A Wireless Embedded Tongue Tactile Biofeedback System for Balance Control

📝 Abstract

We describe the architecture of an original biofeedback system for balance improvement for fall prevention and present results of a feasibility study. The underlying principle of this biofeedback consists of providing supplementary information related to foot sole pressure distribution through a wireless embedded tongue-placed tactile output device. Twelve young healthy adults voluntarily participated in this experiment. They were asked to stand as immobile as possible with their eyes closed in two conditions of nobiofeedback and biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed reduced CoP displacements in the biofeedback relative to the no-biofeedback condition. On the whole, the present findings evidence the effectiveness of this system in improving postural control on young healthy adults. Further investigations are needed to strengthen the potential clinical value of this device.

💡 Analysis

We describe the architecture of an original biofeedback system for balance improvement for fall prevention and present results of a feasibility study. The underlying principle of this biofeedback consists of providing supplementary information related to foot sole pressure distribution through a wireless embedded tongue-placed tactile output device. Twelve young healthy adults voluntarily participated in this experiment. They were asked to stand as immobile as possible with their eyes closed in two conditions of nobiofeedback and biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed reduced CoP displacements in the biofeedback relative to the no-biofeedback condition. On the whole, the present findings evidence the effectiveness of this system in improving postural control on young healthy adults. Further investigations are needed to strengthen the potential clinical value of this device.

📄 Content

Vuillerme et al., Pervasive and Mobile Computing (2008) (DOI 10.1016/j.pmcj.2008.04.001)

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A WIRELESS EMBEDDED TONGUE TACTILE BIOFEEDBACK SYSTEM FOR BALANCE CONTROL

Nicolas VUILLERME1, Nicolas PINSAULT, Olivier CHENU, Anthony FLEURY, Yohan PAYAN and Jacques DEMONGEOT1

Laboratoire TIMC-IMAG, UMR UJF CNRS 5525, La Tronche, France

Address for correspondence:
Nicolas VUILLERME / Jacques DEMONGEOT Laboratoire TIMC-IMAG, UMR UJF CNRS 5525 Faculté de Médecine 38706 La Tronche cédex France. Tel: (33) (0) 4 56 52 01 08 Fax: (33) (0) 4 76 76 88 44 Email: nicolas.vuillerme@imag.fr / jacques.demongeot@imag.fr

Article published in Pervasive and Mobile Computing (2008) (DOI 10.1016/j.pmcj.2008.04.001) Vuillerme et al., Pervasive and Mobile Computing (2008) (DOI 10.1016/j.pmcj.2008.04.001)

2 ABSTRACT

We describe the architecture of an original biofeedback system for balance improvement for fall prevention and present results of a feasibility study. The underlying principle of this biofeedback consists of providing supplementary information related to foot sole pressure distribution through a wireless embedded tongue-placed tactile output device. Twelve young healthy adults voluntarily participated in this experiment. They were asked to stand as immobile as possible with their eyes closed in two conditions of nobiofeedback and biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed reduced CoP displacements in the biofeedback relative to the no- biofeedback condition. On the whole, the present findings evidence the effectiveness of this system in improving postural control on young healthy adults. Further investigations are needed to strengthen the potential clinical value of this device.

Key-words: Balance; Biofeedback; Tongue Display Unit . Vuillerme et al., Pervasive and Mobile Computing (2008) (DOI 10.1016/j.pmcj.2008.04.001)

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1. Introduction 1.1. Balance control in older adults Falls in older adults constitutes a major health care problem (e.g. [4,34]). More than 30% of community-dwelling persons aged 65 or more [9] and 50% of those over the age of 80 [16] fall annually and many fall more than once. In addition to the high medical expenses that falls pose to the public health service, the consequences for older adults are rather dramatic. Falls are associated with physical and psychological trauma, reduced activity, loss of independence, decreased quality of life and even injury-related deaths. For instance, the mortality of elderly nursing home residents, taken over a one-year period after falling, has been reported to be more than twice that of a non-faller control group [12]. That is the reason why prevention of falls has been an important area of research into the health of older adults.
   Although falling represents a complex and multifactorial problem [17,18], the degradation of balance capacities, associated with aging (see [10] for a review), is usually considered as a major contributing factor [3,7,8,27]. Postural control requires the integration of sensory inputs to assess the position and motion of the body in space and the ability to generate forces to control body position [20]. Among the sensory inputs relevant to balance control, the importance of cutaneous information from the foot sole is well recognised (e.g., [14,23]). Indeed, plantar cutaneous mechanoreceptors (deep and plantar-surface) could potentially provide detailed spatial and temporal information about contact pressures under the foot and shear forces resulting from body movement that constitute valuable feedback to the postural control system. For instance, anaesthetising [23], altering [31] or stimulating [2,19,21,29,30,37] plantar cutaneous receptors of the plantar soles have previously been shown to affect postural control during quiet standing. In addition, as the neuromuscular constraints acting on the individual increase, as is the case following muscular fatiguing exercise, the availability and integrity of cutaneous inputs from the plantar soles become of Vuillerme et al., Pervasive and Mobile Computing (2008) (DOI 10.1016/j.pmcj.2008.04.001)

4 greater importance in the appropriate control of balance [44,47]. What is more, one of the more pervasive effects of aging is the decline in plantar-surface sensitivity at various locations across the sole of the foot (e.g., [15,24,49]). The increased sensory thresholds observed in older adults were hypothesized to stem from changes in receptor morphology, reduction of receptor density, decreased elasticity of the skin and decreased nerve conduction [15]. Interestingly, altered plantar cutaneous sensation has even been identified as an important contributing factor to the occurrence of falls in the elderly [17,22]. Within this context, proposing a therapeutic intervention [37] and/or designing a technical assistance [19,29,30] to incre

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