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Postural and Perceptual Measurements during Performance of Static Standing Balance Exercises

Alsubaie, Saud (2017) Postural and Perceptual Measurements during Performance of Static Standing Balance Exercises. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Purpose: Balance training has shown benefits in improving balance in older adults and people with vestibular disorders. However, the evidence for determining the appropriate intensity and progression of balance exercises is very limited. The purpose of this study was to develop a method for quantifying intensity of balance exercises, and to determine guidelines for progressing exercises.
Participants: Sixty-two healthy subjects who were between the ages of 18 and 85 years old (50% female, mean age 55 ± 20 years), and eight participants with vestibular disorders (50% female. mean age 56 ± 16 years) enrolled in the study.
Methods: Healthy subjects were tested during two visits and performed two sets of 24 randomized static standing exercises in each visit. Participants with vestibular disorders were tested in one visit and performed two sets of 16 randomized static standing exercises. The exercises consisted of combinations of the following factors: surface (firm and foam), vision (eyes open and eyes closed), stance (feet apart and semi-tandem), and head movement (still, yaw, and pitch). Postural sway and ratings of perceived difficulty were measured for each exercise. The test-retest reliability of subjects’ performance and their rating of perceived difficulty of different standing balance exercises was examined. Two scales of rating of perceived difficulty of balance exercises were validated by comparing them with quantitative sway measures. The effect of age and vestibular disorders on postural and perceptual measures were tested using linear mixed models.
Results: Position and acceleration sway measures demonstrated acceptable test-retest reliability, while sway velocity measures were the most reliable. The rating of perceived difficulty scales demonstrated fair to substantial agreement with few exceptions. Moderate to strong, positive correlations were observed between the rating of perceived difficulty scales and all sway measures establishing their validity. Sway and ratings of perceived difficulty increased in the older subject groups. Individuals with vestibular disorders did not produce more sway compared with controls, but they did have higher ratings of perceived difficulty.
Conclusion: Quantitative sway measures and ratings of perceived difficulty can be used to prescribe intensity of balance exercises and guide progression during rehabilitation.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Alsubaie, Saudsfa5@pitt.edusfa5
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSparto,
Committee MemberWhitney,
Committee MemberFurman,
Committee MemberSienko,
Committee MemberMarchetti,
Date: 23 January 2017
Date Type: Publication
Defense Date: 1 December 2016
Approval Date: 23 January 2017
Submission Date: 16 November 2016
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 259
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Rating Sway Postural Perceived Difficulty Balance Exercise
Date Deposited: 23 Jan 2017 15:58
Last Modified: 23 Jan 2019 06:15


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