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Kuhn YA, Egger S, Bugnon M, Lehmann N, Taubert M, Taube W. Age-related decline in GABAergic intracortical inhibition can be counteracted by long-term learning of balance skills. J Physiol 2024; 602:3737-3753. [PMID: 38949035 DOI: 10.1113/jp285706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 06/11/2024] [Indexed: 07/02/2024] Open
Abstract
Ageing induces a decline in GABAergic intracortical inhibition, which seems to be associated not only with decremental changes in well-being, sleep quality, cognition and pain management but also with impaired motor control. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. Therefore, the present study investigated whether age-related cortical dis-inhibition could be reversed after 6 months of balance learning and whether improvements in postural control correlated with the extent of reversed dis-inhibition. The results demonstrated that intracortical inhibition can be upregulated in elderly subjects after long-term balance learning and revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition and may therefore be seminal for many pathologies in which the equilibrium between inhibitory and excitatory neurotransmitters is disturbed. KEY POINTS: Ageing induces a decline in GABAergic intracortical inhibition. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. After 6 months of balance learning, intracortical inhibition can be upregulated in elderly subjects. The results of this study also revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition.
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Affiliation(s)
- Yves-Alain Kuhn
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Sven Egger
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Matteo Bugnon
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Nico Lehmann
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Collaborative Research Center 1436 Neural Resources of Cognition, Otto von Guericke University, Magdeburg, Germany
| | - Marco Taubert
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Collaborative Research Center 1436 Neural Resources of Cognition, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral and Brain Science (CBBS), Otto von Guericke University, Universitätsplatz 2, Magdeburg, Germany
| | - Wolfgang Taube
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
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Rizzato A, Bozzato M, Rotundo L, Zullo G, De Vito G, Paoli A, Marcolin G. Multimodal training protocols on unstable rather than stable surfaces better improve dynamic balance ability in older adults. Eur Rev Aging Phys Act 2024; 21:19. [PMID: 38997647 PMCID: PMC11241999 DOI: 10.1186/s11556-024-00353-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND There has been growing interest in using unstable devices in training protocols. This study aimed to assess the effectiveness of two multimodal exercise interventions (i.e., on stable and unstable surfaces) on dynamic balance control and lower limb strength in older adults. METHODS Sixty-two older adults were randomly assigned to two intervention groups (N = 20, stable group; N = 19, unstable group), and to a control group (N = 18). In this single-blinded randomized controlled study, the two intervention groups underwent a 12-week training program twice a week for 45 min, consisting of strength and balance exercises. The stable (ST) group performed the training program over stable surfaces, while the unstable (UNST) group over unstable surfaces. Dynamic balance was assessed by computing the center of pressure (CoP) trajectory while a driven movable platform induced an unexpected perturbation of the base of support. Specifically, we considered the following CoP-related parameters within a 2.5-s temporal window from the beginning of the perturbation: displacement (Area95), mean velocity (Unit Path), anterior-posterior first peak (FP), post perturbation variability (PPV), and maximal oscillations (ΔCoPMax). The dominant quadriceps strength was measured through an isometric maximal voluntary contraction on an instrumented chair. RESULTS Four out of five CoP-related parameters (i.e., Area95, Unit Path, ΔCoPMax, and PPV) significantly improved in the UNST group from a minimum of 14.28% (d = 0.44) to a maximum of 52.82% (d = 0.58). The ST group significantly improved only in two (i.e., ΔCoPMax, and PPV) out of five CoP-related parameters with an enhancement of 12.48% (d = 0.68) and 19.10% (d = 1.06). Both intervention groups increased the maximal isometric quadriceps strength (UNST:17.27%, d = 0.69; ST:22.29%, d = 0.98). The control group did not show changes in any of the parameters considered. CONCLUSIONS Stable surfaces promoted faster increments of muscular strength. Unstable surfaces were more effective in enhancing dynamic balance efficiency. These findings suggested the employment of multimodal training on unstable rather than stable surfaces to potentially lower the incidence of falls in older adults. TRIAL REGISTRATION NCT05769361, retrospectively registered 13 March 2023, https://clinicaltrials.gov/study/NCT05769361?lat=45.3661864&lng=11.8209139&locStr=Padova,%20Italy&distance=50&page=11&rank=107 .
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Affiliation(s)
- Alex Rizzato
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, Padova, 35131, Italy
| | - Matteo Bozzato
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, Padova, 35131, Italy
| | - Luca Rotundo
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, Padova, 35131, Italy
| | - Giuseppe Zullo
- Department of Industrial Engineering, University of Padova, Via Venezia, 1, Padova, 35131, Italy
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, Padova, 35131, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, Padova, 35131, Italy
| | - Giuseppe Marcolin
- Department of Biomedical Sciences, University of Padova, Via Marzolo, 3, Padova, 35131, Italy.
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Malwanage KT, Liyanage E, Weerasinghe V, Antonypillai C, Nanayakkara I. A novel proprioceptive rehabilitation program: A pilot randomized controlled trail as an approach to address proprioceptive deficits in patients with diabetic polyneuropathy. PLoS One 2024; 19:e0305055. [PMID: 38968315 PMCID: PMC11226081 DOI: 10.1371/journal.pone.0305055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/22/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Diabetic polyneuropathy (DPN) is a notable microvascular complication of DM, affecting 16%-66% globally. DPN often leads to proprioceptive deficits in the lower limbs (LL), leading to impaired functional performance. However, evidence supporting proprioceptive rehabilitation programs (PRP) for DPN remains scarce. AIMS This pilot study aims to evaluate the effectiveness of a novel 12-week PRP on LL static and dynamic proprioception and shed light on the potential benefits of PRP for DPN population. METHODS Randomized Controlled Trail was conducted among 30 DPN patients (age 53.25±7.72 years, BMI 24.01±1.41 and DM duration 9.48±6.45 years), randomly allocated to intervention (n = 15) or control (n = 15) groups. The intervention group received PRP 3 times/week for 12 weeks. The control group received no exercise. Both groups received regular diabetic care. Static and dynamic proprioception of both LL were assessed at baseline, 6 weeks and 12 weeks. Position-reposition test was used to assess ankle joint position sense by obtaining difference between target and reproduced angles. Error in detecting knee angle and speed were obtained by performing Lower Limb Matching and Sense of Movement tests respectively to assess dynamic proprioception. RESULTS Two-way ANOVA and paired comparisons revealed, no significant improvement in proprioceptive deficits at 6 weeks (p>0.05), but significant improvement was achieved at 12-weeks (p<0.05) in the intervention group. Mean errors in Pposition re-position(R:p<0.001, L;p<0.001) and Lower limb matching (R:p<0.001, L;p<0.001) tests reduced by 5° and 10° respectively, indicating a70% improvement in the intervention group. Error of detecting speed reduced only on right side by 0.041ms-1 accounting for a 42% improvement. No improvements were observed in the control group. CONCLUSIONS Novel 12-week PRP may yield a significant reduction in LL proprioceptive deficits among DPN patients. Future RCTs with larger samples should compare the effectiveness of this PRP compared with conventional rehabilitation programs.
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Affiliation(s)
- Kavinda T. Malwanage
- Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Esther Liyanage
- Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Vajira Weerasinghe
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Indumathie Nanayakkara
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Kim KM, Kim JS, Needle AR. Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:559-568. [PMID: 38428732 PMCID: PMC11184308 DOI: 10.1016/j.jshs.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/20/2023] [Accepted: 11/27/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND Acute lateral ankle sprains (ALAS) are associated with long-term impairments and instability tied to altered neural excitability. Arthrogenic muscle inhibition (AMI) has been observed in this population; however, relationships with injury-related impairments are unclear, potentially due to the resting, prone position in which AMI is typically measured. Assessing AMI during bipedal stance may provide a better understanding of this relationship. METHODS AMI was assessed in 38 young adults (19 ALAS within 72 h of injury: 10 males, 21.4 ± 2.7 years; 19 healthy controls: 10 males, 21.9 ± 2.2 years; mean ± SD) using the Hoffmann reflex (H-reflex) during bipedal stance. Electrical stimulation was administered to identify the maximal H-reflex (Hmax) and maximal motor response (Mmax) from the soleus, fibularis longus, and tibialis anterior muscles. The primary outcome measure was the Hmax/Mmax ratio. Secondary outcomes included acute symptoms (pain and swelling), postural control during bipedal stance, and self-reported function. RESULTS No significant group-by-limb interactions were observed for any muscle. However, a significant group main effect was observed in the soleus muscle (F(1,35) = 6.82, p = 0.013), indicating significantly lower Hmax/Mmax ratios following ALAS (0.38 ± 0.20) compared to healthy controls (0.53 ± 0.16). Furthermore, lower Hmax/Mmax ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control. CONCLUSION This study supports previous evidence of AMI in patients with ALAS, providing insight into neurophysiologic impacts of musculoskeletal injury. Our results suggest that assessing AMI in a standing position following acute injury may provide valuable insight into how AMI develops and guide potential therapeutic options to curb and offset the formation of joint instability.
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Affiliation(s)
- Kyung-Min Kim
- Department of Sport Science, Sungkyunkwan University, Suwon-si 16419, Republic of Korea
| | - Joo-Sung Kim
- Department of Health and Human Performance, Texas State University, San Marcos, TX 78666, USA
| | - Alan R Needle
- Department of Public Health & Exercise Science, Appalachian State University, Boone, NC 28608, USA; Department of Rehabilitation Science, Appalachian State University, Boone, NC 28608, USA.
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Omofuma I, Carrera R, King-Ori J, Agrawal SK. The effect of transcutaneous spinal cord stimulation on the balance and neurophysiological characteristics of young healthy adults. WEARABLE TECHNOLOGIES 2024; 5:e3. [PMID: 38486863 PMCID: PMC10936317 DOI: 10.1017/wtc.2023.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/01/2023] [Accepted: 10/31/2023] [Indexed: 03/17/2024]
Abstract
Transcutaneous spinal cord stimulation (TSCS) is gaining popularity as a noninvasive alternative to epidural stimulation. However, there is still much to learn about its effects and utility in assisting recovery of motor control. In this study, we applied TSCS to healthy subjects concurrently performing a functional training task to study its effects during a training intervention. We first carried out neurophysiological tests to characterize the H-reflex, H-reflex recovery, and posterior root muscle reflex thresholds, and then conducted balance tests, first without TSCS and then with TSCS. Balance tests included trunk perturbations in forward, backward, left, and right directions, and subjects' balance was characterized by their response to force perturbations. A balance training task involved the subjects playing a catch-and-throw game in virtual reality (VR) while receiving trunk perturbations and TSCS. Balance tests with and without TSCS were conducted after the VR training to measure subjects' post-training balance characteristics and then neurophysiological tests were carried out again. Statistical comparisons using t-tests between the balance and neurophysiological data collected before and after the VR training intervention found that the immediate effect of TSCS was to increase muscle activity during forward perturbations and to reduce balance performance in that direction. Muscle activity decreased after training and even more once TSCS was turned off. We thus observed an interaction of effects where TSCS increased muscle activity while the physical training decreased it.
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Affiliation(s)
- Isirame Omofuma
- Mechanical Engineering Department, Columbia University, New York, NY, USA
| | - Robert Carrera
- Mechanical Engineering Department, Columbia University, New York, NY, USA
| | | | - Sunil K Agrawal
- Mechanical Engineering Department, Columbia University, New York, NY, USA
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Perucca L, Scarano S, Russo G, Robecchi Majnardi A, Caronni A. Fatigue may improve equally after balance and endurance training in multiple sclerosis: a randomised, crossover clinical trial. Front Neurol 2024; 15:1274809. [PMID: 38385033 PMCID: PMC10880192 DOI: 10.3389/fneur.2024.1274809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Fatigue and poor balance are frequent and severe problems in multiple sclerosis (MS) that may interact. Endurance training is known to be effective on fatigue. This study aims to test if balance training is more effective against MS fatigue. Methods A randomised crossover trial was run, recruiting 31 MS people (21 women; median age: 46 years, range: 30-64; median EDSS: 4, range: 2.5-5). Participants received balance and endurance training alternately (15 one-to-one sessions, 5 days/week) and were assessed before (T0), after (T1), and 30 days after treatment ended (T2). The Modified Fatigue Impact Scale (MFIS) with scores linearised through Rasch analysis was the primary outcome (the lower the measure, the better the condition, i.e., the lower the fatigue symptoms). The Equiscale balance scale and posturography (EquiTest) were used to assess balance. Linear mixed-effects models with ANOVA were used for significance testing. Results Thirteen participants had no carryover effect and were included in the primary analysis. Fatigue significantly changed across the three time points (F2,58 = 16.0; p < 0.001), but no difference across treatments was found. Altogether, both treatments significantly improved the MFIS measure at T1 (95%CI: -1.24 logits; mean: -1.67 to -0.81 logits) and T2 (95%CI: -1.04; mean: -1.49 to -0.60) compared to T0 (95%CI: -0.51; mean: -0.95 to -0.08; p ≤ 0.001). Equiscale and posturography highlighted balance improvement after balance training but not after endurance training. Conclusion Balance and endurance training could similarly reduce fatigue in MS patients in the short term. However, only balance training also improved balance in MS.
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Affiliation(s)
- Laura Perucca
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Stefano Scarano
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Giovanna Russo
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Antonio Robecchi Majnardi
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Antonio Caronni
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
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Zhao P, Zhu G, Chen S, Pan Y, Chen K, Huang L, Guo L. Effects of Aquatic Exercise and Floor Curling on Balance Ability and Lower Limb Muscle Strength in Children with Intellectual Disabilities: A Pilot Study in China. CHILDREN (BASEL, SWITZERLAND) 2024; 11:85. [PMID: 38255398 PMCID: PMC10814768 DOI: 10.3390/children11010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Children with intellectual disabilities often face challenges in balance ability and lower limb muscle strength, which negatively impact their daily lives and motor function. Therefore, it is crucial to enhance the balance ability and lower limb muscle strength of children with intellectual disabilities. This study aimed to investigate the effects of a 12-week aquatic exercise and floor curling intervention on the balance ability and lower limb muscle strength of children with intellectual disabilities. Forty-two participants were randomly assigned to the aquatic exercise group, floor curling group, and control group. The aquatic exercise and floor curling groups received a 12-week intervention, while the control group engaged in supervised free activities. The participants' balance ability and lower limb muscle strength were assessed using the Berg Balance Scale and a muscle strength testing device before and after the intervention. The results showed significant improvements in balance ability and lower limb muscle strength for both the aquatic exercise group and the floor curling group after the intervention. The aquatic exercise group demonstrated an average improvement of 10.84% in balance ability and an overall average improvement of 16.28% in lower limb muscle strength. The floor curling group showed an average improvement of 9.04% in balance ability and an overall average improvement of 15.67% in lower limb muscle strength. These improvement results were statistically significant (p < 0.05) and ranged from medium to large effect sizes (d = 0.5~0.8). The findings of this study validate the positive effects of aquatic exercise and floor curling on the balance ability and lower limb muscle strength of children with intellectual disabilities. These interventions can be considered effective approaches for functional rehabilitation in children with intellectual disabilities.
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Affiliation(s)
| | | | | | | | | | | | - Liya Guo
- School of Physical Education, Southwest University, Chongqing 400715, China; (P.Z.); (G.Z.); (S.C.); (Y.P.); (K.C.); (L.H.)
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Bakker LBM, Lamoth CJC, Vetrovsky T, Gruber M, Caljouw SR, Nieboer W, Taube W, van Dieën JH, Granacher U, Hortobágyi T. Neural Correlates of Balance Skill Learning in Young and Older Individuals: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2024; 10:3. [PMID: 38185708 PMCID: PMC10772137 DOI: 10.1186/s40798-023-00668-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/16/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Despite the increasing number of research studies examining the effects of age on the control of posture, the number of annual fall-related injuries and deaths continues to increase. A better understanding of how old age affects the neural mechanisms of postural control and how countermeasures such as balance training could improve the neural control of posture to reduce falls in older individuals is therefore necessary. The aim of this review is to determine the effects of age on the neural correlates of balance skill learning measured during static (standing) and dynamic (walking) balance tasks in healthy individuals. METHODS We determined the effects of acute (1-3 sessions) and chronic (> 3 sessions) balance skill training on balance in the trained and in untrained, transfer balance tasks through a systematic review and quantified these effects by robust variance estimation meta-analysis in combination with meta-regression. We systematically searched PubMed, Web of Science, and Cochrane databases. Balance performance and neural plasticity outcomes were extracted and included in the systematic synthesis and meta-analysis. RESULTS Forty-two studies (n = 622 young, n = 699 older individuals) were included in the systematic synthesis. Seventeen studies with 508 in-analysis participants were eligible for a meta-analysis. The overall analysis revealed that acute and chronic balance training had a large effect on the neural correlates of balance skill learning in the two age groups combined (g = 0.79, p < 0.01). Both age groups similarly improved balance skill performance in 1-3 training sessions and showed little further improvements with additional sessions. Improvements in balance performance mainly occurred in the trained and less so in the non-trained (i.e., transfer) balance tasks. The systematic synthesis and meta-analysis suggested little correspondence between improved balance skills and changes in spinal, cortical, and corticospinal excitability measures in the two age groups and between the time courses of changes in balance skills and neural correlates. CONCLUSIONS Balance skill learning and the accompanying neural adaptations occur rapidly and independently of age with little to no training dose-dependence or correspondence between behavioral and neural adaptations. Of the five types of neural correlates examined, changes in only spinal excitability seemed to differ between age groups. However, age or training dose in terms of duration did not moderate the effects of balance training on the changes in any of the neural correlates. The behavioral and neural mechanisms of strong task-specificity and the time course of skill retention remain unclear and require further studies in young and older individuals. REGISTRATION PROSPERO registration number: CRD42022349573.
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Affiliation(s)
- Lisanne B M Bakker
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands.
| | - Claudine J C Lamoth
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Markus Gruber
- Department of Sport Science, Human Performance Research Centre, University of Konstanz, Constance, Germany
| | - Simone R Caljouw
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Ward Nieboer
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Institute of Sport Sciences and Physical Education, University of Pécs, Pecs, Hungary
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
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Kim KM, Needle AR, Kim JS, An YW, Cruz-Díaz D, Taube W. What interventions can treat arthrogenic muscle inhibition in patients with chronic ankle instability? A systematic review with meta-analysis. Disabil Rehabil 2024; 46:241-256. [PMID: 36650898 DOI: 10.1080/09638288.2022.2161643] [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: 04/04/2022] [Accepted: 12/18/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify, critically appraise, and synthesize the existing evidence regarding the effects of therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability (CAI). MATERIALS AND METHODS Two reviewers independently performed exhaustive database searches in Web of Science, PubMed, Medline, CINAHL, and SPORTDiscus. RESULTS Nine studies were finally included. Five types of disinhibitory interventions were identified: focal ankle joint cooling (FAJC), manual therapy, fibular reposition taping (FRT), whole-body vibration (WBV), and transcranial direct current stimulation (tDCS). There were moderate effects of FAJC on spinal excitability in ankle muscles (g = 0.55, 95% CI = 0.03-1.08, p = 0.040 for the soleus and g = 0.54, 95% CI = 0.01-1.07, p = 0.046 for the fibularis longus). In contrast, manual therapy, FRT, WBV were not effective. Finally, 4 weeks of tDCS combined with eccentric exercise showed large effects on corticospinal excitability in 2 weeks after the intervention (g = 0.99, 95% CI = 0.14-1.85 for the fibularis longus and g = 1.02, 95% CI = 0.16-1.87 for the tibialis anterior). CONCLUSIONS FAJC and tDCS may be effective in counteracting AMI. However, the current evidence of mainly short-term studies to support the use of disinhibitory interventions is too limited to draw definitive conclusions.
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Affiliation(s)
- Kyung-Min Kim
- Department of Sport Science, Sungkyunkwan University, Suwon-si, Korea
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - Alan R Needle
- Department of Public Health & Exercise Science, Appalachian State University, Boone, NC, USA
- Department of Rehabilitation Sciences, Appalachian State University, Boone, NC, USA
| | - Joo-Sung Kim
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - Yong Woo An
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, USA
| | - David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
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Baur H, Pairot De Fontenay B, Sigward S. Editorial: Neuromuscular diagnostics and sensorimotor performance in training and therapy - beyond the pure biomechanical approach. Front Sports Act Living 2023; 5:1296276. [PMID: 37877117 PMCID: PMC10593435 DOI: 10.3389/fspor.2023.1296276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Affiliation(s)
- Heiner Baur
- School of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | | | - Susan Sigward
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
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Hu N, Piirainen JM, Kidgell DJ, Walker S, Avela J. Corticospinal Adaptation to Short-Term Horizontal Balance Perturbation Training. Brain Sci 2023; 13:1209. [PMID: 37626565 PMCID: PMC10452523 DOI: 10.3390/brainsci13081209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Sensorimotor training and strength training can improve balance control. Currently, little is known about how repeated balance perturbation training affects balance performance and its neural mechanisms. This study investigated corticospinal adaptation assessed by transcranial magnetic stimulation (TMS) and Hoffman-reflex (H-reflex) measurements during balance perturbation induced by perturbation training. Fourteen subjects completed three perturbation sessions (PS1, PS2, and PS3). The perturbation system operated at 0.25 m/s, accelerating at 2.5 m/s2 over a 0.3 m displacement in anterior and posterior directions. Subjects were trained by over 200 perturbations in PS2. In PS1 and PS3, TMS and electrical stimulation elicited motor evoked potentials (MEP) and H-reflexes in the right leg soleus muscle, at standing rest and two time points (40 ms and 140 ms) after perturbation. Body sway was assessed using the displacement and velocity of the center of pressure (COP), which showed a decrease in PS3. No significant changes were observed in MEP or H-reflex between sessions. Nevertheless, Δ MEP at 40 ms demonstrated a positive correlation with Δ COP, while Δ H-reflex at 40 ms demonstrated a negative correlation with Δ COP. Balance perturbation training led to less body sway and a potential increase in spinal-level involvement, indicating that movement automaticity may be suggested after perturbation training.
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Affiliation(s)
- Nijia Hu
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (S.W.); (J.A.)
| | - Jarmo M. Piirainen
- Sports Technology Program, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-88610 Vuokatti, Finland;
| | - Dawson J. Kidgell
- School of Primary and Allied Health Care, Department of Physiotherapy, Monash University, Frankston P.O. Box 527, Australia;
| | - Simon Walker
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (S.W.); (J.A.)
| | - Janne Avela
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (S.W.); (J.A.)
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12
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Paillard T. The optimal method for improving postural balance in healthy young and older people: specific training for postural tasks encountered in personal physical practice. Front Physiol 2023; 14:1188496. [PMID: 37449015 PMCID: PMC10338096 DOI: 10.3389/fphys.2023.1188496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
It is well known that regular exercise or physical activity (training) improves postural balance in healthy young and older subjects, but the optimal exercise or physical activity (i.e., likely to induce the greatest postural improvements) and the context in which it is carried out remain to be explored and determined for each population. The most beneficial adaptations would depend, in particular, on gestural conditions (body position, movement and gesture practiced) and material conditions (nature of the ground surface, sports equipment used, type of environment - stable or changing). In fact, the global postural adaptations induced by training do not result from the transfer between different trained and untrained postural tasks, but are the sum of the adaptations related to each trained postural task in healthy young and older subjects. Based on current knowledge, optimal training programs should include the full range of postural tasks encountered in personal physical practice for each population. To date, the method of implementing progressive postural balance tasks with different degrees of difficulty and instability has been used as the effective method to improve postural balance, but it should not be considered as the reference method. Instead, it should be considered as a complementary method to the one based on specific postural tasks. An intervention strategy is proposed for young and older adults consisting of three different steps (general, oriented and specific/ecologic training). However, some parameters still need to be explored and possibly reconsidered in future studies to improve postural balance in an optimal way.
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13
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Grasso C, Barresi M, Tramonti Fantozzi MP, Lazzerini F, Bruschini L, Berrettini S, Andre P, Dolciotti C, De Cicco V, De Cicco D, d'Ascanio P, Orsini P, Montanari F, Faraguna U, Manzoni D. Effects of a short period of postural training on postural stability and vestibulospinal reflexes. PLoS One 2023; 18:e0287123. [PMID: 37307276 DOI: 10.1371/journal.pone.0287123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
The effects of postural training on postural stability and vestibulospinal reflexes (VSRs) were investigated in normal subjects. A period (23 minutes) of repeated episodes (n = 10, 50 seconds) of unipedal stance elicited a progressive reduction of the area covered by centre of pressure (CoP) displacement, of average CoP displacement along the X and Y axes and of CoP velocity observed in this challenging postural task. All these changes were correlated to each other with the only exception of those in X and Y CoP displacement. Moreover, they were larger in the subjects showing higher initial instability in unipedal stance, suggesting that they were triggered by the modulation of sensory afferents signalling body sway. No changes in bipedal stance occurred soon and 1 hour after this period of postural training, while a reduction of CoP displacement was apparent after 24 hours, possibly due to a beneficial effect of overnight sleep on postural learning. The same period of postural training also reduced the CoP displacement elicited by electrical vestibular stimulation (EVS) along the X axis up to 24 hours following the training end. No significant changes in postural parameters of bipedal stance and VSRs could be observed in control experiments where subjects were tested at identical time points without performing the postural training. Therefore, postural training led to a stricter control of CoP displacement, possibly acting through the cerebellum by enhancing feedforward mechanisms of postural stability and by depressing the VSR, the most important reflex mechanism involved in balance maintenance under challenging conditions.
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Affiliation(s)
- Claudia Grasso
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Massimo Barresi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | | | - Francesco Lazzerini
- Department of Surgical, Medical, Molecular Pathology and Critical Cares, University of Pisa, Pisa, Italy
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Cares, University of Pisa, Pisa, Italy
| | - Stefano Berrettini
- Department of Surgical, Medical, Molecular Pathology and Critical Cares, University of Pisa, Pisa, Italy
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Andre
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Cristina Dolciotti
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Paola d'Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Paolo Orsini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Francesco Montanari
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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14
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Martino G, Beck ON, Ting LH. Voluntary muscle coactivation in quiet standing elicits reciprocal rather than coactive agonist-antagonist control of reactive balance. J Neurophysiol 2023; 129:1378-1388. [PMID: 37162064 PMCID: PMC10259861 DOI: 10.1152/jn.00458.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/04/2023] [Accepted: 05/06/2023] [Indexed: 05/11/2023] Open
Abstract
Muscle coactivation increases in challenging balance conditions as well as with advanced age and mobility impairments. Increased muscle coactivation can occur both in anticipation of (feedforward) and in reaction to (feedback) perturbations, however, the causal relationship between feedforward and feedback muscle coactivation remains elusive. Here, we hypothesized that feedforward muscle coactivation would increase both the body's initial mechanical resistance due to muscle intrinsic properties and the later feedback-mediated muscle coactivation in response to postural perturbations. Young adults voluntarily increased leg muscle coactivation using visual biofeedback before support-surface perturbations. In contrast to our hypothesis, feedforward muscle coactivation did not increase the body's initial intrinsic resistance to perturbations, nor did it increase feedback muscle coactivation. Rather, perturbations with feedforward muscle coactivation elicited a medium- to long-latency increase of feedback-mediated agonist activity but a decrease of feedback-mediated antagonist activity. This reciprocal rather than coactivation effect on ankle agonist and antagonist muscles enabled faster reactive ankle torque generation, reduced ankle dorsiflexion, and reduced center of mass (CoM) motion. We conclude that in young adults, voluntary feedforward muscle coactivation can be independently modulated with respect to feedback-mediated muscle coactivation. Furthermore, our findings suggest feedforward muscle coactivation may be useful for enabling quicker joint torque generation through reciprocal, rather than coactivated, agonist-antagonist feedback muscle activity. As such our results suggest that behavioral context is critical to whether muscle coactivation functions to increase agility versus stability.NEW & NOTEWORTHY Feedforward and feedback muscle coactivation are commonly observed in older and mobility impaired adults and are considered strategies to improve stability by increasing body stiffness prior to and in response to perturbations. In young adults, voluntary feedforward coactivation does not necessarily increase feedback coactivation in response to perturbations. Instead, feedforward coactivation enabled faster ankle torques through reciprocal agonist-antagonist muscle activity. As such, coactivation may promote either agility or stability depending on the behavioral context.
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Affiliation(s)
- Giovanni Martino
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, Georgia, United States
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Owen N Beck
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, Georgia, United States
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, United States
| | - Lena H Ting
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, Georgia, United States
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia, United States
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15
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Wang D, Zhou J, Huang Y, Yu H. Identifying the changes in the cortical activity of various brain regions for different balance tasks: A review. NeuroRehabilitation 2023:NRE220285. [PMID: 37125575 DOI: 10.3233/nre-220285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Balance support is critical to a person's overall function and health. Previous neuroimaging studies have shown that cortical structures play an essential role in postural control. OBJECTIVE This review aims to identify differences in the pattern of neural activity induced by balance tasks with different balance control requirements. METHODS Seventy-four articles were selected from the field of balance training and were examined based on four brain function detection technologies. RESULTS In general, most studies focused on the activity changes of various cortical areas during training at different difficulty levels, but more and more attention has also begun to focus on the functional changes of other cortical and deep subcortical structures. Our analysis also revealed the neglect of certain task types. CONCLUSION Based on these results, we identify and discuss future research directions that may contribute to a clear understanding of neural functional plasticity under different tasks.
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Affiliation(s)
- Duojin Wang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Jiankang Zhou
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Yanping Huang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
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16
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Egger S, Wälchli M, Rüeger E, Taube W. Short-term balance consolidation relies on the primary motor cortex: a rTMS study. Sci Rep 2023; 13:5169. [PMID: 36997548 PMCID: PMC10063530 DOI: 10.1038/s41598-023-32065-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
Structural and functional adaptations occur in the primary motor cortex (M1) after only a few balance learning sessions. Nevertheless, the role of M1 in consolidating balance tasks remains to be discussed, as direct evidence is missing due to the fact that it is unclear whether adaptations in M1 are indeed the driving force for balance improvements or merely the consequence of improved balance. The aim of the present study was to investigate whether the primary motor cortex is involved in the learning and consolidation of balance tasks. Thirty participants were randomly allocated into a repetitive transcranial magnetic stimulation (rTMS) or sham-rTMS group. The experimental design included a single balance acquisition phase, followed by either 15 min of low-frequency rTMS (1 Hz at 115% of resting motor threshold to disrupt the involvement of M1) or sham-rTMS, and finally a retention test 24 h later. During the acquisition phase, no differences in balance improvements were observed between the two groups. However, significant differences between the rTMS and the sham-rTMS group were found from the end of the acquisition phase to the retention test. While the rTMS group had a performance loss, the sham-rTMS group displayed significant off-line gains (p = 0.001). For the first time, this finding may propose a causal relationship between the involvement of M1 and the acquisition and consolidation of a balance task.
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Affiliation(s)
- S Egger
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland.
- Medicine Section, Department of Neurosciences and Movement Sciences, Faculty of Science and Medicine, University of Fribourg, Bd de Pérolles 90, Office F440, 1700, Fribourg/Freiburg, Switzerland.
| | - M Wälchli
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - E Rüeger
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - W Taube
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
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17
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Woodhead A, North JS, Hill J, Murphy CP, Kidgell DJ, Tallent J. Corticospinal and spinal adaptations following lower limb motor skill training: a meta-analysis with best evidence synthesis. Exp Brain Res 2023; 241:807-824. [PMID: 36740653 DOI: 10.1007/s00221-023-06563-3] [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: 05/24/2022] [Accepted: 01/21/2023] [Indexed: 02/07/2023]
Abstract
Motor skill training alters the human nervous system; however, lower limb motor tasks have been less researched compared to upper limb tasks. This meta-analysis with best evidence synthesis aimed to determine the cortical and subcortical responses that occur following lower limb motor skill training, and whether these responses are accompanied by improvements in motor performance. Following a literature search that adhered to the PRISMA guidelines, data were extracted and analysed from six studies (n = 172) for the meta-analysis, and 11 studies (n = 257) were assessed for the best evidence synthesis. Pooled data indicated that lower limb motor skill training increased motor performance, with a standardised mean difference (SMD) of 1.09 being observed. However, lower limb motor skill training had no effect on corticospinal excitability (CSE), Hoffmann's reflex (H-reflex) or muscle compound action potential (MMAX) amplitude. The best evidence synthesis found strong evidence for improved motor performance and reduced short-interval cortical inhibition (SICI) following lower limb motor skill training, with conflicting evidence towards the modulation of CSE. Taken together, this review highlights the need for further investigation on how motor skill training performed with the lower limb musculature can modulate corticospinal responses. This will also help us to better understand whether these neuronal measures are underpinning mechanisms that support an improvement in motor performance.
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Affiliation(s)
- Alex Woodhead
- Faculty of Sport, Allied Health and Performance Science, St. Mary's University, Middlesex, Twickenham, TW1 4SX, UK.
| | - Jamie S North
- Faculty of Sport, Allied Health and Performance Science, St. Mary's University, Middlesex, Twickenham, TW1 4SX, UK
| | - Jessica Hill
- Faculty of Sport, Allied Health and Performance Science, St. Mary's University, Middlesex, Twickenham, TW1 4SX, UK
| | - Colm P Murphy
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Dawson J Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, 3199, Australia
| | - Jamie Tallent
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, 3199, Australia.,School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, UK
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18
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Lee J, Kim J. Effects of an 8-week lunge exercise on an unstable support surface on lower-extremity muscle function and balance in middle-aged women. Phys Act Nutr 2022; 26:14-21. [PMID: 36775647 PMCID: PMC9925109 DOI: 10.20463/pan.2022.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/13/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE This study aimed to develop a more effective exercise program for lower extremity muscle function by evaluating the effects of an 8-week lunge exercise performed on an unstable support surface on lower extremity muscle function, body composition, and body balance in middle-aged women. METHODS Twenty participants were divided into two groups (control group: exercise on a stable support surface, n=10; experimental group: exercise on an unsta ble support surface, n=10). Each participant performed the exercise program for 8 weeks (three sessions a week, 50 min/session). RESULTS The results revealed that body fat percentage decreased significantly in the experimental group (p<0.01). Additionally, lower-extremity muscle mass and function increased significantly in both groups (p<0.05), but with no significant difference between the groups. Moreover, the results of the static and dynamic balance tests indicated that balance improved in both groups, with significantly greater improvements in the experimental group than in the control group (p<0.05). CONCLUSION Lunge exercise on stable and unstable support surfaces improves muscle function and static balance in middle-aged women. In particular, lunge exercise on an unstable support surface was more effective at reducing body fat than lunge exercise on a stable support surface and was also found to improve dynamic balance. Therefore, a program consisting of lunge exercises on an unstable support surface may be suitable for body improvements in middle-aged women.
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Affiliation(s)
- Jihoo Lee
- Department of Sports Medicine and Science Graduate School of Konkuk University, Republic of Korea
| | - Jisu Kim
- Department of Sports Medicine and Science Graduate School of Konkuk University, Republic of Korea,Physical Activity & Performance Institute (PAPI), Konkuk University, Republic of Korea,Corresponding author : Jisu Kim, Ph. D. Department of Sports Medicine and Science Graduate School of Konkuk University, Korea 120, Neungdong-ro, Gwangin-gu, Seoul 143-701, Republic of Korea. Tel: +82-2-2049-6034 Fax: 0504-485-4225
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Hu N, Avela J, Kidgell DJ, Nevanperä S, Walker S, Piirainen JM. Reliability of transcranial magnetic stimulation and H-reflex measurement during balance perturbation tasks. Front Physiol 2022; 13:957650. [PMID: 36311220 PMCID: PMC9614306 DOI: 10.3389/fphys.2022.957650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/05/2022] [Indexed: 11/13/2022] Open
Abstract
Following ankle movement, posterior balance perturbation evokes short- (SLR ∼30–50 ms), medium- (MLR ∼50–60 ms), and long-latency responses (LLR ∼70–90 ms) in soleus muscle before voluntary muscle contraction. Transcranial magnetic stimulation (TMS) and Hoffmann-reflex (H-reflex) measurements can provide insight into the contributions of corticospinal and spinal mechanisms to each response. Motor evoked potential (MEP) and H-reflex responses have shown good reliability in some dynamic muscle contraction tasks. However, it is still unclear how reliable these methods are in dynamic balance perturbation and corticospinal modulation during long amplitude balance perturbation tasks. 14 subjects completed two test sessions in this study to evaluate the reliability of MEPs, H-reflex, and corticospinal modulation during balance perturbation. In each session, the balance perturbation system operated at 0.25 m/s, accelerating at 2.5 m/s2 over 0.3 m displacement. MEPs and H-reflexes were elicited in the right leg soleus muscle at four delays after ankle movement (10 ms, 40 ms, 80 ms, and 140 ms), respectively. Test-retest reliability of MEP and H-reflex amplitudes were assessed via intraclass correlation coefficients (ICC) both between- and within-session. Between-session test-retest reliability for MEPs was excellent (ICC = 0.928–0.947), while H-reflex demonstrated moderate-to-good reliability (ICC = 0.626–0.887). Within-session reliability for both MEPs and H-reflex was excellent (ICC = 0.927–0.983). TMS and H-reflex measurements were reliable at different delays after perturbation between- and within-sessions, which indicated that these methods can be used to measure corticospinal excitability during balance perturbation.
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Affiliation(s)
- Nijia Hu
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- *Correspondence: Nijia Hu,
| | - Janne Avela
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Dawson J. Kidgell
- School of Primary and Allied Health Care, Department of Physiotherapy, Monash University, Melbourne, VIC, Australia
| | - Samuli Nevanperä
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Simon Walker
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jarmo M. Piirainen
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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20
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Liu HH, Wang RY, Cheng SJ, Liao KK, Zhou JH, Yang YR. Balance Training Modulates Cortical Inhibition in Individuals with Parkinson's Disease: A Randomized Controlled Trial. Neurorehabil Neural Repair 2022; 36:613-620. [PMID: 36004820 DOI: 10.1177/15459683221119761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Most individuals with Parkinson's disease (PD) develop balance dysfunction. Previous studies showed that individuals with PD have abnormal corticomotor changes related to severity of motor symptoms and disease progression. Cortical disinhibition was observed in PD and this alteration can be an early sign of PD. Balance training seems to be an effective intervention to improve balance in individuals with PD. However, it is not much known about the effect of balance training on cortical neuroplasticity in PD population. OBJECTIVE To investigate the effects of balance training on corticomotor excitability in individuals with PD. METHODS Twenty-eight PD participants were recruited and randomly assigned to either the balance training (BT) or the control (CON) group. Both groups underwent 16 training sessions over 8 weeks. Outcome measures for corticomotor inhibition included the cortical silent period (CSP) and short-interval intracortical inhibition (SICI) on transcranial magnetic stimulation. Balance performance was measured using the Mini-Balance Evaluation Systems Test (Mini-BEST) and the Timed Up and Go (TUG) test. RESULTS Participants in the BT group showed a significant increase in corticomotor inhibition (CSP: P = .028, SICI: P = .04) and a significant improvement in balance performance (Mini-BEST: P = .001, TUG: P = .04) after training. Compared to the CON group, the BT group showed a greater increase in corticomotor inhibition (CSP: P = .017, SICI: P = .046) and better improvement in balance (Mini-BEST: P = .046). CONCLUSION Balance training could modulate corticomotor inhibition in the primary motor cortex and improve balance performance in individuals with PD.
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Affiliation(s)
- Hsin-Hsuan Liu
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei
| | - Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei
| | - Shih-Jung Cheng
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei.,Department of Neurology, MacKay Memorial Hospital, Taipei
| | - Kwong-Kum Liao
- Department of Neurology, Taipei Veterans General Hospital, Taipei
| | - Jun-Hong Zhou
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei.,Preventive Medicine Research Center, National Yang-Ming University, Taipei
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21
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Sun Y, Hurd CL, Barnes MM, Yang JF. Neural Plasticity in Spinal and Corticospinal Pathways Induced by Balance Training in Neurologically Intact Adults: A Systematic Review. Front Hum Neurosci 2022; 16:921490. [PMID: 36061497 PMCID: PMC9428930 DOI: 10.3389/fnhum.2022.921490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
Balance training, defined here as training of postural equilibrium, improves postural control and reduces the rate of falls especially in older adults. This systematic review aimed to determine the neuroplasticity induced by such training in younger (18–30 years old) and older adults (≥65 years old). We focused on spinal and corticospinal pathways, as studied with electrophysiology, in people without neurological or other systemic disorders. We were specifically interested in the change in the excitability of these pathways before and after training. Searches were conducted in four databases: MEDLINE, CINAHL, Scopus, and Embase. A total of 1,172 abstracts were screened, and 14 articles were included. Quality of the studies was evaluated with the Downs and Black checklist. Twelve of the studies measured spinal reflexes, with ten measuring the soleus H-reflex. The H-reflex amplitude was consistently reduced in younger adults after balance training, while mixed results were found in older adults, with many showing an increase in the H-reflex after training. The differences in results between studies of younger vs. older adults may be related to the differences in their H-reflexes at baseline, with older adults showing much smaller H-reflexes than younger adults. Five studies measured corticospinal and intracortical excitability using transcranial magnetic stimulation. Younger adults showed reduced corticospinal excitability and enhanced intracortical inhibition after balance training. Two studies on older adults reported mixed results after training. No conclusions could be drawn for corticospinal and intracortical plasticity given the small number of studies. Overall, balance training induced measurable change in spinal excitability, with different changes seen in younger compared to older adults.
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Affiliation(s)
- Yao Sun
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Caitlin L. Hurd
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Michelle M. Barnes
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jaynie F. Yang
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Neuroscience & Mental Health Institute, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Jaynie F. Yang
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Sozzi S, Schieppati M. Balance Adaptation While Standing on a Compliant Base Depends on the Current Sensory Condition in Healthy Young Adults. Front Hum Neurosci 2022; 16:839799. [PMID: 35399363 PMCID: PMC8989851 DOI: 10.3389/fnhum.2022.839799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/03/2022] [Indexed: 01/06/2023] Open
Abstract
Background Several investigations have addressed the process of balance adaptation to external perturbations. The adaptation during unperturbed stance has received little attention. Further, whether the current sensory conditions affect the adaptation rate has not been established. We have addressed the role of vision and haptic feedback on adaptation while standing on foam. Methods In 22 young subjects, the analysis of geometric (path length and sway area) and spectral variables (median frequency and mean level of both total spectrum and selected frequency windows) of the oscillation of the centre of feet pressure (CoP) identified the effects of vision, light-touch (LT) or both in the anteroposterior (AP) and mediolateral (ML) direction over 8 consecutive 90 s standing trials. Results Adaptation was obvious without vision (eyes closed; EC) and tenuous with vision (eyes open; EO). With trial repetition, path length and median frequency diminished with EC (p < 0.001) while sway area and mean level of the spectrum increased (p < 0.001). The low- and high-frequency range of the spectrum increased and decreased in AP and ML directions, respectively. Touch compared to no-touch enhanced the rate of increase of the low-frequency power (p < 0.05). Spectral differences in distinct sensory conditions persisted after adaptation. Conclusion Balance adaptation occurs during standing on foam. Adaptation leads to a progressive increase in the amplitude of the lowest frequencies of the spectrum and a concurrent decrease in the high-frequency range. Within this common behaviour, touch adds to its stabilising action a modest effect on the adaptation rate. Stabilisation is improved by favouring slow oscillations at the expense of sway minimisation. These findings are preliminary to investigations of balance problems in persons with sensory deficits, ageing, and peripheral or central nervous lesion.
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Affiliation(s)
- Stefania Sozzi
- Centro Studi Attività Motorie (CSAM), Istituti Clinici Scientifici Maugeri SB (IRCCS), Pavia, Italy
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23
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Wu J, Zhang H, Chen Z, Fu R, Yang H, Zeng H, Ren Z. Benefits of Virtual Reality Balance Training for Patients With Parkinson Disease: Systematic Review, Meta-analysis, and Meta-Regression of a Randomized Controlled Trial. JMIR Serious Games 2022; 10:e30882. [PMID: 35230242 PMCID: PMC8924777 DOI: 10.2196/30882] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/07/2021] [Accepted: 12/11/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Virtual reality (VR) balance training is increasingly being pursued in biomedical research, specifically with respect to investigating balance ability with VR. However, existing systematic reviews have found inconsistent conclusions about the efficacy of VR in improving balance in Parkinson disease (PD) patients. OBJECTIVE The goal of the research was to evaluate the impact of VR balance training on the balance ability of patients with PD. METHODS All major databases, including Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, and Wanfang, were searched to identify all relevant studies published in English or Chinese since September 15, 2010. Two researchers independently conducted document retrieval, study selection, data extraction, and methodological quality evaluation. RESULTS A total of 16 randomized controlled trials were analyzed (n=583 patients with PD), with the methodological quality evaluation score ranging from 5 to 8 points. A random effects model was selected to combine effect sizes. Meta-analysis showed that the balance ability of PD was significantly improved after VR training compared with the control group (standardized mean difference [SMD] 2.127, 95% CI 1.202 to 3.052, P<.001, I2=95.1, df=15). It is worth noting that the intervention platform may be the main reason for heterogeneity. Meta regression analysis showed that no training program could predict the impact of VR training (P=.57 to .94) on PD balance ability. Subgroup result showed that a single training time of 0 to 20 minutes (SMD 6.446), 4 to 6 times per week (SMD 4.067), training for 3 to 5 weeks (SMD 62.478), training course reached more than 30 times (SMD 4.405), and 201 to 300 minutes per week (SMD 4.059) maybe have more benefit. CONCLUSIONS A systematic review and meta-analysis confirmed that VR balance training is a highly effective means to improve balance performance with large effects in PD. In addition, we preliminarily extracted dose-effect relationships for training volume, informing clinicians and practitioners to design effective VR balance training for balance ability. Further research is needed to reveal optimal dose-response relationships following VR balance training.
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Affiliation(s)
- Jinlong Wu
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Hui Zhang
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Ziyan Chen
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Ruijia Fu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Hao Yang
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Hongfa Zeng
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Zhanbing Ren
- Department of Physical Education, Shenzhen University, Shenzhen, China
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24
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Xu J, Lopez AJ, Hoque MM, Borich MR, Kesar TM. Temporal Profile of Descending Cortical Modulation of Spinal Excitability: Group and Individual-Specific Effects. Front Integr Neurosci 2022; 15:777741. [PMID: 35197831 PMCID: PMC8859157 DOI: 10.3389/fnint.2021.777741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Sensorimotor control is modulated through complex interactions between descending corticomotor pathways and ascending sensory inputs. Pairing sub-threshold transcranial magnetic stimulation (TMS) with peripheral nerve stimulation (PNS) modulates the Hoffmann’s reflex (H-reflex), providing a neurophysiologic probe into the influence of descending cortical drive on spinal segmental circuits. However, individual variability in the timing and magnitude of H-reflex modulation is poorly understood. Here, we varied the inter-stimulus interval (ISI) between TMS and PNS to systematically manipulate the relative timing of convergence of descending TMS-induced volleys with respect to ascending PNS-induced afferent volleys in the spinal cord to: (1) characterize effective connectivity between the primary motor cortex (M1) and spinal circuits, mediated by both direct, fastest-conducting, and indirect, slower-conducting descending pathways; and (2) compare the effect of individual-specific vs. standard ISIs. Unconditioned and TMS-conditioned H-reflexes (24 different ISIs ranging from −6 to 12 ms) were recorded from the soleus muscle in 10 able-bodied individuals. The magnitude of H-reflex modulation at individualized ISIs (earliest facilitation delay or EFD and individual-specific peak facilitation) was compared with standard ISIs. Our results revealed a significant effect of ISI on H-reflex modulation. ISIs eliciting earliest-onset facilitation (EFD 0 ms) ranged from −3 to −5 ms across individuals. No difference in the magnitude of facilitation was observed at EFD 0 ms vs. a standardized short-interval ISI of −1.5 ms. Peak facilitation occurred at longer ISIs, ranging from +3 to +11 ms. The magnitude of H-reflex facilitation derived using an individual-specific peak facilitation was significantly larger than facilitation observed at a standardized longer-interval ISI of +10 ms. Our results suggest that unique insights can be provided with individual-specific measures of top-down effective connectivity mediated by direct and/or fastest-conducting pathways (indicated by the magnitude of facilitation observed at EFD 0 ms) and other descending pathways that encompass relatively slower and/or indirect connections from M1 to spinal circuits (indicated by peak facilitation and facilitation at longer ISIs). By comprehensively characterizing the temporal profile and inter-individual variability of descending modulation of spinal reflexes, our findings provide methodological guidelines and normative reference values to inform future studies on neurophysiological correlates of the complex array of descending neural connections between M1 and spinal circuits.
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Affiliation(s)
- Jiang Xu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Alejandro J. Lopez
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
- Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, United States
| | - Maruf M. Hoque
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Michael R. Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Trisha M. Kesar
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
- *Correspondence: Trisha M. Kesar
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25
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Lindlöf A. The Vulnerability of the Developing Brain: Analysis of Highly Expressed Genes in Infant C57BL/6 Mouse Hippocampus in Relation to Phenotypic Annotation Derived From Mutational Studies. Bioinform Biol Insights 2022; 16:11779322211062722. [PMID: 35023907 PMCID: PMC8743926 DOI: 10.1177/11779322211062722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/03/2021] [Indexed: 12/06/2022] Open
Abstract
The hippocampus has been shown to have a major role in learning and memory, but also to participate in the regulation of emotions. However, its specific role(s) in memory is still unclear. Hippocampal damage or dysfunction mainly results in memory issues, especially in the declarative memory but, in animal studies, has also shown to lead to hyperactivity and difficulty in inhibiting responses previously taught. The brain structure is affected in neuropathological disorders, such as Alzheimer's, epilepsy, and schizophrenia, and also by depression and stress. The hippocampus structure is far from mature at birth and undergoes substantial development throughout infant and juvenile life. The aim of this study was to survey genes highly expressed throughout the postnatal period in mouse hippocampus and which have also been linked to an abnormal phenotype through mutational studies to achieve a greater understanding about hippocampal functions during postnatal development. Publicly available gene expression data from C57BL/6 mouse hippocampus was analyzed; from a total of 5 time points (at postnatal day 1, 10, 15, 21, and 30), 547 genes highly expressed in all of these time points were selected for analysis. Highly expressed genes are considered to be of potential biological importance and appear to be multifunctional, and hence any dysfunction in such a gene will most likely have a large impact on the development of abilities during the postnatal and juvenile period. Phenotypic annotation data downloaded from Mouse Genomic Informatics database were analyzed for these genes, and the results showed that many of them are important for proper embryo development and infant survival, proper growth, and increase in body size, as well as for voluntary movement functions, motor coordination, and balance. The results also indicated an association with seizures that have primarily been characterized by uncontrolled motor activity and the development of proper grooming abilities. The complete list of genes and their phenotypic annotation data have been compiled in a file for easy access.
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26
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Phu S, Sturnieks DL, Lord SR, Okubo Y. Impact of ageing, fall history and exercise on postural reflexes following unpredictable perturbations: A systematic review and meta-analyses. Mech Ageing Dev 2022; 203:111634. [DOI: 10.1016/j.mad.2022.111634] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 10/19/2022]
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27
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Carrera RM, Omofuma I, Yasin B, Agrawal SK. The Effect of Transcutaneous Spinal Cord Stimulation on Standing Postural Control in Healthy Adults. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3185370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Robert M. Carrera
- Department of Biomedical Engineering, Columbia University,, New York, NY, USA
| | - Isirame Omofuma
- Department of Biomedical Engineering, Columbia University,, New York, NY, USA
| | - Bushra Yasin
- Mechanical Engineering Department, Columbia University, New York, NY, USA
| | - Sunil K. Agrawal
- Departments of Mechanical Engineering and Rehabilitation and, Regenerative Medicine, New York, NY, USA
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28
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Streckmann F, Balke M, Cavaletti G, Toscanelli A, Bloch W, Décard BF, Lehmann HC, Faude O. Exercise and Neuropathy: Systematic Review with Meta-Analysis. Sports Med 2021; 52:1043-1065. [PMID: 34964950 DOI: 10.1007/s40279-021-01596-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Peripheral neuropathies are a prevalent, heterogeneous group of diseases of the peripheral nervous system. Symptoms are often debilitating, difficult to treat, and usually become chronic. Not only do they diminish patients' quality of life, but they can also affect medical therapy and lead to complications. To date, for most conditions there are no evidence-based causal treatment options available. Research has increased considerably since the last review in 2014 regarding the therapeutic potential of exercise interventions for patients with polyneuropathy. OBJECTIVE Our objective in this systematic review with meta-analysis was to analyze exercise interventions for neuropathic patients in order to update a systematic review from 2014 and to evaluate the potential benefits of exercise on neuropathies of different origin that can then be translated into practice. METHODS Two independent reviewers performed a systematic review with meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Inclusion criteria according to the PICOS approach were: neuropathic patients, exercise interventions only, an inactive or non-exercising control group, and solely randomized controlled trials with the following outcome parameters: neuropathic symptoms, balance parameters, functional mobility, gait, health-related quality of life, and HbA1c (glycated hemoglobin). RESULTS A total of 41 randomized, controlled trials met all inclusion criteria, 20 of which could be included in the quantitative analysis. Study quality varied from moderate to high. Current data further support the hypothesis that exercise is beneficial for neuropathic patients. This is best documented for patients with diabetic peripheral neuropathy (DPN) (27 studies) as well as for chemotherapy-induced peripheral neuropathy (CIPN) (nine studies), while there are only few studies (five) on all other causes of neuropathy. We found standardized mean differences in favor of the exercise group of 0.27-2.00 for static balance, Berg Balance Scale, Timed-up-and-go-test, nerve conduction velocity of peroneal and sural nerve as well as for HbA1c in patients with DPN, and standardized mean differences of 0.43-0.75 for static balance, quality of life, and neuropathy-induced symptoms in patients with CIPN. CONCLUSION For DPN, evidence-based recommendations can now be made, suggesting a combination of endurance and sensorimotor training to be most beneficial. For patients with CIPN, sensorimotor training remains the most crucial component. For all other neuropathies, more high-quality research is needed to derive evidence-based recommendations. Overall, it seems that sensorimotor training has great potential to target most neuropathies and combined with endurance training is therefore currently the best treatment option for neuropathies. REGISTRATION NUMBER: (PROSPERO 2019 CRD42019124583)/16.04.2019.
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Affiliation(s)
- Fiona Streckmann
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland. .,Department of Oncology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. .,Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
| | - Maryam Balke
- Department of Early Neurological and Interdisciplinary Rehabilitation, St. Marien-Hospital, Kunibertskloster 11-13, 50668, Cologne, Germany.,Department of Rehabilitation Sciences, University of Witten/Herdecke, Holthauser Talstraße 2, 58256, Ennepetal, Germany
| | - Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery and Milan Center for Neuroscience, University of Milano-Bicocca, via Cadore 48, 20900, Monza, Italy
| | - Alexandra Toscanelli
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Wilhelm Bloch
- Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Bernhard F Décard
- Department of Medicine, Neurologic Clinic and Policlinic, University Hospital Basel and University of Basel, 4031, Basel, Switzerland.,Department of Biomedicine, Neurologic Clinic and Policlinic, University Hospital Basel and University of Basel, 4031, Basel, Switzerland.,Department of Clinical Research, Neurologic Clinic and Policlinic, University Hospital Basel and University of Basel, 4031, Basel, Switzerland
| | - Helmar C Lehmann
- Department of Neurology, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
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Alizadehsaravi L, Koster RAJ, Muijres W, Maas H, Bruijn SM, van Dieën JH. The underlying mechanisms of improved balance after one and ten sessions of balance training in older adults. Hum Mov Sci 2021; 81:102910. [PMID: 34864610 DOI: 10.1016/j.humov.2021.102910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Training improves balance control in older adults, but the time course and neural mechanisms underlying these improvements are unclear. We studied balance robustness and performance, H-reflex gains, paired reflex depression, and co-contraction duration in ankle muscles after one and ten training sessions in 22 older adults (+65 yrs). Mediolateral balance robustness, time to balance loss in unipedal standing on a platform with decreasing rotational stiffness, improved (33%) after one session, with no further improvement after ten sessions. Balance performance, absolute mediolateral center of mass velocity, improved (18.75%) after one session in perturbed unipedal standing and (18.18%) after ten sessions in unperturbed unipedal standing. Co-contraction duration of soleus/tibialis anterior increased (16%) after ten sessions. H-reflex gain and paired reflex depression excitability did not change. H-reflex gains were lower, and soleus/tibialis anterior co-contraction duration was higher in participants with more robust balance after ten sessions, and co-contraction duration was higher in participants with better balance performance at several time-points. Changes in robustness and performance were uncorrelated with changes in co-contraction duration, H-reflex gain, or paired reflex depression. In older adults, balance robustness improved over a single session, while performance improved gradually over multiple sessions. Changes in co-contraction and excitability of ankle muscles were not exclusive causes of improved balance.
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Affiliation(s)
- Leila Alizadehsaravi
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Ruud A J Koster
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Wouter Muijres
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Movement Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Huub Maas
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sjoerd M Bruijn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
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30
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Chen XP, Wang LJ, Chang XQ, Wang K, Wang HF, Ni M, Niu WX, Zhang M. Tai Chi and Yoga for Improving Balance on One Leg: A Neuroimaging and Biomechanics Study. Front Neurol 2021; 12:746599. [PMID: 34721273 PMCID: PMC8548460 DOI: 10.3389/fneur.2021.746599] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 09/13/2021] [Indexed: 12/26/2022] Open
Abstract
The one-leg stance is frequently used in balance training and rehabilitation programs for various balance disorders. There are some typical one-leg stance postures in Tai Chi (TC) and yoga, which are normally used for improving balance. However, the mechanism is poorly understood. Besides, the differences of one-leg stance postures between TC and yoga in training balance are still unknown. Therefore, the aim of the present study was to investigate cortical activation and rambling and trembling trajectories to elucidate the possible mechanism of improving one-leg stance balance, and compare the postural demands during one-leg stance postures between TC and yoga. Thirty-two healthy young individuals were recruited to perform two TC one-leg stance postures, i.e., right heel kick (RHK) and left lower body and stand on one leg (LSOL), two yoga postures, i.e., one-leg balance and Tree, and normal one-leg standing (OLS). Brain activation in the primary motor cortex, supplementary motor area (SMA), and dorsolateral prefrontal cortex (DLPFC) was measured using functional near-infrared spectroscopy. The center of pressure was simultaneously recorded using a force platform and decomposed into rambling and trembling components. One-way repeated-measures analysis of variance was used for the main effects. The relative concentration changes of oxygenated hemoglobin (ΔHbO) in SMA were significantly higher during RHK, LSOL, and Tree than that during OLS (p < 0.001). RHK (p < 0.001), LSOL (p = 0.003), and Tree (p = 0.006) all showed significantly larger root mean square rambling (RmRMS) than that during OLS in the medial–lateral direction. The right DLPFC activation was significantly greater during the RHK than that during the Tree (p = 0.023), OLB (p < 0.001), and OLS (p = 0.013) postures. In conclusion, the RHK, LSOL, and Tree could be used as training movements for people with impaired balance. Furthermore, the RHK in TC may provide more cognitive training in postural control than Tree and OLB in yoga. Knowledge from this study could be used and implemented in training one-leg stance balance.
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Affiliation(s)
- Xin-Peng Chen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Le-Jun Wang
- Physical Education Department, Sport and Health Research Center, Tongji University, Shanghai, China
| | - Xiao-Qian Chang
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Kuan Wang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Hui-Fang Wang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Ming Ni
- Department of Orthopaedics, Pudong New Area Peoples' Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Wen-Xin Niu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
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31
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Surgent O, Dean DC, Alexander AL, Dadalko OI, Guerrero-Gonzalez J, Taylor D, Skaletski E, Travers BG. Neurobiological and behavioural outcomes of biofeedback-based training in autism: a randomized controlled trial. Brain Commun 2021; 3:fcab112. [PMID: 34250479 PMCID: PMC8254423 DOI: 10.1093/braincomms/fcab112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/26/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
The human brain has demonstrated the power to structurally change as a result of movement-based interventions. However, it is unclear whether these structural brain changes differ in autistic individuals compared to non-autistic individuals. The purpose of the present study was to pilot a randomized controlled trial to investigate brain, balance, autism symptom severity and daily living skill changes that result from a biofeedback-based balance intervention in autistic adolescents (13-17 years old). Thirty-four autistic participants and 28 age-matched non-autistic participants underwent diagnostic testing and pre-training assessment (neuroimaging, cognitive, autism symptom severity and motor assessments) and were then randomly assigned to 6 weeks of a balance-training intervention or a sedentary-control condition. After the 6 weeks, neuroimaging, symptom severity and motor assessments were repeated. Results found that both the autistic and non-autistic participants demonstrated similar and significant increases in balance times with training. Furthermore, individuals in the balance-training condition showed significantly greater improvements in postural sway and reductions in autism symptom severity compared to individuals in the control condition. Daily living scores did not change with training, nor did we observe hypothesized changes to the microstructural properties of the corticospinal tract. However, follow-up voxel-based analyses found a wide range of balance-related structures that showed changes across the brain. Many of these brain changes were specific to the autistic participants compared to the non-autistic participants, suggesting distinct structural neuroplasticity in response to balance training in autistic participants. Altogether, these findings suggest that biofeedback-based balance training may target postural stability challenges, reduce core autism symptoms and influence neurobiological change. Future research is encouraged to examine the superior cerebellar peduncle in response to balance training and symptom severity changes in autistic individuals, as the current study produced overlapping findings in this brain region.
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Affiliation(s)
- Olivia Surgent
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Douglas C Dean
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Pediatrics, University of Wisconsin-Madison, Madison, WI 53792, USA
- Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Andrew L Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
- Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
| | - Olga I Dadalko
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Jose Guerrero-Gonzalez
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Desiree Taylor
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Occupational Therapy Program in Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Emily Skaletski
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Occupational Therapy Program in Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Occupational Therapy Program in Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA
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32
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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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Elsotohy NM, Salim YE, Nassif NS, Hanafy AF. Cross-education effect of balance training program in patients with chronic ankle instability: A randomized controlled trial. Injury 2021; 52:625-632. [PMID: 33041018 DOI: 10.1016/j.injury.2020.09.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 02/02/2023]
Abstract
UNLABELLED Chronic ankle instability (CAI) is frequently developed due to failure of the functional rehabilitation after acute ankle sprain. So, there is a need for an alternative way by which we can begin neuro-muscular control retraining sooner. PURPOSE This study was conducted to examine the effect of 6-week Single-limb Balance Training Program of the non-affected side on the Overall Stability Index (OASI), Antero-Posterior Stability Index (APSI), and the Medio-Lateral Stability Index (MLSI) of the affected side in females with unilateral CAI. METHODS Thirty-two female patients with CAI with mean age 20.96 ± 1.69 years participated in this study. They were randomly assigned into three groups: experimental group A (Cross-Education) (n = 11) performed the exercises for the non-affected side, experimental group B (Traditional Training) (n = 11) performed the exercises for the affected side, and Control group C (n = 10) did not perform any exercises. The randomization was done using statistical random tables. Data were collected using the Biodex Balance system before and after training. RESULTS Two-way mixed design MANOVA revealed that there were significant improvements in the mean values of the OASI, APSI and MLSI after training (p < .05) in both the Cross-Education group (A) and Traditional Training group (B) with no significant difference in-between for the OASI, MLSI and APSI after training. There was no significant difference (p > .05) between the pre and post-training mean values of the OASI, MLSI and APSI in the Control group (C). CONCLUSION Single-limb balance training for the non-affected side is effective in improving the postural control of the affected side in patients with CAI.
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Affiliation(s)
- Nadia Magdy Elsotohy
- Demonstrator of Biomechanics, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, 7 Ahmed Ezzayyat street, Bein Essarayat, Giza, Egypt, 0236717691
| | - Yassmin Essam Salim
- Lecturer of Biomechanics, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, 7 Ahmed Ezzayyat Street, Bein Essarayat, Giza, Egypt, 0236717691
| | - Nagui Sobhi Nassif
- Professor of Biomechanics, Departement of Biomechanics, Faculty of Physical Therapy, Cairo University
| | - Abeer Farag Hanafy
- Lecturer of Biomechanics, Department of Biomechanics, Faculty of Physical Therapy, Cairo University, 7 Ahmed Ezzayyat Street, Bein Essarayat, Giza, Egypt, 0236717691.
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Lauber B, Gollhofer A, Taube W. What to train first: Balance or explosive strength? Impact on performance and intracortical inhibition. Scand J Med Sci Sports 2021; 31:1301-1312. [PMID: 33606302 DOI: 10.1111/sms.13939] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/29/2021] [Accepted: 02/16/2021] [Indexed: 01/08/2023]
Abstract
Explosive strength and balance training are commonly applied to enhance explosive strength and balance performance. Even though both training methods are frequently implemented, ordering effects have largely been neglected. Therefore, the present study aimed to investigate ordering effects of balance and explosive strength training on explosive strength and balance performance as well as changes in short-interval intracortical inhibition (SICI). Two groups of subjects either participated in 4 weeks of balance training followed by 4 weeks of explosive strength training (BT-ET) or vice versa (ET-BT). Before, after 4 and 8 weeks, balance performance, as well as explosive strength, was tested. Additionally, SICI was tested during rest as well as during balance perturbations and explosive contractions. The results show a training specific increase in performance with an increase in balance control followed by an increase in explosive strength in the BT-ET, while the ET-BT increased its balance and explosive strength in the opposite order. There were no significant ordering effects. Both groups showed a significant decrease in SICI during the explosive contractions after the eight weeks of training. When SICI was tested during the balance perturbations, SICI initially increased after the first 4 weeks of training but returned to baseline until the end of the eight weeks. It is suggested that the decrease in SICI with prolonged training might show a disengagement of the motor cortex during the balance task. During the explosive contractions, the low SICI levels are beneficial to provide the necessary level of excitatory cortical drive.
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Affiliation(s)
- Benedikt Lauber
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland.,Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
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Kurz A, Lauber B, Franke S, Leukel C. Balance Training Reduces Postural Sway and Improves Sport-specific Performance in Visually Impaired Cross-Country Skiers. J Strength Cond Res 2021; 35:247-252. [PMID: 29781935 DOI: 10.1519/jsc.0000000000002597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Kurz, A, Lauber, B, Franke, S, and Leukel, C. Balance training reduces postural sway and improves sport-specific performance in visually impaired cross-country skiers. J Strength Cond Res 35(1): 247-252, 2021-Balance training is highly effective in reducing sport injuries and causes improvements in postural stability and rapid force production. So far, the positive effects of balance training have been described for healthy athletes. In the present experiments, we questioned whether athletes with disabilities of the visual system can also benefit from balance training. Fourteen visually impaired cross-country skiers participated in this randomized controlled study. The intervention group (N = 7) completed 8 sessions of balance training over a period of 4 weeks (2 times per week), whereas a waiting control group (N = 7) received no training during that time. After training, postural sway was significantly reduced in the intervention group but not in the waiting control group. In addition, sport-specific performance, which was assessed by a standardized Cooper's 12-minute test on roller skis or rollerblades, increased in the intervention group. The change in postural sway from the premeasurement to the postmeasurement correlated with the change in sport-specific performance in all subjects. Our results indicate that balance training is useful for improving postural stability and sport-specific performance in visually impaired cross-country skiers. We propose that balance training should therefore be implemented as part of the training routine in athletes with disabilities of the visual system.
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Affiliation(s)
- Alexander Kurz
- Department of Sport Science, University of Freiburg, Breisgau, Germany.,Bernstein Center Freiburg, University of Freiburg, Breisgau, Germany; and
| | - Benedikt Lauber
- Department of Sport Science, University of Freiburg, Breisgau, Germany
| | - Steffen Franke
- Department of Sport Science, University of Freiburg, Breisgau, Germany
| | - Christian Leukel
- Department of Sport Science, University of Freiburg, Breisgau, Germany.,Bernstein Center Freiburg, University of Freiburg, Breisgau, Germany; and.,Freiburg Institute for Advanced Studies, University of Freiburg, Breisgau, Germany
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da Silva Alves R, Iunes DH, Pereira IC, Borges JBC, Mariano KOP, Carvalho LC. Correlation Between the Trajectory of the Center of Pressure and Thermography of Cancer Patients Undergoing Chemotherapy. J Chiropr Med 2020; 18:278-285. [PMID: 32952473 DOI: 10.1016/j.jcm.2019.04.001] [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: 09/25/2018] [Revised: 04/07/2019] [Accepted: 04/07/2019] [Indexed: 10/23/2022] Open
Abstract
Objective To correlate the potential of the stabilometric parameters of baropodometry with the superficial temperature of the legs of cancer patients during and after treatment. Method This study included 30 volunteers of both sexes, divided into the following groups: chemotherapy-radiotherapy group (CRG) (n = 15; age = 57.13 ± 16.74 years) and cancer group without current treatment (n = 15; age = 63.29 ± 7.34 years). They were assessed for superficial temperature of the legs using infrared thermography with anterior and posterior views. Assessment of postural balance was conducted using a baropodometer in 2 conditions-participants' open eyes and closed eyes-to obtain the center of pressure (COP) of anteroposterior displacement, COP of mediolateral displacement, and COP of displacement area. Results When their eyes were open, the CRG participants presented a high correlation between the displacement of the ML and the surface anterior temperature of both legs (right: r = 0.578, P = .030; left: r = 0.619, P = .018) and posterior region of the right leg (r = 0.571; P = .033), and they presented a high correlation between COP with anterior surface temperature of both legs (right: r = 0.585, P = .028; left: r = 0.540, P = .046). When patients' eyes were closed, no correlation was found between the thermography and the stabilometric parameters evaluated. Conclusion During the chemotherapy-radiotherapy, cancer patients present ML and COP displacement that correlates with infrared thermography evaluation when their eyes are open.
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da Silva Alves R, Iunes DH, Pereira IC, Borges JBC, Prado Mariano KO, Carvalho LC. Correlation Between the Trajectory of the Center of Pressure and Thermography of Cancer Patients Undergoing Chemotherapy. J Chiropr Med 2020; 18:180-187. [PMID: 32884498 DOI: 10.1016/j.jcm.2019.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective The purpose of this study was to correlate potential the stabilometric parameters of baropodometry with the superficial temperature of the legs of cancer patients during and after treatment. Methods This study included 30 volunteers of both sexes, divided into the following groups: chemotherapy-radiotherapy group (n = 15; age = 57.13 ± 16.74 years) and cancer group without current treatment (n = 15; age = 63.29 ± 7.34 years). They were assessed for superficial temperature of the legs using infrared thermography with anterior and posterior views. Assessment of postural balance was conducted using a baropodometer, in 2 conditions-participants' open and closed eyes-to obtain the center of pressure (COP) of anteroposterior displacement, center of pressure of mediolateral displacement (COP-ML), and center of pressure of displacement area. Results When their eyes were open, the chemotherapy-radiotherapy group presented a high correlation between the displacement of the ML and the surface anterior temperature of both legs (right: r = 0.578; P = .030; left: r = 0.619; P = .018) and posterior region of the right leg (r = 0.571; P = .033), and they presented a high correlation between COP with anterior surface temperature of both legs (right: r = 0.585; P = .028; left: r = 0.540; P = .046). When patients' eyes were closed, no correlation was found between the thermography and the stabilometric parameters evaluated. Conclusion During the chemotherapy-radiotherapy, cancer patients present ML and COP displacement that correlates with infrared thermography evaluation when their eyes are open.
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Affiliation(s)
- Ricardo da Silva Alves
- Department of Physical Therapy, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Denise Hollanda Iunes
- Department of Physical Therapy, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | | | | | | | - Leonardo César Carvalho
- Department of Physical Therapy, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
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Potential efficacy of sensorimotor exercise program on pain, proprioception, mobility, and quality of life in diabetic patients with foot burns: A 12-week randomized control study. Burns 2020; 47:587-593. [PMID: 32888746 DOI: 10.1016/j.burns.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/26/2020] [Accepted: 08/05/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Both diabetes mellitus (DM) and burn injuries lead to physical and psychological impairments. Foot burns are still a challenging health condition because of its important sensory role. No previous studies have assessed the physical therapy intervention on diabetic patients with foot burns. Therefore, this study aimed to assess the potential efficacy of sensorimotor exercise on pain, proprioception, mobility, balance, and quality of life in diabetic patients with foot burns. METHODS Between July 2019 and February 2020, thirty-three diabetic patients with foot burns, aged 32 to 46yrs, were enrolled in this randomized control study, and randomized consecutively into two groups, study group (n=16) and control group (n=17). The study group underwent a sensorimotor exercise program thrice a week for 12 consecutive weeks, however the control group did not undergo the exercise intervention. Both groups were instructed to conduct home exercises. Visual analogue scale (VAS), proprioceptive responses, time-up and go (TUG) values, and short form-36 (SF-36) have been assessed prior and subsequent to the study intervention. RESULTS No significant differences were observed between groups regarding baseline data (p˃0.05). Subsequent to 12wk intervention, the study group showed significant improvements in outcome measures (proprioceptive responses, p˂0.05, VAS, p˂0.001, TUG, p=0.003, and SF-36, p˂0.001) and the control group exhibited significant changes in VAS and SF-36 (p=0.004, p=0.043 respectively) however, no significant changes were found in proprioceptive responses and TUG values (p˃0.05). Between groups, the post-intervention comparison demonstrated statistical differences with tending toward the study group (proprioceptive responses, p˂0.05, VAS, p˂0.001, TUG, p=0.013, and SF-36, p=0.046). CONCLUSIONS Sensorimotor exercise training may improve, pain, proprioceptive responses, mobility, balance, and quality of life in diabetic patients with foot burns. Physiotherapists and rehabilitation providers should include the sensorimotor exercise in their protocols in the treatment of diabetic patients with foot burns.
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Multi-session anodal transcranial direct current stimulation enhances lower extremity functional performance in healthy older adults. Exp Brain Res 2020; 238:1925-1936. [DOI: 10.1007/s00221-020-05827-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/02/2020] [Indexed: 12/22/2022]
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Modulation of spinal cord excitability following remote limb ischemic preconditioning in healthy young men. Exp Brain Res 2020; 238:1265-1276. [PMID: 32303809 DOI: 10.1007/s00221-020-05807-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/08/2020] [Indexed: 12/20/2022]
Abstract
Remote limb ischemic preconditioning (RIPC) has shown to improve dynamic postural control in humans. However, studies on the underlying adaptations of spinal cord networks have never been performed. The present work addresses this issue by investigating parameters from the soleus H-reflex recruitment curve (RC), presynaptic mechanisms of reflex modulation (presynaptic inhibition-PSI, and post activation depression-PAD), and the excursion of the center of pressure (CP) recorded during 1 min in upright stance over a compliant surface. A sham ischemic protocol (partial obstruction of blood flow) was applied to the contralateral thigh along four consecutive days. The same procedure was repeated with full obstruction (RIPC) three days after ending the sham protocol. Data were collected before and after both sham and RIPC protocols. The follow-up data were collected five days after the last ischemic intervention. Significant reduction was detected for both the fast oscillations of the CP (higher frequency components) and the parameter estimated from the RC corresponding to the high amplitude H-reflexes (p < 0.05). Even though the magnitude of effects was similar, it was washed out within three days after sham, but persisted for at least five days after RIPC. No significant differences were found for PSI and PAD levels across conditions. These findings indicate that RIPC leads to enduring changes in spinal cord excitability for the latest reflexively recruited motoneurons, along with improvement in balance control. However, these adaptations were not mediated by the presynaptic mechanisms currently assessed.
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Gebel A, Prieske O, Behm DG, Granacher U. Effects of Balance Training on Physical Fitness in Youth and Young Athletes: A Narrative Review. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000548] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Cheng YS, Chien A, Lai DM, Lee YY, Cheng CH, Wang SF, Chang YJ, Wang JL, Hsu WL. Perturbation-Based Balance Training in Postoperative Individuals With Degenerative Cervical Myelopathy. Front Bioeng Biotechnol 2020; 8:108. [PMID: 32154235 PMCID: PMC7044125 DOI: 10.3389/fbioe.2020.00108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/03/2020] [Indexed: 11/28/2022] Open
Abstract
Degenerative cervical myelopathy (DCM) is a common aging condition caused by spinal cord compression. Individuals with DCM often presented with residual balance and functional impairments postoperatively. Perturbation-based balance training (PBT) has been shown to have positive effects on populations with neurological disorders but has yet to be investigated in DCM. The objective of this study was therefore to evaluate the effects of PBT on balance and functional performance in postoperative individuals with DCM. Fifteen postoperative individuals with DCM (DCM group) and 14 healthy adults (healthy control group) were recruited. The DCM group received a 4-weeks PBT using a perturbation treadmill. The outcome measures included mean velocity of center of pressure (COP) during quiet standing; center of mass (COM) variance and reaction time to balance perturbation during standing with forward and backward perturbation; gait speed during level ground walking; Timed Up and Go Test (TUG) and disability questionnaire scores including Visual Analog Scale, Neck Disability Index, and Lower Extremity Function of Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. The assessments were conducted pre- and post-training postoperatively for the DCM group but only once for the healthy control group. Significant improvements were observed in the mean velocity of COP, COM variance, reaction time, gait speed, and TUG in the DCM group. Disability questionnaire scores were not significantly different after training in DCM group. For between-group comparisons, significant differences that were observed pre-training were not observed post-training. The 4-weeks PBT is a potential rehabilitation strategy for addressing balance and functional impairment in postoperative individuals with DCM. In addition, the post-training performance in the DCM group exhibited trends comparable to those of age-matched healthy controls. Furthermore, the training regimens offer a practical reference for future studies on populations with balance disorders. Future studies complemented with neurophysiological assessments could reveal more information of the underlying mechanisms of PBT.
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Affiliation(s)
- Yi-Shan Cheng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Andy Chien
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Dar-Ming Lai
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Yun Lee
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shwu-Fen Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Ju Chang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jaw-Lin Wang
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
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Knoerl R, Gilchrist L, Kanzawa-Lee GA, Donohoe C, Bridges C, Lavoie Smith EM. Proactive Rehabilitation for Chemotherapy-Induced Peripheral Neuropathy. Semin Oncol Nurs 2020; 36:150983. [DOI: 10.1016/j.soncn.2019.150983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Hao J, Zhu X, Bensoussan A. Effects of Nonpharmacological Interventions in Chemotherapy-Induced Peripheral Neuropathy: An Overview of Systematic Reviews and Meta-Analyses. Integr Cancer Ther 2020; 19:1534735420945027. [PMID: 32875921 PMCID: PMC7476348 DOI: 10.1177/1534735420945027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/02/2020] [Accepted: 07/06/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Chemotherapy-induced peripheral neuropathy (CIPN) is one of the prevalent and disabling side effects of cancer treatment. However, management strategies for CIPN currently remain elusive, with treatment restricted to neuropathic pain medications, supportive care, and chemotherapy dosing adjustments. This overview explores evidence on the potential benefits and safety of nonpharmacological interventions in preventing and treating CIPN in cancer patients. METHODS Seven databases were searched for systematic reviews of randomized controlled trials (RCTs). The methodological quality of the selected reviews was assessed by AMSTAR 2, and the quality of evidence was judged by GRADE. Twenty-eight systematic reviews were considered eligible for this review. RESULTS It was found that nonpharmacological interventions (acupuncture, exercise, herbal medicine, nutritional supplements) provided potential benefits for patients with CIPN. Furthermore, Chinese herbal medicine, administered orally or externally, significantly prevented and/or relieved the incidence and severity of CIPN in comparison to control groups (no additional treatment, placebo, and conventional western medicine). However, the quality of evidence and strength of recommendations were compromised by the inconsistencies and imprecision of included studies. The main concerns regarding the quality of systematic reviews included the lack of sufficiently rigorous a priori protocols, and the lack of protocol registration adopted in the included studies. CONCLUSIONS Though looking across reviews, Chinese herbal medicine appear generally effective in CIPN, uncertainty remains about the effects of many other nonpharmacological interventions. The evidence on what works was particularly compromised by reporting and methodological limitations, which requires further investigation to be more certain of their effects.
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Affiliation(s)
- Jie Hao
- Western Sydney University, Sydney, New South Wales, Australia
| | - Xiaoshu Zhu
- Western Sydney University, Sydney, New South Wales, Australia
| | - Alan Bensoussan
- Western Sydney University, Sydney, New South Wales, Australia
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Dunsky A. The Effect of Balance and Coordination Exercises on Quality of Life in Older Adults: A Mini-Review. Front Aging Neurosci 2019; 11:318. [PMID: 31803048 PMCID: PMC6873344 DOI: 10.3389/fnagi.2019.00318] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/01/2019] [Indexed: 12/20/2022] Open
Abstract
The ability to control balance during activities of daily living (ADL) is impaired in older adults as a result of deterioration in the sensory systems (i.e., vestibular, visual, somatosensory), the cognitive system (central nervous system), and the musculoskeletal system. Consequently, many older adults face a risk of falling during their ADL. In most cases, falls and related injuries impair the quality of life and result in physical limitations, anxiety, loss of confidence, and fear of falling. Among a variety of fall prevention interventions, adapted physical activity programs have been suggested for improving balance control during ADL. These programs challenge the sensory, cognitive, and musculoskeletal systems while addressing balance constraints such as orientation in space, changes in direction, and the speed or height of the center of mass during static and dynamic situations resembling ADL. The above-mentioned elements can be dealt with through a combination of balance and coordination exercises that challenge the postural control systems in multiple dimensions—including vertical and horizontal changes of the center of mass, standing on unstable surfaces with a reduced base of support, and changing body directions. Consequently, such exercises require environmental information-processing. The combination of dual-task, function-oriented challenges while controlling balance stimulates the sensory and neuromuscular control mechanisms. Among older adults, these programs have been found to improve static and dynamic stability, as well as a number of aspects in the quality of life. Recently, they have also been found to improve cognitive functions such as memory and spatial cognition.
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Affiliation(s)
- Ayelet Dunsky
- School of Human Movement and Sport Sciences, The Academic College at Wingate, Wingate Institute, Netanya, Israel
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Systematic Balance Exercises Influence Cortical Activation and Serum BDNF Levels in Older Adults. J Clin Med 2019; 8:jcm8111910. [PMID: 31703409 PMCID: PMC6912622 DOI: 10.3390/jcm8111910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 11/17/2022] Open
Abstract
We sought to investigate whether systematic balance training modulates brain area activity responsible for postural control and influence brain-derived neurotrophic factor (BDNF) mRNA protein expression. Seventy-four older adults were randomly divided into three groups (mean age 65.34 ± 3.79 years, 30 females): Classic balance exercises (CBT), virtual reality balance exercises (VBT), and control (CON). Neuroimaging studies were performed at inclusion and after completion of the training or 12 weeks later (CON). Blood samples were obtained to measure BDNF expression. The study revealed significant interaction of sessions and groups: In the motor imagery (MI) condition for supplementary motor area (SMA) activity (Fat peak = 5.25, p < 0.05); in the action observation (AO) condition for left and right supramarginal gyrus/posterior insula (left: Fat peak = 6.48, p < 0.05; right: Fat peak = 6.92, p < 0.05); in the action observation together with motor imagery (AOMI) condition for the middle occipital gyrus (laterally)/area V5 (left: Fat peak = 6.26, p < 0.05; right: Fat peak = 8.37, p < 0.05), and in the cerebellum–inferior semilunar lobule/tonsil (Fat peak = 5.47, p < 0.05). After the training serum BDNF level has increased in CBT (p < 0.001) and in CBT compared to CON (p < 0.05). Systematic balance training may reverse the age-related cortical over-activations and appear to be a factor mediating neuroplasticity in older adults.
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Gebel A, Lesinski M, Behm DG, Granacher U. Effects and Dose-Response Relationship of Balance Training on Balance Performance in Youth: A Systematic Review and Meta-Analysis. Sports Med 2019; 48:2067-2089. [PMID: 29736728 DOI: 10.1007/s40279-018-0926-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Effects and dose-response relationships of balance training on measures of balance are well-documented for healthy young and old adults. However, this has not been systematically studied in youth. OBJECTIVES The objectives of this systematic review and meta-analysis were to quantify effects of balance training (BT) on measures of static and dynamic balance in healthy children and adolescents. Additionally, dose-response relations for BT modalities (e.g. training period, frequency, volume) were quantified through the analysis of controlled trials. DATA SOURCES A computerized systematic literature search was conducted in the electronic databases PubMed and Web of Science from January 1986 until June 2017 to identify articles related to BT in healthy trained and untrained children and adolescents. STUDY ELIGIBILITY CRITERIA A systematic approach was used to evaluate articles that examined the effects of BT on balance outcomes in youth. Controlled trials with pre- and post-measures were included if they examined healthy youth with a mean age of 6-19 years and assessed at least one measure of balance (i.e. static/dynamic steady-state balance, reactive balance, proactive balance) with behavioural (e.g. time during single-leg stance) or biomechanical (e.g. centre of pressure displacements during single-leg stance) test methods. STUDY APPRAISAL AND SYNTHESIS METHODS The included studies were coded for the following criteria: training modalities (i.e. training period, frequency, volume), balance outcomes (i.e. static and dynamic balance) as well as chronological age, sex (male vs. female), training status (trained vs. untrained), setting (school vs. club), and testing method (biomechanical vs. physical fitness test). Weighted mean standardized mean differences (SMDwm) were calculated using a random-effects model to compute overall intervention effects relative to active and passive control groups. Between-study heterogeneity was assessed using I2 and χ2 statistics. A multivariate random effects meta-regression was computed to explain the influence of key training modalities (i.e. training period, training frequency, total number of training sessions, duration of training sessions, and total duration of training per week) on the effectiveness of BT on measures of balance performance. Further, subgroup univariate analyses were computed for each training modality. Additionally, dose-response relationships were characterized independently by interpreting the modality specific magnitude of effect sizes. Methodological quality of the included studies was rated with the help of the Physiotherapy Evidence Database (PEDro) Scale. RESULTS Overall, our literature search revealed 198 hits of which 17 studies were eligible for inclusion in this systematic review and meta-analysis. Irrespective of age, sex, training status, sport discipline and training method, moderate to large BT-related effects were found for measures of static (SMDwm = 0.71) and dynamic (SMDwm = 1.03) balance in youth. However, our subgroup analyses did not reveal any statistically significant effects of the moderator variables age, sex, training status, setting and testing method on overall balance (i.e. aggregation of static and dynamic balance). BT-related effects in adolescents were moderate to large for measures of static (SMDwm = 0.61) and dynamic (SMDwm = 0.86) balance. With regard to the dose-response relationships, findings from the multivariate random effects meta-regression revealed that none of the examined training modalities predicted the effects of BT on balance performance in adolescents (R2 = 0.00). In addition, results from univariate analysis have to be interpreted with caution because training modalities were computed as single factors irrespective of potential between-modality interactions. For training period, 12 weeks of training achieved the largest effect (SMDwm = 1.40). For training frequency, the largest effect was found for two sessions per week (SMDwm = 1.29). For total number of training sessions, the largest effect was observed for 24-36 sessions (SMDwm = 1.58). For the modality duration of a single training session, 4-15 min reached the largest effect (SMDwm = 1.03). Finally, for the modality training per week, a total duration of 31-60 min per week (SMDwm = 1.33) provided the largest effects on overall balance in adolescents. Methodological quality of the studies was rated as moderate with a median PEDro score of 6.0. LIMITATIONS Dose-response relationships were calculated independently for training modalities (i.e. modality specific) and not interdependently. Training intensity was not considered for the calculation of dose-response relationships because the included studies did not report this training modality. Further, the number of included studies allowed the characterization of dose-response relationships in adolescents for overall balance only. In addition, our analyses revealed a considerable between-study heterogeneity (I2 = 66-83%). The results of this meta-analysis have to be interpreted with caution due to their preliminary status. CONCLUSIONS BT is a highly effective means to improve balance performance with moderate to large effects on static and dynamic balance in healthy youth irrespective of age, sex, training status, setting and testing method. The examined training modalities did not have a moderating effect on balance performance in healthy adolescents. Thus, we conclude that an additional but so far unidentified training modality may have a major effect on balance performance that was not assessed in our analysis. Training intensity could be a promising candidate. However, future studies are needed to find appropriate methods to assess BT intensity.
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Affiliation(s)
- Arnd Gebel
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Am Neuen Palais 10, Building 12, 14469, Potsdam, Germany
| | - Melanie Lesinski
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Am Neuen Palais 10, Building 12, 14469, Potsdam, Germany
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NF, Canada
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Am Neuen Palais 10, Building 12, 14469, Potsdam, Germany.
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Reischl SA, Raza SZ, Adkin AL, Patterson JT, Tokuno CD. Examining changes in corticospinal excitability and balance performance in response to social-comparative feedback. Gait Posture 2019; 73:14-19. [PMID: 31299499 DOI: 10.1016/j.gaitpost.2019.07.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/05/2019] [Accepted: 07/02/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Social-comparative feedback informs an individual that their performance was better or worse than the group. Previous studies have found that compared to knowledge of results alone, social-comparative feedback produces a valence response that results in larger improvements in balance performance. However, the neural processes contributing to these motor improvements have not yet been examined. RESEARCH QUESTION Does social-comparative feedback alter corticospinal excitability and consequently, balance performance? METHODS Thirty-six healthy young adults stood and maintained their balance on a stabiliometer for eight trials. After three of the trials, the neutral (i.e., only knowledge of results) group received their performance feedback (i.e., time on balance) while the other two groups also received positive (i.e., performed better than the group) or negative (i.e., performed worse than the group) social-comparative feedback. To measure corticospinal excitability, soleus motor-evoked potentials were elicited using transcranial magnetic stimulation at the beginning of the experiment, after the presentation of feedback, and at the end of the experiment. Pre- and post- ratings of confidence, perceived skill, motivation, and anxiety were also collected. RESULTS The negative feedback group reported decreases in perceived skill (43 ± 29%) and balance confidence (26 ± 28%), while the positive group reported a 13 ± 17% increase in perceived skill. Despite these group differences in feedback perception, all three groups improved their balance performance by ≈35% (p < 0.001) by the eighth trial. However, this improvement in balance performance was not matched by any changes in corticospinal excitability over time (19.2 ± 55.9% change; p = 0.340) or between groups (p = 0.734). SIGNIFICANCE Our findings suggest that social-comparative feedback, as presented in this study, does not affect corticospinal excitability and balance performance differently than knowledge of results (neutral feedback) alone. More arousing and more frequent forms of social-comparative feedback may be necessary for observing larger changes in the functional or neural control of balance.
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Affiliation(s)
| | - Syed Z Raza
- Centre for Neuroscience, Brock University, St. Catharines, ON, Canada
| | - Allan L Adkin
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada; Centre for Neuroscience, Brock University, St. Catharines, ON, Canada
| | - Jae T Patterson
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada; Centre for Neuroscience, Brock University, St. Catharines, ON, Canada
| | - Craig D Tokuno
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada; Centre for Neuroscience, Brock University, St. Catharines, ON, Canada.
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50
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Giboin LS, Loewe K, Hassa T, Kramer A, Dettmers C, Spiteri S, Gruber M, Schoenfeld MA. Cortical, subcortical and spinal neural correlates of slackline training-induced balance performance improvements. Neuroimage 2019; 202:116061. [PMID: 31374329 DOI: 10.1016/j.neuroimage.2019.116061] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/17/2019] [Accepted: 07/27/2019] [Indexed: 02/08/2023] Open
Abstract
Humans develop posture and balance control during childhood. Interestingly, adults can also learn to master new complex balance tasks, but the underlying neural mechanisms are not fully understood yet. Here, we combined broad scale brain connectivity fMRI at rest and spinal excitability measurements during movement. Six weeks of slackline training improved the capability to walk on a slackline which was paralleled by functional connectivity changes in brain regions associated with posture and balance control and by task-specific changes of spinal excitability. Importantly, the performance of trainees was not better than control participants in a different, untrained balance task. In conclusion, slackline training induced large-scale neuroplasticity which solely transferred into highly task specific performance improvements.
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Affiliation(s)
- Louis-Solal Giboin
- Sensorimotor Performance Lab, Human Research Performance Centre, University Konstanz, Germany.
| | - Kristian Loewe
- Dept of Experimental Neurology, Otto-von-Guericke-University Magdeburg, Germany; Dept of Computer Science, Otto-von-Guericke-University Magdeburg, Germany
| | - Thomas Hassa
- Lurija Institute, Kliniken Schmieder Allensbach, Germany
| | - Andreas Kramer
- Sensorimotor Performance Lab, Human Research Performance Centre, University Konstanz, Germany
| | - Christian Dettmers
- Lurija Institute, Kliniken Schmieder Allensbach, Germany; Kliniken Schmieder Konstanz, Germany
| | - Stefan Spiteri
- Lurija Institute, Kliniken Schmieder Allensbach, Germany
| | - Markus Gruber
- Sensorimotor Performance Lab, Human Research Performance Centre, University Konstanz, Germany
| | - Mircea Ariel Schoenfeld
- Dept of Experimental Neurology, Otto-von-Guericke-University Magdeburg, Germany; Lurija Institute, Kliniken Schmieder Allensbach, Germany; Dept of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany; Kliniken Schmieder Heidelberg, Germany
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