Development of postural control during single-leg standing in children aged 3-10 years

Static and dynamic postural control assessment in schoolchildren: Reliability and reference values of the Modified Flamingo Test and Bar Test

INTRODUCTION

Single-leg stance tests have been widely used to evaluate static balance, like the Modified Flamingo Test. The evaluation of dynamic balance on small support surfaces is the objective of some tests like the Bar Test.

RESEARCH QUESTION

How is the performance of postural control during the performance of these tests in schoolchildren between 6 and 11 years of age in both sexes? What are the reference values of these tests in this population?

METHOD

A cross-sectional study in which a total of 282 children. The evaluation included both tests.

RESULTS

The relative reliability was excellent (Intraclass Correlation Coefficient = 0.84-0.98), and the absolute reliability ranged between 4.5% and 7.1% for coefficient variation and between 0.5 and 1.5 for the standard error of measurement. The average results were 3.8 ± 2.7 floor touches for the Modified Flamingo Test and 5 ± 3.5 m for the Bar Test. The results of both tests improve progressively with the increase of age.

DISCUSSION

It can be asserted that children of different ages, as well as boys and girls of the same age, perform differently in these tests. Particularly, according to the analysis based on age subgroups, there were greater improvements in the performance of both tests between 8 and 11 years of age.

CONCLUSIONS

The girls obtained in both tests better results, although between 6 and 7 years of age the differences between sexes are not significant.

Development of the Relationships Among Dynamic Balance Control, Inter-limb Coordination, and Torso Coordination During Gait in Children Aged 3-10 Years

Knowledge about the developmental process of dynamic balance control comprised of upper arms and upper legs coordination and trunk and pelvis twist coordination is important to advance effective balance assessment for abnormal development. However, the mechanisms of these coordination and stability control during gait in childhood are unknown.This study examined the development of dynamic postural stability, upper arm and upper leg coordination, and trunk and pelvic twist coordination during gait, and investigated the potential mechanisms integrating the central nervous system with inter-limb coordination and trunk and pelvic twist coordination to control extrapolated center of the body mass (XCOM). This study included 77 healthy children aged 3-10 years and 15 young adults. The child cohort was divided into four groups by age: 3-4, 5-6, 7-8, and 9-10 years. Participants walked barefoot at a self-selected walking speed along an 8 m walkway. A three-dimensional motion capture system was used for calculating the XCOM, the spatial margin of stability (MoS), and phase coupling movements of the upper arms, upper legs, trunk, and pelvic segments. MoS in the mediolateral axis was significantly higher in the young adults than in all children groups. Contralateral coordination (ipsilateral upper arm and contralateral upper leg combination) gradually changed to an in-phase pattern with increasing age until age 9 years. Significant correlations of XCOMML with contralateral coordination and with trunk and pelvic twist coordination (trunk/pelvis coordination) were found. Significant correlations between contralateral coordination and trunk/pelvis coordination were observed only in the 5-6 years and at 7-8 years groups.Dynamic postural stability during gait was not fully mature at age 10. XCOM control is associated with the development of contralateral coordination and trunk and pelvic twist coordination. The closer to in-phase pattern of contralateral upper limb coordination improved the XCOM fluctuations. Conversely, the out-of-phase pattern (about 90 degrees) of the trunk/pelvis coordination increased theXCOM fluctuation. Additionally, a different control strategy was used among children 3-8 years of age and individuals over 9 years of age, which suggests that 3-4-year-old children showed a disorderly coordination strategy between limb swing and torso movement, and in children 5-8 years of age, limb swing depended on trunk/pelvis coordination.

Development of temporal and spatial characteristics of anticipatory postural adjustments during gait initiation in children aged 3-10 years

This study aimed to analyze the development of direction specificities of temporal and spatial control and the coordination pattern of anticipatory postural adjustment (APA) along the anteroposterior (AP) and mediolateral (ML) directions during gait initiation (GI) in children aged 3-10 years. This study included 72 healthy children aged 3-10 years and 14 young adults. The child population was divided into four groups by age: 3-4, 5-6, 7-8, and 9-10 years. The GI task included GI using the dominant limb. The peak center of feet pressure (COP) shifts during APAs (APA_peak), initiation time of COP shifts (APA_onset), and the COP vectors in the horizontal plane were calculated to evaluate the direction specificity of spatial, temporal, and coordination control, respectively. A difference in direction specificity development was found for the APA_peak. The APA_peak in the mediolateral axis, but not in the anteroposterior axis, was significantly higher in the 7-8 years age group than in other groups. Although APA_onset was not found for direction specificity, a significant difference between the adult and children groups (5-6 years, 7-8 years, and 9-10 years) was observed in the direction of the COP vector. In conclusion, the developmental process of the spatial, temporal, and coordination control of APAs during GI varied with age. Furthermore, the spatial control and coordination pattern of APAs was found to be direction specific. All components of APAs, namely temporal and spatial control, coordination pattern, and direction specificities, should be analyzed to capture the developmental process of anticipatory postural control.

Postural Stability in Athletes: The Role of Age, Sex, Performance Level, and Athlete Shoe Features

The effects of different factors-such as age, sex, performance level, and athletic shoe features-on postural balance in athletes remain unclear. The main objective of our study is to identify the features of postural stability in athletes of different age, sex, performance level, and using different types of athletic shoes. This study assessed postural stability in athletes (n = 936, 6-47 years) in a normal bipedal stance with eyes open (EO) and eyes closed (EC). Postural stability was evaluated based on the center of pressure (COP), sway area (AS), and velocity (VCP) while standing on a stabiloplatform. Children (6-12 years) and teen athletes (13-17 years) showed reduced AS-EO (p < 0.01) and VCP-EO (p < 0.01) compared to control (n = 225, 7-30 years). In male and female athletes aged 18+, only VCP-EC was lower versus control. In females (13-17 and 18+), VCP-EO and EC were lower than in males (p < 0.05). Only in the Shooting group, the athletes' performance levels had an effect on VCP-EO (p = 0.020). Long use of rigid athletic shoes with stiff ankle support was associated with reduced posture stability. Postural stability in athletes was mostly influenced by the athlete's age, and, to a lesser extent, by their sex, performance level, and athlete shoe features.