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Related Manuals for biodex BALANCE SYSTEM SD
Summary of Contents for biodex BALANCE SYSTEM SD
- Page 1 BALANCE SYSTEM SD OPERATION/SERVICE MANUAL 950-440 950-441 950-444 IODEX Biodex Medical Systems, Inc. 20 Ramsey Road, Shirley, New Y ork, 11967-4704, Tel: 800-224-6339 (Int’l 631-924-9000), Fax: 631-924-9338, Email: info@biodex.com, www.biodex.com FN: 10-205 Rev B 3/12...
- Page 2 BALANCE SYSTEM This manual covers installation and operation procedures for the following products: #950-440 System, Balance SD, 115 VAC #950-441 System, Balance SD, 230 VAC #950-444 System, Balance SD, 100 VAC CAUTION Federal law restricts this device to sale or on the order of a medical practitioner. When prescribed for therapeutic purpose, a physician should clearly define the parameters of use (i.e., total work, maximum heart rate, etc.) to reduce the risk of patient injury.
- Page 3 NOte: Service should be provided by qualified personnel only. Please do not attempt installation or repair on your own. Call Biodex Customer Service first, they’ll be glad to help. CAUtION: Modifications to this product are not allowed. Unauthorized modification of the prod- uct can result in hazards to the operator and patient and will void the manufacturer’s warranty.
- Page 4 CONTENTS SYMBOL DEFINITIONS This symbol indicates Type B equipment, which indicates equipment that provides a par- ticular degree of protection against electric shock, particularly with regard to allowable leakage current and reliability of the protective earth connection. For the safe and effective use of this device the operator must consult the accompanying documents prior to use.
- Page 5 • Report Parameters Defined • Progress Reports • Sample Balance Reports 10. Data ..............................10-1 • Assessing Limits of Stability With The Biodex Balance System • Understanding Patient Performance • Balance System Statistics Defined • Changing Normative Data Default 11. System Utilities..........................11-1 •...
- Page 6 Color printer with stand - included Features both static Locking surface ensures and dynamic Transport safe “on-off” patient balance capabilities wheels allow movement easy relocation Figure 1.1: The Biodex Balance System SD primary components and adjustment mechanisms. — 1-1 — INTRODUCTION...
- Page 7 Dynamic or Static Limits of Stability, Postural Stability and Clinical Test of Sensory Integration of Balance (CTSIB). The Balance System SD also serves as a valuable training device to enhance kinesthetic abilities that may provide some degree of compensation for impaired proprioceptive reflex mechanisms following injury.
- Page 8 2. SYSTEM SPECIFICATIONS Dimensions: Base: 30" w x 44" depth x 8" h (76 x 112 x 20 cm) Platform: 21.5" dia (55 cm) Display Height: Adjustable from 53" to 68" h above platform (135 x 173 cm); 76" h (193 cm) maximum from floor.
- Page 9 Mini Keyboard ACK-5010U USB Keyboard Adesso AKB-210 Keyboard Adesso WKB-4000US Keyboard Adesso ACK-540UB Keyboard Adesso AKB-110B Keyboard * Printers and other devices are subject to market availability. Please check with Biodex customer service if questions arise. SYSTEM SPECIFICATIONS — 2-2 —...
- Page 10 3. ASSEMBLY & INSTALLATION The Biodex Balance System SD is shipped in a single carton. Except for the printer, which the user must install as explained below, the entire system is factory assembled and ready to operate. If desired, the system can be configured for PC computer compatibility, allowing the foot plate to be used like a joystick for interactive video game use.
- Page 11 CONTENTS Figure 3.1. The printer power cable should be plugged into the AC receptacle on the rear base of the display support post. The printer USB cable should be plugged into the USB port on back of the display. 1. Reset Button 2.
- Page 12 PaRTS aND aDjuSTMENTS (See Figure 3.3.) Mechanical adjustments to the Biodex Balance System are straightforward and uncomplicated. In fact, there are only three adjustments that need be addressed to accommodate any patient: Support Handle Position, Display Height and Display Tilt. All other test and exercise functions are software controlled.
- Page 13 CONTENTS Auxiliary Serial and NEW 12.1" High resolution color USB Printer Ports touch-screen LCD display Adjustable height display to accommodate each patient Adjustable support handles Color printer with stand - included Features both static Locking surface ensures and dynamic Transport safe “on-off”...
- Page 14 4. CLINICAL CONSIDERATIONS Prior to allowing any patient to use this device, make certain to read and comprehend this entire manual. Ensure that you are completely familiar with all aspects of adjustment, training and testing, as well as patient history. Be sure to adhere to the following clinical guidelines at all times when using this system.
- Page 15 NOte: The Biodex Unweighing System is intended to assist the patient who has balance deficits. Clinicians should not rely on this device to prevent falls. Since the Biodex Balance System allows up to 20-degrees of surface tilt, begin with static or stability level 12 and progress as tolerated.
- Page 16 CONTENTS NOte: The ankle provides a critical source of sensory input, controlling the degree of sway in elderly patients. Repeat bouts of balance training where the joint is displaced nearly to its limits have been shown to increase muscle tone, thus increasing muscle spindle sensitivity and enhancing the somatosensory response.
- Page 17 5. APPLICATIONS ORTHOPEDIC aND SPORTS MEDICINE 1. Bilateral Balance Activities • Select desired training mode • Begin at level 12 or static and progress as tolerated • Begin with handrails in the upright position and progress to lowering them • Move platform as per training protocol •...
- Page 18 5. APPLICATIONS NOTE DE RéFéRENCE Cette activité doit àtre entreprise avec précaution. S’assurer que le patient est capable de réaliser l’activité. S’assurer d’une bonne stabilité bilatérale avant de commencer un travail sur la stabilité unilatérale. S’assurer que le patient sait utiliser l’appui correctement. S’assurer que la stabilité...
- Page 19 6. GETTING STARTED The Biodex Balance System software program is easy to master. Simply follow the screen prompts as they lead you step-by-step through testing and training protocols or software utility options. For each screen, active option keys are highlighted in boldface type. Touch the desired on-screen key to make your selection.
- Page 20 7. THE TRAINING MODES The training modes provide a simple means of setting up a training or exercise session. Six interactive game-like training modes are provided. These allow for fast patient setups, less for- mal protocols than the testing routines, and the ability to change stability level from very unsta- ble to static during the actual training session.
- Page 21 7. THE TRAINING ROUTINE POSTuRaL STaBILITY TRaINING (See Figure 7.2.) The Postural Stability Training mode is designed to emphasize specific movement patterns or strategies by placing markers anywhere on the screen grid. The patient’s score is a tally of how many times the patient can touch targets with the on-screen cursor during any session.
- Page 22 CONTENTS To clear any misplaced or unwanted targets, touch <Clear Target>. Each time this key is pressed, the most recent target added to the screen will be removed. 10. Touch <More Options> to advance to the Postural Stability Training Options screen if desired.
- Page 23 CONTENTS LIMITS OF STaBILITY (LOS) TRaINING ROuTINE (See Figure 7.3.) The Limits of Stability Training screen is designed to challenge the user to move through a movement pattern consistent with the sway envelope. The sway envelope is that area a person can move their COG within their base of support.
- Page 24 8. TESTING A PATIENT Touch the <Keypad> icon for “Height” and enter the patient’s height. Touch <Next> to advance to the Limits of Stability Training screen. At the Limits of Stability Training screen, touch <Stance> to toggle though the patient stance positions until the desired choice, right leg, left leg or both legs, is displayed.
- Page 25 CONTENTS WEIGHT SHIFT TRaINING (See Figure 7.4) This training mode allows for exercise in the most basic of activities weight shifting. The patient has the ability to shift weight in medial/lateral, anterior/posterior and diagonal planes. This can be done with both static and dynamic settings. During this training routine the target zone, defined by two parallel lines, can be rotated to any of three positions while the amount of excur- sion within the target area can be modified to allow for the most limited to most difficult degree of weight shifting.
