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PubMed2005

Kinematic characteristics of postural control during reaching in preterm children with cerebral palsy.

The relationships between kinematic characteristics of sitting posture during reaching movements of the dominant arm and 1) the kinematics of the reaching movement itself and 2) functional performance during daily life activities (PEDI) were assessed in 51 sitting preterm children with cerebral palsy (CP). The children were 2-11 y, 33 had spastic hemiplegia (SH) and 18 bilateral CP (Bi-CP). The data were compared with those of 26 typically developing children (TD). Sitting posture before the onset of reaching of children with CP differed from that of TD children: they sat with a more reclined pelvis and a more collapsed trunk. The more reclined pelvic position was associated with a better quality of reaching movements. The different sitting postures of pelvis and trunk were not related to functional performance during daily life activities. Displacement of the head, trunk, and pelvis of the children with CP did not differ from that of the TD children. Nevertheless, in the children with CP a more stable head, a more mobile trunk, and a more stable pelvis were related to better functional performance and/or a better quality of reaching. This suggests that physiotherapeutic guidance of children with CP should focus rather on the latter postural parameters than on the different sitting posture of pelvis and trunk.

Biomechanical Phenomena↗
PubMed2001

Performance of the basal aldosterone to renin ratio and of the renin stimulation test by furosemide and upright posture in screening for aldosterone-producing adenoma in low renin hypertensives.

An aldosterone-producing adenoma causes surgically correctable hypertension. Screening tests should be assessed for their accuracy and ability to detect aldosterone-producing adenoma in an appropriate population. This study aims to validate the accuracy and efficacy of the basal plasma aldosterone concentration (picomoles per liter) to PRA (nanograms per liter/sec) ratio and of combined stimulation of PRA by the furosemide and upright posture test in screening for aldosterone-producing adenoma in hypertensives with PRA less than 0.28 ng/liter.sec (1 ng/ml.h). Thirty-five aldosterone-producing adenoma and 79 nonaldosterone-producing adenoma patients were retrospectively selected from among 159 patients examined with the furosemide and upright posture test between 1989 and 1999. Selection criteria were based on blood pressure, PRA, and plasma aldosterone concentration. Diagnosis was based on surgical outcome, computed tomography scans with adrenal scintigraphy, or venous sampling. The accuracy and efficacy of basal (aldosterone/PRA ratio) and dynamic (postfurosemide and upright posture PRA) screening tests were assessed based on test sensitivity, specificity, likelihood ratio, and receiver operating characteristics. At a cut-off value of 3,200, the aldosterone/PRA ratio had a high sensitivity of 1.0 and a low specificity of 0.61. The importance was strengthened by using a multilevel likelihood ratio, i.e. positive (aldosterone/PRA ratio >10,000), negative (aldosterone/PRA ratio <3,200), and neutral (intermediate aldosterone/PRA ratio) levels. Patients with a positive level had a likelihood ratio of 7.1 and were likely to have an aldosterone-producing adenoma. The aldosterone/PRA ratio enclosed a larger area under the receiver operating characteristics curve (0.905) than did postfurosemide and upright posture PRA (0.826). In conclusion, the plasma aldosterone concentration to PRA ratio is an effective screening and diagnostic test when a triple level likelihood ratio is applied. The furosemide and upright posture test did not raise the posttest probability over that obtained using the aldosterone/PRA ratio.

Adenoma↗
PubMed1989

Dystonic posturing in complex partial seizures of temporal lobe onset: a new lateralizing sign.

We observed unilateral dystonic posturing of an arm or leg in 41 complex partial seizures (CPS) from 18 patients. In all cases this was contralateral to the ictal discharge. Unilateral automatisms occurred in 39 of 41 seizures on the side opposite the dystonic limb. Version occurred in 11 of the 41 CPS to the same side as the dystonic posturing and always followed the posturing. Subdural recordings of seven seizures showed ictal onset from the mesial basal temporal lobe. At the onset of dystonic posturing, maximum ictal activity was in the basal temporal lobe with minimal involvement of the cerebral convexity. Unilateral dystonic posturing occurs frequently in CPS of temporal lobe onset and is a lateralizing sign with a high degree of specificity. It probably reflects spread of the ictal discharge to basal ganglia structures.

Dystonia↗
PubMed1996

Associated postural adjustments are impaired by a lesion of the cortex.

A ballistic movement of one arm may be accompanied by contractions of contralateral postural muscles known as "associated postural adjustments." Ballistic movements are considered to involve the motor cortex, but it is not known where associated postural adjustments are generated. We recorded the EMG activity in the deltoid and latissimus dorsi muscles during ballistic abduction of the arm in 10 normal subjects and five subjects with lesions of the motor cortex. When subjects with cortical lesions abducted the unaffected arm, the associated postural adjustment in the contralateral latissimus dorsi was significantly smaller than normal. We argue that postural adjustments, like ballistic movements, require the participation of the motor cortex.

Adult↗
PubMed2006

Efficacy of postural reduction in osteoporotic vertebral compression fractures followed by percutaneous vertebroplasty.

OBJECTIVE: Vertebroplasty in the symptomatic osteoporotic vertebral fracture has become increasingly popular. However, there have been some limitations in restoring the height of the collapsed vertebrae and in preventing the leaking of cement. In the severely collapsed vertebrae of more than two thirds of their original height, vertebroplasty is regarded as a contraindication. We tried postural reduction using a soft pillow under the compressed level. This study was undertaken to investigate the effectiveness of the combination of postural reduction and vertebroplasty for re-expansion and stabilization of the osteoporotic vertebral fractures. METHODS: A total of 75 patients with single level vertebral compression fracture were treated with postural reduction followed by vertebroplasty. In 30 patients, the vertebral body was severely collapsed more than two-thirds of its original height. We calculated the compression ratio (anterior height/posterior height) and measured the Cobb angle. We analyzed the degree of re-expansion according to the onset duration. RESULTS: The mean compression ratio was 0.60 +/- 0.15 initially and increased to 0.75 +/- 0.17 after vertebroplasty. The mean Cobb angle was 16.14 +/- 11.29 degrees and corrected to 10.71 +/- 12.08 degrees. The degree of re-expansion showed significant relation with the onset duration. Twenty-eight of 30 (93%) severely collapsed vertebrae re-expanded after postural reduction, which made vertebroplasty possible. CONCLUSION: This new method of vertebroplasty leads to significant restoration of height and correction of kyphosis. The re-expansion was closely related with onset duration. In cases of severely collapsed vertebrae which is able to be re-expanded by postural reduction, vertebroplasty could be applied safely.

Aged↗
PubMed2006

Differential leg function in a sprawled-posture quadrupedal trotter.

Legs of sprawled-posture, quadrupedal trotting geckos (Hemidactylus garnotii) each functioned differently during constant average-speed locomotion. The center of mass decelerated in the first half of a step and accelerated in the second half, as if geckos were bouncing in fore-aft and side-to-side directions. Forelegs decelerated the center of mass only in the fore-aft direction. Hindlegs provided all the acceleration in the latter half of the step. Lateral ground reaction forces were always directed toward the midline and exceeded the magnitude of fore-aft forces. The differential leg function of sprawled-posture geckos resembled sprawled-posture hexapods more than upright-posture quadrupeds. The pattern of leg ground reaction forces observed may provide passive, dynamic stability while minimizing joint moments, yet allow high maneuverability. Integrating limb dynamics with whole body dynamics is required to resolve the trade-offs, if any, that result from stable sprawled-posture running with differential leg function.

Analysis of Variance↗
PubMed2005

Performance and postural interactions during synchronous pointing and leg flexion.

INTRODUCTION/PURPOSE: When several tasks are superimposed in a sequence, their associated postural dynamics interact, being either in opposition or in adequacy. The aim of this study was to test the influence of these postural interactions on the performance of each elementary task composing a sequence. METHODS: Seven subjects performed the following experimental conditions: pointing to a target; right leg flexion; left leg flexion; right leg flexion and pointing (ipsilateral leg sequence, IS); and left leg flexion and pointing (contralateral leg sequence, CS). Movements were performed on a large force plate. Wrist and trunk accelerations were detected with accelerometers. RESULTS: Analysis of the postural dynamics along the lateral axis showed that the direction of the anticipatory postural adjustments (APA) for the pointing was the same as for the contralateral leg flexion, and that it was opposite to that for the ipsilateral leg flexion; that is, APA of the elementary tasks were compatible or in opposition. The performance of the pointing (maximal wrist velocity) was higher in the isolated pointing than in both sequences, and it was higher in CS than in IS. The performance of the leg flexion (maximal vertical velocity of the center of gravity) was higher in both sequences than in the isolated leg flexion, and body weight transfer toward the stance leg was facilitated in CS as compared with IS. CONCLUSION: These results show that the performance of a task depends whether it is done in isolation or in combination with an associated task, and that there exists favorable combinations for task performance. These results are interpreted in terms of compatibility between the postural dynamics associated with each task of the sequence.

