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BLACKBURN, TA, et al.
SINGLE LEG STANCE: DEVELOPMENT OF RELIABLE TESTING PROCEDURE
Berkshire Institute of Orthopedic & Sports Physical Therapy, Wyomissing, PA
Biodex #93-207

CACHUPE, WJC, et al.
RELIABILITY OF BIODEX BALANCE SYSTEM MEASURES
Human Performance Dept. / San Jose State University / June 2000
Biodex #91-198

CAGGIANO, NA, et al.
THE RELATIONSHIP BETWEEN ANKLE KINESTHESIA AND PEAK TORQUE WITH
SINGLE LEG MULTIAXIAL PLATFORM STABILITY
J of Athletic Training, Vol. 34(2):S-31 / April-June 1999
Biodex #91-106

CAMPBELL, MH, et al.
THE CORRELATION BETWEEN ISOKINETIC STRENGTH MEASURES AND FUNCTIONAL
PERFORMANCE IN AN ELDERLY POPULATION
Biodex #93-293

CAVANAUGH, JT, et al.
BALANCE AND POSTOPERATIVE LOWER EXTREMITY JOINT RECONSTRUCTION
Orthopaedic Phys Therapy Clinics of No America; Vol.11:1, 75-99 - March 2002
Biodex #92-244

CLARK, S, et al.
GENERALIZABILITY OF THE LIMITS OF STABILITY TEST IN THE EVALUATION OF
DYNAMIC BALANCE AMONG OLDER ADULTS
Arch Phys Med Rehabil Vol 78:1078-1084, October 1997
Biodex #92-269

DiCOSTANZA, K, et al.
EFFECT OF ADHESIVE MEDIAL LONGITUDINAL ARCH SUPPORT ON POSTURAL SWAY
J of Athletic Training / Vol. 36(2) (suppl) S66, April-June 2001
Biodex #92-227

DOVER, G, et al.
RELIABILITY OF INVERSION AND EVERSION PEAK TORQUE MEASUREMENTS FROM
THE BIODEX SYSTEM 3 ISOKINETIC DYNAMOMETER
J of Athletic Training / Vol. 35 (2) (suppl) / S-91 / April-June 2000
Biodex #91-185

FERRIS, CM, et al.
A COMPARISON OF STRENGTH, PROPRIOCEPTION, LAXITY, FLEXIBILITY, AND BALANCE
BETWEEN BASKETBALL AND NON-BASKETBALL COLLEGIATE FEMALE ATHLETES
J of Athletic Training / Vol. 35 No. 2 (suppl) / S38 / April-June 2000
Biodex #91-189

FINN, JA, et al.
STABILITY PERFORMANCE ASSESSMENT AMONG SUBJECTS OF DISPARATE
BALANCING ABILITIES
Southern Connecticut State University, 501 Crescent St.,
New Haven, CT 06515 Phone: 203-392-6036
Biodex #93-286

CONTENTS

APPENDIX G

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Summary of Contents for 950-440

Page 1: ... SERVICE MANUAL 950 440 950 441 950 444 BIODEX Biodex Medical Systems Inc 20 Ramsey Road Shirley New Y ork 11967 4704 Tel 800 224 6339 Int l 631 924 9000 Fax 631 924 9338 Email info biodex com www biodex com FN 10 205 Rev B 3 12 ...

Page 2: ...tioner When prescribed for therapeutic purpose a physician should clearly define the parameters of use i e total work maximum heart rate etc to reduce the risk of patient injury ATTENTION Droit fédéral limite ce dispositif à la vente ou de l ordre de la profession médicale Lorsque prescrits à des fins thérapeutiques un médecin devrait clairement définir les paramètres d utilisation p ex total trav...

Page 3: ...rotocols this manual contains a Clinical Considerations section where appropriate These comments come from the clini cal experience of our users as well as from published journals The product is intended to remain in one location during operation The product is provid ed with wheels for relocation and should be used when performing this operation It is rec ommended that two persons move the produc...

Page 4: ... operator must consult the accompanying documents prior to use Dangerous Voltage Present Functional Earth Ground General Warning Sign Fuse Alternating current ON power OFF power Date of Manufacture CE Mark Models that bear the ETL Monogram have been Certified for Safety by ETL Intertek in accordance with CAN CSA C22 2 STD 601 1 M90 and UL STD 60601 1 USB connector Authorized European Community Rep...

Page 5: ...t Athlete Single Leg Stability Testing Performing a Fall Risk Test Clinical Test of Sensory Integration and Balance CTSIB overview 9 Reports 9 1 Report Parameters Defined Progress Reports Sample Balance Reports 10 Data 10 1 Assessing Limits of Stability With The Biodex Balance System Understanding Patient Performance Balance System Statistics Defined Changing Normative Data Default 11 System Utili...

Page 6: ...nd USB Printer Ports Adjustable height display to accommodate each patient Adjustable support handles Color printer with stand included Transport wheels allow easy relocation Features both static and dynamic balance capabilities Locking surface ensures safe on off patient movement NEW 12 1 High resolution color touch screen LCD display ...

Page 7: ...including Fall Risk Screening Athletic Single Leg Injury Screening Dynamic or Static Limits of Stability Postural Stability and Clinical Test of Sensory Integration of Balance CTSIB The Balance System SD also serves as a valuable training device to enhance kinesthetic abilities that may provide some degree of compensation for impaired proprioceptive reflex mechanisms following injury An easy to fo...

Page 8: ...eo line jack Video Out Display supports simultaneous analog up to 800 x 600 resolution User Interface and Device Capabilities USB ports Four 1 1 host ports to support Mass Storage Device USB Thumb drive Keyboard Mouse wired and wireless to allow for remote control operation Plus 1 Remote CRT connector 1 Serial communication port Operating Temperature Range 59 F to 86 F 15 C to 30 C Operating Humid...

Page 9: ...ouse Microsoft 1056 1051 Mouse Logitech V220 Mouse HP WX414AA Mouse Dynex DX PWLMSE Mouse Toshiba PA3651U 1ETC Mouse Logitech G500 910 001259 Mouse BTC M859C Mouse Logitech M BJ79 Mouse Dell MOA8BO Mouse Dell M UK DEL3 Mouse Manhattan 176569 Mouse COMPaTIBLE KEYBOaRDS Manufacturer Model Device Type Mini Keyboard ACK 5010U USB Keyboard Adesso AKB 210 Keyboard Adesso WKB 4000US Keyboard Adesso ACK 5...

Page 10: ...r cable Plug the small end into the power receptacle on the back of the printer Do not connect any other equipment to this receptacle 4 Plug the AC plug end of the power cable into power cable port on the back lower base of the Balance System 5 Locate the white USB cable Connect one end of the cable to the USB port on back of the Balance System display Connect the other end of the cable to the USB...

Page 11: ...onnector 3 PS 2 Connector 4 Ethernet activity lights Green indicates connectivity Yellow indicates activity 5 Auxiliary Com Port Serial Port 6 Ethernet Connector RJ 45 7 PCB activity lights Green indicates compact flash activity Yellow indicates power on 8 USB Connectors suggested to use one of these for printers Figure 3 2 Connect the power cable and USB cable to the rear of the printer CONTENTS ...

Page 12: ...tement de l appui 1 Pour régler l angle de l appui le tenir tout en tirant sur le verrou Trouver la position voulue relâcher le verrou pour garder la position ainsi trouvée 2 Pour écarter l appui le baisser tout en tirant sur le verrou To adjust the Display Height 1 Loosen the Display Height Locking Knob 2 Pull up or push down on the display until the desired height is achieved 3 Tighten the locki...

Page 13: ...rts Adjustable height display to accommodate each patient Adjustable support handles Color printer with stand included Transport wheels allow easy relocation Features both static and dynamic balance capabilities Locking surface ensures safe on off patient movement NEW 12 1 High resolution color touch screen LCD display ...

Page 14: ...ty 4 When dealing with post operative patients ensure they possess adequate muscular control to stabilize the joint prior to placing them on the foot platform Inadequate muscular control could lead to increased joint translation 5 When patients are working with their eyes closed ensure that a clinician is ready to assist in case of loss of balance or use the optional patient support stand 6 Since ...

Page 15: ...plus s en servir De cette facon les patients développment leur compréhension du plateau de stabilité en minimisant les risques 9 La courbe d apprentissage du systäme peut influencer les résultats d un examen La littérature clinique suggàre qu il faut réaliser trois examens à blanc avant de faire un examen définitif 10 Régler l écran droit devant les yeux du patient Ceci aidera à maintenir une bonn...

Page 16: ...ient à atteindre le déficit de stabilité Le harnais seul ne peut pas prévenir des chutes 2 Puisque le sysàme de stabilité permet une inclinaison de 20º démarrer avec une stabilité 8 et avancer en fonction de la tolérance rencontrée NOtA Le niveau 8 est le niveau le plus stable et le niveau l est le niveau le moins stable les deux réglages permettent 20ºd inclinaison 3 Des patients particuliérement...

Page 17: ...FaLL PREVENTION 1 Bilateral Exercises Begin with static level weight shifts Progress to dynamic level 12 weight shifts Use circular grid to demonstrate where tendency to fall occurs Have patient perform both anterior posterior and medial lateral exercises 2 Unilateral Exercises Have patient hold platform steady and illustrate how well the patient holds the platform stable Different patterns circle...

Page 18: ...le 3 S assurer que le patient sait utiliser l appui correctement 4 S assurer que la stabilité bilatérale statique sur une seule jambe est adéquate avant de procéder à la stabilité unilaterérale 5 Plus le plateau est instable 8 équivaut à un réglage plus stable le réglage l équivaut à un niveau moins stable plus l activité est difficile ä réaliser S assurer que la patient utilise l appui à tout mom...