- Page 26 CONTENTS Touch the <Keypad> icon for “Name” and enter the patient’s name. Touch <OK> to return to the User Information screen. Touch the <Keypad> icon for “Age” and enter the patient’s age. Touch <OK> to return to the User Information screen. Touch the <Keypad>...
- Page 27 CONTENTS MaZE CONTROL TRaINING (See Figure 7.5.) This mode allows the patient to follow a reproducible pattern of movement throughout a maze in both static and dynamic environments. Three skill levels allow the maze to be modified to create a simple or more difficult environment for the patient to navigate through. Change the platform from static mode to dynamic mode to facilitate progression.
- Page 28 CONTENTS Touch the <Keypad> icon for “Name” and enter the patient’s name. Touch <OK> to return to the User Information screen. Touch the <Keypad> icon for “Age” and enter the patient’s age. Touch <OK> to return to the User Information screen. Touch the <Keypad>...
- Page 29 CONTENTS • To set initial platform stability, touch the appropriate key and then enter the setting from the keypad displayed (static, 12 is most stable, 1 is least stable). Touch <OK> to return to the Maze Control Training Options screen and set the ending platform stability in the same manner.
- Page 30 CONTENTS THE RaNDOM CONTROL TRaINING This training mode allows the patient to perform neuromuscular control activities in random pat- terns generated by the display and is ideal for motor control and vestibular training. The size and speed of the target can be modified for progressions ranging from easy to difficult. While in static mode the patient can work within their sway envelope to move the cursor and attempt to keep it within the moving target.
- Page 31 CONTENTS At the Random Control Training screen, the target circle should be flashing in the center of the stability grid. Touch <Circle Speed > to toggle though the three target circle speeds until the target circle flashes at the desired speed. Touch <Skill Level>...
- Page 32 CONTENTS PERCENT WEIGHT-BEaRING TRaINING (See Figures 7.7 and 7.8.) Percent Weight-Bearing Training provides real-time feedback of the percentage of weight-bear- ing on the patient’s foot, ankle, knee, hip, body side, etc. In this mode targets can be set that encourage patients to focus on % weight-bearing goals in anterior, posterior, medial and lateral movements.
- Page 33 CONTENTS To access The % Weight-Bearing Training Mode: NOte: % Weight-Bearing is used with the platform in static mode only. Position the support handles as per patient protocol. Position the display height and position for patient comfort. At the Main Menu, touch <Training>. The Training Menu screen should now be displayed. Touch <% Weight Bearing>.
- Page 34 CONTENTS 14. When you are finished reviewing the % Weight Bearing Training screen, touch <Print> to print the screen, or <Save Results> to save the training session (numeric data only). 15. After printing or reviewing the screen, press <Start> to immediately begin another training session using the same parameters, or press <Back>...
- Page 35 CONTENTS Select Training or Testing. Protocol creation is same for both. All target placements and goal settings are saved and recalled for custom protocols. Be sure to name the protocol as the protocol can then be recalled exactly as stored for reuse as a custom protocol.
- Page 36 CONTENTS Selecting a Custom Protocol To select a previously created custom protocol simply <Select Custom Protocol> from either the Training or Testing menu screen. A listing of either Training or Testing protocols will appear. Select desired protocol. — 7-17 — THE TRAINING MODES...
- Page 37 8. TESTING The Biodex Balance System SD allows clinicians to assess a patient’s neuromuscular control in a closed-chain, multi-plane test by quantifying the ability of the patient to maintain dynamic uni- lateral or bilateral postural stability on either a static or unstable surface. The degree of surface instability is controlled by the system’s microprocessor-based actuator.
- Page 38 CONTENTS THE POSTuRaL STaBLITIY TEST The Postural Stability Test emphasizes a patient’s ability to maintain center of balance. The patient’s score on this test assesses deviations from center, thus a lower score is more desirable than a higher score. Platform stability can be varied during a this test by selecting <More Options> from the Postural Stability Testing screen.
- Page 39 CONTENTS Figure 8.4. The Postural Stability Testing screen. Figure 8.5. A sample Postural Stability Test Results screen for a bilateral test. — 8-3 — TESTING...
- Page 40 CONTENTS PERFORMNIG a POSTRuaL STaBILITY TEST (See Figures 8.2 and 8.6.) Position support handles as per patient protocol. Position display height and tilt for patient comfort. At the Main Menu, touch <Testing>. The Testing Menu screen should now be displayed. Touch <Postural Stability>.
- Page 41 CONTENTS 14. Press <Start> to release the platform (if not static) and activate the Postural Stability Test screen. 15. With the patient ready to begin the test, touch <Collect Data>. The screen will provide a three- second countdown before beginning the first of three test trials. The display screen will show Total Trial Time, Platform Setting and Stance to the left of the grid.
- Page 42 9. THE BALANCE REPORTS SuGGESTED TEST PROTOCOL FOR GENERaL POSTuRaL STaBILITY BaLaNCE TESTING The test protocol most commonly used with the Biodex Balance System is a Dynamic Balance test as follows: Test Duration: 20 seconds Stability Level: 8 Stance: Two Leg Reliability studies have been done for this protocol.
- Page 43 CONTENTS THE LIMITS OF STaBLITIY (LOS) TEST This test challenges patients to move and control their center of gravity within their base of sup- port. During each test trial, patients must shift their weight to move the cursor from the center target to a blinking target and back as quickly and with as little deviation as possible.
- Page 44 CONTENTS Figure 8.8. The Limits of Stability Test Results screen for a bilateral test. PERFORMNIG a LIMITS OF STaBILITY TEST (See Figures 8.7 and 8.9.) Position support handles as per patient protocol. Position display height and tilt for patient comfort. At the Main Menu, touch <Testing>.
- Page 45 CONTENTS 12. Touch <Clear Tracing> to clear any tracing that remains from previous tests. 13. Touch <More Options> to advance to the Limits of Stability Test Options screen if desired. Here you can set the number of trials, rest countdown, platform stability and limits of stabil- ity hold time.
- Page 46 The test protocol for the Athlete Single Leg Stability Testing allows clinicians to test athletes against data derived from studies using the Biodex Balance System. The low stability level of four will challenge athletes and provide the data necessary to assess the athlete’s single leg pos- tural stability.
- Page 47 CONTENTS Figure 8.11. A sample Athlete Single Leg Stability Results report. — 8-11 — TESTING...
- Page 48 CONTENTS PERFORMING aN aTHLETE SINGLE LEG STaBILITY TEST (See Figures 8.10 - 8.12.) Position support handles as per patient protocol. Position display height and tilt for patient comfort. At the Main Menu, touch <Testing>. The Testing Menu screen should now be displayed. Touch <Athlete Single Leg Stability >.
- Page 49 Paterno MV et al, Neuromuscular Training Improves Single Limb Stability in Young Female Athletes. J Orthopedic Sports Therapy, June 2004 • Arnold BL, Schmitz R, Examination of Balance Measures Produced by the Biodex Stability System. J of Athletic Training 1998:33(4):323-327. •...
- Page 50 CONTENTS PERFORMING a FaLL RISK TEST The Fall Risk test allows identification of potential fall candidates. Test results are compared to age dependent normative data . Scores higher than normative values suggest further assessment for lower extremity strength, proprioception, and vestibular or visual deficiencies. Figure 8.12.
- Page 51 CONTENTS Figure 8.14. A sample Fall Risk Test Results screen. PERFORMING a FaLL RISK TEST (See Figures 8.13 and 8.15.) Position support handles as per patient protocol. Position display height and tilt for patient comfort. At the Main Menu, touch <Testing>. The Testing Menu screen should now be displayed. Touch <Fall Risk>.
- Page 52 10. DATA INTERPRETATION 12. Touch <More Options> to advance to the Fall Risk Test Options screen if desired. Here you can set the Test Trial Time, enter the number of trials and enter the Rest Countdown. You can also toggle the cursor ON/OFF. Touch <OK> to confirm your selections and return to the Fall Risk Testing screen.
- Page 53 NOte: For information on normative data referenced in the Predictive Values Report, see Appendix C. NOte: For information comparing the original Balance System Protocol for Fall Risk Balance Testing to the Balance System SD Protocol for Fall Risk Balance Testing, see note and chart page B-1. References: 1.
- Page 54 Another version of this test called the modified CTSIB is often used. The m-CTSIB eliminates conditions 3 and 6. Biodex Balance products use the m-CTSIB format of 4 conditions as the default with the ability to include the other 2 if desired.
- Page 55 CONTENTS PERFORMING a CTSIB. To perform the CTSIB test, simply follow screen prompts. Select the m-CTSIB from the test screen menu Address each screen as you progress through the menus. The default test conditions are four m-CTSIB conditions. Position Patient: Position the patient’s feet as noted.
- Page 56 CONTENTS Reference: McIlroy WE, Maki BE. Preferred placement of feet during quiet stance: development of a standardized foot placement for balance testing. Clinical Biomechanics Vol 17, No. 1 66-70 1997 If you do not want to follow the default test conditions, Select More Options. Here you can set the Test Trial Time, enter the number of trials, adjust the Rest Countdown, and change which conditions you want to test by simply touching to highlight the conditions you want to do.
- Page 57 CONTENTS Press <OK> to continue to do the test. The Press <START> to being the testing sequence for each condition. Again as with the other tests you will have the option to perform a trial rep prior to each test condition rep.
- Page 58 CONTENTS At the Results screen, touch <Print> to automatically generate a printed report if desired. To save the test data, touch <Save Results> and then touch <OK> in response to the “Save Results for later reporting or export?” prompt. The system will display “Save Results Completed”...
- Page 59 9. REPORTS Biodex Balance System SD offers reports for each of the five test modes. These can be used to objectively measure and record the patient’s ability to stabilize the involved joint under static or dynamic stress. Reports can be generated to reflect single leg, both legs and bilateral comparison testing protocols.
- Page 60 12. SYSTEM UTILITIES Medial/Lateral (M/L) Stability Index: Represents the variance of foot platform displacement in degrees, from level, for motion in the frontal plane. ∑ (0 - X) Medical/Lateral Stability Index = number of samples ∑ Mean Deflection: Average position for the patient in all motions throughout the test. ∑...
- Page 61 CONTENTS Percent Time In Zone/Quadrant: These values represent the percentage of test time the patient spends in each Zone/Quadrant during the test. The Target Zones, A, B, C, and D, are equal to specific ranges of deflection and radiate in con- centric circles from the center of the foot platform as follows: •...
- Page 62 CONTENTS SaMPLE BaLaNCE REPORTS (See Figures 9-1 –9-8.) 9-1: Sample Postural Stability Single Leg Test Report. REPORTS — 9-4 —...
- Page 63 13. BIODEX BALANCE SYSTEM REIMBURSEMENT 9-2: Sample Postural Stability Bilateral Comparison Test Report. — 9-5 — REPORTS...
- Page 64 14. GENERAL MAINTENANCE 9-3: Limits of Stability Single Leg Test Report (unilateral stance). REPORTS — 9-6 —...
- Page 65 15. SERVICE PROCEDURES 9-4: Limits of Stability Test Report (bilateral stance). — 9-7 — REPORTS...
- Page 66 CONTENTS 9-5: Athlete Single Leg Stability Test Report REPORTS — 9-8 —...
- Page 67 CONTENTS 9-6: Fall Risk Test Report. Comparison to normative data can be made for population-specific tests using the Fall Screening and Athlete Single-Leg Stability protocols. — 9-9 — REPORTS...
- Page 68 CONTENTS 9-7: CTSIB Report. Utilizing the CTSIB capabilities clinicians can test patients and compare results to normative data. REPORTS — 9-10 —...
- Page 69 CONTENTS PROGRESS REPORTS Progress Reports graph overall stability scores for each test date selected. The tests are selected from Patient Maintenance on the Utilities Menu. The patient selected must have multiple tests, with resultant Stability Index scores, for either Postural Stability, Fall Risk or Athletic Single Leg test formats.
- Page 70 Balance is a complex process involving visual, vestibular and neuromuscular control. The Biodex Balance System will prove to be a more sensitive test of balance performance because being a dynamic tilting platform it will invoke the neuromuscular control aspects more so than a static force plate type system, as well as the visual and vestibular components.
- Page 71 CONTENTS BaLaNCE SYSTEM STaTISTIC DEFINITIONS Stability Index: Represents the variance of platform displacement in degrees from level. A high number is indicative of the patient having trouble balancing. The patient's Actual Stability Index is represented in the Postural Stability, Athletic Single Leg and Fall Risk Report under the col- umn labeled "Actual Score."...
- Page 72 Patient Data Storage Usage is scaled to 6,000 patient tests. When storage reaches 85% of its capacity, it is suggested that patient tests be deleted or archived. You may archive patient data to a USB memory device or to a computer or network using the Biodex Patient Data Collection Software.
- Page 73 CONTENTS CONFIGuRaTION (See Figure 11.1.) At the System Utilities screen, touch <Configuration> and then enter 781 in response to the "Enter Access Code" prompt. Touch <OK>. The Configuration screen should now be displayed. At this screen users can set values for Screen Time Out, Screen Saver, Date/Time, Fall Risk Defaults, m-CTSIB Defaults and Change Access ID Code.
- Page 74 CONTENTS SCREEN SaVER The Screen Saver setting determines how long the display screen remains ON when the system is no longer in use. Once the selected time expires, the screen fades to black even if the system remains ON. At the Configuration Screen, touch <Screen Saver>. Use the <...
- Page 75 16. TROUBLE-SHOOTING To adjust Fall Risk Platform Setting: At the Configuration Screen, touch <Fall Risk Defaults>. The Fall Risk Defaults screen will appear. Touch the Fall Risk Platform Setting you would like to adjust (Initial or Ending). An adjustment selection screen will appear. Enter the desired platform setting via the key pad displayed.
- Page 76 17. BIBLIOGRAPHY To adjust the CTSIB age Range: 1. At the Configuration Screen, touch < m-CTSIB Defaults>. The m-CTSIB Defaults screen will now be displayed. 2. Select <Age Range>. 3. Select the Age Range you would like to adjust. The From and To values in the range will appear on the screen.
- Page 77 CONTENTS Turn Tone ON/OFF This setting enables or disables an audible tone which signals test or exercise start, completion and countdown between trials. At the Configuration screen, simply touch the ON or OFF icon to select the desired setting. adjust LCD Brightness This setting brightens or darkens the display screen for all applications.
- Page 78 CONTENTS PaTIENT MaNaGEMENT (See Figure 11.4 - 11.6.) At the System Utilities screen, touch <Patient Management > and then enter 781 in response to the "Enter Access Code" prompt. Touch <OK>. The Patient Management screen should now be dis- played. This screen shows a listing of patients and associated saved test and training sessions along with the date performed.
- Page 79 Single Patient Delete Although the Balance System SD display can store a significant number of test records, you may want to decrease the number of stored records from time to time. To delete any full page display of saved reports, touch <Delete>.
- Page 80 CONTENTS Figure 11.6. For multiple export or multiple deletion of patient records, touch <Option> to select records based before or after a selected date, or between two selected dates. Multiple Patient Delete In addition to deleting any single patient record, multiple patient records can be deleted. At the Patient Management screen touch <Multiple Delete>...
- Page 81 12. REIMBURSEMENT Biodex Rehabilitation Equipment is commonly used in rehabilitation services based on a physician referral for these ICD-9 codes. As a result, these CPT codes may be applied. Reimbursement amounts vary among plans and states. Physician referral and ICD-9 codes: V15.88 Personal History of Fall...
- Page 82 13. GENERAL MAINTENANCE The Biodex Balance System requires only the most basic general maintenance, performed on an as-needed basis at least every three to four months. CLEaNING INSTRuCTIONS With the system turned OFF, wipe down all surfaces with a damp cloth. Mild soap and water can be used to remove stains and scuff marks.
- Page 83 APPENDIX A CaLCuLaTION OF LIMITS OF STaBILITY DIRECTION CONTROL Straight Line Distance to Target DIRECTION CONTROL SCORE % = X 100 Actual Distance Traveled WHERE: Straight Line Distance to Actual Target Distance Traveled (trace) CENTER TARGET i =8 (DLOS Scores) OVERALL DIRECTION CONTROL SCORE = i =1 or the Average of all the eight Targets...
- Page 84 CONTENTS BaLaNCE SYSTEM CLINICaL TEST OF SENSORY INTEGRaTION aND BaLaNCE (CTSIB) SWaY INDEX EQuaTION Test Description The objective of this test is to quantitatively determine a score defining a patient’s ability to maintain a stable vertical posture while positioned on a stationary platform. The patient is posi- tioned on a stable platform and instructed to try to maintain a stable vertical posture under a variety of sensatory conditions, eyes open, eyes closed, and vision partially obscured.
- Page 85 CONTENTS The “Score” is defined as the standard deviation of position over the length of the test. The Standard deviation is interpreted to be the absolute vector length deviation from the mean vec- tor end point. Basically, all vectors (X,Y) coordinates are summed and divided by the number of samples, to obtain a vector sum which represents the position of the mean.
- Page 86 APPENDIX B NORMaTIVE DaTa REFERENCED IN PREDICTIVE VaLuES REPORT Joan A. Finn, D.P.E., Exercise Science Department, Southern Connecticut State University, New Haven, CT - May 2010 Testing Protocol: The testing protocol consisted of three 20 second trials using the postural stability testing feature within the BSD software.
- Page 87 APPENDIX C CTSIB NORMaTIVE DaTa COLLECTION aND RELIaBILITY CTSIB reliability and predictive score data were collected from 100 randomly recruited people. All test subjects were healthy, active, working people. Medical history was recorded via a confi- dential questionnaire. The testing and protocol followed IRB approval and was performed on site.
- Page 88 A variety of consequences can occur due to poor balance therefore clinicians need to address each component in order to prevent injury, re- injury or further trauma. The Biodex BioSway provides valuable objective assessment of neuro- muscular control and somatosensory input important to balance.
- Page 89 CONTENTS Figure C.1 Figure C.2 Figures D.1 and D.2: The ankle strategy that is used in response to small perturbations is also called ankle sway. Illustration © Wild Iris Medical Education. A small loss of balance in the backward direction causes contraction of the anterior tibialis, quadri- ceps, and lower abdominal muscles, in that order, to bring the body back into balance.
- Page 90 CONTENTS SENSORY ORGaNIZaTION FOR BaLaNCE Perhaps the most confusing part of a balance evaluation is the part that examines the sensory sys- tem and its contribution to balance. The sensory system includes the eyes, ears, vestibular appara- tus (inner ear), somatosensory system (touch and proprioception), taste, and smell. The parts of the sensory system that contribute directly to balance are the visual, vestibular, and somatosensory (touch and proprioception) systems.
- Page 91 CONTENTS Somatosensory Input Somatosensory input consists of touch and proprioception. Input from these two sensory sources provides critical feedback to the CNS regarding positioning in space, body sway, and changes in terrain. The sensory input from touch and proprioception allows the muscles to make constant, automatic adjustments to maintain balance and avoid falls.
- Page 92 CONTENTS abnormal Internal Representations Individuals’ perceptions of their limits of stability are difficult to assess and understand. Illness and injury, including stroke, clearly affect confidence and may alter perceived stability limits. A person’s stability may be affected by fear of falling, even when the physical ability exists to per- form a task safely.
- Page 93 CONTENTS CTSIB TEST RESuLT INTERPRETaTION (Neurocom) The CTSIB is the Clinical Test for Sensory Integration and Balance. The CTSIB is the standard test for differentiating balance problems as a result of visual, vestibular or somatosensory The CTSIB uses 4 conditions to test contribution of visual, vestibular and somatosensory inputs: 1.
- Page 94 • The Balance System SD should not be used adjacent to or stacked with other equipment. If the Balance System SD is used while positioned adjacent to other equipment, it should be observed to verify normal operation in the configuration in which it will be used.
- Page 95 The Balance System SD is intended for use in the electromagnetic environment specified below. The customer or the user of the Balance System SD should assure that it is used in such an environment. Emission test...
