Search results for: postural balance

Authors: J. W. Kim, Y. R. Kwon, Y. J. Ho, H. M. Jeon, G. M. Eom

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The aim of this study was to investigate the association of anthropometry with static balance in the elderly and their possible gender difference. Forty six subjects (23 men and 23 women) participated in this study. COP (Center of Pressure) was measured on a force-platform during quiet feet-together standing. As outcome measures, mean distance were derived from the COP. Weight was significantly correlated with postural variable only in the elderly men. This result suggests that the gender should be considered when normalizing postural variables.

Keywords: body characteristics, postural balance, elderly, gender difference

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Authors: Ghada M. R. Koura, Ahmed M. F. El Shiwi

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Background: structural scoliosis is a twisting deformity in the curve of vertebral column to the lateral side with simultaneous rotation of the vertebrae, which occurs during the growing years from 10 years to the puberty. Purpose: Studies investigating balance problems specific to scoliotic patients showed that those patients reveal variable balance abnormalities. In this study we evaluated the difference in postural stability responses between female patients (students, office worker and shish weapon players) with structural scoliosis and normal subjects. Methods: sixty subjects participated in this study. Thirty female patients with structural scoliosis with a mean age of (19.5 ± 3.26) years, with Cobb's angle ranged from 20º to 40° in the major curves, and thirty healthy female subjects with a mean age of (19.36 ± 2.41) years. Postural stability of both groups were evaluated by the Biodex Stability System. Results: There was no significant difference between both groups in dynamic balance test. Interpretation/Conclusion: As there was no significant difference between both groups in balance response, it is not recommended to add balance training as an extra physical therapy program for AIS female patients.

Keywords: structural scoliosis, postural stability, female patients, evaluation

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Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

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Authors: Ivan Struhár, Martin Sebera, Lenka Dovrtělová

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The aim of this study was to find out if the special type of exercise with elastic cord can improve the level of postural stability. The exercise programme was conducted twice a week for 3 months. The participants were randomly divided into an experimental group and a control group. The electronic balance board was used for testing of postural stability. All participants trained for 18 hours at the time of experiment without any special form of coordination programme. The experimental group performed 90 minutes plus of coordination exercise. The result showed that differences between pre-test and post-test occurred in the experimental group. It was used the nonparametric Wilcoxon t-test for paired samples (p=0.012; the significance level 95%). We calculated effect size by Cohen´s d. In the experimental group d is 1.96 which indicates a large effect. In the control group d is 0.04 which confirms no significant improvement.

Keywords: balance board, balance training, coordination, stability

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Authors: Sonda Jallouli, Omar Hammouda, Imen Ben Dhia, Salma Sakka, Chokri Mhiri, Mohamed Habib Elleuch, Abedlmoneem Yahia, Sameh Ghroubi

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Multiple sclerosis (MS) is characterized by gender differences with affecting women two to four times more than men, but the disease progression is faster and more severe in men. Fatigue represents one of the most frequent and disabling symptoms related to MS. Results of previous studies regarding gender differences in fatigue perception in MS persons are contradictory. Besides, fatigue has been shown to affect negatively postural balance and functional mobility in MS persons. However, no study has taken into account gender differences in the response of these physical parameters to a fatiguing protocol in MS persons. Given the reduction of autonomy due to the alteration of these parameters induced by fatigue and the importance of gender differences in postural balance training programs in fatigued men and women with MS, the aim of this study was to investigate the effect of gender difference on unipedal postural balance and functional mobility after performing a fatiguing task in MS adults. Methods: Eleven women (30.29 ± 7.99 years) and seven men (30.91 ± 8.19 years) with relapsing-remitting MS performed a fatiguing protocol: three sets of the 5×sit to stand test (5-STST), six-minute walk test (6MWT) followed by three sets of the 5-STST. Unipedal balance, functional mobility, and fatigue perception were measured prefatigue (T0) and post fatigue (T3) using a clinical unipedal balance test, timed up and go test (TUGT), and analogic visual scale of fatigue (VASF), respectively. Heart rate (HR) and rate of perceived exertion (RPE) were recorded before, during and after the fatiguing task. Results: Compared to women, men showed an impairment of unipedal balance on the dominant leg (p<0.001, d=0.52) and mobility (p<0.001, d=3) via reducing unipedal stance time and increasing duration of TUGT execution, respectively. No gender differences were observed in 6MWT, 5-STST, HR, RPE and VASF scores. Conclusion: Fatiguing protocol negatively affected unipedal postural balance and mobility only in men. These gender differences were inconclusive but can be taken into account in postural balance rehabilitation programs for persons with MS.

Keywords: functional mobility, fatiguing exercises, multiple sclerosis, sex differences, unipedal balance

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Authors: K. Chethana, A. S. Guru Prasad, H. N. Vikranth, H. Varun, S. N. Omkar, S. Asokan

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This paper describes a novel application of Fiber Braggs Grating (FBG) sensors on an unstable platform to assess human postural stability and balance. The FBG sensor based Stability Analyzing Device (FBGSAD) developed demonstrates the applicability of FBG sensors in the measurement of plantar strain to assess the postural stability of subjects on unstable platforms during different stances in eyes open and eyes closed conditions on a rocker board. Comparing the Centre of Gravity (CG) variations measured on the lumbar vertebra of subjects using a commercial accelerometer along with FBGSAD validates the study. The results obtained depict qualitative similarities between the data recorded by both FBGSAD and accelerometer, illustrating the reliability and consistency of FBG sensors in biomechanical applications for both young and geriatric population. The developed FBGSAD simultaneously measures plantar strain distribution and postural stability and can serve as a tool/yardstick to mitigate space motion sickness, identify individuals who are susceptible to falls and to qualify subjects for balance and stability, which are important factors in the selection of certain unique professionals such as aircraft pilots, astronauts, cosmonauts etc.

Keywords: biomechanics, fiber bragg gratings, plantar strain measurement, postural stability analysis

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Authors: Ferruh Taspinar, Gulce K. Seyyar, Gamze Kurt, Eda O. Okur, Emrah Afsar, Ismail Saracoglu, Betul Taspinar

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Overweight and obesity has been associated with postural balance. The aim of this study was to investigate the relationship between body composition and balance. One hundred and thirty two young adults (58 male, 74 female) were included in the study. Mean age of participants were found as 21.21±1.51 years. Body composition (body mass index, total body fat ratio, total body muscle ratio) and balance (right anterior, right postero-medial, right postero-lateral, left anterior, left postero-medial, left postero-lateral) were evaluated by Tanita BC-418 and Y balance test, respectively. Pearson correlation analysis was used to evaluate the correlation between the parameters. Significance level in statistical analysis was accepted as 0.05. According to results, no correlation was found between body mass index and balance parameters. There was negative correlation between total body fat ratio and balance parameters (r=0.419-0.509, p˂0.05). On the other hand, positive correlation was found between total body muscle ratio and balance parameters (r=0.390-0.494, p˂0.05). This study demonstrated that body fat and muscle ratio affects the balance. Body composition should be considered in rehabilitation programs including postural balance training.

Keywords: balance, body composition, body mass, young adults

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Authors: Elham Azimzadeh, Fahimeh Khorshidi, Alireza Farsi

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Balance impairment and fear of falling in older adults may reduce their quality of life. Reactive balance training could improve rapid postural responses and fall prevention in the elderly during daily tasks. Performing postural training and simultaneously cognitive dual tasks could be similar to the daily circumstances. Purpose: This study aimed to determine the effect of balance training on stable and unstable surfaces under dual cognitive task conditions on postural control and fear of falling in the elderly. Methods: Thirty non-fallers of older adults (65-75 years) were randomly assigned to two training groups: stable-surface (n=10), unstable-surface (n=10), or a control group (n=10). The intervention groups underwent six weeks of balance training either on a stable (balance board) or an unstable (wobble board) surface while performing a cognitive dual task. The control group received no balance intervention. COP displacements in the anterioposterior (AP) and mediolateral (ML) directions using a computerized balance board, functional balance using TUG, and fear of falling using FES-I were measured in all participants before and after the interventions. Summary of Results: Mixed ANOVA (3 groups * 2 times) with repeated measures and post hoc test showed a significant improvement in both intervention groups in AP index (F= 11/652, P= 0/0002) and functional balance (F= 9/961, P= 0/0001). However, the unstable surface training group had more improvement. However, the fear of falling significantly improved after training on an unstable surface (p= 0/035). All groups had no significant improvement in the ML index (p= 0/817). In the present study, there was an improvement in the AP index after balance training. Conclusion: Unstable surface training may reduce reaction time in posterior ankle muscle activity. Furthermore, focusing attention on cognitive tasks can lead to maintaining balance unconsciously. Most of the daily activities need attention distribution among several activities. So, balance training concurrent to a dual cognitive task is challenging and more similar to the real world. According to the specificity of the training principle, it may improve functional independence and fall prevention in the elderly.

Keywords: cognitive dual task, elderly, fear of falling, postural control, unstable surface

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Authors: K. Rusnakova, D. Gerych, M. Stehlik

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Postural stability is a complex process involving actions of biomechanical, motor, sensory and central nervous system components. Numerous joint systems, muscles involved, the complexity of sporting movements and situations require perfect coordination of the body's movement patterns. To adapt to a constantly changing situation in such a dynamic environment as physical performance, optimal input of information from visual, vestibular and somatosensory sensors are needed. Combat soldiers are required to perform physically and mentally demanding tasks in adverse conditions, and poor postural stability has been identified as a risk factor for lower extremity musculoskeletal injury. The aim of this study is to investigate whether some personality traits are related to the performance of static postural stability among soldiers of combat troops. NEO personality inventory (NEO-PI-R) was used to identify personality traits and the Nintendo Wii Balance Board was used to assess static postural stability of soldiers. Postural stability performance was assessed by changes in center of pressure (CoP) and center of gravity (CoG). A posturographic test was performed for 60 s with eyes opened during quiet upright standing. The results showed that facets of neuroticism and conscientiousness personality traits were significantly correlated with measured parameters of CoP and CoG. This study can help for better understanding the relationship between personality traits and static postural stability. The results can be used to optimize the training process at the individual level.

