thirty-two PwMS were assessed with the Berg Balance Scale (BBS), the composite score (CS) obtained by computerized dynamic posturography (CDP) test and the Modified Fatigue Impact Scale (MFIS). Based on CDP analysis, prevalent VIS, PROP or VEST deficits were identified and patients randomly allocated to a personalized (PRG) or traditional (TRG) rehabilitation group. BBS score showed a significant difference between pre- and post-treatment scores of 6.3 and 2.0 points respectively for PRG and TRG. CS showed a significant difference between pre- and post-treatment scores of 16.6 and 7.6 points respectively for PRG and TRG. No interaction effect was found for MFIS score. BBS and CS showed changes in the PRG group that met clinical relevant difference, underlining that tailored rehabilitation interventions based on patient-specific sensory system impairment could improve balance and postural control in PwMS. © The Author(s), 2015.

Is balance performance reduced after mild traumatic brain injury?: Interim analysis from chronic effects of neurotrauma consortium (CENC) multi-centre study.

PubMed

Walker, William C; Nowak, Kayla J; Kenney, Kimbra; Franke, Laura Manning; Eapen, Blessen C; Skop, Karen; Levin, Harvey; Agyemang, Amma A; Tate, David F; Wilde, Elisabeth A; Hinds, Sidney; Nolen, Tracy L

2018-06-12

Determine if mild traumatic brain injury (mTBI) history is associated with balance disturbances. Chronic Effects of Neurotrauma Consortium (CENC) centres. The CENC multi-centre study enrols post-9/11 era Service Members and Veterans with combat exposure. This sample (n = 322) consisted of enrolees completing initial evaluation by September 2016 at the three sites conducting computerized dynamic post-urography (CDP) testing. Observational study with cross-sectional analyses using structural equation modelling. Comprehensive structured interviews were used to diagnose all lifetime mild traumatic brain injuries (mTBIs). The outcome, Sensory Organization Test (SOT), was measured on CDP dual-plate force platform. Other studied variables were measured by structured interviews, record review and questionnaires. The overall positive/negative mTBI classification did not have a significant effect on the composite equilibrium score. However, the repetitive mTBI classification showed lower scores for participants with ≥ 3 mTBI versus 1-2 lifetime mTBIs. For repetitive mTBI, pain interference acted as a mediator for the indirect effect, and a direct effect was evident on some sensory condition equilibrium scores. These findings show that repeated mTBI, partially mediated by pain, may lead to later balance disturbances among military combatants. Further study of CDP outcomes within this accruing cohort is warranted.

A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

PubMed Central

Ortiz-Gutiérrez, Rosa; Cano-de-la-Cuerda, Roberto; Galán-del-Río, Fernando; Alguacil-Diego, Isabel María; Palacios-Ceña, Domingo; Miangolarra-Page, Juan Carlos

2013-01-01

Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available. PMID:24185843

A Prospective Open-Label Study of Combined Treatment for Idiopathic Parkinson's Disease Using Acupuncture and Bee Venom Acupuncture as an Adjunctive Treatment.

PubMed

Doo, Kyeong-Hee; Lee, Ji-Hyun; Cho, Seung-Yeon; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Kim, Ho; Park, Hi-Joon; Park, Seong-Uk

2015-10-01

The purpose of this study was to examine the effectiveness and safety of combined treatment using acupuncture and bee venom acupuncture (BVA) as an adjunctive treatment for idiopathic Parkinson's disease (PD). Eleven patients (7 men and 4 women) with idiopathic PD who had been receiving a stable dose of anti-parkinsonian medication for at least 4 weeks. Participants received conventional treatment for 12 weeks. Subsequently, they received additional treatment with acupuncture and BVA twice weekly for 12 weeks while still maintaining conventional treatment. All participants were assessed at baseline, 12 weeks, and 24 weeks by using the Unified Parkinson's Disease Rating Scale (UPDRS), the Parkinson's Disease Quality of Life Questionnaire (PDQL), the speed and number of steps required to walk 20 m, and the Beck Depression Inventory (BDI). Maximum excursion and directional control, measured by computerized dynamic posturography (Balance Master(®) System, NeuroCom, San Carlos, CA), were used to assess postural stability. Patients who underwent 12 weeks of twice-weekly combined treatment with acupuncture and BVA showed significant improvements in gait speed, PDQL score, activities of daily living (UPDRS part II), motor symptoms (UPDRS part III), and combined UPDRS part II+III scores compared with assessments after conventional treatment. Combined treatment with acupuncture and BVA showed promising results as a safe adjunctive therapy for PD.

Dynamical structure of center-of-pressure trajectories with and without functional taping in children with cerebral palsy level I and II of GMFCS.

PubMed

Pavão, Silvia Leticia; Ledebt, Annick; Savelsbergh, Geert J P; Rocha, Nelci Adriana C F

2017-08-01

Postural control during quiet standing was examined in typical children (TD) and children with cerebral palsy (CP) level I and II of GMFCS. The immediate effect on postural control of functional taping on the thighs was analyzed. We evaluated 43 TD, 17 CP children level I, and 10 CP children level II. Participants were evaluated in two conditions (with and without taping). The trajectories of the center of pressure (COP) were analyzed by means of conventional posturography (sway amplitude, sway-path-length) and dynamic posturography (degree of twisting-and-turning, sway regularity). Both CP groups showed larger sway amplitude than the TD while only the CP level II showed more regular COP trajectories with less twisting-and-turning. Functional taping didn't affect sway amplitude or sway-path-length. TD children exhibited more twisting-and-turning with functional taping, whereas no effects on postural sway dynamics were observed in CP children. Functional taping doesn't result in immediate changes in quiet stance in CP children, whereas in TD it resulted in faster sway corrections. Children level II invest more attention in postural control than level I, and TD. While quiet standing was more automatized in children level I than in level II, both CP groups showed a less stable balance than TD. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of Corrective Taping on Balance and Gait in Patients With Hallux Valgus.

PubMed

Gur, Gozde; Ozkal, Ozden; Dilek, Burcu; Aksoy, Songul; Bek, Nilgun; Yakut, Yavuz

2017-05-01

Taping is an effective temporary therapy for improving hallux valgus (HV) in adults. Although HV has been demonstrated to impair postural balance, there is a lack of information about how corrective taping affects balance and gait patterns in adults with HV deformity. Eighteen middle-aged female patients (average age, 53.5 years) with HV were included. Corrective tape was applied to correct HV angulation. A series of balance and gait stability tests were performed before applying tape and 1 hour after the tape was applied with a Balance Master computerized posturography device. The study involved the following tests: modified clinical test of sensory interaction and balance (mCTSIB), unilateral stance (US), limit of stability (LoS), step up/over (SUO), and walk across (WA) tests. No significant difference was found between the no-tape and taped condition in the static balance mCTSIB and US tests ( P > .05). The taping intervention resulted in significant improvement in the dynamic balance measures for the LoS test's backward reaction time and left maximum excursion ( P < .05), a significantly higher impact index bilaterally in the SUO assessment ( P < .05), and an increase in step width mean and variability in the WA test ( P < .05). Taping for correcting HV angulation had negative acute effects on dynamic balance in the SUO and WA tests and positive effects in the LoS test. Corrective taping, although a form of conservative treatment for hallux valgus, has been insufficiently studied in terms of effects on balance. Our results show that taping, as an acute effect, may impair balance in middle-aged adults when walking or ascending and descending stairs.

Sensitive Quantitative Assessment of Balance Disorders

NASA Technical Reports Server (NTRS)

Paloski, Willilam H.

2007-01-01

Computerized dynamic posturography (CDP) has become a standard technique for objectively quantifying balance control performance, diagnosing the nature of functional impairments underlying balance disorders, and monitoring clinical treatment outcomes. We have long used CDP protocols to assess recovery of sensory-motor function in astronauts following space flight. The most reliable indicators of post-flight crew performance are the sensory organization tests (SOTs), particularly SOTs 5 and 6, which are sensitive to changes in availability and/or utilization of vestibular cues. We have noted, however, that some astronauts exhibiting obvious signs of balance impairment after flight are able to score within clinical norms on these tests, perhaps as a result of adopting competitive strategies or by their natural skills at substituting alternate sensory information sources. This insensitivity of the CDP protocol could underestimate of the degree of impairment and, perhaps, lead to premature release of those crewmembers to normal duties. To improve the sensitivity of the CDP protocol we have introduced static and dynamic head tilt SOT trials into our protocol. The pattern of postflight recovery quantified by the enhanced CDP protocol appears to more aptly track the re-integration of sensory-motor function, with recovery time increasing as the complexity of sensory-motor/biomechanical task increases. The new CDP protocol therefore seems more suitable for monitoring post-flight sensory-motor recovery and for indicating to crewmembers and flight surgeons fitness for return to duty and/or activities of daily living. There may be classes of patients (e.g., athletes, pilots) having motivation and/or performance characteristics similar to astronauts whose sensory-motor treatment outcomes would also be more accurately monitored using the enhanced CDP protocol. Furthermore, the enhanced protocol may be useful in early detection of age-related balance disorders.

Characterization and Early Detection of Balance Deficits in Fragile X Premutation Carriers With and Without Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS).

PubMed

O'Keefe, Joan A; Robertson-Dick, Erin; Dunn, Emily J; Li, Yan; Deng, Youping; Fiutko, Amber N; Berry-Kravis, Elizabeth; Hall, Deborah A

2015-12-01

Fragile X-associated tremor/ataxia syndrome (FXTAS) results from a "premutation" size 55-200 CGG repeat expansion in the fragile X mental retardation 1 (FMR1) gene. Core motor features include cerebellar gait ataxia and kinetic tremor, resulting in progressive mobility disability. There are no published studies characterizing balance deficits in FMR1 premutation carriers with and without FXTAS using a battery of quantitative measures to test the sensory integration underlying postural control, automatic postural reflexes, and dynamic postural stability limits. Computerized dynamic posturography (CDP) and two performance-based balance measures were administered in 44 premutation carriers, 21 with FXTAS and 23 without FXTAS, and 42 healthy controls to compare balance and functional mobility between these groups. Relationships between FMR1 molecular variables, age, and sex and CDP scores were explored. FXTAS subjects demonstrated significantly lower scores on the sensory organization test (with greatest reductions in the vestibular control of balance), longer response latencies to balance perturbations, and reduced stability limits compared to controls. Premutation carriers without FXTAS also demonstrated significantly delayed response latencies and disrupted sensory weighting for balance control. Advancing age, male sex, increased CGG repeat size, and reduced X activation of the normal allele in premutation carrier women predicted balance dysfunction. These postural control deficits in carriers with and without FXTAS implicate dysfunctional cerebellar neural networks and may provide valuable outcome markers for tailored rehabilitative interventions. Our findings suggest that CDP may provide sensitive measures for early detection of postural control impairments in at-risk carriers and better characterize balance dysfunction and progression in FXTAS.

Computerized Dynamic Adaptive Tests with Immediately Individualized Feedback for Primary School Mathematics Learning

ERIC Educational Resources Information Center

Wu, Huey-Min; Kuo, Bor-Chen; Wang, Su-Chen

2017-01-01

In this study, a computerized dynamic assessment test with both immediately individualized feedback and adaptively property was applied to Mathematics learning in primary school. For evaluating the effectiveness of the computerized dynamic adaptive test, the performances of three types of remedial instructions were compared by a pre-test/post-test…

Persistent Symptoms and Objectively Measured Balance Performance Among OEF/OIF Veterans With Remote Mild Traumatic Brain Injury.

PubMed

Hebert, Jeffrey R; Forster, Jeri E; Stearns-Yoder, Kelly A; Penzenik, Molly E; Brenner, Lisa A

2018-01-30

To investigate linear relationships between dizziness, fatigue, and depression and posttraumatic stress disorder (PTSD) and objectively measured balance performance in Veterans with remote mild traumatic brain injury (mTBI). Academic laboratory; Veterans Affairs Medical Center. Thirty Veterans (28 men) who served in Iraq/Afghanistan and whose most recent mTBI was sustained more than 6 months prior to enrollment. Cross-sectional, observational trial. The Computerized Dynamic Posturography-Sensory Organization Test (CDP-SOT) and the Community Balance and Mobility (CB&M) scale measured balance. Dizziness (Dizziness Handicap Inventory), fatigue (Modified Fatigue Impact Scale), depression-related symptoms (Beck Depression Inventory-II), and PTSD-related symptoms (PTSD Checklist 5) were also measured. Objectively measured balance, CDP-SOT composite, was impaired (mean score of 67.9). CDP-SOT scores correlated with dizziness (r = -0.53; P = .002), fatigue (r = -0.38; P = .03), depression (r = -0.55; P = .001), and PTSD symptoms (r = -0.53; P = .002). Dizziness, time since most recent mTBI, and PTSD symptoms and depression combined explained significant variability in CDP-SOT scores (R = 0.46; P = .003), as did fatigue depression and PTSD symptoms (R = 0.33; P = .01). Impaired balance was identified among the cohort. Findings suggest that dizziness, fatigue, depression and PTSD, and time since most recent mTBI may influence balance performance. Additional research is needed to identify the potentially interrelated natural histories of these co-occurring symptoms.

Continuous equilibrium scores: factoring in the time before a fall.

PubMed

Wood, Scott J; Reschke, Millard F; Owen Black, F

2012-07-01

The equilibrium (EQ) score commonly used in computerized dynamic posturography is normalized between 0 and 100, with falls assigned a score of 0. The resulting mixed discrete-continuous distribution limits certain statistical analyses and treats all trials with falls equally. We propose a simple modification of the formula in which peak-to-peak sway data from trials with falls is scaled according the percent of the trial completed to derive a continuous equilibrium (cEQ) score. The cEQ scores for trials without falls remain unchanged from the original methodology. The cEQ factors in the time before a fall and results in a continuous variable retaining the central tendencies of the original EQ distribution. A random set of 5315 Sensory Organization Test trials were pooled that included 81 falls. A comparison of the original and cEQ distributions and their rank ordering demonstrated that trials with falls continue to constitute the lower range of scores with the cEQ methodology. The area under the receiver operating characteristic curve (0.997) demonstrates that the cEQ retained near-perfect discrimination between trials with and without falls. We conclude that the cEQ score provides the ability to discriminate between ballistic falls from falls that occur later in the trial. This approach of incorporating time and sway magnitude can be easily extended to enhance other balance tests that include fall data or incomplete trials. Copyright © 2012 Elsevier B.V. All rights reserved.

The correlation between white matter hyperintensity and balance disorder and fall risk: An observational, prospective cohort study.

PubMed

Shen, Dong-Chao; Wu, Shuo-Lin; Shi, Yu-Zhi; Wang, Shuo; Zhang, Yu-Mei; Wang, Chun-Xue

2016-09-01

The presence of an association between white matter hyperintensity (WMH) and the risk of falls in older people is uncertain, with little supporting prospective evidence available at present. We aimed to determine whether WMH was associated with dysfunctions of balance and gait, and other sensorimotor factors leading to falls, and the independent factors related to falls in older Chinese people. The protective effect of exercise against falls was also addressed. In a representative sample of hospital-based individuals aged 50 years and older in China, the patients' history of falls, magnetic resonance imaging data, scores on the 9-item Berg Balance Scale (BBS-9) test and timed up-and-go test (TUGT), and sensorimotor measures of computerized dynamic posturography (CDP) were analyzed. Incident falls were recorded prospectively over a 12-month period. Using regression modeling, the association between the risk of falls and baseline WMH was estimated. Only individuals with severe WMH were at an increased risk of falls, and CDP was more sensitive than BBS-9 in detecting WMH-related balance and gait dysfunction. However, WMH was not an independent predictor of falls. Taller height and overweight or obese body habitus were identified as novel protective factors for falls. Female, fall history, and increased TUGT score were identified as independent risk factors for falls in older Chinese people. Although WMH was associated with an increased risk of falls, it was not an independent predictor.

Age-related changes in posture response under a continuous and unexpected perturbation.

PubMed

Tsai, Yi-Ching; Hsieh, Lin-Fen; Yang, Saiwei

2014-01-22

Aging is a critical factor to influence the functional performance during daily life. Without an appropriate posture control response when experiencing an unexpected external perturbation, fall may occur. A novel six-degree-of freedom platform with motion control protocol was designed to provide a real-life simulation of unexpected disturbance in order to discriminate the age-related changes of the balance control and the recovery ability. Twenty older adults and 20 healthy young adults participated in the study. The subjects stood barefoot on the novel movable platform, data of the center of mass (COM) excursion, joint rotation angle and electromyography (EMG) were recorded and compared. The results showed that the older adults had similar patterns of joint movement and COM excursion as the young adults during the balance reactive-recovery. However, larger proximal joint rotation in elderly group induced larger COM sway envelop and therefore loss of the compensatory strategy of posture recovery. The old adults also presented a lower muscle power. In order to keep an adequate joint stability preventing from falling, the EMG activity was increased, but the asymmetric pattern might be the key reason of unstable postural response. This novel design of moveable platform and test protocol comprised the computerized dynamic posturography (CDP) demonstrate its value to assess the possible sensory, motor, and central adaptive impairments to balance control and could be the training tool for posture inability person. © 2013 Elsevier Ltd. All rights reserved.

Determinants of sport-specific postural control strategy and balance performance of amateur rugby players.

PubMed

Chow, Gary C C; Fong, Shirley S M; Chung, Joanne W Y; Chung, Louisa M Y; Ma, Ada W W; Macfarlane, Duncan J

2016-11-01

Postural control strategy and balance performance of rugby players are important yet under-examined issues. This study aimed to examine the differences in balance strategy and balance performance between amateur rugby players and non-players, and to explore training- and injury-related factors that may affect rugby players' balance outcomes. Cross-sectional and exploratory study. Forty-five amateur rugby players and 41 healthy active individuals participated in the study. Balance performance and balance strategies were assessed using the sensory organization test (SOT) of the Smart Equitest computerized dynamic posturography machine. Rugby training history and injury history were solicited from the participants. The SOT strategy scores were 1.99-54.90% lower in the rugby group than in the control group (p<0.05), and the equilibrium scores were 1.06-14.29% lower in the rugby group than in the control group (p<0.05). After accounting for age, sex and body mass index, only length of rugby training (in years) was independently associated with the SOT condition 6 strategy score, explaining 15.7% of its variance (p=0.006). There was no association between SOT condition 6 strategy/equilibrium scores and injury history among the rugby players (p>0.05). Amateur rugby players demonstrated inferior balance strategy and balance performance compared to their non-training counterparts. Their suboptimal balance strategy was associated with insufficient training experience but not with history of injury. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

[Static posturography versus clinical tests in elderly people with vestibular pathology].

PubMed

Ortuño-Cortés, Miguel A; Martín-Sanz, Eduardo; Barona-de Guzmán, Rafael

2008-01-01

Balance can be quantified by clinical tests and through instrumental studies. The objective of this paper is to determine the correlation between static posturography and 4 clinical tests of balance in elderly people with vestibular disorders and to identify its capability to discriminate the groups studied. 60 patients with vestibular disorders and 60 healthy subjects performed 4 clinical tests (one leg standing with opened eyes, Timed Up and Go, Tinetti and Berg tests) and a static posturography analysis (NedSVE/IBV system) under 4 conditions: Romberg Test, Eyes Open (REO), Romberg Test, Eyes Closed (REC), Romberg Test on Foam with Eyes Open (RFEO), and Romberg Test on Foam with Eyes Closed (RFEC). RFEO correlated best with the clinical tests and RFEC was the worst. RFEO distinguished between healthy individuals and decompensated patients. RFEO gave the best information about postural balance in the elderly. RFEC was not useful. Static posturography can be useful to distinguish vestibular compensation status.

A Simple Postflight Measure of Postural Atania in Astronauts

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Harm, D. I.; Kofman, I. S.; Wood, S. J.; Bloomberg, J. J.

2011-01-01

Astronauts returning from space flight universally present with postural ataxia. Throughout the Space Shuttle Program, measurement of ataxia has concentrated on sway in the anterior-posterior (AP) plane. The current investigation, as a part of a larger functional study, concentrated on characterizing postural instability using dynamic stabilographic sway patterns in both the AP and medial-lateral (ML) planes. To accomplish this goal, six astronauts from short-duration (Shuttle) and three from long-duration (ISS) flights were required to recover from a simulated fall. Subjects with eyes open, wearing running shoes lay prone on the floor for 2 minutes and then quickly stood up, maintained a quiet stance for 3 minutes, arms relaxed along the side of the body, and feet comfortably placed on the force plate. Crewmembers were tested twice before flight, on landing day (Shuttle only), and 1, 6, and 30 days after flight. Anterior-posterior and ML center-of-pressure (COP) coordinates were calculated from the ground reaction forces collected at 500 Hz. The 3-minute quiet stance trial was broken into three 1-minute segments for stabilogram diffusion analysis. A mean sway speed (rate of change of COP displacement) was also calculated as an additional postural stability parameter. While there was considerable variation, most of crewmembers tested exhibited increased stochastic activity evidenced by larger short-term COP diffusion coefficients postflight in both the AP and ML planes, suggesting significant changes in postural control mechanisms, particularly control of lower limb muscle function. As expected, postural instability of ISS astronauts on the first day postflight was similar to that of Shuttle crewmembers on landing day. Recoveries of stochastic activity and mean sway speed to baseline levels were typically observed by the 30th day postflight for both long-duration and short-duration crewmembers. Dynamic postural stability characteristics obtained in this low-impact study complement the data measured with computerized dynamic posturography.

Postflight Quiet Stance Stability of Astronauts Following Recovery From a Simulated Fall

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Kofman, I. S.; Fisher, E. A.; Cerisano, J. M.; Lawrence, E. L.; Peters, B. T.; Harm, D. L.; Kulecz, W.; Mulavara, A. P.; Fiedler, M. J.;

Does a Relationship Exist Between Lower Body Power and Balance Scores Among Older Adults?

PubMed

Shim, Andrew; Harr, Brady; Waller, Mike

2018-03-12

Falls are the second-leading cause of unintentional injury and death worldwide. To determine if a relationship exists between lower body power scores and center of pressure (CoP) and limits of stability (LoS) scores. A one-shot case study design (n = 13) was selected for the investigation. All participants were assessed stability scores via computerized posturography to determine CoP and LoS balance scores. Participants stood on a perturbed surface with their eyes open and closed. An experimental stair ramp with a switch mat timing device was used to determine lower body power scores in watts. There was a strong correlation (r = 0.725, p = 0.005) between the posterior (LoS) plane and relative peak power. An intraclass R revealed a strong correlation among the three trials (R = 0.831) performed on the stair ramp. Muscle power output and LoS scores have moderate to strong correlations with balance scores in older adults.

Postural control in restless legs syndrome with medication intervention using pramipexole.

PubMed

Ahlgrén-Rimpiläinen, Aulikki; Lauerma, Hannu; Kähkönen, Seppo; Aalto, Heikki; Tuisku, Katinka; Holi, Matti; Pyykkö, Ilmari; Rimpiläinen, Ilpo

2014-02-01

Central dopamine regulation is involved in postural control and in the pathophysiology of restless legs syndrome (RLS) and Parkinson's disease (PD). Postural control abnormalities have been detected in PD, but there are no earlier studies with regard to RLS and postural control. Computerized force platform posturography was applied to measure the shift and the velocity (CPFV) of center point of forces (CPF) with eyes open (EO) and eyes closed (EC) in controls (n = 12) and prior and after a single day intervention with pramipexole in RLS subjects (n = 12). CPFV (EO) was significantly lower in the RLS group (p < 0.05) than in controls. After pramipexole intake, the difference disappeared and the subjective symptom severity diminished. Pramipexole did not significantly influence CPFV (EC) or CPF shift direction. Subjects with RLS used extensively visual mechanisms to control vestibule-spinal reflexes to improve or compensate the postural stability. Further research is needed to clarify altered feedback in the central nervous system and involvement of dopamine and vision in the postural control in RLS.

Prediction of future falls in a community dwelling older adult population using instrumented balance and gait analysis.

PubMed

Bauer, C M; Gröger, I; Rupprecht, R; Marcar, V L; Gaßmann, K G

2016-04-01

The role of instrumented balance and gait assessment when screening for prospective fallers is currently a topic of controversial discussion. This study analyzed the association between variables derived from static posturography, instrumented gait analysis and clinical assessments with the occurrence of prospective falls in a sample of community dwelling older people. In this study 84 older people were analyzed. Based on a prospective occurrence of falls, participants were categorized into fallers and non-fallers. Variables derived from clinical assessments, static posturography and instrumented gait analysis were evaluated with respect to the association with the occurrence of prospective falls using a forward stepwise, binary, logistic regression procedure. Fallers displayed a significantly shorter single support time during walking while counting backwards, increased mediolateral to anteroposterior sway amplitude ratio, increased fast mediolateral oscillations and a larger coefficient (Coeff) of sway direction during various static posturography tests. Previous falls were insignificantly associated with the occurrence of prospective falls. Variables derived from posturography and instrumented gait analysis showed significant associations with the occurrence of prospective falls in a sample of community dwelling older adults.

Vision preference in dynamic posturography analysed according to vestibular impairment and handicap.

PubMed

Perez, N I; Rama, J I; Martinez Vila, E

2004-01-01

The objective of this work was to characterise the implications of vision preference derived from the sensory organisation test of computerised dynamic posturography, in terms of impairment, disability and handicap. This was a prospective assessment of 88 patients suffering from dizziness who denied experiencing any visually induced vertiginous symptoms. The level of impairment of each patient was estimated by performing a complete analysis of vestibular function by means of the caloric and rotatory stimulation tests. Disability and handicap were determined with the Dizziness Handicap Inventory questionnaire (DHI). The results of the caloric test in patients were independent of vision preference although canal paresis was more frequently abnormal in patients without visual preference. No differences were found in the results of rotatory stimulation by means of impulse and sinusoidal tests, both at high velocities of stimuli, in between patients with and without vision preference. Similarly, the responses in the DHI, a common questionnaire for vestibular disability and handicap and, specifically to questions addressing the problem of visual and vestibular disability, were not able to differentiate either group of patients. Nevertheless, we have found that patients with vision preference tend to have poorer balance. We consider that in the patients studied here, vision preference must be considered as a normal finding as this represents a normal strategy in a subject that relies more heavily on visual cues for his or her postural control.

The effect of height and BMI on computer dynamic posturography parameters in women.

PubMed

Olchowik, Grażyna; Tomaszewski, Marek; Olejarz, Piotr; Warchoł, Jan; Różańska-Boczula, Monika

2014-01-01

The human body's posture control is a complex system of organs and mechanisms which controls the body's centre of gravity (COG) over its base of support (BOS). Computerised Dynamic Posturography (CDP) allows for the quantitative and objective assessment of the sensory and motor components of the body's posture control system as well as of the integration and adaptation mechanisms in the central nervous system. The aim of this study was to assess the relationships between the body's height and BMI on CDP results in a group of young healthy women without any clinical symptoms of balance disorders. It was found that the MS depended significantly on the height and BMI of the subjects as well as on the SOT conditions. As the height and BMI increased the MS value decreased. The postural response latency (LC) in the MCT statistically significantly depended only on height and showed a positive correlation. The postural response latency increased with height. The postural response amplitude for both right and left lower limbs significantly depended on height and BMI, but only for the backward movement of the platform. The response amplitude for all platform translations under all MCT conditions increased with height and BMI. The body's resultant imbalance caused by the platform perturbations in the ADT was greater in shorter people and those with a lower BMI.

Walking on ballast impacts balance.

PubMed

Wade, Chip; Garner, John C; Redfern, Mark S; Andres, Robert O

2014-01-01

Railroad workers often perform daily work activities on irregular surfaces, specifically on ballast rock. Previous research and injury epidemiology have suggested a relationship between working on irregular surfaces and postural instability. The purpose of this study was to examine the impact of walking on ballast for an extended duration on standing balance. A total of 16 healthy adult males walked on a 7.62 m × 4.57 m (25 ft × 15 ft) walking surface of no ballast (NB) or covered with ballast (B) of an average rock size of about 1 inch for 4 h. Balance was evaluated using dynamic posturography with the NeuroCom(®) Equitest System(™) prior to experiencing the NB or B surface and again every 30 min during the 4 h of ballast exposure. Dependent variables were the sway velocity and root-mean-square (RMS) sway components in the medial-lateral and anterior-posterior directions. Repeated measures ANOVA revealed statistically significant differences in RMS and sway velocity between ballast surface conditions and across exposure times. Overall, the ballast surface condition induced greater sway in all of the dynamic posturography conditions. Walking on irregular surfaces for extended durations has a deleterious effect on balance compared to walking on a surface without ballast. These findings of changes in balance during ballast exposure suggest that working on an irregular surface may impact postural control.

Is Tai Chi Chuan effective in improving lower limb response time to prevent backward falls in the elderly?

PubMed

Wong, Alice M K; Pei, Yu-Cheng; Lan, Ching; Huang, Shu-Chun; Lin, Yin-Chou; Chou, Shih-Wei

2009-06-01

To evaluate the training effect of Tai Chi Chuan (TCC) in postural control and backward fall prevention in the elderly, balance assessment and visually guided lower limb response time were analyzed in a case-control study conducted in a community setting. Thirty-one elderly subjects (mean age: 68.2 +/- 6.8 years) participated in the TCC group, 30 community-dwelling elderly subjects with matched age and body composition served as the elderly control group, with 13 young adults (mean age: 27.5 +/- 3.8 years) serving as young controls. The TCC group had practiced TCC regularly five times per week, for over 30 min per day for at least 4 years. Lower limb response time were measured using a computerized dance machine that we developed, which contains two blocks during testing: single and dual feet. The motor planning of the latter is more complex than the former. Postural control was assessed by computerized posturography (Smart Balance Master). Compared to the elderly controls, the TCC group demonstrated significantly better balance performance in sway-referenced support, which is more challenging. Moreover, the TCC group had better dual feet response than the elderly controls in the forward-backward, forward-right and forward-left directions. Practicing TCC may improve motor responses and postural control in the elderly, particularly in more challenging situations. Subjects showed better postural responses to unexpected perturbation in the forward-backward and forward-sideways direction than sideways or backward-sideways directions, which may have clinical relevance.

Comparative impacts of Tai Chi, balance training, and a specially-designed yoga program on balance in older fallers.

PubMed

Ni, Meng; Mooney, Kiersten; Richards, Luca; Balachandran, Anoop; Sun, Mingwei; Harriell, Kysha; Potiaumpai, Melanie; Signorile, Joseph F

2014-09-01

To compare the effect of a custom-designed yoga program with 2 other balance training programs. Randomized controlled trial. Research laboratory. A group of older adults (N=39; mean age, 74.15 ± 6.99 y) with a history of falling. Three different exercise interventions (Tai Chi, standard balance training, yoga) were given for 12 weeks. Balance performance was examined during pre- and posttest using field tests, including the 8-foot up-and-go test, 1-leg stance, functional reach, and usual and maximal walking speed. The static and dynamic balances were also assessed by postural sway and dynamic posturography, respectively. Training produced significant improvements in all field tests (P<.005), but group difference and time × group interaction were not detected. For postural sway, significant decreases in the area of the center of pressure with eyes open (P=.001) and eyes closed (P=.002) were detected after training. For eyes open, maximum medial-lateral velocity significantly decreased for the sample (P=.013). For eyes closed, medial-lateral displacement decreased for Tai Chi (P<.01). For dynamic posturography, significant improvements in overall score (P=.001), time on the test (P=.006), and 2 linear measures in lateral (P=.001) and anterior-posterior (P<.001) directions were seen for the sample. Yoga was as effective as Tai Chi and standard balance training for improving postural stability and may offer an alternative to more traditional programs. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Comparison of Postural Recovery Following Short and Long Duration Spaceflights

NASA Technical Reports Server (NTRS)

Wood, S. J.; Fiedler, J.; Taylor, L. C.; Kozlovskaya, I.; Black, F. O.; Paloski, W. H.

2010-01-01

INTRODUCTION: Post-flight postural ataxia reflects adaptive changes to vestibulo-spinal reflexes and control strategies adopted for movement in weightlessness. Quantitative measures obtained during computerized dynamic posturography (CDP) from US and Russian programs provide insight into the effect of spaceflight duration in terms of both the initial decrements and recovery of postural stability. METHODS: CDP was obtained on 117 crewmembers following Shuttle flights lasting 4-17 days, and on 64 crewmembers following long-duration missions lasting 48-380 days. Although the number and timing of sessions varied, the goal was to characterize postural recovery pooling similar measures from different research and flight medicine programs. This report focuses on eyes closed, head erect conditions with either a fixed or sway-referenced base of support. A smaller subset of subjects repeated the sway-referenced condition while making pitch head movements (+/- 20deg at 0.33Hz). Equilibrium scores were derived from peak-to-peak anterior-posterior sway. Fall probability was modeled using Bayesian statistical methods to estimate parameters of a logit function. RESULTS: The standard Romberg condition was the least sensitive. Longer duration flights led to larger decrements in stability with sway-reference support during the first 1-2 days, although the timecourse of recovery was similar across flight duration with head erect. Head movements led to increased incidence of falls during the first week, with a significantly longer recovery following long duration flights. CONCLUSIONS: The diagnostic assessment of postural instability, and differences in the timecourse of postural recovery between short and long flight durations, are more pronounced during unstable support conditions requiring active head movements.

A Novel Balance Training Program for Children With Developmental Coordination Disorder

PubMed Central

Fong, Shirley S.M.; Guo, X.; Cheng, Yoyo T.Y.; Liu, Karen P.Y.; Tsang, William W.N.; Yam, Timothy T.T.; Chung, Louisa M.Y.; Macfarlane, Duncan J.

2016-01-01

Abstract This study aimed to compare the effectiveness of a specific functional movement–power training (FMPT) program, a functional movement training (FMT) program and no training in the improvement of balance strategies, and neuromuscular performance in children with developmental coordination disorder (DCD). It was a randomized, single-blinded, parallel group controlled trial. Methods: 161 children with DCD (age: 6–10 years) were randomly assigned to the FMPT, FMT, or control groups. The 2 intervention groups received FMPT or FMT twice a week for 3 months. Measurements were taken before, after, and 3 months after the end of the intervention period. The primary outcomes were the composite score and strategy scores on the sensory organization test as measured by a computerized dynamic posturography machine. Secondary outcomes included the knee muscle peak force and the time taken to reach the peak force. The balance strategies adopted in sensory challenging environments of the FMPT participants showed greater improvement from baseline to posttest than those of the FMT participants (7.10 points; 95% confidence interval, 1.51–12.69; P = 0.008) and the control participants (7.59 points; 95% confidence interval, 1.81–13.38; P = 0.005). The FMPT participants also exhibited greater improvement from baseline to the posttest in the knee extensor peak force and time to peak force in the knee flexors. The FMPT program was more effective than the conventional FMT program in the enhancement of balance strategies and neuromuscular performance in children with DCD. PMID:27100457

Hypoxia-induced changes in standing balance.

PubMed

Wagner, Linsey S; Oakley, Sarah R; Vang, Pao; Noble, Brie N; Cevette, Michael J; Stepanek, Jan P

2011-05-01

A few studies in the literature have reported postural changes with hypoxia, but none have quantified the magnitude of change. Further understanding of this condition could have implications for patients at risk for falls, individuals undergoing acute altitude exposure, and pilots and commercial passengers. The objective of this study was to evaluate the effect of different levels of hypoxia (oxygen nitrogen mixtures) on postural standing balance using the computerized dynamic posturography (CDP) system. This improves upon previous protocols by manipulating vision and standing balance with a sway-referenced visual field and/or platform. Additionally, normative data were available for comparison with the cumulative test scores and scores for each condition. Altitude hypoxia was simulated by use of admixing nitrogen to the breathing gas to achieve equivalent altitudes of 1524 m, 2438 m, and 3048 m. Subjects were evaluated using the CDP system. Subjects showed an overall trend toward decreased performance at higher simulated altitudes consistent with the initial hypothesis. Composite standing balance sway scores for the sensory organization subtest of CDP were decreased compared to baseline for simulated altitudes as low as 2438 m (mean sway scores: 81.92 at baseline; 81.85 at 1524 m; 79.15 at 2438 m; 79.15 at 3048 m). Reaction times to unexpected movements in the support surface for the motor control subtest (MCT) increased compared to baseline (mean composite scores: 133.3 at baseline; 135.9 ms at 1524 m; 138.0 ms at 2438 m; 140.9 ms at 3048 m). The CDP testing provided a reliable objective measurement of degradation of balance under hypoxic conditions.

Case report: a balance training program using the Nintendo Wii Fit to reduce fall risk in an older adult with bilateral peripheral neuropathy.

PubMed

Hakim, Renée Marie; Salvo, Charles J; Balent, Anthony; Keyasko, Michael; McGlynn, Deidre

2015-02-01

A recent systematic review supported the use of strength and balance training for older adults at risk for falls, and provided preliminary evidence for those with peripheral neuropathy (PN). However, the role of gaming systems in fall risk reduction was not explored. The purpose of this case report was to describe the use of the Nintendo® Wii™ Fit gaming system to train standing balance in a community-dwelling older adult with PN and a history of recurrent near falls. A 76-year-old patient with bilateral PN participated in 1 h of Nintendo® Wii™ Fit balance training, two times a week for 6 weeks. Examination was conducted using a Computerized Dynamic Posturography system (i.e. Sensory Organization Test (SOT), Limits of Stability (LOS), Adaptation Test (ADT) and Motor Control Test (MCT) and clinical testing with the Berg Balance Scale (BBS), Timed Up and Go (TUG), Activities-specific Balance Confidence (ABC) scale and 30-s Chair Stand. Following training, sensory integration scores on the SOT were unchanged. Maximum excursion abilities improved by a range of 37-86% on the LOS test. MCT scores improved for amplitude with forward translations and ADT scores improved for downward platform rotations. Clinical scores improved on the BBS (28/56-34/56), ABC (57.5-70.6%) and TUG (14.9-10.9 s) which indicated reduced fall risk. Balance training with a gaming system showed promise as a feasible, objective and enjoyable method to improve physical performance and reduce fall risk in an individual with PN.

Postural stability in a population of dancers, healthy non-dancers, and vestibular neuritis patients.

PubMed

Martin-Sanz, Eduardo; Ortega Crespo, Isabel; Esteban-Sanchez, Jonathan; Sanz, Ricardo

2017-09-01

Several studies have indicated better balance control in dancers than in control participants, but some controversy remains. The aim of our study is to evaluate the postural stability in a cohort of dancers, non-dancers, compensated, and non-compensated unilateral vestibular neuritis (VN). This is a prospective study of control subjects, dancers, and VN patients between June 2009 and December 2015. Dancers from the Dance Conservatory of Madrid and VN patients were referred to our department for analysis. After the clinical history, neuro-otological examination, audiogram, and caloric tests, the diagnosis was done. Results from clinical examination were used for the categorization of compensation situation. A computerized dynamic posturography was performed to every subject. Forty dancers and 38 women formed both 'dancer' and 'normal' cohorts. Forty-two compensated and 39 uncompensated patients formed both 'compensated' and 'uncompensated' cohorts. Dancers had significantly greater antero-posterior (AP) body sway than controls during condition 5 and 6 in the Sensory Organization Test (SOT) (p < .05). When we compared the uncompensated cohort with both control and dancers groups, we found significant greater body sway in every SOT studied condition (p < .05). While mean AP body say in SOT 5 and 6, showed greater values in compensated patients than the control group, the mean analysis did not show any statistical difference between the compensated and dancer groups, in such SOT conditions. Dancers demonstrated greater sways than non-dancers when they relied their postural control on vestibular input alone. Compensated patients had a similar posturographic pattern that the dancers cohort, suggesting a similar shift from visual to somatosensory information.

Selective skin sensitivity changes and sensory reweighting following short-duration space flight.

PubMed

Lowrey, Catherine R; Perry, Stephen D; Strzalkowski, Nicholas D J; Williams, David R; Wood, Scott J; Bent, Leah R

2014-03-15

Skin sensory input from the foot soles is coupled with vestibular input to facilitate body orientation in a gravitational environment. Anecdotal observations suggest that foot sole skin becomes hypersensitive following space flight. The veritable level of skin sensitivity and its impact on postural disequilibrium observed post space flight have not been documented. Skin sensitivity of astronauts (n = 11) was measured as vibration perception at the great toe, fifth metatarsal and heel. Frequencies targeted four classes of receptors: 3 and 25 Hz for slow-adapting (SA) receptors and 60 and 250 Hz for fast-adapting (FA) receptors. Data were collected pre- and post-space flight. We hypothesized that skin sensitivity would increase post-space flight and correlate to balance measures. Decreased skin sensitivity was found on landing day at 3 and 25 Hz on the great toe. Hypersensitivity was found for a subset of astronauts (n = 6) with significantly increased sensitivity to 250 Hz at the heel. This subset displayed a greater reduction in computerized dynamic posturography (CDP) equilibrium (EQ) scores (-54%) on landing vs. non-hypersensitive participants (-11%). Observed hyposensitivity of SA (pressure) receptors may indicate a strategy to reduce pressure input during periods of unloading. Hypersensitivity of FAs coupled with reduced EQ scores may reflect targeted sensory reweighting. Altered gravito-inertial environments reduce vestibular function in balance control which may trigger increased weighting of FAs (that signal foot contact, slips). Understanding modulations to skin sensitivity has translational implications for mitigating postural disequilibrium following space flight and for on-Earth preventative strategies for imbalance in older adults.

Vibrotactile neurofeedback balance training in patients with Parkinson's disease: reducing the number of falls.

PubMed

Rossi-Izquierdo, Marcos; Ernst, Arne; Soto-Varela, Andrés; Santos-Pérez, Sofía; Faraldo-García, Ana; Sesar-Ignacio, Angel; Basta, Dietmar

2013-02-01

The aim of this study was to assess effectiveness of balance training with a vibrotactile neurofeedback system in improving overall stability in patients with Parkinson's disease (PD). Ten patients diagnosed with idiopathic PD were included. Individualization of the rehabilitation program started with a body sway analysis of stance and gait tasks (Standard Balance Deficit Test, SBDT) by using the diagnostic tool of the applied device (Vertiguard(®)-RT). Those tasks with the poorest outcome as related to age- and gender-related controls were included in the training program (not more than six tasks). Improvement of postural stability was assessed by performing SBDT, Sensory Organization Test (SOT) of Computerized Dynamic Posturography (CDP), Dizziness Handicap Inventory (DHI), activity-specific balance confidence scale and recording the number of falls over the past three months. Furthermore, scores of SOT and DHI of 10 PD patients previously trained in an earlier study (by using CDP) were compared with results of those in the present study. After neurofeedback training (NFT), there was a statistically significant improvement in body sway (calculated over all training tasks), number of falls, and scores of SOT, DHI and ABC. In comparison with CDP-training, a statistically significant higher increase of SOT score was observed for patients after NFT with the Vertiguard-RT device compared to CDP training. Our results showed that a free-field vibrotactile NFT with Vertiguard(®)-RT device can improve balance in PD patients in everyday life conditions very effectively, which might led in turn to a reduction of falls. Copyright © 2012 Elsevier B.V. All rights reserved.

Foam pad of appropriate thickness can improve diagnostic value of foam posturography in detecting postural instability.

PubMed

Liu, Bo; Leng, Yangming; Zhou, Renhong; Liu, Jingjing; Liu, Dongdong; Liu, Jia; Zhang, Su-Lin; Kong, Wei-Jia

2018-04-01

The present study investigated the effect of foam thickness on postural stability in patients with unilateral vestibular hypofunction (UVH) during foam posturography. Static and foam posturography were performed in 33 patients (UVH group) and 30 healthy subjects (control group) with eyes open (EO) and closed (EC) on firm surface and on 1-5 foam pad(s). Sway velocity (SV) of center of pressure, standing time before falling (STBF) and falls reaction were recorded and analyzed. (1) SVs had an increasing tendency in both groups as the foam pads were added under EO and EC conditions. (2) STBFs, only in UVH group with EC, decreased with foam thickness increasing. (3) Significant differences in SV were found between the control and UVH group with EO (except for standing on firm surface, on 1 and 2 foam pad(s)) and with EC (all surface conditions). (4) Receiver operating characteristic curve analysis showed that the SV could better reflect the difference in postural stability between the two groups while standing on the 4 foam pads with EC. Our study showed that diagnostic value of foam posturography in detecting postural instability might be enhanced by using foam pad of right thickness.

Posturography and risk of recurrent falls in healthy non-institutionalized persons aged over 65.

PubMed

Buatois, Séverine; Gueguen, René; Gauchard, Gérome C; Benetos, Athanase; Perrin, Philippe P

2006-01-01

A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to identify those at high-risk of recurrent falls. Copyright (c) 2006 S. Karger AG, Basel.

Planning Future Instructional Programs through Computerized L2 Dynamic Assessment

ERIC Educational Resources Information Center

Ebadi, Saman; Saeedian, Abdulbaset

2016-01-01

Dynamic Assessment (DA) is a postmodern notion in testing which sees instruction and assessment as inextricably mingled contending that learners will progress if provided with dynamic interactions. The main purpose of the study is to see if the scores generated by the computerized dynamic assessment (C-DA) which is grounded in Vygotsky's…

Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography

PubMed Central

Tanaka, Erika H.; Santos, Paulo F.; Reis, Júlia G.; Rodrigues, Natalia C.; Moraes, Renato; Abreu, Daniela C. C.

2015-01-01

Background: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. Objectives: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Method: Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP) in the anterior-posterior (AP) and medial-lateral (ML) directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm) and unstable (foam). A digital chronometer was activated to measure the time limit (Tlimit) in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. Results: The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01) in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. Conclusions: Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance. PMID:26083602

Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography.

PubMed

Tanaka, Erika H; Santos, Paulo F; Reis, Júlia G; Rodrigues, Natalia C; Moraes, Renato; Abreu, Daniela C C

2015-01-01

Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP) in the anterior-posterior (AP) and medial-lateral (ML) directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm) and unstable (foam). A digital chronometer was activated to measure the time limit (Tlimit) in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01) in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance.

Reduction of falls in older people by improving balance with vestibular rehabilitation (ReFOVeRe study): design and methods.

PubMed

Soto-Varela, Andrés; Gayoso-Diz, Pilar; Rossi-Izquierdo, Marcos; Faraldo-García, Ana; Vaamonde-Sánchez-Andrade, Isabel; del-Río-Valeiras, María; Lirola-Delgado, Antonio; Santos-Pérez, Sofía

2015-12-01

Evaluate the effectiveness of vestibular rehabilitation (VR) to improve the balance in older people, assessed immediately afterwards. (a) To verify the maintenance of improvement of the balance achieved in the medium term (6-12 months). (b) To consider whether this improvement results in a reduction in the number of falls. (c) To compare among themselves the effectiveness of three different methods of VR in improving balance and to explore whether there are differences to achieve a reduction in the number of falls. Experimental study, single-centre, open, randomised (balanced blocks of patients) in four branches in parallel, in 220 elderly patients (over 64 years) with high risk of falls and a follow-up period of 12 months. Department of Otolaryngology of the University Hospital of Santiago. People over 64 years, fulfilling one of the following requirements: (a) At least one fall in the last year. (b) Take at least 16 s or require some support in perform the test "timed up and go". (c) A percentage of average balance in the sensory organisation test (SOT) in the dynamic posturography (CDP) <68%. (d) At least one fall in any of the conditions in the SOT of CDP. Three different protocols of VR. The percentage of average balance in the SOT in CDP. Secondary measures: time and supports in the test of "timed up and go", scores of the dynamic posturography and SwayStar system, and rate of falls.

Postural control and low back pain in elite athletes comparison of static balance in elite athletes with and without low back pain.

PubMed

Oyarzo, Claudio A; Villagrán, Claudio R; Silvestre, Rony E; Carpintero, Pedro; Berral, Francisco J

2014-01-01

Although current research findings suggest that postural control or static balance is impaired in subjects with low back pain, few studies have specifically addressed the effect of low back pain on static balance in elite athletes. Forty-four athletes belonging to Chilean national teams took part in this study; 20 had low back pain and the remaining 24 were healthy controls. Displacement of the centre of pressure was analyzed by computerized platform posturography, using a standardized protocol; subjects were required to stand upright on both feet, with eyes first open then closed. The results showed that, athletes with low back pain used significantly more energy (p< 0.0182) and had a greater displacement of the centre of pressure (p< 0.005) with open eyes to control posture than healthy athletes. It may be concluded that static balance is impaired in elite athletes with low back pain and that analysis of two-footed stance provides a sensitive assessment of static balance in athletes.

The clinical utility of posturography.

PubMed

Visser, Jasper E; Carpenter, Mark G; van der Kooij, Herman; Bloem, Bastiaan R

2008-11-01

Postural instability and falls are common and devastating features of ageing and many neurological, visual, vestibular or orthopedic disorders. Current management of these problems is hampered by the subjective and variable nature of the available clinical balance measures. In this narrative review, we discuss the clinical utility of posturography as a more objective and quantitative measure of balance and postural instability, focusing on several areas where clinicians presently experience the greatest difficulties in managing their patients: (a) to make an appropriate differential diagnosis in patients presenting with falls or balance impairment; (b) to reliably identify those subjects who are at risk of falling; (c) to objectively and quantitatively document the outcome of therapeutic interventions; and (d) to gain a better pathophysiological understanding of postural instability and falls, as a basis for the development of improved treatment strategies to prevent falling. In each of these fields, posturography offers several theoretical advantages and, when applied correctly, provides a useful tool to gain a better understanding of pathophysiological mechanisms in patients with balance disorders, at the group level. However, based on the available evidence, none of the existing techniques is currently able to significantly influence the clinical decision making in individual patients. We critically review the shortcomings of posturography as it is presently used, and conclude with several recommendations for future research.

Study of audiovestibular dysfunction in children with systemic lupus erythematosus.

PubMed

Gad, Ghada Ibrahim; Mohamed, Somaia Tawfik; Awwad, Khaled Salah; Mohamed, Rehab Fetoh

2013-09-01

Inner ear dysfunction in systemic lupus erythematosis patients has been reported but audiovestibular involvement is not well documented especially in pediatrics. This study was designed to evaluate silent audiovestibular dysfunction among SLE children. Case control study examined in allergy and immunology clinic; pediatrics hospital and audiovestibular clinic; Ain Shams University from January 2009 to December 2010. Thirty-five systemic lupus erythematosus children (diagnosed according to American College of Rheumatology); age group 8-16 years, were randomly selected. Five of them were excluded due to one or more exclusion criteria (previous otitis media, stroke, lupus cerebritis, meningitis or encephalitis, audiovestibular symptom). Ten of them refused enrollment or could not complete full battery. Seventeen females and three males, mean age 12.9 ± 2.6 years, completed the study. Control group included 20 normal subjects, age and sex matched. Full clinical assessment, basic audiological evaluation and vestibular testing (videonystagmography VNG and computerized dynamic posturography CDP) were conducted for children included in the study. Five systemic lupus erythematosus patients had sensorineural hearing loss strongly associated with +ve antiphospholipid antibody and two had conductive hearing loss. Two children in control group had conductive hearing loss (p=0.05). Abnormal VNG findings was significantly higher among systemic lupus erythematosus children (40%) compared to controls (0%) and associated with +ve antiphospholipid antibodies (χ(2)=10, p=0.002, Fisher exact test=0.003). Twenty-five percentage of systemic lupus erythematosus children had abnormal CDP findings reflecting impaired balance function associated with positive antiphospholipid antibodies showing significant statistical difference compared to controls (0% affection) (χ(2)=5.7, p=0.017, Fisher exact test=0.047). Silent audiovestibular dysfunction is prevalent among systemic lupus erythematosus children especially those positive for antiphospholipid antibodies necessitating routine regular evaluation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effects of postexercise ice-water and room-temperature water immersion on the sensory organization of balance control and lower limb proprioception in amateur rugby players: A randomized controlled trial.

PubMed

Chow, Gary C C; Yam, Timothy T T; Chung, Joanne W Y; Fong, Shirley S M

2017-02-01

This single-blinded, three-armed randomized controlled trial aimed to compare the effects of postexercise ice-water immersion (IWI), room-temperature water immersion (RWI), and no water immersion on the balance performance and knee joint proprioception of amateur rugby players. Fifty-three eligible amateur rugby players (mean age ± standard deviation: 21.6 ± 2.9 years) were randomly assigned to the IWI group (5.3 °C), RWI group (25.0 °C), or the no immersion control group. The participants in each group underwent the same fatigue protocol followed by their allocated recovery intervention, which lasted for 1 minute. Measurements were taken before and after the fatigue-recovery intervention. The primary outcomes were the sensory organization test (SOT) composite equilibrium score (ES) and the condition-specific ES, which were measured using a computerized dynamic posturography machine. The secondary outcome was the knee joint repositioning error. Two-way repeated measures analysis of variance was used to test the effect of water immersion on each outcome variable. There were no significant within- and between-group differences in the SOT composite ESs or the condition-specific ESs. However, there was a group-by-time interaction effect on the knee joint repositioning error. It seems that participants in the RWI group had lower errors over time, but those in the IWI and control groups had increased errors over time. The RWI group had significantly lower error score than the IWI group at postintervention. One minute of postexercise IWI or RWI did not impair rugby players' sensory organization of balance control. RWI had a less detrimental effect on knee joint proprioception to IWI at postintervention.

The Effects of Long Duration Bed Rest on Functional Mobility and Balance: Relationship to Resting State Motor Cortex Connectivity

NASA Technical Reports Server (NTRS)

Erdeniz, B.; Koppelmans, V.; Bloomberg, J. J.; Kofman, I. S.; DeDios, Y. E.; Riascos-Castaneda, R. F.; Wood, S. J.; Mulavara, A. P.; Seidler, R. D.

2014-01-01

NASA offers researchers from a variety of backgrounds the opportunity to study bed rest as an experimental analog for space flight. Extended exposure to a head-down tilt position during long duration bed rest can resemble many of the effects of a low-gravity environment such as reduced sensory inputs, body unloading and increased cephalic fluid distribution. The aim of our study is to a) identify changes in brain function that occur with prolonged bed rest and characterize their recovery time course; b) assess whether and how these changes impact behavioral and neurocognitive performance. Thus far, we completed data collection from six participants that include task based and resting state fMRI. The data have been acquired through the bed rest facility located at the University of Texas Medical Branch (Galveston, TX). Subjects remained in bed with their heads tilted down 6 degrees below their feet for 70 consecutive days. Behavioral measures and neuroimaging assessments were obtained at seven time points: a) 7 and 12 days before bed rest; b) 7, 30, and 65 days during bed rest; and c) 7 and 12 days after bed rest. Functional connectivity magnetic resonance imaging (FcMRI) analysis was performed to assess the connectivity of motor cortex in and out of bed rest. We found a decrease in motor cortex connectivity with vestibular cortex and the cerebellum from pre bed rest to in bed rest. We also used a battery of behavioral measures including the functional mobility test and computerized dynamic posturography collected before and after bed rest. We will report the preliminary results of analyses relating brain and behavior changes. Furthermore, we will also report the preliminary results of a spatial working memory task and vestibular stimulation during in and out of bed rest.

Recovery trajectories of vestibulopathic subjects after perturbations during locomotion

NASA Technical Reports Server (NTRS)

Wall, C. 3rd; Oddsson, L. I.; Patronik, N.; Sienko, K.; Kentala, E.

2002-01-01

We compared the mediolateral (M/L) responses to perturbations during locomotion of vestibulopathic (VP) subjects to those of controls. Eight subjects with unilateral vestibular loss (100% Reduced Vestibular Response from the caloric test) resulting from surgery for vestibular schwannoma and 11 controls were selected for this study. Despite their known vestibulopathy, all VP subjects scored within the normal range on computerized dynamic posturography Sensory Organization Tests. During gait, subjects were given surface perturbations of the right support-phase foot in two possible directions (forward-right and backward-left) at two possible magnitudes (5 and 10 cm) that were randomly mixed with trials having no perturbations. M/L stability was quantified by estimating the length of the M/L moment arm between the support foot and the trunk, and the M/L accelerations of the sternum and the head. The VP group had greater changes (p < 0.05) in their moment arm responses compared to controls. The number of steps that it took for the moment arm oscillations to return to normal and the variability in the moment arms were greater for the VP group. Differences in the sternum and head accelerations between VP and control groups were not as consistent, but there was a trend toward greater response deviations in the VP group for all 4 perturbation types. Increased response magnitude and variability of the VP group is consistent with an increase in their sensory noise of vestibular inputs due to the surgical lesion. Another possibility is a reduced sensitivity to motion inputs. This perturbation approach may prove useful for characterizing subtle vestibulopathies and similar changes in the human orientation mechanism after exposure to microgravity.

Sex impacts the relation between body composition and physical function in older adults.

PubMed

Valentine, Rudy J; Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

2009-01-01

To determine the sex-specific relationships between physical activity, aerobic fitness, adiposity (%Fat), mineral-free lean mass (MFLM), and balance and gait performance in older adults. Eighty-five female and 49 male sedentary, healthy, community-dwelling older adults (mean [SD] age, 69.6 [5.4] and 70.3 [4.7] years, respectively) were evaluated on habitual physical activity via questionnaire, aerobic fitness by a maximal oxygen consumption treadmill test, whole and regional body composition by dual-energy x-ray absorptiometry, and lower extremity physical function using gait tasks and computerized dynamic posturography. As expected, men had less body fat, more lean mass, and higher aerobic fitness than did women and tended to perform better on all lower extremity physical function tasks (all P 0.50, all P < 0.05). Body fat was related to gait in women (r = -0.38, P < 0.05) but not in men. Neither fitness nor body composition was related to balance in men, whereas in women, leg MFLM was positively associated (r = 0.27, P < 0.05). Women, but not men, with a greater ratio of body weight to leg MFLM performed worse on gait tasks (P < 0.001). There was an interaction with sex for %Fat on gait (P = 0.05) and for leg MFLM on balance (P < 0.05). In sedentary healthy older adults, the relation between body composition, aerobic fitness, and balance and gait differs between sexes such that women are more strongly affected by alterations in body composition. Lower %Fat and preservation of lower body lean mass have important implications for reducing the risk of physical disability, especially in older women.

Effects of postexercise ice-water and room-temperature water immersion on the sensory organization of balance control and lower limb proprioception in amateur rugby players

PubMed Central

Chow, Gary C.C.; Yam, Timothy T.T.; Chung, Joanne W.Y.; Fong, Shirley S.M.

2017-01-01

Abstract Background: This single-blinded, three-armed randomized controlled trial aimed to compare the effects of postexercise ice-water immersion (IWI), room-temperature water immersion (RWI), and no water immersion on the balance performance and knee joint proprioception of amateur rugby players. Methods: Fifty-three eligible amateur rugby players (mean age ± standard deviation: 21.6 ± 2.9 years) were randomly assigned to the IWI group (5.3 °C), RWI group (25.0 °C), or the no immersion control group. The participants in each group underwent the same fatigue protocol followed by their allocated recovery intervention, which lasted for 1 minute. Measurements were taken before and after the fatigue-recovery intervention. The primary outcomes were the sensory organization test (SOT) composite equilibrium score (ES) and the condition-specific ES, which were measured using a computerized dynamic posturography machine. The secondary outcome was the knee joint repositioning error. Two-way repeated measures analysis of variance was used to test the effect of water immersion on each outcome variable. Results: There were no significant within- and between-group differences in the SOT composite ESs or the condition-specific ESs. However, there was a group-by-time interaction effect on the knee joint repositioning error. It seems that participants in the RWI group had lower errors over time, but those in the IWI and control groups had increased errors over time. The RWI group had significantly lower error score than the IWI group at postintervention. Conclusion: One minute of postexercise IWI or RWI did not impair rugby players’ sensory organization of balance control. RWI had a less detrimental effect on knee joint proprioception to IWI at postintervention. PMID:28207546

Mobility assessment: Sensitivity and specificity of measurement sets in older adults

PubMed Central

Panzer, Victoria P.; Wakefield, Dorothy B.; Hall, Charles B.; Wolfson, Leslie I.

2011-01-01

Objective To identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall-risk and predict future falls. Design Observational study with 1-year weekly falls follow-up Setting Mobility laboratory Participants Community-dwelling volunteers (n=74; 65–94 years old) categorized at entry as 27 ‘Non-fallers’ or 47 ‘Fallers’ by Medicare criteria (1 injury fall or >1 non-injury falls in the previous year). Interventions None Outcome Measures Test-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (Falls-status), Tinetti Performance Oriented Mobility Assessment (POMA), Computerized Dynamic Posturography Sensory Organization Test (SOT) and subsequent falls reported weekly. Results Measurement variables were selected that met reliability (ICC > 0.6) and/or discrimination (p<.01) criteria (Clinical variables- Turn- steps, time, Gait- velocity, Step-in-tub-time, and Downstairs- time; Force plate variables- Quiet standing Romberg ratio sway-area, Maximal lean- anterior-posterior excursion, Sit-to-stand medial-lateral excursion and sway-area). Sets were created (3 clinical, 2 force plate) utilizing combinations of variables appropriate for older adults with different functional activity levels and composite scores were calculated. Scores identified entry Falls-status and concurred with POMA and SOT. The Full clinical set (5 measurement variables) produced sensitivity/specificity (.80/.74) to Falls-status. Composite scores were sensitive and specific in predicting subsequent injury falls and multiple falls compared to Falls-status, POMA or SOT. Conclusions Sets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls using tasks that should be appropriate to diverse participants. PMID:21621667

Outcome analysis of individualized vestibular rehabilitation protocols

NASA Technical Reports Server (NTRS)

Black, F. O.; Angel, C. R.; Pesznecker, S. C.; Gianna, C.

2000-01-01

OBJECTIVE: To determine the outcome of vestibular rehabilitation protocols in subjects with peripheral vestibular disorders compared with normal and abnormal control subjects. STUDY DESIGN: Prospective study using repeated measure, matched control design. Subjects were solicited consecutively according to these criteria: vestibular disorder subjects who had abnormal results of computerized dynamic posturography (CDP) sensory organization tests (SOTs) 5 and 6 and underwent rehabilitation; vestibular disorder subjects who had abnormal results of SOTs 5 and 6 and did not undergo rehabilitation; and normal subjects (normal SOTs). SETTING: Tertiary neurotology clinic. SUBJECTS: Men and women over age 18 with chronic vestibular disorders and chief complaints of unsteadiness, imbalance, and/or motion intolerance, and normal subjects. INTERVENTIONS: Pre- and post-rehabilitation assessment included CDP, vestibular disability, and activities of daily living questionnaires. Individualized rehabilitation plans were designed and implemented to address the subject's specific complaints and functional deficits. Supervised sessions were held at weekly intervals, and self-administered programs were devised for daily home use. MAIN OUTCOME MEASURES: CDP composite and SOT scores, number of falls on CDP, and self-assessment questionnaire results. RESULTS: Subjects who underwent rehabilitation (Group A) showed statistically significant improvements in SOTs, overall composite score, and reduction in falls compared with abnormal (Group B) control groups. Group A's performances after rehabilitation were not significantly different from those of normal subjects (Group C) in SOTs 3 through 6, and close to normal on SOTs 1 and 2. Subjects in Group A also reported statistically significant symptomatic improvement. CONCLUSIONS: Outcome measures of vestibular protocol physical therapy confirmed objective and subjective improvement in subjects with chronic peripheral vestibular disorders. These findings support results reported by other investigators.

The effects of attractive vs. repulsive instructional cuing on balance performance.

PubMed

Kinnaird, Catherine; Lee, Jaehong; Carender, Wendy J; Kabeto, Mohammed; Martin, Bernard; Sienko, Kathleen H

2016-03-16

Torso-based vibrotactile feedback has been shown to improve postural performance during quiet and perturbed stance in healthy young and older adults and individuals with balance impairments. These systems typically include tactors distributed around the torso that are activated when body motion exceeds a predefined threshold. Users are instructed to "move away from the vibration". However, recent studies have shown that in the absence of instructions, vibrotactile stimulation induces small (~1°) non-volitional responses in the direction of its application location. It was hypothesized that an attractive cuing strategy (i.e., "move toward the vibration") could improve postural performance by leveraging this natural tendency. Eight healthy older adults participated in two non-consecutive days of computerized dynamic posturography testing while wearing a vibrotactile feedback system comprised of an inertial measurement unit and four tactors that were activated in pairs when body motion exceeded 1° anteriorly or posteriorly. A crossover design was used. On each day participants performed 24 repetitions of Sensory Organization Test condition 5 (SOT5), three repetitions each of SOT 1-6, three repetitions of the Motor Control Test, and five repetitions of the Adaptation Test. Performance metrics included A/P RMS, Time-in-zone and 95 % CI Ellipse. Performance improved with both cuing strategies but participants performed better when using repulsive cues. However, the rate of improvement was greater for attractive versus repulsive cuing. The results suggest that when the cutaneous signal is interpreted as an alarm, cognition overrides sensory information. Furthermore, although repulsive cues resulted in better performance, attractive cues may be as good, if not better, than repulsive cues following extended training.

Pain Perception and Stabilometric Parameters in People With Chronic Low Back Pain After a Pilates Exercise Program

PubMed Central

Patti, Antonino; Bianco, Antonino; Paoli, Antonio; Messina, Giuseppe; Montalto, Maria Alessandra; Bellafiore, Marianna; Battaglia, Giuseppe; Iovane, Angelo; Palma, Antonio

2016-01-01

Abstract Various exercise interventions, such as Pilates exercises and traditional physical therapy methods, are employed to decrease low back pain (LBP). Nonspecific low back pain (NSLBP) is distinct from LBP, however, as the distribution of pain is restricted to the region between the costal margin and the inferior gluteal. The aim of our randomized controlled trial was to evaluate the effects of a program of Pilates exercises on pain perception and stabilometric parameters in patients with NSLBP. Thirty-eight participants were randomly allocated, using a 1:1 scheme, to either the experimental group (EG) or control group (CG). The EG completed a 14-week program of Pilates exercises, performed thrice per week under the supervision of an exercise specialist, while the CG was managed with a social program only. Measures of posturography and Oswestry Disability Index (ODI) for pain perception were obtained at baseline (T0) and after the 14 weeks of intervention (T1). Posturography measures improved for patients in the EG, with both eyes open and eyes closed (P < 0.05). There were no statistical differences in posturography in the CG. ODI decreased significantly in both groups over the 14 weeks of the study protocol: EG, T0, 13.7 ± 5.0 compared with T1, 6.5 ± 4.0 (P < 0.001); and CG, T0, 10.7 ± 7.8 compared with T1, 8.4 ± 7.8 (P < 0.01). A greater extent of reduction in pain was achieved in the EG. The Pilates exercise program yielded improvements in pain and posturography outcomes. Our study also confirms the applicability of posturography in evaluating postural instability in patients with NSLBP. Due to our relatively small study group, future studies would be necessary to confirm our findings. PMID:26765419

Gabapentin can improve postural stability and quality of life in primary orthostatic tremor.

PubMed

Rodrigues, Julian P; Edwards, Dylan J; Walters, Susan E; Byrnes, Michelle L; Thickbroom, Gary; Stell, Rick; Mastaglia, Frank L

2005-07-01

Primary orthostatic tremor (OT) is characterized by leg tremor and instability on standing. High frequency (13-18 Hz) tremor bursting is present in leg muscles during stance, and posturography has shown greater than normal sway. We report on an open-label add-on study of gabapentin in 6 patients with OT. Six patients were studied with surface electromyography, force platform posturography, and a modified Parkinson's disease questionnaire (PDQ-39) quality of life (QOL) scale before and during treatment with gabapentin 300 mg t.d.s. If on other medications for OT, these were continued unchanged. Of the 6 patients, 4 reported a subjective benefit of 50 to 75% with gabapentin, 3 of whom showed reduced tremor amplitude and postural sway of up to 70%. Dynamic balance improved in all 3 patients who completed the protocol. QOL data from 5 patients showed improvement in all cases. No adverse effects were noted. Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway. The findings confirm previous reports of symptomatic benefit with gabapentin and provide justification for larger controlled clinical trials. Further work is required to establish the optimal dosage and to validate the methods used to quantify the response to treatment. Copyright 2005 Movement Disorder Society.

Dynamic Assessment of EFL Learners' Listening Comprehension via Computerized Concept Mapping

ERIC Educational Resources Information Center

Ebadi, Saman; Latif, Shokoufeh Vakili

2015-01-01

In Vygotsky's theory, learner's Zone of Proximal Development (ZPD) and autonomous performance could be further developed through social interaction with an expert. Computerized concept mapping enjoys the advantage of meeting learners' differences and therefore can be applied as a scaffold to support learning process.Taking a dynamic assessment…

Vestibular ataxia following shuttle flights: effects of microgravity on otolith-mediated sensorimotor control of posture.

PubMed

Paloski, W H; Black, F O; Reschke, M F; Calkins, D S; Shupert, C

1993-01-01

Orbital spaceflight exposes astronauts to an environment in which gravity is reduced to negligible magnitudes of 10(-3) to 10(-6) G. Upon insertion into earth orbit, the abrupt loss of the constant linear acceleration provided by gravity removes the otolith stimulus for vestibular sensation of vertical orientation constantly present on Earth. Since the central nervous system (CNS) assesses spatial orientation by simultaneously interpreting sensory inputs from the vestibular, visual, and proprioceptive systems, loss of the otolith-mediated vertical reference input results in an incorrect estimation of spatial orientation, which, in turn, causes a degradation in movement control. Over time, however, the CNS adapts to the loss of gravitational signals. Upon return to Earth, the vertical reference provided by gravitational stimulation of the otolith organ reappears. As a result, a period of CNS readaptation must occur upon return to terrestrial environment. Among the physiological changes observed during the postflight CNS readaptation period is a disruption of postural equilibrium control. Using a dynamic posturography system (modified NeuroCom EquiTest), 16 astronauts were tested at 60, 30, and 10 days preflight and retested at 1 to 5 hours, and 8 days postflight. All astronauts tested demonstrated decreased postural stability immediately upon return to Earth. The most dramatic increases in postural sway occurred during those sensory conditions in which both the visual and proprioceptive feedback information used for postural control were altered by the dynamic posturography system, requiring reliance primarily upon vestibular function for control of upright stance. Less marked but statistically significant increases in sway were observed under those conditions in which visual and foot support surface inputs alone were altered.(ABSTRACT TRUNCATED AT 250 WORDS)

The energy cost for balance control during upright standing.

PubMed

Houdijk, Han; Fickert, Richard; van Velzen, Judith; van Bennekom, Coen

2009-08-01

The aim of this study was to investigate whether balance control during a static upright standing task with and without balance perturbations elicits a significant and meaningful metabolic energy demand and to test whether this energy demand correlates with conventional posturography measures for balance control. Ten healthy subjects were assessed in four 4-min upright standing conditions on a force platform while energy consumption was measured using open circuit respirometry. In the reference condition subjects stood upright in parallel stance without balance perturbation (PS). In the other conditions balance was perturbed by placing the subjects in tandem stance (TS), in tandem stance blind folded (TSBF) and in tandem stance on a balance board (TSBB). Gross and net energy consumption was assessed and various conventional posturography measures were derived from the excursion of the center of pressure (CoP) of the ground reaction force. Energy consumption was substantially affected by all balance perturbations, compared to the reference condition. The highest increase in energy consumption was found for the TSBF condition (increase of 0.86 J kg(-1)s(-1) or 60% of PS). Significant correlations were found between energy consumption and posturography measures. The strongest correlation was found between gross energy consumption and the CoP path and normalized CoP path along the anterior-posterior axis (resp. r=0.57 and r=0.66, p<0.001). It was concluded that the effort for balance control can elicit a meaningful metabolic energy demand. Conventional posturography provided significant, though moderate, predictors of this metabolic effort for balance control.

Results from the balance rehabilitation unit in benign paroxysmal positional vertigo.

PubMed

Kasse, Cristiane Akemi; Santana, Graziela Gaspar; Scharlach, Renata Coelho; Gazzola, Juliana Maria; Branco, Fátima Cristina Barreiro; Doná, Flávia

2010-01-01

Posturography is a useful new tool to study the influence of vestibular diseases on balance. to compare the results from the Balance Rehabilitation Unit (BRU) static posturography in elderly patients with Benign Paroxysmal Positional Vertigo (BPPV), before and after Epley's maneuver. a prospective study of 20 elderly patients with a diagnosis of BPPV. The patients underwent static posturography and the limit of stability (LE) and ellipse area were measured. We also applied the Dizziness Handicap Inventory (DHI) questionnaire to study treatment effectiveness. 80% were females, with a mean age of 68.15 years. After the maneuver, the LE increased significantly (p=0.001). The elliptical area of somatosensory, visual and vestibular conflicts (2,7,8,9 situations) in BRU and the DHI scores decreased significantly (p<0.05) after treatment. the study suggests that elderly patients with BPPV may present static postural control impairment and that the maneuver is effective for the remission of symptoms, to increase in the stability and improvement in postural control in situations of visual, somatosensory and vestibular conflicts.

Open source posturography.

PubMed

Rey-Martinez, Jorge; Pérez-Fernández, Nicolás

2016-12-01

The proposed validation goal of 0.9 in intra-class correlation coefficient was reached with the results of this study. With the obtained results we consider that the developed software (RombergLab) is a validated balance assessment software. The reliability of this software is dependent of the used force platform technical specifications. Develop and validate a posturography software and share its source code in open source terms. Prospective non-randomized validation study: 20 consecutive adults underwent two balance assessment tests, six condition posturography was performed using a clinical approved software and force platform and the same conditions were measured using the new developed open source software using a low cost force platform. Intra-class correlation index of the sway area obtained from the center of pressure variations in both devices for the six conditions was the main variable used for validation. Excellent concordance between RombergLab and clinical approved force platform was obtained (intra-class correlation coefficient =0.94). A Bland and Altman graphic concordance plot was also obtained. The source code used to develop RombergLab was published in open source terms.

Medical Devices Assess, Treat Balance Disorders

NASA Technical Reports Server (NTRS)

2009-01-01

You may have heard the phrase as difficult as walking and chewing gum as a joking way of referring to something that is not difficult at all. Just walking, however, is not all that simple physiologically speaking. Even standing upright is an undertaking requiring the complex cooperation of multiple motor and sensory systems including vision, the inner ear, somatosensation (sensation from the skin), and proprioception (the sense of the body s parts in relation to each other). The compromised performance of any of these elements can lead to a balance disorder, which in some form affects nearly half of Americans at least once in their lifetimes, from the elderly, to those with neurological or vestibular (inner ear) dysfunction, to athletes with musculoskeletal injuries, to astronauts returning from space. Readjusting to Earth s gravity has a significant impact on an astronaut s ability to balance, a result of the brain switching to a different "model" for interpreting sensory input in normal gravity versus weightlessness. While acclimating, astronauts can experience headaches, motion sickness, and problems with perception. To help ease the transition and study the effects of weightlessness on the body, NASA has conducted many investigations into post-flight balance control, realizing this research can help treat patients with balance disorders on Earth as well. In the 1960s, the NASA-sponsored Man Vehicle Laboratory at the Massachusetts Institute of Technology (MIT) studied the effects of prolonged space flight on astronauts. The lab s work intrigued MIT doctoral candidate Lewis Nashner, who began conducting NASA-funded research on human movement and balance under the supervision of Dr. Larry Young in the MIT Department of Aeronautics and Astronautics. In 1982, Nashner s work resulted in a noninvasive clinical technique for assessing the cooperative systems that allow the body to balance, commonly referred to as computerized dynamic posturography (CDP). CDP employs a series of dynamic protocols to isolate and assess balance function deficiencies. The technology was based on Nashner s novel, engineering-inspired concept of balance as an adaptable collaboration between multiple sensory and motor systems. CDP proved useful not only for examining astronauts, but for anyone suffering from balance problems. Today, CDP is the standard medical tool for objectively evaluating balance control.

Virtual reality stimuli for force platform posturography.

PubMed

Tossavainen, Timo; Juhola, Martti; Ilmari, Pyykö; Aalto, Heikki; Toppila, Esko

2002-01-01

People relying much on vision in the control of posture are known to have an elevated risk of falling. Dependence on visual control is an important parameter in the diagnosis of balance disorders. We have previously shown that virtual reality methods can be used to produce visual stimuli that affect balance, but suitable stimuli need to be found. In this study the effect of six different virtual reality stimuli on the balance of 22 healthy test subjects was evaluated using force platform posturography. According to the tests two of the stimuli have a significant effect on balance.

[Comparative evaluation of vertigo in patients after stapedotomy and stapedectomy].

PubMed

Harmat, Kinga; Thurén, Gergely; Simon, László; Nepp, Nelli; Németh, Adrienn; Gerlinger, Imre; Bakó, Péter

2017-09-01

The reason of gradually developing conductive hearing loss in otosclerotic patients is the ossification of the stapes footplate to the surrounding bony structures and the therapy of stapes fixation is mainly surgical. In stapedotomy the footplate of the stapes is fenestrated with laser and microdrill in a diameter of 0.8 mm, whereas in stapedectomy there is complete removal of the footplate followed by the reconstruction of the ossicular chain. In the early postoperative period, temporary vertigo is frequently recorded which significantly influences the recovery. In the Department of Otorhinolaryngology, University of Pécs both stapedectomy and stapedotomy were performed on a daily basis between 01.02.2010 and 15.03.2012. Our study focused on comparing the degree of postoperative vertigo after the two types of surgery. We hypothesized that the smaller fenestration of the stapes footplate during stapedotomy limits exposure to the inner ear reducing the severity of dizziness. Vertigo was evaluated subjectively with a retrospective questionnaire and objectively with static posturography. On the 1st postoperative day, significantly fewer patients reported vertigo in the stapedotomy group and with significantly lower intensity. Results of the questionnaire regarding the later postoperative period showed no significant differences between the groups. Based on the analysis of the posturography test results, no significant difference was detected between the postoperative stability of the two groups. Results of the questionnaire and the posturography showed no correlation. Posturography test results did not confirm the presence of subjective vertigo. Many factors may play a role in the development of vertigo after stapes surgery, but the type of intervention does not influence it. Orv Hetil. 2017; 158(38): 1503-1511.

The role of computerized symbolic manipulation in rotorcraft dynamics analysis

NASA Technical Reports Server (NTRS)

Crespo Da Silva, Marcelo R. M.; Hodges, Dewey H.

1986-01-01

The potential role of symbolic manipulation programs in development and solution of the governing equations for rotorcraft dynamics problems is discussed and illustrated. Nonlinear equations of motion for a helicopter rotor blade represented by a rotating beam are developed making use of the computerized symbolic manipulation program MACSYMA. The use of computerized symbolic manipulation allows the analyst to concentrate on more meaningful tasks, such as establishment of physical assumptions, without being sidetracked by the tedious and trivial details of the algebraic manipulations. Furthermore, the resulting equations can be produced, if necessary, in a format suitable for numerical solution. A perturbation-type solution for the resulting dynamical equations is shown to be possible with a combination of symbolic manipulation and standard numerical techniques. This should ultimately lead to a greater physical understanding of the behavior of the solution than is possible with purely numerical techniques. The perturbation analysis of the flapping motion of a rigid rotor blade in forward flight is presented, for illustrative purposes, via computerized symbolic manipulation with a method that bypasses Floquet theory.

Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet

PubMed Central

Lee, Hong-Jae; Lim, Kil-Byung; Yoo, JeeHyun; Yun, Hyun-Ju; Jeong, Tae-Ho

2015-01-01

Objective To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. Method A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. Result Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (p<0.001) improvements in pain degree and frequency were noted after 1 and 3 months of custom-molded foot orthoses. In addition, significant (p<0.05) improvement in balancing ability was found after 3 months of custom-molded foot orthoses. Conclusion Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot. PMID:26798604

STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

PubMed Central

Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E.; Eckhardt-Henn, Annegret; Dieterich, Marianne

2015-01-01

Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles. PMID:26843786

STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness.

PubMed

Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E; Eckhardt-Henn, Annegret; Dieterich, Marianne

2015-01-01

Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V ), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles.

Verticality Perceptions Associate with Postural Control and Functionality in Stroke Patients

PubMed Central

Baggio, Jussara A. O.; Mazin, Suleimy S. C.; Alessio-Alves, Frederico F.; Barros, Camila G. C.; Carneiro, Antonio A. O.; Leite, João P.; Pontes-Neto, Octavio M.; Santos-Pontelli, Taiza E. G.

2016-01-01

Deficits of postural control and perceptions of verticality are disabling problems observed in stroke patients that have been recently correlated to each other. However, there is no evidence in the literature confirming this relationship with quantitative posturography analysis. Therefore, the objectives of the present study were to analyze the relationship between Subjective Postural Vertical (SPV) and Haptic Vertical (HV) with posturography and functionality in stroke patients. We included 45 stroke patients. The study protocol was composed by clinical interview, evaluation of SPV and HV in roll and pitch planes and posturography. Posturography was measured in the sitting and standing positions under the conditions: eyes open, stable surface (EOSS); eyes closed, stable surface (ECSS); eyes open, unstable surface (EOUS); and eyes closed, unstable surface (ECUS). The median PV in roll plane was 0.34° (-1.44° to 2.54°) and in pitch plane 0.36° (-2.72° to 2.45°). The median of HV in roll and pitch planes were -0.94° (-5.86° to 3.84°) and 3.56° (-0.68° to 8.36°), respectively. SPV in the roll plane was correlated with all posturagraphy parameters in sitting position in all conditions (r = 0.35 to 0.47; p < 0.006). There were moderate correlations with the verticality perceptions and all the functional scales. Linear regression model showed association between speed and SPV in the roll plane in the condition EOSS (R2 of 0.37; p = 0.005), in the condition ECSS (R2 of 0.13; p = 0.04) and in the condition EOUS (R2 of 0.22; p = 0.03). These results suggest that verticality perception is a relevant component of postural control and should be systematically evaluated, particularly in patients with abnormal postural control. PMID:26954679

Motion Estimation and Compensation Strategies in Dynamic Computerized Tomography

NASA Astrophysics Data System (ADS)

Hahn, Bernadette N.

2017-12-01

A main challenge in computerized tomography consists in imaging moving objects. Temporal changes during the measuring process lead to inconsistent data sets, and applying standard reconstruction techniques causes motion artefacts which can severely impose a reliable diagnostics. Therefore, novel reconstruction techniques are required which compensate for the dynamic behavior. This article builds on recent results from a microlocal analysis of the dynamic setting, which enable us to formulate efficient analytic motion compensation algorithms for contour extraction. Since these methods require information about the dynamic behavior, we further introduce a motion estimation approach which determines parameters of affine and certain non-affine deformations directly from measured motion-corrupted Radon-data. Our methods are illustrated with numerical examples for both types of motion.

Three-dimensional head-mounted gaming task procedure maximizes effects of vestibular rehabilitation in unilateral vestibular hypofunction: a randomized controlled pilot trial.

PubMed

Micarelli, Alessandro; Viziano, Andrea; Augimeri, Ivan; Micarelli, Domenico; Alessandrini, Marco

2017-12-01

Considering the emerging advantages related to virtual reality implementation in clinical rehabilitation, the aim of the present study was to discover possible (i) improvements achievable in unilateral vestibular hypofunction patients using a self-assessed head-mounted device (HMD)-based gaming procedure when combined with a classical vestibular rehabilitation protocol (HMD group) as compared with a group undergoing only vestibular rehabilitation and (ii) HMD procedure-related side effects. Therefore, 24 vestibular rehabilitation and 23-matched HMD unilateral vestibular hypofunction individuals simultaneously underwent a 4-week rehabilitation protocol. Both otoneurological measures (vestibulo-ocular reflex gain and postural arrangement by studying both posturography parameters and spectral values of body oscillation) and performance and self-report measures (Italian Dizziness Handicap Inventory; Activities-specific Balance Confidence scale; Zung Instrument for Anxiety Disorders, Dynamic Gait Index; and Simulator Sickness Questionnaire) were analyzed by means of a between-group/within-subject analysis of variance model. A significant post-treatment between-effect was found, and the HMD group demonstrated an overall improvement in vestibulo-ocular reflex gain on the lesional side, in posturography parameters, in low-frequency spectral domain, as well as in Italian Dizziness Handicap Inventory and Activities-specific Balance Confidence scale scores. Meanwhile, Simulator Sickness Questionnaire scores demonstrated a significant reduction in symptoms related to experimental home-based gaming tasks during the HMD procedure. Our findings revealed the possible advantages of HMD implementation in vestibular rehabilitation, suggesting it as an innovative, self-assessed, low-cost, and compliant tool useful in maximizing vestibular rehabilitation outcomes.

Tailored care for somatoform vertigo/dizziness: study protocol for a randomised controlled trial evaluating integrative group psychotherapy.

PubMed

Lahmann, Claas; Henningsen, P; Dieterich, M; Radziej, K; Schmid, G

2015-08-01

Vertigo/dizziness (VD) ranks high in lifetime prevalence and clinical relevance. Nearly half of the complex VD disorders presenting at specialised units for vertigo or otoneurological disorders are not fully explained by an identifiable medical illness, but instead are related to anxiety, depressive, or somatoform disorders. Although there is some evidence that psychotherapy may be effective for these patients, therapeutic options remain unsatisfactory. This report describes the objectives, design and methods of a randomised, controlled clinical trial, evaluating the efficacy of manualised, multimodal group psychotherapy, based on integrative psychotherapy (IPT) and tailored to subgroups of mental disorders in medically unexplained VD. This psychotherapeutic approach will be compared to self-help groups (n = 172; n = 86 per study arm). Improvements with regard to handicap due to VD at 12 months follow-up will serve as primary outcome. Additionally, measures of generic quality of life, severity of vertigo, depression, anxiety, somatisation as well as Head Impulse Test and Computerized Static Posturography will be applied. We will also analyse the cost-effectiveness of this trial. The study aims to improve treatment of this therapeutically underserved population who are often severely impaired in their working and daily lives. ClinicalTrials.gov Identifier: NCT02320851. This is an on-going study; recruitment for the study is about to start.

Postural stability and quality of life after guided and self-training among older adults residing in an institutional setting.

PubMed

Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Moisio-Vilenius, Päivi; Mäkinen, Erja; Toppila, Esko; Pyykkö, Ilmari

2013-01-01

To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly's daily routine and making it more active and exhausting.

Static Posturography: A New Perspective in the Assessment of Lameness in a Canine Model

PubMed Central

Manera, Maria E.; Carrillo, José M.; Batista, Miguel; Rubio, Monica; Sopena, Joaquin; Santana, Angelo

2017-01-01

The aim of this study was to assess the static posturography in dogs as a useful tool for diagnosis of lameness by means of the use of a pressure platform. For this purpose, a series of different parameters (pressure distribution, area of support, mean pressure, maximum pressure and statokinesiograms) were obtained from five lame dogs with unilateral elbow osteoarthritis treated with plasma rich in growth factors. Data were obtained before and 3 months after treatment, and results were compared with a control group of sound dogs of similar conformation. Significant differences were found in the above mentioned parameters between sound and lame limbs. Improvement after 3 months of treatment was also detected, demonstrating that this multi-parametric technique is an effective and reliable method for the assessment of lameness in dogs. PMID:28114312

Static Posturography: A New Perspective in the Assessment of Lameness in a Canine Model.

PubMed

Manera, Maria E; Carrillo, José M; Batista, Miguel; Rubio, Monica; Sopena, Joaquin; Santana, Angelo; Vilar, José M

2017-01-01

The aim of this study was to assess the static posturography in dogs as a useful tool for diagnosis of lameness by means of the use of a pressure platform. For this purpose, a series of different parameters (pressure distribution, area of support, mean pressure, maximum pressure and statokinesiograms) were obtained from five lame dogs with unilateral elbow osteoarthritis treated with plasma rich in growth factors. Data were obtained before and 3 months after treatment, and results were compared with a control group of sound dogs of similar conformation. Significant differences were found in the above mentioned parameters between sound and lame limbs. Improvement after 3 months of treatment was also detected, demonstrating that this multi-parametric technique is an effective and reliable method for the assessment of lameness in dogs.

Effect of Developmental Binocular Vision Abnormalities on Visual Vertigo Symptoms and Treatment Outcome.

PubMed

Pavlou, Marousa; Acheson, James; Nicolaou, Despina; Fraser, Clare L; Bronstein, Adolfo M; Davies, Rosalyn A

2015-10-01

Customized vestibular rehabilitation incorporating optokinetic (OK) stimulation improves visual vertigo (VV) symptoms; however, the degree of improvement varies among individuals. Binocular vision abnormalities (misalignment of ocular axis, ie, strabismus) may be a potential risk factor. This study aimed to investigate the influence of binocular vision abnormalities on VV symptoms and treatment outcome. Sixty subjects with refractory peripheral vestibular symptoms underwent an orthoptic assessment after being recruited for participation in an 8-week customized program incorporating OK training via a full-field visual environment rotator or video display, supervised or unsupervised. Treatment response was assessed at baseline and at 8 weeks with dynamic posturography, Functional Gait Assessment (FGA), and questionnaires for symptoms, symptom triggers, and psychological state. As no significant effect of OK training type was noted for any variables, data were combined and new groups identified on the basis of the absence or presence of a binocular vision abnormality. A total of 34 among 60 subjects consented to the orthoptic assessment, of whom 8 of the 34 had binocular vision abnormalities and 30 of the 34 subjects completed both the binocular function assessment and vestibular rehabilitation program. No significant between-group differences were noted at baseline. The only significant between-group difference was observed for pre-/post-VV symptom change (P = 0.01), with significant improvements noted only for the group without binocular vision abnormalities (P < 0.0005). Common vestibular symptoms, posturography, and the FGA improved significantly for both groups (P < 0.05). Binocular vision abnormalities may affect VV symptom improvement. These findings may have important implications for the management of subjects with refractory vestibular symptoms.Video Abstract available for insights from the authors regarding clinical implication of the study findings (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A115).

Changes in postural control in patients with Parkinson's disease: a posturographic study.

PubMed

Doná, F; Aquino, C C; Gazzola, J M; Borges, V; Silva, S M C A; Ganança, F F; Caovilla, H H; Ferraz, H B

2016-09-01

Postural instability is one of the most disabling features in Parkinson's disease (PD), and often leads to falls that reduce mobility and functional capacity. The objectives of this study were to analyse the limit of stability (LOS) and influence of the manipulation of visual, somatosensorial and visual-vestibular information on postural control in patients with PD and healthy subjects. Cross-sectional. Movement Disorders Unit, university setting. Eighty-two subjects aged between 37 and 83 years: 41 with Parkinson's disease in the 'on' state and 41 healthy subjects with no neurological disorders. Both groups were matched in terms of sex and age. Unified Parkinson's Disease Rating Scale (UPDRS)-motor score, modified Hoehn and Yahr staging, Dynamic Gait Index (DGI) and posturography with integrated virtual reality. The parameters analysed by posturography were LOS area, area of body centre of pressure excursion and balance functional reserve in the standing position in 10 conditions (open and closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual-vestibular interaction). The mean UPDRS motor score and DGI score were 27 [standard deviation (SD) 14] and 21 (SD 3), respectively. Thirteen participants scored between 0 and 19 points, indicating major risk of falls. Posturographic assessment showed that patients with PD had significantly lower LOS area and balance functional reserve values, and greater body sway area in all posturographic conditions compared with healthy subjects. Patients with PD have reduced LOS area and greater postural sway compared with healthy subjects. The deterioration in postural control was significantly associated with major risk of falls. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The clinical use of dynamic posturography in the elderly.

PubMed

Shepard, N T

1989-12-01

We provide an overview of the clinical uses of dynamic posturography. Although the equipment described to perform this testing is expensive, the concepts, especially those for sensory organization, can be applied for +20.00. To apply the six sensory organization conditions, one merely needs some way to disrupt proprioceptive information by maintaining ankle angle and providing for visual conflict stimuli. We found that proprioceptive information can be disrupted easily by asking the patient to stand on a thick (4-inch) dense piece of foam rubber like that used in cushions for furniture. Visual stabilization conflict can be provided by having the patient wear a 19- to 20-inch Japanese lantern with a head-mounting system in the center so that the patient's movements do not reflect themselves in relative movements to the visual environment. With use of these two simple tools, the six sensory organization tests can be approximated in a clinical situation in a short time and can provide some relative information about a patient's postural control capabilities. With minor additional work, a quantitative measure of output that gives indications of the amount of anterior-posterior sway also can be provided. For elderly patients with a variety of problems ranging from general unsteadiness to frank vertigo, the risk of falling can be devastating, and it is important to provide a thorough investigation of the total balance system. The systematic investigation, qualitatively or quantitatively, of integration of sensory input and motor outputs provides a dimension that typically has been lacking in the routine "dizzy patient workup" for all ages but especially for elderly patients. Therefore, the application of the postural maintenance theory with the above-described procedures or variations in these procedures appears to have a great deal of clinical relevance in the evaluation of patients with gait and balance disorders. These types of evaluations represent an adjunct or addition to the evaluation of the vestibular system and the vestibulo-ocular reflexes and by no means should be considered a substitute for that traditional evaluation. It is the combination of information that can provide the clinician with a more global picture of the entire balance system and its functional capabilities.

Computerized Interpretation of Dynamic Breast MRI

DTIC Science & Technology

2006-05-01

correction, tumor segmentation , extraction of computerized features that help distinguish between benign and malignant lesions, and classification. Our...for assessing tumor extent in 3D. The primary feature used for 3D tumor segmentation is the postcontrast enhancement vector. Tumor segmentation is a...Appendix B. 4. Investigation of methods for automatic tumor segmentation We developed an automatic method for assessing tumor extent in 3D. The

A Blackboard-Based Dynamic Instructional Planner. ONR Final Report.

ERIC Educational Resources Information Center

Murray, William R.

Dynamic instructional planning was explored as a control mechanism for intelligent tutoring systems through the development of the Blackboard Instructional Planner--a blackboard software-based dynamic planner for computerized intelligent tutoring systems. The planner, designed to be generic to tutors teaching troubleshooting for complex physical…

Effects of 30-, 60-, and 90-Day Bed Rest on Postural Control in Men and Women

NASA Technical Reports Server (NTRS)

Esteves, Julie; Taylor, Laura C.; Vanya, Robert D.; Dean, S. Lance; Wood, Scott J.

2011-01-01

INTRODUCTION Head-down-tilt bed rest (HDT) has been used as a safe gr ound-based analog to mimic and develop countermeasures for the physiological effects of spaceflight, including decrements in postural stability. The purpose of this investigation was to characterize the effects of 30-, 60-, and 90-day bed rest on postural control in men and women. METHODS Twenty-nine subjects (18M,11F) underwent 13 days of ambula tory acclimatization and were placed in 6? HDT for 30 (n=12), 60 (n=8), or 90 (n=9) days, followed by 14 days of ambulatory recovery. Computerized dynamic posturography (CDP) was used to assess changes in sensory and motor components of postural control, and recovery after HDT. Sensory Organization Tests (SOTs) objectively evaluate one?s ability to effectively use or suppress visual, vestibular, and proprioceptive information for postural control. Stability during the SOTs was assessed using peak-to-peak sway and convergence toward stability limits to derive an equilibrium score. Motor Control Tests (MCTs) evaluate one?s ability to recover from unexpected support surface perturbations, with performance determined by center-of-pressure path length. Whole-body kinematic data were collected to determine body-sway strategy used to maintain stability during each condition. Baselines were determined pre-HDT. Recovery was tracked post-HDT on days 0, 1, 2, and 4. RESULTS Immediately after HDT, subjects showed decreased performance on most SOTs, primarily on sway-referenced support conditions, typically returning to baseline levels within 4 days. MCT performance was not significantly affected. There were no significant gender or duration differences in performance. Kinematic data revealed a tendency to use ankle strategy to maintain an upright stance during most SOT conditions. Interestingly, six subjects (2M,4F) experienced orthostatic intolerance and were unable to complete day 0 testing. CONCLUSION HDT mimics some un loading mechanisms of spaceflight and elicits orthostatic issues present post-spaceflight (contributing to instability); however, it does not sufficiently address the vestibular dysfunction which occurs post-spaceflight.

Which Way is Up? Lessons Learned from Space Shuttle Sensorimotor Research

NASA Technical Reports Server (NTRS)

Wood, S. J.; Reschke, M. F.; Harm, D. L.; Paloski, W. H.; Bloomberg, J. J.

2011-01-01

The Space Shuttle Program provided the opportunity to examine sensorimotor adaptation to space flight in unprecedented numbers of astronauts, including many over multiple missions. Space motion sickness (SMS) severity was highly variable across crewmembers. SMS generally lasted 2-3 days in-flight with approximately 1/3 of crewmembers experiencing moderate to severe symptoms, and decreased incidence in repeat flyers. While SMS has proven difficult to predict from susceptibility to terrestrial analogs, symptoms were alleviated by medications, restriction of early activities, maintaining familiar orientation with respect to the visual environment and maintaining contact cues. Adaptive changes were also reflected by the oculomotor and perceptual disturbances experienced early inflight and by the perceptual and motor coordination problems experienced during re-entry and landing. According to crew self-reports, systematic head movements performed during reentry, as long as paced within one's threshold for motion tolerance, facilitated the early readaptation process. The Shuttle provided early postflight crew access to document the initial performance decrements and time course of recovery. These early postflight measurements were critical to inform the program of risks associated with extending the duration of Shuttle missions. Neurological postflight deficits were documented using a standardized subjective rating by flight surgeons. Computerized dynamic posturography was also implemented as a quantitative means of assessing sensorimotor function to support crew return-to-duty assessments. Towards the end of the Shuttle Program, more emphasis has been placed on mapping physiological changes to functional performance. Future commercial flights will benefit from pre-mission training including exposures to launch and entry G transitions and sensorimotor adaptability assessments. While SMS medication usage will continue to be refined, non-pharmacological countermeasures (e.g., sensory aids) will have both space and Earth-based applications. Early postflight field tests are recommended to provide the evidence base for best practices for future commercial flight programs. Learning Objective: Overview of the Space Shuttle Program regarding adaptive changes in sensorimotor function, including what was learned from research, what was implemented for medical operations, and what is recommended for commercial flights.

Comparison of tai chi vs. strength training for fall prevention among female cancer survivors: study protocol for the GET FIT trial

PubMed Central

2012-01-01

Background Women with cancer are significantly more likely to fall than women without cancer placing them at higher risk of fall-related fractures, other injuries and disability. Currently, no evidence-based fall prevention strategies exist that specifically target female cancer survivors. The purpose of the GET FIT (Group Exercise Training for Functional Improvement after Treatment) trial is to compare the efficacy of two distinct types of exercise, tai chi versus strength training, to prevent falls in women who have completed treatment for cancer. The specific aims of this study are to: 1) Determine and compare the efficacy of both tai chi training and strength training to reduce falls in older female cancer survivors, 2) Determine the mechanism(s) by which tai chi and strength training each reduces falls and, 3) Determine whether or not the benefits of each intervention last after structured training stops. Methods/Design We will conduct a three-group, single-blind, parallel design, randomized controlled trial in women, aged 50–75 years old, who have completed chemotherapy for cancer comparing 1) tai chi 2) strength training and 3) a placebo control group of seated stretching exercise. Women will participate in supervised study programs twice per week for six months and will be followed for an additional six months after formal training stops. The primary outcome in this study is falls, which will be prospectively tracked by monthly self-report. Secondary outcomes are maximal leg strength measured by isokinetic dynamometry, postural stability measured by computerized dynamic posturography and physical function measured by the Physical Performance Battery, all measured at baseline, 3, 6 and 12 months. The sample for this trial (N=429, assuming 25% attrition) will provide adequate statistical power to detect at least a 47% reduction in the fall rate over 1 year by being in either of the 2 exercise groups versus the control group. Discussion The GET FIT trial will provide important new knowledge about preventing falls using accessible and implementable exercise interventions for women following chemotherapy for cancer. ClinicalTrials.gov NCT01635413 PMID:23217054

Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson's Disease - A Pilot Study.

PubMed

Bukowska, Anna A; Krężałek, Piotr; Mirek, Elżbieta; Bujas, Przemysław; Marchewka, Anna

2015-01-01

Idiopathic Parkinson's Disease (PD) is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS) in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT) sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn and Yahr stages 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis, System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance. All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions four times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP), Pattern Sensory Enhancement (PSE) and RAS were used in every 45-min session for practicing daily life activities, balance, pre-gait, and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation. The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control group. In the stability tests with eyes closed, substantial differences were revealed, indicating improvement of proprioception (the sense of body position and movement). These findings suggest a new compensatory strategy for movement and postural control through the use of the auditory system.

Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson’s Disease – A Pilot Study

PubMed Central

Bukowska, Anna A.; Krężałek, Piotr; Mirek, Elżbieta; Bujas, Przemysław; Marchewka, Anna

2016-01-01

Idiopathic Parkinson’s Disease (PD) is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS) in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT) sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn and Yahr stages 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis, System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance. All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions four times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP), Pattern Sensory Enhancement (PSE) and RAS were used in every 45-min session for practicing daily life activities, balance, pre-gait, and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation. The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control group. In the stability tests with eyes closed, substantial differences were revealed, indicating improvement of proprioception (the sense of body position and movement). These findings suggest a new compensatory strategy for movement and postural control through the use of the auditory system. PMID:26858628

Static and dynamic balance performance in patients with osteoporotic vertebral compression fracture.

PubMed

Wang, Ling-Yi; Liaw, Mei-Yun; Huang, Yu-Chi; Lau, Yiu-Chung; Leong, Chau-Peng; Pong, Ya-Ping; Chen, Chia-Lin

2013-01-01

Patients with osteoporotic vertebral compression fracture (OVCF) have postural changes and increased risk of falling. The aim of this study is to compare balance characteristics between patients with OVCF and healthy control subjects. Patients with severe OVCF and control subjects underwent computerised dynamic posturography (CDP) in this case-control study. Forty-seven OVCF patients and 45 controls were recruited. Compared with the control group, the OVCF group had significantly decreased average stability; maximal stability under the `eye open with swayed support surface' (CDP subtest 4) and 'eye closed with swayed support surface' conditions (subtest 5); and decreased ankle strategy during subtests 4 and 5 and under the `swayed vision with swayed support surface' condition (subtest 6). The OVCF group fell more frequently during subtests 5 and 6 and had longer overall reaction time and longer reaction time when moving backward during the directional control test. OVCF patients had poorer static and dynamic balance performance compared with normal control. They had decreased postural stability and ankle strategy with increased fall frequency on a swayed surface; they also had longer reaction times overall and in the backward direction. Therefore, we suggest balance rehabilitation for patients with OVCF to prevent fall.

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

PubMed

Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

2017-12-21

Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001). Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

Healthy Active Duty Military with Lifetime Experience of Mild Traumatic Brain Injury Exhibits Subtle Deficits in Sensory Reactivity and Sensory Integration During Static Balance.

PubMed

Wright, W Geoffrey; Handy, Justin D; Avcu, Pelin; Ortiz, Alejandro; Haran, F Jay; Doria, Michael; Servatius, Richard J

2018-03-01

Postural control and stress reactivity were investigated in active duty coast guard personnel to determine whether they are sensitive to lifetime effects of mild traumatic brain injury (mTBI). A custom-designed and validated virtual reality-based computerized posturography device was used to assess postural stability, whereas emotional reactivity was assessed using the acoustic startle response (ASR), and neurocognitive performance was assessed using the defense-automated neurobehavioral assessment (DANA). It was hypothesized that residual and subtle postural control imbalance and deficits in cognitive and sensory reactivity would be evident in those reporting multiple lifetime mTBI. Active duty military personnel (N = 36; 7 females and 29 males) with no Deployment Limiting Medical Condition were recruited and tested on all assessments. Medical history information provided a history of head injury. Thirty-nine percent of participants reported having a previous mTBI (nine reporting one and five reporting more than one incident). No participant had experienced a head injury within the past year and all were symptom free. A significant effect of number of mTBI was found in the postural assessment (p = 0.002). Lifetime mTBI was associated with suppressed ASR magnitude (p = 0.03) but did not affect neurocognitive performance. The current findings provide new insight into ongoing controversies concerning sensitivity to functional deficits following mTBI and when the window for treatment or restoration ends.

Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall.

PubMed

Honaker, Julie A; Shepard, Neil T

2011-01-01

Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58-78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of >0.25.

Therapeutic effects of an anti-gravity locomotor training (AlterG) on postural balance and cerebellum structure in children with Cerebral Palsy.

PubMed

Rasooli, A H; Birgani, P M; Azizi, Sh; Shahrokhi, A; Mirbagheri, M M

2017-07-01

We evaluated the therapeutic effects of anti-gravity locomotor treadmill (AlterG) training on postural stability in children with Cerebral Palsy (CP) and spasticity, particularly in the lower extremity. AlterG can facilitate walking by reducing the weight of CP children by up to 80%; it can also help subjects maintain an appropriate posture during the locomotor AlterG training. Thus, we hypothesized that AlterG training, for a sufficient period of time, has a potential to produce cerebellum neuroplasticity, and consequently result in an effective permanent postural stability. AlterG training was given for 45 minutes, three times a week for two months. Postural balance was evaluated using posturography. The parameters of the Romberg based posturography were extracted to quantify the Center of Balance (CoP). The neuroplasticity of Cerebellum was evaluated using a Diffusion Tensor Imaging (DTI). The evaluations were done pre- and post-training. The Fractional Anisotropy (FA) feature was used for quantifying structural changes in the cerebellum. The results showed that AlterG training resulted in an increase in average FA value of the cerebellum white matter following the training. The results of the posturography evaluations showed a consistent improvement in postural stability. These results were consistent in all subjects. Our findings indicated that the improvement in the posture was accompanied with the enhancement of the cerebellum white matter structure. The clinical implication is that AlterG training can be considered a therapeutic tool for an effective and permanent improvement of postural stability in CP children.

The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction.

PubMed

Ebrahimi, Amir Abbas; Jamshidi, Ali Ashraf; Movallali, Guita; Rahgozar, Mehdi; Haghgoo, Hojjat Allah

2017-11-01

The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys) with the profound sensorineural hearing loss (PTA>90 dB). They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP). For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT) was completed pre- and post-intervention with SPS (Synapsys, Marseille, France). Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS), vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05). The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program.

Influence of visual control, conduction, and central integration on static and dynamic balance in healthy older adults.

PubMed

Perrin, P P; Jeandel, C; Perrin, C A; Béné, M C

1997-01-01

Aging is associated with decreased balance abilities, resulting in an increased risk of fall. In order to appreciate the visual, somatosensory, and central signals involved in balance control, sophisticated methods of posturography assessment have been developed, using static and dynamic tests, eventually associated with electromyographic measurements. We applied such methods to a population of healthy older adults in order to appreciate the respective importance of each of these sensorial inputs in aging individuals. Posture control parameters were recorded on a force-measuring platform in 41 healthy young (age 28.5 +/- 5.9 years) and 50 older (age 69.8 +/- 5.9 years) adults, using a static test and two dynamic tests performed by all individuals first with eyes open, then with eyes closed. The distance covered by the center of foot pressure, sway area, and anteroposterior oscillations were significantly higher, with eyes open or closed, in older people than in young subjects. Significant differences were noted in dynamic tests with longer latency responses in the group of old people. Dynamic recordings in a sinusoidal test had a more regular pattern when performed eyes open in both groups and evidenced significantly greater instability in old people. These data suggest that vision remains important in maintaining postural control while conduction and central integration become less efficient with age.

Postural stability and quality of life after guided and self-training among older adults residing in an institutional setting

PubMed Central

Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Moisio-Vilenius, Päivi; Mäkinen, Erja; Toppila, Esko; Pyykkö, Ilmari

2013-01-01

Purpose To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. Patients and methods A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Results Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Conclusion Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly’s daily routine and making it more active and exhausting. PMID:24072969

Effects of Artificial Gravity and Bed Rest on Spatial Orientation and Balance Control

NASA Technical Reports Server (NTRS)

Paloski, William H.; Moore, S. T.; Feiveson, A. H.; Taylor, L. C.

2007-01-01

While the vestibular system should be well-adapted to bed rest (a condition it experiences approximately 8/24 hrs each day), questions remain regarding the degree to which repeated exposures to the unusual gravito-inertial force environment of a short-radius centrifuge might affect central processing of vestibular information used in spatial orientation and balance control. Should these functions be impaired by intermittent AG, its feasibility as a counter-measure would be diminished. We, therefore, examined the effects of AG on spatial orientation and balance control in 15 male volunteers before and after 21 days of 6 HDT bed rest (BR). Eight of the subjects were treated with daily 1hr AG exposures (2.5g at the feet; 1.0g at the heart) aboard a short radius (3m) centrifuge, while the other seven served as controls (C). Spatial orientation was assessed by measures of ocular counter-rolling (OCR; rotation of the eye about the line of sight, an otolith-mediated reflex) and subjective visual vertical (SVV; perception of the spatial upright). Both OCR and SVV measurements were made with the subject upright, lying on their left sides, and lying on their right sides. OCR was measured from binocular eye orientation recordings made while the subjects fixated for 10s on a point target directly in front of the face at a distance of 1 m. SVV was assessed by asking subjects (in the dark) to adjust to upright (using a handheld controller) the orientation of a luminous bar randomly perturbed (15) to either side of the vertical meridian. Balance control performance was assessed using a computerized dynamic posturography (CDP) protocol similar to that currently required for all returning crew members. During each session, the subjects completed a combination of trials of sensory organization test (SOT) 2 (eyes closed, fixed platform) and SOT 5 (eyes closed, sway-referenced platform) with and without static and dynamic pitch plane head movements (plus or minus 20 deg., dynamic paced by an audible tone at 0.33Hz). OCR and CDP performance were unaffected by BR and BR+AG; post-BR measures were unchanged from baseline for both AG and C groups. Similarly, BR did not affect SVV in the C group. However, BR+AG disrupted one measure of spatial orientation: SVV error was significantly increased on R+0 and R+1 following BR in the AG group. These results suggest a transient untoward effect on central vestibular processing may accompany repeated exposure to intermittent AG, a potential side-effect that should be studied more closely in future studies.

Surface mapping of spike potential fields: experienced EEGers vs. computerized analysis.

PubMed

Koszer, S; Moshé, S L; Legatt, A D; Shinnar, S; Goldensohn, E S

1996-03-01

An EEG epileptiform spike focus recorded with scalp electrodes is clinically localized by visual estimation of the point of maximal voltage and the distribution of its surrounding voltages. We compared such estimated voltage maps, drawn by experienced electroencephalographers (EEGers), with a computerized spline interpolation technique employed in the commercially available software package FOCUS. Twenty-two spikes were recorded from 15 patients during long-term continuous EEG monitoring. Maps of voltage distribution from the 28 electrodes surrounding the points of maximum change in slope (the spike maximum) were constructed by the EEGer. The same points of maximum spike and voltage distributions at the 29 electrodes were mapped by computerized spline interpolation and a comparison between the two methods was made. The findings indicate that the computerized spline mapping techniques employed in FOCUS construct voltage maps with similar maxima and distributions as the maps created by experienced EEGers. The dynamics of spike activity, including correlations, are better visualized using the computerized technique than by manual interpretation alone. Its use as a technique for spike localization is accurate and adds information of potential clinical value.

Spinocerebellar ataxia in monozygotic twins.

PubMed

Anderson, John H; Christova, Peka S; Xie, Ting-dong; Schott, Kelly S; Ward, Kenneth; Gomez, Christopher M

2002-12-01

Although phenotypic heterogeneity in autosomal dominant spinocerebellar ataxia (SCA) has been explained in part by genotypic heterogeneity, clinical observations suggest the influence of additional factors. To demonstrate, quantitate, and localize physiologic abnormalities attributable to nongenetic factors in the development of hereditary SCA. Quantitative assessments of ocular motor function and postural control in 2 sets of identical twins, one with SCA type 2 and the other with episodic ataxia type 2. University laboratory. Saccadic velocity and amplitude, pursuit gain, and dynamic posturography. We found significant differences in saccade velocity, saccade metrics, and postural stability between each monozygotic twin. The differences point to differential involvement between twins of discrete regions in the cerebellum and brainstem. These results demonstrate the presence of quantitative differences in the severity, rate of progression, and regional central nervous system involvement in monozygotic twins with SCA that must be owing to the existence of nongermline or external factors.

The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis.

PubMed

Prosperini, Luca; Kouleridou, Anna; Petsas, Nikolaos; Leonardi, Laura; Tona, Francesca; Pantano, Patrizia; Pozzilli, Carlo

2011-05-15

The role of static posturography and magnetic resonance imaging (MRI) in identifying patients at high risk of falls was investigated. Relationships between static posturography measures and MRI metrics were also investigated. A total of 31 ambulatory MS patients (EDSS ranging from 2.0 to 5.0) with a predominant balance disorder were recruited. Each patient underwent a static posturography with a monoaxial platform and a conventional 1.5 T brain MRI scan. Measurements of T1-hypointense and T2-hyperintense lesion volumes (LVs), focusing on lesions selectively located at infratentorial levels, were performed by two operators unaware of clinical data. The self-reported number of falls in the previous 6 months was considered as the main outcome measure. Fourteen (45%) patients reported 1 or more falls over the past 6 months. When compared to non-faller patients, they had a higher EDSS score, poorer static standing balance, and greater brainstem and middle cerebellar peduncle (MCP) T2-LVs. A strength correlation between brainstem T2-LV and impaired static standing balance in an open eye condition was also found. In the multivariate analysis, the variables more strictly associated with recurrent falls were greater T2-LV at the MCP (beta: 6.2; p=0.01) and brainstem (beta: 5.8; p=0.001) levels, and a wider displacement of the body center of pressure in the closed eye condition (beta: 0.02; p=0.03). Our data suggests that the damage of specific infratentorial areas negatively affect the static standing balance and may predispose MS patients to accidental falls. These findings might contribute in selecting patients requiring a proper rehabilitation intervention program. Copyright © 2011 Elsevier B.V. All rights reserved.

Clinical applications of computerized thermography

NASA Technical Reports Server (NTRS)

Anbar, Michael

1988-01-01

Computerized or digital, thermography is a rapidly growing diagnostic imaging modality. It has superseded contact thermography and analog imaging thermography which do not allow effective quantization. Medical applications of digital thermography can be classified in two groups: static and dynamic imaging. They can also be classified into macro thermography (resolution greater than 1 mm) and micro thermography (resolution less than 100 microns). Both modalities allow a thermal resolution of 0.1 C. The diagnostic power of images produced by any of these modalities can be augmented by the use of digital image enhancement and image recognition procedures. Computerized thermography has been applied in neurology, cardiovascular and plastic surgery, rehabilitation and sports medicine, psychiatry, dermatology and ophthalmology. Examples of these applications are shown and their scope and limitations are discussed.

The impact of dynamic balance measures on walking performance in multiple sclerosis.

PubMed

Fritz, Nora E; Marasigan, Rhul Evans R; Calabresi, Peter A; Newsome, Scott D; Zackowski, Kathleen M

2015-01-01

Static posture imbalance and gait dysfunction are common in individuals with multiple sclerosis (MS). Although the impact of strength and static balance on walking has been examined, the impact of dynamic standing balance on walking in MS remains unclear. To determine the impact of dynamic balance, static balance, sensation, and strength measures on walking in individuals with MS. Fifty-two individuals with MS (27 women; 26 relapsing-remitting; mean age = 45.6 ± 10.3 years; median Expanded Disability Status Scale score = 3.5) participated in posturography testing (Kistler-9281 force plate), hip flexion, hip extension, ankle dorsiflexion strength (Microfet2 hand-held dynamometer), sensation (Vibratron II), and walk velocity (Optotrak Motion Analysis System). Analyses included, Mann-Whitney, Spearman correlation coefficients, and multiple regression. All measures were abnormal in individuals with MS when compared with norms (P < .05). Static balance (eyes open, feet together [EOFT]), anterior-posterior (AP) dynamic sway, and hip extension strength were strongly correlated with walking velocity (AP sway r = 0.68; hip extension strength r = 0.73; EOFT r = -0.40). Together, AP dynamic sway (ρr = 0.71; P < .001), hip extension strength (ρr = 0.54; P < .001), and EOFT static balance (ρr = -0.41; P = .01) explained more than 70% of the variance in walking velocity (P < .001). AP dynamic sway affects walking performance in MS. A combined evaluation of dynamic balance, static balance, and strength may lead to a better understanding of walking mechanisms and the development of strategies to improve walking. © The Author(s) 2014.

The impact of dynamic balance measures on walking performance in multiple sclerosis

PubMed Central

Fritz, Nora E.; Marasigan, Rhul Evans R.; Calabresi, Peter A.; Newsome, Scott D.; Zackowski, Kathleen M.

2014-01-01

Background Static posture imbalance and gait dysfunction are common in individuals with multiple sclerosis (MS). Although the impact of strength and static balance on walking has been examined, little is known about the impact of dynamic standing balance on walking in MS. Objective To determine the impact of dynamic balance, static balance, sensation, and strength measures to walking in individuals with MS. Methods 52 individuals with MS (27 females; 26 relapsing-remitting; mean age 45.6±10.3 years; median EDSS 3.5 (range 0-7) participated in testing for dynamic and static posturography (Kistler 9281 force plate), hip flexion, hip extension, and ankle dorsiflexion strength (Microfet2 hand-held dynamometer), sensation (Vibratron II) and walk velocity (Optotrak Motion Analysis System). Mann-Whitney tests, Spearman correlation coefficients, and forward stepwise multiple regression were used to assess statistical significance. Results All measures were significantly abnormal in MS subjects when compared to age and sex-matched norms (p<0.05 for all). Static balance (eyes open, feet together [EOFT]), anterior- posterior (AP) dynamic sway, and hip extension strength were strongly correlated with fast walking velocity (AP sway r=0.68; hip extension strength r=0.73; EOFT r=-0.40). Together, AP dynamic sway (ρr=0.71, p<0.001), hip extension strength (ρr=0.54, p<0.001), and EOFT static balance (ρr=-0.41, p=0.01) explained more than 70% of the variance in fast walking velocity (p<0.001). Conclusions These data suggest that AP dynamic sway impacts walking performance in MS. A combined evaluation of dynamic balance, static balance and strength may lead to a better understanding of walking mechanisms as well as the development of strategies to improve walking. PMID:24795162

An Open-Access Educational Tool for Teaching Motion Dynamics in Multi-Axis Servomotor Control

ERIC Educational Resources Information Center

Rivera-Guillen, J. R.; de Jesus Rangel-Magdaleno, J.; de Jesus Romero-Troncoso, R.; Osornio-Rios, R. A.; Guevara-Gonzalez, R. G.

2012-01-01

Servomotors are widely used in computerized numerically controlled (CNC) machines, hence motion control is a major topic covered in undergraduate/graduate engineering courses. Despite the fact that several syllabi include the motion dynamics topic in their courses, there are neither suitable tools available for designing and simulating multi-axis…

A study of commuter airplane design optimization

NASA Technical Reports Server (NTRS)

Keppel, B. V.; Eysink, H.; Hammer, J.; Hawley, K.; Meredith, P.; Roskam, J.

1978-01-01

The usability of the general aviation synthesis program (GASP) was enhanced by the development of separate computer subroutines which can be added as a package to this assembly of computerized design methods or used as a separate subroutine program to compute the dynamic longitudinal, lateral-directional stability characteristics for a given airplane. Currently available analysis methods were evaluated to ascertain those most appropriate for the design functions which the GASP computerized design program performs. Methods for providing proper constraint and/or analysis functions for GASP were developed as well as the appropriate subroutines.

A Computerized Asthma Outcomes Measure Is Feasible for Disease Management.

PubMed

Turner-Bowker, Diane M; Saris-Baglama, Renee N; Anatchkova, Milena; Mosen, David M

2010-04-01

OBJECTIVE: To develop and test an online assessment referred to as the ASTHMA-CAT (computerized adaptive testing), a patient-based asthma impact, control, and generic health-related quality of life (HRQOL) measure. STUDY DESIGN: Cross-sectional pilot study of the ASTHMA-CAT's administrative feasibility in a disease management population. METHODS: The ASTHMA-CAT included a dynamic or static Asthma Impact Survey (AIS), Asthma Control Test, and SF-8 Health Survey. A sample of clinician-diagnosed adult asthmatic patients (N = 114) completed the ASTHMA-CAT. Results were used to evaluate administrative feasibility of the instrument and psychometric performance of the dynamic AIS relative to the static AIS. A prototype aggregate (group-level) report was developed and reviewed by care providers. RESULTS: Online administration of the ASTHMA-CAT was feasible for patients in disease management. The dynamic AIS functioned well compared with the static AIS in preliminary studies evaluating response burden, precision, and validity. Providers found reports to be relevant, useful, and applicable for care management. CONCLUSION: The ASTHMA-CAT may facilitate asthma care management.

Computerized method to compensate for breathing body motion in dynamic chest radiographs

NASA Astrophysics Data System (ADS)

Matsuda, H.; Tanaka, R.; Sanada, S.

2017-03-01

Dynamic chest radiography combined with computer analysis allows quantitative analyses on pulmonary function and rib motion. The accuracy of kinematic analysis is directly linked to diagnostic accuracy, and thus body motion compensation is a major concern. Our purpose in this study was to develop a computerized method to reduce a breathing body motion in dynamic chest radiographs. Dynamic chest radiographs of 56 patients were obtained using a dynamic flat-panel detector. The images were divided into a 1 cm-square and the squares on body counter were used to detect the body motion. Velocity vector was measured using cross-correlation method on the body counter and the body motion was then determined on the basis of the summation of motion vector. The body motion was then compensated by shifting the images based on the measured vector. By using our method, the body motion was accurately detected by the order of a few pixels in clinical cases, mean 82.5% in right and left directions. In addition, our method detected slight body motion which was not able to be identified by human observations. We confirmed our method effectively worked in kinetic analysis of rib motion. The present method would be useful for the reduction of a breathing body motion in dynamic chest radiography.

Enhancing the Learning Achievements and Attitudes of Taiwan Vocational School Students in Accounting with the Dynamic Assessment System

ERIC Educational Resources Information Center

Shih, Ju-Ling; Ku, David Tawei; Hung, Su-Huan

2013-01-01

We investigate how the computerized dynamic assessment system improves the learning achievements of vocational high school students studying accounting. Our experiment was conducted under the one-group pretest-posttest design of 34 junior students. The questionnaire results were analyzed to determine student-learning attitudes and reactions toward…

The Development of Dynamic Facial Expression Recognition at Different Intensities in 4- to 18-Year-Olds

ERIC Educational Resources Information Center

Montirosso, Rosario; Peverelli, Milena; Frigerio, Elisa; Crespi, Monica; Borgatti, Renato

2010-01-01

The primary purpose of this study was to examine the effect of the intensity of emotion expression on children's developing ability to label emotion during a dynamic presentation of five facial expressions (anger, disgust, fear, happiness, and sadness). A computerized task (AFFECT--animated full facial expression comprehension test) was used to…

Computerized Dynamic Assessment (C-DA): Diagnosing L2 Development According to Learner Responsiveness to Mediation

ERIC Educational Resources Information Center

Poehner, Matthew E.; Zhang, Jie; Lu, Xiaofei

2015-01-01

Dynamic assessment (DA) derives from the sociocultural theory of mind as elaborated by Russian psychologist L. S. Vygotsky. By offering mediation when individuals experience difficulties and carefully tracing their responsiveness, Vygotsky (1998) proposed that diagnoses may uncover abilities that have fully formed as well as those still in the…

Postural Variables in Girls Practicing Volleyball

ERIC Educational Resources Information Center

Grabara, Malgorzata; Hadzik, Andrzej

2009-01-01

Study aim: To assess body posture of young female volleyball players in relation to their untrained mates. Material and methods: A group of 42 volleyball players and another of 43 untrained girls, all aged 13-16 years were studied with respect to their body posture indices by using computer posturography. Spinal angles and curvatures were…

Rotor-Bearing Dynamics Technology Design Guide. Part 8. A computerized Data Retrieval System for Fluid Film Bearings

DTIC Science & Technology

1980-10-01

AFAPL-TR-78-6 ’: Part Vill (U ROTOR -BEARING DYNAMICS - TECHNOLOGY DESIGN GUIDE ¢ Part Vil A Comput eri eval Syteftor Fluid Film Bearings SHAKER...Protection," Task 304806, "Aerospace Lubrication," Work Unit 30480685, " Rotor -Bearing Dynamics Design." The work reported herein was performed during the...the previous issue of the Rotor -Bearing Dynamics Technology Design Guide, - one volume dealt with the calculation of performance parameters and pertur

The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study.

PubMed

Yip, Chun Wai; Strupp, Michael

2018-05-01

The Dizziness Handicap Inventory (DHI) is believed to quantitate the handicap related to the presence or severity of underlying vestibular dysfunction. However, patients with chronic vestibular diseases may manifest various degrees of behavioural and physiological adaptation resulting in variances of the DHI. Our primary study objective is to evaluate the correlation between the DHI and measurable vestibular parameters. Secondarily, we compared DHI among different vestibular disorders (central, peripheral and functional), and different types of anatomic deficits (semicircular canal vs otolithic). We also correlated the DHI and posturography. We prospectively evaluated 799 patients with precise vestibular diagnoses using video head impulse testing (vHIT), caloric irrigation, and cervical/ocular vestibular-evoked myogenic potentials (c/oVEMP). Posturography was done for 84 patients. All participants completed the DHI. No significant correlation was found between DHI and (1) vestibulo-ocular reflex parameters: unilateral weakness r = - 0.018, total calorics r = 0.055, vHIT right r = 0.007, vHIT left r = - 0.091, vHIT asymmetry r = 0.013; (2) otolith parameters: cVEMP amplitude right r = - 0.034, amplitude left r = - 0.004, asymmetry r = 0.016; oVEMP amplitude right r = 0.044, amplitude left r = - 0.007, asymmetry r = - 0.008. Patients with central vestibular disorders had higher DHI than those with peripheral (z = - 4.743, p = 0.001) or functional disorders (z = - 2.902, p = 0.004). DHI of patients with deficits of canal or otolith function did not differ significantly from those with no deficits (z = 2.153, p = 0.541). There was no significant correlation between DHI and postural sway on posturography. Therefore, the DHI does not correlate with vestibular tests, and neither reflects the presence nor severity of peripheral vestibular deficits.

The Dynamics of Development on the Dimensional Change Card Sorting Task

ERIC Educational Resources Information Center

van Bers, Bianca M. C. W.; Visser, Ingmar; van Schijndel, Tessa J. P.; Mandell, Dorothy J.; Raijmakers, Maartje E. J.

2011-01-01

A widely used paradigm to study cognitive flexibility in preschoolers is the Dimensional Change Card Sorting (DCCS) task. The developmental dynamics of DCCS performance was studied in a cross-sectional design (N = 93, 3 to 5 years of age) using a computerized version of the standard DCCS task. A model-based analysis of the data showed that…

A motion artefact study and locally deforming objects in computerized tomography

NASA Astrophysics Data System (ADS)

Hahn, Bernadette N.

2017-11-01

Movements of the object during the data collection in computerized tomography can introduce motion artefacts in the reconstructed image. They can be reduced by employing information about the dynamic behaviour within the reconstruction step. However, inaccuracies concerning the movement are inevitable in practice. In this article, we give an explicit characterization of what is visible in an image obtained by a reconstruction algorithm with incorrect motion information. Then, we use this result to study in detail the situation of locally deforming objects, i.e. individual parts of the object have a different dynamic behaviour. In this context, we prove that additional artefacts arise due to the global nature of the Radon transform, even if the motion is exactly known. Based on our analysis, we propose a numerical scheme to reduce these artefacts in the reconstructed image. All our results are illustrated by numerical examples.

Randomized, Sham-Controlled, Feasibility Trial of Hyperbaric Oxygen for Service Members With Postconcussion Syndrome: Cognitive and Psychomotor Outcomes 1 Week Postintervention.

PubMed

Walker, William C; Franke, Laura Manning; Cifu, David X; Hart, Brett B

2014-06-01

Background Mild traumatic brain injury (mTBI) and residual postconcussion syndrome (PCS) are common among combatants of the recent military conflicts in Iraq and Afghanistan. Hyperbaric oxygen (HBO2) is a proposed treatment but has not been rigorously studied for this condition. Objectives In a secondary analysis, examine for possible effects on psychomotor (balance and fine motor) and cognitive performance 1 week after an HBO2 intervention in service members with PCS after mTBI. Methods A randomized, double-blind, sham control, feasibility trial comparing pretreatment and posttreatment was conducted in 60 male active-duty marines with combat-related mTBI and PCS persisting for 3 to 36 months. Participants were randomized to 1 of 3 preassigned oxygen fractions (10.5%, 75%, or 100%) at 2.0 atmospheres absolute (ATA), resulting in respective groups with an oxygen exposure equivalent to (1) breathing surface air (Sham Air), (2) 100% oxygen at 1.5 ATA (1.5 ATAO2), and (3) 100% oxygen at 2.0 ATA (2.0 ATAO2). Over a 10-week period, participants received 40 hyperbaric chamber sessions of 60 minutes each. Outcome measures, including computerized posturography (balance), grooved pegboard (fine motor speed/dexterity), and multiple neuropsychological tests of cognitive performance, were collected preintervention and 1-week postintervention. Results Despite the multiple sensitive cognitive and psychomotor measures analyzed at an unadjusted 5% significance level, this study demonstrated no immediate postintervention beneficial effect of exposure to either 1.5 ATAO2 or 2.0 ATAO2 compared with the Sham Air intervention. Conclusions These results do not support the use of HBO2 to treat cognitive, balance, or fine motor deficits associated with mTBI and PCS. © The Author(s) 2013.

Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.

PubMed

Bogaerts, An; Delecluse, Christophe; Boonen, Steven; Claessens, Albrecht L; Milisen, Koen; Verschueren, Sabine M P

2011-03-01

Falls in the elderly constitute a growing public health problem. This randomized controlled trial investigated the potential benefit of 6 months of whole body vibration (WBV) training and/or vitamin D supplementation on balance, functionality and estimated fall risk in institutionalized elderly women. A total of 113 women (mean age: 79.6) were randomly assigned to either a WBV or a no-training group, receiving either a conventional dose (880 IU/d) or a high dose (1600 IU/d) of vitamin D3. The WBV group performed exercises on a vibration platform 3×/week. Balance was evaluated by computerized posturography. Functionality was assessed by 10 m walk test, Timed up and Go (TUG) performance and endurance capacity (Shuttle Walk). Fall risk was determined with the Physiological Profile Assessment. Performance on the 10 m walk test and on TUG improved over time in all groups. For none of the parameters, high-dose vitamin D resulted in a better performance than conventional dosing. The improvements in the WBV group in endurance capacity, walking at preferred speed, and TUG were significantly larger than the changes with supplementation alone. No additional benefit of WBV training could be detected on fall risk and postural control, although sway velocity and maximal isometric knee extension strength improved only in the WBV group. This trial showed that a high-dose vitamin D supplementation is not more efficient than conventional dosing in improving functionality in institutionalized elderly. WBV training on top of vitamin D supplementation provided an added benefit with regard to walking, TUG performance, and endurance capacity. Copyright © 2010 Elsevier B.V. All rights reserved.

A Computerized Asthma Outcomes Measure Is Feasible for Disease Management

PubMed Central

Turner-Bowker, Diane M.; Saris-Baglama, Renee N.; Anatchkova, Milena; Mosen, David M.

2010-01-01

Objective To develop and test an online assessment referred to as the ASTHMA-CAT (computerized adaptive testing), a patient-based asthma impact, control, and generic health-related quality of life (HRQOL) measure. Study Design Cross-sectional pilot study of the ASTHMA-CAT’s administrative feasibility in a disease management population. Methods The ASTHMA-CAT included a dynamic or static Asthma Impact Survey (AIS), Asthma Control Test, and SF-8 Health Survey. A sample of clinician-diagnosed adult asthmatic patients (N = 114) completed the ASTHMA-CAT. Results were used to evaluate administrative feasibility of the instrument and psychometric performance of the dynamic AIS relative to the static AIS. A prototype aggregate (group-level) report was developed and reviewed by care providers. Results Online administration of the ASTHMA-CAT was feasible for patients in disease management. The dynamic AIS functioned well compared with the static AIS in preliminary studies evaluating response burden, precision, and validity. Providers found reports to be relevant, useful, and applicable for care management. Conclusion The ASTHMA-CAT may facilitate asthma care management. PMID:20852675

Clinical Measures Are Feasible and Sensitive to Assess Balance and Gait Capacities in Older Persons with Mild to Moderate Intellectual Disabilities

ERIC Educational Resources Information Center

Enkelaar, Lotte; Smulders, Ellen; Lantman-de Valk, Henny van Schrojenstein; Weerdesteyn, Vivian; Geurts, Alexander C. H.

2013-01-01

Mobility limitations are common in persons with Intellectual Disabilities (ID). Differences in balance and gait capacities between persons with ID and controls have mainly been demonstrated by instrumented assessments (e.g. posturography and gait analysis), which require sophisticated and expensive equipment such as force plates or a 3D motion…

Righting elicited by novel or familiar auditory or vestibular stimulation in the haloperidol-treated rat: rat posturography as a model to study anticipatory motor control.

PubMed

Clark, Callie A M; Sacrey, Lori-Ann R; Whishaw, Ian Q

2009-09-15

External cues, including familiar music, can release Parkinson's disease patients from catalepsy but the neural basis of the effect is not well understood. In the present study, posturography, the study of posture and its allied reflexes, was used to develop an animal model that could be used to investigate the underlying neural mechanisms of this sound-induced behavioral activation. In the rat, akinetic catalepsy induced by a dopamine D2 receptor antagonist (haloperidol 5mg/kg) can model human catalepsy. Using this model, two experiments examined whether novel versus familiar sound stimuli could interrupt haloperidol-induced catalepsy in the rat. Rats were placed on a variably inclined grid and novel or familiar auditory cues (single key jingle or multiple key jingles) were presented. The dependent variable was movement by the rats to regain equilibrium as assessed with a movement notation score. The sound cues enhanced movements used to regain postural stability and familiar sound stimuli were more effective than unfamiliar sound stimuli. The results are discussed in relation to the idea that nonlemniscal and lemniscal auditory pathways differentially contribute to behavioral activation versus tonotopic processing of sound.

The influence of peripheral neuropathy, gender, and obesity on the postural stability of patients with type 2 diabetes mellitus.

PubMed

Herrera-Rangel, Aline; Aranda-Moreno, Catalina; Mantilla-Ochoa, Teresa; Zainos-Saucedo, Lylia; Jáuregui-Renaud, Kathrine

2014-01-01

To assess the influence of peripheral neuropathy, gender, and obesity on the postural stability of patients with type 2 diabetes mellitus. 151 patients with no history of otology, neurology, or orthopaedic or balance disorders accepted to participate in the study. After a clinical interview and neuropathy assessment, postural stability was evaluated by static posturography (eyes open/closed on hard/soft surface) and the "Up & Go" test. During static posturography, on hard surface, the length of sway was related to peripheral neuropathy, gender, age, and obesity; on soft surface, the length of sway was related to peripheral neuropathy, gender, and age, the influence of neuropathy was larger in males than in females, and closing the eyes increased further the difference between genders. The mean time to perform the "Up & Go" test was 11.6 ± 2.2 sec, with influence of peripheral neuropathy, gender, and age. In order to preserve the control of static upright posture during conditions with deficient sensory input, male patients with type 2 diabetes mellitus with no history of balance disorders may be more vulnerable than females, and obesity may decrease the static postural control in both males and females.

Static posturography and intravenous alcohol.

PubMed

Uimonen, S; Laitakari, K; Bloigu, R; Reinilä, M; Sorri, M

1994-01-01

Twelve health subjects were assessed using static posturography before and after intravenous alcohol infusion in a double-blind experiment. The dose was 0.5 g ethanol per kg body weight in 15 minutes, which raised the blood alcohol concentration to a level of approximately 1 mg/mL. Among other parameters, the average body sway velocity (BSV) and area of body sway (BSA) were measured. BSV was the most sensitive parameter for detecting increased body sway after alcohol infusion, and a significant effect of alcohol on its values was seen at 0.46 to 1.0 mg/mL alcohol concentrations. The second best indicator was the BSA. There was a positive correlation between the BSV and the BSA. The other parameters were not affected. The Romberg quotient remained constant during the alcohol test. The test battery used was relevant to distinguish the effect of alcohol on balance. In this study, acute blood alcohol concentrations of around 0.5 to 1.0 mg/mL affected BSV more significantly than BSA. The authors do not, however, recommend the test for forensic purposes in examining drivers with alcohol in their blood, as there is too much interindividual dispersion in the results.

Virtual-reality balance training with a video-game system improves dynamic balance in chronic stroke patients.

PubMed

Cho, Ki Hun; Lee, Kyoung Jin; Song, Chang Ho

2012-09-01

Stroke is one of the most serious healthcare problems and a major cause of impairment of cognition and physical functions. Virtual rehabilitation approaches to postural control have been used for enhancing functional recovery that may lead to a decrease in the risk of falling. In the present study, we investigated the effects of virtual reality balance training (VRBT) with a balance board game system on balance of chronic stroke patients. Participants were randomly assigned to 2 groups: VRBT group (11 subjects including 3 women, 65.26 years old) and control group (11 subjects including 5 women, 63.13 years old). Both groups participated in a standard rehabilitation program (physical and occupational therapy) for 60 min a day, 5 times a week for 6 weeks. In addition, the VRBT group participated in VRBT for 30 min a day, 3 times a week for 6 weeks. Static balance (postural sway velocity with eyes open or closed) was evaluated with the posturography. Dynamic balance was evaluated with the Berg Balance Scale (BBS) and Timed Up and Go test (TUG) that measures balance and mobility in dynamic balance. There was greater improvement on BBS (4.00 vs. 2.81 scores) and TUG (-1.33 vs. -0.52 sec) in the VRBT group compared with the control group (P < 0.05), but not on static balance in both groups. In conclusion, we demonstrate a significant improvement in dynamic balance in chronic stroke patients with VRBT. VRBT is feasible and suitable for chronic stroke patients with balance deficit in clinical settings.

Vestibular function assessment using the NIH Toolbox

PubMed Central

Schubert, Michael C.; Whitney, Susan L.; Roberts, Dale; Redfern, Mark S.; Musolino, Mark C.; Roche, Jennica L.; Steed, Daniel P.; Corbin, Bree; Lin, Chia-Cheng; Marchetti, Greg F.; Beaumont, Jennifer; Carey, John P.; Shepard, Neil P.; Jacobson, Gary P.; Wrisley, Diane M.; Hoffman, Howard J.; Furman, Gabriel; Slotkin, Jerry

2013-01-01

Objective: Development of an easy to administer, low-cost test of vestibular function. Methods: Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was performed to examine reliability. Results: The DVA and BAM tests are affordable and appropriate for use for individuals 3 through 85 years of age. The DVA had fair to good reliability (0.41–0.94) and sensitivity and specificity (50%–73%), depending on age and optotype chosen. The BAM test was moderately correlated with center of pressure (r = 0.42–0.48) and dynamic posturography (r = −0.48), depending on age and test condition. Both tests differentiated those with and without vestibular impairment and the young from the old. Each test was reliable. Conclusion: The newly created DVA test provides a valid measure of visual acuity with the head still and moving quickly. The novel BAM is a valid measure of balance. Both tests are sensitive to age-related changes and are able to screen for impairment of the vestibular system. PMID:23479540

Multiple sclerosis: changes in microarchitecture of white matter tracts after training with a video game balance board.

PubMed

Prosperini, Luca; Fanelli, Fulvia; Petsas, Nikolaos; Sbardella, Emilia; Tona, Francesca; Raz, Eytan; Fortuna, Deborah; De Angelis, Floriana; Pozzilli, Carlo; Pantano, Patrizia

2014-11-01

To determine if high-intensity, task-oriented, visual feedback training with a video game balance board (Nintendo Wii) induces significant changes in diffusion-tensor imaging ( DTI diffusion-tensor imaging ) parameters of cerebellar connections and other supratentorial associative bundles and if these changes are related to clinical improvement in patients with multiple sclerosis. The protocol was approved by local ethical committee; each participant provided written informed consent. In this 24-week, randomized, two-period crossover pilot study, 27 patients underwent static posturography and brain magnetic resonance (MR) imaging at study entry, after the first 12-week period, and at study termination. Thirteen patients started a 12-week training program followed by a 12-week period without any intervention, while 14 patients received the intervention in reverse order. Fifteen healthy subjects also underwent MR imaging once and underwent static posturography. Virtual dissection of white matter tracts was performed with streamline tractography; values of DTI diffusion-tensor imaging parameters were then obtained for each dissected tract. Repeated measures analyses of variance were performed to evaluate whether DTI diffusion-tensor imaging parameters significantly changed after intervention, with false discovery rate correction for multiple hypothesis testing. There were relevant differences between patients and healthy control subjects in postural sway and DTI diffusion-tensor imaging parameters (P < .05). Significant main effects of time by group interaction for fractional anisotropy and radial diffusivity of the left and right superior cerebellar peduncles were found (F2,23 range, 5.555-3.450; P = .036-.088 after false discovery rate correction). These changes correlated with objective measures of balance improvement detected at static posturography (r = -0.381 to 0.401, P < .05). However, both clinical and DTI diffusion-tensor imaging changes did not persist beyond 12 weeks after training. Despite the low statistical power (35%) due to the small sample size, the results showed that training with the balance board system modified the microstructure of superior cerebellar peduncles. The clinical improvement observed after training might be mediated by enhanced myelination-related processes, suggesting that high-intensity, task-oriented exercises could induce favorable microstructural changes in the brains of patients with multiple sclerosis.

Effects Of Suspension-Line Damping On LADT #3 And Supersonic BLDT Parachute Inflation Dynamics

NASA Technical Reports Server (NTRS)

Poole, Lamont R.

1972-01-01

A two-body computerized mathematical model is used to calculate planar dynamics of the LADT #3 and supersonic BLDT parachute inflations. Results indicate that the calculated loads and motions of the LADT #3 inflation are not affected appreciably by variation in the suspension-line damping coefficient. However, variation of the coefficient results in significant changes in the calculated loads and strain rates of the supersonic BLDT inflation.

Metacognitive Scaffolding in an Innovative Learning Arrangement

ERIC Educational Resources Information Center

Molenaar, Inge; van Boxtel, Carla A. M.; Sleegers, Peter J. C.

2011-01-01

This study examined the effects of metacognitive scaffolds on learning outcomes of collaborating students in an innovative learning arrangement. The triads were supported by computerized scaffolds, which were dynamically integrated into the learning process and took a structuring or problematizing form. In an experimental design the two…

Recovery of postural equilibrium control following spaceflight

NASA Technical Reports Server (NTRS)

Paloski, W. H.; Reschke, M. F.; Black, F. O.; Doxey, D. D.; Harm, D. L.

1992-01-01

Decreased postural stability is observed in most astronauts immediately following spaceflight. Because ataxia may present postflight operational hazards, it is important to determine the incidence of postural instability immediately following landing and the dynamics of recovery of normal postural equilibrium control. It is postulated that postflight postural instability results from in-flight adaptive changes in central nervous system (CNS) processing of sensory information from the visual, vestibular, and proprioceptive systems. The purpose of the present investigation was to determine the magnitude and time course of postflight recovery of postural equilibrium control and, hence, readaptation of CNS processing of sensory information. Thirteen crew members from six spaceflight missions were studied pre- and postflight using a modified commercial posturography system. Postural equilibrium control was found to be seriously disrupted immediately following spaceflight in all subjects. Readaptation to the terrestrial environment began immediately upon landing, proceeded rapidly for the first 10-12 hours, and then proceeded much more slowly for the subsequent 2-4 days until preflight stability levels were reachieved. It is concluded that the overall postflight recovery of postural stability follows a predictable time course.

Role of brain hemispheric dominance in anticipatory postural control strategies.

PubMed

Cioncoloni, David; Rosignoli, Deborah; Feurra, Matteo; Rossi, Simone; Bonifazi, Marco; Rossi, Alessandro; Mazzocchio, Riccardo

2016-07-01

Most of the cerebral functions are asymmetrically represented in the two hemispheres. Moreover, dexterity and coordination of the distal segment of the dominant limbs depend on cortico-motor lateralization. In this study, we investigated whether postural control may be also considered a lateralized hemispheric brain function. To this aim, 15 young subjects were tested in standing position by measuring center of pressure (COP) shifts along the anteroposterior axis (COP-Y) during dynamic posturography before and after continuous Theta Burst Stimulation (cTBS) intervention applied to the dominant or non-dominant M1 hand area as well as to the vertex. We show that when subjects were expecting a forward platform translation, the COP-Y was positioned significantly backward or forward after dominant or non-dominant M1 stimulation, respectively. We postulate that cTBS applied on M1 may have disrupted the functional connectivity between intra- and interhemispheric areas implicated in the anticipatory control of postural stability. This study suggests a functional asymmetry between the two homologous primary motor areas, with the dominant hemisphere playing a critical role in the selection of the appropriate postural control strategy.

The mass-action law based algorithm for cost-effective approach for cancer drug discovery and development.

PubMed

Chou, Ting-Chao

2011-01-01

The mass-action law based system analysis via mathematical induction and deduction lead to the generalized theory and algorithm that allows computerized simulation of dose-effect dynamics with small size experiments using a small number of data points in vitro, in animals, and in humans. The median-effect equation of the mass-action law deduced from over 300 mechanism specific-equations has been shown to be the unified theory that serves as the common-link for complicated biomedical systems. After using the median-effect principle as the common denominator, its applications are mechanism-independent, drug unit-independent, and dynamic order-independent; and can be used generally for single drug analysis or for multiple drug combinations in constant-ratio or non-constant ratios. Since the "median" is the common link and universal reference point in biological systems, these general enabling lead to computerized quantitative bio-informatics for econo-green bio-research in broad disciplines. Specific applications of the theory, especially relevant to drug discovery, drug combination, and clinical trials, have been cited or illustrated in terms of algorithms, experimental design and computerized simulation for data analysis. Lessons learned from cancer research during the past fifty years provide a valuable opportunity to reflect, and to improve the conventional divergent approach and to introduce a new convergent avenue, based on the mass-action law principle, for the efficient cancer drug discovery and the low-cost drug development.

The mass-action law based algorithm for cost-effective approach for cancer drug discovery and development

PubMed Central

Chou, Ting-Chao

2011-01-01

The mass-action law based system analysis via mathematical induction and deduction lead to the generalized theory and algorithm that allows computerized simulation of dose-effect dynamics with small size experiments using a small number of data points in vitro, in animals, and in humans. The median-effect equation of the mass-action law deduced from over 300 mechanism specific-equations has been shown to be the unified theory that serves as the common-link for complicated biomedical systems. After using the median-effect principle as the common denominator, its applications are mechanism-independent, drug unit-independent, and dynamic order-independent; and can be used generally for single drug analysis or for multiple drug combinations in constant-ratio or non-constant ratios. Since the “median” is the common link and universal reference point in biological systems, these general enabling lead to computerized quantitative bio-informatics for econo-green bio-research in broad disciplines. Specific applications of the theory, especially relevant to drug discovery, drug combination, and clinical trials, have been cited or illustrated in terms of algorithms, experimental design and computerized simulation for data analysis. Lessons learned from cancer research during the past fifty years provide a valuable opportunity to reflect, and to improve the conventional divergent approach and to introduce a new convergent avenue, based on the mass-action law principle, for the efficient cancer drug discovery and the low-cost drug development. PMID:22016837

Community Level Impact Assessment--Extension Applications.

ERIC Educational Resources Information Center

Woods, Mike D.; Doeksen, Gerald A.

Using the Oklahoma State University (OSU) computerized community simulation model, extension professionals can provide local decision makers with information derived from an impact model that is dynamic, community specific, and easy to adapt to different communities. The four main sections of the OSU model are an economic account, a capital…

Research Symposium I

NASA Technical Reports Server (NTRS)

2004-01-01

The proceedings of this symposium consist of abstracts of talks presented by interns at NASA Glenn Research Center (GRC). The interns assisted researchers at GRC in projects which primarily address the following topics: aircraft engines and propulsion, spacecraft propulsion, fuel cells, thin film photovoltaic cells, aerospace materials, computational fluid dynamics, aircraft icing, management, and computerized simulation.

Non-Invasive Visualization and Quantitation of Cardiovascular Structure and Function.

ERIC Educational Resources Information Center

Ritman, E. L.; And Others

1979-01-01

Described is a new approach to investigative physiology based on computerized transaxial tomography, in which visualization and measurement of the internal structure of the cardiopulmonary system is possible without postmortem, biopsy, or vivisection procedures. Examples are given for application of the Dynamic Spatial Reconstructor (DSR). (CS)

The Alignment of Technology and Structure through Roles and Networks.

ERIC Educational Resources Information Center

Barley, Stephen R.

1990-01-01

Building on Nagel's theory of social structure, this paper argues that the microsocial dynamics occasioned by new technologies systematically reverberate up levels of analysis. This theory is illustrated by ethnographic and sociometric data drawn from a study comparing usage of traditional and computerized imaging devices in two radiology…

The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke.

PubMed

Sohn, Min Kyun; Jee, Sung Ju; Hwang, Pyoungsik; Jeon, Yumi; Lee, Hyunkeun

2015-12-01

To investigate the effects of a shoulder sling on balance in patients with hemiplegia. Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position.

The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke

PubMed Central

Sohn, Min Kyun; Jee, Sung Ju; Hwang, Pyoungsik; Jeon, Yumi

2015-01-01

Objective To investigate the effects of a shoulder sling on balance in patients with hemiplegia. Methods Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. Results The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. Conclusion The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position. PMID:26798614

Lymphatic Drainage from Renal Tumors In Vivo: A Prospective Sentinel Node Study Using SPECT/CT Imaging.

