[Backward disequilibrium in the elderly: review of symptoms and proposition of a tool for quantitative assessment].
ABSTRACT PURPOSE: Although there is currently no epidemiological data on backward disequilibrium, this disturbance of posture does not seem to be rare in frail elderly. ACTUALITIES AND STRONG POINTS: Backward disequilibrium is characterized by the following criteria: the location of buttocks on the anterior side of the seat while the trunk rested at the back of the armchair in the sitting position; an inadequate forward of the trunk and a backward projection of the trunk outside the base of support during sit-to-stand; and a posterior projection of the center of mass outside the base of support in the standing position. Several pathological situations either somatic (degenerative, ischemic and traumatic brain lesions), psycho-somatic (psychomotor disadaptation syndrome, extended bed confining, non-use) or psychological (depression) affections can entail backward disequilibrium. Falls, loss of autonomy and the risk of the vicious circle with its causes are the main consequences of backward disequilibrium. PROSPECTS AND PROJECTS: Although the geriatrician is familiarized with backward disequilibrium, there is no scale to quantify it. In this paper we review causes, consequences and management of backward disequilibrium, and in order to assess it, we propose a semi-quantitative scale, based on some activities of everyday living which are sitting position, sit-to-stand, back-to-sit and standing position. So, a backward disequilibrium score could be determined.
- SourceAvailable from: free.frProgress in Neurobiology 02/1992; 38(1):35-56. · 9.04 Impact Factor
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ABSTRACT: This study was aimed at demonstrating the existence of a biased postural vertical in humans with a recent cerebral lesion. The postural vertical of patients and controls was analysed comparatively using a self-regulated balancing task, performed in sitting posture. Patients displayed a quite constant (19/22) contralesional tilt of the postural vertical (mean -2.6 degrees), varying with the severity of their spatial neglect and hemianaethesia. Eight of them showed a pathological contralesional bias (mean -5.5 degrees) as compared to normals. This result indicates an asymmetric process of somatic graviceptive information due to some cerebral lesions. When patients were subjected to a transcutaneous electrical stimulation applied onto the contralesional side of the neck, body verticality was especially improved in those who showed a pathological bias in the postural vertical. This effect could thus be due to a reduced distortion in the egocentric co-ordinate system for spatial information processing.Neuroscience Letters 09/1998; 252(2):75-8. · 2.03 Impact Factor
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ABSTRACT: Direct observation of postural and motor abilities appears as very important in assessment of patients showing psychomotor disadaptation syndrome (PDS). We examine feasibility and reliability of mini motor test (MMT) which has been developed in order to establish rehabilitation goals in this population. MMT is a 20-item score which assesses abilities in bed, quality of sitting position, abilities in the standing position, and quality of gait. MMT has been conducted by two different independent investigators, a physiotherapist and a physician, in four different geriatric centers. One hundred and one subjects (mean age: 84.9 +/- 6.0 years) were included in the study. The agreement between the two investigators was highly satisfying for both MMT total score and each item of MMT. Redundancy between items appeared very limited. The difference between investigators for MMT total score did not vary significantly with score of the mini-mental-state examination (MMSE). The correlation between MMT and the Katz index was found significantly negative. MMT is an easy direct-observation test which may be particularly useful in patients who present with severe postural and gait impairment. This test can be used in clinical practice by different professional actors in order to allow an interdisciplinary approach for a common rehabilitation goal in the PDS patients.Archives of Gerontology and Geriatrics 01/2005; 40(2):201-11. · 1.70 Impact Factor