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Context: The Y-Balance Test Lower Quarter (YBT-LQ) is a widely utilized tool for evaluating dynamic postural control, requiring a combination of mobility and strength. This study aimed to investigate the combined relationship between isometric thigh muscle strength and joint kinematics on YBT-LQ performance. Design: Cross-sectional laboratory study. Methods: Isometric quadriceps and hamstrings strength were measured before the YBT-LQ in 39 healthy participants (27 females and 12 males). The test was performed under 3-dimensional markerless motion capture, where joint kinematics were extracted from the maximum reach position from each direction. Three multivariable linear regression models were then used to determine the strongest combination of predictors for YBT-LQ performance. Results: Greater hamstrings strength and increased knee flexion, ankle dorsiflexion, and trunk ipsilateral-flexion joint angles explained 56.8% (P <.001) of the variance in anterior reach. Hip flexion, knee flexion, and ankle dorsiflexion angles were the strongest predictors for posteromedial reach distance, explaining 73.0% of the variance (P <.001). Last, 43.3% (P <.001) of the variance in posterolateral reach distance was predicted by hamstring strength and knee-flexion angle. Conclusions: These results emphasize the importance of hamstring strength in YBT-LQ performance across different reach directions. Additionally, the kinematics illustrate a potential movement strategy for maximizing reach distance on the YBT-LQ in healthy individuals. Clinicians can utilize this information to guide interventions aimed at improving dynamic postural control, particularly by focusing on increasing hamstring strength and testing for impairments in specific movement patterns. [ABSTRACT FROM AUTHOR]

BACKGROUND: Studies have shown that poor dynamic postural control may lead to abnormal movement patterns during exercise, which may increase the risk of lower limb joint and anterior cruciate ligament injury. The stability of the body core is the basis of good dynamic postural control. OBJECTIVE: To investigate the effects of core stability training on dynamic postural control and risk of injury in landing movements, and to compare the differences in training effects between genders. METHODS: Thirty-five college students (male=19, female=16) were recruited for 6 weeks of core stability training. The results of the Y balance test, trunk extensor endurance test, trunk flexor endurance test, lateral bridge endurance test, and landing error scoring system were analyzed before and after training. RESULTS AND CONCLUSION: The 6-week core stability training could improve trunk extensor endurance (P < 0.001), flexor endurance (P < 0.001), and lateral abdominal muscle endurance (P < 0.001). Core stability training could improve forward distance (P=0.026), backward inward distance (P < 0.001), backward outward distance (P=0.005) and comprehensive score (P < 0.001) of Y balance test for male and female college students. Landing error scoring system scoresof both male and female college students significantly decreased after 6 weeks of core stability training (P < 0.001) while increasing knee (P < 0.001) and hip flexion angles (P < 0.001), decreasing knee valgus angle (P < 0.001) at the moment of touchdown, and could increase the maximum knee flexion angle (P < 0.001) and decrease the maximum knee valgus angle (P < 0.001). It is concluded that core stability training improves dynamic postural control and improves landing movement patterns, suggesting that it may help reduce the risk of anterior cruciate ligament injury. There are no sex differences in core stability training in terms of increased trunk flexor endurance, lateral bridge muscle group endurance, improved dynamic postural control, and reduced risk of anterior cruciate ligament injury. [ABSTRACT FROM AUTHOR]

Normal ankle function provides a key contribution to everyday activities, particularly step/stair ascent and descent, where many falls occur. The rising to up-on-the-toes (UTT) 30 second test (UTT-30) is used in the clinical assessment of ankle muscle strength/function and endurance and is typically assessed by an observer counting the UTT movement completed. The aims of this study are: (i) to determine whether inertial measurement units (IMUs) provide valid assessment of the UTT-30 by comparing IMU-derived metrics with those from a force-platform (FP), and (ii) to describe how IMUs can be used to provide valid assessment of the movement dynamics/stability when performing a single UTT movement that is held for 5 s (UTT-stand). Twenty adults (26.2 ± 7.7 years) performed a UTT-30 and a UTT-stand on a force-platform with IMUs attached to each foot and the lumbar spine. We evaluate the agreement/association between IMU measures and measures determined from the FP. For UTT-30, IMU analysis of peaks in plantarflexion velocity and in FP’s centre of pressure (CoP) velocity was used to identify each repeated UTT movement and provided an objective means to discount any UTT movements that were not completed ‘fully’. UTT movements that were deemed to have not been completed ‘fully’ were those that yielded peak plantarflexion and CoP velocity values during the period of rising to up-on-the-toes that were below 1 SD of each participant’s mean peak rising velocity across their repeated UTT. The number of UTT movements detected by the IMU approach (23.5) agreed with the number determined by the FP (23.6), and each approach determined the same number of ‘fully’ completed movements (IMU, 19.9; FP, 19.7). For UTT-stand, IMU-derived movement dynamics/postural stability were moderately-to-strongly correlated with measures derived from the FP. Our findings highlight that the use of IMUs can provide valid assessment of UTT test(s).

Background The Y-Balance Test (YBT), especially the posteromedial (PM) reach direction (PM-YBT), is able to identify dynamic postural control deficits in those who have ankle instability. However, there still exists a need to understand how sensorimotor function at the ankle explains the performance during the PM-YBT. Hypothesis/Purpose The purpose of this study was to determine whether the ability to accurately control eccentric ankle torque explained PM-YBT performance. It was hypothesized that eccentric dorsiflexion/plantarflexion torque control would be positively related to the maximum reach distance (MRD) of PM-YBT. Study Design Cross-sectional study Methods Twelve healthy subjects performed the PM-YBT, maximum voluntary isometric contractions (MVIC) for both dorsiflexion and plantarflexion muscle strength, and then the torque control testing of the ankle. The torque control testing provided a target torque level on a screen in front of the subject and passive rotations of the ankle joint in the sagittal plane at 10 deg/sec between plantarflexion to dorsiflexion. Subjects were then instructed to eccentrically contract the dorsiflexors and plantar flexors to generate torque while the ankle joint rotated. The accuracy of torque control during eccentric dorsiflexion and plantarflexion by calculating absolute errors, the area between the target torque and the produced torque were evaluated. Tibialis anterior and soleus muscle activities were simultaneously recorded during testing. A step-wise linear regression model was used to determine the best model predicted the MRD of the PM-YBT (PM-MRD). Results A step-wise linear regression developed a model explaining only eccentric dorsiflexion torque control predicted higher PM-MRD score (R² = 44%, F1,10 = 7.94, β = -0.67, p = 0.02). Conclusion The accuracy of torque control during eccentric dorsiflexion predicts better performance in the PM-YBT. [ABSTRACT FROM AUTHOR]

