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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
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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
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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.
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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
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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
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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.
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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.
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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
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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.
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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
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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.