Kohei Minami, RPT, MS, Fumiko Nagatomi, RPT, MS, Susumu Watanabe, RPT, PhD,
Akio Tsubahara, MD, PhD
Jpn J Compr Rehabil Sci 5: 50-55, 2014
Objective: Patients with femoral neck or trochanteric
fracture (hip fracture) are considered to be at high risk
for falling. We investigated whether a light fingertip
touch on a stable surface (LT) with a force insufficient
to provide mechanical support of the body could
stabilize static standing. We also investigated whether
the effect differed between LT and heavy fingertip
touch (HT) or between ipsilateral and contralateral
fingertip touch (relative to the fracture).
Methods: Eleven patients with hip fracture who were
hospitalized in a kaifukuki (convalescence) rehabilitation
ward participated in the study. The sway of the center
of pressure (COP) during static standing was measured
and compared under five fingertip touch conditions.
Results: The COP path length was significantly shorter
under every fingertip touch condition than for the
condition without touch: LT with a finger contralateral
to the fracture, 65.5 ± 38.4 cm; LT with a finger
ipsilateral to the fracture, 64.5 ± 32.6 cm; HT with a
finger contralateral to the fracture, 45.1 ± 23.4 cm; HT
with a finger ipsilateral to the fracture, 46.1 ± 26.2 cm;
and without touch, 88.4 ± 33.0 cm (F = 26.9, p < 0.01).
It was also shorter for the HT conditions than for the
LT conditions. However, there was no difference in the
COP path length between fingertip touch with the
upper extremity ipsilateral to the fracture versus that
contralateral to the fracture.
Conclusions: We attribute the beneficial effect of LT
on postural stability during static standing to
somatosensory inputs through the fingertip. The
additional benefit of HT relative to LT must have
stemmed from the addition of mechanical support to
this somatosensory feedback.
Key words: femoral neck or trochanteric fracture, hip fracture, sway of center of pressure, fingertip touch