Page 19: ... time out period System default is 5 minutes This can be adjusted in System Utilities See page 11 1 When the screen is dark and the unit is plugged into wall current just touch the screen and the last viewed screen will be presented SCREEN KEYS The following on screen touch keys are consistent whenever they appear throughout the entire Balance System SD program HOME Touch this key to return to the...

Page 20: ...e saved and recalled for later use by touching the Save icon on the results screen following any training session A patient name is required to save the results If no pre existing name is available the name entry screen will be displayed Fill out the patient infor mation and touch Save to record the training result numeric values along with patient foot position on the platform To recall a patient...

Page 21: ... Setup Information screen should now be displayed If this is a new patient and you want to save this training session after its completion you must enter the patient s name height and weight If you do not need to save the training session touch Next and skip to step 8 5 Touch the Keypad icon for Name and enter the patient s name Touch OK to return to the User Information screen 6 Touch the Keypad ...

Page 22: ...display to begin the training session The Stability Training grid on the screen charts the patient s stability perform ance through the course of the training session touch the Magnifying Glass to enlarge the screen if desired The Elapsed Time from the start of the training session is shown at the top right of the display while the stability level is illustrated by a bar graph in the upper right h...

Page 23: ...tional accuracy of the movement to the blinking targets see Appendix B 1 time counts up Figure 7 3 The Limits of Stability LOS Training Screen To access The Limits of Stability Training Mode 1 Position the support handles as per patient protocol 2 Position the display height and tilt for patient comfort 3 At the Main Menu touch Training The Training Menu screen should now be displayed 4 Touch Limi...

Page 24: ...eys to select the desired platform stability static 12 is most stable 1 is least stable 13 Explain the training protocol to the patient then press Start to begin the LOS training ses sion The LOS Training screen reflects the patient s stability performance through the course of the LOS training session The Elapsed Time from the start of the training session is shown at the top right of the display...

Page 25: ... total All outside boundary hits are subtracted from the total amount of target hits This value equals the net good hits For example Enter 10 as the of target hits There were 4 times the cursor went outside the boundary 10 4 6 good hits Score 6 10 or 60 For weight shift training the time value always counts up NOte A wall hit is counted as one hit within the path to the target hit Figure 7 4 The W...

Page 26: ...reen and set the ending platform stability in the same manner To turn tracing ON OFF touch Tracing to toggle between choices 12 At the Weight Shift Training screen touch the or keys to select the desired plat form stability if not already selected static 12 is most stable 1 is least stable 13 Explain the training protocol to the patient and then press Start on the display to begin the training ses...

Page 27: ...4 in each direction Moderate has 36 targets 18 in each direction Most difficult has 72 targets 36 in each direction In the case of the easiest maze If the wall is hit 6 times the resulting score will be 22 28 78 Figure 7 5 The Maze Control Training screen To access The Maze Control Mode 1 Position the support handles as per patient protocol 2 Position the display height and tilt for patient comfor...

Page 28: ...ol Training Options screen if desired Here you can set the total time for the exercise enter initial and ending platform stability settings change sensitivity and turn tracing ON OFF Touch OK to confirm your selec tions and return to the Maze Control Training Options screen or Cancel to return to the Maze Control Training Options screen without making changes Figure 7 5a The Maze Control Training ...

Page 29: ...wn at the top right of the display while the stability level is illustrated by a bar graph in the upper right corner A running patient score is also provided in the upper right corner Note that the stability level of the foot platform can be changed at any time during the exer cise session NOte If you have selected to enlarge the screen by touching the Magnifying Glass you must return to the norma...

Page 30: ...The Random Control Training screen To access The Random Control Training Mode 1 Position the support handles as per patient protocol 2 Position the display height and tilt for patient comfort 3 At the Main Menu touch Training The Training Menu screen should now be displayed 4 Touch Random Control The User Setup Information screen should now be displayed If this is a new patient and you want to sav...

Page 31: ...N OFF touch Tracing to toggle between choices 12 At the Random Control Training screen touch the or keys to select the desired platform stability if not already selected static 12 is most stable 1 is least stable 13 Explain the training protocol to the patient and then press Start on the display to begin the training session The Stability Training grid on the screen charts the patient s stability ...

Page 32: ...ring training to be an effective mode for communicating what where and how a patient s body weight is located or feels Figure 7 7 The Percent Weight Bearing Training screen NOte Scoring is the percent time spent within the target range The axis will show green when weight bearing is within target settings If desired shift the red Percent Weight Bearing target zone by touching and dragging the appr...

Page 33: ...Entry screen Using the keypads enter the patient s left foot left heel right foot and right heel positions using the midline of the foot and the platform grid as reference points Touch Next to advance to the Weight Bearing Training screen 10 The Weight Bearing Training screen displays a Medial Lateral Anterior Posterior grid If you would prefer a Medial Lateral only grid touch More Options The Mor...

Page 34: ...ning session using the same parameters or press Back to return to the Training Setup screen NOte Scoring is the time spent within the target range Create Save and Recall Custom Protocols Custom protocols are organized as those for Training and those for Testing Creating protocols are the same for either case 1 In System Utilities Select Custom Protocol List 2 A Custom Protocol list will appear 3 S...

