Browsing by Person "Tarfali, Georgia"

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The development and implementation of a portable balance platform for re-education postural stability in older adults
(British Geriatrics Society, 2016-09-16) Tarfali, Georgia; Roeles, Sanne; Childs, Craig; Rowe, Philip
Falls in elderly are the leading cause of injury. A fall can result in serious injuries leading to loss of independence, hospitalization, increased medical costs, and a greater economic burden. Therefore, the development and implementation of effective strategies to prevent falls in elderly is a vital challenge for the health society.
Development of a perturbation protocol to quantity gait resilience using mechanical, visual and auditory perturbations: A case study
(International Society of Biomechanics, 2015-07-16) Roeles, Sanne; Tarfali, Georgia; Steenbrink, Frans; Childs, Craig; Rowe, Philip
Falls are the leading cause of death due to injury in the elderly and therefore a major problem in our aging society. In order to prevent falls it is of great importance that clinicians are able to identify those who are at risk of falling and intervene early. However, capturing gait instability is difficult as the human body is well capable of compensating for impairments and hence it is difficult to distinguish fallers from non-fallers during steady state walking using currently available stability measures1. Most falls in the elderly occur during locomotion as gait resilience is compromised due to aging and therefore the ability to resist external perturbations during walking is also decreased. Measuring the response to external perturbations has been proposed to quantify dynamic stability and to identify fall-risk. However, perturbations used in these studies are unlikely to occur in everyday life and are dangerous and difficult to monitor. Little is known about the type of experimental perturbations that could be used for diagnosis of fallers . Therefore, the aim of this study is to evaluate the feasibility of a protocol that mimics perturbations encountered in daily life like, a push, a trip, a slip, sudden darkness or a loud noise
Effects of simultaneous soft tissue mobilization and capacitive and resistive electric transfer therapy using bracelet electrodes in women with chronic non-specific neck pain: A randomized clinical trial
(SAGE Publications, 2025-05-16) Lytras, Dimitrios; Iakovidis, Paris; Kasimis, Konstantinos; Georgoulas, Vasileios; Algiounidis, Ioannis; Tarfali, Georgia
Background Chronic non-specific neck pain (CNSNP), persisting for over 12 weeks, is commonly associated with myofascial trigger points. Soft tissue mobilization techniques (STMT) and capacitive and resistive electric transfer therapy (TECAR) may reduce pain and improve function. Aim To evaluate the effectiveness of combining STMT with TECAR using resistive bracelet electrodes in women with CNSNP. Method A parallel-group, assessor-blinded randomized controlled trial (RCT) was conducted in accordance with CONSORT guidelines. Eighty women were randomly assigned to an experimental group (STMT + TECAR) or control (STMT only). TECAR was applied at 500 kHz: 10 min of capacitive mode with a conventional electrode, followed by simultaneous STMT and resistive mode using bracelet electrodes. Participants received 15 sessions over five weeks. NPRS, pressure pain thresholds (PPT), cervical range of motion (ROM), and Neck Disability Index (NDI) were assessed at baseline, week 5, and 6-month follow-up. Results The experimental group showed significantly greater improvements at week 5 in NPRS, NDI, all PPT areas, lateral flexion, and right rotation ROM (p < .05). Clinically meaningful improvements in NPRS and NDI were observed only in the experimental group, while both groups achieved clinically significant gains in PPT. Improvements were sustained at six months; left rotation ROM differed only at follow-up. No differences were found in neck flexion or extension. Conclusions Combining STMT with TECAR using bracelet electrodes resulted in superior improvements in pain, function, and ROM in women with CNSNP versus STMT alone, likely due to the synergistic mechanical and thermal effects of the intervention.
Feasibility of a perturbation protocol to quantify dynamic stability
(Gait and Clinical Movement Analysis Society, 2016-05-20) Roeles, Sanne; Tarfali, Georgia; Childs, Craig; Steenbrink, Frans; Rowe, P.
Falls in elderly are the leading cause of injury and therefore considered a major health problem in our ageing society [1]. A fall is the result of an inadequate restoration of balance when it is compromised. The use of external perturbations to evoke loss of balance in a standardized and safe manner is an increasingly popular approach to measur e dynamic stability, offering opp ortunities for fall prevention research [2]. Although a perturbation - paradigm is promising, little is known about the type of perturbation that is most informative to quantify dynamic stability. Therefore, the first aim of this feasibility study was to evaluate whether mechanical, visual and auditory perturbations can be used to affect dynamic stability. The second aim was to evaluate whether we can distinguish between younger and older adults using the response to external perturbations.
