Cerebellar transcranial direct current stimulation improves adaptive postural control.

PubMed

Poortvliet, Peter; Hsieh, Billie; Cresswell, Andrew; Au, Jacky; Meinzer, Marcus

2018-01-01

Rehabilitation interventions contribute to recovery of impaired postural control, but it remains a priority to optimize their effectiveness. A promising strategy may involve transcranial direct current stimulation (tDCS) of brain areas involved in fine-tuning of motor adaptation. This study explored the effects of cerebellar tDCS (ctDCS) on postural recovery from disturbance by Achilles tendon vibration. Twenty-eight healthy volunteers participated in this sham-ctDCS controlled study. Standing blindfolded on a force platform, four trials were completed: 60 s quiet standing followed by 20 min active (anodal-tDCS, 1 mA, 20 min, N = 14) or sham-ctDCS (40 s, N = 14) tDCS; three quiet standing trials with 15 s of Achilles tendon vibration and 25 s of postural recovery. Postural steadiness was quantified as displacement, standard deviation and path derived from the center of pressure (COP). Baseline demographics and quiet standing postural steadiness, and backwards displacement during vibration were comparable between groups. However, active-tDCS significantly improved postural steadiness during vibration and reduced forward displacement and variability in COP derivatives during recovery. We demonstrate that ctDCS results in short-term improvement of postural adaptation in healthy individuals. Future studies need to investigate if multisession ctDCS combined with training or rehabilitation interventions can induce prolonged improvement of postural balance. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Decreasing internal focus of attention improves postural control during quiet standing in young healthy adults.

PubMed

Nafati, Gilel; Vuillerme, Nicolas

2011-12-01

This experiment was designed to investigate whether and how decreasing the amount of attentional focus invested in postural control could affect bipedal postural control. Twelve participants were asked to stand upright as immobile as possible on a force platform in one control condition and one cognitive condition. In the latter condition, they performed a short-term digit-span memory task. Decreased center-of-gravity displacements and decreased center-of-foot-pressure displacements minus center-of-gravity displacements were observed in the cognitive condition relative to the control condition. These results suggest that shifting the attentional focus away from postural control by executing a concurrent attention-demanding task could increase postural performance and postural efficiency.

Decreasing Internal Focus of Attention Improves Postural Control during Quiet Standing in Young Healthy Adults

ERIC Educational Resources Information Center

Nafati, Gilel; Vuillerme, Nicolas

2011-01-01

This experiment was designed to investigate whether and how decreasing the amount of attentional focus invested in postural control could affect bipedal postural control. Twelve participants were asked to stand upright as immobile as possible on a force platform in one control condition and one cognitive condition. In the latter condition, they…

Spinal postural training: Comparison of the postural and mobility effects of electrotherapy, exercise, biofeedback trainer in addition to postural education in university students.

PubMed

Çelenay, Şeyda Toprak; Kaya, Derya Özer; Özüdoğru, Anıl

2015-01-01

Spinal posture and mobility are significant for protecting spine. The aim was to compare effects of different postural training interventions on spinal posture and mobility. Ninety-six university students (ages: 18–25 years) were allocated into Electrical Stimulation (ES) (n = 24), Exercise (n = 24), Biofeedback Posture Trainer (Backtone) (n = 24), and Postural Education (n = 24, Controls) groups. All the groups got postural education. The interventions were carried out 3 days a week for 8 weeks. Spinal Mouse device (Idiag, Fehraltorf, Switzerland) was used to detect thoracic and lumbar curvatures and mobility (degrees) in standing and sitting positions. Paired Student’s t-test, one-way ANOVA, and pairwise post-hoc tests were used. ES decreased thoracic curvature, the exercise decreased thoracic and lumbar curvature and increased thoracic mobility in standing position between pre-post training (p < 0.05). Exercise and Backtone improved thoracic curvature in sitting (p <0.05). In Exercise Group, thoracic curvature decreased compared to Backtone and Education Groups, and thoracic mobility increased compared to all groups (p < 0.05). The exercise was effective and superior in improving thoracic and lumbar curves, and mobility among university students. ES decreased thoracic curve. Biofeedback posture trainer improved sitting posture. A prospective randomized controlled trial, Level 1.

Creative Dance Practice Improves Postural Control in a Child With Cerebral Palsy.

PubMed

Stribling, Kate; Christy, Jennifer

2017-10-01

To investigate the effect of creative dance instruction on postural control and balance in an 11-year-old with spastic triplegic cerebral palsy, Gross Motor Function Classification Scale level II. We conducted 1-hour dance interventions twice weekly for 8 weeks, with a focus on somatosensory awareness and movement in all planes of motion. Computerized dynamic posturography using the SMART Balance Master/EquiTest (NeuroCom) was used to assess postural control and balance reactions before the first class and following the final class. Gains in standing stability, balance recovery, directional control, and endpoint excursion of movement were found. Participation in creative dance lessons appears to improve somatosensory effectiveness and postural control in a child with cerebral palsy. Dance is a fun way to improve balance and coordination. These interventions could be easily implemented into programs for children with cerebral palsy.

Improvement of anticipatory postural adjustments for balance control: effect of a single training session.

PubMed

Kanekar, Neeta; Aruin, Alexander S

2015-04-01

Humans use anticipatory and compensatory postural strategies to maintain and restore balance when perturbed. Inefficient generation and utilization of anticipatory postural adjustments (APAs) is one of the reasons for postural instability. The aim of the study was to investigate the role of training in improvement of APAs and its effect on subsequent control of posture. Thirteen healthy young adults were exposed to predictable external perturbations before and after a single training session consisting of catches of a medicine ball thrown at the shoulder level. 3-D body kinematics, EMG activity of thirteen trunk and lower limb muscles, and ground reaction forces were recorded before and immediately after a single training session. Muscle onsets, EMG integrals, center of pressure (COP), and center of mass (COM) displacements were analyzed during the anticipatory and compensatory phases of postural control. The effect of a single training session was seen as significantly early muscle onsets and larger anticipatory COP displacements. As a result, significantly smaller peak COM displacements were observed after the perturbation indicating greater postural stability. The outcome of this study provides a background for examining the role of training in improvement of APAs and its effect on postural stability in individuals in need. Copyright © 2014 Elsevier Ltd. All rights reserved.

Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial.

PubMed

Lee, Kyeongjin; Lee, Yong Woo

2017-09-01

[Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults.

Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial

PubMed Central

Lee, Kyeongjin; Lee, Yong Woo

2017-01-01

[Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults. PMID:28931994

A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain.

PubMed

Azadinia, Fatemeh; Ebrahimi-Takamjani, Ismail; Kamyab, Mojtaba; Parnianpour, Mohamad; Asgari, Morteza

2017-01-01

Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain. However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute to chronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacral orthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain. Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapy clinic of the School of Rehabilitation Sciences. Patients with nonspecific chronic low back pain aged 20 to 55 years were randomly allocated to the intervention and control groups. Both groups received 8 sessions of physical therapy twice weekly for 4 weeks. The intervention group received nonextensible LSO in addition to routine physical therapy. Pain intensity, functional disability, fear of movement/ (re)injury, and postural stability in 3 levels of postural difficulty were measured before and after 4 weeks of intervention. A 2×2×3 mixed model of analysis of variance (ANOVA) was used to determine the main and interactive effects of the 3 factors including group, time, and postural difficulty conditions for each variable of postural stability. Results: The LSO and control groups displayed significant improvement in postural stability at the most difficult postural task conditions (P-value for 95% area ellipse was 0.003; and for phase plane, the mean total velocity and standard deviation of velocity was <0.001). Both groups exhibited a decrease in pain intensity, Oswestry Disability Index, and Tampa Scale of Kinesiophobia after 4 weeks of intervention. A significant difference between groups was found only for functional disability, with greater improvement in the orthosis group (t = 3.60, P<0.001). Conclusion: Both routine physical therapy and LSO significantly improved clinical and postural stability outcomes immediately after 4 weeks of intervention. The orthosis group did not display superior outcomes, except for functional disability.

A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain

PubMed Central

Azadinia, Fatemeh; Ebrahimi-Takamjani, Ismail; Kamyab, Mojtaba; Parnianpour, Mohamad; Asgari, Morteza

2017-01-01

Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain. However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute to chronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacral orthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain. Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapy clinic of the School of Rehabilitation Sciences. Patients with nonspecific chronic low back pain aged 20 to 55 years were randomly allocated to the intervention and control groups. Both groups received 8 sessions of physical therapy twice weekly for 4 weeks. The intervention group received nonextensible LSO in addition to routine physical therapy. Pain intensity, functional disability, fear of movement/ (re)injury, and postural stability in 3 levels of postural difficulty were measured before and after 4 weeks of intervention. A 2×2×3 mixed model of analysis of variance (ANOVA) was used to determine the main and interactive effects of the 3 factors including group, time, and postural difficulty conditions for each variable of postural stability. Results: The LSO and control groups displayed significant improvement in postural stability at the most difficult postural task conditions (P-value for 95% area ellipse was 0.003; and for phase plane, the mean total velocity and standard deviation of velocity was <0.001). Both groups exhibited a decrease in pain intensity, Oswestry Disability Index, and Tampa Scale of Kinesiophobia after 4 weeks of intervention. A significant difference between groups was found only for functional disability, with greater improvement in the orthosis group (t = 3.60, P<0.001). Conclusion: Both routine physical therapy and LSO significantly improved clinical and postural stability outcomes immediately after 4 weeks of intervention. The orthosis group did not display superior outcomes, except for functional disability. PMID:29445655

Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective?

PubMed

McKeon, Patrick O; Hertel, Jay

2008-01-01

To answer the following clinical questions: (1) Can prophylactic balance and coordination training reduce the risk of sustaining a lateral ankle sprain? (2) Can balance and coordination training improve treatment outcomes associated with acute ankle sprains? (3) Can balance and coordination training improve treatment outcomes in patients with chronic ankle instability? PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Only studies assessing the influence of balance training on the primary outcomes of risk of ankle sprain or instrumented postural control measures derived from testing on a stable force plate using the modified Romberg test were included. Studies had to provide results for calculation of relative risk reduction and numbers needed to treat for the injury prevention outcomes or effect sizes for the postural control measures. We calculated the relative risk reduction and numbers needed to treat to assess the effect of balance training on the risk of incurring an ankle sprain. Effect sizes were estimated with the Cohen d for comparisons of postural control performance between trained and untrained groups. Prophylactic balance training substantially reduced the risk of sustaining ankle sprains, with a greater effect seen in those with a history of a previous sprain. Completing at least 6 weeks of balance training after an acute ankle sprain substantially reduced the risk of recurrent ankle sprains; however, consistent improvements in instrumented measures of postural control were not associated with training. Evidence is lacking to assess the reduction in the risk of recurrent sprains and inconclusive to demonstrate improved instrumented postural control measures in those with chronic ankle instability who complete balance training. Balance training can be used prophylactically or after an acute ankle sprain in an effort to reduce future ankle sprains, but current evidence is insufficient to assess this effect in patients with chronic ankle instability.

Effects of Pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis.

PubMed

Soysal Tomruk, Melda; Uz, Muhammed Zahid; Kara, Bilge; İdiman, Egemen

2016-05-01

Decreased postural control, sensory integration deficits and fatigue are important problems that cause functional impairments in patients with multiple sclerosis (pwMS). To examine the effect of modified clinical Pilates exercises on sensory interaction and balance, postural control and fatigue in pwMS. Eleven patients with multiple sclerosis and 12 healthy matched controls were recruited in this study. Limits of stability and postural stability tests were used to evaluate postural control by Biodex Balance System and sensory interaction assessed. Fatigue was assessed by Modified Fatigue Impact Scale. Pilates exercises were applied two times a week for 10 weeks and measurements were repeated to pwMS after exercise training. Postural control and fatigue (except psychosocial parameter) of pwMS were significantly worser than healthy controls (p<0.05). Significant improvements occurred in sensory interaction (eyes open, foam surface) and total, physical and cognitive scores of fatigue after 10-week modified clinical Pilates training (p<0.05). No significant changes were detected in postural control after the pilates exercises (p>0.05). Ten-week Pilates training is effective to improve sensory interaction and to decrease fatigue. Pilates exercises can be applied safely in ambulatory pwMS for enhance sensory interaction and balance and combat fatigue. More investigations are needed. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of training programs based on ipsilateral voluntary and stimulated contractions on muscle strength and monopedal postural control of the contralateral limb.

PubMed

Kadri, Mohamed Abdelhafid; Noé, Frederic; Nouar, Merbouha Boulahbel; Paillard, Thierry

2017-09-01

To compare the effects of unilateral strength training by stimulated and voluntary contractions on muscle strength and monopedal postural control of the contralateral limb. 36 non-active healthy male subjects were recruited and split randomly into three groups. Two groups of 12 subjects took part in a strength-training program (3 sessions a week over 8 weeks) comprising 43 contractions of the quadriceps femoris of the ipsilateral limb (at 20% of the MVC). One group carried out voluntary contractions exclusively (VOL group), while the other group benefited exclusively from electro-induced contractions (NMES group). The other 12 subjects formed the control (CON) group. Assessments of MVC and monopedal postural control in static and dynamic postural tasks were performed with the ipsilateral (ISPI) and contralateral (CONTRA) limbs before (PRE) and after (POST) completion of the training program. After the training program, the MVC of the IPSI and CONTRA limbs increased similarly for both experimental groups (VOL and NMES). There were no significant improvements of monopedal postural control for the IPSI or CONTRA limbs in either the VOL or NMES experimental group. No change was observed for the CON group over the protocol period. The purposed training program with NMES vs VOL contractions induced strength gains but did not permit any improvement of contralateral monopedal postural control in healthy young subjects. This has potential for therapeutic application and allows clinicians to focus their training programs on dynamic and poly-articular exercises to improve the postural control in young subjects.

The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System.

PubMed

Albiol-Pérez, Sergio; Gil-Gómez, José-Antonio; Muñoz-Tomás, María-Teresa; Gil-Gómez, Hermenegildo; Vial-Escolano, Raquel; Lozano-Quilis, José-Antonio

2017-03-23

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control in all positions. We think that the main factor influencing these results is that patients use more of their available cognitive processing to improve their postural control. The ABAR system allows us to make this assumption because the system requires the continuous attention of patients, promoting cognitive processing.

Improving Postural Control in the Battement Tendu: One Teacher's Reflections and Somatic Exercises

ERIC Educational Resources Information Center

Batson, Glenna

2010-01-01

The battement tendu is introduced early in dance training, remaining integral to a dancer's vocabulary. Although appearing relatively simple to execute, the tendu aesthetic takes years to master. One reason might be that efficient performance requires complex coordination of postural balance. Known as postural control, this coordination appears in…

Vertical Heterophoria and Postural Control in Nonspecific Chronic Low Back Pain

PubMed Central

Matheron, Eric; Kapoula, Zoï

2011-01-01

The purpose of this study was to test postural control during quiet standing in nonspecific chronic low back pain (LBP) subjects with vertical heterophoria (VH) before and after cancellation of VH; also to compare with healthy subjects with, and without VH. Fourteen subjects with LBP took part in this study. The postural performance was measured through the center of pressure displacements with a force platform while the subjects fixated on a target placed at either 40 or 200 cm, before and after VH cancellation with an appropriate prism. Their postural performance was compared to that of 14 healthy subjects with VH and 12 without VH (i.e. vertical orthophoria) studied previously in similar conditions. For LBP subjects, cancellation of VH with a prism improved postural performance. With respect to control subjects (with or without VH), the variance of speed of the center of pressure was higher, suggesting more energy was needed to stabilize their posture in quiet upright stance. Similarly to controls, LBP subjects showed higher postural sway when they were looking at a target at a far distance than at a close distance. The most important finding is that LBP subjects with VH can improve their performance after prism-cancellation of their VH. We suggest that VH reflects mild conflict between sensory and motor inputs involved in postural control i.e. a non optimal integration of the various signals. This could affect the performance of postural control and perhaps lead to pain. Nonspecific chronic back pain may results from such prolonged conflict. PMID:21479210

Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?

PubMed

Horak, Fay B

2006-09-01

Postural control is no longer considered simply a summation of static reflexes but, rather, a complex skill based on the interaction of dynamic sensorimotor processes. The two main functional goals of postural behaviour are postural orientation and postural equilibrium. Postural orientation involves the active alignment of the trunk and head with respect to gravity, support surfaces, the visual surround and internal references. Sensory information from somatosensory, vestibular and visual systems is integrated, and the relative weights placed on each of these inputs are dependent on the goals of the movement task and the environmental context. Postural equilibrium involves the coordination of movement strategies to stabilise the centre of body mass during both self-initiated and externally triggered disturbances of stability. The specific response strategy selected depends not only on the characteristics of the external postural displacement but also on the individual's expectations, goals and prior experience. Anticipatory postural adjustments, prior to voluntary limb movement, serve to maintain postural stability by compensating for destabilising forces associated with moving a limb. The amount of cognitive processing required for postural control depends both on the complexity of the postural task and on the capability of the subject's postural control system. The control of posture involves many different underlying physiological systems that can be affected by pathology or sub-clinical constraints. Damage to any of the underlying systems will result in different, context-specific instabilities. The effective rehabilitation of balance to improve mobility and to prevent falls requires a better understanding of the multiple mechanisms underlying postural control.

The impact of the alexander technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study.

PubMed

Reddy, Pramod P; Reddy, Trisha P; Roig-Francoli, Jennifer; Cone, Lois; Sivan, Bezalel; DeFoor, W Robert; Gaitonde, Krishnanath; Noh, Paul H

2011-10-01

One of the main ergonomic challenges during surgical procedures is surgeon posture. There have been reports of a high number of work related injuries in laparoscopic surgeons. The Alexander technique is a process of psychophysical reeducation of the body to improve postural balance and coordination, permitting movement with minimal strain and maximum ease. We evaluated the efficacy of the Alexander technique in improving posture and surgical ergonomics during minimally invasive surgery. We performed a prospective cohort study in which subjects served as their own controls. Informed consent was obtained. Before Alexander technique instruction/intervention subjects underwent assessment of postural coordination and basic laparoscopic skills. All subjects were educated about the Alexander technique and underwent post-instruction/intervention assessment of posture and laparoscopic skills. Subjective and objective data obtained before and after instruction/intervention were tabulated and analyzed for statistical significance. All 7 subjects completed the study. Subjects showed improved ergonomics and improved ability to complete FLS™ as well as subjective improvement in overall posture. The Alexander technique training program resulted in a significant improvement in posture. Improved surgical ergonomics, endurance and posture decrease surgical fatigue and the incidence of repetitive stress injuries to laparoscopic surgeons. Further studies of the influence of the Alexander technique on surgical posture, minimally invasive surgery ergonomics and open surgical techniques are warranted to explore and validate the benefits for surgeons. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The improvement of postural control in patients with mechanical ankle instability after lateral ankle ligaments reconstruction.

PubMed

Li, Hong-Yun; Zheng, Jie-Jiao; Zhang, Jian; Cai, Ye-Hua; Hua, Ying-Hui; Chen, Shi-Yi

2016-04-01

Lateral ankle sprain is the most common injury. A previous study demonstrated that patients with mechanical ankle instability suffered deficits in postural control, indicating that structural damage of the lateral ankle ligaments may produce a balance deficit. The purpose of this study was to confirm that lateral ligaments reconstruction could improve postural control in patients with mechanical ankle instability. A total of 15 patients were included in the study. Each patient had a history of an ankle sprain with persistent symptoms of ankle instability and a positive anterior drawer test and had been treated nonoperatively for at least 3 months. All patients were diagnosed with lateral ankle ligaments tear by ultrasonography and magnetic resonance imaging. They underwent arthroscopic debridement and open lateral ankle ligaments reconstruction with a modified Broström procedure. One day before and 6 months after the operation, all of the participants underwent single-limb postural sway tests. The anterior drawer test and the American Orthopedic Foot and Ankle Society scale score were used to evaluate the clinical results in these patients. At 6 months after the operation, with the patients' eyes closed, there was significantly decreased postural sway in the anteroposterior direction, the circumferential area, and the total path length on the operated ankles compared with those measurements before the operation. With eyes open, however, no difference was found in postural sway before and after the operation. Postural control was improved by reconstructing the lateral ligaments. IV.

Postural control in restless legs syndrome with medication intervention using pramipexole.

PubMed

Ahlgrén-Rimpiläinen, Aulikki; Lauerma, Hannu; Kähkönen, Seppo; Aalto, Heikki; Tuisku, Katinka; Holi, Matti; Pyykkö, Ilmari; Rimpiläinen, Ilpo

2014-02-01

Central dopamine regulation is involved in postural control and in the pathophysiology of restless legs syndrome (RLS) and Parkinson's disease (PD). Postural control abnormalities have been detected in PD, but there are no earlier studies with regard to RLS and postural control. Computerized force platform posturography was applied to measure the shift and the velocity (CPFV) of center point of forces (CPF) with eyes open (EO) and eyes closed (EC) in controls (n = 12) and prior and after a single day intervention with pramipexole in RLS subjects (n = 12). CPFV (EO) was significantly lower in the RLS group (p < 0.05) than in controls. After pramipexole intake, the difference disappeared and the subjective symptom severity diminished. Pramipexole did not significantly influence CPFV (EC) or CPF shift direction. Subjects with RLS used extensively visual mechanisms to control vestibule-spinal reflexes to improve or compensate the postural stability. Further research is needed to clarify altered feedback in the central nervous system and involvement of dopamine and vision in the postural control in RLS.

Systematic Review of Postural Control and Lateral Ankle Instability, Part II: Is Balance Training Clinically Effective

PubMed Central

McKeon, Patrick O; Hertel, Jay

2008-01-01

Objective: To answer the following clinical questions: (1) Can prophylactic balance and coordination training reduce the risk of sustaining a lateral ankle sprain? (2) Can balance and coordination training improve treatment outcomes associated with acute ankle sprains? (3) Can balance and coordination training improve treatment outcomes in patients with chronic ankle instability? Data Sources: PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Study Selection: Only studies assessing the influence of balance training on the primary outcomes of risk of ankle sprain or instrumented postural control measures derived from testing on a stable force plate using the modified Romberg test were included. Studies had to provide results for calculation of relative risk reduction and numbers needed to treat for the injury prevention outcomes or effect sizes for the postural control measures. Data Extraction: We calculated the relative risk reduction and numbers needed to treat to assess the effect of balance training on the risk of incurring an ankle sprain. Effect sizes were estimated with the Cohen d for comparisons of postural control performance between trained and untrained groups. Data Synthesis: Prophylactic balance training substantially reduced the risk of sustaining ankle sprains, with a greater effect seen in those with a history of a previous sprain. Completing at least 6 weeks of balance training after an acute ankle sprain substantially reduced the risk of recurrent ankle sprains; however, consistent improvements in instrumented measures of postural control were not associated with training. Evidence is lacking to assess the reduction in the risk of recurrent sprains and inconclusive to demonstrate improved instrumented postural control measures in those with chronic ankle instability who complete balance training. Conclusions: Balance training can be used prophylactically or after an acute ankle sprain in an effort to reduce future ankle sprains, but current evidence is insufficient to assess this effect in patients with chronic ankle instability. PMID:18523567

Vibratory noise to the fingertip enhances balance improvement associated with light touch.

PubMed

Magalhães, Fernando Henrique; Kohn, André Fabio

2011-03-01

Light touch of a fingertip on an external stable surface greatly improves the postural stability of standing subjects. The hypothesis of the present work was that a vibrating surface could increase the effectiveness of fingertip signaling to the central nervous system (e.g., by a stochastic resonance mechanism) and hence improve postural stability beyond that achieved by light touch. Subjects stood quietly over a force plate while touching with their right index fingertip a surface that could be either quiescent or randomly vibrated at two low-level noise intensities. The vibratory noise of the contact surface caused a significant decrease in postural sway, as assessed by center of pressure measures in both time and frequency domains. Complementary experiments were designed to test whether postural control improvements were associated with a stochastic resonance mechanism or whether attentional mechanisms could be contributing. A full curve relating body sway parameters and different levels of vibratory noise resulted in a U-like function, suggesting that the improvement in sway relied on a stochastic resonance mechanism. Additionally, no decrease in postural sway was observed when the vibrating contact surface was attached to the subject's body, suggesting that no attentional mechanisms were involved. These results indicate that sensory cues obtained from the fingertip need not necessarily be associated with static contact surfaces to cause improvement in postural stability. A low-level noisy vibration applied to the contact surface could lead to a better performance of the postural control system.

Learning effects of dynamic postural control by auditory biofeedback versus visual biofeedback training.

PubMed

Hasegawa, Naoya; Takeda, Kenta; Sakuma, Moe; Mani, Hiroki; Maejima, Hiroshi; Asaka, Tadayoshi

2017-10-01

Augmented sensory biofeedback (BF) for postural control is widely used to improve postural stability. However, the effective sensory information in BF systems of motor learning for postural control is still unknown. The purpose of this study was to investigate the learning effects of visual versus auditory BF training in dynamic postural control. Eighteen healthy young adults were randomly divided into two groups (visual BF and auditory BF). In test sessions, participants were asked to bring the real-time center of pressure (COP) in line with a hidden target by body sway in the sagittal plane. The target moved in seven cycles of sine curves at 0.23Hz in the vertical direction on a monitor. In training sessions, the visual and auditory BF groups were required to change the magnitude of a visual circle and a sound, respectively, according to the distance between the COP and target in order to reach the target. The perceptual magnitudes of visual and auditory BF were equalized according to Stevens' power law. At the retention test, the auditory but not visual BF group demonstrated decreased postural performance errors in both the spatial and temporal parameters under the no-feedback condition. These findings suggest that visual BF increases the dependence on visual information to control postural performance, while auditory BF may enhance the integration of the proprioceptive sensory system, which contributes to motor learning without BF. These results suggest that auditory BF training improves motor learning of dynamic postural control. Copyright © 2017 Elsevier B.V. All rights reserved.

Virtual Reality Training With Three-Dimensional Video Games Improves Postural Balance and Lower Extremity Strength in Community-Dwelling Older Adults.

PubMed

Lee, Yongwoo; Choi, Wonjae; Lee, Kyeongjin; Song, Changho; Lee, Seungwon

2017-10-01

Avatar-based three-dimensional technology is a new approach to improve physical function in older adults. The aim of this study was to use three-dimensional video gaming technology in virtual reality training to improve postural balance and lower extremity strength in a population of community-dwelling older adults. The experimental group participated in the virtual reality training program for 60 min, twice a week, for 6 weeks. Both experimental and control groups were given three times for falls prevention education at the first, third, and fifth weeks. The experimental group showed significant improvements not only in static and dynamic postural balance but also lower extremity strength (p < .05). Furthermore, the experimental group was improved to overall parameters compared with the control group (p < .05). Therefore, three-dimensional video gaming technology might be beneficial for improving postural balance and lower extremity strength in community-dwelling older adults.

Cognitive tasks promote automatization of postural control in young and older adults.

PubMed

Potvin-Desrochers, Alexandra; Richer, Natalie; Lajoie, Yves

2017-09-01

Researchers looking at the effects of performing a concurrent cognitive task on postural control in young and older adults using traditional center-of-pressure measures and complexity measures found discordant results. Results of experiments showing improvements of stability have suggested the use of strategies such as automatization of postural control or stiffening strategy. This experiment aimed to confirm in healthy young and older adults that performing a cognitive task while standing leads to improvements that are due to automaticity of sway by using sample entropy. Twenty-one young adults and twenty-five older adults were asked to stand on a force platform while performing a cognitive task. There were four cognitive tasks: simple reaction time, go/no-go reaction time, equation and occurrence of a digit in a number sequence. Results demonstrated decreased sway area and variability as well as increased sample entropy for both groups when performing a cognitive task. Results suggest that performing a concurrent cognitive task promotes the adoption of an automatic postural control in young and older adults as evidenced by an increased postural stability and postural sway complexity. Copyright © 2017 Elsevier B.V. All rights reserved.

Postural control in elderly persons with osteoporosis: Efficacy of an intervention program to improve balance and muscle strength: a randomized controlled trial.

PubMed

Burke, Thomaz Nogueira; França, Fábio Jorge Renovato; Ferreira de Meneses, Sarah Rúbia; Cardoso, Viviam Inhasz; Marques, Amélia Pasqual

2010-07-01

To assess the efficacy of an exercise program aiming to improve balance and muscular strength, for postural control and muscular strength of women with osteoporosis. Sample consisted of 33 women with osteoporosis, randomized into one of two groups: intervention group, in which exercises for balance and improvement of muscular strength of the inferior members were performed for 8 wks (n = 17, age 72.8 +/- 3.6 yrs); control group, which was women not practicing exercises (n = 16, age 74.4 +/- 3.7 yrs). At baseline and after 8 wks of treatment, postural control was assessed using a force plate (Balance Master, Neurocom), and muscular strength during ankle dorsiflexion, knee extension, and flexion was assessed by dynamometry. Adherence to the program was 82%. When compared with the control group, individuals in the intervention group significantly improved the center of pressure velocity (P = 0.02) in the modified clinical test of sensory interaction for balance test, center of pressure velocity (P < 0.01), and directional control (P < 0.01) in limits of stability test, isometric force during ankle dorsiflexion (P = 0.01), knee extension (P < 0.01), and knee flexion (P < 0.01). Balance and strength exercises are effective in improving postural control and lower-limb strength in elderly women with osteoporosis.

Effects of Kinesio taping and exercise on forward head posture.

PubMed

Shih, Hsu-Sheng; Chen, Shu-Shi; Cheng, Su-Chun; Chang, Hsun-Wen; Wu, Pei-Rong; Yang, Jin-Shiou; Lee, Yi-Shuang; Tsou, Jui-Yi

2017-01-01

Little is known about the effects of Kinesio taping and therapeutic exercise on correcting forward head posture. To compare Kinesio taping versus therapeutic exercise for forward head posture on static posture, dynamic mobility and functional outcomes. Sixty subjects (31 women, 29 men) with forward head postures participated in this study. They were randomly assigned to either one of the three groups: (1) exercise group (n = 20), (2) taping group (n = 20), and (3) control groups (n = 20). The horizontal forward displacement (HFD) between ear lobe and acromion process, upper cervical and lower cervical angle (UCA, LCA), active range of motion (AROM) of cervical spine, and neck disability index (NDI) were measured before and after a 5-week intervention, and a 2-week follow-up. Data were analyzed by means of a mixed design repeated-measures ANOVA. Both taping and exercise groups showed significant improvements in HFD compared with the control group at post-treatment and follow-up. Compared with the control group, the exercise group exhibited significant improvements in the LCA and the side bending AROM at post-treatment. Both Kinesio taping and therapeutic exercise improve forward head posture after intervention and a 2-week follow-up. The effectiveness of therapeutic exercise is better than taping.

Measures of static postural control moderate the association of strength and power with functional dynamic balance.

PubMed

Forte, Roberta; Boreham, Colin A G; De Vito, Giuseppe; Ditroilo, Massimiliano; Pesce, Caterina

2014-12-01

Age-related reductions in strength and power are considered to negatively impact balance control, but the existence of a direct association is still an issue of debate. This is possibly due to the fact that balance assessment is complex, reflects different underlying physiologic mechanisms and involves quantitative measurements of postural sway or timing of performance during balance tasks. The present study evaluated the moderator effect of static postural control on the association of power and strength with dynamic balance tasks. Fifty-seven healthy 65-75 year old individuals performed tests of dynamic functional balance (walking speed under different conditions) and of strength, power and static postural control. Dynamic balance performance (walking speed) was associated with lower limb strength and power, as well as postural control under conditions requiring postural adjustments (narrow surface walking r(2) = 0.31, p < 0.001). An interaction effect between strength and static postural control was found with narrow surface walking and talking while walking (change of β 0.980, p < 0.001 in strength for 1 SD improvements in static postural control for narrow walking, and [Formula: see text] -0.730, p < 0.01 in talking while walking). These results indicate that good static postural control facilitates the utilisation of lower limb strength to better perform complex, dynamic functional balance tasks. Practical implications for assessment and training are discussed.

Gait, posture and cognition in Parkinson's disease

PubMed Central

Barbosa, Alessandra Ferreira; Chen, Janini; Freitag, Fernanda; Valente, Debora; Souza, Carolina de Oliveira; Voos, Mariana Callil; Chien, Hsin Fen

2016-01-01

Gait disorders and postural instability are the leading causes of falls and disability in Parkinson's disease (PD). Cognition plays an important role in postural control and may interfere with gait and posture assessment and treatment. It is important to recognize gait, posture and balance dysfunctions by choosing proper assessment tools for PD. Patients at higher risk of falling must be referred for rehabilitation as early as possible, because antiparkinsonian drugs and surgery do not improve gait and posture in PD. PMID:29213470

The effects of whole body vibration combined biofeedback postural control training on the balance ability and gait ability in stroke patients.

PubMed

Uhm, Yo-Han; Yang, Dae-Jung

2017-11-01

[Purpose] The purpose of this study was to examine the effect of biofeedback postural control training using whole body vibration in acute stroke patients on balance and gait ability. [Subjects and Methods] Thirty stroke patients participated in this study and were divided into a group of 10, a group for biofeedback postural control training combined with a whole body vibration, one for biofeedback postural control training combined with an aero-step, and one for biofeedback postural control training. Biorescue was used to measure the limits of stability, balance ability, and Lukotronic was used to measure step length, gait ability. [Results] In the comparison of balance ability and gait ability between the groups for before and after intervention, Group I showed a significant difference in balance ability and gait ability compared to Groups II and III. [Conclusion] This study showed that biofeedback postural control training using whole body vibration is effective for improving balance ability and gait ability in stroke patients.

Postural control system influences intrinsic alerting state.

PubMed

Barra, Julien; Auclair, Laurent; Charvillat, Agnès; Vidal, Manuel; Pérennou, Dominic

2015-03-01

Numerous studies using dual-task paradigms (postural and cognitive) have shown that postural control requires cognitive resources. However, the influence of postural control on attention components has never been directly addressed. Using the attention network test (ANT), which assesses specifically each of the 3 components of attention-alertness, orientation, and executive control-within a single paradigm, we investigated the effect of postural balance demand on these 3 components. Forty-two participants completed the ANT in 3 postural conditions: (a) supine, a very stable position; (b) sitting on a chair, an intermediate position; and (c) standing with feet lined up heel to toe, a very instable position known as the Romberg position. Our results revealed that the difficulty of postural control does modulate alerting in such a way that it improves with the level of instability of the position. Regarding the orienting and executive control components of attention, performance was not different when participants were standing upright or seated, whereas in the supine position, performance dropped. The strong and specific interaction between postural control and the alerting system suggests that these mechanisms may share parts of the underlying neural circuits. We discuss the possible implication of the locus coeruleus, known to be involved in both postural balance and alerting. Also, our findings concerning orienting and executive control systems suggest that supine posture could have a specific effect on cognitive activities. These effects are discussed in terms of particularities resulting from the supine position. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Resistance versus Balance Training to Improve Postural Control in Parkinson's Disease: A Randomized Rater Blinded Controlled Study

PubMed Central

Schlenstedt, Christian; Paschen, Steffen; Kruse, Annika; Raethjen, Jan; Weisser, Burkhard; Deuschl, Günther

2015-01-01

Background Reduced muscle strength is an independent risk factor for falls and related to postural instability in individuals with Parkinson’s disease. The ability of resistance training to improve postural control still remains unclear. Objective To compare resistance training with balance training to improve postural control in people with Parkinson’s disease. Methods 40 patients with idiopathic Parkinson’s disease (Hoehn&Yahr: 2.5–3.0) were randomly assigned into resistance or balance training (2x/week for 7 weeks). Assessments were performed at baseline, 8- and 12-weeks follow-up: primary outcome: Fullerton Advanced Balance (FAB) scale; secondary outcomes: center of mass analysis during surface perturbations, Timed-up-and-go-test, Unified Parkinson’s Disease Rating Scale, Clinical Global Impression, gait analysis, maximal isometric leg strength, PDQ-39, Beck Depression Inventory. Clinical tests were videotaped and analysed by a second rater, blind to group allocation and assessment time. Results 32 participants (resistance training: n = 17, balance training: n = 15; 8 drop-outs) were analyzed at 8-weeks follow-up. No significant difference was found in the FAB scale when comparing the effects of the two training types (p = 0.14; effect size (Cohen’s d) = -0.59). Participants from the resistance training group, but not from the balance training group significantly improved on the FAB scale (resistance training: +2.4 points, Cohen’s d = -0.46; balance training: +0.3 points, Cohen’s d = -0.08). Within the resistance training group, improvements of the FAB scale were significantly correlated with improvements of rate of force development and stride time variability. No significant differences were found in the secondary outcome measures when comparing the training effects of both training types. Conclusions The difference between resistance and balance training to improve postural control in people with Parkinson’s disease was small and not significant with this sample size. There was weak evidence that freely coordinated resistance training might be more effective than balance training. Our results indicate a relationship between the enhancement of rate of force development and the improvement of postural control. Trial Registration ClinicalTrials.gov ID: NCT02253563 PMID:26501562

Operationality Improvement Control of Electric Power Assisted Wheelchair by Fuzzy Algorithm Considering Posture Angle

NASA Astrophysics Data System (ADS)

Murakami, Hiroki; Seki, Hirokazu; Minakata, Hideaki; Tadakuma, Susumu

This paper describes a novel operationality improvement control for electric power assisted wheelchairs. “Electric power assisted wheelchair” which assists the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people, however, the performance of the straight and circular road driving must be further improved because the two wheels drive independently. This paper proposes a novel operationality improvement control by fuzzy algorithm to realize the stable driving on straight and circular roads. The suitable assisted torque of the right and left wheels is determined by fuzzy algorithm based on the posture angular velocity, the posture angle of the wheelchair, the human input torque proportion and the total human torque of the right and left wheels. Some experiments on the practical roads show the effectiveness of the proposed control system.

Stochastic resonance whole-body vibration improves postural control in health care professionals: a worksite randomized controlled trial.

PubMed

Elfering, Achim; Schade, Volker; Stoecklin, Lukas; Baur, Simone; Burger, Christian; Radlinger, Lorenz

2014-05-01

Slip, trip, and fall injuries are frequent among health care workers. Stochastic resonance whole-body vibration training was tested to improve postural control. Participants included 124 employees of a Swiss university hospital. The randomized controlled trial included an experimental group given 8 weeks of training and a control group with no intervention. In both groups, postural control was assessed as mediolateral sway on a force plate before and after the 8-week trial. Mediolateral sway was significantly decreased by stochastic resonance whole-body vibration training in the experimental group but not in the control group that received no training (p < .05). Stochastic resonance whole-body vibration training is an option in the primary prevention of balance-related injury at work. Copyright 2014, SLACK Incorporated.

Balance versus resistance training on postural control in patients with Parkinson's disease: a randomized controlled trial.

PubMed

Santos, Suhaila M; da Silva, Rubens A; Terra, Marcelle B; Almeida, Isabela A; de Melo, Lúcio B; Ferraz, Henrique B

2017-04-01

Evidences have shown that physiotherapy programs may improve the balance of individuals with Parkinson's disease (PD), although it is not clear which specific exercise program is better. The aim of this study was to compare the effectiveness of balance versus resistance training on postural control measures in PD patients. Randomized controlled trial. The study was conducted in a physiotherapy outpatient clinic of a university hospital. A total of 40 PD participants were randomly divided into two groups: balance training (BT) and resistance training (RT). The BT group focused on balance training, functional independence and gait while the RT group performed resistance exercises emphasizing the lower limbs and trunk, both supervised by trained physiotherapists. Therapy sessions were held twice a week (at 60 minutes), totaling 24 sessions. The primary outcome was evaluated by force platform with center of pressure sway measures in different balance conditions and the secondary outcome was evaluated by Balance Evaluation Systems Test (BESTest) scale to determine the effects of the intervention on postural control. Significant improvement of postural control (pre vs. post 15.1 vs. 9.6 cm2) was only reported in favor of BT group (d=1.17) for one-legged stand condition on force platform. The standardized mean difference between groups was significantly (P<0.02), with 36% of improvement for BT vs. 0.07% for RT on this condition. Significant improvement (P<0.05) was also observed in favor of BT (in mean 3.2%) for balance gains in some BESTest scores, when compared to RT group (-0.98%). Postural control in Parkinson's disease is improved when training by a directional and specific balance program than a resistance training program. Balance training is superior to resistance training in regard to improving postural control of individuals with PD. Gold standard instruments (high in cost and difficult to access) were used to assess balance, as well as scales with clinical applicability (low cost, easily acceptable, applicable and valid), which can guide the management of physiotherapists both in their decision-making and in clinical practice.

Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention.

PubMed

Ellmers, Toby J; Paraskevopoulos, Ioannis Th; Williams, A Mark; Young, William R

2018-03-22

Published reports suggest a disparity between perceived and actual balance abilities, a trait associated with increased fall-risk in older adults. We investigate whether it is possible to 'recalibrate' these disparities using a novel gaming intervention. We recruited 26 older adults for a 4-week intervention in which they participated in 8-sessions using a novel gaming intervention designed to provide explicit, augmented feedback related to postural control. Measures of perceived balance abilities (Falls Efficacy Scale-International) and actual postural control (limits of stability) were assessed pre- and post-intervention. We used focus groups to elicit the opinions of participants about how the game may have influenced balance abilities and confidence. A stronger alignment was observed between postural control and perceived balance capabilities post-intervention (i.e., significant correlations between Falls Efficacy Scale-International scores and limits of stability which were not present pre-intervention). Also, significant improvements in measures of postural control were observed, with these improvements confined to the aspects of postural control for which the exergame provided explicit, augmented feedback. Qualitative data revealed that the intervention made participants more "aware" of their balance abilities. Our results demonstrate that it is possible to recalibrate the perceptions of older adults relating to their balance abilities through a targeted, short-term intervention. We propose that the post-intervention improvements in postural control may have been, in part, the result of this recalibration; with altered perceptions leading to changes in balance performance. Findings support the application of novel interventions aimed at addressing the psychological factors associated with elderly falls.

The influence of the aquatic environment on the control of postural sway.

PubMed

Marinho-Buzelli, Andresa R; Rouhani, Hossein; Masani, Kei; Verrier, Mary C; Popovic, Milos R

2017-01-01

Balance training in the aquatic environment is often used in rehabilitation practice to improve static and dynamic balance. Although aquatic therapy is widely used in clinical practice, we still lack evidence on how immersion in water actually impacts postural control. We examined how postural sway measured using centre of pressure and trunk acceleration parameters are influenced by the aquatic environment along with the effects of visual information. Our results suggest that the aquatic environment increases postural instability, measured by the centre of pressure parameters in the time-domain. The mean velocity and area were more significantly affected when individuals stood with eyes closed in the aquatic environment. In addition, a more forward posture was assumed in water with eyes closed in comparison to standing on land. In water, the low frequencies of sway were more dominant compared to standing on dry land. Trunk acceleration differed in water and dry land only for the larger upper trunk acceleration in mediolateral direction during standing in water. This finding shows that the study participants potentially resorted to using their upper trunk to compensate for postural instability in mediolateral direction. Only the lower trunk seemed to change acceleration pattern in anteroposterior and mediolateral directions when the eyes were closed, and it did so depending on the environment conditions. The increased postural instability and the change in postural control strategies that the aquatic environment offers may be a beneficial stimulus for improving balance control. Copyright © 2016 Elsevier B.V. All rights reserved.

Immediate effects of Pilates based therapeutic exercise on postural control of young individuals with non-specific low back pain: A randomized controlled trial.

PubMed

Lopes, Susana; Correia, Christophe; Félix, Gonçalo; Lopes, Mário; Cruz, Ana; Ribeiro, Fernando

2017-10-01

Low back pain affects the person's ability to keep balance, especially in challenging conditions. The purpose of this study was to determine the immediate effects of Pilates exercises on postural sway and dynamic balance of young individuals with non-specific low back pain. Controlled laboratory design. Forty-six participants with non-specific low back pain were randomized to a Pilates (n=23, 10 males; age: 21.8±3.2years) and a control group (n=23, 9 males; age: 22.8±3.6years). Postural sway was assessed with a force platform and dynamic balance with the Star Excursion Balance Test, before and after the intervention or rest period. To assess postural sway, participants stood still on an unstable surface set on the force plate for 90s, with eyes closed. The intervention lasted 20min and consisted on four Pilates exercises: single leg stretch (level 1), pelvic press (level 1), swimming (level 1) and kneeling opposite arm and leg reach. At baseline, no differences were found between groups. The Pilates group improved in all the postural sway values (area of CoP: 11.5±3.4 to 9.7±2.7cm 2 , p=0.002 and CoP velocity: 2.8±0.6 to 2.3±0.5cm/s, p<0.001) and in the Star Excursion Balance Test. Control group only improved in CoP velocity, however, this improvement was significantly inferior compared to the Pilates group. Pilates exercises immediately improved postural sway and dynamic balance in young adults with non-specific low back pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

Increased alertness, better than posture prioritization, explains dual-task performance in prosthesis users and controls under increasing postural and cognitive challenge.

PubMed

Howard, Charla L; Perry, Bonnie; Chow, John W; Wallace, Chris; Stokic, Dobrivoje S

2017-11-01

Sensorimotor impairments after limb amputation impose a threat to stability. Commonly described strategies for maintaining stability are the posture first strategy (prioritization of balance) and posture second strategy (prioritization of concurrent tasks). The existence of these strategies was examined in 13 below-knee prosthesis users and 15 controls during dual-task standing under increasing postural and cognitive challenge by evaluating path length, 95% sway area, and anterior-posterior and medial-lateral amplitudes of the center of pressure. The subjects stood on two force platforms under usual (hard surface/eyes open) and difficult (soft surface/eyes closed) conditions, first alone and while performing a cognitive task without and then with instruction on cognitive prioritization. During standing alone, sway was not significantly different between groups. After adding the cognitive task without prioritization instruction, prosthesis users increased sway more under the dual-task than single-task standing (p ≤ 0.028) during both usual and difficult conditions, favoring the posture second strategy. Controls, however, reduced dual-task sway under a greater postural challenge (p ≤ 0.017), suggesting the posture first strategy. With prioritization of the cognitive task, sway was unchanged or reduced in prosthesis users, suggesting departure from the posture second strategy, whereas controls maintained the posture first strategy. Individual analysis of dual tasking revealed that greater postural demand in controls and greater cognitive challenge in prosthesis users led to both reduced sway and improved cognitive performance, suggesting cognitive-motor facilitation. Thus, activation of additional resources through increased alertness, rather than posture prioritization, may explain dual-task performance in both prosthesis users and controls under increasing postural and cognitive challenge.

Are there specific conditions for which expertise in gymnastics could have an effect on postural control and performance?

PubMed

Asseman, François B; Caron, Olivier; Crémieux, Jacques

2008-01-01

The first aim of this study was to analyse the effect of elite training, linked to expertise, in gymnastics on postural performance and control. For this purpose, body sway of expert gymnasts was compared to other sportsmen, non-experts and non-gymnasts, in two different postures: bipedal (easy and unspecific to gymnasts) and unipedal (difficult and fairly specific). The second aim was to compare the groups in the same tasks but in a visual condition for which they were not trained, i.e. with eyes closed. Postural performance was assessed by centre of gravity motion, which was computed from centre of pressure motion, estimating postural control. A significant difference between the two groups was observed for postural performance in the unipedal posture and with eyes open only. Regardless of their posture, the groups were similarly affected by removal of vision. Expertise in gymnastics seemed to improve postural performances only in situations for which their practise is related to, i.e. unipedal with eyes open. These reveal the importance of choosing a relevant postural configuration and visual condition according to the people's training or by extension experience.

Effect of visual attention on postural control in children with attention-deficit/hyperactivity disorder.

PubMed

Bucci, Maria Pia; Seassau, Magali; Larger, Sandrine; Bui-Quoc, Emmanuel; Gerard, Christophe-Loic

2014-06-01

We compared the effect of oculomotor tasks on postural sway in two groups of ADHD children with and without methylphenidate (MPH) treatment against a group of control age-matched children. Fourteen MPH-untreated ADHD children, fourteen MPH-treated ADHD children and a group of control children participated to the study. Eye movements were recorded using a video-oculography system and postural sway measured with a force platform simultaneously. Children performed fixation, pursuits, pro- and anti-saccades. We analyzed the number of saccades during fixation, the number of catch-up saccades during pursuits, the latency of pro- and anti-saccades; the occurrence of errors in the anti-saccade task and the surface and mean velocity of the center of pressure (CoP). During the postural task, the quality of fixation was significantly worse in both groups of ADHD children with respect to control children; in contrast, the number of catch-up saccades during pursuits, the latency of pro-/anti-saccades and the rate of errors in the anti-saccade task did not differ in the three groups of children. The surface of the CoP in MPH-treated children was similar to that of control children, while MPH-untreated children showed larger postural sway. When performing any saccades, the surface of the CoP improved with respect to fixation or pursuits tasks. This study provides evidence of poor postural control in ADHD children, probably due to cerebellar deficiencies. Our study is also the first to show an improvement on postural sway in ADHD children performing saccadic eye movements. Copyright © 2014 Elsevier Ltd. All rights reserved.

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke.

PubMed

Lee, Myung Mo; Lee, Kyeong Jin; Song, Chang Ho

2018-04-27

BACKGROUND Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. MATERIAL AND METHODS Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. RESULTS At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05). CONCLUSIONS Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

Reducing musculoskeletal disorders among computer operators: comparison between ergonomics interventions at the workplace.

PubMed

Levanon, Yafa; Gefen, Amit; Lerman, Yehuda; Givon, Uri; Ratzon, Navah Z

2012-01-01

Typing is associated with musculoskeletal disorders (MSDs) caused by multiple risk factors. This control study aimed to evaluate the efficacy of a workplace intervention for reducing MSDs among computer workers. Sixty-six subjects with and without MSD were assigned consecutively to one of three groups: ergonomics intervention (work site and body posture adjustments, muscle activity training and exercises) accompanied with biofeedback training, the same ergonomics intervention without biofeedback and a control group. Evaluation of MSDs, body posture, psychosocial status, upper extremity (UE) kinematics and muscle surface electromyography were carried out before and after the intervention in the workplace and the motion lab. Our main hypothesis that significant differences in the reduction of MSDs will exist between subjects in the study groups and controls was confirmed (χ(2) = 13.3; p = 0.001). Significant changes were found in UE kinematics and posture as well. Both ergonomics interventions effectively reduced MSD and improved body posture. This study aimed to test the efficacy of an individual workplace intervention programme among computer workers by evaluating musculoskeletal disorders (MSDs), body posture, upper extremity kinematics, muscle activity and psychosocial factors were tested. The proposed ergonomics interventions effectively reduced MSDs and improved body posture.

Influence of dopaminergic medication on automatic postural responses and balance impairment in Parkinson's disease.

PubMed

Bloem, B R; Beckley, D J; van Dijk, J G; Zwinderman, A H; Remler, M P; Roos, R A

1996-09-01

It is still unclear why balance impairment in Parkinson's disease (PD) often responds insufficiently to dopaminergic medication. We have studied this issue in 23 patients with idiopathic PD and 24 healthy controls. Our specific purposes were (a) to investigate the contribution of abnormal automatic postural responses to balance impairment in PD and (b) to assess the influence of dopaminergic medication on abnormal automatic postural responses and balance impairment. Standing subjects received 4 degrees "toe-up" rotational perturbations of a supporting forceplate. We bilaterally recorded posturally destabilizing medium latency (ML) responses from the stretched gastrocnemius muscles and functionally corrective long latency (LL) responses from the shortened tibialis anterior (TA) muscles. We also assessed changes in the center of foot pressure (CFP) and the center of gravity (COG). All patients were tested in the "off" and "on" phases. All controls were tested and retested after 1 h. During the off phase, we found enlarged ML amplitudes and diminished LL amplitudes in patients, together with a markedly increased posterior displacement of the COG. The abnormal ML and LL responses were partially responsible for the increased body sway in patients because the initial forward (destabilizing) displacement of the CFP was increased, while the subsequent backward displacement of the CFP (a measure of the corrective braking action of LL responses) was delayed. Abnormal late automatic or possibly more voluntary postural corrections also contributed substantially to the increased body sway. During the on phase, ML amplitudes were reduced in patients but remained increased compared with controls. LL amplitudes no longer differed between both groups due to a modest, possibly dopamine-related increase in patients and a simultaneous decrease in controls. The abnormal CFP displacement was only partially improved by dopaminergic medication. The later postural corrections were not improved at all. Consequently, the increased posterior COG displacement was not ameliorated during the on phase. We conclude that (a) a combination of abnormal automatic and perhaps more voluntary postural corrections contributes to increased body sway in PD and (b) dopaminergic medication fails to improve balance impairment in PD because early automatic postural responses are only partially corrected, while later occurring postural corrections are not improved at all. These electrophysiological results support clinical observations and suggest that nondopaminergic lesions play a significant role in the pathophysiology of postural abnormalities in PD.

The effects of whole body vibration combined computerized postural control training on the lower extremity muscle activity and cerebral cortex activity in stroke patients.

PubMed

Uhm, Yo-Han; Yang, Dae-Jung

2018-02-01

[Purpose] The purpose of this study was to examine the effect of computerized postural control training using whole body vibration on lower limb muscle activity and cerebral cortical activation in acute stroke patients. [Subjects and Methods] Thirty stroke patients participated and were divided into groups of 10, a group of the computerized postural control training using whole body vibration (Group I), the computerized postural control training combined with aero step (Group II) and computerized postural control training (Group III). MP100 was used to measure lower limb muscle activity, and QEEG-8 was used to measure cerebral cortical activation. [Results] Comparison of muscle activity and cerebral cortical activation before and after intervention between groups showed that Group I had significant differences in lower limb muscle activity and cerebral cortical activation compared to Groups II and III. [Conclusion] This study showed that whole body vibration combined computerized postural control training is effective for improving muscle activity and cerebral cortex activity in stroke patients.

Inadequate interaction between open- and closed-loop postural control in phobic postural vertigo.

PubMed

Wuehr, M; Pradhan, C; Novozhilov, S; Krafczyk, S; Brandt, T; Jahn, K; Schniepp, R

2013-05-01

Phobic postural vertigo (PPV) is characterized by a subjective dizziness and postural imbalance. Changes in postural control strategy may cause the disturbed postural performance in PPV. A better understanding of the mechanisms behind this change in strategy is required to improve the diagnostic tools and therapeutic options for this prevalent disorder. Here we apply stabilogram diffusion analysis (SDA) to examine the characteristics and modes of interaction of open- and closed-loop processes that make up the postural control scheme in PPV. Twenty patients with PPV and 20 age-matched healthy controls were recorded on a stabilometer platform with eyes open and with eyes closed. Spatio-temporal changes of the center of pressure (CoP) displacement were analyzed by means of SDA and complementary CoP amplitude measures. (1) Open-loop control mechanisms in PPV were disturbed because of a higher diffusion activity (p < 0.001). (2) The interaction of open- and closed-loop processes was altered in that the sensory feedback threshold of the system was lowered (p = 0.010). These two changes were comparable to those observed in healthy subjects during more demanding balance conditions such as standing with eyes closed. These data indicate that subjective imbalance in PPV is associated with characteristic changes in the coordination of open- and closed-loop mechanisms of postural control. Patients with PPV use sensory feedback inadequately during undisturbed stance, and this impairs postural performance. These changes are compatible with higher levels of anti-gravity muscle activity and co-contraction during the conscious concentration on control of postural stability.

Effectiveness of Exercise Interventions to Improve Postural Control in Older Adults: A Systematic Review and Meta-Analyses of Centre of Pressure Measurements.

PubMed

Low, Daniel C; Walsh, Gregory S; Arkesteijn, Marco

2017-01-01

Previous reviews have shown balance in older adults to be improved with exercise. However, it is currently unclear whether postural control, indicated by centre of pressure (COP) measurement, can be improved in older adults and thus whether postural control could be a mechanism to improve balance. The purpose of this systematic review was to assess the effectiveness of force platform COP variables to identify changes in postural control following exercise interventions in older adults. In addition, a secondary purpose was to determine whether the exercise types (balance, resistance or multi-component exercise interventions) are equally effective to improve postural control. Randomised controlled trials were identified using searches of databases and reference lists (PROSPERO registration number CRD42014010617). Trials performing exercise interventions, reporting force platform COP measurements, in participants with a mean age of ≥60 years were included. Risk of bias assessments were performed following the Cochrane guidelines. Data were pooled in meta-analyses, and standardised mean differences (SMDs) with 95 % confidence intervals (CIs) were calculated. Twenty-three trials met the inclusion criteria for the systematic review. Twenty-two trials could be defined as either utilising a balance, resistance or multi-component exercise intervention. These 22 trials were used in the meta-analyses. All trials reported measurements of double leg stance; eight trials reported additional stance conditions. The meta-analyses of double leg stance showed that balance exercise interventions significantly decreased total sway path length/velocity [SMD -1.13, 95 % CI -1.75 to -0.51 (eyes open); SMD -0.79, 95 % CI -1.33 to -0.26 (eyes closed)] and anterior-posterior sway path length/velocity [SMD -1.02, 95 % CI -2.01 to -0.02 (eyes open); SMD -0.82, 95 % CI -1.46 to -0.17 (eyes closed)] in both eyes open and eyes closed conditions. Balance exercise interventions also decreased sway area in eyes closed conditions (SMD -0.57, 95 % CI -1.01 to -0.13) and medio-lateral sway path length/velocity in eyes open conditions (SMD -0.8, 95 % CI -1.48 to -0.12). In contrast, neither resistance nor multi-component exercise interventions affected any of the included COP measurements. Postural control is improved by balance exercise interventions. In contrast, strength or multi-component exercise interventions did not influence postural control measurements in older adults. In addition, a lack of standardisation in collection protocol and COP variables calculated across trials was identified.

Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes.

PubMed

Zech, Astrid; Klahn, Philipp; Hoeft, Jon; zu Eulenburg, Christine; Steib, Simon

2014-02-01

Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p < 0.05) in both groups. Significant group by time interactions were found for the BESS score (p < 0.001). The intervention group showed greater improvements (69.3 ± 10.3%) after 10 weeks in comparison to controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

Active video gaming to improve balance in the elderly.

PubMed

Lamoth, Claudine J C; Caljouw, Simone R; Postema, Klaas

2011-01-01

The combination of active video gaming and exercise (exergaming) is suggested to improve elderly people's balance, thereby decreasing fall risk. Exergaming has been shown to increase motivation during exercise therapy, due to the enjoyable and challenging nature, which could support long-term adherence for exercising balance. However, scarce evidence is available of the direct effects of exergaming on postural control. Therefore, the aim of the study was to assess the effect of a six-week videogame-based exercise program aimed at improving balance in elderly people. Task performance and postural control were examined using an interrupted time series design. Results of multilevel analyses showed that performance on the dot task improved within the first two weeks of training. Postural control improved during the intervention. After the intervention period task performance and balance were better than before the intervention. Results of this study show that healthy elderly can benefit from a videogame-based exercise program to improve balance and that all subjects were highly motivated to exercise balance because they found gaming challenging and enjoyable.

Frequency-Specific Fractal Analysis of Postural Control Accounts for Control Strategies

PubMed Central

Gilfriche, Pierre; Deschodt-Arsac, Véronique; Blons, Estelle; Arsac, Laurent M.

2018-01-01

Diverse indicators of postural control in Humans have been explored for decades, mostly based on the trajectory of the center-of-pressure. Classical approaches focus on variability, based on the notion that if a posture is too variable, the subject is not stable. Going deeper, an improved understanding of underlying physiology has been gained from studying variability in different frequency ranges, pointing to specific short-loops (proprioception), and long-loops (visuo-vestibular) in neural control. More recently, fractal analyses have proliferated and become useful additional metrics of postural control. They allowed identifying two scaling phenomena, respectively in short and long timescales. Here, we show that one of the most widely used methods for fractal analysis, Detrended Fluctuation Analysis, could be enhanced to account for scalings on specific frequency ranges. By computing and filtering a bank of synthetic fractal signals, we established how scaling analysis can be focused on specific frequency components. We called the obtained method Frequency-specific Fractal Analysis (FsFA) and used it to associate the two scaling phenomena of postural control to proprioceptive-based control loop and visuo-vestibular based control loop. After that, convincing arguments of method validity came from an application on the study of unaltered vs. altered postural control in athletes. Overall, the analysis suggests that at least two timescales contribute to postural control: a velocity-based control in short timescales relying on proprioceptive sensors, and a position-based control in longer timescales with visuo-vestibular sensors, which is a brand-new vision of postural control. Frequency-specific scaling exponents are promising markers of control strategies in Humans. PMID:29643816

Spatial and temporal analysis of postural control in dyslexic children.

PubMed

Gouleme, Nathalie; Gerard, Christophe Loic; Bui-Quoc, Emmanuel; Bucci, Maria Pia

2015-07-01

The aim of this study is to examine postural control of dyslexic children using both spatial and temporal analysis. Thirty dyslexic (mean age 9.7±0.3years) and thirty non-dyslexic age-matched children participated in the study. Postural stability was evaluated using Multitest Equilibre from Framiral®. Posture was recorded in the following conditions: eyes open fixating a target (EO) and eyes closed (EC) on stable (-S-) and unstable (-U-) platforms. The findings of this study showed poor postural stability in dyslexic children with respect to the non-dyslexic children group, as demonstrated by both spatial and temporal analysis. In both groups of children postural control depends on the condition, and improves when the eyes are open on a stable platform. Dyslexic children have spectral power indices that are higher than in non-dyslexic children and they showed a shorter cancelling time. Poor postural control in dyslexic children could be due to a deficit in using sensory information most likely caused by impairment in cerebellar activity. The reliability of brain activation patterns, namely in using sensory input and cerebellar activity may explain the deficit in postural control in dyslexic children. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Evaluation of the temporal structure of postural sway fluctuations based on a comprehensive set of analysis tools

NASA Astrophysics Data System (ADS)

Kirchner, M.; Schubert, P.; Schmidtbleicher, D.; Haas, C. T.

2012-10-01

The analysis of postural control has a long history. Traditionally, the amount of body sway is solely used as an index of postural stability. Although this leads to some extent to an effective evaluation of balance performance, the control mechanisms involved have not yet been fully understood. The concept of nonlinear dynamics suggests that variability in the motor output is not randomness but structure, providing the stimulus to reveal the functionality of postural sway. The present work evaluates sway dynamics by means of COP excursions in a quiet standing task versus a dual-task condition in three different test times (30, 60, 300 s). Besides the application of traditional methods-which estimate the overall size of sway-the temporal pattern of body sway was quantified via wavelet transform, multiscale entropy and fractal analysis. We found higher sensitivity of the structural parameters to modulations of postural control strategies and partly an improved evaluation of sway dynamics in longer recordings. It could be shown that postural control modifications take place on different timescales corresponding to the interplay of the sensory systems. A continued application of nonlinear analysis can help to better understand postural control mechanisms.

An 8-week thoracic spine stabilization exercise program improves postural back pain, spine alignment, postural sway, and core endurance in university students:a randomized controlled study.

PubMed

Toprak Çelenay, Şeyda; Özer Kaya, Derya

2017-04-18

To investigate the effects of an 8-week thoracic stabilization exercise program on back pain, spinal alignment, postural sway, and core endurance in university students. University students were randomly allocated into exercise (n: 28) and control (n: 25) groups. The exercise program was carried out 3 days a week for 8 weeks. Postural pain, spinal alignment, postural sway, and core endurance were assessed via visual analogue scale, Spinal Mouse, Biodex Balance System, and McGill's trunk muscle endurance tests at the baseline and after 8 weeks of training. Differences were observed for postural pain, thoracic and lumbar curvature, dynamic stability index (eyes closed), and core endurance scores in the exercise group between baseline and week 8 (P < 0.05) and all the parameters were significantly different when compared to those of the control group (P < 0.05). The program decreased postural pain, spinal curvatures, and postural sway, and increased core endurance in university students. The program can be effective in postural pain and misalignment of spine problems related to core weakness and balance disorders.

Evaluation of biofeedback seat insert for improving active sitting posture in children with cerebral palsy. A clinical report.

PubMed

Bertoti, D B; Gross, A L

1988-07-01

Biofeedback devices have been used successfully to improve head control and symmetrical standing in children with cerebral palsy. This clinical report describes a biofeedback seat insert developed to improve erect sitting posture in children with cerebral palsy who have inadequate trunk control. The seat insert is easily placed against the back of any seating device. A momentary-contact pressure switch on the seat insert is activated when the child exerts pressure on it by extending his trunk. The pressure switch then activates a videocassette recorder or can be adapted to activate a television or radio. Five children with spastic cerebral palsy participated in this evaluation of the biofeedback seat insert. The results of this evaluation show that the children used the biofeedback seat insert effectively to actively improve their sitting posture by voluntarily extending their trunk against the pressure switch. The biofeedback seat insert offers physical therapists a valuable therapeutic training tool to encourage carry-over of improved sitting posture away from the clinical setting for children with cerebral palsy.

Postural control and balance self-efficacy in women with fibromyalgia: are there differences?

PubMed

Muto, L H A; Sauer, J F; Yuan, S L K; Sousa, A; Mango, P C; Marques, A P

2015-04-01

Fibromyalgia (FM) is a rheumatic disease characterized by chronic widespread pain and symptoms such as fatigue, sleep disturbances, cognitive difficulties, and depression. Postural instability is a debilitating disorder increasingly recognized as part of FM. To assess and compare postural control and balance self-efficacy in women with and without FM and verify the association of these variables with pain, symptom severity, and strength. Case-control study Physiotherapeutic Clinical Research and Electromyography Laboratory Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Case-control study of 117 women ranging from age 35 to 60 years. Of these, 67 had FM. Posture control was assessed with the modified clinical test of sensory interaction on balance with patients in forceplates, balance self-efficacy with the Activities-specific Balance Confidence Scale, pain severity with the Visual Analog Scale, tender point pain threshold with digital algometry, symptom severity with the fibromyalgia impact questionnaire, and lower limb strength with a dynamometer. Individuals with FM had impaired postural control showing increased speed of oscillation of the center of gravity (P=0.004) and decreased balance self-efficacy (P<0.001). They had moderate to excellent correlations of balance self-efficacy with pain (r=0.7, P<0.01), muscle strength (r=0.52, P<0.01), and symptom severity (r=0.78, P<0.10) compared with the control group. Correlation of postural control with the same variables was weak. Patients with FM have impaired postural control and low balance self-efficacy that are associated with pain, muscle strength, and symptom severity. Postural control and balance self-efficacy needs to be assessed in patients with FM and the treatment goals should be the improvement of postural control and balance self-efficacy.

The upright posture improves plantar stepping and alters responses to serotonergic drugs in spinal rats.

PubMed

Sławińska, Urszula; Majczyński, Henryk; Dai, Yue; Jordan, Larry M

2012-04-01

Recent studies on the restoration of locomotion after spinal cord injury have employed robotic means of positioning rats above a treadmill such that the animals are held in an upright posture and engage in bipedal locomotor activity. However, the impact of the upright posture alone, which alters hindlimb loading, an important variable in locomotor control, has not been examined. Here we compared the locomotor capabilities of chronic spinal rats when placed in the horizontal and upright postures. Hindlimb locomotor movements induced by exteroceptive stimulation (tail pinching) were monitored with video and EMG recordings. We found that the upright posture alone significantly improved plantar stepping. Locomotor trials using anaesthesia of the paws and air stepping demonstrated that the cutaneous receptors of the paws are responsible for the improved plantar stepping observed when the animals are placed in the upright posture.We also tested the effectiveness of serotonergic drugs that facilitate locomotor activity in spinal rats in both the horizontal and upright postures. Quipazine and (±)-8-hydroxy-2-(dipropylamino)tetralin hydrobromide (8-OH-DPAT) improved locomotion in the horizontal posture but in the upright posture either interfered with or had no effect on plantar walking. Combined treatment with quipazine and 8-OH-DPAT at lower doses dramatically improved locomotor activity in both postures and mitigated the need to activate the locomotor CPG with exteroceptive stimulation. Our results suggest that afferent input from the paw facilitates the spinal CPG for locomotion. These potent effects of afferent input from the paw should be taken into account when interpreting the results obtained with rats in an upright posture and when designing interventions for restoration of locomotion after spinal cord injury.

The upright posture improves plantar stepping and alters responses to serotonergic drugs in spinal rats

PubMed Central

Sławińska, Urszula; Majczyński, Henryk; Dai, Yue; Jordan, Larry M

2012-01-01

Recent studies on the restoration of locomotion after spinal cord injury have employed robotic means of positioning rats above a treadmill such that the animals are held in an upright posture and engage in bipedal locomotor activity. However, the impact of the upright posture alone, which alters hindlimb loading, an important variable in locomotor control, has not been examined. Here we compared the locomotor capabilities of chronic spinal rats when placed in the horizontal and upright postures. Hindlimb locomotor movements induced by exteroceptive stimulation (tail pinching) were monitored with video and EMG recordings. We found that the upright posture alone significantly improved plantar stepping. Locomotor trials using anaesthesia of the paws and air stepping demonstrated that the cutaneous receptors of the paws are responsible for the improved plantar stepping observed when the animals are placed in the upright posture. We also tested the effectiveness of serotonergic drugs that facilitate locomotor activity in spinal rats in both the horizontal and upright postures. Quipazine and (±)-8-hydroxy-2-(dipropylamino)tetralin hydrobromide (8-OH-DPAT) improved locomotion in the horizontal posture but in the upright posture either interfered with or had no effect on plantar walking. Combined treatment with quipazine and 8-OH-DPAT at lower doses dramatically improved locomotor activity in both postures and mitigated the need to activate the locomotor CPG with exteroceptive stimulation. Our results suggest that afferent input from the paw facilitates the spinal CPG for locomotion. These potent effects of afferent input from the paw should be taken into account when interpreting the results obtained with rats in an upright posture and when designing interventions for restoration of locomotion after spinal cord injury. PMID:22351637

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke

PubMed Central

Lee, Myung Mo; Lee, Kyeong Jin

2018-01-01

Background Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. Material/Methods Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. Results At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05). Conclusions Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs. PMID:29702630

Acute Effects of Posture Shirts on Rounded-Shoulder and Forward-Head Posture in College Students.

PubMed

Manor, John; Hibberd, Elizabeth; Petschauer, Meredith; Myers, Joseph

2016-12-01

Rounded-shoulder and forward-head posture can be contributing factors to shoulder pain. Corrective techniques such as manual therapy and exercise have been shown to improve these altered postures, but there is little evidence that corrective garments such as posture shirts can alter posture. To determine the acute effects of corrective postureshirt use on rounded-shoulder and forward-head posture in asymptomatic college students. Repeated-measures intervention study with counterbalanced conditions. Research laboratory. 24 members of the general student body of a university, 18-25 y old, with a forward shoulder angle (FSA) >52° and no history of upper-extremity surgery, scoliosis, active shoulder pain, or shoulder pain in the previous 3 mo that restricted participation for 3 consecutive days. Photographic posture assessment under a control condition, under a sham or treatment condition (counterbalanced), under another control condition, and treatment or sham. FSA and forward head angle (FHA) calculated from a lateral photograph. FSA decreased relative to the control condition while participants wore the sham shirt (P = .029) but not the corrective posture shirt (P = 1.00). FHA was unchanged between groups (P = .371). Application of a corrective posture shirt did not acutely alter FSA or FHA, while application of a sham shirt may decrease FSA at rest.

Usefulness of posture training for patients with temporomandibular disorders.

PubMed

Wright, E F; Domenech, M A; Fischer, J R

2000-02-01

Many practitioners have found that posture training has a positive impact on temporomandibular, or TMD, symptoms. The authors conducted a study to evaluate its effectiveness. Sixty patients with TMD and a primary muscle disorder were randomized into two groups: one group received posture training and TMD self-management instructions while the control group received TMD self-management instructions only. Four weeks after the study began, the authors reexamined the subjects for changes in symptoms, pain-free opening and pressure algometer pain thresholds. In addition, pretreatment and posttreatment posture measurements were recorded for subjects in the treatment group. Statistically significant improvement was demonstrated by the modified symptom severity index, maximum pain-free opening and pressure algometer threshold measurements, as well as by the subjects' perceived TMD and neck symptoms. Subjects in the treatment group reported having experienced a mean reduction in TMD and neck symptoms of 41.9 and 38.2 percent, respectively, while subjects in the control group reported a mean reduction in these symptoms of 8.1 and 9.3 percent. Within the treatment group, the authors found significant correlations between improvements in TMD symptoms and improvements in neck symptoms (P < .005) as well as between TMD symptom improvement and the difference between head and shoulder posture measurements at the outset of treatment (P < .05). Posture training and TMD self-management instructions are significantly more effective than TMD self-management instructions alone for patients with TMD who have a primary muscle disorder. Patients with TMD who hold their heads farther forward relative to the shoulders have a high probability of experiencing symptom improvement as a result of posture training and being provided with selfmanagement instructions.

Influence of regular proprioceptive and bioenergetic physical activities on balance control in elderly women.

PubMed

Gauchard, Gérome C; Gangloff, Pierre; Jeandel, Claude; Perrin, Philippe P

2003-09-01

Balance disorders increase considerably with age due to a decrease in posture regulation quality, and are accompanied by a higher risk of falling. Conversely, physical activities have been shown to improve the quality of postural control in elderly individuals and decrease the number of falls. The aim of this study was to evaluate the impact of two types of exercise on the visual afferent and on the different parameters of static balance regulation. Static postural control was evaluated in 44 healthy women aged over 60 years. Among them, 15 regularly practiced proprioceptive physical activities (Group I), 12 regularly practiced bioenergetic physical activities (Group II), and 18 controls walked on a regular basis (Group III). Group I participants displayed lower sway path and area values, whereas Group III participants displayed the highest, both in eyes-open and eyes-closed conditions. Group II participants displayed intermediate values, close to those of Group I in the eyes-open condition and those of Group III in the eyes-closed condition. Visual afferent contribution was more pronounced for Group II and III participants than for Group I participants. Proprioceptive exercise appears to have the best impact on balance regulation and precision. Besides, even if bioenergetic activity improves postural control in simple postural tasks, more difficult postural tasks show that this type of activity does not develop a neurosensorial proprioceptive input threshold as well, probably on account of the higher contribution of visual afferent.

Exergaming as a Viable Therapeutic Tool to Improve Static and Dynamic Balance among Older Adults and People with Idiopathic Parkinson's Disease: A Systematic Review and Meta-Analysis.

PubMed

Harris, Dale M; Rantalainen, Timo; Muthalib, Makii; Johnson, Liam; Teo, Wei-Peng

2015-01-01

The use of virtual reality games (known as "exergaming") as a neurorehabilitation tool is gaining interest. Therefore, we aim to collate evidence for the effects of exergaming on the balance and postural control of older adults and people with idiopathic Parkinson's disease (IPD). Six electronic databases were searched, from inception to April 2015, to identify relevant studies. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were used to calculate effect sizes between experimental and control groups. I (2) statistics were used to determine levels of heterogeneity. 325 older adults and 56 people with IPD who were assessed across 11 -studies. The results showed that exergaming improved static balance (SMD 1.069, 95% CI 0.563-1.576), postural control (SMD 0.826, 95% CI 0.481-1.170), and dynamic balance (SMD -0.808, 95% CI -1.192 to -0.424) in healthy older adults. Two IPD studies showed an improvement in static balance (SMD 0.124, 95% CI -0.581 to 0.828) and postural control (SMD 2.576, 95% CI 1.534-3.599). Our findings suggest that exergaming might be an appropriate therapeutic tool for improving balance and postural control in older adults, but more -large-scale trials are needed to determine if the same is true for people with IPD.

Vision-based posture recognition using an ensemble classifier and a vote filter

NASA Astrophysics Data System (ADS)

Ji, Peng; Wu, Changcheng; Xu, Xiaonong; Song, Aiguo; Li, Huijun

2016-10-01

Posture recognition is a very important Human-Robot Interaction (HRI) way. To segment effective posture from an image, we propose an improved region grow algorithm which combining with the Single Gauss Color Model. The experiment shows that the improved region grow algorithm can get the complete and accurate posture than traditional Single Gauss Model and region grow algorithm, and it can eliminate the similar region from the background at the same time. In the posture recognition part, and in order to improve the recognition rate, we propose a CNN ensemble classifier, and in order to reduce the misjudgments during a continuous gesture control, a vote filter is proposed and applied to the sequence of recognition results. Comparing with CNN classifier, the CNN ensemble classifier we proposed can yield a 96.27% recognition rate, which is better than that of CNN classifier, and the proposed vote filter can improve the recognition result and reduce the misjudgments during the consecutive gesture switch.

Time course of the acute effects of core stabilisation exercise on seated postural control.

PubMed

Lee, Jordan B; Brown, Stephen H M

2017-09-20

Core stabilisation exercises are often promoted for purposes ranging from general fitness to high-performance athletics, and the prevention and rehabilitation of back troubles. These exercises, when performed properly, may have the potential to enhance torso postural awareness and control, yet the potential for achieving immediate gains has not been completely studied. Fourteen healthy young participants performed a single bout of non-fatiguing core stabilisation exercise that consisted of repeated sets of 2 isometric exercises, the side bridge and the four-point contralateral arm-and-leg extension. Seated postural control, using an unstable balance platform on top of a force plate, was assessed before and after exercise, including multiple time points within a 20-minute follow-up period. Nine standard postural control variables were calculated at each time point, including sway displacement and velocity ranges, root mean squares and cumulative path length. Statistical analysis showed that none of the postural control variables were significantly different at any time point following completion of core stabilisation exercise. Thus, we conclude that a single bout of acute core stabilisation exercise is insufficient to immediately improve seated trunk postural control in young healthy individuals.

Postural compensation for vestibular loss and implications for rehabilitation.

PubMed

Horak, Fay B

2010-01-01

This chapter summarizes the role of the vestibular system in postural control so that specific and effective rehabilitation can be designed that facilitates compensation for loss of vestibular function. Patients with bilateral or unilateral loss of peripheral vestibular function are exposed to surface perturbations to quantify automatic postural responses. Studies also evaluated the effects of audio- and vibrotactile-biofeedback to improve stability in stance and gait. The most important role of vestibular information for postural control is to control orientation of the head and trunk in space with respect to gravitoinertial forces, particularly when balancing on unstable surfaces. Vestibular sensory references are particularly important for postural control at high frequencies and velocities of self-motion, to reduce trunk drift and variability, to provide an external reference frame for the trunk and head in space; and to uncouple coordination of the trunk from the legs and the head-in-space from the body CoM. The goal of balance rehabilitation for patients with vestibular loss is to help patients 1) use remaining vestibular function, 2) depend upon surface somatosensory information as their primary postural sensory system, 3) learn to use stable visual references, and 4) identify efficient and effective postural movement strategies.

The influence of Pilates exercises on body balance in the standing position of hearing impaired people.

PubMed

Walowska, Jagoda; Bolach, Bartosz; Bolach, Eugeniusz

2017-11-13

Hearing impairment may affect the body posture maintenance. The aim of the study was to evaluate the effect of modified Pilates exercise program on the body posture maintenance in hearing impaired people. Eighty students (aged 13-24) were enrolled and randomly allocated into two groups: test group (n = 41) which attended an original program based on modified Pilates exercises and control group (n = 39) which attended standard physical education classes. Stabilographic tests were conducted at baseline and after 6-week training program. Both groups showed improved control of body balance in a standing position manifested in reductions of the length of path, surface area, and speed of deflection. Modified Pilates program was significantly more effective in improving body balance control in relaxed posture and with feet together than standard physical education classes. The greater efficiency of the modified Pilates program was expressed in a significant improvement in balance control parameters, i.e., path length, surface area, and speed of deflection. The modified Pilates program was more effective in improving body balance control in the hearing impaired people than standard physical education classes. Modification of physical activity recommendations for hearing impaired students may be considered; however, further research is required. Implications for Rehabilitation Hearing impairment impacts the mental, social and, physical spheres of life as well as deteriorates equivalent reactions and the way body posture is maintained. In hearing impaired people, control of body balance and muscle coordination is often disturbed, thus more attention should be paid to exercises associated with balance which may improve the ability to learn and develop motor skills. Modified Pilates program was significantly more effective in improving body balance control than standard physical education classes in hearing impaired people.

Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study.

PubMed

Zhang, Di; Sessa, Salvatore; Kong, Weisheng; Cosentino, Sarah; Magistro, Daniele; Ishii, Hiroyuki; Zecca, Massimiliano; Takanishi, Atsuo

2015-11-01

Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload. A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli. We found that subliminal visual stimulation is a valid method to improve trainees' upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level. We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.

Tai Chi training reduced coupling between respiration and postural control

PubMed Central

Holmes, Matthew L; Manor, Brad; Hsieh, Wan-hsin; Hu, Kun; Lipsitz, Lewis A; Li, Li

2015-01-01

In order to maintain stable upright stance, the postural control system must account for the continuous perturbations to the body’s center-of-mass including those caused by spontaneous respiration. Both aging and disease increase “posturo-respiratory synchronization;” which reflects the degree to which respiration affects postural sway fluctuations over time. Tai Chi training emphasizes the coordination of respiration and bodily movements and may therefore optimize the functional interaction between these two systems. The purpose of the project was to examine the effect of Tai Chi training on the interaction between respiration and postural control in older adults. We hypothesized that Tai Chi training would improve the ability of the postural control system to compensate for respiratory perturbations and thus, reduce posturo-respiratory synchronization. Participants were recruited from supportive housing facilities and randomized to a 12-week Tai Chi intervention (n=28; 86±5yrs) or educational-control program (n=34, 85±6yrs). Standing postural sway and respiration were simultaneously recorded with a force plate and respiratory belt under eyes-open and eyes-closed conditions. Posturo-respiratory synchronization was determined by quantifying the variation of the phase relationship between the dominant oscillatory mode of respiration and corresponding oscillations within postural sway. Groups were similar in age, gender distribution, height, body mass, and intervention compliance. Neither intervention altered average sway speed, sway magnitude or respiratory rate. As compared to the education-control group, however, Tai Chi training reduced posturo-respiratory synchronization when standing with eyes open or closed (p<0.001). Tai Chi training did not affect traditional parameters of standing postural control or respiration, yet reduced the coupling between respiration and postural control. The beneficial effects of Tai Chi training may therefore stem in part from optimization of this multi-system interaction. PMID:26518241

Use of the Occivator for the correction of forward head posture, and the implications for temporomandibular disorders: a pilot study.

PubMed

Augustine, Catherine; Makofsky, Howard W; Britt, Christina; Adomsky, Barbara; Deshler, Jennifer Matire; Ramirez, Paula; Douris, Peter

2008-04-01

Numerous studies suggest that temporomandibular disorders may be associated with forward head posture. The current study presents a need for an intervention that will effectively facilitate an ideal postural alignment of the head. The Occivator (Posteocentric Systems, Mastic Beach, NY) is an intervention speculated to improve forward head posture (FHP). However there has not been a randomized study to correlate use of the Occivator with improvement of FHP. The purpose of this study was to evaluate the effectiveness of the Occivator as a therapeutic intervention for the correction of FHP. Using a plumb line, twenty-nine (29) subjects were selected on the basis of having FHP. The CROM (cervical range of motion) device was used to determine measurement of forward head position for each group, pre and post an eight week period. The experimental group followed a specific protocol of 20 minutes of stretches and exercises on the Occivator, two times a week for eight weeks. The control group did not receive any intervention. The experimental group as compared to the control group, demonstrated significant improvement for forward head posture (p = .02). Further research is needed to evaluate the effectiveness of the Occivator.

Improving Core Strength to Prevent Injury

ERIC Educational Resources Information Center

Oliver, Gretchen D.; Adams-Blair, Heather R.

2010-01-01

Regardless of the sport or skill, it is essential to have correct biomechanical positioning, or postural control, in order to maximize energy transfer. Correct postural control requires a strong, stable core. A strong and stable core allows one to transfer energy effectively as well as reduce undue stress. An unstable or weak core, on the other…

Use of commercial video games to improve postural balance in patients with multiple sclerosis: A systematic review and meta-analysis of randomised controlled clinical trials.

PubMed

Parra-Moreno, M; Rodríguez-Juan, J J; Ruiz-Cárdenas, J D

2018-03-07

Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear. To analyse existing evidence on the effects of commercial video games on postural balance in patients with MS. We conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: "multiple sclerosis", videogames, "video games", exergam*, "postural balance", posturography, "postural control", balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale. Five randomized controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: -.74; 95% CI, -2.79-1.32; P=.48; I 2 =0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, -1.06-.76; P=.75; I 2 =0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39-7.21; P<.001; I 2 =0%), but these were not greater than the minimum detectable change reported in the literature. The effectiveness of commercial video game therapy for improving postural balance in patients with MS is limited. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke.

PubMed

Park, Yu-Hyung; Lee, Chi-Ho; Lee, Byoung-Hee

2013-01-01

This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (P< 0.05), however, no significant difference was observed in other gait parameters. In conclusion, we demonstrate significant improvement in gait ability in chronic stroke patients who received virtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke.

Yoga Training Has Positive Effects on Postural Balance and Its Influence on Activities of Daily Living in People with Multiple Sclerosis: A Pilot Study.

PubMed

de Oliveira, Gerson; Tavares, Maria da Consolação Cunha Gomes Fernandes; de Faria Oliveira, Jane Domingues; Rodrigues, Marcos Rojo; Santaella, Danilo Forghieri

2016-01-01

There is a little evidence about the influence of yoga as a complementary therapy for postural balance and its influence on activities of daily living in multiple sclerosis (MS) patients. To evaluate the influence of a six-month yoga program on postural balance and subjective impact of postural balance impairment on activities of daily living in people with MS. Randomized controlled pilot study. Protocol developed at the Adaptive Physical Activity Study Department, College of Physical Education, State University of Campinas, Brazil. A total of 12 (11 women) yoga naive people with MS randomly divided into two groups as follows: Control (C-waiting list, n = 6) and Yoga (Y-Yoga training, n = 6). Yoga group practiced postures, breathing exercises, meditation, and relaxation on weekly 60-min classes for a six-month period. The following evaluations were performed at study entry (baseline), and after six months (six months): Berg Balance Scale (BBS), Expanded Disability Status Scale (EDSS), and self-reported postural balance quality and influence of postural balance on activities of daily living. There was a significant improvement in BBS score from baseline to six months only in the Yoga group, especially in subjects with higher EDSS score, with increased quality of self-reported postural balance, and decreased influence of postural balance impairment on activities of daily living. In conclusion, a six-month yoga training is beneficial for people with MS, since it improves postural balance and decreases the influence of postural balance impairment on activities of daily living. A greater sample size is necessary to increase generalization, but it seems that yoga could be included as a feasible complementary therapy for people with MS. Copyright © 2016 Elsevier Inc. All rights reserved.

Perceptive rehabilitation and trunk posture alignment in patients with Parkinson disease: a single blind randomized controlled trial.

PubMed

Morrone, Michelangelo; Miccinilli, Sandra; Bravi, Marco; Paolucci, Teresa; Melgari, Jean M; Salomone, Gaetano; Picelli, Alessandro; Spadini, Ennio; Ranavolo, Alberto; Saraceni, Vincenzo M; DI Lazzaro, Vincenzo; Sterzi, Silvia

2016-12-01

Recent studies aimed to evaluate the potential effects of perceptive rehabilitation in Parkinson Disease reporting promising preliminary results for postural balance and pain symptoms. To date, no randomized controlled trial was carried out to compare the effects of perceptive rehabilitation and conventional treatment in patients with Parkinson Disease. To evaluate whether a perceptive rehabilitation treatment could be more effective than a conventional physical therapy program in improving postural control and gait pattern in patients with Parkinson Disease. Single blind, randomized controlled trial. Department of Physical and Rehabilitation Medicine of a University Hospital. Twenty outpatients affected by idiopathic Parkinson Disease at Hoehn and Yahr stage ≤3. Recruited patients were divided into two groups: the first one underwent individual treatment with Surfaces for Perceptive Rehabilitation (Su-Per), consisting of rigid wood surfaces supporting deformable latex cones of various dimensions, and the second one received conventional group physical therapy treatment. Each patient underwent a training program consisting of ten, 45-minute sessions, three days a week for 4 consecutive weeks. Each subject was evaluated before treatment, immediately after treatment and at one month of follow-up, by an optoelectronic stereophotogrammetric system for gait and posture analysis, and by a computerized platform for stabilometric assessment. Kyphosis angle decreased after ten sessions of perceptive rehabilitation, thus showing a substantial difference with respect to the control group. No significant differences were found as for gait parameters (cadence, gait speed and stride length) within Su-Per group and between groups. Parameters of static and dynamic evaluation on stabilometric platform failed to demonstrate any statistically relevant difference both within-groups and between-groups. Perceptive training may help patients affected by Parkinson Disease into restoring a correct midline perception and, in turn, to improve postural control. Perceptive surfaces represent an alternative to conventional rehabilitation of postural disorders in Parkinson Disease. Further studies are needed to determine if the association of perceptive treatment and active motor training would be useful in improving also gait dexterity.

Trunk muscle exercises as a means of improving postural stability in people with Parkinson's disease: a protocol for a randomised controlled trial.

PubMed

Hubble, Ryan P; Naughton, Geraldine A; Silburn, Peter A; Cole, Michael H

2014-12-31

Exercise has been shown to improve clinical measures of strength, balance and mobility, and in some cases, has improved symptoms of tremor and rigidity in people with Parkinson's disease (PD). However, to date, no research has examined whether improvements in trunk control can remedy deficits in dynamic postural stability in this population. The proposed randomised controlled trial aims to establish whether a 12-week exercise programme aimed at improving dynamic postural stability in people with PD; (1) is more effective than education; (2) is more effective when training frequency is increased; and (3) provides greater long-term benefits than education. Forty-five community-dwelling individuals diagnosed with idiopathic PD with a falls history will be recruited. Participants will complete baseline assessments including tests of cognition, vision, disease severity, fear of falling, mobility and quality of life. Additionally, participants will complete a series of standing balance tasks to evaluate static postural stability, while dynamic postural control will be measured during walking using head and trunk-mounted three-dimensional accelerometers. Following baseline testing, participants will be randomly-assigned to one of three intervention groups, who will receive either exercise once per week, exercise 3 days/week, or education. Participants will repeat the same battery of tests conducted at baseline after the 12-week intervention and again following a further 12-week sustainability period. This study has the potential to show that low-intensity and progressive trunk exercises can provide a non-invasive and effective means for maintaining or improving postural stability for people with PD. Importantly, if the programme is noted to be effective, it could be easily performed by patients within their home environment or under the guidance of available allied health professionals. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001175763). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Thai Elephant-Assisted Therapy Programme in Children with Down Syndrome.

PubMed

Satiansukpong, Nuntanee; Pongsaksri, Maethisa; Sasat, Daranee

2016-06-01

The objectives of this study were to examine the effects of the Thai Elephant-Assisted Therapy Programme for children with Down syndrome (DS) (TETP-D) on balance, postural control and visual motor integration (VMI). A quasi-experimental design with blind control was used. Sixteen children with DS from grades 1 to 6, in a Thailand, public school were recruited for this study. The participants were divided voluntarily into two groups: control and experimental. These both groups received regular school activities, but the experimental group had added treatment, which consisted of TETP-D twice a week for 2 months. The balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency 2, the postural control record form and Beery VMI were applied as outcome measure 1 week before and after the TETP-D. The results showed no significant difference in balance or postural control. However, a significant difference of VMI was shown between the two groups (z = 13.5, p = .04). Children with DS benefited from the TETP-D as it improved their VMI. The TETP-D could improve balance and postural control if provided within a suitable frequency and duration. Further research is needed to test this hypothesis. The limitations of this study are the significant differences in some aspects of the groups at pre-test such as gender and supine flexion of postural control. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Effects of walking with a shopping trolley on spinal posture and loading in subjects with neurogenic claudication.

PubMed

Comer, Christine M; White, Derrick; Conaghan, Philip G; Bird, Howard A; Redmond, Anthony C

2010-10-01

To explore possible mechanisms underpinning symptom relief and improved walking tolerance in patients with neurogenic claudication (NC) when pushing a shopping trolley by evaluating the effects of a shopping trolley on spinal posture and loading patterns. An exploratory study of kinematic and kinetic changes in walking with and without pushing a shopping trolley in persons with NC symptoms and a comparison with asymptomatic control subjects. A primary care-based musculoskeletal service. Participants (n=8) with NC symptoms who have anecdotally reported symptomatic improvement when walking with a shopping trolley and a control group of asymptomatic persons (n=8). Shopping trolley. Changes in lumbar spinal sagittal posture and ground reaction force. Subjects with NC and asymptomatic controls walked with significantly more flexed spinal posture (increase in flexion, 3.40°; z=3.516; P<.001) and reduced mean ground reaction forces (-6.9% of body weight; z=-3.46; P=.001) when walking with a shopping trolley. However, at the midstance point of the gait cycle, controls showed minimal reliance on the trolley, whereas, people with NC showed continued offloading. Both posture and loading are affected by pushing a shopping trolley; however, patients with NC were found to offload the spine throughout the stance phase of gait, whereas asymptomatic controls did not. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Mechanisms of postural control in alcoholic men and women: biomechanical analysis of musculoskeletal coordination during quiet standing.

PubMed

Sullivan, Edith V; Rose, Jessica; Pfefferbaum, Adolf

2010-03-01

Excessive sway during quiet standing is a common sequela of chronic alcoholism even with prolonged sobriety. Whether alcoholic men and women who have remained abstinent from alcohol for weeks to months differ from each other in the degree of residual postural instability and biomechanical control mechanisms has not been directly tested. We used a force platform to characterize center-of-pressure biomechanical features of postural sway, with and without stabilizing conditions from touch, vision, and stance, in 34 alcoholic men, 15 alcoholic women, 22 control men, and 29 control women. Groups were matched in age (49.4 years), general intelligence, socioeconomic status, and handedness. Each alcoholic group was sober for an average of 75 days. Analysis of postural sway when using all 3 stabilizing conditions versus none revealed diagnosis and sex differences in ability to balance. Alcoholics had significantly longer sway paths, especially in the anterior-posterior direction, than controls when maintaining erect posture without balance aids. With stabilizing conditions the sway paths of all groups shortened significantly, especially those of alcoholic men, who demonstrated a 3.1-fold improvement in sway path difference between the easiest and most challenging conditions; the remaining 3 groups, each showed a approximately 2.4-fold improvement. Application of a mechanical model to partition sway paths into open-loop and closed-loop postural control systems revealed that the sway paths of the alcoholic men but not alcoholic women were characterized by greater short-term (open-loop) diffusion coefficients without aids, often associated with muscle stiffening response. With stabilizing factors, all 4 groups showed similar long-term (closed loop) postural control. Correlations between cognitive abilities and closed-loop sway indices were more robust in alcoholic men than alcoholic women. Reduction in sway and closed-loop activity during quiet standing with stabilizing factors shows some differential expression in men and women with histories of alcohol dependence. Nonetheless, enduring deficits in postural instability of both alcoholic men and alcoholic women suggest persisting liability for falling.

Exergaming as a Viable Therapeutic Tool to Improve Static and Dynamic Balance among Older Adults and People with Idiopathic Parkinson’s Disease: A Systematic Review and Meta-Analysis

PubMed Central

Harris, Dale M.; Rantalainen, Timo; Muthalib, Makii; Johnson, Liam; Teo, Wei-Peng

2015-01-01

The use of virtual reality games (known as “exergaming”) as a neurorehabilitation tool is gaining interest. Therefore, we aim to collate evidence for the effects of exergaming on the balance and postural control of older adults and people with idiopathic Parkinson’s disease (IPD). Six electronic databases were searched, from inception to April 2015, to identify relevant studies. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were used to calculate effect sizes between experimental and control groups. I2 statistics were used to determine levels of heterogeneity. 325 older adults and 56 people with IPD who were assessed across 11 ­studies. The results showed that exergaming improved static balance (SMD 1.069, 95% CI 0.563–1.576), postural control (SMD 0.826, 95% CI 0.481–1.170), and dynamic balance (SMD −0.808, 95% CI −1.192 to −0.424) in healthy older adults. Two IPD studies showed an improvement in static balance (SMD 0.124, 95% CI −0.581 to 0.828) and postural control (SMD 2.576, 95% CI 1.534–3.599). Our findings suggest that exergaming might be an appropriate therapeutic tool for improving balance and postural control in older adults, but more ­large-scale trials are needed to determine if the same is true for people with IPD. PMID:26441634

Analyses of balance and flexibility of obese patients undergoing bariatric surgery

PubMed Central

Benetti, Fernanda Antico; Bacha, Ivan Leo; Junior, Arthur Belarmino Garrido; Greve, Júlia Maria D'Andréa

2016-01-01

OBJECTIVE: To assess the postural control and flexibility of obese subjects before and both six and 12 months after bariatric surgery. To verify whether postural control is related to flexibility following weight reductions resulting from bariatric surgery. METHODS: The sample consisted of 16 subjects who had undergone bariatric surgery. All assessments were performed before and six and 12 months after bariatric surgery. Postural balance was assessed using an Accusuway® portable force platform, and flexibility was assessed using a standard chair sit and reach test (Wells' chair). RESULTS: With the force platform, no differences were observed in the displacement area or velocity from the center of pressure in the mediolateral and anteroposterior directions. The displacement speed from the center of pressure was decreased at the six month after the surgery; however, unchanged from baseline at 12 months post-surgery. Flexibility increased over time according to the three measurements tested. CONCLUSIONS: Static postural balance did not change. The velocity of postural adjustment responses were increased at six months after surgery. Therefore, weight loss promotes increased flexibility. Yet, improvements in flexibility are not related to improvements in balance. PMID:26934236

Active ocular vergence improves postural control in elderly as close viewing distance with or without a single cognitive task.

PubMed

Matheron, Eric; Yang, Qing; Delpit-Baraut, Vincent; Dailly, Olivier; Kapoula, Zoï

2016-01-01

Performance of the vestibular, visual, and somatosensory systems decreases with age, reducing the capacity of postural control, and increasing the risk of falling. The purpose of this study is to measure the effects of vision, active vergence eye movements, viewing distance/vergence angle and a simple cognitive task on postural control during an upright stance, in completely autonomous elderly individuals. Participated in the study, 23 elderly subjects (73.4 ± 6.8 years) who were enrolled in a center dedicated to the prevention of falling. Their body oscillations were measured with the DynaPort(®) device, with three accelerometers, placed at the lumbosacral level, near the center of mass. The conditions were the following: eyes open fixating on LED at 20 cm or 150 cm (vergence angle 17.0° and 2.3° respectively) with or without additional cognitive tasks (counting down from one hundred), performing active vergence by alternating the fixation between the far and the near LED (convergence and divergence), eyes closed after having fixated the far LED. The results showed that the postural stability significantly decreased when fixating on the LED at a far distance (weak convergence angle) with or without cognitive tasks; active convergence-divergence between the LEDs improved the postural stability while eye closure decreased it. The privilege of proximity (with increased convergence at near), previously established with foot posturography, is shown here to be valid for accelerometry with the center of mass in elderly. Another major result is the beneficial contribution of active vergence eye movements to better postural stability. The results bring new perspectives for the role of eye movement training to preserve postural control and autonomy in elderly. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Longitudinal Study Evaluating Postural Balance of Young Athletes.

PubMed

Steinberg, Nili; Nemet, Dan; Pantanowitz, Michal; Zeev, Aviva; Hallumi, Monder; Sindiani, Mahmood; Meckel, Yoav; Eliakim, Alon

2016-02-01

Repeated anaerobic conditions during athletic performance may cause general and local fatigue that result in postural balance deficit. Evidence suggests that improved postural balance during athletic training may decrease the risk for fallings and traumatic injuries among athletes. Twenty athletes (12 girls, 8 boys) and 20 controls (12 girls, 8 boys) ages 10-15 years participated in the current study. All athletes were active in an 8-month physical activity program, 3 times per week for 90 min., specific to basketball, soccer, or athletic training. The control children participated in physical education at school only, with no involvement in organized extracurricular sports. All participants were evaluated for postural balance in three assessments over one year (at 4-mo intervals); the Interactive Balance System machine (Tetrax device) was used to assess balance at three test times (pre-, post-, and 10 min) after a session of a repeated sprint anaerobic test, consisting of 12 × 20 m run starting every 20 sec. The athletes had better postural balance than controls. There were different group patterns of change over the sessions; a significant interaction of session and group indicated that postural balance of the groups differed. The contribution of low sway frequencies (F1) and high sway frequencies (F6) differed between the controls and the athletes group. Results suggested that although athletes had better postural balance, improvement should be encouraged during training over the sessions and seasons, with special awareness of the balance deficit that occurs immediately after anaerobic stress and at the end of the season, to decrease the risk of injuries. © The Author(s) 2016.

Current physical activity improves balance control during sensory conflicting conditions in older adults.

PubMed

Buatois, S; Gauchard, G C; Aubry, C; Benetos, A; Perrin, P

2007-01-01

Aging process is characterized by difficulties in ensuring balance control, especially in conditions of reduced or conflicting sensory information, leading to an increased risk of falling. Conversely, the practise of physical activities (PA) has been recognized as a good approach to improve the quality of balance control. This study aimed to investigate the influence of current and/or past PA on balance-related neurosensorial organization in older adults on the maintenance of the upright stance, especially during sensory conflicting situations. Postural control was evaluated by means of the Sensory Organization Test on 130 healthy noninstitutionalized volunteers aged over 65, split into four groups according to the presence or absence of PA before or after retirement. Subjects who practised PA for a long time (Gr1) and subjects who started PA after retirement (Gr2) displayed the best postural performances and better managed sensory conflicting situations compared to subjects who had stopped PA for many years (Gr3) and subjects who had never practised PA (Gr4). Multiple regression analyses revealed that current PA was the major determinant for postural parameters during sensorial conflict compared to age, gender, body mass index and past PA. Regular PA, even when started late in life, allows appropriate reorganization of the different components of postural control during sensory conflicting situations. Indeed, active subjects were more able to compensate for suppressed or perturbed sensory information by an increased usage of another referential and so to correct their posture by adopting a more appropriate balance strategy. Thus, PA counteracts the age-related decline of postural control and could consequently reduce the risk of falling.

Static and dynamic posture control in postlingual cochlear implanted patients: effects of dual-tasking, visual and auditory inputs suppression

PubMed Central

Bernard-Demanze, Laurence; Léonard, Jacques; Dumitrescu, Michel; Meller, Renaud; Magnan, Jacques; Lacour, Michel

2014-01-01

Posture control is based on central integration of multisensory inputs, and on internal representation of body orientation in space. This multisensory feedback regulates posture control and continuously updates the internal model of body's position which in turn forwards motor commands adapted to the environmental context and constraints. The peripheral localization of the vestibular system, close to the cochlea, makes vestibular damage possible following cochlear implant (CI) surgery. Impaired vestibular function in CI patients, if any, may have a strong impact on posture stability. The simple postural task of quiet standing is generally paired with cognitive activity in most day life conditions, leading therefore to competition for attentional resources in dual-tasking, and increased risk of fall particularly in patients with impaired vestibular function. This study was aimed at evaluating the effects of postlingual cochlear implantation on posture control in adult deaf patients. Possible impairment of vestibular function was assessed by comparing the postural performance of patients to that of age-matched healthy subjects during a simple postural task performed in static (stable platform) and dynamic (platform in translation) conditions, and during dual-tasking with a visual or auditory memory task. Postural tests were done in eyes open (EO) and eyes closed (EC) conditions, with the CI activated (ON) or not (OFF). Results showed that the postural performance of the CI patients strongly differed from the controls, mainly in the EC condition. The CI patients showed significantly reduced limits of stability and increased postural instability in static conditions. In dynamic conditions, they spent considerably more energy to maintain equilibrium, and their head was stabilized neither in space nor on trunk: they behaved dynamically without vision like an inverted pendulum while the controls showed a whole body rigidification strategy. Hearing (prosthesis on) as well as dual-tasking did not really improve the dynamic postural performance of the CI patients. We conclude that CI patients become strongly visual dependent mainly in challenging postural conditions, a result they have to be awarded of particularly when getting older. PMID:24474907

Static and dynamic posture control in postlingual cochlear implanted patients: effects of dual-tasking, visual and auditory inputs suppression.

PubMed

Bernard-Demanze, Laurence; Léonard, Jacques; Dumitrescu, Michel; Meller, Renaud; Magnan, Jacques; Lacour, Michel

2013-01-01

Posture control is based on central integration of multisensory inputs, and on internal representation of body orientation in space. This multisensory feedback regulates posture control and continuously updates the internal model of body's position which in turn forwards motor commands adapted to the environmental context and constraints. The peripheral localization of the vestibular system, close to the cochlea, makes vestibular damage possible following cochlear implant (CI) surgery. Impaired vestibular function in CI patients, if any, may have a strong impact on posture stability. The simple postural task of quiet standing is generally paired with cognitive activity in most day life conditions, leading therefore to competition for attentional resources in dual-tasking, and increased risk of fall particularly in patients with impaired vestibular function. This study was aimed at evaluating the effects of postlingual cochlear implantation on posture control in adult deaf patients. Possible impairment of vestibular function was assessed by comparing the postural performance of patients to that of age-matched healthy subjects during a simple postural task performed in static (stable platform) and dynamic (platform in translation) conditions, and during dual-tasking with a visual or auditory memory task. Postural tests were done in eyes open (EO) and eyes closed (EC) conditions, with the CI activated (ON) or not (OFF). Results showed that the postural performance of the CI patients strongly differed from the controls, mainly in the EC condition. The CI patients showed significantly reduced limits of stability and increased postural instability in static conditions. In dynamic conditions, they spent considerably more energy to maintain equilibrium, and their head was stabilized neither in space nor on trunk: they behaved dynamically without vision like an inverted pendulum while the controls showed a whole body rigidification strategy. Hearing (prosthesis on) as well as dual-tasking did not really improve the dynamic postural performance of the CI patients. We conclude that CI patients become strongly visual dependent mainly in challenging postural conditions, a result they have to be awarded of particularly when getting older.

A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

PubMed Central

Ortiz-Gutiérrez, Rosa; Cano-de-la-Cuerda, Roberto; Galán-del-Río, Fernando; Alguacil-Diego, Isabel María; Palacios-Ceña, Domingo; Miangolarra-Page, Juan Carlos

2013-01-01

Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available. PMID:24185843

Balance Training Reduces Brain Activity during Motor Simulation of a Challenging Balance Task in Older Adults: An fMRI Study

PubMed Central

Ruffieux, Jan; Mouthon, Audrey; Keller, Martin; Mouthon, Michaël; Annoni, Jean-Marie; Taube, Wolfgang

2018-01-01

Aging is associated with a shift from an automatic to a more cortical postural control strategy, which goes along with deteriorations in postural stability. Although balance training has been shown to effectively counteract these behavioral deteriorations, little is known about the effect of balance training on brain activity during postural tasks in older adults. We, therefore, assessed postural stability and brain activity using fMRI during motor imagery alone (MI) and in combination with action observation (AO; i.e., AO+MI) of a challenging balance task in older adults before and after 5 weeks of balance training. Results showed a nonsignificant trend toward improvements in postural stability after balance training, accompanied by reductions in brain activity during AO+MI of the balance task in areas relevant for postural control, which have been shown to be over-activated in older adults during (simulation of) motor performance, including motor, premotor, and multisensory vestibular areas. This suggests that balance training may reverse the age-related cortical over-activations and lead to changes in the control of upright posture toward the one observed in young adults. PMID:29472847

Balance Training Reduces Brain Activity during Motor Simulation of a Challenging Balance Task in Older Adults: An fMRI Study.

PubMed

Ruffieux, Jan; Mouthon, Audrey; Keller, Martin; Mouthon, Michaël; Annoni, Jean-Marie; Taube, Wolfgang

2018-01-01

Aging is associated with a shift from an automatic to a more cortical postural control strategy, which goes along with deteriorations in postural stability. Although balance training has been shown to effectively counteract these behavioral deteriorations, little is known about the effect of balance training on brain activity during postural tasks in older adults. We, therefore, assessed postural stability and brain activity using fMRI during motor imagery alone (MI) and in combination with action observation (AO; i.e., AO+MI) of a challenging balance task in older adults before and after 5 weeks of balance training. Results showed a nonsignificant trend toward improvements in postural stability after balance training, accompanied by reductions in brain activity during AO+MI of the balance task in areas relevant for postural control, which have been shown to be over-activated in older adults during (simulation of) motor performance, including motor, premotor, and multisensory vestibular areas. This suggests that balance training may reverse the age-related cortical over-activations and lead to changes in the control of upright posture toward the one observed in young adults.

Influence of paravertebral muscles training on brain plasticity and postural control in chronic low back pain.

PubMed

Massé-Alarie, Hugo; Beaulieu, Louis-David; Preuss, Richard; Schneider, Cyril

2016-07-01

Isometric activation (ISOM) of deep multifidi muscles (MF) can influence postural adjustments and primary motor cortex (M1) function in chronic low back pain (CLBP). In order to better understand how ISOM impacts on CLBP condition, the present study contrasted ISOM after-effects on M1 function, MF postural activation and pain with another training, the global activation of paravertebral muscles (GLOB, hip extension). The main objective of this study was to compare the effects of ISOM and GLOB (3-week training each) on MF postural activation and M1 function in a CLBP population. Twenty-four people with CLBP were randomly allocated to ISOM and GLOB groups for a 3-week daily practice. Pre/post-training after-effects were assessed by the onset of superficial MF (MF-S) activation during ballistic limb movements (bilateral shoulder flexion in standing; unilateral hip extension in prine lying), MF-S corticomotor control tested by transcranial magnetic stimulation of M1, and assessment of pain, kinesiophobia and disability by standardized questionnaires. Both ISOM and GLOB improved pain and disability. However, only ISOM influenced M1 function (decreased corticospinal excitability and increased intracortical inhibition), fastened MF-S postural activation and decreased kinesiophobia. Changes of corticospinal excitability and of MF-S postural adjustments suggest that ISOM better influenced brain plasticity. Future studies should further test whether our novel findings relate to an influence of the exercises on the lumbopelvic control of different muscles and on cognitive function. Clinically, individual's evaluation remains warranted before prescribing one or the other of these two conventional exercises for reducing pain. This original study presents how motor control exercises can influence brain plasticity and postural control in chronic low back pain. This knowledge will impact on the decision of clinicians to prescribe specific exercises with a view of improving motor control in this musculoskeletal condition. Copyright © 2016 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Physical and sporting activities improve vestibular afferent usage and balance in elderly human subjects.

PubMed

Gauchard, G C; Jeandel, C; Perrin, P P

2001-01-01

Ageing is associated with a reduction in balance, in particular through dysfunction of each level of postural control, which results in an increased risk of falling. Conversely, the practice of physical activities has been shown to modulate postural control in elderly people. This study examined the potential positive effects of two types of regular physical and sporting activities on vestibular information and their relation to posture. Gaze and postural stabilisation was evaluated by caloric and rotational vestibular tests on 18 healthy subjects over the age of 60 who regularly practised low-energy or bioenergetic physical activities and on 18 controls of a similar age who only walked on a regular basis. These subjects were also submitted to static and dynamic posturographic tests. The control group displayed less balance control, with a lower vestibular sensitivity and a relatively high dependency on vision compared to the group practising low-energy physical activities, which had better postural control with good vestibular sensitivity and less dependency on vision. The postural control and vestibular sensitivity of subjects practising bioenergetic activities was average, and required higher visual afferent contribution. Low-energy exercises, already shown to have the most positive impact on balance control by relying more on proprioception, also appear to develop or maintain a high level of vestibular sensitivity allowing elderly people practising such exercises to reduce the weight of vision. Copyright 2001 S. Karger AG, Basel

Can vibratory feedback be used to improve postural stability in persons with transtibial limb loss?

PubMed

Rusaw, David; Hagberg, Kerstin; Nolan, Lee; Ramstrand, Nerrolyn

2012-01-01

The use of vibration as a feedback modality to convey motion of the body has been shown to improve measures of postural stability in some groups of patients. Because individuals using transtibial prostheses lack sensation distal to the amputation, vibratory feedback could possibly be used to improve their postural stability. The current investigation provided transtibial prosthesis users (n = 24, mean age 48 yr) with vibratory feedback proportional to the signal received from force transducers located under the prosthetic foot. Postural stability was evaluated by measuring center of pressure (CoP) movement, limits of stability, and rhythmic weight shift while participants stood on a force platform capable of rotations in the pitch plane (toes up/toes down). The results showed that the vibratory feedback increased the mediolateral displacement amplitude of CoP in standing balance and reduced the response time to rapid voluntary movements of the center of gravity. The results suggest that the use of vibratory feedback in an experimental setting leads to improvements in fast open-loop mechanisms of postural control in transtibial prosthesis users.

Continuous Cognitive Task Promotes Greater Postural Stability than an Internal or External Focus of Attention in Older Adults.

PubMed

Richer, Natalie; Polskaia, Nadia; Lajoie, Yves

2017-01-01

Background/Study Context: Recent evidence suggests that removing attention from postural control using either an external focus or a cognitive task will improve stability in healthy young adults. Due to increases in attentional requirements of upright stance in older adults, it is unclear if similar benefits would be observed in this population. The aim of the present study was to examine the effect of attentional focus and of a continuous cognitive task on postural control in older adults. Sixteen healthy older adults (71.9 ± 4.32 years) were asked to stand quietly on a force platform with feet together in three different conditions: internal focus (minimizing movement of the hips), external focus (minimizing movement of markers placed on the hips), and cognitive task (silently counting the occurrence of a single digit in a 3-digit number sequence). A one-way analysis of variance with repeated measures on condition was performed for each postural control measure. Hypotheses were partially supported because the cognitive task led to greater stability than both focus conditions, as evidenced by a smaller sway area (p < .01, η p 2 = .41), reduced sway variability (anterior-posterior: p = .001, η p 2 = .37; medial-lateral: p < .0001, η p 2 = .49), and higher mean power frequency in the anterior-posterior direction (p = .01, η p 2 = .78). However, no difference was observed between internal and external focus conditions. A continuous, attention-demanding cognitive task significantly improved stability in older adults compared with an internal or external focus of attention. This suggests that older adults were able to effectively allocate their attention away from postural control, allowing a more automatic type of control to operate. Future studies should investigate a variety of cognitive tasks to determine the degree of postural improvement that can be observed in older adults.

Assessment of postural asymmetry in mild to moderate Parkinson's disease.

PubMed

Geurts, A C H; Boonstra, T A; Voermans, N C; Diender, M G; Weerdesteyn, V; Bloem, B R

2011-01-01

Asymmetry of symptoms of Parkinson's disease is clinically most evident for appendicular impairments. For axial impairments such as freezing of gait, asymmetry is less obvious. To date, asymmetries in balance control in PD patients have seldom been studied. Therefore, in this study we investigated whether postural control can be asymmetrically affected in mild to moderate PD patients. Seventeen PD patients were instructed to stand as still and symmetrically as possible on a dual force-plate during two trials. Dynamic postural asymmetry was assessed by comparing the centre-of-pressure velocities between both legs. Results showed that four patients (24%) had dynamic postural asymmetry, even after correcting for weight-bearing asymmetry. Hence, this study suggests that postural control can be asymmetrical in early PD. However, future studies should investigate the prevalence of dynamic postural asymmetry, in a larger group of PD patients. It should also be further investigated whether this approach can be used as a tool to support the initial diagnosis or monitor disease progression, or as an outcome measure for interventions aimed at improving balance in PD. Copyright © 2010 Elsevier B.V. All rights reserved.

[Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people].

PubMed

Bae, Jeongyee; Cho, Seong Il

2014-12-01

The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program. Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

Effects of a two-school-year multifactorial back education program in elementary schoolchildren.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2006-08-01

A quasi-experimental pre/post design. To investigate effects of a 2-school-year multifactorial back education program on back posture knowledge and postural behavior in elementary schoolchildren. Additionally, self-reported back or neck pain and fear-avoidance beliefs were evaluated. Epidemiologic studies report mounting nonspecific back pain prevalence among youngsters, characterized by multifactorial risk factors. Study findings of school-based interventions are promising. Furthermore, biomechanical discomfort is found in the school environment. The study sample included 193 intervention children and 172 controls (baseline, 9-to-11-year-olds). The multifactorial intervention consisted of a back education program and the stimulation of postural dynamism in the class through support and environmental changes. Evaluation consisted of a questionnaire, an observation of postural behavior in the classroom, and an observation of material handling during a movement session. The intervention resulted in increased back posture knowledge (P < 0.001), improved postural behavior during material handling (P < 0.001), and decreased duration of trunk flexion (P < 0.05) and neck torsion (P < 0.05) during lesson time. The intervention did not change fear-avoidance beliefs. There was a trend for decreased pain reports in boys of the intervention group (P < 0.09). The intervention resulted in improved postural aspects related to spinal loading. The long-term effect of improved postural behavior at young age on back pain prevalence later in life is of interest for future research.

Head posture measurements among work vehicle drivers and implications for work and workplace design.

PubMed

Eklund, J; Odenrick, P; Zettergren, S; Johansson, H

1994-04-01

An increased risk of musculoskeletal disorders, e.g. from the neck region, has been found among professional drivers of work vehicles. The purpose of this study was to identify causes of postural load and implications for vehicle design and work tasks. A second purpose was to develop the methods for measurement and analysis of head postures. Field measurements of head postures for drivers of fork lift trucks, forestry machines, and cranes were carried out. The equipment used was an electric goniometer measurement system, containing a mechanical transmission between the head and the upper trunk. Methods for data presentation and quantification were developed. The results showed that rotatable and movable driver cabins improved head postures and viewing angles substantially. Narrow window frame structures and large, optimally-placed windows were also advantageous. The steering wheel, controls, and a high backrest restricted shoulder rotation, which increased head rotation in unfavourable viewing angles. Improved workspace layouts and work organization factors such as job enlargement decreased the influence of strenuous postures. The results also showed that head postures should be analysed in two or three dimensions simultaneously, otherwise the postures taken will be underestimated in relation to the maximal voluntary movement.

Tai Chi training reduced coupling between respiration and postural control.

PubMed

Holmes, Matthew L; Manor, Brad; Hsieh, Wan-hsin; Hu, Kun; Lipsitz, Lewis A; Li, Li

2016-01-01

In order to maintain stable upright stance, the postural control system must account for the continuous perturbations to the body's center-of-mass including those caused by spontaneous respiration. Both aging and disease increase "posturo-respiratory synchronization;" which reflects the degree to which respiration affects postural sway fluctuations over time. Tai Chi training emphasizes the coordination of respiration and bodily movements and may therefore optimize the functional interaction between these two systems. The purpose of the project was to examine the effect of Tai Chi training on the interaction between respiration and postural control in older adults. We hypothesized that Tai Chi training would improve the ability of the postural control system to compensate for respiratory perturbations and thus, reduce posturo-respiratory synchronization. Participants were recruited from supportive housing facilities and randomized to a 12-week Tai Chi intervention (n=28; 86 ± 5 yrs) or educational-control program (n=34, 85 ± 6 yrs). Standing postural sway and respiration were simultaneously recorded with a force plate and respiratory belt under eyes-open and eyes-closed conditions. Posturo-respiratory synchronization was determined by quantifying the variation of the phase relationship between the dominant oscillatory mode of respiration and corresponding oscillations within postural sway. Groups were similar in age, gender distribution, height, body mass, and intervention compliance. Neither intervention altered average sway speed, sway magnitude or respiratory rate. As compared to the education-control group, however, Tai Chi training reduced posturo-respiratory synchronization when standing with eyes open or closed (p<0.001). Tai Chi training did not affect traditional parameters of standing postural control or respiration, yet reduced the coupling between respiration and postural control. The beneficial effects of Tai Chi training may therefore stem in part from optimization of this multi-system interaction. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Posture and equilibrium in orthopedic and rheumatologic diseases.

PubMed

Missaoui, B; Portero, P; Bendaya, S; Hanktie, O; Thoumie, P

2008-12-01

Posture and balance may be affected in many spine or lower-limb disorders. An extensive evaluation including clinical tests and movement analysis techniques may be necessary to characterize how rheumatologic or orthopedic diseases are related to static or dynamic changes in postural control. In lower limbs, unbalance may be related to a decreased stability following arthrosis or ligament injuries at knee or ankle levels, while hip lesions appear less associated with such troubles. Spinal diseases at cervical level are frequently associated with postural changes and impaired balance control, related to the major role of sensory inputs during stance and gait. At lower levels, changes are noticed in major scoliosis and may be related to pain intensity in patients with chronic low-back pain. Whatever the initial lesion and the affected level, improvement in clinical or instrumental tests following rehabilitation or brace wearing provides argument for a close relationship between rheumatologic or orthopedic diseases and related impairments in posture and balance control.

Postural control in 13-year-old soccer players

PubMed Central

Bieć, Ewa

2010-01-01

To evaluate the effect of early systematic soccer training on postural control we measured center-of-pressure (COP) variability, range, mean velocity and frequency in bipedal quiet stance with eyes open (EO) and closed (EC) in 44 boys aged 13 (25 boys who practiced soccer for 5–6 years and 19 healthy boys who did not practice sports). The soccer players had better stability, particularly in the medial–lateral plane (M/L); their COP variability and range were lower than in controls in both EO (p < 0.05) and EC (p < 0.0005) condition indicating that the athletes were less dependent on vision than non-athletes. Improved stability of athletes was accompanied by a decrease in COP frequency (p < 0.001 in EO, and p < 0.04 in EC) which accounted for lower regulatory activity of balance system in soccer players. The athletes had lower COP mean velocity than controls (p < 0.0001 in both visual condition), with larger difference in the M/L than A/P plane (p < 0.00001 and p < 0.05, respectively). Postural behavior was more variable within the non-athletes than soccer players, mainly in the EC stances (p < 0.005 for all COP parameters). We conclude that: (1) soccer training described was efficient in improving the M/L postural control in young boys; (2) athletes developed specific postural strategies characterized by decreased COP frequency and lower reliance on vision. PMID:20582432

The Relationship Between the Stomatognathic System and Body Posture

PubMed Central

Cuccia, Antonino; Caradonna, Carola

2009-01-01

In recent years, many researchers have investigated the various factors that can influence body posture: mood states, anxiety, head and neck positions, oral functions (respiration, swallowing), oculomotor and visual systems, and the inner ear. Recent studies indicate a role for trigeminal afferents on body posture, but this has not yet been demonstrated conclusively. The present study aims to review the papers that have shown a relationship between the stomatognathic system and body posture. These studies suggest that tension in the stomatognathic system can contribute to impaired neural control of posture. Numerous anatomical connections between the stomatognathic system’s proprioceptive inputs and nervous structures are implicated in posture (cerebellum, vestibular and oculomotor nuclei, superior colliculus). If the proprioceptive information of the stomatognathic system is inaccurate, then head control and body position may be affected. In addition, the present review discusses the role the myofascial system plays in posture. If confirmed by further research, these considerations can improve our understanding and treatment of muscular-skeletal disorders that are associated with temporomandibular joint disorders, occlusal changes, and tooth loss. PMID:19142553

Does Nordic walking improves the postural control and gait parameters of women between the age 65 and 74: a randomized trial

PubMed Central

Kocur, Piotr; Wiernicka, Marzena; Wilski, Maciej; Kaminska, Ewa; Furmaniuk, Lech; Maslowska, Marta Flis; Lewandowski, Jacek

2015-01-01

[Purpose] To assess the effect of 12-weeks Nordic walking training on gait parameters and some elements of postural control. [Subjects and Methods] Sixty-seven women aged 65 to 74 years were enrolled in this study. The subjects were divided into a Nordic Walking group (12 weeks of Nordic walking training, 3 times a week for 75 minutes) and a control group. In both study groups, a set of functional tests were conducted at the beginning and at the end of the study: the Forward Reach Test (FRT) and the Upward Reach Test (URT) on a stabilometric platform, and the analysis of gait parameters on a treadmill. [Results] The NW group showed improvements in: the range of reach in the FRT test and the URT test in compared to the control group. The length of the gait cycle and gait cycle frequency also showed changes in the NW group compared to the control group. [Conclusion] A 12-week NW training program had a positive impact on selected gait parameters and may improve the postural control of women aged over 65 according to the results selected functional tests. PMID:26834341

Does Nordic walking improves the postural control and gait parameters of women between the age 65 and 74: a randomized trial.

PubMed

Kocur, Piotr; Wiernicka, Marzena; Wilski, Maciej; Kaminska, Ewa; Furmaniuk, Lech; Maslowska, Marta Flis; Lewandowski, Jacek

2015-12-01

[Purpose] To assess the effect of 12-weeks Nordic walking training on gait parameters and some elements of postural control. [Subjects and Methods] Sixty-seven women aged 65 to 74 years were enrolled in this study. The subjects were divided into a Nordic Walking group (12 weeks of Nordic walking training, 3 times a week for 75 minutes) and a control group. In both study groups, a set of functional tests were conducted at the beginning and at the end of the study: the Forward Reach Test (FRT) and the Upward Reach Test (URT) on a stabilometric platform, and the analysis of gait parameters on a treadmill. [Results] The NW group showed improvements in: the range of reach in the FRT test and the URT test in compared to the control group. The length of the gait cycle and gait cycle frequency also showed changes in the NW group compared to the control group. [Conclusion] A 12-week NW training program had a positive impact on selected gait parameters and may improve the postural control of women aged over 65 according to the results selected functional tests.

Balance training reduces falls risk in older individuals with type 2 diabetes.

PubMed

Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

2010-04-01

This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

Reversibility after inhaling salbutamol in different body postures in asthmatic children: a pilot study.

PubMed

Visser, R; van der Palen, J; de Jongh, F H C; Thio, B J

2015-04-01

Pulmonary medication is mostly delivered in the form of medical aerosols to minimize systemic side effects. A major drawback of inhaled medication is that the majority of inhaled particles impacts in the oropharynx at the sharp bend of the airway. Stretching the airway by a forward leaning body posture with the neck extended ("sniffing position") may improve pulmonary deposition and clinical effects. 41 asthmatic children who were planned for standard reversibility testing at the pulmonary function lab, alternately inhaled 200 μgr salbutamol with an Autohaler(®) in the standard or in the forward leaning body posture. Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF), Mean Expiratory Flow at 25% of vital capacity (MEF25) and Mean Expiratory Flow at 75% of vital capacity (MEF75) were analysed. The children in the forward leaning body posture group showed a significantly higher mean FEV1 reversibility than the control group after inhalation of 200 μgr salbutamol (10.2% versus 4.1%, p = 0.019). Additionally, mean MEF75 was significantly more reversible in the forward leaning body posture group versus the standard body posture group (32.2% resp. 8.9%, p = 0.013). This pilot study showed a higher reversibility of FEV1 and MEF75 after inhaling salbutamol in a forward leaning body posture compared to the standard body posture in asthmatic children. This suggests that pulmonary effects of salbutamol can be improved by inhaling in a forward leaning body posture with the neck extended. This effect is possibly due to a higher pulmonary deposition of salbutamol and should be confirmed in a randomized controlled trial. Copyright © 2015 Elsevier Ltd. All rights reserved.

Continuous cognitive task promotes greater postural stability than an internal or external focus of attention.

PubMed

Polskaia, Nadia; Richer, Natalie; Dionne, Eliane; Lajoie, Yves

2015-02-01

Research has demonstrated clear advantages of using an external focus of attention in postural control tasks, presumably since it allows a more automatic control of posture to emerge. However, the influence of cognitive tasks on postural stability has produced discordant results. This study aimed to compare the effects of an internal focus of attention, an external focus of attention and a continuous cognitive task on postural control. Twenty healthy participants (21.4±2.6 years) were recruited for this study. They were asked to stand quietly on a force platform with their feet together in three different attentional focus conditions: an internal focus condition (minimizing movements of the hips), an external focus condition (minimizing movements of markers placed on the hips) and a cognitive task condition (silently counting the total number of times a single digit was verbalized in a 3-digit sequence comprised of 30 numbers). Results demonstrated improved stability while performing the cognitive task as opposed to the internal and external focus conditions, as evidenced by a reduction in sway area, sway variability in the anterior-posterior (AP) and medial-lateral (ML) directions, and mean velocity (ML only). Results suggest that the use of a continuous cognitive task permits attention to be withdrawn from the postural task, thereby facilitating a more automatic control of posture. Copyright © 2014 Elsevier B.V. All rights reserved.

Comparative Effects of Different Balance-Training-Progression Styles on Postural Control and Ankle Force Production: A Randomized Controlled Trial.

PubMed

Cuğ, Mutlu; Duncan, Ashley; Wikstrom, Erik

2016-02-01

Despite the effectiveness of balance training, the exact parameters needed to maximize the benefits of such programs remain unknown. One such factor is how individuals should progress to higher levels of task difficulty within a balance-training program. Yet no investigators have directly compared different balance-training-progression styles. To compare an error-based progression (ie, advance when proficient at a task) with a repetition-based progression (ie, advance after a set amount of repetitions) style during a balance-training program in healthy individuals. Randomized controlled trial. Research laboratory. A total of 28 (16 women, 12 men) physically healthy young adults (age = 21.57 ± 3.95 years, height = 171.60 ± 11.03 cm, weight = 72.96 ± 16.18 kg, body mass index = 24.53 ± 3.7). All participants completed 12 supervised balance-training sessions over 4 weeks. Each session consisted of a combination of dynamic unstable-surface tasks that incorporated a BOSU ball and lasted about 30 minutes. Static balance from an instrumented force plate, dynamic balance as measured via the Star Excursion Balance Test, and ankle force production in all 4 cardinal planes of motion as measured with a handheld dynamometer before and after the intervention. Selected static postural-control outcomes, dynamic postural control, and ankle force production in all planes of motion improved (P < .05). However, no differences between the progression styles were observed (P > .05) for any of the outcome measures. A 4-week balance-training program consisting of dynamic unstable-surface exercises on a BOSU ball improved dynamic postural control and ankle force production in healthy young adults. These results suggest that an error-based balance-training program is comparable with but not superior to a repetition-based balance-training program in improving postural control and ankle force production in healthy young adults.

Locomotor training through a novel robotic platform for gait rehabilitation in pediatric population: short report.

PubMed

Bayón, C; Lerma, S; Ramírez, O; Serrano, J I; Del Castillo, M D; Raya, R; Belda-Lois, J M; Martínez, I; Rocon, E

2016-11-14

Cerebral Palsy (CP) is a disorder of posture and movement due to a defect in the immature brain. The use of robotic devices as alternative treatment to improve the gait function in patients with CP has increased. Nevertheless, current gait trainers are focused on controlling complete joint trajectories, avoiding postural control and the adaptation of the therapy to a specific patient. This paper presents the applicability of a new robotic platform called CPWalker in children with spastic diplegia. CPWalker consists of a smart walker with body weight and autonomous locomotion support and an exoskeleton for joint motion support. Likewise, CPWalker enables strategies to improve postural control during walking. The integrated robotic platform provides means for testing novel gait rehabilitation therapies in subjects with CP and similar motor disorders. Patient-tailored therapies were programmed in the device for its evaluation in three children with spastic diplegia for 5 weeks. After ten sessions of personalized training with CPWalker, the children improved the mean velocity (51.94 ± 41.97 %), cadence (29.19 ± 33.36 %) and step length (26.49 ± 19.58 %) in each leg. Post-3D gait assessments provided kinematic outcomes closer to normal values than Pre-3D assessments. The results show the potential of the novel robotic platform to serve as a rehabilitation tool. The autonomous locomotion and impedance control enhanced the children's participation during therapies. Moreover, participants' postural control was substantially improved, which indicates the usefulness of the approach based on promoting the patient's trunk control while the locomotion therapy is executed. Although results are promising, further studies with bigger sample size are required.

Support surface related changes in feedforward and feedback control of standing posture

PubMed Central

Mohapatra, Sambit; Kukkar, Komal K.; Aruin, Alexander S.

2013-01-01

The aim of the study was to investigate the effect of different support surfaces on feedforward and feedback components of postural control. Nine healthy subjects were exposed to external perturbations applied to their shoulders while standing on a rigid platform, foam, and wobble board with eyes open or closed. Electrical activity of nine trunk and leg muscles and displacements of the center of pressure were recorded and analyzed during the time frames typical of feedforward and feedback postural adjustments. Feedforward control of posture was characterized by earlier activation of anterior muscles when the subjects stood on foam compared to a wobble board or a firm surface. In addition, the magnitude of feedforward muscle activity was the largest when the foam was used. During the feedback control, anterior muscles were activated prior to posterior muscles irrespective of the nature of surface. Moreover, the largest muscle activity was seen when the supporting surface was foam. Maximum CoP displacement occurred when subjects were standing on a rigid surface. Altering support surface affects both feedforward and feedback components of postural control. This information should be taken into consideration in planning rehabilitation interventions geared towards improvement of balance. PMID:24268589

Support surface related changes in feedforward and feedback control of standing posture.

PubMed

Mohapatra, Sambit; Kukkar, Komal K; Aruin, Alexander S

2014-02-01

The aim of the study was to investigate the effect of different support surfaces on feedforward and feedback components of postural control. Nine healthy subjects were exposed to external perturbations applied to their shoulders while standing on a rigid platform, foam, and wobble board with eyes open or closed. Electrical activity of nine trunk and leg muscles and displacements of the center of pressure were recorded and analyzed during the time frames typical of feedforward and feedback postural adjustments. Feedforward control of posture was characterized by earlier activation of anterior muscles when the subjects stood on foam compared to a wobble board or a firm surface. In addition, the magnitude of feedforward muscle activity was the largest when the foam was used. During the feedback control, anterior muscles were activated prior to posterior muscles irrespective of the nature of surface. Moreover, the largest muscle activity was seen when the supporting surface was foam. Maximum CoP displacement occurred when subjects were standing on a rigid surface. Altering support surface affects both feedforward and feedback components of postural control. This information should be taken into consideration in planning rehabilitation interventions geared towards improvement of balance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Non-physical practice improves task performance in an unstable, perturbed environment: motor imagery and observational balance training

PubMed Central

Taube, Wolfgang; Lorch, Michael; Zeiter, Sibylle; Keller, Martin

2014-01-01

For consciously performed motor tasks executed in a defined and constant way, both motor imagery (MI) and action observation (AO) have been shown to promote motor learning. It is not known whether these forms of non-physical training also improve motor actions when these actions have to be variably applied in an unstable and unpredictable environment. The present study therefore investigated the influence of MI balance training (MI_BT) and a balance training combining AO and MI (AO+MI_BT) on postural control of undisturbed and disturbed upright stance on unstable ground. As spinal reflex excitability after classical (i.e., physical) balance training (BT) is generally decreased, we tested whether non-physical BT also has an impact on spinal reflex circuits. Thirty-six participants were randomly allocated into an MI_BT group, in which participants imagined postural exercises, an AO+MI_BT group, in which participants observed videos of other people performing balance exercises and imagined being the person in the video, and a non-active control group (CON). Before and after 4 weeks of non-physical training, balance performance was assessed on a free-moving platform during stance without perturbation and during perturbed stance. Soleus H-reflexes were recorded during stable and unstable stance. The post-measurement revealed significantly decreased postural sway during undisturbed and disturbed stance after both MI_BT and AO+MI_BT. Spinal reflex excitability remained unchanged. This is the first study showing that non-physical training (MI_BT and AO+MI_BT) not only promotes motor learning of “rigid” postural tasks but also improves performance of highly variable and unpredictable balance actions. These findings may be relevant to improve postural control and thus reduce the risk of falls in temporarily immobilized patients. PMID:25538598

The visual control of stability in children and adults: postural readjustments in a ground optical flow.

PubMed

Baumberger, Bernard; Isableu, Brice; Flückiger, Michelangelo

2004-11-01

The aim of this research was to analyse the development of postural reactions to approaching (AOF) and receding (ROF) ground rectilinear optical flows. Optical flows were shaped by a pattern of circular spots of light projected on the ground surface by a texture flow generator. The geometrical structure of the projected scenes corresponded to the spatial organisation of visual flows encountered in open outdoor settings. Postural readjustments of 56 children, ranging from 7 to 11 years old, and 12 adults were recorded by the changes of the centre of foot pressure (CoP) on a force platform during 44-s exposures to the moving texture. Before and after the optical flows exposure, a 24-s motionless texture served as a reference condition. Effect of ground rectilinear optical flows on postural control development was assessed by analysing sway latencies (SL), stability performances and postural orientation. The main results that emerge from this experiment show that postural responses are directionally specific to optical flow pattern and that they vary as a function of the motion onset and offset. Results showed that greater developmental changes in postural control occurred in an AOF (both at the onset and offset of the optical flow) than in an ROF. Onset of an approaching flow induced postural instability, canonical shifts in postural orientation and long latencies in children which were stronger than in the receding flow. This pattern of responses evolved with age towards an improvement in stability performances and shorter SL. The backward decreasing shift of the CoP in children evolved in adults towards forward postural tilt, i.show $132#e. in the opposite direction of the texture's motion. Offset of an AOF motion induced very short SL in children (which became longer in adult subjects), strong postural instability, but weaker shift of orientation compared to the receding one. Postural stability improved and orientation shift evolved to forward inclinations with age. SL remained almost constant across age at both onset and offset of the receding flow. Critical developmental periods seem to occur by the age of 8 and 10 years, as suggested by the transient 'neglect' of the children to optical flows. Linear vection was felt by 90% of the 7 year olds and decreased with age to reach 55% in adult subjects. The mature sensorimotor coordination subserving the postural organisation shown in adult subjects is an example aiming at reducing the postural effects induced by optical flows. The data are discussed in relation to the perceptual importance of mobile visual references on a ground support.

The effect of aging on anticipatory postural control

PubMed Central

Kanekar, Neeta; Aruin, Alexander S.

2014-01-01

The aim of the study was to investigate the differences in anticipatory (APAs) postural adjustments between young and older adults and its effect on subsequent control of posture. Ten healthy older adults and thirteen healthy young adults were exposed to predictable external perturbations using the pendulum-impact paradigm. EMG activity of the trunk and leg muscles, the center of pressure (COP), and center of mass (COM) displacements in the anterior-posterior (AP) direction were recorded and analyzed during the anticipatory and compensatory (CPAs) phases of postural control. The effect of aging was seen as delayed anticipatory muscle activity and larger compensatory muscle responses in older adults as compared to young adults. Moreover, in spite of such larger reactive responses, older adults were still more unstable, exhibiting larger COP and COM peak displacements after the perturbation than young adults when exposed to similar postural disturbances. Nonetheless, while APAs are impaired in older adults, the ability to recruit muscles anticipatorily is largely preserved, however, due to their smaller magnitudes and delayed onsets, it is likely that their effectiveness in reducing the magnitude of CPAs is smaller. The outcome of the study lends support towards investigating the ways of improving anticipatory postural control in people with balance impairments due to aging or neurological disorders. PMID:24449006

The proactive approach--is it worthwhile? A prospective controlled ergonomic intervention study in office workers.

PubMed

Laestadius, Jasminka Goldoni; Ye, Jian; Cai, Xiaodong; Ross, Sandra; Dimberg, Lennart; Klekner, Meg

2009-10-01

Does proactive ergonomics program enhance office worker health and productivity? The investigation was conducted in connection with the move of 1500 office staff to a building with improved ergonomics. It was focused on associations between workstation features, working postures, musculoskeletal pain symptoms, and eye strain before and 18 months after implementation of a proactive ergonomic program. The outcomes were compared between the intervention and a similar reference group. Associations between improvement of postures and less musculoskeletal pain and eye strain were confirmed. A cross association between several features and postures and improved symptoms was noted, along with improved productivity. The study suggests that a proactive program adhering to the OSHA recommendations needs to include an individual workstation assessment to be effective in reducing symptoms and increasing productivity.

Stochastic analysis of motor-control stability, polymer based force sensing, and optical stimulation as a preventive measure for falls

NASA Astrophysics Data System (ADS)

Landrock, Clinton K.

Falls are the leading cause of all external injuries. Outcomes of falls include the leading cause of traumatic brain injury and bone fractures, and high direct medical costs in the billions of dollars. This work focused on developing three areas of enabling component technology to be used in postural control monitoring tools targeting the mitigation of falls. The first was an analysis tool based on stochastic fractal analysis to reliably measure levels of motor control. The second focus was on thin film wearable pressure sensors capable of relaying data for the first tool. The third was new thin film advanced optics for improving phototherapy devices targeting postural control disorders. Two populations, athletes and elderly, were studied against control groups. The results of these studies clearly show that monitoring postural stability in at-risk groups can be achieved reliably, and an integrated wearable system can be envisioned for both monitoring and treatment purposes. Keywords: electro-active polymer, ionic polymer-metal composite, postural control, motor control, fall prevention, sports medicine, fractal analysis, physiological signals, wearable sensors, phototherapy, photobiomodulation, nano-optics.

Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial.

PubMed

Bogaerts, An; Verschueren, Sabine; Delecluse, Christophe; Claessens, Albrecht L; Boonen, Steven

2007-07-01

This randomized controlled trial investigated the effects of a 12 month whole body vibration training program on postural control in healthy older adults. Two hundred and twenty people were randomly assigned to a whole body vibration group (n=94), a fitness group (n=60) or a control group (n=66). The whole body vibration and fitness groups trained three times a week for 1 year. The vibration group performed exercises on a vibration platform and the fitness group performed cardiovascular, strength, balance and stretching exercises. Balance was measured using dynamic computerized posturography at baseline and after 6 and 12 months. Whole body vibration training was associated with reduced falls frequency on a moving platform when vision was disturbed and improvements in the response to toes down rotations at the ankle induced by the moving platform. The fitness group showed reduced falls frequency on the moving surface when vision was disturbed. Thus, whole body vibration training may improve some aspects of postural control in community dwelling older individuals.

Gait post-stroke: Pathophysiology and rehabilitation strategies.

PubMed

Beyaert, C; Vasa, R; Frykberg, G E

2015-11-01

We reviewed neural control and biomechanical description of gait in both non-disabled and post-stroke subjects. In addition, we reviewed most of the gait rehabilitation strategies currently in use or in development and observed their principles in relation to recent pathophysiology of post-stroke gait. In both non-disabled and post-stroke subjects, motor control is organized on a task-oriented basis using a common set of a few muscle modules to simultaneously achieve body support, balance control, and forward progression during gait. Hemiparesis following stroke is due to disruption of descending neural pathways, usually with no direct lesion of the brainstem and cerebellar structures involved in motor automatic processes. Post-stroke, improvements of motor activities including standing and locomotion are variable but are typically characterized by a common postural behaviour which involves the unaffected side more for body support and balance control, likely in response to initial muscle weakness of the affected side. Various rehabilitation strategies are regularly used or in development, targeting muscle activity, postural and gait tasks, using more or less high-technology equipment. Reduced walking speed often improves with time and with various rehabilitation strategies, but asymmetric postural behaviour during standing and walking is often reinforced, maintained, or only transitorily decreased. This asymmetric compensatory postural behaviour appears to be robust, driven by support and balance tasks maintaining the predominant use of the unaffected side over the initially impaired affected side. Based on these elements, stroke rehabilitation including affected muscle strengthening and often stretching would first need to correct the postural asymmetric pattern by exploiting postural automatic processes in various particular motor tasks secondarily beneficial to gait. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Spatial Cues Provided by Sound Improve Postural Stabilization: Evidence of a Spatial Auditory Map?

PubMed Central

Gandemer, Lennie; Parseihian, Gaetan; Kronland-Martinet, Richard; Bourdin, Christophe

2017-01-01

It has long been suggested that sound plays a role in the postural control process. Few studies however have explored sound and posture interactions. The present paper focuses on the specific impact of audition on posture, seeking to determine the attributes of sound that may be useful for postural purposes. We investigated the postural sway of young, healthy blindfolded subjects in two experiments involving different static auditory environments. In the first experiment, we compared effect on sway in a simple environment built from three static sound sources in two different rooms: a normal vs. an anechoic room. In the second experiment, the same auditory environment was enriched in various ways, including the ambisonics synthesis of a immersive environment, and subjects stood on two different surfaces: a foam vs. a normal surface. The results of both experiments suggest that the spatial cues provided by sound can be used to improve postural stability. The richer the auditory environment, the better this stabilization. We interpret these results by invoking the “spatial hearing map” theory: listeners build their own mental representation of their surrounding environment, which provides them with spatial landmarks that help them to better stabilize. PMID:28694770

Treatment and ergonomics training of work-related lower back pain and body posture problems for nurses.

PubMed

Jaromi, Melinda; Nemeth, Andrea; Kranicz, Janos; Laczko, Tamas; Betlehem, Jozsef

2012-06-01

The purpose of the study was to measure the effectiveness of a spine training programme (Back School) in nurses who have been living with chronic low back pain. It was hypothesised that active therapy, ergonomics and education called Back School will significantly decrease the pain intensity levels and improve the body posture of the study participants. A chronic low back pain is a significant work-related health problem among healthcare workers around the world. Proper body posture is essential for decreasing pain in healthcare workers who have history of chronic low back pain. By teaching proper body posture and with the creation of occupational settings that are 'spine-friendly' hospitals and other healthcare settings can significantly lower the suffering of their nursing staff. Single-blinded randomised controlled trial was utilised with six- and 12-months follow-up. The study was carried out at the University of Pecs, Faculty of Health Sciences from 2007 to 2008 involving 124 nurses with low back pain. Participants were randomly assigned to the study group (who have received ergonomics training and education called Back School) with an intervention conducted once a week for a six-week period. The control group received passive physiotherapy once a week for a six-week period. Further follow-up measurements were conducted at six and 12 months, respectively. The study variables and outcome measures were pain intensity and body posture (angle of thoracic kyphosis and lumbar lordosis). The pain intensity was investigated with the Visual Analogue Scale. Body posture was recorded and analysed with the Zebris biomechanical motion analysis system. The statistical analysis of repeated measures indicated a significant decrease in back pain intensity after the therapy in both groups, compared with measurements before the therapy; however, the BS group showed significantly better results during the six-month and one-year follow-up period. The biomechanical analysis of postures after the therapy in the BS group showed significant improvements over the control group; during the follow-up, the difference was still significant, yet slightly reduced. This study has shown that a significant reduction in the pain intensity and improvement in body posture can be achieved by the usage of the active physical therapy methods (Back School) in nurses who are experiencing chronic lower back pain. The Back School programme when compared with the passive physical therapies (such as massage, ultrasound treatment, etc.) shows significant improvement in reduction in pain and greatly improves the posture of healthcare workers. The adoption of the Back School programme for the treatment of the healthcare workers with chronic low back problems should be a treatment of choice and standard that should be adopted when designing occupational healthcare policies and procedures. © 2012 Blackwell Publishing Ltd.

Scapular Bracing and Alteration of Posture and Muscle Activity in Overhead Athletes With Poor Posture

PubMed Central

Cole, Ashley K; McGrath, Melanie L; Harrington, Shana E; Padua, Darin A; Rucinski, Terri J; Prentice, William E

2013-01-01

Context Overhead athletes commonly have poor posture. Commercial braces are used to improve posture and function, but few researchers have examined the effects of shoulder or scapular bracing on posture and scapular muscle activity. Objective To examine whether a scapular stabilization brace acutely alters posture and scapular muscle activity in healthy overhead athletes with forward-head, rounded-shoulder posture (FHRSP). Design Randomized controlled clinical trial. Setting Applied biomechanics laboratory. Patients or Other Participants Thirty-eight healthy overhead athletes with FHRSP. Intervention(s) Participants were assigned randomly to 2 groups: compression shirt with no strap tension (S) and compression shirt with the straps fully tensioned (S + T). Posture was measured using lateral-view photography with retroreflective markers. Electromyography (EMG) of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) in the dominant upper extremity was measured during 4 exercises (scapular punches, W's, Y's, T's) and 2 glenohumeral motions (forward flexion, shoulder extension). Posture and exercise EMG measurements were taken with and without the brace applied. Main Outcome Measure(s) Head and shoulder angles were measured from lateral-view digital photographs. Normalized surface EMG was used to assess mean muscle activation of the UT, MT, LT, and SA. Results Application of the brace decreased forward shoulder angle in the S + T condition. Brace application also caused a small increase in LT EMG during forward flexion and Y's and a small decrease in UT and MT EMG during shoulder extension. Brace application in the S + T group decreased UT EMG during W's, whereas UT EMG increased during W's in the S group. Conclusions Application of the scapular brace improved shoulder posture and scapular muscle activity, but EMG changes were highly variable. Use of a scapular brace might improve shoulder posture and muscle activity in overhead athletes with poor posture. PMID:23672321

Bilateral improvements in lower extremity function after unilateral balance training in individuals with chronic ankle instability.

PubMed

Hale, Sheri A; Fergus, Andrea; Axmacher, Rachel; Kiser, Kimberly

2014-01-01

Bilateral improvements in postural control have been reported among individuals with acute lateral ankle sprains and individuals with chronic ankle instability (CAI) when only the unstable ankle is rehabilitated. We do not know if training the stable ankle will improve function on the unstable side. To explore the effects of a unilateral balance-training program on bilateral lower extremity balance and function in individuals with CAI when only the stable limb is trained. Cohort study. University clinical research laboratory. A total of 34 volunteers (8 men, 26 women; age = 24.32 ± 4.95 years, height = 167.01 ± 9.45 cm, mass = 77.54 ± 23.76 kg) with CAI were assigned to the rehabilitation (n = 17) or control (n = 17) group. Of those, 27 (13 rehabilitation group, 14 control group) completed the study. Balance training twice weekly for 4 weeks. Foot and Ankle Disability Index (FADI), FADI Sport (FADI-S), Star Excursion Balance Test, and Balance Error Scoring System. The rehabilitation and control groups differed in changes in FADI-S and Star Excursion Balance Test scores over time. Only the rehabilitation group improved in the FADI-S and in the posteromedial and anterior reaches of the Star Excursion Balance Test. Both groups demonstrated improvements in posterolateral reach; however, the rehabilitation group demonstrated greater improvement than the control group. When the groups were combined, participants reported improvements in FADI and FADI-S scores for the unstable ankle but not the stable ankle. Our data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle. This further supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation.

Development of adaptive sensorimotor control in infant sitting posture.

PubMed

Chen, Li-Chiou; Jeka, John; Clark, Jane E

2016-03-01

A reliable and adaptive relationship between action and perception is necessary for postural control. Our understanding of how this adaptive sensorimotor control develops during infancy is very limited. This study examines the dynamic visual-postural relationship during early development. Twenty healthy infants were divided into 4 developmental groups (each n=5): sitting onset, standing alone, walking onset, and 1-year post-walking. During the experiment, the infant sat independently in a virtual moving-room in which anterior-posterior oscillations of visual motion were presented using a sum-of-sines technique with five input frequencies (from 0.12 to 1.24 Hz). Infants were tested in five conditions that varied in the amplitude of visual motion (from 0 to 8.64 cm). Gain and phase responses of infants' postural sway were analyzed. Our results showed that infants, from a few months post-sitting to 1 year post-walking, were able to control their sitting posture in response to various frequency and amplitude properties of the visual motion. Infants showed an adult-like inverted-U pattern for the frequency response to visual inputs with the highest gain at 0.52 and 0.76 Hz. As the visual motion amplitude increased, the gain response decreased. For the phase response, an adult-like frequency-dependent pattern was observed in all amplitude conditions for the experienced walkers. Newly sitting infants, however, showed variable postural behavior and did not systemically respond to the visual stimulus. Our results suggest that visual-postural entrainment and sensory re-weighting are fundamental processes that are present after a few months post sitting. Sensorimotor refinement during early postural development may result from the interactions of improved self-motion control and enhanced perceptual abilities. Copyright © 2016 Elsevier B.V. All rights reserved.

Independent walking as a major skill for the development of anticipatory postural control: evidence from adjustments to predictable perturbations.

PubMed

Cignetti, Fabien; Zedka, Milan; Vaugoyeau, Marianne; Assaiante, Christine

2013-01-01

Although there is suggestive evidence that a link exists between independent walking and the ability to establish anticipatory strategy to stabilize posture, the extent to which this skill facilitates the development of anticipatory postural control remains largely unknown. Here, we examined the role of independent walking on the infants' ability to anticipate predictable external perturbations. Non-walking infants, walking infants and adults were sitting on a platform that produced continuous rotation in the frontal plane. Surface electromyography (EMG) of neck and lower back muscles and the positions of markers located on the platform, the upper body and the head were recorded. Results from cross-correlation analysis between rectified and filtered EMGs and platform movement indicated that although muscle activation already occurred before platform movement in non-walking infants, only walking infants demonstrated an adult-like ability for anticipation. Moreover, results from further cross-correlation analysis between segmental angular displacement and platform movement together with measures of balance control at the end-points of rotation of the platform evidenced two sorts of behaviour. The adults behaved as a non-rigid non-inverted pendulum, rather stabilizing head in space, while both the walking and non-walking infants followed the platform, behaving as a rigid inverted pendulum. These results suggest that the acquisition of independent walking plays a role in the development of anticipatory postural control, likely improving the internal model for the sensorimotor control of posture. However, despite such improvement, integrating the dynamics of an external object, here the platform, within the model to maintain balance still remains challenging in infants.

Postural insoles on gait in children with cerebral palsy: Randomized controlled double-blind clinical trial.

PubMed

Pasin Neto, Hugo; Grecco, Luanda André Collange; Ferreira, Luis Alfredo Braun; Duarte, Natália Almeida Carvalho; Galli, Manuela; Oliveira, Claudia Santos

2017-10-01

The aim of the present study was to assess the effect of postural insoles on gait performance in children with Cerebral Palsy (CP). Twenty four children between four and 12 years of age were randomly allocated either the control group (n = 12) or experimental group (n = 12). The control group used placebo insoles and the experimental group used postural insoles. Three-dimensional gait analysis was performed under three conditions: barefoot, in shoes and in shoes with insoles. Three evaluations were carried out: 1)immediately following placement of the insoles; 2)after three months of insole use; and 3)one month after suspending insole use. Regarding the immediate effects and after three months use of insole, significant improvements in gait velocity and cadence were found in the experimental group, along with an increase in foot dorsiflexion, a reduction in knee flexion and a reduction in internal rotation. Conversely, these changes were not maintained in the third assessment, one month after withdrawal of the insoles. The use of postural insoles led to improvements in gait performance in children with CP. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comprehensive Group Therapy of Obesity and Its Impact on Selected Anthropometric and Postural Parameters.

PubMed

Horák, Stanislav; Sovová, Eliška; Pastucha, Dalibor; Konečný, Petr; Radová, Lenka; Calabová, Naděžda; Janoutová, Jana; Janout, Vladimír

2017-12-01

Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroCom's SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions). Copyright© by the National Institute of Public Health, Prague 2017

Performing saccadic eye movements or blinking improves postural control.

PubMed

Rougier, Patrice; Garin, Mélanie

2007-07-01

To determine the relationship between eye movement and postural control on an undisturbed upright stance maintenance protocol, 15 young, healthy individuals were tested in various conditions. These conditions included imposed blinking patterns and horizontal and vertical saccadic eye movements. The directions taken by the center of pressure (CP) were recorded via a force platform on which the participants remained in an upright position. The CP trajectories were used to estimate, via a low-pass filter, the vertically projected movements of the center of gravity (CGv) and consequently the difference CP-CGv. An analysis of the frequency shows that regular bilateral blinking does not produce a significant change in postural control. In contrast, performing saccadic eye movements induces some reduced amplitude for both basic CGv and CP-CGv movements principally along the antero-posterior axis. The present result supports the theory that some ocular movements may modify postural control in the maintenance of the upright standing position in human participants.

Is Tai Chi Chuan effective in improving lower limb response time to prevent backward falls in the elderly?

PubMed

Wong, Alice M K; Pei, Yu-Cheng; Lan, Ching; Huang, Shu-Chun; Lin, Yin-Chou; Chou, Shih-Wei

2009-06-01

To evaluate the training effect of Tai Chi Chuan (TCC) in postural control and backward fall prevention in the elderly, balance assessment and visually guided lower limb response time were analyzed in a case-control study conducted in a community setting. Thirty-one elderly subjects (mean age: 68.2 +/- 6.8 years) participated in the TCC group, 30 community-dwelling elderly subjects with matched age and body composition served as the elderly control group, with 13 young adults (mean age: 27.5 +/- 3.8 years) serving as young controls. The TCC group had practiced TCC regularly five times per week, for over 30 min per day for at least 4 years. Lower limb response time were measured using a computerized dance machine that we developed, which contains two blocks during testing: single and dual feet. The motor planning of the latter is more complex than the former. Postural control was assessed by computerized posturography (Smart Balance Master). Compared to the elderly controls, the TCC group demonstrated significantly better balance performance in sway-referenced support, which is more challenging. Moreover, the TCC group had better dual feet response than the elderly controls in the forward-backward, forward-right and forward-left directions. Practicing TCC may improve motor responses and postural control in the elderly, particularly in more challenging situations. Subjects showed better postural responses to unexpected perturbation in the forward-backward and forward-sideways direction than sideways or backward-sideways directions, which may have clinical relevance.

