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Benistan K, Foy M, Gillas F, Genet F, Kane M, Barbot F, Vaugier I, Bonnyaud C, Gader N. Effects of compression garments on balance in hypermobile Ehlers-Danlos syndrome: a randomized controlled trial. Disabil Rehabil 2024; 46:1841-1850. [PMID: 37194618 DOI: 10.1080/09638288.2023.2209742] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/28/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE To evaluate the immediate and 4-week effects of compression garments (CG) on balance using a force platform during 8 different visual, static, and dynamic conditions in hypermobile Ehlers-Danlos Syndrome (hEDS) patients. METHODS Thirty-six participants were randomly assigned to a group: physiotherapy alone (PT, n = 19) or physiotherapy and daily CG wearing for 4 weeks (PT + CG, n = 17). Both attended 12 physiotherapy sessions (strengthening, proprioception, and balance exercises) for 4 weeks. Primary outcome: sway velocity of the centre of pressure (COP) measured before, immediately with the CG, and at 4 weeks. Secondary outcomes: ellipse area, Romberg quotient, and pain. RESULTS Sway velocity in dynamic conditions decreased immediately with the CG. After 4 weeks of intervention, sway velocity (95% CI 4.36-39.23, effect size 0.93) and area (95% CI 146-3274, effect size 0.45) on the laterally oscillating platform with eyes-closed improved more in the PT + CG group than the PT group. Romberg quotient on foam cushion improved more in the PT + CG than the PT group. Pain decreased in both groups after 4 weeks with no between-group difference. CONCLUSION CG combined with physiotherapy improved dynamic balance measured with COP variables significantly more than physiotherapy alone in people with hEDS. TRIAL REGISTRATION NCT03359135.
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Affiliation(s)
- Karelle Benistan
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
- UMR1179 INSERM, UFR Simone Veil-Santé, Versailles, France
| | - Malika Foy
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
| | - Fabrice Gillas
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
| | - François Genet
- UMR1179 INSERM, UFR Simone Veil-Santé, Versailles, France
- AP-HP, Hôpital Raymond-Poincaré, Service de médecine physique et de réadaptation, Université Paris Saclay, Garches, France
| | - Maimouna Kane
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Frédéric Barbot
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Isabelle Vaugier
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Céline Bonnyaud
- AP-HP, Hôpital Raymond Poincaré, Laboratoire d'analyse du mouvement, Université Paris-Saclay, Garches
- Université de Versailles Saint Quentin en Yvelines, ERPHAN, Versailles, France
| | - Nadra Gader
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
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Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. Effects of proprioception and core stability training on gait parameters of deaf adolescents: a randomized controlled trial. Sci Rep 2023; 13:21867. [PMID: 38072849 PMCID: PMC10710996 DOI: 10.1038/s41598-023-49335-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
The current study aimed to explore the effects of proprioception versus core stability training over 8 weeks on the gait parameters of deaf adolescents. A total of 20 deaf adolescents were randomized into two groups: one group receiving proprioception training (PT, n = 10), another group receiving core stability training (CST, n = 10), and eleven typically developing adolescents assigned into the control group (CON; n = 11). Gait was recorded by two digital cameras; then, using the Kinovea software, the parameters of gait included: gait velocity, cadence, stride length, stride time, stance time, and swing time were calculated in terms of percentages of the walking cycle. After 8 weeks of PT, no significant differences were observed for all gait parameters between PT and control groups (p > 0.05). Also, after 8 weeks of CST, no significant differences were observed in gait velocity and cadence between the CST and control groups (p > 0.05). However, after 8 weeks of CST, stride length (p = 0.02) was higher in the control group; Stride time (p = 0.03), stance time (p = 0.04) and swing time (p = 0.04) were higher in the CST group. Moreover, after 8 weeks of PT, values showed significant improvements in all gait parameters (p = 0.001). Also, after 8 weeks of CST, values showed significant improvements in gait velocity and cadence (p = 0.001), but no significant differences were observed in other gait parameters (p > 0.05). The findings of this study indicated that PT improved all gait parameters, whereas CST improved gait velocity and cadence. The results of the present study also demonstrated that PT had a greater effect on gait parameters of deaf adolescents compared with CST. It seems that PT induces more training effects than CTS for enhancing gait parameters of deaf adolescents.Trial registration: Clinical trial registry number: IRCT20170312033029N2. URL: https://en.irct.ir/trial/25584 .
