BalanceWear® is an aid that provides a unique opportunity to conveniently utilize the resources of the nervous system, which due to a particular neurological disorder, are otherwise not readily available. It is possible to influence the plasticity of the nervous system in order to optimize the quality of the automated moving strategies, which are usually compensating and inappropriate due to instability and impaired postural control.
Postural control can be perceived as a “Postural control is a complex motor skill based on interaction of dynamic sensorimotor processes”(1). Any deterioration in sensory, motor or cognitive subsystems will apparently be manifested in decreased postural control(2). It is therefore essential, in order to be able to provide optimal fall prevention interventions for the individual, that the therapist is able to understand what processes, and how the interaction between them, affect the postural control(3)(4). BalanceWear® certified physiotherapists are able to analyse the individual’s postural challenges in dynamic, function-specific situations, and relate these examination findings to the patient’s neurological disorder and its pathogenesis. Based on the BalanceWear® Assessment Test Protocol, the physiotherapist can identify the patients’ direction-specific loss of postural control and, based on the results, can determine the correct strategic positioning of the weights.
The positioning of the weights in the vest apparently influence the effectiveness of the essential concepts related to good postural control. Through research, it has been possible to document improvements in gait-related parameters, when patients are tested with and without BalanceWear®(5)(6). This is presumably a reflection of the fact that the weights can influence postural orientation and thereby improve the dynamic adjustments that are intended to ensure good alignment of the body’s segmental parts in relation to each other and in relation to the support surface(1). Changes in cadence, velocity and stride length when patients are compared with and without a BalanceWear® vest(5)(6) may be an indication that BalanceWear® provides sufficient additional sensory input to the nervous system to optimize the spatial orientation, since this depends on the brain’s ability to correctly interpret the progressive sensory, visual and vestibular input it receives(1). It is also possible to detect changes in the level of sway when patients’ postural control is tested in the least stable starting position(7). A reduction in the level of sway can be regarded as an improvement in the patient’s ability to maintain postural control. Increased sway is often associated with a decrease in stability(4). The patients’ proactive and reactive strategies are tested according to the BalanceWear® Assessment Test Protocol. Activation of these equilibrium mechanisms depends on the coordination of the various sensorimotor strategies, that are intended to ensure the individual’s centre of gravity relative to the base of support during self-initiated movements or external disturbances(1). The scope of these postural control mechanisms can be regarded as an expression of the efficiency of the core processes. Thus, BalanceWear® is designed specifically to reduce the extent of the postural response mechanisms and ensure that the individual has the most stable starting point, from where smaller compensatory movement strategies can be integrated. BalanceWear® therefore helps patients to achieve more harmonious movements, greater stability and confidence in their own body, which will in turn enable them to dare to perform activities they would not otherwise attempt.
- Horak F. Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls? Age and Ageing. 2006;35-S2:ii7-ii11
- Pollock A, Durward B, Rowe P. What is balance? Clinical Rehabilitation. 2000;14:402-6
- Woollacott M. Editorial systems contributing to balance disorders in older adults. Journal of Gerontology: Medical sciences. 2000;55A(8):M424-M428
- Blaszczyk J, Beck M, Sadowska D. Assessment of postural stability in young healthy subjects based on directional features of posturographic data: Vision and gender effects. Acta Neurobiol
- Gorgas A, Widener G, Gibson-Horn C, Allen D. Gait changes with balance-based torsoweighting in people with multiple sclerosis. Physiother. Res. Int. 2015;20:45-53
- Widener G, Allen D, Gibson-Horn C. Randomized clinical trial of balance-based torso weighting for improving upright mobility in people with multiple sclerosis. Neurorehabilitation and Neural Repair. 2009;23(8):784-791
- Crittendon A, O’Neill D, Widener G, Allen D. Standing data disproves biomechanical mechanism for balance-based torso-weighting. Arch Phys Med Rehabil. 2014;95(1):43-49