- Page 96 Balance System SD is used exceeds the applicable RF compliance by an electromagnetic site levels above, the Balance System SD should be observed to verify survey, should be less than normal operation. If abnormal performance is observed, additional the compliance level in each measures may be necessary, such as re¬orienting or relocating the...
- Page 97 The Balance System SD is intended for use in the electromagnetic environment in which radiated RF disturbance are controlled. The customer or the user of the Balance System SD can help prevent elec- tromagnetic interference by maintaining a minimum distance between portable and mobile RF com- munication equipment (transmitters) and the Balance System SD as recommended below, according to the maximum output power of the communication equipment.
- Page 98 APPENDIX F CLEaNING aND MaINTENaNCE General Maintenance The Biodex Balance SD requires only the most basic general maintenance, performed on an as- needed basis at least every three to four months. Cleaning Instructions With the system turned OFF, wipe down all surfaces with a damp cloth. Mild soap and water can be used to remove stains and scuff marks.
- Page 99 J of Rehabilitation Research & Development (JRRD), Vol. 43, No. 7: 819-824, Nov/Dec 2006 Biodex #91-159 ARNOLD, BL, et al. NORMAL STABILITY PATTERNS AND RELATIONSHIP AS ASSESSED WITH THE BIODEX BALANCE SYSTEM J of Athletic Training, Vol. 32 (2):S-25 / April-June 1997...
- Page 100 SINGLE LEG STANCE: DEVELOPMENT OF RELIABLE TESTING PROCEDURE Berkshire Institute of Orthopedic & Sports Physical Therapy, Wyomissing, PA Biodex #93-207 CACHUPE, WJC, et al. RELIABILITY OF BIODEX BALANCE SYSTEM MEASURES Human Performance Dept. / San Jose State University / June 2000 Biodex #91-198 CAGGIANO, NA, et al.
- Page 101 J of Athletic Training, Vol. 32(2):S-6 / April-June 1997 Biodex #91-110 FREIDHOFF, G, et al. PILOT ASSESSMENT OF THE BIODEX STABILITY SYSTEM WITH NORMALS: TEST/RETEST AND DAY TO DAY RELIABILITY University of Kentucky, Div. of P.T., (Med. Center Annex I, Lexington, KY)
- Page 102 CRITERIA-BASED PROGRESSION THROUGH THE RETURN-T0-SPORT PHASE J of Orthop & Sports Phy Ther, 36;6:385-402, June 2006 Biodex #93-117 NELSON, AJ, et al. USING THE BIODEX UNWEIGHING SYSTEM, BALANCE SYSTEM AND GAIT TRAINER IN AN INTEGRATED REHABILITATION PROGRAM Abstract, May 2001 Biodex #92-217 PAJALA, S, et al.
- Page 103 ATHLETES JOSPT, Vol. 34 (6):305-316, June 2004 Biodex #92-245 PINTO, KK, et al. THE EFFECTS OF ANKLE TAPING AND BALANCE ACTIVITIES ON BIODEX STABILITY MEASUREMENTS J of Athletic Training, Vol. 34(2), S-30 / April-June 1999 Biodex #91-102 RIEMANN, BL, et al.
- Page 104 CONTENTS WILKERSON, GB DYNAMIC JOINT STABILITY: MECHANICAL AND NEUROMUSCULAR INTER-RELATION- SHIPS Biodex Medical Systems Biodex #91-109 WINTERS, KM, et al. DETRAINING REVERSES POSITIVE EFFECTS OF EXERCISE ON THE MUSCULOSKELETAL SYSTEM IN PREMENOPAUSAL WOMEN J of Bone and Mineral Research, Vol 15, No. 12, 2000: 2495-2503 Biodex #92-280 (rev.
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- Page 113 Certified Quality Management System IODEX Biodex Medical Systems, Inc. 20 Ramsey Road, Shirley, New Y ork, 11967-4704, Tel: 800-224-6339 (Int’l 631-924-9000), Fax: 631-924-9338, Email: info@biodex.com, www.biodex.com...