动作发展视角的韵律性身体活动对3～6岁幼儿静态平衡能力的影响

目的:为提高幼儿平衡能力和动作发展水平探寻更好的方式方法。方法:将60名幼儿根据年龄分别随机分为实验组与对照组,实验组进行动作发展视角下的韵律性身体活动,对照组进行一般性的韵律性身体活动,活动时间均为20~30分钟/每天。运动干预周期为1年。干预前后,采用Tekscan足底压力测试系统对受试者进行双脚睁眼、双脚闭眼和单脚睁眼站立测试,选取压力中心(COP)包络面积、压力中心(COP)轨迹长度、压力中心(COP)在前-后和左-右方向上的最大位移值为指标评估幼儿静态平衡能力的变化。结果:实验组各年龄幼儿平衡指标变化整体上具有显著性(P<0.05),其中4岁组在双脚睁眼、闭眼的COP包络面积及单脚睁眼COP轨迹长度与COP左-右位移长度上变化具有非常显著性(P<0.01)。对照组幼儿在单脚睁眼(3岁、4岁、5岁)、双脚睁眼(4岁)和双脚闭眼(4岁、5岁)指标上的变化整体上有显著性(P<0.05)。且干预后实验组与对照组幼儿在多个静态平衡指标上表现出了显著的差异(P<0.05)。结论:(1)幼儿静态平衡能力呈现显著的年龄组间差异,随着年龄增加,幼儿静态平衡能力明显提高。(2)动作发展视角的韵律性身体活动在提高幼儿平衡能力方面明显优于一般性的韵律性身体活动。(3)本研究设计的韵律性身体活动注重采用不同形式和难度的平衡动作练习,将幼儿应掌握的基本动作技能融入其中,可以有效提高幼儿的平衡能力和动作发展。     

前滚翻和拍球锻炼对学前儿童静态平衡能力的影响

目的:探讨不同动作锻炼对儿童静态平衡能力的影响。方法:随机选取南京市公办幼儿园中班2个班级68人,分别进行9周前滚翻和拍球运动干预实验。干预前、后,采用Footscan平衡仪测试系统,对受试者进行单脚睁眼和闭眼站立测试,测试指标为单位时间重心移动轨迹、包络面积、最大位移差值。结果:前滚翻和拍球动作锻炼后,儿童无视觉参与下平衡能力的提高分别达到非常显著水平(P<0.01)和显著水平(P<0.05)。结论:前滚翻和拍球锻炼均能有效提高儿童静态平衡能力;二者相比较,前滚翻比拍球对学前儿童静态平衡能力提高效果更佳。     

24周太极拳锻炼对中老年人静态平衡功能的影响

目的:探讨24周太极拳锻炼对中老年人静态平衡机能的影响。方法:24周简化太极拳和42式太极拳锻炼(每周锻炼4次,每次60分钟)前后,55～65岁中老年人70名分别在双足睁眼、闭眼,单足睁眼、闭眼状态下,采用WIN-POD平衡功能检测系统测试重心动摇总轨迹长(TL)、外周面积(Area)、前后方向和左右方向的动摇指数,其中,双足状态下测试时间为30s,单足状态下测试时间为10 s。结果:24周太极拳锻炼后,(1)双足测试状态下,男性受试者睁眼TL、Area、X轴动摇速度(X speed)、X轴平均摆幅(X dev.)、Y轴平均摆幅(Y dev.)较实验前显著降低(P<0.05);闭眼TL、Area、重心平均动摇速度(Avg.v)显著低于实验前(P<0.05)。女性睁眼Y轴动摇速度(Y speed)显著低于实验前(P<0.05);(2)单足测试条件下,男性受试者睁眼TL、Avg.v、X speed显著低于实验前(P<0.05,P<0.01)。女性受试者睁眼Area、X dev.、Y dev.显著降低(P<0.05,P<0.01);闭眼单位面积轨迹长(L/A)显著高于实验前(P<0.05)、Y dev.显著低于实验前(P<0.05)。结论:24周太极拳锻炼对中老年人静态平衡机能有积极影响。     