PubMed

Kuusk, Teele; De Bruijn, Roderick; Brouwer, Oscar R; De Jong, Jeroen; Donswijk, Maarten; Grivas, Nikolaos; Hendricksen, Kees; Horenblas, Simon; Prevoo, Warner; Valdés Olmos, Renato A; Van Der Poel, Henk G; Van Rhijn, Bas W G; Wit, Esther M; Bex, Axel

2018-06-01

Lymphatic drainage from renal tumors is unpredictable. In vivo drainage studies of primary lymphatic landing sites may reveal the variability and dynamics of lymphatic connections. The purpose of this study was to investigate the lymphatic drainage pattern of renal tumors in vivo with single photon emission/computerized tomography after intratumor radiotracer injection. We performed a phase II, prospective, single arm study to investigate the distribution of sentinel nodes from renal tumors on single photon emission/computerized tomography. Patients with cT1-3 (less than 10 cm) cN0M0 renal tumors of any subtype were enrolled in analysis. After intratumor ultrasound guided injection of 0.4 ml 99m Tc-nanocolloid we performed preoperative imaging of sentinel nodes with lymphoscintigraphy and single photon emission/computerized tomography. Sentinel and locoregional nonsentinel nodes were resected with a γ probe combined with a mobile γ camera. The primary study end point was the location of sentinel nodes outside the locoregional retroperitoneal templates on single photon emission/computerized tomography. Using a Simon minimax 2-stage design to detect a 25% extralocoregional retroperitoneal template location of sentinel nodes on imaging at α = 0.05 and 80% power at least 40 patients with sentinel node imaging on single photon emission/computerized tomography were needed. Of the 68 patients 40 underwent preoperative single photon emission/computerized tomography of sentinel nodes and were included in primary end point analysis. Lymphatic drainage outside the locoregional retroperitoneal templates was observed in 14 patients (35%). Eight patients (20%) had supradiaphragmatic sentinel nodes. Sentinel nodes from renal tumors were mainly located in the respective locoregional retroperitoneal templates. Simultaneous sentinel nodes were located outside the suggested lymph node dissection templates, including supradiaphragmatic sentinel nodes in more than a third of the patients. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Automatic assessment of dynamic contrast-enhanced MRI in an ischemic rat hindlimb model: an exploratory study of transplanted multipotent progenitor cells.

PubMed

Hsu, Li-Yueh; Wragg, Andrew; Anderson, Stasia A; Balaban, Robert S; Boehm, Manfred; Arai, Andrew E

2008-02-01

This study presents computerized automatic image analysis for quantitatively evaluating dynamic contrast-enhanced MRI in an ischemic rat hindlimb model. MRI at 7 T was performed on animals in a blinded placebo-controlled experiment comparing multipotent adult progenitor cell-derived progenitor cell (MDPC)-treated, phosphate buffered saline (PBS)-injected, and sham-operated rats. Ischemic and non-ischemic limb regions of interest were automatically segmented from time-series images for detecting changes in perfusion and late enhancement. In correlation analysis of the time-signal intensity histograms, the MDPC-treated limbs correlated well with their corresponding non-ischemic limbs. However, the correlation coefficient of the PBS control group was significantly lower than that of the MDPC-treated and sham-operated groups. In semi-quantitative parametric maps of contrast enhancement, there was no significant difference in hypo-enhanced area between the MDPC and PBS groups at early perfusion-dependent time frames. However, the late-enhancement area was significantly larger in the PBS than the MDPC group. The results of this exploratory study show that MDPC-treated rats could be objectively distinguished from PBS controls. The differences were primarily determined by late contrast enhancement of PBS-treated limbs. These computerized methods appear promising for assessing perfusion and late enhancement in dynamic contrast-enhanced MRI.

Computerized Tests of Team Performance and Crew Coordination Suitable for Military/Aviation Settings.

PubMed

Lawson, Ben D; Britt, Thomas W; Kelley, Amanda M; Athy, Jeremy R; Legan, Shauna M

2017-08-01

The coordination of team effort on shared tasks is an area of inquiry. A number of tests of team performance in challenging environments have been developed without comparison or standardization. This article provides a systematic review of the most accessible and usable low-to-medium fidelity computerized tests of team performance and determines which are most applicable to military- and aviation-relevant research, such as studies of group command, control, communication, and crew coordination. A search was conducted to identify computerized measures of team performance. In addition to extensive literature searches (DTIC, Psychinfo, PubMed), the authors reached out to team performance researchers at conferences and through electronic communication. Identified were 57 potential tests according to 6 specific selection criteria (e.g., the requirement for automated collection of team performance and coordination processes, the use of military-relevant scenarios). The following seven tests (listed alphabetically) were considered most suitable for military needs: Agent Enabled Decision Group Environment (AEDGE), C3Conflict, the C3 (Command, Control, & Communications) Interactive Task for Identifying Emerging Situations (NeoCITIES), Distributed Dynamic Decision Making (DDD), Duo Wondrous Original Method Basic Awareness/Airmanship Test (DuoWOMBAT), the Leader Development Simulator (LDS), and the Planning Task for Teams (PLATT). Strengths and weaknesses of these tests are described and recommendations offered to help researchers identify the test most suitable for their particular needs. Adoption of a few standard computerized test batteries to study team performance would facilitate the evaluation of interventions intended to enhance group performance in multiple challenging military and aerospace operational environments.Lawson BD, Britt TW, Kelley AM, Athy JR, Legan SM. Computerized tests of team performance and crew coordination suitable for military/aviation settings. Aerosp Med Hum Perform. 2017; 88(8):722-729.

Improvement of Word Problem Solving and Basic Mathematics Competencies in Students with Attention Deficit/Hyperactivity Disorder and Mathematical Learning Difficulties

ERIC Educational Resources Information Center

González-Castro, Paloma; Cueli, Marisol; Areces, Débora; Rodríguez, Celestino; Sideridis, Georgios

2016-01-01

Problem solving represents a salient deficit in students with mathematical learning difficulties (MLD) primarily caused by difficulties with informal and formal mathematical competencies. This study proposes a computerized intervention tool, the integrated dynamic representation (IDR), for enhancing the early learning of basic mathematical…

Computerized modeling techniques predict the 3D structure of H₄R: facts and fiction.

PubMed

Zaid, Hilal; Ismael-Shanak, Siba; Michaeli, Amit; Rayan, Anwar

2012-01-01

The functional characterization of proteins presents a daily challenge r biochemical, medical and computational sciences, especially when the structures are undetermined empirically, as in the case of the Histamine H4 Receptor (H₄R). H₄R is a member of the GPCR superfamily that plays a vital role in immune and inflammatory responses. To date, the concept of GPCRs modeling is highlighted in textbooks and pharmaceutical pamphlets, and this group of proteins has been the subject of almost 3500 publications in the scientific literature. The dynamic nature of determining the GPCRs structure was elucidated through elegant and creative modeling methodologies, implemented by many groups around the world. H₄R which belongs to the GPCR family was cloned in 2000; understandably, its biological activity was reported only 65 times in pubmed. Here we attempt to cover the fundamental concepts of H₄R structure modeling and its implementation in drug discovery, especially those that have been experimentally tested and to highlight some ideas that are currently being discussed on the dynamic nature of H₄R and GPCRs computerized techniques for 3D structure modeling.

Botulinum Toxin Type A Injection for Spastic Equinovarus Foot in Children with Spastic Cerebral Palsy: Effects on Gait and Foot Pressure Distribution

PubMed Central

Choi, Ja Young; Jung, Soojin; Rha, Dong-wook

2016-01-01

Purpose To investigate the effect of intramuscular Botulinum toxin type A (BoNT-A) injection on gait and dynamic foot pressure distribution in children with spastic cerebral palsy (CP) with dynamic equinovarus foot. Materials and Methods Twenty-five legs of 25 children with CP were investigated in this study. BoNT-A was injected into the gastrocnemius (GCM) and tibialis posterior (TP) muscles under the guidance of ultrasonography. The effects of the toxin were clinically assessed using the modified Ashworth scale (MAS) and modified Tardieu scale (MTS), and a computerized gait analysis and dynamic foot pressure measurements using the F-scan system were also performed before injection and at 1 and 4 months after injection. Results Spasticity of the ankle plantar-flexor in both the MAS and MTS was significantly reduced at both 1 and 4 months after injection. On dynamic foot pressure measurements, the center of pressure index and coronal index, which represent the asymmetrical weight-bearing of the medial and lateral columns of the foot, significantly improved at both 1 and 4 months after injection. The dynamic foot pressure index, total contact area, contact length and hind foot contact width all increased at 1 month after injection, suggesting better heel contact. Ankle kinematic data were significantly improved at both 1 and 4 months after injection, and ankle power generation was significantly increased at 4 months after injection compared to baseline data. Conclusion Using a computerized gait analysis and foot scan, this study revealed significant benefits of BoNT-A injection into the GCM and TP muscles for dynamic equinovarus foot in children with spastic CP. PMID:26847306

Reliability and Normative Data for the Dynamic Visual Acuity Test for Vestibular Screening.

PubMed

Riska, Kristal M; Hall, Courtney D

2016-06-01

The purpose of this study was to determine reliability of computerized dynamic visual acuity (DVA) testing and to determine reference values for younger and older adults. A primary function of the vestibular system is to maintain gaze stability during head motion. The DVA test quantifies gaze stabilization with the head moving versus stationary. Commercially available computerized systems allow clinicians to incorporate DVA into their assessment; however, information regarding reliability and normative values of these systems is sparse. Forty-six healthy adults, grouped by age, with normal vestibular function were recruited. Each participant completed computerized DVA testing including static visual acuity, minimum perception time, and DVA using the NeuroCom inVision System. Testing was performed by two examiners in the same session and then repeated at a follow-up session 3 to 14 days later. Intraclass correlation coefficients (ICCs) were used to determine inter-rater and test-retest reliability. ICCs for inter-rater reliability ranged from 0.323 to 0.937 and from 0.434 to 0.909 for horizontal and vertical head movements, respectively. ICCs for test-retest reliability ranged from 0.154 to 0.856 and from 0.377 to 0.9062 for horizontal and vertical head movements, respectively. Overall, raw scores (left/right DVA and up/down DVA) were more reliable than DVA loss scores. Reliability of a commercially available DVA system has poor-to-fair reliability for DVA loss scores. The use of a convergence paradigm and not incorporating the forced choice paradigm may contribute to poor reliability.

The effect of pramipexole therapy on balance disorder and fall risk in Parkinson's disease at early stage: clinical and posturographic assessment.

PubMed

Güler, Sibel; Bir, Levent Sinan; Akdag, Beyza; Ardıc, Fusun

2012-01-01

The aim of this study was to determine balance problems and severity and ratio of postural instability of newly diagnosed, early stage Parkinson's patients who did not receive any antiparkinson treatment before, to evaluate fall risk clinically and posturographically and to examine the effects of pramipexole on these signs and symptoms. Detailed posturographic assessments which involved central vestibular, visual, peripheric vestibular somatosensory field tests were applied to both patient and control subjects and fall risk was determined. There was not statistically significant difference between patients and control subjects before and after drug therapy in the assesment of fall risk in posturography and there was not any improvement with drug usage in the patient group. However, in the analysis of subsystems separately, only the involvement in central vestibular field was more severe and could appear at all positions in Parkinson's patients comparing with the control group, and pramipexole was partially effective in improving this disorder. Central vestibular field is the subsystem that should be examined with first priority. Posturography is relatively reliable in defining fall risk and postural instability ratio in Parkinson's disease. But it should be considered that clinical assessment tools can be more sensitive in the evaluation of balance and postural disorders and in the follow-up of the response to drug therapy.

RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprain.

PubMed

Stecco, Antonio; Stecco, Carla; Macchi, Veronica; Porzionato, Andrea; Ferraro, Claudio; Masiero, Stefano; De Caro, Raffaele

2011-12-01

Recent studies reveal the role of the ankle retinacula in proprioception and functional stability of the ankle, but there is no clear evidence of their role in the outcomes of ankle sprain. 25 patients with outcomes of ankle sprain were evaluated by MRI to analyze possible damage to the ankle retinacula. Patients with damage were subdivided into two groups: group A comprised cases with ankle retinacula damage only, and group B those also with anterior talofibular ligament rupture or bone marrow edema. Both groups were examined by VAS, CRTA and static posturography and underwent three treatments of deep connective tissue massage (Fascial Manipulation technique). All evaluations were repeated after the end of treatment and at 1, 3 and 6 months. At MRI, alteration of at least one of the ankle retinacula was evident in 21 subjects, and a further lesion was also identified in 7 subjects. After treatment, VAS and CRTA evaluations showed a statistically significant decrease in values with respect to those before treatment (p < 0.0001). There were also significant improvements (p < 0.05) in stabilometric platform results. No significant difference was found between groups A and B. The initial benefit was generally maintained at follow-up. The alteration of retinacula at MRI clearly corresponds to the proprioceptive damage revealed by static posturography and clinical examination. Treatment focused on the retinacula may improve clinical outcomes and stabilometric data.

Numerical simulation of dynamics of brushless dc motors for aerospace and other applications. Volume 1: Model development and applications, part B

NASA Technical Reports Server (NTRS)

Demerdash, N. A. O.; Nehl, T. W.

1979-01-01

A mathematical model was developed and computerized simulations were obtained for a brushless dc motor. Experimentally obtained oscillograms of the machine phase currents are presented and the corresponding current and voltage waveforms for various modes of operation of the motor are presented and discussed.

A Head in Virtual Reality: Development of A Dynamic Head and Neck Model

ERIC Educational Resources Information Center

Nguyen, Ngan; Wilson, Timothy D.

2009-01-01

Advances in computer and interface technologies have made it possible to create three-dimensional (3D) computerized models of anatomical structures for visualization, manipulation, and interaction in a virtual 3D environment. In the past few decades, a multitude of digital models have been developed to facilitate complex spatial learning of the…

Quantized Detector Networks

NASA Astrophysics Data System (ADS)

Jaroszkiewicz, George

2017-12-01

Preface; Acronyms; 1. Introduction; 2. Questions and answers; 3. Classical bits; 4. Quantum bits; 5. Classical and quantum registers; 6. Classical register mechanics; 7. Quantum register dynamics; 8. Partial observations; 9. Mixed states and POVMs; 10. Double-slit experiments; 11. Modules; 12. Computerization and computer algebra; 13. Interferometers; 14. Quantum eraser experiments; 15. Particle decays; 16. Non-locality; 17. Bell inequalities; 18. Change and persistence; 19. Temporal correlations; 20. The Franson experiment; 21. Self-intervening networks; 22. Separability and entanglement; 23. Causal sets; 24. Oscillators; 25. Dynamical theory of observation; 26. Conclusions; Appendix; Index.

Machines that go "ping" may improve balance but may not improve mobility or reduce risk of falls: a systematic review.

PubMed

Dennett, Amy M; Taylor, Nicholas F

2015-01-01

To determine the effectiveness of computer-based electronic devices that provide feedback in improving mobility and balance and reducing falls. Randomized controlled trials were searched from the earliest available date to August 2013. Standardized mean differences were used to complete meta-analyses, with statistical heterogeneity being described with the I-squared statistic. The GRADE approach was used to summarize the level of evidence for each completed meta-analysis. Risk of bias for individual trials was assessed with the (Physiotherapy Evidence Database) PEDro scale. Thirty trials were included. There was high-quality evidence that computerized devices can improve dynamic balance in people with a neurological condition compared with no therapy. There was low-to-moderate-quality evidence that computerized devices have no significant effect on mobility, falls efficacy and falls risk in community-dwelling older adults, and people with a neurological condition compared with physiotherapy. There is high-quality evidence that computerized devices that provide feedback may be useful in improving balance in people with neurological conditions compared with no therapy, but there is a lack of evidence supporting more meaningful changes in mobility and falls risk.

Caffeine antagonism of alcohol-induced driving impairment.

PubMed

Liguori, A; Robinson, J H

2001-07-01

The extent to which caffeine antagonizes alcohol-induced impairment of simulated automobile driving at the current lowest legal American limit (0.08% BrAC) was the focus of this study. Fifteen adults swallowed a capsule (0, 200, or 400 mg caffeine) then drank a beverage (0.0 or 0.6 g/kg ethanol) in a within-subject, double-blind, randomized procedure. Forty-five minutes later, participants completed a test battery of subjective effects scales, dynamic posturography, critical flicker fusion (CFF), choice reaction time (CRT), divided attention (Stroop test), and simulated driving. Alcohol alone increased ratings of 'dizzy', 'drug effect', and 'high', slowed CRT and brake latency, and increased body sway. Caffeine alone increased ratings of 'alert' and 'jittery', but did not significantly affect body sway or psychomotor performance. Both caffeine doses comparably counteracted alcohol impairment of brake latency but not CRT or body sway. Brake latency with either alcohol-caffeine combination remained significantly longer than that with placebo. Stroop and CFF performance were unaffected by any drug condition. The results suggest that caffeine may increase alertness and improve reaction time after alcohol use but will not completely counteract alcohol impairment in a driver.

Applications of computerized adaptive testing (CAT) to the assessment of headache impact.

PubMed

Ware, John E; Kosinski, Mark; Bjorner, Jakob B; Bayliss, Martha S; Batenhorst, Alice; Dahlöf, Carl G H; Tepper, Stewart; Dowson, Andrew

2003-12-01

To evaluate the feasibility of computerized adaptive testing (CAT) and the reliability and validity of CAT-based estimates of headache impact scores in comparison with 'static' surveys. Responses to the 54-item Headache Impact Test (HIT) were re-analyzed for recent headache sufferers (n = 1016) who completed telephone interviews during the National Survey of Headache Impact (NSHI). Item response theory (IRT) calibrations and the computerized dynamic health assessment (DYNHA) software were used to simulate CAT assessments by selecting the most informative items for each person and estimating impact scores according to pre-set precision standards (CAT-HIT). Results were compared with IRT estimates based on all items (total-HIT), computerized 6-item dynamic estimates (CAT-HIT-6), and a developmental version of a 'static' 6-item form (HIT-6-D). Analyses focused on: respondent burden (survey length and administration time), score distributions ('ceiling' and 'floor' effects), reliability and standard errors, and clinical validity (diagnosis, level of severity). A random sample (n = 245) was re-assessed to test responsiveness. A second study (n = 1103) compared actual CAT surveys and an improved 'static' HIT-6 among current headache sufferers sampled on the Internet. Respondents completed measures from the first study and the generic SF-8 Health Survey; some (n = 540) were re-tested on the Internet after 2 weeks. In the first study, simulated CAT-HIT and total-HIT scores were highly correlated (r = 0.92) without 'ceiling' or 'floor' effects and with a substantial reduction (90.8%) in respondent burden. Six of the 54 items accounted for the great majority of item administrations (3603/5028, 77.6%). CAT-HIT reliability estimates were very high (0.975-0.992) in the range where 95% of respondents scored, and relative validity (RV) coefficients were high for diagnosis (RV = 0.87) and severity (RV = 0.89); patient-level classifications were accurate 91.3% for a diagnosis of migraine. For all three criteria of change, CAT-HIT scores were more responsive than all other measures. In the second study, estimates of respondent burden, item usage, reliability and clinical validity were replicated. The test-retest reliability of CAT-HIT was 0.79 and alternate forms coefficients ranged from 0.85 to 0.91. All correlations with the generic SF-8 were negative. CAT-based administrations of headache impact items achieved very large reductions in respondent burden without compromising validity for purposes of patient screening or monitoring changes in headache impact over time. IRT models and CAT-based dynamic health assessments warrant testing among patients with other conditions.

Engaging in Problem Posing Activities in a Dynamic Geometry Setting and the Development of Prospective Teachers' Mathematical Knowledge

ERIC Educational Resources Information Center

Lavy, Ilana; Shriki, Atara

2010-01-01

In the present study we explore changes in perceptions of our class of prospective mathematics teachers (PTs) regarding their mathematical knowledge. The PTs engaged in problem posing activities in geometry, using the "What If Not?" (WIN) strategy, as part of their work on computerized inquiry-based activities. Data received from the PTs'…

Various Solution Methods, Accompanied by Dynamic Investigation, for the Same Problem as a Means for Enriching the Mathematical Toolbox

ERIC Educational Resources Information Center

Oxman, Victor; Stupel, Moshe

2018-01-01

A geometrical task is presented with multiple solutions using different methods, in order to show the connection between various branches of mathematics and to highlight the importance of providing the students with an extensive 'mathematical toolbox'. Investigation of the property that appears in the task was carried out using a computerized tool.

Various solution methods, accompanied by dynamic investigation, for the same problem as a means for enriching the mathematical toolbox

NASA Astrophysics Data System (ADS)

Oxman, Victor; Stupel, Moshe

2018-04-01

A geometrical task is presented with multiple solutions using different methods, in order to show the connection between various branches of mathematics and to highlight the importance of providing the students with an extensive 'mathematical toolbox'. Investigation of the property that appears in the task was carried out using a computerized tool.

Development of a protocol for improving the clinical utility of posturography as a fall-risk screening tool.

PubMed

Bigelow, Kimberly Edginton; Berme, Necip

2011-02-01

The usefulness of posturography in the clinical screening of older adults for fall risk has been limited by a lack of standardization in testing methodology and data reporting. This study determines which testing condition and postural sway measures best differentiate recurrent fallers and nonrecurrent fallers. One hundred and fifty older adults were categorized based on their fall status in the past year. Participants performed four quiet-standing tasks, eyes open and eyes closed in both comfortable and narrow stance, for 60 seconds while standing on a force-measuring platform. Traditional and fractal measures were calculated from the center of pressure data. Logistic regression was performed to determine the model for each condition that best discriminated between recurrent fallers and nonrecurrent fallers. The eyes closed comfortable stance condition, with its associated model, best differentiated recurrent fallers and nonrecurrent fallers. Medial-lateral sway velocity, anterior-posterior short-term α-scaling exponent, medial-lateral short-term α-scaling exponent, mean frequency, body mass index, and age were included in this model. Sensitivity of the model was 75%, and specificity was 94%. This resulting model demonstrates potential to differentiate recurrent fallers and nonrecurrent fallers in an eyes closed comfortable stance condition. The inclusion of traditional sway parameters, fractal measures, and personal characteristics in this model demonstrates the importance of considering multiple descriptions of postural stability together rather than using only a single measure to establish fall risk.

[Postural control disorders in initial phases of whiplash].

PubMed

Pleguezuelos Cobo, Eulogio; García-Alsina, Joan; García Almazán, Concepción; Ortiz Fandiño, Javier; Pérez Mesquida, M Engracia; Guirao Cano, Lluis; Samitier Pastor, Beatriz; Perucho Pont, Cristina; Coll Serra, Estel; Matarrubias, Carlos; Reveron, Genoveva

2009-05-02

Dizziness of variable intensity is a frequent complaint in patients who suffered whiplash and largely documented balance disturbances. The objective of the study was to identify balance disorders in early stage of whiplash after road traffic accidents. Ninety nine women were included in the study. Fifty four women had suffered whiplash within two weeks and 45 were included in a healthy control group. Static posturography on a force platform was carried out in all study participants, by means of the Romberg test in four sequential phases, using the postural sway area (SA) as a dependent variable. Visual Analogic Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPH) were used to evaluate pain and function. Postural sway area increased significantly in each of the consecutive phases in both groups. The differences of the means of the postural sway area were statistically significant in all Romberg phases (p=.009 to P=.000). No correlation was found between SA and VAS or NPH scores. There was a positive correlation between the postural sway area standing on a thick foam cushion placed over the plate with closed eyes and the number of days of transitory incapacity (r=0.414; P=.009). Patients with recent whiplash show a postural control disturbance revealed trough a sequential static posturography analysis. This suggests that the balance disorder is not only a consequence of late whiplash syndrome evolution. Therefore, we should promote early instauration of a specific therapeutic approach if and when the patient refers dizziness and related symptoms.

Behavioral Assessment of Spaceflight Effects on Neurocognitive Performance: Extent and Longevity

NASA Technical Reports Server (NTRS)

De Dios, Y. E.; Kofman, I. S.; Gadd, N. E.; Kreutzberg, G. A.; Peters, B. T.; Taylor, L. C.; Campbell, D. J.; Wood, S. J.; Bloomberg, J. J.; Seidler, R. D.;

Vestibular effects of cochlear implantation.

PubMed

Buchman, Craig A; Joy, Jennifer; Hodges, Annelle; Telischi, Fred F; Balkany, Thomas J

2004-10-01

Cochlear implantation (CI) carries with it the potential risk for vestibular system insult or stimulation with resultant dysfunction. As candidate profiles continue to evolve and with the recent development of bilateral CI, understanding the significance of this risk takes on an increasing importance. Between 1997 to 2001, a prospective observational study was carried out in a tertiary care medical center to assess the effects of unilateral CI on the vestibular system. Assessment was performed using the dizziness handicap inventory (DHI), vestibulo-ocular reflex (VOR) testing using both alternate bithermal caloric irrigations (ENG) and rotational chair-generated sinusoidal harmonic accelerations (SHA), and computerized dynamic platform posturography (CDP) at preoperative, 1-month, 4-month, 1-year and 2-year postimplantation visits. CI was carried out without respect to the preoperative vestibular function test results. Specifically, 86 patients were entered into the study after informed consent. For the group as a whole, pair wise comparisons revealed few significant differences between preoperative and postoperative values for VOR testing (ENG and SHA) at any of the follow-up intervals. Likewise, DHI testing was also unchanged except for significant reductions (improvements) in the emotional subcategory scores at both the 4-month and 1-year intervals. CDP results demonstrated substantial improvements in postural sway in the vestibular conditions (5 and 6) as well as composite scores with the device "off" and "on" at the 1-month, 4-month, 1-year, and 2-year intervals. Device activation appeared to improve postural stability in some conditions. Excluding those patients with preoperative areflexic or hyporeflexic responses in the implanted ear (total [warm + cool] caloric response or=21 deg/s maximum slow phase velocity) in total caloric response were observed for 8 (29%) patients at the 4-month interval. These persisted throughout the study period. These changes were accompanied by significant low frequency phase changes on SHA testing confirming a VOR insult. Of interest, no significant changes were detected in the DHI or CDP, and there were no effects of age, sex, device manufacturer, or etiology of hearing loss (HL) for these patients. Unilateral CI rarely results in significant adverse effects on the vestibular system as measured by the DHI, ENG, SHA, and CDP. On the contrary, patients that underwent CI experienced significant improvements in the objective measures of postural stability as measured by CDP. Device activation in music appeared to have an additional positive effect on postural stability during CDP testing. Although VOR testing demonstrated some decreases in response, patients did not suffer from disabling vestibular effects following CI. The mechanism underlying these findings remains speculative. These findings should be considered in counseling patients about CI.

The Effect of a Computerized Simulation on Middle School Students' Understanding of the Kinetic Molecular Theory

ERIC Educational Resources Information Center

Stern, Luli; Barnea, Nitza; Shauli, Sofia

2008-01-01

The objective of this study was to evaluate the effect of a dynamic software simulation on the understanding of the kinetic molecular theory by 7th graders. Students in the control group (n = 62) studied a curricular unit that addressed the differences in arrangement and motion of molecules in the three phases of matter. The experimental group (n…

Sled Control and Safety System

NASA Technical Reports Server (NTRS)

Forrest, L. J.

1982-01-01

Computerized system for controlling motion of linear-track accelerator applied to other automated equipment, such as numerically-controlled machine tools and robot manipulators on assembly lines. System controls motions of sled with sine-wave signal created digitally by microprocessor. Dynamic parameters of sled motion are monitored so sled may be stopped safely if malfunction occurs. Sled is capable of sinusoidal accelerations up to 0.5 g with 125-kg load.

A prototype of a computerized patient record.

PubMed

Adelhard, K; Eckel, R; Hölzel, D; Tretter, W

1995-01-01

Computerized medical record systems (CPRS) should present user and problem oriented views of the patient file. Problem lists, clinical course, medication profiles and results of examinations have to be recorded in a computerized patient record. Patient review screens should give a synopsis of the patient data to inform whenever the patient record is opened. Several different types of data have to be stored in a patient record. Qualitative and quantitative measurements, narratives and images are such examples. Therefore, a CPR must also be able to handle these different data types. New methods and concepts appear frequently in medicine. Thus a CPRS must be flexible enough to cope with coming demands. We developed a prototype of a computer based patient record with a graphical user interface on a SUN workstation. The basis of the system are a dynamic data dictionary, an interpreter language and a large set of basic functions. This approach gives optimal flexibility to the system. A lot of different data types are already supported. Extensions are easily possible. There is also almost no limit concerning the number of medical concepts that can be handled by our prototype. Several applications were built on this platform. Some of them are presented to exemplify the patient and problem oriented handling of the CPR.

Wii Fit exer-game training improves sensory weighting and dynamic balance in healthy young adults.

PubMed

Cone, Brian L; Levy, Susan S; Goble, Daniel J

2015-02-01

The Nintendo Wii Fit is a balance training tool that is growing in popularity due to its ease of access and cost-effectiveness. While considerable evidence now exists demonstrating the efficacy of the Wii Fit, no study to date has determined the specific mechanism underlying Wii Fit balance improvement. This paucity of knowledge was addressed in the present study using the NeuroCom Balance Manager's Sensory Organization Test (SOT) and Limits of Stability (LOS) test. These well-recognized posturography assessments, respectively, measure sensory weighting and dynamic stability mechanisms of balance. Forty healthy, young participants were recruited into two groups: Wii Fit Balance Intervention (WFBI) (n=20) and Control (CON) (n=20). Balance training consisted of seven Wii Fit exer-games played over the course of six consecutive weeks (2-4×/week, 30-45min/day). The WFBI group performed Neurocom testing before and after the intervention, while the CON group was tested along a similar timeline with no intervention. Mixed-design ANOVAs found significant interactions for testing time point and condition 5 of the SOT (p<0.02), endpoint excursion (p<0.01), movement velocity (p<0.02), and response time (p<0.01). These effects were such that greater improvements were seen for the WFBI group following Wii Fit training. These findings suggest that individuals with known issues regarding the processing of multiple sources of sensory information and/or who have limited functional bases of support may benefit most from Wii Fit balance training. Copyright © 2015 Elsevier B.V. All rights reserved.

Improvement of balance in progressive degenerative cerebellar ataxias after Ayurvedic therapy: a preliminary report.

PubMed

Sriranjini, S J; Pal, Pramod Kumar; Devidas, K V; Ganpathy, Selva

2009-01-01

The treatment options for improving the balance in degenerative cerebellar ataxias are very few. Ayurvedic texts have described diverse treatment regimens for this disease. To determine the change in balance indices, if any, by dynamic posturography (Biodex Balance System, USA) in progressive cerebellar ataxia following Ayurvedic treatment. We performed a preliminary open labelled study on ten patients diagnosed with progressive cerebellar ataxia. The patients were treated over a period of one month. Treatment consisted of Shirobasti (therapeutic retention of medicament over the scalp) in male patients and Shirodhara (pouring of a steady stream of medicament on the forehead) in female patients with Dhanvantaram tailam (medicated oil) for 45 minutes daily, followed by Abhyanga (methodical massage) with Dhanvantaram tailam and Bhashpa sweda (steam bath), for 14 days. In addition, the treatment also consisted Abhyantara aushadha (oral medicines) of Maharasnadi kashayam 15ml thrice daily, Dhanvantaram capsules 101 two capsules thrice daily, and Ashwagandha tablet 500 mg one tablet thrice daily, for one month. The patients were assessed on the Biodex balance system before and after the treatment. Results were analyzed using paired samples 't' test. All patients tolerated the treatment well without any adverse events and reported subjective improvement in walking. There was a statistically significant improvement in the overall and anteroposterior balance indices of dynamic stability. Over the short period of the present study, Ayurvedic therapy was found to be safe and, showed improvement in the balance in patients with progressive degenerative cerebellar ataxia. Further randomized placebo-control double-blind studies are needed to validate the results.

Ankle taping does not impair performance in jump or balance tests.

PubMed

Abián-Vicén, Javier; Alegre, Luis M; Fernández-Rodríguez, J Manuel; Lara, Amador J; Meana, Marta; Aguado, Xavier

2008-01-01

This study aimed to investigate the influence of prophylactic ankle taping on two balance tests (static and dynamic balance) and one jump test, in the push off and the landing phase. Fifteen active young subjects (age: 21.0 ± 4.4 years) without previous ankle injuries volunteered for the study. Each participant performed three tests in two different situations: with taping and without taping. The tests were a counter movement jump, static balance, and a dynamic posturography test. The tests and conditions were randomly performed. The path of the center of pressures was measured in the balance tests, and the vertical ground reaction forces were recorded during the push-off and landing phases of the counter movement jump. Ankle taping had no influence on balance performance or in the push off phase of the jump. However, the second peak vertical force value during the landing phase of the jump was 12% greater with ankle taping (0.66 BW, 95% CI -0.64 to 1.96). The use of prophylactic ankle taping had no influence on the balance or jump performance of healthy young subjects. In contrast, the taped ankle increased the second peak vertical force value, which could be related to a greater risk of injury produced by the accumulation of repeated impacts in sports where jumps are frequently performed. Key pointsAnkle taping has no influence on balance performance.Ankle taping does not impair performance during the push-off phase of the jump.Ankle taping could increase the risk of injury during landings by increasing peak forces.

Ankle Taping Does Not Impair Performance in Jump or Balance Tests

PubMed Central

Abián-Vicén, Javier; Alegre, Luis M.; Fernández-Rodríguez, J. Manuel; Lara, Amador J.; Meana, Marta; Aguado, Xavier

2008-01-01

This study aimed to investigate the influence of prophylactic ankle taping on two balance tests (static and dynamic balance) and one jump test, in the push off and the landing phase. Fifteen active young subjects (age: 21.0 ± 4.4 years) without previous ankle injuries volunteered for the study. Each participant performed three tests in two different situations: with taping and without taping. The tests were a counter movement jump, static balance, and a dynamic posturography test. The tests and conditions were randomly performed. The path of the center of pressures was measured in the balance tests, and the vertical ground reaction forces were recorded during the push-off and landing phases of the counter movement jump. Ankle taping had no influence on balance performance or in the push off phase of the jump. However, the second peak vertical force value during the landing phase of the jump was 12% greater with ankle taping (0.66 BW, 95% CI -0.64 to 1.96). The use of prophylactic ankle taping had no influence on the balance or jump performance of healthy young subjects. In contrast, the taped ankle increased the second peak vertical force value, which could be related to a greater risk of injury produced by the accumulation of repeated impacts in sports where jumps are frequently performed. Key pointsAnkle taping has no influence on balance performance.Ankle taping does not impair performance during the push-off phase of the jump.Ankle taping could increase the risk of injury during landings by increasing peak forces. PMID:24149902

The Dynamics of Programming, Control and the Movement Sequential Organization Skills as the Basic Components of Writing (Based on Data from Graphomotor Tests)

ERIC Educational Resources Information Center

Kuzeva, O. A.; Romanova, A. A.; Korneev, A. A.; Akhutina, T. V.

2015-01-01

We present the results of a longitudinal study of the formation of graphomotor skills in elementary school children between the ages of seven and nine (students in the first and second grades). Patterns in how the skills under investigation develop in normal children and those with learning disabilities were revealed using a computerized survey of…

Computerized Interpretation of Dynamic Breast MRI

DTIC Science & Technology

2005-05-01

The interpretation criteria in the current literature fall Breast MRI has emerged as a promising modality for the into two major categories: 5’ 14...is that theraphy , current interpretation schemes might not be sufficiently ro- Despite its well-recognized advantages, applications of bust. MRI in...postcontrast series For the manual delineation, a radiologist (U.B.), blinded were then taken with a time interval of 60 s. Each series to the histological

Distributed Computerized Catalog System

NASA Technical Reports Server (NTRS)

Borgen, Richard L.; Wagner, David A.

1995-01-01

DarkStar Distributed Catalog System describes arbitrary data objects in unified manner, providing end users with versatile, yet simple search mechanism for locating and identifying objects. Provides built-in generic and dynamic graphical user interfaces. Design of system avoids some of problems of standard DBMS, and system provides more flexibility than do conventional relational data bases, or object-oriented data bases. Data-collection lattice partly hierarchical representation of relationships among collections, subcollections, and data objects.

Information Technology Implementation and Sustainment Model: Data Collection Instrument

DTIC Science & Technology

2005-03-01

users (Wing and Bettinger , 2003). A GIS is a computerized system for spatial (geographically-referenced) data management (Davis and Schultz, 1990:3...AFIT/GEM/ENV/05M-15 Abstract The goal of this research was to develop a data collection instrument for an existing information technology...implementation and sustsinment model. In 2003, a unique system dynamics model was developed at the Air Force Institute of Technology to predict the

Does the radiologically isolated syndrome exist? A dual-task cost pilot study.

PubMed

Dattola, Vincenzo; Logiudice, Anna Lisa; Bonanno, Lilla; Famà, Fausto; Milardi, Demetrio; Chillemi, Gaetana; D'Aleo, Giangaetano; Marino, Silvia; Calabrò, Rocco Salvatore; Russo, Margherita

2017-11-01

Simultaneous performance of motor and cognitive tasks may compete for common brain network resources in aging or patients with some neurological diseases, suggesting the occurrence of a cognitive-motor interference. While this phenomenon has been well described for multiple sclerosis (MS) patients, it never has been tested on asymptomatic subject with magnetic resonance imaging (MRI) findings suggestive of demyelinating disease (i.e., radiologically isolated syndrome: RIS). In this pilot study, 10 RIS subjects and 10 sex/age-matched healthy controls were tested by means of static posturography under eyes opened (single-task trial) and while performing two different cognitive tasks (semantic modified word list generation for first dual-task trial and phonemic semantic modified word list generation for second dual-task trial), to estimate the dual-task cost (DTC) of standing balance. In our sample, under cognitive interference (without any substantial differences between semantic and phonemic modified word list generation), the RIS group showed significance differences in CoP (center of pressure) total sway area, ellipse eccentricity, CoP sway path length, CoP median sway velocity along the AP (anteroposterior) axis and along the ML (mediolateral) axis, reflecting a higher negative DTC respect to healthy subjects (which have simply shown a statistical trend, failing to reach a significance, in some trials). The phenomenon of cognitive-motor interference might be unmasked by a dual-task posturography in RIS subjects, too. We hypothesize that this approach could be useful to early reveal the presence of a demyelinating disease and to reach a MS diagnosis in subjects otherwise classified as RIS.

[Experience of a falls prevention unit in an intermediate care hospital].

PubMed

Roca Carbonell, Ferran; Hernandez Ocampo, Erwin Martin; Aragonès Pascual, Jose Maria; Soler, Eulalia; Clapera, Fina; Espaulella Panicot, Joan

2014-01-01

The aim of this study is to determine clinical features and interventions in patients attended in our hospital falls prevention unit. Medical records and evaluation protocols from October 2010 to June 2012 were reviewed. Results are expressed in means and standard deviation. We studied 68 patients: 53 came due to falls (77.9%), and 15 (22%) due to gait disorders. The mean age was 77.6±7.9. Number of women: 63 (92.6%). Previous Barthel Index was 94/100, cognitive impairment 23 (33.8%), polypharmacy 69.1%, orthostatic hypotension 18 (26.4%). Walking speed 0.66± 0.19m/s and Time up and go to (TUG) 16.6±4.5 s. Post-urography detected vestibular dysfunction in 34 patients (77%). Clinical cause of fall and/or gait disorder was multifactorial in 33 (48.5%), Parkinsonism 19 (27.9%), chronic pain/arthropathy 8 (11.4%), and vestibular syndrome 8 (11.4%). Two-thirds (45; 66.1%) of the patients began Physical therapy, and vitamin D was given to 47 (69.1%). Phone calls were made to patients and/or their relatives and noted that after 3 months of the treatment: 48 (70.5%) had no fall; 59 (86.7%) patients followed the recommendations, and 57 (83.8%) were satisfied. In this sample of older patients, mostly female with a good functional and cognitive condition, the causes of the falls were multifactorial in the half of the cases, and the post-urography detected vestibular changes in the half of the patients. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

Fractal dimension approach in postural control of subjects with Prader-Willi Syndrome

PubMed Central

2011-01-01

Background Static posturography is user-friendly technique suitable for the study of the centre of pressure (CoP) trajectory. However, the utility of static posturography in clinical practice is somehow limited and there is a need for reliable approaches to extract physiologically meaningful information from stabilograms. The aim of this study was to quantify the postural strategy of Prader-Willi patients with the fractal dimension technique in addition to the CoP trajectory analysis in time and frequency domain. Methods 11 adult patients affected by Prader-Willi Syndrome (PWS) and 20 age-matched individuals (Control group: CG) were included in this study. Postural acquisitions were conducted by means of a force platform and the participants were required to stand barefoot on the platform with eyes open and heels at standardized distance and position for 30 seconds. Platform data were analysed in time and frequency domain. Fractal Dimension (FD) was also computed. Results The analysis of CoP vs. time showed that in PWS participants all the parameters were statistically different from CG, with greater displacements along both the antero-posterior and medio-lateral direction and longer CoP tracks. As for frequency analysis, our data showed no significant differences between PWS and CG. FD evidenced that PWS individuals were characterized by greater value in comparison with CG. Conclusions Our data showed that while the analysis in the frequency domain did not seem to explain the postural deficit in PWS, the FD method appears to provide a more informative description of it and to complement and integrate the time domain analysis. PMID:21854639

Directional measures of postural sway as predictors of balance instability and accidental falls

PubMed Central

Janusz, Błaszczyk W.; Beck, Monika; Szczepańska, Justyna; Sadowska, Dorota; Bacik, Bogdan; Juras, Grzegorz

2016-01-01

Abstract Despite the obvious advantages and popularity of static posturography, universal standards for posturographic tests have not been developed thus far. Most of the center-of-foot pressure (COP) indices are strongly dependent on an individual experimental design, and are susceptible to distortions, which makes results of their analysis incomparable. In this research, we present a novel approach to the analysis of the COP trajectory based on the directional features of postural sway. Our novel output measures: the sway directional indices (DI) and sway vector (SV) were applied to assess the postural stability in the group of young able-bodied subjects. Towards this aim, the COP trajectories were recorded in 100 students standing still for 60 s, with eyes open (EO) and then, with eyes closed (EC). Each record was subdivided then into 20, 30 and 60 s samples. Interclass correlation coefficients were calculated from the samples. The controlled variables (visual conditions) uniquely affected the output measures, but only in case of proper signal pretreatment (low-pass filtering). In filtering below 6 Hz, the DI and SV provided a unique set of descriptors for postural control. Both sway measures were highly independent of the trial length and the sampling frequency, and were unaffected by the sampling noise. Directional indices of COP filtered at 6 Hz showed high to very high reliability, with ICC range of 0.7-0.9. Results of a single 60 s trial are sufficient to reach acceptable reliability for both DI and SV. In conclusion, the directional sway measures may be recommended as the primary standard in static posturography. PMID:28149395

[Reliability of static posturography in elderly persons].

PubMed

Bauer, C M; Gröger, I; Rupprecht, R; Tibesku, C O; Gassmann, K G

2010-08-01

Static posturography is used to quantify body sway. It is used to assess the balance of elderly persons who are prone to falls. There is still no general opinion concerning the reliability of force platform measurements. The aim of this study was to test the reliability of force platform parameters when measuring elderly persons. The reliability of 11 force platform parameters was tested measuring 30 elderly persons. The following parameters were calculated: mean speed of center of pressure displacement in mm/s, length of sway in mm, sway area in mm(2), amplitudes of center of pressure movement, the axis of oscillation in degrees and the person's angles of inclination in degrees. Three measurements were taken on the same day, with a resting period of 2 min. Four different test conditions were used: normal standing and narrow stand with eyes open and eyes closed, respectively. Reliability was determined by using intraclass correlation coefficients. Six parameters had excellent reliability with a correlation coefficient of >0.9: mean speed of center of pressure movement during narrow stand, area of sway during narrow stand, length of sway during normal and narrow stand, and the angle of inclination in the sagittal plane during normal stand and narrow stand. The condition "narrow stand eyes closed" proved to be the most reliable test position. Six parameters proved to have excellent reliability and are recommended to be used in further investigations. Narrow stand with eyes closed should be used as the test position. The tested protocol proved to be reliable. Whether these parameters can be used to predict falls in elderly persons remains to be investigated.

Chain Dynamics and Structure Property Relation in High Impact Strength Polycarbonate Plastic.

DTIC Science & Technology

1985-01-04

computerized for cases involving more than one kinetic process simultaneously contributing to line narrowing. The model introduces a distributional character...F. O’Gara (Research Assistant) Department of Chemitry , Graduate Student Clark University PhD Clark University June, 1984. 4. The following...on a tetrahedral lattice is compared with a a v ,del by Weber and Hel- fand (8), based on computer simulaticns cct pOlVethvlece type chafins. These two

Gear Drive Testing

NASA Technical Reports Server (NTRS)

1982-01-01

Philadelphia Gear Corporation used two COSMIC computer programs; one dealing with shrink fit analysis and the other with rotor dynamics problems in computerized design and test work. The programs were used to verify existing in-house programs to insure design accuracy by checking its company-developed computer methods against procedures developed by other organizations. Its specialty is in custom units for unique applications, such as Coast Guard ice breaking ships, steel mill drives, coal crusher, sewage treatment equipment and electricity.

Genetic and Dynamic Analysis of Murine Peak Bone Density

DTIC Science & Technology

1998-10-01

number of diseases including Waardenburg syndrome (18, 19) and retinitis pigmentosa (20). Substantial computerized genetic data bases maintained at...411, 1992. 14. Foy, C., Newton, V., Wellesley, D., Harris, R., and Read, A. P. Assignment of the locus for Waardenburg syndrome type 1 to human...Balling, R., Gruss, P., and Strachan, T. Waardenburg’s syndrome patients have mutations in the human homologue of the Pax-3 paired box gene, Nature

Psychometric Testing of the Self-Efficacy for Interdisciplinary Plans of Care Scale.

PubMed

Molle, Elizabeth; Froman, Robin

2017-01-01

Computerized interdisciplinary plans of care have revitalized nurse-centric care plans into dynamic and meaningful electronic documents. To maximize the benefits of these documents, it is important to understand healthcare professionals' attitudes, specifically their confidence, for making computerized interdisciplinary care plans useful and meaningful documents. The purpose of the study was to test the psychometric properties of the Self-Efficacy for Interdisciplinary Plans of Care instrument intended to measure healthcare professionals' self-efficacy for using such documents. Content validity was assessed by an expert review panel. Content validity indices ranged from 0.75 to 1.00, with a scale CVI of 0.94. A sample of 389 healthcare providers completed the 14-item instrument. Principal axis factoring was used to assess factor structure. The exploratory factor analysis yielded a single-factor structure accounting for 71.76% of covariance. Cronbach internal consistency coefficient for the single factor solution was .97. The corrected item-total correlations ranged from 0.71 to 0.90. The coefficient of stability, during a 2-week period, with a subset of the sample (n = 38), was estimated at 0.82. The results of this study suggest that the Self-Efficacy for Interdisciplinary Plans of Care has sturdy reliability and validity for measuring the self-efficacy of healthcare providers to make computerized interdisciplinary plans of care meaningful and useful documents.

Dynamic motion analysis of dart throwers motion visualized through computerized tomography and calculation of the axis of rotation.

PubMed

Edirisinghe, Y; Troupis, J M; Patel, M; Smith, J; Crossett, M

2014-05-01

We used a dynamic three-dimensional (3D) mapping method to model the wrist in dynamic unrestricted dart throwers motion in three men and four women. With the aid of precision landmark identification, a 3D coordinate system was applied to the distal radius and the movement of the carpus was described. Subsequently, with dynamic 3D reconstructions and freedom to position the camera viewpoint anywhere in space, we observed the motion pathways of all carpal bones in dart throwers motion and calculated its axis of rotation. This was calculated to lie in 27° of anteversion from the coronal plane and 44° of varus angulation relative to the transverse plane. This technique is a safe and a feasible carpal imaging method to gain key information for decision making in future hand surgical and rehabilitative practices.

A Historical Perspective on Dynamics Testing at the Langley Research Center

NASA Technical Reports Server (NTRS)

Horta, Lucas G.; Kvaternik, Raymond G.; Hanks, Brantley R.

2000-01-01

The experience and advancement of Structural dynamics testing for space system applications at the Langley Research Center of the National Aeronautics and Space Administration (NASA) over the past four decades is reviewed. This experience began in the 1960's with the development of a technology base using a variety of physical models to explore dynamic phenomena and to develop reliable analytical modeling capability for space systems. It continued through the 1970's and 80's with the development of rapid, computer-aided test techniques, the testing of low-natural frequency, gravity-sensitive systems, the testing of integrated structures with active flexible motion control, and orbital flight measurements, It extended into the 1990's where advanced computerized system identification methods were developed for estimating the dynamic states of complex, lightweight, flexible aerospace systems, The scope of discussion in this paper includes ground and flight tests and summarizes lessons learned in both successes and failures.

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... magnetic media, such as magnetic tapes or magnetic diskettes, containing the computerized information at.... The computerized magnetic media shall be prepared and delivered at the committee's expense and shall... Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal...

Separation of left and right lungs using 3D information of sequential CT images and a guided dynamic programming algorithm

PubMed Central

Park, Sang Cheol; Leader, Joseph Ken; Tan, Jun; Lee, Guee Sang; Kim, Soo Hyung; Na, In Seop; Zheng, Bin

2011-01-01

Objective this article presents a new computerized scheme that aims to accurately and robustly separate left and right lungs on CT examinations. Methods we developed and tested a method to separate the left and right lungs using sequential CT information and a guided dynamic programming algorithm using adaptively and automatically selected start point and end point with especially severe and multiple connections. Results the scheme successfully identified and separated all 827 connections on the total 4034 CT images in an independent testing dataset of CT examinations. The proposed scheme separated multiple connections regardless of their locations, and the guided dynamic programming algorithm reduced the computation time to approximately 4.6% in comparison with the traditional dynamic programming and avoided the permeation of the separation boundary into normal lung tissue. Conclusions The proposed method is able to robustly and accurately disconnect all connections between left and right lungs and the guided dynamic programming algorithm is able to remove redundant processing. PMID:21412104

Separation of left and right lungs using 3-dimensional information of sequential computed tomography images and a guided dynamic programming algorithm.

PubMed

Park, Sang Cheol; Leader, Joseph Ken; Tan, Jun; Lee, Guee Sang; Kim, Soo Hyung; Na, In Seop; Zheng, Bin

2011-01-01

This article presents a new computerized scheme that aims to accurately and robustly separate left and right lungs on computed tomography (CT) examinations. We developed and tested a method to separate the left and right lungs using sequential CT information and a guided dynamic programming algorithm using adaptively and automatically selected start point and end point with especially severe and multiple connections. The scheme successfully identified and separated all 827 connections on the total 4034 CT images in an independent testing data set of CT examinations. The proposed scheme separated multiple connections regardless of their locations, and the guided dynamic programming algorithm reduced the computation time to approximately 4.6% in comparison with the traditional dynamic programming and avoided the permeation of the separation boundary into normal lung tissue. The proposed method is able to robustly and accurately disconnect all connections between left and right lungs, and the guided dynamic programming algorithm is able to remove redundant processing.

[Somatic constitution and the ability to maintain dynamic body equilibrium in girls practicing rhythmic gymnastics].

