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Hu X, Feng T, Li P, Liao J, Wang L. Bilateral Sensorimotor Impairments in Individuals with Unilateral Chronic Ankle Instability: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:33. [PMID: 38589676 PMCID: PMC11001848 DOI: 10.1186/s40798-024-00702-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is manifested by sensorimotor impairments in the sprained ankle, including deficits in sensation, motor function, and central integration or processing. These impairments have a significant impact on physical activities and daily life. Recently, some studies have suggested that bilateral deficits were observed in unilateral CAI, but contradictory evidence disputes this finding. Therefore, the objective of this study was to investigate whether bilateral sensorimotor deficits presented in individuals with unilateral CAI. METHODS Without language restriction, the following databases were retrieved from database inception up until 3 November 2023, including PubMed, WOS, EMBASE, Cochrane, SPORTDiscus and CINAHL. Case-control and cross-sectional studies that investigated bilateral sensorimotor functions in individuals with unilateral CAI were included. Sensorimotor functions contained static and dynamic balance, functional performance, muscle strength and activation, as well as sensation. Outcome measures contained centre-of-pressure parameters, normalised reach distance, activation time and magnitude of muscle, sensory errors and threshold. The risk of bias and quality assessment of included studies were evaluated using a standardised tool recommended by the Cochrane Collaboration and the Epidemiological Appraisal Instrument, respectively. To explore the potential bilateral deficits associated with unilateral CAI, a comprehensive meta-analysis was conducted using Review Manager version 5.4. The analysis compared the injured limb of unilateral CAI with healthy controls and the uninjured limb with healthy controls. The main focus of this study was to investigate the differences between the uninjured limb and healthy controls. A random-effects model was employed and effect sizes were estimated using the standardised mean difference (SMD) with 95% confidence intervals (CIs). Effect sizes were deemed as weak (0.2-0.5), moderate (0.5-0.8), or large (> 0.8). RESULTS A total of 11,442 studies were found; 30 studies were contained in the systematic review and 20 studies were included in the meta-analysis. Compared with healthy controls, those with unilateral CAI presented weak to moderate impairments in their uninjured limbs in static balance with eyes open (SMD = 0.32, 95% CI: 0.08 to 0.56), functional performance (SMD = 0.37; 95% CI: 0.08 to 0.67), kinesthesia (SMD = 0.52; 95% CI: 0.09 to 0.95) and tibialis anterior activation (SMD = 0.60, 95% CI: 0.19 to 1.01). There were no significant differences in other comparisons between the uninjured limb and healthy controls. CONCLUSIONS Patients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinaesthesia. However, further evidence is required to confirm this point due to limited studies included in some analyses and small effect size. REGISTRATION The protocol was registered in the International Prospective Register of Systematic Reviews platform (CRD: 42,022,375,855).
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Affiliation(s)
- Xiaomei Hu
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Tianyi Feng
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Pan Li
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Jingjing Liao
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China.
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De Maio M, Castellani L, Cugusi L, Cortis C, Fusco A. The Effect of a Combined Exercise Program on Postural Control and Fine Motor Skills in Parkinson's Disease: Study Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15216. [PMID: 36429935 PMCID: PMC9691118 DOI: 10.3390/ijerph192215216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Parkinson's disease (PD) is a progressive and neurodegenerative disorder defined by physical symptoms such as hand disability and postural instability. To counteract the detrimental effects of PD, physical activity programs showed improvements in overall aspects of physical functioning. Therefore, this protocol will aim to evaluate the effect a of postural and fine motor skills training program in older adults with PD. PD individuals, with mild to moderate stage PD, aged between 65 to 80 years, will be voluntary selected from the Nursing Home Residences and Rehabilitation Centers. Subsequently, they will be randomly assigned to intervention group (PD) to receive a combined training program (postural control and fine motor skills exercises) or to the Control group (CON) to receive a stretching program. Before (PRE) and after (POST) a 12-week program both groups will perform wobble board (WB) and grooved pegboard (GPT) tests. Different performances between groups will be expected: (1) no significant differences between PD and CON group for WB and GPT test values before the beginning of the training intervention (PRE); (2) significantly better WB and GPT test values in PD subjects after the training intervention (POST) when compared to the base values (PRE); and (3) no significant differences in WB and GPT test values in CON subjects after the training intervention (POST) when compared to the base values (PRE). The findings of the present study protocol could be used for future studies investigating clinical populations, such as PD, and the effects of different rehabilitative interventions aiming to improve postural control and fine motor skills performances assessed by WB and GPT tests.
