Biomedical subjects

Rolf Moe-Nilssen

Publications and source records attributed to Rolf Moe-Nilssen.

14 recordsLinked to original sources

PubMed2006

Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept.

BACKGROUND AND PURPOSE: Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. METHOD: A single-subject experimental study design with ABAA phases was used, and two patients with relapsing-remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self report measures and interviews were used. RESULTS: After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as 'much improved'. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). CONCLUSION: The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS.

Adult↗

PubMed2006

Modulation of gait during visual adaptation to dark.

The authors investigated the modulation of gait during dark adaptation. Twenty-five women (mean age = 72 years, SD = 5 years) walked back and forth on an arbitrarily uneven walkway during normal lighting at speeds ranging from slow to fast. Participants then performed 20 trials at preferred speed after sudden reduction of lighting; the authors compared those trials with point estimates at equivalent speeds representing normal lighting. The authors estimated speed, cadence, mediolateral trunk acceleration, and mediolateral interstep trunk-acceleration variability for each trial. Participants compensated for sudden reduction of lighting by reducing their walking speed. Compared with performance at equivalent speeds during normal lighting, cadence, trunk acceleration, and interstep trunk-acceleration variability initially increased. All variables showed an asymptotic approximation toward normal values during 60-90 s of walking in subdued lighting. The authors suggest that the sudden transition from normal to marginal lighting, rather than marginal lighting itself, may challenge locomotor control.

Adaptation, Ocular↗

PubMed2005

Test-retest reliability of the Progressive Isoinertial Lifting Evaluation (PILE).

STUDY DESIGN: A repeated measures single group design. OBJECTIVES: To investigate test-retest reliability of Progressive Isoinertial Lifting Evaluation on patients with long lasting musculoskeletal problems related to the lumbar spine. SUMMARY OF BACKGROUND DATA: Test-retest reliability has been satisfactory in healthy men. Test-retest reliability for clinical populations has not been reported. METHODS: A total of 31 patients (17 women and 14 men) with long lasting low back pain participated in the study. The patients were tested twice at an interval of 2 days and at the same time of the day. The heaviest load that the patient could lift 4 times was used as outcome measure. RESULTS: The error of measurement indicates that the true result in 95% of cases will be within +/-4.5 kg from the measured value, while the difference between 2 measurements in 95% of cases will be less than 6.4 kg. Intra-class correlation (1,1) was 0.91. CONCLUSIONS: Relative test-retest reliability was high assessed by intra-class correlation, but absolute measurement variability reported as the smallest detectable difference has relevance for the interpretation of clinical test results and should also be considered.

Adult↗

PubMed2005

Interstride trunk acceleration variability but not step width variability can differentiate between fit and frail older adults.

Variability of gait may be regarded as a sign of adaptability and thus a requirement for successful locomotion, or as a sign of impaired balance control. In this study we examined the role of step width variability (SWV) and interstride trunk acceleration variability in two groups of fit and frail old people. We investigated the association of these measures and how they differentiated the two groups. We examined 33 fit older adults (mean age 73 years, S.D. 3.3 years) and 32 frail old people (mean age 80 years, S.D. 4.0 years). Subjects performed timed walking at different speeds ranging from very slow to very fast. SWV was measured from footprints. Trunk accelerations were registered by a triaxial accelerometer and interstride trunk acceleration variability assessed by an unbiased autocorrelation procedure. All measures were normalized to a walking speed of 0.9 m/s to avoid the confounding effect of gait speed on speed dependent gait parameters. SWV demonstrated low association with the trunk variability measures, and did not differ between groups. The frail group had lower mediolateral (P=0.015), but higher vertical (P=0.015) and anteroposterior (P<0.02) trunk variability than the fit group. Trunk variability classified 80% of the subjects correctly into their respective group (sensitivity=0.75, specificity=0.85). The findings are compatible with a notion that mediolateral interstride trunk variability represents a different aspect of motor control than variability in the direction of propulsion.

Acceleration↗

PubMed2004

Effects of home exercises and group training on functional abilities in home-dwelling older persons with mobility and balance problems. A randomized study.