经颅直流电刺激对艺术体操运动员平衡控制能力的影响

目的：探讨经颅直流电刺激（tDCS）对艺术体操运动员平衡控制能力的影响。方法：招募20名国家二级以上艺术体操运动员作为研究对象，随机分为真刺激组（n=10）和假刺激组（n=10）。刺激强度为2 mA，刺激时长为20分钟，刺激位置：阳极位于双侧初级运动皮层，阴极位于背外侧前额叶。经颅电刺激干预前后，通过智能化平衡测试系统（Neurocom）采集被试在睁眼硬地、睁眼软地、闭眼硬地、闭眼软地等四种条件下的改良版临床感觉交互作用平衡系数（Modified CTSIB）。结果：与基线相比，在闭眼软地条件下真刺激干预后Modified CTSIB系数显著下降（P<0.05）；其他条件下，Modified CTSIB系数无显著变化。结论：双侧阳极tDCS干预初级运动皮层-背外侧前额叶可提高艺术体操运动员软地闭眼站立的静态平衡控制能力。非侵入性双侧脑刺激可能是提升闭眼单足平衡控制任务表现的有效手段。     

向心/离心肌肉疲劳对踝关节本体感觉及平衡能力的影响

目的:探讨向心/离心两种不同工作形式引发的肌肉疲劳对踝关节本体感觉及人体站立平衡能力的影响。方法:选取健康男性大学生受试者40名,随机分为向心疲劳组和离心疲劳组,每组20名,分别进行向心/离心工作形式下的疲劳干预(连续踝关节背屈及跖屈运动),并于干预前后分别进行本体感觉测试及站立平衡测试,对目标角度(背屈10°、跖屈25°位)的绝对差值和身体摆动指数进行统计分析。结果:与干预前相比,疲劳干预后两组受试者目标角度的绝对差值增加(P<0.05),身体摆动指数增加(P<0.05);同时,离心疲劳干预组变化更为显著(P<0.05)。结论:踝关节周围肌肉疲劳引发其关节本体感觉及人体平衡控制能力下降,且在离心收缩引发的肌肉疲劳中更为明显。     

老年女性躯干稳定性特征与跌倒风险的研究

目的:检测老年女性躯干稳定性相关特征,探讨其对于老年女性防跌倒的意义。方法:分别对17名有跌倒史和17名对照组老年女性,采用Pro-kin System平衡训练仪测量躯干平衡能力和骨盆控制能力,采用DEXA测量躯干肌肉含量,采用Torso Check测量躯干肌肉力量,同时记录腰椎活动度和进行动态平衡能力测试。运用t检验和pearson相关分析对实验数据进行分析。结果:(1)跌倒组老年女性在闭眼不稳状态下躯干左右摇晃速度和晃动轨迹增加,两组存在显著性差异,骨盆控制测试用时更长;(2)躯干肌肉含量和肌力无显著性差异,但是所有受试者均存在躯干前后、左右肌力明显不对称;(3)躯干肌肉含量、躯干伸肌力量、不稳状态下晃动轨迹面积与起立~行走测试具有低相关性。结论:(1)老年女性躯干晃动增加,尤其是左右晃动增加,骨盆控制能力下降,可能增加跌倒风险;(2)老年女性躯干肌肉含量和躯干力量改善对降低跌倒风险作用不明显;(3)采用坐位不稳状态下测试可以较好地评价老年人群躯干控制能力。     

探戈舞蹈锻炼对有近期跌倒史老年患者平衡能力的影响

目的:观察探戈舞蹈锻炼对有近期跌倒史老年患者平衡能力的影响。方法:舞蹈组为35例有近期跌倒史老年患者,志愿参加探戈舞蹈锻炼,每天活动时间大约80～100min,每周至少坚持5天,4个月为1个学期(疗程)。对照组为37例同龄、同性别参与散步活动者,活动形式为匀速平路步行,活动时间相同,速度在50～70m/min,每周活动频度和疗程与实验组相同。两组对象实验前后分别接受Berg平衡量表(BBS)、单腿支撑时间(OLS)、步速、步长、起立-行走测试(TUGT)和平衡功能测试仪评估。结果:(1)两组对象实验前BBS、OLS、步速、步长和TUGT等指标分布接近(P均>0.05),两组实验后BBS、OLS、步速和步长等指标明显上升,而TUGT则明显下降;与实验后对照组比较,舞蹈组BBS、OLS、步长均显著增加,TUGT显著减少(P均<0.01～0.05)。(2)两组实验后睁眼和闭眼左右摆幅指数和单位面积轨迹长等指标明显上升,而外周面积、矩形面积、总轨迹长、单位轨迹长则明显下降;与实验后对照组比较,舞蹈组睁眼和闭眼左右摆幅指数和闭眼单位面积轨迹长显著增加,而睁眼和闭眼总轨迹长、外周面积以及闭眼单位轨迹长则显著减少(P均<0.01～0.05)。结论:与散步活动比较,探戈舞蹈锻炼改善有近期跌倒史老年患者各项平衡能力指标更为明显。     

