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Costa M, Saldanha PEC, Ferreira AS, Felicio LR, Lemos T. Posturography measures in specific ballet stance position discriminate ballet dancers with different occurrences of musculoskeletal injuries. J Bodyw Mov Ther 2023; 34:41-45. [PMID: 37301555 DOI: 10.1016/j.jbmt.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 05/31/2022] [Accepted: 04/11/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND This study aimed to identify the postural sway variables that can distinguish between ballet dancers with high and low occurrences of musculoskeletal injuries. METHODS Fourteen professional ballet dancers were assigned to a high-occurrence group (N = 5, reports >2 injuries in the previous 6-months) or a low-occurrence group (N = 9, reports ≤1 injury). Center-of-pressure (COP) data were acquired using a force platform during the following tasks: single-leg stance with eyes open, single-leg stance with eyes closed, and demi-pointe stance with eyes open. The COP standard deviation (SD) and range (RA) in both the medial-lateral (ML) and anterior-posterior (AP) directions were estimated. Between-group comparisons were made through Welch's t-tests for unequal sample size along the effect size measure (Cohen's d). Spearman's rho was used to estimate the association between the number of injuries and the COP variables. The statistical threshold was set at 1%. RESULTS A between-group effect was found only for the demi-pointe stance, with large effects for SDML (P = 0.006, d = 1.7), RAAP (P = 0.006, d = 1.7), and RAML (P = 0.005, d = 1.7). An inverse relationship was found between the number of injuries and the demi-pointe's COP range in both directions (Spearman's rho from -0.681 to -0.726, P = 0.007). CONCLUSIONS COP measures taken in ballet-specific positions can distinguish between dancers with a high and low occurrence of musculoskeletal injuries. Suggestions are made to include ballet-specific tasks in the functional assessments of professional dancers.
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Affiliation(s)
- Michelle Costa
- Graduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil
| | - Pedro E C Saldanha
- Graduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil
| | - Arthur S Ferreira
- Graduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil
| | - Lilian R Felicio
- Faculdade de Educação Física e Fisioterapia - FAEFI, Universidade Federal de Uberlândia, Minas Gerais, Brazil
| | - Thiago Lemos
- Graduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil.
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Konarzewski P, Konarzewska U, Kuryliszyn-Moskal A, Terlikowski R, Pauk J, Daunoraviciene K, Pauk K, Dakowicz A, Wojciuk M, Dzięcioł J, Dziecioł-Anikiej Z. What Influences Proprioceptive Impairments in Patients with Rheumatic Diseases? Analysis of Different Factors. Int J Environ Res Public Health 2023; 20:3698. [PMID: 36834394 PMCID: PMC9965454 DOI: 10.3390/ijerph20043698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Rheumatic diseases lead to postural problems, which increase the risk of falls and lead to greater disability. The aim of the present work is to evaluate posture disorders in patients with osteoarthritis (OA) and rheumatoid arthritis (RA), as well as to evaluate the influence of other factors. A total of 71 subjects were enrolled in this study. Joint position sense (JPS) and the functional assessment of proprioception on a balance platform for both lower limbs were examined. The Average Trace Error (ATE), test time (t), and Average Platform Force Variation (AFV) were calculated. Additionally, an equilibrium test was carried out in the one-legged standing position (Single Leg Stance-SLS). The results were compared in several ways and revealed the following: (1) A JPS of 10° plantar flexion in RA obtained significantly worse results when repeating the movement than OA; the ATEs were significantly lower in RA; and RA needed more support during SLS assessment. (2) RA patients with higher DAS28 had statistically significantly higher values in JPS, with 5° plantar flexion and 10° dorsal flexion, SLS assessment, and stabilometric rates. A statistically significant correlation between DAS28 and RA was found in a JPS of 10° plantar flexion. The VAS ruler demonstrated a significant moderate correlation with t. (3) Patients who experienced at least one fall demonstrated higher JPS and t. Our study shows that proprioception is the most influenced by the nature of the disease and the level of disease activity. We can see that the stability and balance functions are also greatly influenced by the patient's falling experience and the level of pain. These findings may be useful in designing an optimal proprioception-enhancing movement training plan.
