Postural Balance

THIS study investigated the role of the plantar cutaneous information in controlling human balance. We hypothesized that the cutaneous afferent messages from the main supporting zones of the feet have sufficient spatial relevance to inform the CNS about the body position with respect to the vertical reference and consequently to induce adapted regulative postural responses. Skin mechanoreceptors of anterior and/or posterior areas of one or both soles of 10 standing subjects were activated by superficial mechanical vibration with high frequency and low amplitude. Variations of the subject's center of pressure (CoP) were recorded. Spatially oriented whole-body tilts were observed for every subject. Their direction depended on the foot areas stimulated and was always opposite to the vibrationsimulated pressure increase. These responses are found to subserve a postural regulative function and we suggest that co-processing of the various cutaneous messages followed a vector addition mode. NeuroReport

Pilates has been appointed as an effective method of physical activity for strengthening abdominal musculature and consequently to improve the balance between agonist and antagonist muscles, and prevention chronic low back pain. The aim of this study was to compare abdominal strength of women practitioners of Pilates with equipment and fitness training practitioners. The sample consisted of 28 women aged 20 to 40, while 15 were fitness training practitioners and 13 practitioners of Pilates. The test used to check abdominal strength was the lowering of the extended leg test, which consists in increasing the angle of lower limbs on pelvis and lumbar spine, putting the abdomen biomechanically unfavorable to comfort, so it can be seen the strength of abdomen through the pressure imposed on lumbar spine on an inflatable bag attached to a manometer. Test results showed that the average obtained by Pilates group (group 1) was 146.4 ± 13.6 degrees, whereas in the fitness training practition...

Background: Mild Traumatic Brain Injury (mTBI) has been identified as a major public and military health concern both in the United States and worldwide. Characterizing the effects of mTBI on postural sway could be an important tool for assessing recovery from the injury. Methodology/Principal Findings: We assess postural sway by motion of the center of pressure (COP). Methods for data reduction include calculation of area of COP and fractal analysis of COP motion time courses. We found that fractal scaling appears applicable to sway power above about 0.5 Hz, thus fractal characterization is only quantifying the secondary effects (a small fraction of total power) in the sway time series, and is not effective in quantifying long-term effects of mTBI on postural sway. We also found that the area of COP sensitively depends on the length of data series over which the COP is obtained. These weaknesses motivated us to use instead Shannon and Renyi entropies to assess postural instability following mTBI. These entropy measures have a number of appealing properties, including capacity for determination of the optimal length of the time series for analysis and a new interpretation of the area of COP. Conclusions: Entropy analysis can readily detect postural instability in athletes at least 10 days post-concussion so that it appears promising as a sensitive measure of effects of mTBI on postural sway.

Background: Diabetic shoes, which are commonly referred to as therapeutic shoes and extra depth shoes, can be categorized under comfort shoes or orthopedic shoes. The purpose of these specially designed footwear options is to preserve and improve foot health by reducing the risk of skin breakdown for those diagnosed with diabetes and suffering from foot abnormalities or deformities. Improper and poorly fitting footwear can cause problems such as calluses, ulcers and blisters that can lead to infection and ultimately even amputation. Objectives: To decrease footwear problems by designing and developing diabetics and orthopedics footwear. To design, simulate and manufacture a diabetic shoe and to contribute to the further development of diabetic footwear as reasonable products for the consumer market. Methods: The design process involved of calculating and optimizing the orthotic insole thickness which has a direct effect on the performance of the shoe. Elasticity theory is applied and the optimum insole thickness is determined based on the critical properties of resilience and compressive stiffness. Furthermore, a SOLIDWORKS static simulation is done and demonstrated that the calculated insole thickness can be effectively used in the production of the shoe. Finally, a case study is done by selecting a 27-year-old study subject with diabetic foot problems and producing a shoe that matches her. Results: Under the assumption of a constant maximum compressive force, a rigorous theoretical analysis showed that the diabetic shoe should be constructed from an insole material with a minimum thickness of 6.66mm. A SOLIDWORKS static simulation showed that, under the application of a maximum compressive force, the maximum compression of the insole material is about 0.211mm. This proves that the insole material has the right resilience and compressive stiffness for the thickness computed. This study proved that the produced shoe is indeed comfortable and effective for peoples with diabetics.

Pennisetum glaucum has been pharmacologically studied for various activities like antidiabetic, anti-microbial and anti-tumor activities. The present study was aimed at investigating the anti-convulsant effect of Pennisetum glaucum supplement in some laboratory animals. Quantitative phytochemical test was carried on Pennisetum glaucum using standard laboratory techniques. In PTZ-induced seizures in mice, 20 swill albino mice were group into 4 negative control which received normal saline, 25% Pennisetum glaucum supplemental group, 50% Pennisetum glaucum supplemental group and diazepam (2 mg/kg) treated group. All the 4 groups received their respective interventions for 14 day. Thirty minutes after the 14 th administration freshly prepared PTZ (85 mg/kg) was subcutaneously injected to all the mice and observed for seizure onset, seizure duration, percentage seizure protection and percentage mortality protection for 30 minute post PTZ injection. Induction of PTZ kindling seizures in wistar rats involves the grouping of 20 rats into 4 (normal saline, 25% Pennisetum glaucum supplemental group, 50% Pennisetum glaucum supplemental group and 200 mg/kg valporic treated group) with each group receiving PTZ (35 mg/kg) on every alternate day for 30 days. Thirty minutes after each PTZ injection rats were observed for the presence/absence of seizures and seizure severity which were evaluated using Racine scale. In Maximal electroshock study, 20 chicks were equally grouped into 4: negative control, 25% Pennisetum glaucum supplemental group, 50% Pennisetum glaucum supplemental group and phenytoin (20 mg/kg) treated group. Maximal electroshock seizures in chicks was induced. Seizure duration, recovery from seizure, seizure protection and mortality protection were the parameters recorded. The results of the study showed a high presence of flavonoids, saponins, tannins, phytate with the least of alkaloids. Also, protein, Magnesium and Phosphorus were revealed. Pennisetum glaucum at 50% supplement offered 40% protection from death and significantly (p≤0.05) decrease the duration of seizure (41.20 ± 3.34vs 137.00 ± 13.13 seconds) whereas diazepam a standard anticonvulsant proved more effective in delaying seizure onset (182.00 ± 10.00vs 72.80 ± 1.32 seconds), offering 60% protection from death and decreasing seizure duration (72.20±19.98vs 137.00 ± 13.13 seconds) in mice. The supplement was able to suppress the progression of seizure to most severe stages 4.4 reached by the control by retarding seizure severity to only stage 3.8 and 2.5 at 25% and 50% Pennisetum glaucum supplemental groups respectively in wistar rats. The supplement also, offered 40% vs 20% protection from seizure when compared to the control. However, phenytoin a standard anticonvulsant offered 100% seizure protection in chicks.

A minimal level of competence in motor skills, ranging from fine coordination to gross motor coordination and balance skills, is necessary to participate in daily physical activities typical of young children. However, while some children execute a whole range of motor tasks easily, others experience considerable difficulties coordinating and controlling their body movements. The latter children are often diagnosed with Developmental Coordination Disorder (DCD) which has been described as one of the six most commonly occurring developmental disorders (Kwan, Cairney, Hay, & Faught, 2013). There is

Neurological sequelae including gait impairment were reported in survivors after methanol intoxication; however, no systematic study has been published so far. We aimed to analyse gait and balance impairment in a group of Czech methanol poisoning survivors. We examined 43 patients (age 46 AE 13 years) 2-8 months after methanol poisoning and 43 healthy controls. Investigations contained a shortened version of Falls Efficacy Scale (FES), clinical tests of gait and balance including Timed Up and Go test (TUG) and gait analysis using GaitRite â system, neurological and neuropsychological examination, brain imaging, EMG and tests of alcohol consumption. Nineteen patients admitted balance and gait impairment according to FES. Mild to moderate parkinsonian signs showed seven patients. Patients were slower (8.8 versus 5.7 s, p < 0.001) and performed more steps (11.1 versus 7.9, p < 0.001) in TUG compared with the controls. Gait analysis revealed shorter step length (76.5 versus 88.7 cm, p < 0.001), increased double support phase (18.8 versus 15.5%, p < 0.001) and wider base of support (11.3 versus 9.6 cm, p = 0.006) in patients. Eleven patients had deficit of executive function and performed higher cadence compared to the patients with normal execution (122.7 versus 115.0 step/min., p = 0.025). Lower limb polyneuropathy was verified in nine patients, without relation with gait or balance parameters. Neuroimaging revealed lesions mainly in the basal ganglia. Methanol poisoning survivors presented slower wide-based gait with shortened steps corresponding with frontal gait disorder. Higher stepping cadence associated with executive deficit supported the evidence of frontal lobe dysfunction related to impairment of basal ganglia and connections in frontal cortico-basal ganglia loops.

The goals of this study were to collect normative data on asymptomatic, ambulatory, community-dwelling adults on a standard diagnostic test of vestibular function in balance and to determine if their responses differ significantly from younger adults. Subjects were divided into four age groups, 18-44 years (young), 45-69 years (middle-aged), 70-79 (old), and 80-89 (elderly). Subjects were seen in the neurotologic diagnostic laboratory at a tertiary care facility. Their dynamic balance was tested under a variety of sensory conditions using the EquiTest (NeuroCom), a standard diagnostic test. The data from one subtest, the Sensory Organization Test (SOT) were evaluated. These data showed significant age-associated declines in overall score and changes in movement strategy. These results suggest that those parts of the vestibular system involved with balance have age-related declines through the end of the life span, even in asymptomatic people, and that these changes do not level off but continue into the ninth decade. Therefore, when elderly people are evaluated for balance disorders age-appropriate norms should be used. These results also suggest that declines in motor performance on laboratory tests are not directly related to reduced independence in essential activities of daily living in elderly people.

In a recent study, De Haart et al. (Arch Phys Med Rehabil 85:886-895, 2004) investigated the recovery of balance in stroke patients using traditional analyses of center-of-pressure (COP) trajectories to assess the effects of health status, rehabilitation, and task conditions like standing with eyes open or closed and standing while performing a cognitive dual task. To unravel the underlying control processes, we reanalyzed these data in terms of stochastic dynamics using more advanced analyses. Dimensionality, local stability, regularity, and scaling behavior of COP trajectories were determined and compared with shuffled and phase-randomized surrogate data. The presence of long-range correlations discarded the possibility that the COP trajectories were purely random. Compared to the healthy controls, the COP trajectories of the stroke patients were characterized by increased dimensionality and instability, but greater regularity in the frontal plane. These findings were taken to imply that the stroke patients actively (i.e., cognitively) coped with the stroke-induced impairment of posture, as reflected in the increased regularity and decreased local stability, by recruiting additional control processes (i.e., more degrees of freedom) and/or by tightening the present control structure while releasing non-essential degrees of freedom from postural control. In the course of rehabilitation, dimensionality stayed fairly constant, whereas local stability increased and regularity decreased. The progressively less regular COP trajectories were interpreted to indicate a reduction of cognitive involvement in postural control as recovery from stroke progressed. Consistent with this interpretation, the dual task condition resulted in less regular COP trajectories of greater dimensionality, reflecting a task-related decrease of active, cognitive contributions to postural control. In comparison with conventional posturography, our results show a clear surplus value of dynamical measures in studying postural control.

The aim of this study was to evaluate tile layers workload at a construction site and its influence to their working ability. The subjects (n = 8) were male tile layers (mean ± SE) age of 36 ± 3.6 years. First the subjects completed a questionnaire and thereafter they performed before and after the working day a test of tile setting on a special wall, where was 3 stages and every stage they must set correctly 14 tiles. In the course of test the electromyographical (EMG) power spectral median frequency (MF) of biceps brachii, trapezius, deltoideus and erector spinae muscles was measured (both sides). The results of questionnaire indicate that the tile layer's most burdened parts of the body were knees, lower back and upper back. Workers complained most about tiredness, skin irritations, dyscomfort in eyes, knee, leg, lower back and neck/shoulder pain. It is important emphasis that all tile layers were taking tiles from a left side. Objectively estimated muscle fatigue emerged before and after the working day when comparing EMG power spectral MF measured at the beginning and end of the tile setting test. The results indicated that the most burdened muscle was right erector spinae for all 3 stages. In case of physical work, it is advisable to make short breaks every hour, so as to avoid the problems caused by overload. The results of this study can be used by specialists of ergonomics and production managers.

Cette étude a permis de répondre aux objectifs et problématiques définis :

Les effets de la méthode Schroth sur la réduction des douleurs et des symptômes associés
à la scoliose chez les patients de Risser 5 : Les résultats montrent une réduction significative
de la douleur au repos et en dynamique, ainsi qu'une amélioration des scores de qualité de vie
(SRS-22) et d'image corporelle (TAPS). Ces améliorations attestent de l'efficacité de la méthode
Schroth dans la gestion des symptômes de la scoliose.

L'évaluation de l'efficacité de la méthode Schroth dans le traitement de la scoliose
idiopathique : La méthode Schroth a démontré des bénéfices notables, y compris une
diminution de la douleur et des gains en flexibilité cervicale et lombaire. Les ajustements dans
les activités de la vie quotidienne (AVQ) ont joué un rôle crucial, renforçant l'efficacité de
l'intervention.

L'influence de la modification des AVQ selon la méthode de Schroth sur la progression
de la courbure scoliotique et la qualité de vie des patients : L'intégration des principes de la
méthode avec des modifications des AVQ a conduit à une gestion améliorée de la scoliose. Les
résultats suggèrent que ces changements ont contribué à une meilleure qualité de vie et une
gestion plus efficace de la courbure scoliotique.

En résumé, cette étude confirme que la méthode Schroth, lorsqu'elle est appliquée en
conjonction avec des ajustements adaptés des AVQ, est efficace pour traiter la scoliose. Les
améliorations observées dans les scores de douleur, les mesures de flexibilité et la qualité de
vie des patientes soulignent les avantages de cette approche intégrée. Ces conclusions s'alignent
avec les résultats rapportés par d'autres centres utilisant la méthode Schroth et les travaux de
Katarina Schroth, renforçant la validité de cette approche dans le traitement de la scoliose
idiopathique.

Several measures of balance obtained from quiet stance on an electronic platform are described. These measures were found to discriminate patients with Parkinson disease (PD) from normal control subjects. First degree relatives of patients with PD show greater variability on these measures. A primary goal is to develop sensitive measures that would be capable of identifying impaired balance in early stages of non-clinical PD.

Background and Aim: Osteoarthritis (OA) is a progressive degenerative joint disorder characterized by cartilage loss, sub­chondral bone remodeling, and chronic pain, and remains a leading cause of disability worldwide. Although radiographic imaging and behavioral testing are widely used in preclinical research, few studies have systematically examined their inter­dependence. This study aimed to radiologically characterize OA progression in rats induced by monosodium iodoacetate (MIA) and to correlate structural alterations with functional and nociceptive outcomes, while exploring potential sex-specific differences and therapeutic responses to non-steroidal anti-inflammatory drugs (NSAIDs).

Materials and Methods: Thirty-six Wistar rats (male and female) were divided into six experimental groups: Healthy controls, OA-induced untreated, and OA-induced meloxicam-treated. Over 28 days, animals underwent serial radiolog­ical assessments and validated behavioral tests, including weight-bearing, rotarod, and Von Frey assays. Statistical anal­yses employed analysis of variance with post hoc testing, ensuring methodological rigor with blinded evaluators and sex-stratified comparisons.

Results: Radiographs revealed classical OA features, joint space narrowing, subchondral bone sclerosis, and osteophyte for­mation, with progressive severity across timepoints. NSAID-treated males demonstrated significant improvement in motor coordination and nociceptive thresholds on days 7 and 14 (p < 0.001), whereas females exhibited only modest or delayed responses despite more severe radiological deterioration. Importantly, structural joint damage did not consistently align with behavioral impairments, underscoring a dissociation between radiographic severity and clinical-like manifestations.

Conclusion: This study provides an integrated evaluation of structural and functional outcomes in experimental OA, high­lighting a complex relationship between radiological changes and behavioral impairments. The findings emphasize the necessity of multimodal assessment strategies in preclinical OA models and reveal sex-specific differences in disease progres­sion and therapeutic response. These insights are crucial for refining translational strategies, advocating for sex-conscious approaches and combined structural-functional endpoints in OA research and drug development.


Keywords: behavioral assessment, experimental rat model, non-steroidal anti-inflammatory drugs, osteoarthritis, radiological analysis, sex differences.

anterior knee pain in young active people and athletes. This study aimed to compare the effectiveness of six weeks of core stability training (CST) and neuromuscular training (NMT) on knee pain, center of pressure (COP) oscillations, and knee function in individuals with PFPS. Methods This is a randomized controlled clinical trial. A total of 45 participants with PFPS were randomly assigned to CST, NMT, or control groups. The interventions were performed at three sessions per week for six weeks. Pain (using the visual analog scale), static balance (COP oscillations measured by a force plate), and knee function (bilateral squat and step-down tests) were assessed before and after the intervention. Data were analyzed using the paired t-test and ANCOVA in SPSS software, version 21. Results Both CST and NMT groups showed significant reductions in pain intensity and COP oscillations, and significant improvements in two knee function tests after interventions (P<0.001), while the control group showed no significant changes after interventions. The NMT group showed more reduction in pain intensity (P=0.001) and COP oscillations (P=0.001) and a greater increase in bilateral squat (P=0.001) and step-down (P=0.001) test scores than the CST after interventions. Conclusion Both CST and NMT methods can be effective in reducing pain and improving static balance and knee function in individuals with PFPS, where the NMT method is more effective. It is recommended that NMT be integrated into standard rehabilitation protocols for these patients to achieve optimal outcomes.

Background and Aims One of the most common causes of knee pain is knee osteoarthritis (KOA). It is a degenerative joint disease, mostly seen in older people. The present study aims to compare the immediate effects of local muscle vibration (LMV) and kinesio tape on quadriceps muscle strength, knee joint proprioception, and pain in people with KOA. Methods This is a quasi-experimental study with a pre-test/post-test design that was conducted on 34 people with KOA aged 45-65 years. They were divided into two groups of 17, including LMV and kinesiotape. For the kinesio tape group, the tapes with 50% stretch were attached to the quadriceps muscles with Y and I patterns from the beginning to the end of the muscles. The other group received LMV at a frequency of 60 Hz applied to the knee front and the quadriceps muscle four times, each session for 5 minutes, considering a 60-second rest interval. The muscle strength was measured using an isometric dynamometer, while the knee joint proprioception was assessed using the joint position sense test and goniometry of digital images, and pain was evaluated using the visual analogue scale (VAS). Results No significant difference was observed between the two groups in the improvement of quadriceps muscle strength (P=0.49) and knee joint proprioception (P=0.972) after intervention. However, a significant reduction was observed in pain (P=0.006), where the LMV group showed more reduction than the kinesio tape group. In the within-group comparison of both groups, results showed that the quadriceps muscle strength was not significantly different before and after intervention in the LMV (P=0.262) or kinesiotape (P=0.088) groups. The knee joint proprioception showed no significant difference in the LMV (P=0.090) or kinesiotape (P=0.087) group, either. However, the pain had a significant decrease in both groups after intervention (P=0.001). Conclusion The immediate effects of LMV and kinesio taping on improving quadriceps muscle strength and knee joint proprioception in people with KOA are not statistically significant. Neither intervention is superior to the other regarding quadriceps muscle strength and knee joint proprioception. Both interventions can reduce knee pain immediately in people with KOA, where LMV is more effective than kinesio taping.

Background: Peripheral neuropathy is a common complication of diabetes mellitus. Peripheral neural damage, in turn, causes balance impairments. Purpose: The aim of the study was to investigate the effects of proprioceptive training program on sway indices and functional balance in diabetic peripheral neuropathy. Participants: Twenty eight diabetic patients were recruited and equally divided into two groups: Proprioceptive training group and control group. Methods: Participants in both groups were examined for balance abilities through Berg balance scale (BBS) and the Biodex Balance System during bipedal stance with closed eyes before and after intervention. Intervention was given twice weekly for 8 weeks. The control group received conventional physiotherapy for 45 minutes while the proprioceptive training group received an additional circuit of 13 stations of balance exercises. Results: No base line differences were found between both groups before treatment. Significant decrease i...

Background and Purpose-Falls are an important issue in older people. We aimed to determine the incidence, circumstances, and predictors of falls in patients with recent acute stroke. Methods-The Auckland Regional Community Stroke (ARCOS) study was a prospective population-based stroke incidence study conducted in Auckland, New Zealand (NZ) during 2002 to 2003. Among 6-month survivors, the location and consequences of any falls were ascertained by self-report as part of a structured interview. Multivariable logistic regression was used to establish associations between risk factors and "any" and "injurious" falls. Results-Of 1104 stroke survivors who completed an interview, 407 (37%) reported at least 1 fall, 151 (37% of fallers, 14% of stroke survivors) sustained an injury that required medical treatment, and 31 (8% of fallers, 3% of stroke survivors) sustained a fracture. The majority of falls occurred indoors at home. Independent factors associated with falls were depressive symptoms, disability, previous falls, and older age. For injurious falls, the positively associated factors were female sex and NZ/European ethnicity and dependence before the stroke, whereas higher levels of activity and normal cognition were negatively associated factors. Conclusions-Falls are common after stroke, and their predictive factors are similar to those for older people in general. Falls prevention programs require implementation in stroke services.

Osteoarthritis, a chronic joint disease induces high degrees of disability and health costs in all parts of the globe. Shoulder or glenohumeral osteoarthritis alone can be very disabling despite advanced surgical joint replacement availability, sophisticated diagnostic and remedial procedures. Discussed herein are data spanning 25 years of study 2000-2025 concerning shoulder osteoarthritis and its probable neuromotor pathogenic interactions and ramifications? A poorly studied topic, the data exploration process employed was designed to garner support for the idea that subnormal joint positional sense mechanisms and others involved in mediating or moderating shoulder movement and stability are an important shoulder osteoarthritis disease correlate and one worthy of efforts to detect this proactively, as well as to intervene accordingly to optimize and protect all shoulder neural structures and related somatosensory functions and avert injury.

Background: Age-related losses in bone mineral density (BMD), muscle strength, balance, and gait have been linked to an increased risk of falls, fractures and disability, but few prospective studies have compared the timing, rate and pattern of changes in each of these measures in middle-aged and older men and women. This is important so that targeted strategies can be developed to optimise specific musculoskeletal and functional performance measures in older adults. Thus, the aim of this 10-year prospective study was to: 1) characterize and compare age-and gender-specific changes in BMD, grip strength, balance and gait in adults aged 50 years and over, and 2) compare the relative rates of changes between each of these musculoskeletal and functional parameters with ageing. Methods: Men (n = 152) and women (n = 206) aged 50, 60, 70 and 80 years recruited for a population-based study had forearm BMD, grip strength, balance and gait velocity re-assessed after 10-years. Results: The annual loss in BMD was 0.5-0.7% greater in women compared to men aged 60 years and older (p < 0.05-< 0.001), but there were no gender differences in the rate of loss in grip strength, balance or gait. From the age of 50 years there was a consistent pattern of loss in grip strength, while the greatest deterioration in balance and gait occurred from 60 and 70 years onwards, respectively. Comparison of the changes between the different measures revealed that the annual loss in grip strength in men and women aged <70 years was 1-3% greater than the decline in BMD, balance and gait velocity. Conclusion: There were no gender differences in the timing (age) and rate (magnitude) of decline in grip strength, balance or gait in Swedish adults aged 50 years and older, but forearm BMD decreased at a greater rate in women than in men. Furthermore, there was heterogeneity in the rate of loss between the different musculoskeletal and function parameters, especially prior to the age of 70 years, with grip strength deteriorating at a greater rate than BMD, balance and gait.

The fear of falling (FOF) is a form of the fear associated with concerns about the consequences of falling due to loss of balance. The fall can be the result of one of 400 factors, including decreased strength, movement organization, and movement coordination. The fear of falling itself can lead to falls. It seems that 8% of falls happen without the presence of any risk factors. The present study is the case of an active 83 years old Caucasian male dweller who has tested clear for fear of falling (FOF). Two days later after the test, he fell. This fact has raised some questions about the tests we are using to evaluate healthy, active seniors. Are they enough?

Objectives: To test the effectiveness of proprioceptive neuromuscular facilitation (PNF) on muscle strength, spasticity, functional mobility, and range of motion (ROM) in hemiplegic patients with foot drop. Methods: This was a single-arm, pre-post study of 30 adults (21-60 years) with hemiplegic foot drop receiving a 14-week PNF. The interventions included contract-relax stretching, resistance training (D1/D2 diagonal patterns), and functional exercises. The assessed outcomes were muscle strength, spasticity, ankle dorsiflexion ROM, and functional mobility. Results: Following the intervention, all outcomes significantly improved. Tibialis anterior (TA) strengthened grade 2 to 3 (P<0.001, r=0.62), and 42% achieved grades 4-5. There were large effect sizes for the quadriceps, hamstrings, and calf muscles (r=0.51-0.62). TA spasticity dropped from grade 3 to 2 (P<0.001, r=0.75), and 68% reached grade ≤2. Functional mobility improved by 5.21 cm (P<0.001, r=0.83), and ankle dorsiflexion ROM increased by 8.5 ° (P<0.001, r=0.52). Discussion: Diagonal patterns and resistance training decrease the degree of spasticity and increase strength and mobility, making it possible to use this PNF type even in comparison to shorter-term protocols. These findings support the use of PNF to address foot drop in stroke rehabilitation.

Reliable balance measures are crucial for effective stroke rehabilitation. This study examines the between-day and within-day reliabilities of the center of pressure (CoP) measures in chronic stroke survivors in different standing positions under the influence of motor and cognitive dual-tasking. Methods: Sixteen people (49.31±15.5 years, 5 females) with chronic stroke were assessed in two sessions, 48 hours apart. Participants completed three balance control conditions: Singletask, motor dual-task, and cognitive dual-task. They performed three trials of open-eye quiet standing and semi-tandem standing. Three trials of closed-eye quiet standing were conducted in the single-task condition. A 2-way random model of the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated for CoP mean velocity, anterior-posterior (AP) and medial-lateral (ML) mean velocity, the standard deviation (SD) of AP and ML velocity, and sway area. Results: Within-day ICC values were higher than between-day values (ICC: 0.78-0.96). Mean velocity and Mean±SD of velocity in the AP direction showed the highest relative and absolute reliabilities in an open-eye quiet standing position (ICC: 0.82-0.92, SEM: 0.67-1.24). Dual-tasking could increase the reliability of the CoP measures, except for the sway area (ICC: 0.53-0.93 changed to 0.84-0.96). MDCs ranged from 1.03 to 7.77 mm/s for velocity-based variables. Conclusion: Assessing the postural control system during dual-task conditions provides more reliable CoP measures, especially in a semi-tandem standing position. These findings can provide clinicians with valuable insights into detecting specific balance problems that poststroke individuals encounter.

Physiological aging leads to a progressive weakening of muscles and tendons, thereby disturbing the ability to control postural balance and consequently increasing exposure to the risks of falls. Here, we introduce a simple and easyto-use neuromuscular electrical stimulation (NMES) training paradigm designed to alleviate the postural control deficit in the elderly, the first hallmarks of which present as functional impairment. Nine pre-frail older women living in a long-term care facility performed 4 weeks of NMES training on their plantarflexor muscles, and seven nontrained, non-frail older women living at home participated in this study as controls. Participants were asked to perform maximal voluntary contractions (MVC) during isometric plantarflexion in a lying position. Musculo-tendinous (MT) stiffness was assessed before and after the NMES training by measuring the displacement of the MT junction and related tendon force during MVC. In a standing position, the limit of stability (LoS) performance was determined through the maximal forward displacement of the center of foot pressure, and related postural sway parameters were computed around the LoS time gap, a high force requiring task. The NMES training induced an increase in MVC, MT stiffness, and LoS. It significantly changed the dynamics of postural balance as a function of the tendon property changes. The study outcomes, together with a multivariate analysis of investigated variables, highlighted the benefits of NMES as a potential tool in combating neuromuscular weakening in the elderly. The presented training-based strategy is valuable in alleviating some of the adverse functional consequences of aging by directly acting on intrinsic biomechanical and muscular properties whose improvements are immediately transferable into a functional context.

Falls are a common complication of advancing Parkinson&#39;s disease (PD). Although numerous risk factors are known, reliable predictors of future falls are still lacking. The objective of this prospective study was to investigate clinical and instrumented tests of balance and gait in both OFF and ON medication states and to verify their utility in the prediction of future falls in PD patients. Forty-five patients with idiopathic PD were examined in defined OFF and ON medication states within one examination day including PD-specific clinical tests, instrumented Timed Up and Go test (iTUG) and computerized dynamic posturography. The same gait and balance tests were performed in 22 control subjects of comparable age and sex. Participants were then followed-up for 6 months using monthly fall diaries and phone calls. During the follow-up period, 27/45 PD patients and 4/22 control subjects fell one or more times. Previous falls, fear of falling, more severe motor impairment in the OFF s...

The number of falls and/or accidental injuries associated with cellular phone use during walking is growing rapidly. Understanding the effects of concurrent cell phone use on human gait may help develop safety guidelines for pedestrians. It was shown previously that older adults had more pronounced dual-task interferences than younger adults when concurrent cognitive task required visual information processing. Thus, cell phone use might have greater impact on walking stability in older than in younger adults. This study examined gait stability and variability during a cell phone dialing task (phone) and two classic cognitive tasks, the Paced Auditory Serial Addition Test (PASAT) and Symbol Digit Modalities Test (SDMT). Nine older and seven younger healthy adults walked on a treadmill at four different conditions: walking only, PASAT, phone, and SDMT. We computed short-term local divergence exponent (LDE) of the trunk motion (local stability), dynamic margins of stability (MOS), step spatiotemporal measures, and kinematic variability. Older and younger adults had similar values of short-term LDE during all conditions, indicating that local stability was not affected by the dual-task. Compared to walking only, older and younger adults walked with significantly greater average mediolateral MOS during phone and SDMT conditions but significantly less ankle angle variability during all dual-tasks and less knee angle variability during PASAT. The current findings demonstrate that healthy adults may try to control foot placement and joint kinematics during cell phone use or another cognitive task with a visual component to ensure sufficient dynamic margins of stability and maintain local stability.

We demonstrated the relationship between the change rates of muscular outputs and horizontal perturbation under stable and unstable conditions in dynamic bench press movement. Twenty-seven male collegiate athletes attended the study. We used a tri-axis accelerometer attached to the barbell shaft to obtain the acceleration data in the bench press and computed peak force output, rate of force development (RFD), and horizontal acceleration trajectory length for 0.2 seconds after the initiation. Significant reduction was found in the peak force output and RFD under stable and unstable conditions, but not in the horizontal acceleration trajectory length. Significant correlation was found between the change rate of RFD and the horizontal acceleration trajectory length under stable and unstable conditions (r=0.55, P<0.01).

OBJECTIVE: The main objective of the study was to find out the effectiveness of stretching and strengthening exercises (Janda's Approach) in College going students with lower crossed syndrome. METHODOLOGY: 50 Students between the ages of 18 to 25 years were screened for lower crossed syndrome and 20 students were screened positive for lower crossed syndrome and were selected for the study. The treatment program was conducted for 4 weeks, scheduled for 16 sessions. The outcome measures were manual muscle testing of the abdominal muscles and gluteal muscles and modified schober test for lumbar flexibility and modified thomas test for hip flexor tightness which were recorded before and after treatment sessions RESULTS: There was increase in strengths of abdominal muscles and gluteal muscles after 4 weeks treatment (p value < 0.001) which was statistically significant and there was reduction in tightness of hip flexor muscles and lumbar flexor muscles (p value < 0.001) which was statistically significant CONCLUSION: On the basis of results of our study we concluded stretching and strengthening exercises (Janda's Approach) are effective in treating lower crossed syndrome in college going students

For quite some time the debate between free weights and machines has caused some significant controversy. Everyone loves to champion squats, deadlifts, and bench presses, but machines are fairly often undermined. Both free weights and machines have directly led to increase in lean muscle mass and proven to improve strength vigorously. Yet functional strength is more than being able to move 3 plates, it's about training in a way thats safe, controlled, and transferable into one's real life movements.

Muscle weakness is consistently associated with falls in the elderly people, typically when present along with other risk factors. However, it remains unknown whether and how muscle weakness alone affects balance. This hampers development of more effective fall prevention strategies. Clinical observations suggest that the amount and distribution of muscle weakness influences balance control. We therefore investigated balance corrections in patients with either predominantly proximal (limb girdle muscular dystrophy (LGMD); n‫)8؍‬ or distal (distal spinal muscular atrophy; n‫)5؍‬ leg weakness, and 27 matched healthy controls. Balance was perturbed using surface tilt rotations that were delivered randomly in eight directions. Balance measures were full body kinematics and surface electromyographic activity (EMG) of leg, arm, and trunk muscles. Both patient groups were more unstable than controls, as reflected by greater excursions of the centre of mass (COM), especially in the pitch (anterior-posterior (AP)) plane. COM displacements were greater in distal weakness patients. Patients with distal weakness had excessive and unstable trunk, knee and ankle movements, and this was present following both forward and backward directed balance perturbations, possibly reflecting the greater use of distal leg muscles in these directions. In contrast, the less weak proximal weakness patients demonstrated unstable trunk and ankle movements only for backward directed balance perturbations. Both patient groups used arm movements to compensate for their instability. We conclude that primarily distal but also proximal muscle weakness leads to significant postural instability. This observation, together with the retained ability of patients to use compensatory arm movements, provides targets that may be amenable to improvement with therapeutic intervention.

Stabilising shifts of the centre of mass (COM) are observed during balance recovery when subjects simultaneously execute voluntary unilateral knee Xexion or unilateral arm raising. Here, we examined whether voluntary lateral trunk bending provided more beneWcial stabilising eVects, and how motor programs of balance corrections are combined with those of the focal voluntary action. The upright balance of 24 healthy young subjects (19-33 years of age) was perturbed using multi-directional rotations of the support-surface. The perturbations consisted of combined pitch and roll rotations (7.5° and 60°/s) presented randomly in six diVerent directions. Three conditions were tested: perturbation of stance only (PO); combined balance perturbation and cued uphill bending of the trunk (CONT); and combined perturbation and cued downhill bending of the trunk (IPS). For comparison, subjects were required to perform trunk bending alone (TO). Outcome measures were biomechanical responses and surface EMG activity of several muscles. Calculated predicted outcomes (PO + TO) were compared with combined measures (CONT or IPS). CONT trunk bending uphill showed two phases of beneWt in balance recovery for laterally but, in contrast to voluntary knee bending, not for posterior directed components of the perturbations. IPS trunk bending had negative eVects on balance. Early balance correcting muscle responses were marginally greater than PO responses. Prominent secondary balance correcting responses, having a similar timing as voluntary responses observed under TO conditions, were seen under CONT only in trunk muscles. These, and later stabilising, responses had amplitudes as expected from PO + TO conditions being signiWcantly greater than PO responses. The ability with which diVerent muscle synergies for balance corrections and voluntary trunk bending were integrated into one indicates a Xexible adjustment of the CNS programs to the demands of both tasks.

To quantify the contribution of sensory information to multisegmental frontal plane balance control in humans, we developed a feedback control model to account for experimental data. Subjects stood with feet close together on a surface that rotated according to a pseudorandom waveform at three different amplitudes. Experimental frequency-response functions and impulseresponse functions were measured to characterize lower body (LB) and upper body (UB) motion evoked during surface rotations while subjects stood with eyes open or closed. The model assumed that corrective torques in LB and UB segments were generated with no time delay from intrinsic musculoskeletal mechanisms and with time delay from sensory feedback mechanisms. It was found that subjects' LB control was primarily based on sensory feedback. Changes in the LB control mechanisms across stimulus amplitude were consistent with the hypothesis that sensory reweighting contributed to amplitude-dependent changes in balance responses whereby subjects decreased reliance on proprioceptive cues that oriented the LB toward the surface and increased reliance on vestibular/visual cues that oriented the LB upright toward earth vertical as stimulus amplitude increased in both eyes open and closed conditions. Sensory reweighting in the LB control system also accounted for most of the amplitudedependent changes observed in UB responses. In contrast to the LB system, sensory reweighting was not a dominant mechanism of UB control, and UB control was more influenced by intrinsic musculoskeletal mechanisms. The proposed model refines our understanding of sensorimotor integration during balance control by including multisegmental motion and explaining how intersegmental interactions influence frontal plane balance responses.

The delay of the sensory-motor feedback loop is a destabilizing factor within the neural control mechanism of quiet standing. The purposes of this study were 1) to experimentally identify the neuromusculoskeletal torque-generation process during standing posture and 2) to investigate the effect of the delay induced by this system on the control mechanism of balance during quiet standing. Ten healthy adults participated in this study. The ankle torque, ankle angle, and electromyograms from the right lower leg muscles were measured. A ground-fixed support device was used to support the subject at his/her knees, without changing the natural ankle angle during quiet standing. Each subject was asked to mimic the ankle torque fluctuation by exerting voluntary ankle extension while keeping the supported standing posture. Using the rectified soleus electromyogram as the input and the ankle torque as the output, a critically damped, second-order system (twitch contraction time of 0.152 ± 0.0...

Better functional outcome is believed by some to occur after hip resurfacing (HR) than conventional 28mm total hip arthroplasty (THA) in young and active patients with hip osteoarthritis. However, the postulated superior outcome of HR over THA may simply be the result of a bias in patient selection or the use of a larger femoral head. We therefore asked whether HR would demonstrate superior functional outcome when compared with a THA with a large-diameter femoral head in a randomized, double-blind study. Gait speed and postural balance evaluations, functional tests, and clinical data were analyzed preoperatively and at 3, 6, and 12 months after surgery. Gait speed was used as the primary outcome measure. Forty-eight patients were randomized in the study and a third group of 14 healthy subjects served as controls. The gait speed and postural balance evaluations, the performance at most functional tests, and clinical scores were similar in HR and large-head THA groups at each followup period. The operated patients reached most control group values at 3 months postoperatively. By these measures, HR did not provide better clinical function over large-head THA. Level of Evidence: Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. One or more of the authors (ML) have received funding from Zimmer, Warsaw, IN. Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Balance is a critical motor skill essential for the development of functional performance. It is complex in nature as it involves many systems, namely the motor system, sensory system and central nervous system. As the human is bipedal, meaning we walk on two legs, the feet are an important factor as they form the base of support from which we balance. Wearing shoes affect development of feet and may affect balance. Current outcome measures for balance in children are indifferent as to wearing shoes or not. The primary aim of this study was to determine whether wearing shoes affects the scores of selected paediatric balance and motor function measures, namely the Paediatric Balance Scale (PBS) and the Bruininks-Oseretsky Test of Motor Proficiency (BOT-MP), and to determine whether this effect is greater in children with balance impairments compared to their age matched peers with typical development (TD). A descriptive, cross-sectional study design was used to determine the effect of wearing shoes on balance. Children four to ten years were recruited from five purposively selected schools in Johannesburg, South Africa. Children were included if they had been referred to physiotherapy or occupational therapy for balance, postural or gross motor concerns. These children were allocated to the mild motor dysfunction group. They were then matched for age and gender with their peers who had never been referred for physiotherapy or occupational therapy. All children were tested with shoes on and barefoot, using the BOT-MP and the PBS. The test scores were compared between groups and between outcome measures. Children had significantly better balance when wearing shoes compared to being barefoot when tested with the BOT-MP. This was found for both the typically developing group (p< 0.0001) and the group with mild motor dysfunction (p< 0.001). No significant difference was found when testing with the PBS within or between the groups. There was also a weak relationship between age and gender with older children having better balance and girls having better balance than boys of the same age. Stellenbosch University 1. My husband, Ashley, and son, Connor, for their infinite patience, support and assistance while completing this study. 2. My parents, Walter and Wendy for their support and encouragement to complete this study as well as their invaluable advice. My brother, Jason, for just being him.

Purpose. The aim of this study was to determine the sample entropy values (SampEn) during the analysis of static equilibrium in healthy people. Methods. We have studied 12 healthy subjects (5 males and 7 females) 18 to 25 years old. The gravity center projection over a dynamometric platform was recorded with both open and closed eyes while in a relaxed and static bipedal position. The test duration was 60 seconds with a sampling frequency of 60 Hz, 3,600 points being obtained for each recording. We analyzed total displacement, dispersion and displacement of the signal on X and Y axis, total swept area and maximal force in each axis. SampEn was calculated from the original X and Y series. Results. All the linear parameters are higher when they are recorded with closed eyes, although the difference is significant only for the total swept area and the values related to Y axis. SampEn values for X axis are 1.53 ± 0.39 (open eyes) and 1.53 ± 0.53 (closed eyes). The values are 1.37 ± 0.42 and 1.06 ± 0.57, respectively, for the Y axis. The gravity center performance over Y axis is more predictable than over the X one, this being even greater with closed eyes. The entropy value in X axis indicates that the system maintains high complexity and that it remains constant regardless of whether the eyes are open or closed.

Purpose: It is still not clear which parameters of sound are the most significant for body reactions and whether the way of sound reception plays a role in body control. The purpose of this study was to determine the influence of frequency, spectrum and loudness of sounds on posture control in healthy women and men. Methods: The study subjects were 29 young adults who were submitted to a 60-second standing test in the bipedal stance on the force platform (AMTI). During the tests, 3 sinusoidal sounds with various timing and 2 musical sounds (guitar and piano) of the frequency 225 Hz, 1000 Hz and 4000 Hz were applied through headphones. The centre of pressure (COP) amplitude was registered. The sway area and COP mean velocity were computed. Results: It was found that high frequency sounds contributed to a significant decrease of sway area values. No significant influence of low frequency sounds on posture control was observed. The influence of the sound spectrum (timbre) on posture control is limited; only the crescendo spectrum improves the body stability in the bipedal stance and not the music spectrum as guitar and piano. The loudness of sound, although extremely high, is not the cause of postural control changing in relation to lower loudness. No effect of gender was found in terms of body stability under different sound conditions. Conclusion: Based on the results, it can be argued that, in general, in a bipedal stance in terms of stability high sound frequency improves posture control, whereas sound spectrum and intensity show a limited impact.

This article by Salvatore Leonardi proposes a novel paradigm for understanding the role of gamma motor neurons (γMNs) in attention. Traditionally viewed as mere regulators of proprioceptive sensitivity during movement (α-γ coactivation), we suggest that γMNs are, in reality, active orchestrators of a brain-controlled sensory preamplification mechanism. This top-down gamma modulation enables precise and targeted attentional focus in all its forms: from internal attention (such as body awareness and interoception) to multimodal external attention (visual, auditory, tactile, chemical). The classical model of proprioception fails to explain how attention can refine perception in the absence of macroscopic movement. The hypothesis outlined here addresses this gap by showing how γMNs can enhance the salience of subtle signals stemming from basal muscle tone, intrinsic body micro-oscillations, or simple motor intention. Through this modulation, muscle spindles become hypersensitive, amplifying proprioceptive feedback and providing a fundamental bodily anchor for the direction and quality of attention. My approach aligns with theories of predictive control and embodied cognition, while distinguishing itself from-and integrating critiques of-the premotor theory of attention. While the latter emphasizes the preparation of macroscopic movements (e.g., saccades) for spatial attention, the γMN hypothesis proposes a more microscopic, peripheral mechanism that supports attention at a deep level, rendering the body an active instrument for sensory exploration. This article offers a concrete neurophysiological mechanism for a unified theory of attention as an intrinsically embodied process, suggesting new directions for future research.

This study aimed to assess the effects of a 6-week training program that combined stretching and strength exercises on the performance of novice football players aged 15 to 18 years. Methods: A double-blind randomized controlled trial (RCT) was conducted with 46 participants divided into four groups: A) dynamic high-intensity resistance training (DHIRT) (n=12), B) static stretching (n=13), AB) Combined DHIRT+stretching (n=11), and C) control (n=10). Performance outcomes included vertical and horizontal jump (VJ and HJ) distances, running speed (RS), acceleration (ACC), endurance (VO₂ max), shooting speed (SS), and heart rate (HR). Repeated-measures analysis of variance (ANOVA) and post-hoc analyses were used to assess group differences and time effects. Results: A repeated-measures ANOVA showed a significant effect of time (η²=0.827) and a significant time-by-group interaction (η²=0.418), indicating substantial intervention effects. Pairwise comparisons revealed that the combined training group (AB) demonstrated statistically significant improvements over the control group (C) in HJ (P=0.003), RS (P=0.003), VO₂ max (P=0.000), endurance (P=0.000), SS (P=0.018), and ACC (P=0.000). Vertical jump (VJ) improved by 2.97%, HJ by 6.85%, and VO₂ max by 5.83% in the combined Group. No significant intergroup differences were observed in HR (P>0.05). Conclusion: Combining DHIRT and static stretching is more effective than either intervention alone for improving football-related physical attributes in novice players.