Читать книгу Vestibular Disorders - Группа авторов - Страница 48

The most apparent recent advance within the realm of posturography has been the drive to validate lower cost alternatives to traditional force-plate systems. In particular, the Nintendo Wii Balance Board (WBB), an accessory for the Wii video game console that contains pressure sensors, has inspired a surge in publications looking at the validity of the system for quantifying posturography, so far the results are very encouraging [36–38]. However, other researchers have expressed concern that the WBB may not be an appropriate alternative to traditional force-plates in some instances [39–41].

Currently, the most promising application of the WBB appears to be balance training; the low-cost and portability of the system makes it suitable for at-home use. Balance training studies with the WBB have already shown significant improvements in functional balance in normal participants [42], as well as in elderly patients [43], and patients with multiple sclerosis [44]. The majority of research in this area so far has focused on the games available for the Wii platform, the Wii Fit suite being the most prominent. However, it is also possible to use the Wii platform with custom software, an option that may further improve the outcomes from balance training [43]. Researchers have also begun to explore the use of virtual reality to enhance what can be done with traditional posturography, particularly within the area of balance training. Early publications for different patient groups (e.g., multiple sclerosis [45], vestibular impairment [46], elderly [47]) show promise and correlate well with the sensory organization task [48].

Though postural sway is most commonly measured using force plates that record center of pressure, other techniques have also been proposed. Accelerometry uses inertial sensors, which can be embedded in body worn devices when portability is of primary importance [49] and for mobile posturographic measurements [50]. Research on accelerometry has shown good correlation with force plate measures [49, 51], high test-retest reliability [49], and sensitivity for detecting changes in balance [51]. While this approach is not new, the technology is becoming increasingly accessible, since most smartphones come equipped with accelerometers and gyroscopes of sufficient sensitivity. Investigators have already begun to establish the accuracy of smartphone and tablet-based accelerometers and gyroscopes for measuring postural control in normal patients [52] and in patient groups associated with abnormal postural sway [53].