Úvod: V klinické neurologické a rehabilitační praxi je dostupná řada nástrojů pro hodnocení rovnováhy, ale jejich používání se na jednotlivých pracovištích v České republice liší. Jedním z testů je Mini-BESTest (The Mini-Balance Evaluation Systems Test), který je klinicky snadno proveditelný, hodnotí proaktivní i reaktivní složku stability a má odpovídající psychometrické vlastnosti. Cíl: Cílem bylo vytvořit oficiální český překlad nástroje Mini-BESTest a navrhnout doporučení pro jeho klinické použití při hodnocení rovnováhy u pacientů v chronickém stadiu CMP. Metody: Oficiální česká verze nástroje Mini-BESTest byla získána formou zpětného překladu a verifikována autorkou originálního testu Fay B. Horak. Výsledky a závěr: Česká verze testu vč. instrukcí pro jeho administraci je nyní k dispozici pro rutinní použití v oblasti neurologie a rehabilitace. Mini-BESTest je spolehlivý a platný nástroj pro hodnocení rovnováhy u pacientů v chronickém stadiu CMP.

Introduction: There are a number of balance assessment tools available in clinical neurological and rehabilitation practice, but their use in individual workplaces within the Czech Republic varies. One of the tests is The Mini-BESTest (the Mini-Balance Evaluation Systems Test), which is clinically easy to perform, evaluates both the anticipatory and reactive postural components of stability, and has corresponding psychometric properties. Aim: The aim was to create an official Czech translation of the Mini-BESTest and propose recommendations for its clinical use in the assessment of balance in patients with chronic stroke. Methods: The official Czech version of the Mini-BESTest was created by means of back translation and verified by the author of the original test Fay B. Horak. Results and conclusion: The Czech version of the Mini-BESTest, including instructions for its administration, is now ready for routine use in the field of neurology and rehabilitation. The Mini-BESTest is a reliable and valid tool for assessing balance in patients with chronic stroke.

• Klíčová slova
• Mini-BESTest,
• MeSH
• cévní mozková příhoda komplikace   MeSH
• diagnostické testy rutinní * metody   MeSH
• lidé MeSH
• posturální rovnováha * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Cíl: Cílem studie bylo ověřit efekt terapie s využitím tenzometrické plošiny a audiovizuální zpětné vazby na rovnováhu u seniorů a porovnat ho s efektem konvenční terapie u kontrolní skupiny. Pacienti a metody: Výzkumná skupina 15 seniorů (12 žen) podstoupila 9 terapeutických jednotek s audiovizuální zpětnou vazbou. Celkem 15 seniorů (14 žen) tvořilo kontrolní skupinu, která absolvovala 9 terapeutických jednotek konvenční fyzioterapie. Obě skupiny podstoupily vstupní vyšetření, stejný počet terapeutických jednotek a výstupní vyšetření. K hodnocení účinku terapie byly zvoleny testy Mini-BESTest, Timed Up and Go test a testování času potřebného ke splnění referenční scény v systému Homebalance. Výsledky: U výzkumné skupiny došlo ke statisticky významnému zlepšení v Mini-BESTestu (p = 0,05), v Timed Up and Go testu (p = 0,01) a v čase referenční scény (medián 68 s). U kontrolní skupiny došlo pouze ke statisticky významnému zlepšení času referenční scény (medián 11 s). Zlepšení v čase referenční scény bylo statisticky významně vyšší u výzkumné skupiny než u kontrolní skupiny (p = 0,01). Závěr: Audiovizuální zpětná vazba je využitelná a bezpečná v terapii poruch rovnováhy u seniorů. Terapie s využitím tenzometrické plošiny a audiovizuální zpětné vazby byla efektivnější než konvenční fyzioterapie bez technických prostředků.

Aim: The purpose of the study was to investigate the effect of therapy based on the use of a force platform and audiovisual feedback on the balance of senior citizens and to compare it to the effect of conventional therapy in control group. Patients and methods: A research group of 15 senior citizens (12 women) underwent 9 therapeutic units with an audiovisual feedback. A control group of 15 senior citizens (14 women) completed 9 therapeutic units of conventional physiotherapy. Both groups underwent an initial examination, the same number of therapeutic units and a final examination. The Mini-BESTest, Timed Up and Go test and the time limit needed to complete the reference scene in the Homebalance system were chosen to evaluate the effect of the therapy. Results: There was a statistically significant improvement in the Mini-BESTest (P = 0.05), Timed Up and Go test (P = 0.01) and in the reference scene completion time (median 68 s) in the research group. The control group had only a statistically significant improvement in the reference scene completion time (median 11 s). The improvement in reference scene completion time was statistically significantly higher in the research group than in the control group (P = 0.01). Conclusion: Audiovisual feedback is a safe and useful tool in the treatment of balance disorders in senior citizens. The therapy with force platform and audiovisual feedback was more effective than conventional physiotherapy which does not employ technical aids.

