Introduction: Balance impairment is a commonly reported symptom of concussion. Very little research has been undertaken regarding the complexities of balance impairment after concussive injury in the pediatric population. Purpose: The objectives of this study were: 1) to identify the factors that are associated with balance impairments in children with concussion; 2) to review and evaluate four commonly used balance measures; and 3) to provide recommendations for the best methods of clinical evaluation of balance in children and youth after concussive injury. Methods: A cross-sectional balance evaluation was completed on 104 children, ages 5-18 who had a confirmed diagnosis of concussion. Four balance measures were examined to determine which was the most appropriate for evaluating balance post-concussion. Results: 37% of children were found to have balance impairment according to the BOT-2. The full logistic regression model was found to be not statistically significant however, mechanism of injury with an odds ratio of 2.1 and 95% CI [0.810, 5.027] indicates that children with sport-related injuries are twice as likely to have balance impairment than those with a non-sports-related injury. Chi-Square analyses showed a statistically significant association for mechanism of injury (χ2=11.05, p = 0.03) and age (χ2 = 0.04, p =-0.02) for children who presented with balance impairments and those who did not. Children with balance impairment may present with different symptom profiles than children without. Conclusion: Using a single method of assessment may not provide an accurate representation of balance impairment in children and youth after concussion. Based on the comparison of measurement properties and application of each measure to 104 children with concussion, the BOT-2 and the CB&M when used together provide the most comprehensive assessment of balance and postural instability in children with concussive injury. Age, mechanism of injury and site of impact may be leading factors in the development of balance impairment. / Thesis / Master of Science Rehabilitation Science (MSc)

xiv, 96 p. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Among older adults, an impaired ability to maintain balance while simultaneously performing cognitive tasks is a common occurrence. Because poor dual-task balance performance is associated with increased fall risk and a decline in cognitive function, interventions to improve dual-task balance performance are needed. Although traditional rehabilitation programs emphasizing training balance under single-task conditions are effective in improving single-task balance performance, it is not known whether single-task training generalizes to balance control under dual-task contexts. Moreover, the effectiveness of approaches to training balance under dual-task conditions is not known. Thus, the purposes of this study were to determine whether elderly individuals with balance impairment can improve their balance performance under dual-task conditions; to investigate whether training balance under single-task conditions generalizes to balance control during dual-task contexts; and to evaluate the effect of instructional set on dual-task balance performance. Specifically, the efficiency of three different training strategies was examined in an effort to understand the mechanisms underlying training-related changes in dual-task balance performance. Twenty-three elderly adults with balance impairment were randomly assigned to 1 of 3 interventions: single-task balance training (ST); dual-task training with fixed-priority instruction (FP); and dual-task training with variable-priority instruction (VP). Clinical and laboratory measures were obtained at baseline and after training. In addition, selected clinical outcomes were repeated after the second week of training to examine interim balance change and at twelve weeks post training to test retention. Results indicate that dual-task training was effective in improving balance under dual-task conditions in the elderly with balance impairment. Training balance under single-task conditions may not generalize to balance control during dual-task contexts. Explicit instruction regarding attentional focus was an important factor for improvement in dual-task performance. The VP instructional set offered advantages over the FP instructional set in terms of the degree of improvement, the rate of learning, and the retention of the dual-task training effect. The dual-task processing skills learned during training were not transferred to novel dual-task conditions. Lastly, the training benefits acquired during VP training could be the result of both automatization of the individual task and the development of task-coordination skills. / Adviser: Marjorie Woollacott

The thesis investigates problems of walking and balance disorders in patients with multiple sclerosis and the effect of group Pilates lessons. The theoretical part provides an overview of the current knowledge about the disease - etiology, pathogenesis, diagnostics, types and symptoms of multiple sclerosis (MS) and the possibilities of therapy. The Pilates method, its history and principles of exercise are described. The aim of the practical part was to evaluate the effect of the Pilates program on walking and balance in MS patients. The group included 32 patients, 21 in the experimental group and 11 in the control group. The experimental group participated on the 10 - week Pilates program. Standardized gait and balance functional test were used for objective assessment; patient outcome measurements were used for subjective evaluation of exercise effect. More detailed gait parameters were obtained using the GAITRite instrument. Measurements were performed before and after therapy. Significant change - improvement (p < 0.05) was observed in some values of balance parameters, walking parameters and even in some subjective questionnaires. Therefore, we suggest, that group exercise lessons supervised by experienced instructor may be beneficial exercise therapy for people with MS and mild disability....

The present thesis deals with the issue of balance disorders in patients with multiple sclerosis (MS) and the effect of individual balance training using biofeedback. It presents an overview of the current knowledge about MS - epidemiology, pathogenesis, diagnostics, types, symptoms and treatment methods. The thesis also describes principles of balance control of the human body, balance deficits in patients with MS and physiotherapeutic treatment. The aim of the experimental part was to evaluate the effect of the Homebalance® system on balance in MS patients and its comparison with conventionally used sensorimotor training. A total of 18 people took part in the research, 9 in the experimental group and 9 in the control group. Standardized tests and functional scales supplemented by standardized questionnaires on balance and gait were used to objectively assess balance. Measurements were performed before and after a series of therapies. After treatment, a significant improvement (p 0,05) was found in some tests and functional scales, but in none of subjective patient reported outcomes. Exercise using the Homebalance® system may be a suitable alternative to classical rehabilitation methods used for balance training in people with MS. Keywords Multiple sclerosis, balance impairment, Homebalance®,...