BACKGROUND AND AIMS: Exercise in older people may reduce falls and improve functional abilities. Less is known about the optimal amount of training. The aim of this study was to determine the effectiveness of home training, and whether group training in addition to home training enhances the effect. METHODS: This randomized trial included 77 persons aged 75 years and older (mean 81, SD 4.5), living at home. Home training (HT) comprised twice-daily functional balance and strength exercises and 3 group meetings. Combined training (CT) included group training twice weekly and the same home exercises. The trial lasted 12 weeks. Physical therapists ran both programs. Exercises and falls were recorded daily. We assessed function at baseline, 3 and 9 months, and falls at one year. RESULTS: Mean participation for group meetings was 2.5 out of 3 (HT group) and, for group training sessions, 21 out of 24 (CT group). The mean numbers of daily home sessions were 1.29 and 1.35 in the HT and CT groups. Overall improvement, but no group differences, were found at 3 months for walking speed, Figure of Eight, Timed Up & Go, Maximum Step Length, Timed Pick-up and Sit-to-stand (p<0.02). Posturography (p=0.85) and isometric quadriceps strength (p=0.26) showed no improvement. Function at 9 months was equivalent to baseline level. There were no group differences in fall rate (p=0.78) or time to first fall (p=0.84). CONCLUSIONS: Daily home training supervised by physical therapists improved functional abilities. Supplementary individualized group training gave no additional effect. The effect on function was not present 6 months after the end of the intervention.

Accidental Falls↗

PubMed2004

Short-term repeatability of body sway during quiet standing in people with hemiparesis and in frail older adults.

OBJECTIVE: To investigate short-term repeatability of a posturographic quiet standing test protocol in people with hemiparesis and in frail older adults. DESIGN: Test-retest design, using 5 different quiet standing task conditions in which size and compliance of the support surface, visual influence, and cognitive demands were manipulated. Retest was performed after 15 minutes. SETTING: Rehabilitation units and day care center. PARTICIPANTS: Twenty-three people with stroke (mean age, 74.4y) and 16 frail older adults (mean age, 82.1y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Repeatability of trunk acceleration root mean square by within-subject standard deviation, coefficient of variation, and intraclass correlation coefficients (ICCs). RESULTS: The ICC(1,2) ranged from.13 to.75 for people with hemiparesis and from.73 to.92 for frail older adults when tested with their eyes open. The least demanding task condition gave the best repeatability. Standing with eyes closed resulted in very low ICC(1,2) in people with hemiparesis (.16) and in frail older adults (-.18). Interpretation of the results was similar for the other 2 reliability measures. CONCLUSIONS: A mean of 2 repeated measures gave adequate repeatability for frail older adults but not for people with stroke when they were tested with their eyes open. This study showed the importance of establishing short-term repeatability relative to each clinical population in which such tests are used.

Aged↗

PubMed2004

Estimation of gait cycle characteristics by trunk accelerometry.

This study reports on the novel use of a portable system to measure gait cycle parameters. Measurements were made by a triaxial accelerometer over the lower trunk during timed walking over a range of self-administered speeds. Signals from each trial were transformed to a horizontal-vertical coordinate system and analyzed by an unbiased autocorrelation procedure to obtain cadence, step length, and measures of gait regularity and symmetry. By curvilinear interpolation, speed-dependent gait parameters could be compared at a normalized speed. It was demonstrated that analysis of gait cycle parameters which previously required fixed laboratory equipment and paced walking procedures, now can be made from data obtained by a timing device and a portable sensor at free walking speeds.

Abdomen↗

PubMed2004

Home training with and without additional group training in physically frail old people living at home: effect on health-related quality of life and ambulation.

