Publications by authors named "Daniel J Goble"

47 Publications

Test-Retest Reliability of the Balance Tracking System Modified Clinical Test of Sensory Integration and Balance Protocol Across Multiple Time Durations.

Med Devices (Auckl) 2021 15;14:355-361. Epub 2021 Nov 15.

Department of Kinesiology, Taylor University, Upland, IN, 46989, USA.

Background: Postural control is critical for body sway control and is subserved by three sources of sensory feedback (ie, vision, proprioception and vestibulation). A method for determining the relative contribution of each sensory feedback source to postural control is the modified clinical test of sensory integration and balance for the balance tracking system (BTrackS). However, this method has not yet been evaluated for test-retest reliability.

Purpose: To determine the test-retest reliability of the modified clinical test of sensory integration and balance protocol for the BTrackS across multiple time intervals.

Methods: Three groups of healthy young adults performed the BTrackS modified clinical test of sensory integration and balance protocol four times separated by either one day, one week or one month. Within each time duration group, and condition, differences in total center of pressure path length were determined from one test session to the next and intra class correlation coefficient categorizations were made.

Results: In all but one case, no significant difference in performance was seen from one testing session to the next. The one significant difference found was a decrease in total center of pressure path length from day 1 to day 2 in the vestibular condition of the group tested daily. Intra class correlation coefficient results largely indicated fair-good reliability across time durations and test conditions.

Conclusion: The present study largely supports use of the BTrackS modified clinical test of sensory integration and balance protocol as a means of probing the sensory contributions to balance performance across multiple time durations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/MDER.S339187DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604651PMC
November 2021

Safety, tolerability, pharmacokinetics, and pharmacodynamics of low dose lysergic acid diethylamide (LSD) in healthy older volunteers.

Psychopharmacology (Berl) 2020 Mar 18;237(3):841-853. Epub 2019 Dec 18.

Eleusis Benefit Corporation, New York, NY, USA.

Research has shown that psychedelics, such as lysergic acid diethylamide (LSD), have profound anti-inflammatory properties mediated by 5-HT receptor signaling, supporting their evaluation as a therapeutic for neuroinflammation associated with neurodegenerative disease.

Objective: This study evaluated the safety, tolerability, pharmacokinetics, and pharmacodynamics of orally repeated administration of 5 μg, 10 μg, and 20 μg LSD in older healthy individuals. In the current paper, we present safety, tolerability, pharmacokinetics, and pharmacodynamic measures that relate to safety, tolerability, and dose response.

Methods: This was a phase 1 double-blind, placebo-controlled, randomized study. Volunteers were randomly assigned to 1 of 4 dose groups (5 μg, 10 μg, 20 μg LSD, and placebo), and received their assigned dose on six occasions (i.e., every 4 days).

Results: Forty-eight older healthy volunteers (mean age = 62.9 years) received placebo (n = 12), 5 μg (n = 12), 10 μg (n = 12), or 20 μg (n = 12) LSD. LSD plasma levels were undetectable for the 5 μg group and peak blood plasma levels for the 10 μg and 20 μg groups occurred at 30 min. LSD was well tolerated, and the frequency of adverse events was no higher than for placebo. Assessments of cognition, balance, and proprioception revealed no impairment.

Conclusions: Our results suggest safety and tolerability of orally administered 5 μg, 10 μg, and 20 μg LSD every fourth day over a 21-day period and support further clinical development of LSD for the treatment and prevention of Alzheimer's disease (AD).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00213-019-05417-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036065PMC
March 2020

BTrackS: A Low-Cost, Portable Force Plate for Objectively Measuring Balance Deficits and Fall Risk.

Home Healthc Now 2019 Nov/Dec;37(6):355-356

Daniel J. Goble, PhD, is an Associate Professor, Exercise Science Program, School of Health Sciences, Oakland University, Rochester, Michigan. Niyati Baweja, PT, is Director of Rehabilitation, Interface Rehab, San Diego, California. Harsimran S. Baweja, PT, PhD, is an Associate Professor, Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/NHH.0000000000000823DOI Listing
April 2020

Normative data for the Balance Tracking System modified Clinical Test of Sensory Integration and Balance protocol.

Med Devices (Auckl) 2019 8;12:183-191. Epub 2019 May 8.

School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA.

Force plate balance testing technology has traditionally been underutilized in clinical and research settings due to the high cost and lack of portability. A relatively new force plate called the Balance Tracking System (BTrackS) has been developed to overcome these barriers. BTrackS recently implemented the modified Clinical Test of Sensory Integration and Balance (mCTSIB) as a means of evaluating various sources of sensory information for postural sway control. The present study aimed to provide much needed normative data for the BTrackS mCTSIB protocol. Data from 604 healthy adults (308 women; 296 men) between the ages of 18 and 29 years were collected according to the BTrackS mCTSIB protocol. The protocol consisted of four, 20-second static standing trials that manipulated relative contributions of the vision, proprioception and vestibular sensory systems through various eyes open/closed and foam/no foam conditions. Comparisons of men versus women and the impact of body size (ie body mass index) were determined so that relevant percentile rankings could be calculated. Analysis of variance showed an interaction between sex and task condition on the BTrackS mCTSIB (<0.001). This interaction indicated that women outperformed men on all conditions, but especially in the fourth trial where eyes were closed and standing was done on a compliant foam surface. Percentile rankings were calculated based on sex and BTrackS mCTSIB condition. No relationship was found between BTrackS mCTSIB results and body size. Normative data provided in this study are vital for establishing potential sensory feedback-based balance dysfunctions that may exist clinically or in laboratory settings. In addition, this data can aid in the tracking of changes over a rehabilitation period and/or the effectiveness of balance interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/MDER.S206530DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519013PMC
May 2019

Normative Data for the BTrackS Balance Test Concussion-Management Tool: Results From 10 045 Athletes Aged 8 to 21 Years.

