Athletic background is related to superior trunk proprioceptive ability, postural control, and neuromuscular responses to sudden perturbations

Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis

INTRODUCTION

Sitting on an unstable surface is a common paradigm to investigate trunk postural control among individuals with low back pain (LBP), by minimizing the influence lower extremities on balance control. Outcomes of many small studies are inconsistent (e.g., some find differences between groups while others do not), potentially due to confounding factors such as age, sex, body mass index [BMI], or clinical presentations. We conducted a systematic review with an individual participant data (IPD) meta-analysis to investigate whether trunk postural control differs between those with and without LBP, and whether the difference between groups is impacted by vision and potential confounding factors.

METHODS

We completed this review according to PRISMA-IPD guidelines. The literature was screened (up to 7th September 2023) from five electronic databases: MEDLINE, CINAHL, Embase, Scopus, and Web of Science Core Collection. Outcome measures were extracted that describe unstable seat movements, specifically centre of pressure or seat angle. Our main analyses included: 1) a two-stage IPD meta-analysis to assess the difference between groups and their interaction with age, sex, BMI, and vision on trunk postural control; 2) and a two-stage IPD meta-regression to determine the effects of LBP clinical features (pain intensity, disability, pain catastrophizing, and fear-avoidance beliefs) on trunk postural control.

RESULTS

Forty studies (1,821 participants) were included for the descriptive analysis and 24 studies (1,050 participants) were included for the IPD analysis. IPD meta-analyses revealed three main findings: (a) trunk postural control was worse (higher root mean square displacement [RMSdispl], range, and long-term diffusion; lower mean power frequency) among individuals with than without LBP; (b) trunk postural control deteriorated more (higher RMSdispl, short- and long-term diffusion) among individuals with than without LBP when vision was removed; and (c) older age and higher BMI had greater adverse impacts on trunk postural control (higher short-term diffusion; longer time and distance coordinates of the critical point) among individuals with than without LBP. IPD meta-regressions indicated no associations between the limited LBP clinical features that could be considered and trunk postural control.

CONCLUSION

Trunk postural control appears to be inferior among individuals with LBP, which was indicated by increased seat movements and some evidence of trunk stiffening. These findings are likely explained by delayed or less accurate corrective responses.

SYSTEMATIC REVIEW REGISTRATION

This review has been registered in PROSPERO (registration number: CRD42021124658).

Wearable Motion Analysis System for Thoracic Spine Mobility With Inertial Sensors

This study presents a wireless wearable portable system designed for the automatic quantitative spatio-temporal analysis of continuous thoracic spine motion across various planes and degrees of freedom (DOF). This includes automatic motion segmentation, computation of the range of motion (ROM) for six distinct thoracic spine movements across three planes, tracking of motion completion cycles, and visualization of both primary and coupled thoracic spine motions. To validate the system, this study employed an Inter-days experimental setting to conduct experiments involving a total of 957 thoracic spine movements, with participation from two representatives of varying age and gender. The reliability of the proposed system was assessed using the Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). The experimental results demonstrated strong ICC values for various thoracic spine movements across different planes, ranging from 0.774 to 0.918, with an average of 0.85. The SEM values ranged from 0.64° to 4.03°, with an average of 1.93°. Additionally, we successfully conducted an assessment of thoracic spine mobility in a stroke rehabilitation patient using the system. This illustrates the feasibility of the system for actively analyzing thoracic spine mobility, offering an effective technological means for non-invasive research on thoracic spine activity during continuous movement states.

Dynamic postural control in women athletes with and without nonspecific low back pain with high and low pain-related anxiety- A case-control study

BACKGROUND

Low back pain is common among athletes and it has been shown that postural control is altered in the general population with nonspecific low back pain (NSLBP). Psychological factors may also predispose individuals to risk of altered postural control. Dynamic postural control is essential to the performance of athletes. This study aimed to compare the dynamic postural control between women athletes with and without NSLBP with high and low pain-related anxiety.

METHODS

Forty-five female athletes (15 NSLBP with high pain-related anxiety, 15 NSLBP with low pain-related anxiety, and 15 healthy (control)) were included. Pain-related anxiety was assessed using the Pain Anxiety Symptom Scale-20 (PASS-20). Based on the cut-off score of 30 for the total score of PASS-20, NSLBP patients were classified into two groups of low and high pain-related anxiety. Participants performed double-leg vertical drop jump (DVJ) and single-leg vertical jump (SVJ) tests on a Kistler force plate (type 9260AA6, Kistler Instruments Inc, Switzerland). The total root mean square (RMS) of the center of pressure (COP), COP displacement in the anteroposterior (AP), and mediolateral (ML) directions, COP mean velocity, and time to stabilization (TTS) in vertical, AP, and total directions were extracted from COP and ground reaction force data using MATLAB software. One-way Analysis of variance (ANOVA) and Welch's ANOVA were employed to compare the groups. In case of significant findings, post hoc tests were performed.

RESULTS

The results showed that during DJV, athletes with high pain-related anxiety had significantly greater TTS in all total, AP, and ML directions than other groups (P < 0.05). Also, the control group showed greater total RMS distance during DJV than either NSLBP group. However, no significant differences in TTS and COP parameters were found between the groups during SVJ (P > 0.05).

CONCLUSIONS

The findings suggest that pain-related anxiety may contribute to athletes' postural control strategies. Therefore, it is important to consider the level of pain-related anxiety during planning postural control exercises for women athletes with NSLBP.

Decision-Making Time and Neuromuscular Coordination in Youth and Senior Soccer Goalkeepers

The aim of this study was to compare soccer goalkeepers' decision-making times following a shot on goal and to determine goalkeepers' movement pattern structures using EMG in a typical game situation (two-on-one). Two groups of goalkeepers (n = 60) took part in the study: Group A, the senior group (22.00 ± 2.35 years of age), and Group B, the youth group (15.38 ± 1.32 years of age). The goalkeepers' decision-making times were measured by using EMG from the moment the attacker struck the ball until the completion of the saving action by the goalkeeper. Subsequently, the goalkeepers' movement pattern structure was determined (for both Groups A and B), and the values of muscle bioelectrical tension during a typical defensive situation in training conditions were revealed. The findings clearly indicate a significantly (p = 0.001) shorter decision-making time in experienced goalkeepers (250-260 ms) than in novices (300-320 ms). In addition, the movement pattern structure confirmed the hypotheses on the economization of effort and the visual-muscular coordination of the postural muscles (calf muscles) that affect soccer goalkeepers. The study also demonstrated a lower bioelectric tension of the gastrocnemius muscle (GAS.MED. RT-p = 0.008; GAS.LAT. RT-p = 0.030) in the expert goalkeepers.

Sport-specific training induced adaptations in postural control and their relationship with athletic performance

Effects of various exercise programs on postural balance control in athletes and their underlying physiological mechanisms have been extensively investigated. However, little is known regarding how challenging sport-specific conditions contribute to the improvement of body balance and to what extent these changes may be explained by sensorimotor and/or neuromuscular function adaptations. Analysis of the literature could provide useful information on the interpretation of changes in postural sway variables in response to long-term sport-specific training and their association with performance measures. Therefore, the aim of this scoping review was (1) to analyze the literature investigating postural control adaptations induced by sport-specific training and their relationship with measures of athletic performance, and (2) to identify gaps in the existing research and to propose suggestions for future studies. A literature search conducted with Scopus, Web of Science, MEDLINE and Cochrane Library was completed by Elsevier, SpringerLink and Google Scholar with no date restrictions. Overall, 126 articles were eligible for inclusion. However, the association between variables of postural balance control and measures of sport-specific performance was investigated in only 14 of the articles. A relationship between static and/or dynamic balance and criterion measures of athletic performance was revealed in shooting, archery, golf, baseball, ice-hockey, tennis, and snowboarding. This may be ascribed to improved ability of athletes to perform postural adjustments in highly balanced task demands. However, the extent to which sport-specific exercises contribute to their superior postural stability is unknown. Although there is a good deal of evidence supporting neurophysiological adaptations in postural balance control induced by body conditioning exercises, little effort has been made to explain balance adaptations induced by sport-specific exercises and their effects on athletic performance. While an enhancement in athletic performance is often attributed to an improvement of neuromuscular functions induced by sport-specific balance exercises, it can be equally well ascribed to their improvement by general body conditioning exercises. Therefore, the relevant experiments have yet to be conducted to investigate the relative contributions of each of these exercises to improving athletic performance.

Influence of Sports Biomechanics on Martial Arts Sports and Comprehensive Neuromuscular Control under the Background of Artificial Intelligence

Neuromuscular control refers to the reflexes of nerves that affect muscle balance and function. In addition, there are interactions between joint structure, muscle function, and the central nervous system. In the integration with other intelligent control methods and optimization algorithms, such as fuzzy control/expert verification and genetic algorithm, it provides nonparametric object models, optimization parameters, reasoning models, and fault diagnosis. The central nervous system is the main research object of neuromuscular control. Martial arts often cause injuries or affect the progress of martial arts because of some irregular movements. Chinese traditional martial arts is another name for “martial arts” in the late Qing Dynasty in China. It is mainly reflected in the individual's application and attainments in martial arts traditional teaching methods and personal cultivation. Therefore, this paper proposes an analysis of the influence of sports biomechanics on martial arts sports and comprehensive neuromuscular control in the context of artificial intelligence. In this paper, the specific research of Wushu sports is carried out mainly in two aspects: sports biomechanics and neuromuscular control. It uses a variety of algorithms, successively using particle swarm algorithm, neural network structure, fitness function, and so on. This paper compares and analyzes their accuracy and then selects the optimal algorithm. It then conducts experimental research on the martial arts movements of professional martial arts Sanda players. The final experimental conclusion shows that, regarding lower limb selective response time and the middle left lower limb prereaction time (L-PMT) of the elite athlete group and the ordinary athlete group, the average movement value of the elite group of 2.336 is significantly greater than that of the ordinary group of 1.938. This shows that, within a certain range, the larger the knee angle and the smaller the hip angle, the stronger the ability to buffer the impact of the ground, without causing greater damage to the muscles and joints.

The Role of Neuromuscular Control of Postural and Core Stability in Functional Movement and Athlete Performance

Balance and core stabilization exercises have often been associated with improved athlete performance and/or decreased incidence of injuries. While these exercises seem to be efficient in the prevention of injuries, there is insufficient evidence regarding their role in sport-specific performance and related functional movements. The aim of this scoping review is (1) to map the literature that investigates whether currently available variables of postural and core stability are functionally related to athlete performance in sports with high demands on body balance and spinal posture and (2) to identify gaps in the literature and suggest further research on this topic. The literature search conducted on MEDLINE, Scopus, Web of Science, PubMed, and Cochrane Library databases was completed by Google Scholar, SpringerLink, and Elsevier. Altogether 21 articles met the inclusion criteria. Findings revealed that postural stability plays an important role in performance in archery, biathlon, gymnastics, shooting, and team sports (e.g., basketball, hockey, soccer, tennis). Also core stability and strength represent an integral part of athlete performance in sports based on lifting tasks and trunk rotations. Variables of these abilities are associated with performance-related skills in cricket, cycling, running, and team sports (e.g., baseball, football, hockey, netball, soccer, tennis). Better neuromuscular control of postural and core stability contribute to more efficient functional movements specific to particular sports. Training programs incorporating general and sport-specific exercises that involve the use of postural and core muscles showed an improvement of body balance, back muscle strength, and endurance. However, there is controversy about whether the improvement in these abilities is translated into athletic performance. There is still a lack of research investigating the relationship of body balance and stability of the core with sport-specific performance. In particular, corresponding variables should be better specified in relation to functional movements in sports with high demands on postural and core stability. Identifying the relationship of passive, active, and neural mechanisms underlying balance control and spinal posture with athlete performance would provide a basis for a multifaced approach in designing training and testing tools addressing postural and core stability in athletes under sport-specific conditions.

Influence of sidestepping expertise and core stability on knee joint loading during change of direction

The aims of this study were twofold: first, to compare core stability and knee joint loading between sidestepping experts and nonexperts; secondly, to determine core predictors of knee joint loading. Thirteen handball male players (experts) and 14 karatekas (nonexperts) performed six unanticipated 45° sidestepping manoeuvers, while trunk and pelvis 3D kinematics as well as ground reaction forces were measured, and peak knee abduction moment (PKAM) was determined. Student t-tests enabled a comparison of both groups and a linear mixed model approach was used to identify PKAM predictors. Sidestepping experts demonstrated significantly lower pelvis rotation towards the new movement direction at the initial contact than nonexperts (4.9° vs. 10.8°) and higher PKAM (0.539 vs. 0.321 Nm/kg-bwt). Trunk medial lean, trunk axial rotation and pelvis anterior tilt at the initial contact predicted PKAM, while trunk axial rotation, pelvis medial lean and posterior ground reaction force predicted PKAM during the weight acceptance phase. Despite higher PKAM, handball players might not be at a higher risk of anterior cruciate ligament injury as the knee joint loading remained at a relatively low level during this sidestepping task. Core stability, in its three dimensions, is a key determinant of knee joint loading.

Recent Ankle Injury, Sport Participation Level, and Tests of Proprioception

OBJECTIVE

Assessing the effects of ankle injury and sport participation level on ankle proprioceptive sensitivity using a joint position reproduction (JPR) test and an inversion movement extent discrimination test.

DESIGN

Cross-sectional.

SETTING

Biomechanics lab.

PARTICIPANTS

Forty-five student athletes ages 21-30 (mean = 24.8 y).

MAIN OUTCOME MEASURES

Participants were tested for ankle inversion sensitivity using 2 devices; movement reproduction error was obtained from JPR in a non-weight-bearing (N-WB) state at 10° and 15° of inversion, and an ankle proprioceptive sensitivity score was obtained from the active movement extent discrimination apparatus (AMEDA), representing the ability to differentiate 5 inversion movement extents between 10.5° and 14.5°, with testing in both N-WB and weight-bearing (WB) states.