OBJECTIVE: To test the effect of two exercise regimes on health-related quality of life (HRQoL) and ambulatory capacity. DESIGN: Randomized controlled trial. SUBJECTS: Seventy-seven community-dwelling physically frail people over 75 years of age (mean = 81, SD = 4.5). INTERVENTIONS: Home training (HT, N= 38) comprised twice daily functional balance and strength exercises and three group meetings. Combined training (CT, N= 39) included group training twice weekly and the same home exercises. Interventions lasted 12 weeks. Physiotherapists ran both programmes. Home exercises were recorded daily. MAIN MEASURES: HRQoL was assessed by SF-36, and ambulatory capacity by walking speed and frequency and duration of outdoor walks. RESULTS: Following intervention, CT improved the SF-36 mental health index significantly more than HT (p = 0.01). The SF-36 physical health index (p = 0.002) and walking speed (p = 0.02) demonstrated improvements, but no group differences. Six months after cessation of intervention there was still overall improvements on the mental health index (p = 0.032), borderline overall improvements on the physical health index (p = 0.057), higher weekly number of outdoor walks for the CT group than for the HT group (p = 0.027) and an improved habitual walking speed in the CT group only (p = 0.022). CONCLUSIONS: HT improved HRQoL and walking speed, but additional group training gave larger benefits on mental health. Group training away from home may be beneficial for mental health and ambulatory capacity.

Activities of Daily Living↗

PubMed2003

Balance and gait in children with dyslexia.

Tests of postural stability have provided some evidence of a link between deficits in gross motor skills and developmental dyslexia. The ordinal-level scales used previously, however, have limited measurement sensitivity, and no studies have investigated motor performance during walking in participants with dyslexia. The purpose of this study was to investigate if continuous-scaled measures of standing balance and gait could discriminate between groups of impaired and normal readers when investigators were blind to group membership during testing. Children with dyslexia ( n=22) and controls ( n=18), aged 10-12 years, performed walking tests at four different speeds (slow-preferred-fast-very fast) on an even and an uneven surface, and tests of unperturbed and perturbed body sway during standing. Body movements were registered by a triaxial accelerometer over the lower trunk, and measures of reaction time, body sway, walking speed, step length and cadence were calculated. Results were controlled for gender differences. Tests of standing balance with eyes closed did not discriminate between groups. All unperturbed standing tests with eyes open showed significant group differences ( P<0.05) and classified correctly 70-77.5% of the subjects into their respective groups. Mean walking speed during very fast walking on both flat and uneven surface was > or =0.2 m/s ( P< or =0.01) faster for controls than for the group with dyslexia. This test classified 77.5% and 85% of the subjects correctly on flat and uneven surface, respectively. Cadence at preferred or very fast speed did not differ statistically between groups, but revealed significant group differences when all subjects were compared at a normalised walking speed ( P< or =0.04). Very fast walking speed as well as cadence at a normalised speed discriminated better between groups when subjects were walking on an uneven surface compared to a flat floor. Continuous-scaled walking tests performed in field settings may be suitable for motor skill assessment as a component of a screening tool for developmental dyslexia.

Child↗

PubMed2003

Forceplate and accelerometer measures for evaluating the effect of muscle fatigue on postural control during one-legged stance.

BACKGROUND AND PURPOSE: The control of balance is vital in many sporting activities as well as in activities of daily life. In order to treat deficiencies properly valid and reliable methods are needed to evaluate different aspects of stability. Muscle fatigue has been proposed to cause a change in postural control strategy, and the use of different tools and variables might therefore elucidate these changes. The aims of the present study were: to investigate if forceplate and accelerometer measurements about postural control during one-legged stance indicate changes in postural control strategy after fatiguing exercise; and to investigate the correlation between forceplate and accelerometer measurements obtained before and after fatiguing exercise. METHOD: The study used an experimental design. Twenty-three healthy women (mean age 26.8 years; range 20-34 years) were studied. Forceplate and accelerometer data were obtained simultaneously and consisted of measures of centre of pressure movements and horizontal trunk acceleration in medio-lateral and antero-posterior directions. The calf muscles of the right leg were fatigued by repeated heel rises. RESULTS: The average amplitude of centre of pressure movements and trunk acceleration increased, whereas the average velocity of centre of pressure movements decreased during fatigue. These changes indicate a change of movement strategy. Moderate correlation between trunk acceleration and centre of pressure movements was seen, confirming the link between the variables, but indicating that different aspects of the ability to control balance were measured. CONCLUSIONS: Calf muscle fatigue has a short-lasting effect on body balance, with measurements indicating a change in postural control strategy. Different tools and variables are needed to identify different balance control strategies. The procedures used in the present study may be modified to identify subjects with inadequate capacity to choose between balance control strategies; they are also applicable in clinical settings outside a laboratory environment.

