Effects of 4-week slackline training on lower limb joint motion and muscle activation

Influence of oral motor tasks on postural muscle activity during dynamic reactive balance

BACKGROUND

Jaw clenching improves dynamic reactive balance on an oscillating platform during forward acceleration and is associated with decreased mean sway speed of different body regions.

OBJECTIVE

It is suggested that jaw clenching as a concurrent muscle activity facilitates human motor excitability, increasing the neural drive to distal muscles. The underlying mechanism behind this phenomenon was studied based on leg and trunk muscle activity (iEMG) and co-contraction ratio (CCR).

METHODS

Forty-eight physically active and healthy adults were assigned to three groups, performing three oral motor tasks (jaw clenching, tongue pressing against the palate or habitual lower jaw position) during a dynamic one-legged stance reactive balance task on an oscillating platform. The iEMG and CCR of posture-relevant muscles and muscle pairs were analysed during platform forward acceleration.

RESULTS

Tongue pressing caused an adjustment of co-contraction patterns of distal muscle groups based on changes in biomechanical coupling between the head and trunk during static balancing at the beginning of the experiment. Neither iEMG nor CCR measurement helped detect a general neuromuscular effect of jaw clenching on the dynamic reactive balance.

CONCLUSION

The findings might indicate the existence of robust fixed patterns of rapid postural responses during the important initial phases of balance recovery.

Slackline training for Paralympic alpine sit skiers: Development of human-device multi-joint coordination

PURPOSE

Para-alpine sit skiers face unique challenges in balance control due to their disabilities and the use of sit skis. This study assessed their multi-joint coordination before and after slackline training.

METHODS

Nine alpine sit skiers (6 M/3 F; 27 ± 8 years; height: 168.3 ± 6.0 cm; body mass: 55.4 ± 6.9 kg) with different disabilities (LW10-LW12) volunteered for the experiment. All subjects performed slackline training for 5 weeks (20 sessions). Joint kinematics were captured by vision-based markerless motion analysis. Root mean square (RMS) amplitude, mean velocity and mean power frequency (MPF) were evaluated.

RESULTS

After training, performance improved significantly with an increase in balance time (1041%, p = 0.002), and a decrease in joint angular velocities and RMS amplitude of the sit ski foot (p < 0.05). Joint synergies were developed through in- or anti-phase movements between joint pairs, particularly involving the hip joints (continuous relative phase angles ~0° or 180°, p < 0.001). Multi-joint coordination shifted from large-RMS amplitude of elbows to low-MPF large-RMS amplitude of the hip and shoulders (p < 0.05), with a significant increase of hip weighting (77.61%, p = 0.031) in the principal component analysis. The coordination was maintained with the change of slackline tension (p < 0.05). Athletes with severe trunk disabilities (LW10) had shorter balance time and poorer coordination than athletes with full trunk functions (LW12).

CONCLUSIONS

Our findings showed the development of joint coordination involving better control of the hip and sit skis during the challenging slackline training task.

Effects of jaw clenching on dynamic reactive balance task performance after 1-week of jaw clenching training

Introduction

Good balance is essential for human daily life as it may help to improve the quality of life and reduce the risk of falls and associated injuries. The influence of jaw clenching on balance control has been shown under static and dynamic conditions. Nevertheless, it has not yet been investigated whether the effects are mainly associated with the dual-task situation or are caused by jaw clenching itself. Therefore, this study investigated the effects of jaw clenching on dynamic reactive balance task performance prior to and after 1 week of jaw clenching training. It was hypothesized that jaw clenching has stabilizing effects resulting in a better dynamic reactive balance performance, and these effects are not related to dual-task benefits.

Methods

A total of 48 physically active and healthy adults (20 women and 28 men) were distributed into three groups, one habitual control group (HAB) and two jaw clenching groups (JAW and INT) that had to clench their jaws during the balance tasks at T1 and T2. One of those two groups, the INT group, additionally practiced the jaw clenching task for 1 week, making it familiar and implicit at T2. The HAB group did not receive any instruction regarding jaw clenching condition. Dynamic reactive balance was assessed using an oscillating platform perturbed in one of four directions in a randomized order. Kinematic and electromyographic (EMG) data were collected using a 3D motion capture system and a wireless EMG system, respectively. Dynamic reactive balance was operationalized by the damping ratio. Furthermore, the range of motion of the center of mass (CoM) in perturbation direction (RoM_{CoM_AP} or RoM_{CoM_ML}), as well as the velocity of CoM (V_CoM) in 3D, were analyzed. The mean activity of the muscles relevant to the perturbation direction was calculated to investigate reflex activities.

Results

The results revealed that jaw clenching had no significant effects on dynamic reactive balance performance or CoM kinematics in any of these three groups, and the automation of jaw clenching in the INT group did not result in a significant change either. However, high learning effects, as revealed by the higher damping ratio values and lower V_CoM at T2, were detected for the dynamic reactive balance task even without any deliberate balance training in the intervention phase. In the case of backward perturbation of the platform, the soleus activity in a short latency response phase increased for the JAW group, whereas it decreased for HAB and INT after the intervention. In the case of forward acceleration of the platform, JAW and INT showed a higher tibialis anterior muscle activity level in the medium latency response phase compared to HAB at T1.

Discussion

Based on these findings, it can be suggested that jaw clenching may lead to some changes in reflex activities. However, the effects are limited to anterior-posterior perturbations of the platform. Nevertheless, high learning effects may have overall overweighed the effects related to jaw clenching. Further studies with balance tasks leading to less learning effects are needed to understand the altered adaptations to a dynamic reactive balance task related to simultaneous jaw clenching. Analysis of muscle coordination (e.g., muscle synergies), instead of individual muscles, as well as other experimental designs in which the information from other sources are reduced (e.g., closed eyes), may also help to reveal jaw clenching effects.

Effects of stochastic resonance whole-body vibration on sensorimotor function in elderly individuals-A systematic review

Introduction

Due to demographic changes, falls are increasingly becoming a focus of health care. It is known that within six months after a fall, two thirds of fallers will fall again. Therefore, therapeutic procedures to improve balance that are simple and can be performed in a short time are needed. Stochastic resonance whole-body vibration (SR-WBV) may be such a procedure.

Method

An electronic search to assess the effectiveness of SR-WBV on balance in the elderly was conducted using databases that included CINAHL Cochrane, PEDro, and PubMed. Included studies were assessed using the Collaboration Risk of Bias Tool by two independent reviewers.

Results

Nine studies showing moderate methodological quality were included. Treatment parameters were heterogeneous. Vibration frequency ranged from 1 to 12 Hz. Six studies found statistically significant improvements of balance from baseline to post measurement after SR-WBV interventions. One article found clinical relevance of the improvement in total time of the "Expanded Time to Get Up and Go Test".

Discussion

Physiological adaptations after balance training are specific and may explain some of the observed heterogeneity. Two out of nine studies assessed reactive balance and both indicated statistically significant improvements after SR-WBV. Therefore, SR-WBV represents a reactive balance training.

Effects of acute slackline exercise on executive function in college students

Background

Physical exercise as an intervention for improving cognitive function, especially executive function, is receiving increasing attention because it is easily accessible, cost-effective and promises many additional health-related benefits. While previous studies focused on aerobic exercise and resistance exercise, recent findings have suggested that exercise with high coordination demand elicits beneficial effects on executive function. We therefore examined the effects of an acute slackline exercise on the executive functions of young adults.

Methods

In a crossover experimental design, 47 healthy participants (21 females), ranging in age from 18 to 27 years (M = 19.17, SD = 1.94) were randomly assigned to different sequences of two conditions (slackline exercise and film-watching). Before and after the 50 min intervention, a modified Simon task was used to assess participants' executive function (inhibitory control and cognitive flexibility).

Results

College students showed better inhibitory control performance as indicated by shorter reaction times following acute slackline exercise than those who participated in the film-watching session. As there was no difference in accuracy between the slackline exercise and film-watching sessions, the shortened reaction time after slackline exercise provides evidence against a simple speed-accuracy trade-off.

Conclusion

Compared with film-watching, acute slackline exercise provides favorable effects on executive function necessitating inhibition in young adults. These findings provide insight into exercise prescription and cognition, and further evidence for the beneficial effects of coordination exercise on executive functions.

Task-Related Hemodynamic Response Alterations During Slacklining: An fNIRS Study in Advanced Slackliners

The ability to maintain balance is based on various processes of motor control in complex neural networks of subcortical and cortical brain structures. However, knowledge on brain processing during the execution of whole-body balance tasks is still limited. In the present study, we investigated brain activity during slacklining, a task with a high demand on balance capabilities, which is frequently used as supplementary training in various sports disciplines as well as for lower extremity prevention and rehabilitation purposes in clinical settings. We assessed hemodynamic response alterations in sensorimotor brain areas using functional near-infrared spectroscopy (fNIRS) during standing (ST) and walking (WA) on a slackline in 16 advanced slackliners. We expected to observe task-related differences between both conditions as well as associations between cortical activity and slacklining experience. While our results revealed hemodynamic response alterations in sensorimotor brain regions such as primary motor cortex (M1), premotor cortex (PMC), and supplementary motor cortex (SMA) during both conditions, we did not observe differential effects between ST and WA nor associations between cortical activity and slacklining experience. In summary, these findings provide novel insights into brain processing during a whole-body balance task and its relation to balance expertise. As maintaining balance is considered an important prerequisite in daily life and crucial in the context of prevention and rehabilitation, future studies should extend these findings by quantifying brain processing during task execution on a whole-brain level.

Slackline Training in Children with Spastic Cerebral Palsy: A Randomized Clinical Trial

Objective: To assess whether a slackline intervention program improves postural control in children/adolescents with spastic cerebral palsy (CP). Design: Randomized controlled trial. Setting: Patients’ association. Participants: Twenty-seven children/adolescents with spastic CP (9–16 years) were randomly assigned to a slackline intervention (n = 14, 13 ± 3 years) or control group (n = 13, 12 ± 2 years). Intervention: Three slackline sessions per week (30 min/session) for 6 weeks. Main outcome measures: The primary outcome was static posturography (center of pressure—CoP—parameters). The secondary outcomes were surface myoelectrical activity of the lower-limb muscles during the posturography test and jump performance (countermovement jump test and Abalakov test). Overall (RPE, >6–20 scale) rating of perceived exertion was recorded at the end of each intervention session. Results: The intervention was perceived as “very light” (RPE = 7.6 ± 0.6). The intervention yielded significant benefits on static posturography (a significant group by time interaction on Xspeed, p = 0.006) and jump performance (a significant group by time interaction on Abalakov test, p = 0.015). Conclusions: Slackline training improved static postural control and motor skills and was perceived as non-fatiguing in children/adolescents with spastic CP.

Exercise and Osteoarthritis

Osteoarthritis (OA) is a degenerative disease of the articular cartilage with subchondral bone lesions. Osteoarthritis etiologies are mainly related to age, obesity, strain, trauma, joint congenital anomalies, joint deformities, and other factors. Osteoarthritis seriously affects the quality of life; however, there is no effective way to cure osteoarthritis. Aerobic exercise refers to a dynamic rhythmic exercise involving the large muscle groups of the body with aerobic metabolism. More and more evidence shows that exercise has become a useful tool for the treatment of osteoarthritis. This chapter will discuss the role of exercise in the prevention and treatment of osteoarthritis.

Effects of Slackline Training on Acceleration, Agility, Jump Performance and Postural Control in Youth Soccer Players

The goal of this study was to assess the effects of a supervised slackline training program in a group of soccer players. Thirty-four male division I under-19 players (16.64 ± 0.81 years) agreed to participate in the study. They were randomly divided into an experimental group (EG) and a control group (CG). The first group (EG) followed a 6-week supervised slackline training program (3 sessions/week; 5-9 min/session), while the CG performed only regular soccer training. Several variables were assessed in all participants: acceleration (20-m sprint test), agility (90º turns test), jump performance (squat jump, countermovement jump), and postural control (Center of Pressure ( CoP) testing: length, area, speed, Xmean, Ymean, Xspeed, Yspeed, Xdeviation, Ydeviation). Ratings of perceived exertion and local muscle ratings of perceived exertions were also recorded after each slackline training session. At post-tests, there was a significant increase only in the EG in acceleration, agility, squat jump and countermovement jump performance, as well as several CoP variables: area in the bipedal support on a firm surface, and length, area and speed in the left leg on a firm surface. The program was rated as “somewhat hard” by the players, while quadriceps, gastrocnemius and tibialis anterior were the most exerted muscles while slacklining. In conclusion, slackline training can be an effective training tool for young, high-level soccer players.

Three months of slackline training elicit only task-specific improvements in balance performance

Slackline training is a challenging and motivating type of balance training, with potential usefulness for fall prevention and balance rehabilitation. However, short-term slackline training seems to elicit mostly task-specific performance improvements, reducing its potential for general fall prevention programs. It was tested whether a longer duration slackline training (three months, 2 sessions per week) would induce a transfer to untrained tasks. Balance performance was tested pre and post slackline training on the slackline used during the training, on a slackline with different slack, and in 5 different non-trained static and dynamic balance tasks (N training = 12, N control = 14). After the training, the training group increased their performance more than the control group in both of the slackline tasks, i.e. walking on the slackline (time × group interaction with p < 0.001 for both tasks). However, no differences between groups were found for the 5 non-trained balance tasks, only a main effect of time for four of them. The long-term slackline training elicited large task-specific performance improvements but no transfer to other non-trained balance tasks. The extensive slackline training that clearly enhanced slackline performance did not improve the capability to keep balance in other tasks and thus cannot be recommended as a general fall prevention program. The significant test-retest effect seen in most of the tested tasks emphasizes the need of a control group to adequately interpret changes in performance following balance training.

Short-term slackline training improves task-specific but not general balance in female handball players

Slackline training has been shown to improve balance and neuromuscular performance. However, recent studies suggested that balance is task-specific, implying that transferability of balance skills is limited and might depend on the similarity of the tasks. This study therefore investigated if short-term slackline training could improve performance in balance tasks that are either more or less similar to the trained slackline task. Furthermore, we assessed potential transfer effects to other neuromuscular performance tests. 25 female handball players (23.7 ± 3.9 years) participated in our study and were matched to either a slackline training (SLT; n = 14) or a control group (CON; n = 11). The intervention comprised 12 sessions with overall 120 minutes of slackline training using single and double slacklines. Slackline standing time and measures of dynamic and static balance were assessed before and after the intervention, as well as power and sprint-related performance parameters. Two-way repeated-measures ANOVA found a significant group × time interaction for slackline standing time, indicating larger training effects for SLT. For the remaining dynamic and static balance tests, no significant interactions were found. With regard to neuromuscular performance, there was a significant group × time interaction only in change of direction. In essence, the study showed that slackline training induced task-specific balance improvements without affecting general balance. This adds further evidence to the task-specificity principle of balance, although the specificity of the sample as well as the briefness of the intervention should be taken into account when generalizing our findings. Nonetheless, this study contains practical implications for team sports interventions and future balance training studies, highlighting the importance of selecting appropriate balance exercises to yield rapid and the desired training outcomes.

Neuromuscular and Kinematic Adaptation in Response to Reactive Balance Training - a Randomized Controlled Study Regarding Fall Prevention

Slips and stumbles are main causes of falls and result in serious injuries. Balance training is widely applied for preventing falls across the lifespan. Subdivided into two main intervention types, biomechanical characteristics differ amongst balance interventions tailored to counteract falls: conventional balance training (CBT) referring to a balance task with a static ledger pivoting around the ankle joint versus reactive balance training (RBT) using externally applied perturbations to deteriorate body equilibrium. This study aimed to evaluate the efficacy of reactive, slip-simulating RBT compared to CBT in regard to fall prevention and to detect neuromuscular and kinematic dependencies. In a randomized controlled trial, 38 participants were randomly allocated either to CBT or RBT. To simulate stumbling scenarios, postural responses were assessed to posterior translations in gait and stance perturbation before and after 4 weeks of training. Surface electromyography during short- (SLR), medium- (MLR), and long-latency response of shank and thigh muscles as well as ankle, knee, and hip joint kinematics (amplitudes and velocities) were recorded. Both training modalities revealed reduced angular velocity in the ankle joint (P < 0.05) accompanied by increased shank muscle activity in SLR (P < 0.05) during marching in place perturbation. During stance perturbation and marching in place perturbation, hip angular velocity was decreased after RBT (P from TTEST, P_t < 0.05) accompanied by enhanced thigh muscle activity (SLR, MLR) after both trainings (P < 0.05). Effect sizes were larger for the RBT-group during stance perturbation. Thus, both interventions revealed modified stabilization strategies for reactive balance recovery after surface translations. Characterized by enhanced reflex activity in the leg muscles antagonizing the surface translations, balance training is associated with improved neuromuscular timing and accuracy being relevant for postural control. This may result in more efficient segmental stabilization during fall risk situations, independent of the intervention modality. More pronounced modulations and higher effect sizes after RBT in stance perturbation point toward specificity of training adaptations, with an emphasis on the proximal body segment for RBT. Outcomes underline the benefits of balance training with a clear distinction between RBT and CBT being relevant for training application over the lifespan.

Adapted Utilitarian Judo: The Adaptation of a Traditional Martial Art as a Program for the Improvement of the Quality of Life in Older Adult Populations

This article reports on the Adapted Utilitarian Judo project. The use of the foundations and technical elements of traditional Judo, adapted and contextualised to the requirements of the older adult population, orienting the activity toward the field of health and the improvement of the quality of life of the older adult. Its mission is to facilitate maintaining and improving the functionality and autonomy of this population, with respect to the performance of the basic and instrumental activities of daily life. At the same it seeks to achieve this while maintaining the essence of the values that are inherent to the practice of Judo as a traditional martial art. It is argued that Judo, once adapted to focus on a utilitarian function, not only allows to actively influence aspects such as maintaining the physical qualities of the elderly but also fosters other key elements for active and healthy ageing by participating in an ongoing group activity, such as socialisation and self-esteem. More specifically, the paper presents how adapted Judo represents an innovation in the treatment of a risk factor associated with aging: the active prevention of falls. We conclude that Adapted Utilitarian Judo (JUA) is both a timely and relevant as a social and educational tool of great value, responds to propos called for by the international scientific community for programs aimed at improving the health and quality of life of the older adult population, especially in Europe, that is ageing at a fast pace.

Effects of traditional balance and slackline training on physical performance and perceived enjoyment in young soccer players

The aim of this study was to evaluate the effects of 12-week balance and slackline training programs on physical performance and perceived enjoyment scale in young soccer players. Forty-one preadolescent soccer players were assigned to two experimental groups performing traditional balance (BLT) or slackline training (SLT), and a control group. Pre-post assessment encompassed Balance Error Scoring System (BESS), Star Excursion Balance test (SEBT), sprint with 90° turns (S90), and countermovement jump (CMJ). The rate of perceived enjoyment scale (PACES) was applied at the end of the experimental period. SLT and BLT improved similarly in BESS, SEBT and S90. No changes were detected in the CMJ. Regarding PACES score, SLT presented significantly higher values than BLT. Young athletes may benefit from a motivating training approach, thus, a designed program based on slackline drills should be preferable to improve physical performance in terms of balance and change of direction ability in preadolescent soccer players.

Learning to balance on a slackline: Development of coordinated multi-joint synergies

Previous research has investigated synergies involved in locomotion and balance reactions; however, there is limited insight into the emergence of skilled balance control with practice of challenging tasks. We explored motor learning of tandem and single leg stance on an unstable surface-a slackline. Balance was tested in 10 naïve healthy adults at four time points: baseline, after one slackline practice session, after 1 week of practice, and 1 week following the final practice session. We recorded kinematics of the upper and lower arms bilaterally, trunk, and thigh and foot unilaterally while participants balanced in tandem and single leg stance on a slackline and narrow rigid beam (transfer task). When participants first attempted to stand on the slackline, they exhibited fast and frequent movements across all joints with actions along the frontal plane (particularly the hip) and fell after a short period (~3 seconds). Performance improved rapidly (fewer falls), and this was accompanied by dampened trunk and foot oscillations and the development of coordinated movement patterns with a progressive emphasis on more distal upper body segments. Continuous relative phase angles between joint pairs began to cluster around either 0° (indicating in-phase movement) or 180° (indicating anti-phase movement). Participants also began to demonstrate coordinated upper body synergies and performance improvements (fewer falls) on the transfer task, while a control group (n = 10) did not exhibit similar synergies or performance improvements. Our findings describe the emergence of coordinated movement synergies involving the upper body as healthy adults learn a challenging balance task.

Devices and tasks involved in the objective assessment of standing dynamic balancing - A systematic literature review

BACKGROUND

Static balancing assessment is often complemented with dynamic balancing tasks. Numerous dynamic balancing assessment methods have been developed in recent decades with their corresponding balancing devices and tasks.

OBJECTIVE

The aim of this systematic literature review is to identify and categorize existing objective methods of standing dynamic balancing ability assessment with an emphasis on the balancing devices and tasks being used.

DATA SOURCES

Three major scientific literature databases (Science Direct, Web of Science, PLoS ONE) and additional sources were used.

STUDY SELECTION

Studies had to use a dynamic balancing device and a task described in detail. Evaluation had to be based on objectively measureable parameters. Functional tests without instrumentation evaluated exclusively by a clinician were excluded. A total of 63 articles were included.

DATA EXTRACTION

The data extracted during full-text assessment were: author and date; the balancing device with the balancing task and the measured parameters; the health conditions, size, age and sex of participant groups; and follow-up measurements.

DATA SYNTHESIS

A variety of dynamic balancing assessment devices were identified and categorized as 1) Solid ground, 2) Balance board, 3) Rotating platform, 4) Horizontal translational platform, 5) Treadmill, 6) Computerized Dynamic Posturography, and 7) Other devices. The group discrimination ability of the methods was explored and the conclusions of the studies were briefly summarized.

LIMITATIONS

Due to the wide scope of this search, it provides an overview of balancing devices and do not represent the state-of-the-art of any single method.

CONCLUSIONS

The identified dynamic balancing assessment methods are offered as a catalogue of candidate methods to complement static assessments used in studies involving postural control.

Could Slackline Training Complement the FIFA 11+ Programme Regarding Training of Neuromuscular Control?

The current study compared changes in neuromuscular control between slackline training and the stabilization training elements of the FIFA 11+ programme. Twenty-five students in 2 groups performed a 12-unit training programme. The slackline training group (n = 13) exclusively trained with a slackline. The stabilization training group (n = 12) practised exercises as described in the second part of the FIFA 11+ programme. Improvements in balance were assessed using three tests for dynamic, quasi-static, and perturbed postural control: the star excursion balance test (SEBT), the closed-eye single-leg stance, and the MFT S3-Check. Both groups significantly improved the stability and sensorimotor index of the MFT S3-Check (p < .001), their range on the SEBT (p < .001), and the duration of closed-eye single-leg stance (p < .001). The group × training interaction was significant for the MFT S3-Check (stability index: p = .042; sensorimotor index: p = .004) and the SEBT (dominant leg: p = .003; averaged both legs: p = .016), with the slackline training group showing a larger training effect than the stabilization training group. The results of the present study suggest that slackline training offers similar - or better - improvements in neuromuscular control as the FIFA 11+ warm-up programme. If compliance with the FIFA 11+ programme is declining, then slacklining might offer an alternative approach to reach the training goals of improved sensorimotor control.

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.

Slacklining and stroke: A rehabilitation case study considering balance and lower limb weakness

To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original independent living setting. The introduction of slacklining as an adjunct therapy was made 12 mo post incident. Slacklining involves balance retention on a tightened band where external environmental changes cause a whole-body dynamic response to retain equilibrium. It is a complex neuromechanical task enabling individualized self-developed response strategies to be learned and adapted. This facilitates the innate process of balance retention, lower-limb and core muscle activation, and stable posture through a combination of learned motor skills and neurological system down regulation. Individuals adopt and follow established sequential motor learning stages where the acquired balance skills are achieved in a challenging composite-chain activity. Slacklining could be considered an adjunct therapy for lower limb stroke rehabilitation where function is compromised due to decreased muscle recruitment, decreased postural control and compromised balance. Initial inpatient rehabilitation involved one-month acute-care, one-month rehabilitation, and one-month transitional care prior to home discharge. A further six months of intensive outpatient rehabilitation was provided with five hourly sessions per week including:supervised and self-managed hydrotherapy, plus one individual and two group falls’ prevention sessions. These were supported by daily home exercises. At 12 mo post incident, recovery plateaued, then regressed following three falls. Rehabilitation was subsequently modified with the hydrotherapy retained and the group sessions replaced with an additional individual session supplemented with slacklining. The slacklining followed stages one and two of a standardized five-stage protocol. Self-reported functional progression resumed with improvement by 14 mo which further increased and was sustained 18 mo (Students’t test P < 0.05). Slacklining’s external stimulations activate global-body responses through innate balance, optimal postural and potentially down-regulated reflex control. Incorporated into stroke rehabilitation programs, slacklining can provide measurable functional gains.

Effects of supervised slackline training on postural instability, freezing of gait, and falls efficacy in people with Parkinson's disease

PURPOSE

The aim of this study was to assess whether supervised slackline training reduces the risk of falls in people with Parkinson's disease (PD).

METHODS

Twenty-two patients with idiopathic PD were randomized into experimental (EG, N = 11) and control (CG, N = 11) groups. Center of Pressure (CoP), Freezing of Gait (FOG), and Falls Efficacy Scale (FES) were assessed at pre-test, post-test and re-test. Rate perceived exertion (RPE, Borg's 6-20 scale) and local muscle perceived exertion (LRPE) were also assessed at the end of the training sessions.

RESULTS

The EG group showed significant improvements in FOG and FES scores from pre-test to post-test. Both decreased at re-test, though they did not return to pre-test levels. No significant differences were detected in CoP parameters. Analysis of RPE and LRPE scores revealed that slackline was associated with minimal fatigue and involved the major lower limb and lumbar muscles.

CONCLUSIONS

These findings suggest that slacklining is a simple, safe, and challenging training and rehabilitation tool for PD patients. It could be introduced into their physical activity routine to reduce the risk of falls and improve confidence related to fear of falling. Implications for Rehabilitation Individuals with Parkinson's disease (PD) are twice as likely to have falls compared to patients with other neurological conditions. This study support slackline as a simple, safe, and challenging training and rehabilitation tool for people with PD, which reduce their risk of falls and improve confidence related to fear of falling. Slackline in people with PD yields a low tiredness or fatigue impact and involves the major lower limb and lumbar muscles.

Slackline training and neuromuscular performance in seniors: A randomized controlled trial

Slackline training (balancing on nylon ribbons) has been shown to improve neuromuscular performance in children and adults. Comparable studies in seniors are lacking. Thus, 32 seniors were randomly assigned [strata: age, gender, physical activity (PA)] to an intervention [INT; n = 16, age: 65 ± 4 years, PA: 9 ± 5 h/week] or control [CON, n = 16, age: 63 ± 4 years, PA: 8 ± 4 h/week] group. Slackline training was given for 6 weeks (3 times per week, attendance 97%). Static and slackline standing balance performance, force development, and maximal strength of the ankle muscles were assessed before and after slackline training. Muscle activity (lower limb and trunk) was recorded during balance testing. Moderate to large group × time interactions (0.02 < P < 0.04, 0.11 < ηp (2)  < 0.17) in favor of INT were found for slackline standing times (INT: left, +278%, P = 0.02; right, +328%, P = 0.03; tandem, +94%, P = 0.007) and muscle activity during single-limb slackline standing [INT: right: rectus abdominis (RA), P = 0.003, -15%; multifidus (MF), P = 0.01, -15%; left: tibialis anterior (TIB), P = 0.03, -12%; soleus (SOL), P = 0.006, -18%; RA, P = 0.04, -11%; MF, P = 0.01, -16%; gastrocnemius medialis (GM), P = 0.02, -19%]. Static balance performance, ankle strength, and power were not affected. Slackline training induced large task-specific improvements of slackline standing performance accompanied with reductions of lower limb and trunk muscle activity. Transfer effects to static balance and strength measures seem limited.

The influence of 'Slacklining' on quadriceps rehabilitation, activation and intensity

OBJECTIVES

To determine and compare the level of quadriceps activation for knee injured participants during kinetic open-chain, closed-chain and composite-chain (Slackline) clinical exercises. Quadriceps activation is a critical component of lower limb movement and subsequently, rehabilitation. However, selective activation can be difficult due to pain, loss of function and impaired neuro-motor activation.

DESIGN

Repeated measures (within-subjects) ANOVA.

METHODS

Consecutive physiotherapy outpatients (n=49, 41.8±16.8 years, range 13-72 years, 57% female) with an acute (<2 weeks) knee injury were recruited. Participants were assessed for quadriceps activation using skin mounted electromyography during five separate clinical quadriceps activation exercises: two open-chain, inner range quads and straight leg raise; two closed-chain, step down and step up; and a composite-chain, slacklining step-up. Outcome measures were: median score on electromyography as measured in microvolts (μV); and perceived exertion on an 11-point numerical rating scale.

RESULTS

Median scores of the open- and closed-chain exercises showed no statistical difference, while composite-chain Slackline exercise showed significantly (p<0.0001) higher quadriceps activation (F(2.52, 121.00)=21.53, p<0.0001) at significantly lower exertion (F(1.62, 77.70)=26.88, p<0.0001).

CONCLUSIONS

The use of Slackline rehabilitation training can provide significant increases in activation and recruitment of the quadriceps for composite-chain exercises in the clinical setting. This activation occurs spontaneously at significantly lower levels of perceived exertion. This spontaneous quadriceps activation in a selective and simple manner is a valuable adjunct exercise for lower limb rehabilitation programmes. This is of particular relevance for the outpatient setting and circumstances where the quadriceps is inhibited and activation is required.