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Doan BK, Pasley JD, Williams J, Tolbert T. Time of day and athlete status effects on the modified clinical test of sensory integration and balance (mCTSIB) and stability evaluation test (SET). Gait Posture 2023; 106:42-46. [PMID: 37651833 DOI: 10.1016/j.gaitpost.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/25/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Concussions or musculoskeletal injuries may impair postural control, which is one diagnostic to help determine return-to-activity decisions. Postural control may be affected by diurnal rhythm. RESEARCH QUESTION Does time of day influence postural control as measured by two Neurocom Balance Master diagnostic protocols, the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) and the Stability Evaluation Test (SET)? METHODS Following Institutional Review Board (IRB) approval, consented participants completed the SET and mCTSIB twice: between 0700 and 1000; and between 1600 and 1900. We randomized and balanced testing order. Familiarization trials were completed for the mCTSIB and SET. Assessments were completed in a controlled laboratory environment. We instructed participants to get a normal night's sleep prior to testing and refrain from caffeine use and exhaustive exercise on the day of testing. Sixty-nine participants (48 female, 21 male: age = 21.42±2.56 years, height = 168.20±7.53 cm, mass = 72.05±16.60 kg) completed the study. Thirty-one of the participants were National Association of Intercollegiate Athletes (NAIA) student-athletes from the sports of baseball, soccer and softball. Average postural sway velocity was measured and compared by time of day for each of the balance conditions in the mCTSIB and SET protocols. RESULTS According to repeated measures ANOVA, there were no significant postural sway velocity main effects by time of day for any of the balance conditions. We found significant postural sway main effects by foam, stance and eyes. We also noted significant ANOVA between participants' differences for athlete status, but not for sex. SIGNIFICANCE These results inform practitioners about the importance of controlling time-of-day between baseline and post-injury testing, which may allow for more flexible, accurate and reliable diagnosis and return-to-activity decisions. Athletes displayed better static postural control, possibly warranting different normative values for diagnostic comparison.
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Affiliation(s)
- Brandon K Doan
- Georgia Gwinnett College, School of Science & Technology, 1000 University Center Lane, Lawrenceville, GA 30043, USA.
| | - Jeffrey D Pasley
- Georgia Gwinnett College, School of Science & Technology, 1000 University Center Lane, Lawrenceville, GA 30043, USA
| | - James Williams
- United Orthopedics, 2030 Powers Ferry Rd SE, Atlanta, GA 30339, USA
| | - Timothy Tolbert
- Brenau University, 500 Washington St SE, Gainesville, GA 30501, USA
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Izadi M, Thomas E, Thomas AC, Bellafiore M. The effect of time-of-day and sleep deprivation on postural control: A systematic review. Gait Posture 2022; 97:94-103. [PMID: 35917703 DOI: 10.1016/j.gaitpost.2022.07.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 06/24/2022] [Accepted: 07/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Postural control (PC) can be affected by circadian rhythm and sleep deprivation, whereby it has been reported the result of PC measurement in clinical and experimental situations can be influenced by both factors. It has been suggested sleepiness can result in deficiency in PC, which in turn can lead to occupational accidents and subsequent injuries. This is while no study critically reviews or summarizes findings surrounding this topic in the literature. RESEARCH QUESTION Is there any significant effect of sleep deprivation and circadian rhythm on PC variables among healthy individuals? METHODS PubMed, Web of Science, Scopus, and Embase were used to detect relevant studies. Only studies that examined the effect of time of day and/or sleep loss on PC among healthy individuals were included in this systematic review. RESULTS Forty-nine studies were included based on the inclusion criteria. Both circadian rhythm and sleep loss had a significant effect on PC, whereas there are inconsistent findings for optimal postural control regarding time of day. In terms of sleep deprivation, all investigations indicated that sleep loss deteriorates PC. SIGNIFICANCE The current systematic review represents a significant effect of circadian rhythm and sleep deprivation on PC, whereby it is suggested that clinicians and researchers consider these factors when measuring PC since it may affect the result of research and clinical test. Moreover, PC may be worsened through sleeplessness; however, some studies revealed there is no linear relationship between time of wakefulness and deteriorating PC due to the influence of circadian rhythm. Hence, while PC, as an objective tool, can help to detect those who are sleep deprived, which in turn can lead to prevent possible musculoskeletal injuries, further studies are needed to reveal more understanding about the effect of sleep loss and circadian rhythm on PC.
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Affiliation(s)
- Mohammad Izadi
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy.
| | - Ewan Thomas
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Abbey C Thomas
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Marianna Bellafiore
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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Marin L, Lovecchio N, Pedrotti L, Manzoni F, Febbi M, Albanese I, Patanè P, Carnevale Pellino V, Vandoni M. Acute Effects of Self-Correction on Spine Deviation and Balance in Adolescent Girls with Idiopathic Scoliosis. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22051883. [PMID: 35271030 PMCID: PMC8914676 DOI: 10.3390/s22051883] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 05/07/2023]
Abstract
Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of spine and trunk with a higher incidence in girls. AIS alters and reduces postural control and balance. Self-correction movement (SCM) is a well-known non-invasive approach to ameliorate spine curve in AIS subjects. We aimed to evaluate the effects of SCM on the spine and on the balance of adolescents with AIS with a new non-invasive instrumentation. Methods: A total of 38 girls with AIS were recruited. To evaluate the acute effects of SCM and the oscillations of center of pressure (COP), we used LiDAR technology combined with a stabilometric platform to evaluate both changes in spinal curves and balance at the same time. Two tests were carried out simultaneously using the two instruments: before the execution of SCM, in the spontaneously assumed position of each subject (SP) and after the execution of SCM, during the achieved position (SC). Sway area, COP medio-lateral and antero-posterior directions, eccentricity of the ellipse and vertebral lateral deviation were recorded. The two conditions were compared with a Wilcoxon signed-rank test. Results: In general, all measures showed lower values in SC condition (p < 0.05), except the variation along the Y axis. Conclusions: Thanks to objective measured data, the therapists observed real-time changes during the performance of SCM, appreciating its efficacy on curve correction.
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Affiliation(s)
- Luca Marin
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Rehabilitation, Città di Pavia Hospital, 27100 Pavia, Italy
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
- Correspondence:
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, 24127 Bergamo, Italy;
| | - Luisella Pedrotti
- Orthopedics Unit, Department of Clinical Surgical Sciences, Diagnostic and Pediatrics, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatric Orthopedics, Città di Pavia Hospital, 27100 Pavia, Italy
| | - Federica Manzoni
- Epidemiological Observatory Unit, Health Protection Agency, 27100 Pavia, Italy;
| | - Massimiliano Febbi
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
| | - Ilaria Albanese
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Pamela Patanè
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
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Does Time of Day influence postural control and gait? A review of the literature. Gait Posture 2022; 92:153-166. [PMID: 34836768 DOI: 10.1016/j.gaitpost.2021.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/13/2021] [Accepted: 10/17/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Like many physiologic processes, Time of Day may influence postural control and gait. A better understanding of diurnal variations in postural control and gait may help to improve diagnoses, reduce falls, and optimize rehabilitation and training routines. This review summarizes the current literature that addresses these questions. RESEARCH QUESTION Does time of day affect postural control and gait? METHODS We searched PubMed, Google Scholar, and IEEE using a combination of keyword and MeSH terms. We included papers that studied human subjects and assessed gait or postural control as a function of time of day. We evaluated the quality of the identified papers based on nine assessment criteria and analyzed them considering the topic (postural control or gait), age, and characteristics of the conducted assessments. We then quantitatively synthesized the results across studies using a meta-analytical approach (i.e., Hedges' g model). RESULTS Twenty-two papers considered the relationship between time of day and postural control, and eleven considered the relationship between time of day and gait. Six studies found that postural control was best in the morning, four described postural control being best in the afternoon, four described optimal postural control in the evening, and eight reported no time of day effect. Two studies found gait best in the morning, five described gait best in the afternoon, two described optimal gait in the evening, and two reported no time of day effect. The results of the quantitative analysis suggest that both postural control and gait were best in the evening. SIGNIFICANCE While there is no clear consensus on whether there is a time of day effect for postural control and gait, the findings of this review provide initial evidence suggesting that a small but statistically significant effect exists in favor of the evening. Standardized testing, including repeated and continuous evaluations, may help provide more definitive information on time of day influences on postural control and gait.
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Displacement of Centre of Pressure during Rehabilitation Exercise in Adolescent Idiopathic Scoliosis Patients. J Clin Med 2021; 10:jcm10132837. [PMID: 34198971 PMCID: PMC8269167 DOI: 10.3390/jcm10132837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 01/03/2023] Open
Abstract
Background. Adolescent idiopathic scoliosis (AIS) is included into the category of pathologies that could affect postural control. Rarely AIS shows symptoms but often compromises the normal positioning of the head, trunk and, more generally, of the limbs in the space. We used a stabilometric platform to evaluate the motor control outcomes during a self-elongation in girls with AIS. Methods. In 10 girls with AIS, we evaluated the center of pressure (COP) modifications on a baropodometric platform in a standing position and after a self-elongation correction. Results. All the outcomes (except the eccentricity) showed an increasement during the self-elongation exercise even if the significant differences were not found. Conclusion. SE correction contributes to ameliorate the COP symmetry with a better repercussion on the balance management. This highlights the importance of repetitions during all activities of daily life.
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Zago M, Condoluci C, Manzia CM, Pili M, Manunza ME, Galli M. Multi-segmental postural control patterns in down syndrome. Clin Biomech (Bristol, Avon) 2021; 82:105271. [PMID: 33477082 DOI: 10.1016/j.clinbiomech.2021.105271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/18/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with Down Syndrome (DS) exhibit less efficient and unstable standing postural control. The specificities of somatosensorial deficits might result in a different utilization of resources and in distinct whole-body kinematic patterns, to date still unexplored. In this paper we aim at addressing multi-segmental coordination patterns in people with DS while maintaining standing balance under different visual conditions (open and closed eyes). METHODS This cross-sectional observational cohort study involved two groups of 23 patients with DS and 12 healthy controls. A 30-s standing balance test allowed to extract (i) the length of the trajectory of the center-of-pressure sway and 95% confidence ellipse area from Ground Reaction forces, and (ii) Principal Movement (PM) components from full-body motion kinematics; the latter were obtained exploiting a Principal Component Analysis-based approach, also embracing a motor-control perspective through the evaluation of the number of modifications applied by the neuromuscular controller on segments' acceleration. FINDINGS Trajectory length was significantly higher in patients; 95% ellipse confidence area did not differ between groups/condition. Postural movement components differed in people with DS from healthy controls not only in the "observable", behavioural phenotype (PM3 and PM8), but also in the amount of activation of the associated control (PM1 to PM8, over-activated in DS) in all spatial directions. INTERPRETATION Results reinforced the prevalence of a medio-lateral hip strategy (instead of an ankle strategy) in maintaining postural stability. Most important, they revealed a less frequent activation of postural patterns in all spatial directions.
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Affiliation(s)
- Matteo Zago
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy.
| | | | | | - Marta Pili
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy
| | - Marta Elisa Manunza
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy
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Amelard R, Murray KR, Hedge ET, Cleworth TW, Noguchi M, Laing AC, Hughson RL. Monocular 3D Sway Tracking for Assessing Postural Instability in Cerebral Hypoperfusion During Quiet Standing. IEEE Trans Neural Syst Rehabil Eng 2020; 28:720-729. [PMID: 32012020 DOI: 10.1109/tnsre.2020.2971340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Postural instability is prevalent in aging and neurodegenerative disease, decreasing quality of life and independence. Quantitatively monitoring balance control is important for assessing treatment efficacy and rehabilitation progress. However, existing technologies for assessing postural sway are complex and expensive, limiting their widespread utility. Here, we propose a monocular imaging system capable of assessing sub-millimeter 3D sway dynamics during quiet standing. Two anatomical targets with known feature geometries were placed on the lumbar and shoulder. Upper and lower trunk 3D kinematic motion were automatically assessed from a set of 2D frames through geometric feature tracking and an inverse motion model. Sway was tracked in 3D and compared between control and hypoperfusion conditions in 14 healthy young adults. The proposed system demonstrated high agreement with a commercial motion capture system (error [Formula: see text], [-0.52, 0.52]). Between-condition differences in sway dynamics were observed in anterior-posterior sway during early and mid stance, and medial-lateral sway during mid stance commensurate with decreased cerebral perfusion, followed by recovered sway dynamics during late stance with cerebral perfusion recovery. This inexpensive single-camera system enables quantitative 3D sway monitoring for assessing neuromuscular balance control in weakly constrained environments.
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Zago M, Moorhead AP, Bertozzi F, Sforza C, Tarabini M, Galli M. Maturity offset affects standing postural control in youth male soccer players. J Biomech 2019; 99:109523. [PMID: 31767282 DOI: 10.1016/j.jbiomech.2019.109523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 10/25/2022]
Abstract
Quantifying the response of postural control in developmental athletes makes it possible to understand critical coordination and learning phases and to improve technical-physical interventions. However, the influence of maturation on postural control amongst young soccer players has neither been tested using quantitative methods, nor over a wide age range. In this study, we examined stabilometric parameters of 238 young male soccer players from 9 to 17 years old relative to maturity offset. Two 30-s tests (eyes open and eyes closed) were recorded on a baropodometric platform at 50 Hz. Participants were split into six groups according to their maturity offset, expressed as years from individual's peak height velocity. Dependent variables were: Sway Area, Center-of-Pressure velocity, standard deviation of the antero-posterior and medio-lateral Center-of-Pressure trajectory, Romberg Quotient. Sway Area was significantly higher in players with maturity offset <-1.5 than in groups with maturity offset > 0.5 years (p < 0.001, large effect). Center-of-Pressure velocity markedly dropped in players with maturity offset >-0.5 years (p < 0.001, very large effect). Antero-posterior standard deviation was higher before than after peak height velocity (p < 0.05, large effect) and significantly higher with closed eyes at some points. Medio-lateral standard deviation was higher in the youngest group of players (maturity offset <-2.5 years, large effect) than in those with maturity offset >-0.5 years. In sum, stabilometric parameters improved with age until zero maturity offset was achieved. Thereafter, variables describing postural control in developing soccer players were almost stable. No evidence of a changing role of vision in postural sway control during maturation was observed.
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Affiliation(s)
- Matteo Zago
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy; E4Sport Lab, Politecnico di Milano, Italy; Fondazione Istituto Farmacologico Filippo Serpero, Milano, Italy.
| | - Alex Patten Moorhead
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy; Dipartimento di Meccanica, Politecnico di Milano, Italy
| | - Filippo Bertozzi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
| | - Chiarella Sforza
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
| | - Marco Tarabini
- E4Sport Lab, Politecnico di Milano, Italy; Dipartimento di Meccanica, Politecnico di Milano, Italy
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy; E4Sport Lab, Politecnico di Milano, Italy
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Nota A, Tecco S, Ehsani S, Padulo J, Baldini A. Postural stability in subjects with temporomandibular disorders and healthy controls: A comparative assessment. J Electromyogr Kinesiol 2017; 37:21-24. [PMID: 28865312 DOI: 10.1016/j.jelekin.2017.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/11/2017] [Accepted: 08/21/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE OF THE STUDY The influence of the stomatognathic apparatus on body posture is a continuously discussed topic with contrasting results. The aim of this study is to analyze differences in postural stability between subjects with and without myogenous TMD. METHODS 25 subjects affected by myogenous TMD according with DC/TMD (6 males, 19 females; mean age 31.75±6.68years) and a healthy control group of 19 subjects (4 Males, 15 Females; mean age 27.26±3.85years) were enrolled in the study. Both groups underwent a posturo-stabilometric force platform exam under different mandibular and visual conditions. Sway area and sway velocity of the COP (Center Of foot Pressure) posturo-stabilometric parameters were evaluated and compared applying Mann-U-Whitney statistical test. RESULTS The sway area and sway velocity parameters resulted statistically significantly higher in the TMD group (sway area p<0.01; sway velocity p<0.05) in mandibular maximum intercuspation and rest positions with eyes open. CONCLUSIONS This study demonstrates a significant difference in body postural stability between subjects with myogenous TMD and healthy controls. In particular, sway area and sway velocity postural parameters are increased in these subjects.
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Affiliation(s)
- Alessandro Nota
- Dental School, Vita-Salute San Raffaele University, Milan, Italy; Faculty of Kinesiology, University of Split, Croatia.
| | - Simona Tecco
- Dental School, Vita-Salute San Raffaele University, Milan, Italy
| | - Shideh Ehsani
- Dental School, Vita-Salute San Raffaele University, Milan, Italy
| | - Johnny Padulo
- Faculty of Kinesiology, University of Split, Croatia; University eCampus, Novedrate, Italy
| | - Alberto Baldini
- Dental School, Vita-Salute San Raffaele University, Milan, Italy; Faculty of Kinesiology, University of Split, Croatia
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