背向行走训练对老年人静态平衡能力及步态的影响

目的:研究老年人背向行走训练对其平衡能力及步态控制能力的影响。方法:30名健康老年女性分为实验组(18人)和对照组(12人),实验组受试者进行为期12周、每周3次、每次40分钟、训练强度控制在心率110~120次/分之间的背向行走训练。运用红外自动示踪运动分析系统(Motion Analysis)、测力台(KistlerForce Plate)、DJ2L-Ⅱ型电子单脚站立测试仪对受试者实验前后静态平衡能力、正常行走的步态特征进行了测量。结果:(1)实验组训练后左、右侧单脚站立时间较训练前显著延长(P<0.05),较之对照组也明显延长;静态闭目站立时前后方向上的身体压力中心波动,实验组较之训练前和对照组均显著减小(P<0.05)。(2)步态运动学测试:实验组训练后躯干最大扭转幅度明显增大(P<0.05)、躯干左右晃动幅度明显减小(P<0.05);各项指标组间比较均未表现出统计学差异。实验组正常行走时摆动腿抬膝高度、脚前部离地高度均显著提高(P<0.05);组间比较,实验组左侧抬膝高度较对照组显著增加(P<0.05)。(3)步态动力学测试:实验组训练后正常行走缓冲时相的最大地面约束力明显降低、蹬伸时相的最大地面约束力显著增加(P<0.05),最大制动力与推进力较实验前也显著增加(P<0.05)。对照组的两次测试无明显变化,组间比较各项动力学指标未表现出统计学差异。结论:背向行走训练能够提高老年人的静态平衡与运动控制能力,提高老年人行走中的下肢蹬伸力量及缓冲控制能力,改善双侧步长的均衡性。     

前庭训练负荷检验及生理指标的变化

目的检查前庭训练中前庭刺激是否适当,评价前庭训练在提高人体前庭功能适应性方面的作用,有助于在前庭训练中对训练量的把握以及训练计划的制定和实施。方法对１０名健康被试者,在不同日期分别进行了线性加速度刺激、连续的科氏加速度累积刺激和间断的科氏累积加速度刺激,刺激的中止指标以受试者感觉的有轻度植物神经症状为准。在实验中对受试者在各项刺激前后前庭－植物神经反应、心电、血压、胃电以及动态姿态平衡等各项生理指标进行了测试。结果１０名受试者,１人３项前庭刺激达到达标水平,他在实验中有轻度运动病症状。实验前后动态姿态平衡的测试表明,大多数受试者,线性加速度刺激前后,前庭觉在维持身体平衡时作用增高;连续的科氏累积加速度刺激前后前庭觉在维持身体平衡时作用下降;间断的累积加速度刺激训练,由于刺激相对较重,对刺激量的把握更难控制,在动态平衡测试中,前庭感觉分在刺激前后的变化个体差异较大。结论本实验所设计的前庭刺激训练方法和制定的检验标准是可行的。通过胃电、血压和心电Ｒ－Ｒ功谱低频百分比增量可以反映被试者前庭刺激中止时的生理状态,为制定前庭训练刺激量提供重要参考。     

基于核心力量训练的健身体操对老年人平衡能力的影响

目的:以核心力量训练原理和方法为基础,研制一套老年人健身体操,并探讨本套健身体操对老年人平衡能力的影响。方法:63名60~69岁老年人分为干预组33人、对照组30人,干预组进行45 min/次、3次/周、连续10周的健身体操干预实验。实验前后测试2组静态平衡、动态平衡及核心肌力等指标。结果:组内比较结果显示,10周干预实验结束后,干预组5个项目测试结果均较实验前显著改善(P<0.01),对照组的各项测试结果较实验前差异无统计学意义。组间比较结果显示,实验前两组5个项目测试结果差异均无统计学意义,10周干预实验结束后,干预组所有测试结果均较对照组显著改善(P<0.01)。结论:本套将核心力量训练与体操相结合的健身体操能提高老年人的平衡能力。     

Validity and variability of center of pressure measures to quantify trunk control in stroke patients during quiet sitting and reaching tasks

BackgroundIn the immediate period following stroke, sitting balance is one of the most important predictors of functional recovery at discharge after rehabilitation. Thus, sitting balance determines the content of the early phase of stroke rehabilitation and an appropriate measurement tool is important.Research QuestionThe aim of this study is to investigate the concurrent validity of center of pressure (CoP) excursions of patients seated on a force plate, as well as to examine the daily variability of trunk control after stroke.MethodsTwenty stroke patients at an inpatient rehabilitation clinic underwent two assessment sessions, on average eight hours apart. Each session comprised two trials: quiet sitting for 30 s; extended reaching in forward, backward, left and right directions. The Trunk Impairment Scale (TIS) was measured during the first session. CoP excursions were measured to determine the outcomes of sway area and sway velocity during stable sitting and the maximal excursions in frontal and sagittal planes during the reaching tasks.ResultsHigh Spearman’s correlations (0.72, 0.79) were found between the TIS and the frontal and sagittal excursions. However, only low correlations between the TIS and the sway area and sway velocity were observed. Within sessions, all CoP outcomes showed high ICCs (0.73–1.00). Between sessions, high ICCs (0.86-0.93) were found except for sway velocity (ICC 0.51). Sway velocity increased significantly between sessions.SignificanceFrontal and sagittal CoP excursions during reaching tasks appear to be valid measurement parameters to evaluate trunk control in patients after stroke. Only small variability was observed and no significant differences between consecutive days.     

Validity study of the standing test for imbalance and disequilibrium (SIDE): Is the amount of body sway in adopted postures consistent with item order?

The standing test for imbalance and disequilibrium (SIDE) is a discriminative measure developed for the purpose of identifying balance deficits that may cause falls. The purpose of the present study was to determine the validity of the sequence of postures used in SIDE. Subjects comprised 30 men with a mean (±standard deviation) age of 21.9 ± 3.11 years (range 19–32 years) and 30 women with a mean age of 20.7 ± 1.24 years (range 19–23 years). Center of pressure (COP) was measured using a stabilometer recording for 30 s with a 20-Hz sampling frequency. The measurement postures that were similar to postures adopted in the SIDE were: standing with feet 20 cm apart; standing with legs close and the insides of both feet touching; two tandem standing positions (with the dominant foot forward and with the non-dominant foot forward); and two single-leg standing positions (on the dominant foot and on the non-dominant foot). We calculated total path length and envelopment area of sway from the COP data. Statistical differences in means were determined using the Tukey–Kramer multiple comparison test. Results indicate that the orders of total path length and envelopment areas of sway in each posture were consistent with the item order of SIDE. Significant differences existed between the means of total path length and envelopment areas of sway in each posture (p < 0.05), with the exception of both tandem standing positions and both one-leg standing positions. The item order of SIDE appears to show concurrent validity in terms of the amount of body sway in the adopted postures.     

Gathering your ‘sea legs’: Extended durations in an offshore environment increases postural sway excursions