• Klíčová slova
• tenzometrická plošina, poruchy rovnováhy,
• MeSH
• lidé MeSH
• počítačová simulace * MeSH
• posturální rovnováha * MeSH
• prospektivní studie MeSH
• randomizované kontrolované studie jako téma MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzorická zpětná vazba MeSH
• terapie cvičením metody   přístrojové vybavení   MeSH
• úrazy pádem prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

Článek se zabývá významem telerehabilitace a popisem její aplikace v praxi. Jako praktický příklad v tuzemských podmínkách realizovatelného a cenově dostupného telerehabilitačního řešení předkládáme kazuistiku pacienta, u kterého jsme k telerehabilitačním intervencím využili interaktivní systém Homebalance pro trénink rovnováhy se stabilometrickou plošinou a vizuální zpětnou vazbou a aplikaci Skype pro on-line videohovor. Celkový přínos, včetně udržitelnosti efektu terapie, byl objektivizován posturografickým vyšetřením a standardizovanými testy. U pacienta došlo po terapii ke zlepšení ve standardizovaných testech Berg Balance Scale, Mini-BESTest, Functional independence measure (FIM) a v posturografickém vyšetření. Zlepšení bylo částečně udržitelné i po dalších čtyřech týdnech bez terapie. Na základě vyplněného strukturovaného dotazníku byl zjištěn také pozitivní subjektivní dojem pacienta.

The article describes the importance of telerehabilitation and provides a description of its application in practice. As a practical example of a feasible and affordable telerehabilitation approach in the domestic context, we present the case report of a patient with whom we have used, as a telerehabilitation intervention, the interactive Home balance system. The system was used for balance training, utilizing a stabilometric platform and visual feedback as well as the Skype application for online video calls. The overall benefits, including sustainability of the effect of the therapy, were objectively verified using posturographic examination and standardized tests. Following therapy, the patient measured improvement in the Berg Balance Scale, Mini-BESTest and Functional Independence Measure (FIM) standardized tests and in posturographic examination. The improvement remained partially sustained even after four weeks without therapy. Based on a structured questionnaire completed by the patient, the positive subjective impression of the patient was also ascertained.

• Klíčová slova
• porucha rovnováhy, Homebalance,
• MeSH
• cévní mozková příhoda komplikace   MeSH
• design vybavení MeSH
• dospělí MeSH
• lidé MeSH
• paréza rehabilitace   MeSH
• posturální rovnováha * fyziologie   MeSH
• rehabilitace po cévní mozkové příhodě * metody   přístrojové vybavení   MeSH
• senzorická zpětná vazba MeSH
• telerehabilitace * metody   přístrojové vybavení   MeSH
• uživatelské rozhraní počítače MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Background: Impaired balance is common in people with multiple sclerosis (MS) and can be present even in those with a mild disability level. With increasing disability, gait, and balance impairment progress, and lead to increased risk of falls. In some recent studies, interactive commercial video games were used for improving balance, but their limitation is their lack of individual training parameter settings needed for rehabilitation purposes. The aim of this study was to evaluate the feasibility and effect of balance exercise in the home setting using the rehabilitation Homebalance® system. Methods: A single-centre, controlled, single blind study with allocation to intervention group or to control group was utilised. Participants were assessed at baseline, after four weeks of home-based balance training, and follow-up after four weeks. The primary outcomes were the Berg Balance Test (BBT). The secondary outcome measures included the Mini-BESTest, Timed Up, and Go Test (part of Mini-BESTest), and spatio-temporal gait parameter evaluation using the GAITRite instrument. The patient reported outcomes (PRO) included the 12-Item MS Walking Scale, Activities-specific Balance Confidence Scale, and the Falls Efficacy Scale. Results: A total of 39 people with Multiple Sclerosis (10 men) were enrolled into the study. The mean age of participants was 40.69 ± 10.2 years, with a mean disease duration 14.76 ± 9.1 years and mean disability level 3.8 ± 1.9 EDSS (EDSS range 1.5-7). Statistically significant improvements within the home exercise group were present for the BBT and the Mini-BESTest. This improvement was more significant in the subgroup with moderate and higher disability (EDSS 4.5-7). All other gait parameters and PRO did not show any improvement. Follow-up assessment after four weeks showed that the reached improvement persisted for a short time period after finishing the regular training regimen. Conclusion: In comparison with no intervention, a short-term programme of home-based balance training using Homebalance® improved balance but not gait performance in a group of people with MS. It seems that home-based balance training tailored according to individual needs by a physiotherapist may be a future approach to consider for telerehabilitation of people with MS.