Keywords: neuroticism, conscientiousness, postural stability, combat troops

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Authors: Hua Cao, Laurent Peyrodie, Olivier Agnani, Cecile Donze

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Multiple sclerosis (MS) is a disease, which affects the central nervous system, and causes balance problem. In clinical, this disorder is usually evaluated using static posturography. Some linear or nonlinear measures, extracted from the posturographic data (i.e. center of pressure, COP) recorded during a balance test, has been used to analyze postural control of MS patients. In this study, the trend (TREND) and the sample entropy (SampEn), two nonlinear parameters were chosen to investigate their relationships with the expanded disability status scale (EDSS) score. Forty volunteers with different EDSS scores participated in our experiments with eyes open (EO) and closed (EC). TREND and two types of SampEn (SampEn1 and SampEn2) were calculated for each combined COP’s position signal. The results have shown that TREND had a weak negative correlation to EDSS while SampEn2 had a strong positive correlation to EDSS. Compared to TREND and SampEn1, SampEn2 showed a better significant correlation to EDSS and an ability to discriminate the MS patients in the EC case. In addition, the outcome of the study suggests that the multi-dimensional nonlinear analysis could provide some information about the impact of disability progression in MS on dynamics of the COP data.

Keywords: balance, multiple sclerosis, nonlinear analysis, postural sway

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Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

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Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

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Authors: Ghada Mohamed Rashad, Doaa Ayoub Elimy, Mohamed Hussein Elgendy, Ahmed Mohamed Fathi Elshiwi, Mahmoud Ghazy

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Background: Flat feet cause changes in foot mobility, foot posture, and load distribution under the foot which influences dynamic balance, that is essential in activities of daily living and for optimal performance in sports activity. Purpose: To investigate the effect of flat feet on dynamic balance including overall stability index (OAI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI). Study Design: The design of the study was an experimental design. Subjects: Forty subjects from both sexes were selected from the Faculty of Physical Therapy, Cairo University, their mean age (23.55 ± 1.74 ) years, divided into two groups, group A (8 males and 12 females) with flat feet, and group B (9 males and 11 females) with normal feet. Methods: The Navicular Drop Test was used to determine if the feet were pronated and Biodex Balance System was used to assess dynamic balance at level 8 and level 4 for both groups. Results: There was no significant difference in dynamic balance including (OSI, APSI and MLSI) of the Biodex at stability level (8) (most stable) (p = 0.56). While there was a significant difference between both groups in all dependent variables at stability level (4) (less stable level) (p = 0.0001). Conclusion: It may be concluded that flat feet have an effect on dynamic balance and there is balance affection in subjects with flat feet.

Keywords: flat feet, dynamic balance, postural stability, types of flat feet, eversion strength

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Authors: Masoumeh Shojaei, Natalie Gedayloo, Amir Sarshin

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The purpose of the present study was to investigate the effect of Isokinetic fatigue of muscles around the ankle, knee, and hip on the indicators of dynamic postural stability. Therefore, 15 female university students (age 19.7± 0.6 years old, weight 54.6± 9.4 kg, and height 163.9± 5.6 cm) participated in within-subjects design for 5 different days. In the first session, the postural stability indices (time to stabilization after jump-landing) without fatigue were assessed by force plate and in each next sessions, one of muscle groups of the lower limb including the muscles around ankles, knees, and hip was randomly exhausted by Biodex Isokinetic dynamometer and the indices were assessed immediately after the fatigue of each muscle group. The method involved landing on a force plate from a dynamic state, and transitioning balance into a static state. Results of ANOVA with repeated measures indicated that there was no significant difference between the time to stabilization (TTS) before and after Isokinetic fatigue of the muscles around the ankle, knee and hip in medial – lateral direction (p > 0.05), but in the anterior – posterior (AP) direction, the difference was statistically significant (p < 0.05). Least Significant Difference (LSD) post hoc test results also showed that there was significant difference between TTS in knee and hip muscles before and after isokinetic fatigue in AP direction. In the other hand knee and hip muscles group were affected by isokinetic fatigue only in AP surface (p < 0.05).

Keywords: dynamic balance, fatigue, lower limb muscles, postural control

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Authors: Radwa Elshorbagy, Alaa Elden Balbaa, Khaled Ayad, Waleed Reda

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Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: to determine the contribution of proximal hip strategy to dynamic postural control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic System. Dynamic postural control was measured before and after fatigue by the Biodex Balance System. Results: Repeated measures MANOVA was used to compare between and within group differences, in group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p=0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p= 0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to rely more on the hip strategy. This means that those patients depend on a top to down instead of down to top strategy clinical relevance: patients with recurrent ankle sprain less efficient in maintaining the dynamic postural control due to the change in motor strategies. Indicating that health care providers and rehabilitation specialists should treat CAI as a global/central and not just as a simple local or peripheral injury.

