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Llorens R.,Polytechnic University of Valencia | Latorre J.,Polytechnic University of Valencia | Noe E.,Servicio de Neurorrehabilitacion | Keshner E.A.,Temple University
Gait and Posture | Year: 2016

Background: Posturography systems that incorporate force platforms are considered to assess balance and postural control with greater sensitivity and objectivity than conventional clinical tests. The Wii Balance Board (WBB) system has been shown to have similar performance characteristics as other force platforms, but with lower cost and size. Objectives: To determine the validity and reliability of a freely available WBB-based posturography system that combined the WBB with several traditional balance assessments, and to assess the performance of a cohort of stroke individuals with respect to healthy individuals. Methods: Healthy subjects and individuals with stroke were recruited. Both groups were assessed using the WBB-based posturography system. Individuals with stroke were also assessed using a laboratory grade posturography system and a battery of clinical tests to determine the concurrent validity of the system. A group of subjects were assessed twice with the WBB-based system to determine its reliability. Results: A total of 144 healthy individuals and 53 individuals with stroke participated in the study. Concurrent validity with another posturography system was moderate to high. Correlations with clinical scales were consistent with previous research. The reliability of the system was excellent in almost all measures. In addition, the system successfully characterized individuals with stroke with respect to the healthy population. Conclusions: The WBB-based posturography system exhibited excellent psychometric properties and sensitivity for identifying balance performance of individuals with stroke in comparison with healthy subjects, which supports feasibility of the system as a clinical tool. © 2015 Elsevier B.V.

Navalon N.,Servicio de Neurorrehabilitacion | Verdecho I.,Servicio de Neurorrehabilitacion | Llorens R.,Polytechnic University of Valencia | Colomer C.,Servicio de Neurorrehabilitacion | And 5 more authors.
Brain Injury | Year: 2014

Objective: To study the characteristics of balance performance in a sample of patients with increasing postural instability after acquired brain injury (ABI) and to establish the clinical utility of a new computerized posturographic system (NedSVE/IBV).Methods: This study included 108 patients with ABI divided into five groups from minimal to severe postural impairment. All patients were assessed with the NedSVE/IBV system and with traditional balance measures. Posturographic analyses included the modified clinical test of sensory interaction on balance, the limits of stability and the weight-shifting test. Sensitivity to detect changes and reproducibility were evaluated in 63 patients who were followed-up for 6 months and in 20 patients who were evaluated on two separate occasions during the same week, respectively.Results: The patients showed reduced stability limits, abnormal postural responses and an increased reliance on visual input with differences in intensity directly related to their degree of balance impairment. Posturographic study showed excellent convergent validity, reproducibility and sensitivity to detect changes.Conclusion: The data suggests that, regardless of the intensity of postural instability, there is a common mechanism of sensory processing to maintain balance after ABI. The NedSVE-IBV system is a valid tool to quantify balance after ABI. © 2014 Informa UK Ltd.

Llorens R.,Polytechnic University of Valencia | Navarro M.D.,Servicio de Neurorrehabilitacion | Alcaniz M.,Polytechnic University of Valencia | Alcaniz M.,Jaume I University | Noe E.,Servicio de Neurorrehabilitacion
Studies in Health Technology and Informatics | Year: 2012

Self-awareness deficits can manifest as a consequence of acquired brain injurydecreasing the motivation and the adherence to the treatment. We present a multitouch system that promotes the role-playing and the self-assessment strategies and challenges the participants in a competitive context. This paper presents aninitial clinical trial to study the effectiveness of the virtual system in the rehabilitation of the self-awareness skills. According the evolution of the participants in the Self-Awareness Deficits Interview and in the Spanish Social Skills Scale, the participants improve the perception of their deficits and disabilities. © 2012 Interactive Media Institute and IOS Press.

Llorens R.,Polytechnic University of Valencia | Alcaniz M.,Polytechnic University of Valencia | Alcaniz M.,Jaume I University | Colomer C.,Servicio de Neurorrehabilitacion | Navarro M.D.,Servicio de Neurorrehabilitacion
Studies in Health Technology and Informatics | Year: 2012

Stroke patients often suffer from hemiparesis, which affects their balance condition and consequently their self-dependency and quality of life. Balance rehabilitation can be a long and tedious process. Virtual rehabilitation systems have been reported to provide therapeutic benefits to the balance recovery of stroke patients while increasing their motivation. This paper presents a follow-up study involving chronic stroke patients to evaluate the clinical effectiveness of a virtual stepping exercise using skeleton tracking through a low-cost Kinect depth sensor. © 2012 Interactive Media Institute and IOS Press.

Navarro M.-D.,Servicio de Neurorrehabilitacion | Llorens R.,Polytechnic University of Valencia | Noe E.,Servicio de Neurorrehabilitacion | Ferri J.,Servicio de Neurorrehabilitacion | And 2 more authors.
Neuropsychological Rehabilitation | Year: 2013

Unilateral spatial neglect is a common consequence of stroke that directly affects the performance of activities of daily living. This impairment is traditionally assessed with paper-and-pencil tests that can lack correspondence to real life and are easily compensated. Virtual reality can immerse patients in more ecological scenarios, thus providing therapists with new tools to assess and train the effects of this impairment in simulated real tasks. This paper presents the clinical validation and convergent validity of a low-cost virtual reality system for training street-crossing in stroke patients with and without neglect. The performance of neglect patients was significantly worse than the performance of non-neglect and healthy participants. In addition, several correlations between the scores in the system and in the traditional scales were detected. © 2013 Taylor & Francis.

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