J Athl Train 2019 Apr 14;54(4):439-444. Epub 2019 Mar 14.

School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, San Diego State University, CA.

Context: Balance tests are a recommended assessment of motor function in concussion protocols. The BTrackS Balance Test (BBT) is a tool for concussion balance testing that uses low-cost force-plate technology to objectively measure postural sway.

Objective: To provide normative data for the BBT in a large population of athletes.

Design: Cross-sectional study.

Setting: Concussion baseline testing at multiple facilities.

Patients Or Other Participants: Male and female athletes (n = 10 045) ages 8 to 21 years.

Intervention(s): Athletes performed three 20-second trials of eyes-closed standing on the BTrackS Balance Plate with feet shoulder-width apart and hands on hips.

Main Outcome Measure(s): Postural sway was measured as the average total center-of-pressure path length over 3 testing trials.

Results: Postural sway was reduced (ie, balance improved) as athlete age increased and was less in female athletes than in male athletes. Percentile ranking tables were calculated based on sex and 2-year age groupings.

Conclusions: Our findings (1) provide context for BBT results performed in the absence of a baseline test, (2) can help mitigate athlete malingering, and (3) might identify individuals with latent neuromuscular injuries during baseline tests.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4085/1062-6050-178-18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522082PMC
April 2019

Postural sway normative data across the adult lifespan: Results from 6280 individuals on the Balance Tracking System balance test.

Geriatr Gerontol Int 2018 Aug 13;18(8):1225-1229. Epub 2018 Jun 13.

School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, San Diego State University, San Diego, California, USA.

Aim: Postural sway measured using force plate technology is a known risk factor for falls in older adults, but is currently underutilized due to the high cost and lack of portability issues associated with most force plate systems. The Balance Tracking System (BTrackS) is a new force plate that alleviates these barriers and has potential for widespread use. The present study provides important normative data for the BTrackS Balance Test of postural sway that improves its translational value to the field of gerontology.

Methods: BTrackS Balance Test postural sway results were accumulated from 6280 community-dwelling individuals across the adult lifespan. Data were assessed for effects of age, sex and body size. Stratified percentile rankings were then calculated.

Results: BTrackS Balance Test results were dependent on age and sex, but not body size. Percentile rankings were, therefore, determined across various age groups for men and women separately, with no consideration of participant body size. A novel interaction was found between the age and sex factors, suggesting enhanced postural sway ability for women that becomes more pronounced with older age.

Conclusions: The results of the present study represent one of the largest sets of normative postural sway data ever published. These data translate directly into the field of gerontology as a tool for determining abnormalities in postural sway, which have been linked to various poor outcomes in older adults, such as high fall risk. Geriatr Gerontol Int 2018; 18: 1225-1229.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ggi.13452DOI Listing
August 2018

Normative Data for the BTrackS Balance Test of Postural Sway: Results from 16,357 Community-Dwelling Individuals Who Were 5 to 100 Years Old.

Phys Ther 2018 09;98(9):779-785

Doctor of Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California.

Background: Postural sway is routinely assessed because increased postural sway is associated with poorer performance of activities of daily living, higher rates of residential care, and increased risk of falling. Force plate technology is one of the most sensitive and objective means of assessing postural sway in the clinic.

Objective: The aim of this study was to provide the first set of normative data for the BTrackS Balance Test (BBT) of postural sway.

Design: The design was descriptive and population based.

Methods: BBT results from 16,357 community-dwelling individuals who were 5 to 100 years old were accumulated and assessed for effects of age, sex, height, and weight. Percentile rankings were calculated for significant groupings.

Results: BBT results were dependent on age and sex but not height or weight. Therefore, percentile rankings were determined for male and female individuals in each age category, with no consideration of participant height or weight.

Limitations: Data were collected by third-party practitioners with various backgrounds in more than 50 locations across the United States and Canada. There was an imbalance in the sample sizes for age and sex groupings.

Conclusions: The findings of this study represent the largest normative dataset ever published for postural sway results. Normative data on the BBT can assist in determining abnormalities in postural sway, which have been linked to negative clinical outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ptj/pzy062DOI Listing
September 2018

Leveling the playing field: Evaluation of a portable instrument for quantifying balance performance.

J Biomech 2018 06 18;75:102-107. Epub 2018 May 18.

College of Health and Human Sciences, Department of Health and Exercise Science, Colorado State University, 951 Plum St, Fort Collins, CO 80523, USA.

