case_images: PMC9422881_01
case_images: NeuroCom report of the modified Clinical Test of Sensory Interaction in Balance (mCTSIB) test at baseline (A and C) and follow-up (B and D) evaluations. In this test the patient is required to stand still on firm surface with eyes open (Firm EO), firm surface with eyes closed (Firm EC), foam surface with eyes open (Foam EO) and foam surface with eyes closed (Foam EC). Three trials of 10 s are performed per condition. Green bars on plots A and B represent the mean centre of gravity (COG) sway velocity of the 3 trials per condition. Grey represents the abnormal area. Notice how this patient dramatically decreased his sway velocity on the Foam EC condition from baseline to follow-up (oval circle). The bottom plots (C and D) show a coordinate system denoting the preferred alignment of the patient's COG during each trial for each condition. The centre circle delimits perfect COG alignment. During testing, the patient is instructed to look straight ahead at a fixation point and receive no feedback about their COG position, so they are unaware of their alignment. The patient achieved a more centred COG preferred alignment at follow-up.
case_images: JRMCC-5-2513-g001.jpg
case_images: PMC9422881_01_JRMCC-5-2513-g001.jpg
case_images: F0001
case_images: The mCTSIB revealed normal use of sensory input to control balance (Fig. 1), which appears to be atypical in individuals with SBMA and may relate to his relatively new onset of symptoms and high functional level.
case_images: NeuroCom report of the limits of stability (LOS) test at baseline (A and C) and follow-up (B and D) evaluations. In this test the patient is required to purposefully lean his body toward targets displayed in 8 directions. These targets represent 100% of his theoretical limits of stability. During the leaning task, the patient must maintain a straight posture, only moving at the ankle, like an inverted pendulum. He received visual feedback about the movement of his centre of gravity (COG). Red and yellow bars on plots A and B represent abnormal endpoint and maximum excursions, respectively. Endpoint excursion is how far the patient moves his COG at the initial motion, and maximum excursion is how far the patient moves his COG during the entire 8-s trial. Green bars represent normal excursions. Grey shading represents abnormal excursions that are 2 standard deviations (SD) from normative mean values. Notice how this patient dramatically increased excursions in the backward direction from baseline to follow-up (oval circle). The bottom plots (C and D) show this patient's COG tracings during the leaning task. During testing, the patient starts in the centre box and leans toward each target in a clockwise manner, starting with target 1. The patient achieved further excursions toward targets 4, 5 and 6, which compose the backward direction, at follow-up.
case_images: JRMCC-5-2513-g002.jpg
case_images: PMC9422881_01_JRMCC-5-2513-g002.jpg
case_images: F0002
case_images: LOS testing (intentional weight shifting towards 8 targets) revealed reduced maximal and endpoint excursions (Fig. 2).