Original Article

Effect of fingertip touch on postural sway during static standing in patients with femoral neck or trochanteric fracture

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

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