Balance is a complex, sensorimotor task requiring an individual to maintain the center of gravity within the base of support. Quantifying balance in a reliable and valid manner is essential to evaluating disease progression, aging complications, and injuries in clinical and research settings. Typically, researchers use force plates to track motion of the center of gravity during a variety of tasks. However, limiting factors such as cost, portability, and availability have hindered postural stability evaluation in these settings. This study compared the "gold standard" for assessing postural stability (i.e., the laboratory-grade force plate) to a more affordable and portable assessment tool (i.e., BTrackS balance plate) in healthy young adults. Correlations and Bland-Altman plots between the center of pressure outcome measures derived from these two instruments were produced. Based on the results of this study, the measures attained from the portable balance plate objectively quantified postural stability with high validity on both rigid and compliant surfaces, demonstrated by thirty-five out of thirty-eight observed postural stability metrics in both surface conditions with a correlation of 0.98 or greater. The low cost, portable system performed similarly to the lab-grade force plate indicating the potential for practitioners and researchers to use the BTrackS balance plate as an alternative to the more expensive force plate option for assessing postural stability, whether in the lab setting or in the field.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbiomech.2018.05.008DOI Listing
June 2018

Effects of a Community-Based Exercise Program on Older Adults' Physical Function, Activities of Daily Living, and Exercise Self-Efficacy: Feeling Fit Club.

J Appl Gerontol 2020 01 4;39(1):40-49. Epub 2018 Mar 4.

San Diego State University, CA, USA.

Community-based exercise programs have demonstrated feasibility, yet many lack controlled studies examining their efficacy. This study examined the efficacy of a community-based exercise program, using a controlled design. Participants ( = 262, = 74.0 years, = 8.4) were women (77%) and men recruited from senior centers served by the county Area Agency on Aging. Intervention participants ( = 133) were newly enrolled in classes. Controls ( = 129) were recruited from matched sites not offering classes. Validated measures of physical function, exercise self-efficacy, balance, and activities of daily living (ADL) confidence were administered at baseline and 3 months. Significant improvements in upper and lower body strength, aerobic endurance, mobility, exercise self-efficacy, and balance were found in the exercisers but not controls. No changes in ADL confidence occurred in exercisers, while significant decreases occurred in controls. Findings support the efficacy of the county-wide program. Building an evidence base for community-delivered programs should provide impetus for increased dissemination through state and national agencies thereby increasing program impact.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0733464818760237DOI Listing
January 2020

A point of application study to determine the accuracy, precision and reliability of a low-cost balance plate for center of pressure measurement.

J Biomech 2018 04 8;71:277-280. Epub 2018 Feb 8.

College of Health and Human Services, School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.

Changes in postural sway measured via force plate center of pressure have been associated with many aspects of human motor ability. A previous study validated the accuracy and precision of a relatively new, low-cost and portable force plate called the Balance Tracking System (BTrackS). This work compared a laboratory-grade force plate versus BTrackS during human-like dynamic sway conditions generated by an inverted pendulum device. The present study sought to extend previous validation attempts for BTrackS using a more traditional point of application (POA) approach. Computer numerical control (CNC) guided application of ∼155 N of force was applied five times to each of 21 points on five different BTrackS Balance Plate (BBP) devices with a hex-nose plunger. Results showed excellent agreement (ICC > 0.999) between the POAs and measured COP by the BBP devices, as well as high accuracy (<1% average percent error) and precision (<0.1 cm average standard deviation of residuals). The ICC between BBP devices was exceptionally high (ICC > 0.999) providing evidence of almost perfect inter-device reliability. Taken together, these results provide an important, static corollary to the previously obtained dynamic COP results from inverted pendulum testing of the BBP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbiomech.2018.01.040DOI Listing
April 2018

On the Nature of Clinical Evaluations With Low Sensitivity for Concussion-Related Balance Deficits.

J Sport Rehabil 2018 May 17;27(3):197-198. Epub 2017 Jul 17.

2 Department of Human Movement Science, Oakland University, Rochester, MI.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/jsr.2017-0039DOI Listing
May 2018

BTrackS Balance Test for Concussion Management is Resistant to Practice Effects.

Clin J Sport Med 2018 03;28(2):177-179

From the School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California.

Objective: Recent guidelines advocate for ongoing balance testing in the assessment of management of concussion injuries. This study sought to determine whether the Balance Tracking System (BTrackS) provides stable balance results over repeated administration and, thus, is a reliable tool for concussion management.

Design: Repeated measures and test-retest reliability.

Setting: University Biomechanics Laboratory.

Participants: Random sample of 20 healthy young adults.

Interventions: Force plate balance testing using BTrackS on days 1, 3, 8, and 15.

Main Outcome Measures: Practice-induced changes in the average center of pressure excursion over 4 repeated administrations of the BTrackS Balance Test (BBT). Test-retest reliability of center of pressure excursion from day 1 to day 15.

Results: No significant practice-induced balance differences were found across testing days (P > 0.4), and test-retest reliability of the BBT was excellent from day 1 to day 15 (R 0.92).