Adult↗
PubMed2001

Stereotypy and motor control: differences in the postural stability dynamics of persons with stereotyped and dyskinetic movement disorders.

We examined whether dynamic measures of postural stability differentiated persons with stereotyped movement disorder from persons with dyskinetic movement disorder. Participants from three groups (stereotypy, dyskinesia, control) were given a goal-oriented postural stability task, and performance was measured using a force platform and computerized posturographic techniques. The results showed that both movement disorder groups differed from the control group in the posture task. Further, the stereotypy and dyskinesia groups demonstrated markedly different postural movement profiles. The postural motion of the stereotypy group was characterized by greater amplitude and variability but lower complexity than the dyskinesia group. These results provide support for a motor control model of stereotypy.

Adult↗
PubMed2006

The importance of recognizing postural pseudoanemia.

The determination of the packed red cell volume and the hemoglobin level has been paramount for monitoring anemia and blood loss for patients in the hospital setting. Recently, these variables have been studied during various control conditions including changes in posture. It has been found that the hematocrit changes markedly with alteration of body posture, in such a way that shifts of estimated blood volume of 1 pint can commonly be elicited by a simple change of posture from supine to upright or vice versa. Therefore, it is important to recognize that in addition to the numerous pathological conditions that may affect the value of the packed cell volume, certain physiological maneuvers may have an equal impact and may confound the accurate assessment of true pathological changes in these variables. Thus, changes in posture can lead to substantial changes in hematocrit, which may be attributed mistakenly to blood loss or acute anemia and may result in a cascade of unnecessary diagnostic costs. In reality, these changes represent postural pseudoanemia, a normal physiological response to a change in position from standing to lying.

Adult↗
PubMed2002

Visually induced motion sickness predicted by postural instability.

We investigated whether postural instability can predict motion sickness and studied relations among instability, motion sickness, and vection. Nine men and 4 women (mean age = 19.85 years) were exposed, while standing, to an optical simulation of body sway. Head motion was recorded using a magnetic tracking system. Postural instabilities were observed prior to the onset of motion sickness. Vection was reported by most participants, including all who became ill. A discriminant analysis revealed that parameters of postural motion accurately predicted motion sickness. The results confirm that postural instability precedes motion sickness and suggest that measures of postural motion may serve as reliable predictors of motion sickness. Potential applications of this research include the development of on-line diagnostic tools that will allow for the prevention of motion sickness in operational and training settings.

Adolescent↗
PubMed1995

[Posture taken by members of the nursing staff during blood collection, intravenous drug administration and serotherapy].

The members of the Nursing Team are submitted, many times, to posture attacks either due to the own requirement of the action or the utilization of improper corporeal posture during its execution. The present study aims at inquiring the type, length, frequency and posture changes adopted by the members of the Nursing Team during the execution of blood collection techniques, administering of intravenous medication and serotherapy. Through direct observation were recorded 10 activities corresponding to each one of the mentioned techniques, realized in attendance of patients from a University Hospital internment unit. The results evidenced that blood collection activity was 50, 35% effectuated in the inclined standing position, followed by the standing straight position, 49, 64%. Intravenous medication administering was executed with frequent adoption of the standing straight posture, 51, 09% (in special with the arm in frontal expansion), 45, 74% in the inclined standing position and 3, 15% seated. Serotherapy technique was executed with predominant adoption of standing position (86, 88%) in special with the arms in frontal expansion and 13, 11% in the inclined standing position. The unnecessary adoption, many times, of inclined standing posture indicates that Nursing personnel have been making possible the happening of spinal column attacks mainly due to the bad utilization of corporeal mechanic. The authors suggest more attention to these aspects, mainly at Nursing courses.

Back Pain↗
PubMedDate not supplied

[Stomatognathic system and body posture in children with sensoriomotor deficits].

