Postural control improvement training model with biological feedback capacity for seniors

ˑ: 

Postgraduate student Yu.A. Gaevaya1, 2
Postgraduate student E.V. Medvedeva2
Associate Professor A.A. Ilyin3
Dr.Med., Professor L.V. Kapilevich1, 2, 4
1National Research Tomsk State University, Tomsk
2National Research Tomsk Polytechnic University, Tomsk
3Tomsk University of Control Systems and Radioelectronics, Tomsk
4Siberian State Medical University, Tomsk

Keywords: senior age, postural control, stabilometry, biological feedback.

Background. Aging process is known to suppress sensory systems sensitivity and musculoskeletal system functionality up to severe postural disorders [9, 12] particularly serious for the 65+ year-olds as reported by the health and social support systems the world over. Thus the US statistics report 6% and 13% of the medical care costs of the 65+ years old groups associated with falls and falls-specific injuries and lethal cases. The UK health system reports about 10% of the ambulance calls from the 65+ year-olds due to falls, with about 60% of these cases resulting in hospitalizations [12]. On the whole, this age group is hospitalized due to falls five times more often than for all other health issues [9, 12].

Regardless of the actual reasons and complications, falls often result in severe maladjustment of seniors with serious changes in their lifestyles – due to not only the physical injuries and related disabilities and physical limitations as such but also the psychological complications diagnosed in almost 50% of the repeated fall-and-injury cases. These people report growing fears of new falls and related anxiety issues that often force them stay home and increase the burden of dependence on their relatives, friends and other caregivers. This is the reason why postural control training systems may be highly beneficial for the senior people post-traumatic socializing initiatives [13].

Presently the research community ranks modern biofeedback-assisted models among the most promising non-invasive rehabilitation service models for seniors [8, 11], particularly when they complement the standard health improvement physical trainings with the motor skills rehabilitation and special adaptive motor stereotypes formation elements [2, 5]. Progress in such trainings is known to bring benefits for the seniors’ mental and emotional health and socializing initiatives [6, 10].

Objective of the study was to develop and test benefits of a new postural control training model with the biofeedback capacity and stabilographic simulator systems for seniors.

Methods and structure of the study. We sampled for the new postural control training model testing 6-month experiment 55+ (59±3.2 on average) year olds (n=40, including 7 men and 33 women) with no diagnosed musculoskeletal and nervous system disorders. The sample gave informed consents for the tests, and the test protocol was approved by the National Research Tomsk State University’s Ethics Committee. The sample was split up into Experimental and Reference Groups (EG, RG) of 20 people each. RG trainings were dominated by the standard health-improvement gymnastics with a special emphasis on the body balancing and movement coordination skills. The RG trainings were run once a week for 45 minutes and complemented by self-reliant 45-min home trainings reported in the checklists and training logbooks.

The EG training was the same as the above plus complemented by biofeedback-assisted postural control training module using Stabilan-01-2 (made by NPO Neurosoft, Ivanovo, Russia) computerized stabilography system. The trainings were facilitated by a Pictures Building simulator and developmental Tetris simulator. The individual progresses were rated by motor pathologies diagnostics, treatment and rehabilitation Trust-M computerized system and biofeedback-assisted Target and Rally test systems. Progresse of the body balancing functions was rated by the pre- versus post-experimental tests using the Stabilan-01-2 system, with the tests run on a slippery surface modeled by GYMSTICK Power Slider 61131-PRO system.

Results and discussion. The pre- versus post-experimental postural control tests found significant progress in both groups, with the EG tested with a higher progress on the whole. Thus in the Romberg's test, the eyes-open postural control statokinesiograms were found to grow almost twice in the EG versus a 40% growth in the RG, with both groups tested with the performance growth. The post-experimental tests found the mean standard deviation of the body pressure center (after the biofeedback-controlled trainings to change in the sagittal plane in the RG, and in both the sagittal and frontal planes in the EG.

The post-experimental stability limit tests found a 35% growth of the front/ back stability limits in the EG. The sensory-vestibular tests found the ellipse length falling by 25% in the RG in the right-left head turning movements – versus a twofold fall in the EG. The vestibular balance test found progress of 5% and 12% in the RG and EG, respectively. It should be emphasized that the stabilographic rehabilitation simulators with the biofeedback capacity were found beneficial for the body mass center control and body balancing skills improvement trainings [7]. The simulator assisted trainings helped improve the movement and postural control with the relevant improvements in the everyday self-servicing and home chores. Of special benefits in the postural control training model were the rehabilitation games that were found to fast improve the upright postural control, minimize the walking/ standing fall/ injury risks and improve the stride and pace on the whole [2-4]

It is also important that the game scenarios with their competitive aspects and natural emotional responses and interest boosting effects helped improve the group motivations for the trainings and, hence, benefits of the postural control training model. A special emphasis was made on the stressors modeling situations to help the trainees cope with their fears and develop the autonomic response control skills to successfully suppress and mitigate the mental/ emotional stress and make progress in the health and postural control improvement trainings [1]

Conclusion. The new biofeedback-assisted postural control training model was tested beneficial as verified by the significant progress of the EG in the static/ dynamic body balancing skills, with decreased body mass center spread areas in the sagittal and frontal planes and shrinkage of the body mass center ellipse on the test stabilograms. The EG was tested with significant progress in the vestibular control reasonably independent of the visual analyzer.