Conclusions: These findings indicate that the BBT does not elicit a practice effect over repeat administrations. BTrackS provides excellent reliability and objectivity, which can increase clinician accuracy when monitoring sport-related concussions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/JSM.0000000000000435DOI Listing
March 2018

Combination of BTrackS and Geri-Fit as a targeted approach for assessing and reducing the postural sway of older adults with high fall risk.

Clin Interv Aging 2017 10;12:351-357. Epub 2017 Feb 10.

School of Exercise and Nutritional Sciences, College of Health and Human Services, San Diego State University, San Diego, CA, USA.

Atypically high postural sway measured by a force plate is a known risk factor for falls in older adults. Further, it has been shown that small, but significant, reductions in postural sway are possible with various balance exercise interventions. In the present study, a new low-cost force-plate technology called the Balance Tracking System (BTrackS) was utilized to assess postural sway of older adults before and after 90 days of a well-established exercise program called Geri-Fit. Results showed an overall reduction in postural sway across all participants from pre- to post-intervention. However, the magnitude of effects was significantly influenced by the amount of postural sway demonstrated by individuals prior to Geri-Fit training. Specifically, more participants with atypically high postural sway pre-intervention experienced an overall postural sway reduction. These reductions experienced were typically greater than the minimum detectable change statistic for the BTrackS Balance Test. Taken together, these findings suggest that BTrackS is an effective means of identifying older adults with elevated postural sway, who are likely to benefit from Geri-Fit training to mitigate fall risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/CIA.S131047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312691PMC
January 2018

Short-duration therapeutic massage reduces postural upper trapezius muscle activity.

Neuroreport 2017 Jan;28(2):108-110

School of Exercise and Nutritional Sciences, College of Health and Human Services, San Diego State University, San Diego, California, USA.

Massage therapy has historically been used as a therapeutic treatment to help reduce pain and promote relaxation. The aim of this study was to investigate the effect of therapeutic massage on the upper trapezius muscles, which are commonly associated with increased muscle tension. This was a randomized crossover study. Seventeen healthy individuals (nine women; 24.5±4.0 years) participated in the study. All individuals participated in two sessions that were held 24 h apart. In one of the sessions, the participants received a moderate pressure massage applied to the shoulders and neck. In the other session, participants sat quietly. The order of the sessions was counterbalanced across participants. Muscle activity, as measured by surface electromyography, of the upper trapezius muscles was recorded. The amount of muscle activity change following massage was compared with the change in muscle activity following quiet sitting. Muscle activity of the upper trapezius reduced significantly (19.3%; P=0.004) following massage compared with muscle activity following quiet sitting (1.0%). Our findings suggest that short-duration moderate pressure massage leads to a reduction in upper trapezius muscle activity. This result has potential implications for clinical populations such as those with chronic neck pain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/WNR.0000000000000718DOI Listing
January 2017

Relationship between changes in vestibular sensory reweighting and postural control complexity.

Exp Brain Res 2017 02 3;235(2):547-554. Epub 2016 Nov 3.

Department of Kinesiology, Coleman Building, University of North Carolina at Greensboro, 1408 Walker Ave., Greensboro, NC, 27412, USA.

Complexity measures have become increasingly prominent in the postural control literature. Several studies have found associations between clinical balance improvements and complexity, but the relationship between sensory reweighting and complexity changes has remained unobserved. The purpose of this study was to determine the relationship between sensory reweighting via Wii Fit balance training and complexity. Twenty healthy adults completed 6 weeks of training. Participants completed the sensory organization test (SOT) before and after the sessions. Complexity of postural control was analyzed through sample entropy of the center-of-pressure velocity time series in the resultant, anterior-posterior (AP), and medial-lateral directions, and compared to SOT summary score changes. Significant differences were found between pre- and post-training for the condition five (p < .001, d = .525) and vestibular summary scores (p < .001, d = .611). Similarly, changes in complexity were observed from pre- to post-training in the resultant (p = .040, d = .427) direction. While the AP velocity was not significant (p = .07, d = .355), its effect size was moderate. A moderate correlation was revealed in the posttest between AP complexity and condition 5 (r = .442, p = .05), as well as between AP complexity and the vestibular summary score (r = .351, p = .13). The results of this study show that a moderate relationship exists between postural control complexity and the vestibular system, suggesting that complexity may reflect the neurosensory organization used to maintain upright stance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00221-016-4814-2DOI Listing
February 2017

Validating the BTrackS Balance Plate as a low cost alternative for the measurement of sway-induced center of pressure.

J Biomech 2016 12 20;49(16):4142-4145. Epub 2016 Oct 20.

School of Exercise and Nutritional Sciences, San Diego State University, 5500 Camanile Drive, San Diego, CA 92182, United States. Electronic address:

The BTrackS Balance Plate (BBP) is a low-cost force plate that provides objective balance assessment and true portability for the user. Given that this technology is relatively new, the purpose of the present study was to provide the first center of pressure (COP) validation of the BBP. Two BBP devices (one new and one used) were compared with a laboratory-grade force plate (LFP) during simultaneous collection of COP that was induced by an inverted pendulum device with human-like sway characteristics. The results of this study showed almost perfect agreement between the BBP devices and the LFP (ICC>0.999), as well as a high degree of BBP accuracy (<1% error magnitude) and precision (<0.2mm regression residuals). These results suggest the BBP can serve as an effective, low-cost solution for objective balance testing in the laboratory or clinic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbiomech.2016.10.020DOI Listing
December 2016

AN INITIAL EVALUATION OF THE BTRACKS BALANCE PLATE AND SPORTS BALANCE SOFTWARE FOR CONCUSSION DIAGNOSIS.