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Affiliation(s)
- Hamed Zarei
- Corrective Exercises and Sports Injury Department, College of Physical Education & Sport Sciences, Faculty of Physical Education & Sport Sciences, University of Guilan, kilometers 10 Rasht-Ghazvin Road, Rasht, 4199613776, Iran.
| | - Ali Asghar Norasteh
- Physiotherapy Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, 4199613776, Iran
| | - Lauren J Lieberman
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, NY, 14420, USA
| | - Michael W Ertel
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
| | - Ali Brian
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
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Rizzato A, Gobbi E, Paoli A, Marcolin G. Validity and reliability of an unstable board for dynamic balance assessment in young adults. PLoS One 2023; 18:e0280057. [PMID: 36608060 PMCID: PMC9821791 DOI: 10.1371/journal.pone.0280057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/20/2022] [Indexed: 01/07/2023] Open
Abstract
Scientific literature is giving greater importance to dynamic balance in fall prevention. Recently, the validity and reliability of the most employed functional tests for dynamic balance assessment has been investigated. Although these functional tests are practical and require minimal equipment, they are inherently subjective, as most do not use instrumented measurement data in the scoring process. Therefore, this study aimed to assess the validity and reliability of an instrumented unstable board for dynamic balance objective assessment in young adults through double-leg standing trials. A test-retest design was outlined with the unstable board positioned over a force platform to collect objective Center of Pressure (CoP) related and kinematic parameters. Fifteen young adults participated in two evaluation sessions (7-day apart) that comprised ten trials per two dynamic conditions (anterior-posterior and medio-lateral oscillations) aiming to maintain the board parallel to the ground. Pearson's correlation coefficient (r) was employed to assess the validity of the kinematic parameters with those derived from the CoP. The test-retest reliability was investigated through Intraclass Correlation Coefficient (ICC), Standard Error of the measurement, Minimal Detectable Change, and Bland-Altman plots. Statistically significant correlations between the CoP and kinematic parameters were found, with r values ranging from 0.66 to 0.95. Good to excellent intrasession (0.89≤ICCs≤0.95) and intersession (0.66≤ICCs≤0.95) ICCs were found for the kinematics parameters. The Bland-Altman plots showed no significant systematic bias. The kinematics parameters derived from the unstable board resulted valid and reliable. The small size of the board makes it a suitable tool for the on-site dynamic balance assessment and a complement of computerized dynamic posturography.
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Affiliation(s)
- Alex Rizzato
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Erica Gobbi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Giuseppe Marcolin
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- * E-mail:
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4
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Siedlecki P, Shoemaker JK, Ivanova TD, Garland SJ. Cardiovascular response to postural perturbations of different intensities in healthy young adults. Physiol Rep 2022; 10:e15299. [PMID: 35531916 PMCID: PMC9082380 DOI: 10.14814/phy2.15299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 04/15/2023] Open
Abstract
The ability to regain control of balance is vital in limiting falls and injuries. Little is known regarding how the autonomic nervous system responds during recovery from balance perturbations of different intensities. The purpose of this study was to examine the cardiovascular response following a standing balance perturbation of varying intensities, quantify cardiac baroreflex sensitivity (cBRS) during standing perturbations, and to establish the stability of the cardiac baroreflex during quiet standing before and after balance disturbances. Twenty healthy participants experienced three different perturbation intensity conditions that each included 25 brief posteriorly-directed perturbations, 8-10 s apart. Three perturbation intensity conditions (low, medium, high) were given in random order. Physiological data were collected in quiet stance for 5 min before testing (Baseline) and again after the perturbation conditions (Recovery) to examine baroreflex stability. Beat-to-beat heart rate (HR) and systolic blood pressure (SBP) analysis post-perturbation indicated an immediate acceleration of the HR for 1-2 s, with elevated SBP 4-5 s post-perturbation. Heart rate changes were greatest in the medium (p = 0.035) and high (p = 0.012) intensities compared to low, while there were no intensity-dependent changes in SBP. The cBRS was not intensity-dependent (p = 0.402) but when perturbation conditions were combined, cBRS was elevated compared to Baseline (p = 0.046). The stability of baseline cBRS was excellent (ICC = 0.896) between quiet standing conditions. In summary, HR, but not SBP or cBRS were intensity-specific during postural perturbations. This was the first study to examine cardiovascular response and cBRS to postural perturbations.
