Virtual reality is a new technology that simulates a three-dimensional virtual world on a com-puter and enables the generation of visual, audio, and haptic feedback for the full immersion of users. Users can interact with and observe objects in three-dimensional visual space without limitation. At present, virtual reality training has been widely used in rehabilitation therapy for balance dysfunction. This paper summarizes related articles and other articles suggesting that virtual reality training can improve balance dysfunction in patients after neurological diseases. When patients perform virtual reality training, the prefrontal, parietal cortical areas and other motor cortical networks are activated. These activations may be involved in the reconstruction of neurons in the cerebral cortex. Growing evidence from clinical studies reveals that virtual reality training improves the neurological function of patients with spinal cord injury, cerebral palsy and other neurological impairments. These ifndings suggest that virtual reality training can acti-vate the cerebral cortex and improve the spatial orientation capacity of patients, thus facilitating the cortex to control balance and increase motion function.

Lateral bending of the trunk has been specifically identified as a high risk factor for lower back disorders. However, few studies have presented in vivo kinematic data of the trunk while performing functional lateral bending tasks. Five healthy male subjects performed lateral lifting and lowering tasks under loading condition ranging from light (2kg) to 100% of a maximum (ML) at a controlled velocity. Single lowering tasks were also performed at 125% and 150% of ML. Video based movement analysis was used to determine kinematics of the trunk, pelvis, shoulders and neck in the frontal plane. Centre of pressure (COP) data was also obtained from a force platform on which the subjects stood when performing the lifting and lowering tasks. Kinematics of the trunk revealed a smooth and relatively large change in angular displacement (between 69°to 55°) toward the unloaded side during the lifting phase. Trunk angular displacement significantly decreased with increasing lifting load. The trunk was additionally divided into four segments representing the lower and upper lumbar regions and the lower and upper thoracic regions. The greatest displacement in these segments took place at the upper lumbar and lower thoracic regions (ranging from 29°to 22°and 23°to 17°, respectively) with the least displacement occurring in the lower lumbar and upper thoracic regions (approx. 6° and 5°, respectively). Both the upper lumbar and lower thoracic segments showed significant decreases in angular displacement with increasing load. During the single lowering trials the trunk rotated toward the loaded side with slightly less magnitude to that recorded during the lowering phase of the heaviest lifting and lowering conditions. Angular displacements of the upper lumbar and lower thoracic segments also decreased with increasing load in single lowering. Identified changes in the COP displacement were also correlated to increasing lifting and lowering load. The main findings of this study indicate that it is the central sections of the trunk that have the greatest motion during

注意缺陷多动障碍平衡功能的客观评定

Objective Although attention deficit hyperactivity disorder (ADHD) is frequently associated with subtle neurological signs, no objective evaluation of the sensory integration, which is essential for maintaining balance, has been reported.Method In this study, we used Balance Master(r) and the modified clinical sensory interaction on balance to test the balance function of ADHD children.Result We found that the sway velocity of center of gravity on conditions, firm surface with eyes closed, foam pad with eyes open and foam pad with eyes closed, was significantly higher (P< 0.03) in ADHD group than in controls. Conclusion We concluded that the sensory inputs, the sensory integration, and/or the inhibition of excessive movement are impaired in ADHD children, which result in the balance dysfunction.

Posture,Gait,and Falls among Older Assistive Ambulatory Device Users

This review article is primarily a summary of research that has been conducted in the author's lab and clinical sites as well some relevant studies from others.These studies mainly focus on how and what the assistive ambulatory devices (AADs),including walkers and canes in the geriatric population,may affect the user's posture and gait,as well as how the AADs may be associated with the rate of falls.Among AAD users,inappropriate use of an AAD was common,including lack of medical consultation for device selection/use,incorrect AAD height,poor AAD maintenance,inability to maintain the right gait pattern,improper posture during ambulation,and placement of a cane in the wrong-sided hand.Older AAD users still fall,despite the help of their device.Forward-leaning posture was frequently identified in the AAD users and was significantly associated with the rate of falls.In an order from a sing-tip cane,tri-tip cane,quad cane,to a rolling walker,the AAD users demonstrated significant decreased velocity,cadence,and increased stance time during ambulation.The author strongly recommend that establishing an outreach community service program and/or performing a simple assessment of a patient' s AAD during the patient's visit to provide education on proper posture and gait patterns might be able to improve the ability of appropriate AAD use for these older AAD users,thus likely decreasing the chance of potential falls among them.