RESULTS

For the 34 athletes with no ankle injury in the previous 12 months, the sensitivity scores achieved on the AMEDA were significantly higher (P < .01) than those for the 11 athletes with ankle injury, and the injury effect was significantly greater in WB (P = .01). In JPR testing, the 2.96° error of reproduction for athletes with no recent ankle injury was not significantly different from the 3.36° error for those with ankle injury (P = .46). Correlation of current sport participation level with JPR showed less error for higher-level performers (r = .49, P = .001) but no significant relationship to WB or N-WB AMEDA scores (both P > .61). WB AMEDA scores were significantly higher for athletes who had competed at a higher level of sport competition when <18 years old (r = -.57, P < .001).

CONCLUSIONS

Previous ankle sprains affected proprioceptive scores on the WB AMEDA and N-WB AMEDA tests, indicating the sensitivity of the AMEDA movement discrimination test to the effects of ankle injury. The correlation between JPR scores and current level of sport participation suggests the sensitivity of the JPR test to current ankle use.

Isokinetic Muscle Strength and Postural Sway of Recreationally Active Older Adults vs. Master Road Runners

Trunk muscle strength and control is an important prerequisite for everyday activities among elderly people decreasing the predisposition to falls. High levels of physical exercise performed by older athletes could offer benefits to core/trunk muscle strength and postural control compared with recreational physical activities and among elderly people with lower levels of physical activity. The present study aimed to compare trunk muscle strength and postural control of older running athletes vs. older physically active adults. Participants were master road runners (RUN, n = 15, six women, 64.3 ± 3.6 years) and physically active elderly (control group, CON, n = 15, six women, 65.4 ± 5.0 years) people that were submitted to the evaluations: esthesiometer, posturography (force plate), and isokinetic test (Biodex dynamometer) of trunk muscle extension and flexion. RUN presented higher values for relative peak torque of trunk extensor muscles at 60°/s (p = 0.046) and 180°/s (p = 0.007) and relative average power during trunk extension at 60°/s (p = 0.008) and 180°/s (p = 0.004) compared to CON. CON had a higher medial-lateral oscillation speed of the center of pressure in the stable condition with eyes closed (p = 0.004) compared to RUN. RUN presented higher isokinetic torque of extensor trunk muscles and better postural control than CON. This supposedly could help with postural control and balance and contribute to the prevention of falls among the elderly. The practice of running systematically by master athletes may partially explained our findings.

Relationship Between Sport Expertise and Postural Skills

The review addresses the relationship between sport expertise (i.e., sport competition level), postural performance (amount of motion of the center of mass/of pressure of foot or ability to preserve body balance), and postural strategy (geometric organization of different body segments as well as neurobiological involvement of organism). Since the conditions of postural evaluation are likely to influence results, the aim is to compare athletes at different competition levels in ecological postural conditions (specific postural conditions related to the sport practiced) and non-ecological postural conditions (decontextualized postural conditions in relation to the sport practiced). Evidence suggests that the most successful athletes in terms of sport competition level have the best postural performance both in ecological and non-ecological postural conditions. However, in non-ecological conditions, the postural tasks should be preferentially challenging or relatively close to the sport practice stance. Moreover, the most successful athletes also have more elaborate postural strategies compared with athletes at lower competition level. Mechanistic explanations as well as conceptual models are proposed to explain the role of different factors influencing the relationship between sport expertise and postural performance and strategy.

Heritability of proprioceptive senses

Heritability studies using the twin model have provided the basis to disentangle genetic and environmental factors that contribute to several complex human traits. However, the relative importance of these factors to individual differences in proprioception is largely unknown despite the fact that proprioceptive senses are of great importance, allowing us to respond to stimuli stemming from the space around us and react to altering circumstances. Hence, a total of 44 healthy male twins (11 MZ and 11 DZ pairs), 19-28 yr old, were examined for movement, position, and force sense at the elbow joint, and their heritability estimates were computed. Results showed that genetic factors explained 1) 72 and 76% of the total variance of movement sense at the start and the end of the movement, respectively, 2) 60 to 77% of the total variance of position sense, depending on the angle of elbow flexion and whether forearm positioning was active or passive, and 3) 73 and 70% of the total variance of the force sense at 90 and 60° of elbow flexion, respectively. It is concluded that proprioception assessed by these conscious sensations is to a substantial degree genetically dependent, with heritability indexes ranging from 0.60 to 0.77, depending on the task. NEW & NOTEWORTHY Proprioceptive acuity varies among people, but it is not known how much of this variability is due to differences in their genes. This study is the first to report that proprioception, expressed as movement sense, position sense, and force sense, is substantially heritable, and it is conceivable that this may have implications for motor learning and control, neural development, and neurorehabilitation.