Transcript Posturography

Presented by: Mike Darnell
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What is Posturography?
Force Platforms
Stabilographic analysis
Computerized Dynamic Posturography
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Sensory Organization Test (SOT)
Motor control Test (MCT)
Adaptation Test (ADT)
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Posturography - A term covering all of the techniques
used to quantify postural control in upright stance, in
either static or dynamic conditions.
Static Posturography (stabilometry) - Places the
subject in a standing posture on a force plate connected
to force and movement transducers, which are able to
detect the tiny oscillations of the body.
Dynamic Posturography (CDP) – Disturbs the
subject’s posture by means of a special apparatus with
a movable platform.
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Measure the ground reaction forces generated by a
body standing on or moving across the platform.
Used to quantify balance, gait,
and other parameters of
biomechanics.
Forces in three perpendicular
directions are usually plotted
against time
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Vertical (Fz)
Horizontal –antero-posterior (Fy)
Lateral –medio-lateral (Fx)
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Postural Sway – A measure of the movement
of the center of gravity within the base of
support.
Postural Stability – Measured on the basis of
the horizontal difference in sway motion
between center of gravity and center of
pressure.
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Measures stability of stance or postural
equilibrium.
Highlights poor posture, instability and
asymmetry.
Variables that can be altered
Base of support (feet together/separated, standing on one
foot, etc)
 Surface (hard or foam)
 Vision (opened v. closed)
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Most common method of measuring postural
sway.
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Is balance getting better or worse?
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Three types of tests:
Sensory Organization Test (SOT)
 Motor Control Test (MCT)
 Adaptation Test (ADT)
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Identifies problems with the patient's ability to
effectively use visual, vestibular, and
proprioceptive information.
Sensory information is eliminated through
calibrated "sway referencing" of the support
surface and/or visual surround.
Patients may display an inability to make
effective use of individual sensory systems.
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Eyes open, fixed surface and visual surround.
Eyes closed, fixed surface.
Eyes open, fixed surface, sway referenced visual surround.
Eyes open, sway referenced surface, fixed visual surround.
Eyes closed, sway referenced surface.
Eyes open, sway referenced surface and visual surround.
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35-year-old female with a chief complaint of dizziness.
Patient history, physical exam, and other diagnostic
tests are inconclusive.
Data from CDP indicate vestibular impairment.
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As a result of CDP data, the patient was referred to
physical therapy
After several PT sessions supplemented by an
individualized home exercise program, the patient
was re-evaluated with CDP.
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Assesses the patient's ability to quickly and
automatically recover from unexpected
external provocations.
Measurements include onset timing, strength
and lateral symmetry of responses.
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Assesses the patient's ability to modify motor
reactions and minimize sway when the support
moves unpredictably in the toes-up or toes-down
direction.
This adaptive test simulates daily life conditions
such as irregular support surfaces.
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Static v. Dynamic Posturography
Relationship of Newton’s laws to force plate
analyses
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How to differentiate between the various tests
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What the individual tests are used to determine
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References:
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Allum, J.H., Shepard, N.T., (1999). An overview of the clinical
use of dynamic posturography in the differential
diagnosis of balance disorders. Journal of Vestibular
Research, 9, 223-252.
Jones, R., (2008). The relationship between postural stability
and virtual environment adaptation. Neuroscience
Letters, 435(3), 204-209.
Parker, K., (2001). Use of force platforms in physics and sport.
Physics Education, 36, 18-22.
Riley, M.A., Clark, S., (2003), Recurrence analysis of human
postural sway during the sensory organization test.
Neuroscience letters, 342, 45-48.
http://resourcesonbalance.com/neurocom/protocols/motorI
mpairment/index.aspx