BACKGROUND: Literature points that body posture is an important aspect in the treatment of children with sensorimotor deficits. Considering individuals with cerebral palsy, reflexes are often more intense than reactions of rectification and equilibrium, causing, therefore, a delay or obstacle in cervical, torso and hip control. This delay has as a consequence an impact on the Stomatognathic System. AIM: To verify the relation between body posture and the Stomatognathic System in this population, regarding posture and function, and its effectiveness in the process of speech-language intervention. METHOD: 17 children with sensorimotor deficits, aged between 1 and 6:3 years, were submitted to an initial assessment, followed by speech-language intervention and re-assessment. Speech-language intervention occurred for a period of 10 months, with weekly individual sessions, always in the presence of the caretaker. All sessions were transcribed in a specific protocol and the assessment and re-assessment sessions were videotaped. RESULTS: A statistically significant improvement of stomatognathic system in 100% of the children was observed, not only of the isolated structures, but also of the whole system. The same was observed for the assessed functions. CONCLUSION: The improvement of body posture of the studied children favored significantly the development and improvement of the stomatognathic system regarding the aspects of posture and function.

Cheek↗
PubMed2001

The influence of posture change on measurements of relative body fat in the bioimpedance analysis method.

The purpose of this study was to clarify the influence of posture change on relative body fat in the bioelectrical impedance analysis (BIA) method. The subjects were 30 Japanese healthy young adult males (age: 19.8 +/- 1.4 years, height: 172.3 +/- 5.8 cm, weight: 67.1 +/- 8.2 kg). We used devices with different body segment inductions, between the hand and foot (H-F BIA) and between hands (H-H BIA), and set four measurement conditions differing in posture (supine or sitting), during rest and measurement. The reliabilities of %BF in the H-H and H-F BIA methods were very high (r = 0.995, 0.966), and the relationship in %BF between the UW method and each BIA method was mid-range (r = 0.767, 0.709). Although there were no differences in %BF among different measurement postures in the H-F BIA method, %BF in the H-H BIA method increased significantly when the posture was changed just before measurement. This indicated that it is necessary to pay attention to the posture change just before measurement in the H-H BIA method.

Adipose Tissue↗
PubMed2005

The effect of posture on respiratory activity of the abdominal muscles.

The purpose of this study was to determine the influence of posture on the expiratory activity of the abdominal muscles. Fifteen young adult men participated in the study. Activities of the external oblique abdominis, internal oblique abdominis, and rectus abdominis muscles were measured electromyographically in various postures. We used a pressure threshold in order to activate the abdominal muscles as these muscles are silent at rest. A spirometer was used to measure the lung volume in various postures. Subjects were placed in the supine, standing, sitting, and sitting-with-elbow-on-the-knee (SEK) positions. Electromyographic activity and mouth pressure were measured during spontaneous breathing and maximal voluntary ventilation under the respiratory load. We observed that the lung volume changed with posture; however, the breathing pattern under respiratory load did not change. During maximal voluntary ventilation, internal oblique abdominis muscle expiratory activity was lower in the SEK position than in any other position, external oblique abdominis muscle inspiratory activity was lower in the supine position than in any other position, and internal oblique abdominis muscle activity was higher in the standing position than in any other position. During spontaneous breathing, external oblique abdominis muscle activity was higher during expiration and inspiration in the SEK position than in any other position. The internal oblique abdominis muscle activity was higher during both inspiration and expiration in the standing position than in any other position. The rectus abdominis muscle activity did not change with changes in posture during both inspiration and expiration. Increase in the external oblique abdominis activity in the SEK position was due to anatomical muscle arrangement that was consistent with the direction of lower rib movement. On the other hand, increase in the internal oblique abdominis activity in the standing position was due to stretching of the abdominal wall by the viscera. We concluded that differences in activity were due to differences in the anatomy of the abdominal muscles and the influence of gravity.

Abdominal Muscles↗
PubMed2005

[Evaluation of effective jaw position and body posture for oral appliance of patients with obstructive sleep apnea syndrome].