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Affiliation(s)
- Marianna De Maio
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Viale dell’Università, 03043 Cassino, Italy
| | - Loriana Castellani
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Viale dell’Università, 03043 Cassino, Italy
| | - Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Viale dell’Università, 03043 Cassino, Italy
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Viale dell’Università, 03043 Cassino, Italy
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Taghavi Asl A, Shojaedin SS, Hadadnezhad M. Comparison of effect of wobble board training with and without cognitive intervention on balance, ankle proprioception and jump landing kinetic parameters of men with chronic ankle instability: a randomized control trial. BMC Musculoskelet Disord 2022; 23:888. [PMID: 36180870 PMCID: PMC9523631 DOI: 10.1186/s12891-022-05706-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 07/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the present study was to compare the effect of a wobble board training (WBT) course with and without cognitive intervention (CI) on balance, ankle proprioception and jump-landing kinetic parameters in active men with chronic ankle instability (CAI). Methods Twenty-one active men in the age range of 18–25 years with CAI were randomly divided into three groups of WBT for five weeks as follows: with CI (n = 7); without CI (n = 7); control (n = 7). In this study, balance was evaluated by Y-Balance Test and Balance Error Scoring System, proprioception was evaluated as active and passive replication of 15-degree inversion angle and Maximum inversion angle minus 5-degrees, and single-leg jump-landing test was used for measurement of kinetic variables as pre-test and post-test in similar conditions. Results Post-test of both groups of WBT with and without CI showed a significant improvement in all variables compared to pre-test (p ≤ 0.05); however, in post-test, there was no significant difference in any of the variables between WBT groups with and without CI (p ≥ 0.05). Conclusions A course of WBT with and without CI leads to a significant improvement in balance, proprioception and jump-landing kinetic parameters, including time to stabilization and center of pressure displacement in active men with CAI. Although the WBT group with CI showed a greater improvement in mean than WBT group without CI, but the difference was not significant in any of the variables. Trial registration Retrospectively Registered. irict.ir Identifier: IRCT20200617047818N1 on 05–02-2021.
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Affiliation(s)
- Abed Taghavi Asl
- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Seyed Sadredin Shojaedin
- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran.
| | - Malihe Hadadnezhad
- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
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Young KL, Morris B, Herda TJ. The Role of Strength and Conditioning in the Prevention and Treatment of Chronic Lateral Ankle Instability. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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ALJawaee MA, Jones MD, Theobald PS, Williams JM. Does wobble board training improve balance in older adults? A systematic review. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1987042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Madawi A. ALJawaee
- Medical Engineering Research Group, School of Engineering, Cardiff University, Cardiff, UK
- Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Michael D. Jones
- Medical Engineering Research Group, School of Engineering, Cardiff University, Cardiff, UK
| | - Peter S. Theobald
- Medical Engineering Research Group, School of Engineering, Cardiff University, Cardiff, UK
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Association between Anthropometric Variables, Sex, and Visual Biofeedback in Dynamic Postural Control Assessed on a Computerized Wobble Board. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11188370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Anthropometrics and sex influence balance performances, and visual information can change anthropometrics’ relation and the postural sway. Therefore, the aim of the present study was to evaluate the effect of anthropometric characteristics, sex, and visual biofeedback and/or their interaction on a computerized wobble board. Twenty-seven (14 females, 13 males) young adults performed three 30-s double leg stance trials on a wobble board during two conditions: with visual and without visual biofeedback. Visual biofeedback improved (p = 0.010) balance on a wobble board with respect to the condition without visual biofeedback. Regardless of sex, no differences between conditions were found (p = 0.088). When investigating the effect of anthropometrics variables, sex, and their interactions on conditions, a significant main effect of the lower limb/height ratio, sex, and their interaction on the condition without visual biofeedback was found (p = 0.0008; R2 = 0.57). For the visual biofeedback condition, significant effects for sex and body mass (p = 0.0012; R2 = 0.43) and sex and whole-body moment of inertia (p = 0.0030; R2 = 0.39) were found. Results from the present study showed (1) visual biofeedback improved wobble board balance performance; (2) a significant main effect of lower limb/height ratio, sex, and their interaction on the wobble board performances without visual biofeedback emerged; (3) significant effects were found for sex and body mass and sex and moment of inertia in the visual biofeedback condition. Findings from the present study could have an impact on training and evaluations protocols, especially when several populations such as children, athletes, older adults and people with balance disorders are involved.