PubMed

Poliszczuk, Tatiana; Broda, Daria

2010-01-01

The greatest similarities in body constitution were noted in competitors practising the same discipline. The similarities increase with the training level. A typical body constitution for a given discipline not only favourably affects athletic performance, but is also the factor preventing sportsrelated contusions. The ability to maintain body equilibrium, together with somatic constitution, are the basic selective criteria in rhythmic gymnastics. The objective of this paper was to determine somatotypes, to evaluate the ability to maintain dynamic body equilibrium in girls practicing rhythmic gymnastics and to develop model characteristics enabling early diagnosis of the disorders equilibrium system function. The sample comprised 19 girls aged 8-11 years, practising rhythmic gymnastics. For the evaluation of the competitors' somatotypes, the Heath-Carter method was used, based on the classic concept of Sheldon's body constitution components. Body equilibrium level was evaluated by means of posturography. The mean values of the endomorphic component I, mesomorphic component II and ectomorphic component III in the gymnasts were 2.65+/-1.29, 2.45+/-0.37 and 3.95+/-0.64 respectively. The mean body mass index (BMI) value for this cohort was 15.32, which means advanced slimness. The level of dynamic equilibrium is determined by the following mean values: the time of reaching the equilibrium, the way of reaching it and the duration of stay at the defined point. The model of above mentioned indicates was developed based on the analysis of it's best results. Body constitution type in the qualified gymnasts is characterised by the prevalence of the ectomorphic component. The study results indicate that female gymnasts are generally slim and lean. It is necessary to monitor BMI in order to exclude weight-related disorders and to observe the changes with age. The poorest result was found when the gymnasts bent in the backward direction as this body position is most difficult to assume and to maintain body equilibrium as compared to all other directions.

Critical factors influencing physicians' intention to use computerized clinical practice guidelines: an integrative model of activity theory and the technology acceptance model.

PubMed

Hsiao, Ju-Ling; Chen, Rai-Fu

2016-01-16

With the widespread use of information communication technologies, computerized clinical practice guidelines are developed and considered as effective decision supporting tools in assisting the processes of clinical activities. However, the development of computerized clinical practice guidelines in Taiwan is still at the early stage and acceptance level among major users (physicians) of computerized clinical practice guidelines is not satisfactory. This study aims to investigate critical factors influencing physicians' intention to computerized clinical practice guideline use through an integrative model of activity theory and the technology acceptance model. The survey methodology was employed to collect data from physicians of the investigated hospitals that have implemented computerized clinical practice guidelines. A total of 505 questionnaires were sent out, with 238 completed copies returned, indicating a valid response rate of 47.1 %. The collected data was then analyzed by structural equation modeling technique. The results showed that attitudes toward using computerized clinical practice guidelines (γ = 0.451, p < 0.001), organizational support (γ = 0.285, p < 0.001), perceived usefulness of computerized clinical practice guidelines (γ = 0.219, p < 0.05), and social influence (γ = 0.213, p < 0.05) were critical factors influencing physicians' intention to use computerized clinical practice guidelines, and these factors can explain 68.6 % of the variance in intention to use computerized clinical practice guidelines. This study confirmed that some subject (human) factors, environment (organization) factors, tool (technology) factors mentioned in the activity theory should be carefully considered when introducing computerized clinical practice guidelines. Managers should pay much attention on those identified factors and provide adequate resources and incentives to help the promotion and use of computerized clinical practice guidelines. Through the appropriate use of computerized clinical practice guidelines, the clinical benefits, particularly in improving quality of care and facilitating the clinical processes, will be realized.

39 CFR 501.15 - Computerized Meter Resetting System.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND DISTRIBUTE POSTAGE EVIDENCING SYSTEMS § 501.15 Computerized Meter Resetting System. (a) Description. The Computerized Meter Resetting System (CMRS) permits customers to reset their postage meters at... 39 Postal Service 1 2010-07-01 2010-07-01 false Computerized Meter Resetting System. 501.15...

Development and preliminary testing of a computerized adaptive assessment of chronic pain.

PubMed

Anatchkova, Milena D; Saris-Baglama, Renee N; Kosinski, Mark; Bjorner, Jakob B

2009-09-01

The aim of this article is to report the development and preliminary testing of a prototype computerized adaptive test of chronic pain (CHRONIC PAIN-CAT) conducted in 2 stages: (1) evaluation of various item selection and stopping rules through real data-simulated administrations of CHRONIC PAIN-CAT; (2) a feasibility study of the actual prototype CHRONIC PAIN-CAT assessment system conducted in a pilot sample. Item calibrations developed from a US general population sample (N = 782) were used to program a pain severity and impact item bank (kappa = 45), and real data simulations were conducted to determine a CAT stopping rule. The CHRONIC PAIN-CAT was programmed on a tablet PC using QualityMetric's Dynamic Health Assessment (DYHNA) software and administered to a clinical sample of pain sufferers (n = 100). The CAT was completed in significantly less time than the static (full item bank) assessment (P < .001). On average, 5.6 items were dynamically administered by CAT to achieve a precise score. Scores estimated from the 2 assessments were highly correlated (r = .89), and both assessments discriminated across pain severity levels (P < .001, RV = .95). Patients' evaluations of the CHRONIC PAIN-CAT were favorable. This report demonstrates that the CHRONIC PAIN-CAT is feasible for administration in a clinic. The application has the potential to improve pain assessment and help clinicians manage chronic pain.

Current and emerging business models in the health care information technology industry: a view from wall street.

PubMed

Frank, Seth

2003-01-01

When we think about health care IT, we don't just think about clinical automation with the movement to computerized physician order entry (CPOE), but also the need to upgrade legacy financial and administrative systems to interact with clinical systems. Technology acceptance by physicians remains low, and computer use by physicians for data entry and analysis remains minimal. We expect this trend to change, and expect increased automation to represent gradual change. The HCIT space is dynamic, with many opportunities, but also many challenges. The unique nature of the end market buyers, existing business models, and nature of the technology makes this a challenging but dynamic area for equity investment.

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Computerized Labor Monitoring System. 884.2800... Devices § 884.2800 Computerized Labor Monitoring System. (a) Identification. A computerized labor monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and...

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... computerized support enforcement systems. 307.15 Section 307.15 Public Welfare Regulations Relating to Public... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.15 Approval of advance planning documents for computerized support enforcement systems. (a...

Arkansas' Curriculum Guide. Competency Based Computerized Accounting.

ERIC Educational Resources Information Center

Arkansas State Dept. of Education, Little Rock. Div. of Vocational, Technical and Adult Education.

This guide contains the essential parts of a total curriculum for a one-year secondary-level course in computerized accounting. Addressed in the individual sections of the guide are the following topics: the complete accounting cycle, computer operations for accounting, computerized accounting and general ledgers, computerized accounts payable,…

Pilot study comparing changes in postural control after training using a video game balance board program and 2 standard activity-based balance intervention programs.

PubMed

Pluchino, Alessandra; Lee, Sae Yong; Asfour, Shihab; Roos, Bernard A; Signorile, Joseph F

2012-07-01

To compare the impacts of Tai Chi, a standard balance exercise program, and a video game balance board program on postural control and perceived falls risk. Randomized controlled trial. Research laboratory. Independent seniors (N=40; 72.5±8.40) began the training, 27 completed. Tai Chi, a standard balance exercise program, and a video game balance board program. The following were used as measures: Timed Up & Go, One-Leg Stance, functional reach, Tinetti Performance Oriented Mobility Assessment, force plate center of pressure (COP) and time to boundary, dynamic posturography (DP), Falls Risk for Older People-Community Setting, and Falls Efficacy Scale. No significant differences were seen between groups for any outcome measures at baseline, nor were significant time or group × time differences for any field test or questionnaire. No group × time differences were seen for any COP measures; however, significant time differences were seen for total COP, 3 of 4 anterior/posterior displacement and both velocity, and 1 displacement and 1 velocity medial/lateral measure across time for the entire sample. For DP, significant improvements in the overall score (dynamic movement analysis score), and in 2 of the 3 linear and angular measures were seen for the sample. The video game balance board program, which can be performed at home, was as effective as Tai Chi and the standard balance exercise program in improving postural control and balance dictated by the force plate postural sway and DP measures. This finding may have implications for exercise adherence because the at-home nature of the intervention eliminates many obstacles to exercise training. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

3-Hz postural tremor in multiple system atrophy cerebellar type (MSA-C)-a static posturography study.

PubMed

Li, Xiaodi; Wang, Yuzhou; Wang, Zhanhang; Xu, Yan; Zheng, Wenhua

2018-01-01

The objective of the study is to evaluate postural dysfunction of multiple system atrophy-parkinsonian type (MSA-P) and cerebellar type (MSA-C) by static posturography exam. A total of 29 MSA-P patients, 40 MSA-C patients, and 23 healthy controls (HC) were recruited and engaged in a sensory organization test (SOT). The amplitude of the postural sway was measured and transformed into energy value by Fourier analyzer. SOT scores, frequency of falls and typical 3-Hz postural tremors during the four stance tasks, and energy value in three different frequency bands were recorded and compared. Compared with HC, SOT scores were significantly lower in MSA groups (P < 0.01). Compared with MSA-P, the vestibular scores were further reduced in MSA-C patients (P < 0.05). Falls were more frequent in MSA groups, especially in SOT4 task (foam surface with eyes closed) or in MSA-C group (P < 0.05). Typical 3-Hz postural tremor was observed in 97.5% MSA-C patients, in 24.1% MSA-P patients but in none of the HC (P < 0.05). Compared with HC, much more energy was consumed in every task, every direction, and nearly every frequency band in MSA groups. Energy value of MSA-C group was significantly higher than that of MSA-P, especially in higher frequency band (2 ~ 20 Hz) or in more difficult stance tasks (SOT 3 ~ 4, foam surface with eyes open or closed) (P < 0.05). Both MSA-P and MSA-C were characterized by severe static postural dysfunction. However, typical 3-Hz postural tremor was predominant in MSA-C and was very useful in the differential diagnosis between MSA-P and MSA-C.

Computerized Adaptive Personality Testing: A Review and Illustration With the MMPI-2 Computerized Adaptive Version.

ERIC Educational Resources Information Center

Forbey, Johnathan D.; Ben-Porath, Yossef S.

2007-01-01

Computerized adaptive testing in personality assessment can improve efficiency by significantly reducing the number of items administered to answer an assessment question. Two approaches have been explored for adaptive testing in computerized personality assessment: item response theory and the countdown method. In this article, the authors…

A Randomized Controlled Trial of the "Cool Teens" CD-ROM Computerized Program for Adolescent Anxiety

ERIC Educational Resources Information Center

Wuthrich, Viviana M.; Rapee, Ronald M.; Cunningham, Michael J.; Lyneham, Heidi J.; Hudson, Jennifer L.; Schniering, Carolyn A.

2012-01-01

Objective: Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This…

Combining computerized social cognitive training with neuroplasticity-based auditory training in schizophrenia.

PubMed

Sacks, Stephanie; Fisher, Melissa; Garrett, Coleman; Alexander, Phillip; Holland, Christine; Rose, Demian; Hooker, Christine; Vinogradov, Sophia

2013-01-01

Social cognitive deficits are an important treatment target in schizophrenia, but it is unclear to what degree they require specialized interventions and which specific components of behavioral interventions are effective. In this pilot study, we explored the effects of a novel computerized neuroplasticity-based auditory training delivered in conjunction with computerized social cognition training (SCT) in patients with schizophrenia. Nineteen clinically stable schizophrenia subjects performed 50 hours of computerized exercises that place implicit, increasing demands on auditory perception, plus 12 hours of computerized training in emotion identification, social perception, and theory of mind tasks. All subjects were assessed with MATRICS-recommended measures of neurocognition and social cognition, plus a measure of self-referential source memory before and after the computerized training. Subjects showed significant improvements on multiple measures of neurocognition. Additionally, subjects showed significant gains on measures of social cognition, including the MSCEIT Perceiving Emotions, MSCEIT Managing Emotions, and self-referential source memory, plus a significant decrease in positive symptoms. Computerized training of auditory processing/verbal learning in schizophrenia results in significant basic neurocognitive gains. Further, addition of computerized social cognition training results in significant gains in several social cognitive outcome measures. Computerized cognitive training that directly targets social cognitive processes can drive improvements in these crucial functions.

Improving the utility of the fine motor skills subscale of the comprehensive developmental inventory for infants and toddlers: a computerized adaptive test.

PubMed

Huang, Chien-Yu; Tung, Li-Chen; Chou, Yeh-Tai; Chou, Willy; Chen, Kuan-Lin; Hsieh, Ching-Lin

2017-07-27

This study aimed at improving the utility of the fine motor subscale of the comprehensive developmental inventory for infants and toddlers (CDIIT) by developing a computerized adaptive test of fine motor skills. We built an item bank for the computerized adaptive test of fine motor skills using the fine motor subscale of the CDIIT items fitting the Rasch model. We also examined the psychometric properties and efficiency of the computerized adaptive test of fine motor skills with simulated computerized adaptive tests. Data from 1742 children with suspected developmental delays were retrieved. The mean scores of the fine motor subscale of the CDIIT increased along with age groups (mean scores = 1.36-36.97). The computerized adaptive test of fine motor skills contains 31 items meeting the Rasch model's assumptions (infit mean square = 0.57-1.21, outfit mean square = 0.11-1.17). For children of 6-71 months, the computerized adaptive test of fine motor skills had high Rasch person reliability (average reliability >0.90), high concurrent validity (rs = 0.67-0.99), adequate to excellent diagnostic accuracy (area under receiver operating characteristic = 0.71-1.00), and large responsiveness (effect size = 1.05-3.93). The computerized adaptive test of fine motor skills used 48-84% fewer items than the fine motor subscale of the CDIIT. The computerized adaptive test of fine motor skills used fewer items for assessment but was as reliable and valid as the fine motor subscale of the CDIIT. Implications for Rehabilitation We developed a computerized adaptive test based on the comprehensive developmental inventory for infants and toddlers (CDIIT) for assessing fine motor skills. The computerized adaptive test has been shown to be efficient because it uses fewer items than the original measure and automatically presents the results right after the test is completed. The computerized adaptive test is as reliable and valid as the CDIIT.

45 CFR 310.40 - What requirements apply for accessing systems and records for monitoring Computerized Tribal IV-D...

Code of Federal Regulations, 2010 CFR

2010-10-01

... records for monitoring Computerized Tribal IV-D Systems and Office Automation? 310.40 Section 310.40... COMPUTERIZED TRIBAL IV-D SYSTEMS AND OFFICE AUTOMATION Accountability and Monitoring Procedures for... monitoring Computerized Tribal IV-D Systems and Office Automation? In accordance with Part 95 of this title...

On line instrument systems for monitoring steam turbogenerators

NASA Astrophysics Data System (ADS)

Clapis, A.; Giorgetti, G.; Lapini, G. L.; Benanti, A.; Frigeri, C.; Gadda, E.; Mantino, E.

A computerized real time data acquisition and data processing for the diagnosis of malfunctioning of steam turbogenerator systems is described. Pressure, vibration and temperature measurements are continuously collected from standard or special sensors including startup or stop events. The architecture of the monitoring system is detailed. Examples of the graphics output are presented. It is shown that such a system allows accurate diagnosis and the possibility of creating a data bank to describe the dynamic characteristics of the machine park.

Vestibular Balance Deficits Following Head Injury: Recommendations Concerning Evaluation and Rehabilitation in the Military Setting

DTIC Science & Technology

2012-02-27

audiogram, magnetic resonance imaging ( MRI ) scan, and a battery of neuro-vestibular tests, etc. (see appendix B). Many of the findings are detailed...bills108/s1217.html 19 E.g., driven by a laptop, tablet PC, or PDA.   42 The authors also considered testing needs immediately after referral (by the... MRI scan   72 Neuro-vestibular testing o Dynamic Computerized Postu rography o Rotat ional chair t est ing of gain, phase, and symmet ry o Step

Multipurpose Rotating Rake Arrays for Integrated Inlet and Fan Stage Performance Measurement

NASA Technical Reports Server (NTRS)

Wolter, John D.

2017-01-01

Low-pressure-ratio fan stage performance measurement requires precise measurement of conditions upstream and downstream of the fan stage. This presentation will discuss the rotating rake arrays used for the recent Boundary Layer Ingesting Inlet-Distortion-Tolerant Fan experiment in the NASA Glenn 8 by 6 foot wind tunnel. To achieve precise measurements, simulations of the rake sampling from pre-test CFD (Computerized Fluid Dynamics) solutions were used to optimize the number and locations of rake instruments.

Analysis of high velocity impact on hybrid composite fan blades

NASA Technical Reports Server (NTRS)

Chamis, C. C.; Sinclair, J. H.

1979-01-01

Recent developments in the analysis of high velocity impact of composite blades are described, using a computerized capability which consists of coupling a composites mechanics code with the direct-time integration features of NASTRAN. The application of the capability to determine the linear dynamic response of an interply hybrid composite aircraft engine fan blade is described in detail. The results also show that the impact stresses reach sufficiently high magnitudes to cause failures in the impact region at early times of the impact event.

The theory of Enceladus and Dione: An application of computerized algebra in dynamical astronomy

NASA Technical Reports Server (NTRS)

Jefferys, W. H.; Ries, L. M.

1974-01-01

A theory of Saturn's satellites Enceladus and Dione is discussed which is literal (all constants of integration appear explicitly), canonically invariant (the Hori-Lie method is used), and which correctly handles the eccentricity-type resonance between the two satellites. Algebraic manipulations are designed to be performed using the TRIGMAN formula manipulation language, and computer programs were developed so that, with minor modifications, they can be used on the Mimas-Tethys and Titan-Hyperion systems.

Effects of Levodopa on Postural Strategies in Parkinson’s disease

PubMed Central

Mancini, Martina; Rocchi, Laura; Horak, Fay

2017-01-01

Altered postural control and balance are major disabling issues of Parkinson’s disease (PD). Static and dynamic posturography have provided insight into PD’s postural deficits; however, little is known about impairments in postural coordination. We hypothesized that subjects with PD would show more ankle strategy during quiet stance than healthy control subjects, who would include some hip strategy, and this stiffer postural strategy would increase with disease progression. We quantified postural strategy and sway dispersion with inertial sensors (one placed on the shank and one on the posterior trunk at L5 level) while subjects were standing still with their eyes open. A total of 70 subjects with PD, including a mild group (H&Y≤2, N=33) and a more severe group (H&Y≥3, N=37), were assessed while OFF and while ON levodopa medication. We also included a healthy control group (N=21). Results showed an overall preference of ankle strategy in all groups while maintaining balance. Postural strategy was significantly lower ON compared to OFF medication (indicating more hip strategy), but no effect of disease stage was found. Instead, sway dispersion was significantly larger in ON compared to OFF medication, and significantly larger in the more severe PD group compared to the mild. In addition, increased hip strategy during stance was associated with poorer self-perception of balance. PMID:27131172

Effects of Levodopa on Postural Strategies in Parkinson's disease.

PubMed

Baston, Chiara; Mancini, Martina; Rocchi, Laura; Horak, Fay

2016-05-01

Altered postural control and balance are major disabling issues of Parkinson's disease (PD). Static and dynamic posturography have provided insight into PD's postural deficits; however, little is known about impairments in postural coordination. We hypothesized that subjects with PD would show more ankle strategy during quiet stance than healthy control subjects, who would include some hip strategy, and this stiffer postural strategy would increase with disease progression. We quantified postural strategy and sway dispersion with inertial sensors (one placed on the shank and one on the posterior trunk at L5 level) while subjects were standing still with their eyes open. A total of 70 subjects with PD, including a mild group (H&Y≤2, N=33) and a more severe group (H&Y≥3, N=37), were assessed while OFF and while ON levodopa medication. We also included a healthy control group (N=21). Results showed an overall preference of ankle strategy in all groups while maintaining balance. Postural strategy was significantly lower ON compared to OFF medication (indicating more hip strategy), but no effect of disease stage was found. Instead, sway dispersion was significantly larger in ON compared to OFF medication, and significantly larger in the more severe PD group compared to the mild. In addition, increased hip strategy during stance was associated with poorer self-perception of balance. Copyright © 2016 Elsevier B.V. All rights reserved.

Computerized adaptive control weld skate with CCTV weld guidance project

NASA Technical Reports Server (NTRS)

Wall, W. A.

1976-01-01

This report summarizes progress of the automatic computerized weld skate development portion of the Computerized Weld Skate with Closed Circuit Television (CCTV) Arc Guidance Project. The main goal of the project is to develop an automatic welding skate demonstration model equipped with CCTV weld guidance. The three main goals of the overall project are to: (1) develop a demonstration model computerized weld skate system, (2) develop a demonstration model automatic CCTV guidance system, and (3) integrate the two systems into a demonstration model of computerized weld skate with CCTV weld guidance for welding contoured parts.

Development of a model protection and dynamic response monitoring system for the national transonic facility

NASA Technical Reports Server (NTRS)

Young, Clarence P., Jr.; Balakrishna, S.; Kilgore, W. Allen

1995-01-01

A state-of-the-art, computerized mode protection and dynamic response monitoring system has been developed for the NASA Langley Research Center National Transonic Facility (NTF). This report describes the development of the model protection and shutdown system (MPSS). A technical description of the system is given along with discussions on operation and capabilities of the system. Applications of the system to vibration problems are presented to demonstrate the system capabilities, typical applications, versatility, and investment research return derived from the system to date. The system was custom designed for the NTF but can be used at other facilities or for other dynamic measurement/diagnostic applications. Potential commercial uses of the system are described. System capability has been demonstrated for forced response testing and for characterizing and quantifying bias errors for onboard inertial model attitude measurement devices. The system is installed in the NTF control room and has been used successfully for monitoring, recording and analyzing the dynamic response of several model systems tested in the NTF.

Stability analysis using SDSA tool

NASA Astrophysics Data System (ADS)

Goetzendorf-Grabowski, Tomasz; Mieszalski, Dawid; Marcinkiewicz, Ewa

2011-11-01

The SDSA (Simulation and Dynamic Stability Analysis) application is presented as a tool for analysing the dynamic characteristics of the aircraft just in the conceptual design stage. SDSA is part of the CEASIOM (Computerized Environment for Aircraft Synthesis and Integrated Optimization Methods) software environment which was developed within the SimSAC (Simulating Aircraft Stability And Control Characteristics for Use in Conceptual Design) project, funded by the European Commission 6th Framework Program. SDSA can also be used as stand alone software, and integrated with other design and optimisation systems using software wrappers. This paper focuses on the main functionalities of SDSA and presents both computational and free flight experimental results to compare and validate the presented software. Two aircraft are considered, the EADS Ranger 2000 and the Warsaw University designed PW-6 glider. For the two cases considered here the SDSA software is shown to be an excellent tool for predicting dynamic characteristics of an aircraft.

An Application of Computerized Axial Tomography (CAT) Technology to Mass Raid Tracking

DTIC Science & Technology

1989-08-01

ESD-TR-89-305 MTR-10542 An Application of Computerized Axial Tomography ( CAT ) Technology to Mass Raid Tracking By John K. Barr August 1989...NO 11. TITLE (Include Security Classification) An Application of Computerized Axial Tomography ( CAT ) Technology to Mass Raid Tracking 12...by block number) Computerized Axial Tomography ( CAT ) Scanner Electronic Support Measures (ESM) Fusion (continued) 19. ABSTRACT (Continue on

Increasing profitability through computerization.

PubMed

Sokol, D J

1988-01-01

The author explores the pragmatic or financial justification for computerizing a dental practice and discusses a computerized approach to precollection and collection for the dental office. The article also deals with the use of computerized correspondence to augment the recall policy of the office and to help generate new patient referrals and discusses the pros and cons of utilizing a dental computer service bureau in implementing these policies.

Influence of computerized sounding out on spelling performance for children who do and do not rely on AAC.

PubMed

McCarthy, Jillian H; Hogan, Tiffany P; Beukelman, David R; Schwarz, Ilsa E

2015-05-01

Spelling is an important skill for individuals who rely on augmentative and alternative communication (AAC). The purpose of this study was to investigate how computerized sounding out influenced spelling accuracy of pseudo-words. Computerized sounding out was defined as a word elongated, thus providing an opportunity for a child to hear all the sounds in the word at a slower rate. Seven children with cerebral palsy, four who use AAC and three who do not, participated in a single subject AB design. The results of the study indicated that the use of computerized sounding out increased the phonologic accuracy of the pseudo-words produced by participants. The study provides preliminary evidence for the use of computerized sounding out during spelling tasks for children with cerebral palsy who do and do not use AAC. Future directions and clinical implications are discussed. We investigated how computerized sounding out influenced spelling accuracy of pseudowords for children with complex communication needs who did and did not use augmentative and alternative communication (AAC). Results indicated that the use of computerized sounding out increased the phonologic accuracy of the pseudo-words by participants, suggesting that computerized sounding out might assist in more accurate spelling for children who use AAC. Future research is needed to determine how language and reading abilities influence the use of computerized sounding out with children who have a range of speech intelligibility abilities and do and do not use AAC.

Integration of a computerized two-finger gripper for robot workstation safety

NASA Technical Reports Server (NTRS)

Sneckenberger, John E.; Yoshikata, Kazuki

1988-01-01

A microprocessor-based controller has been developed that continuously monitors and adjusts the gripping force applied by a special two-finger gripper. This computerized force sensing gripper system enables the endeffector gripping action to be independently detected and corrected. The gripping force applied to a manipulated object is real-time monitored for problem situations, situations which can occur during both planned and errant robot arm manipulation. When unspecified force conditions occur at the gripper, the gripping force controller initiates specific reactions to cause dynamic corrections to the continuously variable gripping action. The force controller for this intelligent gripper has been interfaced to the controller of an industrial robot. The gripper and robot controllers communicate to accomplish the successful completion of normal gripper operations as well as unexpected hazardous situations. An example of an unexpected gripping condition would be the sudden deformation of the object being manipulated by the robot. The capabilities of the interfaced gripper-robot system to apply workstation safety measures (e.g., stop the robot) when these unexpected gripping effects occur have been assessed.

Preliminary analysis of long-range aircraft designs for future heavy airlift missions

NASA Technical Reports Server (NTRS)

Nelms, W. P., Jr.; Murphy, R.; Barlow, A.

1976-01-01

A computerized design study of very large cargo aircraft for the future heavy airlift mission was conducted using the Aircraft Synthesis program (ACSYNT). The study was requested by the Air Force under an agreement whereby Ames provides computerized design support to the Air Force Flight Dynamics Laboratory. This effort is part of an overall Air Force program to study advanced technology large aircraft systems. Included in the Air Force large aircraft program are investigations of missions such as heavy airlift, airborne missile launch, battle platform, command and control, and aerial tanker. The Ames studies concentrated on large cargo aircraft of conventional design with payloads from 250,000 to 350,000 lb. Range missions up to 6500 n.mi. and radius missions up to 3600 n.mi. have been considered. Takeoff and landing distances between 7,000 and 10,000 ft are important constraints on the configuration concepts. The results indicate that a configuration employing conventional technology in all disciplinary areas weighs approximately 2 million pounds to accomplish either a 6500-n.mi. range mission or a 3600-n.mi. radius mission with a 350,000-lb payload.

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

Microcomputer Network for Computerized Adaptive Testing (CAT)

DTIC Science & Technology

1984-03-01

PRDC TR 84-33 \\Q.�d-33- \\ MICROCOMPUTER NETWOJlt FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ) Baldwin Quan Thomas A . Park Gary Sandahl John H...ACCEIIION NO NPRDC TR 84-33 4. TITLE (-d Sul>tlllo) MICROCOMP UTER NETWORK FOR COMPUTERIZED ADA PTIVE TESTING ( CAT ) 1. Q B. uan T. A . Park...adaptive testing ( CAT ) Bayesian sequential testing 20. ABSTitACT (Continuo on ro•••• aide II noco .. _, _., ld-tlly ,.,. t.loclt _._.) DO Computerized

Computerized Adaptive Testing (CAT): A User Manual

DTIC Science & Technology

1984-03-12

NPRDC TR 84-32 COMPUTERIZED ADAPTIVE TESTING ( CAT ): A USER MANUAL Susan Hardwick Lawrence Eastman Ross Cooper Rehab Group, Incorporated San...a ~EI’IOD COVIRED COMPUTERIZED ADAPTIVE TESTING ( CAT ) Final Report Aug 1981-June 1982 A USER MANUAL 1. ~l:l’t,ORMINCI ORCI. RE~ORT NUM.I:R 62-83...II nee• .. _, entl ldentll)’ ,,. llloclr _,.,) A joint-service effort is underway to develop a computerized adaptive testing ( CAT ) system and to

Surgical treatment of diaphyseal stress fractures of the fifth metatarsal in competitive athletes: long-term follow-up and computerized pedobarographic analysis.

PubMed

Pecina, Marko; Bojanic, Ivan; Smoljanovic, Tomislav; Ivkovic, Alan; Mirkovic, Maja; Jelic, Miroslav

2011-01-01

Proximal diaphyseal stress fractures of the fifth metatarsal are common in athletes. Conservative treatment has been shown to result in high rates of delayed union, nonunion, and refracture, so internal fixation has become the treatment of choice in competitive athletes. Twenty top-level athletes with diaphyseal stress fractures fixed with intramedullary malleolar screws were evaluated. Functional outcome was assessed by American Orthopaedic Foot and Ankle Society midfoot score. Static and dynamic maximum vertical force and peak plantar pressures were evaluated with a computerized pedobarograph. Mean follow-up from surgery to interview was 10.3 years (range, 3.5-19.0 years). Clinical healing was 95%, and there has been one refracture (5%). The mean time from surgery to return to sport was 9 weeks (range, 5-14 weeks). Twelve athletes (60%) returned to a higher level of training, 7 (35%) to the same level, and 1 (5%) to a lower level compared with the level of training before injury. Average American Orthopaedic Foot and Ankle Society midfoot score was 93.8 (range, 85-100). During the computerized pedobarographic evaluations, 18 patients (90%) presented with varus of the metatarsus and the midfoot and 2 (10%) presented with a normal plantigrade foot. Intramedullary malleolar screws can yield reliable and effective healing of fifth metatarsal stress fractures in athletes. Varus of the metatarsus and the midfoot were predisposing factors for stress fractures in this population of competitive athletes, and all were recommended to wear orthoses until their competitive careers were completed.

Resources for Improving Computerized Learning Environments.

ERIC Educational Resources Information Center

Yeaman, Andrew R. J.

1989-01-01

Presents an annotated review of human factors literature that discusses computerized environments. Topics discussed include the application of office automation practices to educational environments; video display terminal (VDT) workstations; health and safety hazards; planning educational facilities; ergonomics in computerized offices; and…

An overview of selected information storage and retrieval issues in computerized document processing

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Ihebuzor, Valentine U.

1984-01-01

The rapid development of computerized information storage and retrieval techniques has introduced the possibility of extending the word processing concept to document processing. A major advantage of computerized document processing is the relief of the tedious task of manual editing and composition usually encountered by traditional publishers through the immense speed and storage capacity of computers. Furthermore, computerized document processing provides an author with centralized control, the lack of which is a handicap of the traditional publishing operation. A survey of some computerized document processing techniques is presented with emphasis on related information storage and retrieval issues. String matching algorithms are considered central to document information storage and retrieval and are also discussed.

Identification of dynamic load for prosthetic structures.

PubMed

Zhang, Dequan; Han, Xu; Zhang, Zhongpu; Liu, Jie; Jiang, Chao; Yoda, Nobuhiro; Meng, Xianghua; Li, Qing

2017-12-01

Dynamic load exists in numerous biomechanical systems, and its identification signifies a critical issue for characterizing dynamic behaviors and studying biomechanical consequence of the systems. This study aims to identify dynamic load in the dental prosthetic structures, namely, 3-unit implant-supported fixed partial denture (I-FPD) and teeth-supported fixed partial denture. The 3-dimensional finite element models were constructed through specific patient's computerized tomography images. A forward algorithm and regularization technique were developed for identifying dynamic load. To verify the effectiveness of the identification method proposed, the I-FPD and teeth-supported fixed partial denture structures were investigated to determine the dynamic loads. For validating the results of inverse identification, an experimental force-measuring system was developed by using a 3-dimensional piezoelectric transducer to measure the dynamic load in the I-FPD structure in vivo. The computationally identified loads were presented with different noise levels to determine their influence on the identification accuracy. The errors between the measured load and identified counterpart were calculated for evaluating the practical applicability of the proposed procedure in biomechanical engineering. This study is expected to serve as a demonstrative role in identifying dynamic loading in biomedical systems, where a direct in vivo measurement may be rather demanding in some areas of interest clinically. Copyright © 2017 John Wiley & Sons, Ltd.

Computerized Sociometric Assessment for Preschool Children

ERIC Educational Resources Information Center

Endedijk, Hinke M.; Cillessen, Antonius H. N.

2015-01-01

In preschool classes, sociometric peer ratings are used to measure children's peer relationships. The current study examined a computerized version of preschool sociometric ratings. The psychometric properties were compared of computerized sociometric ratings and traditional peer ratings for preschoolers. The distributions, inter-item…

Dynamics of incremental motion devices associated with planetary exploration spacecraft. [Mariner Jupiter Saturn 1977

NASA Technical Reports Server (NTRS)

Hughes, R. O.

1975-01-01

Incremental motion devices provide accurate and rapid movement of spacecraft science platforms, antennas and related mechanisms. The paper considers the computerized simulation of a stepper motor/gear train/ science platform system that will be launched on the Mariner Jupiter Saturn 1977. It was determined that a smaller stepper motor could be used as the prime mover for the science platform, and it was concluded that the existing digital controller was unable to achieve the required pointing accuracy, and a new controller design was necessary.

Advanced ballistic range technology

NASA Technical Reports Server (NTRS)

Yates, Leslie A.

1994-01-01

The research conducted supported two facilities at NASA Ames Research Center: the Hypervelocity Free-Flight Aerodynamic Facility and the 16-Inch Shock Tunnel. During the grant period, a computerized film-reading system was developed, and five- and six-degree-of-freedom parameter-identification routines were written and successfully implemented. Studies of flow separation were conducted, and methods to extract phase shift information from finite-fringe interferograms were developed. Methods for constructing optical images from Computational Fluid Dynamics solutions were also developed, and these methods were used for one-to-one comparisons of experiment and computations.

NASA/ASEE Summer Faculty Fellowship Program, 1990, Volume 1

NASA Technical Reports Server (NTRS)

Bannerot, Richard B. (Editor); Goldstein, Stanley H. (Editor)

1990-01-01

The 1990 Johnson Space Center (JSC) NASA/American Society for Engineering Education (ASEE) Summer Faculty Fellowship Program was conducted by the University of Houston-University Park and JSC. A compilation of the final reports on the research projects are presented. The topics covered include: the Space Station; the Space Shuttle; exobiology; cell biology; culture techniques; control systems design; laser induced fluorescence; spacecraft reliability analysis; reduced gravity; biotechnology; microgravity applications; regenerative life support systems; imaging techniques; cardiovascular system; physiological effects; extravehicular mobility units; mathematical models; bioreactors; computerized simulation; microgravity simulation; and dynamic structural analysis.

A dual-mode generalized likelihood ratio approach to self-reorganizing digital flight control system design

NASA Technical Reports Server (NTRS)

1976-01-01

Analytic techniques have been developed for detecting and identifying abrupt changes in dynamic systems. The GLR technique monitors the output of the Kalman filter and searches for the time that the failure occured, thus allowing it to be sensitive to new data and consequently increasing the chances for fast system recovery following detection of a failure. All failure detections are based on functional redundancy. Performance tests of the F-8 aircraft flight control system and computerized modelling of the technique are presented.

Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rozen, P.; Gelfond, M.; Zaltzman, S.

1982-08-01

The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with /sup 99m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine mode images of esophageal emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying.

Evaluation of computerized health management information system for primary health care in rural India

PubMed Central

2010-01-01

Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

Dynamic Discharge Arc Driver. [computerized simulation

NASA Technical Reports Server (NTRS)

Dannenberg, R. E.; Slapnicar, P. I.

1975-01-01

A computer program using nonlinear RLC circuit analysis was developed to accurately model the electrical discharge performance of the Ames 1-MJ energy storage and arc-driver system. Solutions of circuit parameters are compared with experimental circuit data and related to shock speed measurements. Computer analysis led to the concept of a Dynamic Discharge Arc Driver (DDAD) capable of increasing the range of operation of shock-driven facilities. Utilization of mass addition of the driver gas offers a unique means of improving driver performance. Mass addition acts to increase the arc resistance, which results in better electrical circuit damping with more efficient Joule heating, producing stronger shock waves. Preliminary tests resulted in an increase in shock Mach number from 34 to 39 in air at an initial pressure of 2.5 torr.

78 FR 17940 - Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

..., Software, Implants, and Components Thereof; Notice of Receipt of Complaint; Solicitation of Comments... Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof, DN 2945; the... importation of certain computerized orthopedic surgical devices, software, implants, and components thereof...

Designing a Computerized Presentation Center.

ERIC Educational Resources Information Center

Christopher, Doris A.

1995-01-01

The Office Systems and Business Education Department at California State University (Los Angeles) developed a computerized presentation center, with multimedia classrooms and a multipurpose room, where students learn computerized presentation design skills, faculty can develop materials for class, and local business can do videoconferencing and…

Incentives and Barriers That Influence Clinical Computerization in Hong Kong: A Population-based Physician Survey

PubMed Central

Leung, Gabriel M.; Yu, Philip L. H.; Wong, Irene O. L.; Johnston, Janice M.; Tin, Keith Y. K.

2003-01-01

Objective: Given the slow adoption of medical informatics in Hong Kong and Asia, we sought to understand the contributory barriers and potential incentives associated with information technology implementation. Design and Measurements: A representative sample of 949 doctors (response rate = 77.0%) was asked through a postal survey to rank a list of nine barriers associated with clinical computerization according to self-perceived importance. They ranked seven incentives or catalysts that may influence computerization. We generated mean rank scores and used multidimensional preference analysis to explore key explanatory dimensions of these variables. A hierarchical cluster analysis was performed to identify homogenous subgroups of respondents. We further determined the relationships between the sets of barriers and incentives/catalysts collectively using canonical correlation. Results: Time costs, lack of technical support and large capital investments were the biggest barriers to computerization, whereas improved office efficiency and better-quality care were ranked highest as potential incentives to computerize. Cost vs. noncost, physician-related vs. patient-related, and monetary vs. nonmonetary factors were the key dimensions explaining the barrier variables. Similarly, within-practice vs external and “push” vs “pull” factors accounted for the incentive variables. Four clusters were identified for barriers and three for incentives/catalysts. Canonical correlation revealed that respondents who were concerned with the costs of computerization also perceived financial incentives and government regulation to be important incentives/catalysts toward computerization. Those who found the potential interference with communication important also believed that the promise of improved care from computerization to be a significant incentive. Conclusion: This study provided evidence regarding common barriers associated with clinical computerization. Our findings also identified possible incentive strategies that may be employed to accelerate uptake of computer systems. PMID:12595409

Can computerized tomography accurately stage childhood renal tumors?

PubMed

Abdelhalim, Ahmed; Helmy, Tamer E; Harraz, Ahmed M; Abou-El-Ghar, Mohamed E; Dawaba, Mohamed E; Hafez, Ashraf T

2014-07-01

Staging of childhood renal tumors is crucial for treatment planning and outcome prediction. We sought to identify whether computerized tomography could accurately predict the local stage of childhood renal tumors. We retrospectively reviewed our database for patients diagnosed with childhood renal tumors and treated surgically between 1990 and 2013. Inability to retrieve preoperative computerized tomography, intraoperative tumor spillage and nonWilms childhood renal tumors were exclusion criteria. Local computerized tomography stage was assigned by a single experienced pediatric radiologist blinded to the pathological stage, using a consensus similar to the Children's Oncology Group Wilms tumor staging system. Tumors were stratified into up-front surgery and preoperative chemotherapy groups. The radiological stage of each tumor was compared to the pathological stage. A total of 189 tumors in 179 patients met inclusion criteria. Computerized tomography staging matched pathological staging in 68% of up-front surgery (70 of 103), 31.8% of pre-chemotherapy (21 of 66) and 48.8% of post-chemotherapy scans (42 of 86). Computerized tomography over staged 21.4%, 65.2% and 46.5% of tumors in the up-front surgery, pre-chemotherapy and post-chemotherapy scans, respectively, and under staged 10.7%, 3% and 4.7%. Computerized tomography staging was more accurate in tumors managed by up-front surgery (p <0.001) and those without extracapsular extension (p <0.001). The validity of computerized tomography staging of childhood renal tumors remains doubtful. This staging is more accurate for tumors treated with up-front surgery and those without extracapsular extension. Preoperative computerized tomography can help to exclude capsular breach. Treatment strategy should be based on surgical and pathological staging to avoid the hazards of inaccurate staging. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

Innovations in Computerized Assessment.

ERIC Educational Resources Information Center

Drasgow, Fritz, Ed.; Olson-Buchanan, Julie B., Ed.

Chapters in this book present the challenges and dilemmas faced by researchers as they created new computerized assessments, focusing on issues addressed in developing, scoring, and administering the assessments. Chapters are: (1) "Beyond Bells and Whistles; An Introduction to Computerized Assessment" (Julie B. Olson-Buchanan and Fritz Drasgow);…

Advanced Composition and the Computerized Library.

ERIC Educational Resources Information Center

Hult, Christine

1989-01-01

Discusses four kinds of computerized access tools: online catalogs; computerized reference; online database searching; and compact disks and read only memory (CD-ROM). Examines how these technologies are changing research. Suggests how research instruction in advanced writing courses can be refocused to include the new technologies. (RS)

Validation of a Self-Administered Computerized System to Detect Cognitive Impairment in Older Adults

PubMed Central

Brinkman, Samuel D.; Reese, Robert J.; Norsworthy, Larry A.; Dellaria, Donna K.; Kinkade, Jacob W.; Benge, Jared; Brown, Kimberly; Ratka, Anna; Simpkins, James W.

2015-01-01

There is increasing interest in the development of economical and accurate approaches to identifying persons in the community who have mild, undetected cognitive impairments. Computerized assessment systems have been suggested as a viable approach to identifying these persons. The validity of a computerized assessment system for identification of memory and executive deficits in older individuals was evaluated in the current study. Volunteers (N = 235) completed a 3-hr battery of neuropsychological tests and a computerized cognitive assessment system. Participants were classified as impaired (n = 78) or unimpaired (n = 157) on the basis of the Mini Mental State Exam, Wechsler Memory Scale-III and the Trail Making Test (TMT), Part B. All six variables (three memory variables and three executive variables) derived from the computerized assessment differed significantly between groups in the expected direction. There was also evidence of temporal stability and concurrent validity. Application of computerized assessment systems for clinical practice and for identification of research participants is discussed in this article. PMID:25332303

Computerized neurocognitive testing in the management of sport-related concussion: an update.

PubMed

Resch, Jacob E; McCrea, Michael A; Cullum, C Munro

2013-12-01

Since the late nineties, computerized neurocognitive testing has become a central component of sport-related concussion (SRC) management at all levels of sport. In 2005, a review of the available evidence on the psychometric properties of four computerized neuropsychological test batteries concluded that the tests did not possess the necessary criteria to warrant clinical application. Since the publication of that review, several more computerized neurocognitive tests have entered the market place. The purpose of this review is to summarize the body of published studies on psychometric properties and clinical utility of computerized neurocognitive tests available for use in the assessment of SRC. A review of the literature from 2005 to 2013 was conducted to gather evidence of test-retest reliability and clinical validity of these instruments. Reviewed articles included both prospective and retrospective studies of primarily sport-based adult and pediatric samples. Summaries are provided regarding the available evidence of reliability and validity for the most commonly used computerized neurocognitive tests in sports settings.

Computerized Numerical Control Curriculum Guide.

ERIC Educational Resources Information Center

Reneau, Fred; And Others

This guide is intended for use in a course in programming and operating a computerized numerical control system. Addressed in the course are various aspects of programming and planning, setting up, and operating machines with computerized numerical control, including selecting manual or computer-assigned programs and matching them with…

An Application of the Rasch Model to Computerized Adaptive Testing.

ERIC Educational Resources Information Center

Wisniewski, Dennis R.

Three questions concerning the Binary Search Method (BSM) of computerized adaptive testing were studied: (1) whether it provided a reliable and valid estimation of examinee ability; (2) its effect on examinee attitudes toward computerized adaptive testing and conventional paper-and-pencil testing; and (3) the relationship between item response…

The Reality, Direction, and Future of Computerized Publications

ERIC Educational Resources Information Center

Levenstein, Nicholas

2012-01-01

Sharing information in digital form by using a computer is a growing phenomenon. Many universities are making their applications available on computer. More than one hundred and thirty-six universities have developed computerized applications on their own or through a commercial vendor. Universities developed computerized applications in order to…

Evaluating a Computerized Aid for Conducting a Cognitive Task Analysis

DTIC Science & Technology

2000-01-01

in conducting a cognitive task analysis . The conduct of a cognitive task analysis is costly and labor intensive. As a result, a few computerized aids...evaluation of a computerized aid, specifically CAT-HCI (Cognitive Analysis Tool - Human Computer Interface), for the conduct of a detailed cognitive task analysis . A

Computerized Classification Testing with the Rasch Model

ERIC Educational Resources Information Center

Eggen, Theo J. H. M.

2011-01-01

If classification in a limited number of categories is the purpose of testing, computerized adaptive tests (CATs) with algorithms based on sequential statistical testing perform better than estimation-based CATs (e.g., Eggen & Straetmans, 2000). In these computerized classification tests (CCTs), the Sequential Probability Ratio Test (SPRT) (Wald,…

Severity of Organized Item Theft in Computerized Adaptive Testing: A Simulation Study

ERIC Educational Resources Information Center

Yi, Qing; Zhang, Jinming; Chang, Hua-Hua

2008-01-01

Criteria had been proposed for assessing the severity of possible test security violations for computerized tests with high-stakes outcomes. However, these criteria resulted from theoretical derivations that assumed uniformly randomized item selection. This study investigated potential damage caused by organized item theft in computerized adaptive…

Computerized Adaptive Assessment of Cognitive Abilities among Disabled Adults.

ERIC Educational Resources Information Center

Engdahl, Brian

This study examined computerized adaptive testing and cognitive ability testing of adults with cognitive disabilities. Adult subjects (N=250) were given computerized tests on language usage and space relations in one of three administration conditions: paper and pencil, fixed length computer adaptive, and variable length computer adaptive.…

Development and Evaluation of a Confidence-Weighting Computerized Adaptive Testing

ERIC Educational Resources Information Center

Yen, Yung-Chin; Ho, Rong-Guey; Chen, Li-Ju; Chou, Kun-Yi; Chen, Yan-Lin

2010-01-01

The purpose of this study was to examine whether the efficiency, precision, and validity of computerized adaptive testing (CAT) could be improved by assessing confidence differences in knowledge that examinees possessed. We proposed a novel polytomous CAT model called the confidence-weighting computerized adaptive testing (CWCAT), which combined a…

Year 2000 Computerized Farm Project. Final Report.

ERIC Educational Resources Information Center

McGrann, James M.; Lippke, Lawrence A.

An ongoing project was funded to develop and demonstrate a computerized approach to operation and management of a commercial-sized farm. Other project objectives were to facilitate the demonstration of the computerized farm to the public and to develop individual software packages and make them available to the public. Project accomplishments…

10 CFR 719.44 - What categories of costs require advance approval?

Code of Federal Regulations, 2014 CFR

2014-01-01

... application software, or non-routine computerized databases, if they are specifically created for a particular matter. For costs associated with the creation and use of computerized databases, contractors and retained legal counsel must ensure that the creation and use of computerized databases is necessary and...

Computerized Diagnostic Testing: Problems and Possibilities.

ERIC Educational Resources Information Center

McArthur, David L.

The use of computers to build diagnostic inferences is explored in two contexts. In computerized monitoring of liquid oxygen systems for the space shuttle, diagnoses are exact because they can be derived within a world which is closed. In computerized classroom testing of reading comprehension, programs deliver a constrained form of adaptive…

45 CFR 307.13 - Security and confidentiality for computerized support enforcement systems in operation after...

Code of Federal Regulations, 2010 CFR

2010-10-01

... ENFORCEMENT SYSTEMS § 307.13 Security and confidentiality for computerized support enforcement systems in... systems in operation after October 1, 1997. (a) Information integrity and security. Have safeguards... 45 Public Welfare 2 2010-10-01 2010-10-01 false Security and confidentiality for computerized...

A First Life with Computerized Business Simulations

ERIC Educational Resources Information Center

Thavikulwat, Precha

2011-01-01

The author discusses the theoretical lens, origins, and environment of his work on computerized business simulations. Key ideas that inform his work include the two dimensions (control and interaction) of computerized simulation, the two ways of representing a natural process (phenotypical and genotypical) in a simulation, which he defines as a…

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS..., organization, services and constraints related to the computerized support enforcement system; (4) The APD must... design, development, installation or enhancement; (5) The APD must contain a description of each...

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS..., organization, services and constraints related to the computerized support enforcement system; (4) The APD must... design, development, installation or enhancement; (5) The APD must contain a description of each...

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS..., organization, services and constraints related to the computerized support enforcement system; (4) The APD must... design, development, installation or enhancement; (5) The APD must contain a description of each...

Protecting Privacy in Computerized Medical Information.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This report analyzes the implications of computerized medical information and the challenges it brings to individual privacy. The report examines the nature of the privacy interest in health care information and the current state of the law protecting that information; the nature of proposals to computerize health care information and the…

45 CFR 310.25 - What conditions apply to acquisitions of Computerized Tribal IV-D Systems?

Code of Federal Regulations, 2010 CFR

2010-10-01

... FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED TRIBAL IV-D SYSTEMS AND OFFICE AUTOMATION... Acquisition Threshold; (c) Software and ownership rights. (1) All procurement and contract instruments must... Computerized Tribal IV-D System software or enhancements thereof and all associated documentation designed...

Computerization of the Newspaper in the 1980s.

ERIC Educational Resources Information Center

Garrison, Bruce

A review of the literature on the computerization of newspaper newsrooms shows that since 1960, computers have assumed an increasingly important role in information collection, news writing and editing, pagination, and news transmission. When newspaper libraries are computerized, reporters are able to find information more quickly and to use…

[Computerized medical record: deontology and legislation].