Normal ankle function provides a key contribution to everyday activities, particularly step/stair ascent and descent, where many falls occur. The rising to up-on-the-toes (UTT) 30 second test (UTT-30) is used in the clinical assessment of ankle muscle strength/function and endurance and is typically assessed by an observer counting the UTT movement completed. The aims of this study are: (i) to determine whether inertial measurement units (IMUs) provide valid assessment of the UTT-30 by comparing IMU-derived metrics with those from a force-platform (FP), and (ii) to describe how IMUs can be used to provide valid assessment of the movement dynamics/stability when performing a single UTT movement that is held for 5 s (UTT-stand). Twenty adults (26.2 ± 7.7 years) performed a UTT-30 and a UTT-stand on a force-platform with IMUs attached to each foot and the lumbar spine. We evaluate the agreement/association between IMU measures and measures determined from the FP. For UTT-30, IMU analysis of peaks in plantarflexion velocity and in FP's centre of pressure (CoP) velocity was used to identify each repeated UTT movement and provided an objective means to discount any UTT movements that were not completed 'fully'. UTT movements that were deemed to have not been completed 'fully' were those that yielded peak plantarflexion and CoP velocity values during the period of rising to up-on-the-toes that were below 1 SD of each participant's mean peak rising velocity across their repeated UTT. The number of UTT movements detected by the IMU approach (23.5) agreed with the number determined by the FP (23.6), and each approach determined the same number of 'fully' completed movements (IMU, 19.9; FP, 19.7). For UTT-stand, IMU-derived movement dynamics/postural stability were moderately-to-strongly correlated with measures derived from the FP. Our findings highlight that the use of IMUs can provide valid assessment of UTT test(s). [ABSTRACT FROM AUTHOR]

This study aims to assess the mechanical and functional effects of the arthroscopic modified Broström procedure (AMBP) on patients with lateral ankle instability. Eight patients with unilateral ankle instability treated with AMBP and eight healthy subjects were recruited. Healthy subjects, preoperative and one-year postoperative patients were assessed using outcome scales and the Star Excursion Balance Test (SEBT) for dynamic postural control. One-dimensional statistical parametric mapping was performed to compare ankle angle and muscle activation curve during stair descent. The patients with lateral ankle instability showed good clinical outcomes and increased posterior lateral reach during the SEBT after the AMBP (p = 0.046). The medial gastrocnemius activation after initial contact was reduced (p = 0.049), and the peroneal longus activation after initial contact was promoted (p = 0.014). The AMBP has functional effects of promoting dynamic postural control and peroneal longus activation within one year of follow-up, which can benefit patients with functional ankle instability. However, the medial gastrocnemius activation was unexpectedly reduced post operation. [ABSTRACT FROM AUTHOR]

The rules governing mountain running force athletes to implement into their training programmes uphill and downhill running on unstable surfaces, which are demanding for hip and ankle as well as for the postural control system. The aim of the present cross-sectional study was to compare highly trained mountain runners (MR) and recreational active non-runners (NR) on range of motion (ROM) and strength in the hip and ankle, as well as dynamic postural control. Thirty MR and thirty-two NR were included in the study. ROM was assessed using a digital inclinometer. Strength was measured using a hand-held dynamometer. Postural control was evaluated using the lower quarter Y-balance test (YBT-LQ). The results showed that MR, in relation to NR, had statistically significant smaller hip external rotation ROM (p = 0.007), lower hip external rotator (p = 0.006) and extensor (p = 0.023) strength and greater normalised anterior reach in the YBT-LQ (p = 0.028). Mountain running training may reduce hip external rotation ROM as well as hip external rotator and extensor strength. Moreover, such training may improve postural control. MR should implement exercises targeted at developing hip ROM and strength. Furthermore, it seems that mountain running training may be a good way to improve postural control. [ABSTRACT FROM AUTHOR]

While the general reliability of the Y balance test has been previously found to be excellent, earlier reviews highlighted a need for a more consistent methodology between studies. The purpose of this test–retest intrarater reliability study was to assess the intrarater reliability of the YBT using different methodologies regarding normalisation for leg length, number of repetitions, and score calculation. Sixteen healthy adult novice recreational runners aged 18–55 years, both women and men, were reviewed in a laboratory environment. Mean calculated scores, intraclass correlation coefficient, standard error of measurement, and minimal detectable change were calculated and analysed between different leg length normalisation and score calculation methods. The number of repetitions needed to reach a plateauing of results was analysed from the mean proportion of maximal reach per successful repetition. The intrarater reliability of the YBT was found to be good to excellent, and it was not affected by the method of score calculation or leg length measurement. The test results plateaued after the sixth successful repetition. Based on this study, it is suggested to use anterior superior iliac spine–medial malleolus length for leg length normalisation because this method was proposed in the original YBT protocol. At least seven successful repetitions should be performed to reach a result plateau. The average of the best three repetitions should be used to mitigate possible outliers and account for the learning effects seen in this study. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Dorsiflexion range of motion is an important factor in the performance of the Star Excursion Balance Test (SEBT). While patients with chronic ankle instability (CAI) commonly experience decreased reach distances on the SEBT, ankle joint mobilization has been suggested to be an effective therapeutic intervention for targeting dorsiflexion range of motion. Clinical Question: What is the evidence to support ankle joint mobilization for improving performance on the SEBT in patients with CAI? Summary of Key Findings: The literature was searched for articles examining the effects of ankle joint mobilization on scores of the SEBT. A total of 3 peer-reviewed articles were retrieved, 2 prospective individual cohort studies and 1 randomized controlled trial. Only 2 articles demonstrated favorable results following 6 sessions of ankle joint mobilization. Clinical Bottom Line: Despite the mixed results, the majority of the available evidence suggests that ankle joint mobilization improves dynamic postural control. Strength of Recommendation: In accordance with the Centre of Evidence Based Medicine, the inconsistent results and the limited high-quality studies indicate that there is level C evidence to support the use of ankle joint mobilization to improve performance on the SEBT in patients with CAI. [ABSTRACT FROM AUTHOR]

