Despite the widespread research about the effects of attentional focus on balance control in different populations, to the best of our knowledge, no study has yet investigated the effects of ...attentional focus instructions on balance control in individuals with chronic low back pain (CLBP). Therefore, this study was aimed to compare the effects of internal focus (IF) and external focus (EF) of attention on quiet standing balance control between individuals with CLBP and healthy controls. Twenty individuals with CLBP and 20 healthy controls were enrolled in this quasi-experimental study. The participants were asked to stand still with eyes open and eyes closed while performing three tasks: baseline standing with no focus instructions, internally focusing on their feet, and externally focusing on two markers were placed on the force platform. Statistical analyses showed a significant main effect of group for mean total velocity (p = 0.02), area (p = 0.01), and displacement in mediolateral (ML) direction (p = 0.003). Moreover, a significant main effect of vision was observed for mean total velocity (p < 0.001), area (p < 0.001), and displacement in anteroposterior (AP) (p < 0.001) and ML directions (p < 0.001). Also, the results revealed a significant main effect of attentional focus for mean total velocity (p < 0.001), area (p < 0.001), and displacement in AP (p < 0.001) and ML directions (p = 0.01). Our results showed that in both healthy controls and individuals with CLBP, EF led to improve quiet standing balance control compared to IF and control conditions. From a clinical perspective, it may be useful for physical therapists to consider the use of instruction cues that direct performer's attention away from the body for improving quiet standing balance control in individuals with CLBP.
•Standing balance control was impaired in individuals with non-specific chronic low back pain (NSCLBP).•External focus (EF) improved quiet standing balance control in all participants.•EF affected balance control in individuals with NSCLBP similar to healthy controls.•Internal focus neither enhances or degrades performance compared to control condition.
Introduction Postural control is essential for humans to maintain balance under both static and dynamic conditions. A variety of unstable support surfaces are used to evaluate postural control. ...Balance foam pads are relatively expensive, whereas natural rubber pads use a natural material with equivalent viscoelastic properties that are inexpensive and widely available. No postural sway and reliable data existed to support the practice of using a natural rubber pad. The purposes of the study were to determine the test-retest reliability of postural sway by using a natural rubber pad and to compare postural sway in healthy adults while using a foam pad, a natural rubber pad and a firm surface. Methods Nineteen healthy participants were measured for centre of pressure (COP) velocity and displacement during a quiet stance, with their eyes closed, on a balance foam pad (blue foam – Airex®), a natural rubber pad and a firm surface on a force platform. Two repeated sessions were conducted three days apart. Intraclass correlation coefficients were used to determine the test-retest reliability. A one-way repeated measures ANOVA was used to compare the three surface conditions. Results The natural rubber pad demonstrated moderate to good reliability for COP velocity and COP displacement. Also, there were no significant differences in anteroposterior (AP) and mediolateral (ML) COP velocity and displacement between the balance foam pad and the natural rubber pad. Conclusions Our findings indicate that a natural rubber pad could be employed as a low-cost alternative to the balance foam pad for evaluating the balance of healthy adults.
Static postural sway can be quantified as variation in body’s center of force (COF) position across time using a plantar pressure plate. We aimed to compare capability of three clinically feasible ...bipedal tasks to extract the contribution of proprioception to postural stability. We measured the postural sway of 24 healthy volunteers (age range 10.2–17.6 years) with a plantar-pressure plate with three different standing tasks: (1) normal standing, (2) normal standing on soft foam, and (3) feet together standing. Each task was repeated eyes closed to emphasize the contribution of proprioception on maintaining the postural stability. The effect of closing the eyes varied among the tasks, and was greatest in the feet together standing task, possibly due to greater proprioceptive demands in the more difficult tasks. It appears that standing feet together is a potential task for quantifying contribution of proprioception to postural stability.
Objective The aim of the present study is to compare the symmetry of postural sway while maintaining static balance in elderly women with and without poor central stability. Methods The statistical ...sample of the study was made up of 16 elderly women over 55 years of age, who were selected using available and targeted sampling. Subjects were placed on the force plate to perform balance analysis, and according to the protocol described in the balance evaluation process section, their posture sway were evaluated in the medio-lateral, anterior-posterior, and total directions. Independent t-tests were conducted using SPSS version 26 statistical software to compare the groups (P < 0.05). Results The research showed that the postural sway of the left support leg in the medio-lateral direction (toward the medial side) and the right support leg in the anterior-posterior direction (toward the posterior side) in the group of elderly women with instability in the central region was higher (P < 0.05). Also, the average index of imbalance in both left and right limbs in both medio-lateral and anterior-posterior directions in two groups of elderly women with and without instability in the central region showed the greatest difference in the medio-lateral direction of the right leg (0.77 cm). Comparing the percentage of balance asymmetry index in the group of elderly women with and without instability in the central region also showed the greatest asymmetry in the medio-lateral direction (P = 0.010, 32.65%). Conclusion From the results of the present research, it can be stated that there is a significant difference between elderly women with and without poor central stability in the symmetry of postural sway while maintaining static balance. Considering that the asymmetry in postural sway has a direct relationship with the loss of balance and the increase of falling, exercises that lead to an increase in central stability and thus improve their physical posture should be considered in the daily training protocol of the elderly.