Keywords: hip strategy, ankle strategy, postural control, dynamic balance

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Authors: R. Harihara Prakash, Shweta R. Parikh, Sangna S. Sheth

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The purpose of this study was to explore the usefulness of the Mini-BESTest compared to the Berg Balance Scale in evaluating balance in people with Parkinson's Disease (PD) of varying severity. Evaluation were done to obtain (1) the distribution of patients scores to look for ceiling effects, (2) concurrent validity with severity of disease, and (3) the sensitivity & specificity of separating people with or without postural response deficits. Methods and Material: Seventy-seven(77) people with Parkinson's Disease were tested for balance deficits using the Berg Balance Scale, Mini-BESTest. Unified Parkinson’s Disease Rating Scale (UPDRS) III and the Hoehn & Yahr (H&Y) disease severity scales were used for classification. Materials used in this study were case record sheet, chair without arm rests or wheels, Incline ramp, stopwatch, a box, 3 meter distance measured out and marked on the floor with tape [from chair]. Statistical analysis used: Multiple Linear regression was carried out of UPDRS jointly on the two scores for the Berg and Mini-BESTest. Receiver operating characteristic curves for classifying people into two groups based on a threshold for the H&Y score, to discriminate between mild PD versus more severe PD.Correlation co-efficient to find relativeness between the two variables. Results: The Mini-BESTest is highly correlated with the Berg (r = 0.732,P < 0.001), but avoids the ceiling compression effect of the Berg for mild PD (skewness −0.714 Berg, −0.512 Mini-BESTest). Consequently, the Mini-BESTest is more effective than the Berg for predicting UPDRS Motor score (P < 0.001 Mini-BESTest versus P = 0.72 Berg), and for discriminating between those with and without postural response deficits as measured by the H&Y (ROC).

Keywords: balance, berg balance scale, MINI BESTest, parkinson's disease

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Authors: Elham Azimzadeh, Saeedeh Sepehri, Hamidollah Hassanlouei

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Obesity is associated with postural instability, might influence the quality of daily life, and could be considered a potential factor for falling in obese people. The fat body mass especially in the abdominal area may increase body sway. Furthermore, loss of visual feedback may induce a larger postural sway in obese people. Moreover, Muscle fatigue may impair the work capacity of the skeletal muscle and may alter joint proprioception. So, the purpose of this study was to investigate the effect of physical fatigue and visual feedback on body sway and strength of lower extremities in obese people. 12 obese (4 female, 8 male; BMI >30 kg/m2), and 12 normal weight (4 female, 8 male; BMI: 20-25 kg/m2) subjects aged 37- 47 years participated in this study. The postural stability test on the Biodex balance system was used to characterize postural control along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions and maximal voluntary contraction (MVC) of knee extensors and flexors were measured before and after the high-intensity exhausting exercise protocol on the ergometer bike to confirm the presence of fatigue. Results indicated that the obese group demonstrated significantly greater body sway, in all indices (ML, AP, overall) compared with the normal weight group (eyes open). However, when visual feedback was eliminated, fatigue impaired the balance in the overall and AP indicators in both groups; ML sway was higher only in the obese group after exerting the fatigue in the eyes closed condition. Also, maximal voluntary contraction of knee extensors was impaired in the fatigued normal group but, there was no significant impairment in knee flexors MVC in both group. According to the findings, peripheral fatigue was associated with altered postural control in upright standing when eyes were closed, and that mechanoreceptors of the feet may be less able to estimate the position of the body COM over the base of support in the loss of visual feedback. This suggests that the overall capability of the postural control system during upright standing especially in the ML direction could be lower due to fatigue in obese individuals and could be a predictor of future falls.

Keywords: maximal voluntary contraction, obesity, peripheral fatigue, postural control, visual feedback

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Authors: Nurtekin Erkmen, Turgut Kaplan, Halil Taskin, Ahmet Sanioglu, Gokhan Ipekoglu

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The aim of this study was to determine the effects of an 8 week soccerspecific technical training with limited vision perception on postural control and technical parameters in 10-12 aged soccer players. Subjects in this study were 24 male young soccer players (age: 11.00 ± 0.56 years, height: 150.5 ± 4.23 cm, body weight: 41.49 ± 7.56 kg). Subjects were randomly divided as two groups: Training and control. Balance performance was measured by Biodex Balance System (BBS). Short pass, speed dribbling, 20 m speed with ball, ball control, juggling tests were used to measure soccer players’ technical performances with a ball. Subjects performed soccer training 3 times per week for 8 weeks. In each session, training group with limited vision perception and control group with normal vision perception committed soccer-specific technical drills for 20 min. Data analyzed with t-test for independent samples and Mann-Whitney U between groups and paired t-test and Wilcoxon test between pre-posttests. No significant difference was found balance scores and with eyes open and eyes closed and LOS test between training and control groups after training (p>0.05). After eight week of training there are no significant difference in balance score with eyes open for both training and control groups (p>0.05). Balance scores decreased in training and control groups after the training (p<0.05). The completion time of LOS test shortened in both training and control groups after training (p<0.05). The training developed speed dribbling performance of training group (p<0.05). On the other hand, soccer players’ performance in training and control groups increased in 20 m speed with a ball after eight week training (p<0.05). In conclusion; the results of this study indicate that soccer-specific training with limited vision perception may not improves balance performance in 10-12 aged soccer players, but it develops speed dribbling performance.