PubMed

Allaert, F A; Dusserre, L

1996-02-01

Computerization of medical records is making headway for patients' follow-up, scientific research, and health expenses control, but it must not alter the guarantees provided to the patients by the medical code of ethics and the law of January 6, 1978. This law, modified on July 1, 1994, requires to register all computerized records of personal data and establishes rights to protect privacy against computer misdemeanor. All medical practitioners using computerized medical records must be aware that the infringement of this law may provoke suing in professional, civil or criminal court.

Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions' implementation levels of computerized systems?

PubMed

Tzeng, Huey-Ming; Hu, Hsou Mei; Yin, Chang-Yi

2011-12-01

Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.

Impaired perception of surface tilt in progressive supranuclear palsy

PubMed Central

Dale, Marian L.; Horak, Fay B.; Wright, W. Geoffrey; Schoneburg, Bernadette M.; Nutt, John G.; Mancini, Martina

2017-01-01

Introduction Progressive supranuclear palsy (PSP) is characterized by early postural instability and backward falls. The mechanisms underlying backward postural instability in PSP are not understood. The aim of this study was to test the hypothesis that postural instability in PSP is a result of dysfunction in the perception of postural verticality. Methods We gathered posturography data on 12 subjects with PSP to compare with 12 subjects with idiopathic Parkinson’s Disease (PD) and 12 healthy subjects. Objective tests of postural impairment included: dynamic sensory perception tests of gravity and of surface oscillations, postural responses to surface perturbations, the sensory organization test of postural sway under altered sensory conditions and limits of stability in stance. Results Perception of toes up (but not toes down) surface tilt was reduced in subjects with PSP compared to both control subjects (p≤0.001 standing, p≤0.007 seated) and subjects with PD (p≤0.03 standing, p≤0.04 seated). Subjects with PSP, PD and normal controls accurately perceived the direction of gravity when standing on a tilting surface. Unlike PD and control subjects, subjects with PSP exerted less postural corrective torque in response to toes up surface tilts. Discussion Difficulty perceiving backward tilt of the surface or body may account for backward falls and postural impairments in patients with PSP. These observations suggest that abnormal central integration of sensory inputs for perception of body and surface orientation contributes to the pathophysiology of postural instability in PSP. PMID:28267762

Practice of Contemporary Dance Promotes Stochastic Postural Control in Aging

PubMed Central

Ferrufino, Lena; Bril, Blandine; Dietrich, Gilles; Nonaka, Tetsushi; Coubard, Olivier A.

2011-01-01

As society ages and the frequency of falls increases, counteracting gait and posture decline is a challenging issue for countries of the developed world. Previous studies have shown that exercise and hazard management help to improve balance and/or decrease the risks for falling in normal aging. Motor activity based on motor-skill learning, particularly dance, can also benefit balance and decreases falls with age. Recent studies have suggested that older dancers have better balance, posture, or gait than non-dancers. Additionally, clinical or laboratory measures have shown improvements in some aspects of balance after dance interventions in elderly trainees. This study examined the impact of contemporary dance (CD) and of fall prevention (FP) programs on postural control of older adults. Posturography of quiet upright stance was performed in 41 participants aged 59–86 years before and after 4.4-month training in either CD or FP once a week. Though classical statistic scores failed to show any effect, dynamic analyses of the center-of-pressure displacements revealed significant changes after training. Specifically, practice of CD enhanced the critical time interval in diffusion analysis, and reduced recurrence and mathematical stability in recurrence quantification analysis, whereas practice of FP induced or tended to induce the reverse patterns. Such effects were obtained only in the eyes open condition. We suggest that CD training based on motor improvisation favored stochastic posture inducing plasticity in motor control, while FP training based on more stereotyped behaviors did not. PMID:22232582

Elderly fall risk prediction using static posturography

PubMed Central

2017-01-01

Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity—0.114 x Eyes Closed Vector Sum Magnitude Velocity—2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older people at risk of multiple falls. PMID:28222191

Elderly fall risk prediction using static posturography.

PubMed

Howcroft, Jennifer; Lemaire, Edward D; Kofman, Jonathan; McIlroy, William E

2017-01-01

Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older people at risk of multiple falls.

Static Posturography and Falls According to Pyramidal, Sensory and Cerebellar Functional Systems in People with Multiple Sclerosis

PubMed Central

Kalron, Alon; Givon, Uri; Frid, Lior; Dolev, Mark; Achiron, Anat

2016-01-01

Balance impairment is common in people with multiple sclerosis (PwMS) and frequently impacts quality of life by decreasing mobility and increasing the risk of falling. However, there are only scarce data examining the contribution of specific neurological functional systems on balance measures in MS. Therefore, the primary aim of our study was to examine the differences in posturography parameters and fall incidence according to the pyramidal, cerebellar and sensory systems functional systems in PwMS. The study included 342 PwMS, 211 women and mean disease duration of 8.2 (S.D = 8.3) years. The study sample was divided into six groups according to the pyramidal, cerebellar and sensory functional system scores, derived from the Expanded Disability Status Scale (EDSS) data. Static postural control parameters were obtained from the Zebris FDM-T Treadmill (zebris® Medical GmbH, Germany). Participants were defined as "fallers" and "non-fallers" based on their fall history. Our findings revealed a trend that PwMS affected solely in the pyramidal system, have reduced stability compared to patients with cerebellar and sensory dysfunctions. Moreover, the addition of sensory impairments to pyramidal dysfunction does not exacerbate postural control. The patients in the pure sensory group demonstrated increased stability compared to each of the three combined groups; pyramidal-cerebellar, pyramidal-sensory and pyramidal-cerebellar-sensory groups. As for fall status, the percentage of fallers in the pure pyramidal, cerebellar and sensory groups were 44.3%, 33.3% and 19.5%, respectively. As for the combined functional system groups, the percentage of fallers in the pyramidal-cerebellar, pyramidal-sensory and pyramidal-cerebellar-sensory groups were 59.7%, 40.7% and 65%, respectively. This study confirms that disorders in neurological functional systems generate different effects on postural control and incidence of falls in the MS population. From a clinical standpoint, the present information can benefit all those engaged in physical rehabilitation of PwMS. PMID:27741268

Computerized detection of breast lesions in multi-centre and multi-instrument DCE-MR data using 3D principal component maps and template matching

NASA Astrophysics Data System (ADS)

Ertas, Gokhan; Doran, Simon; Leach, Martin O.

2011-12-01

In this study, we introduce a novel, robust and accurate computerized algorithm based on volumetric principal component maps and template matching that facilitates lesion detection on dynamic contrast-enhanced MR. The study dataset comprises 24 204 contrast-enhanced breast MR images corresponding to 4034 axial slices from 47 women in the UK multi-centre study of MRI screening for breast cancer and categorized as high risk. The scans analysed here were performed on six different models of scanner from three commercial vendors, sited in 13 clinics around the UK. 1952 slices from this dataset, containing 15 benign and 13 malignant lesions, were used for training. The remaining 2082 slices, with 14 benign and 12 malignant lesions, were used for test purposes. To prevent false positives being detected from other tissues and regions of the body, breast volumes are segmented from pre-contrast images using a fast semi-automated algorithm. Principal component analysis is applied to the centred intensity vectors formed from the dynamic contrast-enhanced T1-weighted images of the segmented breasts, followed by automatic thresholding to eliminate fatty tissues and slowly enhancing normal parenchyma and a convolution and filtering process to minimize artefacts from moderately enhanced normal parenchyma and blood vessels. Finally, suspicious lesions are identified through a volumetric sixfold neighbourhood connectivity search and calculation of two morphological features: volume and volumetric eccentricity, to exclude highly enhanced blood vessels, nipples and normal parenchyma and to localize lesions. This provides satisfactory lesion localization. For a detection sensitivity of 100%, the overall false-positive detection rate of the system is 1.02/lesion, 1.17/case and 0.08/slice, comparing favourably with previous studies. This approach may facilitate detection of lesions in multi-centre and multi-instrument dynamic contrast-enhanced breast MR data.

Distinct eye movement patterns enhance dynamic visual acuity.

PubMed

Palidis, Dimitrios J; Wyder-Hodge, Pearson A; Fooken, Jolande; Spering, Miriam

2017-01-01

Dynamic visual acuity (DVA) is the ability to resolve fine spatial detail in dynamic objects during head fixation, or in static objects during head or body rotation. This ability is important for many activities such as ball sports, and a close relation has been shown between DVA and sports expertise. DVA tasks involve eye movements, yet, it is unclear which aspects of eye movements contribute to successful performance. Here we examined the relation between DVA and the kinematics of smooth pursuit and saccadic eye movements in a cohort of 23 varsity baseball players. In a computerized dynamic-object DVA test, observers reported the location of the gap in a small Landolt-C ring moving at various speeds while eye movements were recorded. Smooth pursuit kinematics-eye latency, acceleration, velocity gain, position error-and the direction and amplitude of saccadic eye movements were linked to perceptual performance. Results reveal that distinct eye movement patterns-minimizing eye position error, tracking smoothly, and inhibiting reverse saccades-were related to dynamic visual acuity. The close link between eye movement quality and DVA performance has important implications for the development of perceptual training programs to improve DVA.

Distinct eye movement patterns enhance dynamic visual acuity

PubMed Central

Palidis, Dimitrios J.; Wyder-Hodge, Pearson A.; Fooken, Jolande; Spering, Miriam

2017-01-01

Dynamic visual acuity (DVA) is the ability to resolve fine spatial detail in dynamic objects during head fixation, or in static objects during head or body rotation. This ability is important for many activities such as ball sports, and a close relation has been shown between DVA and sports expertise. DVA tasks involve eye movements, yet, it is unclear which aspects of eye movements contribute to successful performance. Here we examined the relation between DVA and the kinematics of smooth pursuit and saccadic eye movements in a cohort of 23 varsity baseball players. In a computerized dynamic-object DVA test, observers reported the location of the gap in a small Landolt-C ring moving at various speeds while eye movements were recorded. Smooth pursuit kinematics—eye latency, acceleration, velocity gain, position error—and the direction and amplitude of saccadic eye movements were linked to perceptual performance. Results reveal that distinct eye movement patterns—minimizing eye position error, tracking smoothly, and inhibiting reverse saccades—were related to dynamic visual acuity. The close link between eye movement quality and DVA performance has important implications for the development of perceptual training programs to improve DVA. PMID:28187157

Designing an architectural style for dynamic medical Cross-Organizational Workflow management system: an approach based on agents and web services.

PubMed

Bouzguenda, Lotfi; Turki, Manel

2014-04-01

This paper shows how the combined use of agent and web services technologies can help to design an architectural style for dynamic medical Cross-Organizational Workflow (COW) management system. Medical COW aims at supporting the collaboration between several autonomous and possibly heterogeneous medical processes, distributed over different organizations (Hospitals, Clinic or laboratories). Dynamic medical COW refers to occasional cooperation between these health organizations, free of structural constraints, where the medical partners involved and their number are not pre-defined. More precisely, this paper proposes a new architecture style based on agents and web services technologies to deal with two key coordination issues of dynamic COW: medical partners finding and negotiation between them. It also proposes how the proposed architecture for dynamic medical COW management system can connect to a multi-agent system coupling the Clinical Decision Support System (CDSS) with Computerized Prescriber Order Entry (CPOE). The idea is to assist the health professionals such as doctors, nurses and pharmacists with decision making tasks, as determining diagnosis or patient data analysis without stopping their clinical processes in order to act in a coherent way and to give care to the patient.

A computerized clinical decision support system as a means of implementing depression guidelines.

PubMed

Trivedi, Madhukar H; Kern, Janet K; Grannemann, Bruce D; Altshuler, Kenneth Z; Sunderajan, Prabha

2004-08-01

The authors describe the history and current use of computerized systems for implementing treatment guidelines in general medicine as well as the development, testing, and early use of a computerized decision support system for depression treatment among "real-world" clinical settings in Texas. In 1999 health care experts from Europe and the United States met to confront the well-documented challenges of implementing treatment guidelines and to identify strategies for improvement. They suggested the integration of guidelines into computer systems that is incorporated into clinical workflow. Several studies have demonstrated improvements in physicians' adherence to guidelines when such guidelines are provided in a computerized format. Although computerized decision support systems are being used in many areas of medicine and have demonstrated improved patient outcomes, their use in psychiatric illness is limited. The authors designed and developed a computerized decision support system for the treatment of major depressive disorder by using evidence-based guidelines, transferring the knowledge gained from the Texas Medication Algorithm Project (TMAP). This computerized decision support system (CompTMAP) provides support in diagnosis, treatment, follow-up, and preventive care and can be incorporated into the clinical setting. CompTMAP has gone through extensive testing to ensure accuracy and reliability. Physician surveys have indicated a positive response to CompTMAP, although the sample was insufficient for statistical testing. CompTMAP is part of a new era of comprehensive computerized decision support systems that take advantage of advances in automation and provide more complete clinical support to physicians in clinical practice.

When Small Words Foretell Academic Success: The Case of College Admissions Essays

PubMed Central

Pennebaker, James W.; Chung, Cindy K.; Frazee, Joey; Lavergne, Gary M.; Beaver, David I.

2014-01-01

The smallest and most commonly used words in English are pronouns, articles, and other function words. Almost invisible to the reader or writer, function words can reveal ways people think and approach topics. A computerized text analysis of over 50,000 college admissions essays from more than 25,000 entering students found a coherent dimension of language use based on eight standard function word categories. The dimension, which reflected the degree students used categorical versus dynamic language, was analyzed to track college grades over students' four years of college. Higher grades were associated with greater article and preposition use, indicating categorical language (i.e., references to complexly organized objects and concepts). Lower grades were associated with greater use of auxiliary verbs, pronouns, adverbs, conjunctions, and negations, indicating more dynamic language (i.e., personal narratives). The links between the categorical-dynamic index (CDI) and academic performance hint at the cognitive styles rewarded by higher education institutions. PMID:25551217

The influence of unilateral saccular impairment on functional balance performance and self-report dizziness.

PubMed

McCaslin, Devin L; Jacobson, Gary P; Grantham, Sarah L; Piker, Erin G; Verghese, Susha

2011-09-01

Postural stability in humans is largely maintained by vestibular, visual, and somatosensory inputs to the central nervous system. Recent clinical advances in the assessment of otolith function (e.g., cervical and ocular vestibular evoked myogenic potentials [cVEMPs and oVEMPs], subjective visual vertical [SVV] during eccentric rotation) have enabled investigators to identify patients with unilateral otolith impairments. This research has suggested that patients with unilateral otolith impairments perform worse than normal healthy controls on measures of postural stability. It is not yet known if patients with unilateral impairments of the saccule and/or inferior vestibular nerve (i.e., unilaterally abnormal cVEMP) perform differently on measures of postural stability than patients with unilateral impairments of the horizontal SCC (semicircular canal) and/or superior vestibular nerve (i.e., unilateral caloric weakness). Further, it is not known what relationship exists, if any, between otolith system impairment and self-report dizziness handicap. The purpose of this investigation was to determine the extent to which saccular impairments (defined by a unilaterally absent cVEMP) and impairments of the horizontal semicircular canal (as measured by the results of caloric testing) affect vestibulospinal function as measured through the Sensory Organization Test (SOT) of the computerized dynamic posturography (CDP). A secondary objective of this investigation was to measure the effects, if any, that saccular impairment has on a modality-specific measure of health-related quality of life. A retrospective cohort study. Subjects were assigned to one of four groups based on results from balance function testing: Group 1 (abnormal cVEMP response only), Group 2 (abnormal caloric response only), Group 3 (abnormal cVEMP and abnormal caloric response), and Group 4 (normal control group). Subjects were 92 adult patients: 62 were seen for balance function testing due to complaints of dizziness, vertigo, or unsteadiness, and 30 served as controls. All subjects underwent videonystagmography or electronystagmography (VNG/ENG), vestibular evoked myogenic potentials (VEMPs), self-report measures of self-perceived dizziness disability/handicap (Dizziness Handicap Inventory), and tests of postural control (Neurocom Equitest). Subjects were categorized into one of four groups based on balance function test results. All variables were subjected to a multifactor analysis of variance (ANOVA). The Dizziness Handicap Inventory (DHI) total scores and equilibrium scores served as the dependent variables. Results showed that patients with abnormal unilateral saccular or inferior vestibular nerve function (i.e., abnormal cVEMP) demonstrated significantly impaired postural control when compared to normal participants. However, this group demonstrated significantly better postural stability when compared to the group with abnormal caloric responses alone and the group with abnormal caloric responses and abnormal cVEMP results. Patients with an abnormal cVEMP did not differ significantly on the DHI compared to the other two impaired groups. We interpret these findings as evidence that a significantly asymmetrical cVEMP in isolation negatively impacts performance on measures of postural control compared to normal subjects but not compared to patients with significant caloric weaknesses. However, patients with a unilaterally abnormal cVEMP do not differ from patients with significant caloric weaknesses in regard to self-perceived dizziness handicap. American Academy of Audiology.

Computerized Adaptive Test (CAT) Applications and Item Response Theory Models for Polytomous Items

ERIC Educational Resources Information Center

Aybek, Eren Can; Demirtasli, R. Nukhet

2017-01-01

This article aims to provide a theoretical framework for computerized adaptive tests (CAT) and item response theory models for polytomous items. Besides that, it aims to introduce the simulation and live CAT software to the related researchers. Computerized adaptive test algorithm, assumptions of item response theory models, nominal response…

Computerized Testing of Level III Associate Degree Nursing Students versus Paper and Pencil Testing Methods

ERIC Educational Resources Information Center

Gullo, Shirna R.

2014-01-01

Computerized testing may be one solution to enhance performance on the curricular Health Education Systems Inc. (HESI) exam and the National Council Licensure Exam for Registered Nurses (NCLEX-RN). Due to the integration of improved technological processes and procedures in healthcare for computerized documentation and electronicmedical records,…

Computerized Management of Physical Plant Services.

ERIC Educational Resources Information Center

Hawkey, Earl W.; Kleinpeter, Joseph

Outlining the major areas to be considered when deciding whether or not to computerize physical plant services in higher education institutions, the author points out the shortcomings of manual record keeping systems. He gives five factors to consider when deciding to computerize: (1) time and money, (2) extent of operation, (3) current and future…

The Evaluation of SISMAKOM (Computerized SDI Project).

ERIC Educational Resources Information Center

University of Science, Penang (Malaysia).

A survey of 88 users of SISMAKOM, a computerized selective dissemination of information (SDI) and document delivery service provided by the Universiti Sains Malaysia and four other Malaysian universities, was conducted in August 1982 in order to collect data about SISMAKOM and to assess the value of a computerized SDI service in a developing…

An Assistive Computerized Learning Environment for Distance Learning Students with Learning Disabilities

ERIC Educational Resources Information Center

Klemes, Joel; Epstein, Alit; Zuker, Michal; Grinberg, Nira; Ilovitch, Tamar

2006-01-01

The current study examines how a computerized learning environment assists students with learning disabilities (LD) enrolled in a distance learning course at the Open University of Israel. The technology provides computer display of the text, synchronized with auditory output and accompanied by additional computerized study skill tools which…

The Effect of College Students' Self-Generated Computerized Mind Mapping on Their Reading Achievement

ERIC Educational Resources Information Center

Sabbah, Sabah Salman

2015-01-01

This study explored the potential effect of college students' self-generated computerized mind maps on their reading comprehension. It also investigated the subjects' attitudes toward generating computerized mind maps for reading comprehension. The study was conducted in response to the inability of the foundation-level students, who were learning…

The Impact of Computerization on Archival Finding Aids: A RAMP Study.

ERIC Educational Resources Information Center

Kitching, Christopher

This report is based on a questionnaire sent to 32 selected National Archives and on interviews with archivists from eight countries. Geared to the needs of developing countries, the report covers: (1) the impact of computerization on finding aids; (2) advantages and problems of computerization, including enhanced archival control, integration of…

The effects of whole body vibration combined computerized postural control training on the lower extremity muscle activity and cerebral cortex activity in stroke patients.

PubMed

Uhm, Yo-Han; Yang, Dae-Jung

2018-02-01

[Purpose] The purpose of this study was to examine the effect of computerized postural control training using whole body vibration on lower limb muscle activity and cerebral cortical activation in acute stroke patients. [Subjects and Methods] Thirty stroke patients participated and were divided into groups of 10, a group of the computerized postural control training using whole body vibration (Group I), the computerized postural control training combined with aero step (Group II) and computerized postural control training (Group III). MP100 was used to measure lower limb muscle activity, and QEEG-8 was used to measure cerebral cortical activation. [Results] Comparison of muscle activity and cerebral cortical activation before and after intervention between groups showed that Group I had significant differences in lower limb muscle activity and cerebral cortical activation compared to Groups II and III. [Conclusion] This study showed that whole body vibration combined computerized postural control training is effective for improving muscle activity and cerebral cortex activity in stroke patients.

[Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study].

PubMed

Fumis, Renata Rego Lins; Costa, Eduardo Leite Vieira; Martins, Paulo Sergio; Pizzo, Vladimir; Souza, Ivens Augusto; Schettino, Guilherme de Paula Pinto

2014-01-01

To evaluate the satisfaction of the intensive care unit staff with a computerized physician order entry and to compare the concept of the computerized physician order entry relevance among intensive care unit healthcare workers. We performed a cross-sectional survey to assess the satisfaction of the intensive care unit staff with the computerized physician order entry in a 30-bed medical/surgical adult intensive care unit using a self-administered questionnaire. The questions used for grading satisfaction levels were answered according to a numerical scale that ranged from 1 point (low satisfaction) to 10 points (high satisfaction). The majority of the respondents (n=250) were female (66%) between the ages of 30 and 35 years of age (69%). The overall satisfaction with the computerized physician order entry scored 5.74±2.14 points. The satisfaction was lower among physicians (n=42) than among nurses, nurse technicians, respiratory therapists, clinical pharmacists and diet specialists (4.62±1.79 versus 5.97±2.14, p<0.001); satisfaction decreased with age (p<0.001). Physicians scored lower concerning the potential of the computerized physician order entry for improving patient safety (5.45±2.20 versus 8.09±2.21, p<0.001) and the ease of using the computerized physician order entry (3.83±1.88 versus 6.44±2.31, p<0.001). The characteristics independently associated with satisfaction were the system's user-friendliness, accuracy, capacity to provide clear information, and fast response time. Six months after its implementation, healthcare workers were satisfied, albeit not entirely, with the computerized physician order entry. The overall users' satisfaction with computerized physician order entry was lower among physicians compared to other healthcare professionals. The factors associated with satisfaction included the belief that digitalization decreased the workload and contributed to the intensive care unit quality with a user-friendly and accurate system and that digitalization provided concise information within a reasonable time frame.

Automation of orbit determination functions for National Aeronautics and Space Administration (NASA)-supported satellite missions

NASA Technical Reports Server (NTRS)

Mardirossian, H.; Beri, A. C.; Doll, C. E.

1990-01-01

The Flight Dynamics Facility (FDF) at Goddard Space Flight Center (GSFC) provides spacecraft trajectory determination for a wide variety of National Aeronautics and Space Administration (NASA)-supported satellite missions, using the Tracking Data Relay Satellite System (TDRSS) and Ground Spaceflight and Tracking Data Network (GSTDN). To take advantage of computerized decision making processes that can be used in spacecraft navigation, the Orbit Determination Automation System (ODAS) was designed, developed, and implemented as a prototype system to automate orbit determination (OD) and orbit quality assurance (QA) functions performed by orbit operations. Based on a machine-resident generic schedule and predetermined mission-dependent QA criteria, ODAS autonomously activates an interface with the existing trajectory determination system using a batch least-squares differential correction algorithm to perform the basic OD functions. The computational parameters determined during the OD are processed to make computerized decisions regarding QA, and a controlled recovery process is activated when the criteria are not satisfied. The complete cycle is autonomous and continuous. ODAS was extensively tested for performance under conditions resembling actual operational conditions and found to be effective and reliable for extended autonomous OD. Details of the system structure and function are discussed, and test results are presented.

Automation of orbit determination functions for National Aeronautics and Space Administration (NASA)-supported satellite missions

NASA Technical Reports Server (NTRS)

Mardirossian, H.; Heuerman, K.; Beri, A.; Samii, M. V.; Doll, C. E.

1989-01-01

The Flight Dynamics Facility (FDF) at Goddard Space Flight Center (GSFC) provides spacecraft trajectory determination for a wide variety of National Aeronautics and Space Administration (NASA)-supported satellite missions, using the Tracking Data Relay Satellite System (TDRSS) and Ground Spaceflight and Tracking Data Network (GSTDN). To take advantage of computerized decision making processes that can be used in spacecraft navigation, the Orbit Determination Automation System (ODAS) was designed, developed, and implemented as a prototype system to automate orbit determination (OD) and orbit quality assurance (QA) functions performed by orbit operations. Based on a machine-resident generic schedule and predetermined mission-dependent QA criteria, ODAS autonomously activates an interface with the existing trajectory determination system using a batch least-squares differential correction algorithm to perform the basic OD functions. The computational parameters determined during the OD are processed to make computerized decisions regarding QA, and a controlled recovery process isactivated when the criteria are not satisfied. The complete cycle is autonomous and continuous. ODAS was extensively tested for performance under conditions resembling actual operational conditions and found to be effective and reliable for extended autonomous OD. Details of the system structure and function are discussed, and test results are presented.

Spacelab user implementation assessment study (software requirements analysis). Volume 1: Executive study

NASA Technical Reports Server (NTRS)

1976-01-01

The primary objective of this study was to develop an integrated approach for the development, implementation, and utilization of all software that is required to efficiently and cost-effectively support advanced technology laboratory flight and ground operations. It was recognized that certain aspects of the operations would be mandatory computerized services; computerization of other aspects would be optional. Thus, the analyses encompassed not only alternate computer utilization and implementations but trade studies of the programmatic effects of non-computerized versus computerized approaches to the operations. A general overview of the study is presented.

Stiffness reductions during tensile fatigue testing of graphite/epoxy angle-ply laminates

NASA Technical Reports Server (NTRS)

Odom, E. M.; Adams, D. F.

1982-01-01

Tensile fatigue data was generated under carefully controlled test conditions. A computerized data acquisition system was used to permit the measurement of dynamic modulus without interrupting the fatigue cycling. Two different 8-ply laminate configurations, viz, + or - 45 (2s) and + or - 67.5 (2s), of a T300/5208 graphite/epoxy composite were tested. The + or - 45 (2s) laminate did exhibit some modulus decay, although there was no well-defined correlation with applied stress level or number of cycles. The + or - 67.5 (2s) laminate did not exhibit any measurable modulus decay. Secondary effects observed included a small but distinct difference between modulus as measured statically and dynamically, a slight recovery of the modulus decay after a test interruption, and a significant viscoelastic (creep) response of the + or - 45 (2s) laminate during fatigue testing.

Closed loop performance of a brushless dc motor powered electromechanical actuator for flight control applications. [computerized simulation for Shuttle Orbiter applications

NASA Technical Reports Server (NTRS)

Demerdash, N. A.; Nehl, T. W.

1980-01-01

A comprehensive digital model for the analysis and possible optimization of the closed loop dynamic (instantaneous) performance of a power conditioner fed, brushless dc motor powered, electromechanical actuator system (EMA) is presented. This model was developed for the simulation of the dynamic performance of an actual prototype EMA built for NASA-JSC as a possible alternative to hydraulic actuators for consideration in Space Shuttle Orbiter applications. Excellent correlation was achieved between numerical model simulation and experimental test results obtained from the actual hardware. These results include: various current and voltage waveforms in the machine-power conditioner (MPC) unit, flap position as well as other control loop variables in response to step commands of change of flap position. These results with consequent conclusions are detailed in the paper.

Orbital Maneuvering Engine Feed System Coupled Stability Investigation, Computer User's Manual

NASA Technical Reports Server (NTRS)

Schuman, M. D.; Fertig, K. W.; Hunting, J. K.; Kahn, D. R.

1975-01-01

An operating manual for the feed system coupled stability model was given, in partial fulfillment of a program designed to develop, verify, and document a digital computer model that can be used to analyze and predict engine/feed system coupled instabilities in pressure-fed storable propellant propulsion systems over a frequency range of 10 to 1,000 Hz. The first section describes the analytical approach to modelling the feed system hydrodynamics, combustion dynamics, chamber dynamics, and overall engineering model structure, and presents the governing equations in each of the technical areas. This is followed by the program user's guide, which is a complete description of the structure and operation of the computerized model. Last, appendices provide an alphabetized FORTRAN symbol table, detailed program logic diagrams, computer code listings, and sample case input and output data listings.

Computerized general practice based networks yield comparable performance with sentinel data in monitoring epidemiological time-course of influenza-like illness and acute respiratory illness.

PubMed

Truyers, Carla; Lesaffre, Emmanuel; Bartholomeeusen, Stefaan; Aertgeerts, Bert; Snacken, René; Brochier, Bernard; Yane, Fernande; Buntinx, Frank

2010-03-22

Computerized morbidity registration networks might serve as early warning systems in a time where natural epidemics such as the H1N1 flu can easily spread from one region to another. In this contribution we examine whether general practice based broad-spectrum computerized morbidity registration networks have the potential to act as a valid surveillance instrument of frequently occurring diseases. We compare general practice based computerized data assessing the frequency of influenza-like illness (ILI) and acute respiratory infections (ARI) with data from a well established case-specific sentinel network, the European Influenza Surveillance Scheme (EISS). The overall frequency and trends of weekly ILI and ARI data are compared using both networks. Detection of influenza-like illness and acute respiratory illness occurs equally fast in EISS and the computerized network. The overall frequency data for ARI are the same for both networks, the overall trends are similar, but the increases and decreases in frequency do not occur in exactly the same weeks. For ILI, the overall rate was slightly higher for the computerized network population, especially before the increase of ILI, the overall trend was almost identical and the increases and decreases occur in the same weeks for both networks. Computerized morbidity registration networks are a valid tool for monitoring frequent occurring respiratory diseases and the detection of sudden outbreaks.

45 CFR 310.20 - What are the conditions for funding the installation, operation, maintenance and enhancement of...

Code of Federal Regulations, 2010 CFR

2010-10-01

... installation, operation, maintenance and enhancement of Computerized Tribal IV-D Systems and Office Automation... HEALTH AND HUMAN SERVICES COMPUTERIZED TRIBAL IV-D SYSTEMS AND OFFICE AUTOMATION Funding for Computerized Tribal IV-D Systems and Office Automation § 310.20 What are the conditions for funding the installation...

45 CFR 310.35 - Under what circumstances would emergency FFP be available for Computerized Tribal IV-D Systems?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Under what circumstances would emergency FFP be... AND OFFICE AUTOMATION Funding for Computerized Tribal IV-D Systems and Office Automation § 310.35 Under what circumstances would emergency FFP be available for Computerized Tribal IV-D Systems? (a...

A Case Study of Different Types of Arguments Emerging from Explorations in an Interactive Computerized Environment

ERIC Educational Resources Information Center

Lavy, Ilana

2006-01-01

This paper presents a description of the different types of arguments that emerged as two students, working in a computerized environment, engaged in an investigation of several number theory concepts. The emerging arguments are seen as a result of the influence of the computerized environment together with collaborative learning. Using…

Development of a Computerized In-Basket Exercise for the Classroom: A Sales Management Example

ERIC Educational Resources Information Center

Pearson, Michael M.; Barnes, John W.; Onken, Marina H.

2006-01-01

This article follows the development of a sales management in-basket exercise for use in the classroom. The authors have computerized the exercise and added features to allow for additional and more quantitative input from the students. The exercise has evolved and been tested in numerous classroom situations. The computerized in-basket exercise…

Technology and Language Testing. A Collection of Papers from the Annual Colloquium on Language Testing Research (7th, Princeton, New Jersey, April 6-9, 1985).

ERIC Educational Resources Information Center

Stansfield, Charles W., Ed.

This collection of essays on measurement theory and language testing includes: "Computerized Adaptive Testing: Implications for Language Test Developers" (Peter Tung); "The Promise and Threat of Computerized Adaptive Assessment of Reading Comprehension" (Michael Canale); "Computerized Rasch Analysis of Item Bias in ESL…

Vocational Education as an Innovation in the Republic of China--Computerization of School Administration.

ERIC Educational Resources Information Center

Chang, Frank Tien-Jin

Computerized school administration has become one of the most crucial innovations in vocational education in Taiwan in the Republic of China. As these educators begin to design or purchase computerized information systems for their own schools, they must first define their specific information needs. Next, they should pay attention to…

Assessment Outcomes: Computerized Instruction in a Human Gross Anatomy Course.

ERIC Educational Resources Information Center

Bukowski, Elaine L.

2002-01-01

The first of three successive classes of beginning physical therapy students (n=17) completed traditional cadaver anatomy lecture/lab; the next 17 a self-study computerized anatomy lab, and the next 20 both lectures and computer lab. No differences in study times and course or licensure exam performance appeared. Computerized self-study is a…

Application of a minicomputer-based system in measuring intraocular fluid dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bronzino, J.D.; D'Amato, D.P.; O'Rourke, J.

A complete, computerized system has been developed to automate and display radionuclide clearance studies in an ophthalmology clinical laboratory. The system is based on a PDP-8E computer with a 16-k core memory and includes a dual-drive Decassette system and an interactive display terminal. The software controls the acquisition of data from an NIM scaler, times the procedures, and analyzes and simultaneously displays logarithmically converted data on a fully annotated graph. Animal studies and clinical experiments are presented to illustrate the nature of these displays and the results obtained using this automated eye physiometer.

Ergodicity of a singly-thermostated harmonic oscillator

NASA Astrophysics Data System (ADS)

Hoover, William Graham; Sprott, Julien Clinton; Hoover, Carol Griswold

2016-03-01

Although Nosé's thermostated mechanics is formally consistent with Gibbs' canonical ensemble, the thermostated Nosé-Hoover (harmonic) oscillator, with its mean kinetic temperature controlled, is far from ergodic. Much of its phase space is occupied by regular conservative tori. Oscillator ergodicity has previously been achieved by controlling two oscillator moments with two thermostat variables. Here we use computerized searches in conjunction with visualization to find singly-thermostated motion equations for the oscillator which are consistent with Gibbs' canonical distribution. Such models are the simplest able to bridge the gap between Gibbs' statistical ensembles and Newtonian single-particle dynamics.

Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia: correlation with manometric measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rozen, P.; Gelfond, M.; Zaltzman, S.

1982-08-01

The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with /sup 99//sup m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine' mode images of esophagela emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying.

A randomized controlled trial of the Cool Teens CD-ROM computerized program for adolescent anxiety.

PubMed

Wuthrich, Viviana M; Rapee, Ronald M; Cunningham, Michael J; Lyneham, Heidi J; Hudson, Jennifer L; Schniering, Carolyn A

2012-03-01

Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This paper describes the results of a small randomized controlled trial of the Cool Teens program for adolescent anxiety, and examines potential barriers to treatment and user preferences of computerized technology in this population. Forty-three adolescents with a primary diagnosis of anxiety were randomly allocated to the Cool Teens program, a 12-week computerized cognitive-behavioral therapy program for anxiety management, or a 12-week wait list. Effects on symptoms, negative thoughts, and life interference were assessed at post-treatment and 3-month follow-up, based on diagnosis as well as self and maternal report. Using mixed-model analyses, at post-treatment and follow-up assessments, adolescents in the Cool Teens condition, compared with those on the wait list, were found to have significant reductions in the total number of anxiety disorders, the severity of the primary anxiety disorder, and the average severity for all disorders. These results were matched by significant reductions in mother and child questionnaire reports of anxiety, internalizing symptoms, automatic thoughts, and life interference. Further few barriers to treatment were found, and user preferences indicated that the computerized treatment was well suited to adolescents with anxiety. The Cool Teens program is efficacious for treatment of adolescent anxiety. Clinical trial registration information-A randomized controlled trial of the Cool Teens computerized program for anxious adolescents compared with waist list; http://www.anzctr.org.au; ACTRN12611000508976. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Influence of Computerized Sounding Out on Spelling Performance for Children who do and not rely on AAC

PubMed Central

McCarthy, Jillian H.; Hogan, Tiffany P.; Beukelman, David R.; Schwarz, Ilsa E.

2015-01-01

Purpose Spelling is an important skill for individuals who rely on augmentative alternative communication (AAC). The purpose of this study was to investigate how computerized sounding out influenced spelling accuracy of pseudo-words. Computerized sounding out was defined as a word elongated, thus providing an opportunity for a child to hear all the sounds in the word at a slower rate. Methods Seven children with cerebral palsy, four who use AAC and three who do not, participated in a single subject AB design. Results The results of the study indicated that the use of computerized sounding out increased the phonologic accuracy of the pseudo-words produced by participants. Conclusion The study provides preliminary evidence for the use of computerized sounding out during spelling tasks for children with cerebral palsy who do and do not use AAC. Future directions and clinical implications are discussed. PMID:24512195

45 CFR 310.15 - What are the safeguards and processes that comprehensive Tribal IV-D agencies must have in place...

Code of Federal Regulations, 2014 CFR

2014-10-01

... comprehensive Tribal IV-D agencies must have in place to ensure the security and privacy of Computerized Tribal... ensure the security and privacy of Computerized Tribal IV-D Systems and Office Automation? (a..., accuracy, completeness, access to, and use of data in the Computerized Tribal IV-D System and Office...

Computerized Adaptive Testing for Polytomous Motivation Items: Administration Mode Effects and a Comparison with Short Forms

ERIC Educational Resources Information Center

Hol, A. Michiel; Vorst, Harrie C. M.; Mellenbergh, Gideon J.

2007-01-01

In a randomized experiment (n = 515), a computerized and a computerized adaptive test (CAT) are compared. The item pool consists of 24 polytomous motivation items. Although items are carefully selected, calibration data show that Samejima's graded response model did not fit the data optimally. A simulation study is done to assess possible…

Does the Computer Make a Difference? Computerized versus Face-to-Face versus Self-Report Assessment of Alcohol, Drug and Tobacco Use.

ERIC Educational Resources Information Center

Skinner, Harvey A.; Allen, Barbara A.

1983-01-01

Compared histories of alcohol, drug, and tobacco use obtained by computerized interview, face-to-face interview, and self-report in clients (N=150) from an addiction treatment center. Multivariate analyses revealed no important differences. The computerized interview was rated less friendly but faster and more interesting. (Author/JAC)

Computerized and Paper-and-Pencil Versions of the Rosenberg Self-Esteem Scale: A Comparison of Psychometric Features and Respondent Preferences.

ERIC Educational Resources Information Center

Vispoel, Walter P.; Boo, Jaeyool; Bleiler, Timothy

2001-01-01

Evaluated the characteristics of computerized and paper-and-pencil versions of the Rosenberg Self-Esteem Scale (SES) using scores for 224 college students. Results show that mode of administration has little effect on the psychometric properties of the SES although the computerized version took longer and was preferred by examinees. (SLD)

Chemical Understanding and Graphing Skills in an Honors Case-Based Computerized Chemistry Laboratory Environment: The Value of Bidirectional Visual and Textual Representations

ERIC Educational Resources Information Center

Dori, Yehudit J.; Sasson, Irit

2008-01-01

The case-based computerized laboratory (CCL) is a chemistry learning environment that integrates computerized experiments with emphasis on scientific inquiry and comprehension of case studies. The research objective was to investigate chemical understanding and graphing skills of high school honors students via bidirectional visual and textual…

Performances on the CogState and Standard Neuropsychological Batteries Among HIV Patients Without Dementia

PubMed Central

Overton, Edgar Turner; Kauwe, John S.K.; Paul, Rob; Tashima, Karen; Tate, David F.; Patel, Pragna; Carpenter, Chuck; Patty, David; Brooks, John T.; Clifford, David B

2013-01-01

HIV-associated neurocognitive disorders (HAND) remain prevalent but challenging to diagnose particularly among non-demented individuals. To determine whether a brief computerized battery correlates with formal neurocognitive testing, we identified 46 HIV-infected persons who had undergone both formal neurocognitive testing and a brief computerized battery. Simple detection tests correlated best with formal neuropsychological testing. By multivariable regression model, 53% of the variance in the composite Global Deficit Score was accounted for by elements from the brief computerized tool (p<0.01). These data confirm previous correlation data with the computerized battery, yet illustrate remaining challenges for neurocognitive screening. PMID:21877204

The equivalence of computerized and paper-and-pencil psychological instruments: implications for measures of negative affect.

PubMed

Schulenberg, S E; Yutrzenka, B A

1999-05-01

The use of computerized psychological assessment is a growing practice among contemporary mental health professionals. Many popular and frequently used paper-and-pencil instruments have been adapted into computerized versions. Although equivalence for many instruments has been evaluated and supported, this issue is far from resolved. This literature review deals with recent research findings that suggest that computer aversion negatively impacts computerized assessment, particularly as it relates to measures of negative affect. There is a dearth of equivalence studies that take into account computer aversion's potential impact on the measurement of negative affect. Recommendations are offered for future research in this area.

Computerized symbolic manipulation in structural mechanics Progress and potential

NASA Technical Reports Server (NTRS)

Noor, A. K.; Andersen, C. M.

1978-01-01

Status and recent applications of computerized symbolic manipulation to structural mechanics problems are summarized. The applications discussed include; (1) generation of characteristic arrays of finite elements; (2) evaluation of effective stiffness and mass coefficients of continuum models for repetitive lattice structures; and (3) application of Rayleigh-Ritz technique to free vibration analysis of laminated composite elliptic plates. The major advantages of using computerized symbolic manipulation in each of these applications are outlined. A number of problem areas which limit the realization of the full potential of computerized symbolic manipulation in structural mechanics are examined and some of the means of alleviating them are discussed.

45 CFR 310.30 - Under what circumstances would FFP be suspended or disallowed in the costs of Computerized Tribal...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Under what circumstances would FFP be suspended or... SYSTEMS AND OFFICE AUTOMATION Funding for Computerized Tribal IV-D Systems and Office Automation § 310.30 Under what circumstances would FFP be suspended or disallowed in the costs of Computerized Tribal IV-D...

Computerized Biomechanical Man-Model

DTIC Science & Technology

1976-07-01

Force Systems Command Wright-Patterson AFB, Ohio ABSTRACT The COMputerized BIomechanical MAN-Model (called COMBIMAN) is a computer interactive graphics...concept was to build a mock- The use of mock-ups for biomechanical evalua- up which permitted the designer to visualize the tion has long been a tool...of the can become an obstacle to design change. Aerospace Medical Research Laboratory, we are developing a computerized biomechanical man-model

The Neurological Basis and Potential Modification of Emotional Intelligence through Affective/Behavioral Training

DTIC Science & Technology

2010-10-01

facial trustworthiness; facial displays of anger) presented subliminally . Furthermore, the responsiveness of these regions to subliminal stimulation ...develop, or program the computerized stimulation paradigms for use during functional neuroimaging (i.e., MJT; BMAT; EFAT). These paradigms will be...programming began on the computerized functional MRI stimulation paradigms using e-prime software. • Quarter #2: Programming of all computerized functional

Multimodal Intervention Trial for Cognitive Deficits in Neurofibromatosis Type 1: Efficacy of Computerized Cognitive Training and Stimulant Medication

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-15-1-0508 TITLE: Multimodal Intervention Trial for Cognitive Deficits in Neurofibromatosis Type 1: Efficacy of...Computerized Cognitive Training and Stimulant Medication PRINCIPAL INVESTIGATOR: Maria T. Acosta, M.D. CONTRACTING ORGANIZATION: Children’s National Health...database. 15. SUBJECT TERMS Neurofibromatosis, cognition , pediatric, computerized training programs, working memory 16. SECURITY CLASSIFICATION OF: 17

Computerized Memory Training Leads to Sustained Improvement in Visuospatial Short-Term Memory Skills in Children with Down Syndrome

ERIC Educational Resources Information Center

Bennett, Stephanie J.; Holmes, Joni; Buckley, Sue

2013-01-01

This study evaluated the impact of a computerized visuospatial memory training intervention on the memory and behavioral skills of children with Down syndrome. Teaching assistants were trained to support the delivery of a computerized intervention program to individual children over a 10-16 week period in school. Twenty-one children aged 7-12…

A Study on the Implementation of the Ecotran Systems, Inc. Computerized Routing and Scheduling Pupil Transportation System. San Diego Unified School District, Superintendent's Organizational Study Team.

ERIC Educational Resources Information Center

Carriedo, Ruben; And Others

The San Diego Unified School District (California) began operating a computerized routing and scheduling system for its pupil transportation services at the beginning of the 1985-86 academic school year. The computerized system, provided by Ecotran Systems, Inc. (ECO) of Cleveland, Ohio experienced an inordinate number of difficulties. A…

Computerized tomography versus magnetic resonance imaging: a comparative study in hypothalamic-pituitary and parasellar pathology.

PubMed

Webb, S M; Ruscalleda, J; Schwarzstein, D; Calaf-Alsina, J; Rovira, A; Matos, G; Puig-Domingo, M; de Leiva, A

1992-05-01

We wished to analyse the relative value of computerized tomography and magnetic resonance in patients referred for evaluation of pituitary and parasellar lesions. We performed a separate evaluation by two independent neuroradiologists of computerized tomography and magnetic resonance images ordered numerically and anonymously, with no clinical data available. We studied 40 patients submitted for hypothalamic-pituitary study; 31 were carried out preoperatively, of which histological confirmation later became available in 14. The remaining nine patients were evaluated postoperatively. Over 40 parameters relating to the bony margins, cavernous sinuses, carotid arteries, optic chiasm, suprasellar cisterns, pituitary, pituitary stalk and extension of the lesion were evaluated. These reports were compared with the initial ones offered when the scans were ordered, and with the final diagnosis. Concordance between initial computerized tomography and magnetic resonance was observed in 27 cases (67.5%); among the discordant cases computerized tomography showed the lesion in two, magnetic resonance in 10, while in the remaining case reported to harbour a microadenoma on computerized tomography the differential diagnosis between a true TSH-secreting microadenoma and pituitary resistance to thyroid hormones is still unclear. Both neuroradiologists coincided in their reports in 32 patients (80%); when the initial report was compared with those of the neuroradiologists, concordance was observed with at least one of them in 34 instances (85%). Discordant results were observed principally in microadenomas secreting ACTH or PRL and in delayed puberty. In the eight patients with Cushing's disease (histologically confirmed in six) magnetic resonance was positive in five and computerized tomography in two; the abnormal image correctly identified the side of the lesion at surgery. In patients referred for evaluation of Cushing's syndrome or hyperprolactinaemia (due to microadenomas) or after surgery, magnetic resonance is clearly preferable to computerized tomography. In macroadenomas both scans are equally diagnostic but magnetic resonance offers more information on pituitary morphology and neighbouring structures. Nevertheless, there are cases in which the results of computerized tomography and magnetic resonance will complement each other, since different parameters are analysed with each examination and discordant results are encountered.

Dynamic-thresholding level set: a novel computer-aided volumetry method for liver tumors in hepatic CT images

NASA Astrophysics Data System (ADS)

Cai, Wenli; Yoshida, Hiroyuki; Harris, Gordon J.

2007-03-01

Measurement of the volume of focal liver tumors, called liver tumor volumetry, is indispensable for assessing the growth of tumors and for monitoring the response of tumors to oncology treatments. Traditional edge models, such as the maximum gradient and zero-crossing methods, often fail to detect the accurate boundary of a fuzzy object such as a liver tumor. As a result, the computerized volumetry based on these edge models tends to differ from manual segmentation results performed by physicians. In this study, we developed a novel computerized volumetry method for fuzzy objects, called dynamic-thresholding level set (DT level set). An optimal threshold value computed from a histogram tends to shift, relative to the theoretical threshold value obtained from a normal distribution model, toward a smaller region in the histogram. We thus designed a mobile shell structure, called a propagating shell, which is a thick region encompassing the level set front. The optimal threshold calculated from the histogram of the shell drives the level set front toward the boundary of a liver tumor. When the volume ratio between the object and the background in the shell approaches one, the optimal threshold value best fits the theoretical threshold value and the shell stops propagating. Application of the DT level set to 26 hepatic CT cases with 63 biopsy-confirmed hepatocellular carcinomas (HCCs) and metastases showed that the computer measured volumes were highly correlated with those of tumors measured manually by physicians. Our preliminary results showed that DT level set was effective and accurate in estimating the volumes of liver tumors detected in hepatic CT images.

Mixed results in the safety performance of computerized physician order entry.

PubMed

Metzger, Jane; Welebob, Emily; Bates, David W; Lipsitz, Stuart; Classen, David C

2010-04-01

Computerized physician order entry is a required feature for hospitals seeking to demonstrate meaningful use of electronic medical record systems and qualify for federal financial incentives. A national sample of sixty-two hospitals voluntarily used a simulation tool designed to assess how well safety decision support worked when applied to medication orders in computerized order entry. The simulation detected only 53 percent of the medication orders that would have resulted in fatalities and 10-82 percent of the test orders that would have caused serious adverse drug events. It is important to ascertain whether actual implementations of computerized physician order entry are achieving goals such as improved patient safety.

Information technology and medication safety: what is the benefit?

PubMed Central

Kaushal, R; Bates, D

2002-01-01



 Medication errors occur frequently and have significant clinical and financial consequences. Several types of information technologies can be used to decrease rates of medication errors. Computerized physician order entry with decision support significantly reduces serious inpatient medication error rates in adults. Other available information technologies that may prove effective for inpatients include computerized medication administration records, robots, automated pharmacy systems, bar coding, "smart" intravenous devices, and computerized discharge prescriptions and instructions. In outpatients, computerization of prescribing and patient oriented approaches such as personalized web pages and delivery of web based information may be important. Public and private mandates for information technology interventions are growing, but further development, application, evaluation, and dissemination are required. PMID:12486992

[Introduction of computerized anesthesia-recording systems and construction of comprehensive medical information network for patients undergoing surgery in the University of Tokyo Hospital].

PubMed

Kitamura, Takayuki; Hoshimoto, Hiroyuki; Yamada, Yoshitsugu

2009-10-01

The computerized anesthesia-recording systems are expensive and the introduction of the systems takes time and requires huge effort. Generally speaking, the efficacy of the computerized anesthesia-recording systems on the anesthetic managements is focused on the ability to automatically input data from the monitors to the anesthetic records, and tends to be underestimated. However, once the computerized anesthesia-recording systems are integrated into the medical information network, several features, which definitely contribute to improve the quality of the anesthetic management, can be developed; for example, to prevent misidentification of patients, to prevent mistakes related to blood transfusion, and to protect patients' personal information. Here we describe our experiences of the introduction of the computerized anesthesia-recording systems and the construction of the comprehensive medical information network for patients undergoing surgery in The University of Tokyo Hospital. We also discuss possible efficacy of the comprehensive medical information network for patients during surgery under anesthetic managements.

Antipsychotic treatment in schizophrenia: the role of computerized neuropsychological assessment.

PubMed

Kertzman, Semion; Reznik, Ilya; Grinspan, Haim; Weizman, Abraham; Kotler, Moshe

2008-01-01

The present study analyzes the role of neurocognitive assessment instruments in the detection of the contribution of antipsychotic treatment to cognitive functioning. Recently, a panel of experts suggested six main domains (working memory; attention/vigilance; verbal/visual learning and memory; reasoning and problem solving; speed of processing) implicated in schizophrenia-related cognitive deficits, which serve as a theoretical base for creation of real-time computerized neurocognitive batteries. The high sensitivity of computerized neuropsychological testing is based on their ability to adopt the reaction time (RT) paradigm for the assessment of brain function in a real-time regime. This testing is highly relevant for the monitoring of the cognitive effects of antipsychotics. Computerized assessment assists in the identification of state- and trait-related cognitive impairments. The optimal real-time computerized neurocognitive battery should composite balance between broad and narrow coverage of cognitive domains relevant to the beneficial effects of antipsychotics and will enable better planning of treatment and rehabilitation programs.

Features of Computerized Educational Games in Sciences of the Elementary Phase in Jordan from the Point of View of Specialists in Teaching Science and Computer Subjects

ERIC Educational Resources Information Center

Al Sarhan, Khaled Ali; AlZboon, Saleem Odeh; Olimat, Khalaf Mufleh; Al-Zboon, Mohammad Saleem

2013-01-01

The study aims at introducing the features of the computerized educational games in sciences at the elementary school in Jordan according to the specialists in teaching science and computer subjects, through answering some questions such as: What are the features of the computerized educational games in sciences at the elementary schools in Jordan…

The Effects of a Computerized Professional Development Program on Teachers and Students with and without Disabilities in Secondary General Education Classes

ERIC Educational Resources Information Center

Schumaker, Jean B.; Fisher, Joseph B.; Walsh, Lisa D.

2010-01-01

Effects of a computerized professional development (PD) program were investigated in two studies. For each, teachers were randomly assigned to either a Virtual Workshop (VW) group that used a computerized program for PD or to an Actual Workshop (AW) group that participated in a live PD session. In Study 1, the teachers' knowledge about and…

Health technology assessment review: Computerized glucose regulation in the intensive care unit - how to create artificial control

PubMed Central

2009-01-01

Current care guidelines recommend glucose control (GC) in critically ill patients. To achieve GC, many ICUs have implemented a (nurse-based) protocol on paper. However, such protocols are often complex, time-consuming, and can cause iatrogenic hypoglycemia. Computerized glucose regulation protocols may improve patient safety, efficiency, and nurse compliance. Such computerized clinical decision support systems (Cuss) use more complex logic to provide an insulin infusion rate based on previous blood glucose levels and other parameters. A computerized CDSS for glucose control has the potential to reduce overall workload, reduce the chance of human cognitive failure, and improve glucose control. Several computer-assisted glucose regulation programs have been published recently. In order of increasing complexity, the three main types of algorithms used are computerized flowcharts, Proportional-Integral-Derivative (PID), and Model Predictive Control (MPC). PID is essentially a closed-loop feedback system, whereas MPC models the behavior of glucose and insulin in ICU patients. Although the best approach has not yet been determined, it should be noted that PID controllers are generally thought to be more robust than MPC systems. The computerized Cuss that are most likely to emerge are those that are fully a part of the routine workflow, use patient-specific characteristics and apply variable sampling intervals. PMID:19849827

Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients.

PubMed

Mittal, M; Kumar, A; Srivastava, D; Sharma, P; Sharma, S

2015-01-01

Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups.

Freezing behavior as a response to sexual visual stimuli as demonstrated by posturography.

PubMed

Mouras, Harold; Lelard, Thierry; Ahmaidi, Said; Godefroy, Olivier; Krystkowiak, Pierre

2015-01-01

Posturographic changes in motivational conditions remain largely unexplored in the context of embodied cognition. Over the last decade, sexual motivation has been used as a good canonical working model to study motivated social interactions. The objective of this study was to explore posturographic variations in response to visual sexual videos as compared to neutral videos. Our results support demonstration of a freezing-type response in response to sexually explicit stimuli compared to other conditions, as demonstrated by significantly decreased standard deviations for (i) the center of pressure displacement along the mediolateral and anteroposterior axes and (ii) center of pressure's displacement surface. These results support the complexity of the motor correlates of sexual motivation considered to be a canonical functional context to study the motor correlates of motivated social interactions.

Microcomputer Network for Computerized Adaptive Testing (CAT): Program Listing. Supplement.

DTIC Science & Technology

1984-03-01

UMICROCOMPUTER NETWORK FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ): PROGRAM LISTING in APPROVED FOR PUBLIC RELEASE;IDISTRIBUTION UNLIMITEDPs DTIC ’ Akf 3 0 1-d84...NETWORK FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ).- PROGRAM LISTING , ,j Baldwin Quan Thomas A. Park Gary Sandahl John H. Wolfe Reviewed by James R. McBride A...Center San Diego, California 92152 V.% :-, CONTENTrS Page CATPROJECT.TEXT CAT system driver textfile I 1 ADMINDIR- Subdirectory - Test administration

Computerized Adaptive Screening Test (CAST): Development for Use in Military Recruiting Stations

DTIC Science & Technology

1984-01-01

testing ( CAT ) 20. ABSTRACT (Continuo on rover .. efdo II neco .. ., ond Identity bJ’ 11/oclr -llor) The Computerized Adaptive Screening Test (CAST...effort is in progress to develop a computerized adaptive testing ( CAT ) system and to evaluate its potential for use in the military entrance...U.S. Marine Corps) has been designated as lead service for CAT system development; and the Navy Personnel Research and Development Center, as lead

Application of a computerized environmental information system to master and sector planning

NASA Technical Reports Server (NTRS)

Stewart, J. C.

1978-01-01

A computerized composite mapping system developed as an aid in the land use decision making process is described. Emphasis is placed on consideration of the environment in urban planning. The presence of alluvium, shallow bedrock, surface water, and vegetation growth are among the environmental factors considered. An analysis of the Shady Grove Sector planning is presented as an example of the use of computerized composite mapping for long range planning.

The ABC's required for establishing a practical computerized plant engineering management data base system

NASA Technical Reports Server (NTRS)

Maiocco, F. R.; Hume, J. P.

1976-01-01

A system's approach is outlined in the paper to assist facility and Plant Engineers improve their organization's data management system. The six basic steps identified may appear somewhat simple; however, adequate planning, proper resources, and the involvement of management will determine the success of a computerized facility management data base. Helpful suggestions are noted throughout the paper to insure the development of a practical computerized data management system.

Biobehavioural analysis of the vestibular system and posture control in patients with cervicogenic dizziness. A cross-sectional study.

PubMed

Grande-Alonso, M; Moral Saiz, B; Mínguez Zuazo, A; Lerma Lara, S; La Touche, R

2018-03-01

Cervicogenic dizziness is a musculoskeletal disorder mainly characterised by dizziness and disequilibrium associated with neck pain. The pathophysiology is unclear and the neurophysiological basis remains to be ascertained. The aim of this study is to compare the vestibulo-ocular reflex and postural control between patients with cervicogenic dizziness and asymptomatic subjects, and to assess the association between debilitating dizziness and other psychosocial variables. A total of 20 patients and 22 asymptomatic subjects were selected. Vestibulo-ocular reflex was assessed by performing the head impulse test. Computerised dynamic posturography was used to evaluate the postural control by means of the sensory organisation test. In addition, subjects self-reported their degree of disability due to dizziness, cervical disability, kinesiophobia, and state of anxiety and depression. There were no differences in the vestibulo-ocular reflex (P>.05). However, we found differences with a medium-to-large effect size (d>0.60) in variables related to proprioception and visual information integration; the former variable set was related to disability due to dizziness. Disability due to dizziness presents strong-to-moderate associations with cervical disability, kinesiophobia, and anxiety. Our data rule out changes in the vestibular system in cervicogenic dizziness, but they do point to proprioceptive impairment. According to our results, the association between dizziness-related disability and other psychosocial factors in cervicogenic dizziness is very relevant for clinical medicine and for future research projects. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial.

PubMed

Meldrum, Dara; Herdman, Susan; Moloney, Roisin; Murray, Deirdre; Duffy, Douglas; Malone, Kareena; French, Helen; Hone, Stephen; Conroy, Ronan; McConn-Walsh, Rory

2012-03-26

Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unknown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus® (NWFP) is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy. In a single (assessor) blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP) vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis). Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks) and at 6 months. Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated. Clinical trials.gov identifier: NCT01442623.

Development of postural control and maturation of sensory systems in children of different ages a cross-sectional study.

PubMed

Sá, Cristina Dos Santos Cardoso de; Boffino, Catarina Costa; Ramos, Renato Teodoro; Tanaka, Clarice

To evaluate the stability, postural adjustments and contributions of sensory information for postural control in children. 40 boys and 40 girls were equally divided into groups of 5, 7, 9 and 12 years (G5, G7, G9 and G12). All children were submitted to dynamic posturography using a modified sensory organization test, using four sensory conditions: combining stable or sway referencing platform with eyes opened, or closed. The area and displacements of the center of pressure were used to determine stability, while the adjustments were used to measure the speed of the center of pressure displacements. These measurements were compared between groups and test conditions. Stability tends to increase with age and to decrease with sensory manipulation with significant differences between G5 and G7 in different measures. G7 differed from G12 under the conditions of stable and sway platform with eyes open. G9 did not differ from G12. Similar behavior was observed for adjustments, especially in anterior-posterior directions. Postural stability and adjustments were associated with age and were influenced by sensory manipulation. The ability to perform anterior-posterior adjustments was more evident and sensory maturation occurred firstly on the visual system, then proprioceptive system, and finally, the vestibular system, reaching functional maturity at nine years of age. Seven-year-olds seem to go through a period of differentiated singularity in postural control. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Comprehensive Group Therapy of Obesity and Its Impact on Selected Anthropometric and Postural Parameters.

PubMed

Horák, Stanislav; Sovová, Eliška; Pastucha, Dalibor; Konečný, Petr; Radová, Lenka; Calabová, Naděžda; Janoutová, Jana; Janout, Vladimír

2017-12-01

Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroCom's SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions). Copyright© by the National Institute of Public Health, Prague 2017

Effect of 30-min +3 Gz centrifugation on vestibular and autonomic cardiovascular function

NASA Technical Reports Server (NTRS)

Schlegel, Todd T.; Wood, Scott J.; Brown, Troy E.; Harm, Deborah L.; Rupert, A. H.

2003-01-01

INTRODUCTION: Repeated exposure to increased +Gz enhances human baroreflex responsiveness and improves tolerance to cardiovascular stress. However, it is not known whether such enhancements might also result from a single, more prolonged exposure to increased +Gz. Our study was designed to investigate whether baroreflex function and orthostatic tolerance are acutely improved by a single prolonged exposure to +3 Gz, and moreover, whether changes in autonomic cardiovascular function resulting from exposure to increased +Gz are correlated with changes in otolith function. METHODS: We exposed 15 healthy human subjects to +3 Gz centrifugation for up to 30 min or until symptoms of incipient G-induced loss of consciousness (G-LOC) ensued. Tests of autonomic cardiovascular function both before and after centrifugation included: 1) power spectral determinations of beat-to-beat R-R intervals and arterial pressures; 2) carotid-cardiac baroreflex tests; 3) Valsalva tests; and 4) 30-min head-up tilt tests. Otolith function was assessed during centrifugation by the linear vestibulo-ocular reflex and both before and after centrifugation by measurements of ocular counter-rolling and dynamic posturography. RESULTS: Of the 15 subjects who underwent prolonged +3 Gz, 4 were intolerant to 30 min of head-up tilt before centrifugation but became tolerant to such tilt after centrifugation. The Valsalva-related baroreflex as well as a measure of the carotid-cardiac baroreflex were also enhanced after centrifugation. No significant vestibular-autonomic relationships were detected beyond a vestibular-cerebrovascular interaction reported earlier in a subset of seven participants. CONCLUSIONS: A single prolonged exposure to +3 Gz centrifugation acutely improves baroreflex function and orthostatic tolerance.

A new methodology based on functional principal component analysis to study postural stability post-stroke.

PubMed

Sánchez-Sánchez, M Luz; Belda-Lois, Juan-Manuel; Mena-Del Horno, Silvia; Viosca-Herrero, Enrique; Igual-Camacho, Celedonia; Gisbert-Morant, Beatriz

2018-05-05

A major goal in stroke rehabilitation is the establishment of more effective physical therapy techniques to recover postural stability. Functional Principal Component Analysis provides greater insight into recovery trends. However, when missing values exist, obtaining functional data presents some difficulties. The purpose of this study was to reveal an alternative technique for obtaining the Functional Principal Components without requiring the conversion to functional data beforehand and to investigate this methodology to determine the effect of specific physical therapy techniques in balance recovery trends in elderly subjects with hemiplegia post-stroke. A randomized controlled pilot trial was developed. Thirty inpatients post-stroke were included. Control and target groups were treated with the same conventional physical therapy protocol based on functional criteria, but specific techniques were added to the target group depending on the subjects' functional level. Postural stability during standing was quantified by posturography. The assessments were performed once a month from the moment the participants were able to stand up to six months post-stroke. The target group showed a significant improvement in postural control recovery trend six months after stroke that was not present in the control group. Some of the assessed parameters revealed significant differences between treatment groups (P < 0.05). The proposed methodology allows Functional Principal Component Analysis to be performed when data is scarce. Moreover, it allowed the dynamics of recovery of two different treatment groups to be determined, showing that the techniques added in the target group increased postural stability compared to the base protocol. Copyright © 2018 Elsevier Ltd. All rights reserved.

Computerized assessment of communication for cognitive stimulation for people with cognitive decline using spectral-distortion measures and phylogenetic inference.

PubMed

Pham, Tuan D; Oyama-Higa, Mayumi; Truong, Cong-Thang; Okamoto, Kazushi; Futaba, Terufumi; Kanemoto, Shigeru; Sugiyama, Masahide; Lampe, Lisa

2015-01-01

Therapeutic communication and interpersonal relationships in care homes can help people to improve their mental wellbeing. Assessment of the efficacy of these dynamic and complex processes are necessary for psychosocial planning and management. This paper presents a pilot application of photoplethysmography in synchronized physiological measurements of communications between the care-giver and people with dementia. Signal-based evaluations of the therapy can be carried out using the measures of spectral distortion and the inference of phylogenetic trees. The proposed computational models can be of assistance and cost-effectiveness in caring for and monitoring people with cognitive decline.

Computerized Assessment of Communication for Cognitive Stimulation for People with Cognitive Decline Using Spectral-Distortion Measures and Phylogenetic Inference

PubMed Central

Pham, Tuan D.; Oyama-Higa, Mayumi; Truong, Cong-Thang; Okamoto, Kazushi; Futaba, Terufumi; Kanemoto, Shigeru; Sugiyama, Masahide; Lampe, Lisa

2015-01-01

Therapeutic communication and interpersonal relationships in care homes can help people to improve their mental wellbeing. Assessment of the efficacy of these dynamic and complex processes are necessary for psychosocial planning and management. This paper presents a pilot application of photoplethysmography in synchronized physiological measurements of communications between the care-giver and people with dementia. Signal-based evaluations of the therapy can be carried out using the measures of spectral distortion and the inference of phylogenetic trees. The proposed computational models can be of assistance and cost-effectiveness in caring for and monitoring people with cognitive decline. PMID:25803586

Development of an engineering analysis of progressive damage in composites during low velocity impact

NASA Technical Reports Server (NTRS)

Humphreys, E. A.

1981-01-01

A computerized, analytical methodology was developed to study damage accumulation during low velocity lateral impact of layered composite plates. The impact event was modeled as perfectly plastic with complete momentum transfer to the plate structure. A transient dynamic finite element approach was selected to predict the displacement time response of the plate structure. Composite ply and interlaminar stresses were computed at selected time intervals and subsequently evaluated to predict layer and interlaminar damage. The effects of damage on elemental stiffness were then incorporated back into the analysis for subsequent time steps. Damage predicted included fiber failure, matrix ply failure and interlaminar delamination.

The theory of Enceladus and Dione - An application of computerized algebra in dynamical astronomy

NASA Technical Reports Server (NTRS)

Jefferys, W. H.; Ries, L. M.

1975-01-01

The orbits of the satellites of the outer planets are poorly known, due to lack of attention over the past half century. We have been developing a new theory of Saturn's satellites Enceladus and Dione which is literal (all constants of integration appear explicitly), canonically invariant (the Hori-Lie method is used), and which correctly handles the eccentricity-type resonance between the two satellites. The algebraic manipulations are being performed using the TRIGMAN formula manipulation language, and the programs have been developed so that with minor modifications they can be used on the Mimas-Tethys and Titan-Hyperion systems.

Case report: whiplash-associated disorder from a low-velocity bumper car collision: history, evaluation, and surgery.

PubMed

Duffy, Michael F; Stuberg, Wayne; DeJong, Stacey; Gold, Kurt V; Nystrom, N Ake

2004-09-01

Case report of a patient with a whiplash-associated disorder following a bumper car collision. Imaging studies failed to provide an anatomic explanation for the debilitating symptoms. To report a chronic, debilitating pain syndrome after a low-velocity bumper car collision while using complex range-of-motion data for the diagnosis, prognosis, and surgical indication in whiplash-associated disorder. The controversy of whiplash-associated disorder mainly concerns pathophysiology and collision dynamics. Although many investigations attempt to define a universal lesion or determine a threshold of force that may cause permanent injury, no consensus has been reached. Eight years after a low-velocity collision, the patient underwent surgical excision of multiple painful trigger points in the posterior neck. Computerized motion analysis was used for pre- and postoperative evaluations. Surgical treatment resulted in an increase in total active range of motion by 20%, reduced intake of pain medication, doubled the number of work hours, and generally led to a dramatic improvement in quality of life. This case of whiplash-associated disorder after a low-velocity collision highlights the difficulty in defining threshold of injury in regard to velocity. It also illustrates the value of computerized motion analysis in confirming the diagnosis of whiplash-associated disorder and in the evaluation of prognosis and treatment.

The Effectiveness of a 3D Computerized Tutorial to Enhance Learning of the Canine Larynx and Hyoid Apparatus.

PubMed

Nemanic, Sarah; Mills, Serena; Viehdorfer, Matt; Clark, Terri; Bailey, Mike

Teaching the anatomy of the canine larynx and hyoid apparatus is challenging because dissection disassembles and/or damages these structures, making it difficult to understand their three-dimensional (3D) anatomy and spatial interrelationships. This study assessed the effectiveness of an interactive, computerized 3D tutorial for teaching the anatomy of the canine larynx and hyoid apparatus using a randomized control design with students enrolled in the first-year professional program at Oregon State University College of Veterinary Medicine. All first-year students from 2 consecutive years were eligible. All students received the traditional methods of didactic teaching and dissection to learn the anatomy of the canine larynx and hyoid apparatus, after which they were divided into two statistically equal groups based on their cumulative anatomy test scores from the prior term. The tutorial group received an interactive, computerized tutorial developed by the investigators containing 3D images of the canine larynx and hyoid apparatus, while the control group received the same 3D images without the computerized tutorial. Both groups received the same post-learning assessment and survey. Sixty-three first-year students participated in the study, 28 in the tutorial group, and 35 in the control group. Post-learning assessment and survey scores were both significantly higher among students in the computerized tutorial group than those in the control group. This study demonstrates that a 3D computerized tutorial is more effective in teaching the anatomy of the canine hyoid apparatus and larynx than 3D images without a tutorial. Students likewise rated their learning experience higher when using the 3D computerized tutorial.

An Analysis of Minimum System Requirements to Support Computerized Adaptive Testing.

DTIC Science & Technology

1986-09-01

adaptive test ( CAT ); adaptive test ing A;4SRAC:’ (Continue on reverie of necessary and ident4f by block number) % This pape-r discusses the minimum system...requirements needed to develop a computerized adaptive test ( CAT ). It lists some of the benefits of adaptive testing, establishes a set of...discusses the minimum system requirements needed to develop a computerized adaptive test ( CAT ). It lists some of the benefits of adaptive testing

Build Your Own Inventory System. Annual Cost: $100.00 (Approximate). Fixed Assets, Materials and Supplies. The Practical Elements for a Computerized, Continuing Inventory System in Schools and Use in Determining a Measure for Instructional Cost.

ERIC Educational Resources Information Center

Payne, Arnold, Comp.

This publication presents performance flow charts and other accompanying forms that are elements of an economical computerized continuing inventory system. The system described here is intended to serve school systems as an adequate fixed asset system and to provide a computerized inventory model that offers support for costs of future educational…

Comparison of Centralized-Manual, Centralized-Computerized, and Decentralized-Computerized Order and Management Information Models for the Turkish Air Force Logistics System.

DTIC Science & Technology

1986-09-01

differentiation between the systems. This study will investigate an appropriate Order Processing and Management Information System (OP&MIS) to link base-level...methodology: 1. Reviewed the current order processing and information model of the TUAF Logistics System. (centralized-manual model) 2. Described the...RDS program’s order processing and information system. (centralized-computerized model) 3. Described the order irocessing and information system of

Computerized proof techniques for undergraduates

NASA Astrophysics Data System (ADS)

Smith, Christopher J.; Tefera, Akalu; Zeleke, Aklilu

2012-12-01

The use of computer algebra systems such as Maple and Mathematica is becoming increasingly important and widespread in mathematics learning, teaching and research. In this article, we present computerized proof techniques of Gosper, Wilf-Zeilberger and Zeilberger that can be used for enhancing the teaching and learning of topics in discrete mathematics. We demonstrate by examples how one can use these computerized proof techniques to raise students' interests in the discovery and proof of mathematical identities and enhance their problem-solving skills.

Language Research Center's Computerized Test System (LRC-CTS) - Video-formatted tasks for comparative primate research

NASA Technical Reports Server (NTRS)

Rumbaugh, Duane M.; Washburn, David A.; Savage-Rumbaugh, E. S.; Hopkins, William D.; Richardson, W. K.

1991-01-01

Automation of a computerized test system for comparative primate research is shown to improve the results of learning in standard paradigms. A mediational paradigm is used to determine the degree to which criterion in the learning-set testing reflects stimulus-response associative or mediational learning. Rhesus monkeys are shown to exhibit positive transfer as the criterion levels are shifted upwards, and the effectiveness of the computerized testing system is confirmed.

Clinical evaluation of the WOMAC 3.0 OA Index in numeric rating scale format using a computerized touch screen version.

PubMed

Theiler, R; Spielberger, J; Bischoff, H A; Bellamy, N; Huber, J; Kroesen, S

2002-06-01

The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index is a previously described self-administered questionnaire covering three domains: pain, stiffness and function. It has been validated in patients with osteoarthritis (OA) of the hip or knee in a paper-based format. To validate the WOMAC 3.0 using a numerical rating scale in a computerized touch screen format allowing immediate evaluation of the questionnaire. In the computed version cartoons, written and audio instruments were included in order facilitate application. Fifty patients, demographically balanced, with radiographically proven primary hip or knee OA completed the classical paper and the new computerized WOMAC version. Subjects were randomized either to paper format or computerized format first to balance possible order effects. The intra-class correlation coefficients for pain, stiffness and function values were 0.915, 0.745 and 0.940, respectively. The Spearman correlation coefficients for pain, stiffness and function were 0.88, 0.77 and 0.87, respectively. These data indicate that the computerized WOMAC OA index 3.0 is comparable to the paper WOMAC in all three dimensions. The computerized version would allow physicians to get an immediate result and if present a direct comparison with a previous exam. Copyright 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.

Multitasking capacities in persons diagnosed with schizophrenia: a preliminary examination of their neurocognitive underpinnings and ability to predict real world functioning.

PubMed

Laloyaux, Julien; Van der Linden, Martial; Levaux, Marie-Noëlle; Mourad, Haitham; Pirri, Anthony; Bertrand, Hervé; Domken, Marc-André; Adam, Stéphane; Larøi, Frank

2014-07-30

Difficulties in everyday life activities are core features of persons diagnosed with schizophrenia and in particular during multitasking activities. However, at present, patients׳ multitasking capacities have not been adequately examined in the literature due to the absence of suitable assessment strategies. We thus recently developed a computerized real-life activity task designed to take into account the complex and multitasking nature of certain everyday life activities where participants are required to prepare a room for a meeting. Twenty-one individuals diagnosed with schizophrenia and 20 matched healthy controls completed the computerized task. Patients were also evaluated with a cognitive battery, measures of symptomatology and real world functioning. To examine the ecological validity, 14 other patients were recruited and were given the computerized version and a real version of the meeting preparation task. Results showed that performance on the computerized task was significantly correlated with executive functioning, pointing to the major implication of these cognitive processes in multitasking situations. Performance on the computerized task also significantly predicted up to 50% of real world functioning. Moreover, the computerized task demonstrated good ecological validity. These findings suggest the importance of evaluating multitasking capacities in patients diagnosed with schizophrenia in order to predict real world functioning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Computerized photogrammetry used to calculate the brow position index.

PubMed

Naif-de-Andrade, Naif Thadeu; Hochman, Bernardo; Naif-de-Andrade, Camila Zirlis; Ferreira, Lydia Masako

2012-10-01

The orbital region is of vital importance to facial expression. Brow ptosis, besides having an impact on facial harmony, is a sign of aging. Various surgical techniques have been developed to increase the efficacy of brow-lift surgery. However, no consensus method exists for an objective measurement of the eyebrow position due to the curvature of the face. Therefore, this study aimed to establish a method for measuring the eyebrow position using computerized photogrammetry. For this study, 20 orbital regions of 10 volunteers were measured by direct anthropometry using a digital caliper and by indirect anthropometry (computerized photogrammetry) using standardized digital photographs. Lines, points, and distances were defined based on the position of the anthropometric landmarks endocanthion and exocanthion and then used to calculate the brow position index (BPI). Statistical analysis was performed using Student's t test with a significance level of 5 %. The BPI values obtained by computerized photogrammetric measurements did not differ significantly from those obtained by direct anthropometric measurements (p > 0.05). The mean BPI was 84.89 ± 10.30 for the computerized photogrammetric measurements and 85.27 ± 10.67 for the direct anthropometric measurements. The BPI defined in this study and obtained by computerized photogrammetry is a reproducible and efficient method for measuring the eyebrow position. This journal requires that authors assign a level of evidence to each article.

Supporting Patient Care in the Emergency Department with a Computerized Whiteboard System

PubMed Central

Aronsky, Dominik; Jones, Ian; Lanaghan, Kevin; Slovis, Corey M.

2008-01-01

Efficient information management and communication within the emergency department (ED) is essential to providing timely and high-quality patient care. The ED whiteboard (census board) usually serves as an ED’s central access point for operational and patient-related information. This article describes the design, functionality, and experiences with a computerized ED whiteboard, which has the ability to display relevant operational and patient-related information in real time. Embedded functionality, additional whiteboard views, and the integration with ED and institutional information system components, such as the computerized patient record or the provider order entry system, provide rapid access to more detailed information. As an information center, the computerized whiteboard supports our ED environment not only for providing patient care, but also for operational, educational, and research activities. PMID:18096913

Effects of alcohol on body-sway patterns in human subjects.

PubMed

Nieschalk, M; Ortmann, C; West, A; Schmäl, F; Stoll, W; Fechner, G

1999-01-01

The vestibulospinal aspects of vestibular function are commonly neglected in the evaluation of alcohol-induced intoxication. Thus, in the present study the effect of an acute intoxication with a low or moderate quantity of alcohol was examined with respect to the equilibrium in 30 healthy subjects. The blood alcohol concentration (BAC) was measured 30 min after the ingestion of the last alcohol, ranging between 0.22 and 1.59 per thousand. Stability of stance was quantified by static platform posturography in Romberg-test conditions with eyes open and eyes closed. Among other parameters, the average body sway path (SP) and area of body sway (SA) were assessed. Posturography revealed a significant increase in body sway. There was a positive correlation between SA (or SP) and BAC both with eyes open and eyes closed. Multiple group comparisons revealed that the large-alcohol-dose group (BAC > or = 1.0 per thousand) could be clearly differentiated from test cases with BAC lower than 0.8 per thousand. Sway area was the most sensitive parameter for detecting increased body sway after alcohol ingestion. The area increase, present not only with eyes closed but with eyes open, revealed an inadequate compensation of the ethanol-induced ataxia by visual stabilization. The Romberg's quotient, which denotes eyes closed relative to eyes open, remained constant. The increase in sway path with eyes closed showed an omnidirectional sway. A comparison of the sway pattern of subjects after acute ethanol ingestion with the data of patients with permanent cerebellar lesions suggested that the acute effect of alcohol resembles that of a lesion of the spinocerebellum. This finding contrasts with earlier studies, which postulated an acute effect of ethanol resembling that in patients with an atrophy of the anterior lobe of the cerebellum due to chronic alcohol abuse. In seven cases of the lower dose group (BAC < or = 0.8 per thousand), a reduction in body sway after alcohol ingestion was observed. This finding may be consistent with a dose-related biphasic action of alcohol, which - besides its well-known depressant effects with high doses - also shows stimulatory action with small doses.

Feasibility Study for a Computerized Serials Control System in the Defense Communications Agency Technical and Management Information Center.

DTIC Science & Technology

1984-06-20

AD-A162 ±88 FEASIBILITY STUDY FOR A COMPUTERIZED SERIALS CONTROL 1/1 SYSTEM IN THE DEFENS (U) DEFENSE COMMUNICATIONS AGENCY WASHINGTON DC TECHNICAL...NATIONAL BUREAU OF STANDARDS- 1963-A 0FEASIBILITY STUDY FOR A COMPUTERIZED SERIALS CONTROL SYSTEM IN THE DEFENSE COMMUNICATIONS 0AGENCY TECHNICAL AND...ABSTRACT 21. ABSTRACT SECURITY CLASSIFICATION UNCLASSIFIED/UNLIMITED R1 SAME AS RPT. 0 DTIC USERS 0 UNCLASSIFIED 22&. NAME OF RESPONSIBLE INDIVIDUAL 22b

Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons?

PubMed Central

Hirschmann, Michael T.; Schmid, Rahel; Dhawan, Ranju; Skarvan, Jiri; Rasch, Helmut; Friederich, Niklaus F.; Emery, Roger

2011-01-01

With the cases described, we strive to introduce single photon emission computerized tomography in combination with conventional computer tomography (SPECT/CT) to shoulder surgeons, illustrate the possible clinical value it may offer as new diagnostic radiologic modality, and discuss its limitations. SPECT/CT may facilitate the establishment of diagnosis, process of decision making, and further treatment for complex shoulder pathologies. Some of these advantages were highlighted in cases that are frequently seen in most shoulder clinics. PMID:22058640

Computer programs: Mechanical and structural design criteria: A compilation

NASA Technical Reports Server (NTRS)

1973-01-01

Computerized design criteria for turbomachinery and the constraints imposed by very high rotational fields are presented along with a variety of computerized design criteria of interest to structural designers.

Effects of intensive whole-body vibration training on muscle strength and balance in adults with chronic stroke: a randomized controlled pilot study.

PubMed

Tankisheva, Ekaterina; Bogaerts, An; Boonen, Steven; Feys, Hilde; Verschueren, Sabine

2014-03-01

To investigate the effects of a 6-week whole body vibration (WBV) training program in patients with chronic stroke. Randomized controlled pilot trial with 6 weeks' follow-up. University hospital. Adults with chronic stroke (N=15) were randomly assigned to an intervention (n=7) or a control group (n=8). Supervised, intensive WBV training. The vibration group performed a variety of static and dynamic squat exercises on a vibration platform with vibration amplitudes of 1.7 and 2.5mm and frequencies of 35 and 40Hz. The vibration lasted 30 to 60 seconds, with 5 to 17 repetitions per exercise 3 times weekly for 6 weeks. Participants in the control group continued their usual activities and were not involved in any additional training program. The primary outcome variable was the isometric and isokinetic muscle strength of the quadriceps (isokinetic dynamometer). Additionally, hamstrings muscle strength, static and dynamic postural control (dynamic posturography), and muscle spasticity (Ashworth Scale) were assessed. Compliance with the vibration intervention was excellent, and the participants completed all 18 training sessions. Vibration frequencies of both 35 and 40Hz were well tolerated by the patients, and no adverse effects resulting from the vibration were noted. Overall, the effect of intensive WBV intervention resulted in significant between-group differences in favor of the vibration group only in isometric knee extension strength (knee angle, 60°) (P=.022) after 6 weeks of intervention and in isokinetic knee extension strength (velocity, 240°/s) after a 6-week follow-up period (P=.005), both for the paretic leg. Postural control improved after 6 weeks of vibration in the intervention group when the patients had normal vision and a sway-referenced support surface (P<.05). Muscle spasticity was not affected by vibration (P>.05). These preliminary results suggest that intensive WBV might potentially be a safe and feasible way to increase some aspect of lower limb muscle strength and postural control in adults with chronic stroke. Further studies should focus on evaluating how the training protocol should be administered to achieve the best possible outcome, as well as comparing this training protocol to other interventions. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Solving Infeasibility Problems in Computerized Test Assembly.

ERIC Educational Resources Information Center

Timminga, Ellen

1998-01-01

Discusses problems of diagnosing and repairing infeasible linear-programming models in computerized test assembly. Demonstrates that it is possible to localize the causes of infeasibility, although this is not always easy. (SLD)

The School Building Principal and Inventory Control: A Case for Computerization.

ERIC Educational Resources Information Center

Stronge, James

1987-01-01

General and special purpose database programs are appropriate for inventory control at the school building level. A fixed asset equipment inventory example illustrates the feasibility of computerized inventory control. (MLF)

Using Computerized Bilingual Dictionaries To help Maximize English Vocabulary Learning at Japanese Colleges.

ERIC Educational Resources Information Center

Loucky, John Paul

2003-01-01

Compares various computerized bilingual dictionaries for their relative effectiveness in helping Japanese college students at several language proficiency levels to access new English target vocabulary. (Author/VWL)

Computerized Adaptive Testing: Overview and Introduction.

ERIC Educational Resources Information Center

Meijer, Rob R.; Nering, Michael L.

1999-01-01

Provides an overview of computerized adaptive testing (CAT) and introduces contributions to this special issue. CAT elements discussed include item selection, estimation of the latent trait, item exposure, measurement precision, and item-bank development. (SLD)

Designing Computerized Provider Order Entry Software in Iran: The Nurses' and Physicians' Viewpoints.

PubMed

Khammarnia, Mohammad; Sharifian, Roxana; Zand, Farid; Keshtkaran, Ali; Barati, Omid

2016-09-01

This study aimed to identify the functional requirements of computerized provider order entry software and design this software in Iran. This study was conducted using review documentation, interview, and focus group discussions in Shiraz University of Medical Sciences, as the medical pole in Iran, in 2013-2015. The study sample consisted of physicians (n = 12) and nurses (n = 2) in the largest hospital in the southern part of Iran and information technology experts (n = 5) in Shiraz University of Medical Sciences. Functional requirements of the computerized provider order entry system were examined in three phases. Finally, the functional requirements were distributed in four levels, and accordingly, the computerized provider order entry software was designed. The software had seven main dimensions: (1) data entry, (2) drug interaction management system, (3) warning system, (4) treatment services, (5) ability to write in software, (6) reporting from all sections of the software, and (7) technical capabilities of the software. The nurses and physicians emphasized quick access to the computerized provider order entry software, order prescription section, and applicability of the software. The software had some items that had not been mentioned in other studies. Ultimately, the software was designed by a company specializing in hospital information systems in Iran. This study was the first specific investigation of computerized provider order entry software design in Iran. Based on the results, it is suggested that this software be implemented in hospitals.

Anthropometric and computerized tomographic measurements of lower extremity lean body mass.

PubMed

Buckley, D C; Kudsk, K A; Rose, B S; Fatzinger, P; Koetting, C A; Schlatter, M

1987-02-01

The loss of lean muscle mass is one of the hallmarks of protein-calorie malnutrition. Anthropometry is a standardized technique used to assess the response of muscle mass to nutrition therapy by quantifying the muscle and fat compartments. That technique does not accurately reflect actual limb composition, whereas computerized tomography does. Twenty lower extremities on randomly chosen men and women patients were evaluated by anthropometry and computerized tomography. Total area, muscle plus bone area, total volume, and muscle plus bone volume were correlated, using Heymsfield's equation and computerized tomography-generated areas. Anthropometrics overestimated total and muscle plus bone cross-sectional areas at almost every level. Anthropometry overestimated total area and total volume by 5% to 10% but overestimated muscle plus bone area and muscle plus bone volume by as much as 40%. Anthropometry, while easily performed and useful in large population groups for epidemiological studies, offers a poor assessment of lower extremity composition. On the other hand, computerized tomography is also easily performed and, while impractical for large population groups, does offer an accurate assessment of the lower extremity tissue compartments and is an instrument that might be used in research on lean muscle mass.

Economics of infection control surveillance technology: cost-effective or just cost?

PubMed

Furuno, Jon P; Schweizer, Marin L; McGregor, Jessina C; Perencevich, Eli N

2008-04-01

Previous studies have suggested that informatics tools, such as automated alert and decision support systems, may increase the efficiency and quality of infection control surveillance. However, little is known about the cost-effectiveness of these tools. We focus on 2 types of economic analyses that have utility in assessing infection control interventions (cost-effectiveness analysis and business-case analysis) and review the available literature on the economics of computerized infection control surveillance systems. Previous studies on the effectiveness of computerized infection control surveillance have been limited to assessments of whether these tools increase the sensitivity and specificity of surveillance over traditional methods. Furthermore, we identified only 2 studies that assessed the costs associated with computerized infection control surveillance. Thus, it remains unknown whether computerized infection control surveillance systems are cost-effective and whether use of these systems improves patient outcomes. The existing data are insufficient to allow for a summary conclusion on the cost-effectiveness of infection control surveillance technology. All future studies of computerized infection control surveillance systems should aim to collect outcomes and economic data to inform decision making and assist hospitals with completing business-cases analyses.

[Computerized acquisition and elaboration of clinical data in Rheumatology during ten years: state of art and prospectives

PubMed

Troise Rioda, W.; Nervetti, A.

2001-01-01

The well known complexity to collect the clinical data of patients and in particular in the area of rheumatology push us to develop a computerized clinical chart in order to facilitate the classification, evaluation and monitoring of these patients. The proposed computerized clinical chart is easy to use but at the same time is a very potent tool that allow the clinicians to organize the classic rheumatological pathologies as well as the more complexes or even rare. The proposed clinical chart is based on a relational database (FileMaker Pro 5.0v1) available for both the actual operative systems implemented on personal computers (Windows and Macintosh); this allow the full compatibility among the two systems, the possibility of exchanging data without any loss of information. The computerized clinical chart is structured on modules for specific pathologies and for homogeneous groups of illnesses. Basically the modules are defined correlated files of data for a specific pathology but that can be used also as a common pool for different pathologies. Our experience, based on ten years of use, indicates in the computerized rheumatological clinical chart an indispensable tool for rheumatologists with a real friendly use.

A Multisite, Randomized Controlled Clinical Trial of Computerized Cognitive Remediation Therapy for Schizophrenia.

PubMed

Gomar, Jesús J; Valls, Elia; Radua, Joaquim; Mareca, Celia; Tristany, Josep; del Olmo, Francisco; Rebolleda-Gil, Carlos; Jañez-Álvarez, María; de Álvaro, Francisco J; Ovejero, María R; Llorente, Ana; Teixidó, Cristina; Donaire, Ana M; García-Laredo, Eduardo; Lazcanoiturburu, Andrea; Granell, Luis; Mozo, Cristina de Pablo; Pérez-Hernández, Mónica; Moreno-Alcázar, Ana; Pomarol-Clotet, Edith; McKenna, Peter J

2015-11-01

The effectiveness of cognitive remediation therapy (CRT) for the neuropsychological deficits seen in schizophrenia is supported by meta-analysis. However, a recent methodologically rigorous trial had negative findings. In this study, 130 chronic schizophrenic patients were randomly assigned to computerized CRT, an active computerized control condition (CC) or treatment as usual (TAU). Primary outcome measures were 2 ecologically valid batteries of executive function and memory, rated under blind conditions; other executive and memory tests and a measure of overall cognitive function were also employed. Carer ratings of executive and memory failures in daily life were obtained before and after treatment. Computerized CRT was found to produce improvement on the training tasks, but this did not transfer to gains on the primary outcome measures and most other neuropsychological tests in comparison to either CC or TAU conditions. Nor did the intervention result in benefits on carer ratings of daily life cognitive failures. According to this study, computerized CRT is not effective in schizophrenia. The use of both active and passive CCs suggests that nature of the control group is not an important factor influencing results. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

Diagnostic Yield of Transbronchial Biopsy in Comparison to High Resolution Computerized Tomography in Sarcoidosis Cases

PubMed

Akten, H Serpil; Kilic, Hatice; Celik, Bulent; Erbas, Gonca; Isikdogan, Zeynep; Turktas, Haluk; Kokturk, Nurdan

2018-04-25

This study aimed to evaluate the diagnostic yield of fiberoptic bronchoscopic (FOB) transbronchial biopsy and its relation with quantitative findings of high resolution computerized tomography (HRCT). A total of 83 patients, 19 males and 64 females with a mean age of 45.1 years diagnosed with sarcoidosis with complete records of high resolution computerized tomography were retrospectively recruited during the time period from Feb 2005 to Jan 2015. High resolution computerized tomography scans were retrospectively assessed in random order by an experienced observer without knowledge of the bronchoscopic results or lung function tests. According to the radiological staging with HRCT, 2.4% of the patients (n=2) were stage 0, 19.3% (n=16) were stage 1, 72.3% (n=60) were stage 2 and 6.0% (n=5) were stage 3. This study showed that transbronchial lung biopsy showed positive results in 39.7% of the stage I or II sarcoidosis patients who were diagnosed by bronchoscopy. Different high resolution computerized tomography patterns and different scores of involvement did make a difference in the diagnostic accuracy of transbronchial biopsy (p=0.007). Creative Commons Attribution License

[Modernized study on eye's signs of blood-stasis syndrome].

PubMed

Wu, Rui; Xie, Jian-xiang; Zhao, Feng-da

2011-03-01

To make out a computerized formula to diagnose eye's signs of blood-stasis syndrome (BSS), and to improve the previous diagnostic methods by naked eyes. The formula was created by detecting and analyzing the changes of eye's signs in 544 patients (261 of non-BSS and 283 of BSS) quantitatively, adopting computer's color scale principle. And the sensitivity, specificity and accuracy of the formula were verified in 382 patients (97 non-BSS and 285 of BSS). The computerized integral was compared with the naked eye integral, and the normal reference value was calculated with percentile. Various observatory indices of eye's sign were positively correlated with BSS. The specificity of the computerized method was 83.5%, and the diagnostic sensitivity was 89.8%, the accuracy 88.2%, and the correct index 0.733. Comparisons between the computerized integral method and the naked eye integral method showed significant difference in patients of non-BSS or of BSS in various degrees (including mild, moderate and severe) (P < 0.01). The reference value of the naked eye method was below 15. The computerized formula of eye's signs has higher specificity and sensitivity in the diagnosis of BSS, while the naked eye integral method is proved to be useful.

Stabilometer Computerized Analog Recording System for Studying Gross Motor Skill Learning

ERIC Educational Resources Information Center

Chasey, William C., Jr.; And Others

1976-01-01

The stabilometer computerized analog recording system (SCARS) provides for storing analog and digital information on a single channel audio tape recorder at lower cost and greater versatility than other systems. (MB)

Freezing Behavior as a Response to Sexual Visual Stimuli as Demonstrated by Posturography

PubMed Central

Mouras, Harold; Lelard, Thierry; Ahmaidi, Said; Godefroy, Olivier; Krystkowiak, Pierre

2015-01-01

Posturographic changes in motivational conditions remain largely unexplored in the context of embodied cognition. Over the last decade, sexual motivation has been used as a good canonical working model to study motivated social interactions. The objective of this study was to explore posturographic variations in response to visual sexual videos as compared to neutral videos. Our results support demonstration of a freezing-type response in response to sexually explicit stimuli compared to other conditions, as demonstrated by significantly decreased standard deviations for (i) the center of pressure displacement along the mediolateral and anteroposterior axes and (ii) center of pressure’s displacement surface. These results support the complexity of the motor correlates of sexual motivation considered to be a canonical functional context to study the motor correlates of motivated social interactions. PMID:25992571

Longitudinal posturography and rotational testing in children 3-9 years of age: Normative data

PubMed Central

Casselbrant, Margaretha L.; Mandel, Ellen M.; Sparto, Patrick J; Perera, Subashan; Redfern, Mark S.; Fall, Patricia A.; Furman, Joseph M.

2010-01-01

Objective To obtain normative longitudinal vestibulo-ocular and balance test data in children from ages 3 to 9 with normal middle-ear status. Study Design Prospective, longitudinal cohort Setting Tertiary care pediatric hospital Subjects and Methods Three-year-old children were entered and tested yearly. Subjects underwent earth vertical axis rotation testing using sinusoidal and constant velocity stimuli and performed the Sensory Organization Test. Results One hundred forty-eight children were entered and usable data were collected on 127 children. A linear increase in the vestibulo-ocular reflex gain as children aged was found, without a change in the phase of the response. An age-related linear increase in Equilibrium Scores, indicating reduced postural sway, was also observed. Conclusion These normative data can be used in the evaluation of dizziness and balance disorders in children. PMID:20416461

Computerized Working-Memory Training as a Candidate Adjunctive Treatment for Addiction

PubMed Central

Bickel, Warren K.; Moody, Lara; Quisenberry, Amanda

2014-01-01

Alcohol and other drug dependencies are, in part, characterized by deficits in executive functioning, including working memory. Working-memory training is a candidate computerized adjunctive intervention for the treatment of alcoholism and other drug dependencies. This article reviews emerging evidence for computerized working memory training as an efficacious adjunctive treatment for drug dependence and highlights future challenges and opportunities in the field of working-memory training, including duration of training needed, persistence of improvements and utility of booster sessions, and selection of patients based on degree of deficits. PMID:26259006

The Lanchester square-law model extended to a (2,2) conflict

NASA Astrophysics Data System (ADS)

Colegrave, R. K.; Hyde, J. M.

1993-01-01

A natural extension of the Lanchester (1,1) square-law model is the (M,N) linear model in which M forces oppose N forces with constant attrition rates. The (2,2) model is treated from both direct and inverse viewpoints. The inverse problem means that the model is to be fitted to a minimum number of observed force levels, i.e. the attrition rates are to be found from the initial force levels together with the levels observed at two subsequent times. An approach based on Hamiltonian dynamics has enabled the authors to derive a procedure for solving the inverse problem, which is readily computerized. Conflicts in which participants unexpectedly rally or weaken must be excluded.

Intelligent Computerized Training System

NASA Technical Reports Server (NTRS)

Wang, Lui; Baffes, Paul; Loftin, R. Bowen; Hua, Grace C.

1991-01-01

Intelligent computer-aided training system gives trainees same experience gained from best on-the-job training. Automated system designed to emulate behavior of experienced teacher devoting full time and attention to training novice. Proposes challenging training scenarios, monitors and evaluates trainee's actions, makes meaningful comments in response to errors, reponds to requests for information, gives hints when appropriate, and remembers strengths and weaknesses so it designs suitable exercises. Used to train flight-dynamics officers in deploying satellites from Space Shuttle. Adapted to training for variety of tasks and situations, simply by modifying one or at most two of its five modules. Helps to ensure continuous supply of trained specialists despite scarcity of experienced and skilled human trainers.

Computerized Cognitive Screen (CoCoSc): A Self-Administered Computerized Test for Screening for Cognitive Impairment in Community Social Centers.

PubMed

Wong, Adrian; Fong, Ching-Hang; Mok, Vincent Chung-Tong; Leung, Kam-Tat; Tong, Raymond Kai-Yu

2017-01-01

Computerized cognitive tests may serve as a preliminary, low-cost method to identify individuals with suspected cognitive impairment in the community. To develop a self-administered computerized test, namely the "Computerized Cognitive Screen (CoCoSc), Hong Kong version", for screening of individuals with cognitive impairment (CI) in community settings. The CoCoSc is a 15-min computerized cognitive screen covering memory, executive functions, orientation, attention and working memory, and prospective memory administered on a touchscreen computer. Individuals with CI and cognitively normal controls were administered the CoCoSc and the Montreal Cognitive Assessment (MoCA). Validity of the CoCoSc was assessed based on the relationship with the MoCA using Pearson correlation. Receiver operating characteristic curve (ROC) was used to examine the ability of the CoCoSc to differentiate CI from controls. Fifty-nine individuals with CI and 101 controls were recruited. Seventy-five (46.9%) participants had ≤6 years of education. Performance on the CoCoSc differed between normal and CI groups in both low and high education subgroups. Total scores of the CoCoSc and MoCA were significantly correlated (r = 0.71, p < 0.001). The area under ROC was 0.78, p < 0.001 for the CoCoSc total score in differentiating the CI group from the cognitively normal group. A cut-off of ≤30 on the CoCoSc was associated with a sensitivity of 0.78 and specificity of 0.69. The CoCoSc was well accepted by attendees of community social centers. The CoCoSc is a promising computerized cognitive screen for self-administration in community social centers. It is feasible for testing individuals with high or low education levels.

Computer versus paper system for recognition and management of sepsis in surgical intensive care.