The purpose of this study was to explore the effects of arm movements on postural control when standing under different sensory conditions in healthy young and older adults. Fifteen young (mean ± SD ...age; 21.3 ± 4.2 years) and 15 older (mean ± SD age; 73.3 ± 5.0 years) adults completed the modified Romberg test, which uses four task manipulations (i.e. eyes open and eyes closed on a firm and foam surface) to compromise the fidelity of sensory feedback mechanisms. Each participant completed the tasks under two arm movement conditions: restricted and free arm movements. Centre of pressure (COP) range and frequency were calculated to characterise postural performance and strategy, respectively. Older adults showed greater COP range with restricted compared to free arm movements during all modified sensory conditions, with these effects most prominent in the medio-lateral (ML) plane (all p < .05, Cohen's d = 0.69-1.61). Compared to the free arm movement condition, there was an increase in ML displacement and frequency when arm movements were restricted during only the most challenging (i.e. vestibular dominant) task in young adults (all p < .05, d = 0.645-0.83). Finally, main age effects for the arm restriction cost (p < .05) indicates a greater reliance on an upper body strategy in older compared to young adults, independent of sensory availability/accuracy. These findings indicate that older adults compensate for the loss of accuracy in sensory input by increasing reliance on upper body movement strategies.
Wearable sensors are de facto revolutionizing the assessment of standing balance. The aim of this work is to review the state-of-the-art literature that adopts this new posturographic paradigm, i.e., ...to analyse human postural sway through inertial sensors directly worn on the subject body. After a systematic search on PubMed and Scopus databases, two raters evaluated the quality of 73 full-text articles, selecting 47 high-quality contributions. A good inter-rater reliability was obtained (Cohen's kappa = 0.79). This selection of papers was used to summarize the available knowledge on the types of sensors used and their positioning, the data acquisition protocols and the main applications in this field (e.g., "active aging", biofeedback-based rehabilitation for fall prevention, and the management of Parkinson's disease and other balance-related pathologies), as well as the most adopted outcome measures. A critical discussion on the validation of wearable systems against gold standards is also presented.
Objectives. Knee injuries are prevalent among professional tennis players and have a significant impact on their athletic performance and longevity. This study aimed to evaluate the dynamic and ...postural balance differences between injured and healthy professional tennis players, reflecting the broader implications of knee injuries on player stability and performance. Materials and methods. A total of 80 professional tennis players, comprising 40 individuals in the knee injury group (IG) and 40 individuals in the non-injury group (NIG), were selected to participate in this cross-sectional study. Participants’ postural sway was assessed under various conditions, including standing on different surfaces with open and closed eyes using a Wii Balance Board. The Y-Balance Test was performed to evaluate the player’s dynamic balance. An Independent t-test was used to examine the difference in postural sway and dynamic balance between the two groups. Results. The results of this study indicated that players with knee injuries showed significantly worse performance in both dynamic balance (p<0.05 for non-dominant legs) and postural sway (significant differences in mean velocity on foam surfaces with eyes open and closed, p<0.001). These findings suggest that knee injuries contribute to substantial deficits in balance control, which could affect overall athletic performance and injury risk. Conclusion. The study underscores the necessity of incorporating targeted balance and proprioceptive training into rehabilitation programs for tennis players recovering from knee injuries. By improving balance, these interventions can enhance neuromuscular control, reduce reinjury risk, and support better overall performance in high-stakes environments. Future research should focus on refining balance training programs to maximize recovery outcomes and minimize injury impacts.
•Dancers present a greater variability of the trembling component than non-athletes.•The expertise in ballet dance increases postural sway.•Dancers characterized by more automated postural control ...(irregular COP signal).
The purpose of this study was to examine the postural sway characteristics of the ballet dance experts in quiet standing and at their limits of stability with an approach not used before in dancers.
The study was conducted on thirteen female ballet dancers and thirteen non-training females. The data were collected with a use of a force plate. To gain a better insight into the postural control processes, we used the rambling-trembling and sample entropy analyses in the COP data processing.
The main findings of the study showed professional dancers to have higher values of postural sway characteristics in comparison to the non-trainees while performing simple motor tasks. Also, higher values of the trembling component in the group of dancers during quiet standing and the inclined positions were observed. This might be a sign of higher capacity of the postural system to deal with postural instability in dancers.
Our results confirmed that the visual information is important in the process of postural control of dancers’, which is proven by increased dislocations of the COP without visual feedback. The sample entropy results indicated more irregular characteristics of postural sway in ballet dancers representing more automated postural control. The data analysis methods showed high sensitivity to the subtle changes in postural control due to the dance training.
We evaluate the effect of droxidopa on gait and balance measures in nine patients with Parkinson's disease and neurogenic orthostatic hypotension. Computerized gait/balance analysis showed a ...significant effect of droxidopa in reducing postural sway. Future studies may determine if such effect translates into improvement in postural reflexes and falls.
•We evaluated the effect droxidopa on balance and gait in patients with Parkinson's disease with orthostatic hypotension.•Droxidopa improved several balance parameters measured through computerized analysis.•Droxidopa showed a significant reduction on postural sway.
PDF