Effects on muscle strength, maximal jump height, flexibility and postural sway after soccer and Zumba exercise among female hospital employees: a 9-month randomised controlled trial.

PubMed

Barene, Svein; Holtermann, Andreas; Oseland, Harald; Brekke, Ole-Lars; Krustrup, Peter

2016-10-01

This 9-month randomised controlled workplace physical activity trial investigated the effects of soccer and Zumba exercise, respectively, on muscle strength, maximal jump height, sit-and-reach flexibility and postural sway among female workers. A total of 107 female hospital employees aged 25-63 were cluster-randomised to a soccer group, a Zumba group or a control group. Training was conducted outside working hours as two to three 1-h weekly sessions the first 3 months and once a week the last 6 months. Tests were conducted at baseline, after 3 and 9 months. The soccer group improved maximal neck extension strength both after 3 (1.2 kg; P < 0.05) and 9 months (1.7 kg; P < 0.01) compared to the control group. The Zumba group improved maximal trunk extension strength (3.1 kg; P = 0.04) after 3 months, with improvements in postural sway velocity moment (-9.2 mm(2)/s; P < 0.05) and lower limb lean mass (0.4 kg; P < 0.05) after 9 months. No significant intervention effects were revealed in vertical jump height or sit-and-reach flexibility. The present study indicates that workplace-initiated soccer and Zumba exercise may be beneficial for improvement of the neck and trunk strength, which may have preventive effects with regard to future perceived muscle pain in the respective body regions. Furthermore, the Zumba group revealed positive effects on lower limb lean mass and postural sway compared to the control group.

The effects of Transcutaneous Electrical Nerve Stimulation on postural control in patients with chronic low back pain.

PubMed

Rojhani-Shirazi, Z; Rezaeian, T

2015-01-01

Objective: The effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with low back pain which is not well known. This study aimed to evaluate the effects of TENS on postural control in chronic low back pain. Methods: This study was an experimental research design. Twenty-eight patients with chronic LBP (25-45 Y/ O) participated and by using a random allocation, were divided to samples who participated in this study. The mean center of pressure (COP) velocity and displacement were measured before, immediately and 30 min after the intervention. The tests were done with eyes open and closed on a force platform. Sensory electrical stimulation was applied through the TENS device. The descriptive statistics, independent sample T-test and ANOVA with repeated measurement on time were used for data analysis. Results: The results of the present study demonstrated that the application of the sensory electrical stimulation in chronic LBP patients showed a statistically significant improvement in postural control in Medio-lateral direction with no corresponding effect on the anterior-posterior direction immediately following the TENS application and 30 minutes after it in closed eyes conditions as compared to baseline. The application of TENS decreased the displacement and velocity of COP (p≤0.05), 30 minutes after the application of sensory electrical stimulation. The results showed that the mean displacement and velocity of COP decreased in eyes open position (p≤0.05). Also, immediately and 30 minutes after the application of sensory electrical stimulation, COP displacement and velocity in ML direction with eyes closed significantly decreased in the intervention group in comparison with control group (p≤0.05). Conclusion: The application of TENS in patients with chronic low back pain could improve postural control in these patients.

The effects of Transcutaneous Electrical Nerve Stimulation on postural control in patients with chronic low back pain

PubMed Central

Rojhani-Shirazi, Z; Rezaeian, T

2015-01-01

Objective: The effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with low back pain which is not well known. This study aimed to evaluate the effects of TENS on postural control in chronic low back pain. Methods: This study was an experimental research design. Twenty-eight patients with chronic LBP (25-45 Y/ O) participated and by using a random allocation, were divided to samples who participated in this study. The mean center of pressure (COP) velocity and displacement were measured before, immediately and 30 min after the intervention. The tests were done with eyes open and closed on a force platform. Sensory electrical stimulation was applied through the TENS device. The descriptive statistics, independent sample T-test and ANOVA with repeated measurement on time were used for data analysis. Results: The results of the present study demonstrated that the application of the sensory electrical stimulation in chronic LBP patients showed a statistically significant improvement in postural control in Medio-lateral direction with no corresponding effect on the anterior-posterior direction immediately following the TENS application and 30 minutes after it in closed eyes conditions as compared to baseline. The application of TENS decreased the displacement and velocity of COP (p≤0.05), 30 minutes after the application of sensory electrical stimulation. The results showed that the mean displacement and velocity of COP decreased in eyes open position (p≤0.05). Also, immediately and 30 minutes after the application of sensory electrical stimulation, COP displacement and velocity in ML direction with eyes closed significantly decreased in the intervention group in comparison with control group (p≤0.05). Conclusion: The application of TENS in patients with chronic low back pain could improve postural control in these patients. PMID:28255392

Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy.

PubMed

El-Shamy, Shamekh Mohamed; Abd El Kafy, Ehab Mohamed

2014-01-01

The purpose of this study was to evaluate the effects of balance training on postural control and fall risk in children with diplegic cerebral palsy. Thirty spastic diplegic cerebral palsied children (10-12 years) were included in this study. Children were randomly assigned into two equal-sized groups: control and study groups. Participants in both groups received a traditional physical therapy exercise program. The study group additionally received balance training on the Biodex balance system. Treatment was provided 30 min/d, 3 d/week for 3 successive months. To evaluate the limit of stability and fall risk, participated children received baseline and post-treatment assessments using the Biodex balance system. Overall directional control, total time to complete the test, overall stability index of the fall risk test and total score of the pediatric balance scale were measured. Children in both groups showed significant improvements in the mean values of all measured variables post-treatment (p < 0.05). The results also showed significantly better improvement in the measured parameters for the study group, as compared to the control group (p < 0.05). Balance training on Biodex system is a useful tool that can be used in improving postural balance control in children with diplegic cerebral palsy.

The Effects of Slackline Balance Training on Postural Control in Older Adults.

PubMed

Thomas, Monika; Kalicinski, Michael

2016-07-01

The present study investigated whether slackline training enhances postural control in older adults. Twenty-four participants were randomized into an intervention and a control group. The intervention group received 6 weeks of slackline training, two times per week. Pre-post measurement included the time of different standing positions on a balance platform with and without an external disturbance and the acceleration of the balance platform. Results showed significantly improved standing times during one-leg stance without external disturbance and a significantly reduced acceleration of the balance platform for the intervention group after the training period during tandem stance with and without an external disturbance. We conclude that slackline training in older adults has a positive impact on postural control and thus on the reduction of fall risk.

Vehicle height and posture control of the electronic air suspension system using the hybrid system approach

NASA Astrophysics Data System (ADS)

Sun, Xiaoqiang; Cai, Yingfeng; Chen, Long; Liu, Yanling; Wang, Shaohua

2016-03-01

The electronic air suspension (EAS) system can improve ride comfort, fuel economy and handling safety of vehicles by adjusting vehicle height. This paper describes the development of a novel controller using the hybrid system approach to adjust the vehicle height (height control) and to regulate the roll and pitch angles of the vehicle body during the height adjustment process (posture control). The vehicle height adjustment system of EAS poses challenging hybrid control problems, since it features different discrete modes of operation, where each mode has an associated linear continuous-time dynamic. In this paper, we propose a novel approach to the modelling and controller design problem for the vehicle height adjustment system of EAS. The system model is described firstly in the hybrid system description language (HYSDEL) to obtain a mixed logical dynamical (MLD) hybrid model. For the resulting model, a hybrid model predictive controller is tuned to improve the vehicle height and posture tracking accuracy and to achieve the on-off statuses direct control of solenoid valves. The effectiveness and performance of the proposed approach are demonstrated by simulations and actual vehicle tests.

The Importance of Postural Control in Relation to Technical Abilities in Small-Sided Soccer Games

PubMed Central

Edis, Çağlar; Vurgun, Hikmet

2016-01-01

Abstract Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3) small-sided games (SSGs). Sixteen trained male amateur soccer players volunteered to take part in the study (age 17.2 ± 1.02 years, body height 176.25 ± 0.07 m, body mass 67.67 ± 13.27 kg). Following familiarization sessions, postural control was evaluated using one-leg and both-leg quiet-stance positions by measuring postural sway with a Tekscan HR Mat™ in anterior–posterior and medial–lateral directions. Later, 1:1, 2:2 and 3:3 SSGs were performed at two-day intervals and the technical variables specified for each game were analyzed. A Spearman’s rank-order correlation analysis demonstrated the relationship between postural control and soccer-specific technical variables in 1:1 (r-values ranging from 0.582 to 0.776), 2:2 (rvalues ranging from 0.511 to 0.740) and 3:3 (r-values ranging from 0.502 to 0.834) SSGs. In addition, a Wilcoxon signed rank test revealed differences between SSGs in terms of several variables. The results of the study showed that higher postural control levels are among the important variables that affect success in the performance of technical skills under rival pressure and suddenly changing conditions. Therefore, it is recommended that in addition to its use for injury prevention purposes, balance training should be conducted to improve branch-specific technical skills and to increase the levels of their successful performance in a game. PMID:28149410

The Importance of Postural Control in Relation to Technical Abilities in Small-Sided Soccer Games.

PubMed

Edis, Çağlar; Vural, Faik; Vurgun, Hikmet

2016-12-01

Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3) small-sided games (SSGs). Sixteen trained male amateur soccer players volunteered to take part in the study (age 17.2 ± 1.02 years, body height 176.25 ± 0.07 m, body mass 67.67 ± 13.27 kg). Following familiarization sessions, postural control was evaluated using one-leg and both-leg quiet-stance positions by measuring postural sway with a Tekscan HR Mat™ in anterior-posterior and medial-lateral directions. Later, 1:1, 2:2 and 3:3 SSGs were performed at two-day intervals and the technical variables specified for each game were analyzed. A Spearman's rank-order correlation analysis demonstrated the relationship between postural control and soccer-specific technical variables in 1:1 (r-values ranging from 0.582 to 0.776), 2:2 (rvalues ranging from 0.511 to 0.740) and 3:3 (r-values ranging from 0.502 to 0.834) SSGs. In addition, a Wilcoxon signed rank test revealed differences between SSGs in terms of several variables. The results of the study showed that higher postural control levels are among the important variables that affect success in the performance of technical skills under rival pressure and suddenly changing conditions. Therefore, it is recommended that in addition to its use for injury prevention purposes, balance training should be conducted to improve branch-specific technical skills and to increase the levels of their successful performance in a game.

[Posture and aging. Current fundamental studies and management concepts].

PubMed

Mourey, F; Camus, A; Pfitzenmeyer, P

2000-02-19

FUNDAMENTAL IMPORTANCE OF POSTURE: In the elderly subject, preservation of posture is fundamental to maintaining functional independence. In recent years, there has been much progress in our understanding of the mechanisms underlying strategies used to control equilibrium in the upright position. Physiological aging, associated with diverse disease states, dangerously alters the postural function, particularly anticipated adjustments which allow an adaptation of posture to movement. CLINICAL ASSESSMENT OF POSTURE: Several tests have been developed to assess posture in the elderly subject, particularly the time it takes to start walking. We selected certain tests which can be used in everyday practice to predict falls: the stance test, the improved Romberg test, the "timed get up and go test", measurement of walking cadence, assessment of balance reactions, sitting-standing and standing-sitting movements and capacity to get up off the floor. PATIENT CARE: Elderly patients with equilibrium disorders can benefit from specific personalized rehabilitation protocols. Different techniques have been developed for multiple afferential stimulation, reprogramming postural strategies, and correcting for deficient motor automatisms.

How performing a repetitive one-legged stance modifies two-legged postural control.

PubMed

Burdet, Cyril; Vuillerme, Nicolas; Rougier, Patrice R

2011-10-01

The proprioceptive cues in the control of movement is recognized as playing a major role in postural control. However, little is known about its possible increased contribution to postural control consecutive to repetitive muscular activations. To test this, the short-term effects induced by a 1-legged exercise on 2-legged postural control with the eyes closed were assessed in healthy subjects. The center-of-pressure (CP) displacements obtained using a force platform were split into 2 elementary movements: center-of-gravity vertical projection (CGv) and the difference (CP - CGv). These movements assessed the net postural performance and the level of neuromuscular activity, respectively, and were processed afterward (a) through variances, mean velocity, and the average surface covered by the trajectories and (b) a fractional Brownian motion (fBm) modeling. The latter provides further information about how much the subject controls the movements and the spatiotemporal relation between the successive control mechanisms. No difference was found using the classical parameters. In contrast, fBm parameters showed statistically significant changes in postural control after 1-legged exercises: The spatial and temporal coordinates of the transition points for the CG movements along the anteroposterior axis are decreased. Because the body movement control does not rely on visual or vestibular cues, this ability to trigger the corrective process of the CG movements more quickly in the postexercise condition and once a more reduced distance has been covered emphasizes how prior muscular activation improves body movement detection. As a general rule, these data show that the motor systems control body motions better after repetitive stimulation of the sensory cues. These insights should be of interest in physical activities based on a precise muscular length control.

Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke.

PubMed

Rajachandrakumar, Roshanth; Fraser, Julia E; Schinkel-Ivy, Alison; Inness, Elizabeth L; Biasin, Lou; Brunton, Karen; McIlroy, William E; Mansfield, Avril

2017-02-01

Anticipatory postural adjustments, executed prior to gait initiation, help preserve lateral stability when stepping. Atypical patterns of anticipatory activity prior to gait initiation may occur in individuals with unilateral impairment (e.g., stroke). This study aimed to determine the prevalence, correlates, and consequences of atypical anticipatory postural adjustment patterns prior to gait initiation in a sub-acute stroke population. Forty independently-ambulatory individuals with sub-acute stroke stood on two force plates and initiated gait at a self-selected speed. Medio-lateral centre of pressure displacement was calculated and used to define anticipatory postural adjustments (shift in medio-lateral centre of pressure >10mm from baseline). Stroke severity, motor recovery, and functional balance and mobility status were also obtained. Three patterns were identified: single (typical), absent (atypical), and multiple (atypical) anticipatory postural adjustments. Thirty-five percent of trials had atypical anticipatory postural adjustments (absent and multiple). Frequency of absent anticipatory postural adjustments was negatively correlated with walking speed. Multiple anticipatory postural adjustments were more prevalent when leading with the non-paretic than the paretic limb. Trials with multiple anticipatory postural adjustments had longer duration of anticipatory postural adjustment and time to foot-off, and shorter unloading time than trials with single anticipatory postural adjustments. A high prevalence of atypical anticipatory control prior to gait initiation was found in individuals with stroke. Temporal differences were identified with multiple anticipatory postural adjustments, indicating altered gait initiation. These findings provide insight into postural control during gait initiation in individuals with sub-acute stroke, and may inform interventions to improve ambulation in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease.

PubMed

Huang, Cheng-Ya; Chen, Yu-An; Hwang, Ing-Shiou; Wu, Ruey-Meei

2018-03-31

To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). University research laboratory. Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. Not applicable. Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Improving strength and postural control in young skiers: whole-body vibration versus equivalent resistance training.

PubMed

Mahieu, Nele N; Witvrouw, Erik; Van de Voorde, Danny; Michilsens, Diny; Arbyn, Valérie; Van den Broecke, Wouter

2006-01-01

Several groups have undertaken studies to evaluate the physiologic effects of whole-body vibration (WBV). However, the value of WBV in a training program remains unknown. To investigate whether a WBV program results in a better strength and postural control performance than an equivalent exercise program performed without vibration. Randomized, controlled trial. Laboratory. Thirty-three Belgian competitive skiers (ages = 9-15 years). Subjects were assigned to either the WBV group or the equivalent resistance (ER) group for 6 weeks of training at 3 times per week. Isokinetic plantar and dorsiflexion peak torque, isokinetic knee flexion and extension peak torque, explosive strength (high box test), and postural control were assessed before and after the training period. Both training programs significantly improved isokinetic ankle and knee muscle strength and explosive strength. Moreover, the increases in explosive strength and in plantar-flexor strength at low speed were significantly higher in the WBV group than in the ER group after 6 weeks. However, neither WBV training nor ER training seemed to have an effect on postural control. A strength training program that includes WBV appears to have additive effects in young skiers compared with an equivalent program that does not include WBV. Therefore, our findings support the hypothesis that WBV training may be a beneficial supplementary training technique in strength programs for young athletes.

Caloric vestibular stimulation and postural control in patients with spatial neglect following stroke.

PubMed

Sturt, Ruth; Punt, T David

2013-01-01

The impact of spatial neglect remains a substantial challenge to patients undergoing rehabilitation following stroke. Beyond the relatively well-described implications for visuospatial function, neglect is increasingly shown to have a negative impact on the wider aspects of sensori-motor performance with corresponding implications for activities including gait and balance. Caloric vestibular stimulation (CVS) administered to the contralesional ear has previously been shown to improve performance in patients with spatial neglect. Here, in Experiment One, we investigated the effect of CVS on clinical measures of spatial neglect and postural control in three groups of patients following stroke; left brain damaged patients (LBD, n = 6), right brain damaged patients without neglect (RBD-, n = 6), and right brain damaged patients with neglect (RBD+ , n = 6). While post-stimulation scores demonstrated an improvement for participants with spatial neglect, further analysis of postural scores indicated that improvement was selective for asymmetrical activities, with symmetrical activities remaining unchanged. We interpret these results with reference to the related problem of extinction which predicts that activities demanding synchronous bilateral activity (symmetrical activities) would cause greater difficulties for patients with neglect. In Experiment Two, we tested a further six RBD+ patients on the same measures following CVS to the ipsilesional (right) ear. There was no significant improvement in perceptual or postural scores. Our findings are supportive of previous studies that demonstrate improvement in perception and movement for patients with spatial neglect following contralesional CVS and suggest that these improvements may have clinical benefits.

Testing postural control among various osteoporotic patient groups: a literature review.

PubMed

de Groot, Maartje H; van der Jagt-Willems, Hanna C; van Campen, Jos P C M; Lems, Willem F; Lamoth, Claudine J C

2012-10-01

Osteoporosis can cause vertebral fractures, which might lead to a flexed posture, impaired postural control and consequently increased fall risk. Therefore, the aim of the present review was to examine whether postural control of patients with osteoporosis, vertebral fractures, thoracic kyphosis and flexed posture is affected. Furthermore, instruments measuring postural control were evaluated and examined for sensitivity and easy clinical use. Until February 2011, electronic databases were systematically searched for cross-sectional studies. Methodological quality was assessed with a modified Downs & Black scale. Of the 518 found studies, 18 studies were included. Postural control was generally affected for patients with vertebral fractures, thoracic kyphosis and flexed posture. Patients with osteoporosis had impaired postural control when assessed with computerized instruments. Easy performance-based tests did not show any impairments. There is evidence for an impaired postural control in all patient groups included. Impaired postural control is an important risk factor for falls. Functional performance tests are not sensitive and specific enough to detect affected postural control in patients with osteoporosis. To detect impaired postural control among osteoporotic patients and to obtain more insight into the underlying mechanisms of postural control, computerized instruments are recommended, such as easy-to-use ambulant motion-sensing (accelerometry) technology. © 2012 Japan Geriatrics Society.

Balance ability and postural stability among patients with painful shoulder disorders and healthy controls

PubMed Central

2013-01-01

Background In therapeutic settings, patients with shoulder pain often exhibit deficient coordinative abilities in their trunk and lower extremities. The aim of the study was to investigate 1) if there is a connection between shoulder pain and deficits in balance ability and postural stability, 2) if pain intensity is related to balance ability and postural stability, and 3) if there is a connection between body mass index (BMI) and balance ability and postural stability. Methods In this case–control study, patients (n = 40) with pathological shoulder pain (> 4 months) were matched with a healthy controls (n = 40) and were compared with regard to their balance ability and postural stability. Outcome parameters were postural stability, balance ability and symmetry index which were measured using the S3-Check system. In addition, the influence of shoulder pain intensity and BMI on the outcome parameters was analysed. Results Patients with shoulder pain showed significantly worse results in measurements of postural stability right/left (p < 0.01) and front/back (p < 0.01) as well as balance ability right/left (p = 0.01) and front/back (p < 0.01) compared to healthy controls. There were no significant group differences with regard to symmetry index. However, there was a significant (p < 0.01) symmetry shift towards the affected side within the shoulder pain group. There was no correlation between pain intensity and measurements of balance ability or postural stability. Likewise, no correlation between BMI and deficiencies in balance ability and postural stability was established. Conclusions Patients with pathological shoulder pain (> 4 months) have deficiencies in balance ability and postural stability; however the underlying mechanisms for this remain unclear. Neither pain intensity nor BMI influenced the outcome parameters. Patients with shoulder pain shift their weight to the affected side. Further research is needed to determine if balance training can improve rehabilitation results in patients with shoulder pathologies. PMID:24088342

Effects of reduced plantar cutaneous sensation on static postural control in individuals with and without chronic ankle instability.

PubMed

Song, Kyeongtak; Kang, Tae Kyu; Wikstrom, Erik A; Jun, Hyung-Pil; Lee, Sae Yong

2017-10-01

The purpose of this study was to determine how reduced plantar cutaneous sensation influences static postural control in individuals with and without CAI. A case-control study design. Twenty-six individuals with self-reported CAI and 26 matched healthy controls participated in this study. The plantar aspect of the participants' foot was then submersed in ice water (0°C) for 10min to reduce plantar sensation. Before and after the cooling procedure, plantar cutaneous sensation thresholds and single leg balance with eyes open and closed were assessed. Significantly, higher scores were observed in both groups after ice water submersion (p<0.001) indicating a significant reduction in the plantar cutaneous sensitivity after the cooling procedure. In single limb balance with eyes open, there were significant intervention main effects for the TTB ML mean (p<0.001), TTB AP mean (p=0.035) and TTB ML SD (p=0.021); indicating postural control improvement in both groups post-cooling. In single limb balance with eyes closed, Group×Intervention interactions were observed for the TTB AP mean (p=0.003) and TTB AP SD (p=0.017); indicating postural control deficits in CAI group post-cooling, but no changes in the control group. The main finding of this study was that reduced plantar cutaneous sensation induced by an ice submersion procedure caused eyes closed postural control impairments in those with CAI but not healthy controls. The present investigation demonstrated that the ability to dynamically reweight among sensory inputs to maintain postural stability appears to be diminished in CAI patients compared to healthy controls. Copyright © 2016. Published by Elsevier Ltd.

Voluntarily controlled but not merely observed visual feedback affects postural sway

PubMed Central

Asai, Tomohisa; Hiromitsu, Kentaro; Imamizu, Hiroshi

2018-01-01

Online stabilization of human standing posture utilizes multisensory afferences (e.g., vision). Whereas visual feedback of spontaneous postural sway can stabilize postural control especially when observers concentrate on their body and intend to minimize postural sway, the effect of intentional control of visual feedback on postural sway itself remains unclear. This study assessed quiet standing posture in healthy adults voluntarily controlling or merely observing visual feedback. The visual feedback (moving square) had either low or high gain and was either horizontally flipped or not. Participants in the voluntary-control group were instructed to minimize their postural sway while voluntarily controlling visual feedback, whereas those in the observation group were instructed to minimize their postural sway while merely observing visual feedback. As a result, magnified and flipped visual feedback increased postural sway only in the voluntary-control group. Furthermore, regardless of the instructions and feedback manipulations, the experienced sense of control over visual feedback positively correlated with the magnitude of postural sway. We suggest that voluntarily controlled, but not merely observed, visual feedback is incorporated into the feedback control system for posture and begins to affect postural sway. PMID:29682421

Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

PubMed

Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

2018-04-01

The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

Posture and cognition in the elderly: interaction and contribution to the rehabilitation strategies.

PubMed

Borel, L; Alescio-Lautier, B

2014-01-01

In this paper we review the effects of aging on sensory systems and their impact on posture, balance and gait. We also address cognitive aging and attempt to specify which altered cognitive functions negatively impact balance and walking. The role of cognition in postural control is tested with dual-task experiments. This situation results in deleterious effects due to an attentional overload. Given the human cognitive system has limited capacities, we propose that simultaneously performing two tasks depends on the capacity of each individual to perform these tasks on a continuum between automatic execution to highly controlled performance. A level of maximum control exceeds the subject's attentional capacity, which makes it impossible to perform both tasks simultaneously. The subject therefore prioritizes one of the tasks. We use representative dual-task studies from the literature to illustrate the relationship between the different cognitive components and their impact on the control of posture and gait in elderly subjects with altered cognitive capacities and with elderly subjects who are fallers or who have altered sensory-motor capacities. Recently this postural-cognitive relationship was addressed with a new approach. We report how cognitive training can improve dual-task management and we attempt to define the cognitive mechanisms that may be responsible for better postural balance. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Adaptations in movement performance after plyometric training on mini-trampoline in children.

PubMed

Arabatzi, Fotini

2018-01-01

Deficits in postural control and skill performance are important intrinsic fall risk factors. Thus, the purpose of this study was to investigate the impact of trampoline plyometrics on postural control, and jumping height in prepubertal children. Twenty-two school children were assigned to either a trampoline group (TPLG, N.=12, 7 girls and 5 boys, age =9.30±0.55 years) or a control group (CG, N.=12, 8 girls and 4 boys, age =9.30±0.55 years). The TPLG participated in 4 weeks plyometric training on a mini-trampoline (3 times per week) integrated in their physical education lessons while the CG attended the standard physical education curriculum at school. Pre- and postintervention included the measurements of postural sway and maximum height in countermovement and drop jump. Postural sway decreased significantly (P<0.05) in normal quiet stance (NQS) for the TPLG but not for the CG. Statistically significant decreases in postural sway in the anteroposterior direction during one-leg stance (OLS) were found for the TPLG whereas postural sway was unchanged at both directions for control group. Furthermore, statistically significant improvements in jump height were found only for TPLG after training (P<0.05). Training on elastic surface could be incorporated into children's exercise programs aiming to enhance balance and lower-limb strength to reduce injury rates. For injury prevention during trampoline training, close supervision by experienced personnel is recommended.

Balance Training Reduces Falls Risk in Older Individuals With Type 2 Diabetes

PubMed Central

Morrison, Steven; Colberg, Sheri R.; Mariano, Mira; Parson, Henri K.; Vinik, Arthur I.

2010-01-01

OBJECTIVE This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50–75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. RESULTS Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. CONCLUSIONS Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes. PMID:20097781

Does a crouched leg posture enhance running stability and robustness?

PubMed

Blum, Yvonne; Birn-Jeffery, Aleksandra; Daley, Monica A; Seyfarth, Andre

2011-07-21

Humans and birds both walk and run bipedally on compliant legs. However, differences in leg architecture may result in species-specific leg control strategies as indicated by the observed gait patterns. In this work, control strategies for stable running are derived based on a conceptual model and compared with experimental data on running humans and pheasants (Phasianus colchicus). From a model perspective, running with compliant legs can be represented by the planar spring mass model and stabilized by applying swing leg control. Here, linear adaptations of the three leg parameters, leg angle, leg length and leg stiffness during late swing phase are assumed. Experimentally observed kinematic control parameters (leg rotation and leg length change) of human and avian running are compared, and interpreted within the context of this model, with specific focus on stability and robustness characteristics. The results suggest differences in stability characteristics and applied control strategies of human and avian running, which may relate to differences in leg posture (straight leg posture in humans, and crouched leg posture in birds). It has been suggested that crouched leg postures may improve stability. However, as the system of control strategies is overdetermined, our model findings suggest that a crouched leg posture does not necessarily enhance running stability. The model also predicts different leg stiffness adaptation rates for human and avian running, and suggests that a crouched avian leg posture, which is capable of both leg shortening and lengthening, allows for stable running without adjusting leg stiffness. In contrast, in straight-legged human running, the preparation of the ground contact seems to be more critical, requiring leg stiffness adjustment to remain stable. Finally, analysis of a simple robustness measure, the normalized maximum drop, suggests that the crouched leg posture may provide greater robustness to changes in terrain height. Copyright © 2011 Elsevier Ltd. All rights reserved.

Practice of Contemporary Dance Promotes Stochastic Postural Control in Aging

PubMed Central

Ferrufino, Lena; Bril, Blandine; Dietrich, Gilles; Nonaka, Tetsushi; Coubard, Olivier A.

2011-01-01

As society ages and the frequency of falls increases, counteracting gait and posture decline is a challenging issue for countries of the developed world. Previous studies have shown that exercise and hazard management help to improve balance and/or decrease the risks for falling in normal aging. Motor activity based on motor-skill learning, particularly dance, can also benefit balance and decreases falls with age. Recent studies have suggested that older dancers have better balance, posture, or gait than non-dancers. Additionally, clinical or laboratory measures have shown improvements in some aspects of balance after dance interventions in elderly trainees. This study examined the impact of contemporary dance (CD) and of fall prevention (FP) programs on postural control of older adults. Posturography of quiet upright stance was performed in 41 participants aged 59–86 years before and after 4.4-month training in either CD or FP once a week. Though classical statistic scores failed to show any effect, dynamic analyses of the center-of-pressure displacements revealed significant changes after training. Specifically, practice of CD enhanced the critical time interval in diffusion analysis, and reduced recurrence and mathematical stability in recurrence quantification analysis, whereas practice of FP induced or tended to induce the reverse patterns. Such effects were obtained only in the eyes open condition. We suggest that CD training based on motor improvisation favored stochastic posture inducing plasticity in motor control, while FP training based on more stereotyped behaviors did not. PMID:22232582

Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study.

PubMed

Lee, Myung-Mo; Shin, Doo-Chul; Song, Chang-Ho

2016-07-01

[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

Incidence of vertical phoria on postural control during binocular vision: what perspective for prevention to nonspecific chronic pain management?

PubMed

Matheron, Eric; Kapoula, Zoï

2015-01-01

Vertical heterophoria (VH) is the latent vertical misalignment of the eyes when the retinal images are dissociated, vertical orthophoria (VO) when there is no misalignment. Studies on postural control, during binocular vision in upright stance, reported that healthy subjects with small VH vs. VO are less stable, but the experimental cancellation of VH with an appropriate prism improves postural stability. The same behavior was recorded in nonspecific chronic back pain subjects, all with VH. It was hypothesized that, without refraction problems, VH indicates a perturbation of the somaesthetic cues required in the sensorimotor loops involved in postural control and the capacity of the CNS to optimally integrate these cues, suggesting prevention possibilities. Sensorimotor conflict can induce pain and modify sensory perception in some healthy subjects; some nonspecific pain or chronic pain could result from such prolonged conflict in which VH could be a sign, with new theoretical and clinical implications.

Comparative Effects of Different Balance-Training–Progression Styles on Postural Control and Ankle Force Production: A Randomized Controlled Trial

PubMed Central

Cuğ, Mutlu; Duncan, Ashley; Wikstrom, Erik

2016-01-01

Context:  Despite the effectiveness of balance training, the exact parameters needed to maximize the benefits of such programs remain unknown. One such factor is how individuals should progress to higher levels of task difficulty within a balance-training program. Yet no investigators have directly compared different balance-training–progression styles. Objective:  To compare an error-based progression (ie, advance when proficient at a task) with a repetition-based progression (ie, advance after a set amount of repetitions) style during a balance-training program in healthy individuals. Design:  Randomized controlled trial. Setting:  Research laboratory. Patients or Other Participants:  A total of 28 (16 women, 12 men) physically healthy young adults (age = 21.57 ± 3.95 years, height = 171.60 ± 11.03 cm, weight = 72.96 ± 16.18 kg, body mass index = 24.53 ± 3.7). Intervention(s):  All participants completed 12 supervised balance-training sessions over 4 weeks. Each session consisted of a combination of dynamic unstable-surface tasks that incorporated a BOSU ball and lasted about 30 minutes. Main Outcome Measure(s):  Static balance from an instrumented force plate, dynamic balance as measured via the Star Excursion Balance Test, and ankle force production in all 4 cardinal planes of motion as measured with a handheld dynamometer before and after the intervention. Results:  Selected static postural-control outcomes, dynamic postural control, and ankle force production in all planes of motion improved (P < .05). However, no differences between the progression styles were observed (P > .05) for any of the outcome measures. Conclusions:  A 4-week balance-training program consisting of dynamic unstable-surface exercises on a BOSU ball improved dynamic postural control and ankle force production in healthy young adults. These results suggest that an error-based balance-training program is comparable with but not superior to a repetition-based balance-training program in improving postural control and ankle force production in healthy young adults. PMID:26878257

Pilot randomised controlled trial of face-down positioning following macular hole surgery.

PubMed

Lange, C A K; Membrey, L; Ahmad, N; Wickham, L; Maclaren, R E; Solebo, L; Xing, W; Bunce, C; Ezra, E; Charteris, D; Aylward, B; Yorston, D; Gregor, Z; Zambarakji, H; Bainbridge, J W

2012-02-01

This was a pilot randomised controlled trial (RCT) to investigate the effect of post-operative face-down positioning on the outcome of macular hole surgery and to inform the design of a larger definitive study. In all, 30 phakic eyes of 30 subjects with idiopathic full-thickness macular holes underwent vitrectomy with dye-assisted peeling of the ILM and 14% perfluoropropane gas. Subjects were randomly allocated to posture face down for 10 days (posturing group) or to avoid a face-up position only (non-posturing group). The primary outcome was anatomical hole closure. Macular holes closed in 14 of 15 eyes (93.3%; 95% confidence interval (CI) 68-100%) in the posturing group and in 9 of 15 (60%; 95% CI 32-84%) in the non-posturing group. In a subgroup analysis of outcome according to macular hole size, all holes smaller than 400 μm closed regardless of posturing (100%). In contrast, holes larger than 400 μm closed in 10 of 11 eyes (91%; 95% CI 58-99%) in the posturing group and in only 4 of 10 eyes (40%; 95% CI 12-74%) in the non-posturing group (Fisher's exact test P=0.02). Post-operative face-down positioning may improve the likelihood of macular hole closure, particularly for holes larger than 400 μm. These results support the case for a RCT.

Effect of ankle-foot orthosis on postural control after stroke: a systematic review.

PubMed

Guerra Padilla, M; Molina Rueda, F; Alguacil Diego, I M

2014-09-01

Stroke is currently the main cause of permanent disability in adults. The impairments are a combination of sensory, motor, cognitive and emotional changes that result in restrictions on the ability to perform basic activities of daily living (BADL). Postural control is affected and causes problems with static and dynamic balance, thus increasing the risk of falls and secondary injuries. The purpose of this review was to compile the literature to date, and assess the impact of ankle-foot orthosis (AFO) on postural control and gait in individuals who have suffered a stroke. The review included randomised and controlled trials that examined the effects of AFO in stroke patients between 18 and 80 years old, with acute or chronic evolution. No search limits on the date of the studies were included, and the search lasted until April 2011. The following databases were used: Pubmed, Trip Database, Cochrane library, Embase, ISI Web Knowledge, CINHAL and PEDro. Intervention succeeded in improving some gait parameters, such as speed and cadence. However it is not clear if there was improvement in the symmetry, postural sway or balance. Because of the limitations of this systematic review, due to the clinical diversity of the studies and the methodological limitations, 0these results should be considered with caution. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Internet-based home training is capable to improve balance in multiple sclerosis: a randomized controlled trial.

PubMed

Frevel, D; Mäurer, M

2015-02-01

Balance disorders are common in multiple sclerosis. Aim of the study is to investigate the effectiveness of an Internet-based home training program (e-Training) to improve balance in patients with multiple sclerosis. A randomized, controlled study. Academic teaching hospital in cooperation with the therapeutic riding center Gut Üttingshof, Bad Mergentheim. Eighteen multiple sclerosis patients (mean EDSS 3,5) took part in the trial. Outcome of patients using e-Training (N.=9) was compared to the outcome of patients receiving hippotherapy (N.=9), which can be considered as an advanced concept for the improvement of balance and postural control in multiple sclerosis. After simple random allocation patients received hippotherapy or Internet-based home training (balance, postural control and strength training) twice a week for 12 weeks. Assessments were done before and after the intervention and included static and dynamic balance (primary outcome). Isometric muscle strength of the knee and trunk extension/flexion (dynamometer), walking capacity, fatigue and quality of life served as secondary outcome parameters. Both intervention groups showed comparable and highly significant improvement in static and dynamic balance capacity, no difference was seen between the both intervention groups. However looking at fatigue and quality of life only the group receiving hippotherapy improved significantly. Since e-Training shows even comparable effects to hippotherapy to improve balance, we believe that the established Internet-based home training program, specialized on balance and postural control training, is feasible for a balance and strength training in persons with multiple sclerosis. We demonstrated that Internet-based home training is possible in patients with multiple sclerosis.

Effect of chest physiotherapy on the removal of mucus in patients with cystic fibrosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rossman, C.M.; Waldes, R.; Sampson, D.

1982-07-01

We studied the effectiveness of some of the components of a physiotherapy regimen on the removal of mucus from the lungs of 6 subjects with cystic fibrosis. On 5 randomized study days, after inhalation of a /sup 99/mTc-human serum albumin aerosol to label primarily the large airways, the removal of lung radioactivity was measured during 40 min of (a) spontaneous cough while at rest (control), (b) postural drainage, (c) postural drainage plus mechanical percussion, (d) combined maneuvers (postural drainage, deep breathing with vibrations, and percussion) administered by a physiotherapist, (e) directed vigorous cough. Measurements continued for an additional 2 hmore » of quiet rest. Compared with the control day, all forms of intervention significantly improved the removal of mucus: cough (p less than 0.005), physiotherapy maneuvers (0.005 less than or equal to p less than 0.01), postural drainage (p less than 0.05), and postural drainage plus percussion (p less than 0.01). However, there was no significant difference between regimented cough alone and therapist-administered combined maneuvers, nor between postural drainage alone and with mechanical percussion. We conclude that in cystic fibrosis, vigorous, regimented cough sessions may be as effective as therapist-administered physiotherapy in removing pulmonary secretions. Postural drainage, although better than the control maneuver, was not as effective as cough and was not enhanced by mechanical percussion. Frequent, vigorous self-directed cough sessions are potentially as useful as more complex measures for effective bronchial toilet.« less

A randomised controlled trial among cleaners--effects on strength, balance and kinesiophobia.

PubMed

Jørgensen, Marie Birk; Ektor-Andersen, John; Sjøgaard, Gisela; Holtermann, Andreas; Søgaard, Karen

2011-10-10

Cleaners constitute a job group with poor health and low socioeconomic resources. Therefore, there is a great need for scientifically documented health promoting initiatives for cleaners. However, both workplace initiatives and high quality intervention studies are lacking. The aim of this study was to evaluate the effects of a 3-month workplace trial with interventions to improve physical or cognitive behavioural resources among cleaners. A cluster randomised controlled trial was conducted among 294 female cleaners from 9 workplaces. The participants were allocated to three groups: Physical coordination training (PCT, n = 95), Cognitive behavioural theory-based training (CBTr, n = 99) and Reference group (REF, n = 100). Interventions were conducted during work hours for an average of 1 hour/week. Muscle strength was measured by maximal voluntary contractions in trunk/extension, and shoulder abduction/elevation. Postural balance was measured on a force platform. Kinesiophobia was measured with Tampa Scale for Kinesiophobia. Test and questionnaires were completed at baseline and at 3-month follow-up and analyses followed the intention-to-treat (ITT) principle with last observation carried forward in case of missing data at follow-up. Reports and analyses are given on true observations as well. ITT-analyses revealed that PCT improved strength of the trunk (p < .05) and postural balance (p < .05) compared to CBTr and REF. Based on true observations the strength and balance improvements corresponded to ~20% and ~16%, respectively. ITT-analyses showed that CBTr reduced kinesiophobia compared to PCT and REF (p < .05). Based on true observations, the improvement corresponded to a ~16% improvement. This workplace-based intervention study including PCT and CBTr among cleaners improved strength and postural balance from PCT, and kinesiophobia from CBTr. The improved strength, postural balance and kinesiophobia may improve the cleaners' tolerance for high physical work demands. Future studies should investigate the potential in the combination of PCT and CBTr in a workplace intervention. Current controlled trials ISRCTN96241850.

Effects of a salsa dance training on balance and strength performance in older adults.

PubMed

Granacher, Urs; Muehlbauer, Thomas; Bridenbaugh, Stephanie A; Wolf, Madeleine; Roth, Ralf; Gschwind, Yves; Wolf, Irene; Mata, Rui; Kressig, Reto W

2012-01-01

Deficits in static and particularly dynamic postural control and force production have frequently been associated with an increased risk of falling in older adults. The objectives of this study were to investigate the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in seniors. Twenty-eight healthy older adults were randomly assigned to an intervention group (INT, n = 14, age 71.6 ± 5.3 years) to conduct an 8-week progressive salsa dancing programme or a control group (CON, n = 14, age 68.9 ± 4.7 years). Static postural control was measured during one-legged stance on a balance platform and dynamic postural control was obtained while walking on an instrumented walkway. Leg extensor power was assessed during a countermovement jump on a force plate. Programme compliance was excellent with participants of the INT group completing 92.5% of the dancing sessions. A tendency towards an improvement in the selected measures of static postural control was observed in the INT group as compared to the CON group. Significant group × test interactions were found for stride velocity, length and time. Post hoc analyses revealed significant increases in stride velocity and length, and concomitant decreases in stride time. However, salsa dancing did not have significant effects on various measures of gait variability and leg extensor power. Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate. Age-related deficits in measures of static and particularly dynamic postural control can be mitigated by salsa dancing in older adults. High physical activity and fitness/mobility levels of our participants could be responsible for the nonsignificant findings in gait variability and leg extensor power. Copyright © 2012 S. Karger AG, Basel.

Hand posture classification using electrocorticography signals in the gamma band over human sensorimotor brain areas

NASA Astrophysics Data System (ADS)

Chestek, Cynthia A.; Gilja, Vikash; Blabe, Christine H.; Foster, Brett L.; Shenoy, Krishna V.; Parvizi, Josef; Henderson, Jaimie M.

2013-04-01

Objective. Brain-machine interface systems translate recorded neural signals into command signals for assistive technology. In individuals with upper limb amputation or cervical spinal cord injury, the restoration of a useful hand grasp could significantly improve daily function. We sought to determine if electrocorticographic (ECoG) signals contain sufficient information to select among multiple hand postures for a prosthetic hand, orthotic, or functional electrical stimulation system.Approach. We recorded ECoG signals from subdural macro- and microelectrodes implanted in motor areas of three participants who were undergoing inpatient monitoring for diagnosis and treatment of intractable epilepsy. Participants performed five distinct isometric hand postures, as well as four distinct finger movements. Several control experiments were attempted in order to remove sensory information from the classification results. Online experiments were performed with two participants. Main results. Classification rates were 68%, 84% and 81% for correct identification of 5 isometric hand postures offline. Using 3 potential controls for removing sensory signals, error rates were approximately doubled on average (2.1×). A similar increase in errors (2.6×) was noted when the participant was asked to make simultaneous wrist movements along with the hand postures. In online experiments, fist versus rest was successfully classified on 97% of trials; the classification output drove a prosthetic hand. Online classification performance for a larger number of hand postures remained above chance, but substantially below offline performance. In addition, the long integration windows used would preclude the use of decoded signals for control of a BCI system. Significance. These results suggest that ECoG is a plausible source of command signals for prosthetic grasp selection. Overall, avenues remain for improvement through better electrode designs and placement, better participant training, and characterization of non-stationarities such that ECoG could be a viable signal source for grasp control for amputees or individuals with paralysis.

Fingertip touch improves postural stability in patients with peripheral neuropathy.

PubMed

Dickstein, R; Shupert, C L; Horak, F B

2001-12-01

The purpose of this work was to determine whether fingertip touch on a stable surface could improve postural stability during stance in subjects with somatosensory loss in the feet from diabetic peripheral neuropathy. The contribution of fingertip touch to postural stability was determined by comparing postural sway in three touch conditions (light, heavy and none) in eight patients and eight healthy control subjects who stood on two surfaces (firm or foam) with eyes open or closed. In the light touch condition, fingertip touch provided only somatosensory information because subjects exerted less than 1 N of force with their fingertip to a force plate, mounted on a vertical support. In the heavy touch condition, mechanical support was available because subjects transmitted as much force to the force plate as they wished. In the no touch condition, subjects held the right forefinger above the force plate. Antero-posterior (AP) and medio-lateral (ML) root mean square (RMS) of center of pressure (CoP) sway and trunk velocity were larger in subjects with somatosensory loss than in control subjects, especially when standing on the foam surface. The effects of light and heavy touch were similar in the somatosensory loss and control groups. Fingertip somatosensory input through light touch attenuated both AP and ML trunk velocity as much as heavy touch. Light touch also reduced CoP sway compared to no touch, although the decrease in CoP sway was less effective than with heavy touch, particularly on the foam surface. The forces that were applied to the touch plate during light touch preceded movements of the CoP, lending support to the suggestion of a feedforward mechanism in which fingertip inputs trigger the activation of postural muscles for controlling body sway. These results have clinical implications for understanding how patients with peripheral neuropathy may benefit from a cane for postural stability in stance.

Promoting balance and strength in the middle-aged workforce.

PubMed

Granacher, U; Wick, C; Rueck, N; Esposito, C; Roth, R; Zahner, L

2011-01-01

The prevalence of sustaining fall-related injuries is high in the middle-aged workforce. Deficits in postural control/muscle strength represent important fall-risk factors. The objective of this study was to examine the impact of balance and strength training followed by detraining on postural control and muscle strength in the workforce. Thirty-two adults with sedentary office work participated in this study and were assigned to an intervention (age 56.0 ± 3.7 yrs) or a control group (age 55.5 ± 3.4 yrs). The intervention group participated in 8 weeks of balance and strength training conducted at the worksite, followed by 8 weeks of detraining. Tests included the measurement of (a) total centre of pressure (COP) displacements during one-legged standing, (b) gait velocity and stride-to-stride variability, (c) peak isometric/isokinetic torque and rate of torque development (RTD) of the plantar flexors, and (d) jumping height. After training, significant improvements in COP displacements, gait velocity, peak isometric/isokinetic torque, RTD, and jumping height were observed. During detraining, muscle strength deteriorated, whereas postural control improved. This fall-preventive training program conducted at the worksite proved to be feasible and effective. It is suggested that this training program should be permanently conducted to maintain/improve muscle strength. © Georg Thieme Verlag KG Stuttgart · New York.

Bilateral Improvements in Lower Extremity Function After Unilateral Balance Training in Individuals With Chronic Ankle Instability

PubMed Central

Hale, Sheri A.; Fergus, Andrea; Axmacher, Rachel; Kiser, Kimberly

2014-01-01

Context: Bilateral improvements in postural control have been reported among individuals with acute lateral ankle sprains and individuals with chronic ankle instability (CAI) when only the unstable ankle is rehabilitated. We do not know if training the stable ankle will improve function on the unstable side. Objective: To explore the effects of a unilateral balance-training program on bilateral lower extremity balance and function in individuals with CAI when only the stable limb is trained. Design: Cohort study. Setting: University clinical research laboratory. Patients or Other Participants: A total of 34 volunteers (8 men, 26 women; age = 24.32 ± 4.95 years, height = 167.01 ± 9.45 cm, mass = 77.54 ± 23.76 kg) with CAI were assigned to the rehabilitation (n = 17) or control (n = 17) group. Of those, 27 (13 rehabilitation group, 14 control group) completed the study. Intervention(s): Balance training twice weekly for 4 weeks. Main Outcome Measure(s): Foot and Ankle Disability Index (FADI), FADI Sport (FADI-S), Star Excursion Balance Test, and Balance Error Scoring System. Results: The rehabilitation and control groups differed in changes in FADI-S and Star Excursion Balance Test scores over time. Only the rehabilitation group improved in the FADI-S and in the posteromedial and anterior reaches of the Star Excursion Balance Test. Both groups demonstrated improvements in posterolateral reach; however, the rehabilitation group demonstrated greater improvement than the control group. When the groups were combined, participants reported improvements in FADI and FADI-S scores for the unstable ankle but not the stable ankle. Conclusions: Our data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle. This further supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation. PMID:24568231

A procedure to detect abnormal sensorimotor control in adolescents with idiopathic scoliosis.

PubMed

Pialasse, Jean-Philippe; Mercier, Pierre; Descarreaux, Martin; Simoneau, Martin

2017-09-01

This work identifies, among adolescents with idiopathic scoliosis, those demonstrating impaired sensorimotor control through a classification procedure comparing the amplitude of their vestibular-evoked postural responses. The sensorimotor control of healthy adolescents (n=17) and adolescents with idiopathic scoliosis (n=52) with either mild (Cobb angle≥15° and ≤30°) or severe (Cobb angle >30°) spine deformation was assessed through galvanic vestibular stimulation. A classification procedure sorted out adolescents with idiopathic scoliosis whether the amplitude of their vestibular-evoked postural response was dissimilar or similar to controls. Compared to controls, galvanic vestibular stimulation evoked larger postural response in adolescents with idiopathic scoliosis. Nonetheless, the classification procedure revealed that only 42.5% of all patients showed impaired sensorimotor control. Consequently, identifying patients with sensorimotor control impairment would allow to apply personalized treatments, help clinicians to establish prognosis and hopefully improve the condition of patients with adolescent idiopathic scoliosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Postural stability and the influence of concurrent muscle activation--Beneficial effects of jaw and fist clenching.

PubMed

Ringhof, Steffen; Leibold, Timo; Hellmann, Daniel; Stein, Thorsten

2015-10-01

Recent studies reported on the potential benefits of submaximum clenching of the jaw on human postural control in upright unperturbed stance. However, it remained unclear whether these effects might also be observed among active controls. The purpose of the present study, therefore, was to comparatively examine the influence of concurrent muscle activation in terms of submaximum clenching of the jaw and submaximum clenching of the fists on postural stability. Posturographic analyses were conducted with 17 healthy young adults on firm and foam surfaces while either clenching the jaw (JAW) or clenching the fists (FIST), whereas habitual standing served as the control condition (CON). Both submaximum tasks were performed at 25% maximum voluntary contraction, assessed, and visualized in real time by means of electromyography. Statistical analyses revealed that center of pressure (COP) displacements were significantly reduced during JAW and FIST, but with no differences between both concurrent clenching activities. Further, a significant increase in COP displacements was observed for the foam as compared to the firm condition. The results showed that concurrent muscle activation significantly improved postural stability compared with habitual standing, and thus emphasize the beneficial effects of jaw and fist clenching for static postural control. It is suggested that concurrent activities contribute to the facilitation of human motor excitability, finally increasing the neural drive to the distal muscles. Future studies should evaluate whether elderly or patients with compromised postural control might benefit from these physiological responses, e.g., in the form of a reduced risk of falling. Copyright © 2015 Elsevier B.V. All rights reserved.

Does hippotherapy effect use of sensory information for balance in people with multiple sclerosis?

PubMed

Lindroth, Jodi L; Sullivan, Jessica L; Silkwood-Sherer, Debbie

2015-01-01

This case-series study aimed to determine if there were observable changes in sensory processing for postural control in individuals with multiple sclerosis (MS) following physical therapy using hippotherapy (HPOT), or changes in balance and functional gait. This pre-test non-randomized design study, with follow-up assessment at 6 weeks, included two females and one male (age range 37-60 years) with diagnoses of relapse-remitting or progressive MS. The intervention consisted of twelve 40-min physical therapy sessions which included HPOT twice a week for 6 weeks. Sensory organization and balance were assessed by the Sensory Organization Test (SOT) and Berg Balance Scale (BBS). Gait was assessed using the Functional Gait Assessment (FGA). Following the intervention period, all three participants showed improvements in SOT (range 1-8 points), BBS (range 2-6 points), and FGA (average 4 points) scores. These improvements were maintained or continued to improve at follow-up assessment. Two of the three participants no longer over-relied on vision and/or somatosensory information as the primary sensory input for postural control, suggesting improved use of sensory information for balance. The results indicate that HPOT may be a beneficial physical therapy treatment strategy to improve balance, functional gait, and enhance how some individuals with MS process sensory cues for postural control. Randomized clinical trials will be necessary to validate results of this study.

Vibration-enhanced posture stabilization achieved by tactile supplementation: may blind individuals get extra benefits?

PubMed

Magalhães, Fernando Henrique; Kohn, André Fabio

2011-08-01

Diminished balance ability poses a serious health risk due to the increased likelihood of falling, and impaired postural stability is significantly associated with blindness and poor vision. Noise stimulation (by improving the detection of sub-threshold somatosensory information) and tactile supplementation (i.e., additional haptic information provided by an external contact surface) have been shown to improve the performance of the postural control system. Moreover, vibratory noise added to the source of tactile supplementation (e.g., applied to a surface that the fingertip touches) has been shown to enhance balance stability more effectively than tactile supplementation alone. In view of the above findings, in addition to the well established consensus that blind subjects show superior abilities in the use of tactile information, we hypothesized that blind subjects may take extra benefits from the vibratory noise added to the tactile supplementation and hence show greater improvements in postural stability than those observed for sighted subjects. If confirmed, this hypothesis may lay the foundation for the development of noise-based assistive devices (e.g., canes, walking sticks) for improving somatosensation and hence prevent falls in blind individuals. Copyright © 2011 Elsevier Ltd. All rights reserved.

Does increased postural threat lead to more conscious control of posture?

PubMed

Huffman, J L; Horslen, B C; Carpenter, M G; Adkin, A L

2009-11-01

Although it is well established that postural threat modifies postural control, little is known regarding the underlying mechanism(s) responsible for these changes. It is possible that changes in postural control under conditions of elevated postural threat result from a shift to a more conscious control of posture. The purpose of this study was to determine the influence of elevated postural threat on conscious control of posture and to determine the relationship between conscious control and postural control measures. Forty-eight healthy young adults stood on a force plate at two different surface heights: ground level (LOW) and 3.2-m above ground level (HIGH). Centre of pressure measures calculated in the anterior-posterior (AP) direction were mean position (AP-MP), root mean square (AP-RMS) and mean power frequency (AP-MPF). A modified state-specific version of the Movement Specific Reinvestment Scale was used to measure conscious motor processing (CMP) and movement self-consciousness (MSC). Balance confidence, fear of falling, perceived stability, and perceived and actual anxiety indicators were also collected. A significant effect of postural threat was found for movement reinvestment as participants reported more conscious control and a greater concern about their posture at the HIGH height. Significant correlations between CMP and MSC with AP-MP were observed as participants who consciously controlled and were more concerned for their posture leaned further away from the platform edge. It is possible that changes in movement reinvestment can influence specific aspects of posture (leaning) but other aspects may be immune to these changes (amplitude and frequency).

Systematic review of postural control and lateral ankle instability, part I: can deficits be detected with instrumented testing.

PubMed

McKeon, Patrick O; Hertel, Jay

2008-01-01

To answer the following clinical questions: (1) Is poor postural control associated with increased risk of a lateral ankle sprain? (2) Is postural control adversely affected after acute lateral ankle sprain? (3) Is postural control adversely affected in those with chronic ankle instability? PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Only studies assessing postural control measures in participants on a stable force plate performing the modified Romberg test were included. To be included, a study had to address at least 1 of the 3 clinical questions stated above and provide adequate results for calculation of effect sizes or odds ratios where applicable. We calculated odds ratios with 95% confidence intervals for studies assessing postural control as a risk factor for lateral ankle sprains. Effect sizes were estimated with the Cohen d and associated 95% confidence intervals for comparisons of postural control performance between healthy and injured groups, or healthy and injured limbs, respectively. Poor postural control is most likely associated with an increased risk of sustaining an acute ankle sprain. Postural control is impaired after acute lateral ankle sprain, with deficits identified in both the injured and uninjured sides compared with controls. Although chronic ankle instability has been purported to be associated with altered postural control, these impairments have not been detected consistently with the use of traditional instrumented measures. Instrumented postural control testing on stable force plates is better at identifying deficits that are associated with an increased risk of ankle sprain and that occur after acute ankle sprains than at detecting deficits related to chronic ankle instability.

Ground Kayak Paddling Exercise Improves Postural Balance, Muscle Performance, and Cognitive Function in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.

PubMed

Choi, Wonjae; Lee, Seungwon

2018-06-10

BACKGROUND Kayaking is an interesting and posturally challenging activity; however, kayaking may be limited by safety issues in older adults. The aim of this study was to determine whether ground kayak paddling (GKP) exercise can improve postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment. MATERIAL AND METHODS Sixty participants were randomly allocated to a GKP group (n=30; mean age, 74 years) or a control group (n=30; mean age, 74 years). GKP exercise consisted 5 types of exercise protocols, including paddling and multi-directional reaching with repetitive trunk and upper-extremities movements, which was performed for 60 min twice a week for 6 weeks. The outcome measures included the Timed Up and Go Test, the Functional Reach Test, the Berg Balance Scale, the Arm Curl Test, handgrip strength, and the Montreal Cognitive Assessment. RESULTS In this study, adherence to the regimen was 96% in the GKP group. Postural balance, muscle performance, and cognitive function were significantly improved after intervention (p<0.05), and all the values in the GKP group, except for the Berg Balance Scale scores, were significantly decreased or increased compared to the control group. Differences between the 2 groups were Timed Up and Go Test -0.74 s; Functional Reach Test +7.20 cm; Arm Curl Test +5.56 repetitions; right handgrip strength +3.57 kg; left handgrip strength +3.08 kg; and Montreal Cognitive Assessment, +3.46 score (p<0.05). CONCLUSIONS GKP exercise improves the physical and psychological ability of older adults with mild cognitive impairment.

Compensatory but not anticipatory adjustments are altered in older adults during lateral postural perturbations.

PubMed

Claudino, Renato; dos Santos, Eloá C C; Santos, Marcio J

2013-08-01

This study investigated anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) and their relationship in older adults during lateral postural perturbations. Unpredictable and predictable postural disturbances were induced by a swinging pendulum that impacted at the shoulder level of two groups of older adults, non-fallers (20) and fallers (20), and in a group of young control subjects (20). The electromyographic (EMG) activity of the postural muscles and the center of pressure (COP) displacement were recorded and quantified within the time intervals typical for APAs and CPAs. Both groups of older adults (non-fallers and fallers) showed higher magnitude of EMG activity in the lateral muscles and increased COP displacement, particularly, during the CPAs time interval when compared to the young group. Older adults, however, were able to change the electrical activity of the muscles during the predictable task by generating APAs with similar magnitudes of those found in young subjects. Compensatory but not anticipatory adjustments are altered in older adults during predictable lateral postural perturbations. These findings provide new data on the role of APAs and CPAs in their relationship in older adults during external lateral perturbations and may advance current rehabilitative management strategies to improve balance control in older individuals. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Use of information entropy measures of sitting postural sway to quantify developmental delay in infants

PubMed Central

Deffeyes, Joan E; Harbourne, Regina T; DeJong, Stacey L; Kyvelidou, Anastasia; Stuberg, Wayne A; Stergiou, Nicholas

2009-01-01

Background By quantifying the information entropy of postural sway data, the complexity of the postural movement of different populations can be assessed, giving insight into pathologic motor control functioning. Methods In this study, developmental delay of motor control function in infants was assessed by analysis of sitting postural sway data acquired from force plate center of pressure measurements. Two types of entropy measures were used: symbolic entropy, including a new asymmetric symbolic entropy measure, and approximate entropy, a more widely used entropy measure. For each method of analysis, parameters were adjusted to optimize the separation of the results from the infants with delayed development from infants with typical development. Results The method that gave the widest separation between the populations was the asymmetric symbolic entropy method, which we developed by modification of the symbolic entropy algorithm. The approximate entropy algorithm also performed well, using parameters optimized for the infant sitting data. The infants with delayed development were found to have less complex patterns of postural sway in the medial-lateral direction, and were found to have different left-right symmetry in their postural sway, as compared to typically developing infants. Conclusion The results of this study indicate that optimization of the entropy algorithm for infant sitting postural sway data can greatly improve the ability to separate the infants with developmental delay from typically developing infants. PMID:19671183

The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus.

PubMed

Abram, Katrin; Bohne, Silvia; Bublak, Peter; Karvouniari, Panagiota; Klingner, Carsten M; Witte, Otto W; Guntinas-Lichius, Orlando; Axer, Hubertus

2016-01-01

Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients. Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic posturography (CDP), and neuropsychological assessment. Examinations were done before and after spinal tap test. The gait score showed a significant improvement 24 h after spinal tap test in all subtests and in the sum score (p < 0.003), while neuropsychological assessment did not reveal significant differences 72 h after spinal tap test. CDP showed significant improvements after spinal tap test in the Sensory Organization Tests 2 (p = 0.017), 4 (p = 0.001), and 5 (p = 0.009) and the composite score (p = 0.01). Patients showed best performance in somatosensory and worst performance in vestibular dominated tests. Vestibular dominated tests did not improve significantly after spinal tap test, while somatosensory and visual dominated tests did. Postural stability in NPH is predominantly affected by deficient vestibular functions, which did not improve after spinal tap test. Conditions which improved best were mainly independent from visual control and are based on proprioceptive functions.

The effect of cap lamp lighting on postural control and stability

PubMed Central

Sammarco, John J.; Pollard, Jonisha P.; Porter, William L.; Dempsey, Patrick G.; Moore, Caitlin T.

2015-01-01

Researchers at the National Institute for Occupational Safety and Health (NIOSH) are conducting mine illumination research with the objective of improving miner safety. Slips, trips, and falls (STFs) are the second leading accident class (18.1%, n = 2,374) of nonfatal lost-time injuries at underground mines (MSHA, 2005–2009). Factors contributing to STFs include recognition of hazards as well as postural balance and age. Improved lighting may enable better hazard recognition and reduce the impact of postural balance and age. Previous research has shown that cap lamp technology that used light-emitting diodes (LEDs) has improved hazard detection. This study was an initial investigation to determine if cap lamp lighting significantly influences measures of static postural stability (displacement and velocity of center of pressure). Results of this investigation showed no significant differences in the balance measures of interest between cap lamps tested. However, balance was shown to significantly decline (p < 0.05) when tested in an underground coal mine compared to the laboratory testing condition. Relevance to industry: Underground coal mine workers wear cap lamps on their hard hats as their primary light source to illuminate nearby areas where their vision is directed. Proper illumination may improve miner safety by improving their STF hazard recognition and balance. PMID:26472917

Individualized exergame training improves postural control in advanced degenerative spinocerebellar ataxia: A rater-blinded, intra-individually controlled trial.

PubMed

Schatton, Cornelia; Synofzik, Matthis; Fleszar, Zofia; Giese, Martin A; Schöls, Ludger; Ilg, Winfried

2017-06-01

Treatment options are rare in degenerative ataxias, especially in advanced, multisystemic disease. Exergame training might offer a novel treatment strategy, but its effectiveness has not been investigated in advanced stages. We examined the effectiveness of a 12-week home-based training with body-controlled videogames in 10 young subjects with advanced degenerative ataxia unable or barely able to stand. Training was structured in two 6-weeks phases, allowing to adapt the training according to individual training progress. Rater-blinded clinical assessment (Scale for the Assessment and Rating of Ataxia; SARA), individual goal-attainment scoring (GAS), and quantitative movement analysis were performed two weeks before training, immediately prior to training, and after training phases 1 and 2 (intra-individual control design). This study is registered with ClinicalTrials.gov, NCT02874911). After intervention, ataxia symptoms were reduced (SARA -2.5 points, p < 0.01), with benefits correlating to the amount of training (p = 0.04). Goal attainment during daily living was higher than expected (GAS: 0.45). Movement analysis revealed reduced body sway while sitting (p < 0.01), which correlated with improvements in SARA posture and gait (p = 0.005), indicating training-induced improvements in posture control mechanisms. This study provides first evidence that, even in advanced stages, subjects with degenerative ataxia may benefit from individualized training, with effects translating into daily living and improving underlying control mechanisms. The proposed training strategy can be performed at home, is motivating and facilitates patient self-empowerment. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Effects of vibrotherapy on postural control, functionality and fatigue in multiple sclerosis patients. A randomised clinical trial].

PubMed

Alguacil Diego, I M; Pedrero Hernández, C; Molina Rueda, F; Cano de la Cuerda, R

2012-04-01

Postural and balance disorders, functionality impairment and fatigue, are the most incapacitating problems in multiple sclerosis (MS) patients. Whole Body Vibration (WBV), through the transmission of mechanical stimuli, appears to be a useful therapeutic tool in the treatment of neurological diseases. The objective of this study is to assess the effect of the WBV on postural control, balance, functionality and fatigue in patients with MS. A total of 34 patients with mild-moderate MS were randomised into a control group and an intervention group. For the intervention group, the protocol consisted of 5 consecutive days, daily series of 5 periods of 1 minute of duration of WBV at a frequency of 6 Hz. Posturographic assessment using the Sensory Organization Test (SOT) and Motor Control Test (MCT), the Timed Get Up and Go Test, 10 metres Test, the Berg Balance Scale and Krupp's Fatigue Severity Scale were used before and after intervention. The analysis showed improvements in the intervention group for conditions SOT 1, SOT 3 and latency in MCT. In the comparison between groups, only the latency or reaction time in MCT improved significantly in favour of the intervention group (from 173.78±12.46 to 161.25±13.64 ms; P=.04). No side-effects were found. The results of this pilot study show that WBV can improve, in the short-term, the time of response to recover the uprightness after sudden disturbances, appearing as a possible therapeutic tool maintaining balance and posture. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

The influence of foot posture on dorsiflexion range of motion and postural control in those with chronic ankle instability.

PubMed

Hogan, Kathleen K; Powden, Cameron J; Hoch, Matthew C

2016-10-01

To investigate the effect of foot posture on postural control and dorsiflexion range of motion in individuals with chronic ankle instability. The study employed a cross-sectional, single-blinded design. Twenty-one individuals with self-reported chronic ankle instability (male=5; age=23.76(4.18)years; height=169.27(11.46)cm; weight=73.65(13.37)kg; number of past ankle sprains=4.71(4.10); episode of giving way=17.00(18.20); Cumberland Ankle Instability Score=18.24(4.52); Ankle Instability Index=5.86(1.39)) participated. The foot posture index was used to categorize subjects into pronated (n=8; Foot Posture Index=7.50(0.93)) and neutral (n=13; Foot Posture Index=3.08(1.93)) groups. The dependent variables of dorsiflexion ROM and dynamic and static postural control were collected for both groups at a single session. There were no significant differences in dorsiflexion range of motion between groups (p=0.22) or any of the eyes open time-to-boundary variables (p>0.13). The pronated group had significantly less dynamic postural control than the neutral group as assessed by the anterior direction of the Star Excursion Balance Test (p<0.04). However, the pronated group had significantly higher time-to-boundary values than the neutral group for all eyes closed time-to-boundary variables (p≤0.05), which indicates better eyes closed static postural control. Foot posture had a significant effect on dynamic postural control and eyes closed static postural control in individuals with chronic ankle instability. These findings suggest that foot posture may influence postural control in those with chronic ankle instability. Copyright © 2016 Elsevier Ltd. All rights reserved.

One month of contemporary dance modulates fractal posture in aging

PubMed Central

Coubard, Olivier A.; Ferrufino, Lena; Nonaka, Tetsushi; Zelada, Oscar; Bril, Blandine; Dietrich, Gilles

2013-01-01

Understanding the human aging of postural control and how physical or motor activity improves balance and gait is challenging for both clinicians and researchers. Previous studies have evidenced that physical and sporting activity focusing on cardiovascular and strength conditioning help older adults develop their balance and gait and/or decrease their frequency of falls. Motor activity based on motor-skill learning has also been put forward as an alternative to develop balance and/or prevent falls in aging. Specifically dance has been advocated as a promising program to boost motor control. In this study, we examined the effects of contemporary dance (CD) on postural control of older adults. Upright stance posturography was performed in 38 participants aged 54–89 years before and after the intervention period, during which one half of the randomly assigned participants was trained to CD and the other half was not trained at all (no dance, ND). CD training lasted 4 weeks, 3 times a week. We performed classical statistic scores of postural signal and dynamic analyses, namely signal diffusion analysis (SDA), recurrence quantification analysis (RQA), and detrended fluctuation analysis (DFA). CD modulated postural control in older trainees, as revealed in the eyes closed condition by a decrease in fractal dimension and an increase in DFA alpha component in the mediolateral plane. The ND group showed an increase in length and mean velocity of postural signal, and the eyes open a decrease in RQA maximal diagonal line in the anteroposterior plane and an increase in DFA alpha component in the mediolateral plane. No change was found in SDA in either group. We suggest that such a massed practice of CD reduced the quantity of exchange between the subject and the environment by increasing their postural confidence. Since CD has low-physical but high-motor impact, we conclude that it may be recommended as a useful program to rehabilitate posture in aging. PMID:24611047

The balance effect of acupuncture therapy among stroke patients.

PubMed

Huang, Shih-Wei; Wang, Wei-Te; Yang, Tsung-Hsien; Liou, Tsan-Hon; Chen, Guan-Yu; Lin, Li-Fong

2014-08-01

To analyze how acupuncture therapy affects balance in patients experiencing their first stroke and to identify the stroke group with greatest improvement in balance after acupuncture intervention. Retrospective case-control study. Ward of a medical university hospital. A total of 629 stroke patients were enrolled initially; 345 patients met the study criteria and 132 were analyzed (66 each in the study and control groups). The study group received physiotherapy combined with acupuncture and the control group received only physiotherapy. The Postural Assessment Scale for Stroke patients (PASS) was used to evaluate balance. This balance scale system can be subdivided into static balance (PASS-MP, maintain posture) and dynamic balance (PASS-CP, change posture). This study revealed no statistically significant improvement of balance in the study group (t test). When patients with high Brunnstrom stage (Br stage) and low Br stage were analyzed separately, once again no statistical difference was detected between the study and control groups of those with high Br stage. However, among low-Br stage patients, the study group showed significant improvement in static balance (mean PASS-MP score±standard deviation: 4.7±3.7) compared with the control group (PASS-MP score: 2.8±2.7) (p<0.05). In first-ever stroke patients with a low Br stage, acupuncture therapy can improve static balance during rehabilitation. However, the effect on balance was limited among high-Br stage patients. This study provides information valuable to patients with hemiplegic stroke because it suggests that acupuncture can be used to improve balance. A prospective double-blind, randomized, controlled study design is recommended for future studies in patients with hemiplegic stroke.

An active balance board system with real-time control of stiffness and time-delay to assess mechanisms of postural stability.

PubMed

Cruise, Denise R; Chagdes, James R; Liddy, Joshua J; Rietdyk, Shirley; Haddad, Jeffrey M; Zelaznik, Howard N; Raman, Arvind

2017-07-26

Increased time-delay in the neuromuscular system caused by neurological disorders, concussions, or advancing age is an important factor contributing to balance loss (Chagdes et al., 2013, 2016a,b). We present the design and fabrication of an active balance board system that allows for a systematic study of stiffness and time-delay induced instabilities in standing posture. Although current commercial balance boards allow for variable stiffness, they do not allow for manipulation of time-delay. Having two controllable parameters can more accurately determine the cause of balance deficiencies, and allows us to induce instabilities even in healthy populations. An inverted pendulum model of human posture on such an active balance board predicts that reduced board rotational stiffness destabilizes upright posture through board tipping, and limit cycle oscillations about the upright position emerge as feedback time-delay is increased. We validate these two mechanisms of instability on the designed balance board, showing that rotational stiffness and board time-delay induced the predicted postural instabilities in healthy, young adults. Although current commercial balance boards utilize control of rotational stiffness, real-time control of both stiffness and time-delay on an active balance board is a novel and innovative manipulation to reveal balance deficiencies and potentially improve individualized balance training by targeting multiple dimensions contributing to standing balance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of neck exercise on high-school students' neck-shoulder posture.

PubMed

Lee, Myoung-Hyo; Park, Su-Jin; Kim, Jin-Sang

2013-05-01

[Purpose] This study examined the effects of deep flexor muscle-strengthening exercise on the neck-shoulder posture, and the strength and endurance of the deep flexor muscles of high-school students. [Subjects] The subjects were 30 seventeen-year-old female high-school students who complained about bad posture and chronic neck-shoulder pain. They were randomly divided into an experimental group of 15 subjects, who performed a deep flexor muscle-strengthening exercise and a control group of 15 subjects, who performed a basic stretching exercise. [Methods] The experimental group of 15 subjects performed a deep flexor muscle-strengthening exercise consisting of low-load training of the cranio-cervical flexor muscle, and the control group of 15 subjects performed a basic stretching exercise consisting of seven motions. [Results] The experimental group showed statistically significant changes in head tilt angle, neck flexion angle, forward shoulder angle, and the result of the cranio-cervical flexion test after the training. In contrast, the control group showed no statistically significant changes in these measures following the training. When the results of the groups were compared, statistically significant differences were found for all items between the experimental group and the control group. [Conclusion] Strengthening cranio-cervical flexor muscles is important for the adjustment of neck posture, and maintaining their stability is required to improve neck-shoulder posture.

The effect of firefighter protective garments, self-contained breathing apparatus and exertion in the heat on postural sway.

PubMed

White, Scott C; Hostler, David

2017-08-01

Fire suppression wearing thermal protective clothing (TPC) and self-contained breathing apparatus (SCBA) challenges a firefighter's balance and may explain firefighter falls. Postural control based on force plate centre of pressure (COP) was compared for healthy subjects wearing TPC and SCBA before and after 20 min of heavy physical exertion in hot conditions. Baseline measures with and without TPC and SCBA (two different SCBA cylinder masses) were compared before and after exertion that included elements of fire suppression activities in an environmental chamber. COP excursion and variability increased with exertion for TPC and SCBA conditions compared to non-stressed conditions. The two different cylinder masses had no significant effect. Wearing TPC and SCBA when physically stressed in a hot environment increases postural sway and exacerbates postural control. Subjects compensated for the extra mass and adjusted to control postural sway with the addition of TPC and SCBA, but the stress protocol amplified these adjustments. Practitioner Summary: Firefighters wear thermal protective clothing (TPC) and self-contained breathing apparatus (SCBA) when heat-stressed and fatigued. Wearing TPC and SCBA was found to negatively impact balance when stressed, but not for non-stressed or two different sized SCBA tanks. Simulating fire-ground conditions wearing TPC and SCBA should be considered for improving balance.

Effect of mat pilates exercise on postural alignment and body composition of middle-aged women.

PubMed

Lee, Hyo Taek; Oh, Hyun Ok; Han, Hui Seung; Jin, Kwang Youn; Roh, Hyo Lyun

2016-06-01

[Purpose] This study attempted to examine whether Pilates is an effective exercise for improving the postural alignment and health of middle-aged women. [Subjects and Methods] The participants in this study were 36 middle-aged women (20 in the experimental group, 16 in the control group). The experimental group participated in Pilates exercise sessions three times a week for 12 weeks. Body alignment and composition measurements before and after applying the Pilates exercise program were performed with a body composition analyzer and a three-dimensional scanner. [Results] Postural alignment in the sagittal and horizontal planes was enhanced in the Pilates exercise group. Trunk alignment showed correlations with body fat and muscle mass. [Conclusion] The Pilates exercises are performed symmetrically and strengthen the deep muscles. Moreover, the results showed that muscle mass was correlated with trunk postural alignment and that the proper amount of muscle is critical in maintaining trunk postural alignment.

The influence of hip abductor muscle performance on dynamic postural stability in females with patellofemoral pain.

PubMed

Lee, Szu-Ping; Souza, Richard B; Powers, Christopher M

2012-07-01

Hip abductors play an important role in maintaining trunk and pelvis stability during unipedal tasks. The purpose of the study was to compare postural stability between individuals with patellofemoral pain (PFP) and pain-free controls. A secondary purpose was to evaluate the effect of a hip stabilizing brace on postural stability. Twenty females with PFP (27.3±6.3 years) and 19 controls (26.1±4.5 years) participated. Each subject performed a unipedal step-down balance task with the stance leg on a force platform from which center of pressure (COP) excursion was recorded. Quantitative COP excursion patterns (mean and peak displacements) were used as measures of postural stability. For subjects with PFP, postural stability also was quantified following the application of a hip stabilizing brace. Hip abductor strength was significantly lower in PFP group compared to the control group (1.39±0.4 vs. 1.62±0.26 N/kg-BW, p=0.046). Peak and mean medial-lateral COP displacements during the balance task were greater in the PFP group (39.8±6.7 vs. 24.3±3.8 mm, p<0.001; 24.7±16.3 vs. 13.5±4.4 mm, p=0.005). Application of the hip stabilizing brace reduced the peak and mean COP displacement (39.8±6.7 vs. 24.7±4.7 mm, p<0.001; 24.7±16.3 vs. 16.8±15.1 mm, p=0.02). Our results demonstrate that females with PFP exhibit impaired medial-lateral postural stability when compared to control subjects. Application of a hip stabilizing brace significantly improved stability to a level comparable to the controls. Copyright © 2012 Elsevier B.V. All rights reserved.

Compensatory postural adjustments in Parkinson's disease assessed via a virtual reality environment.

PubMed

Yelshyna, Darya; Gago, Miguel F; Bicho, Estela; Fernandes, Vítor; Gago, Nuno F; Costa, Luís; Silva, Hélder; Rodrigues, Maria Lurdes; Rocha, Luís; Sousa, Nuno

2016-01-01

Postural control is a complex dynamic mechanism, which integrates information from visual, vestibular and somatosensory systems. Idiopathic Parkinson's disease (IPD) patients are unable to produce appropriate reflexive responses to changing environmental conditions. Still, it is controversial what is due to voluntary or involuntary postural control, even less what is the effect of levodopa. We aimed to evaluate compensatory postural adjustments (CPA), with kinematic and time-frequency analyzes, and further understand the role of dopaminergic medication on these processes. 19 healthy subjects (Controls) and 15 idiopathic Parkinson's disease (IPD) patients in the OFF and ON medication states, wearing IMUs, were submitted to a virtual reality scenario with visual downward displacements on a staircase. We also hypothesized if CPA would involve mechanisms occurring in distinct time scales. We subsequently analyzed postural adjustments on two frequency bands: low components between 0.3 and 1.5 Hz (LB), and high components between 1.5 and 3.5 Hz (HB). Vertical acceleration demonstrated a greater power for discriminating IPD patients from healthy subjects. Visual perturbation significantly increased the power of the HB in all groups, being particularly more evident in the OFF state. Levodopa significantly increased their basal power taking place on the LB. However, controls and IPD patients in the ON state revealed a similar trend of the control mechanism. Results indicate an improvement in muscular stiffness provided by levodopa. They also suggest the role of different compensatory postural adjustment patterns, with LB being related to inertial properties of the oscillating mass and HB representing reactions to the ongoing visual input-changing scenario. Copyright © 2015 Elsevier B.V. All rights reserved.

Systematic Review of Postural Control and Lateral Ankle Instability, Part I: Can Deficits Be Detected With Instrumented Testing

PubMed Central

McKeon, Patrick O; Hertel, Jay

2008-01-01

Objective: To answer the following clinical questions: (1) Is poor postural control associated with increased risk of a lateral ankle sprain? (2) Is postural control adversely affected after acute lateral ankle sprain? (3) Is postural control adversely affected in those with chronic ankle instability? Data Sources: PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Study Selection: Only studies assessing postural control measures in participants on a stable force plate performing the modified Romberg test were included. To be included, a study had to address at least 1 of the 3 clinical questions stated above and provide adequate results for calculation of effect sizes or odds ratios where applicable. Data Extraction: We calculated odds ratios with 95% confidence intervals for studies assessing postural control as a risk factor for lateral ankle sprains. Effect sizes were estimated with the Cohen d and associated 95% confidence intervals for comparisons of postural control performance between healthy and injured groups, or healthy and injured limbs, respectively. Data Synthesis: Poor postural control is most likely associated with an increased risk of sustaining an acute ankle sprain. Postural control is impaired after acute lateral ankle sprain, with deficits identified in both the injured and uninjured sides compared with controls. Although chronic ankle instability has been purported to be associated with altered postural control, these impairments have not been detected consistently with the use of traditional instrumented measures. Conclusions: Instrumented postural control testing on stable force plates is better at identifying deficits that are associated with an increased risk of ankle sprain and that occur after acute ankle sprains than at detecting deficits related to chronic ankle instability. PMID:18523566

Postural Complexity Differs Between Infant Born Full Term and Preterm During the Development of Early Behaviors

PubMed Central

Dusing, Stacey C; Izzo, Theresa A.; Thacker, Leroy R.; Galloway, James C

2014-01-01

Background and Aims Postural control differs between infants born preterm and full term at 1–3 weeks of age. It is unclear if differences persist or alter the development of early behaviors. The aim of this longitudinal study was to compare changes in postural control variability during development of head control and reaching in infants born preterm and full term. Methods Eighteen infants born preterm (mean gestational age 28.3±3.1 weeks) were included in this study and compared to existing data from 22 infants born full term. Postural variability was assessed longitudinally using root mean squared displacement and approximate entropy of the center of pressure displacement from birth to 6 months as measures of the magnitude of the variability and complexity of postural control. Behavioral coding was used to quantify development of head control and reaching. Results Group differences were identified in postural complexity during the development of head control and reaching. Infants born preterm used more repetitive and less adaptive postural control strategies than infants born full term. Both groups changed their postural complexity utilized during the development of head control and reaching. Discussion Early postural complexity was decreased in infants born preterm, compared to infants born full term. Commonly used clinical assessments did not identify these early differences in postural control. Altered postural control in infants born preterm influenced ongoing skill development in the first six months of life. PMID:24485170

Improvement in automatic postural coordination following alexander technique lessons in a person with low back pain.

PubMed

Cacciatore, Timothy W; Horak, Fay B; Henry, Sharon M

2005-06-01

The relationship between abnormal postural coordination and back pain is unclear. The Alexander Technique (AT) aims to improve postural coordination by using conscious processes to alter automatic postural coordination and ongoing muscular activity, and it has been reported to reduce low back pain. This case report describes the use of the AT with a client with low back pain and the observed changes in automatic postural responses and back pain. The client was a 49-year-old woman with a 25-year history of left-sided, idiopathic, lumbrosacral back pain. Automatic postural coordination was measured using a force plate during horizontal platform translations and one-legged standing. The client was tested monthly for 4 months before AT lessons and for 3 months after lessons. Before lessons, she consistently had laterally asymmetric automatic postural responses to translations. After AT lessons, the magnitude and asymmetry of her responses and balance improved and her low back pain decreased. Further research is warranted to study whether AT lessons improve low back pain-associated abnormalities in automatic postural coordination and whether improving automatic postural coordination helps to reduce low back pain.

The immediate effects of foot orthoses on functional performance in individuals with patellofemoral pain syndrome.

PubMed

Barton, C J; Menz, H B; Crossley, K M

2011-03-01

Patellofemoral pain syndrome (PFPS) often results in reduced functional performance. There is growing evidence for the use of foot orthoses to treat this multifactorial condition. In this study, the immediate effects of foot orthoses on functional performance and the association of foot posture and footwear with improvements in function were evaluated. Fifty-two individuals with PFPS (18-35 years) were prescribed prefabricated foot orthoses (Vasyli Pro; Vasyli International, Labrador, Australia). Functional outcome measures evaluated included the change in (1) pain and (2) ease of a single-leg squat on a five-point Likert scale, and change in the number of (3) pain-free step downs and (4) single-leg rises from sitting. The association of foot posture using the Foot Posture Index, navicular drop and calcaneal angle relative to subtalar joint neutral; and the footwear motion control properties scale score with improved function were evaluated using Spearman's ρ statistics. Prefabricated foot orthoses produced significant improvements (p<0.05) for all functional outcome measures. A more pronated foot type and poorer footwear motion control properties were found to be associated with reduced pain during the single-leg squat and improvements in the number of pain-free single-leg rises from sitting when wearing foot orthoses. In addition, a more pronated foot type was also found to be associated with improved ease of completing a single-leg squat when wearing foot orthoses. Prefabricated foot orthoses provide immediate improvements in functional performance, and these improvements are associated with a more pronated foot type and poorer footwear motion control properties.

Improved postural control after dynamic balance training in older overweight women.

PubMed

Bellafiore, Marianna; Battaglia, Giuseppe; Bianco, Antonino; Paoli, Antonio; Farina, Felicia; Palma, Antonio

2011-01-01

Many studies have reported a greater frequency of falls among older women than men in conditions which stress balance. Previously, we found an improvement in static balance in older women with an increased support surface area and equal load redistribution on both feet, in response to a dynamic balance training protocol. The aim of the present study was to examine whether the same training program and body composition would have effects on the postural control of older overweight women. Ten healthy women (68.67 ± 5.50 yrs; 28.17 ± 3.35 BMI) participated in a five-week physical activity program. This included dynamic balance exercises, such as heel-to-toe walking in different directions, putting their hands on their hips, eyes open (EO) or closed (EC), with a tablet on their heads, going up and down one step, and walking on a mat. Postural stability was assessed before and after training with an optoelectronic platform and a uni-pedal balance performance test. Body composition of the trunk, upper limbs and lower limbs was measured by bio-impedance analysis. The mean speed (MS), medial-lateral MS (MS-x), anterior-posterior MS (MS-y), sway path (SP) and ellipse surface area (ESA) of the pressure center was reduced after training in older women. However, only MS, MS-x, MS-y and SP significantly decreased in bipodalic conditions with EO and MS-y also with EC (p<0.05). Instead, in monopodalic conditions, we found a significant reduction in the ESA of both feet with EO and EC. These data were associated with a significant increase in the lean mass of lower limbs and a higher number of participants who improved their ability to maintain unipedal static balance. Our dynamic balance training protocol appears to be feasible, safe and repeatable for older overweight women and to have positive effects in improving their lateral and anterior-posterior postural control, mainly acting on the visual and skeletal muscle components of the balance control system.

Population Differences in Postural Response Strategy Associated with Exposure to a Novel Continuous Perturbation Stimuli: Would Dancers Have Better Balance on a Boat?

PubMed

Duncan, Carolyn A; Ingram, Tony G J; Mansfield, Avril; Byrne, Jeannette M; McIlroy, William E

2016-01-01

Central or postural set theory suggests that the central nervous system uses short term, trial to trial adaptation associated with repeated exposure to a perturbation in order to improve postural responses and stability. It is not known if longer-term prior experiences requiring challenging balance control carryover as long-term adaptations that influence ability to react in response to novel stimuli. The purpose of this study was to determine if individuals who had long-term exposure to balance instability, such as those who train on specific skills that demand balance control, will have improved ability to adapt to complex continuous multidirectional perturbations. Healthy adults from three groups: 1) experienced maritime workers (n = 14), 2) novice individuals with no experience working in maritime environments (n = 12) and 3) individuals with training in dance (n = 13) participated in the study. All participants performed a stationary standing task while being exposed to five 6 degree of freedom motions designed to mimic the motions of a ship at sea. The balance reactions (change-in-support (CS) event occurrences and characteristics) were compared between groups. Results indicate dancers demonstrated significantly fewer CS events than novices during the first trial, but did not perform as well as those with offshore experience. Linear trend analyses revealed that short-term adaptation across all five trials was dependent on the nature of participant experience, with dancers achieving postural stability earlier than novices, but later than those with offshore experience. These results suggest that long term previous experiences also have a significant influence on the neural control of posture and balance in the development of compensatory responses.

Effects of sensory augmentation on postural control and gait symmetry of transfemoral amputees: a case description.

PubMed

Pagel, Anna; Arieta, Alejandro Hernandez; Riener, Robert; Vallery, Heike

2016-10-01

Despite recent advances in leg prosthetics, transfemoral amputees still experience limitations in postural control and gait symmetry. It has been hypothesized that artificial sensory information might improve the integration of the prosthesis into the human sensory-motor control loops and, thus, reduce these limitations. In three transfemoral amputees, we investigated the effect of Electrotactile Moving Sensation for Sensory Augmentation (EMSSA) without training and present preliminary findings. Experimental conditions included standing with open/closed eyes on stable/unstable ground as well as treadmill walking. For standing conditions, spatiotemporal posturographic measures and sample entropy were derived from the center of pressure. For walking conditions, step length and stance duration were calculated. Conditions without feedback showed effects congruent with findings in the literature, e.g., asymmetric weight bearing and step length, and validated the collected data. During standing, with EMSSA a tendency to influence postural control in a negative way was found: Postural control was less effective and less efficient and the prosthetic leg was less involved. Sample entropy tended to decrease, suggesting that EMSSA demanded increased attention. During walking, with EMSSA no persistent positive effect was found. This contrasts the positive subjective assessment and the positive effect on one subject's step length.

Head movements and postures as pain behavior

PubMed Central

Al-Hamadi, Ayoub; Limbrecht-Ecklundt, Kerstin; Walter, Steffen; Traue, Harald C.

2018-01-01

Pain assessment can benefit from observation of pain behaviors, such as guarding or facial expression, and observational pain scales are widely used in clinical practice with nonverbal patients. However, little is known about head movements and postures in the context of pain. In this regard, we analyze videos of three publically available datasets. The BioVid dataset was recorded with healthy participants subjected to painful heat stimuli. In the BP4D dataset, healthy participants performed a cold-pressor test and several other tasks (meant to elicit emotion). The UNBC dataset videos show shoulder pain patients during range-of-motion tests to their affected and unaffected limbs. In all videos, participants were sitting in an upright position. We studied head movements and postures that occurred during the painful and control trials by measuring head orientation from video over time, followed by analyzing posture and movement summary statistics and occurrence frequencies of typical postures and movements. We found significant differences between pain and control trials with analyses of variance and binomial tests. In BioVid and BP4D, pain was accompanied by head movements and postures that tend to be oriented downwards or towards the pain site. We also found differences in movement range and speed in all three datasets. The results suggest that head movements and postures should be considered for pain assessment and research. As additional pain indicators, they possibly might improve pain management whenever behavior is assessed, especially in nonverbal individuals such as infants or patients with dementia. However, in advance more research is needed to identify specific head movements and postures in pain patients. PMID:29444153

Relationship between body composition and postural control in prepubertal overweight/obese children: A cross-sectional study.

PubMed

Villarrasa-Sapiña, Israel; Álvarez-Pitti, Julio; Cabeza-Ruiz, Ruth; Redón, Pau; Lurbe, Empar; García-Massó, Xavier

2018-02-01

Excess body weight during childhood causes reduced motor functionality and problems in postural control, a negative influence which has been reported in the literature. Nevertheless, no information regarding the effect of body composition on the postural control of overweight and obese children is available. The objective of this study was therefore to establish these relationships. A cross-sectional design was used to establish relationships between body composition and postural control variables obtained in bipedal eyes-open and eyes-closed conditions in twenty-two children. Centre of pressure signals were analysed in the temporal and frequency domains. Pearson correlations were applied to establish relationships between variables. Principal component analysis was applied to the body composition variables to avoid potential multicollinearity in the regression models. These principal components were used to perform a multiple linear regression analysis, from which regression models were obtained to predict postural control. Height and leg mass were the body composition variables that showed the highest correlation with postural control. Multiple regression models were also obtained and several of these models showed a higher correlation coefficient in predicting postural control than simple correlations. These models revealed that leg and trunk mass were good predictors of postural control. More equations were found in the eyes-open than eyes-closed condition. Body weight and height are negatively correlated with postural control. However, leg and trunk mass are better postural control predictors than arm or body mass. Finally, body composition variables are more useful in predicting postural control when the eyes are open. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of the Coordination between Posture and Manual Control

ERIC Educational Resources Information Center

Haddad, Jeffrey M.; Claxton, Laura J.; Keen, Rachel; Berthier, Neil E.; Riccio, Gary E.; Hamill, Joseph; Van Emmerik, Richard E. A.

2012-01-01

Studies have suggested that proper postural control is essential for the development of reaching. However, little research has examined the development of the coordination between posture and manual control throughout childhood. We investigated the coordination between posture and manual control in children (7- and 10-year-olds) and adults during…

Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: an experimental trial.

PubMed

Ross, Scott E; Arnold, Brent L; Blackburn, J Troy; Brown, Cathleen N; Guskiewicz, Kevin M

2007-12-17

Ankle sprains are common injuries that often lead to functional ankle instability (FAI), which is a pathology defined by sensations of instability at the ankle and recurrent ankle sprain injury. Poor postural stability has been associated with FAI, and sports medicine clinicians rehabilitate balance deficits to prevent ankle sprains. Subsensory electrical noise known as stochastic resonance (SR) stimulation has been used in conjunction with coordination training to improve dynamic postural instabilities associated with FAI. However, unlike static postural deficits, dynamic impairments have not been indicative of ankle sprain injury. Therefore, the purpose of this study was to examine the effects of coordination training with or without SR stimulation on static postural stability. Improving postural instabilities associated with FAI has implications for increasing ankle joint stability and decreasing recurrent ankle sprains. This study was conducted in a research laboratory. Thirty subjects with FAI were randomly assigned to either a: 1) conventional coordination training group (CCT); 2) SR stimulation coordination training group (SCT); or 3) control group. Training groups performed coordination exercises for six weeks. The SCT group received SR stimulation during training, while the CCT group only performed coordination training. Single leg postural stability was measured after the completion of balance training. Static postural stability was quantified on a force plate using anterior/posterior (A/P) and medial/lateral (M/L) center-of-pressure velocity (COPvel), M/L COP standard deviation (COPsd), M/L COP maximum excursion (COPmax), and COP area (COParea). Treatment effects comparing posttest to pretest COP measures were highest for the SCT group. At posttest, the SCT group had reduced A/P COPvel (2.3 +/- 0.4 cm/s vs. 2.7 +/- 0.6 cm/s), M/L COPvel (2.6 +/- 0.5 cm/s vs. 2.9 +/- 0.5 cm/s), M/L COPsd (0.63 +/- 0.12 cm vs. 0.73 +/- 0.11 cm), M/L COPmax (1.76 +/- 0.25 cm vs. 1.98 +/- 0.25 cm), and COParea (0.13 +/- 0.03 cm2 vs. 0.16 +/- 0.04 cm2) than the pooled means of the CCT and control groups (P < 0.05). Reduced values in COP measures indicated postural stability improvements. Thus, six weeks of coordination training with SR stimulation enhanced postural stability. Future research should examine the use of SR stimulation for decreasing recurrent ankle sprain injury in physically active individuals with FAI.

Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: an experimental trial

PubMed Central

Ross, Scott E; Arnold, Brent L; Blackburn, J Troy; Brown, Cathleen N; Guskiewicz, Kevin M

2007-01-01

Background Ankle sprains are common injuries that often lead to functional ankle instability (FAI), which is a pathology defined by sensations of instability at the ankle and recurrent ankle sprain injury. Poor postural stability has been associated with FAI, and sports medicine clinicians rehabilitate balance deficits to prevent ankle sprains. Subsensory electrical noise known as stochastic resonance (SR) stimulation has been used in conjunction with coordination training to improve dynamic postural instabilities associated with FAI. However, unlike static postural deficits, dynamic impairments have not been indicative of ankle sprain injury. Therefore, the purpose of this study was to examine the effects of coordination training with or without SR stimulation on static postural stability. Improving postural instabilities associated with FAI has implications for increasing ankle joint stability and decreasing recurrent ankle sprains. Methods This study was conducted in a research laboratory. Thirty subjects with FAI were randomly assigned to either a: 1) conventional coordination training group (CCT); 2) SR stimulation coordination training group (SCT); or 3) control group. Training groups performed coordination exercises for six weeks. The SCT group received SR stimulation during training, while the CCT group only performed coordination training. Single leg postural stability was measured after the completion of balance training. Static postural stability was quantified on a force plate using anterior/posterior (A/P) and medial/lateral (M/L) center-of-pressure velocity (COPvel), M/L COP standard deviation (COPsd), M/L COP maximum excursion (COPmax), and COP area (COParea). Results Treatment effects comparing posttest to pretest COP measures were highest for the SCT group. At posttest, the SCT group had reduced A/P COPvel (2.3 ± 0.4 cm/s vs. 2.7 ± 0.6 cm/s), M/L COPvel (2.6 ± 0.5 cm/s vs. 2.9 ± 0.5 cm/s), M/L COPsd (0.63 ± 0.12 cm vs. 0.73 ± 0.11 cm), M/L COPmax (1.76 ± 0.25 cm vs. 1.98 ± 0.25 cm), and COParea (0.13 ± 0.03 cm2 vs. 0.16 ± 0.04 cm2) than the pooled means of the CCT and control groups (P < 0.05). Conclusion Reduced values in COP measures indicated postural stability improvements. Thus, six weeks of coordination training with SR stimulation enhanced postural stability. Future research should examine the use of SR stimulation for decreasing recurrent ankle sprain injury in physically active individuals with FAI. PMID:18086314

Balance control and anti‐gravity muscle activity during the experience of fear at heights

PubMed Central

Wuehr, Max; Kugler, Guenter; Schniepp, Roman; Eckl, Maria; Pradhan, Cauchy; Jahn, Klaus; Huppert, Doreen; Brandt, Thomas

2014-01-01

Abstract Fear of heights occurs when a visual stimulus causes the apprehension of losing balance and falling. A moderate form of visual height intolerance (vHI) affects about one third of the general population and has relevant consequences for the quality of life. A quantitative evaluation of balance mechanisms in persons susceptible to vHI during height exposure is missing. VHI‐related changes in postural control were assessed by center‐of‐pressure displacements and electromyographic recordings of selected leg, arm, and neck muscles in 16 subjects with vHI while standing at heights on an emergency balcony versus standing in the laboratory at ground level. Characteristics of open‐ and closed‐loop postural control were analyzed. Body sway and muscle activity parameters were correlated with the subjective estimates of fear at heights. During height exposure, (1) open‐loop control was disturbed by a higher diffusion activity (P < 0.001) and (2) the sensory feedback threshold for closed‐loop control was lowered (P < 0.010). Altered postural control was predominantly associated with increased co‐contraction of leg muscles. Body sway and leg and neck muscle co‐contraction correlated with the severity of subjective anxiety (P < 0.050). Alterations in postural control diminished if there were nearby stationary contrasts in the visual surrounding or if subjects stood with eyes closed. The performance of a cognitive dual task also improved impaired balance. Visual heights have two behavioral effects in vHI subjects: A change occurs in (1) open‐ and closed‐loop postural control strategy and (2) co‐contraction of anti‐gravity leg and neck muscles, both of which depend on the severity of evoked fear at heights. PMID:24744901

Balance control and anti-gravity muscle activity during the experience of fear at heights.

PubMed

Wuehr, Max; Kugler, Guenter; Schniepp, Roman; Eckl, Maria; Pradhan, Cauchy; Jahn, Klaus; Huppert, Doreen; Brandt, Thomas

2014-02-01

Fear of heights occurs when a visual stimulus causes the apprehension of losing balance and falling. A moderate form of visual height intolerance (vHI) affects about one third of the general population and has relevant consequences for the quality of life. A quantitative evaluation of balance mechanisms in persons susceptible to vHI during height exposure is missing. VHI-related changes in postural control were assessed by center-of-pressure displacements and electromyographic recordings of selected leg, arm, and neck muscles in 16 subjects with vHI while standing at heights on an emergency balcony versus standing in the laboratory at ground level. Characteristics of open- and closed-loop postural control were analyzed. Body sway and muscle activity parameters were correlated with the subjective estimates of fear at heights. During height exposure, (1) open-loop control was disturbed by a higher diffusion activity (P < 0.001) and (2) the sensory feedback threshold for closed-loop control was lowered (P < 0.010). Altered postural control was predominantly associated with increased co-contraction of leg muscles. Body sway and leg and neck muscle co-contraction correlated with the severity of subjective anxiety (P < 0.050). Alterations in postural control diminished if there were nearby stationary contrasts in the visual surrounding or if subjects stood with eyes closed. The performance of a cognitive dual task also improved impaired balance. Visual heights have two behavioral effects in vHI subjects: A change occurs in (1) open- and closed-loop postural control strategy and (2) co-contraction of anti-gravity leg and neck muscles, both of which depend on the severity of evoked fear at heights.

Spherical Lenses and Prisms Lead to Postural Instability in Both Dyslexic and Non Dyslexic Adolescents

PubMed Central

Kapoula, Zoi; Gaertner, Chrystal; Matheron, Eric

2012-01-01

There is controversy as to whether dyslexic children present systematic postural deficiency. Clinicians use a combination of ophthalmic prisms and proprioceptive soles to improve postural performances. This study examines the effects of convergent prisms and spherical lenses on posture. Fourteen dyslexics (13–17 years-old) and 11 non dyslexics (13–16 years-old) participated in the study. Quiet stance posturography was performed with the TechnoConcept device while subjects fixated a target at eye-level from a distance of 1_m. Four conditions were run: normal viewing; viewing the target with spherical lenses of −1 diopter (ACCOM1) over each eye; viewing with −3 diopters over each eye (ACCOM3); viewing with a convergent prism of 8 diopters per eye. Relative to normal viewing, the −1 lenses increased the surface of body sway significantly whereas the −3 diopter lenses only resulted in a significant increase of antero-posterior body sway. Thus, adolescents would appear to cope more effectively with stronger conflicts rather than subtle ones. The prism condition resulted in a significant increase in both the surface and the antero-posterior body sway. Importantly, all of these effects were similar for the two groups. Wavelet analysis (time frequency domain) revealed high spectral power of antero-posterior sway for the prism condition in both groups. In the ACCOM3 condition, the spectral power of antero-posterior sway decreased for non dyslexics but increased for dyslexics suggesting that dyslexics encounter more difficulty with accommodation. The cancelling time for medium range frequency (believed to be controlled by the cerebellum), was shorter in dyslexics, suggesting fewer instances of optimal control. We conclude that dyslexics achieve similar postural performances albeit less efficiently. Prisms and lenses destabilize posture for all teenagers. Thus, contrary to adults, adolescents do not seem to use efferent, proprioceptive ocular motor signals to improve their posture, at least not immediately when confronted to convergence accommodation conflict. PMID:23144786

Does a mineral wristband affect balance? A randomized, controlled, double-blind study.

PubMed

Hansson, Eva Ekvall; Beckman, Anders; Persson, Liselott

2015-06-26

Having good balance is a facilitating factor in the performance of everyday activities. Good balance is also essential in various sport activities in order to both get results and prevent injury. A common measure of balance is postural sway, which can be measured both antero-posteriorly and medio-laterally. There are several companies marketing wristbands whose intended function is to improve balance, strength and flexibility. Randomized controlled trials have shown that wristbands with holograms have no effect on balance but studies on wristbands with minerals seem to be lacking. The aim of this study was to investigate if the mineral wristband had any effect on postural sway in a group of healthy individuals. Randomized, controlled, double-blind study. The study group consisted of 40 healthy persons. Postural sway was measured antero-posteriorly and medio-laterally on a force plate, to compare: the mineral wristband, a placebo wristband, and without any wristband. The measurements were performed for 30 s, in four situations: with open eyes and closed eyes, standing on a firm surface and on foam. Analyses were made with multilevel technique. The use of wristband with or without minerals did not alter postural sway. Closed eyes and standing on foam both prolonged the dependent measurement, irrespective if it was medio-lateral or antero-posterior. Wearing any wristband (mineral or placebo) gave a small (0.22-0.36 mm/s) but not statistically significant reduction of postural sway compared to not wearing wristband. This study showed no effect on postural sway by using the mineral wristband, compared with a placebo wristband or no wristband. Wearing any wristband at all (mineral or placebo) gave a small but not statistically significant reduction in postural sway, probably caused by sensory input.

Effects of aging and tactile stochastic resonance on postural performance and postural control in a sensory conflict task.

PubMed

Dettmer, Marius; Pourmoghaddam, Amir; Lee, Beom-Chan; Layne, Charles S

2015-01-01

Postural control in certain situations depends on functioning of tactile or proprioceptive receptors and their respective dynamic integration. Loss of sensory functioning can lead to increased risk of falls in challenging postural tasks, especially in older adults. Stochastic resonance, a concept describing better function of systems with addition of optimal levels of noise, has shown to be beneficial for balance performance in certain populations and simple postural tasks. In this study, we tested the effects of aging and a tactile stochastic resonance stimulus (TSRS) on balance of adults in a sensory conflict task. Nineteen older (71-84 years of age) and younger participants (22-29 years of age) stood on a force plate for repeated trials of 20 s duration, while foot sole stimulation was either turned on or off, and the visual surrounding was sway-referenced. Balance performance was evaluated by computing an Equilibrium Score (ES) and anterior-posterior sway path length (APPlength). For postural control evaluation, strategy scores and approximate entropy (ApEn) were computed. Repeated-measures ANOVA, Wilcoxon signed-rank tests, and Mann-Whitney U-tests were conducted for statistical analysis. Our results showed that balance performance differed between older and younger adults as indicated by ES (p = 0.01) and APPlength (0.01), and addition of vibration only improved performance in the older group significantly (p = 0.012). Strategy scores differed between both age groups, whereas vibration only affected the older group (p = 0.025). Our results indicate that aging affects specific postural outcomes and that TSRS is beneficial for older adults in a visual sensory conflict task, but more research is needed to investigate the effectiveness in individuals with more severe balance problems, for example, due to neuropathy.

Interference between oculomotor and postural tasks in 7-8-year-old children and adults.

PubMed

Legrand, Agathe; Doré Mazars, Karine; Lemoine, Christelle; Nougier, Vincent; Olivier, Isabelle

2016-06-01

Several studies in adults having observed the effect of eye movements on postural control provided contradictory results. In the present study, we explored the effect of various oculomotor tasks on postural control and the effect of different postural tasks on eye movements in eleven children (7.8 ± 0.5 years) and nine adults (30.4 ± 6.3 years). To vary the difficulty of the oculomotor task, three conditions were tested: fixation, prosaccades (reactive saccades made toward the target) and antisaccades (voluntary saccades made in the direction opposite to the visual target). To vary the difficulty of postural control, two postural tasks were tested: Standard Romberg (SR) and Tandem Romberg (TR). Postural difficulty did not affect oculomotor behavior, except by lengthening adults' latencies in the prosaccade task. For both groups, postural control was altered in the antisaccade task as compared to fixation and prosaccade tasks. Moreover, a ceiling effect was found in the more complex postural task. This study highlighted a cortical interference between oculomotor and postural control systems.

The effect of labyrinthectomy on postural control of upside-down swimming catfish, Synodontis nigriventris, under pseudomicrogravity.

PubMed

Ohnishi, K; Yamamoto, T; Takahashi, A; Tanaka, H; Koyama, M; Ohnishi, T

1999-08-01

The catfish (Synodontis nigriventris) has a unique habitat of keeping an upside-down posture under normal gravity. We examined its postural control under pseudomicrogravity generated artificially, and the effect of unilateral labyrinthectomy on the postural control. The stable swimming posture under pseudomicrogravity was observed in the upside-down swimming catfish but not in the catfish (Corydoras paleatus), which has normal swimming habitat. Furthermore, although S. nigriventris but not C. paleatus could keep the stable swimming posture under normal gravity condition after unilateral labyrinthectomy, the labyrinthectomized fishes could not keep it under pseudomicrogravity. Seven days after the operation, S. nigriventris alone partially recovered the ability to keep an upside-down swimming posture, and did completely, to the control level, 25 days after the operation. Furthermore, when S. nigriventris was under pseudomicrogravity in dark conditions, it showed disturbed swimming postures. These results suggest that the upside-down swimming catfish has superior ability of postural control depending on the labyrinth.

Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial

PubMed Central

Campos de Oliveira, Laís; Gonçalves de Oliveira, Raphael; Pires-Oliveira, Deise Aparecida de Almeida

2015-01-01

[Purpose] The aim of the present study was to determine the effects of Pilates on lower leg strength, postural balance and the health-related quality of life (HRQoL) of older adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age, 64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks. The following evaluations were performed before and after the interventions: isokinetic torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group analysis, the EG demonstrated significant improvement in all variables. In the inter-group analysis, the EG demonstrated significant improvement in most variables. [Conclusion] Pilates exercises led to significant improvement in isokinetic torque of the knee extensors and flexors, postural balance and aspects of the health-related quality of life of older adults. PMID:25931749

A randomized intervention trial to reduce mechanical exposures in the Colombian flower industry.

PubMed

Barrero, L H; Ceballos, C; Ellegast, R; Pulido, J A; Monroy, M; Berrio, S; Quintana, L A

2014-01-01

Evidence on effectiveness of ergonomic interventions to reduce mechanical demands of the upper extremity is scarce in agriculture. To conduct an ergonomic intervention to reduce mechanical exposures on workers during manual flower cutting, while emphasizing postural education and reduction of force requirements. Seventy seven workers (20 to 55 years old; 80% women) from six companies that cultivate roses participated in this study. Participants from three companies were randomly assigned to control and intervention groups. A postural education program and a maintenance program was designed and implemented in the intervention group aiming to achieve more neutral postures of the wrist and forearm and to reduce force requirements during rose cutting. Changes in self-reported effort and upper extremity postures, kinematics and muscular activity between baseline and follow-up assessments were evaluated. Most of the observed changes in the evaluated mechanical exposures were moderate for both groups. The intervention group showed differential improvements compared to the control group for 95th percentile forearm pronation (intervention group went from 50.6 to 35.6°; control group went from 18.4 to 34.7°); and to some degree for the maximum wrist radial deviation (the intervention group went from 17° to 7.6°; control group went from 10.1° to 7.8°). Also, the mean elbow flexion for the control group was reduced from 62.3 to 48.4°, whereas it increased from 52.2 to 57.3° in the intervention group. No differential changes between the intervention and control groups were observed for the kinematic variables, except for an unexpected reduction in the 95th percentile velocity of wrist flexion-extension in the control group, which was not observed in the intervention group. Lastly, although observed changes in muscular activity were not statistically significant, improvements were observed for the intervention group for the flexor and extensor carpi radialis and the flexor carpi ulnaris; although the opposite was true for the extensor carpi ulnaris. Important although sometimes mixed results were achieved with this field intervention, focusing on postural and force requirement demands. The positive results are encouraging considering the presence of typical limitations observed in field intervention studies.

Does extending the dual-task functional exercises workout improve postural balance in individuals with ID?

PubMed

Mikolajczyk, Edyta; Jankowicz-Szymanska, Agnieszka

2015-03-01

Maintaining postural balance, overcoming visual and motor coordination disorders and experiencing problems with low general fitness - typical of intellectually disabled individuals - adversely affect the performance quality of their activities of daily living (ADLs). Physical fitness and postural balance can be improved by taking part in special intervention programs. Our study was designed to test whether extending the dual-task intervention program (combining ADLs with balance exercises on unstable surfaces) from 12 to 24 weeks additionally improved postural balance in individuals with intellectual disability (ID). We also attempted to assess whether the effects of the above intervention program were still noticeable after 8 weeks of holidays, in which participants did not take any rehabilitation exercises. A total of 34 adolescents, aged 14-16 years (15.06±0.9), with moderate ID took part in our study. The experimental group (E) consisted of 17 individuals, who continued the intervention program originated 3 months earlier, and the control group (C) comprised the same number of participants. Postural balance was assessed on a stabilometric platform Alfa. Having extended the workout period by another 12 weeks, we noticed that the path length of the center of pressure (COP) covered by participants on tests with their eyes open and closed significantly shortened. After a lapse of 8 weeks from the completion of the program, the experimental group revealed a statistically significant decrease in the velocity along the medio-lateral (M/L) and anterior-posterior (A/P) axes. The remaining variables stayed at the same level and the control group did not demonstrate any statistically significant changes. Dual-task exercises, in which enhancing functional tasks of daily living is combined with a parallel stimulation of balance reactions, may improve static balance in persons with ID. Copyright © 2014 Elsevier Ltd. All rights reserved.

Acceleration feedback improves balancing against reflex delay

PubMed Central

Insperger, Tamás; Milton, John; Stépán, Gábor

2013-01-01

A model for human postural balance is considered in which the time-delayed feedback depends on position, velocity and acceleration (proportional–derivative–acceleration (PDA) feedback). It is shown that a PDA controller is equivalent to a predictive controller, in which the prediction is based on the most recent information of the state, but the control input is not involved into the prediction. A PDA controller is superior to the corresponding proportional–derivative controller in the sense that the PDA controller can stabilize systems with approximately 40 per cent larger feedback delays. The addition of a sensory dead zone to account for the finite thresholds for detection by sensory receptors results in highly intermittent, complex oscillations that are a typical feature of human postural sway. PMID:23173196

Dental Hygiene Students' Self-Assessment of Ergonomics Utilizing Photography.

PubMed

Partido, Brian B

2017-10-01

Due to postural demands, dental professionals are at high risk for developing work-related musculoskeletal disorders (WMSDs). Dental clinicians' lack of ergonomic awareness may impede the clinical application of recommendations to improve their posture. The aim of this study was to determine whether feedback involving photography and self-assessment would improve dental hygiene students' ergonomic scores and accuracy of their ergonomic self-assessments. The study involved a randomized control design and used a convenience sample of all 32 junior-year dental hygiene students enrolled in the autumn 2016 term in The Ohio State University baccalaureate dental hygiene program. Sixteen students were randomly assigned to each of two groups (control and training). At weeks one and four, all participants were photographed and completed ergonomic self-evaluations using the Modified-Dental Operator Posture Assessment Instrument (M-DOPAI). During weeks two and three, participants in the training group were photographed again and used those photographs to complete ergonomic self-assessments. All participants' pre-training and post-training photographs were given ergonomic scores by three raters. Students' self-assessments in the control group and faculty evaluations of the training group showed significant improvement in scores over time (F(1,60)=4.25, p<0.05). In addition, the accuracy of self-assessment significantly improved for students in the training group (F(1,30)=8.29, p<0.01). In this study, dental hygiene students' self-assessments using photographs resulted in improvements in their ergonomic scores and increased accuracy of their ergonomic self-assessments. Any improvement in ergonomic score or awareness can help reduce the risks for WMSDs, especially among dental clinicians.

Taekwondo Training Improves Sensory Organization and Balance Control in Children with Developmental Coordination Disorder: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Fong, Shirley S. M.; Tsang, William W. N.; Ng, Gabriel Y. F.

2012-01-01

Children with developmental coordination disorder (DCD) have poorer postural control and are more susceptible to falls and injuries than their healthy counterparts. Sports training may improve sensory organization and balance ability in this population. This study aimed to evaluate the effects of three months of Taekwondo (TKD) training on the…

Postural control is associated with cognition and fear of falling in patients with multiple sclerosis.

PubMed

Perrochon, A; Holtzer, R; Laidet, M; Armand, S; Assal, F; Lalive, P H; Allali, G

2017-04-01

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease affecting various neurological domains, such as postural control, cognition, fear of falling, depression-anxiety, and fatigue. This study examined the associations of cognitive functions, fear of falling, depression-anxiety, and fatigue with postural control in patients with MS. Postural control (sway velocity) of 63 patients with MS (age 39.0 ± 8.9 years; %female 57%; Expanded Disability Status Scale score median (interquartile range) 2.0 (1.5)) was recorded on two platforms at stable and unstable conditions. Cognition, fear of falling, depression-anxiety, and fatigue were evaluated by a comprehensive neuropsychological assessment. The associations between these domains and postural control have been measured by multivariable linear regression (adjusted for age, gender, disability, and education). In stable condition, only working memory was associated with postural control (p < 0.05). In unstable condition, working memory, executive functions, attention/processing speed, and fear of falling were associated with postural control (p < 0.05). Specific cognitive domains and fear of falling were associated with postural control in MS patients, particularly in unstable condition. These findings highlight the association of cognitive functions and fear of falling with postural control in MS.

Effects of nanotechnologies-based devices on postural control in healthy subjects.

PubMed

Malchiodi Albedi, Giovanna; Corna, Stefano; Aspesi, Valentina; Clerici, Daniela; Parisio, Cinzia; Seitanidis, Jonathan; Cau, Nicola; Brugliera, Luigia; Capodaglio, Paolo

2017-09-05

The aim of the present preliminary randomized controlled study was to ascertain whether the use of newly developed nanotechnologies-based patches can influence posture control of healthy subjects. Thirty healthy female subjects (age 39.4 years, BMI 22.74 kg/m2) were randomly assigned to two groups: one with active patches and a control group with sham patches. Two patches were applied with a tape: one on the subject's sternum and the other on the C7 apophysis. Body sway during quiet upright stance was recorded with a dynamometric platform. Each subject was tested under two visual conditions, eyes open and closed. We used a blocked stratified randomization procedure conducted by a third party. Subjects wearing the sham patches showed a significant increase of the centre of pressure sway area after 4 hours when they performed the habitual moderate-intensity work activities. In the active patch group, a decrease of the sway path was evident, providing evidence of an enhanced balance control. Our preliminary findings on healthy subjects indicate that nanotechnological devices generating ultra-low electromagnetic fields can improve posture control.

Understanding balance differences in individuals with multiple sclerosis with mild disability: an investigation of differences in sensory feedback on postural control during a Romberg task.

PubMed

Denommé, Luke T; Mandalfino, Patricia; Cinelli, Michael E

2014-06-01

A major presenting symptom in 'individuals with multiple sclerosis with mild balance disability' (IwMS) is poor postural control, resulting from slowed spinal somatosensory conduction. Postural control deficits in IwMS are most apparent when vision is removed and the base of support is reduced such is the case during tandem and single support stances. The current study used center of pressure (COP) measurements to determine whether postural control differences exist between IwMS and either 'healthy age-matched individuals' (HAMI) or 'community-dwelling older adults' (OA). Postural control was evaluated using a Romberg standing task, which required participants to stand with their feet together and hands by their sides for 45 s with either their eyes open or closed. Results revealed that COP velocity root mean square was greater in IwMS and their COP position was closer to their self-selected maximum stability limits (e.g., greater Standing Index proportion) when vision was removed compared to HAMI. Conversely, IwMS displayed similar postural control characteristics to OA. The current study highlights two novel findings: (1) the utility of novel COP measurements to assess differences in the level of postural control in IwMS; and (2) the benefit of assessing postural control levels in IwMS to not only a population with a fully intact and functional postural control system (HAMI) but also to another population that is thought to experience postural control deficits (OA).

Effects of weight management program on postural stability and neuromuscular function among obese children: study protocol for a randomized controlled trial.

PubMed

Sun, Fenghua; Wang, Li-Juan; Wang, Lin

2015-04-10

Childhood obesity is one of the most critical public health problems in the world. It is associated with low neuromuscular function and postural deformities. Whether weight loss can improve postural stability and neuromuscular control, benefit daily activities, or prevent injury is unknown. Therefore, this study attempts to investigate the effect of a 6 month weight management program on postural stability and neuromuscular control among obese children. We will conduct a prospective, single-blind, randomized controlled trial with 120 prepubescent obese children. Participants will be randomly assigned to a weight management group or a control group. The weight management group will participate in a dietary and exercise program. The control group will receive health education. After the intervention, participants will be followed for 6 months with no active intervention. The primary and secondary outcomes will be assessed at the baseline, and after 6 months and 12 months. Primary outcome measures will include body weight, body height, body mass index, waist circumference, hip circumference, and body fat percentage. Secondary outcome measures will include three-dimensional functional biomechanics in different tasks, proprioception tests of the knee and ankle, neuromuscular response of the leg muscles, and muscle strength tests of the knee and ankle. Furthermore, adverse events will be recorded and analyzed. An intention-to-treat analysis will be performed if any participants withdraw from the trial. The important features of this trial include the randomization procedures and large sample size. This study attempts to estimate the effect of weight loss intervention on outcomes, including daily life function, postural stability, and neuromuscular control in prepubescent obese children. Therefore, our results can be useful for obese children, medical staff, and healthcare decision makers. Chinese Clinical Trial Registry ChiCTR-IOB-15005874.

Posture-Motor and Posture-Ideomotor Dual-Tasking: A Putative Marker of Psychomotor Retardation and Depressive Rumination in Patients With Major Depressive Disorder.

PubMed

Aftanas, Lyubomir I; Bazanova, Olga M; Novozhilova, Nataliya V

2018-01-01

Background: Recent studies have demonstrated that the assessment of postural performance may be a potentially reliable and objective marker of the psychomotor retardation (PMR) in the major depressive disorder (MDD). One of the important facets of MDD-related PMR is reflected in disrupted central mechanisms of psychomotor control, heavily influenced by compelling maladaptive depressive rumination. In view of this we designed a research paradigm that included sequential execution of simple single-posture task followed by more challenging divided attention posture tasks, involving concurring motor and ideomotor workloads. Another difficulty dimension assumed executing of all the tasks with eyes open (EO) (easy) and closed (EC) (difficult) conditions. We aimed at investigating the interplay between the severity of MDD, depressive rumination, and efficiency of postural performance. Methods: Compared with 24 age- and body mass index-matched healthy controls (HCs), 26 patients with MDD sequentially executed three experimental tasks: (1) single-posture task of maintaining a quiet stance (ST), (2) actual posture-motor dual task (AMT); and (3) mental/imaginary posture-motor dual task (MMT). All the tasks were performed in the EO and the EC conditions. The primary dependent variable was the amount of kinetic energy ( E ) expended for the center of pressure deviations (CoPDs), whereas the absolute divided attention cost index showed energy cost to the dual-tasking vs. the single-posture task according to the formula: Δ E = ( E Dual-task - E Single-task ). Results: The signs of PMR in the MDD group were objectively indexed by deficient posture control in the EC condition along with overall slowness of fine motor and ideomotor activity. Another important and probably more challenging feature of the findings was that the posture deficit manifested in the ST condition was substantially and significantly attenuated in the MMT and AMT performance dual-tasking activity. A multiple linear regression analysis evidenced further that the dual-tasking energy cost (i.e., Δ E ) significantly predicted clinical scores of severity of MDD and depressive rumination. Conclusion: The findings allow to suggest that execution of concurrent actual or imaginary fine motor task with closed visual input deallocates attentional resources from compelling maladaptive depressive rumination thereby attenuating severity of absolute dual-tasking energy costs for balance maintenance in patients with MDD. Significance: Quantitative assessment of PMR through measures of the postural performance in dual-tasking may be useful to capture the negative impact of past depressive episodes, optimize the personalized treatment selection, and improve the understanding of the pathophysiological mechanisms underlying MDD.

Peripheral neuropathy may not be the only fundamental reason explaining increased sway in diabetic individuals.

PubMed

Bonnet, Cédrick T; Ray, Christopher

2011-08-01

Individuals with diabetic neuropathy sway more than control individuals while standing. This review specifically evaluated whether peripheral sensory neuropathy can be the only fundamental reason accounting for significant increased sway within this population. Twenty-six experimental articles were selected using MEDLINE and reference lists of relevant articles. The articles chosen investigated kinematic data of postural behaviour in controls and individuals with diabetic neuropathy during stance. Results of literature were compared with four expectations related to the peripheral sensory neuropathy fundamental hypothesis. Consistent with the peripheral sensory neuropathy hypothesis, the literature showed that individuals with diabetic neuropathy sway more than controls in quiet stance and even more so if their visual or vestibular systems were perturbed. Inconsistent with the hypothesis, individuals with diabetic neuropathy are more destabilised than controls in conditions altering sensation of the feet and legs (standing on a sway-referenced surface). The review showed that the peripheral sensory neuropathy hypothesis may not be the only fundamental cause accounting for significant increased postural sway in individuals with diabetic neuropathy. Visual impairments and changes in postural coordination may explain the divergence between expectations and results. In order to develop interventions aimed at improving postural control in individuals with diabetic neuropathy, scientific exploration of these new expectations should be detailed. Also at the practical level, the review discussed which additional sensory information - at the level of the hands and feet - may be more beneficial in individuals with diabetic neuropathy to reduce their postural sway. Copyright © 2011 Elsevier Ltd. All rights reserved.

Postural Instability Caused by Extended Bed Rest Is Alleviated by Brief Daily Exposure to Low Magnitude Mechanical Signals

PubMed Central

Muir, Jesse; Judex, Stefan; Qin, Yi-Xian; Rubin, Clinton

2011-01-01

Loss of postural stability, as exacerbated by chronic bed rest, aging, neuromuscular injury or disease, results in a marked increase in the risk of falls, potentiating severe injury and even death. To investigate the capacity of low magnitude mechanical signals (LMMS) to retain postural stability under conditions conducive to its decline, twenty-nine healthy adult subjects underwent 90 days of 6-degree head down tilt bed-rest. Treated subjects underwent a daily 10 minute regimen of 30 Hz LMMS at either a 0.3g-force (n=12) or 0.5g force (n=5). Control subjects (n=13) received no LMMS treatment. Postural stability, quantified by dispersions of the plantar-based center of pressure, deteriorated significantly from baseline in control subjects, with displacement and velocity at 60d increasing 98.7% and 193% respectively, while the LMMS group increased only 26.7% and 6.4%, reflecting a 73% and 97% relative retention in stability as compared to control. Increasing LMMS magnitude from 0.3 to 0.5g had no significant influence on outcomes. LMMS failed to spare loss of muscle extension strength, but helped to retain flexion strength (e.g., 46.2% improved retention of baseline concentric flexion strength vs. untreated controls; p=0.01). These data suggest the potential of extremely small mechanical signals as a non-invasive means of preserving postural control under the challenge of chronic bed rest, and may ultimately represent non-pharmacologic means of reducing the risk of debilitating falls in elderly and infirm. PMID:21273076

Assessment of Postural Control in Children with Cerebral Palsy: A Review

ERIC Educational Resources Information Center

Pavao, Silvia Leticia; dos Santos, Adriana Neves; Woollacott, Marjorie Hines; Rocha, Nelci Adriana Cicuto Ferreira

2013-01-01

This paper aimed to review studies that assessed postural control (PC) in children with cerebral palsy (CP) and describe the methods used to investigate postural control in this population. It also intended to describe the performance of children with CP in postural control. An extensive database search was performed using the keywords: postural…

Report: EPA’s Office of Environmental Information Should Improve Ariel Rios and Potomac Yard Computer Room Security Controls

EPA Pesticide Factsheets

Report #12-P-0879, September 26, 2012. The security posture and in-place environmental control review of the computer rooms in the Ariel Rios and Potomac Yard buildings revealed numerous security and environmental control deficiencies.

Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials.

PubMed

In, Taesung; Lee, Kyeongjin; Song, Changho

2016-10-28

BACKGROUND Virtual reality reflection therapy (VRRT) is a technically enhanced version of the mirror therapy concept. The aim of this study was to investigate whether VRRT could improve the postural balance and gait ability of patients with chronic stroke. MATERIAL AND METHODS Twenty-five patients with chronic stroke were randomly allocated into the VRRT group (n=13) and the control group (n=12). The participants in both groups performed a conventional rehabilitation program for 30 minutes. The VRRT group also performed a VRRT program for 30 minutes, five times a week for 4 weeks. The control group performed conventional rehabilitation program and a placebo VRRT program. Outcome measures included Berg Balance Scale (BBS), the Functional Reaching Test (FRT), and the Timed Up and Go (TUG) test (for dynamic balance ability), postural sway (for static balance ability), and 10 meter walking velocity (10 mWV) for gait ability. RESULTS There were statistically significant improvements in the VRRT group compared with the control group for BBS, FRT, TUG, postural sway (mediolateral sway distance with eyes open and eyes closed, anteroposterior and total sway distance with eyes open but not with eyes closed), and 10 mWV (p<0.05). CONCLUSIONS Applying VRRT (even as a home treatment) along with a conventional rehabilitation program for patients with chronic stroke might be even more beneficial than conventional rehabilitation program alone in improving affected lower limb function. Future studies should investigate the effectiveness of VRRT with optimal patient selection, and duration and intensity of training.

Effects of running with backpack loads during simulated gravitational transitions: Improvements in postural control

NASA Astrophysics Data System (ADS)

Brewer, Jeffrey David

The National Aeronautics and Space Administration is planning for long-duration manned missions to the Moon and Mars. For feasible long-duration space travel, improvements in exercise countermeasures are necessary to maintain cardiovascular fitness, bone mass throughout the body and the ability to perform coordinated movements in a constant gravitational environment that is six orders of magnitude higher than the "near weightlessness" condition experienced during transit to and/or orbit of the Moon, Mars, and Earth. In such gravitational transitions feedback and feedforward postural control strategies must be recalibrated to ensure optimal locomotion performance. In order to investigate methods of improving postural control adaptation during these gravitational transitions, a treadmill based precision stepping task was developed to reveal changes in neuromuscular control of locomotion following both simulated partial gravity exposure and post-simulation exercise countermeasures designed to speed lower extremity impedance adjustment mechanisms. The exercise countermeasures included a short period of running with or without backpack loads immediately after partial gravity running. A novel suspension type partial gravity simulator incorporating spring balancers and a motor-driven treadmill was developed to facilitate body weight off loading and various gait patterns in both simulated partial and full gravitational environments. Studies have provided evidence that suggests: the environmental simulator constructed for this thesis effort does induce locomotor adaptations following partial gravity running; the precision stepping task may be a helpful test for illuminating these adaptations; and musculoskeletal loading in the form of running with or without backpack loads may improve the locomotor adaptation process.

Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials

PubMed Central

In, Taesung; Lee, Kyeongjin; Song, Changho

2016-01-01

Background Virtual reality reflection therapy (VRRT) is a technically enhanced version of the mirror therapy concept. The aim of this study was to investigate whether VRRT could improve the postural balance and gait ability of patients with chronic stroke. Material/Methods Twenty-five patients with chronic stroke were randomly allocated into the VRRT group (n=13) and the control group (n=12). The participants in both groups performed a conventional rehabilitation program for 30 minutes. The VRRT group also performed a VRRT program for 30 minutes, five times a week for 4 weeks. The control group performed conventional rehabilitation program and a placebo VRRT program. Outcome measures included Berg Balance Scale (BBS), the Functional Reaching Test (FRT), and the Timed Up and Go (TUG) test (for dynamic balance ability), postural sway (for static balance ability), and 10 meter walking velocity (10 mWV) for gait ability. Results There were statistically significant improvements in the VRRT group compared with the control group for BBS, FRT, TUG, postural sway (mediolateral sway distance with eyes open and eyes closed, anteroposterior and total sway distance with eyes open but not with eyes closed), and 10 mWV (p<0.05). Conclusions Applying VRRT (even as a home treatment) along with a conventional rehabilitation program for patients with chronic stroke might be even more beneficial than conventional rehabilitation program alone in improving affected lower limb function. Future studies should investigate the effectiveness of VRRT with optimal patient selection, and duration and intensity of training. PMID:27791207

Study on an advanced early rehabilitation training system for postural control using a tilting bed

NASA Astrophysics Data System (ADS)

Yu, Chang-Ho; Kim, Kyong; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

2005-12-01

It proposed a new early rehabilitation training system for postural control using a tilting bed, a visual display and a force plate. The conventional rehabilitation systems for postural control can't be applied to the patients lying in bed because the rehabilitation training using those systems is only possible when the patient can stand up by himself or herself. Moreover, there did not exist any device that could provide the sense of balance or the sensation of walking to the patients in bed. The software for the system consists of the training program and the analysis program. The training program was designed to improve the ability of postural control of the subjects by repeated training of moving the center of pressure (COP) applied to the forceplate. The training program consists of the COP maintaining training and the COP movement training in horizontal, vertical, 45° and -45° directions. The analysis program consists of the COP moving time analysis modules, the COP maintaining time analysis module. Through the experiments with real people, it verified the effectiveness of the new early rehabilitation training system. The results showe that this system is an effective system for early rehabilitation training and that our system might be useful as clinical equipment.

Should high-power posing be integrated in physical therapy?

PubMed

Ge, Weiqing; Bennett, Teale K; Oller, Jeremy C

2017-04-01

[Purpose] Postural assessment and correction is a common approach in patient management to decrease symptoms and improve function for patients. The purpose of this study was to determine the effects of high-power posing on muscle strength and pain threshold. [Subjects and Methods] Thirty-one subjects, 16 females and 15 males, mean age 28.9 (SD 10.8) years old, were recruited through a convenience sampling on the university campus. The research design was a randomized controlled trial. In the experimental group, the subjects were instructed to stand in a high-power posture. In the control group, the subjects were instructed to stand in a low-power posture. Grip strength and pain threshold measurements were conducted before and after the postural intervention. [Results] The grip strength changed by -3.4 (-3.7, 0.3) % and 1.7 (-3.6, 5.3) % for the experimental and control groups, respectively. The pain threshold changed by 0.6 (-9.9, 10.4) % and 15.1 (-9.3, 24.4) % for the experimental and control groups, respectively. However, both changes were not significant as all the 95% CIs included 0. [Conclusions] The data did not show significant benefits of high-power posing in increasing grip strength and pain threshold compared to low-power posing.

Should high-power posing be integrated in physical therapy?

PubMed Central

Ge, Weiqing; Bennett, Teale K.; Oller, Jeremy C.

2017-01-01

[Purpose] Postural assessment and correction is a common approach in patient management to decrease symptoms and improve function for patients. The purpose of this study was to determine the effects of high-power posing on muscle strength and pain threshold. [Subjects and Methods] Thirty-one subjects, 16 females and 15 males, mean age 28.9 (SD 10.8) years old, were recruited through a convenience sampling on the university campus. The research design was a randomized controlled trial. In the experimental group, the subjects were instructed to stand in a high-power posture. In the control group, the subjects were instructed to stand in a low-power posture. Grip strength and pain threshold measurements were conducted before and after the postural intervention. [Results] The grip strength changed by −3.4 (−3.7, 0.3) % and 1.7 (−3.6, 5.3) % for the experimental and control groups, respectively. The pain threshold changed by 0.6 (−9.9, 10.4) % and 15.1 (−9.3, 24.4) % for the experimental and control groups, respectively. However, both changes were not significant as all the 95% CIs included 0. [Conclusions] The data did not show significant benefits of high-power posing in increasing grip strength and pain threshold compared to low-power posing. PMID:28533612

Back posture education in elementary schoolchildren: stability of two-year intervention effects.

PubMed

Geldhof, E; Cardon, G; De Bourdeaudhuij, I; De Clercq, D

2007-09-01

The study's first objective was to evaluate class teachers' efforts to promote good body mechanics after a structured back education program was finished and to evaluate whether their support during follow-up resulted in better intervention effects at 1-year follow-up. Secondary, the stability of intervention effects on children's back posture knowledge, fear-avoidance beliefs and back pain reports following a 2-school-year multi-factorial back education program was evaluated at 1-year follow-up. An additional focus was put on what young children learned about good body mechanics in the obligatory school curriculum compared to intensive back posture promotion. The quasi-experimental study included at baseline 398 elementary schoolchildren aged 8-11 years. The back education program consisted of 13 h back education and the stimulation of postural dynamism in the class through support and environmental changes lasting 2 school-years. Controls received the obligatory curriculum, not including back education. Evaluation consisted of a questionnaire, which was filled out by 121 intervention children and 124 controls at baseline, post-test and follow-up. Teachers were interviewed at the end of the follow-up school-year. Teachers continued with initiatives to increase postural dynamism in the class when they had been instructed about that matter. However, teachers' efforts to continue the promotion of good body mechanics showed no additional effect on children's knowledge. Improved back posture knowledge demonstrated stability at 1-year follow-up. Whereas the obligatory curriculum provided children with fundamental postural knowledge, the back posture program added important aspects. Fear-avoidance beliefs and self-reported pain were not increased at 1-year follow-up. The stable intervention effects point out that intensive implementation of a structured multifactorial back education program in the elementary school curriculum is effective.

Effect of mat pilates exercise on postural alignment and body composition of middle-aged women

PubMed Central

Lee, Hyo Taek; Oh, Hyun Ok; Han, Hui Seung; Jin, Kwang Youn; Roh, Hyo Lyun

2016-01-01

[Purpose] This study attempted to examine whether Pilates is an effective exercise for improving the postural alignment and health of middle-aged women. [Subjects and Methods] The participants in this study were 36 middle-aged women (20 in the experimental group, 16 in the control group). The experimental group participated in Pilates exercise sessions three times a week for 12 weeks. Body alignment and composition measurements before and after applying the Pilates exercise program were performed with a body composition analyzer and a three-dimensional scanner. [Results] Postural alignment in the sagittal and horizontal planes was enhanced in the Pilates exercise group. Trunk alignment showed correlations with body fat and muscle mass. [Conclusion] The Pilates exercises are performed symmetrically and strengthen the deep muscles. Moreover, the results showed that muscle mass was correlated with trunk postural alignment and that the proper amount of muscle is critical in maintaining trunk postural alignment. PMID:27390396

Effects of physical training on age-related balance and postural control.

PubMed

Lelard, T; Ahmaidi, S

2015-11-01

In this paper, we review the effects of physical activity on balance performance in the elderly. The increase in the incidence of falls with age reflects the disorders of balance-related to aging. We are particularly interested in age-related changes in the balance control system as reflected in different static and dynamic balance tests. We report the results of studies demonstrating the beneficial effects of physical activity on postural balance. By comparing groups of practitioners of different physical activities, it appears that these effects on postural control depend on the type of activity and the time of practice. Thus, we have focused in the present review on "proprioceptive" and "strength" activities. Training programs offering a combination of several activities have demonstrated beneficial effects on the incidence of falls, and we present and compare the effects of these two types of training activities. It emerges that there are differential effects of programs of activities: while all activities improve participants' confidence in their ability, the "proprioceptive" activities rather improve performance in static tasks, while "strength" activities tend to improve performance in dynamic tasks. These effects depend on the targeted population and will have a greater impact on the frailest subjects. The use of new technologies in the form of "exergames" may also be proposed in home-based exercises. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Exergaming and Static Postural Control in Individuals With a History of Lower Limb Injury

PubMed Central

Sims, Jennifer; Cosby, Nicole; Saliba, Ethan N.; Hertel, Jay; Saliba, Susan A.

2013-01-01

Context: Therapeutic exercise programs that incorporate real-time feedback have been reported to enhance outcomes in patients with lower extremity joint injuries. The Wii Fit has been purported to improve balance, strength, flexibility, and fitness. Objective: To determine the effects of Wii Fit rehabilitation on postural control and self-reported function in patients with a history of lower limb injury. Design: Single-blinded, randomized controlled trial. Setting: Laboratory. Patients or Other Participants: Twenty-eight physically active participants with a history of lower limb injuries were randomly assigned to 1 of 3 groups (9 Wii Fit, 10 traditional, 9 control). Intervention(s): Intervention groups performed supervised rehabilitation 3 d/wk for a total of 12 sessions. Main Outcome Measure(s): Time to boundary (TTB) and the Star Excursion Balance Test (SEBT) were conducted at baseline, 2 weeks, and 4 weeks. Self-reported function was measured at baseline and 4-week follow-up. Between-groups differences were compared using repeated-measures multivariate analysis of variance. Results: With the eyes open, both intervention groups improved (P < .05) in the mean and the SD of the TTB anterior-posterior minima. In the eyes-closed condition, a time main effect (P < .05) for absolute TTB medial-lateral minima was observed. A time main effect was also noted in the posteromedial and posterolateral reach directions of the SEBT. When the scores for each group were pooled, improvement (P < .05) in self-reported function was demonstrated at 4-week follow-up. Conclusions: Rehabilitation using the Wii Fit and traditional exercises improved static postural control in patients with a history of lower extremity injury. PMID:23675790

How Plantar Exteroceptive Efficiency Modulates Postural and Oculomotor Control: Inter-Individual Variability.

PubMed

Foisy, Arnaud; Kapoula, Zoï

2016-01-01

In a previous experiment, we showed that among young and healthy subjects, thin plantar inserts improve postural control and modify vergence amplitudes. In this experiment, however, significant inter-individual variability was observed. We hypothesize that its origin could be attributed to a different reliance upon feet cutaneous afferents. In order to test this hypothesis, we re-analyzed the data relative to 31 young (age 25.7 ± 3.8) and healthy subjects who participated in the first experiment after having classified them into two groups depending on their Plantar Quotient (PQ = Surface area of CoPfoam/Surface area of CoPfirm ground × 100). Foam decreases the information arising from the feet, normally resulting in a PQ > 100. Hence, the PQ provides information on the weight of plantar cutaneous afferents used in postural control. Twelve people were Plantar-Independent Subjects, as indicated by a PQ < 100. These individuals did not behave like the Normal Plantar Quotient Subjects: they were almost insensitive to the plantar stimulations in terms of postural control and totally insensitive in terms of oculomotor control. We conclude that the inter-individual variability observed in our first experiment is explained by the subjects' degree of plantar reliance. We propose that plantar independence is a dysfunctional situation revealing inefficiency in plantar cutaneous afferents. The latter could be due to a latent somatosensory dysfunction generating a noise which prevents the CNS from correctly processing and using feet somatosensory afferents both for balance and vergence control: Plantar Irritating Stimulus. Considering the non-noxious nature and prevalence of this phenomenon, these results can be of great interest to researchers and clinicians who attempt to trigger postural or oculomotor responses through mechanical stimulation of the foot sole.

Neural basis of postural focus effect on concurrent postural and motor tasks: phase-locked electroencephalogram responses.

PubMed

Huang, Cheng-Ya; Zhao, Chen-Guang; Hwang, Ing-Shiou

2014-11-01

Dual-task performance is strongly affected by the direction of attentional focus. This study investigated neural control of a postural-suprapostural procedure when postural focus strategy varied. Twelve adults concurrently conducted force-matching and maintained stabilometer stance with visual feedback on ankle movement (visual internal focus, VIF) and on stabilometer movement (visual external focus, VEF). Force-matching error, dynamics of ankle and stabilometer movements, and event-related potentials (ERPs) were registered. Postural control with VEF caused superior force-matching performance, more complex ankle movement, and stronger kinematic coupling between the ankle and stabilometer movements than postural control with VIF. The postural focus strategy also altered ERP temporal-spatial patterns. Postural control with VEF resulted in later N1 with less negativity around the bilateral fronto-central and contralateral sensorimotor areas, earlier P2 deflection with more positivity around the bilateral fronto-central and ipsilateral temporal areas, and late movement-related potential commencing in the left frontal-central area, as compared with postural control with VIF. The time-frequency distribution of the ERP principal component revealed phase-locked neural oscillations in the delta (1-4Hz), theta (4-7Hz), and beta (13-35Hz) rhythms. The delta and theta rhythms were more pronounced prior to the timing of P2 positive deflection, and beta rebound was greater after the completion of force-matching in VEF condition than VIF condition. This study is the first to reveal the neural correlation of postural focusing effect on a postural-suprapostural task. Postural control with VEF takes advantage of efficient task-switching to facilitate autonomous postural response, in agreement with the "constrained-action" hypothesis. Copyright © 2014 Elsevier B.V. All rights reserved.

Standing Postural Control in Individuals with Autism Spectrum Disorder: Systematic Review and Meta-Analysis

ERIC Educational Resources Information Center

Lim, Yi Huey; Partridge, Katie; Girdler, Sonya; Morris, Susan L.

2017-01-01

Impairments in postural control affect the development of motor and social skills in individuals with autism spectrum disorder (ASD). This review compared the effect of different sensory conditions on static standing postural control between ASD and neurotypical individuals. Results from 19 studies indicated a large difference in postural control…

Postural perturbations: new insights for treatment of balance disorders

NASA Technical Reports Server (NTRS)

Horak, F. B.; Henry, S. M.; Shumway-Cook, A.; Peterson, B. W. (Principal Investigator)

1997-01-01

This article reviews the neural control of posture as understood through studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new view of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implications for rehabilitation of balance disorders and demonstrate how an understanding of the specific systems underlying postural control can help to focus and enrich our therapeutic approaches. By understanding the basic systems underlying control of balance, such as strategy selection, rapid latencies, coordinated temporal spatial patterns, force control, and context-specific adaptations, therapists can focus their treatment on each patient's specific impairments. Research on postural responses to surface translations has shown that balance is not based on a fixed set of equilibrium reflexes but on a flexible, functional motor skill that can adapt with training and experience. More research is needed to determine the extent to which quantification of automatic postural responses has practical implications for predicting falls in patients with constraints in their postural control system.

Report: EPA’s Radiation and Indoor Environments National Laboratory Should Improve Its Computer Room Security Controls

EPA Pesticide Factsheets

Report #12-P-0847, September 21, 2012.Our review of the security posture and in-place environmental controls of EPA’s Radiation and Indoor Environments National Laboratory computer room disclosed an array of security and environmental control deficiencies.

Virtual Reality Telerehabilitation for Postural Instability in Parkinson's Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial

PubMed Central

Geroin, Christian; Dimitrova, Eleonora; Boldrini, Paolo; Waldner, Andreas; Bonadiman, Silvia; Regazzo, Sara; Stirbu, Elena; Primon, Daniela; Bosello, Christian; Gravina, Aristide Roberto; Peron, Luca; Trevisan, Monica; Garcia, Alberto Carreño; Menel, Alessia; Bloccari, Laura; Valè, Nicola; Saltuari, Leopold; Tinazzi, Michele

2017-01-01

Introduction Telerehabilitation enables patients to access remote rehabilitation services for patient-physiotherapist videoconferencing in their own homes. Home-based virtual reality (VR) balance training has been shown to reduce postural instability in patients with Parkinson's disease (PD). The primary aim was to compare improvements in postural stability after remotely supervised in-home VR balance training and in-clinic sensory integration balance training (SIBT). Methods In this multicenter study, 76 PD patients (modified Hoehn and Yahr stages 2.5–3) were randomly assigned to receive either in-home VR telerehabilitation (n = 38) or in-clinic SIBT (n = 38) in 21 sessions of 50 minutes each, 3 days/week for 7 consecutive weeks. VR telerehabilitation consisted of graded exergames using the Nintendo Wii Fit system; SIBT included exercises to improve postural stability. Patients were evaluated before treatment, after treatment, and at 1-month follow-up. Results Analysis revealed significant between-group differences in improvement on the Berg Balance Scale for the VR telerehabilitation group (p = 0.04) and significant Time × Group interactions in the Dynamic Gait Index (p = 0.04) for the in-clinic group. Both groups showed differences in all outcome measures over time, except for fall frequency. Cost comparison yielded between-group differences in treatment and equipment costs. Conclusions VR is a feasible alternative to in-clinic SIBT for reducing postural instability in PD patients having a caregiver. PMID:29333454

A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease

PubMed Central

Saengsirisuwan, Vitoon; Carlson-Kuhta, Patricia; Horak, Fay B.

2012-01-01

Background Little is known about the effects of use of a cane on balance during perturbed gait or whether people with Parkinson disease (PD) benefit from using a cane. Objectives The purpose of this study was to evaluate the effects of cane use on postural recovery from a slip due to repeated surface perturbations in individuals with PD compared with age- and sex-matched individuals who were healthy. Design This was a prospective study with 2 groups of participants. Methods Fourteen individuals with PD (PD group) and 11 individuals without PD (control group) walked across a platform that translated 15 cm rightward at 30 cm/s during the single-limb support phase of the right foot. Data from 15 trials in 2 conditions (ie, with and without an instrumented cane in the right hand) were collected in random order. Outcome measures included lateral displacement of body center of mass (COM) due to the slip and compensatory step width and length after the perturbation. Results Cane use improved postural recovery from the first untrained slip, characterized by smaller lateral COM displacement, in the PD group but not in the control group. The beneficial effect of cane use, however, occurred only during the first perturbation, and those individuals in the PD group who demonstrated the largest COM displacement without a cane benefited the most from use of a cane. Both PD and control groups gradually decreased lateral COM displacement across slip exposures, but a slower learning rate was evident in the PD group participants, who required 6, rather than 3, trials for adapting balance recovery. Limitations Future studies are needed to examine the long-term effects of repeated slip training in people with PD. Conclusions Use of a cane improved postural recovery from an unpracticed slip in individuals with PD. Balance in people with PD can be improved by training with repeated exposures to perturbations. PMID:22628583

A cane improves postural recovery from an unpracticed slip during walking in people with Parkinson disease.

PubMed

Boonsinsukh, Rumpa; Saengsirisuwan, Vitoon; Carlson-Kuhta, Patricia; Horak, Fay B

2012-09-01

Little is known about the effects of use of a cane on balance during perturbed gait or whether people with Parkinson disease (PD) benefit from using a cane. The purpose of this study was to evaluate the effects of cane use on postural recovery from a slip due to repeated surface perturbations in individuals with PD compared with age- and sex-matched individuals who were healthy. This was a prospective study with 2 groups of participants. Fourteen individuals with PD (PD group) and 11 individuals without PD (control group) walked across a platform that translated 15 cm rightward at 30 cm/s during the single-limb support phase of the right foot. Data from 15 trials in 2 conditions (ie, with and without an instrumented cane in the right hand) were collected in random order. Outcome measures included lateral displacement of body center of mass (COM) due to the slip and compensatory step width and length after the perturbation. Cane use improved postural recovery from the first untrained slip, characterized by smaller lateral COM displacement, in the PD group but not in the control group. The beneficial effect of cane use, however, occurred only during the first perturbation, and those individuals in the PD group who demonstrated the largest COM displacement without a cane benefited the most from use of a cane. Both PD and control groups gradually decreased lateral COM displacement across slip exposures, but a slower learning rate was evident in the PD group participants, who required 6, rather than 3, trials for adapting balance recovery. Future studies are needed to examine the long-term effects of repeated slip training in people with PD. Use of a cane improved postural recovery from an unpracticed slip in individuals with PD. Balance in people with PD can be improved by training with repeated exposures to perturbations.

Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial.

PubMed

Martínez-Amat, Antonio; Hita-Contreras, Fidel; Lomas-Vega, Rafael; Caballero-Martínez, Isabel; Alvarez, Pablo J; Martínez-López, Emilio

2013-08-01

The purpose of this study was to evaluate the effect of a 12-week-specific proprioceptive training program on postural stability, gait, balance, and fall prevention in adults older than 65 years. The present study was a controlled clinical trial. Forty-four community dwelling elderly subjects (61-90 years; mean age, 78.07 ± 5.7 years) divided into experimental (n = 20) and control (n = 24) groups. The participants performed the Berg balance test before and after the training program, and we assessed participants' gait, balance, and the risk of falling, using the Tinetti scale. Medial-lateral plane and anterior-posterior plane displacements of the center of pressure, Sway area, length and speed, and the Romberg quotient about surface, speed, and distance were calculated in static posturography analysis (EPS pressure platform) under 2 conditions: eyes open and eyes closed. After a first clinical evaluation, patients were submitted to 12 weeks proprioception training program, 2 sessions of 50 minutes every week. This program includes 6 exercises with the BOSU and Swiss ball as unstable training tools that were designed to program proprioceptive training. The training program improved postural balance of older adults in mediolateral plane with eyes open (p < 0.05) and anterior-posterior plane with eyes closed (p < 0.01). Significant improvements were observed in Romberg quotient about surface (p < 0.05) and speed (p < 0.01) but not about distance (p > 0.05). After proprioception training, gait (Tinetti), and balance (Berg) test scores improved 14.66% and 11.47% respectively. These results show that 12 weeks proprioception training program in older adults is effective in postural stability, static, and dynamic balance and could lead to an improvement in gait and balance capacity, and to a decrease in the risk of falling in adults aged 65 years and older.

The effects of feedback on computer workstation posture habits.

PubMed

Epstein, Rhonda; Colford, Sean; Epstein, Ethan; Loye, Brandon; Walsh, Michael

2012-01-01

Repetitive stress injuries (RSI) and musculoskeletal disorders in the United States and worldwide are increasing at an alarming rate due to the advent of ubiquitous computer usage. Factors that lead to computer-related musculoskeletal disorders (MSD) include inadequately designed workstations, poor posture, and lack of knowledge about proper ergonomics and use habits. Studies have documented the negative impact of improper posture and the MSD seen in students and office workers due to frequent computer usage. Determine if the frequency (single vs. continuous reminder) and/or use of feedback affects posture at a computer workstation. Observations of posture habits were made in three local schools and one local company. Feedback effects were tested on the students (ages 10-15). Real time feedback was given in two studies. In one study, instructions and a verbal reminder were given to students and in a second study, a prototype 'Posture Pad' was developed to provide continuous feedback to the user. Verbal reminders to sit correctly led to transient improvement of posture. Use of the 'Posture Pad' resulted in significant improvement in posture with subjects exhibiting correct posture 98 ± 5% of the time. Real time feedback about how one is sitting is an effective mechanism for non-transient improvement of posture at computer workstations.

Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial.

PubMed

Mikó, Ibolya; Szerb, Imre; Szerb, Anna; Poor, Gyula

2017-02-01

To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.

Influences of arm proprioception and degrees of freedom on postural control with light touch feedback.

PubMed

Rabin, Ely; DiZio, Paul; Ventura, Joel; Lackner, James R

2008-02-01

Lightly touching a stable surface with one fingertip strongly stabilizes standing posture. The three main features of this phenomenon are fingertip contact forces maintained at levels too low to provide mechanical support, attenuation of postural sway relative to conditions without fingertip touch, and center of pressure (CP) lags changes in fingertip shear forces by approximately 250 ms. In the experiments presented here, we tested whether accurate arm proprioception and also whether the precision fingertip contact afforded by the arm's many degrees of freedom are necessary for postural stabilization by finger contact. In our first experiment, we perturbed arm proprioception and control with biceps brachii vibration (120-Hz, 2-mm amplitude). This degraded postural control, resulting in greater postural sway amplitudes. In a second study, we immobilized the touching arm with a splint. This prevented precision fingertip contact but had no effect on postural sway amplitude. In both experiments, the correlation and latency of fingertip contact forces to postural sway were unaffected. We conclude that postural control is executed based on information about arm orientation as well as tactile feedback from light touch, although precision fingertip contact is not essential. The consistent correlation and timing of CP movement and fingertip forces across conditions in which postural sway amplitude and fingertip contact are differentially disrupted suggests posture and the fingertip are controlled in parallel with feedback from the fingertip in this task.

Management of postural sensory conflict and dynamic balance control in late-stage Parkinson's disease.

PubMed

Colnat-Coulbois, S; Gauchard, G C; Maillard, L; Barroche, G; Vespignani, H; Auque, J; Perrin, P P

2011-10-13

Parkinson's disease (PD) is known to affect postural control, especially in situations needing a change in balance strategy or when a concurrent task is simultaneously performed. However, few studies assessing postural control in patients with PD included homogeneous population in late stage of the disease. Thus, this study aimed to analyse postural control and strategies in a homogeneous population of patients with idiopathic advanced (late-stage) PD, and to determine the contribution of peripheral inputs in simple and more complex postural tasks, such as sensory conflicting and dynamic tasks. Twenty-four subjects with advanced PD (duration: median (M)=11.0 years, interquartile range (IQR)=4.3 years; Unified Parkinson's Disease Rating Scale (UPDRS): M "on-dopa"=13.5, IQR=7.8; UPDRS: M "off-dopa"=48.5, IQR=16.8; Hoehn and Yahr stage IV in all patients) and 48 age-matched healthy controls underwent static (SPT) and dynamic posturographic (DPT) tests and a sensory organization test (SOT). In SPT, patients with PD showed reduced postural control precision with increased oscillations in both anterior-posterior and medial-lateral planes. In SOT, patients with PD displayed reduced postural performances especially in situations in which visual and vestibular cues became predominant to organize balance control, as was the ability to manage balance in situations for which visual or proprioceptive inputs are disrupted. In DPT, postural restabilization strategies were often inefficient to maintain equilibrium resulting in falls. Postural strategies were often precarious, postural regulation involving more hip joint than ankle joint in patients with advanced PD than in controls. Difficulties in managing complex postural situations, such as sensory conflicting and dynamic situations might reflect an inadequate sensory organization suggesting impairment in central information processing. Copyright © 2011. Published by Elsevier Ltd.

Relationships between trunk performance, gait and postural control in persons with multiple sclerosis.

PubMed

Freund, Jane E; Stetts, Deborah M; Vallabhajosula, Srikant

2016-06-30

Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system. Compared to healthy individuals, persons with multiple sclerosis (PwMS) have increased postural sway in quiet stance, decreased gait speed and increased fall incidence. Trunk performance has been implicated in postural control, gait dysfunction, and fall prevention in older adults. However, the relationship of trunk performance to postural control and gait has not been adequately studied in PwMS. To compare trunk muscle structure and performance in PwMS to healthy age and gendered-matched controls (HC); to determine the effects of isometric trunk endurance testing on postural control in both populations; and to determine the relationship of trunk performance with postural control, gait and step activity in PwMS. Fifteen PwMS and HC completed ultrasound imaging of trunk muscles, 10 m walk test, isometric trunk endurance tests, and postural sway test. Participants wore a step activity monitor for 7 days. PwMS had worse isometric trunk endurance compared to HC. PwMS trunk flexion endurance negatively correlated to several postural control measures and positively correlated to gait speed and step activity. Clinicians should consider evaluation and interventions directed at impaired trunk endurance in PwMS.

Individual differences in brainstem and basal ganglia structure predict postural control and balance loss in young and older adults.

PubMed

Boisgontier, Matthieu P; Cheval, Boris; Chalavi, Sima; van Ruitenbeek, Peter; Leunissen, Inge; Levin, Oron; Nieuwboer, Alice; Swinnen, Stephan P

2017-02-01

It remains unclear which specific brain regions are the most critical for human postural control and balance, and whether they mediate the effect of age. Here, associations between postural performance and corticosubcortical brain regions were examined in young and older adults using multiple structural imaging and linear mixed models. Results showed that of the regions involved in posture, the brainstem was the strongest predictor of postural control and balance: lower brainstem volume predicted larger center of pressure deviation and higher odds of balance loss. Analyses of white and gray matter in the brainstem showed that the pedunculopontine nucleus area appeared to be critical for postural control in both young and older adults. In addition, the brainstem mediated the effect of age on postural control, underscoring the brainstem's fundamental role in aging. Conversely, lower basal ganglia volume predicted better postural performance, suggesting an association between greater neural resources in the basal ganglia and greater movement vigor, resulting in exaggerated postural adjustments. Finally, results showed that practice, shorter height and heavier weight (i.e., higher body mass index), higher total physical activity, and larger ankle active (but not passive) range of motion were predictive of more stable posture, irrespective of age. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of a classroom-based behavioral intervention package on the improvement of children's sitting posture in Japan.

PubMed

Noda, Wataru; Tanaka-Matsumi, Junko

2009-03-01

The present study evaluates the effect of a classroom-based behavioral intervention package to improve Japanese elementary school children's sitting posture in regular classrooms (N=68). This study uses a multiple-baseline design across two classrooms with a modified repeated reversal within each class. The article defines appropriate sitting posture as behavior composed of four components (feet, buttocks, back, and a whole body). The intervention package includes modeling, correspondence training, prompt, and reinforcement, among others. The authors counted the number of children with appropriate sitting posture in each classroom across all 28 sessions throughout the study. Interobserver agreement of appropriate sitting posture ranged from 80% to 100%. As a result of the intervention, the mean proportion of children with appropriate posture increased from approximately 20% to 90%. In addition, their academic writing productivity increased with the improved sitting posture. Teachers' acceptance of the intervention program proved to be excellent.

The Association between Hearing Loss, Postural Control, and Mobility in Older Adults: A Systematic Review.

PubMed

Agmon, Maayan; Lavie, Limor; Doumas, Michail

2017-06-01

Degraded hearing in older adults has been associated with reduced postural control and higher risk of falls. Both hearing loss (HL) and falls have dramatic effects on older persons' quality of life (QoL). A large body of research explored the comorbidity between the two domains. The aim of the current review is to describe the comorbidity between HL and objective measures of postural control, to offer potential mechanisms underlying this relationship, and to discuss the clinical implications of this comorbidity. PubMed and Google Scholar were systematically searched for articles published in English up until October 15, 2015, using combinations of the following strings and search words: for hearing: Hearing loss, "Hearing loss," hearing, presbycusis; for postural control: postural control, gait, postural balance, fall, walking; and for age: elderly, older adults. Of 211 screened articles, 7 were included in the systematic review. A significant, positive association between HL and several objective measures of postural control was found in all seven studies, even after controlling for major covariates. Severity of hearing impairment was connected to higher prevalence of difficulties in walking and falls. Physiological, cognitive, and behavioral processes that may influence auditory system and postural control were suggested as potential explanations for the association between HL and postural control. There is evidence for the independent relationship between HL and objective measures of postural control in the elderly. However, a more comprehensive understanding of the mechanisms underlying this relationship is yet to be elucidated. Concurrent diagnosis, treatment, and rehabilitation of these two modalities may reduce falls and increase QoL in older adults. American Academy of Audiology

Pilot study comparing changes in postural control after training using a video game balance board program and 2 standard activity-based balance intervention programs.

PubMed

Pluchino, Alessandra; Lee, Sae Yong; Asfour, Shihab; Roos, Bernard A; Signorile, Joseph F

2012-07-01

To compare the impacts of Tai Chi, a standard balance exercise program, and a video game balance board program on postural control and perceived falls risk. Randomized controlled trial. Research laboratory. Independent seniors (N=40; 72.5±8.40) began the training, 27 completed. Tai Chi, a standard balance exercise program, and a video game balance board program. The following were used as measures: Timed Up & Go, One-Leg Stance, functional reach, Tinetti Performance Oriented Mobility Assessment, force plate center of pressure (COP) and time to boundary, dynamic posturography (DP), Falls Risk for Older People-Community Setting, and Falls Efficacy Scale. No significant differences were seen between groups for any outcome measures at baseline, nor were significant time or group × time differences for any field test or questionnaire. No group × time differences were seen for any COP measures; however, significant time differences were seen for total COP, 3 of 4 anterior/posterior displacement and both velocity, and 1 displacement and 1 velocity medial/lateral measure across time for the entire sample. For DP, significant improvements in the overall score (dynamic movement analysis score), and in 2 of the 3 linear and angular measures were seen for the sample. The video game balance board program, which can be performed at home, was as effective as Tai Chi and the standard balance exercise program in improving postural control and balance dictated by the force plate postural sway and DP measures. This finding may have implications for exercise adherence because the at-home nature of the intervention eliminates many obstacles to exercise training. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Auditory biofeedback substitutes for loss of sensory information in maintaining stance.

PubMed

Dozza, Marco; Horak, Fay B; Chiari, Lorenzo

2007-03-01

The importance of sensory feedback for postural control in stance is evident from the balance improvements occurring when sensory information from the vestibular, somatosensory, and visual systems is available. However, the extent to which also audio-biofeedback (ABF) information can improve balance has not been determined. It is also unknown why additional artificial sensory feedback is more effective for some subjects than others and in some environmental contexts than others. The aim of this study was to determine the relative effectiveness of an ABF system to reduce postural sway in stance in healthy control subjects and in subjects with bilateral vestibular loss, under conditions of reduced vestibular, visual, and somatosensory inputs. This ABF system used a threshold region and non-linear scaling parameters customized for each individual, to provide subjects with pitch and volume coding of their body sway. ABF had the largest effect on reducing the body sway of the subjects with bilateral vestibular loss when the environment provided limited visual and somatosensory information; it had the smallest effect on reducing the sway of subjects with bilateral vestibular loss, when the environment provided full somatosensory information. The extent that all subjects substituted ABF information for their loss of sensory information was related to the extent that each subject was visually dependent or somatosensory-dependent for their postural control. Comparison of postural sway under a variety of sensory conditions suggests that patients with profound bilateral loss of vestibular function show larger than normal information redundancy among the remaining senses and ABF of trunk sway. The results support the hypothesis that the nervous system uses augmented sensory information differently depending both on the environment and on individual proclivities to rely on vestibular, somatosensory or visual information to control sway.

Obesity Impact on the Attentional Cost for Controlling Posture

PubMed Central

Mignardot, Jean-Baptiste; Olivier, Isabelle; Promayon, Emmanuel; Nougier, Vincent

2010-01-01

Background This study investigated the effects of obesity on attentional resources allocated to postural control in seating and unipedal standing. Methods Ten non obese adults (BMI = 22.4±1.3, age = 42.4±15.1) and 10 obese adult patients (BMI = 35.2±2.8, age = 46.2±19.6) maintained postural stability on a force platform in two postural tasks (seated and unipedal). The two postural tasks were performed (1) alone and (2) in a dual-task paradigm in combination with an auditory reaction time task (RT). Performing the RT task together with the postural one was supposed to require some attentional resources that allowed estimating the attentional cost of postural control. 4 trials were performed in each condition for a total of 16 trials. Findings (1) Whereas seated non obese and obese patients exhibited similar centre of foot pressure oscillations (CoP), in the unipedal stance only obese patients strongly increased their CoP sway in comparison to controls. (2) Whatever the postural task, the additional RT task did not affect postural stability. (3) Seated, RT did not differ between the two groups. (4) RT strongly increased between the two postural conditions in the obese patients only, suggesting that body schema and the use of internal models was altered with obesity. Interpretation Obese patients needed more attentional resources to control postural stability during unipedal stance than non obese participants. This was not the case in a more simple posture such as seating. To reduce the risk of fall as indicated by the critical values of CoP displacement, obese patients must dedicate a strong large part of their attentional resources to postural control, to the detriment of non-postural events. Obese patients were not able to easily perform multitasking as healthy adults do, reflecting weakened psycho-motor abilities. PMID:21187914

Characterization of postural control impairment in women with fibromyalgia

PubMed Central

Sempere-Rubio, Núria; López-Pascual, Juan; Aguilar-Rodríguez, Marta; Cortés-Amador, Sara; Espí-López, Gemma; Villarrasa-Sapiña, Israel

2018-01-01

The main goal of this cross-sectional study was to detect whether women with fibromyalgia syndrome (FMS) have altered postural control and to study the sensory contribution to postural control. We also explored the possibility that self-induced anxiety and lower limb strength may be related to postural control. For this purpose, 129 women within an age range of 40 to 70 years were enrolled. Eighty of the enrolled women had FMS. Postural control variables, such as Ellipse, Root mean square (RMS) and Sample entropy (SampEn), in both directions (i.e. mediolateral and anteroposterior), were calculated under five different conditions. A force plate was used to register the center of pressure shifts. Furthermore, isometric lower limb strength was recorded with a portable dynamometer and normalized by lean body mass. The results showed that women with FMS have impaired postural control compared with healthy people, as they presented a significant increase in Ellipse and RMS values (p<0.05) and a significant decrease in SampEn in both directions (p<0.05). Postural control also worsens with the gradual alteration of sensory inputs in this population (p<0.05). Performing a stressor dual task only impacts Ellipse in women with FMS (p>0.05). There were no significant correlations between postural control and lower limb strength (p>0.05). Therefore, women with FMS have impaired postural control that is worse when sensory inputs are altered but is not correlated with their lower limb strength. PMID:29723223

The effect of visual-vestibulosomatosensory conflict induced by virtual reality on postural stability in humans.

PubMed

Nishiike, Suetaka; Okazaki, Suzuyo; Watanabe, Hiroshi; Akizuki, Hironori; Imai, Takao; Uno, Atsuhiko; Kitahara, Tadashi; Horii, Arata; Takeda, Noriaki; Inohara, Hidenori

2013-01-01

In this study, we examined the effects of sensory inputs of visual-vestibulosomatosensory conflict induced by virtual reality (VR) on subjective dizziness, posture stability and visual dependency on postural control in humans. Eleven healthy young volunteers were immersed in two different VR conditions. In the control condition, subjects walked voluntarily with the background images of interactive computer graphics proportionally synchronized to their walking pace. In the visual-vestibulosomatosensory conflict condition, subjects kept still, but the background images that subjects experienced in the control condition were presented. The scores of both Graybiel's and Hamilton's criteria, postural instability and Romberg ratio were measured before and after the two conditions. After immersion in the conflict condition, both subjective dizziness and objective postural instability were significantly increased, and Romberg ratio, an index of the visual dependency on postural control, was slightly decreased. These findings suggest that sensory inputs of visual-vestibulosomatosensory conflict induced by VR induced motion sickness, resulting in subjective dizziness and postural instability. They also suggest that adaptation to the conflict condition decreases the contribution of visual inputs to postural control with re-weighing of vestibulosomatosensory inputs. VR may be used as a rehabilitation tool for dizzy patients by its ability to induce sensory re-weighing of postural control.

Relationship between antigravity control and postural control in young children.

PubMed

Sellers, J S

1988-04-01

The purposes of this study were 1) to determine the relationship between antigravity control (supine flexion and prone extension) and postural control (static and dynamic balance), 2) to determine the quality of antigravity and postural control, and 3) to determine whether sex and ethnic group differences correlate with differences in antigravity control and postural control in young children. I tested 107 black, Hispanic, and Caucasian children in a Head Start program, with a mean age of 61 months. The study results showed significant relationships between antigravity control and postural control. Subjects' supine flexion performance was significantly related to the quantity and quality of their static and dynamic balance performance, whereas prone extension performance was related only to the quality of dynamic balance performance. Quality scale measurements (r = .90) indicated that the children in this study had not yet developed full antigravity or postural control. The study results revealed differences between sexes in the quality of static balance and prone extension performance and ethnic differences in static balance, dynamic balance, and prone extension performance.

Strength and coordination training are both effective in reducing the postural tremor amplitude of older adults.

PubMed

Keogh, Justin W L; Morrison, Steve; Barrett, Rod

2010-01-01

The current study investigated the effect of 2 different types of unilateral resistance training on the postural tremor output of 19 neurologically healthy men age 70-80 yr. The strength- (n = 7) and coordination-training (n = 7) groups trained twice a week for 6 wk, performing dumbbell biceps curls, wrist flexions, and wrist extensions, while the control group (n = 5) maintained their normal activities. Changes in index-finger tremor (RMS amplitude, peak, and proportional power) and upper limb muscle coactivation were assessed during 4 postural conditions that were performed separately with the trained and untrained limbs. The 2 training groups experienced significantly greater reductions in mean RMS tremor amplitude, peak, and proportional tremor power 8-12 Hz and upper limb muscle coactivation, as well as greater increases in strength, than the control group. These results further demonstrate the benefits of resistance training for improving function in older adults.

Therapist-Designed Adaptive Riding in Children With Cerebral Palsy: Results of a Feasibility Study.

PubMed

Angsupaisal, Mattana; Visser, Baudina; Alkema, Anne; Meinsma-van der Tuin, Marja; Maathuis, Carel G B; Reinders-Messelink, Heleen; Hadders-Algra, Mijna

2015-08-01

It is debatable whether adaptive riding (AR) in children with cerebral palsy (CP) improves postural control and gross motor development. The study aim was to explore the feasibility of an extensive assessment protocol for a randomized controlled trial of therapist-designed adaptive riding (TDAR) in children with CP, with the goals of assessing the effect on child outcomes and evaluating working mechanisms of sitting postural control. A pretest-posttest group design with 2 baseline measurements was used. Six children (1 girl, 5 boys; age range=6-12 years, median age=8 years 9 months) with bilateral spastic CP (Gross Motor Function Classification System level III) participated. Outcomes were evaluated 3 times (T0, T1, and T2) at 6-week intervals. T0 and T1 were baseline measurements; between T1 and T2, a TDAR intervention including an integrated program of postural challenge exercises (2 times per week for 1 hour) was applied. The complex protocol included the 88-item Gross Motor Function Measure (GMFM-88) and electromyographic (EMG) recording of postural muscle activity during reaching while sitting (EMG recording at T1 and T2 only). The protocol was feasible. Median GMFM-88 scores changed from 64.4 at T0 to 66.7 at T1 and from 66.7 at T1 to 73.2 at T2. The change scores for all children exceeded the minimal clinically important difference of the GMFM-88. Five of 6 children showed a decrease in stereotyped top-down recruitment between T1 and T2. Study limitations included the lack of a control group, small sample size, and potential assessor bias for all but the EMG parameters. The feasibility of the complex protocol was established. The data suggested that a 6-week TDAR intervention may improve gross motor function and may reduce stereotyped postural adjustments in children with CP. The limited results warrant replication in a well-powered randomized controlled trial. © 2015 American Physical Therapy Association.

A new methodology based on functional principal component analysis to study postural stability post-stroke.

PubMed

Sánchez-Sánchez, M Luz; Belda-Lois, Juan-Manuel; Mena-Del Horno, Silvia; Viosca-Herrero, Enrique; Igual-Camacho, Celedonia; Gisbert-Morant, Beatriz

2018-05-05

A major goal in stroke rehabilitation is the establishment of more effective physical therapy techniques to recover postural stability. Functional Principal Component Analysis provides greater insight into recovery trends. However, when missing values exist, obtaining functional data presents some difficulties. The purpose of this study was to reveal an alternative technique for obtaining the Functional Principal Components without requiring the conversion to functional data beforehand and to investigate this methodology to determine the effect of specific physical therapy techniques in balance recovery trends in elderly subjects with hemiplegia post-stroke. A randomized controlled pilot trial was developed. Thirty inpatients post-stroke were included. Control and target groups were treated with the same conventional physical therapy protocol based on functional criteria, but specific techniques were added to the target group depending on the subjects' functional level. Postural stability during standing was quantified by posturography. The assessments were performed once a month from the moment the participants were able to stand up to six months post-stroke. The target group showed a significant improvement in postural control recovery trend six months after stroke that was not present in the control group. Some of the assessed parameters revealed significant differences between treatment groups (P < 0.05). The proposed methodology allows Functional Principal Component Analysis to be performed when data is scarce. Moreover, it allowed the dynamics of recovery of two different treatment groups to be determined, showing that the techniques added in the target group increased postural stability compared to the base protocol. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Effects of Pilates Training on Balance Control and Self-Reported Health Status in Community-Dwelling Older Adults: A Randomized Controlled Trial.

PubMed

Gabizon, Hadas; Press, Yan; Volkov, Ilia; Melzer, Itshak

2016-07-01

To evaluate the effect of a group-based Pilates training program on balance control and health status in healthy older adults. A single-blind, randomized, controlled trial. General community. A total of 88 community-dwelling older adults (age 71.15 ± 4.30 years), without evidence of functional balance impairment, were recruited and allocated at random to a Pilates intervention group (n = 44) or a control group (n = 44). The Pilates intervention group received 36 training sessions over three months (3 sessions a week), while the control group did not receive any intervention. Standing upright postural stability, performance-based measures of balance, and self-reported health status was assessed in both groups at baseline and at the end of the intervention period. Compared with the control group, the Pilates intervention did not improve postural stability, baseline functional measures of balance, or health status. The results suggest that because Pilates training is not task specific, it does not improve balance control or balance function in independent older adults.

The effects of spaceflight on open-loop and closed-loop postural control mechanisms: human neurovestibular studies on SLS-2

NASA Technical Reports Server (NTRS)

Collins, J. J.; De Luca, C. J.; Pavlik, A. E.; Roy, S. H.; Emley, M. S.; Young, L. R. (Principal Investigator)

1995-01-01

Stabilogram-diffusion analysis was used to examine how prolonged periods in microgravity affect the open-loop and closed-loop postural control mechanisms. It was hypothesized that following spaceflight: (1) the effective stochastic activity of the open-loop postural control schemes in astronauts is increased; (2) the effective stochastic activity and uncorrelated behavior, respectively, of the closed-loop postural control mechanisms in astronauts are increased; and (3) astronauts utilized open-loop postural controls schemes for shorter time intervals and smaller displacements. Four crew members and two alternates from the 14-day Spacelab Life Sciences 2 Mission were included in the study. Each subject was tested under eyes-open, quiet-standing conditions on multiple preflight and postflight days. The subjects' center-of-pressure trajectories were measured with a force platform and analyzed according to stabilogram-diffusion analysis. It was found that the effective stochastic activity of the open-loop postural control schemes in three of the four crew members was increased following spaceflight. This result is interpreted as an indication that there may be in-flight adaptations to higher-level descending postural control pathways, e.g., a postflight increase in the tonic activation of postural muscles. This change may also be the consequence of a compensatory (e.g., "stiffening") postural control strategy that is adopted by astronauts to account for general feeling of postflight unsteadiness. The crew members, as a group, did not exhibit any consistent preflight/postflight differences in the steady-state behavior of their closed-loop postural control mechanisms or in the functional interaction of their open-loop and closed-loop postural control mechanisms. These results are interpreted as indications that although there may be in-flight adaptations to the vestibular system and/or proprioceptive system, input from the visual system can compensate for such changes during undisturbed stance.

The impact of office chair features on lumbar lordosis, intervertebral joint and sacral tilt angles: a radiographic assessment.

PubMed

De Carvalho, Diana; Grondin, Diane; Callaghan, Jack

2017-10-01

The purpose of this study was to determine which office chair feature is better at improving spine posture in sitting. Participants (n = 28) were radiographed in standing, maximum flexion and seated in four chair conditions: control, lumbar support, seat pan tilt and backrest with scapular relief. Measures of lumbar lordosis, intervertebral joint angles and sacral tilt were compared between conditions and sex. Sitting consisted of approximately 70% of maximum range of spine flexion. No differences in lumbar flexion were found between the chair features or control. Significantly more anterior pelvic rotation was found with the lumbar support (p = 0.0028) and seat pan tilt (p < 0.0001). Males had significantly more anterior pelvic rotation and extended intervertebral joint angles through L1-L3 in all conditions (p < 0.0001). No one feature was statistically superior with respect to minimising spine flexion, however, seat pan tilt resulted in significantly improved pelvic posture. Practitioner Summary: Seat pan tilt, and to some extent lumbar supports, appear to improve seated postures. However, sitting, regardless of chair features used, still involves near end range flexion of the spine. This will increase stresses to the spine and could be a potential injury generator during prolonged seated exposures.

Evaluating a novel analgesic strategy for ring castration of ram lambs.

PubMed

Paull, David R; Small, Alison H; Lee, Caroline; Palladin, Pierre; Colditz, Ian G

2012-09-01

To evaluate the analgesic efficacy of the NSAIDs flunixin and meloxicam administered locally to the scrotum before ring castration. Randomised, controlled, prospective study. Forty eight single born male Merino lambs. Lambs, aged approximately 4 weeks, were allocated to four groups for castration. Groups were: sham control; castration + saline; castration + flunixin; castration + meloxicam. Drugs (5 mL) were administered subcutaneously around the circumference of the scrotum immediately before castration. Cortisol, rectal temperature, haematology and plasma haptoglobin were measured before and up to 48 hours after treatment. Behaviour recorded by video for 12 hours after treatment was classified as pain avoidance behaviours in the first hour and postural behaviours in three 4 hour intervals. Ring castration (saline group) induced a bi-phasic increase in cortisol with peaks at 90 minutes and 24 hours but no significant changes in haematology, haptoglobin or rectal temperature. Pain avoidance behaviours were increased and teat seeking decreased. Normal lying and normal standing postures were decreased and abnormal ventral lying, statue standing, abnormal standing and total abnormal postures increased. Flunixin decreased cortisol at 90 minutes (60.3 versus 117.3 nmol L(-1) ) and cortisol AUC (0-6 hours), decreased elevated leg movement (2.5 versus 5.4 events) and sum of pain avoidance behaviours (8.5 versus 16.7 events), improved time spent in normal ventral lying and decreased abnormal ventral lying and total abnormal postures compared to saline treated lambs. In a similar contrast, meloxicam caused non-significant decreases in cortisol at 90 minutes, cortisol AUC (0-6 hours) and pain avoidance behaviours, and significantly improved the postural behaviours normal ventral lying (26.7 versus 15.4%) and normal standing (13.9 versus 7.5%), and reduced abnormal standing and total abnormal postures. Physiological and behavioural responses associated with ring castration for both NSAID treatment groups were generally greater than sham controls. Locally administered NSAIDs provided partial analgesia for ring castration. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

Temporal parameter change of human postural control ability during upright swing using recursive least square method

NASA Astrophysics Data System (ADS)

Goto, Akifumi; Ishida, Mizuri; Sagawa, Koichi

2010-01-01

The purpose of this study is to derive quantitative assessment indicators of the human postural control ability. An inverted pendulum is applied to standing human body and is controlled by ankle joint torque according to PD control method in sagittal plane. Torque control parameters (KP: proportional gain, KD: derivative gain) and pole placements of postural control system are estimated with time from inclination angle variation using fixed trace method as recursive least square method. Eight young healthy volunteers are participated in the experiment, in which volunteers are asked to incline forward as far as and as fast as possible 10 times over 10 [s] stationary intervals with their neck joint, hip joint and knee joint fixed, and then return to initial upright posture. The inclination angle is measured by an optical motion capture system. Three conditions are introduced to simulate unstable standing posture; 1) eyes-opened posture for healthy condition, 2) eyes-closed posture for visual impaired and 3) one-legged posture for lower-extremity muscle weakness. The estimated parameters Kp, KD and pole placements are applied to multiple comparison test among all stability conditions. The test results indicate that Kp, KD and real pole reflect effect of lower-extremity muscle weakness and KD also represents effect of visual impairment. It is suggested that the proposed method is valid for quantitative assessment of standing postural control ability.

A small sample test of the factor structure of postural movement and bilateral motor integration using structural equation modeling.

PubMed

Lin, Chin-Kai; Wu, Huey-Min; Lin, Chung-Hui; Wu, Yuh-Yih; Wu, Pei-Fang; Kuo, Bor-Chen; Yeung, Kwok-Tak

2012-10-01

The goal of this study was to examine the relationship between the validity of postural movement and bilateral motor integration in terms of sensory integration theory. Participants in this study were 61 Chinese children ages 48 to 70 months. Structural equation modeling was applied to assess the relation between measures tapping postural movement and bilateral motor integration: for postural movement, the measures involve the Monkey Task, Side-Sit Co-contraction, Prone on Elbows, Wheelbarrow Walk, Airplane, and Scooter Board Co-contraction from the DeGangi-Berk Test of Sensory Integration, and Standing Balance with Eyes Closed/Opened in Southern California Sensory Integration Tests. For bilateral motor integration, the measures chosen were the Rolling Pin Activity, Jump and Turn, Diadokokinesis, Drumming, and Upper Extremity Control from the DeGangi-Berk Test of Sensory Integration, and Cross the Midline in Southern California Sensory Integration Tests (SCSIT). Postural movement was highly correlated with the bilateral motor integration. The factor structure fit the theoretical conceptualization, classifying postural movement and bilateral motor integration together in the same category. Therapists could combine two separate objectives (postural movement and bilateral motor integration) of intervention in an activity to improve the adaptive skills based on the vestibular-proprioceptive integration.

Impairments of postural stability, core endurance, fall index and functional mobility skills in patients with patello femoral pain syndrome.

PubMed

Yilmaz Yelvar, Gul Deniz; Çirak, Yasemin; Dalkilinç, Murat; Demir, Yasemin Parlak; Baltaci, Gul; Kömürcü, Mahmut; Yelvar, Gul Deniz Yilmaz

2016-06-30

Postural control allows performance of daily and sports activities. The previous studies show that postural sway inceases in orthopaedic injuries such as osteoarthritis and total knee arthroplasty. To compare postural sway, risk of falling and function between individuals with and without patellofemoral pain syndrome (PFS). This study included 22 subjects with patellofemoral pain syndrome, age-matched pain-free 22 females serving as a control group. Visual anolog scale and Kujala were used to evaluate the pain. Posturographic assesment was performed by Tetrax posturographic device. Biering Modified Sorenson test for extensor endurance and sit-up test for flexor endurance were used for the evaluation of trunk endurance. Timed get-up and go test was used for lower extremity function. The Student's t Test was used to compare variables between the groups. The Pearson correlation coefficients were calculated to examine correlation between the quantitative variables. Postural sway included eyes open without pillow, eyes open on pillow, eyes closed on pillow, risk of falling, function and postural stabilization included flexor endurance, extansor endurance are impared in patient with patellofemoral pain syndrome when compare to controls. In subjects with PFPS increased postural sway significantly associated with body mass index (r= 0.52), pain duration (r= 0.43), postural control (extansor endurance) (r= -0.50) and risk of falling (r= 0.62) on pillow with open eyes. In addition we found function significantly related with postural control (extansor endurance and flexor endurance) (r= -0.59 and r= -0.59) and risk of falling (r= 0.77)CONCLUSIONS: Decreased neuromuscular control of the trunk core and increased postural sway and falling risk were found in patients with PFPS. Patients may be evaluated for deficits in postural control and falling risk before treatment.

Poor sitting posture and a heavy schoolbag as contributors to musculoskeletal pain in children: an ergonomic school education intervention program

PubMed Central

Syazwan, AI; Azhar, MN Mohamad; Anita, AR; Azizan, HS; Shaharuddin, MS; Hanafiah, J Muhamad; Muhaimin, AA; Nizar, AM; Rafee, B Mohd; Ibthisham, A Mohd; Kasani, Adam

2011-01-01

Objectives The purpose of this study was to evaluate a multidisciplinary, interventional, ergonomic education program designed to reduce the risk of musculoskeletal problems by reducing schoolbag weight and correcting poor sitting posture. Methods Data were collected twice before and twice following intervention using the Standardized Nordic Body Map Questionnaire, a rapid upper limb assessment for posture evaluation, and schoolbag weight measurement in children aged 8 and 11 years attending two schools within the central region of Malaysia. Results Students who received the ergonomic intervention reported significant improvements in their sitting posture in a classroom environment and reduction of schoolbag weight as compared with the controls. Conclusion A single-session, early intervention, group ergonomics education program for children aged 8 and 11 years is appropriate and effective, and should be considered as a strategy to reduce musculoskeletal pain among schoolchildren in this age group. PMID:22003301

Assisting people with multiple disabilities actively correct abnormal standing posture with a Nintendo Wii balance board through controlling environmental stimulation.

PubMed

Shih, Ching-Hsiang; Shih, Ching-Tien; Chu, Chiung-Ling

2010-01-01

The latest researches adopted software technology turning the Nintendo Wii Balance Board into a high performance change of standing posture (CSP) detector, and assessed whether two persons with multiple disabilities would be able to control environmental stimulation using body swing (changing standing posture). This study extends Wii Balance Board functionality for standing posture correction (i.e., actively adjust abnormal standing posture) to assessed whether two persons with multiple disabilities would be able to actively correct their standing posture by controlling their favorite stimulation on/off using a Wii Balance Board with a newly developed standing posture correcting program (SPCP). The study was performed according to an ABAB design, in which A represented baseline and B represented intervention phases. Data showed that both participants significantly increased time duration of maintaining correct standing posture (TDMCSP) to activate the control system to produce environmental stimulation during the intervention phases. Practical and developmental implications of the findings were discussed.

Standing postural instability in patients with schizophrenia: Relationships with psychiatric symptoms, anxiety, and the use of neuroleptic medications.

PubMed

Matsuura, Yukako; Fujino, Haruo; Hashimoto, Ryota; Yasuda, Yuka; Yamamori, Hidenaga; Ohi, Kazutaka; Takeda, Masatoshi; Imura, Osamu

2015-03-01

The purpose of this study was to assess postural instability in patients with schizophrenia using a pressure-sensitive platform and to examine the effects of anxiety, psychiatric symptoms, and the use of neuroleptic medications on postural sway. Participants were 23 patients with schizophrenia and 23 healthy controls. We found that the patients showed greater overall postural instability than the controls. Furthermore, they demonstrated greater instability when the test was performed with the eyes closed than with the eyes open. However, removal of visual input had less impact on the indices of postural instability in the patients than in the controls, suggesting that schizophrenia is associated with difficulties in integrating visual information and proprioceptive signals. Furthermore, in contrast to the controls, anxiety exacerbated postural instability in the patients. There were significant associations between postural stability and psychiatric symptoms in the patients without extrapyramidal symptoms, whereas medication dose did not significantly correlate with postural stability. Copyright © 2015 Elsevier B.V. All rights reserved.

Postural control in chronic obstructive pulmonary disease: a systematic review.

PubMed

Porto, E F; Castro, A A M; Schmidt, V G S; Rabelo, H M; Kümpel, C; Nascimento, O A; Jardim, J R

2015-01-01

Patients with chronic obstructive pulmonary disease (COPD) fall frequently, although the risk of falls may seem less important than the respiratory consequences of the disease. Nevertheless, falls are associated to increased mortality, decreased independence and physical activity levels, and worsening of quality of life. The aims of this systematic review was to evaluate information in the literature with regard to whether impaired postural control is more prevalent in COPD patients than in healthy age-matched subjects, and to assess the main characteristics these patients present that contribute to impaired postural control. Five databases were searched with no dates or language limits. The MEDLINE, PubMed, EMBASE, Web of Science, and PEDro databases were searched using "balance", "postural control", and "COPD" as keywords. The search strategies were oriented and guided by a health science librarian and were performed on March 27, 2014. The studies included were those that evaluated postural control in COPD patients as their main outcome and scored more than five points on the PEDro scale. Studies supplied by the database search strategy were assessed independently by two blinded researchers. A total of 484 manuscripts were found using the "balance in COPD or postural control in COPD" keywords. Forty-three manuscripts appeared more than once, and 397 did not evaluate postural control in COPD patients as the primary outcome. Thus, only 14 studies had postural control as their primary outcome. Our study examiners found only seven studies that had a PEDro score higher than five points. The examiners' interrater agreement was 76.4%. Six of those studies were accomplished with a control group and one study used their patients as their own controls. The studies were published between 2004 and 2013. Patients with COPD present postural control impairment when compared with age-matched healthy controls. Associated factors contributing to impaired postural control were muscle weakness, physical inactivity, elderly age, need for supplemental oxygen, and limited mobility.

Postural Ataxia in Cerebellar Downbeat Nystagmus: Its Relation to Visual, Proprioceptive and Vestibular Signals and Cerebellar Atrophy.

PubMed

Helmchen, Christoph; Kirchhoff, Jan-Birger; Göttlich, Martin; Sprenger, Andreas

2017-01-01

The cerebellum integrates proprioceptive, vestibular and visual signals for postural control. Cerebellar patients with downbeat nystagmus (DBN) complain of unsteadiness of stance and gait as well as blurred vision and oscillopsia. The aim of this study was to elucidate the differential role of visual input, gaze eccentricity, vestibular and proprioceptive input on the postural stability in a large cohort of cerebellar patients with DBN, in comparison to healthy age-matched control subjects. Oculomotor (nystagmus, smooth pursuit eye movements) and postural (postural sway speed) parameters were recorded and related to each other and volumetric changes of the cerebellum (voxel-based morphometry, SPM). Twenty-seven patients showed larger postural instability in all experimental conditions. Postural sway increased with nystagmus in the eyes closed condition but not with the eyes open. Romberg's ratio remained stable and was not different from healthy controls. Postural sway did not change with gaze position or graviceptive input. It increased with attenuated proprioceptive input and on tandem stance in both groups but Romberg's ratio also did not differ. Cerebellar atrophy (vermal lobule VI, VIII) correlated with the severity of impaired smooth pursuit eye movements of DBN patients. Postural ataxia of cerebellar patients with DBN cannot be explained by impaired visual feedback. Despite oscillopsia visual feedback control on cerebellar postural control seems to be preserved as postural sway was strongest on visual deprivation. The increase in postural ataxia is neither related to modulations of single components characterizing nystagmus nor to deprivation of single sensory (visual, proprioceptive) inputs usually stabilizing stance. Re-weighting of multisensory signals and/or inappropriate cerebellar motor commands might account for this postural ataxia.

Postural Ataxia in Cerebellar Downbeat Nystagmus: Its Relation to Visual, Proprioceptive and Vestibular Signals and Cerebellar Atrophy

PubMed Central

Helmchen, Christoph; Kirchhoff, Jan-Birger; Göttlich, Martin; Sprenger, Andreas

2017-01-01

Background The cerebellum integrates proprioceptive, vestibular and visual signals for postural control. Cerebellar patients with downbeat nystagmus (DBN) complain of unsteadiness of stance and gait as well as blurred vision and oscillopsia. Objectives The aim of this study was to elucidate the differential role of visual input, gaze eccentricity, vestibular and proprioceptive input on the postural stability in a large cohort of cerebellar patients with DBN, in comparison to healthy age-matched control subjects. Methods Oculomotor (nystagmus, smooth pursuit eye movements) and postural (postural sway speed) parameters were recorded and related to each other and volumetric changes of the cerebellum (voxel-based morphometry, SPM). Results Twenty-seven patients showed larger postural instability in all experimental conditions. Postural sway increased with nystagmus in the eyes closed condition but not with the eyes open. Romberg’s ratio remained stable and was not different from healthy controls. Postural sway did not change with gaze position or graviceptive input. It increased with attenuated proprioceptive input and on tandem stance in both groups but Romberg’s ratio also did not differ. Cerebellar atrophy (vermal lobule VI, VIII) correlated with the severity of impaired smooth pursuit eye movements of DBN patients. Conclusions Postural ataxia of cerebellar patients with DBN cannot be explained by impaired visual feedback. Despite oscillopsia visual feedback control on cerebellar postural control seems to be preserved as postural sway was strongest on visual deprivation. The increase in postural ataxia is neither related to modulations of single components characterizing nystagmus nor to deprivation of single sensory (visual, proprioceptive) inputs usually stabilizing stance. Re-weighting of multisensory signals and/or inappropriate cerebellar motor commands might account for this postural ataxia. PMID:28056109

Assessing Somatosensory Utilization during Unipedal Postural Control.

PubMed

Goel, Rahul; De Dios, Yiri E; Gadd, Nichole E; Caldwell, Erin E; Peters, Brian T; Reschke, Millard F; Bloomberg, Jacob J; Oddsson, Lars I E; Mulavara, Ajitkumar P

2017-01-01

Multisensory-visual, vestibular and somatosensory information is integrated for appropriate postural control. The primary goal of this study was to assess somatosensory utilization during a functional motor task of unipedal postural control, in normal healthy adults. Assessing individual bias in the utilization of individual sensory contributions during postural control may help customization of rehabilitation protocols. In this study, a test paradigm of unipedal stance control in supine orientation with and without vision was assessed. Postural control in this test paradigm was hypothesized to utilize predominantly contributions of somatosensory information from the feet and ankle joint, with minimal vestibular input. Fourteen healthy subjects "stood" supine on their dominant leg while strapped to a backpack frame that was freely moving on air-bearings, to remove available otolith tilt cues with respect to gravity that influences postural control when standing upright. The backpack was attached through a cable to a pneumatic cylinder that provided a gravity-like load. Subjects performed three trials each with Eyes-open (EO) and Eyes-closed (EC) while loaded with 60% body weight. There was no difference in unipedal stance time (UST) across the two conditions with EC condition challenging the postural control system greater than the EO condition. Stabilogram-diffusion analysis (SDA) indicated that the critical mean square displacement was significantly different between the two conditions. Vestibular cues, both in terms of magnitude and the duration for which relevant information was available for postural control in this test paradigm, were minimized. These results support our hypothesis that maintaining unipedal stance in supine orientation without vision, minimizes vestibular contribution and thus predominantly utilizes somatosensory information for postural control.

Advantages and disadvantages of stiffness instructions when studying postural control.

PubMed

Bonnet, Cédrick T

2016-05-01

To understand the maintenance of upright stance, researchers try to discover the fundamental mechanisms and attentional resources devoted to postural control and eventually to the performance of other tasks (e.g., counting in the head). During their studies, some researchers require participants to stand as steady as possible and other simply ask participants to stand naturally. Surprisingly, a clear and direct explanation of the usefulness of the steadiness requirement seems to be lacking, both in experimental and methodological discussions. Hence, the objective of the present note was to provide advantages and disadvantages of this steadiness requirement in studies of postural control. The advantages may be to study fundamental postural control, to eliminate useless postural variability, to control spurious body motions and to control the participants' thoughts. As disadvantages, this steadiness requirement only leads to study postural control in unnatural upright stance, it changes the focus of attention (internal vs. external) and the nature of postural control (unconscious vs. conscious), it increases the difficulty of a supposedly easy control task and it eliminates or reduces the opportunity to record exploratory behaviors. When looking carefully at the four advantages of the steadiness requirement, one can believe that they are, in fact, more disadvantageous than advantageous. Overall therefore, this requirement seems illegitimate and it is proposed that researchers should not use it in the study of postural control. They may use this requirement only if they search to know the limit until which participants can consciously reduce their postural sway. Copyright © 2015 Elsevier B.V. All rights reserved.

Assessing Somatosensory Utilization during Unipedal Postural Control

PubMed Central

Goel, Rahul; De Dios, Yiri E.; Gadd, Nichole E.; Caldwell, Erin E.; Peters, Brian T.; Reschke, Millard F.; Bloomberg, Jacob J.; Oddsson, Lars I. E.; Mulavara, Ajitkumar P.

2017-01-01

Multisensory—visual, vestibular and somatosensory information is integrated for appropriate postural control. The primary goal of this study was to assess somatosensory utilization during a functional motor task of unipedal postural control, in normal healthy adults. Assessing individual bias in the utilization of individual sensory contributions during postural control may help customization of rehabilitation protocols. In this study, a test paradigm of unipedal stance control in supine orientation with and without vision was assessed. Postural control in this test paradigm was hypothesized to utilize predominantly contributions of somatosensory information from the feet and ankle joint, with minimal vestibular input. Fourteen healthy subjects “stood” supine on their dominant leg while strapped to a backpack frame that was freely moving on air-bearings, to remove available otolith tilt cues with respect to gravity that influences postural control when standing upright. The backpack was attached through a cable to a pneumatic cylinder that provided a gravity-like load. Subjects performed three trials each with Eyes-open (EO) and Eyes-closed (EC) while loaded with 60% body weight. There was no difference in unipedal stance time (UST) across the two conditions with EC condition challenging the postural control system greater than the EO condition. Stabilogram-diffusion analysis (SDA) indicated that the critical mean square displacement was significantly different between the two conditions. Vestibular cues, both in terms of magnitude and the duration for which relevant information was available for postural control in this test paradigm, were minimized. These results support our hypothesis that maintaining unipedal stance in supine orientation without vision, minimizes vestibular contribution and thus predominantly utilizes somatosensory information for postural control. PMID:28443004

Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers

PubMed Central

Sirois-Leclerc, Geneviève; Remaud, Anthony

2017-01-01

Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources. PMID:28323843

Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers.

PubMed

Sirois-Leclerc, Geneviève; Remaud, Anthony; Bilodeau, Martin

2017-01-01

Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources.

Effect of vibration on muscle strength imbalance in lower extremity using multi-control whole body vibration platform.

PubMed

Yu, Chang Ho; Seo, Shin Bae; Kang, Seung Rok; Kim, Kyung; Kwon, Tae Kyu

2015-01-01

This study shows the improvement of muscle activity and muscle strength imbalance in the lower extremities through independent exercise loads in vibration platform. Twenty females of age 20 participated in this study. The subjects were divided into WBV group, with more than 10% of muscle strength imbalance between left and right the lower extremities, and control group, with less than 10% of muscle strength imbalance between left and right the lower extremities. As the prior experiment showed, different exercise postures provide different muscular activities. As a result, the highest muscular activity was found to be in the low squat posture. Therefore, the LS posture was selected for the exercise in this experiment. Vibration intensities were applied to dominant muscle and non-dominant muscle, and the vibration frequency was fixed at 25Hz for the WBV group. The control group was asked to perform the same exercise as the WBV group, without stimulated vibration. This exercise was conducted for a total of 4 weeks. As a result, the WBV group which showed an average deviation of 16% before the experiment, tended to decrease approximately to 5%. In this study, vibration exercise using load deviation is shown to be effective in improving the muscle strength imbalance.

Exploiting arm posture synergies in activities of daily living to control the wrist rotation in upper limb prostheses: A feasibility study.

PubMed

Montagnani, Federico; Controzzi, Marco; Cipriani, Christian

2015-01-01

Although significant technological advances have been made in the last forty years, natural and effortless control of upper limb prostheses is still an open issue. Commercially available myoelectric prostheses present limited Degrees of Freedom (DoF) mainly because of the lack of available and reliable independent control signals from the human body. Thus, despite the crucial role that an actuated wrist could play in a transradial prosthesis in terms of avoiding compensatory movements, commercial hand prostheses present only manually adjustable passive wrists or actuated rotators controlled by (unnatural) sequential control strategies. In the present study we investigated the synergies between the humeral orientation with respect to the trunk and the forearm pronation/supination angles during the execution of a wide range of activities of daily living, in healthy subjects. Our results showed consistent postural synergies between the two selected body segments for almost the totality of the activities of daily living under investigation. This is a promising result because these postural synergies could be exploited to automatically control the wrist rotator unit in transradial prostheses improving the fluency and the dexterity of the amputee.

Effects of transcranial direct current stimulation (tDCS) on multiscale complexity of dual-task postural control in older adults.

PubMed

Zhou, Diange; Zhou, Junhong; Chen, Hu; Manor, Brad; Lin, Jianhao; Zhang, Jue

2015-08-01

Transcranial direct current stimulation (tDCS) targeting the prefrontal cortex reduces the size and speed of standing postural sway in younger adults, particularly when performing a cognitive dual task. Here, we hypothesized that tDCS would alter the complex dynamics of postural sway as quantified by multiscale entropy (MSE). Twenty healthy older adults completed two study visits. Center-of-pressure (COP) fluctuations were recorded during single-task (i.e., quiet standing) and dual-task (i.e., standing while performing serial subtractions) conditions, both before and after a 20-min session of real or sham tDCS. MSE was used to estimate COP complexity within each condition. The percentage change in complexity from single- to dual-task conditions (i.e., dual-task cost) was also calculated. Before tDCS, COP complexity was lower (p = 0.04) in the dual-task condition as compared to the single-task condition. Neither real nor sham tDCS altered complexity in the single-task condition. As compared to sham tDCS, real tDCS increased complexity in the dual-task condition (p = 0.02) and induced a trend toward improved serial subtraction performance (p = 0.09). Moreover, those subjects with lower dual-task COP complexity at baseline exhibited greater percentage increases in complexity following real tDCS (R = -0.39, p = 0.05). Real tDCS also reduced the dual-task cost to complexity (p = 0.02), while sham stimulation had no effect. A single session of tDCS targeting the prefrontal cortex increased standing postural sway complexity with concurrent non-postural cognitive task. This form of noninvasive brain stimulation may be a safe strategy to acutely improve postural control by enhancing the system's capacity to adapt to stressors.

Postural Performance and Strategy in the Unipedal Stance of Soccer Players at Different Levels of Competition

PubMed Central

Paillard, Thierry; Noé, Frédéric; Rivière, Terence; Marion, Vincent; Montoya, Richard; Dupui, Philippe

2006-01-01

Context: Sport training enhances the ability to use somatosensory and otolithic information, which improves postural capabilities. Postural changes are different according to the sport practiced, but few authors have analyzed subjects' postural performances to discriminate the expertise level among highly skilled athletes within a specific discipline. Objective: To compare the postural performance and the postural strategy between soccer players at different levels of competition (national and regional). Design: Repeated measures with 1 between-groups factor (level of competition: national or regional) and 1 within-groups factor (vision: eyes open or eyes closed). Dependent variables were center-of-pressure surface area and velocity; total spectral energy; and percentage of low-, medium-, and high-frequency band. Setting: Sports performance laboratory. Patients or Other Participants: Fifteen national male soccer players (age = 24 ± 3 years, height = 179 ± 5 cm, mass = 72 ± 3 kg) and 15 regional male soccer players (age = 23 ± 3 years, height = 174 ± 4 cm, mass = 68 ± 5 kg) participated in the study. Intervention(s): The subjects performed posturographic tests with eyes open and closed. Main Outcome Measure(s): While subjects performed static and dynamic posturographic tests, we measured the center of foot pressure on a force platform. Spatiotemporal center-of-pressure measurements were used to evaluate the postural performance, and a frequency analysis of the center-of-pressure excursions (fast Fourier transform) was conducted to estimate the postural strategy. Results: Within a laboratory task, national soccer players produced better postural performances than regional players and had a different postural strategy. The national players were more stable than the regional players and used proprioception and vision information differently. Conclusions: In the test conditions specific to playing soccer, level of playing experience influenced postural control performance measures and strategies. PMID:16791302

Postural performance and strategy in the unipedal stance of soccer players at different levels of competition.

PubMed

Paillard, Thierry; Noé, Frédéric; Rivière, Terence; Marion, Vincent; Montoya, Richard; Dupui, Philippe

2006-01-01

Sport training enhances the ability to use somatosensory and otolithic information, which improves postural capabilities. Postural changes are different according to the sport practiced, but few authors have analyzed subjects' postural performances to discriminate the expertise level among highly skilled athletes within a specific discipline. To compare the postural performance and the postural strategy between soccer players at different levels of competition (national and regional). Repeated measures with 1 between-groups factor (level of competition: national or regional) and 1 within-groups factor (vision: eyes open or eyes closed). Dependent variables were center-of-pressure surface area and velocity; total spectral energy; and percentage of low-, medium-, and high-frequency band. Sports performance laboratory. Fifteen national male soccer players (age = 24 +/- 3 years, height = 179 +/- 5 cm, mass = 72 +/- 3 kg) and 15 regional male soccer players (age = 23 +/- 3 years, height = 174 +/- 4 cm, mass = 68 +/- 5 kg) participated in the study. The subjects performed posturographic tests with eyes open and closed. While subjects performed static and dynamic posturographic tests, we measured the center of foot pressure on a force platform. Spatiotemporal center-of-pressure measurements were used to evaluate the postural performance, and a frequency analysis of the center-of-pressure excursions (fast Fourier transform) was conducted to estimate the postural strategy. Within a laboratory task, national soccer players produced better postural performances than regional players and had a different postural strategy. The national players were more stable than the regional players and used proprioception and vision information differently. In the test conditions specific to playing soccer, level of playing experience influenced postural control performance measures and strategies.

Postural Control in Children with Autism.

ERIC Educational Resources Information Center

Kohen-Raz, Reuven; And Others

1992-01-01

Postural control was evaluated in 91 autistic, 166 normal, and 18 mentally retarded children using a computerized posturographic procedure. In comparison to normal children, the autistic subjects were less likely to exhibit age-related changes in postural performance, and postures were more variable and less stable. (Author/JDD)

Five-week sensory motor training program improves functional performance and postural control in young male soccer players - A blind randomized clinical trial.

PubMed

Heleno, Lucas Rafael; da Silva, Rubens A; Shigaki, Leonardo; Araújo, Cynthia Gobbi Alves; Coelho Candido, Cristiane Regina; Okazaki, Victor Hugo Alves; Frisseli, Ariobaldo; Macedo, Christiane de S Guerino

2016-11-01

Sensory motor training programs are used in the rehabilitation and prevention of injuries among soccer players. Inconsistencies are found in the literature regarding the duration of the protocols and the exercises and equipment used. To evaluate the benefits of a five-week sensory motor training program on the functional performance and postural control of young soccer players. The study sample comprised 22 young male soccer players who were evaluated using: the Figure-of-Eight Test (F8), Side Hop Test (SHT), Star Excursion Balance Test (SEBT), and a force platform. The players were randomly divided into a control group (N = 10), who continued their soccer practice sessions and an intervention group (N = 12), who continued their soccer practice sessions and were also enrolled in a supervised five-week sensory motor training program. After the five-week training program, the intervention group obtained significant results in the F8, SHT and SEBT, as well as in the following parameters: area of pressure of sway center (COP), mean velocity and mean frequency of COP. The five-week sensory motor training program, carried out with easily available and low cost equipment, was effective at improving functional performance and postural control in young soccer players. Copyright © 2016 Elsevier Ltd. All rights reserved.

Illusory visual motion stimulus elicits postural sway in migraine patients

PubMed Central

Imaizumi, Shu; Honma, Motoyasu; Hibino, Haruo; Koyama, Shinichi

2015-01-01

Although the perception of visual motion modulates postural control, it is unknown whether illusory visual motion elicits postural sway. The present study examined the effect of illusory motion on postural sway in patients with migraine, who tend to be sensitive to it. We measured postural sway for both migraine patients and controls while they viewed static visual stimuli with and without illusory motion. The participants’ postural sway was measured when they closed their eyes either immediately after (Experiment 1), or 30 s after (Experiment 2), viewing the stimuli. The patients swayed more than the controls when they closed their eyes immediately after viewing the illusory motion (Experiment 1), and they swayed less than the controls when they closed their eyes 30 s after viewing it (Experiment 2). These results suggest that static visual stimuli with illusory motion can induce postural sway that may last for at least 30 s in patients with migraine. PMID:25972832

Otolith and Vertical Canal Contributions to Dynamic Postural Control

NASA Technical Reports Server (NTRS)

Black, F. Owen

1999-01-01

The objective of this project is to determine: 1) how do normal subjects adjust postural movements in response to changing or altered otolith input, for example, due to aging? and 2) how do patients adapt postural control after altered unilateral or bilateral vestibular sensory inputs such as ablative inner ear surgery or ototoxicity, respectively? The following hypotheses are under investigation: 1) selective alteration of otolith input or abnormalities of otolith receptor function will result in distinctive spatial, frequency, and temporal patterns of head movements and body postural sway dynamics. 2) subjects with reduced, altered, or absent vertical semicircular canal receptor sensitivity but normal otolith receptor function or vice versa, should show predictable alterations of body and head movement strategies essential for the control of postural sway and movement. The effect of altered postural movement control upon compensation and/or adaptation will be determined. These experiments provide data for the development of computational models of postural control in normals, vestibular deficient subjects and normal humans exposed to unusual force environments, including orbital space flight.

Postural Control Impairments in Individuals With Autism Spectrum Disorder: A Critical Review of Current Literature

PubMed Central

Memari, Amir Hossein; Ghanouni, Parisa; Shayestehfar, Monir; Ghaheri, Banafsheh

2014-01-01

Context: Motor impairments in individuals with autism spectrum disorder (ASD) have been frequently reported. In this review, we narrow our focus on postural control impairments to summarize current literature for patterns, underlying mechanisms, and determinants of posture in this population. Evidence Acquisition: A literature search was conducted through Medline, ISI web of Knowledge, Scopus and Google Scholar to include studies between 1992 and February 2013. Results: Individuals with ASD have problems in maintaining postural control in infancy that well persists into later years. However, the patterns and underlying mechanisms are still unclear. Conclusions: Examining postural control as an endophenotype or early diagnostic marker of autism is a conceptual premise which should be considered in future investigations. At the end of the review, methodological recommendations on the assessment of postural control have also been provided. PMID:25520765

Comparative study of state-of-the-art myoelectric controllers for multigrasp prosthetic hands.

PubMed

Segil, Jacob L; Controzzi, Marco; Weir, Richard F ff; Cipriani, Christian

2014-01-01

A myoelectric controller should provide an intuitive and effective human-machine interface that deciphers user intent in real-time and is robust enough to operate in daily life. Many myoelectric control architectures have been developed, including pattern recognition systems, finite state machines, and more recently, postural control schemes. Here, we present a comparative study of two types of finite state machines and a postural control scheme using both virtual and physical assessment procedures with seven nondisabled subjects. The Southampton Hand Assessment Procedure (SHAP) was used in order to compare the effectiveness of the controllers during activities of daily living using a multigrasp artificial hand. Also, a virtual hand posture matching task was used to compare the controllers when reproducing six target postures. The performance when using the postural control scheme was significantly better (p < 0.05) than the finite state machines during the physical assessment when comparing within-subject averages using the SHAP percent difference metric. The virtual assessment results described significantly greater completion rates (97% and 99%) for the finite state machines, but the movement time tended to be faster (2.7 s) for the postural control scheme. Our results substantiate that postural control schemes rival other state-of-the-art myoelectric controllers.

Benefit of bi-ocular visual stimulation for postural control in children with strabismus.

PubMed

Gaertner, Chrystal; Creux, Charlotte; Espinasse-Berrod, Marie-Andrée; Orssaud, Christophe; Dufier, Jean-Louis; Kapoula, Zoï

2013-01-01

Vision is important for postural control as is shown by the Romberg quotient (RQ): with eyes closed, postural instability increases relative to eyes open (RQ = 2). Yet while fixating at far distance, postural stability is similar with eyes open and eyes closed (RQ = 1). Postural stability can be better with both eyes viewing than one eye, but such effect is not consistent among healthy subjects. The first goal of the study is to test the RQ as a function of distance for children with convergent versus divergent strabismus. The second goal is to test whether vision from two eyes relative to vision from one eye provides better postural stability. Thirteen children with divergent strabismus and eleven with convergent strabismus participated in this study. Posturtography was done with the Techno concept device. Experiment 1, four conditions: fixation at 40 cm and at 200 cm both with eyes open and eyes covered (evaluation of RQ). Experiment 2, six conditions: fixation at 40 cm and at 200 cm, with both eyes viewing or under monocular vision (dominant and non-dominant eye). For convergent strabismus, the groups mean value of RQ was 1.3 at near and 0.94 at far distance; for divergent, it was 1.06 at near and 1.68 at far. For all children, the surface of body sway was significantly smaller under both eyes viewing than monocular viewing (either eye). Increased RQ value at near for convergent and at far for divergent strabismus is attributed to the influence of the default strabismus angle and to better use of ocular motor signals. Vision with the two eyes improves postural control for both viewing distances and for both types of strabismus. Such benefit can be due to complementary mechanisms: larger visual field, better quality of fixation and vergence angle due to the use of visual inputs from both eyes.

Validity of the Instrumented Push and Release Test to Quantify Postural Responses in Persons With Multiple Sclerosis.

PubMed

El-Gohary, Mahmoud; Peterson, Daniel; Gera, Geetanjali; Horak, Fay B; Huisinga, Jessie M

2017-07-01

To test the validity of wearable inertial sensors to provide objective measures of postural stepping responses to the push and release clinical test in people with multiple sclerosis. Cross-sectional study. University medical center balance disorder laboratory. Total sample N=73; persons with multiple sclerosis (PwMS) n=52; healthy controls n=21. Stepping latency, time and number of steps required to reach stability, and initial step length were calculated using 3 inertial measurement units placed on participants' lumbar spine and feet. Correlations between inertial sensor measures and measures obtained from the laboratory-based systems were moderate to strong and statistically significant for all variables: time to release (r=.992), latency (r=.655), time to stability (r=.847), time of first heel strike (r=.665), number of steps (r=.825), and first step length (r=.592). Compared with healthy controls, PwMS demonstrated a longer time to stability and required a larger number of steps to reach stability. The instrumented push and release test is a valid measure of postural responses in PwMS and could be used as a clinical outcome measures for patient care decisions or for clinical trials aimed at improving postural control in PwMS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Noise-Enhanced Human Balance Control

NASA Astrophysics Data System (ADS)

Priplata, Attila; Niemi, James; Salen, Martin; Harry, Jason; Lipsitz, Lewis A.; Collins, J. J.

2002-11-01

Noise can enhance the detection and transmission of weak signals in certain nonlinear systems, via a mechanism known as stochastic resonance. Here we show that input noise can be used to improve motor control in humans. Specifically, we show that the postural sway of both young and elderly individuals during quiet standing can be significantly reduced by applying subsensory mechanical noise to the feet. We further demonstrate with input noise a trend towards the reduction of postural sway in elderly subjects to the level of young subjects. These results suggest that noise-based devices, such as randomly vibrating shoe inserts, may enable people to overcome functional difficulties due to age-related sensory loss.

Effects of a prior stretching of the plantarflexor muscles on the capacity to control upright stance maintenance in healthy adults.

PubMed

Rougier, Patrice; Burdet, Cyril; Genthon, Nicolas

2006-10-01

To assess whether prior stretching of a muscle can induce improved postural control, 15 healthy adults stood still upright with their eyes closed before and after a series of bilateral stretches of the triceps surae muscles. The analysis focused on the center of pressure (CP) and the vertical projection of the center of gravity (CGv) trajectories and their difference (CP - CGv). The prolonged stretching induced a forward shift of the mean position of the CGv. The frequency analysis showed a constancy of the amplitudes of both basic movements whereas an increased mean power frequency was seen for the CP - CGv movements. A fractional Brownian motion modeling of the trajectories indicates shortest time intervals and lower covered distances by the CGv before a change in its control occurs along the antero-posterior axis. This reorganization is thought to be a result of improved body movement detection, which allows postural control over the longest time intervals to be triggered more rapidly.

Reliable change of the sensory organization test.

PubMed

Broglio, Steven P; Ferrara, Michael S; Sopiarz, Kay; Kelly, Michael S

2008-03-01

To establish the sensitivity and specificity of the NeuroCom Sensory Organization Test (SOT) and provide practitioners with cut-scores for clinical decision making using estimates of reliable change. Retrospective cohort study. Research laboratory. Healthy (n = 66) and concussed (n = 63) young adult participants. Postural control assessments on the NeuroCom SOT were completed twice (baseline and follow-up) for both groups. Postconcussion assessments were administered within 24 hours of injury diagnosis. The reliable change technique was used to calculated cut-scores for each SOT variable (composite balance; somatosensory, visual, and vestibular ratios) at the 95%, 90%, 85%, 80%, 75%, and 70% confidence interval levels. When cut-scores were applied to the post-concussion evaluations, sensitivity and specificity varied with SOT variable and confidence interval. An evaluation for change on one or more SOT variable resulted in the highest combined sensitivity (57%) and specificity (80%) at the 75% confidence interval. Use of reliable change scores to detect significant changes in performance on the SOT resulted in decreased sensitivity and improved specificity compared to a previous report. These findings indicate that some concussed athletes may not show large changes in postconcussion postural control and this postural control evaluation should not be used in exclusion of other assessment techniques. The postural control assessment should be combined with other evaluative measures to gain the highest sensitivity to concussive injuries.

Age Related Decline in Postural Control Mechanisms.

ERIC Educational Resources Information Center

Stelmach, George E.; And Others

1989-01-01

Studied voluntary and reflexive mechanisms of postural control of young (N=8) and elderly (N=8) adults through measurement of reflexive reactions to large-fast and small-slow ankle rotation postural disturbances. Found reflexive mechanisms relatively intact for both groups although elderly appeared more disadvantaged when posture was under the…

Hip strength and star excursion balance test deficits of patients with chronic ankle instability.

PubMed

McCann, Ryan S; Crossett, Ian D; Terada, Masafumi; Kosik, Kyle B; Bolding, Brenn A; Gribble, Phillip A

2017-11-01

To examine isometric hip strength in those with and without CAI, and determine the degree of Star Excursion Balance Test (SEBT) variance explained by isometric hip strength. Single-blinded, cross-sectional, case-control study. Thirty individuals with CAI, 29 lateral ankle sprain (LAS) copers, and 26 healthy controls participated. We assessed dynamic postural control with the SEBT anterior (SEBT-ANT), posteromedial (SEBT-PM), and posterolateral (SEBT-PL) reaches, and isometric hip extension (EXT), abduction (ABD) and external rotation (ER) strength with hand-held dynamometry. The CAI and LAS coper groups' involved limbs and randomly selected limbs in controls were tested. Separate Kruskal-Wallis tests compared SEBT scores and isometric hip strength between groups. Backwards linear regression models determined the degree of SEBT variance explained by isometric hip strength. Statistical significance was set a priori at P<0.05. The CAI group had lower SEBT-ANT scores compared to LAS copers (P=0.03) and controls (P=0.03). The CAI group had lower ABD compared to LAS copers (P=0.03) and controls (P=0.02). The CAI group had lower ER compared to LAS copers (P=0.01) and controls (P=0.01). ER (R 2 =0.25, P=0.01) and ABD (R 2 =0.25, P=0.01) explained 25% of the CAI group's SEBT-PM and SEBT-PL variances, respectively. The CAI group had deficient dynamic postural control and isometric hip strength compared to LAS copers and controls. Additionally, the CAI group's isometric hip strength significantly influenced dynamic postural control performance. Future CAI rehabilitation strategies should consider hip muscular strengthening to facilitate improvements in dynamic postural control. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study.

PubMed

Sinaki, Mehrsheed; Lynn, Susan G

2002-04-01

To assess the effect of a proprioceptive dynamic posture training program on balance in osteoporotic women with kyphotic posture. Subjects were randomly assigned to either a proprioceptive dynamic posture training program or exercise only group. Anthropometric measurements, muscle strength, level of physical activity, computerized dynamic posturography, and spine radiography were performed at baseline and 1 mo. At the 1-mo follow-up, three groups were formed on the basis of the baseline computerized dynamic posturography results. In general, groups 1 and 2 had no significant change at 1 mo, whereas group 3 improved balance significantly at 1 mo. The subjects who had abnormal balance and used the proprioceptive dynamic posture training program had the most significant improvement in balance. Improved balance could reduce the risk of falls.

Functional Neuroanatomy for Posture and Gait Control

PubMed Central

Takakusaki, Kaoru

2017-01-01

Here we argue functional neuroanatomy for posture-gait control. Multi-sensory information such as somatosensory, visual and vestibular sensation act on various areas of the brain so that adaptable posture-gait control can be achieved. Automatic process of gait, which is steady-state stepping movements associating with postural reflexes including headeye coordination accompanied by appropriate alignment of body segments and optimal level of postural muscle tone, is mediated by the descending pathways from the brainstem to the spinal cord. Particularly, reticulospinal pathways arising from the lateral part of the mesopontine tegmentum and spinal locomotor network contribute to this process. On the other hand, walking in unfamiliar circumstance requires cognitive process of postural control, which depends on knowledges of self-body, such as body schema and body motion in space. The cognitive information is produced at the temporoparietal association cortex, and is fundamental to sustention of vertical posture and construction of motor programs. The programs in the motor cortical areas run to execute anticipatory postural adjustment that is optimal for achievement of goal-directed movements. The basal ganglia and cerebellum may affect both the automatic and cognitive processes of posturegait control through reciprocal connections with the brainstem and cerebral cortex, respectively. Consequently, impairments in cognitive function by damages in the cerebral cortex, basal ganglia and cerebellum may disturb posture-gait control, resulting in falling. PMID:28122432

Characterization of postural control deficit in whiplash patients by means of linear and nonlinear analyses - A pilot study.

PubMed

Madeleine, Pascal; Nielsen, Mogens; Arendt-Nielsen, Lars

2011-04-01

The ability to maintain balance is diminished in patients suffering from a whiplash injury. The aim of this study was to characterize the variability of postural control in patients with chronic whiplash injury. For this purpose, we analyzed static postural recordings from 11 whiplash patients and sex- and age-matched asymptomatic healthy volunteers. Static postural recordings were performed randomly with eyes open, eyes closed, and eyes open and speaking (dual task). Spatial-temporal changes of the center of pressure displacement were analyzed to assess the amplitude and structure of postural variability by computing, respectively, the standard deviation/coefficient of variation and sample entropy/fractal dimension of the time series. The amplitude of variability of the center of pressure was larger among whiplash patients compared with controls (P<0.001) while fractal dimension was lower (P<0.001). The sample entropy increased during both eyes closed and a simple dual task compared with eyes open (P<0.05). The analysis of postural control dynamics revealed increased amplitude of postural variability and decreased signal dimensionality related to the deficit in postural stability found in whiplash patients. Linear and nonlinear analyses can thus be helpful for the quantification of postural control in normal and pathological conditions. Copyright © 2010 Elsevier Ltd. All rights reserved.

Impaired postural balance correlates with complex walking performance in mildly disabled persons with multiple sclerosis.

PubMed

Brincks, John; Andersen, Elisabeth Due; Sørensen, Henrik; Dalgas, Ulrik

2017-01-01

It is relevant to understand the possible influence of impaired postural balance on walking performance in multiple sclerosis (MS) gait rehabilitation. We expected associations between impaired postural balance and complex walking performance in mildly disabled persons with MS, but not in healthy controls. Thirteen persons with MS (Expanded Disability Status Scale = 2.5) and 13 healthy controls' walking performance were measured at fast walking speed, Timed Up & Go and Timed 25 Feet Walking. Postural balance was measured by stabilometry, 95% confidence ellipse sway area and sway velocity. Except from sway velocity (p = 0.07), significant differences were found between persons with MS and healthy controls in postural balance and walking. Significant correlations were observed between sway area and Timed Up & Go (r = 0.67) and fastest safe walking speed (r = -0.63) in persons with MS but not in healthy controls (r = 0.52 and r = 0.24, respectively). No other significant correlations were observed between postural balance and walking performance in neither persons with MS nor healthy controls. Findings add to the understanding of postural balance and walking in persons with MS, as impaired postural balance was related to complex walking performance. Exercises addressing impaired postural balance are encouraged in early MS gait rehabilitation.

Relationship between postural alignment in sitting by photogrammetry and seated postural control in post-stroke subjects.

PubMed

Iyengar, Y R; Vijayakumar, K; Abraham, J M; Misri, Z K; Suresh, B V; Unnikrishnan, B

2014-01-01

This study was executed to find out correlation between postural alignment in sitting measured through photogrammetry and postural control in sitting following stroke. A cross-sectional study with convenient sampling consisting of 45 subjects with acute and sub-acute stroke. Postural alignment in sitting was measured through photogrammetry and relevant angles were obtained through software MB Ruler (version 5.0). Seated postural control was measured through Function in Sitting Test (FIST). Correlation was obtained using Spearman's Rank Correlation co-efficient in SPSS software (version 17.0). Moderate positive correlation (r = 0.385; p < 0.01) was found between angle of lordosis and angle between acromion, lateral epicondyle and point between radius and ulna. Strong negative correlation (r = -0.435; p < 0.01) was found between cranio-vertebral angle and kyphosis. FIST showed moderate positive correlation (r = 0.3446; p < 0.05) with cranio-vertebral angle and strong positive correlation (r = 0.4336; p < 0.01) with Brunnstrom's stage of recovery in upper extremity. Degree of forward head posture in sitting correlates directly with seated postural control and inversely with degree of kyphosis in sitting post-stroke. Postural control in sitting post-stroke is directly related with Brunnstrom's stage of recovery in affected upper extremity in sitting.

Static postural control among school-aged youth with Down syndrome: A systematic review.

PubMed

Maïano, Christophe; Hue, Olivier; Tracey, Danielle; Lepage, Geneviève; Morin, Alexandre J S; Moullec, Grégory

2018-05-01

Youth with Down syndrome are characterized by motor delays when compared to typically developing (TD) youth, which may be explained by a lower postural control or reduced postural tone. In the present article, we summarize research comparing the static postural control, assessed by posturography, between youth with Down syndrome and TD youth. A systematic literature search was performed in 10 databases and seven studies, published between 2001 and 2017, met our inclusion criteria. Based on the present reviewed findings, it is impossible to conclude that children with Down syndrome present significantly lower static postural control compared to TD children. In contrast, findings showed that adolescents with Down syndrome tended to present significantly lower static postural control compared to TD adolescents when visual and plantar cutaneous inputs were disturbed separately or simultaneously. The present findings should be interpreted with caution given the limitations of the small number of reviewed studies. Therefore, the static postural control among youth with Down syndrome should be further investigated in future rigorous studies examining the contribution of a range of sensory information. Copyright © 2018 Elsevier B.V. All rights reserved.

Techniques and Methods for Testing the Postural Function in Healthy and Pathological Subjects

PubMed Central

Paillard, Thierry; Noé, Frédéric

2015-01-01

The different techniques and methods employed as well as the different quantitative and qualitative variables measured in order to objectify postural control are often chosen without taking into account the population studied, the objective of the postural test, and the environmental conditions. For these reasons, the aim of this review was to present and justify the different testing techniques and methods with their different quantitative and qualitative variables to make it possible to precisely evaluate each sensory, central, and motor component of the postural function according to the experiment protocol under consideration. The main practical and technological methods and techniques used in evaluating postural control were explained and justified according to the experimental protocol defined. The main postural conditions (postural stance, visual condition, balance condition, and test duration) were also analyzed. Moreover, the mechanistic exploration of the postural function often requires implementing disturbing postural conditions by using motor disturbance (mechanical disturbance), sensory stimulation (sensory manipulation), and/or cognitive disturbance (cognitive task associated with maintaining postural balance) protocols. Each type of disturbance was tackled in order to facilitate understanding of subtle postural control mechanisms and the means to explore them. PMID:26640800

Techniques and Methods for Testing the Postural Function in Healthy and Pathological Subjects.

PubMed

Paillard, Thierry; Noé, Frédéric

2015-01-01

The different techniques and methods employed as well as the different quantitative and qualitative variables measured in order to objectify postural control are often chosen without taking into account the population studied, the objective of the postural test, and the environmental conditions. For these reasons, the aim of this review was to present and justify the different testing techniques and methods with their different quantitative and qualitative variables to make it possible to precisely evaluate each sensory, central, and motor component of the postural function according to the experiment protocol under consideration. The main practical and technological methods and techniques used in evaluating postural control were explained and justified according to the experimental protocol defined. The main postural conditions (postural stance, visual condition, balance condition, and test duration) were also analyzed. Moreover, the mechanistic exploration of the postural function often requires implementing disturbing postural conditions by using motor disturbance (mechanical disturbance), sensory stimulation (sensory manipulation), and/or cognitive disturbance (cognitive task associated with maintaining postural balance) protocols. Each type of disturbance was tackled in order to facilitate understanding of subtle postural control mechanisms and the means to explore them.

A New Standing Posture Detector to Enable People with Multiple Disabilities to Control Environmental Stimulation by Changing Their Standing Posture through a Commercial Wii Balance Board

ERIC Educational Resources Information Center

Shih, Ching-Hsiang; Shih, Ching-Tien; Chiang, Ming-Shan

2010-01-01

This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using body swing (changing standing posture) and a Wii Balance Board with a newly developed standing posture detection program (i.e. a new software program turns a Wii Balance Board into a precise standing posture detector). The…

Pedunculopontine network dysfunction in Parkinson's disease with postural control and sleep disorders.

PubMed

Gallea, Cecile; Ewenczyk, Claire; Degos, Bertrand; Welter, Marie-Laure; Grabli, David; Leu-Semenescu, Smaranda; Valabregue, Romain; Berroir, Pierre; Yahia-Cherif, Lydia; Bertasi, Eric; Fernandez-Vidal, Sara; Bardinet, Eric; Roze, Emmanuel; Benali, Habib; Poupon, Cyril; François, Chantal; Arnulf, Isabelle; Lehéricy, Stéphane; Vidailhet, Marie

2017-05-01

The objective of this study was to investigate pedunculopontine nucleus network dysfunctions that mediate impaired postural control and sleep disorder in Parkinson's disease. We examined (1) Parkinson's disease patients with impaired postural control and rapid eye movement sleep behavior disorder (further abbreviated as sleep disorder), (2) Parkinson's disease patients with sleep disorder only, (3) Parkinson's disease patients with neither impaired postural control nor sleep disorder, and (4) healthy volunteers. We assessed postural control with clinical scores and biomechanical recordings during gait initiation. Participants had video polysomnography, daytime sleepiness self-evaluation, and resting-state functional MRIs. Patients with impaired postural control and sleep disorder had longer duration of anticipatory postural adjustments during gait initiation and decreased functional connectivity between the pedunculopontine nucleus and the supplementary motor area in the locomotor network that correlated negatively with the duration of anticipatory postural adjustments. Both groups of patients with sleep disorder had decreased functional connectivity between the pedunculopontine nucleus and the anterior cingulate cortex in the arousal network that correlated with daytime sleepiness. The degree of dysfunction in the arousal network was related to the degree of connectivity in the locomotor network in all patients with sleep disorder, but not in patients without sleep disorder or healthy volunteers. These results shed light on the functional neuroanatomy of pedunculopontine nucleus networks supporting the clinical manifestation and the interdependence between sleep and postural control impairments in Parkinson's disease. © 2016 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Regularity of center-of-pressure trajectories depends on the amount of attention invested in postural control

PubMed Central

Donker, Stella F.; Roerdink, Melvyn; Greven, An J.

2007-01-01

The influence of attention on the dynamical structure of postural sway was examined in 30 healthy young adults by manipulating the focus of attention. In line with the proposed direct relation between the amount of attention invested in postural control and regularity of center-of-pressure (COP) time series, we hypothesized that: (1) increasing cognitive involvement in postural control (i.e., creating an internal focus by increasing task difficulty through visual deprivation) increases COP regularity, and (2) withdrawing attention from postural control (i.e., creating an external focus by performing a cognitive dual task) decreases COP regularity. We quantified COP dynamics in terms of sample entropy (regularity), standard deviation (variability), sway-path length of the normalized posturogram (curviness), largest Lyapunov exponent (local stability), correlation dimension (dimensionality) and scaling exponent (scaling behavior). Consistent with hypothesis 1, standing with eyes closed significantly increased COP regularity. Furthermore, variability increased and local stability decreased, implying ineffective postural control. Conversely, and in line with hypothesis 2, performing a cognitive dual task while standing with eyes closed led to greater irregularity and smaller variability, suggesting an increase in the “efficiency, or “automaticity” of postural control”. In conclusion, these findings not only indicate that regularity of COP trajectories is positively related to the amount of attention invested in postural control, but also substantiate that in certain situations an increased internal focus may in fact be detrimental to postural control. PMID:17401553

Postural complexity influences development in infants born preterm with brain injury: relating perception-action theory to 3 cases.

PubMed

Dusing, Stacey C; Izzo, Theresa; Thacker, Leroy R; Galloway, James Cole

2014-10-01

Perception-action theory suggests a cyclical relationship between movement and perceptual information. In this case series, changes in postural complexity were used to quantify an infant's action and perception during the development of early motor behaviors. Three infants born preterm with periventricular white matter injury were included. Longitudinal changes in postural complexity (approximate entropy of the center of pressure), head control, reaching, and global development, measured with the Test of Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, were assessed every 0.5 to 3 months during the first year of life. All 3 infants demonstrated altered postural complexity and developmental delays. However, the timing of the altered postural complexity and the type of delays varied among the infants. For infant 1, reduced postural complexity or limited action while learning to control her head in the midline position may have contributed to her motor delay. However, her ability to adapt her postural complexity eventually may have supported her ability to learn from her environment, as reflected in her relative cognitive strength. For infant 2, limited early postural complexity may have negatively affected his learning through action, resulting in cognitive delay. For infant 3, an increase in postural complexity above typical levels was associated with declining neurological status. Postural complexity is proposed as a measure of perception and action in the postural control system during the development of early behaviors. An optimal, intermediate level of postural complexity supports the use of a variety of postural control strategies and enhances the perception-action cycle. Either excessive or reduced postural complexity may contribute to developmental delays in infants born preterm with white matter injury. © 2014 American Physical Therapy Association.

Balance evaluation in haemophilic preadolescent patients using Nintendo Wii Balance Board®.

PubMed

Pérez-Alenda, S; Carrasco, J J; Aguilar-Rodríguez, M; Martínez-Gómez, L; Querol-Giner, M; Cuesta-Barriuso, R; Torres-Ortuño, A; Querol, F

2017-01-01

Alterations in the musculoskeletal system, especially in the lower limbs, limit physical activity and affect balance and walking. Postural impairments in haemophilic preteens could increase the risk of bleeding events and deteriorate the physical condition, promoting the progression of haemophilic arthropathy. This study aims to evaluate static postural balance in haemophilic children, assessed by means of the Wii Balance Board ® (WBB). Nineteen children with haemophilia and 19 without haemophilia aged 9-10 years, have participated in this study. Postural balance was assessed by performing four tests, each one lasting 15 s: bipodal eyes open (BEO), bipodal eyes closed (BEC), monopodal dominant leg (MD) and monopodal non-dominant leg (MND). Two balance indices, standard deviation of amplitude (SDA) and standard deviation of velocity (SDV) were calculated in the anterior-posterior (AP) and medial-lateral (ML) directions. Index values were higher in haemophilic group and the differences were statistically significant (P < 0.05) in only six (SDAAP in BEO, BEC and MD conditions, SDAML in BEO, SDVAP in BEO and SDVML in MND condition) of 16 parameters analysed. Tests performed indicate a poorer static postural balance in the haemophilic cohort compared to the control group. Accordingly, physiotherapy programmes, physical activity and sports should be designed to improve the postural balance with the aim of preventing joint deterioration and improving quality of life. © 2016 John Wiley & Sons Ltd.

What Are the Treatments for Symptoms in Klinefelter Syndrome?

MedlinePlus

... any or all of the following: Physical therapists design activities and exercises to build motor skills and strength and to improve muscle control, posture, and balance. Occupational therapists help build skills ...

Improving precise positioning of surgical robotic instruments by a three-side-view presentation system on telesurgery.

PubMed

Hori, Kenta; Kuroda, Tomohiro; Oyama, Hiroshi; Ozaki, Yasuhiko; Nakamura, Takehiko; Takahashi, Takashi

2005-12-01

For faultless collaboration among the surgeon, surgical staffs, and surgical robots in telesurgery, communication must include environmental information of the remote operating room, such as behavior of robots and staffs, vital information of a patient, named supporting information, in addition to view of surgical field. "Surgical Cockpit System, " which is a telesurgery support system that has been developed by the authors, is mainly focused on supporting information exchange between remote sites. Live video presentation is important technology for Surgical Cockpit System. Visualization method to give precise location/posture of surgical instruments is indispensable for accurate control and faultless operation. In this paper, the authors propose three-side-view presentation method for precise location/posture control of surgical instruments in telesurgery. The experimental results show that the proposed method improved accurate positioning of a telemanipulator.

Implication of Posture Analysing Software to Evaluate the Postural Changes after Corrective Exercise Strategy on Subjects with Upper Body Dysfunction-A Randomized Controlled Trial

PubMed Central

Sudhakar, S; Porcelvan, S; Francis, T.G. Tilak; Rathnamala, D; Radhakrishnan, R

2017-01-01

Introduction The postural adaptation is very common now a days in school going children, office desk oriented job, computer users and frequent mobile users, and in all major industrial workers. Several studies have documented a high incidence of postural abnormalities in a given population; however, methods of postural measurement were poorly defined. The implication of postural pro software to analyse the postural imbalance of upper body dysfunction is very rare and literature studies says that the kinematic changes in particular segment will produce pain/discomfort and thereby lesser productivity of subjects. Aim To evaluate the postural changes in subjects with upper body dysfunction after a corrective exercise strategy using postural analysis software and pectoralis minor muscle length testing. Materials and Methods After explaining the procedure and benefits, informed consent was taken from the participating subjects (age 25-55 years). Subjects with upper body dysfunction were randomly allocated into two groups (each group 30 subjects). The Group–A received the corrective exercise strategy and Group-B received the conventional exercise for eight weeks of study duration (15 reps each exercise, total duration of 40 min; four days/week. Pre and Post posture analysis were analysed using posture pro software along with flexibility of pectoralis minor was assessed using ruler scale method. Results After interpretation of data, both the group showed the postural alteration and pectoralis minor muscle length changes, p-value (p<0.01) of both group showed highly significant changes. But comparing the both groups, the subjects who received the corrective exercise strategy shown more percentage of improvement in posture alteration (56.25%), pectoralis minor muscle length changes (68.69%) than the conventional exercise received subjects in posture alteration (24.86%) and pectoralis minor muscle length changes (21.9%). Conclusion Altered postural changes and pectoralis minor muscle flexibility before and after the corrective exercise strategy evaluated by postural analysis software method shown to be a significant tool in clinical practice, which is easier and reproducible method. PMID:28893030

Examining the stability of dual-task posture and reaction time measures in older adults over five sessions: a pilot study.

PubMed

Jehu, Deborah A; Paquet, Nicole; Lajoie, Yves

2016-12-01

Improved performance may be inherent due to repeated exposure to a testing protocol. However, limited research has examined this phenomenon in postural control. The aim was to determine the influence of repeated administration of a dual-task testing protocol once per week for 5 weeks on postural sway and reaction time. Ten healthy older adults (67.0 ± 6.9 years) stood on a force plate for 30 s in feet apart and semi-tandem positions while completing simple reaction time (SRT) and choice reaction time (CRT) tasks. They were instructed to stand as still as possible while verbally responding as fast as possible to the stimuli. No significant differences in postural sway were shown over time (p > 0.05). A plateau in average CRT emerged as the time effect revealed longer CRT during session 1 compared to sessions 3-5 (p < 0.05). Furthermore, the time effect for within-subject variability of CRT uncovered no plateaus as it was less variable in session 5 than sessions 1-4 (p < 0.05). The lack of a plateau in variability of CRT may have emerged as older adults may require longer to reach optimal performance potential in a dual-task context. Postural sway and SRT were stable over the 5 testing sessions, but variability of CRT continued to improve over time. These findings form a basis for future studies to examine performance-related improvements due to repeated exposure to a testing protocol in a dual-task setting.

Effect of six weeks of dura disc and mini-trampoline balance training on postural sway in athletes with functional ankle instability.

PubMed

Kidgell, Dawson J; Horvath, Deanna M; Jackson, Brendan M; Seymour, Philip J

2007-05-01

Lateral ankle sprain (LAS) is one of the most common injuries incurred during sporting activities, and effective rehabilitation programs for this condition are challenging to develop. The purpose of this research was to compare the effect of 6 weeks of balance training on either a mini-trampoline or a dura disc on postural sway and to determine if the mini-trampoline or the dura disc is more effective in improving postural sway. Twenty subjects (11 men, 9 women) with a mean age of 25.4 +/- 4.2 years were randomly allocated into a control group, a dura disc training (DT) group, or a mini-trampoline (MT) group. Subjects completed 6 weeks of balance training. Postural sway was measured by subjects performing a single limb stance on a force plate. The disbursement of the center of pressure was obtained from the force plate in the medial-lateral and the anterior-posterior sway path and was subsequently used for pretest and posttest analysis. After the 6-week training intervention, there was a significant (p < 0.05) difference in postural sway between pre- and posttesting for both the MT (pretest = 56.8 +/- 20.5 mm, posttest = 33.3 +/- 8.5 mm) and DT (pretest = 41.3 +/- 2.6 mm, posttest = 27.2 +/- 4.8 mm) groups. There was no significant (p > 0.05) difference detected for improvements between the MT and DT groups. These results indicate that not only is the mini-trampoline an effective tool for improving balance after LAS, but it is equally as effective as the dura disc.

Wavelet Transform Analysis of the Power Spectrum of Centre of Pressure Signals to Detect the Critical Point Interval of Postural Control

NASA Astrophysics Data System (ADS)

Singh, Neeraj Kumar; Snoussi, Hichem; Hewson, David; Duchêne, Jacques

The aim of this study was to develop a method to detecting the critical point interval (CPI) when sensory feedback is used as part of a closed-loop postural control strategy. Postural balance was evaluated using centre of pressure (COP) displacements from a force plate for 17 control and 10 elderly subjects under eyes open, eyes closed, and vibration conditions. A modified local-maximum-modulus wavelet transform analysis using the power spectrum of COP signals was used to calculate CPI. Lower CPI values indicate increased closed-loop postural control with a quicker response to sensory input. Such a strategy requires greater energy expenditure due to the repeated muscular interventions to remain stable. The CPI for elderly occurred significantly quicker than for controls, indicating tighter control of posture. Similar results were observed for eyes closed and vibration conditions. The CPI parameter can be used to detect differences in postural control due to ageing.

Ergonomic design of crane cabins: a case study from a steel plant in India.

PubMed

Ray, Pradip Kumar; Tewari, V K

2012-01-01

The study, carried out at the Batch Annealing Furnace (BAF) shop of Cold Rolling Mill (CRM) at an integrated steel plant of India, concerns ergonomic evaluation and redesign of a manually-operated Electrical Overhead Travelling (EOT) crane cabin. The crane cabin is a complex worksystem consisting of the crane operator and twelve specific machine components embedded in a closed workspace. A crane operator has to perform various activities, such as loading and unloading of coils, setting and removal of convector plates, and routine maintenance work. Initially, an operator had to work in standing posture with bent back most of the time. Ergonomically poor design of the chair and the controls, awkward work postures, and insufficient vision angle resulting in musculoskeletal disorders (MSDs) are some of the critical problems observed.. The study, conceived as an industry-academia joint initiative, was undertaken by a design team, the members of which were drawn from both the company concerned and the institute. With the project executed successfully, a number of lessons, such as how to minimize the anthropometric mismatch, how to improve the layout of the components and controls within enclosed workspace, and how to improve work posture minimizing risk of MSDs have been learned.

Research on Safety and Compliance of a New Lower Limb Rehabilitation Robot

PubMed

Feng, Yongfei; Wang, Hongbo; Yan, Hao; Wang, Xincheng; Jin, Zhennan; Vladareanu, Luige

2017-01-01

The lower limb rehabilitation robot is an application of robotic technology for stroke people with lower limb disabilities. A new applicable and effective sitting/lying lower limb rehabilitation robot (LLR-Ro) is proposed, which has the mechanical limit protection, the electrical limit protection, and the software protection to prevent the patient from the secondary damage. Meanwhile, as a new type of the rehabilitation robots, its hip joint rotation ranges are different in the patient sitting training posture and lying training posture. The mechanical leg of the robot has a variable workspace to work in both training postures. So, if the traditional mechanical limit and the electrical limit cannot be used in the hip joint mechanism design, a follow-up limit is first proposed to improve the compatibility of human-machine motion. Besides, to eliminate the accident interaction force between the patient and LLR-Ro in the process of the passive training, an amendment impedance control strategy based on the position control is proposed to improve the compliance of the LLR-Ro. A simulation experiment and an experiment with a participant show that the passive training of LLR-Ro has compliance. © 2017 Yongfei Feng et al.

Research on Safety and Compliance of a New Lower Limb Rehabilitation Robot

PubMed Central

Yan, Hao; Wang, Xincheng; Jin, Zhennan; Vladareanu, Luige

2017-01-01

The lower limb rehabilitation robot is an application of robotic technology for stroke people with lower limb disabilities. A new applicable and effective sitting/lying lower limb rehabilitation robot (LLR-Ro) is proposed, which has the mechanical limit protection, the electrical limit protection, and the software protection to prevent the patient from the secondary damage. Meanwhile, as a new type of the rehabilitation robots, its hip joint rotation ranges are different in the patient sitting training posture and lying training posture. The mechanical leg of the robot has a variable workspace to work in both training postures. So, if the traditional mechanical limit and the electrical limit cannot be used in the hip joint mechanism design, a follow-up limit is first proposed to improve the compatibility of human-machine motion. Besides, to eliminate the accident interaction force between the patient and LLR-Ro in the process of the passive training, an amendment impedance control strategy based on the position control is proposed to improve the compliance of the LLR-Ro. A simulation experiment and an experiment with a participant show that the passive training of LLR-Ro has compliance. PMID:29065571

Evaluation of influence of stretching therapy and ergonomic factors on postural control in patients with chronic non-specific low back pain.

PubMed

Gawda, Piotr; Dmoszyńska-Graniczka, Magdalena; Pawlak, Halina; Cybulski, Marek; Kiełbus, Michał; Majcher, Piotr; Buczaj, Agnieszka; Buczaj, Marcin

2015-01-01

The vertical orientation of the body in the upright standing position is maintained by keeping the body's centre of gravity (COG) upright, above the base of support, by a dynamic interplay of visual, vestibular, and somatosensory control systems. The objectives of this study were: to compare the postural control strategy between people with and without low back pain (LBP), to estimate the influence of the stretching therapy on the postural control strategy, and to discover the relationship between the restriction of spine mobility and occurrence of some ergonomic factors. The study consisted of 32 patients with LBP and 25 healthy controls. Postural characteristics of the subjects were measured with the use of a computerized force platform. The software programme filters and measures COG sway velocity in different conditions. Additional measurements and tests were conducted in patients after stretching therapy. Based on survey research, all individuals were selected and evaluated from the aspect of ergonomics. The results of the COG sway velocity vary under the testing conditions. From the aspect of ergonomic attitude and influence of the rehabilitation, results varied in the groups. Ergonomic factors are often accompanied by the appearance of LBP. The restrictions within the musculoskeletal system cause disorders in muscle synergies, which is expressed by an increase in the angular velocity of the COG. In patients with chronic back pain syndrome, selected stretching therapy techniques improves the range of motion of the spine and reduces pain.

A balance and proprioception intervention programme to enhance combat performance in military personnel.

PubMed

Funk, Shany; Jacob, T; Ben-Dov, D; Yanovich, E; Tirosh, O; Steinberg, N

2018-02-01

Optimal functioning of the lower extremities under repeated movements on unstable surfaces is essential for military effectiveness. Intervention training to promote proprioceptive ability should be considered in order to limit the risk for musculoskeletal injuries. The aim of this study was to assess the effect of a proprioceptive intervention programme on static and dynamic postural balance among Israel Defense Forces combat soldiers. Twenty-seven male soldiers, aged 18-20 years, from a physical fitness instructor's course, were randomly divided into two groups matched by age and army unit. The intervention group (INT) underwent 4 weeks of proprioceptive exercises for 10 min daily; the control group underwent 4 weeks of upper body stretching exercises for 10 min daily. All participants were tested pre and postintervention for both static and dynamic postural balance. Significant interaction (condition*pre-post-test*group) was found for static postural balance, indicating that for the INT group, in condition 3 (on an unstable surface-BOSU), the post-test result was significantly better compared with the pretest result (p<0.05). Following intervention, the INT group showed significant correlations between static postural stability in condition 2 (eyes closed) and the dynamic postural stability (length of time walked on the beam following fatigue) ( r ranged from 0.647 to 0.822; p<0.05). The proprioceptive intervention programme for combat soldiers improved static postural balance on unstable surfaces, and improved the correlation between static postural balance in the eyes closed condition and dynamic postural balance following fatigue. Further longitudinal studies are needed to verify the relationship between proprioception programmes, additional weight bearing and the reduction of subsequent injuries in combat soldiers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Role of Neuromuscular Changes in Aging and Knee Osteoarthritis on Dynamic Postural Control

PubMed Central

Takacs, Judit; Carpenter, Mark G.; Garland, S. Jayne; Hunt, Michael A.

2013-01-01

Knee osteoarthritis (OA) is a chronic joint condition, with 30% of those over the age of 75 exhibiting severe radiographic disease. Nearly 50% of those with knee OA have experienced a fall in the past year. Falls are a considerable public health concern, with a high risk of serious injury and a significant socioeconomic impact. The ability to defend against a fall relies on adequate dynamic postural control, and alterations in dynamic postural control are seen with normal aging. Neuromuscular changes associated with aging may be responsible for some of these alterations in dynamic postural control. Even greater neuromuscular deficits, which may impact dynamic postural control and the ability to defend against a fall, are seen in people with knee OA. There is little evidence to date on how knee OA affects the ability to respond to and defend against falls and the neuromuscular changes that contribute to balance deficits. As a result, this review will: summarize the key characteristics of postural responses to an external perturbation, highlight the changes in dynamic postural control seen with normal aging, review the neuromuscular changes associated with aging that have known and possible effects on dynamic postural control, and summarize the neuromuscular changes and balance problems in knee OA. Future research to better understand the role of neuromuscular changes in knee OA and their effect on dynamic postural control will be suggested. Such an understanding is critical to the successful creation and implementation of fall prevention and treatment programs, in order to reduce the excessive risk of falling in knee OA. PMID:23696951

Regional volumes in brain stem and cerebellum are associated with postural impairments in young brain-injured patients.

PubMed

Drijkoningen, David; Leunissen, Inge; Caeyenberghs, Karen; Hoogkamer, Wouter; Sunaert, Stefan; Duysens, Jacques; Swinnen, Stephan P

2015-12-01

Many patients with traumatic brain injury (TBI) suffer from postural control impairments that can profoundly affect daily life. The cerebellum and brain stem are crucial for the neural control of posture and have been shown to be vulnerable to primary and secondary structural consequences of TBI. The aim of this study was to investigate whether morphometric differences in the brain stem and cerebellum can account for impairments in static and dynamic postural control in TBI. TBI patients (n = 18) and healthy controls (n = 30) completed three challenging postural control tasks on the EquiTest® system (Neurocom). Infratentorial grey matter (GM) and white matter (WM) volumes were analyzed with cerebellum-optimized voxel-based morphometry using the spatially unbiased infratentorial toolbox. Volume loss in TBI patients was revealed in global cerebellar GM, global infratentorial WM, middle cerebellar peduncles, pons and midbrain. In the TBI group and across both groups, lower postural control performance was associated with reduced GM volume in the vermal/paravermal regions of lobules I-IV, V and VI. Moreover, across all participants, worse postural control performance was associated with lower WM volume in the pons, medulla, midbrain, superior and middle cerebellar peduncles and cerebellum. This is the first study in TBI patients to demonstrate an association between postural impairments and reduced volume in specific infratentorial brain areas. Volumetric measures of the brain stem and cerebellum may be valuable prognostic markers of the chronic neural pathology, which complicates rehabilitation of postural control in TBI. © 2015 Wiley Periodicals, Inc.

Effects of Lifetime Occupational Pesticide Exposure on Postural Control Among Farmworkers and Non-Farmworkers.

PubMed

Sunwook, Kim; Nussbaum, Maury A; Quandt, Sara A; Laurienti, Paul J; Arcury, Thomas A

2016-02-01

The aim of the study was to assess potential chronic effects of pesticide exposure on postural control, by examining postural balance of farmworkers and non-farmworkers diverse self-reported lifetime exposures. Balance was assessed during quiet upright stance under four experimental conditions (2 visual × 2 cognitive difficulty). Significant differences in baseline balance performance (eyes open without cognitive task) between occupational groups were apparent in postural sway complexity. When adding a cognitive task to the eyes open condition, the influence of lifetime exposure on complexity ratios appeared different between occupational groups. Removing visual information revealed a negative association of lifetime exposure with complexity ratios. Farmworkers and non-farmworkers may use different postural control strategies even when controlling for the level of lifetime pesticide exposure. Long-term exposure can affect somatosensory/vestibular sensory systems and the central processing of sensory information for postural control.

Effects of lifetime occupational pesticide exposure on postural control among farmworkers and non-farmworkers

PubMed Central

Sunwook, Kim; Nussbaum, Maury A.; Quandt, Sara A.; Laurienti, Paul J.; Arcury, Thomas A.

2015-01-01

Objective Assess potential chronic effects of pesticide exposure on postural control, by examining postural balance of farmworkers and non-farmworkers diverse self-reported lifetime exposures. Methods Balance was assessed during quiet upright stance under four experimental conditions (2 visual × 2 cognitive difficulty). Results Significant differences in baseline balance performance (eyes open without cognitive task) between occupational groups were apparent in postural sway complexity. When adding a cognitive task to the eyes open condition, the influence of lifetime exposure on complexity ratios appeared different between occupational groups. Removing visual information revealed a negative association of lifetime exposure with complexity ratios. Conclusions Farmworkers and non-farmworkers may use different postural control strategies even when controlling for the level of lifetime pesticide exposure. Long-term exposure can affect somatosensory/vestibular sensory systems and the central processing of sensory information for postural control. PMID:26849257

Supervised resistance training results in changes in postural control in patients with multiple sclerosis.

PubMed

Huisinga, Jessie M; Filipi, Mary L; Stergiou, Nicholas

2012-01-01

Postural disturbances are one of the first reported symptoms in patients with Multiple Sclerosis (MS). The purpose of this study was to investigate the effect of supervised resistance training on postural control in MS patients. Postural control was assessed using amount of sway variability [Root Mean Square (RMS)] and temporal structure of sway variability [Lyapunov Exponent (LyE)] from 15 MS patients. Posture was evaluated before and after completion of three months of resistance training. There were significant differences between MS patients pretraining and healthy controls for both LyE (p = .000) and RMS (p = .002), but no differences between groups after training. There was a significant decrease in RMS (p = .025) and a significant increase in LyE (p = .049) for MS patients pre- to posttraining. The findings suggested that postural control of MS patients could be affected by a supervised resistance training intervention.

Supervised learning of postural tasks in patients with poststroke hemiparesis, Parkinson's disease or cerebellar ataxia.

PubMed

Ioffe, M E; Ustinova, K I; Chernikova, L A; Kulikov, M A

2006-01-01

Supervised learning of different postural tasks in patients with lesions of the motor cortex or pyramidal system (poststroke hemiparesis: 20 patients), nigro-striatal system (Parkinson's disease: 33 patients) and cerebellum (spinocerebellar ataxia: 37 patients) was studied. A control group consisted of 13 healthy subjects. The subjects stood on a force platform and were trained to change the position of the center of pressure (CP) presented as a cursor on a monitor screen in front of the patient. Subjects were instructed to align the CP with the target and then move the target by shifting the CP in the indicated direction. Two different tasks were used. In "Balls", the target (a ball) position varied randomly, so the subject learned a general strategy of voluntary CP control. In "Bricks", the subject had to always move the target in a single direction (downward) from the top to the bottom of the screen, so that a precise postural coordination had to be learned. The training consisted of 10 sessions for each task. The number of correctly performed trials for a session (2 min for each task) was scored. The voluntary control of the CP position was initially impaired in all groups of patients in both tasks. In "Balls", there were no differences between the groups of the patients on the first day. The learning course was somewhat better in hemiparetic patients than in the other groups. In "Bricks", the initial deficit was greater in the groups of parkinsonian and cerebellar patients than in hemiparetic patients. However, learning was more efficient in parkinsonian than in hemiparetic and cerebellar patients. After 10 days of training, the hemiparetic and cerebellar patients completed the acquisition at a certain level whereas the parkinsonian patients showed the ability for further improvement. The results suggest that motor cortex, cerebellum, and basal ganglia are involved in voluntary control of posture and learning different postural tasks. However, these structures play different roles in postural control and learning: basal ganglia are mainly involved in learning a general strategy of CP control while the function of the motor cortex chiefly concerns learning a specific CP trajectory. The cerebellum is involved in both kinds of learning.

The role of postural control in the association between aerobic capacity and walking capacity in chronic stroke: a cross-sectional analysis.

PubMed

Outermans, Jacqueline C; van de Port, Ingrid; Kwakkel, Gert; Visser-Meily, Johanna M; Wittink, Harriet

2018-03-12

Reports on the association between aerobic capacity and walking capacity in people after stroke show disparate results. To determine (1) if the predictive validity of peak oxygen uptake (VO2peak) for walking capacity post stroke is different from that of maximal oxygen uptake (VO2max) and (2) if postural control, hemiplegic lower extremity muscle strength, age and gender distort the association between aerobic capacity and walking capacity. Cross-sectional study. General community in Utrecht, the Netherlands. Community-dwelling people more than three months after stroke. Measurement of aerobic capacity were performed with cardiopulmonary exercise testing (CPET) and differentiated between the achievement of VO2peak or VO2max. Measurement of walking capacity with the Six Minute Walk Test (6MWT), postural control with the Performance Oriented Mobility Assessment (POMA) and hemiplegic lower extremity muscle strength with the Motricity Index (MI-LE). Fifty-one out of 62 eligible participants, aged 64.7 (±12.5) years were included. Analysis of covariance (ANCOVA) showed a nonsignificant difference between the predictive validities of VO2max (N = 22, β = 0.56; 95%CI 0.12 - 0.97) and VO2peak (N = 29, β = 0.72; 95%CI 0.38 - 0.92). Multiple regression analysis of the pooled sample showed a significant decrease in the β value of VO2peak (21.6%) for the 6MWT when adding the POMA as a covariate in the association model. VO2peak remained significantly related to 6MWT after correcting for the POMA (β = 0.56 (95%CI 0.39 - 0.75)) CONCLUSIONS: The results suggest similar predictive validity of aerobic capacity for walking capacity in participants achieving VO2max compared to those only achieving VO2peak. Postural control confounds the association between aerobic capacity and walking capacity. Aerobic capacity remains a valid predictor of walking capacity. Aerobic capacity is an important factor associated with walking capacity after stroke. However, to understand this relationship, postural control needs to be measured. Both aerobic capacity and postural control may need to be addressed during interventions aiming to improve walking capacity after stroke.

Postural control assessment in students with normal hearing and sensorineural hearing loss.

PubMed

Melo, Renato de Souza; Lemos, Andrea; Macky, Carla Fabiana da Silva Toscano; Raposo, Maria Cristina Falcão; Ferraz, Karla Mônica

2015-01-01

Children with sensorineural hearing loss can present with instabilities in postural control, possibly as a consequence of hypoactivity of their vestibular system due to internal ear injury. To assess postural control stability in students with normal hearing (i.e., listeners) and with sensorineural hearing loss, and to compare data between groups, considering gender and age. This cross-sectional study evaluated the postural control of 96 students, 48 listeners and 48 with sensorineural hearing loss, aged between 7 and 18 years, of both genders, through the Balance Error Scoring Systems scale. This tool assesses postural control in two sensory conditions: stable surface and unstable surface. For statistical data analysis between groups, the Wilcoxon test for paired samples was used. Students with hearing loss showed more instability in postural control than those with normal hearing, with significant differences between groups (stable surface, unstable surface) (p<0.001). Students with sensorineural hearing loss showed greater instability in the postural control compared to normal hearing students of the same gender and age. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Postural orientation and equilibrium processes associated with increased postural sway in autism spectrum disorder (ASD).

PubMed

Wang, Zheng; Hallac, Rami R; Conroy, Kaitlin C; White, Stormi P; Kane, Alex A; Collinsworth, Amy L; Sweeney, John A; Mosconi, Matthew W

2016-01-01

Increased postural sway has been repeatedly documented in children with autism spectrum disorder (ASD). Characterizing the control processes underlying this deficit, including postural orientation and equilibrium, may provide key insights into neurophysiological mechanisms associated with ASD. Postural orientation refers to children's ability to actively align their trunk and head with respect to their base of support, while postural equilibrium is an active process whereby children coordinate ankle dorsi-/plantar-flexion and hip abduction/adduction movements to stabilize their upper body. Dynamic engagement of each of these control processes is important for maintaining postural stability, though neither postural orientation nor equilibrium has been studied in ASD. Twenty-two children with ASD and 21 age and performance IQ-matched typically developing (TD) controls completed three standing tests. During static stance, participants were instructed to stand as still as possible. During dynamic stances, participants swayed at a comfortable speed and magnitude in either anterior-posterior (AP) or mediolateral (ML) directions. The center of pressure (COP) standard deviation and trajectory length were examined to determine if children with ASD showed increased postural sway. Postural orientation was assessed using a novel virtual time-to-contact (VTC) approach that characterized spatiotemporal dimensions of children's postural sway (i.e., body alignment) relative to their postural limitation boundary, defined as the maximum extent to which each child could sway in each direction. Postural equilibrium was quantified by evaluating the amount of shared or mutual information of COP time series measured along the AP and ML directions. Consistent with prior studies, children with ASD showed increased postural sway during both static and dynamic stances relative to TD children. In regard to postural orientation processes, children with ASD demonstrated reduced spatial perception of their postural limitation boundary towards target directions and reduced time to correct this error during dynamic postural sways but not during static stance. Regarding postural equilibrium, they showed a compromised ability to decouple ankle dorsi-/plantar-flexion and hip abduction/adduction processes during dynamic stances. These results suggest that deficits in both postural orientation and equilibrium processes contribute to reduced postural stability in ASD. Specifically, increased postural sway in ASD appears to reflect patients' impaired perception of their body movement relative to their own postural limitation boundary as well as a reduced ability to decouple distinct ankle and hip movements to align their body during standing. Our findings that deficits in postural orientation and equilibrium are more pronounced during dynamic compared to static stances suggests that the increased demands of everyday activities in which children must dynamically shift their COP involve more severe postural control deficits in ASD relative to static stance conditions that often are studied. Systematic assessment of dynamic postural control processes in ASD may provide important insights into new treatment targets and neurodevelopmental mechanisms.

Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review.

PubMed

Mustapa, Amirah; Justine, Maria; Mohd Mustafah, Nadia; Jamil, Nursuriati; Manaf, Haidzir

2016-01-01

Purpose. The aim of this paper is to review the published studies on the characteristics of impairments in the postural control and gait performance in diabetic peripheral neuropathy (DPN). Methods. A review was performed by obtaining publication of all papers reporting on the postural control and gait performance in DPN from Google Scholar, Ovid, SAGE, Springerlink, Science Direct (SD), EBSCO Discovery Service, and Web of Science databases. The keywords used for searching were "postural control," "balance," "gait performance," "diabetes mellitus," and "diabetic peripheral neuropathy." Results. Total of 4,337 studies were hit in the search. 1,524 studies were screened on their titles and citations. Then, 79 studies were screened on their abstract. Only 38 studies were eligible to be selected: 17 studies on postural control and 21 studies on the gait performance. Most previous researches were found to have strong evidence of postural control impairments and noticeable gait deficits in DPN. Deterioration of somatosensory, visual, and vestibular systems with the pathologic condition of diabetes on cognitive impairment causes further instability of postural and gait performance in DPN. Conclusions. Postural instability and gait imbalance in DPN may contribute to high risk of fall incidence, especially in the geriatric population. Thus, further works are crucial to highlight this fact in the hospital based and community adults.

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report.

PubMed

Chisholm, Amanda E; Alamro, Raed A; Williams, Alison M M; Lam, Tania

2017-04-11

Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI). Three individuals with motor-complete SCI from C7-T4, assumed to have no voluntary motor function below the chest, underwent robotic gait training. The participants were randomly assigned to Ekso-Lokomat-Ekso or Lokomat-Ekso-Lokomat for 10 sessions within each intervention phase for a total of 30 sessions. We evaluated static and dynamic balance control through analysis of center of pressure (COP) movements after each intervention phase. Surface electromyography was used to compare activity of the abdominal and erector spinae muscles during Ekso and Lokomat walking. We observed improved postural stability after training with Ekso compared to Lokomat during static balance tasks, indicated by reduced COP root mean square distance and ellipse area. In addition, Ekso training increased total distance of COP movements during a dynamic balance task. The trunk muscles showed increased activation during Ekso overground walking compared to Lokomat walking. Our findings suggest that the Ekso actively recruits trunk muscles through postural control mechanisms, which may lead to improved balance during sitting. Developing effective training strategies to reactivate the trunk muscles is important to facilitate independence during seated balance activity in people with SCI.

Recovery of postural equilibrium control following spaceflight

NASA Technical Reports Server (NTRS)

Paloski, W. H.; Reschke, M. F.; Black, F. O.; Doxey, D. D.; Harm, D. L.

1992-01-01

Decreased postural stability is observed in most astronauts immediately following spaceflight. Because ataxia may present postflight operational hazards, it is important to determine the incidence of postural instability immediately following landing and the dynamics of recovery of normal postural equilibrium control. It is postulated that postflight postural instability results from in-flight adaptive changes in central nervous system (CNS) processing of sensory information from the visual, vestibular, and proprioceptive systems. The purpose of the present investigation was to determine the magnitude and time course of postflight recovery of postural equilibrium control and, hence, readaptation of CNS processing of sensory information. Thirteen crew members from six spaceflight missions were studied pre- and postflight using a modified commercial posturography system. Postural equilibrium control was found to be seriously disrupted immediately following spaceflight in all subjects. Readaptation to the terrestrial environment began immediately upon landing, proceeded rapidly for the first 10-12 hours, and then proceeded much more slowly for the subsequent 2-4 days until preflight stability levels were reachieved. It is concluded that the overall postflight recovery of postural stability follows a predictable time course.

Improvement of posture stability by vibratory stimulation following anterior cruciate ligament reconstruction.

PubMed

Brunetti, O; Filippi, G M; Lorenzini, M; Liti, A; Panichi, R; Roscini, M; Pettorossi, V E; Cerulli, G

2006-11-01

Surgical reconstruction of the anterior cruciate ligament (ACL) may reduce, but it does not always eliminate, knee and body instability because of a persisting proprioceptive deficit. In order to enhance body stability, a new protocol of treatment has been proposed consisting of mechanical vibration (100 Hz frequency and < 20 microm amplitude) of the quadriceps muscle in the leg that has undergone ACL reconstruction. In our trials, stimulation was performed when the quadriceps muscle was kept isometrically contracted. Treatment was started one month after surgery. Vibration was applied for short periods over three consecutive days. Nine months after treatment, postural stability was re-evaluated with the subjects standing on one leg with open and with closed eyes. The postural stability of the subjects having undergone vibration treatment, standing on the operated leg was significantly improved one day after treatment when evaluated as mean of speed and elliptic area of the center of pressure. The improvement persisted and increased during the following weeks. Peak torques of the operated leg extensor muscles also increased and reached values close to that of the leg, which had not been operated. Conversely, the balance of the untreated subjects standing on the operated leg did not improve and the restoration of the extensor muscle peak torque was poor. It is concluded that short lasting proprioceptive activation by vibration may lead to a faster and more complete equilibrium recovery probably by permanently changing the network controlling knee posture.

Eye Movements Affect Postural Control in Young and Older Females

PubMed Central

Thomas, Neil M.; Bampouras, Theodoros M.; Donovan, Tim; Dewhurst, Susan

2016-01-01

Visual information is used for postural stabilization in humans. However, little is known about how eye movements prevalent in everyday life interact with the postural control system in older individuals. Therefore, the present study assessed the effects of stationary gaze fixations, smooth pursuits, and saccadic eye movements, with combinations of absent, fixed and oscillating large-field visual backgrounds to generate different forms of retinal flow, on postural control in healthy young and older females. Participants were presented with computer generated visual stimuli, whilst postural sway and gaze fixations were simultaneously assessed with a force platform and eye tracking equipment, respectively. The results showed that fixed backgrounds and stationary gaze fixations attenuated postural sway. In contrast, oscillating backgrounds and smooth pursuits increased postural sway. There were no differences regarding saccades. There were also no differences in postural sway or gaze errors between age groups in any visual condition. The stabilizing effect of the fixed visual stimuli show how retinal flow and extraocular factors guide postural adjustments. The destabilizing effect of oscillating visual backgrounds and smooth pursuits may be related to more challenging conditions for determining body shifts from retinal flow, and more complex extraocular signals, respectively. Because the older participants matched the young group's performance in all conditions, decreases of posture and gaze control during stance may not be a direct consequence of healthy aging. Further research examining extraocular and retinal mechanisms of balance control and the effects of eye movements, during locomotion, is needed to better inform fall prevention interventions. PMID:27695412

Eye Movements Affect Postural Control in Young and Older Females.

PubMed

Thomas, Neil M; Bampouras, Theodoros M; Donovan, Tim; Dewhurst, Susan

2016-01-01

Visual information is used for postural stabilization in humans. However, little is known about how eye movements prevalent in everyday life interact with the postural control system in older individuals. Therefore, the present study assessed the effects of stationary gaze fixations, smooth pursuits, and saccadic eye movements, with combinations of absent, fixed and oscillating large-field visual backgrounds to generate different forms of retinal flow, on postural control in healthy young and older females. Participants were presented with computer generated visual stimuli, whilst postural sway and gaze fixations were simultaneously assessed with a force platform and eye tracking equipment, respectively. The results showed that fixed backgrounds and stationary gaze fixations attenuated postural sway. In contrast, oscillating backgrounds and smooth pursuits increased postural sway. There were no differences regarding saccades. There were also no differences in postural sway or gaze errors between age groups in any visual condition. The stabilizing effect of the fixed visual stimuli show how retinal flow and extraocular factors guide postural adjustments. The destabilizing effect of oscillating visual backgrounds and smooth pursuits may be related to more challenging conditions for determining body shifts from retinal flow, and more complex extraocular signals, respectively. Because the older participants matched the young group's performance in all conditions, decreases of posture and gaze control during stance may not be a direct consequence of healthy aging. Further research examining extraocular and retinal mechanisms of balance control and the effects of eye movements, during locomotion, is needed to better inform fall prevention interventions.

Return of Postural Control to Baseline After Anaerobic and Aerobic Exercise Protocols

PubMed Central

Fox, Zachary G; Mihalik, Jason P; Blackburn, J Troy; Battaglini, Claudio L; Guskiewicz, Kevin M

2008-01-01

Context: With regard to sideline concussion testing, the effect of fatigue associated with different types of exercise on postural control is unknown. Objective: To evaluate the effects of fatigue on postural control in healthy college-aged athletes performing anaerobic and aerobic exercise protocols and to establish an immediate recovery time course from each exercise protocol for postural control measures to return to baseline status. Design: Counterbalanced, repeated measures. Setting: Research laboratory. Patients Or Other Participants: Thirty-six collegiate athletes (18 males, 18 females; age  =  19.00 ± 1.01 years, height  =  172.44 ± 10.47 cm, mass  =  69.72 ± 12.84 kg). Intervention(s): Participants completed 2 counterbalanced sessions within 7 days. Each session consisted of 1 exercise protocol followed by postexercise measures of postural control taken at 3-, 8-, 13-, and 18-minute time intervals. Baseline measures were established during the first session, before the specified exertion protocol was performed. Main Outcome Measure(s): Balance Error Scoring System (BESS) results, sway velocity, and elliptical sway area. Results: We found a decrease in postural control after each exercise protocol for all dependent measures. An interaction was noted between exercise protocol and time for total BESS score (P  =  .002). For both exercise protocols, all measures of postural control returned to baseline within 13 minutes. Conclusions: Postural control was negatively affected after anaerobic and aerobic exercise protocols as measured by total BESS score, elliptical sway area, and sway velocity. The effect of exertion lasted up to 13 minutes after each exercise was completed. Certified athletic trainers and clinicians should be aware of these effects and their recovery time course when determining an appropriate time to administer sideline assessments of postural control after a suspected mild traumatic brain injury. PMID:18833307

Return of postural control to baseline after anaerobic and aerobic exercise protocols.

PubMed

Fox, Zachary G; Mihalik, Jason P; Blackburn, J Troy; Battaglini, Claudio L; Guskiewicz, Kevin M

2008-01-01

With regard to sideline concussion testing, the effect of fatigue associated with different types of exercise on postural control is unknown. To evaluate the effects of fatigue on postural control in healthy college-aged athletes performing anaerobic and aerobic exercise protocols and to establish an immediate recovery time course from each exercise protocol for postural control measures to return to baseline status. Counterbalanced, repeated measures. Research laboratory. Thirty-six collegiate athletes (18 males, 18 females; age = 19.00 +/- 1.01 years, height = 172.44 +/- 10.47 cm, mass = 69.72 +/- 12.84 kg). Participants completed 2 counterbalanced sessions within 7 days. Each session consisted of 1 exercise protocol followed by postexercise measures of postural control taken at 3-, 8-, 13-, and 18-minute time intervals. Baseline measures were established during the first session, before the specified exertion protocol was performed. Balance Error Scoring System (BESS) results, sway velocity, and elliptical sway area. We found a decrease in postural control after each exercise protocol for all dependent measures. An interaction was noted between exercise protocol and time for total BESS score (P = .002). For both exercise protocols, all measures of postural control returned to baseline within 13 minutes. Postural control was negatively affected after anaerobic and aerobic exercise protocols as measured by total BESS score, elliptical sway area, and sway velocity. The effect of exertion lasted up to 13 minutes after each exercise was completed. Certified athletic trainers and clinicians should be aware of these effects and their recovery time course when determining an appropriate time to administer sideline assessments of postural control after a suspected mild traumatic brain injury.

Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial.

PubMed

Katzman, W B; Vittinghoff, E; Lin, F; Schafer, A; Long, R K; Wong, S; Gladin, A; Fan, B; Allaire, B; Kado, D M; Lane, N E

2017-10-01

A 6-month randomized controlled trial of spine-strengthening exercise and posture training reduced both radiographic and clinical measures of kyphosis. Participants receiving the intervention improved self-image and satisfaction with their appearance. Results suggest that spine-strengthening exercise and postural training may be an effective treatment option for older adults with hyperkyphosis. The purpose of the present study is to determine in a randomized controlled trial whether spine-strengthening exercises improve Cobb angle of kyphosis in community-dwelling older adults. We recruited adults ≥60 years with kyphosis ≥40° and enrolled 99 participants (71 women, 28 men), mean age 70.6 ± 0.6 years, range 60-88, with baseline Cobb angle 57.4 ± 12.5°. The intervention included group spine-strengthening exercise and postural training, delivered by a physical therapist, 1-h, three times weekly for 6 months. Controls received four group health education meetings. The primary outcome was change in the gold standard Cobb angle of kyphosis measured from standing lateral spine radiographs. Secondary outcomes included change in kyphometer-measured kyphosis, physical function (modified Physical Performance Test, gait speed, Timed Up and Go, Timed Loaded Standing, 6-Min Walk), and health-related quality of life (HRQoL) (PROMIS global health and physical function indexes, SRS-30 self-image domain). ANCOVA was used to assess treatment effects on change from baseline to 6 months in all outcomes. There was a -3.0° (95% CI -5.2, -0.8) between-group difference in change in Cobb angle, p = 0.009, favoring the intervention and approximating the magnitude of change from an incident vertebral fracture. Kyphometer-measured kyphosis (p = 0.03) and SRS-30 self-esteem (p < 0.001) showed favorable between-group differences in change, with no group differences in physical function or additional HRQoL outcomes, p > 0.05. Spine-strengthening exercise and posture training over 6 months reduced kyphosis compared to control. Our randomized controlled trial results suggest that a targeted kyphosis-specific exercise program may be an effective treatment option for older adults with hyperkyphosis. ClinicalTrials.gov; identifier NCT01751685.

Water-based vs. non-water-based physiotherapy for rehabilitation of postural deformities in Parkinson's disease: a randomized controlled pilot study.

PubMed

Volpe, Daniele; Giantin, Maria Giulia; Manuela, Pilleri; Filippetto, Consuelo; Pelosin, Elisa; Abbruzzese, Giovanni; Antonini, Angelo

2017-08-01

To compare the efficacy of two physiotherapy protocols (water-based vs. non-water-based) on postural deformities of patients with Parkinson's disease. A single blind, randomized controlled pilot study. Inpatient (Rehabilitative Department). A total of 30 patients with idiopathic Parkinson's disease. Participants were randomly assigned to one of two eight-week treatment groups: Water-based ( n = 15) or non-water-based physiotherapy exercises ( n = 15). Changes in the degree of cervical and dorsal flexion and in the angle of lateral inclination of the trunk (evaluated by means of a posturographic system) were used as primary outcomes. Unified Parkinson Disease Rating Scale section III, Time Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence, Falls Efficacy Scale and the Parkinson's disease quality of life questionnaire (39 items) were the secondary outcomes. All outcomes were assessed at baseline, at the end of training and eight weeks after treatment. Patients were always tested at the time of their optimal antiparkinsonian medication ('on' phase). After the treatment, only Parkinson's disease subjects randomized to water-based treatment showed a significant improvement of trunk posture with a significant reduction of cervical flexion (water-based group: -65.2°; non-water-based group: +1.7°) and dorsal flexion (water-based group: -22.5°; non-water-based group: -6.5°) and lateral inclination of the trunk (water-based group: -2.3°; non-water-based group: +0.3°). Both groups presented significant improvements in the secondary clinical outcomes without between-group differences. Our results show that water-based physiotherapy was effective for improving postural deformities in patients with Parkinson's disease.

No beneficial effects of vitamin D supplementation on muscle function or quality of life in primary hyperparathyroidism: results from a randomized controlled trial.

PubMed

Rolighed, Lars; Rejnmark, Lars; Sikjaer, Tanja; Heickendorff, Lene; Vestergaard, Peter; Mosekilde, Leif; Christiansen, Peer

2015-05-01

Impairments of muscle function and strength in patients with primary hyperparathyroidism (PHPT) are rarely addressed, although decreased muscle function may contribute to increased fracture risk. We aimed to assess the changes in muscle strength, muscle function, postural stability, quality of life (QoL), and well-being during treatment with vitamin D or placebo before and after parathyroidectomy (PTX) in PHPT patients. A randomized placebo-controlled trial. We included 46 PHPT patients, mean age 58 (range 29-77) years and 35 (76%) were women. Daily treatment with 70 μg (2800 IU) cholecalciferol or placebo for 52 weeks. Treatment was administered 26 weeks before PTX and continued for 26 weeks after PTX. Changes in QoL and measures of muscle strength and function. Preoperatively, 25-hydroxyvitamin D (25OHD) increased significantly (50-94 nmol/l) compared with placebo (57-52 nmol/l). We did not measure any beneficial effects of supplementation with vitamin D compared with placebo regarding well-being, QoL, postural stability, muscle strength, or function. In all patients, we measured marked improvements in QoL, well-being (P<0.01), muscle strength in the knee flexion and extension (P<0.001), and muscle function tests (P<0.01) after surgical cure. Postural stability improved during standing with eyes closed (P<0.05), but decreased with eyes open (P<0.05). Patients with PHPT and 25OHD levels around 50 nmol/l did not benefit from vitamin D supplementation concerning muscle strength, muscle function, postural stability, well-being, or QoL. Independent of preoperative 25OHD levels, PTX improved these parameters. © 2015 European Society of Endocrinology.

Foam pad of appropriate thickness can improve diagnostic value of foam posturography in detecting postural instability.

PubMed

Liu, Bo; Leng, Yangming; Zhou, Renhong; Liu, Jingjing; Liu, Dongdong; Liu, Jia; Zhang, Su-Lin; Kong, Wei-Jia

2018-04-01

The present study investigated the effect of foam thickness on postural stability in patients with unilateral vestibular hypofunction (UVH) during foam posturography. Static and foam posturography were performed in 33 patients (UVH group) and 30 healthy subjects (control group) with eyes open (EO) and closed (EC) on firm surface and on 1-5 foam pad(s). Sway velocity (SV) of center of pressure, standing time before falling (STBF) and falls reaction were recorded and analyzed. (1) SVs had an increasing tendency in both groups as the foam pads were added under EO and EC conditions. (2) STBFs, only in UVH group with EC, decreased with foam thickness increasing. (3) Significant differences in SV were found between the control and UVH group with EO (except for standing on firm surface, on 1 and 2 foam pad(s)) and with EC (all surface conditions). (4) Receiver operating characteristic curve analysis showed that the SV could better reflect the difference in postural stability between the two groups while standing on the 4 foam pads with EC. Our study showed that diagnostic value of foam posturography in detecting postural instability might be enhanced by using foam pad of right thickness.

Side-alternating vibration training for balance and ankle muscle strength in untrained women.

PubMed

Spiliopoulou, Styliani I; Amiridis, Ioannis G; Tsigganos, Georgios; Hatzitaki, Vassilia

2013-01-01

Side-alternating vibration (SAV) may help reduce the risk of falling by improving body balance control. Such training has been promoted as a strength-training intervention because it can increase muscle activation through an augmented excitatory input from the muscle spindles. To determine the effect of SAV training on static balance during 3 postural tasks of increasing difficulty and lower limb strength. Randomized controlled clinical trial. Laboratory. A total of 21 healthy women were divided into training (n = 11; age = 43.35 ± 4.12 years, height = 169 ± 6.60 cm, mass = 68.33 ± 11.90 kg) and control (n = 10; age = 42.31 ± 3.73 years, height = 167 ± 4.32 cm, mass = 66.29 ± 10.74 kg) groups. The training group completed a 9-week program during which participants performed 3 sessions per week of ten 15-second isometric contractions with a 30-second active rest of 3 exercises (half-squat, wide-stance squat, 1-legged half-squat) on an SAV plate (acceleration = 0.91-16.3g). The control group did not participate in any form of exercise over the 9-week period. We evaluated isokinetic and isometric strength of the knee extensors and flexors and ankle plantar flexors, dorsiflexors, and evertors. Static balance was assessed using 3 tasks of increasing difficulty (quiet bipedal stance, tandem stance, 1-legged stance). The electromyographic activity of the vastus lateralis, semitendinosus, medial gastrocnemius, tibialis anterior, and peroneus longus was recorded during postural task performance, baseline and pretraining, immediately posttraining, and 15 days posttraining. After training in the training group, ankle muscle strength improved (P = .03), whereas knee muscle strength remained unaltered (P = .13). Improved ankle-evertor strength was observed at all angular velocities (P = .001). Postural sway decreased in both directions but was greater in the mediolateral (P < .001) than anteroposterior (P = .02) direction. The electromyographic activity of the peroneus longus increased during the sharpened tandem (P = .001) and 1-legged tasks (P = .007). No changes were seen in the control group for any measures. The SAV training could enhance ankle muscle strength and reduce postural sway during static balance performance. The reduction in mediolateral sway could be associated with the greater use of ankle evertors due to their strength improvement.

Postural trials: expertise in rhythmic gymnastics increases control in lateral directions.

PubMed

Calavalle, A R; Sisti, D; Rocchi, M B L; Panebianco, R; Del Sal, M; Stocchi, V

2008-11-01

The first aim of this paper was to investigate if expertise in rhythmic gymnastics influences postural performance even in an easy non-specific task such as bipedal posture. Rhythmic gymnastics is a unique female sport which encompasses aspects of both artistic gymnastics and ballet and includes the use of a small apparatus (rope, hoop, ball, clubs and ribbon). Most previous studies have shown that expertise achieved by artistic gymnasts and dancers improves postural steadiness only in the situations for which those athletes are trained. Literature has not yet compared rhythmic gymnasts to other athletes in terms of their postural strategies. Hence, the study presented herein tested a group of high level rhythmic gymnasts and a group of female university students, trained in other sports, in the bipedal posture under eyes open and closed conditions. A force platform was used to record body sway. (1) Distance from the centre of sway, (2) lateral and (3) antero-posterior displacements were analyzed in time and frequency domains. Comparing the two groups, it was found that rhythmic gymnasts had better strategies than students in simple postural tasks, especially in lateral directions and in the period from 0.05 to 2 s. The most interesting finding in this study is that rhythmic gymnastics training seems to have a direct effect on the ability to maintain bipedal posture, which may confirm the "transfer" hypothesis of rhythmic gymnastics expertise to bipedal postural sway, especially in medio-lateral displacements. This finding has never been reported in previous studies on artistic gymnasts and ballet dancers. Furthermore, the present study confirmed the visual dependence of all the athletes, irrespective of their disciplines, in their postural trials.

A Yoga Strengthening Program Designed to Minimize the Knee Adduction Moment for Women with Knee Osteoarthritis: A Proof-Of-Principle Cohort Study

PubMed Central

2015-01-01

People with knee osteoarthritis may benefit from exercise prescriptions that minimize knee loads in the frontal plane. The primary objective of this study was to determine whether a novel 12-week strengthening program designed to minimize exposure to the knee adduction moment (KAM) could improve symptoms and knee strength in women with symptomatic knee osteoarthritis. A secondary objective was to determine whether the program could improve mobility and fitness, and decrease peak KAM during gait. The tertiary objective was to evaluate the biomechanical characteristics of this yoga program. In particular, we compared the peak KAM during gait with that during yoga postures at baseline. We also compared lower limb normalized mean electromyography (EMG) amplitudes during yoga postures between baseline and follow-up. Primary measures included self-reported pain and physical function (Knee injury and Osteoarthritis Outcome Score) and knee strength (extensor and flexor torques). Secondary measures included mobility (six-minute walk, 30-second chair stand, stair climbing), fitness (submaximal cycle ergometer test), and clinical gait analysis using motion capture synchronized with electromyography and force measurement. Also, KAM and normalized mean EMG amplitudes were collected during yoga postures. Forty-five women over age 50 with symptomatic knee osteoarthritis, consistent with the American College of Rheumatology criteria, enrolled in our 12-week (3 sessions per week) program. Data from 38 were analyzed (six drop-outs; one lost to co-intervention). Participants experienced reduced pain (mean improvement 10.1–20.1 normalized to 100; p<0.001), increased knee extensor strength (mean improvement 0.01 Nm/kg; p = 0.004), and increased flexor strength (mean improvement 0.01 Nm/kg; p = 0.001) at follow-up compared to baseline. Participants improved mobility on the six-minute walk (mean improvement 37.7 m; p<0.001) and 30-second chair stand (mean improvement 1.3; p = 0.006) at follow-up compared to baseline. Fitness and peak KAM during gait were unchanged between baseline and follow-up. Average KAM during the yoga postures were lower than that of normal gait. Normalized mean EMG amplitudes during yoga postures were up to 31.0% of maximum but did not change between baseline and follow-up. In this cohort study, the yoga-based strengthening postures that elicit low KAMs improved knee symptoms and strength in women with knee OA following a 12 week program (3 sessions per week). The program also improved mobility, but did not improve fitness or reduce peak KAM during gait. The KAM during the yoga postures were lower than that of normal gait. Overall, the proposed program may be useful in improving pain, strength, and mobility in women with knee osteoarthritis. Clinical efficacy needs to be assessed using a randomized controlled trial design. Trial Registration ClinicalTrials.gov NCT02146105 PMID:26367862

Additional Haptic Information Provided by Anchors Reduces Postural Sway in Young Adults Less Than Does Light Touch

PubMed Central

Moraes, Renato; Bedo, Bruno L. S.; Santos, Luciana O.; Batistela, Rosangela A.; Santiago, Paulo R. P.; Mauerberg-deCastro, Eliane

2018-01-01

This study investigated the effect of adding haptic information to the control of posture, as well as comparing the effect of both the “light touch” (LT) and “anchor system” (AS) paradigms on postural sway. Additionally, it compared the effect of location and number of points of contact to the control of posture in young adults. The location consisted of using the anchors tied to the finger and held by the hands, and, for LT, the fingertip. For the number of points of contact, participants used two hands, and then separately the dominant hand, and the non-dominant hand, for both anchor and LT paradigms. Participants stood upright with feet-together and in tandem position while performing tasks that combined the use of anchors and LT, points of contact (hand grip and finger), and number of points of contact (two hands and one hand). In this study, the anchors consist of holding in each hand a flexible cable with the other end attached to the ground. The LT consists of slightly touching a rigid surface with the tip of the index finger. The results showed, first, that the anchors improved postural control less than did the LT. Second, they revealed that holding the anchors with the hands or with them tied to the fingertip resulted in a similar reduction in postural sway only in the tandem position. For the feet-together position, the anchors tied to the fingertip were ineffective. Similarly, the use of one or two hands did not affect the contribution of the anchors. However, using two hands in the LT condition was more effective than was one hand. Third, our results showed the presence of a temporal delay between force and center-of-pressure (COP) for the anchors, only in the AP direction with feet-together. In conclusion, overall, the anchors were less effective in reducing postural sway than was the LT. The anchors attached to fingertips were as effective as the hand-held anchors in the tandem position, yet ineffective during foot-together standing. Force-COP timing explains reduced postural sway with LT but not for the anchor; hence, exploratory and supra-postural components may be involved. PMID:29922122

A multicentre randomized controlled trial of gentle assisted pushing in the upright posture (GAP) or upright posture alone compared with routine practice to reduce prolonged second stage of labour (the Gentle Assisted Pushing study): study protocol.

PubMed

Hofmeyr, G Justus; Singata, Mandisa; Lawrie, Theresa; Vogel, Joshua P; Landoulsi, Sihem; Seuc, Armando H; Gülmezoglu, A Metin

2015-12-16

Fundal pressure (pushing on the upper part of the uterus in the direction of the birth canal) is often performed in routine practice, however the benefit and indications for its use are unclear and vigorous pressure is potentially harmful. There is some evidence that it may be applied routinely or to expedite delivery in some situations (e.g. fetal distress or maternal exhaustion), particularly in settings where other methods of achieving delivery (forceps, vacuum) are not available. Gentle assisted pushing (GAP) is an innovative method of applying gentle but steady pressure to the uterine fundus with the woman in an upright posture. This trial aims to evaluate the use of GAP in an upright posture, or upright posture alone, on reducing the mean time of delivery and the associated maternal and neonatal complications in women not having delivered following 15-30 min in the second stage of labour. We will conduct a multicentre, randomized, unblinded, controlled trial with three parallel arms (1:1:1). 1,145 women will be randomized at three hospitals in South Africa. Women will be eligible for inclusion if they are ≥18 years old, nulliparous, gestational age ≥ 35 weeks, have a singleton pregnancy in cephalic presentation and vaginal delivery anticipated. Women with chronic medical conditions or obstetric complications are not eligible. If eligible women are undelivered following 15-30 min in the second stage of labour, they will be randomly assigned to: 1) GAP in the upright posture, 2) upright posture only and 3) routine practice (recumbent/supine posture). The primary outcome is the mean time from randomization to complete delivery. Secondary outcomes include operative delivery, adverse neonatal outcomes, maternal adverse events and discomfort. This trial will establish whether upright posture and/or a controlled method of applying fundal pressure (GAP) can improve labour outcomes for women and their babies. If fundal pressure is found to have a measurable beneficial effect, this gentle approach can be promoted as a replacement for the uncontrolled methods currently in use. If it is not found to be useful, fundal pressure can be discouraged.

Saccadic Eye Movement Improves Plantar Sensation and Postural Balance in Elderly Women.

PubMed

Bae, Youngsook

2016-06-01

Vision, proprioception and plantar sensation contribute to the control of postural balance (PB). Reduced plantar sensation alters postural response and is at an increased risk of fall, and eye movements reduce the postural sway. Therefore, the aim of this study was to study the improvement of plantar sensation and PB after saccadic eye movement (SEM) and pursuit eye movement (PEM) in community-dwelling elderly women. Participants (104 females; 75.11 ± 6.25 years) were randomly allocated into the SEM group (n = 52) and PEM groups (n = 52). The SEM group performed eye fixation and SEM for 5 minutes, and the PEM group performed eye fixation and PEM for 5 minutes. The plantar sensation was measured according to the plantar surface area of the feet in contact with the floor surface before and after the intervention. Before and after SEM and PEM with the eyes open and closed, PB was measured as the area (mm(2)), length (cm), and velocity (cm/s) of the fluctuation of the center of pressure (COP). The plantar sensation of both feet improved in both groups (p < 0.01). Significant decreases in the area, length, and velocity of the COP were observed in the eye open and close in both groups (p < 0.01). The length and velocity of the COP significantly decreased in the SEM group compared to the PEM group (p < 0.05). In conclusion, SEM and PEM are effective interventions for improving plantar sensation and PB in elderly women, with greater PB improvement after SEM.

Postural Stability of Patients with Schizophrenia during Challenging Sensory Conditions: Implication of Sensory Integration for Postural Control.

PubMed

Teng, Ya-Ling; Chen, Chiung-Ling; Lou, Shu-Zon; Wang, Wei-Tsan; Wu, Jui-Yen; Ma, Hui-Ing; Chen, Vincent Chin-Hung

2016-01-01

Postural dysfunctions are prevalent in patients with schizophrenia and affect their daily life and ability to work. In addition, sensory functions and sensory integration that are crucial for postural control are also compromised. This study intended to examine how patients with schizophrenia coordinate multiple sensory systems to maintain postural stability in dynamic sensory conditions. Twenty-nine patients with schizophrenia and 32 control subjects were recruited. Postural stability of the participants was examined in six sensory conditions of different level of congruency of multiple sensory information, which was based on combinations of correct, removed, or conflicting sensory inputs from visual, somatosensory, and vestibular systems. The excursion of the center of pressure was measured by posturography. Equilibrium scores were derived to indicate the range of anterior-posterior (AP) postural sway, and sensory ratios were calculated to explore ability to use sensory information to maintain balance. The overall AP postural sway was significantly larger for patients with schizophrenia compared to the controls [patients (69.62±8.99); controls (76.53±7.47); t1,59 = -3.28, p<0.001]. The results of mixed-model ANOVAs showed a significant interaction between the group and sensory conditions [F5,295 = 5.55, p<0.001]. Further analysis indicated that AP postural sway was significantly larger for patients compared to the controls in conditions containing unreliable somatosensory information either with visual deprivation or with conflicting visual information. Sensory ratios were not significantly different between groups, although small and non-significant difference in inefficiency to utilize vestibular information was also noted. No significant correlations were found between postural stability and clinical characteristics. To sum up, patients with schizophrenia showed increased postural sway and a higher rate of falls during challenging sensory conditions, which was independent of clinical characteristics. Patients further demonstrated similar pattern and level of utilizing sensory information to maintain balance compared to the controls.

Neuromechanical tuning of nonlinear postural control dynamics

NASA Astrophysics Data System (ADS)

Ting, Lena H.; van Antwerp, Keith W.; Scrivens, Jevin E.; McKay, J. Lucas; Welch, Torrence D. J.; Bingham, Jeffrey T.; DeWeerth, Stephen P.

2009-06-01

Postural control may be an ideal physiological motor task for elucidating general questions about the organization, diversity, flexibility, and variability of biological motor behaviors using nonlinear dynamical analysis techniques. Rather than presenting "problems" to the nervous system, the redundancy of biological systems and variability in their behaviors may actually be exploited to allow for the flexible achievement of multiple and concurrent task-level goals associated with movement. Such variability may reflect the constant "tuning" of neuromechanical elements and their interactions for movement control. The problem faced by researchers is that there is no one-to-one mapping between the task goal and the coordination of the underlying elements. We review recent and ongoing research in postural control with the goal of identifying common mechanisms underlying variability in postural control, coordination of multiple postural strategies, and transitions between them. We present a delayed-feedback model used to characterize the variability observed in muscle coordination patterns during postural responses to perturbation. We emphasize the significance of delays in physiological postural systems, requiring the modulation and coordination of both the instantaneous, "passive" response to perturbations as well as the delayed, "active" responses to perturbations. The challenge for future research lies in understanding the mechanisms and principles underlying neuromechanical tuning of and transitions between the diversity of postural behaviors. Here we describe some of our recent and ongoing studies aimed at understanding variability in postural control using physical robotic systems, human experiments, dimensional analysis, and computational models that could be enhanced from a nonlinear dynamics approach.

Postural control under clinorotation in upside-down catfish, Synodontis nigriventris.

PubMed

Ohnishi, K; Takahashi, A; Koyama, M; Ohnishi, T

1996-12-01

The upside-down catfish Synodontis nigriventris has a unique habit of swimming and resting upside-down in free water. This behavior leads to the assumption that the catfish has a specific gravity information processing system. We examined the postural control behaviors in the catfish under clinorotation which is usually used for producing pseudo-microgravity. Synodontis nigriventris kept its body posture at a stable area of the rotated flask in which the catfish was kept, when it was clinorotated at the rate of 60 rpm. In contrast to Synodontis nigriventris, a related species, Corydoras paleatus, did not show such steady postural control. When the flask was rotated at a lower rate of 30 rpm or a higher rate of 100 rpm, Synodontis nigriventris as well as Corydoras paleatus showed a considerable disturbed control of body posture. In this condition, they were frequently rotated with the flask. These findings suggest that Synodontis nigriventris has a high ability to keep upside-down posture and the gravity sensation in this catfish is likely to contribute to its different postural control from that of many other fishes.

Letter to the Editor: On "Advantages and disadvantages of stiffness instructions when studying postural control" by C.T. Bonnet: You just can't win: Advantages and disadvantages of the postural stability requirement.

PubMed

Lajoie, Y; Richer, N; Jehu, D A; Polskaia, N; Saunders, D

2016-05-01

In the examination of postural control, instructions to stand as still as possible are common and promote a relatively unnatural sway pattern. The validity of the stability requirement is discussed in the present commentary in response to the discussion initiated by Cedrick T. Bonnet. The advantages of using the stability requirement include: evaluating unbiased postural control, reducing variability in postural sway, manipulating focus of attention, examining the ability to maintain an upright stance, and ecological validity of testing. The disadvantages include: constraining natural postural sway, increasing the complexity of the control condition, promoting an internal focus of attention, and reducing the ability to detect exploratory behaviour. After evaluating the aforementioned advantages and disadvantages, the present commentary suggests that researchers should strive to provide specific instructions to maintain feet, arm and eye position without specifically requiring participants to reduce their postural sway. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of intermittent feedback control on robustness of human-like postural control system

NASA Astrophysics Data System (ADS)

Tanabe, Hiroko; Fujii, Keisuke; Suzuki, Yasuyuki; Kouzaki, Motoki

2016-03-01

Humans have to acquire postural robustness to maintain stability against internal and external perturbations. Human standing has been recently modelled using an intermittent feedback control. However, the causality inside of the closed-loop postural control system associated with the neural control strategy is still unknown. Here, we examined the effect of intermittent feedback control on postural robustness and of changes in active/passive components on joint coordinative structure. We implemented computer simulation of a quadruple inverted pendulum that is mechanically close to human tiptoe standing. We simulated three pairs of joint viscoelasticity and three choices of neural control strategies for each joint: intermittent, continuous, or passive control. We examined postural robustness for each parameter set by analysing the region of active feedback gain. We found intermittent control at the hip joint was necessary for model stabilisation and model parameters affected the robustness of the pendulum. Joint sways of the pendulum model were partially smaller than or similar to those of experimental data. In conclusion, intermittent feedback control was necessary for the stabilisation of the quadruple inverted pendulum. Also, postural robustness of human-like multi-link standing would be achieved by both passive joint viscoelasticity and neural joint control strategies.

Effect of intermittent feedback control on robustness of human-like postural control system.

PubMed

Tanabe, Hiroko; Fujii, Keisuke; Suzuki, Yasuyuki; Kouzaki, Motoki

2016-03-02

Humans have to acquire postural robustness to maintain stability against internal and external perturbations. Human standing has been recently modelled using an intermittent feedback control. However, the causality inside of the closed-loop postural control system associated with the neural control strategy is still unknown. Here, we examined the effect of intermittent feedback control on postural robustness and of changes in active/passive components on joint coordinative structure. We implemented computer simulation of a quadruple inverted pendulum that is mechanically close to human tiptoe standing. We simulated three pairs of joint viscoelasticity and three choices of neural control strategies for each joint: intermittent, continuous, or passive control. We examined postural robustness for each parameter set by analysing the region of active feedback gain. We found intermittent control at the hip joint was necessary for model stabilisation and model parameters affected the robustness of the pendulum. Joint sways of the pendulum model were partially smaller than or similar to those of experimental data. In conclusion, intermittent feedback control was necessary for the stabilisation of the quadruple inverted pendulum. Also, postural robustness of human-like multi-link standing would be achieved by both passive joint viscoelasticity and neural joint control strategies.

Effect of intermittent feedback control on robustness of human-like postural control system

PubMed Central

Tanabe, Hiroko; Fujii, Keisuke; Suzuki, Yasuyuki; Kouzaki, Motoki

2016-01-01

Humans have to acquire postural robustness to maintain stability against internal and external perturbations. Human standing has been recently modelled using an intermittent feedback control. However, the causality inside of the closed-loop postural control system associated with the neural control strategy is still unknown. Here, we examined the effect of intermittent feedback control on postural robustness and of changes in active/passive components on joint coordinative structure. We implemented computer simulation of a quadruple inverted pendulum that is mechanically close to human tiptoe standing. We simulated three pairs of joint viscoelasticity and three choices of neural control strategies for each joint: intermittent, continuous, or passive control. We examined postural robustness for each parameter set by analysing the region of active feedback gain. We found intermittent control at the hip joint was necessary for model stabilisation and model parameters affected the robustness of the pendulum. Joint sways of the pendulum model were partially smaller than or similar to those of experimental data. In conclusion, intermittent feedback control was necessary for the stabilisation of the quadruple inverted pendulum. Also, postural robustness of human-like multi-link standing would be achieved by both passive joint viscoelasticity and neural joint control strategies. PMID:26931281

Neural Control of Posture in Individuals with Persisting Postconcussion Symptoms.

PubMed

Helmich, Ingo; Berger, Alisa; Lausberg, Hedda

2016-12-01

Postural instability has been shown to characterize individuals who suffered from long-term symptoms after mild traumatic brain injury. However, recordings of neural processes during postural control are difficult to realize with standard neuroimaging techniques. Thus, we used functional nearinfrared spectroscopy to investigate brain oxygenation of individuals with persistent postconcussion symptoms (pPCS) during postural control in altered environments. We compared brain oxygenation and postural sway during balance control in three groups: individuals suffering from pPCS, individuals with a history of mild traumatic brain injury but without pPCS, and healthy controls. Individuals were investigated during postural control tasks with six different conditions: i) eyes opened, ii) eyes closed, and iii) blurred visual input, each while standing a) on a stable and b) an unstable surface. In all groups, during the eyes closed/unstable surface condition as compared with the other conditions, the postural sway increased as well as the brain oxygenation in frontal brain cortices. In the most difficult balance condition, as compared with the other two groups, subjects with pPCS applied more force over time to keep balance as measured by the force plate system with a significantly greater activation in frontopolar/orbitofrontal areas of the right hemisphere. As subjects with pPCS applied more force over time to control balance, we propose that with regard to cognitive processes, the increase of cerebral activation in these individuals indicates an increase of attention-demanding processes during postural control in altered environments.

The effects of trunk extensor and abdominal muscle fatigue on postural control and trunk proprioception in young, healthy individuals.

PubMed

Larson, Dennis J; Brown, Stephen H M

2018-02-01

The purpose of this study was to induce both trunk extensor and abdominal muscle fatigue, on separate occasions, and compare their effects on standing postural control and trunk proprioception, as well as look at the effects of a recovery period on these outcome measures. A total of 20 individuals participated, with 10 (5 males and 5 females) completing either a standing postural control or lumbar axial repositioning protocol. Participants completed their randomly assigned protocol on two occasions, separated by at least 4  days, with either their trunk extensor or abdominal muscles being fatigued on either day. Postural control centre of pressure variables and trunk proprioception errors were compared pre- and post-fatigue. Results showed that both trunk extensor and abdominal muscle fatigue significantly degraded standing postural control immediately post-fatigue, with recovery occurring within 2 min post-fatigue. In general, these degradative effects on postural control appeared to be greater when the trunk extensor muscles were fatigued compared to the abdominal muscles. No statistically significant changes in trunk proprioception were found after either fatigue protocol. The present findings demonstrate our body's ability to quickly adapt and reweight somatosensory information to maintain postural control and trunk proprioception, as well as illustrate the importance of considering the abdominal muscles, along with the trunk extensor muscles, when considering the impact of fatigue on trunk movement and postural control. Copyright © 2017 Elsevier B.V. All rights reserved.

Improvements in musculoskeletal health and computing behaviors: Effects of a macroergonomics office workplace and training intervention.

PubMed

Robertson, Michelle M; Huang, Yueng Hsiang; Lee, Jin

2017-07-01

Computer use and its association with musculoskeletal and visual symptoms is an escalating concern. Organizations are shifting to a more proactive injury prevention perspective. Accordingly, a macroergonomics intervention consisting of flexible workplace design and office ergonomics training was designed to examine the effects on worker's computing behaviors, postures, and musculoskeletal discomfort, and their relationship to psychosocial factors. Participants were assigned to either group: 1) no-intervention control 2) flexible Workplace-only (WP-only), and 3) flexible Workplace + Training (WP+T). Observational findings indicate both intervention groups experienced positive, significant changes in improved workstation arrangements and computing postures, with the WP+T intervention group exhibiting a higher, significant change of behavioral translation. Also, significant, positive relationships between observed postures and musculoskeletal discomfort/pain were found. The intervention effect was stronger when management was responsive to workers' ergonomics needs. This study suggests that a macroergonomics intervention can produce beneficial effects for office and computer workers and organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Evaluation of the electromyography activity of pelvic floor muscle during postural exercises using the Wii Fit Plus©. Analysis and perspectives in rehabilitation].

PubMed

Steenstrup, B; Giralte, F; Bakker, E; Grise, P

2014-12-01

The aim of this work was to evaluate the effect of postural awareness by using the Wii Fit Plus© on the quality of the baseline (automatic) activity of the pelvic floor muscles (PFM) measured by intravaginal surface electromyography (sEMG). Four healthy continent female subjects, all able to perform a voluntary contraction, undertook 2 sets of 3 various exercises offered by the software Wii Fit Plus© using the Wii balance board© (WBB): one set without any visual control and the second set with postural control and sEMG visual feedback. Simultaneously, we recorded the sEMG activity of the PFM. Mean baseline activity of PFM in standing position at start was 2.87 mV, at submaximal voluntary contraction the sEMG activity raised at a mean of 14.43 mV (7.87-21.89). In the first set of exercises on the WBB without any visual feedback, the automatic activity of the PFM increased from 2.87 mV to 8.75 mV (7.96-9.59). In the second set, with visual postural and sEMG control, mean baseline sEMG activity even raised at 11.39 mV (10.17-11.58). Among women able of a voluntary contraction of PFM, visualisation of posture with the help of the WBB and of sEMG activity of the PFM during static and dynamic Wii Fit Plus© activities, may improve the automatic activation of the PFMs. 4. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Reliability of center of pressure measures for assessing the development of sitting postural control through the stages of sitting.

PubMed

Wickstrom, Jordan; Stergiou, Nick; Kyvelidou, Anastasia

2017-07-01

Cerebral palsy (CP) impairs an individual's ability to move and control one's posture. Unfortunately, the signs and symptoms of CP may not be apparent before age two. Evaluating sitting posture is a potential way to assess the developing mechanisms that contribute to CP. The purpose of this project was to determine the reliability of linear and nonlinear measures, including inter- and intrastage reliability, when used to analyze the center of pressure (COP) time series during the stages of sitting development in children with typical development (TD) and with/at-risk for cerebral palsy (CP). We hypothesized that nonlinear tools would be more reliable than linear tools in assessing childrens' sitting development, and reliability would increase with development. COP data was recorded for three trials at eight sessions. Linear parameters used were root mean square, range of sway for the anterior-posterior (AP) and medial-lateral (ML) directions, and sway path. Nonlinear parameters used were Approximate Entropy, the largest Lyapunov Exponent, and Correlation Dimension for the AP and ML direction. Participants consisted of 33 children with TD and 26 children with/at-risk for CP. Our results determined that COP is a moderately reliable method for assessing the development of sitting postural control in stages in both groups. Thus, clinicians may be able to use measures from COP data across stages to assess the efficacy of therapeutic interventions that are intended to improve sitting postural abilities in children with/at-risk for CP. Copyright © 2017 Elsevier B.V. All rights reserved.

Static Postural Control in Youth With Osteogenesis Imperfecta Type I.

PubMed

Pouliot-Laforte, Annie; Lemay, Martin; Rauch, Frank; Veilleux, Louis-Nicolas

2017-10-01

To assess static postural control in eyes-open and eyes-closed conditions in individuals with osteogenesis imperfecta (OI) type I as compared with typically developing (TD) individuals and to explore the relation between postural control and lower limb muscle function. Cross-sectional study. Outpatient department of a pediatric orthopedic hospital. A convenience sample (N=38) of individuals with OI type I (n=22; mean age, 13.1y; range, 6-21y) and TD individuals (n=16; mean age, 13.1y; range, 6-20y) was selected. Participants were eligible if they were between 6 and 21 years and if they did not have any fracture or surgery in the lower limb in the 12 months before testing. Not applicable. Postural control was assessed through static balance tests and muscle function through mechanographic tests on a force platform. Selected postural parameters were path length, velocity, 90% confidence ellipse area, and the ellipse's length of the mediolateral and anteroposterior axes. Mechanographic parameters were peak force and peak power as measured using the multiple two-legged hopping and the single two-legged jump test, respectively. Individuals with OI type I had poorer postural control than did TD individuals as indicated by longer and faster displacements and a larger ellipse area. Muscle function was unrelated to postural control in the OI group. Removing visual information resulted in a larger increase in postural control parameters in the OI group than in the TD group. A proprioceptive deficit could explain poorer postural control in individuals with OI type I. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effect of cognitive challenge on the postural control of patients with ACL reconstruction under visual and surface perturbations.

PubMed

Lion, Alexis; Gette, Paul; Meyer, Christophe; Seil, Romain; Theisen, Daniel

2018-02-01

Our study aimed to evaluate the effect of cognitive challenge on double-leg postural control under visual and surface perturbations of patients with anterior cruciate ligament reconstruction (ACLR) cleared to return to sport. Double-leg stance postural control of 19 rehabilitated patients with ACLR (age: 24.8 ± 6.7 years, time since surgery: 9.2 ± 1.6 months) and 21 controls (age: 24.9 ± 3.7 years) was evaluated in eight randomized situations combining two cognitive (with and without silent backward counting in steps of seven), two visual (eyes open, eyes closed) and two surface (stable support, foam support) conditions. Sway area and sway path of the centre of foot pressure were measured during three 20-s recordings for each situation. Higher values indicated poorer postural control. Generally, postural control of patients with ACLR and controls was similar for sway area and sway path (p > 0.05). The lack of visual anchorage and the disturbance of the plantar input by the foam support increased sway area and sway path (p < 0.001) similarly in both groups. The addition of the cognitive task decreased sway area and sway path (p < 0.001) similarly in both groups. Patients with ACLR who recently completed their rehabilitation have normalized postural control during double-leg stance tests. The use of a dual task paradigm under increased task complexity modified postural control, but in a similar way in patients with ACLR than in healthy controls. Double-leg stance tests, even under challenging conditions, are not sensitive enough to reveal postural control differences between rehabilitated patients with ACLR and controls. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of a predefined mini-trampoline training programme on balance, mobility and activities of daily living after stroke: a randomized controlled pilot study.

PubMed

Miklitsch, Claudia; Krewer, Carmen; Freivogel, Susanna; Steube, Diethard

2013-10-01

To investigate the effects of a predefined mini-trampoline therapy programme for increasing postural control, mobility and the ability to perform activities of daily living after stroke. Randomized non-blinded controlled pilot study. Neurological rehabilitation hospital. First-time stroke; age 18-80 years; independent standing ability for a minimum of 2 minutes. Patients were randomized into two groups: the mini-trampoline group (n = 20) received 10 sessions of balance training using the mini-trampoline over three weeks. The patients of the control group (n =20) participated 10 times in a group balance training also over three weeks. Postural control (Berg Balance Scale, BBS), mobility and gait endurance (timed 'up and go' test, TUG; 6-minute walk test, 6MWT) and the ability to perform activities of daily living (Barthel Index, BI). Measurements were undertaken prior to and after the intervention period. Both groups were comparable before the study. The mini-trampoline group improved significantly more in the BBS (P = 0.003) compared to the control group. Mean or median differences of both groups showed improvements in the TUG 10.12 seconds/7.23 seconds, the 6MWT 135 m/75 m and the BI 20 points/13 points for the mini-trampoline and control group, respectively. These outcome measurements did not differ significantly between the two groups. A predefined mini-trampoline training programme resulted in significantly increased postural control in stroke patients compared to balance training in a group. Although not statistically significant, the mini-trampoline training group showed increased improvement in mobility and activities of daily living. These differences could have been statistically significant if we had investigated more patients (i.e. a total sample of 84 patients for the TUG, 98 patients for the 6MWT, and 186 patients for the BI).

Does robotic gait training improve balance in Parkinson's disease? A randomized controlled trial.

PubMed

Picelli, Alessandro; Melotti, Camilla; Origano, Francesca; Waldner, Andreas; Gimigliano, Raffaele; Smania, Nicola

2012-09-01

Treadmill training (with or without robotic assistance) has been reported to improve balance skills in patients with Parkinson's disease (PD). However, its effectiveness on postural instability has been evaluated mainly in patients with mild to moderate PD (Hoehn & Yahr stage ≤3). Patients with more severe disease may benefit from robot-assisted gait training performed by the Gait-Trainer GT1, as a harness supports them with their feet placed on motor-driven footplates. The aim of this study was to determine whether robot-assisted gait training could have a positive influence on postural stability in patients with PD at Hoehn & Yahr stage 3-4. Thirty-four patients with PD at Hoehn & Yahr stage 3-4 were randomly assigned into two groups. All patients received twelve, 40-min treatment sessions, three days/week, for four consecutive weeks. The Robotic Training group (n = 17) underwent robot-assisted gait training, while the Physical Therapy group (n = 17) underwent a training program not specifically aimed at improving postural stability. Patients were evaluated before, immediately after and 1-month post-treatment. Primary outcomes were: Berg Balance scale; Nutt's rating. A significant improvement was found after treatment on the Berg Balance Scale and the Nutt's rating in favor of the Robotic Training group (Berg: 43.44 ± 2.73; Nutt: 1.38 ± 0.50) compared to the Physical Therapy group (Berg: 37.27 ± 5.68; Nutt: 2.07 ± 0.59). All improvements were maintained at the 1-month follow-up evaluation. Robot-assisted gait training may improve postural instability in patients with PD at Hoehn & Yahr stage 3-4. Copyright © 2012 Elsevier Ltd. All rights reserved.

Postural Stability in Young Adults with Down Syndrome in Challenging Conditions

PubMed Central

Bieć, Ewa; Zima, Joanna; Wójtowicz, Dorota; Wojciechowska-Maszkowska, Bożena; Kręcisz, Krzysztof; Kuczyński, Michał

2014-01-01

To evaluate postural control and performance in subjects with Down syndrome (SwDS), we measured postural sway (COP) in quiet stance in four 20-second tests: with eyes open or closed and on hard or foam surface. Ten SwDS and eleven healthy subjects participated, aged 29.8 (4.8) and 28.4 (3.9), respectively. The time-series recorded with the sampling rate of 100 Hz were used to evaluate postural performance (COP amplitude and mean velocity) and strategies (COP frequency, fractal dimension and entropy). There were no intergroup differences in the amplitude except the stance on foam pad with eyes open when SwDS had larger sway. The COP velocity and frequency were larger in SwDS than controls in all trials on foam pad. During stances on the foam pad SwDS increased fractal dimension showing higher complexity of their equilibrium system, while controls decreased sample entropy exhibiting more conscious control of posture in comparison to the stances on hard support surface. This indicated that each group used entirely different adjustments of postural strategies to the somatosensory challenge. It is proposed that the inferior postural control of SwDS results mainly from insufficient experience in dealing with unpredictable postural stimuli and deficit in motor learning. PMID:24728178

Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input.

PubMed

Sprenger, Andreas; Wojak, Jann F; Jandl, Nico M; Helmchen, Christoph

2017-01-01

Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive deprivation heavily destabilizes BVF, even when visual control is provided.

Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input

PubMed Central

Sprenger, Andreas; Wojak, Jann F.; Jandl, Nico M.; Helmchen, Christoph

2017-01-01

Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive deprivation heavily destabilizes BVF, even when visual control is provided. PMID:28919878

Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review

PubMed Central

Mustapa, Amirah; Mohd Mustafah, Nadia; Jamil, Nursuriati

2016-01-01

Purpose. The aim of this paper is to review the published studies on the characteristics of impairments in the postural control and gait performance in diabetic peripheral neuropathy (DPN). Methods. A review was performed by obtaining publication of all papers reporting on the postural control and gait performance in DPN from Google Scholar, Ovid, SAGE, Springerlink, Science Direct (SD), EBSCO Discovery Service, and Web of Science databases. The keywords used for searching were “postural control,” “balance,” “gait performance,” “diabetes mellitus,” and “diabetic peripheral neuropathy.” Results. Total of 4,337 studies were hit in the search. 1,524 studies were screened on their titles and citations. Then, 79 studies were screened on their abstract. Only 38 studies were eligible to be selected: 17 studies on postural control and 21 studies on the gait performance. Most previous researches were found to have strong evidence of postural control impairments and noticeable gait deficits in DPN. Deterioration of somatosensory, visual, and vestibular systems with the pathologic condition of diabetes on cognitive impairment causes further instability of postural and gait performance in DPN. Conclusions. Postural instability and gait imbalance in DPN may contribute to high risk of fall incidence, especially in the geriatric population. Thus, further works are crucial to highlight this fact in the hospital based and community adults. PMID:27525281

Posture and posturology, anatomical and physiological profiles: overview and current state of art.

PubMed

Carini, Francesco; Mazzola, Margherita; Fici, Chiara; Palmeri, Salvatore; Messina, Massimo; Damiani, Provvidenza; Tomasello, Giovanni

2017-04-28

posture is the position of the body in the space, and is controlled by a set of anatomical structures. The maintenance and the control of posture are a set of interactions between muscle-skeletal, visual, vestibular, and skin system. Lately there are numerous studies that correlate the muscle-skeletal and the maintenance of posture. In particular, the correction of defects and obstruction of temporomandibular disorders, seem to have an impact on posture. The aim of this work is to collect information in literature on posture and the influence of the stomatognathic system on postural system. Comparison of the literature on posture and posturology by consulting books and scientific sites. the results obtained from the comparison of the literature show a discrepancy between the thesis. Some studies support the correlation between stomatognathic system and posture, while others deny such a correlation. further studies are necessary to be able to confirm one or the other argument.

Effects of the removal of vision on body sway during different postures in elite gymnasts.

PubMed

Asseman, F; Caron, O; Crémieux, J

2005-03-01

The aim of this study was to analyse the effects of the removal of vision on postural performance and postural control in function of the difficulty and specificity of the posture. Twelve elite gymnasts were instructed to be as stable as possible with eyes open and eyes closed in three postures: bipedal, unipedal, and handstand ranked from the less difficult and less specific to the more difficult and more specific. The ratios eyes closed on eyes open, computed on CP surface and CP mean velocity, which respectively represents postural performance and postural control, were similar in the bipedal and handstand postures. They were highly increased in the unipedal one. The effect of the removal of vision and so the role of vision on body sway was not directly linked to the difficulty or specificity of the posture; other tasks' characteristics like the segments configuration also played a role.

Water-level representation by men and women as a function of rod-and-frame test proficiency and visual and postural information.

PubMed

Robert, M; Ohlmann, T

1994-01-01

In the water-level task, it has been repeatedly shown that, compared with men, women more often fail to represent the surface of a liquid as horizontal regardless of the tilt of the container. An attempt was made to reduce this robust gender gap through the manipulation of relevant upright references conveyed both by the position of the stimuli and the posture of the subject. It was reasoned that bringing the women to focus on such gravitational references through postural adjustment might help their performance equal that of men, thus shedding some light on the nature of the difficulty they experience in the standard setting. A lesser effect was anticipated among men. However, the results showed that, even after controlling for proficiency in the correlated visuospatial situation of the rod-and-frame test, the performance of men always surpassed that of women. Irrespective of gender, water-level representation on vertical sheets was unaffected by the subject's posture, whereas it improved when horizontal sheets were coupled with the most unstable posture. Whereas the persistence of the yet-unaccounted-for gender difference was underscored, the contributions of visual and postural cues issued at arm and full-body levels were discussed.

STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

PubMed Central

Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E.; Eckhardt-Henn, Annegret; Dieterich, Marianne

2015-01-01

Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles. PMID:26843786

STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness.

PubMed

Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E; Eckhardt-Henn, Annegret; Dieterich, Marianne

2015-01-01

Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V ), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles.

Generalization of Posture Training to Computer Workstations in an Applied Setting

ERIC Educational Resources Information Center

Sigurdsson, Sigurdur O.; Ring, Brandon M.; Needham, Mick; Boscoe, James H.; Silverman, Kenneth

2011-01-01

Improving employees' posture may decrease the risk of musculoskeletal disorders. The current paper is a systematic replication and extension of Sigurdsson and Austin (2008), who found that an intervention consisting of information, real-time feedback, and self-monitoring improved participant posture at mock workstations. In the current study,…

The effects of workstation changes and behavioral interventions on safe typing postures in an office.

PubMed

Gravina, Nicole; Lindstrom-Hazel, Debra; Austin, John

2007-01-01

The purpose of the present study was to determine the effectiveness of an ergonomic and behavioral safety intervention for improving participants' safe typing postures in a library office setting. A single-subject multiple baseline design across five participants was employed to evaluate the effects of the four independent variables (workstation adjustment, equipment trial (rollermouse mouse alternative), peer observations, and graphic feedback). Six participant postures were observed repeatedly while participants worked at their workstations throughout the study. Each of the interventions resulted in improvements in safety for more than one posture compared to the previous phase. Results of the study indicate that a comprehensive ergonomic program that includes a workstation adjustment and a behavioral safety approach may be helpful to produce maximum improvements in employees' safe ergonomic postures.

Back posture education in elementary schoolchildren: a 2-year follow-up study.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2007-06-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13-14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters' lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 +/- 0.8 years) and 101 controls (mean age 13.2 +/- 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential.

Back posture education in elementary schoolchildren: a 2-year follow-up study

PubMed Central

Geldhof, Elisabeth; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2006-01-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13–14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters’ lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 ± 0.8 years) and 101 controls (mean age 13.2 ± 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential. PMID:17013655

The effect of pramipexole therapy on balance disorder and fall risk in Parkinson's disease at early stage: clinical and posturographic assessment.

PubMed

Güler, Sibel; Bir, Levent Sinan; Akdag, Beyza; Ardıc, Fusun

2012-01-01

The aim of this study was to determine balance problems and severity and ratio of postural instability of newly diagnosed, early stage Parkinson's patients who did not receive any antiparkinson treatment before, to evaluate fall risk clinically and posturographically and to examine the effects of pramipexole on these signs and symptoms. Detailed posturographic assessments which involved central vestibular, visual, peripheric vestibular somatosensory field tests were applied to both patient and control subjects and fall risk was determined. There was not statistically significant difference between patients and control subjects before and after drug therapy in the assesment of fall risk in posturography and there was not any improvement with drug usage in the patient group. However, in the analysis of subsystems separately, only the involvement in central vestibular field was more severe and could appear at all positions in Parkinson's patients comparing with the control group, and pramipexole was partially effective in improving this disorder. Central vestibular field is the subsystem that should be examined with first priority. Posturography is relatively reliable in defining fall risk and postural instability ratio in Parkinson's disease. But it should be considered that clinical assessment tools can be more sensitive in the evaluation of balance and postural disorders and in the follow-up of the response to drug therapy.

Postural Stability in Healthy Child and Youth Athletes: The Effect of Age, Sex, and Concussion-Related Factors on Performance.

PubMed

Paniccia, Melissa; Wilson, Katherine E; Hunt, Anne; Keightley, Michelle; Zabjek, Karl; Taha, Tim; Gagnon, Isabelle; Reed, Nick

Postural stability plays a key role in sport performance, especially after concussion. Specific to healthy child and youth athletes, little is known about the influence development and sex may have on postural stability while considering other subjective clinical measures used in baseline/preinjury concussion assessment. This study aims to describe age- and sex-based trends in postural stability in uninjured child and youth athletes at baseline while accounting for concussion-related factors. (1) Postural stability performance will improve with age, (2) females will display better postural stability compared to males, and (3) concussion-like symptoms will affect postural stability performance in healthy children and youth. Cross-sectional study. Level 3. This study comprised 889 healthy/uninjured child and youth athletes (54% female, 46% male) between the ages of 9 and 18 years old. Participants completed preseason baseline testing, which included demographic information (age, sex, concussion history), self-report of concussion-like symptoms (Post-Concussion Symptom Inventory [PCSI]-Child and PCSI-Youth), and measures of postural stability (BioSway; Biodex Medical Systems). Two versions of the PCSI were used (PCSI-C, 9- to 12-year-olds; PCSI-Y, 13- to 18-year-olds). Postural stability was assessed via sway index under 4 sway conditions of increasing difficulty by removing visual and proprioceptive cues. In children aged 9 to 12 years old, there were significant age- ( P < 0.05) and sex-based effects ( P < 0.05) on postural stability. Performance improved with age, and girls performed better than boys. For youth ages 13 to 18 years old, postural stability also improved with age ( P < 0.05). In both child and youth subgroups, postural stability worsened with increasing concussion-like symptoms ( P < 0.05). There are developmental and baseline symptom trends regarding postural stability performance. These findings provide a preliminary foundation for postconcussion comparisons and highlight the need for a multimodal approach in assessing and understanding physical measures such as postural stability.

Intervention in the First Weeks of Life for Infants Born Late Preterm: A Case Series

PubMed Central

Dusing, Stacey C.; Lobo, Michele A.; Lee, Hui-Min; Galloway, James Cole

2013-01-01

Infants born late preterm (34–36 weeks of gestation) account for 350,000 US births per year, are at risk for developmental delays, and are rarely included in intervention studies. Purpose To describe a novel parent delivered movement intervention program for very young infants and outcomes following intervention and to evaluate the feasibility of using a comprehensive set of outcome measures. Summary of Key Points Two infants born late preterm received intervention from 0.5 to 2.0 months of adjusted age. Development, postural control, reaching, and object exploration assessments were completed at 3 time points. The intervention was well tolerated by the family. Improvements in developmental outcomes, postural control, and object exploration are presented. Statement of Conclusion Very early movement experience provided daily by parents may improve development. In combination, norm-referenced and behavioral measures appear sensitive to changes in infant behaviors. PMID:23542201

Therapeutic effects of a horse riding simulator in children with cerebral palsy.

PubMed

Silva e Borges, Maria Beatriz; Werneck, Maria José da Silva; da Silva, Maria de Lourdes; Gandolfi, Lenora; Pratesi, Riccardo

2011-10-01

To evaluate the efficacy of horse ridding simulator on the sitting postural control of children with spastic diplegia. Forty children were randomly divided in a group using the simulator (RS) and a group performing conventional physical therapy (CT). FScan/Fmat equipment was used to register maximal displacement in antero-posterior (AP) and medio-lateral (ML) directions with children in sitting position. At the pre and post intervention stage both groups were classified according to the Gross Motor Function Classification System (GMFCS) and, after intervention, by the AUQEI questionnaire (Autoquestionnaire Qualité de vie Enfant Image). Comparison between groups disclosed statistically significant pos-intervention improvement both in the AP (p<0.0001) as in the ML (p<0.0069) direction in the RS group. The horse ridding simulator produced significant improvement in the postural control of children in sitting position, additionally showing a higher motor functionality and a better acceptance of the therapeutic intervention.

Adaptive Gait Control for a Quadruped Robot on 3D Path Planning

NASA Astrophysics Data System (ADS)

Igarashi, Hiroshi; Kakikura, Masayoshi

A legged walking robot is able to not only move on irregular terrain but also change its posture. For example, the robot can pass under overhead obstacles by crouching. The purpose of our research is to realize efficient path planning with a quadruped robot. Therefore, the path planning is expected to extended in three dimensions because of the mobility. However, some issues of the quadruped robot, which are instability, workspace limitation, deadlock and slippage, complicate realizing such application. In order to improve these issues and reinforce the mobility, a new static gait pattern for a quadruped robot, called TFG: Trajectory Following Gait, is proposed. The TFG intends to obtain high controllability like a wheel robot. Additionally, the TFG allows to change it posture during the walk. In this paper, some experimental results show that the TFG improves the issues and it is available for efficient locomotion in three dimensional environment.

Postural control as a function of time-of-day: influence of a prior strenuous running exercise or demanding sustained-attention task

PubMed Central

2013-01-01

Background The current experiment investigated the impact of two potential confounding variables on the postural balance in young participants: the induced-experimental activity prior to the static postural measurements and the well-documented time-of-day effects. We mainly hypothesized that an exhaustive exercise and a high attention-demanding task should result in alterations of postural control. Methods Ten participants performed three experimental sessions (differentiated by the activity – none, cognitive or physical – prior of the assessment of postural stability), separated by one day at least. Each session included postural balance assessments around 8 a.m., 12.00 p.m. and 5 p.m. ± 30 min. The physical and cognitive activities were performed only before the 12 o’clock assessment. The postural tests consisted of four conditions of quiet stance: stance on a firm surface with eyes open; stance on a firm surface with eyes closed; stance on a foam surface with eyes open and stance on a foam surface with eyes closed. Postural performance was assessed by various center of pressure (COP) parameters. Results Overall, the COP findings indicated activity-related postural impairment, with an increase in body sway in the most difficult conditions (with foam surface), especially when postural measurements are recorded just after the running exercise (physical session) or the psychomotor vigilance test (cognitive session). Conclusions Even if no specific influence of time-of-day on static postural control is demonstrated, our results clearly suggest that the activities prior to balance tests could be a potential confounding variable to be taken into account and controlled when assessing clinical postural balance. PMID:23452958

Short-term effects of 890-nanometer radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study.

PubMed

Hsieh, Ru-Lan; Lo, Min-Tzu; Liao, Wei-Cheng; Lee, Wen-Chung

2012-05-01

To investigate the effects of short-term light therapy with 890-nm radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis (OA). A double-blind, randomized, placebo-controlled study. Rehabilitation clinic. Women (n=62) and men (n=10) with a mean age of 61.2 years (range, 40-88y). All patients fulfilled the combined clinical and radiographic criteria for knee OA as established by the American College of Rheumatology, and all had obtained a Kellgren-Lawrence score of 2 or more. Participants received 6 sessions, lasting 40 minutes each, of active or placebo radiation treatment over the knee joints for 2 weeks (wavelength, 890nm; radiant power output, 6.24W; power density, 34.7mW/cm(2) for 40 minutes; total energy, 41.6J/cm(2) per knee per session). Participants were assessed weekly over 4 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and physical function. Physical activity (timed stair climbing, 10-m fast-speed walking, and chair-rising time) and postural stability (using the postural stability evaluation system) were also assessed. The pain score on WOMAC was the primary outcome variable. Data were analyzed by repeated-measures analysis of covariance. Compared with baseline, no significant improvement was observed between groups for pain (P=.546), stiffness (P=.573), or physical function (P=.904). No significant improvement was noted for physical activity including the 10-m fast-speed walking time (P=.284), stair-climbing time (P=.202), stair-descending time (P=.468), chair-rising time (P=.499), or postural stability (P=.986) at the 4 follow-up assessments. Follow-up assessments were conducted after 1 week of treatment (thus, after 3 treatments); after 2 weeks of treatment (thus, after 6 treatments); and 1 and 2 weeks, respectively, after treatment was terminated. Although we found a significant time effect for the 10-m fast-speed walking time (P<.001) in the 2 groups, and a significant group effect in the improvement of stair-climbing time in the treatment group (P=.032), the group × time interaction effects were not significant. Short-term 890-nm radiation therapy for patients with knee OA provided no beneficial effect in improving pain, physical activity, and postural stability. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Difference in postural control between patients with functional and mechanical ankle instability.

PubMed

Chen, Henry; Li, Hong-Yun; Zhang, Jian; Hua, Ying-Hui; Chen, Shi-Yi

2014-10-01

Lateral ankle sprain is one of the most common injuries. Since the structural and pathological differences in mechanical ankle instability (MAI) and functional ankle instability (FAI) may not be the same, it may be better to treat these as separate groups. The purpose of this study was to compare the difference in postural sway between MAI and FAI in patients with chronic ankle instability (CAI). Twenty-six patients with CAI and 14 healthy control participants were included in the study. The CAI patients were subdivided into MAI (15 patients) and FAI (11 patients) groups. Patients who were diagnosed with lateral ankle ligaments rupture by magnetic resonance imaging and ultrasonography were assigned to the MAI group. All participants performed single-limb postural sway tests 3 times on each leg with eyes closed and open. The average distances from the mean center of pressure position in the mediolateral and anteroposterior directions were recorded and compared among the 3 groups. The unstable ankles in the MAI group showed significantly greater postural sway in the anterior, posterior, and medial directions compared with those in the control group with eyes closed. With eyes open, significantly greater postural sway was found in the anterior direction. In the FAI group, no difference was found in postural sway compared with those in the control group. The MAI group showed significantly greater postural sway in the anterior direction compared with the FAI group with eyes closed and open. No significant difference in postural sway was found between the unstable and stable ankles in the MAI or FAI groups, with or without vision. Patients with MAI have deficits in postural control, especially in anterior-posterior directions. However, no difference was found in postural sway in patients with FAI compared with healthy people. As MAI patients suffer from deficits in postural control, balance training should be applied in those patients. In addition, special training should also include the contralateral side after a unilateral ankle ligament injured. © The Author(s) 2014.

What's the secret behind the benefits of whole-body vibration training in patients with COPD? A randomized, controlled trial.

PubMed

Gloeckl, Rainer; Jarosch, Inga; Bengsch, Ulrike; Claus, Magdalena; Schneeberger, Tessa; Andrianopoulos, Vasileios; Christle, Jeffrey W; Hitzl, Wolfgang; Kenn, Klaus

2017-05-01

Several studies have shown that whole-body vibration training (WBVT) improves exercise capacity in patients with severe COPD. The aim of this study was to investigate the determinants of improved exercise capacity following WBVT. Seventy-four COPD patients (FEV 1 : 34 ± 9%predicted) were recruited during a 3-week inpatient pulmonary rehabilitation (PR) program. Conventional endurance and strength exercises were supplemented with self-paced dynamic squat training sessions (4bouts*2min, 3times/wk). Patients were randomly allocated to either a WBVT-group performing squat training on a side-alternating vibration platform (Galileo) at a high intensity (24-26 Hz) or a control group performing squat training without WBVT. Patients in the WBVT group significantly improved postural balance in several domains compared to the control-group (i.e. tandem stance: WBVT +20% (95%CI 14 to 26) vs. control -10% (95%CI 6 to 15), p < 0.001; one-leg stance: WBVT +11% (95%CI 4 to 19) vs. control -8% (95%CI -19 to 3), p = 0.009). Six-minute walk distance and muscle power but not muscle strength were also significantly improved compared to control group. Implementation of WBVT improves postural balance performance and muscle power output. The neuromuscular adaptation related to improved balance performance may be an important mechanism of the improvement in exercise capacity after WBVT especially in COPD patients with impaired balance performance and low exercise capacity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Postural Control and Emotion in Children with Autism Spectrum Disorders

PubMed Central

Gouleme, Nathalie; Scheid, Isabelle; Peyre, Hugo; Seassau, Magali; Maruani, Anna; Clarke, Julia; Delorme, Richard; Bucci, Maria Pia

2017-01-01

Abstract Autism Spectrum Disorders subjects (ASD) are well known to have deficits in social interaction. We recorded simultaneously eye movements and postural sway during exploration of emotional faces in children with ASD and typically developing children (TD). We analyzed several postural and ocular parameters. The results showed that all postural parameters were significantly greater in children with ASD; ASD made significantly fewer saccades and had shorter fixation time than TD, particularly in the eyes, and especially for unpleasant emotions. These results suggest that poor postural control of ASD and their impaired visual strategies could be due to a lack of interest in social cognition, causing a delay in the development of the cortical areas, and thus could have an effect on their postural control. PMID:29177103

Ice skating promotes postural control in children.

PubMed

Keller, M; Röttger, K; Taube, W

2014-12-01

High fall rates causing injury and enormous financial costs are reported for children. However, only few studies investigated the effects of balance training in children and these studies did not find enhanced balance performance in postural (transfer) tests. Consequently, it was previously speculated that classical balance training might not be stimulating enough for children to adequately perform these exercises. Therefore, the aim of this study is to evaluate the influence of ice skating as an alternative form of balance training. Volunteers of an intervention (n = 17; INT: 13.1 ± 0.4 years) and a control group (n = 13; CON: 13.2 ± 0.3 years) were tested before and after training in static and dynamic postural transfer tests. INT participated in eight sessions of ice skating during education lessons, whereas CON participated in normal physical education. Enhanced balance performance was observed in INT but not in CON when tested on an unstable free-swinging platform (P < 0.05) or when performing a functional reach test (P < 0.001). This is the first study showing significantly enhanced balance performance after ice skating in children. More importantly, participating children improved static and dynamic balance control in postural tasks that were not part of the training. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Age-related changes and sex differences in postural control adaptability in children during periodic floor oscillation with eyes closed.

PubMed

Fujiwara, Katsuo; Kiyota, Takeo; Mammadova, Aida; Yaguchi, Chie

2011-01-01

We investigated age-related changes and sex differences in adaptability of anticipatory postural control in children. Subjects comprised 449 children (4-12 years old) and 109 young adults (18-29 years old). Subjects stood with eyes closed on a force-platform fixed to a floor oscillator. We conducted five trials of 1-minute oscillation (0.5 Hz frequency, 2.5 cm amplitude) in the anteroposterior direction. Postural steadiness was quantified as the mean speed of the center of pressure in the anteroposterior direction (CoPy). In young adults, CoPy speed decreased rapidly until the third trial for both sexes. Adaptability was evaluated by changes in steadiness. The adaptability of children was categorized as "good," "moderate," and "poor," compared with a standard variation of the mean CoPy speed regression line between the first and fifth trials in young adults. Results were as follows: (1) anticipatory postural control adaptability starts to develop from age 6 in boys and 5 in girls, and greatly improves at age 7-8 in boys and 6 in girls; (2) the adaptability of children at age 11-12 (74% of boys and 63% of girls were categorized as "good") has not yet reached the same level as for young adults; (3) the adaptability at age 11-12 for girls is temporarily disturbed due to early puberty.

Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial.

PubMed

Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A; Arroyo-Morales, Manuel; Saavedra-Hernández, Manuel; Fernández-Sola, Cayetano; Moreno-Lorenzo, Carmen

2011-09-01

To determine the effect of myofascial release techniques on pain symptoms, postural stability and physical function in fibromyalgia syndrome. A randomized, placebo-controlled trial was undertaken. Eighty-six patients with fibromyalgia syndrome were randomly assigned to an experimental group and a placebo group. Patients received treatments for 20 weeks. The experimental group underwent 10 myofascial release modalities and the placebo group received sham short-wave and ultrasound electrotherapy. Outcome variables were number of tender points, pain, postural stability, physical function, clinical severity and global clinical assessment of improvement. Outcome measures were assessed before and immediately after, at six months and one year after the last session of the corresponding intervention. After 20 weeks of myofascial therapy, the experimental group showed a significant improvement (P  <  0.05) in painful tender points, McGill Pain Score (20.6 ± 6.3, P < 0.032), physical function (56.10 ± 17.3, P < 0.029), and clinical severity (5.08 ± 1.03, P < 0.039). At six months post intervention, the experimental group had a significantly lower mean number of painful points, pain score (8.25 ± 1.13, P < 0.048), physical function (58.60 ± 16.30, P < 0.049) and clinical severity (5.28 ± 0.97, P < 0.043). At one year post intervention, the only significant improvements were in painful points at second left rib and left gluteal muscle, affective dimension, number of days feeling good and clinical severity. The results suggest that myofascial release techniques can be a complementary therapy for pain symptoms, physical function and clinical severity but do not improve postural stability in patients with fibromyalgia syndrome.

Neuromuscular Fatigue Alters Postural Control and Sagittal Plane Hip Biomechanics in Active Females With Anterior Cruciate Ligament Reconstruction

PubMed Central

Frank, Barnett S.; Gilsdorf, Christine M.; Goerger, Benjamin M.; Prentice, William E.; Padua, Darin A.

2014-01-01

Background: Females with history of anterior cruciate ligament (ACL) injury and subsequent ligament reconstruction are at high risk for future ACL injury. Fatigue may influence the increased risk of future injury in females by altering lower extremity biomechanics and postural control. Hypothesis: Fatigue will promote lower extremity biomechanics and postural control deficits associated with ACL injury. Study Design: Descriptive laboratory study. Methods: Fourteen physically active females with ACL reconstruction (mean age, 19.64 ± 1.5 years; mean height, 163.52 ± 6.18 cm; mean mass, 62.6 ± 13.97 kg) volunteered for this study. Postural control and lower extremity biomechanics were assessed in the surgical limb during single-leg balance and jump-landing tasks before and after a fatigue protocol. Main outcome measures were 3-dimensional hip and knee joint angles at initial contact, peak angles, joint angular displacements and peak net joint moments, anterior tibial shear force, and vertical ground reaction force during the first 50% of the loading phase of the jump-landing task. During the single-leg stance task, the main outcome measure was center of pressure sway speed. Results: Initial contact hip flexion angle decreased (t = −2.82, P = 0.01; prefatigue, 40.98° ± 9.79°; postfatigue, 36.75° ± 8.61°) from pre- to postfatigue. Hip flexion displacement (t = 2.23, P = 0.04; prefatigue, 45.19° ± 14.1°; postfatigue, 47.48° ± 14.21°) and center of pressure sway speed (t = 3.95, P < 0.05; prefatigue, 5.18 ± 0.96 cm/s; postfatigue, 6.20 ± 1.72 cm/s) increased from pre- to postfatigue. There was a trending increase in hip flexion moment (t = 2.14, P = 0.05; prefatigue, 1.66 ± 0.68 Nm/kg/m; postfatigue, 1.91 ± 0.62 Nm/kg/m) from pre- to postfatigue. Conclusion: Fatigue may induce lower extremity biomechanics and postural control deficits that may be associated with ACL injury in physically active females with ACL reconstruction. Clinical Relevance: Rehabilitation and maintenance programs should incorporate activities that aim to improve muscular endurance and improve the neuromuscular system’s tolerance to fatiguing exercise in efforts to maintain stability and safe landing technique during subsequent physical activity. PMID:24982701

The effect of six weeks endurance training on dynamic muscular control of the knee following fatiguing exercise.

PubMed

Hassanlouei, H; Falla, D; Arendt-Nielsen, L; Kersting, U G

2014-10-01

The aim of the study was to examine whether six weeks of endurance training minimizes the effects of fatigue on postural control during dynamic postural perturbations. Eighteen healthy volunteers were assigned to either a 6-week progressive endurance training program on a cycle ergometer or a control group. At week 0 and 7, dynamic exercise was performed on an ergometer until exhaustion and immediately after, the anterior-posterior centre of pressure (COP) sway was analyzed during full body perturbations. Maximal voluntary contractions (MVC) of the knee flexors and extensors, muscle fiber conduction velocity (MFCV) of the vastus lateralis and medialis during sustained isometric knee extension contractions, and power output were measured. Following the training protocol, maximum knee extensor and flexor force and power output increased significantly for the training group with no changes observed for the control group. Moreover, the reduction of MFCV due to fatigue changed for the training group only (from 8.6% to 3.4%). At baseline, the fatiguing exercise induced an increase in the centre of pressure sway during the perturbations in both groups (>10%). The fatiguing protocol also impaired postural control in the control group when measured at week 7. However, for the training group, sway was not altered after the fatiguing exercise when assessed at week 7. In summary, six weeks of endurance training delayed the onset of muscle fatigue and improved the ability to control balance in response to postural perturbations in the presence of muscle fatigue. Results implicate that endurance training should be included in any injury prevention program. Copyright © 2014 Elsevier Ltd. All rights reserved.

Diurnal changes in postural control in normal children: Computerized static and dynamic assessments.

PubMed

Bourelle, Sophie; Taiar, Redha; Berge, Benoit; Gautheron, Vincent; Cottalorda, Jerome

2014-01-01

Mild traumatic brain injury (mTBI) causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, little is known regarding the normal pattern of postural control in young children. This study was therefore conducted as an effort to fill this knowledge gap. Eight normal school-aged children participated. Posture assessment was conducted before (7-8 a.m. in the morning) and after (4-7 p.m. in the afternoon) school on regular school days using the Balance Master® evaluation system composed of 3 static tests and 2 dynamic balance tests. A significant difference in the weight-bearing squats was detected between morning hours and afternoon hours (P < 0.05). By end of afternoon, the body weight was borne mainly on the left side with the knee fully extended and at various degrees of knee flexion. A significantly better directional control of the lateral rhythmic weight shifts was observed at the end of the afternoon than at morning hours (P < 0.05). In summary, most of our findings are inconsistent with results from previous studies in adults, suggesting age-related differences in posture control in humans. On a regular school day, the capacity of postural control and laterality or medio-lateral balance in children varies between morning and afternoon hours. We suggest that posturographic assessment in children, either in normal (e.g., physical education and sports training) or in abnormal conditions (e.g., mTBI-associated balance disorders), be better performed late in the afternoon.

Case history: improved maxillary growth and development following digit sucking elimination and orofacial myofunctional therapy.

PubMed

Green, Shari

2013-11-01

Orofacial myologists are frequently called upon to address retained oral habit concerns. During this process, current I.A.O.M. recommended treatment includes addressing tongue, lip, and jaw rest posture concerns. Following digit sucking remediation, we may also be called upon to address these rest posture issues, and tongue thrust more aggressively together. In this process, facial growth and development and jaw structure may coincidentally improve as a result of 'nature taking its course' by addressing both swallow AND rest posture. In a select subset of clients, dramatic improvements may occur if the timing is right. This article discusses one such case that appears to have yielded a significant improvement in oral postures influencing improved facial and oral growth and development.

Postural strategies assessed with inertial sensors in healthy and parkinsonian subjects

PubMed Central

Baston, Chiara; Mancini, Martina; Schoneburg, Bernadette; Horak, Fay; Rocchi, Laura

2015-01-01

The present study introduces a novel instrumented method to characterize postural movement strategies to maintain balance during stance (ankle and hip strategy), by means of inertial sensors, positioned on the legs and on the trunk. We evaluated postural strategies in subjects with2 types of parkinsonism: idiopathic Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP),and inage-matched control subjects standing under perturbed conditions implementedby the Sensory Organization Test (SOT).Coordination between the upper and lower segments of the body during postural sway was measured using a covariance index over time, by a sliding-window algorithm. Afterwards, a postural strategy index was computed. We also measuredthe amount of postural sway, as adjunctive information to characterize balance, by the root mean square of the horizontal trunk acceleration signal (RMS). Results showed that control subjects were able to change their postural strategy, whilst PSP and PD subjects persisted in use of an ankle strategy in all conditions.PD subjects had RMS values similar to control subjects even without changing postural strategy appropriately, whereas PSP subjects showed much larger RMS values than controls, resulting in several falls during the most challenging SOT conditions (5 and 6). Results are in accordance with the corresponding clinical literature describing postural behavior in the same kind of subjects. The proposed strategy index, based on the use ofinertial sensors on the upper and lower body segments, isa promising and unobtrusive toolto characterize postural strategies performed to attain balance. PMID:24656713

Experience of handicap and anxiety in phobic postural vertigo.

PubMed

Holmberg, Johan; Karlberg, Mikael; Harlacher, Uwe; Magnusson, Mans

2005-03-01

We found a difference in gender distribution in a population of phobic postural vertigo patients compared with dizzy patients seen in general neuro-otological practice. It appears as if women with phobic postural vertigo suffer more and are more handicapped by dizziness than both men with phobic postural vertigo and a population with dizziness. These differences may reflect other causes of phobic postural vertigo besides anxiety, such as gender-related coping behaviour and postural strategy. Anxiety influences the degree of suffering and handicap in dizzy patients. Experiences of anxiety and handicap were investigated among a population with phobic postural vertigo. Using the Dizziness Handicap Inventory, the Vertigo Symptom Scale and the Vertigo Handicap Questionnaire, 34 consecutive patients with phobic postural vertigo were compared with a population of 95 consecutive patients seen at a balance disorder clinic. Patients with phobic postural vertigo scored higher than the control subjects with respect to all parameters with the exception of the physical subscale of the Dizziness Handicap Inventory. Because there were significantly more women in the control group we performed a gender-specific analysis of the results. The higher test scores among patients with phobic postural vertigo can be explained by the higher scores among women in this group, while the test results for men were more similar to those of the control group.

Postural Control Deficits in Autism Spectrum Disorder: The Role of Sensory Integration

ERIC Educational Resources Information Center

Doumas, Michail; McKenna, Roisin; Murphy, Blain

2016-01-01

We investigated the nature of sensory integration deficits in postural control of young adults with ASD. Postural control was assessed in a fixed environment, and in three environments in which sensory information about body sway from visual, proprioceptive or both channels was inaccurate. Furthermore, two levels of inaccurate information were…

Dynamic multi-segmental postural control in patients with chronic non-specific low back pain compared to pain-free controls: A cross-sectional study.

PubMed

McCaskey, Michael A; Wirth, Brigitte; Schuster-Amft, Corina; de Bruin, Eling D

2018-01-01

Reduced postural control is thought to contribute to the development and persistence of chronic non-specific low back pain (CNLBP). It is therefore frequently assessed in affected patients and commonly reported as the average amount of postural sway while standing upright under a variety of sensory conditions. These averaged linear outcomes, such as mean centre of pressure (CP) displacement or mean CP surface areas, may not reflect the true postural status. Adding nonlinear outcomes and multi-segmental kinematic analysis has been reported to better reflect the complexity of postural control and may detect subtler postural differences. In this cross-sectional study, a combination of linear and nonlinear postural parameters were assessed in patients with CNLBP (n = 24, 24-75 years, 9 females) and compared to symptom-free controls (CG, n = 34, 22-67 years, 11 females). Primary outcome was postural control measured by variance of joint configurations (uncontrolled manifold index, UI), confidence ellipse surface areas (CEA) and approximate entropy (ApEn) of CP dispersion during the response phase of a perturbed postural control task on a swaying platform. Secondary outcomes were segment excursions and clinical outcome correlates for pain and function. Non-parametric tests for group comparison with P-adjustment for multiple comparisons were conducted. Principal component analysis was applied to identify patterns of segmental contribution in both groups. CNLBP and CG performed similarly with respect to the primary outcomes. Comparison of joint kinematics revealed significant differences of hip (P < .001) and neck (P < .025) angular excursion, representing medium to large group effects (r's = .36 - .51). Significant (P's < .05), but moderate correlations of ApEn (r = -.42) and UI (r = -.46) with the health-related outcomes were observed. These findings lend further support to the notion that averaged linear outcomes do not suffice to describe subtle postural differences in CNLBP patients with low to moderate pain status.

Leisure sports and postural control: can a black belt protect your balance from aging?

PubMed

Krampe, Ralf T; Smolders, Caroline; Doumas, Michail

2014-03-01

To determine potential benefits of intensive leisure sports for age-related changes in postural control, we tested 3 activity groups comprising 70 young (M = 21.67 years, SD = 2.80) and 73 older (M = 62.60 years, SD = 5.19) men. Activity groups were martial artists, who held at least 1st Dan (black belt), sportive individuals exercising sports without explicit balance components, and nonsportive controls. Martial artists had an advantage over sportive individuals in dynamic posture tasks (upright stance on a sway-referenced platform), and these 2 active groups showed better postural control than nonsportive participants. Age-related differences in postural control were larger in nonsportive men compared with the 2 active groups, who were similar in this respect. In contrast, negative age differences in other sensorimotor and cognitive functions did not differ between activity groups. We concluded that individuals engaging in intensive recreational sports have long-term advantages in postural control. However, even in older martial artists with years of practice in their sports, we observed considerable differences favoring the young. (c) 2014 APA, all rights reserved.

Invariant density analysis: modeling and analysis of the postural control system using Markov chains.

PubMed

Hur, Pilwon; Shorter, K Alex; Mehta, Prashant G; Hsiao-Wecksler, Elizabeth T

2012-04-01

In this paper, a novel analysis technique, invariant density analysis (IDA), is introduced. IDA quantifies steady-state behavior of the postural control system using center of pressure (COP) data collected during quiet standing. IDA relies on the analysis of a reduced-order finite Markov model to characterize stochastic behavior observed during postural sway. Five IDA parameters characterize the model and offer physiological insight into the long-term dynamical behavior of the postural control system. Two studies were performed to demonstrate the efficacy of IDA. Study 1 showed that multiple short trials can be concatenated to create a dataset suitable for IDA. Study 2 demonstrated that IDA was effective at distinguishing age-related differences in postural control behavior between young, middle-aged, and older adults. These results suggest that the postural control system of young adults converges more quickly to their steady-state behavior while maintaining COP nearer an overall centroid than either the middle-aged or older adults. Additionally, larger entropy values for older adults indicate that their COP follows a more stochastic path, while smaller entropy values for young adults indicate a more deterministic path. These results illustrate the potential of IDA as a quantitative tool for the assessment of the quiet-standing postural control system.

Relationship between postural control and fine motor skills in preterm infants at 6 and 12 months adjusted age.

PubMed

Wang, Tien-Ni; Howe, Tsu-Hsin; Hinojosa, Jim; Weinberg, Sharon L

2011-01-01

We examined the relationship between postural control and fine motor skills of preterm infants at 6 and 12 mo adjusted age. The Alberta Infant Motor Scale was used to measure postural control, and the Peabody Developmental Motor Scales II was used to measure fine motor skills. The data analyzed were taken from 105 medical records from a preterm infant follow-up clinic at an urban academic medical center in south Taiwan. Using multiple regression analyses, we found that the development of postural control is related to the development of fine motor skills, especially in the group of preterm infants with delayed postural control. This finding supports the theoretical assumption of proximal-distal development used by many occupational therapists to guide intervention. Further research is suggested to corroborate findings.

Postural control and the relation with cervical sensorimotor control in patients with idiopathic adult-onset cervical dystonia.

PubMed

De Pauw, J; Mercelis, R; Hallemans, A; Van Gils, G; Truijen, S; Cras, P; De Hertogh, W

2018-03-01

Cervical dystonia (CD) is a movement disorder characterized by involuntary muscle contractions leading to an abnormal head posture or movements of the neck. Dysfunctions in somatosensory integration are present and previous data showed enlarged postural sway in stance. Postural control during quiet sitting and the correlation with cervical sensorimotor control were investigated. Postural control during quiet sitting was measured via body sway parameters in 23 patients with CD, regularly receiving botulinum toxin treatment and compared with 36 healthy controls. Amplitude and velocity of displacements of the center of pressure (CoP) were measured by two embedded force plates at 1000 Hz. Three samples of 30 s were recorded with the eyes open and closed. Disease-specific characteristics were obtained in all patients by the Tsui scale, Cervical Dystonia Impact Profile (CDIP-58) and Toronto Western Spasmodic Rating Scale (TWSTRS). Cervical sensorimotor control was assessed with an infrared Vicon system during a head repositioning task. Body sway amplitude and velocity were increased in patients with CD compared to healthy controls. CoP displacements were doubled in patients without head tremor and tripled in patients with a dystonic head tremor. Impairments in cervical sensorimotor control were correlated with larger CoP displacements (r s ranged from 0.608 to 0.748). Postural control is impaired and correlates with dysfunction in cervical sensorimotor control in patients with CD. Treatment is currently focused on the cervical area. Further research towards the potential value of postural control exercises is recommended.

Whole-body vibration versus proprioceptive training on postural control in post-menopausal osteopenic women.

PubMed

Stolzenberg, Nils; Belavý, Daniel L; Rawer, Rainer; Felsenberg, Dieter

2013-07-01

To prevent falls in the elderly, especially those with low bone density, is it necessary to maintain muscle coordination and balance. The aim of this study was to examine the effect of classical balance training (BAL) and whole-body vibration training (VIB) on postural control in post-menopausal women with low bone density. Sixty-eight subjects began the study and 57 completed the nine-month intervention program. All subjects performed resistive exercise and were randomized to either the BAL- (N=31) or VIB-group (N=26). The BAL-group performed progressive balance and coordination training and the VIB-group underwent, in total, four minutes of vibration (depending on exercise; 24-26Hz and 4-8mm range) on the Galileo Fitness. Every month, the performance of a single leg stance task on a standard unstable surface (Posturomed) was tested. At baseline and end of the study only, single leg stance, Romberg-stance, semi-tandem-stance and tandem-stance were tested on a ground reaction force platform (Leonardo). The velocity of movement on the Posturomed improved by 28.3 (36.1%) (p<0.001) in the VIB-group and 18.5 (31.5%) (p<0.001) in the BAL-group by the end of the nine-month intervention period, but no differences were seen between the two groups (p=0.45). Balance tests performed on the Leonardo device did not show any significantly different responses between the two groups after nine months (p≥0.09). Strength training combined with either proprioceptive training or whole-body vibration was associated with improvements in some, but not all, measures of postural control in post-menopausal women with low bone density. The current study could not provide evidence for a significantly different impact of whole-body vibration or balance training on postural control. Copyright © 2013 Elsevier B.V. All rights reserved.

The Use of Cognitive Cues for Anticipatory Strategies in a Dynamic Postural Control Task - Validation of a Novel Approach to Dual-Task Testing.

PubMed

Laessoe, Uffe; Grarup, Bo; Bangshaab, Jette

2016-01-01

Dual-task testing is relevant in the assessment of postural control. A combination of a primary (motor) and a secondary (distracting cognitive) tasks is most often used. It remains a challenge however, to standardize and monitor the cognitive task. In this study a new dual-task testing approach with a facilitating, rather than distracting, cognitive component was evaluated. Thirty-one community-dwelling elderly and fifteen young people were tested with respect to their ability to use anticipatory postural control strategies. The motor task consisted of twenty-five repetitive tasks in which the participants needed to exceed their limit of stability in order to touch one out of eight lights. The participants performed three tests. In two of the tests the color cues of the lights allowed the participants to utilize cognitive strategies to plan their next movement and improve their performance time. The young performed the baseline motor task test in an average of 29 seconds, while the average time for the elderly was 44 seconds. When comparing the performance time with a leading cue to the time with no cue, the young group improved their performance time significantly better than the elderly did: young: 17% (5), elderly: 5% (8); p<0.001. Similar differences were seen with a more complicated leading cue: young: 12% (5), elderly: 4% (9); p<0.01. The reliability of the test showed moderate to substantial agreement (ICC = 0.74), with a small learning effect between two sessions. The dual-task test was sensitive enough to discriminate between elderly and young people. It revealed that the elderly did not utilize cognitive cues for their anticipatory postural control strategies as well as the young were able to. The test procedure was feasible and comprehensible for the participants, and it may be relevant to standardize a similar test for an alternative dual-task approach in the clinical setting.

The effects of yoga on shoulder and spinal actions for women with breast cancer-related lymphoedema of the arm: A randomised controlled pilot study.

PubMed

Loudon, Annette; Barnett, Tony; Piller, Neil; Immink, Maarten A; Visentin, Denis; Williams, Andrew D

2016-09-02

We aimed to evaluate the effect of an 8-week yoga intervention on the shoulder and spinal actions of women with breast cancer-related arm lymphoedema. A randomised controlled pilot trial. The intervention group (n = 12) completed eight weeks of daily yoga sessions while the control group (n = 11) continued with best current care including information on compression sleeves, skin care, risks of temperature variations and recommended safe use of affected arm. Lumbo-pelvic posture, range of motion (ROM) in the shoulder and spine, and strength in shoulder and pectoral major and minor, and serratus anterior were taken at baseline, week 8 and after a 4-week follow-up. Outcome assessors were blinded to allocation. At week eight the intervention group had an improvement in lumbo-pelvic posture, as indicated by a reduction in pelvic obliquity compared to the control group (mean difference = -8.39°, 95 % CI: -15.64 to -1.13°, p = 0.023). A secondary finding was that strength in shoulder abduction significantly increased following the yoga intervention in both the affected (9.5 kg; CI: 0.34 to 18.66, p = 0.042) and non-affected arm (11.58 kg; CI: 0.25 to 22.91; p = 0.045). There were no significant between group changes in any ROM measures as a result of the yoga intervention. This pilot study demonstrates that participation in yoga may provide benefits for posture and strength in women with Breast Cancer Related Lymphoedema. The improvements may be attributed to the focus of yoga on overall postural and functional movement patterns. Further trials with longer intervention that follow this methodology are warranted. The Australian New Zealand Clinical Trials Registry ACTRN12611000202965 .

Posture control and the risk of industrial accident: a stabilographic investigation in a naval shipyard.

PubMed

Moll van Charante, A W; Snijders, C J; Mulder, P G

1991-10-01

In a previous case-control study on the effect of impaired perceptual acuity on the risk of industrial injuries at a naval shipyard, three factors which might influence the perception and processing of sensory impressions--alcohol consumption, hearing loss exceeding 20 decibels (dB) and exposure to noise exceeding 82 dB(A)--were found to contribute to the risk of injury. According to recent reports, these factors can all lead to impaired posture control. Because in general about 40% of all accidents are associated with falling, tripping, slipping and the like, a supplementary study has been carried out to unravel possible confounding effects of posture control on these three risk factors. Cases (who had suffered two or more accidents during the preceding 4 years) and controls (who had been accident-free in the same period) were compared as regards posture control measured during silence or noise. No significant difference in posture control was found between cases and controls, either in silence or during exposure to heavy noise.

Chronic Low Quality Sleep Impairs Postural Control in Healthy Adults.

PubMed

Furtado, Fabianne; Gonçalves, Bruno da Silva B; Abranches, Isabela Lopes Laguardia; Abrantes, Ana Flávia; Forner-Cordero, Arturo

2016-01-01

The lack of sleep, both in quality and quantity, is an increasing problem in modern society, often related to workload and stress. A number of studies have addressed the effects of acute (total) sleep deprivation on postural control. However, up to date, the effects of chronic sleep deficits, either in quantity or quality, have not been analyzed. Thirty healthy adults participated in the study that consisted of registering activity with a wrist actigraph for more than a week before performing a series of postural control tests. Sleep and circadian rhythm variables were correlated and the sum of activity of the least active 5-h period, L5, a rhythm variable, obtained the greater coefficient value with sleep quality variables (wake after sleep onset WASO and efficiency sleep). Cluster analysis was performed to classify subjects into two groups based on L5 (low and high). The balance tests scores used to asses postural control were measured using Biodex Balance System and were compared between the two groups with different sleep quality. The postural tests were divided into dynamic (platform tilt with eyes open, closed and cursor) and static (clinical test of sensory integration). The results showed that during the tests with eyes closed, the group with worse sleep quality had also worse postural control performance. Lack of vision impairs postural balance more deeply in subjects with chronic sleep inefficiency. Chronic poor sleep quality impairs postural control similarly to total sleep deprivation.

Impairment of Postural Control in Rabbits With Extensive Spinal Lesions

PubMed Central

Lyalka, V. F.; Orlovsky, G. N.; Deliagina, T. G.

2009-01-01

Our previous studies on rabbits demonstrated that the ventral spinal pathways are of primary importance for postural control in the hindquarters. After ventral hemisection, postural control did not recover, whereas after dorsal or lateral hemisection it did. The aim of this study was to examine postural capacity of rabbits after more extensive lesion (3/4 section of the spinal cord at T12 level), that is, with only one ventral quadrant spared (VQ animals). They were tested before (control) and after lesion on the platform periodically tilted in the frontal plane. In control animals, tilts of the platform regularly elicited coordinated electromyographic (EMG) responses in the hindlimbs, which resulted in generation of postural corrections and in maintenance of balance. In VQ rabbits, the EMG responses appeared only in a part of tilt cycles, and they could be either correctly or incorrectly phased in relation to tilts. Because of a reduced value and incorrect phasing of EMG responses on both sides, this muscle activity did not cause postural corrective movements in the majority of rabbits, and the body swayed together with the platform. In these rabbits, the ability to perform postural corrections did not recover during the whole period of observation (≤30 days). Low probability of correct EMG responses to tilts in most rabbits as well as an appearance of incorrect responses to tilts suggest that the spinal reflex chains, necessary for postural control, have not been specifically selected by a reduced supraspinal drive transmitted via a single ventral quadrant. PMID:19164112

Chronic Low Quality Sleep Impairs Postural Control in Healthy Adults

PubMed Central

Gonçalves, Bruno da Silva B.; Abranches, Isabela Lopes Laguardia; Abrantes, Ana Flávia

2016-01-01

The lack of sleep, both in quality and quantity, is an increasing problem in modern society, often related to workload and stress. A number of studies have addressed the effects of acute (total) sleep deprivation on postural control. However, up to date, the effects of chronic sleep deficits, either in quantity or quality, have not been analyzed. Thirty healthy adults participated in the study that consisted of registering activity with a wrist actigraph for more than a week before performing a series of postural control tests. Sleep and circadian rhythm variables were correlated and the sum of activity of the least active 5-h period, L5, a rhythm variable, obtained the greater coefficient value with sleep quality variables (wake after sleep onset WASO and efficiency sleep). Cluster analysis was performed to classify subjects into two groups based on L5 (low and high). The balance tests scores used to asses postural control were measured using Biodex Balance System and were compared between the two groups with different sleep quality. The postural tests were divided into dynamic (platform tilt with eyes open, closed and cursor) and static (clinical test of sensory integration). The results showed that during the tests with eyes closed, the group with worse sleep quality had also worse postural control performance. Lack of vision impairs postural balance more deeply in subjects with chronic sleep inefficiency. Chronic poor sleep quality impairs postural control similarly to total sleep deprivation. PMID:27732604

Effects of vision and cognitive load on static postural control in subjects with and without patellofemoral pain syndrome.

PubMed

Zeinalzadeh, Afsaneh; Talebian, Saeed; Naghdi, Soofia; Salavati, Mahyar; Nazary-Moghadam, Salman; Zeynalzadeh Ghoochani, Bahareh

2018-04-01

To compare the effects of vision and cognitive load on static postural control in subjects with and without patellofemoral pain syndrome (PFPS). Twenty-eight PFPS patients and 28 controls participated in the study. Postural control was assessed in isolation as well as with visual manipulation and cognitive loading on symptomatic limb. The outcome measures of postural control were quantified in terms of area, anterior-posterior (AP), medial-lateral (ML), and mean velocity (MV) of the displacements of center of pressure (COP). In addition, cognitive performance (auditory Stroop task) was measured in the forms of average reaction time and error ratio in baseline (sitting) and different postural conditions. PFPS subjects showed greater increases in area (p = 0.01), AP (p = 0.01), and ML (p = 0.05) displacements of COP in the blindfolded tasks as compared to control group. However, cognitive load did not differently affect postural control in the two groups. Although PFPS and control group had similar reaction times in the sitting position (p = 0.29), PFPS subjects had longer reaction times than healthy subjects in dual task conditions (p = 0.04). Visual inputs seem to be essential for discriminating postural control between PFPS and healthy individuals. PFPS patients biased toward decreasing cognitive performance more than healthy subjects when they perform the single leg stance and cognitive task concurrently.

Determining Underground Mining Work Postures Using Motion Capture and Digital Human Modeling

PubMed Central

Lutz, Timothy J.; DuCarme, Joseph P.; Smith, Adam K.; Ambrose, Dean

2017-01-01

According to Mine Safety and Health Administration (MSHA) data, during 2008–2012 in the U.S., there were, on average, 65 lost-time accidents per year during routine mining and maintenance activities involving remote-controlled continuous mining machines (CMMs). To address this problem, the National Institute for Occupational Safety and Health (NIOSH) is currently investigating the implementation and integration of existing and emerging technologies in underground mines to provide automated, intelligent proximity detection (iPD) devices on CMMs. One research goal of NIOSH is to enhance the proximity detection system by improving its capability to track and determine identity, position, and posture of multiple workers, and to selectively disable machine functions to keep workers and machine operators safe. Posture of the miner can determine the safe working distance from a CMM by way of the variation in the proximity detection magnetic field. NIOSH collected and analyzed motion capture data and calculated joint angles of the back, hips, and knees from various postures on 12 human subjects. The results of the analysis suggests that lower body postures can be identified by observing the changes in joint angles of the right hip, left hip, right knee, and left knee. PMID:28626796

Effects of community-based virtual reality treadmill training on balance ability in patients with chronic stroke.

PubMed

Kim, Nara; Park, YuHyung; Lee, Byoung-Hee

2015-03-01

[Purpose] We aimed to examine the effectiveness of a community-based virtual reality treadmill training (CVRTT) program on static balance abilities in patients with stroke. [Subjects and Methods] Patients (n = 20) who suffered a stroke at least 6 months prior to the study were recruited. All subjects underwent conventional physical therapy for 60 min/day, 5 days/week, for 4 weeks. Additionally, the CVRTT group underwent community-based virtual reality scene exposure combined with treadmill training for 30 min/day, 3 days/week, for 4 weeks, whereas the control group underwent conventional physical therapy, including muscle strengthening, balance training, and indoor and outdoor gait training, for 30 min/day, 3 days/week, for 4 weeks. Outcome measurements included the anteroposterior, mediolateral, and total postural sway path lengths and speed, which were recorded using the Balancia Software on a Wii Fit(™) balance board. [Results] The postural sway speed and anteroposterior and total postural sway path lengths were significantly decreased in the CVRTT group. Overall, the CVRTT group showed significantly greater improvement than the control group. [Conclusions] The present study results can be used to support the use of CVRTT for effectively improving balance in stroke patients. Moreover, we determined that a CVRTT program for stroke patients is both feasible and suitable.

Influence of dental occlusion on postural control and plantar pressure distribution.

PubMed

Scharnweber, Benjamin; Adjami, Frederic; Schuster, Gabriele; Kopp, Stefan; Natrup, Jörg; Erbe, Christina; Ohlendorf, Daniela

2017-11-01

The number of studies investigating correlations between the temporomandibular system and body posture, postural control or plantar pressure distribution is continuously increasing. If a connection can be found, it is often of minor influence or for only a single parameter. However, small subject groups are critical. This study was conducted to define correlations between dental parameters, postural control and plantar pressure distribution in healthy males. In this study, 87 male subjects with an average age of 25.23 ± 3.5 years (ranging from 18 to 35 years) were examined. Dental casts of the subjects were analyzed. Postural control and plantar pressure distribution were recorded by a force platform. Possible orthodontic and orthopedic factors of influence were determined by either an anamnesis or a questionnaire. All tests performed were randomized and repeated three times each for intercuspal position (ICP) and blocked occlusion (BO). For a statistical analysis of the results, non-parametric tests (Wilcoxon-Matched-Pairs-Test, Kruskall-Wallis-Test) were used. A revision of the results via Bonferroni-Holm correction was considered. ICP increases body sway in the frontal (p ≤ 0.01) and sagittal planes (p ≤ 0.03) compared to BO, whereas all other 29 correlations were independent of the occlusion position. For both of the ICP or BO cases, Angle-class, midline-displacement, crossbite, or orthodontic therapy were found to have no influence on postural control or plantar pressure distribution (p > 0.05). However, the contact time of the left foot decreased (p ≤ 0.001) while detecting the plantar pressure distribution in each position. Persistent dental parameters have no effect on postural sway. In addition, postural control and plantar pressure distribution have been found to be independent postural criteria.

Effect of chronic low level manganese exposure on postural balance: A pilot study of residents in southwest Ohio

PubMed Central

Standridge, J. S.; Bhattacharya, Amit; Succop, Paul; Cox, Cyndy; Haynes, Erin

2009-01-01

OBJECTIVE The objective of this study was to determine the effect of non-occupational exposure to manganese on postural balance. METHODS Residents living near a ferromanganese refinery provided hair and blood samples after postural balance testing. The relationship between hair manganese and postural balance was analyzed with logistic regression. Following covariate adjustment, postural balance was compared with control data by analysis of covariance. RESULTS Mean hair manganese was 4.4 µg/g. A significantly positive association was found between hair manganese and sway area (EO, p=0.05; EC, p=0.04) and sway length (EO, p=0.05; EC, p=0.04). Postural balance of residents was significantly larger than controls in 5 out of 8 postural balance outcomes. CONCLUSION Preliminary findings suggest subclinical impairment in postural balance among residents chronically exposed to ambient Mn. A prospective study with a larger sample size is warranted. PMID:19092498

Attention is associated with postural control in those with chronic ankle instability.

PubMed

Rosen, Adam B; Than, Nicholas T; Smith, William Z; Yentes, Jennifer M; McGrath, Melanie L; Mukherjee, Mukul; Myers, Sara A; Maerlender, Arthur C

2017-05-01

Chronic ankle instability (CAI) is often debilitating and may be affected by a number of intrinsic and environmental factors. Alterations in neurocognitive function and attention may contribute to repetitive injury in those with CAI and influence postural control strategies. Thus, the purpose of this study was to determine if there was a difference in attentional functioning and static postural control among groups of Comparison, Coper and CAI participants and assess the relationship between them within each of the groups. Recruited participants performed single-limb balance trials and completed the CNS Vital Signs (CNSVS) computer-based assessment to assess their attentional function. Center of pressure (COP) velocity (COPv) and maximum range (COPr), in both the anteroposterior (AP) and mediolateral (ML) directions were calculated from force plate data. Simple attention (SA), which measures self-regulation and attention control was extracted from the CNSVS. Data from 45 participants (15 in each group, 27=female, 18=male) was analyzed for this study. No significant differences were observed between attention or COP variables among each of the groups. However, significant relationships were present between attention and COP variables within the CAI group. CAI participants displayed significant moderate to large correlations between SA and AP COPr (r=-0.59, p=0.010), AP COPv (r=-0.48, p=0.038) and ML COPr (r=-0.47, p=0.034). The results suggest a linear relationship of stability and attention in the CAI group. Attentional self-regulation may moderate how those with CAI control postural stability. Incorporating neurocognitive training focused on attentional control may improve outcomes in those with CAI. Copyright © 2017 Elsevier B.V. All rights reserved.

Biomechanical investigation of prolonged driving in an ergonomically designed truck seat prototype.

PubMed

Cardoso, Michelle; McKinnon, Colin; Viggiani, Dan; Johnson, Michel J; Callaghan, Jack P; Albert, Wayne J

2018-03-01

A postural evaluation during a prolonged driving task was conducted to determine the ergonomic validity of a new freely adjustable truck seat prototype. Twenty participants were recruited to perform two 2-h simulated driving sessions. Postures were assessed using motion capture, accelerometers and pressure pads. Subjective discomfort was also monitored in 15-min increments using ratings of perceived discomfort (RPD) and the Automotive Seating Discomfort Questionnaire. Participants had a more neutral spine posture during the first hour of the drive and reported lower RPDs while sitting in the prototype. Pairing the gluteal backrest panel with the adjustable seat pan helped reduce the average sitting pressure. The industry-standard truck seat may lead to the development of poor whole body posture, and the proposed ergonomic redesign of a new truck seat helped improve sitting posture and reduce perceived discomfort. Practitioner Summary: A new freely adjustable truck seat prototype was compared to an Industry standard seat to assess hypothesised improvements to sitting posture and discomfort for long haul driving. It was found that the adjustable panels in the prototype helped promote spine posture, reduce sitting pressure and improved discomfort ratings.

Postural correction reduces hip pain in adult with acetabular dysplasia: A case report.

PubMed

Lewis, Cara L; Khuu, Anne; Marinko, Lee N

2015-06-01

Developmental dysplasia of the hip is often diagnosed in infancy, but less severe cases of acetabular dysplasia are being detected in young active adults. The purpose of this case report is to present a non-surgical intervention for a 31-year-old female with mild acetabular dysplasia and an anterior acetabular labral tear. The patient presented with right anterior hip and groin pain, and she stood with the trunk swayed posterior to the pelvis (swayback posture). The hip pain was reproduced with the anterior impingement test. During gait, the patient maintained the swayback posture and reported 6/10 hip pain. Following correction of the patient's posture, the patient's pain rating was reduced to a 2/10 while walking. The patient was instructed to maintain the improved posture. At the 1 year follow-up, she demonstrated significantly improved posture in standing and walking. She had returned to recreational running and was generally pain-free. The patient demonstrated improvement on self-reported questionnaires for pain, function, and activity. These findings suggest that alteration of posture can have an immediate and lasting effect on hip pain in persons with structural abnormality and labral pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Postural correction reduces hip pain in adult with acetabular dysplasia: a case report

PubMed Central

Lewis, Cara L.; Khuu, Anne; Marinko, Lee

2015-01-01

Developmental dysplasia of the hip is often diagnosed in infancy, but less severe cases of acetabular dysplasia are being detected in young active adults. The purpose of this case report is to present a non-surgical intervention for a 31-year-old female with mild acetabular dysplasia and an anterior acetabular labral tear. The patient presented with right anterior hip and groin pain, and she stood with the trunk swayed posterior to the pelvis (swayback posture). The hip pain was reproduced with the anterior impingement test. During gait, the patient maintained the swayback posture and reported 6/10 hip pain. Following correction of the patient’s posture, the patient’s pain rating was reduced to a 2/10 while walking. The patient was instructed to maintain the improved posture. At the 1 year follow-up, she demonstrated significantly improved posture in standing and walking. She had returned to recreational running and was generally pain-free. The patient demonstrated improvement on self-reported questionnaires for pain, function and activity. These findings suggest that alteration of posture can have an immediate and lasting effect on hip pain in persons with structural abnormality and labral pathology. PMID:25731688

Gabapentin can improve postural stability and quality of life in primary orthostatic tremor.

PubMed

Rodrigues, Julian P; Edwards, Dylan J; Walters, Susan E; Byrnes, Michelle L; Thickbroom, Gary; Stell, Rick; Mastaglia, Frank L

2005-07-01

Primary orthostatic tremor (OT) is characterized by leg tremor and instability on standing. High frequency (13-18 Hz) tremor bursting is present in leg muscles during stance, and posturography has shown greater than normal sway. We report on an open-label add-on study of gabapentin in 6 patients with OT. Six patients were studied with surface electromyography, force platform posturography, and a modified Parkinson's disease questionnaire (PDQ-39) quality of life (QOL) scale before and during treatment with gabapentin 300 mg t.d.s. If on other medications for OT, these were continued unchanged. Of the 6 patients, 4 reported a subjective benefit of 50 to 75% with gabapentin, 3 of whom showed reduced tremor amplitude and postural sway of up to 70%. Dynamic balance improved in all 3 patients who completed the protocol. QOL data from 5 patients showed improvement in all cases. No adverse effects were noted. Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway. The findings confirm previous reports of symptomatic benefit with gabapentin and provide justification for larger controlled clinical trials. Further work is required to establish the optimal dosage and to validate the methods used to quantify the response to treatment. Copyright 2005 Movement Disorder Society.

Continuous and difficult discrete cognitive tasks promote improved stability in older adults.

PubMed

Lajoie, Yves; Jehu, Deborah A; Richer, Natalie; Chan, Alan

2017-06-01

Directing attention away from postural control and onto a cognitive task affords the emergence of automatic control processes. Perhaps the continuous withdrawal of attention from the postural task facilitates an automatization of posture as opposed to only intermittent withdrawal; however this is unknown in the aging population. Twenty older adults (69.9±3.5years) stood with feet together on a force platform for 60s while performing randomly assigned discrete and continuous cognitive tasks. Participants were instructed to stand comfortably with their arms by their sides while verbally responding to the auditory stimuli as fast as possible during the discrete tasks, or mentally performing the continuous cognitive tasks. Participants also performed single-task standing. Results demonstrate significant reductions in sway amplitude and sway variability for the difficult discrete task as well as the continuous tasks relative to single-task standing. The continuous cognitive tasks also prompted greater frequency of sway in the anterior-posterior direction compared to single-standing and discrete tasks, and greater velocity in both directions compared to single-task standing, which could suggest ankle stiffening. No differences in the simple discrete condition were shown compared to single-task standing, perhaps due to the simplicity of the task. Therefore, we propose that the level of difficulty of the task, the specific neuropsychological process engaged during the cognitive task, and the type of task (discrete vs. continuous) influence postural control in older adults. Dual-tasking is a common activity of daily living; this work provides insight into the age-related changes in postural stability and attention demand. Copyright © 2017 Elsevier B.V. All rights reserved.

Influence of Electrotactile Tongue Feedback on Controlling Upright Stance during Rotational and/or Translational Sway-referencing with Galvanic Vestibular Stimulation

NASA Technical Reports Server (NTRS)

Wood, Scott J.; Tyler, Mitchell E.; Bach-y-Rita, Paul; MacDougall, Hamish G.; Moore, Steven T.; Stallings, Valerie L.; Paloski, William H.; Black, F. Owen

2007-01-01

Integration of multi-sensory inputs to detect tilts relative to gravity is critical for sensorimotor control of upright orientation. Displaying body orientation using electrotactile feedback to the tongue has been developed by Bach-y-Rita and colleagues as a sensory aid to maintain upright stance with impaired vestibular feedback. MacDougall et al. (2006) recently demonstrated that unpredictably varying Galvanic vestibular stimulation (GVS) significantly increased anterior-posterior (AP) sway during rotational sway referencing with eyes closed. The purpose of this study was to assess the influence of electrotactile feedback on postural control performance with pseudorandom binaural bipolar GVS. Postural equilibrium was measured with a computerized hydraulic platform in 10 healthy adults (6M, 4F, 24-65 y). Tactile feedback (TF) of pitch and roll body orientation was derived from a two-axis linear accelerometer mounted on a torso belt and displayed on a 144-point electrotactile array held against the anterior dorsal tongue (BrainPort, Wicab, Inc., Middleton, WI). Subjects were trained to use TF by voluntarily swaying to draw figures on their tongue, both with and without GVS. Subjects were required to keep the intraoral display in their mouths on all trials, including those that did not provide TF. Subjects performed 24 randomized trials (20 s duration with eyes closed) including four support surface conditions (fixed, rotational sway-referenced, translating the support surface proportional to AP sway, and combined rotational-translational sway-referencing), each repeated twice with and without GVS, and with combined GVS and TF. Postural performance was assessed using deviations from upright (peak-to-peak and RMS sway) and convergence toward stability limits (time and distance to base of support boundaries). Postural stability was impaired with GVS in all platform conditions, with larger decrements in performance during trials with rotation sway-referencing. Electrotactile feedback improved performance with GVS toward non-GVS levels, again with the greatest improvement during trials with rotation sway-referencing. These results demonstrate the effectiveness of tongue electrotactile feedback in providing sensory substitution to maintain postural stability with distorted vestibular input.

Prone position improves lung mechanical behavior and enhances gas exchange efficiency in mechanically ventilated chronic obstructive pulmonary disease patients.

PubMed

Mentzelopoulos, Spyros D; Zakynthinos, Spyros G; Roussos, Charris; Tzoufi, Maria J; Michalopoulos, Argyris S

2003-06-01

Pronation might favorably affect respiratory system (rs) mechanics and function in volume-controlled, mode-ventilated chronic obstructive pulmonary disease (COPD) patients. We studied 10 COPD patients, initially positioned supine (baseline supine [supine(BAS)]) and then randomly and consecutively changed to protocol supine (supine(PROT)), semirecumbent, and prone positions. Rs mechanics and inspiratory work (W(I)) were assessed at baseline (0.6 L) (all postures) and sigh (1.2 L) (supine(BAS) excluded) tidal volume (V(T)) with rapid airway occlusion during constant-flow inflation. Hemodynamics and gas exchange were assessed in all postures. There were no complications. Prone positioning resulted in (a) increased dynamic-static chest wall (cw) elastance (at both V(Ts)) and improved oxygenation versus supine(BAS), supine(PROT), and semirecumbent, (b) decreased additional lung (L) resistance-elastance versus supine(PROT) and semirecumbent at sigh V(T), (c) decreased L-static elastance (at both V(Ts)) and improved CO(2) elimination versus supine(BAS) and supine(PROT), and (d) improved oxygenation versus all other postures. Semirecumbent positioning increased mainly additional cw-resistance versus supine(BAS) and supine(PROT) at baseline. V(T) W(I)-sub-component changes were consistent with changes in rs, cw, and L mechanical properties. Total rs-W(I) and hemodynamics were unaffected by posture change. After pronation, five patients were repositioned supine (supine(POSTPRO)). In supine(POSTPRO), static rs-L elastance were lower, and oxygenation was still improved versus supine(BAS). Pronation of mechanically ventilated COPD patients exhibits applicability and effectiveness and improves oxygenation and sigh-L mechanics versus semirecumbent ("gold standard") positioning. By assessing respiratory mechanics, inspiratory work, hemodynamics, and gas exchange, we showed that prone positioning of mechanically ventilated chronic obstructed pulmonary disease patients improves oxygenation and lung mechanics during sigh versus semirecumbent positioning. Furthermore, certain pronation-related benefits versus preprone-supine positioning (reduced lung elastance and improved oxygenation) are maintained in the postprone supine position.

Age-Related Changes in Dynamic Postural Control and Attentional Demands are Minimally Affected by Local Muscle Fatigue

PubMed Central

Remaud, Anthony; Thuong-Cong, Cécile; Bilodeau, Martin

2016-01-01

Normal aging results in alterations in the visual, vestibular and somtaosensory systems, which in turn modify the control of balance. Muscle fatigue may exacerbate these age-related changes in sensory and motor functions, and also increase the attentional demands associated with dynamic postural control. The purpose of this study was to investigate the effect of aging on dynamic postural control and posture-related attentional demands before and after a plantar flexor fatigue protocol. Participants (young adults: n = 15; healthy seniors: n = 13) performed a dynamic postural task along the antero-posterior (AP) and the medio-lateral (ML) axes, with and without the addition of a simple reaction time (RT) task. The dynamic postural task consisted in following a moving circle on a computer screen with the representation of the center of pressure (COP). This protocol was repeated before and after a fatigue task where ankle plantar flexor muscles were targeted. The mean COP-target distance and the mean COP velocity were calculated for each trial. Cross-correlation analyses between the COP and target displacements were also performed. RTs were recorded during dual-task trials. Results showed that while young adults adopted an anticipatory control mode to move their COP as close as possible to the target center, seniors adopted a reactive control mode, lagging behind the target center. This resulted in longer COP-target distance and higher COP velocity in the latter group. Concurrently, RT increased more in seniors when switching from static stance to dynamic postural conditions, suggesting potential alterations in the central nervous system (CNS) functions. Finally, plantar flexor muscle fatigue and dual-tasking had only minor effects on dynamic postural control of both young adults and seniors. Future studies should investigate why the fatigue-induced changes in quiet standing postural control do not seem to transfer to dynamic balance tasks. PMID:26834626

Static postural stability in women with stress urinary incontinence: Effects of vision and bladder filling.

PubMed

Chmielewska, Daria; Stania, Magdalena; Słomka, Kajetan; Błaszczak, Edward; Taradaj, Jakub; Dolibog, Patrycja; Juras, Grzegorz

2017-11-01

This case-control study was designed to compare static postural stability between women with stress urinary incontinence and continent women and it was hypothesized that women with incontinence aged around 50 years also have balance disorders. Eighteen women with incontinence and twelve women without incontinence aged 50-55 years participated in two 60-s trials of each of four different testing conditions: eyes open/full bladder, eyes open/empty bladder, eyes closed/full bladder, eyes closed/empty bladder. The center of foot pressure (COP): sway range, root mean square, velocity (in the antero-posterior and medio-lateral directions), and COP area were recorded. The stabilograms were decomposed into rambling and trembling components. The groups of women with and without incontinence differed during the full bladder condition in antero-posterior COP sway range, COP area, and rambling trajectory (range in the antero-posterior and medio-lateral directions, root mean square in the antero-posterior and medio-lateral directions and velocity in the antero-posterior direction). The women with incontinence had more difficulty controlling their postural balance than continent women while standing with a full bladder. Therefore, developing therapeutic management focused on strengthening the women's core muscles and improving their postural balance seems advisable. © 2017 Wiley Periodicals, Inc.

Evaluation of the lambda model for human postural control during ankle strategy.

PubMed

Micheau, Philippe; Kron, Aymeric; Bourassa, Paul

2003-09-01

An accurate modeling of human stance might be helpful in assessing postural deficit. The objective of this article is to validate a mathematical postural control model for quiet standing posture. The postural dynamics is modeled in the sagittal plane as an inverted pendulum with torque applied at the ankle joint. The torque control system is represented by the physiological lambda model. Two neurophysiological command variables of the central nervous system, designated lambda and micro, establish the dynamic threshold muscle at which motoneuron recruitment begins. Kinematic data and electromyographic signals were collected on four young males in order to measure small voluntary sway and quiet standing posture. Validation of the mathematical model was achieved through comparison of the experimental and simulated results. The mathematical model allows computation of the unmeasurable neurophysiological commands lambda and micro that control the equilibrium position and stability. Furthermore, with the model it is possible to conclude that low-amplitude body sway during quiet stance is commanded by the central nervous system.

Postural Stabilization Strategies to Motor Contagion Induced by Action Observation Are Impaired in Parkinson’s Disease

PubMed Central

Pelosin, Elisa; Bisio, Ambra; Pozzo, Thierry; Lagravinese, Giovanna; Crisafulli, Oscar; Marchese, Roberta; Abbruzzese, Giovanni; Avanzino, Laura

2018-01-01

Postural reactions can be influenced by concomitant tasks or different contexts and are modulated by a higher order motor control. Recent studies investigated postural changes determined by motor contagion induced by action observation (chameleon effect) showing that observing a model in postural disequilibrium induces an increase in healthy subjects’ body sway. Parkinson’s disease (PD) is associated with postural instability and impairments in cognitively controlled balance tasks. However, no studies investigated if viewing postural imbalance might influence postural stability in PD and if patients are able to inhibit a visual postural perturbation. In this study, an action observation paradigm for assessing postural reaction to motor contagion in PD subjects and healthy older adults was used. Postural stability changes were measured during the observation of a static stimulus (control condition) and during a point-light display of a gymnast balancing on a rope (biological stimulus). Our results showed that, during the observation of the biological stimulus, sway area and antero-posterior and medio-lateral displacements of center of pressure significantly increased only in PD participants, whereas correct stabilization reactions were present in elderly subjects. These results demonstrate that PD leads to a decreased capacity to control automatic imitative tendencies induced by motor contagion. This behavior could be the consequence either of an inability to inhibit automatic imitative tendencies or of the cognitive load requested by the task. Whatever the case, the issue about the ability to inhibit automatic imitative tendencies could be crucial for PD patients since it might increase falls risk and injuries. PMID:29545771

Postural strategies assessed with inertial sensors in healthy and parkinsonian subjects.

PubMed

Baston, Chiara; Mancini, Martina; Schoneburg, Bernadette; Horak, Fay; Rocchi, Laura

2014-01-01

The present study introduces a novel instrumented method to characterize postural movement strategies to maintain balance during stance (ankle and hip strategy), by means of inertial sensors, positioned on the legs and on the trunk. We evaluated postural strategies in subjects with 2 types of Parkinsonism: idiopathic Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP), and in age-matched control subjects standing under perturbed conditions implemented by the Sensory Organization Test (SOT). Coordination between the upper and lower segments of the body during postural sway was measured using a covariance index over time, by a sliding-window algorithm. Afterwards, a postural strategy index was computed. We also measured the amount of postural sway, as adjunctive information to characterize balance, by the root mean square of the horizontal trunk acceleration signal (RMS). showed that control subjects were able to change their postural strategy, whilst PSP and PD subjects persisted in use of an ankle strategy in all conditions. PD subjects had RMS values similar to control subjects even without changing postural strategy appropriately, whereas PSP subjects showed much larger RMS values than controls, resulting in several falls during the most challenging SOT conditions (5 and 6). Results are in accordance with the corresponding clinical literature describing postural behavior in the same kind of subjects. The proposed strategy index, based on the use of inertial sensors on the upper and lower body segments, is a promising and unobtrusive tool to characterize postural strategies performed to attain balance. Copyright © 2014 Elsevier B.V. All rights reserved.

Effects of disease severity and medication state on postural control asymmetry during challenging postural tasks in individuals with Parkinson's disease.

PubMed

Barbieri, Fabio A; Polastri, Paula F; Baptista, André M; Lirani-Silva, Ellen; Simieli, Lucas; Orcioli-Silva, Diego; Beretta, Victor S; Gobbi, Lilian T B

2016-04-01

The aim of this study was to investigate the effects of disease severity and medication state on postural control asymmetry during challenging tasks in individuals with Parkinson's disease (PD). Nineteen people with PD and 11 neurologically healthy individuals performed three standing task conditions: bipedal standing, tandem and unipedal adapted standing; the individuals with PD performed the tasks in ON and OFF medication state. The participants with PD were distributed into 2 groups according to disease severity: unilateral group (n=8) and bilateral group (n=11). The two PD groups performed the evaluations both under and without the medication. Two force plates were used to analyze the posture. The symmetric index was calculated for various of center of pressure. ANOVA one-way (groups) and two-way (PD groups×medication), with repeated measures for medication, were calculated. For main effects of group, the bilateral group was more asymmetric than CG. For main effects of medication, only unipedal adapted standing presented effects of PD medication. There was PD groups×medication interaction. Under the effects of medication, the unilateral group presented lower asymmetry of RMS in anterior-posterior direction and area than the bilateral group in unipedal adapted standing. In addition, the unilateral group presented lower asymmetry of mean velocity, RMS in anterior-posterior direction and area in unipedal standing and area in tandem adapted standing after a medication dose. Postural control asymmetry during challenging postural tasks was dependent on disease severity and medication state in people with PD. The bilateral group presented higher postural control asymmetry than the control and unilateral groups in challenging postural tasks. Finally, the medication dose was able to reduce postural control asymmetry in the unilateral group during challenging postural tasks. Copyright © 2015 Elsevier B.V. All rights reserved.

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control.

PubMed

Bonnet, Cédrick T; Delval, Arnaud; Defebvre, Luc

2014-11-15

Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease. Copyright © 2014 the American Physiological Society.

Effect of Modified Otago Exercises on Postural Balance, Fear of Falling, and Fall Risk in Older Fallers With Knee Osteoarthritis and Impaired Gait and Balance: A Secondary Analysis.

PubMed

Mat, Sumaiyah; Ng, Chin Teck; Tan, Pey June; Ramli, Norlisah; Fadzli, Farhana; Rozalli, Faizatul Izza; Mazlan, Mazlina; Hill, Keith D; Tan, Maw Pin

2018-03-01

Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited. To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems. Randomized controlled trial. University of Malaya Medical Centre. Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds. Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated. Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale-International (short FES-I) were assessed at baseline and 6 months. Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES-I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found. Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes. I. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Lateral stepping for postural correction in Parkinson's disease.

PubMed

King, Laurie A; Horak, Fay B

2008-03-01

To characterize the lateral stepping strategies for postural correction in patients with Parkinson's disease (PD) and the effect of their anti-parkinson medication. Observational study. Outpatient neuroscience laboratory. Thirteen participants with idiopathic PD in their on (PD on) and off (PD off) levodopa state and 14 healthy elderly controls. Movable platform with lateral translations of 12 cm at 14.6 cm/s ramp velocity. The incidence and characteristics of 3 postural strategies were observed: lateral side-step, crossover step, or no step. Corrective stepping was characterized by latency to step after perturbation onset, step velocity, and step length and presence of an anticipatory postural adjustment (APA). Additionally, percentages of trials resulting in falls were identified for each group. Whereas elderly control participants never fell, PD participants fell in 24% and 35% of trials in the on and off medication states, respectively. Both PD and control participants most often used a lateral side-step strategy; 70% (control), 67% (PD off), and 73% (PD on) of all trials, respectively. PD participants fell most often when using a crossover strategy (75% of all crossover trials) or no-step strategy (100% of all no-step trials). In the off medication state, PD participants' lateral stepping strategies were initiated later than controls (370+/-37 ms vs 280+/-10 ms, P<.01), and steps were smaller (254+/-20 mm vs 357+/-17 mm, P<.01) and slower (0.99+/-0.08 m/s vs 1.20+/-0.07 m/s, P<.05). No differences were found between the PD off versus PD on state in the corrective stepping characteristics. Unlike control participants, PD participants often (56% of side-step strategy trials) failed to activate an APA before stepping, although their APAs, when present, were of similar latency and magnitude as for control participants. Levodopa on or off state did not significantly affect falls, APAs, or lateral step latency, velocity, or amplitude (P>.05). PD participants showed significantly more postural instability and falls than age-matched controls when stepping was required for postural correction in response to lateral disequilibrium. Although PD participants usually used a similar lateral stepping strategy as controls in response to lateral translations, lack of an anticipatory lateral weight shift, and bradykinetic characteristics of the stepping responses help explain the greater rate of falls in participants with PD. Differences were not found between the levodopa on and off states. The results suggest that rehabilitation aimed at improving lateral stability in PD should include facilitating APAs before a lateral side-stepping strategy with faster and larger steps to recover equilibrium.

Body posture in children with obesity - the relationship to physical activity (PA).

PubMed

Brzęk, Anna; Sołtys, Jacek; Gallert-Kopyto, Weronika; Gwizdek, Katarzyna; Plinta, Ryszard

2016-01-01

The modern world of electronic devices offers children and young people various forms of leisure activities, while reducing the need for natural movement, necessary for normal psychomotor development. Sedentary life contributes to an increased body weight and, thereby, to the development of body posture abnormalities. The aim of the study was to evaluate body posture, leisure activities, and the number of hours spent using electronic devices among children with obesity. The study involved 51 children with obesity (BMI above 95 percentile) - A group, and 69 children with normal body weight at the age of 9-13 years (10.98 ± 1.29) - B group (control). Body posture has been evaluated with the scoliometer, the digital inclinometer and the plumb line. The hump ratio has been calculated on the basis of SOSORT recommendations. Time spent in front of electronic devices based on a questionnaire results has also been calculated. Children with obesity have more body posture defects in the sagittal plane than children with normal z-scores (p<0.001). 46.8% of children in group A have distorted depth of the two curvatures of the spine. In the control group, the majority of deviations have been observed in the evaluation of the ATR (Angle Trunk Rotation) at the lumbar spine (p<0.05), while in group A, at the level of the thoracic spine (40.42% vs. 23.07%). Both groups of respondents use electronic devices at least 3 days a week (p>0.05). Obese children often use mobile devices, while children with normal body weight often use desktop equipment. Definitely more body posture abnormalities are found in the group of obese children. Children use electronic devices regardless of weight. It is worth to expand educational activities with programs that improve the quality of body posture through a daily change of abnormal patterns. © Polish Society for Pediatric Endocrinology and Diabetology.

Ergonomic strategies to improve radiographers' posture during mammography activities.

PubMed

Cernean, Nicolai; Serranheira, Florentino; Gonçalves, Pedro; Sá Dos Reis, Cláudia

2017-08-01

To identify alternatives for radiographers' postures while performing mammography that can contribute to reduce the risk of work-related musculoskeletal disorders (WRMSDs). Radiographers' postures to positioning craniocaudal (CC) and mediolateral oblique (MLO) views were simulated without any intervention for three scenarios: radiographer/patient with similar statures, radiographer smaller than patient and radiographer taller than patient. Actions were taken to modify the postures: seated radiographer; patient on a step; seated patient; radiographer on a step. All the postures were analysed using kinovea 0.8.15 software and the angles were measured twice and classified according to European standard EN1005-4: 2005. The non-acceptable angles were measured mainly during MLO positioning when radiographer was taller than the patient: 139° and 120° for arm-flexion and abduction, 72° for trunk and -24° for head/neck-flexion. The introduction of alternative postures (radiographer seated), allowed improvements in posture (60° and 99° for arm flexion and abduction, 14° for trunk and 0° for head/neck flexion), being classified as acceptable. The alternative postures simulated have the potential to reduce the risk of developing WRMSDs when radiographers and patients have different statures. • Radiographers' postures in mammography can contribute to work-related musculoskeletal disorders • Non-acceptable posture was identified for MLO breast positioning (radiographer taller than patient) • Adapting posture to patient biotype reduces the WRMSD risk for radiographers.

Comparison of the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy young women.

PubMed

Shirazi, Zahra Rojhani; Jahromi, Fatemeh Nikhalat

2013-09-01

The maintenance of balance is an essential requirement for the performance of daily tasks and sporting activities and muscular fatigue is a factor to impair postural control, so this study was done to compare the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy subjects. Fifteen healthy female students (24.3 ± 2.6 years) completed three testing session with a break period of at least 2 days. During each session, postural control was assessed during two 30-s trials of bipedal stance with eyes close before and after the fatigue protocol. Fatigue protocols were performed by 60% of their unfatigued Maximum Voluntary Contraction of unilateral ankle plantar flexors, bilateral lumbar extensors and bilateral neck extensors. One of the three fatigue protocols was performed on each session. The result showed that fatigue had a significant effect on COP velocity and it increase COP velocity but there was not found any difference in postural sway between muscle groups. Localized muscle fatigue caused deficits in postural control regardless of the location of fatigue. Authors suggest the possibility of the contributions of central mechanisms to postural deficits due to fatigue and it seems that difference was not between muscle groups due to central fatigue.

Personality traits and individual differences predict threat-induced changes in postural control.

PubMed

Zaback, Martin; Cleworth, Taylor W; Carpenter, Mark G; Adkin, Allan L

2015-04-01

This study explored whether specific personality traits and individual differences could predict changes in postural control when presented with a height-induced postural threat. Eighty-two healthy young adults completed questionnaires to assess trait anxiety, trait movement reinvestment (conscious motor processing, movement self-consciousness), physical risk-taking, and previous experience with height-related activities. Tests of static (quiet standing) and anticipatory (rise to toes) postural control were completed under low and high postural threat conditions. Personality traits and individual differences significantly predicted height-induced changes in static, but not anticipatory postural control. Individuals less prone to taking physical risks were more likely to lean further away from the platform edge and sway at higher frequencies and smaller amplitudes. Individuals more prone to conscious motor processing were more likely to lean further away from the platform edge and sway at larger amplitudes. Individuals more self-conscious about their movement appearance were more likely to sway at smaller amplitudes. Evidence is also provided that relationships between physical risk-taking and changes in static postural control are mediated through changes in fear of falling and physiological arousal. Results from this study may have indirect implications for balance assessment and treatment; however, further work exploring these factors in patient populations is necessary. Copyright © 2015 Elsevier B.V. All rights reserved.

Characterizing Postural Sway during Quiet Stance Based on the Intermittent Control Hypothesis

NASA Astrophysics Data System (ADS)

Nomura, Taishin; Nakamura, Toru; Fukada, Kei; Sakoda, Saburo

2007-07-01

This article illustrates a signal processing methodology for the time series of postural sway and accompanied electromyographs from the lower limb muscles during quiet stance. It was shown that the proposed methodology was capable of identifying the underlying postural control mechanisms. A preliminary application of the methodology provided evidence that supports the intermittent control hypothesis alternative to the conventional stiffness control hypothesis during human quiet upright stance.

Aging and Posture Control: Changes in Sensory Organization and Muscular Coordination.

ERIC Educational Resources Information Center

Woollacott, Marjorie H.; And Others

1986-01-01

Examined two aspects of balance control in the older adult: coordination of timing and amplitude of muscle responses to postural perturbations, and ability of the participant to reorganize sensory inputs and subsequently modify postural responses as a consequence of changing environmental conditions. (Author/ABB)

Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components.

PubMed

Hsieh, Ru-Lan; Lee, Wen-Chung; Lo, Min-Tzu; Liao, Wei-Cheng

2013-02-01

To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. An age-matched, case-controlled trial with a cross-sectional design. A teaching hospital. Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included reduced activity (r=.38, P=.001), physical domain and function (r=.34-.48, P=.001 to P<.004), activities of daily living (r=.51, P<.001), and sports and recreation (r=.35, P=.003). A moderate association between postural stability and the ICF components of personal and environmental factors was observed, including age (r=.52, P<.001) and quality of life (r=0.4, P=.001). Patients with knee osteoarthritis displayed lower postural stability and achieved lower scores in the environmental domain of quality-of-life measures than did controls. The postural stability of patients with knee osteoarthritis was weakly to moderately associated with the following ICF components: body functions and structures, activities and participation, and personal and environmental factors. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Postural response latencies are related to balance control during standing and walking in patients with multiple sclerosis

PubMed Central

Huisinga, Jessie M.; St. George, Rebecca J.; Spain, Rebecca; Overs, Shannon; Horak, Fay B.

2015-01-01

Objective To understand examined the relationship between postural response latencies obtained during postural perturbations and representative measures of balance during standing (sway variables) and during walking (trunk motion). Design Cross-sectional Setting University medical center balance disorders laboratory Participants Forty persons with MS were compared with 20 similar aged control subjects. Twenty subjects with MS had normal walking velocity group and 20 had slow walking velocity based on the 25-foot walk time greater than 5 seconds. Interventions None Main Outcome Measures Postural response latency, sway variables, trunk motion variables Results: We found that subjects with MS with either slow or normal walking velocities had significantly longer postural response latencies than the healthy control group. Postural response latency was not correlated with the 25-ft walk time. Postural response latency was significantly correlated with center of pressure sway variables during quiet standing: root mean square (ρ = 0.334, p=0.040), range (ρ=0.385, p=0.017), mean velocity (ρ=0.337, p=0.038), and total sway area (ρ=0.393, p=0.015). Postural response latency was also significantly correlated with motion of the trunk during walking: sagittal plane range of motion (ρ=0.316, p=0.050) and standard deviation of transverse plane range of motion (ρ=-0.430, p=0.006). Conclusions These findings clearly indicate that slow postural responses to external perturbations in patients with MS contribute to disturbances in balance control, both during standing and walking. PMID:24445088

Anticipatory and compensatory postural adjustments in sitting in children with cerebral palsy.

PubMed

Bigongiari, Aline; de Andrade e Souza, Flávia; Franciulli, Patrícia Martins; Neto, Semaan El Razi; Araujo, Rubens Correa; Mochizuki, Luis

2011-06-01

The aim of this study was to examine postural control in children with cerebral palsy performing a bilateral shoulder flexion to grasp a ball from a sitting posture. The participants were 12 typically developing children (control) without cerebral palsy and 12 children with cerebral palsy (CP). We analyzed the effect of ball mass (1 kg and 0.18 kg), postural adjustment (anticipatory, APA, and compensatory, CPA), and groups (control and CP) on the electrical activity of shoulder and trunk muscles with surface electromyography (EMG). Greater mean iEMG was seen in CPA, with heavy ball, and for posterior trunk muscles (p<.05). The children with CP presented the highest EMG and level of co-activation (p<.05). Linear regression indicated a positive relationship between EMG and aging for the control group, whereas that relationship was negative for participants with CP. We suggest that the main postural control strategy in children is based on corrections after the beginning of the movement. The linear relationship between EMG and aging suggests that postural control development is affected by central nervous disease which may lead to an increase in muscle co-activation. Copyright © 2011 Elsevier B.V. All rights reserved.

Postural control in man: the phylogenetic perspective.

PubMed

Gramsbergen, Albert

2005-01-01

Erect posture in man is a recent affordance from an evolutionary perspective. About eight million years ago, the stock from which modern humans derived split off from the ape family, and from around sixty-thousand years ago, modern man developed. Upright gait and manipulations while standing pose intricate cybernetic problems for postural control. The trunk, having an older evolutionary history than the extremities, is innervated by medially descending motor systems and extremity muscles by the more recent, laterally descending systems. Movements obviously require concerted actions from both systems. Research in rats has demonstrated the interdependencies between postural control and the development of fluent walking. Only 15 days after birth, adult-like fluent locomotion emerges and is critically dependent upon postural development. Vesttibular deprivation induces a retardation in postural development and, consequently, a retarded development of adult-like locomotion. The cerebellum obviously has an important role in mutual adjustments in postural control and extremity movements, or, in coupling the phylogenetic older and newer structures. In the human, the cerebellum develops partly after birth and therefore is vulnerable to adverse perinatal influences. Such vulnerability seems to justify focusing our scientific research efforts onto the development of this structure.

Relationship between craniomandibular disorders and poor posture.

PubMed

Nicolakis, P; Nicolakis, M; Piehslinger, E; Ebenbichler, G; Vachuda, M; Kirtley, C; Fialka-Moser, V

2000-04-01

The purpose of this research was to show that a relationship between craniomandibular disorders (CMD) and postural abnormalities has been repeatedly postulated, but still remains unproven. This study was intended to test this hypothesis. Twenty-five CMD patients (mean age 28.2 years) were compared with 25 gender and age matched controls (mean age 28.3 years) in a controlled, investigator-blinded trial. Twelve postural and ten muscle function parameters were examined. Measurements were separated into three subgroups, consisting of those variables associated with the cervical region, the trunk in the frontal plane, and the trunk in the sagittal plane. Within these subgroups, there was significantly more dysfunction in the patients, compared to control subjects (Mann-Whitney U test p < 0.001, p < 0.05, p < 0.01). Postural and muscle function abnormalities appeared to be more common in the CMD group. Since there is evidence of the mutual influence of posture and the craniomandibular system, control of body posture in CMD patients is recommended, especially if they do not respond to splint therapy. Whether poor posture is the reason or the result of CMD cannot be distinguished by the data presented here.

The Effect of Joint Mobilization on Dynamic Postural Control in Patients With Chronic Ankle Instability: A Critically Appraised Topic.

PubMed

Kosik, Kyle B; Gribble, Phillip A

2018-01-01

Clinical Scenario: Dorsiflexion range of motion is an important factor in the performance of the Star Excursion Balance Test (SEBT). While patients with chronic ankle instability (CAI) commonly experience decreased reach distances on the SEBT, ankle joint mobilization has been suggested to be an effective therapeutic intervention for targeting dorsiflexion range of motion. What is the evidence to support ankle joint mobilization for improving performance on the SEBT in patients with CAI? Summary of Key Findings: The literature was searched for articles examining the effects of ankle joint mobilization on scores of the SEBT. A total of 3 peer-reviewed articles were retrieved, 2 prospective individual cohort studies and 1 randomized controlled trial. Only 2 articles demonstrated favorable results following 6 sessions of ankle joint mobilization. Clinical Bottom Line: Despite the mixed results, the majority of the available evidence suggests that ankle joint mobilization improves dynamic postural control. Strength of Recommendation: In accordance with the Centre of Evidence Based Medicine, the inconsistent results and the limited high-quality studies indicate that there is level C evidence to support the use of ankle joint mobilization to improve performance on the SEBT in patients with CAI.

A new standing posture detector to enable people with multiple disabilities to control environmental stimulation by changing their standing posture through a commercial Wii Balance Board.

PubMed

Shih, Ching-Hsiang; Shih, Ching-Tien; Chiang, Ming-Shan

2010-01-01

This study assessed whether two persons with multiple disabilities would be able to control environmental stimulation using body swing (changing standing posture) and a Wii Balance Board with a newly developed standing posture detection program (i.e. a new software program turns a Wii Balance Board into a precise standing posture detector). The study was performed according to an ABAB design, in which A represented baseline and B represented intervention phases. Both participants significantly increased their target response (body swing) to activate the control system to produce environmental stimulation during the intervention phases. Practical and developmental implications of the findings were discussed.

Balance Training Enhances Vestibular Function and Reduces Overactive Proprioceptive Feedback in Elderly

PubMed Central

Wiesmeier, Isabella K.; Dalin, Daniela; Wehrle, Anja; Granacher, Urs; Muehlbauer, Thomas; Dietterle, Joerg; Weiller, Cornelius; Gollhofer, Albert; Maurer, Christoph

2017-01-01

Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training program on these postural control impairments using a brain network model based on system identification techniques. Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model. Results: With balance training, the elderly subjects significantly reduced their overly large postural reactions and approximated those of younger subjects. Less significant differences between elderly and young subjects' postural control, namely larger spontaneous sway amplitudes, velocities, and frequencies, larger overall time delays and a weaker motor feedback compared to young subjects were not significantly affected by the balance training. Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits. PMID:28848430

The internal representation of head orientation differs for conscious perception and balance control

PubMed Central

Dalton, Brian H.; Rasman, Brandon G.; Inglis, J. Timothy

2017-01-01

Key points We tested perceived head‐on‐feet orientation and the direction of vestibular‐evoked balance responses in passively and actively held head‐turned postures.The direction of vestibular‐evoked balance responses was not aligned with perceived head‐on‐feet orientation while maintaining prolonged passively held head‐turned postures. Furthermore, static visual cues of head‐on‐feet orientation did not update the estimate of head posture for the balance controller.A prolonged actively held head‐turned posture did not elicit a rotation in the direction of the vestibular‐evoked balance response despite a significant rotation in perceived angular head posture.It is proposed that conscious perception of head posture and the transformation of vestibular signals for standing balance relying on this head posture are not dependent on the same internal representation. Rather, the balance system may operate under its own sensorimotor principles, which are partly independent from perception. Abstract Vestibular signals used for balance control must be integrated with other sensorimotor cues to allow transformation of descending signals according to an internal representation of body configuration. We explored two alternative models of sensorimotor integration that propose (1) a single internal representation of head‐on‐feet orientation is responsible for perceived postural orientation and standing balance or (2) conscious perception and balance control are driven by separate internal representations. During three experiments, participants stood quietly while passively or actively maintaining a prolonged head‐turned posture (>10 min). Throughout the trials, participants intermittently reported their perceived head angular position, and subsequently electrical vestibular stimuli were delivered to elicit whole‐body balance responses. Visual recalibration of head‐on‐feet posture was used to determine whether static visual cues are used to update the internal representation of body configuration for perceived orientation and standing balance. All three experiments involved situations in which the vestibular‐evoked balance response was not orthogonal to perceived head‐on‐feet orientation, regardless of the visual information provided. For prolonged head‐turned postures, balance responses consistent with actual head‐on‐feet posture occurred only during the active condition. Our results indicate that conscious perception of head‐on‐feet posture and vestibular control of balance do not rely on the same internal representation, but instead treat sensorimotor cues in parallel and may arrive at different conclusions regarding head‐on‐feet posture. The balance system appears to bypass static visual cues of postural orientation and mainly use other sensorimotor signals of head‐on‐feet position to transform vestibular signals of head motion, a mechanism appropriate for most daily activities. PMID:28035656

Age-related effects on postural control under multi-task conditions.

PubMed

Granacher, Urs; Bridenbaugh, Stephanie A; Muehlbauer, Thomas; Wehrle, Anja; Kressig, Reto W

2011-01-01

Changes in postural sway and gait patterns due to simultaneously performed cognitive (CI) and/or motor interference (MI) tasks have previously been reported and are associated with an increased risk of falling in older adults. The objectives of this study were to investigate the effects of a CI and/or MI task on static and dynamic postural control in young and elderly subjects, and to find out whether there is an association between measures of static and dynamic postural control while concurrently performing the CI and/or MI task. A total of 36 healthy young (n = 18; age: 22.3 ± 3.0 years; BMI: 21.0 ± 1.6 kg/m(2)) and elderly adults (n = 18; age: 73.5 ± 5.5 years; BMI: 24.2 ± 2.9 kg/m(2)) participated in this study. Static postural control was measured during bipedal stance, and dynamic postural control was obtained while walking on an instrumented walkway. Irrespective of the task condition, i.e. single-task or multiple tasks, elderly participants showed larger center-of-pressure displacements and greater stride-to-stride variability than younger participants. Associations between measures of static and dynamic postural control were found only under the single-task condition in the elderly. Age-related deficits in the postural control system seem to be primarily responsible for the observed results. The weak correlations detected between static and dynamic measures could indicate that fall-risk assessment should incorporate dynamic measures under multi-task conditions, and that skills like erect standing and walking are independent of each other and may have to be trained complementarily. Copyright © 2010 S. Karger AG, Basel.

Neuromuscular Control and Coordination during Cycling

ERIC Educational Resources Information Center

Li, Li

2004-01-01

The neuromuscular control aspect of cycling has been investigated through the effects of modifying posture and cadence. These studies show that changing posture has a more profound influence on neuromuscular coordination than does changing slope. Most of the changes with standing posture occur late in the downstroke: increased ankle and knee joint…

A method to model anticipatory postural control in driver braking events.

PubMed

Östh, Jonas; Eliasson, Erik; Happee, Riender; Brolin, Karin

2014-09-01

Human body models (HBMs) for vehicle occupant simulations have recently been extended with active muscles and postural control strategies. Feedback control has been used to model occupant responses to autonomous braking interventions. However, driver postural responses during driver initiated braking differ greatly from autonomous braking. In the present study, an anticipatory postural response was hypothesized, modelled in a whole-body HBM with feedback controlled muscles, and validated using existing volunteer data. The anticipatory response was modelled as a time dependent change in the reference value for the feedback controllers, which generates correcting moments to counteract the braking deceleration. The results showed that, in 11 m/s(2) driver braking simulations, including the anticipatory postural response reduced the peak forward displacement of the head by 100mm, of the shoulder by 30 mm, while the peak head flexion rotation was reduced by 18°. The HBM kinematic response was within a one standard deviation corridor of corresponding test data from volunteers performing maximum braking. It was concluded that the hypothesized anticipatory responses can be modelled by changing the reference positions of the individual joint feedback controllers that regulate muscle activation levels. The addition of anticipatory postural control muscle activations appears to explain the difference in occupant kinematics between driver and autonomous braking. This method of modelling postural reactions can be applied to the simulation of other driver voluntary actions, such as emergency avoidance by steering. Copyright © 2014. Published by Elsevier B.V.

Motor Control Training for the Shoulder with Smart Garments.

PubMed

Wang, Qi; De Baets, Liesbet; Timmermans, Annick; Chen, Wei; Giacolini, Luca; Matheve, Thomas; Markopoulos, Panos

2017-07-22

Wearable technologies for posture monitoring and posture correction are emerging as a way to support and enhance physical therapy treatment, e.g., for motor control training in neurological disorders or for treating musculoskeletal disorders, such as shoulder, neck, or lower back pain. Among the various technological options for posture monitoring, wearable systems offer potential advantages regarding mobility, use in different contexts and sustained tracking in daily life. We describe the design of a smart garment named Zishi to monitor compensatory movements and evaluate its applicability for shoulder motor control training in a clinical setting. Five physiotherapists and eight patients with musculoskeletal shoulder pain participated in the study. The attitudes of patients and therapists towards the system were measured using standardized survey instruments. The results indicate that patients and their therapists consider Zishi a credible aid for rehabilitation and patients expect it will help towards their recovery. The system was perceived as highly usable and patients were motivated to train with the system. Future research efforts on the improvement of the customization of feedback location and modality, and on the evaluation of Zishi as support for motor learning in shoulder patients, should be made.

Surgical management of anomalous head posture because of horizontal gaze palsy or acquired vertical nystagmus.

PubMed

Campos, E C; Schiavi, C; Bellusci, C

2003-07-01

To confirm the effectiveness of the Kestenbaum-Anderson principle in the surgical management of compensatory head posture because of horizontal gaze palsy and acquired vertical nystagmus. Nine patients with anomalous head posture because of horizontal gaze palsy, and four patients with acquired vertical nystagmus and oscillopsia and compensatory torticollis underwent surgery according to the Kestenbaum-Anderson principle. As in the treatment of congenital nystagmus, the eyes have to be shifted in the orbits, in the direction of anomalous head posture. Homonymously based prisms were used preoperatively to assess the potential benefit of surgery. At the time of surgery, the clinical conditions of the patients had been stable for at least 1 year. After surgery, compensatory head posture and visual performances improved in all cases and the results remained stable for at least 2 years. Contrary to what is generally believed, the ocular condition of the patients with compensatory head posture secondary to neurological causes can be often improved with surgery. The aim of surgery is obviously not to modify ocular motility, but rather to improve the head position.

Comparison of postural stability between injured and uninjured ballet dancers.

PubMed

Lin, Cheng-Feng; Lee, I-Jung; Liao, Jung-Hsien; Wu, Hong-Wen; Su, Fong-Chin

2011-06-01

Ballet movements require a limited base of support; thus, ballet dancers require a high level of postural control. However, postural stability in ballet dancers is still unclear and needs to be understood. To evaluate ballet dancers' postural stability in performing single-leg standing, the en pointe task, and the first and fifth positions and to determine differences in task performance among healthy nondancers, healthy dancers, and dancers with ankle sprains. Controlled laboratory study. Injured dancers, uninjured dancers, and nondancers were recruited for this study (N = 33 age-matched participants; n= 11 per group). The tasks tested were single-leg standing with eyes open and closed, first position, fifth position, and en pointe. Center of pressure parameters were calculated from the ground-reaction force collected with 1 force plate. Analysis of variance was used to assess the differences of center of pressure parameters among 3 groups in single-leg standing; independent t test was used to examine the differences of center of pressure parameters between injured and uninjured dancers. During single-leg standing, injured dancers had significantly greater maximum displacement in the medial-lateral direction and total trajectory of center of pressure, compared with the uninjured dancers and nondancers. During the first and fifth positions, the injured dancers demonstrated significantly greater standard deviation of center of pressure position in the medial-lateral and anterior-posterior directions, compared with the uninjured dancers. During en pointe, the injured dancers had significantly greater maximum displacement in the medial-lateral direction and the anterior-posterior direction, compared with the uninjured dancers. The injured and uninjured dancers demonstrated differences in postural stability in the medial-lateral direction during single-leg standing and the ballet postures. Although the injured dancers received ballet training, their postural stability may still be inferior to that of the nondancers. This study is a first step in understanding that injured ballet dancers do not have the same postural stability as uninjured dancers and that it is even inferior to that of nondancers, which is important to understand for further study on rehabilitation. The future development of effective balance training programs for ballet dancers with ankle injuries should emphasize improvements in medial-lateral directional balance.

The effectiveness of a training method using self-modeling webcam photos for reducing musculoskeletal risk among office workers using computers.

PubMed

Taieb-Maimon, Meirav; Cwikel, Julie; Shapira, Bracha; Orenstein, Ido

2012-03-01

An intervention study was conducted to examine the effectiveness of an innovative self-modeling photo-training method for reducing musculoskeletal risk among office workers using computers. Sixty workers were randomly assigned to either: 1) a control group; 2) an office training group that received personal, ergonomic training and workstation adjustments or 3) a photo-training group that received both office training and an automatic frequent-feedback system that displayed on the computer screen a photo of the worker's current sitting posture together with the correct posture photo taken earlier during office training. Musculoskeletal risk was evaluated using the Rapid Upper Limb Assessment (RULA) method before, during and after the six weeks intervention. Both training methods provided effective short-term posture improvement; however, sustained improvement was only attained with the photo-training method. Both interventions had a greater effect on older workers and on workers suffering more musculoskeletal pain. The photo-training method had a greater positive effect on women than on men. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

An intergenerational approach in the promotion of balance and strength for fall prevention - a mini-review.

PubMed

Granacher, Urs; Muehlbauer, Thomas; Gollhofer, Albert; Kressig, Reto W; Zahner, Lukas

2011-01-01

The risk of sustaining a fall is particularly high in children and seniors. Deficits in postural control and muscle strength either due to maturation, secular declines or biologic aging are two important intrinsic risk factors for falls. During life span, performance in variables of static postural control follows a U-shaped curve with children and seniors showing larger postural sway than healthy adults. Measures of dynamic postural control (i.e. gait speed) as well as isometric (i.e. maximal strength) and dynamic muscle strength (i.e. muscular power) follow an inverted U-shaped curve during life span, again with children and seniors showing deficits compared to adults. There is evidence that particularly balance and resistance training are effective in counteracting these neuromuscular constraints in both children and seniors. Further, these training regimens are able to reduce the rate of sustaining injuries and falls in these age groups. An intergenerational intervention approach is suggested to enhance the effectiveness of these training programs by improving compliance and increasing motivation of children and seniors exercising together. Thus, the objectives of this mini-review are: (1) to describe the epidemiology and etiology of falls in children and seniors; (2) to discuss training programs that counteract intrinsic fall risk factors by reducing the rate of falling, and (3) to present an intergenerational approach that has the potential to make training programs even more effective by including children and seniors together in one exercise group. Copyright © 2010 S. Karger AG, Basel.

The postural control can be optimized by the first movement initiation condition encountered when submitted to muscle fatigue.

PubMed

Monjo, Florian; Forestier, Nicolas

2017-08-01

We investigated whether and how the movement initiation condition (IC) encountered during the early movements performed following focal muscle fatigue affects the postural control of discrete ballistic movements. For this purpose, subjects performed shoulder flexions in a standing posture at maximal velocity under two movement IC, i.e., in self-paced conditions and submitted to a Stroop-like task in which participants had to trigger fast shoulder flexions at the presentation of incongruent colors. Shoulder flexion kinematics, surface muscle activity of focal and postural muscles as well as center-of-pressure kinematics were recorded. The initial IC and the order in which subjects were submitted to these two conditions were varied within two separate experimental sessions. IC schedule was repeated before and after fatigue protocols involving shoulder flexors. The aim of this fatigue procedure was to affect acceleration-generating capacities of focal muscles. In such conditions, the postural muscle activity preceding and accompanying movement execution is expected to decrease. Following fatigue, when subjects initially moved in self-paced conditions, postural muscle activity decreased and scaled to the lower focal peak acceleration. This postural strategy then transferred to the Stroop-like task. In contrast, when subjects initially moved submitted to the Stroop-like task, postural muscle activity did not decrease and this transferred to self-paced movements. Regarding the center-of-pressure peak velocity, which is indicative of the efficiency of the postural actions generated in stabilizing posture, no difference appeared between the two sessions post-fatigue. This highlights an optimization of the postural actions when subjects first moved in self-paced conditions, smaller postural muscle activation levels resulting in similar postural consequences. In conclusion, the level of neuromuscular activity associated with the postural control is affected and can be optimized by the initial movement IC experienced post-fatigue. Beyond the fundamental contributions arising from these results, we point out potential applications for trainers and sports instructors. Copyright © 2017 Elsevier B.V. All rights reserved.

Effectiveness of a lumbopelvic monitor and feedback device to change postural behaviour: a protocol for the ELF cluster randomised controlled trial

PubMed Central

Milosavljevic, Stephan

2017-01-01

Introduction Low back pain (LBP) is the most common, costly and disabling musculoskeletal disorder worldwide, and is prevalent in healthcare workers. Posture is a modifiable risk factor for LBP shown to reduce the prevalence of LBP. Our feasibility research suggests that postural feedback might help healthcare workers avoid hazardous postures. The Effectiveness of Lumbopelvic Feedback (ELF) trial will investigate the extent to which postural monitor and feedback (PMF) can reduce exposure to hazardous posture associated with LBP. Methods This is a participant-blinded, randomised controlled trial with blocked cluster random allocation. Participants will include volunteer healthcare workers recruited from aged care institutions and hospitals. A postural monitoring and feedback device will monitor and record lumbopelvic forward bending posture, and provide audio feedback whenever the user sustains a lumbopelvic forward bending posture that exceeds predefined thresholds. The primary outcome measure will be postural behaviour (exceeding thresholds). Secondary outcome measures will be incidence of LBP, participant-reported disability and adherence. Following baseline assessment, we will randomly assign participants to 1 of 2 intervention arms: a feedback group and a no-feedback control group. We will compare between-group differences of changes in postural behaviour by using a repeated measures mixed-effect model analysis of covariance (ANCOVA) at 6 weeks. Postural behaviour baseline scores, work-related psychosocial factors and disability scores will be input as covariates into the statistical models. We will use logistic mixed model analysis and Cox's proportional hazards for assessing the effect of a PMF on LBP incidence between groups. Discussion Posture is a modifiable risk factor for low back disorders. Findings from the ELF trial will inform the design of future clinical trials assessing the effectiveness of wearable technology on minimising hazardous posture during daily living activities in patients with low back disorders. Trial registration number ACTRN12616000449437. PMID:28073798

Ergonomic intervention for improving work postures during notebook computer operation.

PubMed

Jamjumrus, Nuchrawee; Nanthavanij, Suebsak

2008-06-01

This paper discusses the application of analytical algorithms to determine necessary adjustments for operating notebook computers (NBCs) and workstations so that NBC users can assume correct work postures during NBC operation. Twenty-two NBC users (eleven males and eleven females) were asked to operate their NBCs according to their normal work practice. Photographs of their work postures were taken and analyzed using the Rapid Upper Limb Assessment (RULA) technique. The algorithms were then employed to determine recommended adjustments for their NBCs and workstations. After implementing the necessary adjustments, the NBC users were then re-seated at their workstations, and photographs of their work postures were re-taken, to perform the posture analysis. The results show that the NBC users' work postures are improved when their NBCs and workstations are adjusted according to the recommendations. The effectiveness of ergonomic intervention is verified both visually and objectively.

Postural Stability in Older Adults With Alzheimer Disease.

PubMed

Mesbah, Normala; Perry, Meredith; Hill, Keith D; Kaur, Mandeep; Hale, Leigh

2017-03-01

The prevalence of adults with Alzheimer disease (AD) aged >65 years is increasing and estimated to quadruple by 2051. The aim of this study was to investigate postural stability in people with mild to moderate AD and factors contributing to postural instability compared with healthy peers (controls). A computerized systematic search of databases and a hand search of reference lists for articles published from 1984 onward (English-language articles only) were conducted on June 2, 2015, using the main key words "postural stability" and "Alzheimer's disease." Sixty-seven studies were assessed for eligibility (a confirmed diagnosis of AD, comparison of measured postural stability between participants with AD and controls, measured factors potentially contributing to postural instability). Data were extracted, and Downs and Black criteria were applied to evaluate study quality. Eighteen articles were analyzed using qualitative synthesis and reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Strength of evidence was guided by the Grading of Recommendations Assessment, Development and Evaluation. Strong evidence was found that: (1) older adults with mild to moderate AD have reduced static and functional postural stability compared with healthy peers (controls) and (2) attentional demand during dual-task activity and loss of visual input were key factors contributing to postural instability. Deta-analysis was not possible due to heterogeneity of the data. Postural stability is impaired in older adults with mild to moderate AD. Decreasing visual input and concentrating on multiple tasks decrease postural stability. To reduce falls risk, more research discerning appropriate strategies for the early identification of impairment of postural stability is needed. Standardization of population description and consensus on outcome measures and the variables used to measure postural -instability and its contributing factors are necessary to ensure meaningful synthesis of data. © 2017 American Physical Therapy Association

Engaging Cervical Spinal Cord Networks to Reenable Volitional Control of Hand Function in Tetraplegic Patients.

PubMed

Lu, Daniel C; Edgerton, V Reggie; Modaber, Morteza; AuYong, Nicholas; Morikawa, Erika; Zdunowski, Sharon; Sarino, Melanie E; Sarrafzadeh, Majid; Nuwer, Marc R; Roy, Roland R; Gerasimenko, Yury

2016-11-01

Paralysis of the upper limbs from spinal cord injury results in an enormous loss of independence in an individual's daily life. Meaningful improvement in hand function is rare after 1 year of tetraparesis. Therapeutic developments that result in even modest gains in hand volitional function will significantly affect the quality of life for patients afflicted with high cervical injury. The ability to neuromodulate the lumbosacral spinal circuitry via epidural stimulation in regaining postural function and volitional control of the legs has been recently shown. A key question is whether a similar neuromodulatory strategy can be used to improve volitional motor control of the upper limbs, that is, performance of motor tasks considered to be less "automatic" than posture and locomotion. In this study, the effects of cervical epidural stimulation on hand function are characterized in subjects with chronic cervical cord injury. Herein we show that epidural stimulation can be applied to the chronic injured human cervical spinal cord to promote volitional hand function. Two subjects implanted with a cervical epidural electrode array demonstrated improved hand strength (approximately 3-fold) and volitional hand control in the presence of epidural stimulation. The present data are sufficient to suggest that hand motor function in individuals with chronic tetraplegia can be improved with cervical cord neuromodulation and thus should be comprehensively explored as a possible clinical intervention. © The Author(s) 2016.

Measuring postural control during mini-squat posture in men with early knee osteoarthritis.

PubMed

Petrella, M; Gramani-Say, K; Serrão, P R M S; Lessi, G C; Barela, J A; Carvalho, R P; Mattiello, S M

2017-04-01

Studies have suggested a compromised postural control in individuals with knee osteoarthritis (OA) evidenced by larger and faster displacement of center of pressure (COP). However, quantification of postural control in the mini-squat posture performed by patients with early knee OA and its relation to muscle strength and self-reported symptoms have not been investigated. The main aim of this cross-sectional, observational, controlled study was to determine whether postural control in the mini-squat posture differs between individuals with early knee OA and a control group (CG) and verify the relation among knee extensor torque (KET) and self-reported physical function, stiffness and pain. Twenty four individuals with knee OA grades I and II (OAG) (mean age: 52.35±5.00) and twenty subjects without knee injuries (CG) (mean age: 51.40±8.07) participated in this study. Participants were assessed in postural control through a force plate (Bertec Mod. USA), which provided information about the anterior-posterior (AP) and medial-lateral (ML) COP displacement during the mini-squat, in isometric, concentric and eccentric knee extensor torque (KET) (90°/s) through an isokinetic dynamometer (BiodexMulti-Joint System3, Biodex Medical Incorporation, New York, NY, USA), and in self-reported symptoms through the WOMAC questionnaire. The main outcomes measured were the AP and ML COP amplitude and velocity of displacement; isometric, concentric, and eccentric KET and self-reported physical function, stiffness and pain. No significant differences were found between groups for postural control (p>0.05). Significant lower eccentric KET (p=0.01) and higher scores for the WOMAC subscales of pain (p=<0.001), stiffness (p=0.001) and physical function (p<0.001) were found for the OAG. Moderate and negative correlations were found between the AP COP amplitude of displacement and physical function (ρ=-0.40, p=0.02). Moderate and negative correlations were observed between the AP COP velocity of displacement and physical function (ρ=0.47, p=0.01) and stiffness (ρ=-0.45, p=0.02). The findings of the present study emphasize the importance of rehabilitation from the early degrees of knee OA to prevent postural instability and the need to include quadriceps muscle strengthening, especially by eccentric contractions. The relationship between the self-reported symptoms and a lower and slower COP displacement suggest that the postural control strategy during tasks with a semi-flexed knee should be further investigated. Copyright © 2017 Elsevier B.V. All rights reserved.

Unilateral Hearing Loss Is Associated With Impaired Balance in Children: A Pilot Study.

PubMed

Wolter, Nikolaus E; Cushing, Sharon L; Vilchez-Madrigal, Luis D; James, Adrian L; Campos, Jennifer; Papsin, Blake C; Gordon, Karen A

2016-12-01

To determine if children with unilateral sensorineural hearing loss (UHL) demonstrate impaired balance compared with their normal hearing (NH) peers. Prospective, case-control study. Balance was assessed in14 UHL and 14 NH children using the Bruininks-Oseretsky Test-2 (BOT-2) and time to fall (TTF) in an immersive, virtual-reality laboratory. Postural control was quantified by center of pressure (COP) using force plates. The effect of vision on balance was assessed by comparing scores and COP characteristics on BOT-2 tasks performed with eyes open and closed. Balance ability as measured by the BOT-2 score was significantly worse in children with UHL compared with NH children (p = 0.004). TTF was shorter in children with UHL compared with NH children in the most difficult tasks when visual and somatosensory inputs were limited (p < 0.01). Visual input improved postural control (reduced COP variability) in both groups in all tasks (p < 0.05) but postural control as measured by COP variability was more affected in children with UHL when visual input was removed while performing moderately difficult tasks (i.e., standing on one foot) (p = 0.02). In this pilot study, children with UHL show poorer balance skills than NH children. Significant differences in TTF between the two groups were only seen in the most difficult tasks and therefore may be missed on routine clinical assessment. Children with UHL appear to rely more on vision for maintaining postural control than their NH peers. These findings may point to deficits not only in the hearing but also the vestibular portion of the inner ear.

Extrinsic finger and thumb muscles command a virtual hand to allow individual finger and grasp control.

PubMed

Birdwell, J Alexander; Hargrove, Levi J; Weir, Richard F ff; Kuiken, Todd A

2015-01-01

Fine-wire intramuscular electrodes were used to obtain electromyogram (EMG) signals from six extrinsic hand muscles associated with the thumb, index, and middle fingers. Subjects' EMG activity was used to control a virtual three-degree-of-freedom (DOF) hand as they conformed the hand to a sequence of hand postures testing two controllers: direct EMG control and pattern recognition control. Subjects tested two conditions using each controller: starting the hand from a predefined neutral posture before each new posture and starting the hand from the previous posture in the sequence. Subjects demonstrated their abilities to simultaneously, yet individually, move all three DOFs during the direct EMG control trials; however, results showed subjects did not often utilize this feature. Performance metrics such as failure rate and completion time showed no significant difference between the two controllers.

Light and heavy touch reduces postural sway and modifies axial tone in Parkinson’s disease

PubMed Central

Franzén, Erika; Paquette, Caroline; Gurfinkel, Victor; Horak, Fay

2014-01-01

Background Light touch with a stable object reduces postural sway by increasing axial postural tone in healthy subjects. However, it is unknown whether subjects with Parkinson’s disease (PD), who have more postural sway and higher axial postural tone than healthy subjects, can benefit from haptic touch. Objective To investigate the effect of light and heavy touch on postural stability and hip tone in subjects with PD. Methods Fourteen subjects with mid-stage PD, and 14 healthy control subjects were evaluated during quiet standing with eyes closed with their arms: 1) crossed, 2) lightly touching a fixed rigid bar in front of them and 3) firmly gripping the bar. Postural sway was measured with a forceplate and axial hip tone was quantified using a unique device that measures the resistance of the hips to yaw rotation while maintaining active stance. Results Subjects with PD significantly decreased their postural sway with light or heavy touch (p<0.001 vs. arms crossed), similarly as control subjects. Without touch, hip tone was larger in PD subjects. With touch, however, tone values were similar in both groups. This change in hip tone with touch was highly correlated with the initial amount of tone (PD: r=− 0.72 to −0.95 and controls: r=−0.74 to−0.85). Conclusions We showed, for the first time, that subjects with PD benefit from touch similarly to control subjects and that despite higher axial postural tone, PD subjects are able to modulate their tone with touch. Future studies should investigate the complex relationship between touch and postural tone. PMID:22415944

Assessment of Relationships Between Joint Motion Quality and Postural Control in Patients With Chronic Ankle Joint Instability.

PubMed

Bączkowicz, Dawid; Falkowski, Krzysztof; Majorczyk, Edyta

2017-08-01

Study Design Controlled laboratory study, cross-sectional. Background Lateral ankle sprains are among the most common injuries encountered during athletic participation. Following the initial injury, there is an alarmingly high risk of reinjury and development of chronic ankle instability (CAI), which is dependent on a combination of factors, including sensorimotor deficits and changes in the biomechanical environment of the ankle joint. Objective To evaluate CAI-related disturbances in arthrokinematic motion quality and postural control and the relationships between them. Methods Sixty-three male subjects (31 with CAI and 32 healthy controls) were enrolled in the study. For arthrokinematic motion quality analysis, the vibroarthrographic signals were collected during ankle flexion/extension motion using an acceleration sensor and described by variability (variance of mean squares [VMS]), amplitude (mean of 4 maximal and 4 minimal values [R4]), and frequency (vibroarthrographic signal bands of 50 to 250 Hz [P1] and 250 to 450 Hz [P2]) parameters. Using the Biodex Balance System, single-leg dynamic balance was measured by overall, anteroposterior, and mediolateral stability indices. Results Values of vibroarthrographic parameters (VMS, R4, P1 and P2) were significantly higher in the CAI group than those in the control group (P<.01). Similar results were obtained for all postural control parameters (overall, anteroposterior, and mediolateral stability indices; P<.05). Moreover, correlations between the overall stability index and VMS, and P1 and P2, as well as between the anteroposterior stability index and P1 and P2, were observed in the CAI patient group, but not in controls. Conclusion In patients with CAI, deficits in both quality of ankle arthrokinematic motion and postural control were present. Therefore, physical therapy interventions focused on improving ankle neuromuscular control and arthrokinematic function are necessary in CAI patient care. J Orthop Sports Phys Ther 2017;47(8):570-577. Epub 4 Nov 2016. doi:10.2519/jospt.2017.6836.

Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial.

PubMed

Jorgensen, Martin G; Laessoe, Uffe; Hendriksen, Carsten; Nielsen, Ole Bruno Faurholt; Aagaard, Per

2013-07-01

Older adults show increased risk of falling and major risk factors include impaired lower extremity muscle strength and postural balance. However, the potential positive effect of biofeedback-based Nintendo Wii training on muscle strength and postural balance in older adults is unknown. This randomized controlled trial examined postural balance and muscle strength in community-dwelling older adults (75±6 years) pre- and post-10 weeks of biofeedback-based Nintendo Wii training (WII, n = 28) or daily use of ethylene vinyl acetate copolymer insoles (controls [CON], n = 30). Primary end points were maximal muscle strength (maximal voluntary contraction) and center of pressure velocity moment during bilateral static stance. Intention-to-treat analysis with adjustment for age, sex, and baseline level showed that the WII group had higher maximal voluntary contraction strength (18%) than the control group at follow up (between-group difference = 269 N, 95% CI = 122; 416, and p = .001). In contrast, the center of pressure velocity moment did not differ (1%) between WII and CON at follow-up (between-group difference = 0.23 mm(2)/s, 95% CI = -4.1; 4.6, and p = .92). For secondary end points, pre-to-post changes favoring the WII group were evident in the rate of force development (p = .03), Timed Up and Go test (p = .01), short Falls Efficacy Scale-International (p = .03), and 30-second repeated Chair Stand Test (p = .01). Finally, participants rated the Wii training highly motivating at 5 and 10 weeks into the intervention. Biofeedback-based Wii training led to marked improvements in maximal leg muscle strength (maximal voluntary contraction; rate of force development) and overall functional performance in community-dwelling older adults. Unexpectedly, static bilateral postural balance remained unaltered with Wii training. The high level of participant motivation suggests that biofeedback-based Wii exercise may ensure a high degree of compliance to home- and/or community-based training in community-dwelling older adults.

Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain.

PubMed

Tsao, Henry; Hodges, Paul W

2008-08-01

This study investigated long-term effects of training on postural control using the model of deficits in activation of transversus abdominis (TrA) in people with recurrent low back pain (LBP). Nine volunteers with LBP attended four sessions for assessment and/or training (initial, two weeks, four weeks and six months). Training of repeated isolated voluntary TrA contractions were performed at the initial and two-week session with feedback from real-time ultrasound imaging. Home program involved training twice daily for four weeks. Electromyographic activity (EMG) of trunk and deltoid muscles was recorded with surface and fine-wire electrodes. Rapid arm movement and walking were performed at each session, and immediately after training on the first two sessions. Onset of trunk muscle activation relative to prime mover deltoid during arm movements, and the coefficient of variation (CV) of EMG during averaged gait cycle were calculated. Over four weeks of training, onset of TrA EMG was earlier during arm movements and CV of TrA EMG was reduced (consistent with more sustained EMG activity). Changes were retained at six months follow-up (p<0.05). These results show persistence of motor control changes following training and demonstrate that this training approach leads to motor learning of automatic postural control strategies.

Static and dynamic single leg postural control performance during dual-task paradigms.

PubMed

Talarico, Maria K; Lynall, Robert C; Mauntel, Timothy C; Weinhold, Paul S; Padua, Darin A; Mihalik, Jason P

2017-06-01

Combining dynamic postural control assessments and cognitive tasks may give clinicians a more accurate indication of postural control under sport-like conditions compared to single-task assessments. We examined postural control, cognitive and squatting performance of healthy individuals during static and dynamic postural control assessments in single- and dual-task paradigms. Thirty participants (female = 22, male = 8; age = 20.8 ± 1.6 years, height = 157.9 ± 13.0 cm, mass = 67.8 ± 20.6 kg) completed single-leg stance and single-leg squat assessments on a force plate individually (single-task) and concurrently (dual-task) with two cognitive assessments, a modified Stroop test and the Brooks Spatial Memory Test. Outcomes included centre of pressure speed, 95% confidence ellipse, squat depth and speed and cognitive test measures (percentage of correct answers and reaction time). Postural control performance varied between postural control assessments and testing paradigms. Participants did not squat as deep and squatted slower (P < 0.001) during dual-task paradigms (≤12.69 ± 3.4 cm squat depth, ≤16.20 ± 4.6 cm · s -1 squat speed) compared to single-task paradigms (14.57 ± 3.6 cm squat depth, 19.65 ± 5.5 cm · s -1 squat speed). The percentage of correct answers did not change across testing conditions, but Stroop reaction time (725.81 ± 59.2 ms; F 2,58  = 7.725, P = 0.001) was slowest during single-leg squats compared to baseline (691.64 ± 80.1 ms; P = 0.038) and single-task paradigms (681.33 ± 51.5 ms; P < 0.001). Dynamic dual-task assessments may be more challenging to the postural control system and may better represent postural control performance during dynamic activities.

Impaired perception of surface tilt in progressive supranuclear palsy

PubMed Central

Dale, Marian L.; Horak, Fay B.; Wright, W. Geoffrey; Schoneburg, Bernadette M.; Nutt, John G.; Mancini, Martina

2017-01-01

Introduction Progressive supranuclear palsy (PSP) is characterized by early postural instability and backward falls. The mechanisms underlying backward postural instability in PSP are not understood. The aim of this study was to test the hypothesis that postural instability in PSP is a result of dysfunction in the perception of postural verticality. Methods We gathered posturography data on 12 subjects with PSP to compare with 12 subjects with idiopathic Parkinson’s Disease (PD) and 12 healthy subjects. Objective tests of postural impairment included: dynamic sensory perception tests of gravity and of surface oscillations, postural responses to surface perturbations, the sensory organization test of postural sway under altered sensory conditions and limits of stability in stance. Results Perception of toes up (but not toes down) surface tilt was reduced in subjects with PSP compared to both control subjects (p≤0.001 standing, p≤0.007 seated) and subjects with PD (p≤0.03 standing, p≤0.04 seated). Subjects with PSP, PD and normal controls accurately perceived the direction of gravity when standing on a tilting surface. Unlike PD and control subjects, subjects with PSP exerted less postural corrective torque in response to toes up surface tilts. Discussion Difficulty perceiving backward tilt of the surface or body may account for backward falls and postural impairments in patients with PSP. These observations suggest that abnormal central integration of sensory inputs for perception of body and surface orientation contributes to the pathophysiology of postural instability in PSP. PMID:28267762

Acute alcohol administration improves skilled reaching success in intact but not 6-OHDA dopamine depleted rats: a subsystems analysis of the motoric and anxiolytic effects of alcohol.

PubMed

Metz, Gerlinde A; Gonzalez, Claudia L R; Piecharka, Dionne M; Whishaw, Ian Q

2003-06-16

Low doses of alcohol impair movement and reduce anxiety. Most assessments of movement under ethyl alcohol (alcohol) in the rat have been tests of whole body movements, however. There has been no examination of the effects of alcohol on skilled limb movements, such as reaching for food with a forelimb. This was the purpose of the present study. Rats were trained to reach through a slot of a box with a forelimb in order to obtain a food pellet located on an external shelf. Once asymptotic performance was achieved, rats were given alcohol (20 ml of 8, 12 or 20% (v/v) solution) in separate tests to establish a relationship between alcohol ingestion and skilled reaching performance. Acute treatment with all doses of alcohol impaired postural support, but doses of 8 and 12% alcohol improved skilled reaching success. Qualitative analysis of the movements used for reaching at doses of 8 and 12% indicated that some limb components of the reaching movement were also impaired, perhaps secondarily due to impaired posture. In contrast, the reaching success of rats with unilateral dopamine depletion, induced with the neurotoxin 6-hydroxydopamine (6-OHDA) in the nigrostriatal bundle, was impaired by the same dose of alcohol that improved reaching success in control rats. The finding of improved success in reaching associated with reduced postural support in normal rats suggests a differential action of alcohol on movement subsystems underlying posture relative to skilled movement that depends upon an intact dopaminergic system. The results are also discussed with respect to the relationship of subsystems of movement and anxiety.

Guide to Good Posture

MedlinePlus

... Affect how well your joints move Affect your balance and increase your risk of falling Make it harder to digest your food Make it harder to breathe How can I improve my posture in general? Be mindful of your posture during everyday activities, ...

Postural Stability is Altered by Blood Shift

NASA Astrophysics Data System (ADS)

Marais, M.; Denise, P.; Guincetre, J. Y.; Normand, H.

2008-06-01

Non-vestibular influences as shift in blood volume changed perception of body posture. Then, factors affecting blood shift may alter postural control. The purpose of our study was to investigate the effects of leg venous contention on postural stability. Twelve subjects were studied on a balance plate for 5 minutes with the eyes closed, in 3 conditions: with no leg venous contention or grade 1 and 3 support stockings. Standard deviation of x and y position was calculated before and after the closure of the eyes. Strong venous contention altered postural stability, after the eyes were closed, during the first 10 s of standing. As support stockings prevent blood shift induced by upright posture, this result is in line with the hypothesis that blood shifts influence the perception of body orientation and postural control among others factors as vision, vestibular inputs... This strong venous contention could induce an increase of fall.

Development of Postural Muscles and Their Innervation

PubMed Central

IJkema-Paassen, J.; Gramsbergen, A.

2005-01-01

Control of posture is a prerequisite for efficient motor performance. Posture depends on muscles capable of enduring contractions, whereas movements often require quick, forceful muscle actions. To serve these different goals, muscles contain fibers that meet these different tasks. Muscles with strong postural functions mainly consist of slow muscle fibers with a great resistance against fatigue. Flexor muscles in the leg and arm muscles are mainly composed of fast muscle fibers producing relatively large forces that are rapidly fatigable. Development of the neuromuscular system continues after birth. We discuss in the human baby and in animal experiments changes in muscle fiber properties, regression from polyneural into mononeural innervation, and developmental changes in the motoneurons of postural muscles during that period. The regression of poly-neural innervation in postural muscles and the development of dendrite bundles of their motoneurons seem to be linked to the transition from the immature into the adult-like patterns of moving and postural control. PMID:16097482

Nonlinear Variability of Body Sway in Patients with Phobic Postural Vertigo

PubMed Central

Schniepp, Roman; Wuehr, Max; Pradhan, Cauchy; Novozhilov, Sergej; Krafczyk, Siegbert; Brandt, Thomas; Jahn, Klaus

2013-01-01

Background: Subjective postural imbalance is a key symptom in the somatoform phobic postural vertigo (PPV). It has been assumed that more attentional control of body posture and / or co-contraction of leg muscles during standing is used to minimize the physiological body sway in PPV. Here we analyze nonlinear variability of body sway in patients with PPV in order to disclose changes in postural control strategy associated with PPV. Methods: Twenty patients with PPV and 20 age-matched healthy subjects (HS) were recorded on a stabilometer platform with eyes open (EO), eyes closed (EC), and while standing on a foam rubber with eyes closed (ECF). Spatio-temporal changes of the center of pressure (CoP) displacement were analyzed to assess the structure of postural variability by computing the scaling exponent α and the sample entropy (SEn) of the time series. Results: With EO on firm ground α and SEn of CoP displacement were significantly lower in patients (p < 0.001). For more difficult conditions (EC, ECF) postural variability in PPV assimilated to that of HS. Conclusion: Postural control in PPV patients differs from HS under normal stance condition. It is characterized by a reduced scaling behavior and higher regularity. These changes in the structure of postural variability might suggest an inappropriate attentional involvement with stabilizing strategies, which are used by HS only for more demanding balance tasks. PMID:23966974

Lower regulatory frequency for postural control in patients with fibromyalgia and chronic fatigue syndrome.

PubMed

Rasouli, Omid; Vasseljen, Ottar; Fors, Egil A; Lorås, Håvard W; Stensdotter, Ann-Katrin

2018-01-01

As many similar symptoms are reported in fibromyalgia (FM) and chronic fatigue syndrome (CFS), underlying defcits may potentially also be similar. Postural disequilibrium reported in both conditions may thus be explained by similar deviations in postural control strategies. 75 females (25/group FM, CFS and control, age 19-49 years) performed 60 s of quiet standing on a force platform in each of three conditions: 1) firm surface with vision, 2) firm surface without vision and, 3) compliant surface with vision. Migration of center of pressure was decomposed into a slow and a fast component denoting postural sway and lateral forces controlling postural sway, analyzed in the time and frequency domains. Main effects of group for the antero-posterior (AP) and medio-lateral (ML) directions showed that patients displayed larger amplitudes (AP, p = 0.002; ML, p = 0.021) and lower frequencies (AP, p < 0.001; ML, p < 0.001) for the slow component, as well as for the fast component (amplitudes: AP, p = 0.010; ML, p = 0.001 and frequencies: AP, p = 0.001; ML, p = 0.029) compared to controls. Post hoc analyses showed no significant differences between patient groups. In conclusion, both the CFS- and the FM-group differed from the control group. Larger postural sway and insufficient control was found in patients compared to controls, with no significant differences between the two patient groups.

Lower regulatory frequency for postural control in patients with fibromyalgia and chronic fatigue syndrome

PubMed Central

Rasouli, Omid; Vasseljen, Ottar; Fors, Egil A.; Lorås, Håvard W.

2018-01-01

As many similar symptoms are reported in fibromyalgia (FM) and chronic fatigue syndrome (CFS), underlying defcits may potentially also be similar. Postural disequilibrium reported in both conditions may thus be explained by similar deviations in postural control strategies. 75 females (25/group FM, CFS and control, age 19–49 years) performed 60 s of quiet standing on a force platform in each of three conditions: 1) firm surface with vision, 2) firm surface without vision and, 3) compliant surface with vision. Migration of center of pressure was decomposed into a slow and a fast component denoting postural sway and lateral forces controlling postural sway, analyzed in the time and frequency domains. Main effects of group for the antero-posterior (AP) and medio-lateral (ML) directions showed that patients displayed larger amplitudes (AP, p = 0.002; ML, p = 0.021) and lower frequencies (AP, p < 0.001; ML, p < 0.001) for the slow component, as well as for the fast component (amplitudes: AP, p = 0.010; ML, p = 0.001 and frequencies: AP, p = 0.001; ML, p = 0.029) compared to controls. Post hoc analyses showed no significant differences between patient groups. In conclusion, both the CFS- and the FM-group differed from the control group. Larger postural sway and insufficient control was found in patients compared to controls, with no significant differences between the two patient groups. PMID:29617424

Cognition and balance control: does processing of explicit contextual cues of impending perturbations modulate automatic postural responses?

PubMed

Coelho, Daniel Boari; Teixeira, Luis Augusto

2017-08-01

Processing of predictive contextual cues of an impending perturbation is thought to induce adaptive postural responses. Cueing in previous research has been provided through repeated perturbations with a constant foreperiod. This experimental strategy confounds explicit predictive cueing with adaptation and non-specific properties of temporal cueing. Two experiments were performed to assess those factors separately. To perturb upright balance, the base of support was suddenly displaced backwards in three amplitudes: 5, 10 and 15 cm. In Experiment 1, we tested the effect of cueing the amplitude of the impending postural perturbation by means of visual signals, and the effect of adaptation to repeated exposures by comparing block versus random sequences of perturbation. In Experiment 2, we evaluated separately the effects of cueing the characteristics of an impending balance perturbation and cueing the timing of perturbation onset. Results from Experiment 1 showed that the block sequence of perturbations led to increased stability of automatic postural responses, and modulation of magnitude and onset latency of muscular responses. Results from Experiment 2 showed that only the condition cueing timing of platform translation onset led to increased balance stability and modulation of onset latency of muscular responses. Conversely, cueing platform displacement amplitude failed to induce any effects on automatic postural responses in both experiments. Our findings support the interpretation of improved postural responses via optimized sensorimotor processes, at the same time that cast doubt on the notion that cognitive processing of explicit contextual cues advancing the magnitude of an impending perturbation can preset adaptive postural responses.

Differences in body posture, strength and flexibility in schoolchildren with overweight and obesity: A quasi-experimental study.

PubMed

Schwanke, Natalí Lippert; Pohl, Hildegard Hedwig; Reuter, Cézane Priscila; Borges, Tássia Silvana; de Souza, Sonimar; Burgos, Miria Suzana

2016-04-01

Body posture and its components have been widely discussed, given the high prevalence of musculoskeletal disorders in children and adolescents. Among children and adolescents with overweight and obesity issues, these changes can be pronounced. This study sought to investigate whether a global exercise routine could result in positive changes in the angles and distances measured in postural assessments and in the number of abdominal and flexibility exercise repetitions performed by children and adolescents with overweight or obesity. A quasi-experimental design including an experimental group (EG) and a control group (CG) was used. The primary outcome variables included ratings of body posture (using SAPO software) and measures of abdominal muscle strength (number of sit-ups) and flexibility. The EG received an interdisciplinary intervention the included 48 sessions of global postural exercises performed three times a week. Of the 46 schoolchildren evaluated (EG, n = 23 and CG, n = 23), significant changes were observed in the EG from pre-to post-test in the thoracic angle (p = 0.001) and abdominal muscle strength (p = 0.016) for boys and in the thoracic angle (p = 0.010), abdominal muscle strength (p = 0.003) and flexibility (p = 0.010) for girls. Overall, the exercise program led to changes in the angle and distance measurements obtained in postural evaluations and contributed to increases in the number of repetitions of abdominal and flexibility exercises, indicating improvements in the EG group's body posture and health indicators. Copyright © 2015 Elsevier Ltd. All rights reserved.

Athletic background is related to superior trunk proprioceptive ability, postural control, and neuromuscular responses to sudden perturbations.

PubMed

Glofcheskie, Grace O; Brown, Stephen H M

2017-04-01

Trunk motor control is essential for athletic performance, and inadequate trunk motor control has been linked to an increased risk of developing low back and lower limb injury in athletes. Research is limited in comparing relationships between trunk neuromuscular control, postural control, and trunk proprioception in athletes from different sporting backgrounds. To test for these relationships, collegiate level long distance runners and golfers, along with non-athletic controls were recruited. Trunk postural control was investigated using a seated balance task. Neuromuscular control in response to sudden trunk loading perturbations was measured using electromyography and kinematics. Proprioceptive ability was examined using active trunk repositioning tasks. Both athlete groups demonstrated greater trunk postural control (less centre of pressure movement) during the seated task compared to controls. Athletes further demonstrated faster trunk muscle activation onsets, higher muscle activation amplitudes, and less lumbar spine angular displacement in response to sudden trunk loading perturbations when compared to controls. Golfers demonstrated less absolute error and variable error in trunk repositioning tasks compared to both runners and controls, suggestive of greater proprioceptive ability. This suggests an interactive relationship between neuromuscular control, postural control, and proprioception in athletes, and that differences exist between athletes of various training backgrounds. Copyright © 2017 Elsevier B.V. All rights reserved.

Body-Earth Mover's Distance: A Matching-Based Approach for Sleep Posture Recognition.

PubMed

Xu, Xiaowei; Lin, Feng; Wang, Aosen; Hu, Yu; Huang, Ming-Chun; Xu, Wenyao

2016-10-01

Sleep posture is a key component in sleep quality assessment and pressure ulcer prevention. Currently, body pressure analysis has been a popular method for sleep posture recognition. In this paper, a matching-based approach, Body-Earth Mover's Distance (BEMD), for sleep posture recognition is proposed. BEMD treats pressure images as weighted 2D shapes, and combines EMD and Euclidean distance for similarity measure. Compared with existing work, sleep posture recognition is achieved with posture similarity rather than multiple features for specific postures. A pilot study is performed with 14 persons for six different postures. The experimental results show that the proposed BEMD can achieve 91.21% accuracy, which outperforms the previous method with an improvement of 8.01%.

Effect of expertise in shooting and Taekwondo on bipedal and unipedal postural control isolated or concurrent with a reaction-time task.

PubMed

Negahban, Hossein; Aryan, Najmolhoda; Mazaheri, Masood; Norasteh, Ali Asghar; Sanjari, Mohammad Ali

2013-06-01

It was hypothesized that training in 'static balance' or 'dynamic balance' sports has differential effects on postural control and its attention demands during quiet standing. In order to test this hypothesis, two groups of female athletes practicing shooting, as a 'static balance' sport, and Taekwondo, as a 'dynamic balance' sport, and a control group of non-physically active females voluntarily participated in this study. Postural control was assessed during bipedal and unipedal stance with and without performing a Go/No-go reaction time task. Visual and/or support surface conditions were manipulated in bipedal and unipedal stances in order to modify postural difficulty. Mixed model analysis of variance was used to determine the effects of dual tasking on postural and cognitive performance. Similar pattern of results were found in bipedal and unipedal stances, with Taekwondo practitioners displaying larger sway, shooters displaying lower sway and non-athletes displaying sway characteristics intermediate to Taekwondo and shooting athletes. Larger effect was found in bipedal stance. Single to dual-task comparison of postural control showed no significant effect of mental task on sway velocity in shooters, indicating less cognitive effort invested in balance control during bipedal stance. We suggest that expertise in shooting has a more pronounced effect on decreased sway in static balance conditions. Furthermore, shooters invest less attention in postures that are more specific to their training, i.e. bipedal stance. Copyright © 2012 Elsevier B.V. All rights reserved.

Biostereometric Analysis Of Therapeutic Results In The Treatment Of Chronic, Progressive, Decompensating Postural Back Strain

NASA Astrophysics Data System (ADS)

Johnson, David M.

1980-07-01

A two year pilot program for biostereometric analysis of treatment effectiveness in five patients with chronic decompensating back strain has been completed. The patients came from the investigators family practice of osteopathic medicine. They all manifested objective signs of ligamentous and muscular strain of their postural biomechanics due to the combined effects of prior injury to the musculoskeletal system, gravity strain and the passage of time. Two of the patients were treated with osteopathic manipulative treatment plus a pelvic leverage treatment device developed by Martin Jungman, M.D. Two patients received osteopathic treatment alone and the fifth individual switched from control to full program status in the middle of the study after the second stereophotography recording. Signs and symptoms of all patients' gravity strain syndrome changed during the program. Those patients who had the full combination of treatment modalities showed the most positive and significant postural changes as demonstrated by the biostereometric technique developed and performed by the Department of Biostereometrics, Texas Institute of Rehabilitation and Research, Baylor College of Medicine, Houston, Texas. Improvement was clearly demonstrated more quickly than with the prior radiographic measuring methods. X-ray and other studies have also been done on this group. All of the data has not been processed yet in this program. The test patients have improved posture, muscle mass and tone, more stamina and reduced pain.

A Prospective Randomized Trial of Postural Changes vs Passive Supine Lying during the Second Stage of Labor under Epidural Analgesia

PubMed Central

Simarro, María; Espinosa, José Angel; Salinas, Cecilia; Ojea, Ricardo; Salvadores, Paloma; Walker, Carolina; Schneider, José

2017-01-01

There exist very few studies comparing different postures or postural changes during labor in parturients with epidural analgesia. Aim: To disclose whether the intervention of a multidisciplinary nursing team including a physiotherapist during the second stage of labor improves the obstetric outcome in parturients with epidural analgesia. Design: Prospective randomized trial. Setting: University-affiliated hospital. Population: Women undergoing labor with epidural analgesia after a normal gestation. Methods: 150 women were randomized either to actively perform predefined postural changes during the passive phase of the second stage of labor under the guidance of the attending physiotherapist (study group), or to carry out the whole second stage of labor lying in the traditional supine position (control group). Results: There were significantly more eutocic deliveries (p = 0.005) and, conversely, significantly less instrumental deliveries (p < 0.05) and cesarean sections (p < 0.05) in the study group. The total duration of the second stage of labor was significantly shorter (p < 0.01) in the study group. This was at the expense of the passive phase of the second stage of labor (p < 0.01). Significantly less episiotomies were performed in the study group (31.2% vs 17.8%, p < 0.05). Conclusion: The intervention of a physiotherapist during the second stage of labor significantly improved the obstetric outcome. PMID:29099021

Postural control deficit during sit-to-walk in patients with Parkinson's disease and freezing of gait.

PubMed

Mezzarobba, Susanna; Grassi, Michele; Valentini, Roberto; Bernardis, Paolo

2018-03-01

The intricate linkage between Freezing of Gait (FoG) and postural control in Parkinson's disease (PD) is unclear. We analyzed the impact of FoG on dynamic postural control. 24 PD patients, 12 with (PD + FoG), 12 without FoG (PD-FoG), and 12 healthy controls, were assessed in ON state. Mobility and postural control were measured with clinical scales (UPDRS III, BBS, MPAS) and with kinematic and kinetic analysis during three tasks, characterized by levels of increasing difficulty to plan sequential movement of postural control: walk (W), gait initiation (GI) and sit-to-walk (STW). The groups were balanced by age, disease duration, disease severity, mobility and balance. During STW, the spatial distribution of COP trajectories in PD + FoG patients are spread over medial-lateral space more than in the PD-FoG (p < .001). Moreover, the distribution of COP positions. in the transition between sit-to-stand and gait initiation, is not properly shifted toward the leading leg, as in PD-FoG and healthy controls, but it is more centrally dispersed (p < .01) with a delayed weight forward progression (p < .05). In GI task and walk task, COM and COP differences are less evident and even absent between PD patients. PD + FoG show postural control differences in STW, compared with PD-FoG and healthy. Different spatial distribution of COP trajectories, between two PD groups are probably due to a deficit to plan postural control during a more demanding motor pattern, such as STW. Copyright © 2018 Elsevier B.V. All rights reserved.

Combining Workstation Design and Performance Management to Increase Ergonomically Correct Computer Typing Postures

ERIC Educational Resources Information Center

Culig, Kathryn M.; Dickinson, Alyce M.; Lindstrom-Hazel, Debra; Austin, John

2008-01-01

The effects of workstation changes and a performance management (PM) package on seven typing postures were examined for seven office workers. Workstation adjustments were implemented first. Two participants increased five safe postures by 50% or more. The effects of a PM package on postures that did not improve by 50% were then examined using a…

Postural Balance Following Aerobic Fatigue Tests: A Longitudinal Study Among Young Athletes.

PubMed

Steinberg, Nili; Eliakim, Alon; Zaav, Aviva; Pantanowitz, Michal; Halumi, Monder; Eisenstein, Tamir; Meckel, Yoav; Nemet, Dan

2016-01-01

General fatigue can cause aggravation of postural balance, with increased risk for injuries. The present longitudinal study aimed to evaluate the postural balance of young athletes following field aerobic tests throughout 1 year of training. Thirty children from a sports center in Nazareth, participating in a 3 times/week training program (specific to basketball, soccer, or athletic training), were assessed. Postural balance parameters were taken before, immediately after, and 10 min after a 20 m shuttle-run aerobic test, at 3 time points during 1 training year (Start/Y, Mid/Y, and End/Y). Fitness improved at the Mid/Y and End/Y compared to Start/Y. Postural balance significantly deteriorated immediately after the aerobic test and improved significantly in the 10-min testing in all 3 time points, with significant deterioration in the End/Y compared with the Start/Y. In conclusions, postural balance deteriorates immediately after aerobic exercises, and at the end of the year. To better practice drills related to postural balance and possibly to prevent injuries, it is best for young athletes to properly rest immediately following aerobic exercises and to practice postural balance mainly at the beginning and at the middle of the training year.

Physiological complexity and system adaptability: evidence from postural control dynamics of older adults.

PubMed

Manor, Brad; Costa, Madalena D; Hu, Kun; Newton, Elizabeth; Starobinets, Olga; Kang, Hyun Gu; Peng, C K; Novak, Vera; Lipsitz, Lewis A

2010-12-01

The degree of multiscale complexity in human behavioral regulation, such as that required for postural control, appears to decrease with advanced aging or disease. To help delineate causes and functional consequences of complexity loss, we examined the effects of visual and somatosensory impairment on the complexity of postural sway during quiet standing and its relationship to postural adaptation to cognitive dual tasking. Participants of the MOBILIZE Boston Study were classified into mutually exclusive groups: controls [intact vision and foot somatosensation, n = 299, 76 ± 5 (SD) yr old], visual impairment only (<20/40 vision, n = 81, 77 ± 4 yr old), somatosensory impairment only (inability to perceive 5.07 monofilament on plantar halluxes, n = 48, 80 ± 5 yr old), and combined impairments (n = 25, 80 ± 4 yr old). Postural sway (i.e., center-of-pressure) dynamics were assessed during quiet standing and cognitive dual tasking, and a complexity index was quantified using multiscale entropy analysis. Postural sway speed and area, which did not correlate with complexity, were also computed. During quiet standing, the complexity index (mean ± SD) was highest in controls (9.5 ± 1.2) and successively lower in the visual (9.1 ± 1.1), somatosensory (8.6 ± 1.6), and combined (7.8 ± 1.3) impairment groups (P = 0.001). Dual tasking resulted in increased sway speed and area but reduced complexity (P < 0.01). Lower complexity during quiet standing correlated with greater absolute (R = -0.34, P = 0.002) and percent (R = -0.45, P < 0.001) increases in postural sway speed from quiet standing to dual-tasking conditions. Sensory impairments contributed to decreased postural sway complexity, which reflected reduced adaptive capacity of the postural control system. Relatively low baseline complexity may, therefore, indicate control systems that are more vulnerable to cognitive and other stressors.