References

  1. Vangrevnch O.A., Donskaya O.G., Zubkov A.A. et al. Game biocontrol and stress-dependent states. Byulleten SO RAMN. 2004. v. 113. No. 3. pp. 53-60.
  2. Alptekin K., Karan A., Diracoglu D. et al.  Investigating the effectiveness of postural muscle electrostimulation and static posturography feedback exercises in elders with balance disorder. Journal of Back and Musculoskeletal Rehabilitation. 2016. 29(1). pp. 151-159.
  3. Davlet'yarova K.V., Korshunov S.D., Rogov A.V. et al. Biomechanical characteristics of walking of patients with cerebral palsy. Teoriya i Praktika Fizicheskoy Kultury. 2015. 7. pp. 26-28.
  4. Davletyarova K.V., Medvedeva E.V., Ovchinnikova N.A. et al. Characteristics of brain bioelectric activity in disabled students: Combining cognitive and physical loads. Novosibirsk State Pedagogical University Bulletin. 2018. 8(5). pp. 245-265.
  5. Ghomashchi H. Investigating the effects of visual biofeedback therapy on recovery of postural balance in stroke patients using a complexity measure. Topics in Stroke Rehabilitation. 2016. 23(3). pp. 178-183.
  6. Hung J.-W., Yu M.-Y., K.-C.Chang et al. Feasibility of Using Tetrax Biofeedback Video Games for Balance Training in Patients With Chronic Hemiplegic Stroke. PM and R. 2016. 8(10). pp. 962-970.
  7. Illarionova A.V., Kapilevich L.V. Distinctive features of intramuscular and intermuscular coordination at power graduation in the context of balance training. Teoriya i Praktika Fizicheskoy Kultury. 2014. 12. pp. 44-46.
  8. Kapilevich, L.V., Koshelskaya E.V., Krivoschekov S.G. Physiological basis of the improvement of movement accuracy on the basis of stabilographic training with biological feedback. Human Physiology. 2015. 41(4). pp. 404-411.
  9. Lord S.R., Sherrington C., Menz H.B., Close J. C.T. Falls in Older People: Risk Factors and Strategies for Prevention. New York: Cambridge University Press, 2007. 408 p.
  10. Maciaszek, J. Effects of Posturographic Platform Biofeedback Training on the Static and Dynamic Balance of Older Stroke Patients. Journal of Stroke and Cerebrovascular Diseases. 2018. 27(7). pp. 1969-1974.
  11. Nogueira P.A., Urbano J., Reis L.P. et al. Review of Commercial and Medical-Grade Physiological Monitoring Devices for Biofeedback-Assisted Quality of Life Improvement Studies.  Journal of Medical Systems. 2018. 42(6). no. 101.
  12. Tinetti M.E., Baker D.I., King M. et al. Effect of dissemination of evidence in reducing injuries from falls. The New England journal of medicine. 2008. Jul 17, Vol. 359, no. 3. pp. 252–261.
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Corresponding author: kapil@yandex.ru

Abstract

Objective of the study was to develop and test benefits of a new postural control training model with the biofeedback capacity and stabilographic simulator systems for seniors.

Methods and structure of the study. We sampled for the new postural control training model testing 6-month experiment 55+ (59±3.2 on average) year olds (n=40, including 7 men and 33 women) with no diagnosed musculoskeletal and nervous system disorders. The sample gave informed consents for the tests, and the test protocol was approved by the National Research Tomsk State University’s Ethics Committee. The sample was split up into Experimental and Reference Groups (EG, RG) of 20 people each. RG trainings were dominated by the standard health-improvement gymnastics with a special emphasis on the body balancing and movement coordination skills. The RG trainings were run once a week for 45 minutes and complemented by self-reliant 45-min home trainings reported in the checklists and training logbooks.

The EG training was the same as the above plus complemented by biofeedback-assisted postural control training module using Stabilan-01-2 (made by NPO Neurosoft, Ivanovo, Russia) computerized stabilography system.

Results and discussion. The new biofeedback-assisted postural control training model was tested beneficial as verified by the significant progress of the EG in the static/ dynamic body balancing skills, with decreased body mass center spread areas in the sagittal and frontal planes and shrinkage of the body mass center ellipse on the test stabilograms. The EG was tested with significant progress in the vestibular control reasonably independent of the visual analyzer.