Keywords: Young soccer players, vision perception, postural control, technical

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Authors: Radwa El Shorbagy, Alaa El Din Balbaa, Khaled Ayad, Waleed Reda

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Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: to determine the contribution of proximal hip strategy to dynamic postural control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic System. Dynamic postural control was measured before and after fatigue by the Biodex Balance System Results: Repeated measures MANOVA was used to compare between and within group differences, In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p= 0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p= 0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to relay more on the hip strategy. This means that those patients depend on a top to down instead of down to top strategy clinical relevance: patients with recurrent ankle sprain less efficient in maintaining the dynamic postural control due to the change in motor strategies. Indicating that health care providers and rehabilitation specialists should treat CAI as a global/central and not just as a simple local or peripheral injury.

Keywords: ankle sprain, fatigue hip muscles, dynamic balance

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Authors: Saeid Bahiraei, Hassan Daneshmandi , Ali Asghar Norasteh

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The present study aims at the effects of 8 weeks of selected corrective exercise training in stable and unstable levels on the postural control people with ID. Problems and limitations of movement in individuals with intellectual disability (ID) are highly common, which particularly may cause the loss of basic performance and limitation of the person's independence in doing their daily activities. In the present study, thirty-four young adult intellectual disabilities were selected randomly and divided into three groups. In order to measure the balance variable indicators, BESTest was used. The intervention group did the selected performance exercise in 8 weeks (3 times of 45 to 50 minutes a week). Meanwhile, the control group did not experience any kind of exercise. Statistical analysis was performed in SPSS on a significant level (p<0/05). The results showed the compromise between time and the group in all the BESTest tests is significant (P=0/001). The results of the research test compared to the studied groups with time measurements showed that there is a significant difference in the unstable group in Biomechanical constraints (P<0/05). And also, a significant difference exists in the stable and unstable level instability limits/Vertically, Postural responses, and Anticipatory postural adjustment variables (except for the follow-up and pre-test levels), Stability in Gait and Sensory Orientation in the pre-test, post-test, and follow up- pre-test stage of the test (P<0/05). In the comparison between the times of measurement with the groups under study, the results showed that Biomechanical Constraints, Anticipatory Postural adjustment and Postural responses at the pre-test-follow upstage, there was a significant difference between unstable-stable and unstable-control groups (P<0/05), it was also significant between all groups in Stability Limits/Vertically, Sensory Orientation, Stability in Gait and Overall stability index variables (P<0/05). The findings showed that the practice group at an unstable level has move improvement compared to the practice group at a stable level. In conclusion, this study presents evidence that shows selected performative practices can be recognized as a comprehensive and effective mediator in the betterment and improvement of the balance in intellectually disabled people and also affect the performative and moving activities.

Keywords: intellectual disability, BSETest, rehabilitation, postural control

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Authors: Elham Ghandali, Saeed Talebian Moghadam, Mohammad Reza Hadian, Gholamreza Olyaei, Shohreh Jalaie, Elaheh Sajjadi

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Purpose: A few studies have examined the effect of Tai Chi on balance in elderly patients with knee osteoarthritis (OA). The aim of this study was to determine the balance measures in elderly patients with knee OA after Tai Chi exercises. For this purpose, 14 females and 6 males with knee OA were chosen. The area and mean velocity of the center of pressure movements (CoP) were measured by force plate in standing positions (on foam and rigid surfaces). The measurements of area and mean velocity of CoP were performed before and after 60 min of Tai Chi sessions (twice a week for 8 weeks). Results: The results showed that the area of CoP in a standing position on a rigid surface was significantly decreased (P < 0.01) after Tai Chi exercises. Furthermore, the mean velocity of CoP was significantly decreased after Tai Chi exercises on both rigid and foam surfaces (P < 0.001). Our study also indicated that changes in surfaces (rigid and foam) would cause significant differences regarding the area of CoP in standing positions. How- ever, similar findings were not found regarding the mean velocity of CoP. Considering the effects of Tai Chi on the mean velocity of CoP, it might be concluded that motor control and Postural stability improvements have occurred. Conclusions: Therefore, based on these results, Tai Chi exercises could be recommended for elderly patients with knee OA as part of their rehabilitation and physical therapy protocols.

Keywords: Tai Chi, balance, knee osteoarthritis, elderly patients, different surfaces

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Authors: Tariq Ali Gujar, Anita Hökelmann

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Postural balance plays essential role throughout life in daily activities. Somatosensory, visual and vestibular inputs play the fundamental role in maintaining body equilibrium to balance the posture. The aim of this study was to find out electroencephalography (EEG) responses during balance activity of young people during Sensory Organization Balance Test. The outcome of this study will help to create the fitness and neurorehabilitation plan. 25 young people (25 ± 3.1 years) have been analyzed on Balance Master NeuroCom® with the coupling of Brain Vision 32 electrode wireless EEG system during the Sensory Organization Test. From the results it has been found that the balance score of samples is significantly higher under the influence of somatosensory input as compared to visual and vestibular input (p < 0.05). The EEG between somatosensory and visual input to balance the posture showed significantly higher (p < 0.05) alpha and beta activities during somatosensory input in somatosensory, attention and visual functions of the cortex whereas executive and motor functions of the cerebral cortex showed significantly higher (p < 0.05) alpha EEG activity during the visual input. The results suggest that somatosensory and attention function of the cerebral cortex has alpha and beta activity, respectively high during somatosensory and vestibular input in maintaining balance. In patients with balance impairments both physical and cognitive training, including neurofeedback will be helpful to improve balance abilities.

Keywords: balance, electroencephalography activity, somatosensory, visual, vestibular

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Authors: Chin-Chih Chiou, Tai-Yuan Su, Ti-Yu Chen, Wen-Yu Chiu, Chungyu Chen

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The purpose of this study was to investigate the effect of reaction time (RT) or balance performance as the number of stimulus-response choices increases, the amount of information processing of 0-bit and 1-bit conditions based on Hick’s law, using the dual-task design. Eighteen children (age: 9.38 ± 0.27 years old) were recruited as the participants for this study, and asked to assess RT and balance performance separately and simultaneously as following five conditions: simple RT (0-bit decision), choice RT (1-bit decision), single balance control, balance control with simple RT, and balance control with choice RT. Biodex 950-300 balance system and You-Shang response timer were used to record and analyze the postural stability and information processing speed (RT) respectively for the participants. Repeated measures one-way ANOVA with HSD post-hoc test and 2 (balance) × 2 (amount of information processing) repeated measures two-way ANOVA were used to test the parameters of balance performance and RT (α = .05). The results showed the overall stability index in the 1-bit decision was lower than in 0-bit decision, and the mean deflection in the 1-bit decision was lower than in single balance performance. Simple RTs were faster than choice RTs both in single task condition and dual task condition. It indicated that the chronometric approach of RT could use to infer the attention requirement of the secondary task. However, this study did not find that the balance performance is interfered for children by the increasing of the amount of information processing.

Keywords: capacity theory, reaction time, Hick’s law, balance

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Authors: Yaser Kazemzadeh, Keyvan Molanoruzy, Mojtaba Izady

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The balance is the key component of motor skills to maintain postural control and the execution of complex skills. The present study was designed to evaluate the impact of soft knee pads on static and dynamic balance of male athletes. For this aim, thirty young athletes in different sport fields with 3 years professional sport training background and thirty healthy young men nonathletic (age: 24.5 ± 2.9, 24.3 ± 2.4, weight: 77.2 ± 4.3 and 80/9 ± 6/3 and height: 175 ± 2/84, 172 ± 5/44 respectively) as subjects selected. Then, subjects in two manner (without knee and with soft knee pads made of neoprene) execute standard error test (BESS) to assess static balance and star test to assess dynamic balance. For analyze of data, t-tests and one-way ANOVA were significant 05/0 ≥ α statistical analysis. The results showed that the use of soft knee significantly reduced error rate in static balance test (p ≥ 0/05). Also, use a soft knee pads decreased score of athlete group and increased score of nonathletic group in star test (p ≥ 0/05). These findings, indicates that use of knees affects static and dynamic balance in athletes and nonathletic in different manner and may increased athletic performance in sports that rely on static balance and decreased performance in sports that rely on dynamic balance.

Keywords: static balance, dynamic balance, soft knee, athletic men, non athletic men

Procedia PDF Downloads 264

Authors: Mei Teng Woo, Keith Davids, Jarmo Liukkonen, Jia Yi Chow, Timo Jaakkola

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Wearable garments such as tapes, compression garments, and braces could improve proprioception and reduced postural sway. The aim of this study was to examine the effects of wearable garments on postural regulation in a sample of community-dwelling elderly individuals, aged 65 years. It was hypothesized that wearable garments such as socks would provide stimulation to lower leg mechanoreceptors, and help participants achieve better postural regulation. Participants (N=63) performed a 30-s Romberg balance test protocol under four conditions (barefoot; wearing commercial socks; wearing clinical compression socks; wearing non-clinical compression socks), in a counterbalanced order, with four levels of performance difficulty: (1) standing on a stable surface with open eyes (SO); (2) a stable surface with closed eyes (SC); (3) a foam surface with open eyes (FO); and (4) a foam surface with closed eyes (FC). Centre of pressure (CoP) measurements included postural sway area (C90 area), trace length (TL) and sway velocity. Thirty-five participants (55.6%) showed positive effects of wearing the socks (responded group). In the responded group, it was revealed that socks showed significant differences in SO, SC and FO conditions for the two CoP measurements - TL and sway velocity (p < 0.05). In contrast, in the non-responded group, barefoot condition significantly decreased the TL and velocity in the SO condition. From the positive effects observed in the responded group, it is possible that wearable garments provide sensory cues that could interact with a biological cueing system to enhance performance in the postural regulation system. This study suggests that individuals respond to the socks treatments differently and future research should be undertaken to examine the factors that benefited the responded group of participants.

Keywords: community-dwelling, elderly adults, postural regulation, wearable garments

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Authors: Andreia Guimaraes Farnese, Mateus Fernandes Reu Urban, Leandro Procopio, Renato Zangaro, Regiane Albertini

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Senescence changes include postural balance, inferring the risk of falls, and can lead to fractures, bedridden, and the risk of death. Physical activity, e.g., cardiovascular exercises, is notable for improving balance due to brain cell stimulations, but fine coordination exercises also elevate cell brain metabolism. This study aimed to verify whether the elderly person who performs fine motor activity has a balance similar to that of those who practice physical activity. The subjects were divided into three groups according to the activity practice: control group (CG) with seven participants for the sedentary individuals, motor coordination group (MCG) with six participants, and activity practitioner group (PAG) with eight participants. Data comparisons were from the Berg balance scale, Time up and Go test, and stabilometric analysis. Descriptive statistical and ANOVA analyses were performed for data analysis. The results reveal that including fine motor activities can improve the balance of the elderly and indirectly decrease the risk of falls.

Keywords: balance, barapodometer, coordination, elderly

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Authors: Boris Barbolyas, Kristina Buckova, Tomas Volensky, Cyril Belavy, Ladislav Dedik

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Background: Based on statokinezigram, the human balance control is often studied. Approach to human postural reaction analysis is based on a combination of stabilometry output signal with retroreflective marker data signal processing, analysis, and understanding, in this study. The study shows another original application of Method of Developed Statokinesigram Trajectory (MDST), too. Methods: In this study, the participants maintained quiet bipedal standing for 10 s on stabilometry platform. Consequently, bilateral vibration stimuli to Achilles tendons in 20 s interval was applied. Vibration stimuli caused that human postural system took the new pseudo-steady state. Vibration frequencies were 20, 60 and 80 Hz. Participant's body segments - head, shoulders, hips, knees, ankles and little fingers were marked by 12 retroreflective markers. Markers positions were scanned by six cameras system BTS SMART DX. Registration of their postural reaction lasted 60 s. Sampling frequency was 100 Hz. For measured data processing were used Method of Developed Statokinesigram Trajectory. Regression analysis of developed statokinesigram trajectory (DST) data and retroreflective marker developed trajectory (DMT) data were used to find out which marker trajectories most correlate with stabilometry platform output signals. Scaling coefficients (λ) between DST and DMT by linear regression analysis were evaluated, too. Results: Scaling coefficients for marker trajectories were identified for all body segments. Head markers trajectories reached maximal value and ankle markers trajectories had a minimal value of scaling coefficient. Hips, knees and ankles markers were approximately symmetrical in the meaning of scaling coefficient. Notable differences of scaling coefficient were detected in head and shoulders markers trajectories which were not symmetrical. The model of postural system behavior was identified by MDST. Conclusion: Value of scaling factor identifies which body segment is predisposed to postural instability. Hypothetically, if statokinesigram represents overall human postural system response to vibration stimuli, then markers data represented particular postural responses. It can be assumed that cumulative sum of particular marker postural responses is equal to statokinesigram.

Keywords: center of pressure (CoP), method of developed statokinesigram trajectory (MDST), model of postural system behavior, retroreflective marker data

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Authors: Mustafa Gulsen, Nihan Pekyavas, Emine Atıcı

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Purpose: The aim of this study is to investigate the effects of Kinesio taping on postural stability and in young soccer players. Subjects and Methods: 62 volunteered soccer players from Cayyolu Sports Club were included in our study. Permissions were also taken from the club directors about the inclusion of their players to our study. Soccer players between the age of 12 and 16 were included in our study. Players that had previous injury on lower extremities were excluded from the study. Players were randomly divided into two groups: Kinesio taping (KT) (n=31), and control group (n = 31). KT application including gastrocnemius and quadriceps femoris muscle facilitation techniques were applied to the first group. A rest time for 45 minutes was given in order to see the best effectiveness of the tape. The second group was set as the control group and no application was made. All participants were assessed before the application and 45 minutes later. In order to provide the double-blind design of the study, an experienced physiotherapist has done the assessments and another experienced physiotherapist has done the taping. The patients were randomly assigned to one of the two groups using an online random allocation software program. Postural stability was assessed by using Tetrax Interactive Balance System. Thermographic assessment was done by using FLIR E5 (FLIR Systems AB, Sweden) thermal camera in order to see which muscles have the most thermal activity while maintaining postural stability. Results: Statistically significant differences were found in all assessment parameters in both Kinesio Taping and control groups (all p<0.05) except thermal imaging of dominant gastrocnemius muscle results (p=0.668) (Table 1). In comparison of the two groups, statistically significant differences were found in all parameters (all p<0.05). Conclusion: In this study, we investigated the effects of Kinesio taping on postural stability in young soccer players and found that KT application on Quadriceps and Gastrocnemius muscles may have decreased the risk of falling more than the control group. According to thermal imaging assessments, both Quadriceps and Gastrocnemius muscles may be active in maintaining postural stability but in KT group, the temperature of these muscles are higher which leads us to think that they are more activated.

Keywords: Kinesio taping, fall risk, muscle temperature, postural stability

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Authors: Ayça Utkan Karasu, Elif Balevi Batur, Gülçin Kaymak Karataş

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The aim of this study was to examine the efficiency of virtual reality exercises with Nintendo Wii system on balance and independence in motor functions. This randomized controlled assessor-blinded study included 23 stroke inpatients with hemiparesis all within 12 months poststroke. Patients were randomly assigned to control group (n=11) or experimental group (n=12) via block randomization method. Control group participated in a conventional balance rehabilitation programme. Study group received a four-week balance training programme five times per week with a session duration of 20 minutes in addition to the conventional balance rehabilitation programme. Balance was assessed by the Berg’s balance scale, the functional reach test, the timed up and go test, the postural assessment scale for stroke, the static balance index. Also, displacement of centre of pressure sway and centre of pressure displacement during weight shifting was calculated by Emed-SX system. Independence in motor functions was assessed by The Functional Independence Measure (FIM) ambulation and FIM transfer subscales. The outcome measures were evaluated at baseline, 4th week (posttreatment), 8th week (follow-up). Repeated measures analysis of variance was performed for each of the outcome measure. Significant group time interaction was detected in the scores of the Berg’s balance scale, the functional reach test, eyes open anteroposterior and mediolateral center of pressure sway distance, eyes closed anteroposterior center of pressure sway distance, center of pressure displacement during weight shifting to effected side, unaffected side and total centre of pressure displacement during weight shifting (p < 0.05). Time effect was statistically significant in the scores of the Berg’s balance scale, the functional reach test, the timed up and go test, the postural assessment scale for stroke, the static balance index, eyes open anteroposterior and mediolateral center of pressure sway distance, eyes closed mediolateral center of pressure sway distance, the center of pressure displacement during weight shifting to effected side, the functional independence measure ambulation and transfer scores (p < 0.05). Virtual reality exercises with Nintendo Wii system combined with a conventional balance rehabilitation programme enhances balance performance and independence in motor functions in stroke patients.

Keywords: balance, hemiplegia, stroke rehabilitation, virtual reality

Procedia PDF Downloads 193

Authors: Azza M. Atya, Mahmoud M. Nasser

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Background/ /Significance: Peripheral neuropathy is one of the long term serious complications of diabetes, which may attribute to postural instability and alteration of planter pressure. Whole body vibration (WBV) is a somatosensory stimulation type of exercise that has been emerged in sport training and rehabilitation of neuromuscular disorders. Purpose: The aim of this study was to investigate the effect of whole Body Vibration on antroposterior (AP), mediolateral (ML) posture stability and planter foot pressure in patients with diabetic neuropathy. Subjects: forty diabetic patients with moderate peripheral neuropathy aged from 35 to 50 years, were randomly assigned to WBV group (n=20) and control group (n=20). Methods and Materials: the WBV intervention consisted of three session weekly for 8 weeks (frequency 20 Hz, peak-to peak displacement 4mm, acceleration 3.5 g). Biodex balance system was used for postural stability assessment and the foot scan plate was used to measure the mean peak pressure under the first and lesser metatarsals. The main Outcome measures were antroposterior stability index (APSI), mediolateral stability index (MLSI), overall stability index (OSI),and mean peak foot pressure. Analyses: Statistical analysis was performed using the SPSS software package (SPSS for Windows Release 18.0). T-test was used to compare between the pre- and post-treatment values between and within groups. Results: For the 40 study participants (18male and 22 females) there were no between-group differences at baseline. At the end of 8 weeks, Subjects in WBV group experienced significant increase in postural stability with a reduction of mean peak of planter foot pressure (P<0.05) compared with the control group. Conclusion: The result suggests that WBV is an effective therapeutic modality for increasing postural stability and reducing planter pressure in patients with diabetic neuropathy.

Keywords: whole body vibration, diabetic neuropathy, posture stability, foot pressure

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Authors: Badriah Alayidi, Emad Alyahya

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Background: Most people with Multiple Sclerosis (MS) report worsening balance as the condition progresses. Poor balance control is also well known to be a significant risk factor for both falling and fear of falling. The increased risk of falls with disease progression thus makes balance control an essential target of gait rehabilitation amongst people with MS. Intervention programs have developed various methods to improve balance control, and accumulating evidence suggests that exercise programs may help people with MS improve their balance. Among these methods, virtual reality (VR) is growing in popularity as a balance-training technique owing to its potential benefits, including better compliance and greater user happiness. However, it is not clear if a VR environment will induce different balance control mechanisms in MS as compared to healthy individuals or traditional environments. Therefore, this study aims to examine how individuals with MS control their balance in a VR setting. Methodology: The proposed study takes an empirical approach to estimate and determine the role of balance response in persons with MS using a VR environment. It will use primary data collected through patient observations, physiological and biomechanical evaluation of balance, and data analysis. Results: The preliminary systematic review and meta-analysis indicated that there was variability in terms of the outcome assessing balance response in people with MS. The preliminary results of these assessments have the potential to provide essential indicators of the progression of MS and contribute to the individualization of treatment and evaluation of the interventions’ effectiveness. The literature describes patients who have had the opportunity to experiment in VR settings and then used what they have learned in the real world, suggesting that this VR setting could be more appealing than conditional settings. The findings of the proposed study will be beneficial in estimating and determining the effect of VR on balance control in persons with MS. In previous studies, VR was shown to be an interesting approach to neurological rehabilitation, but more data are needed to support this approach in MS. Conclusions: The proposed study enables an assessment of balance and evaluations of a variety of physiological implications related to neural activity as well as biomechanical implications related to movement analysis.

Keywords: multiple sclerosis, virtual reality, postural control, balance

Procedia PDF Downloads 39