• Publikační typ
• časopisecké články MeSH

INTRODUCTION: One of the most debilitating problems encountered by people with multiple sclerosis (MS) is the loss of balance and coordination. Our study aimed to comprehensively evaluate the effectiveness of one year of Tai-chi exercise in patients with MS using both subjective and objective methods, including posturography. METHODS: This was a single-group longitudinal one-year study performed from the 1st of January 2019 to the 1st of January 2020. The primary outcomes of interest were the Mini-Balance Evaluation Systems Test (Mini-BESTest) and static posturography measures as objective methods to detect subtle changes associated with postural control/balance impairment. Secondary outcomes were measures of depression, anxiety, cognitive performance, and quality of life. All objective and subjective parameters were assessed four times: at baseline, and after three, six and 12 months of regular Tai-chi training. The difference was calculated as a subtraction of baseline values from every timepoint value for each measurement. If the normality test was passed, parametric one-sample t-test was used, if failed, Wilcoxon signed ranks test was used to test the difference between the baseline and each timepoint. Alpha was set to 0.017 using Bonferroni correction for multiple comparisons. RESULTS: Out of 25 patients with MS enrolled, 15 women with MS (mean age 44.27 years) were included for statistical analyses after completing the 12-month program. After 12 months, significant improvements were found in all objective balance and gait tests: Mini-BESTest (p<0.001), static posturography measures (total area of the centre of foot pressure - TA; p = 0.015), 25 Feet Walk Test (25FWT; p = 0.001), anxiety (Beck Anxiety Inventory - BAI; p = 0.005) and cognition tests (Paced Auditory Serial Addition Test - PASAT; p = 0.003). Measures of depression (Beck Depression Inventory - BDI; p = 0.071), cognition (Symbol Digit Modalities Test - SDMT; p = 0.079), and health-related quality of life (European Quality of Life 5-Dimensions Questionnaire - EQ-5D-5L; p = 0.095) showed a trend of improvement but were not significant, which could be the result of a small sample and increased bias due the type II error. CONCLUSION: According to these preliminary results, this study indicates the possible beneficial effects of long-term Tai-chi training on patients with MS. Although these findings need to be confirmed by further studies with a larger sample of participants of both genders and require more rigorous randomized controlled trials (RCT) design, our findings support the recommendation of regular and long-term Tai-chi exercise in patients with MS. GOV IDENTIFIER (RETROSPECTIVELY REGISTERED): NCT05474209.

• MeSH
• dospělí MeSH
• kognice MeSH
• kvalita života MeSH
• lidé MeSH
• posturální rovnováha MeSH
• prospektivní studie MeSH
• roztroušená skleróza * komplikace   terapie   MeSH
• taiči * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. METHODS: A literature review was conducted. Identified instruments were evaluated systematically and classified as "recommended," "suggested," or "listed." Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. RESULTS: One rating scale was classified as "recommended" (UPDRS-derived Postural Instability and Gait Difficulty score) and 2 as "suggested" (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini-BESTest, Dynamic Gait Index) also fulfilled criteria for "recommended" and 2 for "suggested" (FOG score, Gait and Balance Scale). Four questionnaires were "recommended" (Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly-Modified). Four tests were classified as "recommended" (6-minute and 10-m walk tests, Timed Up-and-Go, Functional Reach). CONCLUSION: We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD-specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD-specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society.

• MeSH
• diagnostické techniky a postupy normy   MeSH
• lidé MeSH
• neurologické poruchy chůze diagnóza   etiologie   MeSH
• Parkinsonova nemoc komplikace   diagnóza   MeSH
• posturální rovnováha * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH