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Jouira G, Alexe DI, Moraru CE, Rekik G, Alexe CI, Marinău MA, Sahli S. The influence of cognitive load and vision variability on postural balance in adolescents with intellectual disabilities. Front Neurol 2024; 15:1385286. [PMID: 38882695 PMCID: PMC11176554 DOI: 10.3389/fneur.2024.1385286] [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: 02/12/2024] [Accepted: 05/10/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction This study aimed to investigate the impact of cognitive load, particularly its escalation during the execution of the same test, under varying vision conditions, on postural balance among adolescents with intellectual disability (ID). Methods Twenty adolescents underwent balance assessments under different visual conditions (Open Eyes (OE), Closed Eyes (CE), Flash, Goggles, Visual Stimulation (VS)) and task settings (Single Task (ST), Dual Task (DT) without challenges, and DT with challenges). The cognitive test was assessed using Verbal Fluency (VF). Results and discussion Significant effects were found for Task (p < 0.001, ηp2 = 0.85), indicating that CoP values significantly increased (p < 0.05) with the introduction of the DT. Dual Task Cost (DTC) demonstrated significant effects for Vision (p = 0.008, ηp2 = 0.62), with values varying significantly (p < 0.05) among different vision conditions, especially in CE and Flash conditions. Visual Dependency Quotient (VDQ) analyses revealed significant effects of condition (p < 0.001, ηp2 = 0.84), with significant changes observed in CE/OE and Flash/OE conditions (p < 0.05). Significant effects were observed for Cognitive performance in the Challenge condition (p < 0.001, ηp2 = 0.86), with decreased performance with cognitive task challenges, particularly in Flash and Goggles conditions (p < 0.05). In conclusion, cognitive tasks, especially challenging ones, and visual variations significantly impact postural balance in adolescents with ID.
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Affiliation(s)
- Ghada Jouira
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Dan Iulian Alexe
- Department of Physical and Occupational Therapy, "Vasile Alecsandri" University of Bacău, Bacău, Romania
| | - Cristina Elena Moraru
- Department of Physical Education and Sport, "Alexandru Ioan Cuza" University of Iaşi, Iaşi, Romania
| | - Ghazi Rekik
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Tanyu Research Laboratory, Taipei, Taiwan
| | - Cristina Ioana Alexe
- Department of Physical Education and Sports Performance, "Vasile Alecsandri" University of Bacău, Bacău, Romania
| | - Marius Alin Marinău
- Department of Physical Education, Sport and Kinetotherapy, University of Oradea, Oradea, Romania
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
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ERDEM M, BALAL M, DEMİRKIRAN M. Postural stability in early Parkinson’s disease: effect of cognitive dual-tasking. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1126396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose: The primary aim of this study is to evaluate postural stability by using a static posturography in patients with early Parkinson’s disease (PD). Secondly, this paper addresses the need for illustrating the effect of dual-tasking on postural stability in early PD patients.
Materials and Methods: Twenty-nine early PD patients with maximum 5 years of disease duration were included in this study. The selected group had no clinical PI while their age- and sex-matched healthy controls were carried out. Neurological examination and mini-mental state examination (MMSE) were performed in all subjects. Unified Parkinson Disease Rating Scale (UPDRS) and modified Hoehn and Yahr (H&Y) scores were recorded in PD patients. Postural stability was assessed in all subjects on a static posturography platform under three different conditions: eyes open, eyes closed and a cognitive task of producing words with given letters.
Results: The mean age of the PD was 59.2±10.5 whereas the control groups mean age was 56.3±7.6 (p>0.05). The female-male ratio was 9/20 in the PD and 12/17 in the control group. There was no important difference between the two groups in terms of demographic characteristics. In the PD group, the mean UPDRS was 12.8±4.9. The patients were mostly receiving polytherapy.
Eye closure and cognitive task caused an increase in most sway parameters in both groups.
Conclusion: Early PD patients on medication, postural stability is preserved and cognitive dual-tasking does not affect postural stability in these patients in the early stage.
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Affiliation(s)
- Miray ERDEM
- ADANA CITY TRAINING AND RESEARCH HOSPITAL, DEPARTMENT OF NEUROLOGY
| | - Mehmet BALAL
- CUKUROVA UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NEUROLOGY
| | - Meltem DEMİRKIRAN
- CUKUROVA UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NEUROLOGY
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Zawadka-Kunikowska M, Klawe JJ, Tafil-Klawe M, Bejtka M, Rzepiński Ł, Cieślicka M. Cognitive Function and Postural Control Strategies in Relation to Disease Progression in Patients with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912694. [PMID: 36231994 PMCID: PMC9566250 DOI: 10.3390/ijerph191912694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/01/2023]
Abstract
AIM This study assessed the influence of performing an additional cognitive task on center of pressure (COP) displacement in the early and advanced stages of patients with Parkinson's disease (PD) compared to age-matched healthy controls (HCs). METHODS The study included 40 HCs and 62 patients with PD: early PD (n = 38) and advanced PD (n = 24). COP parameters were determined by static posturography during quiet standing with open eyes (ST, single task) and simultaneous performance of a cognitive task (DT, dual task). Cognitive functioning was examined with a Mini Mental State Examination, number-counting-backward test, and number of enunciated words during DT. RESULTS In the advanced-PD group, DT significantly reduced the sway radius (p = 0.009), area of stabilogram (p = 0.034), medio-lateral length (p = 0.027), and velocity (p = 0.033) compared to ST. In HCs, DT showed a significant increase in the sway radius (p = 0.006), total length (p = 0.039), sway velocity (p = 0.037), anterior-posterior length, and sway velocity. Both PD groups showed worse cognitive performance compared to HCs. CONCLUSIONS Both early and advanced patients with PD showed significant delay in cognitive performance associated with executive function compared to the HCs. During additional cognitive tasks, patients with advanced stages of PD may reduce stabilographic parameters in medio-lateral direction, and this is probably an adaptive strategy to restore balance.
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Affiliation(s)
- Monika Zawadka-Kunikowska
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Jacek J. Klawe
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Małgorzata Tafil-Klawe
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Monika Bejtka
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Łukasz Rzepiński
- Department of Neurology, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
- Sanitas-Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland
| | - Mirosława Cieślicka
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
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de Oliveira FCL, Larivière C, Dallaire M, Mecheri H, Ngomo S, da Silva RA. Immediate Effect of Lumbosacral Orthosis and Abdominal Drawing-In Maneuver on Postural Control in Adults With Nonspecific Chronic Low Back Pain. J Manipulative Physiol Ther 2022; 45:425-435. [PMID: 36400598 DOI: 10.1016/j.jmpt.2022.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 08/26/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the immediate effects of lumbosacral orthosis and the abdominal drawing-in maneuver on the trunk postural control of adults with chronic low back pain compared with asymptomatic controls during 1-legged and semi-tandem stances. METHODS An experimental and comparative study (cross-sectional design) was conducted in a laboratory setting. Twenty adults with chronic low back pain and 20 asymptomatic controls randomly performed 2 postural balance tasks over a force platform, considering 3 experimental conditions: (1) natural posture (baseline-control), (2) lumbosacral orthosis, and (3) abdominal drawing-in maneuver. Linear variables (mean amplitude, ellipse area, and sway velocity) derived from the center of pressure were computed, and 2-way analysis of variance (group × condition) for repeated measures were conducted. RESULTS No group × condition interactions (.139 ≤ P ≤.938) were detected in any center of pressure parameters. No condition effect was detected, but a group effect (P = .042) was observed for 1 center of pressure parameter. The chronic low back pain group presented with a lower mean anteroposterior center of pressure amplitude than asymptomatic controls (∆ = 0.31 ± 0.66 cm [95% confidence interval, 0.05-0.56], P = .019) during the semi-tandem stance balance task. CONCLUSION Neither lumbosacral orthosis nor the abdominal drawing-in maneuver showed immediate improvement in trunk postural control in any group. Thus, clinicians should not expect immediate benefits or improvements yielded by lumbosacral orthosis or the abdominal drawing-in maneuver when patients with chronic low back pain undergo these interventions.
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Affiliation(s)
- Fábio Carlos Lucas de Oliveira
- Department of Health Sciences, Intersectoral Center in Sustainable Health, BioNR Research Laboratory, University of Quebec at Chicoutimi (UQAC), Saguenay, Quebec, Canada; Research Unit in Sport and Physical Activity (CIDAF), Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Christian Larivière
- Occupational Health and Safety Research Robert-Sauvé Institute (IRSST), Montreal, Québec, Canada
| | - Mathieu Dallaire
- Department of Health Sciences, Intersectoral Center in Sustainable Health, BioNR Research Laboratory, University of Quebec at Chicoutimi (UQAC), Saguenay, Quebec, Canada; Occupational Health and Safety Research Robert-Sauvé Institute (IRSST), Montreal, Québec, Canada
| | - Hakim Mecheri
- Occupational Health and Safety Research Robert-Sauvé Institute (IRSST), Montreal, Québec, Canada
| | - Suzy Ngomo
- Department of Health Sciences, Intersectoral Center in Sustainable Health, BioNR Research Laboratory, University of Quebec at Chicoutimi (UQAC), Saguenay, Quebec, Canada; Physical Therapy Program, University of Quebec at Chicoutimi (UQAC), Saguenay, Quebec, Canada
| | - Rubens A da Silva
- Department of Health Sciences, Intersectoral Center in Sustainable Health, BioNR Research Laboratory, University of Quebec at Chicoutimi (UQAC), Saguenay, Quebec, Canada; Physical Therapy Program, University of Quebec at Chicoutimi (UQAC), Saguenay, Quebec, Canada; Integrated Health and Social Services Center of Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services-Bay Hospital, Saguenay, Quebec, Canada; Doctoral and Master Programs in Human Movement and Rehabilitation, Evangélica University of Goiás, Anapolis, Goiás, Brazil.
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Fadillioglu C, Kanus L, Möhler F, Ringhof S, Hellmann D, Stein T. Influence of Controlled Stomatognathic Motor Activity on Sway, Control and Stability of the Center of Mass During Dynamic Steady-State Balance—An Uncontrolled Manifold Analysis. Front Hum Neurosci 2022; 16:868828. [PMID: 35399352 PMCID: PMC8989727 DOI: 10.3389/fnhum.2022.868828] [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: 02/03/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple sensory signals from visual, somatosensory and vestibular systems are used for human postural control. To maintain postural stability, the central nervous system keeps the center of mass (CoM) within the base of support. The influence of the stomatognathic motor system on postural control has been established under static conditions, but it has not yet been investigated during dynamic steady-state balance. The purpose of the study was to investigate the effects of controlled stomatognathic motor activity on the control and stability of the CoM during dynamic steady-state balance. A total of 48 physically active and healthy adults were assigned to three groups with different stomatognathic motor conditions: jaw clenching, tongue pressing and habitual stomatognathic behavior. Dynamic steady-state balance was assessed using an oscillating platform and the kinematic data were collected with a 3D motion capturing system. The path length (PL) of the 3D CoM trajectory was used for quantifying CoM sway. Temporal dynamics of the CoM movement was assessed with a detrended fluctuation analysis (DFA). An uncontrolled manifold (UCM) analysis was applied to assess the stability and control of the CoM with a subject-specific anthropometric 3D model. The statistical analysis revealed that the groups did not differ significantly in PL, DFA scaling exponents or UCM parameters. The results indicated that deliberate jaw clenching or tongue pressing did not seem to affect the sway, control or stability of the CoM on an oscillating platform significantly. Because of the task-specificity of balance, further research investigating the effects of stomatognathic motor activities on dynamic steady-state balance with different movement tasks are needed. Additionally, further analysis by use of muscle synergies or co-contractions may reveal effects on the level of muscles, which were not visible on the level of kinematics. This study can contribute to the understanding of postural control mechanisms, particularly in relation to stomatognathic motor activities and under dynamic conditions.
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Affiliation(s)
- Cagla Fadillioglu
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- *Correspondence: Cagla Fadillioglu
| | - Lisa Kanus
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | - Felix Möhler
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Steffen Ringhof
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Daniel Hellmann
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany
| | - Thorsten Stein
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Zhang T, Lv Z, Gao S. Tai Chi Training as a Primary Daily Care Plan for Better Balance Ability in People With Parkinson's Disease: An Opinion and Positioning Article. Front Neurol 2022; 12:812342. [PMID: 35002945 PMCID: PMC8739955 DOI: 10.3389/fneur.2021.812342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ting Zhang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China.,University Hospital, Zhejiang Normal University, Jinhua, China
| | - Zhenyu Lv
- Department of Chinese Medicine, Naval Special Medical Center, Naval Medical University, Shanghai, China
| | - Song Gao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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Abstract
Downward gazing is often observed when walking requires guidance. This gaze behavior is thought to promote walking stability through anticipatory stepping control. This study is part of an ongoing effort to investigate whether downward gazing also serves to enhance postural control, which can promote walking stability through a feedback/reactive mechanism. Since gaze behavior alone gives no indication as to what information is gathered and the functions it serves, we aimed to investigate the cognitive demands associated with downward gazing, as they are likely to differ between anticipatory and feedback use of visual input. To do so, we used a novel methodology to compromise walking stability in a manner that could not be resolved through modulation of stepping. Then, using interference methodology and neuroimaging, we tested for (1) interference related to dual tasking, and (2) changes in prefrontal activity. The novel methodology resulted in an increase in the time spent looking at the walking surface. Further, while some dual-task interference was observed, indicating that this gaze behavior is cognitively demanding, several gaze parameters pertaining to downward gazing and prefrontal activity correlated. These correlations revealed that a greater tendency to gaze onto the walking surface was associated with lower PFC activity, as is expected when sensory information is used through highly automatic, and useful, neural circuitry. These results, while not conclusive, do suggest that gazing onto the walking surface can be used for purposes other than anticipatory stepping control, bearing important motor-control and clinical implications.
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Fadillioglu C, Kanus L, Möhler F, Ringhof S, Schindler HJ, Stein T, Hellmann D. Influence of controlled masticatory muscle activity on dynamic reactive balance. J Oral Rehabil 2021; 49:327-336. [PMID: 34811784 DOI: 10.1111/joor.13284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/27/2021] [Accepted: 11/06/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The influence of the stomatognatic system on human posture control has been investigated under static conditions, but the effects on dynamic balance have not yet been considered. OBJECTIVE Investigating the influence of different functional stomatognatic activities (jaw clenching (JAW), tongue pressing (TON) and habitual jaw position (HAB)) on postural performance during a dynamic reactive balance task. METHODS Forty-eight physically active and healthy adults were assigned to three groups differing in oral-motor tasks (JAW, TON or HAB). Dynamic reactive balance was assessed by an oscillating platform which was externally perturbed in four directions. Performance was quantified by means of Lehr's damping ratio. Mean speeds of the selected anatomical regions (head, trunk, pelvis, knee and foot) were analysed to determine significant performance differences. RESULTS The groups differed significantly in balance performance in direction F (i.e., forwards acceleration of the platform). Post hoc tests revealed that the JAW group had significantly better performance compared with both the HAB and TON groups. Better performance was associated with a decreased mean speed of the analysed anatomical regions. CONCLUSION JAW can improve dynamic reactive balance but the occurrence of positive effects seems to be task-specific and not general. TON seems not to have any observable effects on dynamic reactive balance performance, at least when evaluating it with an oscillating platform. JAW might be a valuable strategy which could possibly reduce the risk of falls in elderly people; however, further investigations are still needed.
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Affiliation(s)
- Cagla Fadillioglu
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Lisa Kanus
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | - Felix Möhler
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Steffen Ringhof
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Hans J Schindler
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany.,Research Group Biomechanics, Institute for Mechanics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Thorsten Stein
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Daniel Hellmann
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany.,Dental Academy for Continuing Professional Development, Karlsruhe, Germany
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Tai Chi practitioners have lower fall risks under dual-task conditions during stair descending. PLoS One 2021; 16:e0246292. [PMID: 33539403 PMCID: PMC7861538 DOI: 10.1371/journal.pone.0246292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/15/2021] [Indexed: 12/02/2022] Open
Abstract
Stairs are among the most hazardous locations, and stair descending contributes to a high risk of falls among the elderly under dual-task (DT) conditions. The purpose of this study was to determine whether the practitioners of Tai Chi (TC), one type of mind-body exercise, have lower fall risks under DT conditions during stair descending, compared with their no-exercise (NE) counterparts. Fifteen TC practitioners with at least 10 years of experience in TC and fifteen NE participants were recruited in this study. They were asked to descend a six-step staircase under single-task (ST) and DT conditions. An eight-camera motion analysis system and two force plates were used for data collection. Results showed group by DT interactions in walking velocity (p = 0.016) and center of mass–center of pressure inclination angle (COM–COP IA) in the anteroposterior directions (p = 0.026). Group effects observed with foot clearance (p = 0.031), trunk (p = 0.041) and head (p = 0.002) tilt angles, and COM–COP IA in the mediolateral (p = 0.006) directions. Significant DT effects only detected in foot clearance (p = 0.004). Although both groups of participants adopted a more cautious gait strategy under the dual-task condition, the TC practitioners were less influenced by the DT paradigm than their NE counterparts. Our observations indicated that TC practitioners have lower fall risks under DT conditions during stair descending.
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