Int J Sports Phys Ther 2016 Apr;11(2):149-55

San Diego State University, School of Exercise and Nutritional Sciences, College of Health and Human Sciences, San Diego, CA, USA.

Background: As recently dictated by the American Medical Society, balance testing is an important component in the clinical evaluation of concussion. Despite this, previous research on the efficacy of balance testing for concussion diagnosis suggests low sensitivity (∼30%), based primarily on the popular Balance Error Scoring System (BESS). The Balance Tracking System (BTrackS, Balance Tracking Systems Inc., San Diego, CA, USA) consists of a force plate (BTrackS Balance Plate) and software (BTrackS Sport Balance) which can quickly (<2 min) perform concussion balance testing with gold standard accuracy.

Purpose: The present study aimed to determine the sensitivity of the BTrackS Balance Plate and Sports Balance Software for concussion diagnosis.

Study Design: Cross-Sectional Study.

Methods: Preseason baseline balance testing of 519 healthy Division I college athletes playing sports with a relatively high risk for concussions was performed with the BTrackS Balance Test. Testing was administered by certified athletic training staff using the BTrackS Balance Plate and Sport Balance software. Of the baselined athletes, 25 later experienced a concussion during the ensuing sport season. Post-injury balance testing was performed on these concussed athletes within 48 of injury and the sensitivity of the BTrackS Balance Plate and Sport Balance software was estimated based on the number of athletes showing a balance decline according to the criteria specified in the Sport Balance software. This criteria is based on the minimal detectable change statistic with a 90% confidence level (i.e. 90% specificity).

Results: Of 25 athletes who experienced concussions, 16 had balance declines relative to baseline testing results according to the BTrackS Sport Balance software criteria. This corresponds to an estimated concussion sensitivity of 64%, which is twice as great as that reported previously for the BESS.

Conclusions: The BTrackS Balance Plate and Sport Balance software has the greatest concussion sensitivity of any balance testing instrument reported to date.

Level Of Evidence: Level 2 (Individual cross sectional diagnostic study).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827358PMC
April 2016

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

Gait Posture 2015 Feb 7;41(2):711-5. Epub 2015 Feb 7.

San Diego State University, Department of Exercise and Nutritional Sciences Sensorimotor and Rehabilitation Technology Laboratory, 5500 Campanile Drive, San Diego, CA 92182-7251, USA. Electronic address:

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gaitpost.2015.01.030DOI Listing
February 2015

Short-Term Adaptation of Joint Position Sense Occurs during and after Sustained Vibration of Antagonistic Muscle Pairs.

Front Hum Neurosci 2014 4;8:896. Epub 2014 Nov 4.

School of Exercise and Nutritional Sciences, San Diego State University , San Diego, CA , USA.

Proprioception is critical for the control of many goal-directed activities of daily living. While contributions from skin and joint receptors exist, the muscle spindle is thought to play an important role in allowing accurate judgments of limb position and movement to occur. The discharges elicited from muscle spindles can be degraded by simultaneous agonist-antagonist tendon vibration, causing proprioception to be distorted. Despite this, changes in limb perception that may result from sensory adaptation to this stimulus remain misunderstood. The purpose of this study was, therefore, to investigate short-term proprioceptive adaptation resulting from vibration of antagonistic muscle pairs. We measured elbow joint position sense in 21 healthy young adults while 80 Hz vibration was applied simultaneously to the distal tendons of the elbow flexor and extensor muscles. Matching errors were then analyzed during early and late adaptation phases to assess short-term adaptation to the vibration stimuli. Participants committed significant undershoot errors during the early adaptation phase, but were comparable to baseline measurements during the late adaptation phase. When we removed the vibration stimuli and conducted a second joint position matching task, matching variability increased significantly, and participants committed overshoot errors. These results bring into question the efficacy of simultaneous agonist-antagonist tendon vibration to degrade proprioceptive acuity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fnhum.2014.00896DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220122PMC
November 2014

The Influence of Task Difficulty and Participant Age on Balance Control in ASD.

J Autism Dev Disord 2015 May;45(5):1419-27

School of Exercise and Nutritional Sciences, College of Health and Human Services, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA.

Impairments in sensorimotor integration are reported in Autism Spectrum Disorder (ASD). Poor control of balance in challenging balance tasks is one suggested manifestation of these impairments, and is potentially related to ASD symptom severity. Reported balance and symptom severity relationships disregard age as a potential covariate, however, despite its involvement in balance development. We tested balance control during increasingly difficult balance conditions in children with ASD and typically developing peers, and investigated relationships between balance control and diagnostic/symptom severity metrics for participants with ASD, including age as a covariate. Balance deficits in ASD were exacerbated by stance alterations, but were not related to symptom severity when age was considered. These findings support impaired balance in ASD, especially in challenging conditions, but question a link between balance and symptom severity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10803-014-2303-7DOI Listing
May 2015

Functional Brain Activation Associated with Inhibitory Control Deficits in Older Adults.