PURPOSE: The aim of this study was to evaluate whether substantial airflow changes occur by changing both jaw position and body posture in normal subjects and patients with obstructive sleep apnea syndrome (OSAS). METHODS: Fifteen normal controls (9 males and 6 females) and 15 male OSAS patients participated in this study. For all subjects their maximum forced inspiratory flow (FIF(25-75)) curve was measured in seven positions as follows: a) 0% jaw forward-upright position, b) 0% jaw forward-supine position, c) 50% jaw forward-supine position, d) 75% jaw forward-supine position, e) 0% jaw forward-lateral position, f) 50% jaw forward-lateral position, and g) 75% jaw forward-lateral position. RESULTS: Although FIF(25-75) was increased by changing the body posture from supine to lateral in normal subjects, it was not increased by increasing the jaw forward position of them. On the other hand, the more forward the jaw position, the more FIF(25-75) increased in OSAS patients. However, it was not increased by changing the body posture of them. There were no significant differences between the 50% forward and 75% forward jaw positions in both groups. CONCLUSIONS: In normal subjects, change of jaw position was more effective than that of body posture for FIF(25-75). However, in OSAS patients, change of body posture was more effective than that of jaw position for FIF(25-75). It was suggested that the treatment effect in the 50% forward position was similar to that in the 75% forward position.

Adult↗
PubMed2003

Malocclusion associated with abnormal posture.

Growth and development of maxillofacial morphology and oral function are closely interrelated. Oral function is comprised of articulation, swallowing, and chewing. Malocclusion may be caused by abnormal functions such as mouth breathing, tongue thrust swallowing, and unilateral chewing and by abnormal postures of oral circumferential muscles such as forward tongue thrust, tongue biting, and low tongue at rest. Forces from unintentional and habitual behaviors constantly acting on the maxillofacial and alveolar regions can cause the bony structures to generally deform, resulting in jaw deformity and malocclusion. Oral function also plays a vital role in maintaining body posture. In this study, clinical observations of oral postures examined maxillary protrusion and open bite, anterior crossbite and facial asymmetry. The unstable forces induced by abnormal posture were correlated with the varieties of malocclusion. Morphology, function, and posture were shown to be closely interrelated and to influence each other.

Child↗
PubMed1993

Prevention of barium aspiration during videofluoroscopic swallowing studies: value of change in posture.

OBJECTIVE: We investigated the frequency with which changes in the position of a patient's head or body eliminated aspiration of liquid barium during videofluoroscopic swallowing studies in patients with oropharyngeal dysphagia. We also studied factors that influenced the effect of posture on aspiration. SUBJECTS AND METHODS: The study group comprised 165 patients consecutively referred for videofluoroscopic examination of the oropharyngeal stages of swallowing in whom aspiration of barium occurred while swallowing 1, 3, 5, or 10 ml of thin liquid barium or drinking barium from a cup. When aspiration occurred, the patient changed to one of five postures (chin down, chin up, head rotated, head tilted, and lying down), selected on the basis of the specific swallowing abnormality causing the aspiration. RESULTS: Changes in head or body position eliminated aspiration of at least one bolus of barium in 127 (77%) of the 165 patients, and of all four boluses plus drinking barium from a cup in 41 patients (25%). Postural changes were less beneficial in preventing aspiration in patients with substantial language or cognitive defects or restricted head movement. CONCLUSIONS: Postural techniques can eliminate aspiration of barium of at least small volumes in most patients. Expansion of the oropharyngeal swallowing study to include the effect of various postures can be done with minimal risk of increased aspiration.

Barium Sulfate↗
PubMed1995

Postural stability in diabetic polyneuropathy.

OBJECTIVE: To examine whether sensory changes in lower limbs associated with diabetic sensory polyneuropathy compromise postural stability in different visual sensory conditions. RESEARCH DESIGN AND METHODS: The presence and severity of sensory neuropathy was evaluated with a clinical scale and measures of nerve conduction velocity in the lower limbs. Balance control was evaluated by testing subjects' postural stability (with a force platform) with vision, without vision, and during a recovery period after being without vision. RESULTS: Neuropathic patients showed larger ranges of sway, a faster sway speed, and a greater dispersion of sway than control subjects in all conditions. They also exhibited similar or less stable postural performance with vision than that of control subjects without vision. There was a strong relationship between the severity of the neuropathy and the postural stability. CONCLUSIONS: This experiment highlights that even with vision, the postural stability of neuropathic patients is impaired and may put them at higher risk of falling when performing more challenging daily tasks.

Aged↗