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BACKGROUND: Knee osteoarthritis (OA) impairs postural control and may affect how the lower limb joints are used for postural control. OBJECTIVE: To investigate how individuals with knee OA use lower limb joints for static postural control. METHODS: Ten patients with knee OA and thirteen healthy controls performed quiet standing for 30 s. The standard deviation of the center of mass (COM) and lower limb joint motions in the anterior-posterior (AP) and medial-lateral (ML) planes were calculated from three-dimensional marker trajectories. Pearson’s correlation analysis and independent t-tests were conducted to investigate the relationship between COM and lower limb joint motion and to compare group difference, respectively. RESULTS: The AP hip angular velocity alone in the knee OA group and the AP hip and knee angular velocity in the control group were significantly correlated with the AP COM velocity. The ML hip angular velocity was significantly correlated with the ML COM velocity in both groups. The knee OA group exhibited a significantly larger standard deviation of AP COM velocity than the control group. CONCLUSIONS: Individuals with knee OA depended solely on the contribution of the hip to the AP COM velocity, which could not be successfully controlled by the knee.

Background: The stochastic resonance (SR) phenomenon has been used to improve postural control through the application of imperceptible noise to the somatosensory system. White noise signals have been applied in numerous SR studies on postural control. However, because the SR effect depends on the noise structure, the stimulation effects of signals with different structures, such as pink noise and chaotic signals, on postural control, must be determined to achieve better clinical applications of SR technology. Research question: During quiet standing, how is postural control affected by subthreshold electrical stimulation to the knee joints when signals with different structures (white noise, pink noise, and chaotic signals) are used? Methods: Sixteen healthy young adults stood quietly for 40s with their eyes closed. To evaluate postural sway, we calculated the mean velocity, root mean square (CoP_RMS), and range (CoP_Range) values for the center of pressure (CoP) in the anteroposterior direction. The standing task was conducted under subthreshold electrical stimulation with white noise, pink noise, and chaotic signals based on the Lorenz system, in addition to the no-stimulation condition. The four stimulation conditions were randomized within each set and repeated seven times. Results: Significant effects of stimulation were observed in the CoP_RMS and CoP_Range values. The CoP_RMS value under the pink noise signal was significantly lower than that under the no-stimulation condition. The CoP_Range value also tended to decrease under the pink noise signal compared with the no-stimulation condition; however, the differences were not statistically significant. No significant changes were found with the white noise and chaotic signals compared with the no-stimulation condition. Significance: We demonstrated that the pink noise signal was more effective in reducing postural sway than the white noise and chaotic signals based on the Lorenz system during quiet standing.

Patients with hallux rigidus (HR) tend to develop a characteristic alteration in walking to lessening pain and compensate for the limited range of motion at the first metatarsophalangeal (MTP1) joint that might be affected balance and gait. The goal of this study was to perform an integrated biomechanical description of gait and balance of symptomatic patients with either grade as III or IV HR in comparison with healthy subjects. Eleven patients (7 men) with HR (60 ± 7 years, 1.60 ± 0.07 m, and 70 ± 13 kg) and 16 (7 men) healthy subjects (70 ± 8 years, 1.66 ± 0.10 m, and 74 ± 14 kg) were included. Subjects performed 2 tasks: walking (5 trials of straight walking for at least 6 meters) and bipedal quiet standing for 30 seconds. For these 2 tasks the following variables were measured: range of motion of the MTP1 joint, plantar pressure distribution during the stance phase of walking, and the postural sway during quiet standing. Plantar pressure was measured in up 15 walking trials with a mat pressure sensor. The MTP1 joint range of motion for flexion/extension during walking was significantly smaller for the patients with HR than for the control group (HR: 14 ± 8°, control: 44 ± 5°; t(17) = -9.7, p.001). The forefoot plantar pressure distribution among different regions of the foot in patients with HR was not statistically different than the control group, but there was a tendency of higher pressures in the lateral metatarsal heads (p = .06). As description of the postural sway during quiet standing, the center of pressure area was not different between HR and the control group (p.05). Decreased MTP1 joint range of motion for flexion/extension during walking in symptomatic high-grade HR patients can be associated with higher pressure in the lateral metatarsal heads while the impact on postural sway is not affected.

Background Postural sway during quiet standing has been shown as a useful task to assess risk of falling in older adults. While the risk of falling is consistently reported to be higher in older females than males, the sex-related differences in postural sway are not consistent across the studies. Research question What are the effects of age and sex on postural sway during quiet standing during different stance conditions? Methods We examined the effects of age (40 young and 34 older adults), sex (37 males and 37 females), and their interaction on the postural sway during different stance conditions. We compared the center of pressure (CoP) velocity, amplitude and frequency during parallel (eyes open and eyes closed) and semi-tandem (eyes open) stances. Results Our results suggest that postural sway is similar between sexes in young participants, while older males exhibit larger postural sway than older female participants (10/21 outcomes). Older female participants exhibited lower CoP amplitude (but larger total and anterior-posterior CoP velocity) compared to young female participants. We also found that the increase in the postural sway with increasing task difficulty is more pronounced in older vs. young adults. Significance This study shows that ageing-related changes in postural sway are sex- and task-specific. Researchers and clinicians need to be aware of these effects when comparing groups or monitoring changes in time.

In previous studies, the influence of plantar sensation has been examined using various textured surfaces with different stiffness materials to assess static balance. This study investigated the effects of a Firm Textured Surface (FTS) along with age and sex-related influences on postural control under different visual conditions. Forty subjects (20 elderly, 10 males, mean age 68.30, 10 females, mean age 68.00, and 20 young people, 10 males, mean age 25.45, 10 females, mean age 27.30) participated in this study maintained a quiet standing on FTS, foam and firm surfaces with eyes open and closed. The center of pressure displacement (CoPDISP), CoP velocity (CoPVEL), and sway velocity of the CoP in anteroposterior (AP) and mediolateral (ML) direction (VA/P and VM/L) were measured. FTS was associated with lower postural sway measures in both the groups with eyes open and closed. However, the foam surface showed the worst results in all postural parameters under all experimental conditions. Separate four-way ANOVAs were applied to each dependent variable. The main effects of surface (p p p DISP, CoPVEL and VA/P; p = 0.0003 for VM/L) were significant in each of the four fitted models. Sex was never significant, either as a main effect or an interaction with other experimental factors. Eyes open were able to reduce the negative effects of the foam surfaces but without vision the proprioceptive sensory system cues of the body state become more important for maintaining balance. A good stimulation with rigid texture should be considered as relief to reduce the physiological-related decline of afferent information with age.

Individuals with motor incomplete spinal cord injuries (iSCI) often have impaired abilities to maintain upright balance. For able-bodied (AB) individuals, the ankle and hip joint accelerations are in antiphase to minimize the postural sway during quiet standing. Here we investigated how interjoint coordination between the ankle and hip joints was affected in individuals with iSCI, leading to their larger postural sway during quiet standing. Data from 16 individuals with iSCI, 14 age- and sex-matched AB individuals, and 13 young AB individuals were analyzed. The participants performed quiet standing during which kinematic and kinetic data were recorded. Postural sway was quantified using center-of-pressure velocity and center-of-mass acceleration. Individual ankle and hip joint kinematics were quantified, and the interjoint coordination was assessed using the cancellation index (CI), goal-equivalent variance (GEV), nongoal-equivalent variance (NGEV), and uncontrolled manifold (UCM) ratio. Individuals with iSCI displayed greater postural sway compared with AB individuals. The contribution of ankle angular acceleration toward one's sway was significantly greater for those with iSCI compared with AB groups. CI and the UCM ratios were not statistically different between the groups, while GEV and NGEV were significantly greater for the iSCI group compared with the AB groups. We demonstrated that individuals with iSCI show larger postural sway compared with the AB individuals during quiet standing, primarily due to larger ankle joint acceleration. We also demonstrated that the interjoint coordination between ankle and hip joint is not affected in individuals with iSCI, which is not successfully able to reduce the large COM acceleration.

Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), soleus and medial gastrocnemius were collected bilaterally. The iSCI-group exhibited more co-contractions than the AB-group (EO: 0.208% vs. 75.163%, p = 0.004; EC: 1.767% vs. 92.373%, p = 0.016). Furthermore, postural sway was larger during co-contractions than during no co-contraction in the iSCI-group (EO: 1.405 cm/s

Freezing of gait (FoG) is one of the main reasons for movement initiation disorders and abnormal coupling of posture and gait in Parkinson's disease (PD). Patients with FoG have poor postural control when compared to patients without FoG. However, the nature of the interrelationship between FoG and domains of postural control remains unknown. The aim of this study was to estimate the association between different domains of postural control and severity of FoG in patients with moderate-to-severe PD. Thirty patients with idiopathic PD with FoG (age range 45-80 years, Hoehn & Yahr stages 3 and 4) participated in the study. We evaluated objective (FoG-ratio during turning task) and subjective (New Freezing of Gait Questionnaire, NFoG-Q) measures of FoG severity, reactive postural adjustments in response to an external perturbation, first step anticipatory adjustment for step initiation and quiet standing stability. In the multiple regression analysis, step initiation was the strongest significant correlation of the NFoG-Q score explaining 23% of the variance of the assessment. For the objective FoG measure, mediolateral CoP amplitude in quiet standing and mediolateral CoP amplitude in step initiation explained 39% of the variance of the FoG-ratio. As main conclusions, this study identified the association between objective and subjective measure for FoG severity and postural control domains. The results support conducting step initiation training during rehabilitation of individuals with FoG.

Spontaneous postural sway during quiet standing has been considered a simple output error of postural control. However, as postural sway and inherent body orientation evoke compensatory activity of the plantar flexors, they might contribute to blood circulation under gravitational stress via the muscle pump. Hence, the present study employed an external support device to attenuate the plantar flexor activity in supported standing (SS), to experimentally identify its physiological impact on blood circulation. Eight healthy young subjects performed two 5-min quiet standing trials (i.e., normal standing (NS) and SS), and the beat-to-beat interval (RRI) and blood pressure (BP) were compared between trials. We confirmed that postural sway and corresponding plantar flexor activity, quantified by the anteroposterior displacement of the foot center of pressure and lower back position with respect to the wall, and by the amplitude of electromyography and mechanomyography, respectively, were attenuated in SS, while mean body orientation angle and relative position of the BP sensor were comparable to NS. The 5-min averages of diastolic BP and mean arterial pressure during SS were significantly higher than during NS, while RRI and systolic BP did not change. These could be interpreted as an increase in peripheral vascular resistance; meanwhile, in NS, this effect was replaced by the muscle pump of the plantar flexors. The muscle contractions related to spontaneous postural sway and body orientation produce substantial physiological impact on blood circulation during quiet standing.

Background The variability of center of pressure (COP) is a measure of stability commonly examined during quiet standing. While more recent research has examined the variability of COP during walking, an adequate comparison between shod and unshod walking conditions has yet to be made. Research question What is the influence of athletic footwear on the variability of COP displacement during walking? Methods In this intervention study, twenty healthy women (age 18–30 years) completed 2, 10-min walking trials, 1 shod and 1 unshod, during which ground reaction forces (GRF) and COP movement were collected by an instrumental treadmill. COP displacement was examined in the medial-lateral (ML) and anterior-posterior (AP) directions after being divided into quadrants based on the peaks and trough of each steps associated vertical GRF. A single MANOVA was used to determine effects of footwear and limb for each quadrant with the probability of a Type I error set at 0.05. Results Significant differences in variability were seen between footwear conditions in all quadrants in the AP direction and quadrants one and four in the ML direction. These results may be due to the structure of footwear, including midsole cushioning, altering the dynamics of the foot during walking. Significance The results of this study suggest that on average, athletic footwear reduces the variability of COP displacement in ML and AP directions. This may have implications for populations for whom variability of COP is determined to be undesirable.

BACKGROUND People with migraine exhibit postural control impairments. These patients also have an increased light sensitivity due to the disease, and it remains during the headache-free period. It is currently unknown if increased lighting levels can alter the balance control, especially in individuals with visual hypersensitivity, such as migraineurs. This study aimed to assess the balance and photophobia of women with migraine and non-headache controls under different light conditions. METHODS This cross-sectional study consisted of 14 women with migraine (mean ± SD 30.6 ± 8.1 years old) and 14 women without any kind of headache (mean ± SD 27.2 ± 2.8 years old) screened from a tertiary headache clinical hospital and the local community. Quiet standing balance was evaluated during bipodal and unipodal support, under 3 light conditions: ambient (AMB) - 270 lx, visual discomfort threshold (VDT) - 400 lx, and intense visual discomfort (IVD) - 2000 lx. Sway area of the center of pressure was processed and compared between groups. The association of migraine with the risk of presenting a greater imbalance in the discomfort lighting conditions was verified. RESULTS Compared to the non-headache controls, the migraine group presented greater sway area in bipodal stance under the 3 light conditions (mean difference (95% CI)): AMB 0.81 cm2 (0.19 to 1.43), P = .011; VDT 3.17 cm2 (0.74 to 5.60), P = .001; IVD 5.56 cm2 (2.75 to 8.37), P

Summary Background. Depending on the level of lesion, spinal cord injury (SCI) individuals have limited ability to stand and walk. They have to use various assistive devices to restore their abilities. The aim of this study was to evaluate the stability of SCI individuals during walking and quiet standing. Material and methods. Three groups: normal subjects and SCI individuals with complete and incomplete lesions, were enrolled. Stability of the subjects was evaluated based on center of pressure (COP) sways in quiet standing and spatiotemporal gait parameters in walking. The difference between the stability of normal and SCI subjects was determined by use of the two-sample t test. The correlation between the mean values of stability parameters in standing and walking and lesion level was determined by use of Pearson’s correlation. Results. The stability of SCI subjects during quiet standing was better than that of normal subjects. How­ever, their dynamic stability was significantly less than normal subjects. The dynamic stability of complete and incomplete SCI subjects did not differ significantly (P-value

Background: People with Parkinson's disease (PD) often have backward displacement of their center of pressure (COP) during quiet standing and reduced stability limits, as compared to healthy controls. These kinetic characteristics may induce postural instability in people with PD.Objective: To investigate the short-term effects on COP displacements during quiet standing and forward leaning brought about by the post-incline leaning after-effects in people with PD.Methods: Twenty participants with PD were randomly divided into two groups (tilting and control groups). The tilting group was required to stand upright quietly on a tilting board angled to raise the front part of the feet. The control group was asked to voluntarily lean their bodies forward as far as possible. The total time of the intervention was 60 seconds for each group. The COP displacements during quiet standing and forward leaning were recorded before and after the intervention.Results: In the tilting group, the COP significantly shifted forward after the intervention compared to that before the intervention during quiet standing as well as forward stability limits; this did not happen in the control group.Conclusions: The post-incline leaning after-effects may induce the short-term effects of forward shifting of COP during quiet standing and expand the forward stability limits in people with PD.

Postural control is often quantified by recording the trajectory of the center of pressure (COP)—also called stabilogram—during human quiet standing. This quantification has many important applications, such as the early detection of balance degradation to prevent falls, a crucial task whose relevance increases with the aging of the population. Due to the complexity of the quantification process, the analyses of sway patterns have been performed empirically using a number of variables, such as ellipse confidence area or mean velocity. This study reviews and compares a wide range of state‐of‐the‐art variables that are used to assess the risk of fall in elderly from a stabilogram. When appropriate, we discuss the hypothesis and mathematical assumptions that underlie these variables, and we propose a reproducible method to compute each of them. Additionally, we provide a statistical description of their behavior on two datasets recorded in two elderly populations and with different protocols, to hint at typical values of these variables. First, the balance of 133 elderly individuals, including 32 fallers, was measured on a relatively inexpensive, portable force platform (Wii Balance Board, Nintendo) with a 25‐s open‐eyes protocol. Second, the recordings of 76 elderly individuals, from an open access database commonly used to test static balance analyses, were used to compute the values of the variables on 60‐s eyes‐open recordings with a research laboratory standard force platform., The lack of description of calculation methods for the variables extracted from the stabilogram limits reproducibility and comparison between studies. We propose an explicit corpus of postural variables with their values computed on two databases.