Cereb Cortex 2016 Jan 1;26(1):12-22. Epub 2014 Aug 1.

Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium Leuven Research Institute for Neuroscience & Disease (LIND), KU Leuven, Leuven, Belgium.

In young adults, canceling an initiated action depends on the right inferior frontal cortex (IFC), presupplementary motor area (preSMA), and the basal ganglia. Older adults show response inhibition deficits, but how this relates to functional brain activation remains unclear. Using event-related functional magnetic resonance imaging, we tested whether older adults (N = 20) exhibit overactivation during stop-signal inhibition as shown for attentional control tasks, or reduced activity compared with young adults (N = 20). We used a modified stop-signal task involving coupled bimanual responses and manipulated whether both or just one hand was cued to stop. Stop-task difficulty was matched across groups. We found a group by condition interaction in supramarginal gyrus, anterior insula, rIFC, and preSMA, with activation increasing for successful Stop versus Go trials in the young adults only. Comparing the groups on Stop trials revealed preSMA and striatum hypoactivity for older adults. White matter tracts connecting rIFC, preSMA, and the subthalamic nuclei were associated with stronger activation of preSMA in older adults, suggesting that maintenance of the brain's structure has positive implications for brain function.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/cercor/bhu165DOI Listing
January 2016

Using the Wii Fit as a tool for balance assessment and neurorehabilitation: the first half decade of "Wii-search".

J Neuroeng Rehabil 2014 Feb 8;11:12. Epub 2014 Feb 8.

Sensory-Motor and Rehabilitative Technology Laboratory (SMaRTlab), School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-7251, USA.

The Nintendo Wii Fit was released just over five years ago as a means of improving basic fitness and overall well-being. Despite this broad mission, the Wii Fit has generated specific interest in the domain of neurorehabilitation as a biobehavioral measurement and training device for balance ability. Growing interest in Wii Fit technology is likely due to the ubiquitous nature of poor balance and catastrophic falls, which are commonly seen in older adults and various disability conditions. The present review provides the first comprehensive summary of Wii Fit balance research, giving specific insight into the system's use for the assessment and training of balance. Overall, at the time of the fifth anniversary, work in the field showed that custom applications using the Wii Balance Board as a proxy for a force platform have great promise as a low cost and portable way to assess balance. On the other hand, use of Wii Fit software-based balance metrics has been far less effective in determining balance status. As an intervention tool, positive balance outcomes have typically been obtained using Wii Fit balance games, advocating their use for neurorehabilitative training. Despite this, limited sample sizes and few randomized control designs indicate that research regarding use of the Wii Fit system for balance intervention remains subject to improvement. Future work aimed at conducting studies with larger scale randomized control designs and a greater mechanistic focus is recommended to further advance the efficacy of this impactful neurorehabilitation tool.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1743-0003-11-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922272PMC
February 2014

An alternative to the balance error scoring system: using a low-cost balance board to improve the validity/reliability of sports-related concussion balance testing.

Clin J Sport Med 2014 May;24(3):256-62

College of Health and Human Services, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California.

Objective: Recent guidelines advocate sports medicine professionals to use balance tests to assess sensorimotor status in the management of concussions. The present study sought to determine whether a low-cost balance board could provide a valid, reliable, and objective means of performing this balance testing.

Design: Criterion validity testing relative to a gold standard and 7 day test-retest reliability.

Setting: University biomechanics laboratory.

Participants: Thirty healthy young adults.

Assessment Of Risk Factors: Balance ability was assessed on 2 days separated by 1 week using (1) a gold standard measure (ie, scientific grade force plate), (2) a low-cost Nintendo Wii Balance Board (WBB), and (3) the Balance Error Scoring System (BESS).

Main Outcome Measures: Validity of the WBB center of pressure path length and BESS scores were determined relative to the force plate data. Test-retest reliability was established based on intraclass correlation coefficients.

Results: Composite scores for the WBB had excellent validity (r = 0.99) and test-retest reliability (R = 0.88). Both the validity (r = 0.10-0.52) and test-retest reliability (r = 0.61-0.78) were lower for the BESS.

Conclusions: These findings demonstrate that a low-cost balance board can provide improved balance testing accuracy/reliability compared with the BESS.

Clinical Relevance: This approach provides a potentially more valid/reliable, yet affordable, means of assessing sports-related concussion compared with current methods.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/JSM.0000000000000016DOI Listing
May 2014

Bimanual motor coordination in older adults is associated with increased functional brain connectivity--a graph-theoretical analysis.

PLoS One 2013 29;8(4):e62133. Epub 2013 Apr 29.

Motor Control Laboratory, Research Center for Movement Control and Neuroplasticity, Group Biomedical Sciences, KU Leuven, Leuven-Heverlee, Belgium.

