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Tzu Chuan Yen, Nima Toosizadeh, Carol Howe, Michael Dohm, Jane Mohler and Bijan Najafi

Balance assessments could render useful objective performance measures to evaluate the efficacy of low back surgeries, yet these assessments have not been collectively examined to determine longitudinal sensitivity across surgical interventions. The purpose of this review was to determine sensitivity of balance measurements for disparate spinal disorders after surgical intervention. We searched PubMed, Embase, Scopus, the Cochrane Library, Web of Science, and CINAHL. Articles were selected based on: (1) sample consisted of low back disorder individuals and (2) balance measurements were obtained both pre- and postsurgery. Most of the articles addressed 2 specific low back disorders: (1) adolescent idiopathic scoliosis/spinal fusion and (2) disc herniation/decompression surgery. For scoliosis patients, body sway increased (14–97%) immediately following surgery but gradually reduced (1–33%) approaching the 1-year post spinal fusion assessment. For patients with disc herniation, sway range, sway velocity, sway area, and sway variability all decreased (19–42%) immediately postsurgery. Balance assessments for adolescents with idiopathic scoliosis who underwent surgical intervention should be performed with visual occlusion, focus on time domain parameters, and evaluated with longer follow-up times. Patients with disc herniation who underwent decompression surgery should have balance assessments with visual deprivation, test conditions specifically addressing hip strategy, and correlation with pain.

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Gurtej S. Grewal, Rachel Baisch, Jacqueline Lee-Eng, Stephaine Wu, Beth Jarrett, Neil Humble and Bijan Najafi

Context:

Improvements in postural stability in figure skaters can play a significant role in performance, as well as reducing fall risk.

Objective:

To explore the effect of custom foot insoles on postural stability in advanced figure skaters.

Design:

Exploratory study.

Setting:

Out of laboratory.

Participants:

Nine advanced figure skaters were recruited and 7 completed the study (age 38 ± 18.5 y, body-mass index 25 ± 3.6 kg/m2).

Intervention:

Custom foot insoles.

Main Outcome Measures:

Primary outcome of changes in postural stability (PS) quantified by center-of-mass sway with secondary outcomes of ankleand hip-joint sway and joint range of motion. Sway measurements were assessed using body-worn sensors while participants wore skates on ice. PS was assessed in single-leg stance, as well as during gliding on the dominant foot.

Results:

A significant improvement in static PS was observed after 6-wk use of custom insoles. Center-of-mass sway reduced significantly on average by 48.44% (P = .023), and ankle-joint sway reduced by 45.7% (P = .05) during single-leg-stance balance measurements. During the gliding maneuver nonsignificant changes were observed for both ankle- and knee-joint range of motion.

Conclusion:

The results of this study suggest proof of concept toward benefits of custom insoles in improving postural stability in advanced figure skaters. To generalize the findings, randomized controlled trials with larger sample sizes are warranted.