The Acute Effects in Postural Sway as a Result of Self-Myofascial Release on the Lower Extremities in Collegiate Female Athletes

Myofascial release is a popular therapy technique used to manipulate connective muscle tissue to become more pliable. The maintenance of body posture relies on mechanoreceptors located in connective tissue, thus manipulation of connective tissue should affect postural control. The effects of this phenomenon have not been well studied, leaving room for this investigation.

PURPOSE

To observe if postural sway scores changed before and after foam rolling proximal (quadriceps and hamstrings) in comparison to distal (calves) muscles.

METHODS

Thirty-six, college-aged female athletes (age 20.39 ± 0.25 years, mass 68.70 ± 1.97 kg, height 170.18 ± 1.56 cm.) performed approximately two and one-half minutes of moderate intensity foam rolling to their calves (n = 19, Group A) or to their hamstrings and quadricep muscle (n = 17, Group B). Center of Pressure (CoP) and Limit of Stability (LoS) testing was assessed both pre- and post-foam rolling using a computerized posturography balance plate. CoP sway was measured under both eyes open (EO) and eye closed (EC) Conditions on both stable and unstable surfaces. LoS was measured in the Anterior, Posterior, Left, and Right Directions. Effects of foam rolling on CoP and LoS were assessed using a repeated-measures MANOVA (α = 0.05).

RESULTS

Eyes Open Stable Surface had the lowest postural sway (p = 0.001). However, CoP did not differ for any condition either between Groups (p ≥ 0.6) or from pre- to post-foam rolling (p = 0.3). LoS significantly differed between Directions such that LoS was greater in the frontal plane than in the sagittal plane (p = 0.011). There was also a significant Time X Group X Direction interaction effect (p = 0.001) such that LoS for Group A decreased after foam rolling (mean change = -1.621 cm) but increased for Group B after foam rolling (mean change = + 0.878 cm). No differences were found for any other Direction (p ≥ 0.1).

CONCLUSION

This study demonstrated CoP and LoS improvements between the two groups based on acute effects of foam rolling intervention. Further research is suggested to determine if long-term gains are observed within or between groups.

Balance and gait in individuals with diabetic peripheral neuropathy

BACKGROUND

Diabetic Peripheral Neuropathy (DPN) causes various physical problems such as the increased risk of falling, loss of balance and coordination while standing or walking, susceptibility to injuries due to sensory loss.

AIMS

The aim of the study was to evaluate and compare the effects of neuropathic pain (NP) in individuals with DPN on balance and gait.

METHODS

This prospective controlled study was conducted on 42 adults aged between 40-65 years. The participants were divided into three groups; individuals with DPN and NP (DPN+NP/n = 14), individuals with DPN without NP (DPN-NP/n = 14), and the control group (n = 14), respectively. The Force Plate system and Core Balance System measured static and dynamic postural balance and stability limits. Gait and dynamic plantar pressure distribution analyses were performed with a computerized gait evaluation system.

RESULTS

The score of LANSS, and VAS during gait were higher in DPN+NP group than in DPN-NP (p < 0.05). No significant difference was observed between the groups in balance parameters (p > 0.05). The right-left heel maximum forces were lower in both groups with DPN compared to the control group (p < 0.05). In terms of spatiotemporal parameters of the gait, there was a difference between the groups only in step width and left single support line parameters (p < 0.05).

CONCLUSIONS

The results of this study indicate that the individuals with DPN have an increased step width, their left single support line was shortened, and the maximum force on the heel decreased. The NP did not cause any change in balance and gait parameters.

Interactive Game-Based Platform System for Assessing and Improving Posture Control in the Elderly

Inadequate response to balance perturbations lead to posture instability in the elderly. The fall risks are increased by a reduced capacity to control the center of pressure (COP) displacement within the safety limit of the supporting base. This study developed an interactive evaluation and training platform. The system incorporated a computerized program with instantaneous force plate evaluation. Ten young subjects underwent a baseline evaluation and twenty-nine community-dwelling elderly received pre- and post-intervention testing. The ability to reach the stability limit was assessed by measuring the maximum voluntary excursion of the COP in anterior-posterior and medial-lateral directions. Functional mobility tests including Berg Balance Scale, Timed-Up-and-Go and functional reach were used as functional outcomes. The experimental group (n = 15) received a 40 min intervention three times a week for six weeks. The interactive game-based training focused on multi-directional weight shifting by tracing a COPcontrolled target to challenge an individual's stability limit. The control group (n = 14) maintained daily activities as usual. The young group revealed a superior COP displacement through active ankle control than the elderly, especially in the anterior-posterior direction. The experimental group improved their COP displacement control more in the medial-lateral direction due to the predominant side-to-side gameplay movement. The functional outcome measures were also significantly improved after training. Using the COPcontrolled game-based program, the stability limit was challenged to facilitate dynamic posture control by an incremental increase in self-initiated perturbations. The platform system could assist in transferring the immediate training effects into daily functional mobility in the elderly.

Age-Related Differences in Intermuscular Coherence EMG-EMG of Ankle Joint Antagonist Muscle Activity during Maximal Leaning

BACKGROUND

Intermuscular synchronization is one of the fundamental aspects of maintaining a stable posture and is of great importance in the aging process. This study aimed to assess muscle synchronization and postural stabilizer asymmetry during quiet standing and the limits of stability using wavelet analysis. Intermuscular synchrony and antagonistic sEMG-sEMG (surface electromyography) coherence asymmetry were evaluated in the tibialis anterior and soleus muscles.

METHODS

The study involved 20 elderly (aged 65 ± 3.6) and 20 young (aged 21 ± 1.3) subjects. The task was to perform a maximum forward bend in a standing position. The prone test was divided into three phases: quiet standing (10 s), dynamic learning, and maintenance of maximum leaning (20 s). Wavelet analysis of coherence was performed in the delta and beta bands.

RESULTS

Young subjects modulated interface coherences to a greater extent in the beta band. Analysis of postural stability during standing tasks showed that only the parameter R2b (the distance between the maximal and minimal position central of pressure), as an indicator for assessing the practical limits of stability, was found to be significantly associated with differences in aging.

CONCLUSION

The results showed differences in the beta and delta band oscillations between young and older subjects in a postural task involving standing quietly and leaning forward.

Balance factors affecting the quality of life in patients with knee osteoarthritis

Background

Knee osteoarthritis (OA) affects the quality of life (QOL) and balance control of elderly people; our study explored the balance factors that affected the QOL in patients with knee OA.

Objectives

To determine the balance factors that affected the QOL of patients with knee OA who attended general clinics.

Method

A total of 30 healthy controls and 60 patients with mild-to-moderate bilateral knee OA, all aged 55–75 years, were enrolled in our cross-sectional study. All participants were interviewed; the Medical Outcomes Study 36-Item Short-Form Health Survey was used to assess their QOL in eight dimensions, and the Balance Master System was used to evaluate their balance control according to six parameters. Descriptive statistics were used to reduce the data; an independent t-test determined differences between the two groups, and a multiple regression analysis was undertaken to establish associations between variables from the balance control test and SH36 physical and mental health components. The level of statistical significance was set at 5%.

Results

In the OA group, significant negative correlations were observed between sway velocity and the physical health component (p = 0.003) and between sway velocity and the mental health component (p = 0.006). Thus, sway velocity had a major impact on the QOL of patients with knee OA.

Conclusions

The sway velocity at the centre of gravity in balance control was a crucial factor for determining the QOL of patients with bilateral knee OA.

Clinical implications

Sway velocity is a key factor affecting the QOL and may provide a basis to formulate preventive actions and design treatment goals for patients with knee OA.

The Effects of Static Stretching On Dynamic Postural Control During Maximum Forward Leaning Task

The purpose of this study was to determine how the application of static stretching to ankle plantar flexors affects postural control during maximum forward leaning. Twenty-six volunteer males (age 21.4 ± 1.2 years) were randomly assigned to stretching and control conditions. Participants conducted 5-min stretching on a stretch board for the stretching condition and were kept standing for 6-min for the control condition. Before and after intervention, the range of motion (ROM) at ankle dorsiflexion and the center of pressure (COP) excursion during maximal forward leaning were determined. Mean anteroposterior COP position, COP velocity and COP areas were calculated to compare the change in postural control. After stretching, ROM was significantly increased. During maximal forward leaning after stretching, both COP position and velocity showed significant increases compared to before stretching. Moreover, COP position and velocity in the stretching condition were significantly higher than in the control condition after stretching. No significant differences were found in COP area before and after stretching. Five-minute stretching increased not only ROM but also the anterior limit of stability while maintaining posture and led to faster COP shift than before stretching. These results indicate that static stretching would improve dynamic postural control as well.

Combining the Copenhagen Adduction Exercise and Nordic Hamstring Exercise Improves Dynamic Balance Among Male Athletes: A Randomized Controlled Trial

BACKGROUND

Copenhagen adduction exercise (CAE) and Nordic hamstring exercise (NHE) reduce the incidence of groin and hamstring injuries. Efficient dynamic balance can improve motor performance and reduce the risk of injuries in athletes. However, the effects of these exercises on dynamic balance have not been investigated.

HYPOTHESIS

CAE and NHE, as well as a combination of both exercises, would improve dynamic balance among amateur male athletes.

STUDY DESIGN

Randomized controlled trial.

LEVEL OF EVIDENCE

Level 1.

METHODS

A total of 200 male athletes aged 21.9 ± 2.4 years were included in the study and randomly assigned to 4 groups: CAE group (n = 50), NHE group (n = 50), CAE and NHE group (n = 50), and a control group (n = 50). A total of 177 male athletes completed the study. The primary outcome measure was the limit of stability (LoS), which was measured using the Biodex Stability System to assess the performance of the dynamic balance. The LoS of the athletes' performance was measured pre- and postintervention after 6 weeks.

RESULTS

The LoS significantly improved in all treatment groups, including CAE (44.5% ± 5.3%), NHE (43.2% ± 5.3%), and CAE + NHE (48.4% ± 5.1%) groups when compared with the control group (28.3% ± 4.8%) after 6 weeks (all Ps < 0.01). The improvement of LoS was significantly greater in the CAE + NHE group compared with other groups (CAE, NHE, and control groups).

CONCLUSION

There was a significant increase in dynamic balance performance postintervention among male athletes. CAE and NHE may improve injury prevention programs.

CLINICAL RELEVANCE

The results of this study provide evidence for athlete trainers and coaches to consider including the CAE and NHE as components of injury prevention programs to improve balance capacity and performance in athletes. Such improvements in balance may prevent injury risk and decrease absenteeism and injury-related financial burdens.

Effect of quadriceps and calf muscles fatigue on standing balance in healthy young adult males

OBJECTIVE

The present study aimed to compare the effects of quadriceps or calf muscles fatigue on static and dynamic standing balance in young healthy adult males.

METHODS

Forty-five healthy, physically active male adults aged 18-30 years were randomly divided into three groups; Quadriceps muscle fatigue group (n=15), Calf muscles fatigue group (n=15), and a control group (n=15). The Modified Clinical Test of Sensory Interaction on Balance, Unilateral Stance, and Limits of Stability (reaction time and movement velocity) were selected as outcome measures for this study.

RESULTS

The results showed a non-significant difference between pretest and posttest balance scores (p>0.05) for quadriceps and calf muscles fatigue on balance. Similarly, there were non-significant differences in posttest balance scores when comparing fatigue effects between the groups (p>0.05).

CONCLUSIONS

These results suggested that the fatigue of the quadriceps or calf muscles did not influence standing balance in healthy young adult males. Future longitudinal studies are recommended to further understanding the mechanisms behind localized muscle fatigue effects on standing balance in subjects of different age groups of both genders.

Instrumented functional reach test differentiates individuals at high risk for Parkinson's disease from controls

The functional reach (FR) test as a complex measure of balance including limits of stability has been proven to differentiate between patients with Parkinson’s disease (PD) and controls (CO). Recently, it has been shown that the instrumentation of the FR (iFR) with a wearable sensor may increase this diagnostic accuracy. This cross-sectional study aimed at investigating whether the iFR has the potential to differentiate individuals with high risk for PD (HRPD) from CO, as the delineation of such individuals would allow for, e.g., early neuromodulation. Thirteen PD patients, 13 CO, and 31 HRPD were investigated. HRPD was defined by presence of an enlarged area of hyperechogenicity in the mesencephalon on transcranial sonography and either one motor sign or two risk and prodromal markers of PD. All participants were asked to reach with their right arm forward as far as possible and hold this position for 10 s. During this period, sway parameters were assessed with an accelerometer (Dynaport, McRoberts) worn at the lower back. Extracted parameters that differed significantly between PD patients and CO in our cohort [FR distance (shorter in PD), anterior–posterior and mediolateral acceleration (both lower in PD)] as well as JERK, which has been shown to differentiate HRPD from CO and PD in a previous study, were included in a model, which was then used to differentiate HRPD from CO. The model yielded an area under the curve of 0.77, with a specificity of 85%, and a sensitivity of 74%. These results suggest that the iFR can contribute to an assessment panel focusing on the definition of HRPD individuals.

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

PURPOSE

The purpose of this study was to evaluate the effects of balance training on postural control and fall risk in children with diplegic cerebral palsy.

METHODS

Thirty spastic diplegic cerebral palsied children (10-12 years) were included in this study. Children were randomly assigned into two equal-sized groups: control and study groups. Participants in both groups received a traditional physical therapy exercise program. The study group additionally received balance training on the Biodex balance system. Treatment was provided 30 min/d, 3 d/week for 3 successive months. To evaluate the limit of stability and fall risk, participated children received baseline and post-treatment assessments using the Biodex balance system. Overall directional control, total time to complete the test, overall stability index of the fall risk test and total score of the pediatric balance scale were measured.

RESULTS

Children in both groups showed significant improvements in the mean values of all measured variables post-treatment (p < 0.05). The results also showed significantly better improvement in the measured parameters for the study group, as compared to the control group (p < 0.05).

CONCLUSION

Balance training on Biodex system is a useful tool that can be used in improving postural balance control in children with diplegic cerebral palsy.