In bimanual coordination, older and younger adults activate a common cerebral network but the elderly also have additional activation in a secondary network of brain areas to master task performance. It remains unclear whether the functional connectivity within these primary and secondary motor networks differs between the old and the young and whether task difficulty modulates connectivity. We applied graph-theoretical network analysis (GTNA) to task-driven fMRI data in 16 elderly and 16 young participants using a bimanual coordination task including in-phase and anti-phase flexion/extension wrist movements. Network nodes for the GTNA comprised task-relevant brain areas as defined by fMRI activation foci. The elderly matched the motor performance of the young but showed an increased functional connectivity in both networks across a wide range of connectivity metrics, i.e., higher mean connectivity degree, connection strength, network density and efficiency, together with shorter mean communication path length between the network nodes and also a lower betweenness centrality. More difficult movements showed an increased connectivity in both groups. The network connectivity of both groups had "small world" character. The present findings indicate (a) that bimanual coordination in the aging brain is associated with a higher functional connectivity even between areas also activated in young adults, independently from task difficulty, and (b) that adequate motor coordination in the context of task-driven bimanual control in older adults may not be solely due to additional neural recruitment but also to aging-related changes of functional relationships between brain regions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0062133PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639273PMC
November 2013

The influence of spatial working memory on ipsilateral remembered proprioceptive matching in adults with cerebral palsy.

Exp Brain Res 2012 Nov 14;223(2):259-69. Epub 2012 Sep 14.

Sensory-Motor and Rehabilitative Technology Laboratory, School of Exercise and Nutritional Sciences, College of Health and Human Services, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-7251, USA.

Somatosensation is frequently impaired in individuals with Cerebral Palsy (CP). This includes the sense of proprioception, which is an important contributor to activities of daily living. One means of determining proprioceptive deficits in CP has been use of an Ipsilateral Remembered (IR) position matching test. The IR test requires participants to replicate, without vision, memorized joint/limb positions previously experienced by the same (i.e. ipsilateral) effector. Given the memory component inherent to this task, the present study sought to determine the extent to which IR proprioceptive matching might be influenced by known spatial working memory deficits. Eleven adults with CP underwent IR elbow position matching, where blindfolded individuals were given either a short (2 s) or long (15 s) duration to memorize the target elbow angle. A standard clinical measure of spatial working memory (i.e. Corsi block-tapping task) was also administered. The results showed that the directional (i.e. constant) error produced across trials did not differ between the short and long target duration conditions. However, it was found that participants were significantly more consistent in their matches (i.e. had smaller variable errors) when given more time to encode proprioceptive targets in the long duration condition. The benefit of having more time was greatest for those individuals with the highest variable errors in the short target condition, and a significant association was seen between improvements in variable error and greater performance on 4/5 spatial working memory measures. These findings provide the best evidence to date that IR position matching tests are influenced by spatial working memory.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00221-012-3256-8DOI Listing
November 2012

Brain activity during ankle proprioceptive stimulation predicts balance performance in young and older adults.

J Neurosci 2011 Nov;31(45):16344-52

Motor Control Laboratory, Research Center for Movement Control and Neuroplasticity, Department of Biomedical Kinesiology, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.

Proprioceptive information from the foot/ankle provides important information regarding body sway for balance control, especially in situations where visual information is degraded or absent. Given known increases in catastrophic injury due to falls with older age, understanding the neural basis of proprioceptive processing for balance control is particularly important for older adults. In the present study, we linked neural activity in response to stimulation of key foot proprioceptors (i.e., muscle spindles) with balance ability across the lifespan. Twenty young and 20 older human adults underwent proprioceptive mapping; foot tendon vibration was compared with vibration of a nearby bone in an fMRI environment to determine regions of the brain that were active in response to muscle spindle stimulation. Several body sway metrics were also calculated for the same participants on an eyes-closed balance task. Based on regression analyses, multiple clusters of voxels were identified showing a significant relationship between muscle spindle stimulation-induced neural activity and maximum center of pressure excursion in the anterior-posterior direction. In this case, increased activation was associated with greater balance performance in parietal, frontal, and insular cortical areas, as well as structures within the basal ganglia. These correlated regions were age- and foot-stimulation side-independent and largely localized to right-sided areas of the brain thought to be involved in monitoring stimulus-driven shifts of attention. These findings support the notion that, beyond fundamental peripheral reflex mechanisms, central processing of proprioceptive signals from the foot is critical for balance control.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1523/JNEUROSCI.4159-11.2011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6633212PMC
November 2011

Compromised encoding of proprioceptively determined joint angles in older adults: the role of working memory and attentional load.

Exp Brain Res 2012 Jan 18;216(1):35-40. Epub 2011 Oct 18.

School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182-7251, USA.

