Thursday-Abstracts

Official Journal of the American College of Sports Medicine
1259 Board #205 May 30, 9:00 AM - 10:30 AM
underlying Motor Control of the romberg and Wii Balance
assessments in Concussed athletes
Nicholas G. Murray 1 , Anthony P. Salvatore 1 , Joe Tomaka 1 ,
Arthur Islas 2 , Rebecca J. Reed-Jones 1 . 1 The University of Texas
at El Paso, El Paso, TX. 2 Texas Tech University Health Sciences
Center, El Paso, TX.
(No relationships reported)
Approximately 300,000 sports-related concussion injuries occur yearly in the United
States. Balance disturbances, which occur in approximately 30% of these injuries, are
typically assessed via the Romberg Test. Recently, the NCAA has recommended the
WiiFit as an alternative measure of balance post-concussion However, the reliability
and validity of the Wii, and its relationship to the Romberg test, are unknown.
PurPOsE: This study examined relationships among the WiiFit Balance Test,
the Romberg Test, and composite scores on the ImPACT test in a sample of postconcussed
athletes. Composite scores were included as indicators of the motor
processes underlying the balance tests.
METhOd: 55 post-concussed athletes (40 male) completed the Romberg Test
(-/+), the WiiFit balance test, and ImPACT test. WiiFit balance performance was
operationalized as the number of successfully completed trials (of 5 trials of increasing
difficulty) within 30 seconds. Pearson’s correlations examined univariate associations
among the variables. ROC curves evaluated the sensitivity and specificity of each
balance test against performance on the ImPACT. Lastly, a multiple regression analysis
examined whether the Romberg and Wii tests shared redundant or unique variance
with ImPACT composite score.
rEsuLTs: The Romberg test and Wii balance test were not significantly related (r
= -.029, p = .832). The Romberg correlated positively with ImPACT scores (r = .26,
p = .041), whereas Wii trials did not (r = -.20, p = .155). Romberg scores positively
correlated with ImPACT Visual Processing Speed Score (r = .27, p = .036) and
Reaction Time score (r = .34, p =0.006). In contrast, Wii trials correlated negatively
with the ImPACT Visual Memory Score (r = -.41, p = .003). The Romberg test resulted
in sensitivity = 0.55 and specificity = 0.77, while the Wii had specificity and sensitivity
values of 0.76 and 0.57 respectively. Lastly, a multiple regression analysis suggested
that Wii balance scores accounted for variance in overall ImPACT scores (b= -.37, p <
.05) independently of variance accounted for by Romberg scores.
CONCLusION: The Wii Fit balance game and Romberg assess unique aspects of
balance and motor control. The Romberg test relates directly to single sensory motor
processing, while the Wii balance game related to multi-sensory motor processing.
1260 Board #206 May 30, 9:00 AM - 10:30 AM
Balance and sensibility Impairments In adults diagnosed
With hiv: Effectiveness Of an Exercise Program
Maryvi Gonzalez-sola 1 , Martin Rosario 1 , Angel Rosado 2 , Alexis
Ortiz 3 . 1 University of Puerto Rico, Medical Sciences Campus,
San Juan, Puerto Rico. 2 Polytechnic University of Puerto Rico,
San Juan, Puerto Rico. 3 Texas Woman’s University, School of
Physical Therapy, Texas, TX.
(No relationships reported)
Balance and sensibility impairments are common in adults diagnosed with HIV as a
consequence of infection and from secondary effects of medications.
PurPOsE aNd hyPOThEsIs: To assess the effectiveness of a three-month
exercise program on to balance and sensibility in adults diagnosed with HIV. We
hypothesized participation in a three-month exercise program will improve balance and
foot sensation in individulas diagnosed with HIV.
METhOds: Participants (n = 16) were assessed previous to participating in a
community-based physical fitness exercise program and three months after program
initiation. Balance was measured with a MatScan as the displacement of the
center of pressure in cube centimeters in two conditions; eyes open and eyes closed.
Sensibility was evaluated by Semmes-Weinstein monofilaments. Paired t-tests were
used to compare pre and post balance and sensibility values for both conditions.
rEsuLTs: Balance values with the eyes open improved significantly (p = 0.04) from
baseline (3.78 ± 1.4 cm 2 ) to three months (0.84 ± 0.14 cm 2 ) post exercise participation.
Although, balance with eyes closed improved over time (2.26 ± 0.56 cm 2 to 1.42 ±
0.37 cm 2 ), such improvement was not statistically significant (p = 0.15). Sensibility
values did not change after the intervention.
CONCLusIONs: Participation in a fitness program appears to improve balance
with opened eyes suggesting improvement throughout the visual, vestibular, and
proprioceptive systems without improvements in sensibility scoress.