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Affiliation(s)
| | | | | | - S. Jayne Garland
- Faculty of Health SciencesWestern UniversityLondonOntarioCanada
- Department of Physiology & PharmacologyWestern UniversityLondonOntarioCanada
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McCamley J, Bergamini E, Grimpampi E. Balance on different unstable supports: a complementary approach based on linear and non-linear analyses. Med Biol Eng Comput 2022; 60:863-873. [PMID: 35141819 DOI: 10.1007/s11517-022-02504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- John McCamley
- Human Motion Laboratory, MORE Foundation, 18444 N 25th Ave., Suite 110, Phoenix, AZ, 85023, USA
- Center for Research in Human Movement Variability, Department of Biomechanics, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Elena Bergamini
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Piazza Lauro de Bosis 15, 00135, Rome, Italy.
| | - Eleni Grimpampi
- Decathlon SportsLab, Movement Sciences Department, 4 Rue Professeur Langevin, 59000, Lille, France
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Lee SY, Park SY. Comparison among low intensity bridge exercises using suspension devices based on muscle activity and subjective difficulty. J Back Musculoskelet Rehabil 2022; 35:61-66. [PMID: 34334373 DOI: 10.3233/bmr-200057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recent clinical studies have revealed the advantages of using suspension devices. Although the supine, lateral, and forward leaning bridge exercises are low-intensity exercises with suspension devices, there is a lack of studies directly comparing exercise progression by measuring muscular activity and subjective difficulty. OBJECTIVE To identify how the variations in the bridge exercise affects trunk muscle activity, the present study investigated changes in neuromuscular activation during low-intensity bridge exercises. We furthermore explored whether the height of the suspension point affects muscle activation and subjective difficulty. METHODS Nineteen asymptomatic male participants were included. Three bridge exercise positions, supine bridge (SB), lateral bridge (LB), forward leaning (FL), and two exercise angles (15 and 30 degrees) were administered, thereby comparing six bridge exercise conditions with suspension devices. Surface electromyography and subjective difficulty data were collected. RESULTS The rectus abdominis activity was significantly higher with the LB and FL exercises compared with the SB exercise (p< 0.05). The erector spinae muscle activity was significantly higher with the SB and LB exercises, compared with the FL exercise (p< 0.05). The LB exercise significantly increased the internal oblique muscle activity, compared with other exercise variations (p< 0.05). The inclination angle of the exercise only affected the internal oblique muscle and subjective difficulty, which were significantly higher at 30 degrees compared with 15 degrees (p< 0.05). CONCLUSIONS Relatively higher inclination angle was not effective in overall activation of the trunk muscles; however, different bridge-type exercises could selectively activate the trunk muscles. The LB and SB exercises could be good options for stimulating the internal oblique abdominis, and the erector spinae muscle, while the FL exercise could minimize the erector spinae activity and activate the abdominal muscles.
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Affiliation(s)
- Sang-Yeol Lee
- Department of Physical Therapy, Department of Physical Therapy, College of Science, Kyungsung University, Busan, Korea
| | - Se-Yeon Park
- Department of Physical Therapy, Uiduk University, Gyeongju, Korea
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7
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Marcori AJ, Monteiro PHM, Oliveira JA, Doumas M, Teixeira LA. Single Leg Balance Training: A Systematic Review. Percept Mot Skills 2022; 129:232-252. [PMID: 35084234 DOI: 10.1177/00315125211070104] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Single leg balance training promotes significant increments in balance control, but previous reviews on balance control have not analyzed this form of balance training. Accordingly, we aimed to review the single leg balance training literature to better understand the effects of applying this training to healthy individuals. We searched five databases-PubMed, EMBASE, Scopus, Lilacs, and Scielo-with the following inclusion criteria: (a) peer-reviewed articles published in English; (b) analysis of adult participants who had no musculoskeletal injuries or diseases that might impair balance control; and (c) use of methods containing at least a pre-test, exclusive single leg balance training, and a post-test assessment. We included 13 articles meeting these criteria and found that single leg balance training protocols were effective in inducing balance control gains in either single- or multiple-session training and with or without progression of difficulty. Balance control gains were achieved with different amounts of training, ranging from a single short session of 10 minutes to multiple sessions totaling as much as 390 min of unipedal balance time. Generalization of balance gains to untrained tasks and cross-education between legs from single leg balance training were consistent across studies. We concluded that single leg balance training can be used in various contexts to improve balance performance in healthy individuals. These results extend knowledge of expected outcomes from this form of training and aid single leg balance exercise prescription regarding volume, frequency, and potential progressions.
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Affiliation(s)
- Alexandre J Marcori
- School of Physical Education and Sports, 28133University of São Paulo, São Paulo, Brazil
| | - Pedro H M Monteiro
- School of Physical Education and Sports, 28133University of São Paulo, São Paulo, Brazil
| | - Júlia A Oliveira
- School of Physical Education and Sports, 28133University of São Paulo, São Paulo, Brazil
| | - Michail Doumas
- School of Psychology, 1596Queen's University, Belfast, Northern Ireland
| | - Luis A Teixeira
- School of Physical Education and Sports, 28133University of São Paulo, São Paulo, Brazil
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UÇAR S, BAYAZIT B. Fitness Yapan Sporculara Uygulanan Power Plate ve Both Sides Up Egzersizlerinin Denge Gelişimine Etkisi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.952564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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9
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Promsri A. Modulation of bilateral lower-limb muscle coordination when performing increasingly challenging balance exercises. Neurosci Lett 2021; 767:136299. [PMID: 34699944 DOI: 10.1016/j.neulet.2021.136299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/10/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022]
Abstract
Balance exercises have proven effective in enhancing and regaining neuromuscular control. However, how the bilateral homonymous muscles are coordinated to achieve bipedal equilibrium remains unclear. In terms of increasingly difficult balance tasks, the current study focused on two levels of muscle coordination: individual homonymous muscles and groups of homonymous muscles. In 25 physically active young adults, a cross-correlation between the bilateral electromyographic (EMG) signals of both legs (i.e., bilateral EMG-EMG correlation) was conducted on seven muscles measured when performing bipedal balancing on three different support surface instabilities. Then, the patterns of bilateral EMG-EMG cross-correlation coefficients were determined through a principal component analysis (PCA). It was hypothesized that modulations of bilateral lower-limb muscle coordination should be observed in the specific relevant muscles or in the patterns of bilateral muscle coordination. The results showed that only the first hypothesis was supported as changes in the strength of bilateral EMG-EMG correlation (p ≤ 0.005) and in the time delays (p < 0.001) were mostly restricted in the lower-leg muscles. The dorsiflexor and plantar flexor muscles showed opposite coordination behaviors. Larger bilateral EMG-EMG correlation and shorter time delays appeared only in the tibialis anterior muscle, suggesting that bilateral dorsiflexor muscle coordination is needed for exercising on multiaxial-unstable platforms.
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Affiliation(s)
- Arunee Promsri
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, 19 Moo 2, Maeka, Muang, Phayao 56000, Thailand; Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria; Unit of Excellence in Well-Being and Health Innovation, School of Allied Health Sciences, University of Phayao, 19 Moo 2, Maeka, Muang, Phayao 56000, Thailand.
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10
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Bakker LBM, Nandi T, Lamoth CJC, Hortobágyi T. Task specificity and neural adaptations after balance learning in young adults. Hum Mov Sci 2021; 78:102833. [PMID: 34175684 DOI: 10.1016/j.humov.2021.102833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/11/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Lisanne B M Bakker
- University of Groningen, University Medical Center Groningen, the Netherlands,.
| | - Tulika Nandi
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Claudine J C Lamoth
- University of Groningen, University Medical Center Groningen, the Netherlands
| | - Tibor Hortobágyi
- University of Groningen, University Medical Center Groningen, the Netherlands,; Institute of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary; Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
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11
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Promsri A, Mohr M, Federolf P. Principal postural acceleration and myoelectric activity: Interrelationship and relevance for characterizing neuromuscular function in postural control. Hum Mov Sci 2021; 77:102792. [PMID: 33862279 DOI: 10.1016/j.humov.2021.102792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/15/2021] [Accepted: 04/01/2021] [Indexed: 12/19/2022]
Abstract
One approach to investigating sensorimotor control is to assess the accelerations that produce changes in the kinematic state of the system. When assessing complex whole-body movements, structuring the multi-segmental accelerations is important. A useful structuring can be achieved through a principal component analysis (PCA) performed on segment positions followed by double-differentiation to obtain "principal accelerations" (PAs). In past research PAs have proven sensitive to altered motor control strategies, however, the interrelationship between PAs and muscle activation (surface electromyography, sEMG) have never been determined. The purpose of the current study was therefore to assess the relationship between PAs and sEMG signals recorded from muscles controlling the ankle joint during one-leg standing trials. It was hypothesized that medium correlation should be observed when accounting for neurophysiologic latencies (electro-mechanical delay). Unipedal balancing on a level-rigid ground was performed by 25 volunteers. sEMG activities were recorded from the tibialis anterior, peroneus longus, gastrocnemius medialis, and soleus muscles of the stance leg. The first eight PA-time series were determined from kinematic marker data. Then, a cross-correlation analysis was performed between sEMG and PA time series. We found that peak correlation coefficients for many participants aligned at time delays between 0.116 and 0.362 s and were typically in the range small to medium (|r| = 0.1 to 0.6). Thus, the current study confirmed a direct association between many principal accelerations PA(t) and muscle activation signals recorded from four muscles crossing the ankle joint complex. The combined analysis of PA and sEMG signals allowed exploring the neuromuscular function of each muscle in different postural movement components.
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Affiliation(s)
- Arunee Promsri
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, A-6020 Innsbruck, Austria; Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, 19 Moo 2 Maeka, Muang, Phayao 56000, Thailand; Unit of Excellence in Well-Being and Health Innovation, School of Allied Health Sciences, University of Phayao, 19 Moo2 Maeka, Muang, Phayao 56000, Thailand.
| | - Maurice Mohr
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, A-6020 Innsbruck, Austria.
| | - Peter Federolf
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, A-6020 Innsbruck, Austria.
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Tsai YY, Chang GC, Hwang IS. Changes in postural strategy of the lower limb under mechanical knee constraint on an unsteady stance surface. PLoS One 2020; 15:e0242790. [PMID: 33253285 PMCID: PMC7703948 DOI: 10.1371/journal.pone.0242790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022] Open
Abstract
Joint constraint could limit the available degrees of freedom in a kinematic chain for maintaining postural stability. This study investigated adaptive changes in postural synergy due to bracing of bilateral knee joints, usually thought to have a trifling impact on upright stance. Twenty-four young adults were requested to maintain balance on a stabilometer plate as steadily as possible while wearing a pair of knee orthoses, either unlocked (the non-constraint (NC) condition) or locked to restrict knee motion (the knee constraint (KC) condition). Knee constraint led to a significant increase in the regularity of the stabilometer angular velocity. More than 95% of the variance properties of the joint angular velocities in the lower limb were explained by the first and second principal components (PC1 and PC2), which represented the ankle strategy and the combined knee and hip strategy, respectively. In addition to the increase trend in PC1 regularity, knee constraint enhanced the mutual information of the stabilometer angular velocity and PC1 (MISTBV-PC1) but reduced the mutual information of the stabilometer angular velocity and PC2 (MISTBV-PC2). The MISTBV-PC1 was also positively correlated to stance steadiness on the stabilometer in the KC condition. In summary, in the knee constraint condition, postural synergy on the stabilometer was reorganized to increase reliance on ankle strategies to maintain equilibrium. In particular, a stable stabilometer stance under knee constraint is associated with a high level of coherent ankle–stabilometer interaction.
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Affiliation(s)
- Yi-Ying Tsai
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Gwo-Ching Chang
- Department of information Engineering, I-Shou University, Kaohsiung City, Taiwan
| | - Ing-Shiou Hwang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- * E-mail:
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13
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Chang YS, Arefin MS, You YL, Kuo LC, Su FC, Wu HW, Lin CF. Effect of Novel Remodeled Bicycle Pedal Training on Balance Performance in Athletes With Functional Ankle Instability. Front Bioeng Biotechnol 2020; 8:600187. [PMID: 33195176 PMCID: PMC7642596 DOI: 10.3389/fbioe.2020.600187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 09/30/2020] [Indexed: 12/26/2022] Open
Abstract
Context Appropriate training without risk of injury is a critical concern for athletes. Remodeled bicycle pedal training with multi-directional challenges may be effective in improving the balance performance of athletes with functional ankle instability (FAI). Objective To evaluate the effects of 6-week modified bicycle pedal training on the balance ability and proprioception of athletes with FAI. Design Randomized controlled trial. Setting University motion analysis laboratory. Participants Fourteen healthy athletes (healthy group) and twenty-six athletes with FAI and an age of 18 to 30 years old. The participants with FAI were randomly distributed to two groups, designated as the training group (AI-T group) and non-training group (AI-NT group), respectively. The athletes in the AI-T group received 6-week remodeled bicycle pedal training, while those in the AI-NT group received no intervention at all. Intervention A 6-week training using modified bicycle pedal capable of moving freely during loading cycle vs no intervention. Main Outcome Measures The passive ankle joint position sense (JPS) in four angles and the center of pressure (COP) parameters were analyzed during single-leg standing with and without vision, respectively. Results A 6-week remodeled pedal training: (1) significantly improved the passive JPS of ankle in all directions (P < 0.05); (2) reduced the excursion of the COP in the medial-lateral (ML) direction (p < 0.05), the velocity of the COP in the ML direction (p < 0.05), and the RMS of the COP in the ML direction (P < 0.05) during single-leg standing both with and without vision. Conclusion The remodeled bicycle pedal training improved the passive JPS and reduced the postural sway in single-leg standing both with and without vision. Therefore, remodeled bicycle pedal training can be considered for inclusion in rehabilitation programs for athletes with FAI to restore the proprioception and balance ability.
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Affiliation(s)
- Yi-Shuo Chang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Md Samsul Arefin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Lin You
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Hong-Wen Wu
- Department of Physical Education, National Taiwan University of Sport, Taichung, Taiwan
| | - Cheng-Feng Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
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14
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Fusco A, Fuchs PX, De Maio M, Wagner H, Cortis C. A novel approach to measuring wobble board performance in individuals with chronic ankle instability. Heliyon 2020; 6:e04937. [PMID: 32984618 PMCID: PMC7498757 DOI: 10.1016/j.heliyon.2020.e04937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/28/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022] Open
Abstract
Computerized wobble boards (WB) are used to objectively assess balance in healthy and chronic ankle instability individuals. As in field setting health professionals might not own WB, objective evaluations are not always feasible. Therefore, the aim of this tudy was to investigate the contribution of sagittal plane joints angular-displacement and anthropometrics to predict equations to estimate WB performance by portable two-dimensional motion analysis (2D-MA) and cross-validate the developed equations in chronic ankle instability individuals. Thirty-nine healthy and twenty chronic ankle instability individuals stood on a WB in single stance position. The balance test consisted of three 30s trials per limb keeping the platform flat at 0°. Trials were video recorded, and three time-segments joints angular-displacement analyzed with 2D-MA: segment 1 (T1) including 30s data, segment 2 (T2) from second 0 to 10, segment 3 (T3) only the first 5s. Mixed regression for multilevel models was used to estimate WB performance for each time-segment and to examine limb differences for the predicted WB performance in chronic ankle instability sample. The accuracy of the equations to detect injured limbs was calculated via area under the curve for receiver operating characteristic. Ankle and knee angular-displacement parameters, body height and lower limb length were the major predictors of WB performance for the extrapolated models (p < 0.05; R2 = 0.83-0.56). The measured WB performance and T1 model showed significant (p < 0.05) performance differences between the injured and uninjured limbs. Receiver operating characteristic analysis showed an asymptotic significance of 0.03 for T1 equation with area under the curve of 0.70. The proposed models provide different methods to quantify the performance and accurately detect the injured limb in individuals with unilateral chronic ankle instability, when measuring balance via WB might not be feasible. App-makers may use the equations to provide an automatic all-in-one system to monitor the performance status and progress.
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Affiliation(s)
- Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
- Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49, A-5400 Hallein (Rif), Salzburg, Austria
| | - Philip X. Fuchs
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
- Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49, A-5400 Hallein (Rif), Salzburg, Austria
| | - Marianna De Maio
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
| | - Herbert Wagner
- Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49, A-5400 Hallein (Rif), Salzburg, Austria
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
- Corresponding author.
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15
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Schedler S, Brueckner D, Kiss R, Muehlbauer T. Effect of practice on learning to maintain balance under dynamic conditions in children: are there sex differences? BMC Sports Sci Med Rehabil 2020; 12:15. [PMID: 32166038 PMCID: PMC7059683 DOI: 10.1186/s13102-020-00166-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/24/2020] [Indexed: 11/15/2022]
Abstract
Background In youth, sex-related differences in balance performances have been reported with girls usually outperforming same-aged boys. However, it is not known whether sex also has an influence on learning of a new balance task in primary school-aged children. Therefore, the present study investigated sex-related differences in children learning to maintain balance under dynamic conditions. Methods Thirty-two children (16 girls, 16 boys) aged 8.5 ± 0.5 years practiced balancing on a stabilometer (i.e., to keep it as horizontal as possible) for seven trials (90 s each) on two consecutive days. Knowledge of results (KR) (i.e., time in balance) was provided after each trial. On day three learning was assessed using a retention test (i.e., balance task only) and a test of automation (i.e., balance plus concurrent motor interference task). Root-mean-square-error (RMSE) was recorded for all trials and used for further analysis. Results During practicing (Day 1, Day 2) RMSE values significantly decreased over the days (p = 0.019, d = 0.92) and trials (p = 0.003, d = 0.70) in boys and girls. Further, the main effect of sex showed a tendency toward significance (p = 0.082, d = 0.67). On day 3, the girls showed significantly smaller RMSE values compared to boys in the retention (p = 0.012, d = 1.00) and transfer test (p = 0.045, d = 0.74). Conclusions Performance increases during the acquisition phase tended to be larger in girls than in boys. Further, learning (i.e., retention and automation) was significantly larger in girls compared to boys. Therefore, practitioners (e.g., teachers, coaches) should supply boys and grils with balance exercises of various task difficulties and complexities to address their diverse learning progress.
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Affiliation(s)
- Simon Schedler
- 1Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
| | - Dennis Brueckner
- 1Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
| | - Rainer Kiss
- Department of Health and Social Affairs, FHM Bielefeld - University of Applied Sciences, Bielefeld, Germany
| | - Thomas Muehlbauer
- 1Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
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16
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Promsri A, Haid T, Federolf P. Complexity, Composition, and Control of Bipedal Balancing Movements as the Postural Control System Adapts to Unstable Support Surfaces or Altered Feet Positions. Neuroscience 2020; 430:113-124. [DOI: 10.1016/j.neuroscience.2020.01.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/14/2020] [Accepted: 01/19/2020] [Indexed: 10/25/2022]
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17
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Tuning of Standing Postural Responses to Instability and Cost Function. Neuroscience 2020; 428:100-110. [PMID: 31917343 DOI: 10.1016/j.neuroscience.2019.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/23/2019] [Accepted: 12/27/2019] [Indexed: 11/20/2022]
Abstract
Whole-body movements are performed daily, and humans must constantly take into account the inherent instability of a standing posture. At times these movements may be performed in risky environments and when facing different costs of failure. The aim of the study was to test the hypothesis that in upright stance participants continuously estimate both probability of failure and cost of failure such that their postural responses will be based on these estimates. We designed a snowboard riding simulation experiment where participants were asked to control the position of a moving snowboard within a snow track in a risky environment. Cost functions were provided by modifying the penalty of riding in the area adjacent to the snow track. Uncertainty was modified by changing the gain of postural responses while participants were standing on a rocker board. We demonstrated that participants continually evaluated the environmental cost function and compensated for additional risk with feedback-based postural changes, even when probability of failure was negligible. Results showed also that the participants' estimates of the probability of failure accounted for their own inherent instability. Moreover, participants showed a tendency to overweight large probabilities of failure with more biomechanically constrained standing postures that results in suboptimal estimates of risky environments. Overall, our results suggest that participants tune their standing postural responses by empirically estimating the cost of failure and the uncertainty level in order to minimize the risk of falling when cost is high.
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18
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Madhuranga PVH, Mathangasinghe Y, Anthony DJ. Improving balance with wobble board exercises in stroke patients: single-blind, randomized clinical trial. Top Stroke Rehabil 2019; 26:595-601. [PMID: 31348727 DOI: 10.1080/10749357.2019.1645439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: A primary objective in stroke rehabilitation is to restore functional balance, in order to reduce falls.Objectives: To identify the efficacy and safety of wobble board exercises when combined with conventional physiotherapy, in improving balance in hemiplegic patients following ischemic strokes.Methods: A block-randomized, controlled, observer blinded, superiority trial was conducted on ambulatory hemiplegic patients following ischemic strokes of middle cerebral artery territory. Subjects in the control group received a conventional physiotherapy regime. Subjects in the intervention group received training on a wobble board combined with conventional physiotherapy. Main Outcome measures were the improvement of Four-Square Step Test (FSST) and the Berg Balance Scale (BBS), both of which assess functional balance at the end of 6 weeks.Results: Thirty patients were randomly assigned for intervention (n = 15) and control (n = 15) groups. One patient dropped out from the study, leaving 29 eligible for the analysis. Intervention and control groups were comparable in sociodemographic characteristics and pre-test scores of balance. A repeated-measures MANOVA showed a significant difference in improvement of balance between the two study groups after 6 weeks [F(1,28) = 32.6,p = .000; Wilk's lambda = .46]. The improvement of mean score of balance in interventional group was greater than in the control group [BBS:9.5 (intervention group),5.5 (control group); FSST:3.9 (intervention group),1.7 (control group)]. There were no injuries in both groups.Conclusions: Wobble board exercises, when combined with the conventional physiotherapy, are safe and effective in restoring functional balance in patients with hemiplegia following ischemic strokes.
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Affiliation(s)
| | - Yasith Mathangasinghe
- Department of Anatomy, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Dimonge Joseph Anthony
- Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Department of Anatomy, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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19
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Brueckner D, Göpfert B, Kiss R, Muehlbauer T. Effects of motor practice on learning a dynamic balance task in healthy young adults: A wavelet-based time-frequency analysis. Gait Posture 2019; 70:264-269. [PMID: 30909006 DOI: 10.1016/j.gaitpost.2019.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/06/2019] [Accepted: 03/20/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous research showed changes in amplitude- or time-derived measures of electromyographic (EMG) activity with motor learning. However, an analysis of the EMG spectral content (e.g., via wavelet technique) has not been included in these investigations yet. OBJECTIVE The aim of this study was to use conventional, amplitude-derived EMG parameters along with modern, wavelet-based time-frequency EMG measures to assess the effects of motor practice on learning a dynamic balance task. METHODS Nineteen young male adults (mean age: 26 ± 6 years) practiced a dynamic balance task for two days. Delayed retention test was performed on the third day. On a behavioral level, the root-mean-square error (RMSE) of the stability platform angle was calculated and used as outcome measure. On a neuromuscular level, EMG data from the tibialis anterior (TA) and the gastrocnemius medialis (GM) muscle were unilaterally recorded and analysed by calculating the integrated EMG (iEMG) and the EMG intensity (via continuous wavelet transforms). RESULTS Two days of practice resulted in significantly improved balance performance (i.e., lower RMSE) and TA/GM activation (i.e., reduced iEMG and EMG intensity) that was still present during the retention test on day 3. There was also evidence of practice-related changes in the EMG intensity pattern as indicated by an intensity shift from higher to lower frequency components. CONCLUSIONS We conclude that motor practice leads to improvements in movement effectiveness as indicated by reduced RMSE and in movement efficiency (i.e., decreased iEMG and EMG intensity, intensity shift). In addition to conventional amplitude-derived EMG parameters, modern, wavelet-based time-frequency EMG measures are appropriate to detect practice-related changes in muscle activation.
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Affiliation(s)
- Dennis Brueckner
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
| | - Beat Göpfert
- Center of Biomechanics and Biocalorimetry, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Rainer Kiss
- Department of Health and Social Affairs, FHM Bielefeld - University of Applied Sciences, Bielefeld, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany.
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