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THE USE OF ALTERED SENSORY CONDITIONS AS INTERVENTION FOR BALANCE IMPAIRED ADULTS. Fasick M, Stoecker J, Rheault W; Advocate Lutheran General Hospital, Park Ridge, IL and Finch University of Health Sciences, North Chicago, IL. mfasick@earthlink.net. PURPOSE: The purpose of this study was to determine if the use of altered sensory conditions, incorporated into a complete PT intervention, would improve balance compared to a control group where altered sensory conditions were not provided. The study was based on the concept that balance is modulated largely through vestibular, visual and somatosensory inputs. By altering one or more of these systems it was thought that the other systems would be enhanced, as would be the central processing for balance responses. The visual and somatosensory systems were chosen to be altered, based upon clinical feasibility. SUBJECTS: A sample of convenience was enrolled from an inpatient rehabilitation unit located within a large mid-western teaching hospital. Thirty-six subjects were enrolled in the study: 16 men and 20 women, with an average age of 73. Subject diagnoses included: general debility, stroke, brain injury and "other neurological disorders" (in order of frequency). METHODS: All subjects received 90 minutes of physical therapy for 8 days. For subjects in the experimental group, 20 minutes of their therapy time was devoted to balance related activities under one or more altered sensory conditions. For visual alteration, eyes-closed and dimmed lighting were used. For somatosensory alteration, stance on varying degrees of foam, a trampoline and a rocker board were used. The control group received therapy without alteration of sensory inputs. Balance was measured using: the Balance Master® Limits of Stability test (LOS) and static sway measurements; the Berg Balance Scale (BBS); the Five Meter Walk Test (5mWT) and the Falls Efficacy Scale (FES). ANALYSIS: Rasch Analysis was performed on the BBS and FES to convert the data to an interval scale. Independent t-tests were then performed on all instruments, comparing the experimental and control groups. An ANCOVA was performed using age and cognition as covariates. A total of 5 subjects dropped out due to discharge from the unit prior to completion of intervention days. RESULTS: The experimental group improved significantly more than the control group (p = 0.04) when using the ANCOVA to analyze BBS data, using age as a covariate. Other comparisons did not reach a level of significance. CONCLUSIONS: The use of altered sensory conditions, as an adjunct in balance training, appears to be more effective in improving balance than balance training without altered sensory conditions. Physical therapists should consider the use of this intervention in the treatment of adults with balance impairments. FUNDING SOURCE: None.
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