Page 35: ... same for both 5 All target placements and goal settings are saved and recalled for custom protocols 6 Be sure to name the protocol as the protocol can then be recalled exactly as stored for reuse as a custom protocol CONTENTS THE TRAINING MODES 7 16 ...

Page 36: ...ct a previously created custom protocol simply Select Custom Protocol from either the Training or Testing menu screen 2 A listing of either Training or Testing protocols will appear Select desired protocol CONTENTS 7 17 THE TRAINING MODES ...

Page 37: ...isons quickly document differences between each lower extremity Static testing measures the angular excursion of the patient s center of gravity Body height must come into play for static measures A person s Center of Gravity COG is approximately 55 of their height Based on the selected height an appropriate static measure scaling is applied Testing in this mode is ideal for baseline testing for m...

Page 38: ...ble than a higher score Platform stability can be varied during a this test by selecting More Options from the Postural Stability Testing screen Clinicians can also set trial time number of trials starting and ending platform stability rest countdowns or bilateral test Figure 8 2 The Patient Position screen with patient positions entered Figure 8 3 The Postural Stability Testing Options screen CON...

Page 39: ...Figure 8 4 The Postural Stability Testing screen Figure 8 5 A sample Postural Stability Test Results screen for a bilateral test CONTENTS 8 3 TESTING ...

Page 40: ...Stance to scroll through the three stance positions provided left right or both 11 Touch Tracing to toggle tracing ON or OFF as desired 12 Touch Clear Tracing to clear any tracing that remains from previous tests 13 Touch More Options to advance to the Postural Stability Test Options screen if desired Here you can set the Test Trial Time enter initial and ending platform stability settings enter t...

Page 41: ... the second test trial and continue in the same manner to complete trials two and three 17 After completing the test a Test Complete message is displayed Touch Results to advance to the Postural Stability Test Results screen NOte If you have selected Bilateral Test the system will begin by testing the initial side as set up above After the third trial on the initial side is finished touch Test Oth...

Page 42: ...roblems You will see this by testing single leg involved and uninvolved Balance training will improve their control Geriatric patients can also be tested for excessive sway The direction of the sway is important with regards to the predisposition of a falls direction Falling to either side significantly increas es the chances of a hip fracture 1 2 3 References 1 Cumming Robert G Klineburg Robin J ...

Page 43: ...sin gle leg LOS test may be performed but no bilateral comparison is provided This test is a good indicator of dynamic control within a normalized sway envelope Poor con trol inconsistencies or increased times suggests further assessment for lower extremity strength proprioception vestibular or visual deficiencies may be indicated The default setting for the LOS test is 75 LOS moderate still level...

Page 44: ...ation screen 7 Touch the appropriate Height key to highlight the patient height range setting desired Touch Next to advance to the Patient Position screen 8 Position the patient on the system and explain the test protocol Press Start on the display to activate the cursor and have the patient move the cursor to the center point on the grid 9 Touch Record to bring up the Position Patient Entry scree...

Page 45: ...ing and Stance to the left of the grid Trial Number and score are displayed to the right of the grid NOte To stop a test in progress at any time and return to the Limits of Stability Testing screen with the platform locked touch Cancel or Stop 16 When the first trial is finished the screen will display Trial 1 Complete the platform will return to the locked position and a 10 second rest countdown ...

Page 46: ...ta derived from studies using the Biodex Balance System The low stability level of four will challenge athletes and provide the data necessary to assess the athlete s single leg pos tural stability Figure 8 9 The Athlete Single Leg Stability Testing screen Figure 8 10 The Athlete Single Leg Stability Testing Options screen CONTENTS TESTING 8 10 ...

Page 47: ...Figure 8 11 A sample Athlete Single Leg Stability Results report CONTENTS 8 11 TESTING ...

Page 48: ...Athlete Single Leg Stability Testing screen 10 At the Athlete Single Leg Stability Testing screen touch Stance to toggle between left and right leg positioning 11 Touch Tracing to toggle tracing ON or OFF as desired 12 Touch Clear Tracing to clear any tracing that remains from previous tests 13 Touch More Options to advance to the More Options screen if desired Here you can set the Test Trial Time...

Page 49: ...ty Test Results screen 18 At the Athlete Single Leg Stability Test Results screen touch Print to automatically gener ate a printed report if desired 19 To save the test data touch Save Results and then touch OK in response to the Save Results for later reporting or export prompt The system will display Save Results Completed after the results are saved 20 To return to the Opening Menu from the Ath...

Page 50: ...ults are compared to age dependent normative data1 Scores higher than normative values suggest further assessment for lower extremity strength proprioception and vestibular or visual deficiencies Figure 8 12 The Fall Risk Testing screen Figure 8 13 The Fall Risk Testing Options screen CONTENTS TESTING 8 14 ...

Page 51: ...screen 7 Touch the appropriate Height key to highlight the patient height range setting desired Touch Next to advance to the Patient Position screen 8 Position the patient on the system and explain the test protocol Press Start on the display to activate the cursor and have the patient move the cursor to the center point on the grid 9 Touch Record to bring up the Position Patient Entry screen Usin...

Page 52: ...rial Time and Platform Setting to the left of the grid Trial Number and score are dis played to the right of the grid NOte To stop a test in progress at any time and return to the Fall Risk Testing screen with the plat form locked touch Cancel or Stop 15 When the first trial is finished the screen will display Trial 1 Complete the platform will return to the locked position and the rest countdown ...

Page 53: ...oception and vestibular or visual deficiencies Poor balance is a major contributor to falls Strength particularly high speed and proprioceptive training have demon strated positive results in balance improvement 1 NOte For information on normative data referenced in the Predictive Values Report see Appendix C NOte For information comparing the original Balance System Protocol for Fall Risk Balance...

Page 54: ...Visual Conflict conditions will require some type of glasses that provide a distorted yet transparent image Commercially available Prism type glasses are com monly used Other improvised glasses are 3D glasses or clear safety glasses in which the lenses have been marred or covered with Scotch type tape What is being measured during the CTSIB test Sway Index Stability Index The Sway Index is really ...

Page 55: ...ggested center patient and enter new foot position The foot angle is determined by the line that is parallel with the inside of the foot NOte Foot placement is based on height 53 defaults to a foot angle of 10 10 and Heel position of F7 F15 respectively 53 59 defaults to a foot angle of 10 10 and Heel position of E7 E15 respectively 59 65 and 65 73 default to a foot angle of 10 10 and Heel positio...

Page 56: ...n and change which conditions you want to test by simply touching to highlight the conditions you want to do You can also toggle the cursor ON OFF The cursor should be OFF during the actual test Touch OK to confirm your selections and return to the Testing screen Use the or keys to set the Test Trial time in five second increments during the routine the system will count down from the time setting...

Page 57: ...ial rep prior to each test condition rep The practice rep can be stopped at anytime to proceed to the test rep After completing the condition the next test condition will follow until all conditions have been completed When the last condition is completed a Test Complete message is displayed Touch Results to advance to the CTSIB Test Results screen CONTENTS 8 21 TESTING ...

Page 58: ...de the descrip tion for 6 conditions The 4 condition m CTSIB test is the preferred test protocol anyway 2 The results are presented relative to the upper limit of the normal reference data Patient results will either be better equal to or worse than normal The higher the Sway Index score the more unstable the patient was for the condition Total instability where they had to hold onto something or ...

Page 59: ... most stable released setting A setting of one is the least stable foot platform setting Stability settings of 12 through one allow the foot platform a full 20 degrees of deflection from level in any direction For patient centering prior to testing the foot platform deflection is limited to less than five degrees Overall Stability Index SI Represents the variance of foot platform displacement in d...

Page 60: ...nge of values from which the mean was calculated were close together NOte Mean A P and M L Deflections are from the patient s actual position in contrast to the Stability Index which is a variance from level as established during the centering patient portion of the test proto col The resulting scores for Mean A P and M L Deflections are not statistically effected by the centering process 12 SYSTE...

Page 61: ...he Both Feet protocol Quadrant 1 right anterior Quadrant 2 left anterior Quadrants represent the four quarters of the Test Grid in the X and Y axis as follows For the Both Feet protocol Quadrant 3 left posterior Quadrant 4 right posterior For the Single Foot protocol Quadrant 1 lateral anterior Quadrant 2 medial anterior Quadrant 3 medial posterior Quadrant 4 lateral posterior Test Grid Provides a...

Page 62: ...SaMPLE BaLaNCE REPORTS See Figures 9 1 9 8 9 1 Sample Postural Stability Single Leg Test Report CONTENTS REPORTS 9 4 ...

Page 63: ...9 2 Sample Postural Stability Bilateral Comparison Test Report 13 BIODEX BALANCE SYSTEM REIMBURSEMENT 9 5 REPORTS ...

Page 64: ...9 3 Limits of Stability Single Leg Test Report unilateral stance 14 GENERAL MAINTENANCE REPORTS 9 6 ...

Page 65: ...9 4 Limits of Stability Test Report bilateral stance 15 SERVICE PROCEDURES 9 7 REPORTS ...

Page 66: ...9 5 Athlete Single Leg Stability Test Report CONTENTS REPORTS 9 8 ...

Page 67: ...9 6 Fall Risk Test Report Comparison to normative data can be made for population specific tests using the Fall Screening and Athlete Single Leg Stability protocols CONTENTS 9 9 REPORTS ...

Page 68: ...9 7 CTSIB Report Utilizing the CTSIB capabilities clinicians can test patients and compare results to normative data CONTENTS REPORTS 9 10 ...

Page 69: ...ostural Stability Progress Report To Print a Progress Report 1 Touch Utilities on the Main Menu The System Utilities screen should now be displayed 2 Touch Patient Management and enter code 781 to advance to the Patient Management screen 3 Touch the desired patient test and then touch Progress Report Note that the report will be limited to the specific test type selected 4 Up to ten test records c...

Page 70: ...e to be a more sensitive test of balance performance because being a dynamic tilting platform it will invoke the neuromuscular control aspects more so than a static force plate type system as well as the visual and vestibular components The Biodex Balance System will provide an accurate reliable assessment of a patient s balance performance This objective measure can be correlated to actual functi...

Page 71: ...ould your patient s Actual Values not fit into the range of the Predictive Values there maybe a balance problem Bilateral comparisons can be made to determine progress made dur ing rehabilitation on the Comparative Report see Figure 9 2 Anterior Posterior Stability Index Represents the variance of platform displacement in degrees from level for motion in the sagittal plane Medial Lateral Stability...

Page 72: ...S includes CONFIGURATION PATIENT MANAGEMENT CUSTOM PROTOCOL LIST PATIENT DATA STORAGE USAGE PLATFORM SET UP SOFTWARE AND HARDWARE INFORMATION HOURS OF USE Patient Data Storage usage Meter Patient Data Storage Usage is scaled to 6 000 patient tests When storage reaches 85 of its capacity it is suggested that patient tests be deleted or archived You may archive patient data to a USB memory device or...

Page 73: ... touch OK to return to the Main Menu Figure 11 1 The Configuration screen SET SCREEN TIME OuT The Screen Time Out setting determines how long the display screen remains ON when the system is no longer in use following a test exercise Once the selected time expires the system returns to the Main Menu 1 At the Configuration Screen touch Set Screen Time Out The Set Test Exercise Complete Screen Time ...

Page 74: ... reports 1 At the Configuration Screen touch Set Date Time The Set System Date Time screen should now be displayed 2 Touch the parameter to set so that the selected field is highlighted 3 Use the or arrows to increase or decrease the value displayed for the highlighted parameter 4 Repeat steps 2 and 3 until you have adjusted all the parameters you wish to correct 5 Touch OK to confirm your changes...

Page 75: ...Configuration Screen touch Fall Risk Defaults The Fall Risk Defaults screen will now be displayed 2 Touch to highlight the predictive value you wish to adjust 3 Use the or arrows to increase or decrease the value displayed M CTSIB DEFauLT SETTINGS See Figure 11 3 At the m CTSIB Default Settings screen users can set which conditions of the CTSIB they want as defaults for testing as well as the abil...

Page 76: ...e 3 Select the Add Age Range button at the bottom of the screen 4 A new Age Range screen will appear The From and To values in the range will also appear on the screen 5 Select the value you would like to set Adjust the value using the or arrows or the key pad displayed 6 Press OK to save the new age range and return to the m CTSIB Age Range screen 7 Press OK from the m CTSIB Age Range screen to r...

Page 77: ...the scale is lightest adjust Tone Volume This setting raises or lowers the volume of the audible tone which signals test or exercise start completion and countdown between trials 1 At the Configuration screen simply touch along the Tone Volume Bar Scale until the desired level is achieved The left end of the scale is least loud the right end of the scale is most loud Select Measure units Printer R...

Page 78: ...tients and associated saved test and training sessions along with the date performed Use the or arrows to scroll through the list of patient tests Figure 11 4 The Patient Management Screen View Test Results See Figure 11 4 To view the results of any test displayed simply touch the desired entry on the Patient Management screen to produce an on screen report Figure 11 6 A single stored patient Post...

Page 79: ...elete prompt The page displayed will be deleted from the display memory The delete function only works with pages you cannot select a specific test or patient to delete without deleting every test and patient displayed on the screen Multiple Patient Export See Figure 11 6 NOte Store patient records on a USB memory device Manage view and print reports with Patient Data Collection Software Biodex pa...

Page 80: ...le patient records The Multiple Patient Data Delete screen should now be displayed 2 Three options are available for multiple delete all delete all patient records prior to delete all patient records prior to selected date and from to delete all records between selected dates Touch Options until the desired option is displayed For prior to and from to touch the date displayed to advance to the dat...

Page 81: ... and states 97110 Therapeutic procedure one or more areas each 15 minutes therapeutic exercise to develop strength endurance range of motion and flexibility 97112 Neuromuscular reeducation of movement balance coordination kinesthetic sense posture and or proprioception for sitting and or standing activities 97116 Gait Training includes stair climbing 97530 Therapeutic activities direct one on one ...

Page 82: ...aINTENaNCE PROCEDuRES Lubricate the spring assemblies with white lithium grease Lubricate the eight push plates with white lithium grease Lubricate the acme threaded rods with white lithium grease NOte When checking for lubrication it may only be necessary to re distribute the existing grease CAUtION Some steps of these procedure require the Balance System to be turned ON When this is the case use...

Page 83: ...SCORE X 100 WHERE A 1 APPENDIX A APPENDIX A Actual Distance Traveled trace Straight Line Distance to Target Actual Distance Traveled Straight Line Distance to Target OVERALL DIRECTION CONTROL SCORE or the Average of all the eight Targets DLOS Scores 8 i 8 i 1 CENTER TARGET ...

Page 84: ...e subject s resultant center of pressure COP The center of pressure is the patient s center of gravity projection on the platform resulting from sway angle and the patient height Data is sampled at the rate of 20Hz Each recorded sample consists of a X Y coordinate What is displayed is the sway angle derived from the position of the COG from zero and the height of the patients COG taken as 55 times...

Page 85: ...eted to be the absolute vector length deviation from the mean vec tor end point Basically all vectors X Y coordinates are summed and divided by the number of samples to obtain a vector sum which represents the position of the mean and N 1 2 2 φ sqrt Σ Xn sx Yn sy n 0 N CONTENTS A 3 APPENDIX A Xn N 1 N 0 sx Yn N 1 N 0 sy ...

Page 86: ...LTS Table 1 and Table 2 include descriptive statistics for age and balance independent variables Statistical analyses identified significant differences in balance scores for both independent vari ables These differences are included in the text presented after each Table Table 1 Stability Index Differences among age Groups Youngest Sec youngest Third oldest Oldest Group 1 Group 2 Group 3 Group 4 ...

Page 87: ...80621 gender 0 Height meters 101 1 45 2 00 1 7263 11410 Weight KG 101 44 09 137 73 81 4784 19 06182 Waist CM 59 26 00 44 00 34 4576 4 01000 bmi 101 12 50 44 60 27 3748 5 50826 Valid N listwise 0 Reliability The resultant ICC is 81 which is considered acceptable Intraclass Correlation Coefficient Intraclass Correlation 95 Confidence Interval F Test with True Value 0 Lower Bound Upper Bound Value df...

Page 88: ...kes advan tage of pathways that link together groups of muscles in a flexible and repeatable sequence This linking or packaging of muscle groups allows the brain to respond to an infinite variety of cir cumstances by drawing on muscle responses that have been successful in the past This linking or packaging of muscles in a repeatable sequence is called a movement strategy Utilizing a movement stra...

Page 89: ...uch as on an icy surface or when the surface is shorter than the length of the foot In the hip strategy activation of muscles is from the trunk down or proximal to distal A loss of balance in the forward direction causes contraction of the lower back and hamstring muscles in that order to regain balance When the hip strategy is used the muscles of the lower leg anterior tibialis and gastrocnemius ...

Page 90: ... vision is providing proprio ceptive information to the CNS as well visual proprioception Vision works in conjunction with the vestibular system comparing information about velocity and rotation from the vestibular system with actual visual information The visual system is a combination of both central and peripheral vision although some research has suggested that peripheral vision is more import...

Page 91: ...iated with peripheral neuropathies stroke and other neurologic disorders can have a profound effect on balance A person with sensory loss eg bilateral lower leg peripheral neuropathy who does not receive normal sensory input from the sensory receptors in the feet and ankles will attempt to compen sate by depending more on visual and vestibular input for balance If there is significant sensory loss...

Page 92: ...late to normal aging Some changes i e slowed gait decrease in lower extremity strength decreased ROM can be easily addressed with a daily exercise pro gram Other changes i e declining visual ability including loss of visual acuity declining visu al fields light dark adaptation increased sensitivity to glare loss of peripheral vision and depth perception are more complex and may require assessment ...

Page 93: ... situations depending on the activity or circumstance demands The COG sway scores indicate how well the patient accomplished this Lower scores reflect little movement which are consider better than higher scores which reflect more movement Firm Surface Eyes Open vs Eyes Closed Normal individuals standing on a firm surface have similar amounts of sway with eyes open or closed On a firm surface when...

Page 94: ...ts for internal and external components may result in increased emissions or decreased immunity of the equipment The Balance System SD should not be used adjacent to or stacked with other equipment If the Balance System SD is used while positioned adjacent to other equipment it should be observed to verify normal operation in the configuration in which it will be used List of Cable accessories The...

Page 95: ...s A EN 61000 3 2 Voltage fluctuations Complies and flickerEN 61000 3 3 Immunity manufacturer s declaration electromagnetic immunity The Balance System SD is intended for use in the electromagnetic environment specified below The customer or the user of the Balance System SD should assure that it is used in such an environment Immunity test IEC 60601 1 2 IEC 60601 1 2 Electromagnetic Test level Com...

Page 96: ...of the transmitter Recommended separation distance d 1 2 P 150 KHz to 80 MHz d 1 2 P 80 MHz to 800 MHz d 2 3 P 800 MHz to 2 5 GHz where P is the maximum output power rating of the transmitter in watt W according to the transmitter manufacturer and is the recommended separtion distance in meters m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey a should be...

Page 97: ...z 80 MHz to 800 MHz 800 MHz to 2 5 GHz d 1 2 P d 1 2 P d 2 3 P 0 01 0 12 0 12 0 23 0 1 0 38 0 38 0 73 1 1 2 1 2 2 3 10 3 8 3 8 7 3 100 12 12 23 For transmitters rated at a maximum output power not listed above the recommended separation distance d in meters m can be estimated using the equation applicable to the frequency of the trans mitter where P is the maximum output power rating of the transm...

Page 98: ... inspect all locking and adjustment mechanisms for signs of wear or damage If you have any questions or need further assistance contact the Biodex Customer Service Department CAUtION Some steps of these procedures require the Balance SD to be turned ON When this is the case use extreme caution working on the system AtteNtION Certaines étapes de la présente marche à suivre nécessitent que le systèm...

Page 99: ...92 286 DYNAMIC POSTURAL BALANCE IN ANKYLOSING SPONDYLITIS PATIENTS Abstract only Rheumatology Oxford 2005 Nov 8 Biodex 93 105 BALDWIN S et al RELIABILITY OF DYNAMIC BILATERAL POSTURAL STABILITY ON THE BIODEX STABILITY SYSTEM IN OLDER ADULTS Med Sci Sports Exer 2004 36 5 S30 Biodex 92 290 BALLARD T PRODUCT PROFILE THE BIODEX BALANCE SYSTEM Biodex Medical Systems Biodex 91 111 BEHAN E A COMPARISON O...

Page 100: ...44 CLARK S et al GENERALIZABILITY OF THE LIMITS OF STABILITY TEST IN THE EVALUATION OF DYNAMIC BALANCE AMONG OLDER ADULTS Arch Phys Med Rehabil Vol 78 1078 1084 October 1997 Biodex 92 269 DiCOSTANZA K et al EFFECT OF ADHESIVE MEDIAL LONGITUDINAL ARCH SUPPORT ON POSTURAL SWAY J of Athletic Training Vol 36 2 suppl S66 April June 2001 Biodex 92 227 DOVER G et al RELIABILITY OF INVERSION AND EVERSION ...

Page 101: ...CANNING AND MEN TAL FLEXIBILITY IN COLLEGIATE FOOTBALL PLAYERS J of Athletic Training Vol 34 2 S85 April June 1999 Biodex 91 108 JORDEN RA et al THE INFLUENCE OF ANKLE ORTHOSES AND EXERCISE ON POSTURAL STABILITY J of Athletic Training Vol 36 2 suppl S 78 April June 2001 Biodex 92 228 LAUFER Y et al EFFECT OF ATTENTION FOCUS ON ACQUISITION AND RETENTION OF POSTURAL CON TROL FOLLOWING ANKLE SPRAIN A...

Page 102: ...004 33 6 602 7 Biodex 92 288 Abstract MYER GD et al REHABILITATION AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION CRITERIA BASED PROGRESSION THROUGH THE RETURN T0 SPORT PHASE J of Orthop Sports Phy Ther 36 6 385 402 June 2006 Biodex 93 117 NELSON AJ et al USING THE BIODEX UNWEIGHING SYSTEM BALANCE SYSTEM AND GAIT TRAINER IN AN INTEGRATED REHABILITATION PROGRAM Abstract May 2001 Biodex 92 217 PAJA...

Page 103: ... et al INTERTESTER AND INTRATESTER RELIABILITY OF A DYNAMIC BALANCE PROTOCOL USING THE BIODEX STABILITY SYSTEM J of Sports Rehab 7 95 101 1998 Biodex 93 271 SIERI T and BERETTA G FALL RISK ASSESSMENT IN VERY OLD MALES AND FEMALES LIVING IN NURSING HOMES Disability and Rehabilitation 2004 Vol 26 No 12 718 723 Biodex 93 106 SIUDMAK PG et al CORRELATIONS BETWEEN DYNAMIC BALANCE PERFORMANCE AND ISOKIN...

Page 104: ...ION SHIPS Biodex Medical Systems Biodex 91 109 WINTERS KM et al DETRAINING REVERSES POSITIVE EFFECTS OF EXERCISE ON THE MUSCULOSKELETAL SYSTEM IN PREMENOPAUSAL WOMEN J of Bone and Mineral Research Vol 15 No 12 2000 2495 2503 Biodex 92 280 rev Aug 25 2011 CONTENTS APPENDIX G G 6 ...

Page 105: ... R 1 REPLACEMENT REPLACEMENT ...

Page 106: ...REPLACEMENT REPLACEMENT R 2 ...

Page 107: ...REPLACEMENT PARTS R 3 REPLACEMENT ...

Page 108: ...REPLACEMENT PARTS REPLACEMENT R 4 ...

Page 109: ...REPLACEMENT PARTS R 5 REPLACEMENT ...

Page 110: ...REPLACEMENT PARTS REPLACEMENT R 6 ...

Page 111: ...REPLACEMENT PARTS R 7 REPLACEMENT ...

Page 112: ...REPLACEMENT PARTS REPLACEMENT R 8 ...

Page 113: ...IODEX Biodex Medical Systems Inc 20 Ramsey Road Shirley New Y ork 11967 4704 Tel 800 224 6339 Int l 631 924 9000 Fax 631 924 9338 Email info biodex com www biodex com Certified Quality Management System ...

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