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Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG80. [PMID: 33789434 DOI: 10.2519/jospt.2021.0302] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.
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Fusco A, Fuchs PX, De Maio M, Wagner H, Cortis C. A novel approach to measuring wobble board performance in individuals with chronic ankle instability. Heliyon 2020; 6:e04937. [PMID: 32984618 PMCID: PMC7498757 DOI: 10.1016/j.heliyon.2020.e04937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/28/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022] Open
Abstract
Computerized wobble boards (WB) are used to objectively assess balance in healthy and chronic ankle instability individuals. As in field setting health professionals might not own WB, objective evaluations are not always feasible. Therefore, the aim of this tudy was to investigate the contribution of sagittal plane joints angular-displacement and anthropometrics to predict equations to estimate WB performance by portable two-dimensional motion analysis (2D-MA) and cross-validate the developed equations in chronic ankle instability individuals. Thirty-nine healthy and twenty chronic ankle instability individuals stood on a WB in single stance position. The balance test consisted of three 30s trials per limb keeping the platform flat at 0°. Trials were video recorded, and three time-segments joints angular-displacement analyzed with 2D-MA: segment 1 (T1) including 30s data, segment 2 (T2) from second 0 to 10, segment 3 (T3) only the first 5s. Mixed regression for multilevel models was used to estimate WB performance for each time-segment and to examine limb differences for the predicted WB performance in chronic ankle instability sample. The accuracy of the equations to detect injured limbs was calculated via area under the curve for receiver operating characteristic. Ankle and knee angular-displacement parameters, body height and lower limb length were the major predictors of WB performance for the extrapolated models (p < 0.05; R2 = 0.83-0.56). The measured WB performance and T1 model showed significant (p < 0.05) performance differences between the injured and uninjured limbs. Receiver operating characteristic analysis showed an asymptotic significance of 0.03 for T1 equation with area under the curve of 0.70. The proposed models provide different methods to quantify the performance and accurately detect the injured limb in individuals with unilateral chronic ankle instability, when measuring balance via WB might not be feasible. App-makers may use the equations to provide an automatic all-in-one system to monitor the performance status and progress.
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Affiliation(s)
- Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
- Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49, A-5400 Hallein (Rif), Salzburg, Austria
| | - Philip X. Fuchs
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
- Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49, A-5400 Hallein (Rif), Salzburg, Austria
| | - Marianna De Maio
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
| | - Herbert Wagner
- Department of Sports Science and Kinesiology, University of Salzburg, Schlossallee 49, A-5400 Hallein (Rif), Salzburg, Austria
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo - Località Folcara, 03043 Cassino (FR), Italy
- Corresponding author.
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Effects of Differential Jump Training on Balance Performance in Female Volleyball Players. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10175921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The purpose of this study was to determine whether coordinative jump training that induces neuromuscular stimuli can affect balance performance, associated with injury risk, in elite-level female volleyball players. During the competitive season, the balance performance of 12 elite female players (highest Austrian division) was obtained via a wobble board (WB; 200 Hz) placed on an AMTI force plate (1000 Hz). Three identically repeated measurements defined two intervals (control and intervention phases), both comparable in duration and regular training. The intervention included 6 weeks of differential training (8 sessions of 15–20 min) that delivered variations in dynamics around the ankle joints. Multilevel mixed models were used to assess the effect on postural control. WB performance decreased from 27.0 ± 13.2% to 19.6 ± 11.3% during the control phase and increased to 54.5 ± 16.2% during the intervention (β = 49.1 ± 3.5; p < 0.001). Decreased sway area [cm²] (β = −7.5 ± 1.6; p < 0.001), anterior–posterior (β = −4.1 ± 0.4; p < 0.001) and mediolateral sway [mm] (β = −2.7 ± 0.6; p = 0.12), and mean velocity [mm∙s−1] (β = −9.0 ± 3.6; p < 0.05) were observed during the intervention compared with the control phase. Inter-limb asymmetry was reduced (β = −41.8 ± 14.4; p < 0.05). The applied training concept enhanced balance performance and postural control in elite female volleyball players. Due to the low additional physiological loads of the program and increased injury risk during the competitive season, we recommend this intervention for supporting injury prevention during this period.
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Fisher JP, Ravalli S, Carlson L, Bridgeman LA, Roggio F, Scuderi S, Maniaci M, Cortis C, Fusco A, Musumeci G. The " Journal of Functional Morphology and Kinesiology" Journal Club Series: Utility and Advantages of the Eccentric Training through the Isoinertial System. J Funct Morphol Kinesiol 2020; 5:E6. [PMID: 33467222 PMCID: PMC7739338 DOI: 10.3390/jfmk5010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 12/14/2022] Open
Abstract
We are glad to introduce the first Journal Club of volume five, the first issue. This edition is focused on relevant studies published in the last years in the field of eccentric training, chosen by our editorial board members and their colleagues. We hope to stimulate your curiosity in this field and to share with you the passion for the sport, seen also from a scientific point of view. The editorial board members wish you an inspiring lecture.
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Affiliation(s)
- James P. Fisher
- School of Sport, Health and Social Science, Solent University, Southampton SO14 0YN, UK
| | - Silvia Ravalli
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Sciences Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Luke Carlson
- Discover Strength, 10160 6th Avenue North, Suite A, Plymouth, MN 55441, USA
| | - Lee A. Bridgeman
- Department of Sport and Exercise Science, Solent University, East Park Terrace, Southampton SO14 0YN, UK
| | - Federico Roggio
- Research Center on Motor Activities (CRAM), University of Catania, 95123 Catania, Italy
| | - Simone Scuderi
- Research Center on Motor Activities (CRAM), University of Catania, 95123 Catania, Italy
| | - Mario Maniaci
- Research Center on Motor Activities (CRAM), University of Catania, 95123 Catania, Italy
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino e Lazio Meridionale, 03043 Cassino, Italy
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino e Lazio Meridionale, 03043 Cassino, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Sciences Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, 95123 Catania, Italy
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Fusco A, Giancotti GF, Fuchs PX, Wagner H, da Silva RA, Cortis C. Y balance test: Are we doing it right? J Sci Med Sport 2019; 23:194-199. [PMID: 31601458 DOI: 10.1016/j.jsams.2019.09.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/13/2019] [Accepted: 09/21/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The multifaceted characteristic and task-specificity of postural control clearly reflects the need of knowing which factors could influence the balance measures in order to provide reliable and unbiased information. Therefore, this study aimed to investigate the effects of selected anthropometric characteristics, sex, lower limb's strength and dominance on the Y balance test (YBT). DESIGN Descriptive laboratory study. METHODS Forty-two young adults performed the YBT. The raw and normalized reach distances values were recorded. ANOVA was used to examine differences between sex and limb dominance, whereas multiple linear regression models were built to identify variables associated with better postural control. RESULTS No significant sex differences were observed, except for the normalized anterior direction (p=0.0324). No significant differences between limbs emerged. Regression models significantly explained between 8-49% of the variance. Trunk length, strength, and the interaction between sex with strength were the major predictors of the raw measures. Unexpectedly, lower limb length explained only 0.08% of the raw anterior direction variance. Strength and its interaction with sex were positively associated with normalized measures. Surprisingly, the relative lower limb length variable was negatively associated with the normalized measures. Each % point increase in relative lower limb length was associated with a decrease in normalized performance ranging from 1.73 to 4.91%. CONCLUSIONS Anthropometric characteristics, sex and lower limb strength differently influenced the YBT measures, regardless of limb dominance. Consequently, these variables should be controlled to limit the variability for an accurate evaluation of postural balance, especially if different YBT measures are used.
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Affiliation(s)
- Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Italy; Department of Sports Science and Kinesiology, University of Salzburg, Austria
| | | | - Philip X Fuchs
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Italy; Department of Sports Science and Kinesiology, University of Salzburg, Austria
| | - Herbert Wagner
- Department of Sports Science and Kinesiology, University of Salzburg, Austria
| | - Rubens A da Silva
- Département des Sciences de la Santé, Laboratoire de recherche BioNR, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Canada
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Italy.
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