title: Improving impaired balance function: real-time versus carry-over effects of prosthetic feedback.
abstract: This study investigated whether training with realtime prosthetic biofeedback (BF) of trunk sway induces a carry-over improvement in balance control once BF is removed. 12 healthy older adults and 7 uncompensated unilateral vestibular loss patients were tested. All participants performed a battery of 14 balance and gait tasks (pre-test) upon their initial lab visit during which trunk angular sway was measured at L1-3. They then received balance BF training on a subset of 7 tasks, three times per week, for two consecutive weeks. BF was provided using a multi-modal biofeedback system with graded vibrotactile, auditory, and visual cues in relation to subject-specific angular displacement thresholds. Performance on the battery of the 14 balance and gait tasks (without BF) was re-assessed immediately after the 2 week training period, as well as 1 week later to examine BF carry-over effects. Significant reductions in trunk angular displacement were observed with the real-time BF, compared to the pre-test trials. The effects of BF persisted when BF was removed immediately after the final training session. BF carry-over effects were less evident at one week post-training. This evidence supports the potential short-term effects of BF training in a limited number of tasks after the BF is removed in healthy elderly subjects and those with vestibular loss. However, the prospect for longer term (>1 week) effects of prosthetic training on balance control remains currently unknown.
authors.affiliation: Dept of ORL, University Hospital of Basel, Switzerland. jallum@uhbs.ch
authors.forename: John H J
authors.initials: JH
authors.lastname: Allum
authors.forename: Mark G
authors.initials: MG
authors.lastname: Carpenter
authors.forename: Brian C
authors.initials: BC
authors.lastname: Horslen
authors.forename: Justin R
authors.initials: JR
authors.lastname: Davis
authors.forename: Flurin
authors.initials: F
authors.lastname: Honegger
authors.forename: Kok-Sing
authors.initials: KS
authors.lastname: Tang
authors.forename: Paul
authors.initials: P
authors.lastname: Kessler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001676:Biofeedback, Psychology / Q000379:methods*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D019736:Prostheses and Implants; D016896:Treatment Outcome; D015837:Vestibular Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation*