Using balance training to improve the performance of youth basketball players

Integration of cognitive-motor dual-task training in physical sessions of highly-skilled basketball players

We investigated the effects of a cognitive-motor dual-task training (CMDT) integrated into a physical training circuit. Specific tests on sprint, agility, and cognitive processes associated with anticipatory event-related potential (ERP) components and behavioural performance during a cognitive discrimination response task (DRT) were evaluated before and after the intervention. Thirty skilled basketball players were recruited and divided into an experimental group executing the "physical CMDT" and a control group performing standard physical training. The CMDT session was performed by four athletes simultaneously who executed different circuits. One circuit was the CMDT, implemented with interactive devices thus engaging strong motor control, preparedness, and quick decision-making during task performance. Results on physical performance showed that only the experimental group improved in completion time on sprint (5.83%) and agility (3.55%) tests. At the brain level, we found that in the DRT the motor anticipation increased by over 50%, and the response time became 10% faster. Instead, regarding cognitive preparation, both protocols were equally effective and response accuracy parallelly increased in the post-test. In conclusion, the proposed "physical CMDT" integrated into a group session, can improve sprint and agility and the neural correlate of this effect is the increase of motor preparation in the premotor cortex in only five weeks.

The effects of functional training on physical fitness and skill-related performance among basketball players: a systematic review

Background: Evidence suggests that functional training (FT) positively impacts physical fitness and sports performance. However, a systematic review addressing the effects of FT on basketball players remains absent. This systematic review aims to explore the influence of FT on physical fitness and skill-related performance in basketball players. Methods: We searched six databases: Web of Science, Scopus, PubMed, China National Knowledge Infrastructure (CNKI), EBSCOhost, and Google Scholar. The search utilized a combination of keywords related to FT, physical fitness, and basketball. The Eligibility Criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines were followed in this systematic review. Results: 11 studies were ultimately included in this review, collectively recruiting 333 basketball players. These studies demonstrated that FT significantly improved muscle strength, linear speed, cardiovascular endurance, flexibility, balance, and muscular endurance. However, the effects of FT on power, change-of-direction speed, and basketball-related performance were inconsistent. Most studies showed FT significantly improves these three variables, but a small number of studies did not find positive effects of FT using specific tests including standing long jump, Sargent jump, touch high, lane agility, lateral shuffle, dribbling line drill, and free-throw tests. Conclusion: FT is an effective training method for enhancing physical fitness including muscle strength, linear speed, cardiovascular endurance, flexibility, balance, and muscular endurance. However, the effects of FT on power, change-of-direction speed, and basketball-related performance were divergent. Some tests were not improved after FT potentially due to the short program lengths and training session durations, varied athletic levels of players examined, and different foci of the FT exercises administered. The collective evidence suggests FT programs, especially the specific exercises prescribed, should be tailored to the desired training objectives. More studies investigating the effects of FT on physical fitness and basketball-related performance with established tests are encouraged in the future to expand the current evidence base. Systematic Review Registration: https://inplasy.com/, Identifier INPLASY202360072.

The effect of core stability training on the balance ability of young male basketball players

Introduction: This study aimed to investigate the impact of a 10-week Core Stability Training (CST) compared to Traditional Strength Training (TST) on the balance abilities of adolescent male basketball players. Methods: Subjects (age: 15.70 ± 0.75, height: 178.4 ± 8.31, weight: 66.55 ± 8.34) were randomly assigned to either the Core Stability Training group or the Traditional Strength Training group. Three selected balance assessment indicators included the Single-leg Standing with Eyes Closed Test, Star Excursion Balance Test, and Core Four-Direction Endurance Test. Results: 1) The scores were significantly different in both groups before and after the Single-leg Standing with Eyes Closed Test; (p < 0.01, d = 1.692, d = 1.837); 2) In the Star Excursion Balance Test, the scores of the experimental group showed significant difference (p < 0.05) or highly significant difference (p < 0.01) with an average effect size of (d = 1.727) when the left or right foot supported in the other directions before and after the training. However, there was no significant difference in scores in the c direction when the left foot supported (p > 0.05, d = 0.954); 3) In the Core Four-Direction Endurance Test, there were no significant differences in scores for the control group before and after training (p > 0.05, d = 0.567), while the experimental group showed significant differences in scores before and after training (p < 0.05, d = 1.889). Discussion: Both CST and TST were effective in enhancing the balance abilities of adolescent basketball players. CST, in particular, demonstrated improvements in dynamic balance and agility across multiple planes. Basketball coaches are encouraged to consider incorporating CST training programs into their overall training plans for optimal balance enhancement.

Effects of Combined Upper and Lower Limb Plyometric Training Interventions on Physical Fitness in Athletes: A Systematic Review with Meta-Analysis

Objective: We aimed to meta-analyze the effects of combined upper and lower limb plyometric training (ULLPT) on physical fitness attributes in athletes. Methods: A systematic literature search was conducted in Web of Science, SPORTDiscus, PubMed, and SCOPUS, for up to 13 August 2022. Controlled studies with baseline and follow-up measures were included if they examined the effects of ULLPT on at least one measure of physical fitness indices in athletes. A random effects meta-analysis was performed using the Comprehensive Meta-Analysis software. Results: Fifteen moderate-to-high-quality studies with 523 participants aged 12−22.4 years were included in the analyses. Small to large (ES = 0.42−1.66; p = 0.004 to <0.001) effects were noted for upper and lower body muscle power, linear sprint speed, upper and lower body muscle strength, agility, and flexibility, while no significant effects on static and dynamic balance were noted (ES = 0.44−0.10; all p > 0.05). Athletes’ sex, age, and training program variables had no modulator role on the effects of ULLPT in available data sets. Conclusions: ULLPT induces distinct neuro-muscular adaptations in the upper and lower body musculature and is an efficient method for enhancing athletes’ physical fitness.

Effect of balance training on footwork performance in badminton: An interventional study

Badminton is a racket sport that requires a wide variety of proficient postural changes and moves including jumps, lunges, quick changes in direction, and rapid arm movements. Efficient movement in badminton court entails reaching the shuttlecock in as few steps as possible while maintaining good balance. Balance training is an unexplored component in badminton training protocol, though balance is important in injury prevention and performance enhancement. We aimed to investigate the effectiveness of balance training on sport-specific footwork performance of school-level competitive badminton players. We conducted a controlled trial involving 20 male badminton players (age 12.85±0.67 years). Participants were stratified according to their level of performance in the game, and payers from each stratum were randomly assigned to control and intervention groups. The control group (n = 8) engaged in 2 hours of ordinary badminton training, whereas the intervention group (n = 12) underwent 30 minutes of balance training followed by 1 hour and 30 minutes of ordinary badminton training, 2 days per week for 8 weeks. We tested the participants at baseline and after 8 weeks for static balance (Unipedal Stance Test), dynamic balance (Star Excursion Balance Test) and sport-specific footwork performance (shuttle run time and push-off times during stroke-play). On pre- vs. post-intervention comparisons, both groups improved in static balance (eyes opened) (p<0.05), but only the intervention group improved in dynamic balance (p = 0.036) and shuttle-run time (p = 0.020). The intervention group also improved push-off times for front forehand (p = 0.045), side forehand (p = 0.029) and rear around-the-head shots (p = 0.041). These improvements in push-off times varied between 19-36% of the baseline. None of the footwork performance measures significantly improved in the control group. Our findings indicate that incorporating a 30-minute balance training program into a regular training schedule improves dynamic balance, and on-court sport-specific footwork performance in adolescent competitive badminton players, after 8 weeks of training.

CORE VS PLYOMETRIC TRAINING EFFECTS ON DYNAMIC BALANCE IN YOUNG MALE SOCCER PLAYERS

ABSTRACT Introduction: Today, different types and volumes of strength training are used to increase the performance of athletes. However, the effect of this training on dynamic balance in young soccer players is a matter of curiosity. Objective: The purpose of this study is to determine the effects of core and plyometric training on dynamic balance in young male soccer players. Materials and Methods: Eighteen male soccer players between 17 and 18 years of age participated in the study voluntarily. Subjects were randomly separated into three groups: core training group (C, n=6), plyometric training group (P, n=6), and control group (Con, n=6). Group C and P subjects participated in the determined training programs, in addition to soccer training, two days a week for eight weeks. The Con group only continued their soccer training. The Y-balance test (before and after eight weeks) was applied to determine the balance performance of the subjects. Results: After eight weeks of core training, significant differences in anterior (ANT) and posteromedial (PM) balance performance on the dominant side and in ANT, PM, and posterolateral (PL) balance performance on the non-dominant side were observed in group C subjects. The PL and PM balance performance of group P subjects after plyometric training was found to be significantly different on both sides. Conclusion: As a result, it was determined that applying core and plyometric training in addition to soccer training increases dynamic balance. We recommend that trainers and coaches use core and plyometric exercises in their training, as these programs will provide a positive performance increase in balance and gains in muscle strength. Level of Evidence III; Prospective comparative study.

Scoring of Human Body-Balance Ability on Wobble Board Based on the Geometric Solution

Many studies have reported that the human body-balance ability was essential in the early detection and self-management of chronic diseases. However, devices to measure balance, such as motion capture and force plates, are expensive and require a particular space for installation as well as specialized knowledge for analysis. Therefore, this study aimed to propose and verify a new algorithm to score the human body-balance ability on the wobble board (HBBAWB), based on a geometric solution using a cheap and portable device. Although the center of gravity (COG), the projected point of the center of mass (COM) on the fixed ground, has been used as the index for the balance ability, generally, it was not proper to use the COG under the condition of no fixed environment. The reason was that the COG index did not include the information on the slope for the wobble. Thus, this study defined the new index as the perpendicular-projection point (PPP), which was the projected point of the COM on the tilted plane. The proposed geometric solution utilized the relationship among three points, the PPP, the COM, and the middle point between the two feet, via linear regression. The experimental results found that the geometric solution, which utilized the relationship between the three angles of the equivalent model, enabled us to score the HBBAWB.

Balance on different unstable supports: a complementary approach based on linear and non-linear analyses

Maintenance of postural control is a complex task that requires the integration of different sensory-motor processes. To improve postural control, balance training is often implemented using unstable surfaces. Little is known, however, about how different surfaces compare in terms of postural control strategy. Non-linear dynamical system analysis, like recurrent quantification analysis (RQA) applied to the center of pressure (CoP) trajectory, represents a useful tool in this respect. The aim of this study is to investigate the effects of different unstable supports on the CoP trajectory through a complementary approach based on linear and non-linear analyses. Seventeen healthy adults performed barefoot single-leg balance trials on a force plate and on three different balance training devices (soft disc, foam pad, and pillow). Sets of parameters were extracted from the CoP trajectories using classical stabilometric analysis (sway path, mean velocity, root mean square) and RQA (percent recurrence and determinism, maximum line length, entropy). Both classical and RQA analyses highlighted significant differences between stable (force plate) and unstable conditions (p < 0.001). Conversely, only classical stabilometric parameters showed significant differences among the considered balance training devices, indicating that the different characteristics of the devices do not influence the dynamic/temporal structure of the CoP trajectory. Analysis of the center of pressure trajectory during single-leg standing on three different balance training devices and on a rigid surface using both linear and non-linear techniques.

Effects of Different Balance Training Volumes on Children's Dynamic Balance

Concerning balance training, the most effective design of several load dimensions (e. g., training frequency, volume) is unclear. Thus, we determined the effects of different balance training volumes on dynamic balance in healthy children. Three groups of 20 children (age: 11.0±0.7 years; 47% females) were randomly assigned to a balance training group using a low or a high training volume or an active control group that performed regular physical education lessons. All groups trained for 8 weeks (2 sessions/week), whereby balance training volume amounted to 4 min/session and 18-24 min/session for the low- and high-volume group, respectively. Pre- and post-training, balance performance was assessed using the Lower Quarter Y-Balance Test and the Timed-Up-and-Go Test. Fifty-five children completed the study and significant Test x Group interactions were detected for both outcome measures in favor of the two balance training groups. Additionally, improvements in the high-volume group were significantly larger for some measures (Y-balance test anterior reach distance: p <.001, d =.94; Timed-Up-and-Go time: p =.003, d =.81) compared to the low-volume group. The results indicate that balance training is effective to improve balance performance in healthy children and it seems that a 36-48 min/week compared to an 8 min/week training volume provides additional effects.

Effects of Plyometric Jump Training on Balance Performance in Healthy Participants: A Systematic Review With Meta-Analysis

Background: Postural balance represents a fundamental movement skill for the successful performance of everyday and sport-related activities. There is ample evidence on the effectiveness of balance training on balance performance in athletic and non-athletic population. However, less is known on potential transfer effects of other training types, such as plyometric jump training (PJT) on measures of balance. Given that PJT is a highly dynamic exercise mode with various forms of jump-landing tasks, high levels of postural control are needed to successfully perform PJT exercises. Accordingly, PJT has the potential to not only improve measures of muscle strength and power but also balance. Objective: To systematically review and synthetize evidence from randomized and non-randomized controlled trials regarding the effects of PJT on measures of balance in apparently healthy participants. Methods: Systematic literature searches were performed in the electronic databases PubMed, Web of Science, and SCOPUS. A PICOS approach was applied to define inclusion criteria, (i) apparently healthy participants, with no restrictions on their fitness level, sex, or age, (ii) a PJT program, (iii) active controls (any sport-related activity) or specific active controls (a specific exercise type such as balance training), (iv) assessment of dynamic, static balance pre- and post-PJT, (v) randomized controlled trials and controlled trials. The methodological quality of studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. This meta-analysis was computed using the inverse variance random-effects model. The significance level was set at p <0.05. Results: The initial search retrieved 8,251 plus 23 records identified through other sources. Forty-two articles met our inclusion criteria for qualitative and 38 for quantitative analysis (1,806 participants [990 males, 816 females], age range 9-63 years). PJT interventions lasted between 4 and 36 weeks. The median PEDro score was 6 and no study had low methodological quality (≤3). The analysis revealed significant small effects of PJT on overall (dynamic and static) balance (ES = 0.46; 95% CI = 0.32-0.61; p < 0.001), dynamic (e.g., Y-balance test) balance (ES = 0.50; 95% CI = 0.30-0.71; p < 0.001), and static (e.g., flamingo balance test) balance (ES = 0.49; 95% CI = 0.31-0.67; p < 0.001). The moderator analyses revealed that sex and/or age did not moderate balance performance outcomes. When PJT was compared to specific active controls (i.e., participants undergoing balance training, whole body vibration training, resistance training), both PJT and alternative training methods showed similar effects on overall (dynamic and static) balance (p = 0.534). Specifically, when PJT was compared to balance training, both training types showed similar effects on overall (dynamic and static) balance (p = 0.514). Conclusion: Compared to active controls, PJT showed small effects on overall balance, dynamic and static balance. Additionally, PJT produced similar balance improvements compared to other training types (i.e., balance training). Although PJT is widely used in athletic and recreational sport settings to improve athletes' physical fitness (e.g., jumping; sprinting), our systematic review with meta-analysis is novel in as much as it indicates that PJT also improves balance performance. The observed PJT-related balance enhancements were irrespective of sex and participants' age. Therefore, PJT appears to be an adequate training regime to improve balance in both, athletic and recreational settings.

The Effect of Combining Plyometrics Exercises and Balance Exercises in Improving Dynamic Balance among Female College Athletes: A Randomized Controlled Trial

INTRODUCTION

Plyometrics and balance exercises have been shown to reduce lower limb injury incidence. The effects of combining these exercises on dynamic balance have not been investigated.

OBJECTIVE

This study aimed to evaluate the effect of plyometrics and balance exercises and a combination of both exercises on postural stability among female athletes compared to those who did not perform any specific exercise (control).

DESIGN

Randomized controlled trial.

SETTING

Sports Medicine Laboratory.

PARTICIPANTS

Two hundred female athletes aged 21.9±2.4 years were randomly assigned to a plyometrics exercises group (n = 50), a balance exercises group (n = 50), a combination of both exercises group (n = 50), or a control group (n = 50). One hundred seventy-nine female college athletes completed the study.

INTERVENTIONS

Plyometrics exercises, balance exercises and a combination of both exercises.

OUTCOME MEASURES

Limits of stability, which was assessed using the Biodex Stability System to assess the performance of the dynamic balance. It was measured pre and post-intervention after six weeks.

RESULTS

There were no differences in baseline data between groups (p = .557). All groups showed significant improvements in limits of stability (p < .001). The most marked improvement in the limits of stability was shown in the combination group compared to the control group (MD = 4.1 %, 95% CI [2.8, 5.3], p < .001).

CONCLUSIONS

Combining plyometrics and balance exercises significantly increases the dynamic balance performance post-intervention among female athletes compared to the control group. This article is protected by copyright. All rights reserved.

Influence of Fatigue on Some Kinematic Parameters of Basketball Passing

Kinematic analysis is an objective method for examining basketball technique. However, there are just a few studies featuring a kinematic analysis of passing. The purpose of this study was to determine whether the kinematic parameters and accuracy of passing changed when players were under the influence of fatigue. Eleven Croatian basketball players who are members of the youth national program (age: 18.36 ± 0.67 years; height: 192.32 ± 9.98 cm; weight: 83.35 ± 11.19 kg; body fat: 15.00 ± 4.40%, arm span: 194.34 ± 10.39 cm) participated in fatigue and non-fatigue repetitive tests. A Xsens suit was used to analyze the kinematic parameters of push passing; a radar gun was used to determine ball speed; heart rate and blood lactate were used to identify fatigue and non-fatigue state. There was a significant difference in angular velocities of shoulder (p = 0.01), elbow (p = 0.04), and wrist (p = 0.01), accuracy (p = 0.01), ball speed (p = 0.00), pelvis position (p = 0.00), and velocity of the pelvis in X-axis (p = 0.00) between fatigue and non-fatigue state. Fatigue influences some kinematic parameters and accuracy of passing. The findings of this study suggest that coaches conduct as many drills as possible in situational conditions that are similar to the conditions during the basketball game itself.

Effects of Combined Balance and Plyometric Training on Athletic Performance in Female Basketball Players

Bouteraa, I, Negra, Y, Shephard, RJ, and Chelly, MS. Effects of combined balance and plyometric training on athletic performance in female basketball players. J Strength Cond Res 34(7): 1967-1973, 2020-The purpose of this study was to examine the effect of 8 weeks combined balance and plyometric training on the physical fitness of female adolescent basketball players. Twenty-six healthy regional-level players were randomly assigned to either an experimental group (E; n = 16, age = 16.4 ± 0.5) or a control group (C; n = 10, age = 16.5 ± 0.5). C maintained their normal basketball training schedule, whereas for 8 weeks E replaced a part of their standard regimen by biweekly combined training sessions. Testing before and after training included the squat jump (SJ), countermovement jump (CMJ), drop jump (DJ), 5-, 10-, and 20-m sprints, Stork balance test (SBT), Y-balance test (YBT) and modified Illinois change of direction test (MICODT). Results indicated no significant intergroup differences in SJ and CMJ height; however, E increased their DJ height (p < 0.05, Cohens'd = 0.11). No significant intergroup differences were found for sprint performance or SBT, but dynamic YBT tended to a significant group interaction (p = 0.087, d = 0.006). Post hoc analysis also showed a significant increase of MICODT for E (Δ 6.68%, p = 0.041, d = 0.084). In summary, the addition of 8 weeks of balance and plyometric training to regular in-season basketball training proved a safe and feasible intervention that enhanced DJ height, balance, and agility for female adolescent basketball players relative to the standard basketball training regimen.

Effects of an 8-week basketball-specific proprioceptive training with a single-plane instability balance platform

BACKGROUND

To avoid injuries in basketball players, they are recommended to pay more attention to improve their body balance. Therefore new training methods and equipment need to be devised. This study examined the effects of an 8-week basketball-specific proprioception training program while using a new developed one plane instability balance board during warm-up for improving balance ability in basketball players. Players who obtained basketball-specific balance training were compared to a control group.

METHODS

Thirty-one male university basketball players (age: 21.35, SD = 0.605 years; height: 190.97, SD = 1.88; body mass: 86.95, SD = 2.61) participated in this study. Seventeen participants were assigned to the basketball-specific 8-week balance training group (BTG) while 14 participants served as a control group (CG). Both groups were tested with the Y balance test (YBT) and postural stability test (PST) at baseline and 8 weeks later.

RESULTS

The results indicate significant improvements in the overall YBT for both legs in BTG, but not in CG. However, no group differences were found for dynamic balance performance, but static balance (i.e., postural stability) differed between groups after 8 weeks. A statistically significant moderate inverse correlation was computed between the total score of YBT and the total score of the overall stability index (r=-0.404; p= 0.041).

CONCLUSIONS

An 8-week basketball-specific proprioception training program with a single-plane instability balance platform improved balance ability (Y balance test and postural stability test) of basketball players.

Effects of lateral ankle sprain on range of motion, strength and postural balance in competitive basketball players: a cross-sectional study

BACKGROUND

Lateral ankle sprain is the most common injury in basketball, and many of these sprains resulted in residual functional deficits. This study aimed to compare ankle strength and range of motion, and postural balance between competitive basketball players with and without lateral ankle sprain.

METHODS

This was a cross-sectional study involving 42 male competitive basketball players. Subjects were divided into the injured and uninjured groups based on self-reported questionnaires. Ankle range of motion (ROM) was measured using a goniometer, ankle isokinetic strength testing performed using Biodex System 4 PRO, and single-leg stability tests performed using Biodex Balance System SD.

RESULTS

Between the injured and uninjured ankles, there was a decrease in plantarflexion ROM (44.89±6.85 vs. 50.75±9.31, P<0.05) and an increase in eversion ROM (14.50±5.63 vs. 11.74±4.53, P<0.05). There was a reduction in inversion and plantarflexion strength at 30°/s peak torque and 120 °/s peak torque (P<0.05). However, no significant difference observed in the postural stability indexes between the two groups.

CONCLUSIONS

This study proves that there are residual ROM and strength deficits after an ankle sprain, however, these deficits do not affect their balance ability.

A Review of Countermovement and Squat Jump Testing Methods in the Context of Public Health Examination in Adolescence: Reliability and Feasibility of Current Testing Procedures

BACKGROUND

In the context of a public health physical fitness (PF) examination in adolescence, a countermovement jump (CMJ) and a squat jump (SJ) are two vertical jump (VJ) tests widely used to evaluate lower limb muscle strength and power, respectively. The main criticism of both the CMJ and SJ test is the lack of test standardization. Therefore, the objectives of this review are: (a) to gather information about both jumps; (b) to investigate whether it is possible to identify common procedures referred to in the CMJ and SJ technical execution, and (c) to design standard operating procedures (SOPs) to promote CMJ and SJ standardization in an adolescent population aged 12-18 years.

METHODS

The review partially adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Due to growing attention in monitoring physical health through field tests in recent years, articles were collected using the PubMed, Web of Science, and Scopus databases from January 2009 to July 2019. Original articles in which CMJ or SJ were used to assess the muscular strength in adolescents were eligible for further analysis. Articles written in English was imposed as a limit.

RESULTS

A total of 117 studies met the inclusion criteria. The description of the CMJ and SJ test procedures was different within the literature, with discrepancies in the jump technique, number of jumps, and measurement devices used.

CONCLUSIONS

A lack of method standardization for both the CMJ and the SJ test was identified. Based on the literature, SOPs for both VJs were proposed. These are useful in the context of public health PF examination in adolescents, as they facilitate an unbiased comparison of jump performance data between published studies.

Effects and Dose-Response Relationship of Balance Training on Balance Performance in Youth: A Systematic Review and Meta-Analysis

BACKGROUND

Effects and dose-response relationships of balance training on measures of balance are well-documented for healthy young and old adults. However, this has not been systematically studied in youth.

OBJECTIVES

The objectives of this systematic review and meta-analysis were to quantify effects of balance training (BT) on measures of static and dynamic balance in healthy children and adolescents. Additionally, dose-response relations for BT modalities (e.g. training period, frequency, volume) were quantified through the analysis of controlled trials.

DATA SOURCES

A computerized systematic literature search was conducted in the electronic databases PubMed and Web of Science from January 1986 until June 2017 to identify articles related to BT in healthy trained and untrained children and adolescents.

STUDY ELIGIBILITY CRITERIA

A systematic approach was used to evaluate articles that examined the effects of BT on balance outcomes in youth. Controlled trials with pre- and post-measures were included if they examined healthy youth with a mean age of 6-19 years and assessed at least one measure of balance (i.e. static/dynamic steady-state balance, reactive balance, proactive balance) with behavioural (e.g. time during single-leg stance) or biomechanical (e.g. centre of pressure displacements during single-leg stance) test methods.

STUDY APPRAISAL AND SYNTHESIS METHODS

The included studies were coded for the following criteria: training modalities (i.e. training period, frequency, volume), balance outcomes (i.e. static and dynamic balance) as well as chronological age, sex (male vs. female), training status (trained vs. untrained), setting (school vs. club), and testing method (biomechanical vs. physical fitness test). Weighted mean standardized mean differences (SMD_wm) were calculated using a random-effects model to compute overall intervention effects relative to active and passive control groups. Between-study heterogeneity was assessed using I² and χ² statistics. A multivariate random effects meta-regression was computed to explain the influence of key training modalities (i.e. training period, training frequency, total number of training sessions, duration of training sessions, and total duration of training per week) on the effectiveness of BT on measures of balance performance. Further, subgroup univariate analyses were computed for each training modality. Additionally, dose-response relationships were characterized independently by interpreting the modality specific magnitude of effect sizes. Methodological quality of the included studies was rated with the help of the Physiotherapy Evidence Database (PEDro) Scale.

RESULTS

Overall, our literature search revealed 198 hits of which 17 studies were eligible for inclusion in this systematic review and meta-analysis. Irrespective of age, sex, training status, sport discipline and training method, moderate to large BT-related effects were found for measures of static (SMD_wm = 0.71) and dynamic (SMD_wm = 1.03) balance in youth. However, our subgroup analyses did not reveal any statistically significant effects of the moderator variables age, sex, training status, setting and testing method on overall balance (i.e. aggregation of static and dynamic balance). BT-related effects in adolescents were moderate to large for measures of static (SMD_wm = 0.61) and dynamic (SMD_wm = 0.86) balance. With regard to the dose-response relationships, findings from the multivariate random effects meta-regression revealed that none of the examined training modalities predicted the effects of BT on balance performance in adolescents (R² = 0.00). In addition, results from univariate analysis have to be interpreted with caution because training modalities were computed as single factors irrespective of potential between-modality interactions. For training period, 12 weeks of training achieved the largest effect (SMDwm = 1.40). For training frequency, the largest effect was found for two sessions per week (SMDwm = 1.29). For total number of training sessions, the largest effect was observed for 24-36 sessions (SMDwm = 1.58). For the modality duration of a single training session, 4-15 min reached the largest effect (SMDwm = 1.03). Finally, for the modality training per week, a total duration of 31-60 min per week (SMDwm = 1.33) provided the largest effects on overall balance in adolescents. Methodological quality of the studies was rated as moderate with a median PEDro score of 6.0.

LIMITATIONS

Dose-response relationships were calculated independently for training modalities (i.e. modality specific) and not interdependently. Training intensity was not considered for the calculation of dose-response relationships because the included studies did not report this training modality. Further, the number of included studies allowed the characterization of dose-response relationships in adolescents for overall balance only. In addition, our analyses revealed a considerable between-study heterogeneity (I² = 66-83%). The results of this meta-analysis have to be interpreted with caution due to their preliminary status.

CONCLUSIONS

BT is a highly effective means to improve balance performance with moderate to large effects on static and dynamic balance in healthy youth irrespective of age, sex, training status, setting and testing method. The examined training modalities did not have a moderating effect on balance performance in healthy adolescents. Thus, we conclude that an additional but so far unidentified training modality may have a major effect on balance performance that was not assessed in our analysis. Training intensity could be a promising candidate. However, future studies are needed to find appropriate methods to assess BT intensity.

Effects of Increasing Balance Task Difficulty on Postural Sway and Muscle Activity in Healthy Adolescents

Evidence-based prescriptions for balance training in youth have recently been established. However, there is currently no standardized means available to assess and quantify balance task difficulty (BTD). Therefore, the objectives of this study were to examine the effects of graded BTD on postural sway, lower limb muscle activity and coactivation in adolescents. Thirteen healthy high-school students aged 16 to 17 volunteered to participate in this cross-sectional study. Testing involved participants to stand on a commercially available balance board with an adjustable pivot that allowed six levels of increasing task difficulty. Postural sway [i.e., total center of pressure (CoP) displacements] and lower limb muscle activity were recorded simultaneously during each trial. Surface electromyography (EMG) was applied in muscles encompassing the ankle (m. tibialis anterior, medial gastrocnemius, peroneus longus) and knee joint (m. vastus medialis, biceps femoris). The coactivation index (CAI) was calculated for ankle and thigh muscles. Repeated measures analyses of variance revealed a significant main effect of BTD with increasing task difficulty for postural sway (p < 0.001; d = 6.36), muscle activity (p < 0.001; 2.19 < d < 4.88), and CAI (p < 0.001; 1.32 < d < 1.41). Multiple regression analyses showed that m. tibialis anterior activity best explained overall CoP displacements with 32.5% explained variance (p < 0.001). The observed increases in postural sway, lower limb muscle activity, and coactivation indicate increasing postural demands while standing on the balance board. Thus, the examined board can be implemented in balance training to progressively increase BTD in healthy adolescents.

The effect of block and traditional periodization training models on jump and sprint performance in collegiate basketball players

This study investigated the effect of block periodization (BP) and traditional periodization (TP) approaches on jumping and sprinting performance in collegiate basketball players during an 8-week pre-season period. Ten collegiate male basketball players (mean±SD; age: 21.5±1.7 years; body mass: 83.5±8.9 kg; stature: 192.5±5.4 cm) from the same team were equally assigned to a training group (BP or TP). BP and TP were designed with different numbers of power sessions (BP=8; TP=16) and recovery days (BP=14; TP=8). Counter-movement jump (CMJ) and 20-m sprint performance was measured prior to training commencement (baseline) and every 2 weeks thereafter (week 2, week 4, week 6 and week 8). Within-group, between-group and individual changes were assessed using magnitude-based statistics. Substantially higher (likely positive) CMJ scores were evident in week 8 compared to baseline, week 2 and week 4 with BP training. Substantially higher CMJ values were only observed in week 2 (likely positive) compared to baseline, with TP training. Sprint data showed likely negative differences in week 6 compared to baseline in both TP and BP, with no substantial differences in week 8. The only performance difference between TP and BP training was in CMJ in week 8 (very likely negative). Individual analysis showed that only three athletes demonstrated a negative predicted score (i.e. lower sprinting time) in BP, while all players following the TP model demonstrated positive predicted scores. BP training showed substantially higher jumping performance compared to TP, while no improvement in sprinting performance was observed in either training approach. Basketball coaches should consider using BP training rather than TP to train players' jumping abilities.

The effects of instrument-assisted soft tissue mobilization on active range of motion, functional fitness, flexibility, and isokinetic strength in high school basketball players

Although many studies have focused on stretching techniques for athletes, no comprehensive studies have investigated the use of the instrument-assisted soft tissue mobilization (IASTM) technique in young basketball players. The active properties of muscle and subjective reporting of functional ability were used to identify the effects of IASTM on the calf muscle. Active range of motion (AROM), functional fitness, and isokinetic lower strength in the knees and ankles were measured in 40 healthy young basketball players. They were divided into the IASTM group (n= 20) and a control group (CG, n= 20). Twenty asymptomatic young basketball players were treated with IASTM six times per week for 8 weeks. The remaining 20 participants did not receive a treatment intervention between tests and served as the control. Ankle AROM (two knee positions of 0∘ and 45∘ flexion), functional fitness at the knee and ankle (side-step and vertical jump), and isokinetic peak torque were determined during ankle dorsiflexion (DF) and plantar flexion (PF) and knee extension (EX) and flexion (FX). The data were analyzed using repeated-measures analysis of variance. Significant differences were observed between the two groups in IASTM and control AROM 0∘ knee flexion (right: DF; p< 0.001 and PF; p< 0.001; left: DF; p< 0.001 and PF; p= 0.011), AROM 45∘ knee flexion (right: DF; p< 0.001 and PF; p= 0.009; left: DF; p< 0.001 and PF; p= 0.001), functional fitness (side step; p= 0.001, sit and reach; p= 0.025, vertical jump; p= 0.001), ankle isokinetic strength 30∘/sec (right: DF; p= 0.001 and PF; p= 0.001; left: DF; p< 0.001 and PF; p= 0.002), ankle isokinetic strength 120∘/sec (right: DF; p= 0.049 and PF; p= 0.001; left: DF; p= 0.023 and PF; p< 0.001), knee isokinetic strength 60∘/sec (right: EX; p= 0.001, FX; p= 0.001 and hamstring and quadriceps ratio [H/Q]; p= 0.001, left: EX; p= 0.001, FX; p= 0.001 and H/Q; p= 0.001), and knee isokinetic strength 180∘/sec (right: EX; p= 0.001, FX; p= 0.001 and H/Q; p= 0.001; left: EX; p= 0.001, FX; p= 0.010 and H/Q; p= 0.001). These results suggest that IASTM improves functional fitness and lower body muscle strength in young basketball players.

Is Young Age a Limiting Factor When Training Balance? Effects of Child-Oriented Balance Training in Children and Adolescents

PURPOSE

Balance training (BT) studies in children reported conflicting results without evidence for improvements in children under the age of 8. The aim of this study therefore was to compare BT adaptations in children of different age groups to clarify whether young age prevents positive training outcomes.

METHODS

The effects of 5 weeks of child-oriented BT were tested in 77 (38 girls and 39 boys) participants of different age groups (6-7 y, 11-12 y, and 14-15 y) and compared with age-matched controls. Static and dynamic postural control, explosive strength, and jump height were assessed.

RESULTS

Across age groups, dynamic postural sway decreased (-18.7%; P = .012; [Formula: see text]) and explosive force increased (8.6%; P = .040; [Formula: see text]) in the intervention groups. Age-specific improvements were observed in dynamic postural sway, with greatest effects in the youngest group (-28.8%; P = .026; r = .61).

CONCLUSION

In contrast to previous research using adult-oriented balance exercises, this study demonstrated for the first time that postural control can be trained from as early as the age of 6 years in children when using child-oriented BT. Therefore, the conception of the training seems to be essential in improving balance skills in young children.

Effects of a 3-month recreative exercise applied to individuals with intellectual disability on their electromyogram (EMG) variations and balance performance

Objective: The objective of the present study was to determine how 3-month recreative exercises affect the balance performance of individuals with intellectual disability (ID) and to evaluate the electromyogram (EMG) changes following exercises. Methods: Eleven individuals (M=14.18, S.D=1.94) with mild intellectual disability (MID) who attend the school for children with ID and to the vocational school were included in the study. In the study, the subjects were applied a recreative exercise program (60 min/3 days/12 weeks) and their balance, EMG, and aerobic and anaerobic performances were evaluated by means of the pretest-posttest model. Results: When the EMG values in our study were examined, differences were found in terms of EMG₃-VL muscle variable (P=0.075/2=0.038), EMG₃-RF muscle variable (P=0.080/2=0.040), and EMG₅-RF muscle variable (P=0.066/2=0.033). The exercise program decreased the EMG values significantly. When the balance scores were evaluated, significant differences were found in terms of the variables of Balance 2 (after 30 s) (P=0.077/2=0.039) and Balance 3 (after 3 min) (P=0.084/2=0.042). The exercise program significantly decreased the balance values. Conclusion: Consequently, it was determined that 3-month recreative exercises applied to individuals with ID lowered the EMG and Balance values during and after the exercise. In this context, it is thought that the people working with the children with MID need to consider the parameters constituting the balance in a detailed way in their exercise practices and to include activities improving their balance skills into their programs, and that recreative exercises can also provide contribution in this term.

Improvements in Orientation and Balancing Abilities in Response to One Month of Intensive Slackline-Training. A Randomized Controlled Feasibility Study

Background: Slackline-training has been shown to improve mainly task-specific balancing skills. Non-task specific effects were assessed for tandem stance and preferred one-leg stance on stable and perturbed force platforms with open eyes. It is unclear whether transfer effects exist for other balancing conditions and which component of the balancing ability is affected. Also, it is not known whether slackline-training can improve non-visual-dependent spatial orientation abilities, a function mainly supported by the hippocampus.

Objective: To assess the effect of one-month of slackline-training on different components of balancing ability and its transfer effects on non-visual-dependent spatial orientation abilities.

Materials and Methods: Fifty subjects aged 18–30 were randomly assigned to the training group (T) (n = 25, 23.2 ± 2.5 years; 12 females) and the control group (C) (n = 25, 24.4 ± 2.8 years; 11 females). Professional instructors taught the intervention group to slackline over four consecutive weeks with three 60-min-trainings in each week. Data acquisition was performed (within 2 days) by blinded investigators at the baseline and after the training. Main outcomes Improvement in the score of a 30-item clinical balance test (CBT) developed at our institute (max. score = 90 points) and in the average error distance (in centimeters) in an orientation test (OT), a triangle completion task with walking and wheelchair conditions for 60°, 90°, and 120°.

Results: Training group performed significantly better on the closed-eyes conditions of the CBT (1.6 points, 95% CI: 0.6 to 2.6 points vs. 0.1 points, 95% CI: –1 to 1.1 points; p = 0.011, ηp2 = 0.128) and in the wheelchair (vestibular) condition of the OT (21 cm, 95% CI: 8–34 cm vs. 1 cm, 95% CI: –14–16 cm; p = 0.049, ηp2 = 0.013).

Conclusion: Our results indicate that one month of intensive slackline training is a novel approach for enhancing clinically relevant balancing abilities in conditions with closed eyes as well as for improving the vestibular-dependent spatial orientation capability; both of the benefits are likely caused by positive influence of slackline-training on the vestibular system function.

Masseter Muscle Activity in Track and Field Athletes: A Pilot Study

Teeth clenching has been shown to improve remote muscle activity (by augmentation of the Hoffmann reflex), and joint fixation (by decreased reciprocal inhibition) in the entire body. Clenching could help maintain balance, improve systemic function, and enhance safety. Teeth clenching from a sports dentistry viewpoint was thought to be important and challenging. Therefore, it is quite important to investigate mastication muscles' activity and function during sports events for clarifying a physiological role of the mastication muscle itself and involvement of mastication muscle function in whole body movement. Running is a basic motion of a lot of sports; however, a mastication muscles activity during this motion was not clarified. Throwing and jumping operation were in a same situation. The purpose of this study was to investigate the presence or absence of masseter muscle activity during track and field events. In total, 28 track and field athletes took part in the study. The Multichannel Telemetry system was used to monitor muscle activity, and the electromyograms obtained were synchronized with digital video imaging. The masseter muscle activity threshold was set 15% of maximum voluntary clenching. As results, with few exceptions, masseter muscle activity were observed during all analyzed phases of the 5 activities, and that phases in which most participants showed masseter muscle activity were characterized by initial acceleration, such as in the short sprint, from the commencement of throwing to release in both the javelin throw and shot put, and at the take-off and landing phases in both jumps.

Effects of training on postural stability in young basketball players

BACKGROUND

in basketball, balance ability is important to reduce non-contact injuries. The purpose of the present study was to investigate the effect of training on balance.

METHODS

thirty-two healthy male volunteers were recruited from amateur basketball teams. They were asked to perform the Balance Error Scoring System BESS test in order to measure the number of stability errors in six conditions. The test was performed at the beginning of the season (T0) and after 12 weeks (T1). In both cases the test was carried out before (pre-session) and after a training session (post-session).

RESULTS

the comparison of the total BESS scores both pre- and post-session showed a statistically significant increase of stability errors at both T0 and T1 (T0: pre-session 8.6±6.1 errors, post-session 10.7±6.3 errors; t=-4.03; p=0.002) (T1: pre-session 7.2±3.8 errors, post-session 9.1±5.4 errors; t=-1.93; p=0.03). Between T0 and T1 we noticed a reduction of errors which reached a statistical significance during the pre-session time (t=2.75; p=0.0049).

CONCLUSION

stability improved after 12 weeks of training, even for those conditions for which no specific training was done to improve, such as on the soft surface and feet aligned in a tandem stance.

Non-physical practice improves task performance in an unstable, perturbed environment: motor imagery and observational balance training

For consciously performed motor tasks executed in a defined and constant way, both motor imagery (MI) and action observation (AO) have been shown to promote motor learning. It is not known whether these forms of non-physical training also improve motor actions when these actions have to be variably applied in an unstable and unpredictable environment. The present study therefore investigated the influence of MI balance training (MI_BT) and a balance training combining AO and MI (AO+MI_BT) on postural control of undisturbed and disturbed upright stance on unstable ground. As spinal reflex excitability after classical (i.e., physical) balance training (BT) is generally decreased, we tested whether non-physical BT also has an impact on spinal reflex circuits. Thirty-six participants were randomly allocated into an MI_BT group, in which participants imagined postural exercises, an AO+MI_BT group, in which participants observed videos of other people performing balance exercises and imagined being the person in the video, and a non-active control group (CON). Before and after 4 weeks of non-physical training, balance performance was assessed on a free-moving platform during stance without perturbation and during perturbed stance. Soleus H-reflexes were recorded during stable and unstable stance. The post-measurement revealed significantly decreased postural sway during undisturbed and disturbed stance after both MI_BT and AO+MI_BT. Spinal reflex excitability remained unchanged. This is the first study showing that non-physical training (MI_BT and AO+MI_BT) not only promotes motor learning of “rigid” postural tasks but also improves performance of highly variable and unpredictable balance actions. These findings may be relevant to improve postural control and thus reduce the risk of falls in temporarily immobilized patients.