Coordinated movements of both lower limbs may be a clinically important indicator of motor control during quiet standing. From a neurological point of view, it is known that extensive coupling of muscles must be coordinated an upright posture. However, movement coordination between the lower limbs is the final motor output, is unknown. In this study, we focussed on the ground reaction force (GRF) vector and clarified the time and frequency characteristics of the force vectors of both lower limbs.A total of 16 healthy young adults and 18 healthy older adults participated and placed each bare foot on one of two force plates to measure the GRF vectors (i.e., anteroposterior, mediolateral, and vertical) of each lower limb and determine the centre of mass (COM) acceleration in the anteroposterior direction (COMacc). Characteristics of the coordination of both lower limbs during movements were analysed using coherence analysis and cross-correlation function analysis (CCF).The coherence levels of the force vectors of both lower limbs were higher in all three directions and significantly increased in the older adults. CCF analysis showed that the force vectors of both lower limbs were negatively correlated at the zero-time lag. Moreover, a weak correlation was observed between COMacc and coherence values.The assessment of bilateral lower limb connectivity using force vectors can be used as an evaluation method to reflect changes in the ability to control bipedal standing during ageing.

The existence of a learning effect by which subjects progressively reduce body sway over the course of repetitive stabilometric measurements is currently debated. Also, the position and orientation of the feet on the platform can have a substantial influence on the outcome measurements. The aim of the present work was to assess the effect of feet positions on mean total velocity (V) of the center of pressure and the area (AR) covered by its displacements during quiet standing. A group of 35 healthy young subjects was examined during two successive sessions consisting of five recordings with their feet placed either in the recommended (standard, SP) or their usual most comfortable (UP) position. Results show a slight decreasing trend that failed to be statistically significant checked with Friedman's ANOVA (SP AR, χ2(4)=6.10, p=0.19 and V, χ2(4)=8.66, p=0.07 and UP AR, χ2(4)=2.32, p=0.68 and V, χ2(4)=1.19, p=0.88). Nonetheless, values of AR and V showed a notable decrement especially evident in the SP exam reaching, respectively, 24% and 11% from baseline, whereas variability measured by the coefficient of variation was the same in the two exams. Given the results, a learning effect should not be ruled out with confidence. Also, usual foot placement would be preferable to avoid this effect. Further research is needed to take into consideration the great variability of stabilometric measurements and the fact that different subjects could adapt more readily to the test conditions than others.

Background: Postural control impairments following a stroke have impact on mobility, reduce independence and increase the risk of falls. Assessing these impairments during tasks representative of real-life situations, such as quiet standing (QS) and voluntary stepping response (VSR) will enhance our understanding of how the postural control system is impaired in individuals post-stroke (IPS). It will also inform the development of a more targeted and effective rehabilitation to prevent falls in IPS.\ud Objectives: Identify the postural control impairments encountered by IPS during QS and VSR. \ud Methods: Twenty IPS and sixteen healthy controls were recruited to perform QS and VSR tasks while ground reaction forces and whole-body motion were measured. Displacement and speed variation of the COM, centre of pressure (COP) displacement and spatiotemporal data were calculated and compared between groups. \ud Results: During QS, IPS exhibited greater maximal COP displacement in mediolateral direction, COM displacement in vertical direction and COM speed excursions compared to controls. During VSR, IPS exhibited smaller step length, braking force, posterior foot placement in relation to the pelvis and COM anteroposterior excursion compared to controls. IPS presented less static and dynamic postural stability compared to controls. \ud Conclusions: Greater postural sway during QS, smaller anteroposterior COM displacement before losing balance and altered voluntary recovering steps during VSR could place IPS at more risk of falling when they face a postural challenge in the community. These novel results will improve the current knowledge base and should be considered in IPS rehabilitation.

Background: The Informational Manual Therapy (IMT) is a therapeutic touch. This study aims to assess the effect of IMT on quiet standing, pain and health status in university population. Methods: An experiment was conducted on subjects utilizing a comparative paired analysis both before and after the intervention. One IMT session was performed on 57 healthy individuals aged from 18 to 65 years. The primary outcome was quiet standing assessed by the Satel 40 Hz stabilometric force platform. Secondary outcomes were bodily pain assessed by the 36-Item Short Form Survey (SF-36) and health status by EQ-5D-3L. The primary outcome was evaluated before and immediately after treatment. Results: The individuals were divided into 3 age groups, 18–35 (52.6%), 35–50 (29.8%) and 51–65 (17.6%). Statistically significant differences were immediately observed after the session ended when comparing the pre-post quiet stance scores in a number of length parameters: L, Lx, Ly and stabilometry amplitude on Y-axis with eyes open and closed. Significant differences were also found when testing bodily pain (SF-36) and anxiety (5Q-5D-3L). Conclusion: One session of IMT produced positive effects when testing quiet standing with eyes open and eyes closed, as well as a significant reduction in pain and anxiety for those tested. Further research is suggested. info:eu-repo/semantics/publishedVersion

Background: Astronauts returning to earth usually demonstrate reduced orthostatic tolerance when assessed on a tilt table or quiet standing, but no studies have evaluated postflight orthostatic tolerance during activities of daily living, when it is most clinically relevant. Ambulatory blood pressure (BP) variability also is associated with orthostatic intolerance in certain patient populations and can capture clinically significant orthostatic hypotension during activities of daily living, especially when measured on a beat-to-beat basis. We evaluated the impact of prolonged spaceflight on orthostatic tolerance and BP profiles in astronauts. Methods: Ambulatory beat-to-beat BP was recorded using a portable device for multiple 24-hour time periods before, during, and after 6 months of spaceflight in 12 astronauts (4 women; age 48±5 [mean±SD] years). BP variability in the time domain was calculated as the SD. Systolic BP distribution during activities of daily living was characterized by skewness and kurtosis. Results: In contrast with results from previous studies that used tilt tables or stand tests, no astronaut experienced orthostatic intolerance/hypotension during activities of daily living before or after spaceflight. Also, 24-hour systolic BP decreased in space (120±10 mm Hg before spaceflight versus 106±9 mm Hg during spaceflight; P P >0.05). The skewness of systolic BP increased in space (0.74±0.51 versus 1.43±1.00; P =0.001), indicating that signal fluctuations became asymmetrical; however, it returned to preflight levels after landing (0.51±0.42). The kurtosis increased in space (5.01±7.67 versus 11.10±11.79; P =0.010), suggesting that fluctuations concentrated around the mean with a narrow distribution; however, it also returned to preflight levels (2.21±2.56) after return to earth. Conclusions: Given current countermeasures including in-flight exercise training and volume resuscitation on return, no astronauts experienced orthostatic hypotension or intolerance during routine (for landing day) activities in the initial 24 hours after landing following 6 months in space. Prolonged exposure to spaceflight had little impact on systolic BP variability and its distribution, although the latter showed a transient change in space (accompanied by mild relative hypotension), all of which returned to preflight values after return to earth.

PURPOSE To evaluate postural symmetry in sitting and standing for children with hemiplegic cerebral palsy (hCP) following the Combined Approach to Treatment for Children with Hemiplegia (CATCH) protocol, an intervention combining Constraint Induced Movement Therapy, Bimanual Intensive Therapy and Neuro-Developmental Treatment. METHODS The study included 10 children with a diagnosis of hCP and 10 typically developing age-matched peers. Subjects participated in a CATCH camp for six hours daily for eight consecutive days. Postural symmetry measurements in quiet sitting and standing were obtained using a Boditrak pressure-mapping system at four time points: prior to start of camp (T1), first day of camp (T2), last day of camp (T3), and one month post-camp (T4). RESULTS Significant differences (p< 0.05) were found in quiet sitting when comparing postural symmetry pre-intervention and one-month post camp. In quiet standing, significant differences (p< 0.05) were found when pre-intervention was compared to one-month post-intervention. One month post-intervention, the intervention group showed no significant difference from the comparison group. CONCLUSIONS Children with hCP demonstrate improvement in postural symmetry in sitting and standing following participation in a CATCH camp. Following the intervention, children with hCP continued to improve postural symmetry and approach age-matched peers.

Body sway has usually been studied during symmetrical standing while lower limbs equally contributed in upright posture. The present study aimed to examine the dynamics of body sway while turning during standing with symmetrical and asymmetrical weight distribution between the legs. Subjects performed a body turn of 30° to the right and left during quiet standing and standing with the right or left foot loaded with 70% of body weight. We found that body turn in the symmetrical posture induced weight increase on the foot contralateral to the turning direction and the common center of pressure (COP) velocity increase. Body turn in the asymmetrical posture induced further loading of the foot that was initially overloaded; also turning in the direction of the unloaded foot affects weight distribution more than turning in the direction of the overloaded foot. The posture transition from symmetrical to asymmetrical induced the common COP velocity increase and forward protraction of the unloaded foot COP. Turning in the asymmetrical posture produced further increase of the common COP velocity and further forward protraction of the unloaded foot COP. Moreover, when the left leg was unloaded this resulted not only in left leg's COP forward, but also in left leg's COP lateral protraction, and left leg's COP frontal velocity increase. These findings reveal that body position and weight distribution between the feet interact to stabilize upright posture and show the effect of footedness during turning in asymmetrical standing.

The details on how the position of balance examination is achieved (preceding movement) and what is happening after (subsequent movement) is scarce. We hypothesised that the postural sway in quiet standing can differ due to demanded stability or mobility associated with the preceding and subsequent action. The body sway will be lower with high stability demand task than a condition with high mobility task. Thirteen female ballet students were examined (aged 15.1 ± 0.95 years). Participants were examined in the single-legged standing position as a part of gait initiation (G-I, high mobility) and termination (G-T, high stability) task with the use of force plate. The following Centre of Pressure (COP) variables were analysed: range and standard deviation of COP position, mean COP velocity for AP (anterio-posterior) and ML (medio-lateral) planes. The results showed that for ML plane, body sway was larger for G-I than G-T task. The lowest values of all variables in AP plane (except the COP range) were for G-T task. This difference, confirm our hypothesis, where this difference is not caused by the skills of the participants, but due to the measuring procedure and motor behaviour before and after achieving the measurement position. Our conclusion is limited to the specific posture and homogenous participants.

Made available in DSpace on 2019-10-06T16:08:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação para o Desenvolvimento da UNESP (FUNDUNESP) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Postural control asymmetry is an important aspect of Parkinson's disease (PD) that may be associated with falls. The aim of this study was to compare the postural control asymmetry during postural tasks between fallers and non-fallers in people with PD and neurological healthy age-matched controls (CG). Individuals with idiopathic PD (n = 24) and CG (n = 24) were sub-divided into groups of fallers and non-fallers based on their fall history over the past year. Participants performed blocks of three 30-s trials of quiet standing with feet in a side-by-side and semi-tandem stance position. The center of pressure parameters for each limb were measured and used to calculate the symmetry index. Fallers compared to non-fallers had decreased asymmetry of vertical force in the side-by-side condition. During the tandem-front leg condition, PD non-fallers increased asymmetry of the medial-lateral velocity of sway compared to CG non-fallers. In addition, for the tandem–back leg condition, PD non-fallers increased asymmetry of total displacement and medial-lateral root mean square and mean velocity of sway compared to PD fallers. The results of the study did not support the hypothesis that PD fallers are more asymmetric than PD non-fallers. On the contrary, our results indicated that PD non-fallers had higher postural control asymmetry, especially during the more challenging (semi-tandem standing) postural task. São Paulo State University (UNESP) – Campus Bauru Graduate Program in Movement Science Human Movement Research Laboratory (MOVI-LAB) Department of Physical Education University of British Columbia School of Kinesiology São Paulo State University (UNESP) – Campus Rio Claro Graduate Program in Movement Science Posture and Gait Studies Laboratory (LEPLO) Department of Physical Education São Paulo State University (UNESP) – Campus Bauru Graduate Program in Movement Science Human Movement Research Laboratory (MOVI-LAB) Department of Physical Education São Paulo State University (UNESP) – Campus Rio Claro Graduate Program in Movement Science Posture and Gait Studies Laboratory (LEPLO) Department of Physical Education FUNDUNESP: 0716/011 FAPESP: 2012/24040-9 FAPESP: 2013/00925-4

Background The use of high-heeled shoes (HHS) introduces instability into the wearer’s balance system but how high-heel experience might influence standing balance is less examined in literature. Research question (1) Does foot stability decrease in both the antero-posterior (AP) and medial-lateral (ML) directions with increasing heel height during quiet standing? (2) Does high-heel experience improve the wearer’s foot stability during quiet standing in high-heeled conditions? Methods Twenty-four young females (12 regular and 12 non-regular HHS wearers) were recruited to perform quiet standing while wearing shoes with heel heights of 1 cm, 5 cm, 8 cm and 10 cm. The effects of heel height on the mean center of pressure (COP), their variability (standard deviations) and mean COP velocities in both the AP and ML directions were analysed by one-way repeated measures ANOVA and Bonferroni post-hoc test. The effects of high-heel experience were analysed through independent samples t-tests. Results The variability of the COP in both directions increased with heel height, although significance was found only in the ML direction. The COP velocities in both directions were highest for the 1 cm heel, decreased as the heel increased to 8 cm and increased again for the 10 cm heel. Experienced HHS wearers exhibited significantly smaller COP variances (AP) for the 8 cm and 10 cm heels, smaller COP velocities (AP) for all heels, and smaller COP variances (ML) and COP velocities (ML) for the 10 cm heel. Significance The use of HHS results in greater stability distortions in both AP and ML directions but high-heel experience improves balance control under high-heeled conditions. Our findings enhance the understanding of how high-heel experience might influence standing balance in different heel height, and highlights the importance of the ML components of the in-foot COP measures in the examination of standing balance in HHS.

Quiet standing exhibits strongly intermittent variability that has inspired at least two interpretations. First, variability can be intermittent through the alternating engagement and disengagement of complementary control processes at distinct scales. A second and perhaps deeper way to interpret this intermittency is through the possibility that postural control depends on cascade-like interactions across many timescales at once, suggesting specific non-Gaussian distributional properties at different timescales. Multiscale probability density function (PDF) analysis shows that quiet standing on a stable surface exhibits a crossover from low, increasing non-Gaussianity (consistent with exponential distributions) at shorter timescales, reflecting inertial control, towards higher non-Gaussianity. Feedback-based control at medium to longer timescales yields a linear decrease characteristic of cascade dynamics. Destabilizing quiet standing with unstable surface or closed eyes serves to attenuate inertial control and to elicit more of the feedback-based control over progressively shorter timescales. The result was to strengthen the appearance of the linear decay indicating cascade dynamics. Finally, both linear and nonlinear indices of postural sway also govern the relative strength of crossover or of linear decay, suggesting that tempering of non-Gaussianity across log-timescale is a function of both extrinsic constraints and endogenous postural control. These results provide new evidence that cascading interactions across longer-timescales supporting postural corrections can even recruit shorter-timescale processes with novel task constraints that can destabilize posture.

Background Studies on short-term upright quiet standing tasks have presented contradictory findings about postural control in people with Parkinson’s disease (pwPD). Prolonged trial durations might better depict body sway and discriminate pwPD and controls. Objective The aim of this study was to investigate postural control in pwPD during a prolonged standing task. Methods A total of 26 pwPD and 25 neurologically healthy individuals performed 3 quiet standing trials (60 s) before completing a constrained prolonged standing task for 15 minutes. Motion capture was used to record body sway (Vicon, 100 Hz). To investigate the body sway behavior during the 15 minutes of standing, the analysis was divided into three 5-minute-long phases: early, middle, and late. The following body sway parameters were calculated for the anterior-posterior (AP) and medial-lateral (ML) directions: velocity, root-mean-square, and detrended fluctuations analysis (DFA). The body sway area was also calculated. Two-way ANOVAs (group and phases) and 1-way ANOVA (group) were used to compare these parameters for the prolonged standing and quiet standing, respectively. Results pwPD presented smaller sway area ( P < .001), less complexity (DFA; AP: P < .009; ML: P < .01), and faster velocity (AP: P < .002; ML: P < .001) of body sway compared with the control group during the prolonged standing task. Although the groups swayed similarly (no difference for sway area) during quiet standing, they presented differences in sway area during the prolonged standing task ( P < .001). Conclusions Prolonged standing task reduced adaptability of the postural control system in pwPD. In addition, the prolonged standing task may better analyze the adaptability of the postural control system in pwPD.

We assessed 168 patients with multiple sclerosis (MS) by force platform to obtain the dual-task cost (DTC) of balance, that is, the change in postural sway from quiet standing to dual-task condition (Stroop test). After a median follow-up time of 3.5 years from this assessment, disability progression occurred in 45 (27%) patients. Disability progression was predicted by the adoption of a ‘posture second’ strategy, that is, values of DTC of balance exceeding those obtained from 62 healthy controls, even after controlling by demographic and clinical characteristics. The DTC of balance may potentially represent a novel and easy tool to predict MS progression.

Methods used to assess quiet standing in unilateral prosthesis users often assume validity of an inverted pendulum model despite this being shown as invalid in some instances. The aim of the current study was to evaluate the validity of a proposed unilaterally-constrained pin-controller model in explaining postural control in unilateral prosthesis users. Prosthesis users were contrasted against the theoretical model as were able-bodied controls that stood on a platform which unilaterally constrained movement of the CoP. All participants completed bouts of quiet standing with eyes open, eyes closed and with feedback on inter-limb weight bearing asymmetry. Correlation coefficients were used to infer inverted pendulum behavior in both the anteroposterior and mediolateral directions and were derived from both kinematic (body attached markers) and kinetic (centre of pressure) experimental data. Larger, negative correlation coefficients reflected better model adherence, whilst low or no correlation reflected poorer model adherence. Inverted pendulum behavior derived from kinematic data, indicated coefficients of high magnitude in both mediolateral (all cases range 0.71–0.78) and anteroposterior (0.88–0.91) directions, irrespective of groups. Inverted pendulum behavior derived from kinetic data in the anteroposterior direction indicated validity of the model with large negative coefficients associated with the unconstrained/intact limbs (prosthesis users: − 0.45 to − 0.65, control group: − 0.43 to − 0.72), small coefficients in constrained/prosthetic limbs (prosthesis users: − 0.02 to 0.07, control group: 0.13–0.26) and large negative coefficients in combined conditions (prosthesis users: − 0.36 to − 0.56, control group: − 0.71 to − 0.82). For the mediolateral direction, coefficients were negligible for individual limbs (0.03–0.17) and moderate to large negative correlations, irrespective of group (− 0.31 to − 0.73). Data suggested both prosthesis users’ and able-bodied individuals’ postural control conforms well to that predicted by a unilaterally-constrained pin-controller model, which has implications for the fundamental control of posture in transtibial prosthesis users.

A cross-sectional, prospective, between-subjects design was used in this study to establish the differences in sensory reweighting of postural control among different ages during adolescence. A total of 153 adolescents (five age groups; 13–17 years old) performed bipedal standing in three sensory conditions (i.e., with visual restriction, vestibular disturbance, and proprioceptive disturbance). Center of pressure displacement signals were measured in mediolateral and anteroposterior directions to characterize reweighting in the sensory system in static postural control when sensory information is disturbed or restricted during adolescent growth. The results indicate a development of postural control, showing large differences between subjects of 13–14 years old and older adolescents. A critical change was found in sensory reweighting during bipedal stance with disturbance of proprioceptive information at 15 years old. Adolescents of 13–14 years old showed less postural control and performance than older adolescents during the disturbance of proprioceptive information. Moreover, the results demonstrated that the visual system achieves its development around 15–16 years old. In conclusion, this research suggests that a difference of sensory reweighting under this type of sensorial condition and sensory reweight systems would seem to achieve stabilization at the age of 15.

Background: The aim of this study was to investigate differences in static and dynamic plantar pressure and other foot geometry variables between female Olympic-style weightlifters and an age- and sex-matched control group. Methods: The study involved 24 national-level competitive weightlifters and 24 physical education students. Leg dominance was determined and baropodometry was used to assess plantar pressure and foot posture during quiet standing and walking. For all variables basic descriptive statistics were calculated (mean &plusmn, standard deviation). Student&rsquo, s t test was used to compare the between-group differences. Spearman&rsquo, s rank correlation coefficients were calculated to determine the association between BMI (Body Mass Index) and average and peak plantar pressure. Results: No significant differences were observed in plantar pressure distribution between the two groups. A moderate correlation was found between BMI and non-dominant limb peak and average plantar pressure in the group of weightlifters in the static condition and in the control group in the dynamic condition. Conclusions: Olympic-style weightlifting may affect plantar pressure distribution and foot posture in female weightlifters. BMI may also correlate with peak and average plantar pressure in this population. Further research is needed to determine if Olympic-style weightlifting may affect plantar pressure distribution and foot posture in female weightlifters.

Fall risk is a serious problem especially for the elderly. Fall accident causes fracture, and it leads to bedridden. Early detection of balance inability and rehabilitation training is important to decrease the risk. Quiet standing test is one of the physical tests to assess the balance inability of human. When the human is standing, he/she controls the plantar force to keep the balance. Center of pressure (COP) is the representative parameter to explain the plantar force movement. During the quiet standing test, COP fluctuates unconsciously. There are many researches that analyze the relationship between the COP fluctuation and balance inability. Many statistical indicators have been developed to assess the fluctuation specification.In contrast, several researchers have been tried to reveal the COP fluctuation mechanism by introducing stochastic mathematical model. Ornstein-Uhlenbeck process and diffusion equation are often introduced to the model. The mathematical models have been developed, and analyzed how visual input is related to the model parameters. If the mathematical model can explain the COP fluctuation completely, it becomes easier to assess the balance ability by comparing the model parameters.However, statistical indicators are still used in the clinical cases, thus there is room to discuss which statistical indicators to be used for assessment. The purpose of this research is to explore the relationship between statistical indicators and numerical model by evaluating whether the numerical model reproduces the same values with real data. The reproduced indicators and original indicators are compared, and the magnitude of the errors are evaluated.

Purpose: The aim of the study was to compare the results of six balance tests collected on AMTI AccuSway Plus ACS force platform between healthy female and male children and adolescents. We also searched for possible correlation of the balance measures with subjects’ age. Methods: 228 healthy 6- to 18-year-old subjects (111 boys and 117 girls) participated in the study. Six balance tests were performed with the use of AMTI AccuSway Plus ACS platform: quiet standing for 30s, maximal voluntary sways of the body in the sagittal plane (anterior-posterior – AP test) for 30 s, and in the frontal plane (left-right – ML test) for 30s. All tests were performed in two conditions: eyes open and eyes closed. Results: During quiet standing with eyes open, most balance measures were lower in girls (p < 0.05). In AP and ML tests with eyes open, a few balance parameters were different between boys and girls (p < 0.05). In quiet standing, AP and ML tests with eyes closed, there were no between-gender differences (p > 0.05). In quiet standing with eyes open and closed most balance parameters were negatively correlated with age (p < 0.05). Conclusions: Quiet standing postural sway characteristics depended on gender under normal visual conditions and it was similar in boys and girls under visual deprivation conditions. The vision was differently used by females and males in balance tasks. Static postural stability improved with age regardless of visual conditions.

Made available in DSpace on 2020-12-12T02:20:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-10-15 The aim of this study was to investigate the effects of wearing virtual reality head-mounted goggles (VR) on body sway in young adults. We run two experiments, in which we compared the body sway while standing during the conditions of 1) wearing and non-wearing VR with eyes-opened (experiment #1), 2) wearing and no-wearing VR with eyes-closed (experiment #2), and 3) wearing VR with eyes-opened when the scene was turned on and off (experiment #2). Forty-four (experiment #1) and fifteen (experiment #2) young adults were instructed to remain as still as possible on a force plate for 60-s and performed three trials in each quiet standing condition. The center of pressure (CoP) displacement, mean velocity, root mean square (RMS), area and median frequency of sway were calculated in both experiments. In the experiment #1, wearing VR condition with eyes-opened largely increased the AP and ML CoP displacement, AP mean velocity, AP and ML RMS, and area (p < 0.05) compared to non-wearing VR with eyes-opened. In the experiment #2, no differences were found for any conditions (eyes-closed and eyes-opened with turned on and off VR scene). In conclusion, wearing VR head-mounted goggles increased body sway of young adults during standing postural task, when the individuals were with eyes-opened. However, the effects of wearing VR head-mounted goggles on body sway disappeared when the individuals were with eyes-closed or the google scene was turned off the scene compared to not wearing VR head-mounted goggles with eyes-closed or turned on scene, respectively. São Paulo State University (UNESP) Human Movement Research Laboratory (MOVI-LAB) Graduate Program in Movement Science Department of Physical Education, Campus Bauru São Paulo State University (UNESP) Laboratory of Information Vision and Action (LIVIA) Graduate Program in Movement Science Department of Physical Education, Campus Bauru São Paulo State University (UNESP) Department of Physical Therapy and Occupational Therapy University of São Paulo (USP) School of Arts Sciences and Humanities (EACH), Campus São Paulo São Paulo State University (UNESP) Human Movement Research Laboratory (MOVI-LAB) Graduate Program in Movement Science Department of Physical Education, Campus Bauru São Paulo State University (UNESP) Laboratory of Information Vision and Action (LIVIA) Graduate Program in Movement Science Department of Physical Education, Campus Bauru São Paulo State University (UNESP) Department of Physical Therapy and Occupational Therapy

Background Falling is the most common accident of daily living and the second most prevalent cause of accidental death in the world. The complex nature of risk factors associated with falling makes those at risk amongst the elderly population difficult to identify. Commonly used clinical tests have limitations when it comes to reliably detecting the risk of falling, but existing laboratory tests, such as force platform measurements, represent one method of overcoming this lack of a test. Despite their widespread use, however, Center of Pressure (COP) signal analysis techniques vary and there is currently no consensus on which features should be used diagnostically. Our objective is to identify, through a systematic review and meta-analysis, the COP characteristics of older adults (≥ 60 years old) during quiet bipedal stance which will allow fallers to be distinguished from non-fallers. Methods The systematic review will include both prospective and retrospective articles. Five databases will be searched: PubMed, Cochrane CENTRAL, EMBASE, and ScienceDirect. In addition, a search of gray literature will be performed using Google Scholar and ClinicalTrials.gov. Searches will be circumscribed to include only older adults (aged over 60 years) who underwent a bipedal quiet standing measure of their balance and for whom the number of falls was reported. Two authors will independently assess the risk of bias for each included article using a 26-item checklist. Funnel plots will be drawn to attest of possible publication biases for each COP parameters. The results will be synthesized descriptively and a meta-analysis will be undertaken. When trial methodological heterogeneity is too great for pooling of the data into a meta-analysis, evidence strength will be evaluated using best evidence analysis. Discussion Despite the numerous advantages of posturography, the diversity of studies exploring balance in older fallers has led to uncertainty regarding the method’s ability to reliably identify fall-prone older adults. It is expected that the findings from this systematic review will help clinicians use bipedal quiet standing measures as a diagnostic test and allow researchers to explore COP characteristics to create better models for fall prevention care. Systematic review registration PROSPERO CRD42018098671 Electronic supplementary material The online version of this article (10.1186/s13643-019-1147-9) contains supplementary material, which is available to authorized users.

BACKGROUND Evaluation of the effect of a pad on foot morphologies in patients with medial tibial stress syndrome (MTSS) requires more reliable and objective methods, rather than conventional subjective observations. OBJECTIVE The objective of this study was to investigate the effect of pads on foot morphologies during quiet standing in athletes with MTSS. METHODS We measured three-dimensional foot morphologies in 30 feet with MTSS and 40 healthy feet. RESULTS The analysis showed that Hallux valgus degree, calcaneal angle, arch height, and arch height ratio differed significantly as a result of the pad support, compared to no pad support in the MTSS group. The pad support only resulted in significant differences in arch height, compared to no support in the control group. Furthermore, thumb side angle, calcaneal angle, and arch height ratio were significantly different between the MTSS and control groups. CONCLUSIONS Our study results suggest that changes in foot morphologies because of the use of a pad can be measured objectively in patients with MTSS.

STUDY DESIGN Retrospective analysis. OBJECTIVE To describe the dynamic fluctuation of truncal shift parameters during quiet standing in healthy young individuals using biomechanical analyses. SUMMARY OF BACKGROUND DATA Coronal decompensation (CD) and sagittal vertical axis (SVA) are the key radiographic parameters to assess static truncal stability, with the known cut-off value of 4 cm for SVA in determining severity of spinal deformity. These values are obtained at a specific moment during quiet standing, when the posture innately changes. Thus, unassessed truncal sway could potentially compromise the reliability of these measurements. METHODS Previously obtained biomechanical data with 11 male, healthy participants aged 16 to 29 were used to quantify the dynamic sway of standing posture. The participants were instructed to quietly stand with surface reflective markers for 130 seconds. The midpoint of bilateral acromia was used as a surrogate for C7 vertebral body. The time series of coronal and sagittal shifts of C7 to sacrum were measured as quasi-coronal decompensation (CD) and quasi-sagittal vertical axis (SVA) to simulate CD and SVA on radiographs. A force platform was also used to measure the center of pressure (COP) displacement. RESULTS The group averages of the dynamic sway range were 20.2 ± 4.1 mm (range: 15.1-28.6) in the sagittal plane (quasi-SVA) and 9.8 ± 3.2 mm (range: 5.5-15.2) in the coronal plane (quasi-CD). There were significant correlations between quasi-CD sway and medial-lateral COP velocity (Pearson r = 0.65, P = 0.03), as well as between quasi-SVA sway and COP sway area (r = 0.65, P = 0.03). CONCLUSION Given the considerable fluctuation of quasi-SVA and quasi-CD during quiet standing, the reliability of radiographic measurement using CD and SVA at a specific moment can be substantially compromised. The assessment based on the currently proposed cut-off values should be interpreted with caution, and repeat examinations are warranted. LEVEL OF EVIDENCE 4.

Research question The purpose of this study was to examine the postural sway characteristics of the ballet dance experts in quiet standing and at their limits of stability with an approach not used before in dancers. Methods The study was conducted on thirteen female ballet dancers and thirteen non-training females. The data were collected with a use of a force plate. To gain a better insight into the postural control processes, we used the rambling-trembling and sample entropy analyses in the COP data processing. Results The main findings of the study showed professional dancers to have higher values of postural sway characteristics in comparison to the non-trainees while performing simple motor tasks. Also, higher values of the trembling component in the group of dancers during quiet standing and the inclined positions were observed. This might be a sign of higher capacity of the postural system to deal with postural instability in dancers. Importance Our results confirmed that the visual information is important in the process of postural control of dancers’, which is proven by increased dislocations of the COP without visual feedback. The sample entropy results indicated more irregular characteristics of postural sway in ballet dancers representing more automated postural control. The data analysis methods showed high sensitivity to the subtle changes in postural control due to the dance training.

Parkinson's disease (PD) is associated with alterations in motor outputs such as center of pressure (CoP) adjustments during quiet standing and foot kinematics during walking. Previous research suggests that the complexity of motor outputs reflects the number of control processes stabilizing a specific movement, providing a measure that is linked to the neurological control of the movement. The Entropic Half Life (EnHL) represents a new method for assessing motor output complexity. We hypothesized that there will be a lack of neuromuscular control pathways for PD patients, resulting in a decrease in motor output complexity. We computed the EnHL of CoP adjustments during quiet standing and foot kinematics during walking of 70 PD patients and 33 age-matched controls. Patients with PD showed longer EnHL values compared to controls, suggesting a tighter motor control. Excluding vision led to a decrease of EnHL of CoP in both groups. EnHL was correlated with spatio-temporal gait parameters. We compared EnHL with the pull test and the timed up-and-go test. No significant differences were present in the pull test, yet motor output complexity was correlated with the timed up-and-go test. The results suggest a reduced complexity in motor outputs of PD patients affecting distinct motor functions.

Prolonged walking could alter postural control leading to an increased risk of falls in older adults. The aim of this study was to determine the effect of level and uphill prolonged walking on the postural control of older adults. Sixteen participants (64 ± 5 years) attended 3 visits. Postural control was assessed during quiet standing and the limits of stability immediately pre, post and post 15 min rest a period of 30 min walking on level and uphill (5.25%) gradients on separate visits. Each 30 min walk was divided into 3 10 min blocks, the limits of stability were measured between each block. Postural sway elliptical area (PRE: 1.38 ± 0.22 cm2, POST: 2.35 ± 0.50 cm2, p = .01), medio-lateral (PRE: 1.33 ± 0.03, POST: 1.40 ± 0.03, p = .01) and anterio-posterior detrended fluctuation analysis alpha exponent (PRE: 1.43 ± 0.02, POST: 1.46 ± 0.02, p = .04) increased following walking. Medio-lateral alpha exponent decreased between post and post 15 min’ rest (POST: 1.40 ± 0.03, POST15: 1.36 ± 0.03, p = .03). Forward limits of stability decreased between the second walking interval and post 15 min’ rest (Interval 2: 28.1 ± 1.6%, POST15: 25.6 ± 1.6%, p = .01) and left limits of stability increased from pre-post 15 min’ rest (PRE: 27.7 ± 1.2%, POST15: 29.4 ± 1.1%, p = .01). The neuromuscular alterations caused by prolonged walking decreased the anti-persistence of postural sway and altered the limits of stability in older adults. However, 15 min’ rest was insufficient to return postural control to pre-exercise levels.

The objective of the present study was to investigate loading of the operated leg during quiet standing and sit-to-stand (STS) movement for 1 year after total hip arthroplasty (THA).One hundred and fifty-eight patients with end-stage hip osteoarthritis (OA) who had undergone unilateral primary THA participated in this study. The load distribution on the operated and non-operated legs was computed by measuring the vertical reaction force of the operated and non-operated legs during quiet standing and STS movement. We investigated the load distribution using Pressure Distribution Measurement Platform preoperatively and 1, 2, 3, 6, and 12 months postoperatively.Loading of the operated leg during quiet standing was restored 1 month postoperatively. Loading of the operated leg during STS movement was higher within 2 months postoperatively than the preoperative levels and continued to increase 1 year postoperatively. Loading of the operated leg was lower during STS movement than that during quiet standing, even 1 year postoperatively.A longitudinal and dynamic assessment of loading of the operated leg after THA is clinically important, and the loading during STS movement might continue to increase for a year after THA.

Holding asymmetrical loads in the hands is common during many daily and occupational activities which, depending on the load mass, may alter postural stability. The purpose of this study was to determine the effect of load magnitude held asymmetrically in the hand on postural sway in older people. Eighteen healthy older adults (age 65.9 ± 5.7 years) were assessed in the following conditions; (1) standing without an external load (0%), (2) standing while holding a grocery bag containing 5%, (3) 10% and (4) 20% body mass in the dominant hand. The total displacement of the centre of pressure (COP) in the anteroposterior and mediolateral directions (cm), mean COP velocity (cm s−1) and COP area (cm2) were used to indirectly assess postural sway. The COP area (R 2 = 0.96), anteroposterior (R 2 = 0.85) and mediolateral (R 2 = 0.84) COP displacement increased linearly with additional load. The 20% load condition elicited the greatest increase in postural sway (d = 2.1–3.6) compared to 0%, while the 5% load had no effects on sway (P ≥ 0.05). In contrast, the mean COP velocity decreased by similar amounts when holding a load at 5% (d = 1.6), 10% (d = 1.4) and 20% (d = 1.5) body mass, compared to 0% (all P

To date, no postural studies have investigated the specific relationship between linear (anteroposterior (AP) and mediolateral (ML)) postural sway and the free moment (FM) over the range of biomechanically important frequencies. The goal of the current paper is to study the relationship between FM and the AP/ML movements during quiet standing with respect to individual frequencies. Mean squared coherence, which measures the degree of the relationship between two signals as a function of frequency, is employed to address this question. The results showed that, in two conditions (eyes opened and eyes closed), at very low frequencies (0.5Hz), AP and FM were strongly correlated (0.8) while there was a weak correlation between ML and FM (∼0.2). The situation reversed from (0.5 to 1.5Hz), with AP/FM correlation decreasing, and ML/FM correlation peaking slightly below 1.0Hz. Both conditions were only weakly correlated beyond 1.5Hz. It is suggested that these observations arise from differences in ankle activation between the left and right sides, whereas at higher frequencies, high coherence between ML and FM is a hip control strategy.

Postural control during quiet standing was examined in typical children (TD) and children with cerebral palsy (CP) level I and II of GMFCS. The immediate effect on postural control of functional taping on the thighs was analyzed. We evaluated 43 TD, 17 CP children level I, and 10 CP children level II. Participants were evaluated in two conditions (with and without taping). The trajectories of the center of pressure (COP) were analyzed by means of conventional posturography (sway amplitude, sway-path-length) and dynamic posturography (degree of twisting-and-turning, sway regularity). Both CP groups showed larger sway amplitude than the TD while only the CP level II showed more regular COP trajectories with less twisting-and-turning. Functional taping didn't affect sway amplitude or sway-path-length. TD children exhibited more twisting-and-turning with functional taping, whereas no effects on postural sway dynamics were observed in CP children. Functional taping doesn't result in immediate changes in quiet stance in CP children, whereas in TD it resulted in faster sway corrections. Children level II invest more attention in postural control than level I, and TD. While quiet standing was more automatized in children level I than in level II, both CP groups showed a less stable balance than TD.

Whole body vibration (WBV) can affect postural control and muscular activation. The purpose of this study was to investigate the center-of-mass (COM) movement of children and young adults before, during, immediately after, and 5min after 40-s WBV in quiet standing. Fourteen young adults (mean age 24.5 years) and fourteen children (mean age 8.1 years) participated in the study. A full-body 35-marker set was placed on the participants and used to calculate COM. Forty-second standing trials were collected before, during, immediately after, and 5min after WBV with an frequency of 28Hz and an amplitude of1mm. Two visual conditions were provided: eyes-open (EO) and eyes-closed (EC). COM variables included time-domain measures (average velocity, range, sway area and fractal dimension), frequency-domain measures (total power and median frequency), and detrended fluctuation analysis (DFA) scaling exponent in both anterior-posterior (AP) and medial-lateral (ML) directions. Results show that during WBV both children and adults increased average velocity and median frequency, but decreased range and the DFA scaling exponent. Immediately after WBV both groups increased the range, but showed pre-vibration values for most of the COM variables. Comparing to adults, children displayed a higher COM velocity, range, fractal dimension, and total power, but a lower DFA scaling exponent at all phases. The results suggest that both children and adults can quickly adapt their postural control system to WBV and maintain balance during and after vibration. Children display some adult-like postural control during and after WBV; however, their postural development continues into adolescence.

The Nintendo Wii Balance Board (WBB) has become popular as a low-cost alternative to research-grade force plates. The purposes of this study were to characterize a series of technical specifications for the WBB, to compare balance control metrics derived from time-varying center of pressure (COP) signals collected simultaneously from a WBB and a research-grade force plate, and to investigate the effects of battery life. Drift, linearity, hysteresis, mass accuracy, uniformity of response, and COP accuracy were assessed from a WBB. In addition, 6 participants completed an eyes-closed quiet standing task on the WBB (at 3 battery life levels) mounted on a force plate while sway was simultaneously measured by both systems. Characterization results were all associated with less than 1% error. R2 values reflecting WBB sensor linearity were > .99. Known and measured COP differences were lowest at the center of the WBB and greatest at the corners. Between-device differences in quiet stance COP summary metrics were of limited clinical significance. Lastly, battery life did not affect WBB COP accuracy, but did influence 2 of 8 quiet stance WBB parameters. This study provides general support for the WBB as a low-cost alternative to research-grade force plates for quantifying COP movement during standing.

Abstarct Objectives Challenging quiet standing tasks for the ankle, knee, hip, and neck joints were used to test the effect of pre-cueing on the reaction time of articular stabilization strategies. Method We assessed balance recovery in 15 subjects who were exposed to backward translations on a movable platform during two conditions: alerted, where participants gazed at a countdown light that pre-cued the onset of the platform translation; and unalerted, without onset time pre-cue. Results We compared the angular variation of the ankle, knee, hip, and neck joints between the two conditions over four window epochs (0–50 ms; 50–100 ms; 100–150 ms; 150–200 ms). When comparing the window epochs of the ankle and hip joints between conditions, a significant effect was observed in the first and second windows. In the second and third windows, a significant effect was only observed in the alerted group, thereby indicating a faster stability for alerted condition. No significant effect was observed for the knee joint, while a significant effect was observed in the neck joint during the third and fourth windows of the alerted condition. Conclusions Pre-cueing can modify the synergies of the automatic reactive postural responses, prioritizing the stabilization of main joints such as the ankle and hip over that of the neck and knee. It was suggested that joint stabilization in the hip occurred due to the involuntary anticipation preprogrammed in the cortex by the visual pre-cue.

Background Aging is associated with declining balance, which may increase fall risk and reduce independence. There is a paucity of work examining functional tasks (e.g., standing from a chair, lifting) related to fall risk. Additionally, many past studies have considered older adults as one age group, rather than viewing aging as a continuum across older adulthood. Research question How are age and balance measures related in healthy, independently-dwelling older adults during functional tasks? Methods Thirty-eight older (60–89 years old) and 21 younger (18–30 years old) independently-dwelling adults performed quiet standing, sit-stand-sit, sit-stand-gait initiation, and lifting, while ground reaction forces and whole-body motion were measured. Variability of the net center of pressure displacement (root-mean-square; antero-posterior and mediolateral), and minimum margin of stability (anterior, posterior, mediolateral, and/or medial and lateral) were extracted. Regression analyses were used to identify relationships with age for both the full participant sample and the older adult cohort, accounting for sex and task characteristics. Results Age was significantly related to balance measures for both participant samples; net center of pressure root-mean-square and minimum margin of stability tended to increase and decrease with age, respectively. For older adults, significant relationships were primarily in the antero-posterior and mediolateral directions for sit-stand-gait initiation and sit-stand-sit, respectively. Relationships did not appear to be simply a function of differences in task performance with age. Significance Some evidence of balance declines during functional tasks was observed across older adulthood, including declines that did not appear in the full participant sample. However, further work with a more diverse older adult cohort will be required to confirm these results. Findings may contribute to the development of strategies for improving balance control and reducing fall risk in older adults, by identifying the balance measures most likely to decline across older adulthood as potential target tasks for interventions.

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 $1.5 \times 10^{-4}\,\,\text {mm}$ , [−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.

Hemiplegic paralysis after stroke may augment postural instability and decrease the balance control ability for standing. The center of mass acceleration (COMacc) is considered to be an effective indicator of postural stability for standing balance control. However, it is less studied how the COMacc could be affected by the muscle activities on lower-limbs in post-stroke hemiplegic patients. This study aimed to examine the effects of hemiplegic paralysis in post-stroke individuals on the amplitude and structural variabilities of COMacc and surface electromyography (sEMG) signals during quiet standing. Eleven post-stroke hemiplegic patients and the same number of gender- and age-matched healthy volunteers participated in the experiment. The sEMG signals of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles of the both limbs, and the COMacc in the anterior-posterior direction with and without visual feedback (VF vs. NVF) were recorded simultaneously during quiet standing. The sEMG and COMacc were analyzed using root mean square (RMS) or standard deviation (SD), and a modified detrended fluctuation analysis based on empirical mode decomposition (EMD-DFA). Results showed that the SD and the scale exponent α of EMD-DFA of the COMacc from the patients were significantly higher than the values from the controls under both VF (p < 0.01) and NVF (p < 0.001) conditions. The RMSs of TA and LG on the non-paretic limbs were significantly higher than those on paretic limbs (p < 0.05) for both the patients and controls (p < 0.05). The TA of both the paretic and non-paretic limbs of the patients showed augmented α values than the TA of the controls (p < 0.05). The α of the TA and LG of non-paretic limbs, and the α of COMacc were significantly increased after removing visual feedback in patients (p < 0.05). These results suggested an increased amplitude variability but decreased structural variability of COMacc, associated with asymmetric muscle contraction between the paretic and the non-paretic limbs in hemiplegic paralysis, revealing a deficiency in integration of sensorimotor information and a loss of flexibility of postural control due to stroke.

Background Neurotoxic cancer treatments can cause chemotherapy-induced peripheral neuropathy and postural control deficits that cancer survivors report as a concern. Exercise-based sensorimotor training has emerged as a promising treatment for symptoms including balance deficits, however, more study is needed to optimize engagement and participation. We evaluated feasibility, satisfaction, and preliminary efficacy of a novel balance training program for cancer survivors: partnered, Adapted Argentine Tango dance (Tango). Methods Twenty-two individuals participated (n = 22). Tango classes (1 h) were offered twice/week. At baseline, midpoint (8 classes), and conclusion of the training (15 or 16 classes), we assessed postural control by measuring center-of-pressure (CoP) measures during quiet standing with eyes closed. We also documented attendance, barriers to attendance, and satisfaction (7 point scale; 1 high). At conclusion, we analyzed whether 1) attendance and satisfaction met feasibility criteria; 2) postural control improved among participants who were outside of normal range at baseline; and 3) co-enrolling with a companion increased attendance. Findings Feasibility criteria were met: more than half of participants attended more than half the classes offered with a mean satisfaction rate of 1.2 (SD 0.4). Those who enrolled with a companion (n = 9) attended more sessions than those who did not (n = 13) (Mann-Whitney U value = 20; p = 0.012). Participants with demonstrated deficits (n = 9) improved in 3 CoP measures at midpoint (i.e., medial-lateral sway, ellipse area, medial-lateral velocity), retaining improvement in 2 CoP measures at endpoint (i.e., medial-lateral sway, ellipse area). Interpretation Partnered, Adapted Argentine Tango is feasible for cancer survivors and may improve postural control. Enrolling with a companion improved attendance.