THE EFFECTS OF MYLAR TECHNOLOGY ON BALANCE AND SWAY VELOCITY USING

April 14, 2011

THE EFFECTS OF MYLAR TECHNOLOGY ON BALANCE AND SWAY VELOCITY

USING NEUROCOM INSTRUMENTATION

By: Eberline, Thomas; Hudson, Seth; Johnson, Benjamin; Lieberman, Micah; McDonald, Ian

Advisor: Rodger Tepe, PhD

A senior research project submitted in partial requirement for the degree Doctor of Chiropractic

Eberline; Hudson, et al: Mylar Technology and Balance 1

THE EFFECTS OF MYLAR TECHNOLOGY ON BALANCE AND

SWAY VELOCITY USING NEUROCOM INSTRUMENTATION

By: Eberline, Thomas; Hudson, Seth; Johnson, Benjamin; Lieberman, Micah; McDonald, Ian

Abstract

Purpose

The purpose of this study was to investigate if the Mylar Technology that is embedded in Power

Balance bracelets can increase functional sway velocity, and improve balance in participants

through a double blind study designed and performed by senior interns at Logan College of

Chiropractic‟s research facility. Active balance and stability was measured by the use of the

NeuroCom International‟s Balance Master System and two of its tests: Modified Clinical Test of

Sensory Interaction and Balance (mCTSIB), Limits of Stability test (LOS).

Methods

This study was comprised of one group of twenty-five (25) consenting participants; each

participant was part of both the control group as well as the experimental group. Participant

recruitment was executed through fliers around Logan College of Chiropractic, and through

classroom announcements. Participants were required to be of ages 18 to 45 years old and in

good health, with no known injuries/ailments at the time of the experiment which would change

the results of the study. These ailments included known vestibular problems, known muscle

strains, sprains, or tears. Also, participants could not have been on any muscle relaxers

throughout the course of the study or any other medication that could hinder motor control or

tonicity of one‟s muscles. Participants were also asked to self-report their height and weight.

Results

The results obtained from the mCTSIB test and the LOS tests yielded no significant increase in

performance when the subjected were wearing the Power Balance bracelets as opposed to

wearing a sham bracelet. The only increase in performance noted was found with the Directional

Control test. There was a 1.5% increase in control of movement in the intended direction versus

extraneous movement. All other tests performed showed either a slightly higher or equal

performance by the sham group.

Conclusion

No evidence was obtained which showed an increase in balance or sway velocity while a subject

was wearing a Power Balance bracelet. Any positive result apart from this experiment is likely

due to some immeasurable attribute such as a placebo effect. However, the data so not support

any improvement in performance be it physiologic or placebo induced.

Key Words

Balance, sway velocity, equilibrium


THE EFFECTS OF MYLAR TECHNOLOGY ON BALANCE AND

SWAY VELOCITY USING NEUROCOM INSTRUMENTATION

Introduction

The purpose of this study was to investigate whether the Mylar Technology that is

embedded in Power Balance bracelets can improve balance and increase functional sway

velocity in participants through a double blind study designed and performed by senior interns at

Logan College of Chiropractic‟s research facility. Relationships between overall control and

stability when performing the tasks of NeuroCom‟s tests during the control period versus the

placebo period of investigation will be the main concentration of data collection. Studies of

functional balance, control, and sway velocity and their relationships together have clinical

value; especially when analyzed with NeuroCom‟s system. For instance, these interpretations

using NeuroCom can aid in diagnosis and treatment of conditions like short leg and upper cross

syndromes, as well as more serious conditions such as multiple sclerosis. However, this study is

not designed for clinical outcomes, the latter statement on the uses of balance, control and sway

velocity must be mentioned to provide the significance of these qualities.

This investigation will study active or uncontrolled trends, as well as active or functional

balance and the data will be collected with the aid of the NeuroCom Basic Balance Master 8.3.0.

The NeuroCom can also be used for assessing balance deficits and as a neurological re-education

tool in treating various balance disorders.


According to Logan College of Chiropractic‟s Research Department1, the NeuroCom

Balance Master system is described as:

“(A system) designed to identify potential fall candidates, determine ankle and knee

status, limits of stability, and other factors in balance compromised patients. Test

results are compared to age and gender dependent normal ranges to determine the

appropriate levels of balance control and stability. Balance training is both a function

of proprioception and stabilization exercises, sway velocity conditioning and weight-

shifting exercises. The NeuroCom uses a safe, controlled and reproducible Force

Plate that measures deflection of axial load forces on four strain gauges. Starting

with a completely firm surface and progressing through levels of instability, the

patient facilitates activities that distract the patient from concentrating on balance.

The device documents and records patient progress through a series of reproducible

neuromuscular training protocols and biofeedback graphics. The NeuroCom Balance

Master evaluates neuromuscular control by quantifying the ability to maintain

dynamic postural stability on both a stable and unstable surface. The surface

instability is created by the addition of a foam block to the force platform. The

NeuroCom Balance Master is extremely effective, providing instantaneous feedback

that makes it easy for patients to relate to and reproduce specified motion patterns.

Starting with a completely firm surface, progressing through an unstable surface,

maximum stimulation of joint mechanoreceptors is insured.”

Methods

1 Assessed February 20, 2011 on the world wide web at:

http://www.logan.edu/SubPages.aspx?pID=227&mhID=261&shID=135&splpID=23


Participants

This study was approved by the Logan College Institutional Review Board. Twenty-five

(25) consenting Logan College of Chiropractic students, both male and female, between the ages

of 18 and 45 volunteered to participate in this study. Prospective students were excluded from

the study if any of the following applied: currently taking medications of muscle relaxers or any

medication that can cause a decrease in motor control or normal spasticity of muscle,

past/present vestibular problems, known muscle strains/sprains/ tears, pregnancy, spinal cord

injuries, and any lower extremity injury within the last six months.

Instruments

The measurements of this investigation, as stated, were performed with the use of one

primary instrument to keep the correlation of data as precise or controlled as possible.

NeuroCom‟s Basic Balance Master 8.3.0 was the primary instrument utilized when participants

performed balance and functional control activities. These movements and activities were

collected and evaluated by this system‟s computer program. The NeuroCom equipment consists

of a balance plate and computer software that assesses the active balance parameters.

Measurement capable functional movements that were utilized were collected during a Modified

Clinical Test of Sensory Interaction and Balance (CTSIB) and the Limit‟s of Stability (LOS) test.

Procedures

After the participants signed a consent form and fulfilled the initial requirement to

partake in the investigation, the participants were directed to the NeuroCom system. Here, they

were put through a series of tests. The first test, a Modified Clinical Test of Sensory Interaction


and Balance (CTSIB) was performed on each of the participants. This measured balance (via

Center of Gravity calculations) on a stable and unstable surface; with eyes open and closed. The

Limits of Stability (LOS) test was second and as the participant, on a completely firm surface,

progressed through levels of instability. The individual facilitated activities that distracted them

from concentrating on balance. This instability was created by the addition of a foam block to the

force platform. The resulting data was compiled by the computer program and saved in specific

file formats so further interpretation and analysis could be applied. After confirming proper

compilations of data following completion of the two tests, the participants were dismissed.

Results

Data were collected for all research subjects using the NeuroCom Balance Master

System. Figures 1 and 2 provide examples of the data collection for the Modified CTSIB test

and the LOS test. The Modified CTSIB test consisted of twelve trials, three with the subject‟s

eyes open on a firm surface, three with the subject‟s eyes closed on a firm surface, three with the

subject‟s eyes open on foam surface, and three with the subject‟s eyes closed on a foam surface.

The values from the twelve trials were then averaged to determine a comprehensive or average

score for comparison. The trials were performed in order to determine the effects of the Mylar

technology versus a sham study on sway velocity. The LOS test was performed to monitor the

patient‟s reaction time, movement velocity, endpoint excursion, maximum excursion, and

directional control. These parameters involved in this test are intended to compare the effects of

the Mylar Technology on the participant‟s center of gravity to a sham test.


Figure 1: example CTSIB data report

Modified Clinical Test of Sensory Interaction and Balance (mCTSIB) - Comprehensive Report

1. The COG traces for each trial shown at the top of the report also include numerical values

indicating the sway velocity in degrees per second and total duration (in seconds) of the trial.

2. Mean COG Sway Velocity for each condition is shown as a bar graph.

3. Comp or Composite Sway is the mean sway velocity averaged over the thirty (25) trials.

4. COG Alignment reflects the patient's Center of Gravity (COG) position relative to the center of the

base of support at the start of each trial of the SOT. Normal individuals maintain their COG near the

center of the support base.

5. The shaded area on each graphic represents performance outside of the normative data range.

Green bars indicate performance within the normal range; Red bars indicate performance outside the

normal range. A numerical value is given at the top of each bar.


Figure 2: Example LOS data report

Limits of Stability (LOS) - Comprehensive Report

1. The COG traces for each trial are shown at the top left of the report.

2. Reaction Time (RT) is the time in seconds between the command to move and the

patient's first movement.

3. Movement Velocity (MVL) is the average speed of COG movement in degrees per

second.

4. Endpoint Excursion (EPE) is the distance of the first movement toward the

designated target, expressed as a percentage of maximum LOS distance. The endpoint

is considered to be the point at which the initial movement toward the target ceases.

5. Maximum Excursion (MXE) is the maximum distance achieved during the trial.

6. Directional Control (DCL) is a comparison of the amount of movement in the

intended direction (towards the target) to the amount of extraneous movement (away

from the target).

7. The shaded area on each graphic represents performance outside of the normative

data range. Green bars indicate performance within the normal range; Red bars


Results

Review of the data acquired in the Modified CTSIB test shows no significant impact of

the Power Balance bracelet on sway velocity. In fact, the average comprehensive score for the

sham test was .1 degree/sec higher than the average comprehensive score for the Power Balance

test group. Figure 3 demonstrates this comparison.

Figure 3: (mCTSIB) Comprehensive Sway analysis

All but one of the Limits of Stability tests demonstrated no significant increase in

performance with the subject wearing the Power Balance bracelet. These tests included Reaction

Time, Movement Velocity, Endpoint Excursion, and Maximal Excursion, see Figures 4, 5, 6, and

8. Directional Control (Figure 7), however, was increased with the Mylar Technology group.

The average of the Comprehensive Directional Control values for the sham group was 77.9%

and the average of the Comprehensive Directional Control values for the Power Balance group

was 79.4%. This is the only significant increase in performance noted with the subjects wearing

indicate performance outside the normal range. A numerical value is given at the top

of each bar.


the Power Balance bracelet. The other tests, Reaction Time, Movement Velocity, Endpoint

Excursion, and Maximal Excursion yielded slightly higher or equal performance by the sham

group. Thus, according to this research study, there is no significant evidence to support the

claim that Mylar Technology improves balance, coordination, and overall performance aside

from a plausible mild increase in directional control. However, this result is likely due to

outlying numbers found within the values obtained during the test.

Figure 4: Movement Velocity (MVL) - average speed of center of gravity movement in

degrees/sec

Eberline; Hudson, et al: Mylar Technology and Balance

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Figure 5: Endpoint Excursion (EPE) - distance of the first movement toward the

designated target, expressed as a percentage of maximum LOS distance. The endpoint is

considered to be the point at which the initial movement toward the target ceases.

Figure 6: Maximum Excursion (MXE) - maximum distance achieved during the trial.


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Figure 7: Directional Control (DCL) - a comparison of the amount of movement in the

intended direction (towards the target) to the amount of extraneous movement (away

from the target).

Figure 8: Reaction Time (RT) - the time in seconds between the command to move and

the patient's first movement.


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Discussion

The purpose of this study was to investigate and observe if the Mylar Technology that is

embedded in Power Balance bracelets can improve balance and increase functional sway

velocity in participants through a double blind study. This was performed and completed with

the NeuroCom application and its various measurements, which were selected based on their

ability to analyze and collect the data needed for this specific investigation.

Strengths and Limitations

The NeuroCom system can collect data that allows measurements of various movements

or parameters; which was utilized to minimize human error. The NeuroCom can be used as a

clinical balance training tool, but it was not utilized in this manner for the current investigation

discussed. The individual strengths of NeuroCom‟s Balance Master 8.3.0 include active balance

assessment and utilization as an outcome assessment tool for clinical use and in a research

setting.

Limitations of this study include the population sampled, participant error, and researcher

error. All of the participants were full-time students at Logan College of Chiropractic. The

NeuroCom data may have also been affected by a lack of adequate or unclear participant

instructions. However, a potentially more limiting factor of the experiment may exist, in that

activities of daily living for these students consist of prolonged seated positions of posture and

cervical flexion. These characteristics can yield biomechanical compensations such as anterior

head carriage and upper-cross syndrome. Since varying postures or structures between the

participants were not taken into consideration in experimental design, this can be described as a


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limitation of the study. For instance, varying postures can lead to differing points of Center of

Gravity (COG) which could influence collected data one way or another in comparison to other

individual‟s representative collected numbers.

Another argument that could be raised against the results found in this experiment is that

there may be a quick learning curve for the tests performed. The subjects‟ results might be

inaccurate due to learning the order or procedure of a certain test. This is not a likely outcome of

this experiment. A double blind study eliminates a specific order of testing. Also, according to

Wrisley et al, a quick learning curve was noticed for sensory organization testing but plateaued

fairly quickly as well (Diane M. Wrisley, 2007). It is important to note that this study was

performed over a much longer and intensive period of testing so the implied learning curve may

not be as much of an effect in a shorter testing period.

Future Research Recommendations

As stated in the „Strengths and Limitations‟ section, the study‟s participating individuals‟

varying or comparably different structural/anatomical makeup (i.e. posture or structural defects)

and lifestyle characteristics (i.e. Sedentary or Active) could be screened in order to determine

their effects on the results. The participants could be placed in groups depending on

observations after gathering the overall individual characteristics. The investigation could be

designed to be instrumentally identical, but the data collection would then be split further into‟

anatomically‟ similar and „lifestyle‟ similar participants to study data in purpose of investigating

the idea that Mylar Technology affects one „type‟ of person more than the other or to find if no

difference exists at all.


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Varying self-reported activity levels could have been monitored before the study and

before participants were accepted to begin collection of data. The self-reporting of activity levels

could be defined on a questionnaire as „Inactive‟, „Moderately Active‟, and „Highly Active‟. For

possibly more accurate or credible data interpretation, participants in the study could be selected

based on similar lifestyle descriptions and anatomical make-up. This could be done to try and

increase the chance that their reaction times and balance could be accurately or appropriately

incorporated into the study for comparison. If four (4) or five (5) participants are „Inactive‟ and

the majority of the other participants are „Highly Active‟, then the data could be skewed when

trying to relate benefits of Power Balance‟s Mylar Technology from one individual to the others

due to lack of consistency among the participant‟s COGs, reaction times, balance, etc.

To ensure accurate data collection for NeuroCom applications, proper placement of the

participants on the stable (firm platform) and unstable surface (foam pad) and the foam pad on

the firm platform should be double checked for accuracy each time. Slight alterations of

placement of any of the above statements affect participant weight bearing, weight shift, and

body weight displacement (measured by COG). Another strong recommendation would be to

always include a demonstration of how the participant should shift their weight (at the ankles)

and allow a few more unmeasured practice sessions prior to NeuroCom testing. These above

suggestions were not always completely performed in this research investigation and these

specific changes in researcher detail or precision could ensure more accurate or purposeful data

collection.


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Conclusion

In conclusion the results from this experiment do not support the claims made by Power

Balance. The bracelets embedded with holographic Mylar Technology neither greatly improved

balance nor sway velocity of the subjects. This statement is supported by the data obtained from

the mCTSIB and LOS tests. In fact, the sham group performed better or equal in all but one of

the tests, Directional Control.

These results show that any positive effect on performance while wearing a Power

Balance bracelet is likely due to something other than a physiological response to the embedded

holograms. The natural positive frequencies embedded in the bracelets holograms do not seem

to affect balance or sway velocity performance. This study did not measure speed, strength, or

mental focus, all important aspects of athletic performance. Thus it is not safe to say that the

results obtained completely disprove Power Balance‟s claims about improved athletic

performance.

Any immeasurable positive effects of the bracelets could possibly be due to a placebo

effect. The brain can cause great differences in the way the body reacts to stimulus. If the

subject truly believes the Mylar Technology works then they are more likely to demonstrate a

positive result. This makes it difficult to truly prove or disprove the theories involved. The only

way to completely prove the bracelets‟ effectiveness would be for researchers to notice

significant results in subjects who believe the bracelets will not work. This study did not poll the

participants in this manner however significant positive changes were not demonstrated by the

results obtained.


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References

1. Beecker, H.K. "The Powerful Placebo." J Am Med Association 1955 Dec 24: 159(17):

1602-6.

2. Diane M. Wrisley, P. P. (2007). Learning Effects of Repetitive Administrations of the

Sensory. Archives of Physical Medicine and Rehabilitation, 1049-1054.

3. Larsen-Merrill J and Lazaro R. Use of the NeuroCom Balance Master Training Protocol

to Improve Functional Performance in a Person with Multiple Sclerosis. J Student

Physical Ther Research 2008 1(1):12-27.

4. Power Balance, (2011, March 3). Retrieved from http://www.powerbalance.com/

5. Tucker Ph.D. R. (2011, January 12). Power Balance scam unraveled. Retrieved from

www.health24.com/fitness/FitnessDoc_articles/16-4596,60576.asp

Acknowledgements

The student research team would like to thank the following individuals for their contributions to

this project:

Institutional Review Board Committtee Members: Donna Mannello, DC; Gary Sanders,

PhD; John Gutweiler, PhD; Brian Snyder, DC; E. Terrence Jones, PhD; Glenn Bub,

DC; Joan Schmelig, Ronald Grant, DC; W. Utech, STM.

Rodger Tepe, M.Ed., Ph.D., Project Advisor – for project oversight and direction.

THE EFFECTS OF MYLAR TECHNOLOGY ON BALANCE AND SWAY VELOCITY USING

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