Background: The application of wearable sensor technology in an exercise intervention provides a new method for the standardization and accuracy of intervention. Considering that the deterioration of musculoskeletal conditions is of serious concern in patients with neurodegenerative diseases, it is worthwhile to clarify the effect of wearable sensor-based exercise on musculoskeletal disorders in such patients compared with traditional exercise. Methods: Five health science-related databases, including PubMed, Cochrane Library, Embase, Web of Science, and Ebsco Cumulative Index to Nursing and Allied Health, were systematically searched. The protocol number of the study is PROSPERO CRD42022319763. Randomized controlled trials (RCTs) that were published up to March 2022 and written in English were included. Balance was the primary outcome measure, comprising questionnaires on postural stability and computerized dynamic posturography. The secondary outcome measures are motor symptoms, mobility ability, functional gait abilities, fall-associated self-efficacy, and adverse events. Stata version 16.0 was used for statistical analysis, and the weighted mean difference (WMD) was selected as the effect size with a 95% confidence interval (CI). Results: Fifteen RCTs involving 488 participants with mean ages ranging from 58.6 to 81.6 years were included in this review, with 14 of them being pooled in a quantitative meta-analysis. Only five included studies showed a low risk of bias. The Berg balance scale (BBS) was used in nine studies, and the pooled data showed a significant improvement in the wearable sensor-based exercise group compared with the traditional exercise group after 3-12-week intervention (WMD = 1.43; 95% CI, 0.50 to 2.36, P = 0.003). A significant change in visual score was found both postassessment and at 1-month follow-up assessment (WMD = 4.38; 95% CI, 1.69 to 7.07, P = 0.001; I2 = 0.0%). However, no significant differences were found between the two groups in the secondary outcome measures (all p > 0.05). No major adverse events were reported. Conclusion: The wearable sensor-based exercise had advantages in improving balance in patients with neurodegenerative diseases, while there was a lack of evidence in motor symptoms, mobility, and functional gait ability enhancement. Future studies are recommended to construct a comprehensive rehabilitation treatment system for the improvement in both postural control and quality of life. [ABSTRACT FROM AUTHOR]

While the general reliability of the Y balance test has been previously found to be excellent, earlier reviews highlighted a need for a more consistent methodology between studies. The purpose of this test–retest intrarater reliability study was to assess the intrarater reliability of the YBT using different methodologies regarding normalisation for leg length, number of repetitions, and score calculation. Sixteen healthy adult novice recreational runners aged 18–55 years, both women and men, were reviewed in a laboratory environment. Mean calculated scores, intraclass correlation coefficient, standard error of measurement, and minimal detectable change were calculated and analysed between different leg length normalisation and score calculation methods. The number of repetitions needed to reach a plateauing of results was analysed from the mean proportion of maximal reach per successful repetition. The intrarater reliability of the YBT was found to be good to excellent, and it was not affected by the method of score calculation or leg length measurement. The test results plateaued after the sixth successful repetition. Based on this study, it is suggested to use anterior superior iliac spine–medial malleolus length for leg length normalisation because this method was proposed in the original YBT protocol. At least seven successful repetitions should be performed to reach a result plateau. The average of the best three repetitions should be used to mitigate possible outliers and account for the learning effects seen in this study.

BACKGROUND: It is important for clinicians and researchers to perform dynamic postural control evaluation for predicting musculoskeletal conditions, injury prevention, and rehabilitation. OBJECTIVE: The purpose of this study was to investigate the relationship (1) between the eccentric strength of the knee extensors and star excursion balance test (SEBT), and (2) between the knee proprioception and SEBT. METHODS: Forty healthy young adults participated in this study. The eccentric peak torque (EPT) of the knee extensors, joint position sense, and force sense were measured. The participants also performed SEBT. Pearson's product-moment correlation and multiple linear regression analysis were used to determine the relationship between the variables and SEBT. RESULTS: The posteromedial direction of the SEBT was positively and strongly correlated with EPT (r = 0.74, P < 0.01). The anterior and posterolateral directions were positively and moderately correlated with EPT (r = 0.46, P < 0.01, and r = 0.69, P < 0.01, respectively.). However, knee proprioception was not correlated with all the directions of SEBT (P > 0.05). According to the results of multiple linear regression analysis, EPT of the knee extensors significantly predicted SEBT reach distances. CONCLUSION: The eccentric strength of the knee extensors seems to be an essential factor in dynamic postural control. However, the knee proprioception did not show a significant correlation with SEBT. [ABSTRACT FROM AUTHOR]

Background: Individuals with chronic ankle instability (CAI) have known balance impairments thought to be the result of an inability to reweight sensory information. CAI patients place greater emphasis on visual information during single-limb stance than healthy controls but this evidence is based on removing visual information during static conditions.Research Question: Does perturbed optical flow effect step kinematics and variability in those with CAI differently than healthy controls? What is the relationship among ankle laxity, plantar cutaneous sensation, and susceptibility to perturbed optical flow in those with CAI?Methods: 17 CAI patients and 17 healthy individuals participated in a crossover experimental study. Participants walked on a treadmill at 1.25 m/s while watching a speed-matched virtual hallway with and without continuous mediolateral (ML) optical flow perturbations. Three-dimensional pelvic and foot kinematics were recorded at 100 Hz for at least 300 consecutive steps in each condition. Step width (SW) and step length (SL) values were calculated from consecutive heel positions. Gait variability was characterized as the standard deviation of step width (SWV), step length (SLV), and ML sacrum motion (SMV) across all steps performed in each condition.Results: The CAI group exhibited a greater change in SWV (p = 0.037), SLV (p = 0.040), and ML SMV (p = 0.047) from the perturbed to unperturbed conditions relative to the healthy controls. A condition main effect was also noted for SW (p < 0.001) and SL (p < 0.001) as ML optical flow perturbations resulted in significant changes in SW and SL relative to the normal walking condition.Significance: Walking with ML optical flow perturbations induced greater variability changes in those with CAI relative to controls. When combined with the existing literature, this finding suggests that CAI individuals have a greater reliance on visual information in both static and dynamic (i.e. walking gait) conditions relative to healthy individuals. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop and evaluate a drop-and-stick (DS) test method and to assess dynamic postural control in senior elite (SE), junior elite (JE), and junior development (JD) surfers. Nine SE, 22 JE, and 17 JD competitive surfers participated in a single testing session. The athletes completed 5 drop-and-stick trials barefoot from a predetermined box height (0.5 m). The lowest and highest time-to-stabilization (TTS) trials were discarded, and the average of the remaining trials was used for analysis. The SE group demonstrated excellent single-measures repeatability (ICC = .90) for TTS, whereas the JE and JD demonstrated good single-measures repeatability (ICC .82 and .88, respectively). In regard to relative peak landing force (rPLF), SE demonstrated poor single-measures reliability compared with JE and JD groups. Furthermore, TTS for the SE (0.69 ± 0.13 s) group was significantly (P = .04) lower than the JD (0.85 ± 0.25 s). There were no significant (P = .41) differences in the TTS between SE (0.69 ± 0.13 s) and JE (0.75 ± 0.16 s) groups or between the JE and JD groups (P = .09). rPLF for the SE (2.7 ± 0.4 body mass; BM) group was significantly lower than the JE (3.8 ± 1.3 BM) and JD (4.0 ± 1.1 BM), with no significant (P = .63) difference between the JE and JD groups. A possible benchmark approach for practitioners would be to use TTS and rPLF as a qualitative measure of dynamic postural control using a reference scale to discriminate among groups. [ABSTRACT FROM AUTHOR]

This study explored the fatigue effect on postural control (PC) across menstrual cycle phases (MCPs) in female athletes. Isometric maximal voluntary contraction (IMVC), the center of pressure sway area (CoParea), CoP length in the medio-lateral (CoPLX) and antero-posterior (CoPLY) directions, and Y-balance test (YBT) were assessed before and after a fatiguing exercise during the follicular phase (FP), mid-luteal phase (LP), and premenstrual phase (PMP). Baseline normalized reach distances (NRDs) for the YBT were lower (p = 0.00) in the PMP compared to others MCPs, but the IMVC, CoParea, CoPLX, and CoPLY remained unchanged. After exercise, the IMVC and the NRD decrease was higher at PMP compared to FP (p = 0.00) and LP (p = 0.00). The CoParea, CoPLX, and CoPLY increase was higher in the PMP compared to FP (p = 0.00) and LP (p = 0.00). It was concluded that there is an accentuated PC impairment after exercise observed at PMP.

Muscular fatigue can affect postural control processes by impacting on the neuromuscular and somatosensory system. It is assumed that this leads to an increased risk of injury, especially in sports such as alpine skiing that expose the body to strong and rapidly changing external forces. In this context, posture constraints and contraction-related muscular pressure may lead to muscular deoxygenation. This study investigates whether these constraints and pressure affect static and dynamic postural control. To simulate impaired blood flow in sports within a laboratory task, oxygen saturation was manipulated locally by using an inflatable cuff to induce blood flow restriction (BFR). Twenty-three subjects were asked to stand on a perturbatable platform used to assess postural-related movements. Using a 2 × 2 within-subject design, each participant performed postural control tasks both with and without BFR. BFR resulted in lower oxygenation of the m. quadriceps femoris (p = 0.024) and was associated with a significantly lower time to exhaustion (TTE) compared to the non-restricted condition [F(1,19) = 16.22, p < 0.001, ηp2 = 0.46]. Perturbation resulted in a significantly increased TTE [F(1,19) = 7.28, p = 0.014, ηp2 = 0.277]. There were no significant effects on static and dynamic postural control within the saturation conditions. The present data indicate that BFR conditions leads to deoxygenation and a reduced TTE. Postural control and the ability to regain stability after perturbation were not affected within this investigation.

Muscular fatigue can affect postural control processes by impacting on the neuromuscular and somatosensory system. It is assumed that this leads to an increased risk of injury, especially in sports such as alpine skiing that expose the body to strong and rapidly changing external forces. In this context, posture constraints and contraction-related muscular pressure may lead to muscular deoxygenation. This study investigates whether these constraints and pressure affect static and dynamic postural control. To simulate impaired blood flow in sports within a laboratory task, oxygen saturation was manipulated locally by using an inflatable cuff to induce blood flow restriction (BFR). Twenty-three subjects were asked to stand on a perturbatable platform used to assess postural-related movements. Using a 2 × 2 within-subject design, each participant performed postural control tasks both with and without BFR. BFR resulted in lower oxygenation of the m. quadriceps femoris (p = 0.024) and was associated with a significantly lower time to exhaustion (TTE) compared to the non-restricted condition [ F (1,19) = 16.22, p < 0.001, η p 2 = 0.46]. Perturbation resulted in a significantly increased TTE [ F (1,19) = 7.28, p = 0.014, η p 2 = 0.277]. There were no significant effects on static and dynamic postural control within the saturation conditions. The present data indicate that BFR conditions leads to deoxygenation and a reduced TTE. Postural control and the ability to regain stability after perturbation were not affected within this investigation. [ABSTRACT FROM AUTHOR]

This study explored the fatigue effect on postural control (PC) across menstrual cycle phases (MCPs) in female athletes. Isometric maximal voluntary contraction (IMVC), the center of pressure sway area (CoParea), CoP length in the medio-lateral (CoPLX) and antero-posterior (CoPLY) directions, and Y-balance test (YBT) were assessed before and after a fatiguing exercise during the follicular phase (FP), mid-luteal phase (LP), and premenstrual phase (PMP). Baseline normalized reach distances (NRDs) for the YBT were lower (p = 0.00) in the PMP compared to others MCPs, but the IMVC, CoParea, CoPLX, and CoPLY remained unchanged. After exercise, the IMVC and the NRD decrease was higher at PMP compared to FP (p = 0.00) and LP (p = 0.00). The CoParea, CoPLX, and CoPLY increase was higher in the PMP compared to FP (p = 0.00) and LP (p = 0.00). It was concluded that there is an accentuated PC impairment after exercise observed at PMP. [ABSTRACT FROM AUTHOR]

Context: Ankle-dorsiflexion range of motion has often been measured in the weight-bearing condition in the clinical setting; however, little is known about the relationship between the weight-bearing-lunge test (WBLT) and both ankle kinematics and performance on dynamic postural-control tests. Objective: To examine whether ankle kinematics and performance on the Lower Quarter Y-Balance Test (YBT-LQ) are correlated with results of the WBLT using an inclinometer and tape measure. Design: Cross-sectional. Setting: University motionanalysis laboratory. Participants: 30 physically active participants. Interventions: None. Main Outcome Measures: The WBLT was evaluated using an inclinometer and a tape measure. The reach distances in the anterior, posteromedial, and posterolateral directions on the YBT-LQ were normalized by limb length. Ankle dorsiflexion during the YBT-LQ was recorded using a 3-dimensional motion-analysis system. Simple linear regression was used to examine the relationship between the WBLT results and both ankle dorsiflexion and the normalized reach distance in each direction on the YBT-LQ. Results: The WBLT results were significantly correlated with ankle dorsiflexion in all directions on the YBT-LQ (P < .05). A strong correlation was found between the inclinometer measurement of the WBLT and ankle dorsiflexion (r = .74, r2 = .55), whereas the tape-measure results on the WBLT were moderately correlated with ankle dorsiflexion (r = .64, r2 = .40) during the anterior reach on the YBT-LQ. Only the normalized anterior reach distance was significantly correlated with the results for the inclinometer (r = .68, r2 = .46) and the tape measure (r = .64, r2 = .41) on the WBLT. Conclusions: Inclinometer measurements on the WBLT can be an appropriate tool for predicting the amount of ankle dorsiflexion during the YBT-LQ. Furthermore, WBLT should be measured in those who demonstrate poor dynamic balance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate whether low-handicap elite golfers with chronic low back pain (CLBP) exhibit deficits in dynamic postural control and whether CLBP affects golfers in terms of their golf swing parameters. A total of fifteen Division 1 college golfers were recruited as participants. Of these, six of whom experienced CLBP, while the remaining participants were healthy. In this study, CLBP was defined as experiencing chronic pain symptoms for more than six months. The Star Excursion Balance Test (SEBT) was administered to examine dynamic posture control in both groups. The TrackMan Golf Launch Monitor Simulator was used to collect data on the performance parameters of the swing of the participants. The results for both feet in the medial, lateral, posterior, posteromedial, and posterolateral directions indicated that the CLBP group scored lower than the control group. However, the CLBP group scored higher for the right foot in the anterolateral direction. The parameters for the club speed and ball carry of the CLBP group were lower than those of the control group. Further, the CLBP group exhibited a more upright swing plane relative to the control group. Taken together, our findings suggest that SEBT may be feasible and highly accessible to assess golf swing performance of elite players with CLBP. [ABSTRACT FROM AUTHOR]

Knee joint stability is important for postural stability. Abnormal weight distribution is common in individuals with unilateral osteoarthritis of knee (OA knee) as compensatory mechanism for pain and joint malalignments. Various forms of conventional physiotherapy interventions have been used to prevent further degenerative process. Star excursion balance test (SEBT) has been invented to assess dynamic postural stability. This present study was aimed to investigate effects of SEBT as a postural control exercise training tool (SEBTx) in persons with unilateral OA knee. Fourteen participants were randomly assigned to control group (n = 7) and SEBTx group (n = 7). The control group received weekly routine physiotherapy interventions (joint mobilization, ultrasound therapy, transcutaneous electrical nerve stimulation, and taping). In addition to the routine interventions, the SEBTxgroup was instructed to perform SEBTxfor 30 min/session, 3 sessions/ week, for 4 weeks. Primary outcome (weight distributionon posturography in 8 directions -- anterior, Rt. anterolateral, Rt.lateral, Rt. posterolateral, posterior, Lt. posterolateral, Lt. lateral, Lt. anterolateral)was measured at baseline and4 weeks post-intervention. Secondary outcomes numeric pain rating scale (NPRS) and Timed Up and Go test (TUG) were used to assess pain and dynamic balance, respectively. Results showed that weight distribution in SEBTx group significantly improved in the Lt. posterolateral and posterior directions post-intervention. Moreover, NPRS in SEBTx group significantly reduced from 47.9±7.4 to 33.3±6.0. Lastly, TUG significantly reduced from 13.5±0.9 to 11.5±0.7 s in SEBTx group. In conclusion, the SEBTx should be applied to improve postural balance in individuals with unilateral (OA knee). [ABSTRACT FROM AUTHOR]

Abstract Background Agonist and antagonist muscle co-contractions during motor tasks are greater in the elderly than in young adults. During normal walking, muscle co-contraction increases with gait speed in young adults, but not in elderly adults. However, no study has compared the effects of speed on muscle co-contraction of the ankle joint during dynamic postural control in young and elderly adults. We compared muscle co-contractions of the ankle joint between young and elderly subjects during a functional stability boundary test at different speeds. Methods Fifteen young adults and 16 community-dwelling elderly adults participated in this study. The task was functional stability boundary tests at different speeds (preferred and fast). Electromyographic evaluations of the tibialis anterior and soleus were recorded. The muscle co-contraction was evaluated using the co-contraction index (CI). Results There were no statistically significant differences in the postural sway parameters between the two age groups. Elderly subjects showed larger CI in both speed conditions than did the young subjects. CI was higher in the fast speed condition than in the preferred speed condition in the young subjects, but there was no difference in the elderly subjects. Moreover, after dividing the analytical range into phases (acceleration and deceleration phases), the CI was larger in the deceleration phase than in the acceleration phase in both groups, except for the young subjects in the fast speed conditions. Conclusions Our results showed a greater muscle co-contraction of the ankle joint during dynamic postural control in elderly subjects than in young subjects not only in the preferred speed condition but also in the fast speed condition. In addition, the young subjects showed increased muscle co-contraction in the fast speed condition compared with that in the preferred speed condition; however, the elderly subjects showed no significant difference in muscle co-contraction between the two speed conditions. This indicates that fast movements cause different influences on dynamic postural control in elderly people, particularly from the point of view of muscle activation. These findings highlight the differences in the speed effects on muscle co-contraction of the ankle joint during dynamic postural control between the two age groups.

Maintaining dynamic postural control is essential for netball players as they frequently find themselves on one leg having to make a precise pass. Evaluation of the physical profile of elite university netball players found poor balance during preseason. The research aimed to determine if a six-week exercise programme incorporating core stability, m. gluteus medius strengthening and proprioceptive balance exercises would lead to improvement in dynamic postural control in netball players. A crossover randomised clinical trial was performed on nineteen all-female university level netball players. The 19 participants were randomly divided into two groups. Group A (n=8) participated in the exercise programme three times a week for six weeks, while Group B (n=8) acted as the control group after which roles were reversed. Participants were assessed at baseline, after six and 12 weeks using the Star Excursion Balance Test. A statistically significant improvement (p<0.05) was found in dynamic postural control across three reach directions (anterior, medial and posterior) post participation in the exercise programme. A programme incorporating core stability, m. gluteus medius and proprioceptive balance exercises could be beneficial for improving dynamic postural control in all-female university level netball players. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that orthotic intervention can alter dynamic balance in elderly people. This study compared the effect of textured and prefabricated insoles on dynamic postural control in older adults. Methods: Thirty elderly people were tested with prefabricated and textured insoles in combination with medical and sports shoes. Reach distance of participants was measured in anteromedial, medial, and posteromedial directions of the Star Excursion Balance Test. Results: Significant footwear-dependent differences were seen in all reach directions. The reach distance was longer for barefoot than for other conditions in the 3 evaluated directions (P < .015). Conclusions: The use of prefabricated and textured insoles with 2 different shoes significantly reduced reach distance compared with when barefoot. [ABSTRACT FROM AUTHOR]

To present a case of a right-handed professional tennis player with a left internal abdominal oblique muscle tear sustained while serving. We document the progress of a rehabilitation program consisting of primarily kinetic chain isokinetic strength training where symmetrical measurements (<10% side difference) of force and dynamic postural control were used as criteria for return to sport. Isokinetic exercises (bilateral rotational pull, unilateral vertical press and unilateral anterior push) to target trunk specific demands of the serve (flexion, rotation and lateral flexion) were done using robotic resistance. Dynamic postural control was assessed using the hand reach star excursion balance test (HSEBT). The rehabilitation program lasted 3.5 weeks (eight sessions). At baseline isokinetic strength tests that imposed concentric muscle function demands of the injured muscle had lower force measurements (range: -32.1 to −71.9%). These force measurements improved (range: 166.1–296.5%) and were symmetrical (range: +1.6 to +7.3%) on return to sport. In addition, the HSEBT test with the greatest asymmetry (−20 cm) improved to symmetrical (+2 cm) on return to sport. Symmetrical isokinetic force and dynamic postural control measurements were successful return to sport criteria as the player since has remained pain free (2 years). [ABSTRACT FROM AUTHOR]

This cohort study aimed to provide normative Y Balance Test scores for an elite Rugby Union population, while investigating the effect player age groups (senior/under-20), playing positions (forwards/backs) and anthropometrics (height and body mass) had on performance. Two-hundred and sixty-one elite male under-20 (n = 50) and senior (n = 211) players completed baseline Y Balance Test during the 2015/2016 season. One-way ANCOVA and post-hoc t-tests were used to investigate the effect playing position, player group, height and weight had on performance. The cohort was then stratified into groups (age group and/or playing position), and normative percentiles were presented. There was a statistically significant difference (p < 0.05) in Y Balance Test performance between playing positions, when controlling for age group. This difference did not remain when controlling for player body mass. Post-hoc analysis demonstrated that backs had a longer normalised reach distance, with medium-large and small-medium effect sizes for the under-20 and senior cohorts respectively. The one-way ANCOVA analysis suggests that this difference is likely due to the larger differences in player body mass between forward and back playing positions. The normative values presented in this paper may be used by clinicians and researchers to aid injury prevention and rehabilitation strategies. [ABSTRACT FROM AUTHOR]

In Parkour activity, the aim is to move from one place to another as quickly and efficiently as possible by running, climbing, swinging, vaulting, rolling, crawling and jumping on tiny obstacles ... . Performing these actions places a great demand on the postural control system. The purpose of the present study was to investigate postural control of Parkour practitioners - called Traceurs - compared to recreationally active (RA) subjects in different postural conditions after manipulating the visual and/or proprioceptive sensory inputs. Ten Traceurs (mean experience 5.9 ± 0.9 years; >5 hours per week) and 10 RA subjects participated in this study. We measured the centre of pressure area (CoPA) of the upright standing bipedal and unipedal postures in different postural conditions: on a firm and on a foam surfaces; on an oscillating surface in the sagittal plane and in the frontal plane in eyes open and eyes closed. To evaluate vision contribution, the Romberg index (RI) was calculated. Results showed that Traceurs presented a significant (P < .001) lower CoPA values compared to RA subjects in eyes closed condition, suggesting that they were able to maintain a better balance control when vision is removed. Traceurs seems to be less dependent on visual cues (lower RI values) and proprioceptive inputs for maintaining balance than RA subjects. According to our study, Parkour training (experience for at least five years with a minimum of five hours per week) may improve postural abilities of young adult practitioners in specific postural conditions. [ABSTRACT FROM AUTHOR]

A fall during walking is a common problem in diabetic patients due to neuromuscular complications of the foot, especially intrinsic foot muscles (IFMs). Short-foot exercise (SFE) has been reported to strengthen IFMs in healthy individuals. This present study was aimed to investigate effects of SFE on medial longitudinal arch integrity (navicular drop test, NDT) and dynamic postural control (star excursion balance test, SEBT). The SEBT values were measured on single-leg standing in 8 directions (anterior, anteromedial, medial, posteromedial, posterior, posterolateral, lateral, and anterolateral) at baseline, week 4, 8, and 12 (follow up) in 15 diabetic patients: control group (n = 7) and SFE group (n = 8). Results showed that NDT was reduced in SFE group compared to control at week 8 and follow up. The normalized SEBT values in SFE group was significantly higher than baseline only in medial direction and increased from baselines in anteromedial, medial, and posteromedial directions at week 4 and 8, respectively. At the follow-up point, only posteromedial direction showed an improvement of normalized SEBT in SFE group. In conclusion, 8-week SFE reduced foot pronation and improved dynamic postural control in a single-leg standing phase of diabetic foot. The SFE should be continuously applied to diabetic foot since the benefits were not well persistent in the follow-up phase. [ABSTRACT FROM AUTHOR]

Dual-task (DT) paradigms have been used in gait research to assess the automaticity of locomotion, particularly in people with Parkinson’s disease (PD). In people with PD, reliance on cortical control during walking leads to greater interference between cognitive and locomotor tasks. Yet, recent studies have suggested that even healthy gait requires cognitive control, and that these cognitive contributions occur at specific phases of the gait cycle. Here, we examined whether changes in gait stability, elicited by simultaneous cognitive DTs, were specific to certain phases of the gait cycle in people with PD. Phase-dependent local dynamic stability (LDS) was calculated for 95 subjects with PD and 50 healthy control subjects during both single task and DT gait at phases corresponding to (1) heel contact—weight transfer, (2) toe-off—early swing, and (3) single-support—mid swing. PD-related DT interference was evident only for the duration of late swing and LDS during the heel contact—weight transfer phase of gait. No PD-related DT costs were found in other traditional spatiotemporal gait parameters. These results suggest that PD-related DT interference occurs only during times where cortical activity is needed for planning and postural adjustments. These results challenge our understanding of DT costs while walking, particularly in people with PD, and encourage researchers to re-evaluate traditional concepts of DT interference.

The relationship between dynamic postural control, functional mobility and team handball throwing performance, velocity and accuracy, is largely unknown. The hand reach star excursion balance test (HSEBT) is a full kinetic chain assessment tool of these factors. Specifically, L135 and R135 (extension) reaches elicit joint movement combinations similar to the cocking and acceleration phase, while the L45 and R45 (flexion) reaches elicit joint movement combinations similar to the follow-through. The purpose of this study was to determine if specific HSEBT reach measures correlate with team handball throwing performance. Eleven elite female team handball players (21.7 ± 1.8 years; 71.3 ± 9.6 kg; 1.75 ± 0.07 m) executed selected HSEBT reaches before performing five valid step-up overhead throws (1x1m target) from which throwing velocity (motion capture) and accuracy (mean radial error) were quantified. Significant relationships between HSEBT measures and mean radial error, but not throwing velocity were established. Specifically, extension composite scores (L135+R135) for the dominant (150.7 ± 17.4cm) and nondominant foot (148.1 ± 17.5 cm) were correlated with mean radial error (p < 0.05). Also, specific reaches on the dominant (L135: 87.4 ± 5.6 cm; R135: 63.4 ± 11.8 cm) and non-dominant (R135: 87.0 ± 6.1 cm) foot were correlated with throwing error (p < 0.05). The lack of significant findings to throwing velocity might be due to a ceiling effect of both L135 and R135 and of throwing velocity. We conclude that while there may be other reasons for handball players to train and test functional mobility and dynamic postural control as measured in the HSEBT, no beneficial effect on throwing performance should be expected in an elite group of handball players. [ABSTRACT FROM AUTHOR]

Background and Objective: Some individuals, copers, despite of an acute lateral ankle sprain could return to high-level physical activities, without development of functional ankle instability (FAI). Study about differences between copers and FAI groups results in identify factors that cause FAI. The aim of this study was to compare the effect of cognitive demands on dynami postural control in FAI, copers and uninjured heathy controls. Subjects and Methods: Forty two individuals in three groups with FAI, copers and uninjured healthy controls participated in this study. Dynamic postural stability with and without cognitive demands, was assessed. Repeated measure ANOVA was used to determine possible significant interactions for the 2 factors. Results: Interaction of group by cognitive difficulty was significant for overal stability index (OSI) (P<0.001) and mediolateral stability index (MLSI) (P=0.005). A significant increase in OSI and MLSI observed in FAI group during dual task compared to the single task performance (P<0.05). However, a significant decrease in OSI was demonstrated in copers during dual task condition (P=0.004). Conclusion: The results showed that concurrent performance of cognitive task could affect postural control after first lateral ankle sprain. Responses to cognitive perturbations can be considered as an important factor to identify adaptation mechanisms in copers and distinguish between copers and FAI groups. [ABSTRACT FROM AUTHOR]

Introduction: The objectives of this study were to compare muscle activation time and dynamic postural variables in athletes with and without chronic ankle instability during jump-landing, followed by a choice reaction time task which was provided by the visual stimulus. Methods: Nineteen athletes [11 healthy athletes and 8 athletes with chronic ankle instability (CAI)] participated in this cross-sectional study. After informing them about the procedure and goals of the study, they started jump-landing protocol in response to the visual stimulus. Muscle activation time and dynamic postural control data were taken using an electromyographic (EMG) machine and force plate, respectively. Results: The results of the two-way repeated measurement analysis of variance (ANOVA) showed that there were significant differences in athletes with and without CAI for medial/lateral stability index (MLSI; tested leg effect: p=0.006); the pre-motor time of the gastroc-soleus, peroneus longus, and peroneus brevis (interaction effects of the tested leg and the tested group: p=0.001, p=0.015 and p=0.006, respectively) and the pre-motor time of the tibialis anterior (tested group effect: p=0.036). Conclusion: More attention should be on the muscle activation time because changes in this parameter may be one of the preliminary risk factors for instability, although cohort studies are required to prove it. A more challenging task with more sensitivity for differentiating between stable and unstable ankle is needed. Level of evidence: IIIb. [ABSTRACT FROM AUTHOR]

Background: A reliable measure of dynamic postural control is needed for inclusion in the sports-related concussion assessment battery. Currently, there is not a clinical gold standard. The Limits of Stability (LOS) test has potential to be a useful tool to collect objective data on important dynamic postural stability variables. Psychometric properties of the LOS test with healthy young adults are yet to be established. Hypothesis/Purpose: The purpose of this study was to examine the intra-session and test-retest reliability for the LOS on the NeuroCom® VSR Sport when performed by young adults. Study Design: Reliability study Methods: Twenty-seven healthy university students completed four trials of the LOS in each of two testing sessions one week apart. Relative reliability was measured within each session with an intraclass correlation coefficient (ICC[3,k]) for Session 1 and Session 2, respectively, on each of the five dependent variables (movement velocity [MVL], directional control [DCL], maximum excursion [MXE], endpoint excursion [EPE], and reaction time [RT]) provided by the Neurocom. Test-retest reliability was assessed using a repeated-measures analysis of variance along with an ICC (3,k) for relative reliability. An ICC value of 0.90 or higher was defined as having a high reliability, moderate reliability for ICC values between 0.80-0.89, and below 0.80 as questionable. Results: The reliability within each session for LOS composite scores for MVL, DCL, and MXE was moderate to high (ICC[3,k]=0.89-0.95). These same three variables also had high levels of test-retest reliability (ICC[3,k]=0.95-0.96). EPE and RT had moderate reliability over time (ICC[3,k]=0.88) but differences for within session reliability. Conclusions: LOS provides a reliable measure of dynamic postural control for young adults. Two trials are recommended at baseline with the first being an adaptation trial to ensure accuracy of findings. Care needs to be taken when interpreting EPE and DCL scores on post-injury tests due to a learning effect for those variables. Level of Evidence: 2c [ABSTRACT FROM AUTHOR]

Dual-task (DT) paradigms have been used in gait research to assess the automaticity of locomotion, particularly in people with Parkinson's disease (PD). In people with PD, reliance on cortical control during walking leads to greater interference between cognitive and locomotor tasks. Yet, recent studies have suggested that even healthy gait requires cognitive control, and that these cognitive contributions occur at specific phases of the gait cycle. Here, we examined whether changes in gait stability, elicited by simultaneous cognitive DTs, were specific to certain phases of the gait cycle in people with PD. Phasedependent local dynamic stability (LDS) was calculated for 95 subjects with PD and 50 healthy control subjects during both single task and DT gait at phases corresponding to (1) heel contact-weight transfer, (2) toe-off-early swing, and (3) single-support-mid swing. PD-related DT interference was evident only for the duration of late swing and LDS during the heel contact-weight transfer phase of gait. No PD-related DT costs were found in other traditional spatiotemporal gait parameters. These results suggest that PD-related DT interference occurs only during times where cortical activity is needed for planning and postural adjustments. These results challenge our understanding of DT costs while walking, particularly in people with PD, and encourage researchers to re-evaluate traditional concepts of DT interference. [ABSTRACT FROM AUTHOR]

Purpose: To determine the more effective ankle brace (lace-up or Aircast ankle brace) at providing dynamic postural control in volleyball players with unstable ankle under functional fatigue conditions. Methods: Subjects of this study participated in 3 separate testing sessions and did not use or used a different brace at each session i.e. no brace (NB), lace-up ankle brace (AB), and Aircast ankle brace (AA). Through each testing sessions the functional fatigue protocol was performed and dynamic postural control test was performed by Biodex Balance System (single leg stability testing in difficulty level 4) after induced functional fatigue. They were 15 volleyball players with at least 3 years playing record in the national and or Kerman Province leagues at youth and teenagers levels (mean age 19.46±1.50 years, mean height 182.53±5.28 cm, mean mass 67.70±5.91 kg, VO2max 52.05±2.97 mL/kg/min) and stratified sampling method was used. All two by two comparisons were performed by using 1-way repeated measures analysis to investigate the effects of different braces. Data analysis was done by SPSS 16 and significance level was P≤0.05. Results: According to the results, both types of ankle brace could improve dynamic postural control under functional fatigue condition. Although lace-up ankle brace was more efficient than Aircast ankle brace, the difference was not statistically significant. Conclusion: In athletes with unstable ankle, a brace can prevent ankle sprain via improving dynamic postural control in fatigue condition.

Objectives: The Y Balance Test is one of the most commonly used dynamic balance assessments, providing an insight into the integration of the sensorimotor subsystems. In recent times, there has been an increase in interest surrounding it's use in various clinical populations demonstrating alterations in motor function. Therefore, it is important to examine the effect physiological influences such as fatigue play in dynamic postural control, and establish a timeframe for its recovery.Design: Descriptive laboratory study.Methods: Twenty male and female (age 23.75±4.79years, height 174.12±8.45cm, mass 69.32±8.76kg) partaking in competitive sport, completed the Y Balance Test protocol at 0, 10 and 20min, prior to a modified 60s Wingate fatiguing protocol. Post-fatigue assessments were then completed at 0, 10 and 20 min post-fatiguing intervention.Results: Intraclass correlation coefficients demonstrated excellent intra-session reliability (0.976-0.982) across the three pre-fatigue YBT tests. Post-hoc paired sample t-tests demonstrated that all three reach directions demonstrated statistically significant differences between pre-fatigue and the first post-fatigue measurement (anterior; p=0.019, posteromedial; p=0.019 & posterolateral; p=0.003). The anterior reach direction returned to pre-fatigue levels within 10min (p=0.632). The posteromedial reach direction returned to pre-fatigue levels within 20min (p=0.236), while the posterolateral direction maintained a statistically significant difference at 20min (p=0.023).Conclusions: Maximal anaerobic fatigue has a negative effect on normalised Y balance test scores in all three directions. Following the fatiguing protocol, dynamic postural control returns to pre-fatigue levels for the anterior (<10min), posteromedial (<20min) and posterolateral (>20min). [ABSTRACT FROM AUTHOR]

Objectives: To examine isometric hip strength in those with and without CAI, and determine the degree of Star Excursion Balance Test (SEBT) variance explained by isometric hip strength.Design: Single-blinded, cross-sectional, case-control study.Methods: Thirty individuals with CAI, 29 lateral ankle sprain (LAS) copers, and 26 healthy controls participated. We assessed dynamic postural control with the SEBT anterior (SEBT-ANT), posteromedial (SEBT-PM), and posterolateral (SEBT-PL) reaches, and isometric hip extension (EXT), abduction (ABD) and external rotation (ER) strength with hand-held dynamometry. The CAI and LAS coper groups' involved limbs and randomly selected limbs in controls were tested. Separate Kruskal-Wallis tests compared SEBT scores and isometric hip strength between groups. Backwards linear regression models determined the degree of SEBT variance explained by isometric hip strength. Statistical significance was set a priori at P<0.05.Results: The CAI group had lower SEBT-ANT scores compared to LAS copers (P=0.03) and controls (P=0.03). The CAI group had lower ABD compared to LAS copers (P=0.03) and controls (P=0.02). The CAI group had lower ER compared to LAS copers (P=0.01) and controls (P=0.01). ER (R2=0.25, P=0.01) and ABD (R2=0.25, P=0.01) explained 25% of the CAI group's SEBT-PM and SEBT-PL variances, respectively.Conclusions: The CAI group had deficient dynamic postural control and isometric hip strength compared to LAS copers and controls. Additionally, the CAI group's isometric hip strength significantly influenced dynamic postural control performance. Future CAI rehabilitation strategies should consider hip muscular strengthening to facilitate improvements in dynamic postural control. [ABSTRACT FROM AUTHOR]

Objective The present study aimed to evaluate the postural control perturbations by the center of pressure parameters in two main approaches, cochlear implant turned “on” and “off”. Methods We included 25 children aged 8–10 years with unilateral cochlear implants and bilateral vestibular hypofunction deficit. To evaluate the postural function, each children was asked to stand on the force plate under 3 different conditions and cochlear implant turned “on” and “off”: Condition (A) double stance from open eyes to closed eyes, Condition (B) double stance with open eyes engaging in the dual task and Condition (C) From double leg stance to one leg stance with open eyes for assessment of dynamic postural control. Also to calculate the center of pressure parameters, we designed new software for the force plate Results In condition A: although the results demonstrated an overall reduction in the mean of center of pressure parameters when the cochlear implant was “on”, only the significant differences were seen in mean and standard deviations for anterior-posterior displacement, mediolateral displacement, area and mean velocity (P =0.00, P=0.04, P=0.02 and P=0.00, respectively) in open eyes In condition B: no significant difference was found between “on” and “off” cochlear implant in single or dual-task situations. In condition C: mean velocity variable demonstrated a significant difference (P=0.00) in the cochlear implant “on” condition in double leg stance only. Also, anterior-posterior displacement demonestrated a significant difference (P=0.00) when the cochlear implant was turned “on” in one leg stance situation. Conclusion The results of our study show that auditory information can improve postural stability and reduce body sways in different situations as an underlying system for reinforcement of the postural control in children without complete normal balance subsystems. [ABSTRACT FROM AUTHOR]

Weight shifting is a key ability to both train and monitor in rehabilitation processes. In the last decade, active video game consoles (AVGC) have been viewed as a promising and appealing way to facilitate weight shifting ability. However, to date, no commercially available AVGC have been specifically developed for balance and postural control throughout rehabilitation processes. The present study aims to establish a proof of concept about the possibility to integrate into a unique AVGC, a board, monitoring the player centre of pressure, and a Kinect, which takes into account the postural movement and player motor function capacity. [ABSTRACT FROM AUTHOR]

Objective: The literature has consistently shown that the Star Excursion Balance Test (SEBT) is a reliable and valid tool to anticipate the risk of lower extremity injury, assess dynamic postural control differences among groups, and assess the effectiveness of balance training programs in both healthy individuals and people with lower extremity injuries. However, there is no standard administration technique for the SEBT in research, clinical practice, or performance settings. Therefore, the purpose of this investigation was to compare six different combinations (3 different foot alignments × 2 hand positions) on the SEBT performance in those with chronic ankle instability (CAI). Design: Repeated Measures Design. Setting: University Research Laboratory. Participants: Twenty-five university students with CAI (12 males, 13 females; age: 20.3 ± 2.4 years, height: 172.7 ± 7.4 cm, weight: 77.5 ± 15.3 kg., BMI: 25.9 ± 4.0 kg/m2) voluntarily participated in the study. Methods: Six different SEBT positions were used to assess dynamic postural control. Three foot positions: 1) Foot centered; 2) Toe fixed; and 3) Toe-heel changing and two hand placements: 1) Hands free and 2) Hands on the hips were used in this study. After 6familiarization trials for each condition, three Star Excursion Balance Test scores were recorded. Main outcome measures: Normalized reach distance (% of leg length) in the anterior, posteromedial, and posterolateral directions as well as a composite reach score quantified dynamic postural control. Results: Both foot alignment and hand position significantly altered normalized SEBT reach distance in the anterior (p < 0.003), posteromedial (p < 0.001), posterolateral (p < 0.001), and composite reach scores (p < 0.001). Conclusion: Different foot alignments and hand constraints significantly altered normalized reach distances and the composite score in individuals with CAI. These results do not suggest that any combination of foot alignments and/or hand constraints is superior. However, changing the toe/heel position, while maintaining hands on the hips, may provide the best standardization for clinicians and researchers. [ABSTRACT FROM AUTHOR]