Perceiving the positions and movements of one's body segments (i.e., proprioception) is critical for movement control. However, this ability declines with older age as has been demonstrated by joint angle matching paradigms in the absence of vision. The aim of the present study was to explore the extent to which reduced working memory and attentional load influence older adult proprioceptive matching performance. Older adults with relatively HIGH versus LOW working memory ability as determined by backward digit span and healthy younger adults, performed memory-based elbow position matching with and without attentional load (i.e., counting by 3 s) during target position encoding. Even without attentional load, older adults with LOW digit spans (i.e., 4 digits or less) had larger matching errors than younger adults. Further, LOW older adults made significantly greater errors when attentional loads were present during proprioceptive target encoding as compared to both younger and older adults with HIGH digit span scores (i.e., 5 digits or greater). These results extend previous position matching results that suggested greater errors in older adults were due to degraded input signals from peripheral mechanoreceptors. Specifically, the present work highlights the role cognitive factors play in the assessment of older adult proprioceptive acuity using memory-based matching paradigms. Older adults with LOW working memory appear prone to compromised proprioceptive encoding, especially when secondary cognitive tasks must be concurrently executed. This may ultimately result in poorer performance on various activities of daily living.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00221-011-2904-8DOI Listing
January 2012

White matter fractional anisotropy predicts balance performance in older adults.

Neurobiol Aging 2012 Sep 26;33(9):1900-12. Epub 2011 Aug 26.

Research Center for Movement Control and Neuroplasticity, Department of Biomedical Kinesiology, K.U. Leuven, Heverlee, Belgium.

Aging is characterized by brain structural changes that may compromise motor functions. In the context of postural control, white matter integrity is crucial for the efficient transfer of visual, proprioceptive and vestibular feedback in the brain. To determine the role of age-related white matter decline as a function of the sensory feedback necessary to correct posture, we acquired diffusion weighted images in young and old subjects. A force platform was used to measure changes in body posture under conditions of compromised proprioceptive and/or visual feedback. In the young group, no significant brain structure-balance relations were found. In the elderly however, the integrity of a cluster in the frontal forceps explained 21% of the variance in postural control when proprioceptive information was compromised. Additionally, when only the vestibular system supplied reliable information, the occipital forceps was the best predictor of balance performance (42%). Age-related white matter decline may thus be predictive of balance performance in the elderly when sensory systems start to degrade.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neurobiolaging.2011.06.013DOI Listing
September 2012

The neural basis of central proprioceptive processing in older versus younger adults: an important sensory role for right putamen.

Hum Brain Mapp 2012 Apr 22;33(4):895-908. Epub 2011 Mar 22.

Motor Control Laboratory, Research Center for Movement Control and Neuroplasticity, Department of Biomedical Kinesiology, K.U. Leuven, Belgium.

Our sense of body position and movement independent of vision (i.e., proprioception) relies on muscle spindle feedback and is vital for performing motor acts. In this study, we first sought to elucidate age-related differences in the central processing of proprioceptive information by stimulating foot muscle spindles and by measuring neural activation with functional magnetic resonance imaging. We found that healthy older adults activated a similar, distributed network of primary somatosensory and secondary-associative cortical brain regions as young individuals during the vibration-induced muscle spindle stimulation. A significant decrease in neural activity was also found in a cluster of right putamen voxels for the older age group when compared with the younger age group. Given these differences, we performed two additional analyses within each group that quantified the degree to which age-dependent activity was related to (1) brain structure and (2) a behavioral measure of proprioceptive ability. Using diffusion tensor imaging, older (but not younger) adults with higher mean fractional anisotropy were found to have increased right putamen neural activity. Age-dependent right putamen activity seen during tendon vibration was also correlated with a behavioral test of proprioceptive ability measuring ankle joint position sense in both young and old age groups. Partial correlation tests determined that the relationship between elderly joint position sense and neural activity in right putamen was mediated by brain structure, but not vice versa. These results suggest that structural differences within the right putamen are related to reduced activation in the elderly and potentially serve as biomarker of proprioceptive sensibility in older adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hbm.21257DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6870471PMC
April 2012

Motor learning with augmented feedback: modality-dependent behavioral and neural consequences.

Cereb Cortex 2011 Jun 28;21(6):1283-94. Epub 2010 Oct 28.

Motor Control Laboratory, Department of Biomedical Kinesiology, Katholieke Universiteit Leuven, Tervuursevest 101, Heverlee, Belgium.

Sensory information is critical to correct performance errors online during the execution of complex tasks and can be complemented by augmented feedback (FB). Here, 2 groups of participants acquired a new bimanual coordination pattern under different augmented FB conditions: 1) visual input reflecting coordination between the 2 hands and 2) auditory pacing integrating the timing of both hands into a single temporal structure. Behavioral findings revealed that the visual group became dependent on this augmented FB for performance, whereas the auditory group performed equally well with or without augmented FB by the end of practice. Functional magnetic resonance imaging (fMRI) results corroborated these behavioral findings: the visual group showed neural activity increases in sensory-specific areas during practice, supporting increased reliance on augmented FB. Conversely, the auditory group showed a neural activity decrease, specifically in areas associated with cognitive/sensory monitoring of motor task performance, supporting the development of a control mode that was less reliant on augmented FB sources. Finally, some remnants of brain activity in sensory-specific areas in the absence of augmented FB were found for the visual group only, illustrating ongoing reliance on these areas. These findings provide the first neural account for the "guidance hypothesis of information FB," extensively supported by behavioral research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/cercor/bhq209DOI Listing
June 2011
-->