Vol. 45 No. 5 Supplement S243
1261 Board #207 May 30, 9:00 AM - 10:30 AM
Influence of Cognitive Function on Clinical Balance
assessments in Community-dwelling Elderly
Stephanie A. Bomberger, Bonita L. Marks, FACSM, Abbie E.
Smith-Ryan, Tiffany E. Shubert. University of North Carolina at
Chapel Hill, Chapel Hill, NC.
(No relationships reported)
Deficits to balance, mobility, muscle strength, and cognition are risk factors for
falling. In the clinical setting, performance assessments are commonly used to identify
physical deficits; however cognition is rarely screened or assessed. Identifying balance,
mobility or strength tests associated with cognitive performance may enable clinicians
to better assess the risk factors associated with falling and develop appropriate
interventions.
PurPOsE: To investigate relationships between cognitive function, balance, mobility,
and muscular strength in higher functioning community-dwelling elderly volunteers.
METhOds: This was a cross-sectional study. Age-adjusted multiple regression
models were used to assess relationships between cognitive function (Symbol Digit
Modalities Test, SDMT) and performance assessments of balance (Single-Leg Stance
Test, SLS; Tandem Stance Test, TS; Four Square Step Test, FSST); mobility (gait
velocity per 10-Meter Walk,10MW); and muscular strength (Timed Chair Rise, TCR).
rEsuLTs: Data from 107 older adults (75% female), aged 65-93 years (mean 78.1
± 7.2) were analyzed. All completed 12+ years of school; 82% completed postsecondary
education. Age was a significant in all models, uniquely responsible for
29-30% of the variability in SDMT score (p < 0.01). The FSST (β = -0.289, p < 0.01)
and gait velocity (β = 0.256, p < 0.01) were the only significant predictors for SDMT
performance.
CONCLusIONs: Faster gait velocity (10MW) and faster FSST (dynamic balance)
performance may be predictive of better cognitive function. In a clinical setting, the
FSST and 10MW are reliable and valid assessments of fall risk. These two assessments
may also provide additional insight about cognitive and physical risk factors, without
having to do a formal cognitive assessment. This may aid clinicians in prescribing
balance intervention protocols tailored to cognitive ability that will be efficacious for
reducing fall risk.
1262 Board #208 May 30, 9:00 AM - 10:30 AM
Best Predictors of Impending Loss of Balance in single Leg
stance
KyungMo Han 1 , Mark D. Ricard 2 , KiHong Kim 3 . 1 San Jose State
University, San Jose, CA. 2 The University of Texas at Arlington,
Arlington, TX. 3 Dankook University, Cheonan, Republic of
Korea.
(No relationships reported)
The typical measures of balance from center of pressure variables include radial area, x
& y: amplitude, area, velocity and mean frequency. Single leg stance trials in which the
subjects loose balance are typically discarded. We theorized that the data just prior to
the loss of balance contain valuable information on impending loss of balance.
PurPOsE: To determine which center of pressure variables are significantly different
between stable and unstable (impending loss of balance) in single leg stance.
METhOds: Sixteen (8 females, 8 males) healthy college age subjects (age =
20.8±2.4 yrs, height = 157.5±6.3 cm, mass = 63.3±7.9 kg) were participated in the
study. Each subject completed 8 trials of single leg balance on a force platform.
The force data were sampled for 15 seconds at 60 Hz and low pass filtered with a
10 Hz cutoff. The first trial where the subject lost balance was retained for analysis.
Impending loss of balance was identified by visual inspection of vertical, anteriorposterior,
and medial-lateral force signals. The center of pressure data were separated
into stable and unstable epochs within each loss of balance trial. Total travel distance,
radial area, x & y: amplitude, area, velocity and mean frequency for stable and
unstable phases in single leg stance were compared using dependent t-tests.
rEsuLTs: There were no differences between stable and unstable phases for:
Vx (0.15±0.73 cm/s, −0.14±1.29 cm/s), Vy(−0.03±0.38 cm/s, −1.34±3.00 cm/s), x
Amplitude (0.08±0.02 cm, 0.08±0.07 cm), x Range (4.02±0.09 cm, 3.65±3.00 cm),
and XY area (22.21±11.87 cm2, 42.78±42.87 cm2), respectively p>0.05. There were
significant differences between stable and unstable phases for: Total travel distance
(0.13±0.04 cm, 0.26±0.11 cm), y Amplitude (0.08±0.03 cm, 0.23±0.10 cm), y Range
(5.31±2.37 cm, 10.48±4.52 cm), radial area(1.50±0.47 cm2, 2.39±1.29 cm2), x mean
frequency (3.67±1.23 Hz, 5.56±1.25 Hz), and y mean frequency (2.17±0.98 Hz,
5.49±1.54 Hz), respectively, p