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Meditouch/
Balance Tutor Sport Edition
Scientific Context
La postura es la posición del cuerpo o partes del cuerpo. El control postural, es una función motora vital y ha sido definido como el control de la posición del cuerpo en el tiempo con el fin del equilibrio y orientación. Existen 2 tipos de equilibrio: Respuestas proactivas y respuestas reactivas.
1_Proactive responses
Postural control responses used by body when it is aware of coming perturbations (expected perturbations). For example, walking in the street with no obstacle during the gate.
In this case body “sees” and feels the pavement and plans its movement according to the situation. For example, if the pavement is slippery (oil or snow on it), body decreases its movement and gets stabilized before walking on it and will be more careful while walking on it.
This type of answer is responsible of maintaining the center of gravity inside the base of support continuously during the performance of the task
2_Reactive responses
Postural control responses used by body when it doesn´t expect an external obstacle as a slippery or a trip on during walking.
The aim of the body is to maintain the center of gravity inside the base of support of it, getting the center of mass to its initial position after suffering a perturbation. This strategy is known as Automatic Postural Apparition (APA). If the first strategy is not enough to keep the center of gravity inside the base support of the body, then a second strategy is performed (compensatory step). In this case, body will try to create a new safe position of the center of mass. Body creates this new position carrying out a compensatory step to the opposite site of the perturbation in order to amplify the base of support.
Motor Control
There are two main types of devices for balance treatment:
- Active devices that change the center of mass of the body through external force (the engine of the device is moving the center of mass of the patient). In this case, the force performed by the device obliges the body to adjust to this change.
- Passive devices as tilting boards that don´t have their own capacity to move the center of mass of the patient.
BalanceTutor
The system consists of a treadmill for balance rehabilitation and training either in static or dynamic mode. The system consists of a running treadmill and a powerful rehabilitation software that allows the planning and control of different perturbations. Through the lateral and forward/back accelerations, it can simulate and control slips and trips on.
Thank to BalanceTutor and to the training of the reactive response through unexpected perturbations, the patient reduces the reaction time and the quality of the corrective/predictive step. This means balance and movement coordination improvement, which helps patients with functional activities while preventing falls or injuries.
In the following video it is explained the BalanceTutor system, Sport Edition:
While the person is training on the system, balance evaluations are done to save this data, for tracing the progression of the person.
BalanceTutor systemhas multiple applications as the following described:
• Stimulates weight bearing.
• Improves the corrective/preventive step response.
• Vestibular rehabilitation.
• Specific muscle activation.
• Specific muscle groups strengthening.
• Multi task training for coordination improvement.
• Somatosensory system training.
• Static and dynamic balance improvement.
• Improves speed and quality of walking.
The system can be used in different fields, as neurological rehabilitation. In the same way, it is used in the trauma rehabilitation in the following cases:
• Joints surgery and fracture.
• Muscle or tendon sprain.
• Amputation.
• Muscle weakening.
• Phrostesis use.
• Ligaments sprain.
Unique features of BalanceTutor:
• Proprioceptive rehabilitation.
• Automatic response evaluation.
• Customized training.
• Post surgery rehabilitation.
• Normal injuries prevention.
• Objective documentation.
Scientific Studies
Although working the reactive responses of people with unexpected perturbations is something quite new, there is already certain scientific studies that show the efficacy to improve balance and for fall prevention, as the followings:
1. erturbation training can reduce community dwelling older adults annual risk: a randomized controlled trial.
“Pay YC 2014”
• RCT 212 patients.
• 1 session. 1 perturbation against 24.
• Fall risk reduces 50% in one year.
2. Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials.
“Mansfield 2015”
• 8 estudies with 404 patients.
• People trained with perturbations had less fall risk OR 0.7 and total falls in this group was the half than in the control.
3. Unexpected perturbations training improves balance control and voluntary stepping times in older adults – a double blind randomized control trial.
“Kurz I, 2016”
• RCT. 53 patients.
• 24 sessions with perturbations in CM vs CM without perturbations.
• Improvement of gate times and balance control
In the following links you will see two scientific studies carried out with the BalanceTutor system for fall prevention and walk improvement:
Fall prevention:
Walk improvement in neurological patient: