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Rodrigues A, Bevilaqua-Grossi D, Florencio LL, Pinheiro CF, Dach F, Bigal M, Carvalho GF. Balance alterations are associated with neck pain and neck muscle endurance in migraine. Musculoskelet Sci Pract 2023; 66:102811. [PMID: 37357054 DOI: 10.1016/j.msksp.2023.102811] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Migraine patients may present with both cervical and balance dysfunctions. The neck plays an important role in balance by providing substantial proprioceptive input, which is integrated in the central nervous system and influences the balance control systems. Whether balance and neck dysfunctions are associated in patients with migraine is still to be explored. OBJECTIVES This study aimed to assess the association between the sensory organization test of balance with neck pain features, cervical strength, endurance, and range of motion in patients with migraine. METHODS Sixty-five patients with migraine underwent the sensory organization test assessed with the Equitest-Neurocom® device. Maximum voluntary isometric contraction, cervical flexion and extension range of motion, and cervical flexor and extensor endurance were assessed. In addition, the features of migraine and neck pain were collected. Patients were dichotomized according to cut-off scores of balance performance and the association between outcomes were explored. RESULTS Patients with reduced balance performance presented a higher frequency of migraine (p = 0.035), a higher frequency of aura (p = 0.002), greater neck pain intensity (p = 0.013), and decreased endurance of cervical flexors (p = 0.010) and extensors (p < 0.0001). The total balance score was correlated with age (r = -0.33; p = 0.007), migraine frequency (r = -0.29; p = 0.021), neck pain intensity (r = -0.26; p = 0.038), and endurance of the cervical flexors (r = 0.39; p = 0.001) and extensors (r = 0.36; p = 0.001). Migraine frequency, neck pain intensity, and endurance of the cervical flexors can predict 21% of the sensory organization test variability. CONCLUSION Neck pain features and endurance of the cervical muscles are related to reduced balance performance in patients with migraine. These results shed light to a better understanding of balance alterations in migraine patients.
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Affiliation(s)
- Amanda Rodrigues
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Lidiane Lima Florencio
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.
| | - Carina Ferreira Pinheiro
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | | | - Gabriela Ferreira Carvalho
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Germany.
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Hao Z, Yang Y, Hua A, Gao Y, Wang J. Age-Related Changes in Standing Balance in Preschoolers Using Traditional and Nonlinear Methods. Front Physiol 2021; 12:625553. [PMID: 33692702 PMCID: PMC7937647 DOI: 10.3389/fphys.2021.625553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Considerable disagreement exists on the linearity of the development of standing balance in children. This study aimed to use different traditional and nonlinear methods to investigate age-related changes in standing balance in preschoolers. A sample of 118 preschoolers took part in this study. A force platform was used to record the center of pressure during standing balance over 15 s in three conditions: eyes open, eyes closed, and/or head extended backward. Detrended fluctuation analysis (DFA), recurrence quantification analysis (RQA), and traditional measures were used to evaluate standing balance. The main results are as follows: (1) Higher range and SD in the anterior-posterior (AP) direction were observed for 5-year-old than for 4-year-old children, while higher DFA coefficient (at shorter time scales) and higher determinism and laminarity in the AP direction were found for 5-year-old children compared to 3- and 4-year-old children; and (2) as sensory conditions became more challenging, all traditional measures increased and DFA coefficients (at shorter and longer time scales) decreased in the AP and mediolateral directions, while determinism and laminarity significantly declined in the AP direction. In conclusion, although increased postural sway, 5-year-old preschool children's balance performance improved, and their control strategy changed significantly compared with the younger preschoolers. Sensory perturbation (eye closure and/or head extension) changed preschoolers' balance performance and control strategy. Moreover, both traditional and nonlinear methods provided complementary information on the control of standing balance in preschoolers.
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Affiliation(s)
- Zengming Hao
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Yi Yang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Anke Hua
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Ying Gao
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Jian Wang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China.,Center for Psychological Sciences, Zhejiang University, Hangzhou, China
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3
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Shibata D. Improvement of dynamic postural stability by an exercise program. Gait Posture 2020; 80:178-184. [PMID: 32521472 DOI: 10.1016/j.gaitpost.2020.05.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 05/15/2020] [Accepted: 05/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Central processing of multi-sensory feedback and motor commands responsible for force production are critical for postural control. An exercise program was developed to realign spinal curvature, but its effect on postural control is unknown. RESEARCH QUESTION To what extent would the exercise program influence on center of pressure (CoP) sway on stable and unstable surfaces? METHODS Subjects (n = 30) were randomly assigned into one of three groups: exercise on a cylinder-shaped tube (98-cm length, 15-cm diameter, n = 10), exercise on a flat surface (n = 10), and a control group that laid supine on a flat surface (n = 10). Standing posture of each subject was quantified using anterior-, posterior-, and lateral-view photography. Each subject's CoP sway was measured while standing on a static and dynamic platform with eyes open and eyes closed. Subjects were instructed to stand still when the platform was held stationary (e.g., no tilt) during the static condition. During the dynamic condition the platform was allowed to tilt in response to changes of CoP and subjects were instructed to maintain the platform in a horizontal position. RESULTS Only when subjects performed the exercise program on the tube, the angles of neck flexion and pelvis tilt decreased, and CoP sway in the sagittal, but not frontal plane, decreased during the dynamic platform conditions with both eyes open and eyes closed (p < 0.05). SIGNIFICANCE It is speculated that performing the exercise program on the tube might enhance a) central processing of somatosensory and vestibular inputs, b) motor commands responsible for force production in postural control, and c) biomechanical advantage by the realigned posture. The exercise program can be used by a variety of populations as home-exercise to realign the neck and pelvic posture and improve dynamic postural stability.
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Affiliation(s)
- Daisuke Shibata
- Athletic Training Education Program, Department of Health Exercise and Sports Sciences, University of New Mexico, New Mexico, USA.
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Khademolhosseini Y, Pirouzi S, Ghanbari A, Arabzadeh S, Rezaei I. Head and neck extension more than 30° may disturb standing balance in healthy older adults. Geriatr Nurs 2020; 41:490-495. [PMID: 32145993 DOI: 10.1016/j.gerinurse.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
Although there is clinical evidence of postural instability at extreme angles of head extension, the effects of lower angles on balance have been not investigated. This study aimed to investigate the effects of different head and neck extension angles on standing balance in older adults, and to determine the critical angle of instability. Twenty-eight healthy older adults were tested at 0°, 20°, 30° and 40° head and neck extension. The center of pressure (COP) parameters were recorded with a force plate. Significant differences were observed between 30° and 40° compared to 0° in anteroposterior and mediolateral COP displacement and total COP velocity, and between 40° and 0° in mediolateral COP velocity. Head and neck extension at 30° was the critical angle associated with the appearance of instability, and this value should be considered in the ergonomic design of work and living spaces, exercise programming and daily activities in older adults.
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Affiliation(s)
| | - Soraya Pirouzi
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Ghanbari
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soudeh Arabzadeh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Rezaei
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Nisand M, Callens C, Destieux C, Dyer JO, Chanson JB, Sauleau E, Mutter C. Baropodometric quantification and implications of muscle coactivation in the lower limbs caused by head movement: A prospective study. J Bodyw Mov Ther 2020; 24:228-234. [DOI: 10.1016/j.jbmt.2019.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/12/2019] [Indexed: 11/30/2022]
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Beyond deficit or compensation: new insights on postural control after long-term total visual loss. Exp Brain Res 2016; 235:437-446. [PMID: 27770165 DOI: 10.1007/s00221-016-4799-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
Loss of vision is well known to affect postural control in blind subjects. This effect has classically been framed in terms of deficit or compensation depending on whether body sway increases or decreases in comparison with that of sighted subjects with the eyes open. However, studies have shown that postural responses can be modulated by the context and that changes in postural sway may not necessarily mean a worsened or improved postural control. The goal of our study was to test whether balance is affected by the context in blind subjects. Additional to the quantification of center of pressure (COP) displacement, measurements of body motion (COG) and the correspondent net neuromuscular response (COP-COG) were evaluated in anterior-posterior and medial-lateral directions. Thirty-eight completely blind and thirty-two sighted subjects participated of this study. The volunteers were asked to stand barefoot on a force platform for 60 s in two different conditions: feet apart and feet together. Sighted participants performed the tests with both the eyes open and eyes closed. Results showed that the COP-COG displacements in the blind group were greater than those of the sighted group with eyes open in almost all conditions tested, but not in eyes closed condition. However, the COP and COG results confirmed that the postural responses were context dependent. Together these results suggest that total visual loss does not just lead to a balance deficit or compensation, but to a specific postural signature that might imply in enhancing COP, COG and/or COP-COG in specific postural conditions.
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Sensory Re-Weighting in Human Bipedal Postural Control: The Effects of Experimentally-Induced Plantar Pain. PLoS One 2013; 8:e65510. [PMID: 23840337 PMCID: PMC3694088 DOI: 10.1371/journal.pone.0065510] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 05/01/2013] [Indexed: 11/19/2022] Open
Abstract
The present study was designed to assess the effects of experimentally-induced plantar pain on the displacement of centre of foot pressure during unperturbed upright stance in different sensory conditions of availability and/or reliability of visual input and somatosensory input from the vestibular system and neck. To achieve this goal, fourteen young healthy adults were asked to stand as still as possible in three sensory conditions: (1) No-vision, (2) Vision, and (3) No-vision - Head tilted backward, during two experimental conditions: (1) a No-pain condition, and (2) a condition when a painful stimulation was applied to the plantar surfaces of both feet (Plantar-pain condition). Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed that (1) experimentally-induced plantar pain increased CoP displacements in the absence of vision (No-vision condition), (2) this deleterious effect was more accentuated when somatosensory information from the vestibular and neck was altered (No-vision - Head tilted backward condition) and (3) this deleterious effect was suppressed when visual information was available (Vision condition). From a fundamental point of view, these results lend support to the sensory re-weighting hypothesis whereby the central nervous system dynamically and selectively adjusts the relative contributions of sensory inputs (i.e. the sensory weightings) in order to maintain balance when one or more sensory channels are altered by the task (novel or challenging), environmental or individual conditions. From a clinical point of view, the present findings further suggest that prevention and treatment of plantar pain may be relevant for the preservation or improvement of balance control, particularly in situations (or individuals) in which information provided by the visual, neck proprioceptive and vestibular systems is unavailable or disrupted.
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8
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Does forward head posture affect postural control in human healthy volunteers? Gait Posture 2013; 38:352-3. [PMID: 23219786 DOI: 10.1016/j.gaitpost.2012.11.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 10/12/2012] [Accepted: 11/13/2012] [Indexed: 02/02/2023]
Abstract
Proprioceptive afferent input from neck muscles plays an important role in postural control. Forward head posture has the potential to impair proprioceptive information from neck muscles and contribute to postural control deficits in patients with neck pain. This study investigated whether induced forward head posture affects postural control in healthy participants when compared to natural head posture. Centre of pressure sway area, distance covered and mean velocity were measured during 30s of static standing using a force platform with 25 healthy individuals (mean age ± SD = 20.76 ± 2.19 years) in 8 different conditions. Base of support, eyes open or closed and natural or forward head posture varied within these testing conditions. The majority of comparisons between natural and forward head posture were not statistically significant (p>0.05). This suggests that induced forward head posture in young healthy adults does not challenge them enough to impair postural control. Future studies should evaluate whether forward head posture affects postural control of individuals with chronic neck pain.
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Johnson MB, Van Emmerik REA. Is head-on-trunk extension a proprioceptive mediator of postural control and sit-to-stand movement characteristics? J Mot Behav 2011; 43:491-8. [PMID: 22122272 DOI: 10.1080/00222895.2011.631954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
During stance, head extension increases postural sway, possibly due to interference with sensory feedback. The sit-to-stand movement is potentially destabilizing due to the development of momentum as the trunk flexes forward and the body transitions to a smaller base of support. It is unclear what role head orientation plays in the postural and movement characteristics of the sit-to-stand transition. The authors assessed how moving from sitting to standing with head-on-trunk extension compared with moving with the head neutral or flexed, or with moving with the head facing forward in space (which would involve head-on-trunk extension, but not head-in-space extension) in healthy, young participants. Head-on-trunk extension increased center of pressure variability, but decreased movement velocities, movement duration, and trunk flexion compared with flexed and neutral head-on-trunk orientations. Similarities in movement characteristics between head-on-trunk extension and the forward head-in-space orientation suggest that stabilizing the head in space does not fully counteract the postural and movement changes due to head-on-trunk extension. Findings suggest that proprioceptive feedback from the neck muscles contributes to the regulation of posture and movement, and therefore should not be overlooked in research on the role of sensory feedback in postural control.
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Affiliation(s)
- Molly B Johnson
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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10
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Ustinova K, Perkins J. Gaze and viewing angle influence visual stabilization of upright posture. Brain Behav 2011; 1:19-25. [PMID: 22398978 PMCID: PMC3217671 DOI: 10.1002/brb3.10] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 05/19/2011] [Accepted: 05/27/2011] [Indexed: 11/13/2022] Open
Abstract
Focusing gaze on a target helps stabilize upright posture. We investigated how this visual stabilization can be affected by observing a target presented under different gaze and viewing angles. In a series of 10-second trials, participants (N = 20, 29.3 ± 9 years of age) stood on a force plate and fixed their gaze on a figure presented on a screen at a distance of 1 m. The figure changed position (gaze angle: eye level (0°), 25° up or down), vertical body orientation (viewing angle: at eye level but rotated 25° as if leaning toward or away from the participant), or both (gaze and viewing angle: 25° up or down with the rotation equivalent of a natural visual perspective). Amplitude of participants' sagittal displacement, surface area, and angular position of the center of gravity (COG) were compared. Results showed decreased COG velocity and amplitude for up and down gaze angles. Changes in viewing angles resulted in altered body alignment and increased amplitude of COG displacement. No significant changes in postural stability were observed when both gaze and viewing angles were altered. Results suggest that both the gaze angle and viewing perspective may be essential variables of the visuomotor system modulating postural responses.
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Affiliation(s)
- Ki Ustinova
- Graduate Program in Physical Therapy, Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University Michigan 48859
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11
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Vestibular and neck somatosensory weighting changes with trunk extensor muscle fatigue during quiet standing. Exp Brain Res 2009; 202:253-9. [PMID: 20035323 DOI: 10.1007/s00221-009-2122-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2008] [Accepted: 12/01/2009] [Indexed: 10/20/2022]
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12
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Postural changes during eye-head movements. PROGRESS IN BRAIN RESEARCH 2008. [PMID: 18718323 DOI: 10.1016/s0079-6123(08)00649-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
We investigated postural sway in young subjects during eye-head movements. Subjects stood on the force plate wearing a helmet on which a laser spot was attached. Visual targets were presented stepwise at 60 degrees to right and left or 50 degrees to upward and downward of the straight-ahead position. Subjects were asked to look at the targets quickly by directing the laser spot to the target. The anterior-posterior component of centre of pressures (COPs) exhibited the largest changes and shortest latencies during downward movements. Most of the subjects showed COP changes preceding the onset of downward head movements, and these changes were associated with EMG activity of biceps femoris and gastrocnemius. When subjects were asked to look at the target only by eyes, no consistent change was detected in ground reaction forces. These results indicate that the eye-head movements elicited the COP changes that preceded the onset of head movements.
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Differential postural effects of plantar–flexor muscle fatigue under normal, altered and improved vestibular and neck somatosensory conditions. Exp Brain Res 2008; 191:99-107. [PMID: 18663436 DOI: 10.1007/s00221-008-1500-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2007] [Accepted: 07/10/2008] [Indexed: 10/21/2022]
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Vuillerme N, Chenu O, Pinsault N, Fleury A, Demongeot J, Payan Y. Can a plantar pressure–based tongue-placed electrotactile biofeedback improve postural control under altered vestibular and neck proprioceptive conditions? Neuroscience 2008; 155:291-6. [PMID: 18597943 DOI: 10.1016/j.neuroscience.2008.05.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 05/07/2008] [Accepted: 05/07/2008] [Indexed: 11/27/2022]
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Vuillerme N, Pinsault N, Chenu O, Boisgontier M, Demongeot J, Payan Y. How a plantar pressure-based, tongue-placed tactile biofeedback modifies postural control mechanisms during quiet standing. Exp Brain Res 2007; 181:547-54. [PMID: 17476487 DOI: 10.1007/s00221-007-0953-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Accepted: 03/31/2007] [Indexed: 10/23/2022]
Abstract
The purpose of the present study was to determine the effects of a plantar pressure-based, tongue-placed tactile biofeedback on postural control mechanisms during quiet standing. To this aim, 16 young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements, recorded using a force platform, were used to compute the horizontal displacements of the vertical projection of the centre of gravity (CoG( v )) and those of the difference between the CoP and the vertical projection of the CoG (CoP-CoG( v )). Analysis of the CoP-CoG( v ) displacements showed larger root mean square (RMS) and mean power frequencies (MPF) in the Biofeedback than in the No-biofeedback condition. Stabilogram-diffusion analysis further showed a concomitant increased spatial and reduced temporal transition point co-ordinates at which the corrective processes were initiated and an increased persistent behaviour of the CoP-CoG( v ) displacements over the short-term region. Analysis of the CoG( v ) displacements showed decreased RMS and increased MPF in the Biofeedback relative to the No-biofeedback condition. Stabilogram-diffusion analysis further indicated that these effects mainly stem from reduced spatio-temporal transition point co-ordinates at which the corrective process involving CoG( v ) displacements is initiated and an increased anti-persistent behaviour of the CoG( v ) displacements over the long-term region. Altogether, the present findings suggest that the main way the plantar pressure-based, tongue-placed tactile biofeedback improves postural control during quiet standing is via both a reduction of the correction thresholds and an increased efficiency of the corrective mechanism involving the CoG( v ) displacements.
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Affiliation(s)
- Nicolas Vuillerme
- Faculté de Médecine, Laboratoire TIMC-IMAG, UMR UJF CNRS 5525, 38706, La Tronche cédex, France.
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Moncayo R, Moncayo H. A musculoskeletal model of low grade connective tissue inflammation in patients with thyroid associated ophthalmopathy (TAO): the WOMED concept of lateral tension and its general implications in disease. BMC Musculoskelet Disord 2007; 8:17. [PMID: 17319961 PMCID: PMC1820789 DOI: 10.1186/1471-2474-8-17] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Accepted: 02/23/2007] [Indexed: 12/16/2022] Open
Abstract
Background Low level connective tissue inflammation has been proposed to play a role in thyroid associated ophthalmopathy (TAO). The aim of this study was to investigate this postulate by a musculoskeletal approach together with biochemical parameters. Methods 13 patients with TAO and 16 controls were examined. Erythrocyte levels of Zn, Cu, Ca2+, Mg, and Fe were determined. The musculoskeletal evaluation included observational data on body posture with emphasis on the orbit-head region. The angular foot position in the frontal plane was quantified following gait observation. The axial orientation of the legs and feet was evaluated in an unloaded supine position. Functional propioceptive tests based on stretch stimuli were done by using foot inversion and foot rotation. Results Alterations in the control group included neck tilt in 3 cases, asymmetrical foot angle during gait in 2, and a reaction to foot inversion in 5 cases. TAO patients presented facial asymmetry with displaced eye fissure inclination (mean 9.1°) as well as tilted head-on-neck position (mean 5.7°). A further asymmetry feature was external rotation of the legs and feet (mean 27°). Both foot inversion as well as foot rotation induced a condition of neuromuscular deficit. This condition could be regulated by gentle acupressure either on the lateral abdomen or the lateral ankle at the acupuncture points gall bladder 26 or bladder 62, respectively. In 5 patients, foot rotation produced a phenomenon of moving toes in the contra lateral foot. In addition foot rotation was accompanied by an audible tendon snapping. Lower erythrocyte Zn levels and altered correlations between Ca2+, Mg, and Fe were found in TAO. Conclusion This whole body observational study has revealed axial deviations and body asymmetry as well as the phenomenon of moving toes in TAO. The most common finding was an arch-like displacement of the body, i.e. eccentric position, with foot inversion and head tilt to the contra lateral side and tendon snapping. We propose that eccentric muscle action over time can be the basis for a low grade inflammatory condition. The general implications of this model and its relations to Zn and Se will be discussed.
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Affiliation(s)
- Roy Moncayo
- WOMED, Karl-Kapferer-Strasse 5, A-6020 Innsbruck, Austria
| | - Helga Moncayo
- WOMED, Karl-Kapferer-Strasse 5, A-6020 Innsbruck, Austria
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17
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Carrick FR, Oggero E, Pagnacco G, Brock JB, Arikan T. Posturographic testing and motor learning predictability in gymnasts. Disabil Rehabil 2007; 29:1881-9. [PMID: 17852265 DOI: 10.1080/09638280601141335] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE One aim of this study was to find if there was a difference between balance and stability between elite level gymnasts and non-gymnasts. Another aim was to find if there was a relationship between dynamic posturographic scores associated with sway fatigue or adaptability and the ability to learn new gymnastic routines. The ultimate aim of the study was to improve gymnastic performance while reducing the probability of injury. METHODS Computer dynamic posturography (CDP) provided stability scores, fatigability ratios and adaptation ratios in elite level gymnasts and non-gymnasts controls. Relationships between the postural integrity of gymnasts and non-gymnasts were calculated. The gymnasts were trained in a novel gymnastic routine and performance outcomes were compared to the CDP outcomes. RESULTS Tests of postural stability have shown that gymnasts have greater postural stability than non-gymnasts. Gymnasts whose adaptability scores were higher were able to learn and perform new motor routines better than those with lower adaptability scores or high fatigability ratios. CONCLUSIONS While gymnasts have greater postural integrity than do non-gymnasts, CDP can identify individuals whose ability to perform new motor activities might be impaired. Methodology to improve functional stability not associated with the motor task may contribute to increased sports performance and decreased probability of injury.
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Affiliation(s)
- Frederick R Carrick
- Carrick Institute for Clinical Ergonomics Rehabilitation and Applied Neuroscience, Cape Canaveral, Florida 32920, USA.
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Fukushima J, Asaka T, Ikeda N, Ito Y. Postural Control during Downward Head Movements in Young Subjects. J Phys Ther Sci 2007. [DOI: 10.1589/jpts.19.205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Junko Fukushima
- Division of Physical Therapy, Department of Health Sciences, Hokkaido University School of Medicine
| | - Tadayoshi Asaka
- Division of Physical Therapy, Department of Health Sciences, Hokkaido University School of Medicine
| | - Natsumi Ikeda
- Division of Physical Therapy, Department of Health Sciences, Hokkaido University School of Medicine
| | - Yumi Ito
- Division of Physical Therapy, Department of Health Sciences, Hokkaido University School of Medicine
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Fukushima J, Asaka T, Ikeda N, Ito Y. Postural Control during Downward Head Movements in Young Subjects. J Phys Ther Sci 2007. [DOI: 10.1589/jpts.29.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kapoula Z, Lê TT. Effects of distance and gaze position on postural stability in young and old subjects. Exp Brain Res 2006; 173:438-45. [PMID: 16525804 DOI: 10.1007/s00221-006-0382-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2005] [Accepted: 01/26/2006] [Indexed: 10/24/2022]
Abstract
Visual stabilization of posture is known to improve when the distance to target fixation decreases; this is attributed to increased angular size of retinal slip induced by body sway. At near distance, however, the eyes converge and efferent or afferent oculomotor signals could also be involved in posture stabilization. The goal of this study is to test whether the distance effect exists for both young and elderly and to test the role of vergence itself and of gaze position. Eighteen young (25.3 years) and 17 elderly (61.6 years) subjects were asked to fixate a target in quiet stance presented either at close (40 cm) or at far distance (200 cm); the vergence angle was 9 degrees and 2 degrees , respectively. For each distance, three gaze positions were studied straight-ahead (0 degrees ), 15 degrees up or down. We found a decrease in the surface of center of pressure (CoP), of standard deviation of antero-posterior and lateral body sway and of speed variance at near distance that occurs for both young and elderly. At far distance, the surface of CoP is smaller for 15 degrees up or down gaze in comparison with straight-ahead position, but at near distance there is no such gaze position effect. In an additional experiment, subjects fixated a target at far distance (200 cm) but prisms were used to cause the eyes to converge by an amount similar to that required for 40 cm viewing distance. The use of prisms decreased surface of CoP to values similar to those for natural near viewing distance. The effect of gaze position and of convergence (experiment with prisms) leads us to suggest that in addition to retinal slip, the ocular motor signals and perhaps related neck muscle activity are involved in postural stabilization. Finally, the elderly presented higher speed variance of CoP than the young subjects even though the surface itself was similar to adult values. We suggest that increment of speed variance is the first sign of senescence in postural control.
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Affiliation(s)
- Zoï Kapoula
- Laboratoire de Physiologie de la Perception et de l'Action (LPPA), IRIS Group, UMR 7152, CNRS-Collège de France, Paris, France.
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