PubMed

Croft, Chasen A; Moore, Frederick A; Efron, Philip A; Marker, Peggy S; Gabrielli, Andrea; Westhoff, Lynn S; Lottenberg, Lawrence; Jordan, Janeen; Klink, Victoria; Sailors, R Matthew; McKinley, Bruce A

2014-02-01

A system to provide surveillance, diagnosis, and protocolized management of surgical intensive care unit (SICU) sepsis was undertaken as a performance improvement project. A system for sepsis management was implemented for SICU patients using paper followed by a computerized system. The hypothesis was that the computerized system would be associated with improved process and outcomes. A system was designed to provide early recognition and guide patient-specific management of sepsis including (1) modified early warning signs-sepsis recognition score (MEWS-SRS; summative point score of ranges of vital signs, mental status, white blood cell count; after every 4 hours) by bedside nurse; (2) suspected site assessment (vascular access, lung, abdomen, urinary tract, soft tissue, other) at bedside by physician or extender; (3) sepsis management protocol (replicable, point-of-care decisions) at bedside by nurse, physician, and extender. The system was implemented first using paper and then a computerized system. Sepsis severity was defined using standard criteria. In January to May 2012, a paper system was used to manage 77 consecutive sepsis encounters (3.9 ± 0.5 cases per week) in 65 patients (77% male; age, 53 ± 2 years). In June to December 2012, a computerized system was used to manage 132 consecutive sepsis encounters (4.4 ± 0.4 cases per week) in 119 patients (63% male; age, 58 ± 2 years). MEWS-SRS elicited 683 site assessments, and 201 had sepsis diagnosis and protocol management. The predominant site of infection was abdomen (paper, 58%; computer, 53%). Recognition of early sepsis tended to occur more using the computerized system (paper, 23%; computer, 35%). Hospital mortality rate for surgical ICU sepsis (paper, 20%; computer, 14%) was less with the computerized system. A computerized sepsis management system improves care process and outcome. Early sepsis is recognized and managed with greater frequency compared with severe sepsis or septic shock. The system has a beneficial effect as a clinical standard of care for SICU patients. Therapeutic study, level III.

Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

PubMed

Staszewska, Anna; Zaki, Pearl; Lee, Joon

2017-10-06

Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious illness. ©Anna Staszewska, Pearl Zaki, Joon Lee. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 06.10.2017.

Computerized tomography using video recorded fluoroscopic images

NASA Technical Reports Server (NTRS)

Kak, A. C.; Jakowatz, C. V., Jr.; Baily, N. A.; Keller, R. A.

1975-01-01

A computerized tomographic imaging system is examined which employs video-recorded fluoroscopic images as input data. By hooking the video recorder to a digital computer through a suitable interface, such a system permits very rapid construction of tomograms.

The Deference Due the Oracle: Computerized Text Analysis in a Basic Writing Class.

ERIC Educational Resources Information Center

Otte, George

1989-01-01

Describes how a computerized text analysis program can help students discover error patterns in their writing, and notes how students' responses to analyses can reduce errors and improve their writing. (MM)

Evaluation of the Salt Lake City Computerized Rider Information System

DOT National Transportation Integrated Search

1985-11-01

The Utah Transit Authority (UTA) Computerized Rider Information System (CRIS) project involved the installation of an automated telephone service to quickly provide bus stop-specific schedule and service information to residents throughout the Author...

An overview of Virginia's computerized crash records systems.

DOT National Transportation Integrated Search

1995-01-01

This report identifies the various components of Virginia's computerized crash records systems and explains how these components process crash data. Emphasis has been placed on recording information that was previously not documented. Most of the sta...

Technology in the Assessment of Learning Disability.

ERIC Educational Resources Information Center

Bigler, Erin D.; Lajiness-O'Neill, Renee; Howes, Nancy-Louise

1998-01-01

Reviews recent neuroradiologic and brain imaging techniques in the assessment of learning disability. Technologies reviewed include computerized tomography; magnetic resonance imaging; electrophysiological and metabolic imaging; computerized electroencepholographic studies of evoked potentials, event-related potentials, spectral analysis, and…

Computerization of material test data reporting system : interim report.

DOT National Transportation Integrated Search

1973-09-01

This study was initiated to provide an integrated system of reporting, storing, and retrieving of construction and material test data using computerized (storage-retrieval) and quality control techniques. The findings reported in this interim report ...

Performances on the CogState and standard neuropsychological batteries among HIV patients without dementia.

PubMed

Overton, Edgar Turner; Kauwe, John S K; Paul, Robert; Tashima, Karen; Tate, David F; Patel, Pragna; Carpenter, Charles C J; Patty, David; Brooks, John T; Clifford, David B

2011-11-01

HIV-associated neurocognitive disorders remain prevalent but challenging to diagnose particularly among non-demented individuals. To determine whether a brief computerized battery correlates with formal neurocognitive testing, we identified 46 HIV-infected persons who had undergone both formal neurocognitive testing and a brief computerized battery. Simple detection tests correlated best with formal neuropsychological testing. By multivariable regression model, 53% of the variance in the composite Global Deficit Score was accounted for by elements from the brief computerized tool (P < 0.01). These data confirm previous correlation data with the computerized battery. Using the five significant parameters from the regression model in a Receiver Operating Characteristic curve, 90% of persons were accurately classified as being cognitively impaired or not. The test battery requires additional evaluation, specifically for identifying persons with mild impairment, a state upon which interventions may be effective.

Disclosure of sensitive behaviors across self-administered survey modes: a meta-analysis.

PubMed

Gnambs, Timo; Kaspar, Kai

2015-12-01

In surveys, individuals tend to misreport behaviors that are in contrast to prevalent social norms or regulations. Several design features of the survey procedure have been suggested to counteract this problem; particularly, computerized surveys are supposed to elicit more truthful responding. This assumption was tested in a meta-analysis of survey experiments reporting 460 effect sizes (total N =125,672). Self-reported prevalence rates of several sensitive behaviors for which motivated misreporting has been frequently observed were compared across self-administered paper-and-pencil versus computerized surveys. The results revealed that computerized surveys led to significantly more reporting of socially undesirable behaviors than comparable surveys administered on paper. This effect was strongest for highly sensitive behaviors and surveys administered individually to respondents. Moderator analyses did not identify interviewer effects or benefits of audio-enhanced computer surveys. The meta-analysis highlighted the advantages of computerized survey modes for the assessment of sensitive topics.

Computerization in industry causes problems for people with reading and writing difficulties (dyslexia).

PubMed

Knutsson, A

1986-01-01

For 10 years computerization in industry has advanced at a rapid pace. A problem which has not received attention is that of people with reading and writing difficulties who experience severe problems when they have to communicate with a computer monitor screen. These individuals are often embarrassed by their difficulties and conceal them from their fellow workers. A number of case studies are described which show the form the problems can take. In one case, an employee was compelled to move from department to department as each was computerized in turn. Computers transform a large number of manual tasks in industry into jobs which call for reading and writing skills. Better education at elementary school and at the workplace in connection with computerization are the most important means of overcoming this problem. Moreover, computer programs could be written in a more human way.

Computerized NCLEX-RN and NCLEX-PN preparation programs. Comparative review, 1997.

PubMed

Riner, M E; Mueller, C; Ihrke, B; Smolen, R A; Wilson, M; Richardson, V; Stone, C; Zwirn, E E

1997-01-01

The computerized test taking market continues to expand to meet the needs of nursing students studying to prepare for the NCLEX-RN and the NCLEX-PN. In addition, currently registered nurses may choose to use these software programs to review clinical knowledge in areas in which they are not currently practicing. This article reviewed software designed for personal use, review books with complete disks, on-site institutional testing and consultation, and school of nursing LANs. The costs of software for personal use is priced reasonably and provides flexibility for students to use as their schedule permits. The cost of institutional licenses is moderate and most programs provide multiple on-site use rights. The marketplace has responded to the computerized NCLEX testing now in place nationally. As new formats are developed and new uses identified, nursing faculty and students can expect to see an expanded use of computerized testing.

Computerized Alerts Improve Outpatient Laboratory Monitoring of Transplant Patients

PubMed Central

Staes, Catherine J.; Evans, R. Scott; Rocha, Beatriz H.S.C.; Sorensen, John B.; Huff, Stanley M.; Arata, Joan; Narus, Scott P.

2008-01-01

Authors evaluated the impact of computerized alerts on the quality of outpatient laboratory monitoring for transplant patients. For 356 outpatient liver transplant patients managed at LDS Hospital, Salt Lake City, this observational study compared traditional laboratory result reporting, using faxes and printouts, to computerized alerts implemented in 2004. Study alerts within the electronic health record notified clinicians of new results and overdue new orders for creatinine tests and immunosuppression drug levels. After implementing alerts, completeness of reporting increased from 66 to >99 %, as did positive predictive value that a report included new information (from 46 to >99 %). Timeliness of reporting and clinicians' responses improved after implementing alerts (p <0.001): median times for clinicians to receive and complete actions decreased to 9 hours from 33 hours using the prior traditional reporting system. Computerized alerts led to more efficient, complete, and timely management of laboratory information. PMID:18308982

Meta-cognitive skills training enhances computerized cognitive remediation outcomes among individuals with first-episode psychosis.

PubMed

Breitborde, Nicholas J K; Woolverton, Cindy; Dawson, Spencer C; Bismark, Andrew; Bell, Emily K; Bathgate, Christina J; Norman, Kaila

2017-06-01

Meta-cognitive skills training (MST) is a frequent component of cognitive remediation programmes for individuals with psychosis. However, no study has investigated whether incorporating such activities produces increased clinical benefits compared with computerized cognitive remediation alone. Individuals with first-episode psychosis who completed computerized cognitive remediation with concurrent meta-cognitive skills training (CCR + MST) were compared with a historical control group who received computerized cognitive remediation alone (CCR) and did not differ from the CCR + MST group with regard to pre-intervention cognition, diagnosis, age, duration of psychotic illness or sex. Participants completed assessments of cognition and real-world functioning before and after 6 months of treatment. Individual receiving CCR + MST experience greater gains in cognition and real-world functioning than individuals who received CCR. MST may be an important component within cognitive remediation programmes for first-episode psychosis. © 2015 Wiley Publishing Asia Pty Ltd.

Validity of a Manual Soft Tissue Profile Prediction Method Following Mandibular Setback Osteotomy

PubMed Central

Kolokitha, Olga-Elpis

2007-01-01

Objectives The aim of this study was to determine the validity of a manual cephalometric method used for predicting the post-operative soft tissue profiles of patients who underwent mandibular setback surgery and compare it to a computerized cephalometric prediction method (Dentofacial Planner). Lateral cephalograms of 18 adults with mandibular prognathism taken at the end of pre-surgical orthodontics and approximately one year after surgery were used. Methods To test the validity of the manual method the prediction tracings were compared to the actual post-operative tracings. The Dentofacial Planner software was used to develop the computerized post-surgical prediction tracings. Both manual and computerized prediction printouts were analyzed by using the cephalometric system PORDIOS. Statistical analysis was performed by means of t-test. Results Comparison between manual prediction tracings and the actual post-operative profile showed that the manual method results in more convex soft tissue profiles; the upper lip was found in a more prominent position, upper lip thickness was increased and, the mandible and lower lip were found in a less posterior position than that of the actual profiles. Comparison between computerized and manual prediction methods showed that in the manual method upper lip thickness was increased, the upper lip was found in a more anterior position and the lower anterior facial height was increased as compared to the computerized prediction method. Conclusions Cephalometric simulation of post-operative soft tissue profile following orthodontic-surgical management of mandibular prognathism imposes certain limitations related to the methods implied. However, both manual and computerized prediction methods remain a useful tool for patient communication. PMID:19212468

Validity of a manual soft tissue profile prediction method following mandibular setback osteotomy.

PubMed

Kolokitha, Olga-Elpis

2007-10-01

The aim of this study was to determine the validity of a manual cephalometric method used for predicting the post-operative soft tissue profiles of patients who underwent mandibular setback surgery and compare it to a computerized cephalometric prediction method (Dentofacial Planner). Lateral cephalograms of 18 adults with mandibular prognathism taken at the end of pre-surgical orthodontics and approximately one year after surgery were used. To test the validity of the manual method the prediction tracings were compared to the actual post-operative tracings. The Dentofacial Planner software was used to develop the computerized post-surgical prediction tracings. Both manual and computerized prediction printouts were analyzed by using the cephalometric system PORDIOS. Statistical analysis was performed by means of t-test. Comparison between manual prediction tracings and the actual post-operative profile showed that the manual method results in more convex soft tissue profiles; the upper lip was found in a more prominent position, upper lip thickness was increased and, the mandible and lower lip were found in a less posterior position than that of the actual profiles. Comparison between computerized and manual prediction methods showed that in the manual method upper lip thickness was increased, the upper lip was found in a more anterior position and the lower anterior facial height was increased as compared to the computerized prediction method. Cephalometric simulation of post-operative soft tissue profile following orthodontic-surgical management of mandibular prognathism imposes certain limitations related to the methods implied. However, both manual and computerized prediction methods remain a useful tool for patient communication.

Impact of implementing electronic clinical practice guidelines for the diagnosis, control and treatment of cardiovascular risk factors: A pre-post controlled study.

PubMed

Comin, Eva; Catalan-Ramos, Arantxa; Iglesias-Rodal, Manuel; Grau, Maria; Del Val, Jose Luis; Consola, Alicia; Amado, Ester; Pons, Angels; Mata-Cases, Manel; Franzi, Alicia; Ciurana, Ramon; Frigola, Eva; Cos, Xavier; Davins, Josep; Verdu-Rotellar, Jose M

To evaluate the impact of computerized clinical practice guidelines on the management, diagnosis, treatment, control, and follow-up of the main cardiovascular risk factors: hypertension, hypercholesterolaemia, and type 2 diabetes mellitus. Pre-post controlled study. Catalonia, autonomous community located in north-eastern Spain. Individuals aged 35-74 years assigned to general practitioners of the Catalan Health Institute. The intervention group consisted of individuals whose general practitioners had accessed the computerized clinical practice guidelines at least twice a day, while the control group consisted of individuals whose general practitioner had never accessed the computerized clinical practice guidelines platform. The Chi-squared test was used to detect significant differences in the follow-up, control, and treatment variables for all three disorders (hypertension, hypercholesterolaemia, and type 2 diabetes mellitus) between individuals assigned to users and non-users of the computerized clinical practice guidelines, respectively. A total of 189,067 patients were included in this study, with a mean age of 56 years (standard deviation 12), and 55.5% of whom were women. Significant differences were observed in hypertension management, treatment and control; type 2 diabetes mellitus management, treatment and diagnoses, and the management and control of hypercholesterolaemia in both sexes. Computerized clinical practice guidelines are an effective tool for the control and follow-up of patients diagnosed with hypertension, type 2 diabetes mellitus, and hypercholesterolaemia. The usefulness of computerized clinical practice guidelines to diagnose and adequately treat individuals with these disorders remains unclear. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Outpatient Prescribing Errors and the Impact of Computerized Prescribing

PubMed Central

Gandhi, Tejal K; Weingart, Saul N; Seger, Andrew C; Borus, Joshua; Burdick, Elisabeth; Poon, Eric G; Leape, Lucian L; Bates, David W

2005-01-01

Background Medication errors are common among inpatients and many are preventable with computerized prescribing. Relatively little is known about outpatient prescribing errors or the impact of computerized prescribing in this setting. Objective To assess the rates, types, and severity of outpatient prescribing errors and understand the potential impact of computerized prescribing. Design Prospective cohort study in 4 adult primary care practices in Boston using prescription review, patient survey, and chart review to identify medication errors, potential adverse drug events (ADEs) and preventable ADEs. Participants Outpatients over age 18 who received a prescription from 24 participating physicians. Results We screened 1879 prescriptions from 1202 patients, and completed 661 surveys (response rate 55%). Of the prescriptions, 143 (7.6%; 95% confidence interval (CI) 6.4% to 8.8%) contained a prescribing error. Three errors led to preventable ADEs and 62 (43%; 3% of all prescriptions) had potential for patient injury (potential ADEs); 1 was potentially life-threatening (2%) and 15 were serious (24%). Errors in frequency (n=77, 54%) and dose (n=26, 18%) were common. The rates of medication errors and potential ADEs were not significantly different at basic computerized prescribing sites (4.3% vs 11.0%, P=.31; 2.6% vs 4.0%, P=.16) compared to handwritten sites. Advanced checks (including dose and frequency checking) could have prevented 95% of potential ADEs. Conclusions Prescribing errors occurred in 7.6% of outpatient prescriptions and many could have harmed patients. Basic computerized prescribing systems may not be adequate to reduce errors. More advanced systems with dose and frequency checking are likely needed to prevent potentially harmful errors. PMID:16117752

Foot and Ankle Kinematics and Dynamic Electromyography: Quantitative Analysis of Recovery From Peroneal Neuropathy in a Professional Football Player.

PubMed

Prasad, Nikhil K; Coleman Wood, Krista A; Spinner, Robert J; Kaufman, Kenton R

The assessment of neuromuscular recovery after peripheral nerve surgery has typically been a subjective physical examination. The purpose of this report was to assess the value of gait analysis in documenting recovery quantitatively. A professional football player underwent gait analysis before and after surgery for a peroneal intraneural ganglion cyst causing a left-sided foot drop. Surface electromyography (SEMG) recording from surface electrodes and motion parameter acquisition from a computerized motion capture system consisting of 10 infrared cameras were performed simultaneously. A comparison between SEMG recordings before and after surgery showed a progression from disorganized activation in the left tibialis anterior and peroneus longus muscles to temporally appropriate activation for the phase of the gait cycle. Kinematic analysis of ankle motion planes showed resolution from a complete foot drop preoperatively to phase-appropriate dorsiflexion postoperatively. Gait analysis with dynamic SEMG and motion capture complements physical examination when assessing postoperative recovery in athletes.

Usefulness of a centralized system of data collection for the development of an international multicentre registry of spondyloarthritis

PubMed Central

Schiotis, Ruxandra; Font, Pilar; Zarco, Pedro; Almodovar, Raquel; Gratacós, Jordi; Mulero, Juan; Juanola, Xavier; Montilla, Carlos; Moreno, Estefanía; Ariza Ariza, Rafael; Collantes-Estevez, Eduardo

2011-01-01

Objective. To present the usefulness of a centralized system of data collection for the development of an international multicentre registry of SpA. Method. The originality of this registry consists in the creation of a virtual network of researchers in a computerized Internet database. From its conception, the registry was meant to be a dynamic acquiring system. Results. REGISPONSER has two developing phases (Conception and Universalization) and gathers several evolving secondary projects (REGISPONSER-EARLY, REGISPONSER-AS, ESPERANZA and RESPONDIA). Each sub-project answered the necessity of having more specific and complete data of the patients even from the onset of the disease so, in the end, obtaining a well-defined picture of SpAs spectrum in the Spanish population. Conclusion. REGISPONSER is the first dynamic SpA database composed of cohorts with a significant number of patients distributed by specific diagnosis, which provides basic specific information of the sub-cohorts useful for patients’ evaluation in rheumatology ambulatory consulting. PMID:20823095

Computerized parts list system coordinates engineering releases, parts control, and manufacturing planning

NASA Technical Reports Server (NTRS)

Horton, W.; Kinsey, M.

1967-01-01

Computerized parts list system compiles and summarize all pertinent and available information on complex new systems. The parts list system consists of three computer subroutines - list of parts, parts numerical sequence list, and specifications list.

45 CFR 307.0 - Scope of this part.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) The requirement for computerized support enforcement systems; (b) The functional requirements that a statewide computerized support enforcement system must meet; (c) Security and confidentiality requirements... to approving an advance planning document (APD); (e) The requirements and procedures for the...

The Computerized Reference Department: Buying the Future.

ERIC Educational Resources Information Center

Kriz, Harry M.; Kok, Victoria T.

1985-01-01

Basis for systematic computerization of academic research library's reference, collection development, and collection management functions emphasizes productivity enhancement for librarians and support staff. Use of microcomputer and university's mainframe computer to develop applications of database management systems, electronic spreadsheets,…

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Disbursements made and reimbursements received for the cost of transportation, ground services and facilities...'s software capabilities, such as user guides, technical manuals, formats, layouts and other... software and the computerized information prepared or maintained by the committee. ...

Comparing the Cognitive Process of Circular Causality in Two Patients with Strokes through Qualitative Analysis.

PubMed

Derakhshanrad, Seyed Alireza; Piven, Emily; Ghoochani, Bahareh Zeynalzadeh

2017-10-01

Walter J. Freeman pioneered the neurodynamic model of brain activity when he described the brain dynamics for cognitive information transfer as the process of circular causality at intention, meaning, and perception (IMP) levels. This view contributed substantially to establishment of the Intention, Meaning, and Perception Model of Neuro-occupation in occupational therapy. As described by the model, IMP levels are three components of the brain dynamics system, with nonlinear connections that enable cognitive function to be processed in a circular causality fashion, known as Cognitive Process of Circular Causality (CPCC). Although considerable research has been devoted to study the brain dynamics by sophisticated computerized imaging techniques, less attention has been paid to study it through investigating the adaptation process of thoughts and behaviors. To explore how CPCC manifested thinking and behavioral patterns, a qualitative case study was conducted on two matched female participants with strokes, who were of comparable ages, affected sides, and other characteristics, except for their resilience and motivational behaviors. CPCC was compared by matrix analysis between two participants, using content analysis with pre-determined categories. Different patterns of thinking and behavior may have happened, due to disparate regulation of CPCC between two participants.

Effect of Sustained Human Centrifugation on Autonomic Cardiovascular and Vestibular Function

NASA Technical Reports Server (NTRS)

Schlegel, Todd T.; Wood, Scott J.; Brown, Troy E.; Benavides, Edgar W.; Harm, Deborah L.; Rupert, A. H.

2002-01-01

Repeated exposure to +Gz enhances human baroreflex responsiveness and improves tolerance to cardiovascular stress. However, both sustained exposure to +Gx and changes in otolith function resulting from the gravitational changes of space flight and parabolic flight may adversely affect autonomic cardiovascular function and orthostatic tolerance. HYPOTHESES: Baroreflex function and orthostatic tolerance are acutely improved by a single sustained (30 min) exposure to +3Gz but not +3Gx. Moreover, after 30 min of +3Gx, any changes that occur in autonomic cardiovascular function will relate commensurately to changes in otolith function. METHODS: Twenty-two healthy human subjects were first exposed to 5 min of +3 Gz centrifugation and then subsequently up to a total of30 min of either +3Gz (n = 15) or +3Gx (n = 7) centrifugation. Tests of autonomic cardiovascular function both before and after both types of centrifugation included: (a) power spectral determinations of beat-to-beat R-R intervals and arterial pressures; (b) carotid-cardiac baroreflex tests; ( c) Valsalva tests; and (d) 30-min head-up tilt (HUT) tests. Otolith function was assessed during centrifugation by the linear vestibulo-ocular reflex and both before and after centrifugation by measurements of ocular counter-rolling and dynamic posturography. RESULTS: All four +3Gz subjects who were intolerant to HUT before centrifugation became tolerant to HUT after centrifugation. The operational point of the carotid-cardiac baroreflex and the Valsalva-related baroreflex were also enhanced in the +3Gz group but not in the +3Gx group. No significant vestibular-autonomic relationships were detected, other than a significant vestibular-cerebrovascular interaction reported previously. CONCLUSIONS: A single, sustained exposure to +3 Gz centrifugation acutely improves baroreflex function and orthostatic tolerance whereas a similar exposure to +3 Gx centrifugation appears to have less effect.

Documentation of validity for the AT-SAT computerized test battery. Volume 2

DOT National Transportation Integrated Search

2001-03-01

This document is a comprehensive report on a large-scale research project to develop and validate a : computerized selection battery to hire Air Traffic Control Specialists (ATCSs) for the Federal Aviation : Administration (FAA). The purpose of this ...

Documentation of validity for the AT-SAT computerized test battery. Volume 1

DOT National Transportation Integrated Search

2001-03-01

This document is a comprehensive report on a large-scale research project to develop and validate a : computerized selection battery to hire Air Traffic Control Specialists (ATCSs) for the Federal Aviation : Administration (FAA). The purpose of this ...

Computerized Budget Monitoring.

ERIC Educational Resources Information Center

Stein, Julian U.; Rowe, Joe N.

1989-01-01

This article discusses the importance of budget monitoring in fiscal management; describes ways in which computerized budget monitoring increases accuracy, efficiency, and flexibility; outlines steps in the budget process; and presents sample reports, generated using the Lotus 1-2-3 spreadsheet and graphics program. (IAH)

Enhancing GDOT's Computerized Pavement Condition Evaluation System for Pavement Condition Survey

DOT National Transportation Integrated Search

2017-09-01

The Computerized Pavement Condition Evaluation System (COPACES) is a software tool that has been used by the Georgia Department of Transportation (GDOT) for its statewide pavement condition survey since the late 1990s. The previous version was releas...

Some performance effects of age and low blood alcohol levels on a computerized neuropsychological test.

DOT National Transportation Integrated Search

1995-02-01

COGSCREEN is a computerized test battery developed for the Federal Aviation Administration as an airman neuropsychological screening instrument for cognitive functioning. This study explored a multifaceted application of the sensitivity of the batter...

Computerized Cognition Laboratory.

ERIC Educational Resources Information Center

Motes, Michael A.; Wiegmann, Douglas A.

1999-01-01

Describes a software package entitled the "Computerized Cognition Laboratory" that helps integrate the teaching of cognitive psychology and research methods. Allows students to explore short-term memory, long-term memory, and decision making. Can also be used to teach the application of several statistical procedures. (DSK)

Nursing informatics: the trend of the future.

PubMed

Nagelkerk, J; Ritola, P M; Vandort, P J

1998-01-01

Nursing informatics is a combination of computer, information, and nursing sciences. This new and expanding field addresses the efficient and effective use of information for nurses. Preparing nurses for computerization is essential to confront an explosion of sophisticated computerized technology in the workplace. It is critical in a competitive health care market for preparing nurses to use the most cost-effective methods. A model is presented that identifies six essential factors for preparing nurses for computerization. Strong leadership, effective communication, organized training sessions, established time frames, planned change, and tailored software are the essential factors to consider for development of a successful educational program.

An analysis of computerization in primary care practices.

PubMed

Condon, James V; Smith, Sherry P

2002-12-01

To remain profitable, primary care practices, the front-line health care providers, must provide excellent patient care and reduce expenses while providing payers with accurate data. Many primary care practices have turned to computer technology to achieve these goals. This study examined the degree of computerization of primary care providers in the Augusta, Georgia, metropolitan area as well as the level of awareness of the Health Insurance Portability and Accountability Act (HIPAA) by primary care providers and its potential effect on their future computerization plans. The study's findings are presented and discussed as well as a number of recommendations for practice managers.

THE VALIDITY OF HUMAN AND COMPUTERIZED WRITING ASSESSMENT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald L. Boring

2005-09-01

This paper summarizes an experiment designed to assess the validity of essay grading between holistic and analytic human graders and a computerized grader based on latent semantic analysis. The validity of the grade was gauged by the extent to which the student’s knowledge of the topic correlated with the grader’s expert knowledge. To assess knowledge, Pathfinder networks were generated by the student essay writers, the holistic and analytic graders, and the computerized grader. It was found that the computer generated grades more closely matched the definition of valid grading than did human generated grades.

Computerization of the standard corsi block-tapping task affects its underlying cognitive concepts: a pilot study.

PubMed

Claessen, Michiel H G; van der Ham, Ineke J M; van Zandvoort, Martine J E

2015-01-01

The tablet computer initiates an important step toward computerized administration of neuropsychological tests. Because of its lack of standardization, the Corsi Block-Tapping Task could benefit from advantages inherent to computerization. This task, which requires reproduction of a sequence of movements by tapping blocks as demonstrated by an examiner, is widely used as a representative of visuospatial attention and working memory. The aim was to validate a computerized version of the Corsi Task (e-Corsi) by comparing recall accuracy to that on the standard task. Forty university students (Mage = 22.9 years, SD = 2.7 years; 20 female) performed the standard Corsi Task and the e-Corsi on an iPad 3. Results showed higher accuracy in forward reproduction on the standard Corsi compared with the e-Corsi, whereas backward performance was comparable. These divergent performance patterns on the 2 versions (small-to-medium effect sizes) are explained as a result of motor priming and interference effects. This finding implies that computerization has serious consequences for the cognitive concepts that the Corsi Task is assumed to assess. Hence, whereas the e-Corsi was shown to be useful with respect to administration and registration, these findings also stress the need for reconsideration of the underlying theoretical concepts of this task.

The Relationship Between Computer Experience and Computerized Cognitive Test Performance Among Older Adults

PubMed Central

2013-01-01

Objective. This study compared the relationship between computer experience and performance on computerized cognitive tests and a traditional paper-and-pencil cognitive test in a sample of older adults (N = 634). Method. Participants completed computer experience and computer attitudes questionnaires, three computerized cognitive tests (Useful Field of View (UFOV) Test, Road Sign Test, and Stroop task) and a paper-and-pencil cognitive measure (Trail Making Test). Multivariate analysis of covariance was used to examine differences in cognitive performance across the four measures between those with and without computer experience after adjusting for confounding variables. Results. Although computer experience had a significant main effect across all cognitive measures, the effect sizes were similar. After controlling for computer attitudes, the relationship between computer experience and UFOV was fully attenuated. Discussion. Findings suggest that computer experience is not uniquely related to performance on computerized cognitive measures compared with paper-and-pencil measures. Because the relationship between computer experience and UFOV was fully attenuated by computer attitudes, this may imply that motivational factors are more influential to UFOV performance than computer experience. Our findings support the hypothesis that computer use is related to cognitive performance, and this relationship is not stronger for computerized cognitive measures. Implications and directions for future research are provided. PMID:22929395

Reading Comprehension: A Computerized Intervention with Primary-age Poor Readers.

PubMed

Horne, Joanna Kathryn

2017-05-01

The current study investigates the effectiveness of a computerized reading comprehension programme on the reading accuracy, reading comprehension and reading rate of primary-age poor readers. There is little published literature relating to computerized reading interventions in UK primary schools, and no previous studies have investigated the Comprehension Booster programme. Thirty-eight children (26 boys and 12 girls; aged 6:7 to 11:0) from two schools in East Yorkshire, UK, took part. Half of the participants (the intervention group) undertook the Comprehension Booster programme for a 6-week period, whilst the other half (the control group) continued with their usual teaching. Significant effects of the intervention were found, with increases in reading accuracy and reading comprehension for the intervention group. It is concluded that computerized reading programmes can be effective in improving reading skills, and these are particularly useful for pupils with reading difficulties in disadvantaged areas, where resources are limited and family support in reading is lower. However, such programmes are not a replacement for good teaching, and regular monitoring of children with reading difficulties is required. Further research is necessary to compare the programme used here to other conventional and computerized intervention programmes, using a larger sample. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

The effect of sleep deprivation on vocal expression of emotion in adolescents and adults.

PubMed

McGlinchey, Eleanor L; Talbot, Lisa S; Chang, Keng-Hao; Kaplan, Katherine A; Dahl, Ronald E; Harvey, Allison G

2011-09-01

Investigate the impact of sleep deprivation on vocal expression of emotion. Within-group repeated measures analysis involving sleep deprivation and rested conditions. Experimental laboratory setting. Fifty-five healthy participants (24 females), including 38 adolescents aged 11-15 y and 17 adults aged 30-60 y. A multimethod approach was used to examine vocal expression of emotion in interviews conducted at 22:30 and 06:30. On that night, participants slept a maximum of 2 h. Interviews were analyzed for vocal expression of emotion via computerized text analysis, human rater judgments, and computerized acoustic properties. Computerized text analysis and human rater judgments indicated decreases in positive emotion in all participants at 06:30 relative to 22:30, and adolescents displayed a significantly greater decrease in positive emotion via computerized text analysis relative to adults. Increases in negative emotion were observed among all participants using human rater judgments. Results for the computerized acoustic properties indicated decreases in pitch, bark energy (intensity) in certain high frequency bands, and vocal sharpness (reduction in high frequency bands > 1000 Hz). These findings support the importance of sleep for healthy emotional functioning in adults, and further suggest that adolescents are differentially vulnerable to the emotional consequences of sleep deprivation.

A comparison of computer-assisted and manual wound size measurement.

PubMed

Thawer, Habiba A; Houghton, Pamela E; Woodbury, M Gail; Keast, David; Campbell, Karen

2002-10-01

Accurate and precise wound measurements are a critical component of every wound assessment. To examine the reliability and validity of a new computerized technique for measuring human and animal wounds, chronic human wounds (N = 45) and surgical animal wounds (N = 38) were assessed using manual and computerized techniques. Using intraclass correlation coefficients, intrarater and interrater reliability of surface area measurements obtained using the computerized technique were compared to those obtained using acetate tracings and planimetry. A single measurement of surface area using either technique produced excellent intrarater and interrater reliability for both human and animal wounds, but the computerized technique was more precise than the manual technique for measuring the surface area of animal wounds. For both types of wounds and measurement techniques, intrarater and interrater reliability improved when the average of three repeated measurements was obtained. The precision of each technique with human wounds and the precision of the manual technique with animal wounds also improved when three repeated measurement results were averaged. Concurrent validity between the two techniques was excellent for human wounds but poor for the smaller animal wounds, regardless of whether single or the average of three repeated surface area measurements was used. The computerized technique permits reliable and valid assessment of the surface area of both human and animal wounds.

In person versus Computer Screening for Intimate Partner Violence Among Pregnant Patients

PubMed Central

Dado, Diane; Schussler, Sara; Hawker, Lynn; Holland, Cynthia L.; Burke, Jessica G.; Cluss, Patricia A.

2012-01-01

Objective To compare in person versus computerized screening for intimate partner violence (IPV) in a hospital-based prenatal clinic and explore women’s assessment of the screening methods. Methods We compared patient IPV disclosures on a computerized questionnaire to audio-taped first obstetric visits with an obstetric care provider and performed semi-structured interviews with patient participants who reported experiencing IPV. Results Two-hundred and fifty patient participants and 52 provider participants were in the study. Ninety-one (36%) patients disclosed IPV either via computer or in person. Of those who disclosed IPV, 60 (66%) disclosed via both methods, but 31 (34%) disclosed IPV via only one of the two methods. Twenty-three women returned for interviews. They recommended using both types together. While computerized screening was felt to be non-judgmental and more anonymous, in person screening allowed for tailored questioning and more emotional connection with the provider. Conclusion Computerized screening allowed disclosure without fear of immediate judgment. In person screening allows more flexibility in wording of questions regarding IPV and opportunity for interpersonal rapport. Practice Implications Both computerized or self-completed screening and in person screening is recommended. Providers should address IPV using non-judgmental, descriptive language, include assessments for psychological IPV, and repeat screening in person, even if no patient disclosure occurs via computer. PMID:22770815

In person versus computer screening for intimate partner violence among pregnant patients.

PubMed

Chang, Judy C; Dado, Diane; Schussler, Sara; Hawker, Lynn; Holland, Cynthia L; Burke, Jessica G; Cluss, Patricia A

2012-09-01

To compare in person versus computerized screening for intimate partner violence (IPV) in a hospital-based prenatal clinic and explore women's assessment of the screening methods. We compared patient IPV disclosures on a computerized questionnaire to audio-taped first obstetric visits with an obstetric care provider and performed semi-structured interviews with patient participants who reported experiencing IPV. Two-hundred and fifty patient participants and 52 provider participants were in the study. Ninety-one (36%) patients disclosed IPV either via computer or in person. Of those who disclosed IPV, 60 (66%) disclosed via both methods, but 31 (34%) disclosed IPV via only one of the two methods. Twenty-three women returned for interviews. They recommended using both types together. While computerized screening was felt to be non-judgmental and more anonymous, in person screening allowed for tailored questioning and more emotional connection with the provider. Computerized screening allowed disclosure without fear of immediate judgment. In person screening allows more flexibility in wording of questions regarding IPV and opportunity for interpersonal rapport. Both computerized or self-completed screening and in person screening is recommended. Providers should address IPV using non-judgmental, descriptive language, include assessments for psychological IPV, and repeat screening in person, even if no patient disclosure occurs via computer. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Computerized Adaptive Testing: From Inquiry to Operation [Book Review].

ERIC Educational Resources Information Center

Gierl, Mark J.

1998-01-01

This book documents the research, development, and implementation efforts that allowed the U.S. Department of Defense to initiate the Computerized Adaptive Testing Armed Services Vocational Aptitude Battery Program for enlistment testing. Traces the history of this program over 30 years. (SLD)

Applications of satellite snow cover in computerized short-term streamflow forecasting. [Conejos River, Colorado

NASA Technical Reports Server (NTRS)

Leaf, C. F.

1975-01-01

A procedure is described whereby the correlation between: (1) satellite derived snow-cover depletion and (2) residual snowpack water equivalent, can be used to update computerized residual flow forecasts for the Conejos River in southern Colorado.

Computerized Drug Information Services

ERIC Educational Resources Information Center

And Others; Smith, Daniel R.

1972-01-01

To compare computerized services in chemistry, pharmacology, toxicology, and clinical medicine of pharmaceutical interest, equivalent profiles were run on magnetic tape files of CA-Condensates," CBAC," Excerpta Medica," MEDLARS" and Ringdoc." The results are tabulated for overlap of services, relative speed of citing references, and unique…

Computerized Fleet Maintenance.

ERIC Educational Resources Information Center

Cataldo, John J.

The computerization of school bus maintenance records by the Niskayuna (New York) Central School District enabled the district's transportation department to engage in management practices resulting in significant savings. The district obtains computer analyses of the work performed on all vehicles, including time spent, parts, labor, costs,…

Computerizing Maintenance Management Improves School Processes.

ERIC Educational Resources Information Center

Conroy, Pat

2002-01-01

Describes how a Computerized Maintenance Management System (CMMS), a centralized maintenance operations database that facilitates work order procedures and staff directives, can help individual school campuses and school districts to manage maintenance. Presents the benefits of CMMS and things to consider in CMMS selection. (EV)

Sustaining Indigenous Languages in Cyberspace.

ERIC Educational Resources Information Center

Cazden, Courtney B.

This paper describes how certain types of electronic technologies, specifically CD-ROMs, computerized databases, and telecommunications networks, are being incorporated into language and culture revitalization projects in Alaska and around the Pacific. The paper presents two examples of CD-ROMs and computerized databases from Alaska, describing…

Validation of a computerized algorithm to quantify fetal heart rate deceleration area.

PubMed

Gyllencreutz, Erika; Lu, Ke; Lindecrantz, Kaj; Lindqvist, Pelle G; Nordstrom, Lennart; Holzmann, Malin; Abtahi, Farhad

2018-05-16

Reliability in visual cardiotocography interpretation is unsatisfying, which has led to development of computerized cardiotocography. Computerized analysis is well established for antenatal fetal surveillance, but has yet not performed sufficiently during labor. We aimed to investigate the capacity of a new computerized algorithm compared to visual assessment in identifying intrapartum fetal heart rate baseline and decelerations. Three-hundred-and-twelve intrapartum cardiotocography tracings with variable decelerations were analysed by the computerized algorithm and visually examined by two observers, blinded to each other and the computer analysis. The width, depth and area of each deceleration was measured. Four cases (>100 variable decelerations) were subject to in-depth detailed analysis. The outcome measures were bias in seconds (width), beats per minute (depth), and beats (area) between computer and observers by using Bland-Altman analysis. Interobserver reliability was determined by calculating intraclass correlation and Spearman rank analysis. The analysis (312 cases) showed excellent intraclass correlation (0.89-0.95) and very strong Spearman correlation (0.82-0.91). The detailed analysis of > 100 decelerations in 4 cases revealed low bias between the computer and the two observers; width 1.4 and 1.4 seconds, depth 5.1 and 0.7 beats per minute, and area 0.1 and -1.7 beats. This was comparable to the bias between the two observers; 0.3 seconds (width), 4.4 beats per minute (depth), and 1.7 beats (area). The intraclass correlation was excellent (0.90-0.98). A novel computerized algorithm for intrapartum cardiotocography analysis is as accurate as gold standard visual assessment with high correlation and low bias. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review.

PubMed

Patel, Minal R; Vichich, Jennifer; Lang, Ian; Lin, Jessica; Zheng, Kai

2017-04-01

The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill "best" behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Reliability, validity and sensitivity of a computerized visual analog scale measuring state anxiety.

PubMed

Abend, Rany; Dan, Orrie; Maoz, Keren; Raz, Sivan; Bar-Haim, Yair

2014-12-01

Assessment of state anxiety is frequently required in clinical and research settings, but its measurement using standard multi-item inventories entails practical challenges. Such inventories are increasingly complemented by paper-and-pencil, single-item visual analog scales measuring state anxiety (VAS-A), which allow rapid assessment of current anxiety states. Computerized versions of VAS-A offer additional advantages, including facilitated and accurate data collection and analysis, and applicability to computer-based protocols. Here, we establish the psychometric properties of a computerized VAS-A. Experiment 1 assessed the reliability, convergent validity, and discriminant validity of the computerized VAS-A in a non-selected sample. Experiment 2 assessed its sensitivity to increase in state anxiety following social stress induction, in participants with high levels of social anxiety. Experiment 1 demonstrated the computerized VAS-A's test-retest reliability (r = .44, p < .001); convergent validity with the State-Trait Anxiety Inventory's state subscale (STAI-State; r = .60, p < .001); and discriminant validity as indicated by significantly lower correlations between VAS-A and different psychological measures relative to the correlation between VAS-A and STAI-State. Experiment 2 demonstrated the VAS-A's sensitivity to changes in state anxiety via a significant pre- to during-stressor rise in VAS-A scores (F(1,48) = 25.13, p < .001). Set-order administration of measures, absence of clinically-anxious population, and gender-unbalanced samples. The adequate psychometric characteristics, combined with simple and rapid administration, make the computerized VAS-A a valuable self-rating tool for state anxiety. It may prove particularly useful for clinical and research settings where multi-item inventories are less applicable, including computer-based treatment and assessment protocols. The VAS-A is freely available: http://people.socsci.tau.ac.il/mu/anxietytrauma/visual-analog-scale/. Copyright © 2014 Elsevier Ltd. All rights reserved.

A new color vision test to differentiate congenital and acquired color vision defects.

PubMed

Shin, Young Joo; Park, Kyu Hyung; Hwang, Jeong-Min; Wee, Won Ryang; Lee, Jin Hak

2007-07-01

To investigate the efficacy of a novel computer-controlled color test for the differentiation of congenital and acquired color vision deficiency. Observational cross-sectional study. Thirty-one patients with congenital color vision deficiency and 134 patients with acquired color vision deficiency with a Snellen visual acuity better than 20/30 underwent an ophthalmologic examination including the Ishihara color test, Hardy-Rand-Rittler test, Nagel anomaloscopy, and the Seohan computerized hue test between June, 2003, and January, 2004. To investigate the type of color vision defect, a graph of the Seohan computerized hue test was divided into 4 quadrants and error scores in each quadrant were summated. The ratio between the sums of error scores of quadrants I and III (Q1+Q3) and those of quadrants II and IV (Q2+Q4) was calculated. Error scores and ratio in quadrant analysis of the Seohan computerized hue test. The Seohan computerized hue test showed that the sum of Q2+Q4 was significantly higher than the sum of Q1+Q3 in congenital color vision deficiency (P<0.01, paired t test) and that the sum of Q2+Q4 was significantly lower than the sum of Q1+Q3 in acquired color vision deficiency (P<0.01, paired t test). In terms of discriminating congenital and acquired color vision deficiency, the ratio in quadrant analysis had 93.3% sensitivity and 98.5% specificity with a reference value of 1.5 by the Seohan computerized hue test (95% confidence interval). The quadrant analysis and ratio of (Q2+Q4)/(Q1+Q3) using the Seohan computerized hue test effectively differentiated congenital and acquired color vision deficiency.

The effectiveness of computerized drug-lab alerts: a systematic review and meta-analysis.

PubMed

Bayoumi, Imaan; Al Balas, Mosab; Handler, Steven M; Dolovich, Lisa; Hutchison, Brian; Holbrook, Anne

2014-06-01

Inadequate lab monitoring of drugs is a potential cause of ADEs (adverse drug events) which is remediable. To determine the effectiveness of computerized drug-lab alerts to improve medication-related outcomes. Citations from the Computerized Clinical Decision Support System Systematic Review (CCDSSR) and MMIT (Medications Management through Health Information Technology) databases, which had searched MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts from 1974 to March 27, 2013. Randomized controlled trials (RCTs) of clinician-targeted computerized drug lab alerts conducted in any healthcare setting. Two reviewers performed full text review to determine study eligibility. A single reviewer abstracted data and evaluated validity of included studies using Cochrane handbook domains. Thirty-six studies met the inclusion criteria (25 single drug studies with 22,504 participants, 14 targeting anticoagulation; 11 multi-drug studies with 56,769 participants). ADEs were reported as an outcome in only four trials, all targeting anticoagulants. Computerized drug-lab alerts did not reduce ADEs (OR 0.89, 95% CI 0.79-1.00, p=0.05), length of hospital stay (SMD 0.00, 95%CI -0.93 to 0.93, p=0.055, 1 study), likelihood of hypoglycemia (OR 1.29, 95% CI 0.31-5.37) or likelihood of bleeding, but were associated with increased likelihood of prescribing changes (OR 1.73, 95% CI 1.21-2.47) or lab monitoring (OR 1.47, 95% confidence interval 1.12-1.94) in accordance with the alert. There is no evidence that computerized drug-lab alerts are associated with important clinical benefits, but there is evidence of improvement in selected clinical surrogate outcomes (time in therapeutic range for vitamin K antagonists), and changes in process outcomes (lab monitoring and prescribing decisions). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Computerized symptom and quality-of-life assessment for patients with cancer part II: acceptability and usability.

PubMed

Mullen, Kristin H; Berry, Donna L; Zierler, Brenda K

2004-09-01

To determine the acceptability and usability of a computerized quality-of-life (QOL) and symptom assessment tool and the graphically displayed QOL and symptom output in an ambulatory radiation oncology clinic. Descriptive, cross-sectional. Radiation oncology clinic located in an urban university medical center. 45 patients with cancer being evaluated for radiation therapy and 10 clinicians, who submitted 12 surveys. Acceptability of the computerized assessment was measured with an online, 16-item, Likert-style survey delivered as 45 patients undergoing radiation therapy completed a 25-item QOL and symptom assessment. Usability of the graphic output was assessed with clinician completion of a four-item paper survey. Acceptability and usability of computerized patient assessment. The patient acceptability survey indicated that 70% (n = 28) liked computers and 10% (n = 4) did not. The program was easy to use for 79% (n = 26), easy to understand for 91% (n = 30), and enjoyable for 71% (n = 24). Seventy-six percent (n = 25) believed that the amount of time needed to complete the computerized survey was acceptable. Sixty-six percent (n = 21) responded that they were satisfied with the program, and none of the participants chose the very dissatisfied response. Eighty-three percent (n = 10) of the clinicians found the graphic output helpful in promoting communication with patients, 75% (n = 9) found the output report helpful in identifying appropriate areas of QOL deficits or concerns, and 83% (n = 10) indicated that the output helped guide clinical interactions with patients. The computer-based QOL and symptom assessment tool is acceptable to patients, and the graphically displayed QOL and symptom output is useful to radiation oncology nurses and physicians. Wider application of computerized patient-generated data can continue in various cancer settings and be tested for clinical and organizational outcomes.

COMPUTERIZED SHAWNEE LIME/LIMESTONE SCRUBBING MODEL USERS MANUAL

EPA Science Inventory

The manual gives a general description of a computerized model for estimating design and cost of lime or limestone scrubber systems for flue gas desulfurization (FGD). It supplements PB80-123037 by extending the number of scrubber options which can be evaluated. It includes spray...

SHAWNEE LIME/LIMESTONE SCRUBBING COMPUTERIZED DESIGN/COST-ESTIMATE MODEL USERS MANUAL

EPA Science Inventory

The manual gives a general description of the Shawnee lime/limestone scrubbing computerized design/cost-estimate model and detailed procedures for using it. It describes all inputs and outputs, along with available options. The model, based on Shawnee Test Facility scrubbing data...

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2014 CFR

2014-04-01

... monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Computerized Labor Monitoring System. 884.2800... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Monitoring...

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2012 CFR

2012-04-01

... monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Computerized Labor Monitoring System. 884.2800... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Monitoring...

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2013 CFR

2013-04-01

... monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Computerized Labor Monitoring System. 884.2800... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Monitoring...

Using Computerized Clinical Nursing Data Bases for Nursing Research.

ERIC Educational Resources Information Center

Nail, Lillian M.; Lange, Linda L.

1996-01-01

Addresses the recognition of differences between clinical and research data in using computerized clinical nursing databases and the issues of privacy and confidentiality for patients whose records are involved. Describes procedures for assessing the quality and usability of these data for nursing research. (SK)

40 CFR 51.358 - Test equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Test equipment. 51.358 Section 51.358....358 Test equipment. Computerized emission test systems are required for performing an official emissions test on subject vehicles. (a) Performance features of computerized emission test systems. The...

COMPUTERIZED FGD BYPRODUCT PRODUCTION AND MARKETING SYSTEM: USERS MANUAL

EPA Science Inventory

The users manual describes a computerized system--consisting of a number of integrated programs, models, and data bases--that has been developed to compare the costs of power plant strategies designed to meet clean air regulations. It describes the data bases, programs, and proce...

Procedures for Selecting Items for Computerized Adaptive Tests.

ERIC Educational Resources Information Center

Kingsbury, G. Gage; Zara, Anthony R.

1989-01-01

Several classical approaches and alternative approaches to item selection for computerized adaptive testing (CAT) are reviewed and compared. The study also describes procedures for constrained CAT that may be added to classical item selection approaches to allow them to be used for applied testing. (TJH)

COMP (Computerized Operational Materials Prescription).

ERIC Educational Resources Information Center

Rosenkranz, Catherine I.

Described is Project COMP (Computerized Operational Materials Prescription), an individualized reading instructional program for educable mentally retarded (EMR) children in regular or special classes. The program is designed to correlate with the Wisconsin Design for Reading (WDR) and to utilize a diagnostic teaching specialist who uses specific…

Termination Criteria for Computerized Classification Testing

ERIC Educational Resources Information Center

Thompson, Nathan A.

2011-01-01

Computerized classification testing (CCT) is an approach to designing tests with intelligent algorithms, similar to adaptive testing, but specifically designed for the purpose of classifying examinees into categories such as "pass" and "fail." Like adaptive testing for point estimation of ability, the key component is the…

Total Library Computerization for Windows.

ERIC Educational Resources Information Center

Combs, Joseph, Jr.

1999-01-01

Presents a general review of features of version 2.1 of Total Library Computerization (TLC) for Windows from On Point, Inc. Includes information about pricing, hardware and operating systems, modules/functions available, user interface, security, on-line catalog functions, circulation, cataloging, and documentation and online help. A table…