Gait perturbations to discriminate between older adults with and without history of falls
(International Society of Posture & Gait Research, 2017-06-29) Roeles, Sanne; Rowe, Philip; Bruijn, Sjoerd; Childs, Craig; Tarfali, Georgia; Steenbrink, Frans; Pijnappels, Mirjam
BACKGROUND AND AIM: While falls among older adults are considered a major health problem, the sensitivity of conventional fall risk assessments to identify individuals at risk is poor [1]. Among the main risk factors for falls are balance and gait impairments [2]. The ability to resist or recover from gait perturbations to prevent falling requires fast and accurate responses and might discriminate between fallers and non-fallers. We therefore investigated the ability to discriminate between older adults with and without history of falls using medio-lateral and anterior-posterior gait perturbations. METHODS: Twenty-five older adults (14 females; 74.0±11.1 years of age) walked at a fixed treadmill speed (1.03±0.20 m/s) on the GRAIL (Motekforce Link BV, Amsterdam, The Netherlands). Trunk and lower limb kinematics were collected (Vicon, Oxford, UK) during steady state walking and in response to four types of perturbations: ipsi-lateral and contra-lateral platform sway and unilateral belt acceleration and deceleration. Maximum pelvic velocity per step in the medio-lateral and anterior-posterior direction was calculated during baseline walking and the first step after each perturbation. Participants were categorized as fallers or non-fallers based on their self-reported fall history over the past 12 months. Additionally, falls efficacy score (FES), physical activity questionnaire (PAQ), one-legged stance test (OLST) and the timed up and go (TUG) test were assessed. Differences between fallers and non-fallers were analysed using one-way ANOVAs. RESULTS: Seven participants (28%) reported at least one fall in the past 12 months and were categorized as fallers. Fallers showed significantly lower maximum pelvic velocity in response to the deceleration perturbation compared to non-fallers (F=5.651; p=0.026). No significant differences in maximum pelvic velocity were found during baseline walking and for the other perturbation types (Figure 1). Moreover, no significant differences were found between fallers and nonfallers for the conventional measures (i.e. the FES, PAQ, OLST and TUG). CONCLUSIONS: We successfully discriminated fallers from non-fallers based on the recovery from deceleration perturbations, while we were not able to do so by means of the conventional measures. Fallers had more difficulties in maintaining walking speed as indicated by the lower maximum pelvic velocity. On average, their maximum pelvic velocity was negative, meaning that their position on the treadmill became more rearward after the deceleration perturbation. Therefore, assessing the ability to recover from deceleration perturbations may be used to identify fall risk in older adults. The added value of other perturbation outcomes and strategies to recover from perturbations will be discussed. [1] Gates S. et al. (2008). J Rehabil Res Dev, 45(8): 1105-16. [2] Ambrose, AF et al. (2013). Maturitas, 75(1): 51-61.
Gait stability in response to platform, belt, and sensory perturbations in young and older adults
(Springer, 2018-06-27) Roeles, S.; Rowe, P. J.; Bruijn, S. M.; Childs, C. R.; Tarfali, Georgia; Steenbrink, F.; Pijnappels, M.
Perturbation-based gait assessment has been used to quantify gait stability in older adults. However, knowledge on which perturbation type is most suitable to identify poor gait stability is lacking. We evaluated the effects of ipsi- and contra-lateral sway, belt acceleration and deceleration, and visual and auditory perturbations on medio-lateral (ML) and anterior-posterior (AP) margins of stability (MoS) in young and older adults. We aimed to evaluate (1) which perturbation type disturbed the gait pattern substantially, (2) how participants recovered, and (3) whether recovery responses could discriminate between young and older adults. Nine young (25.1 ± 3.4 years) and nine older (70.1 ± 7.6 years) adults walked on the CAREN Extended (Motek BV, The Netherlands). The perturbation effect was quantified by deviation in MoS over six post-perturbation steps compared to baseline walking. Contra-lateral sway and deceleration perturbations resulted in the largest ML (1.9–4 times larger than other types) and AP (1.6–5.6 times larger than other types) perturbation effects, respectively. After both perturbation types, participants increased MoS by taking wider, shorter, and faster steps. No differences between young and older adults were found. We suggest to evaluate the potential of using contra-lateral sway and deceleration perturbations for fall risk identification by including both healthy and frail older adults.
Unsupervised IMU-based evaluation of at-home exercise programmes: A feasibility study
(BMC, 2022-02-19) Komaris, Dimitrios-Sokratis; Tarfali, Georgia; O’Flynn, Brendan; Tedesco, Salvatore
Background: The benefits to be obtained from home-based physical therapy programmes are dependent on the proper execution of physiotherapy exercises during unsupervised treatment. Wearable sensors and appropriate movement-related metrics may be used to determine at-home exercise performance and compliance to a physical therapy program. Methods: A total of thirty healthy volunteers (mean age of 31 years) had their movements captured using wearable inertial measurement units (IMUs), after video recordings of five different exercises with varying levels of complexity were demonstrated to them. Participants were then given wearable sensors to enable a second unsupervised data capture at home. Movement performance between the participants’ recordings was assessed with metrics of movement smoothness, intensity, consistency and control. Results: In general, subjects executed all exercises similarly when recording at home and as compared with their performance in the lab. However, participants executed all movements faster compared to the physiotherapist’s demonstrations, indicating the need of a wearable system with user feedback that will set the pace of movement. Conclusion: In light of the Covid-19 pandemic and the imperative transition towards remote consultation and tele-rehabilitation, this work aims to promote new tools and methods for the assessment of adherence to home-based physical therapy programmes. The studied IMU-derived features have shown adequate sensitivity to evaluate home-based programmes in an unsupervised manner. Cost-effective wearables, such as the one presented in this study, can support therapeutic exercises that ought to be performed with appropriate speed, intensity, smoothness and range of motion.
Using low cost sensors to augment an upper limb trainer with automated movement feedback
(2017-11-19) Collins, Ross; Tarfali, Georgia; Kerr, Andy
Introduction: The recovery of upper limb movement is a major concern for stroke survivors. While the majority recover some function, it is often insufficient for activities of daily living. Repetitive arm movement can help improve recovery, however this can be difficult to perform independently. The Move-Able arm trainer (Move-Able Ltd, UK) is a user friendly device designed for stroke survivors to exercise their upper limb on their own, however, at present it lacks the ability to provide performance feedback.