Acceleration↗

PubMed2003

The effect of gait speed on lateral balance control during walking in healthy elderly.

The aim of this paper was to investigate the effect of speed dependency on lateral gait parameters. In 36 healthy elderly (mean age=72.5 years, S.D.=3.2 years), walking at four different self-administered speeds, mediolateral trunk acceleration and step width (SW), but not step-width variability (SWV), were found to have quadratic relations to gait speed. Normalizing for speed by curvilinear interpolation, and controlling for subject characteristics, disclosed smaller SW (adjusted R2=0.41, P<0.001), but larger SWV (adjusted R2=0.26, P=0.01) with increasing age in multiple regression models. These relations were camouflaged at preferred speed.

Acceleration↗

PubMed2002

Trunk accelerometry as a measure of balance control during quiet standing.

The goal was to investigate whether body sway measured by trunk accelerometry during quiet standing could differentiate between young and elderly healthy subjects, and between conditions with eyes open and closed on firm and compliant surfaces. Raw data demonstrated poor discrimination, but horizontal transformation to eliminate a constant gravity component disclosed consistent mean differences across groups (P < or = 0.0025), and also between conditions (P < or = 0.0005), except for the most marginal difference. When drift associated with very low frequency body sway was adjusted for, a significant difference appeared also here (P = 0.001). This study indicates that trunk accelerometry can discriminate between populations and conditions during quiet standing.

Acceleration↗

PubMed2002

Back Performance Scale for the assessment of mobility-related activities in people with back pain.

BACKGROUND AND PURPOSE: Activities that require mobility of the trunk are often limited in patients with back problems. For this study, 5 tests (Sock Test, Pick-up Test, Roll-up Test, Fingertip-to-Floor Test, and Lift Test), all requiring sagittal-plane mobility, were performed, and the test scores were combined by the authors in a scale called the Back Performance Scale (BPS) to obtain a performance measure of mobility-related activities. SUBJECTS: The participants were 288 patients with long-lasting musculoskeletal pain. METHODS: The basis for constructing a sum scale (BPS), discriminative ability, and responsiveness to important change of the BPS were examined in patients with back pain. RESULTS: Bivariate correlations (rs) of scores among tests ranged from.27 to.50, and correlations between separate tests and the BPS ranged from.63 to.73. The Cronbach alpha was.73. The BPS sum scores discriminated between patients with different return to work status and were higher for back pain than for other musculoskeletal pain. Responsiveness was high (effect size=1.33) in patients who had changed and low (effect size=0.31) in patients who had not changed, using return to work as an external indicator of important change. The BPS was more responsive than the separate tests. DISCUSSION AND CONCLUSION: The BPS appears to measure an aspect of physical performance that is of clinical importance to patients with back pain.

Adult↗

PubMed1999

Dynamic adjustments of walking behavior dependent on noxious input in experimental low back pain.

The aim of this study was to explore whether accelerations of the lower back during walking are temporarily attenuated by experimentally-induced low back pain, as compared with normal walking. Transient low back pain was induced by injection of 1 ml 6% hypertonic saline in the longissimus dorsi muscle in 20 healthy subjects. Acceleration was measured during walking at self-selected speeds before and repeatedly after the injection by a portable, triaxial accelerometer positioned over the L3 region. Data were subsequently adjusted for differences in walking speeds between trials and subjects. Pain was reported on a 0-10 point scale during walking until pain was no longer present. Lumbar acceleration sample mean was attenuated for the anteroposterior (P=0.002) and mediolateral (P=0.002) sensing axes as well as for the vector sum (P=0.005) at maximal pain compared to pretest values. The vertical axis showed no significant changes. Values returned to pretest level when pain was no longer present. Regardless of the initial increase and subsequent decrease in pain after injection, there was a linear relationship between pain and acceleration in 15 of the 20 subjects (0.89>/=R(2)>/=0.36, P</=0.002), suggesting a continuous dynamic adjustment of motor behavior dependent on the noxious input. It appears that this new method is suitable for detection of continuous subconscious changes of body accelerations during walking in relation to pain.

Acceleration↗