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Affiliation(s)
| | | | - Anna Kuryliszyn-Moskal
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Str., 15-096 Białystok, Poland
| | - Robert Terlikowski
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Str., 15-096 Białystok, Poland
| | - Jolanta Pauk
- Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Bialystok University of Technology, Wiejska 45C, 15-352 Białystok, Poland
| | - Kristina Daunoraviciene
- Department of Biomechanical Engineering, Faculty of Mechanics, Vilnius Gediminas Technical University, Plytinės g. 25, LT-10105 Vilnius, Lithuania
| | - Konrad Pauk
- Warsaw Medical University, Zwirki i Wigury 61, 02-091 Warsaw, Poland
| | - Agnieszka Dakowicz
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Str., 15-096 Białystok, Poland
| | - Mariusz Wojciuk
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Str., 15-096 Białystok, Poland
| | - Janusz Dzięcioł
- Department of Human Anatomy, Faculty of Medicine, Medical University of Bialystok, Mickiewicza 2A Str., 15-230 Bialystok, Poland
| | - Zofia Dziecioł-Anikiej
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Str., 15-096 Białystok, Poland
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Zeng Z, Shan J, Zhang Y, Wang Y, Li C, Li J, Chen W, Ye Z, Ye X, Chen Z, Wu Z, Zhao C, Xu X. Asymmetries and relationships between muscle strength, proprioception, biomechanics, and postural stability in patients with unilateral knee osteoarthritis. Front Bioeng Biotechnol 2022; 10:922832. [PMID: 36185430 PMCID: PMC9523444 DOI: 10.3389/fbioe.2022.922832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background: The pathological mechanism of knee osteoarthritis (KOA) is unknown. KOA degeneration may be associated with changes in muscle strength, proprioception, biomechanics, and postural stability. Objective: This study aimed to assess asymmetries in muscle strength, proprioception, biomechanics, and postural stability of bilateral lower limbs in patients with unilateral KOA and healthy controls and analyze correlations between KOA and these parameters. Methods: A total of 50 patients with unilateral KOA (age range: 50-70) and 50 healthy subjects were recruited as study participants (age range: 50-70). Muscle strength, proprioception, femorotibial angle (FTA), femoral condylar–tibial plateau angle (FCTP), average trajectory error (ATE), and center of pressure (COP) sways areas were accessed in study participants, and the correlation between these variables was investigated. Results: In patients with unilateral KOA, lower limb muscle strength was significantly lower on the symptomatic side than on the asymptomatic side (p < 0.01), while the proprioception (degree error), FTA, FCTP, and ATE were substantially higher compared to the asymptomatic side (p < 0.01). However, no significant difference was observed in the healthy controls (p > 0.05). Patients with unilateral KOA had lower muscle strength than healthy controls (p < 0.05), but their proprioception (degree error: the difference between the target and reproduction angles), ATE, and COP sway areas were higher (p < 0.05). Muscle strength was found to be negatively correlated with ATE and COP sways areas (p < 0.05), whereas proprioception (degree error) was positively correlated with ATE and COP sways areas (p < 0.05) in all study participants. However, no correlation was found between FTA, FCTP, and ATE, COP sways areas in patients with unilateral KOA (p > 0.05). Conclusion: In patients with unilateral KOA, muscle strength, proprioception, biomechanics, and postural stability of bilateral limbs are asymmetrical in unilateral KOA patients. Muscle strength, proprioception, and postural stability are significantly associated variables, and changes in these variables should be considered in KOA prevention and rehabilitation.
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Affiliation(s)
- Ziquan Zeng
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Jiaxin Shan
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yilong Zhang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weijian Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zugui Wu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Chuanxi Zhao, ; Zugui Wu,
| | - Chuanxi Zhao
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Chuanxi Zhao, ; Zugui Wu,
| | - Xuemeng Xu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Chuanxi Zhao, ; Zugui Wu,
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Ingemann-Molden S, Pessoto Hirata R, Bach Jensen M, Graven-Nielsen T, Riis A. Difference in postural stability between STarT Back Tool subgroups of patients with low back pain under conditions of sensory deprivation and cognitive load. J Int Med Res 2022; 50:3000605221112046. [PMID: 35854633 PMCID: PMC9310071 DOI: 10.1177/03000605221112046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective We explored differences in postural stability between subgroups of patients
with low back pain (LBP) and varying risk levels for developing chronicity
measured using the Subgroups for Targeted Treatment (STarT) Back Tool. Methods This was a cross-sectional, single-session, double-blind experimental study
among 65 participants who had LBP for more than 14 days. Postural stability
was assessed by measuring the center of pressure (COP) range, displacement
area, and velocity in anterior–posterior and mediolateral directions under
four sensory and cognitive conditions: (i) eyes open and counting forward,
(ii) eyes closed and counting forward, (iii) eyes closed and counting
forward in multiples of seven, and (iv) eyes closed and counting backward in
multiples of seven. The participants were stratified into low-/medium-
(n = 53) and high-risk (n = 9) subgroups. Results There were no significant between-group differences among patients with LBP
stratified as having a low/medium or high risk of chronicity in postural
stability and sensory and cognitive conditions. Conclusions Impaired postural stability is important to consider when treating patients
with LBP. However, we found that these impairments were not strongly
aggravated in groups with a higher risk of chronicity, as measured using the
STarT Back Tool.
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Affiliation(s)
| | | | | | | | - Allan Riis
- Center for General Practice at Aalborg University, Aalborg, Denmark
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Soares FDS, Foppa N, Dionisio VC. Could emotional and sensitization status affect postural sway in adults with knee osteoarthritis? Physiother Res Int 2021; 27:e1928. [PMID: 34714573 DOI: 10.1002/pri.1928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 10/09/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The manipulation of sensory conditions and attentional demand affect the postural sway in older adults with knee osteoarthritis (KOA). However, it is not known if emotional and sensitization status affects postural sway in this population. This study aimed to test if older adults with mild and moderate knee osteoarthritis with symptoms of depression and high sensitization would change the profile of postural sway. METHODS Design: A cross-sectional study was undertaken. PARTICIPANTS The center of pressure parameters of 30 older adults with mild and moderate knee osteoarthritis and 15 healthy controls were evaluated under different conditions manipulating the visual and attentional demand. We used the pressure pain threshold to measure the sensitization status. Furthermore, we applied the Beck Depression Inventory index to assess emotional status. RESULTS Manipulating the visual demand affected the center of pressure parameters for both groups, without differences between them. Compared to the healthy control group, the knee osteoarthritis group presented with worse scores on the Beck Depression Inventory, lower pressure pain threshold scores, and the correlations between the symptoms of depression and sensitization status ranged from weak to moderate. Finally, in the knee osteoarthritis group, we observed few and weak significant associations between the center of pressure parameters and the Beck Depression Inventory and the pressure pain threshold scores. DISCUSSION Emotional and sensitization status seem not to be more associated with the center of pressure of older adults with mild to moderate KOA than healthy adults. Thus, it suggests that this population can safely maintain postural sway, irrespective of depression symptoms and high sensitization.
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Affiliation(s)
- Fabiana da Silva Soares
- Physical Therapy Course, Federal University of Uberlandia, Uberlândia, Brazil.,Doctor Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Brazil
| | - Natalia Foppa
- Physical Therapy Course, Federal University of Uberlandia, Uberlândia, Brazil
| | - Valdeci Carlos Dionisio
- Physical Therapy Course, Federal University of Uberlandia, Uberlândia, Brazil.,Doctor Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Brazil
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Hirata RP, Thomsen MJ, Larsen FG, Støttrup N, Duarte M. The effects of pain and a secondary task on postural sway during standing. Hum Mov Sci 2021; 79:102863. [PMID: 34418802 DOI: 10.1016/j.humov.2021.102863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 05/31/2021] [Accepted: 08/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pain impairs available cognitive resources and somatosensory information, but its effects on postural control during standing are inconclusive. The aim of this study was to investigate whether postural sway is affected by the presence of pain and a secondary task during standing. METHODS Sixteen healthy subjects stood as quiet as possible at a tandem stance for 30s on a force platform at different conditions regarding the presence of pain and a secondary task. Subjects received painful stimulations on the right upper arm or lower leg according to a relative pain threshold [pain 7 out 10 on a Visual Analog Scale (VAS) - 0 representing "no pain" and 10 "worst pain imaginable"] using a computer pressurized cuff. The secondary task consisted of pointing to a target using a head-mounted laser-pointer as visual feedback. Center of Pressure (COP) sway area, velocity, mean frequency and sample entropy were calculated from force platform measures. FINDINGS Compared to no painful condition, pain intensity (leg: VAS = 7; arm VAS = 7.4) increased following cuff pressure conditions (P < .01). Pain at the leg decreased COP area (P < .05), increased COP velocity (P < .05), mean frequency (P < .05) and sample entropy (P < .05) compared with baseline condition regardless the completion of the secondary task. During condition with pain at the leg, completion of the secondary task reduced COP velocity (P < .001) compared with condition without secondary task. INTERPRETATION Pain in the arm did not affect postural sway. Rather, postural adaptations seem dependent on the location of pain as pain in the lower leg affected postural sway. The completion of a secondary task affected postural sway measurements and reduced the effect of leg pain on postural sway. Future treatment interventions could benefit from dual-task paradigm during balance training aiming to improve postural control in patients suffering from chronic pain.
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Affiliation(s)
- Rogerio Pessoto Hirata
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark.
| | - Mikkel Jacobi Thomsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark
| | - Frederik Greve Larsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark
| | - Nicolai Støttrup
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark
| | - Marcos Duarte
- Federal University of ABC, Biomedical Engineering, São Bernardo do Campo, São Paulo, Brazil
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Ye J, Simpson MW, Liu Y, Lin W, Zhong W, Cai S, Zou L. The Effects of Baduanjin Qigong on Postural Stability, Proprioception, and Symptoms of Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Front Med (Lausanne) 2020; 6:307. [PMID: 31998728 PMCID: PMC6966958 DOI: 10.3389/fmed.2019.00307] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/05/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Knee osteoarthritis is a common disease affecting a large number of old individuals worldwide. This study aimed to explore the effects of Baduanjin Qigong in patients with knee osteoarthritis. Methods: Fifty participants with knee osteoarthritis were randomly assigned to either an experimental group (n = 25) or a control group (n = 25). Participants in the experimental group received Baduanjin Qigong training for 12 weeks, with three sessions per week lasting 40 min per session. Participants in the control group did not receive any additional physical training. All of participants completed outcome (proprioception, postural stability, and functional ability) assessments at three time points (baseline, Week 8, 12). Results: Proprioception and Western Ontario and McMaster Universities Osteoarthritis Index function were statistically improved at eighth and 12th week of the intervention in the Baduanjin Qigong group (p < 0.05), while the control group did not have any significant changes. For postural stability at the anterior-posterior direction with eyes closed, Baduanjin Qigong group showed significant improvement compared to controls after the 12 weeks of intervention (p < 0.05). Conclusions: Regular Baduanjin Qigong practice helped the improvement of knee joint proprioception and postural stability, and reduction of pain, stiffness, and functional impairments of old adults with knee osteoarthritis. Well-designed randomized controlled trials with long-term assessment are needed. The trial was registered in Chinese Clinical Trial Registry (ChiCTR-IOR-16010042). URL: http://www.chictr.org.cn/hvshowproject.aspx?id=10550.
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Affiliation(s)
- Jiajia Ye
- Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Michael William Simpson
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yang Liu
- Department of Kinesiology and Program in Neuroscience, Indiana University Bloomington, Bloomington, IN, United States
| | - Wei Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Weihong Zhong
- Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shuhe Cai
- Department of Orthopaedic Rehabilitation, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China
| | - Liye Zou
- Exercise and Mental Health Laboratory, Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China
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Goel R, Nakagome S, Rao N, Paloski WH, Contreras-Vidal JL, Parikh PJ. Fronto-Parietal Brain Areas Contribute to the Online Control of Posture during a Continuous Balance Task. Neuroscience 2019; 413:135-153. [DOI: 10.1016/j.neuroscience.2019.05.063] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 11/25/2022]
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