Balance TutorBalance Tutor

MediTouch/

Balance Tutor

Functions

Independent living requires sufficient postural control for active daily living activities including sitting, standing, walking and running.

A fall will result if balance is lost when the person is standing, walking or running. Falls burden the economy with excessive direct and indirect costs. With approx. 1/3 of adults over 65 suffering from a fall, it is no surprise that each year falls are the most common cause of injury death in this age group. At the same time, falls result in 90% of hip fractures in older adults and are the most common cause of non-fatal injuries.

An intrinsic recognition of the static and dynamic movement of the Centre of Mass (COM) is achieved by an integration of sensory input from the vestibular, visual and the somatosensory system. The integration of this sensory information together with sufficient motor and cognitive movement ability enables postural control. This postural control will initiate the appropriate postural response needed to maintain balance and keep the COM over the basis of support.

The postural control response is divided into two main categories namely proactive and reactive responses.

The proactive response is a group of responses intended to keep the COM stable over the basis of support. If the COM shifts from the basis of support then the reactive response is the group of responses needed to return the COM or re-stabilize the COM over the basis of support.

Balance will be lost because of an insufficient proactive response following an expected perturbation.  An unexpected perturbation like a slip or a trip will elicit a reactive response such as a compensatory step. The ability to initiate an effective compensatory step is the best line of defense when balance is lost and a fall is initiated.

In order to perform ADL activities the person will need sufficient proactive and reactive postural control responses. Scientific research shows that in addition to aging, both neurological and orthopedic injury and disease may affect both postural control responses. In addition, research shows that optimal balance rehabilitation needs to integrate evaluation and practice of both these responses.  However, because of the lack of both safety and treatment customization possibilities, traditional balance therapy can only practice proactive postural control.

MediTouch has developed the BalanceTutor an innovative dynamic and static postural control and gait trainer.  The system consists of a treadmill mounted on a moving force plate platform. The platform moves in the medial/ lateral and forward/ backward plains to simulate a slip and a trip in both the static and dynamic mode. The therapist customizes the training program and performs evaluations through integrated user friendly software. The system is safe as a safety harness and an emergency stop button are included in BalanceTutor. 

The BalanceTutor allows the therapist to objectively and quantitatively evaluate compensatory step initiation time and performance, (pause) as well as gate. This is achieved by combining image processing and center of pressure measurements. In addition to the direction of displacement, the speed, and dosage of perturbation can be customized to the patient's ability and rehabilitation needs. Movement biofeedback and instructions on functional body position can be also provided during training.  The patient is therefore challenged during training while standing, walking and even running.

Research has shown practice with the BalanceTutor significantly improves both reaction time and compensatory step scores which prevents falls and leads to an improved quality of life.

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