BackgroundMal de debarquement (MdD), or often called ‘sea legs’, is the perception of self-motion after exposure to passive movement such as being on a boat at sea. Previous studies highlight sensory re-organization difficulties and postural control impairments after disembarking from sea travel in experienced crew members. However, the impact of MdD in individuals with minimal offshore experience, defined as participating in less than 2 offshore excursions per year, has not been investigated.Research questionDoes exposure to boat motion while at sea alter static postural control after disembarking in individuals with minimal offshore experience?MethodsHealthy adults (n = 24) with minimal offshore experience had their static balance assessed on a force platform before (PRE) and after (POST) a 7-h deep sea fishing excursion. Static balance was tested in eyes open (EO), eyes closed (EC), eyes open on a foam surface (EOF), and eyes closed on a foam surface (ECF) conditions. Sway excursions, sway velocity and sway variability in the medial-lateral (ML) and anterior-posterior (AP) directions were computed and then compared PRE/POST using a paired t-test (p < 0.05).ResultsSignificant increases in ML sway excursion (p = 0.004), ML sway range (p < 0.001), ML sway variability (p < 0.001), AP sway excursion (p = 0.045), AP sway range (p = 0.020), and AP sway variability (p = 0.030) were observed at POST during EOF. Significant increases in ML sway excursion (p = 0.027), AP sway excursion (p = 0.020), and AP sway variability (p = 0.014) at POST were also observed during ECF. No differences were found in the EO condition (p > 0.05).SignificanceIncreases in postural sway excursion and variability were observed in individuals with minimal offshore experience after disembarking. Our findings suggest sensory re-organization difficulties in order to maintain an upright posture in challenging sensory conditions are dependent on vestibular and somatosensory inputs following exposure to boat motion at sea.     

A multiple domain postural control assessment in people with Parkinson’s disease: traditional,non-linear,and rambling and trembling trajectories analysis

BackgroundPostural impairment is one of the most debilitating symptoms in people with Parkinson's disease (PD), which show faster and more variable oscillation during quiet stance than neurologically healthy individuals. Despite the center of pressure parameters can characterize PD’s body sway, they are limited to uncover underlying mechanisms of postural stability and instability.Research questionDo a multiple domain analysis, including postural adaptability and rambling and trembling components, explain underlying postural stability and instability mechanisms in people with PD?MethodTwenty-four individuals (12 people with PD and 12 neurologically healthy peers) performed three 60-s trials of upright quiet standing on a force platform. Traditional and non-linear parameters (Detrended Fluctuation Analysis- DFA and Multiscale Entropy- MSE) and rambling and trembling trajectories were calculated for anterior-posterior (AP) and medial-lateral (ML) directions.ResultsPDG’s postural control was worse compared to CG, displaying longer displacement, higher velocity, and RMS. Univariate analyses revealed largely longer displacement and RMS only for the AP direction and largely higher velocity for both AP and ML directions. Also, PD individuals showed lower AP complexity, higher AP and ML DFA, and increased AP and ML displacement, velocity, and RMS of rambling and trembling components compared to neurologically healthy individuals.SignificanceBased upon these results, people with PD have a lower capacity to adapt posture and impaired both rambling and trembling components compared to neurologically healthy individuals. These findings provide new insights to explain the larger, faster, and more variable sway in people with PD.     

Effects of vertical center of mass redistribution on body sway parameters during quiet standing

Body sway is usually described by center of foot pressure (COP)-derived parameters. Their sensitivity to vertical center of mass (COM) redistribution below its natural position has not yet been examined during quiet stance tasks. We examined the effects of both lowering and raising the COM on the following body sway parameters: cumulative, medial-lateral and anterior-posterior COP average velocity, amplitude and frequency. For this purpose, 13 healthy male subjects performed a quiet stance balance task with feet positioned in parallel stance (PS) at hip width apart and with hands holding a stick across the rear part of the shoulders. Each subject carried out five different modifications of the PS task in a randomized order: no additional load, an additional load of 10 kg and 30 kg suspended from the waist at mid-lower leg height, and an additional load of 10 kg and 30 kg across the rear of the shoulders. The studied body sway parameters proved to be sensitive to these manipulations. Specifically, lowering and raising the COM was mirrored in a systematic decrease/increase of the velocity, amplitude, and frequency parameters, indicating a larger effect in the anterior-posterior direction. These results suggest that the elevation of the body COM from a lower to a higher position systematically decreases the postural control during quiet standing, and consequently, increases the intensity of the balancing task. Thus, this type of physical manipulation could provide the basis for a simple progression in functional resistance training for persons with compromised balance.     

Dynamic balance is impaired after a match in young elite soccer players

PurposeThe aim of this study is to assess the effect of actual match effort on dynamic balance abilities in young elite soccer players.MethodsSeventeen Under 15 male players who compete at national level participated in the study. Their dynamic balance was assessed by having them jump starting with both feet on the ground in a standing position and land on one foot only. Their vertical time to stabilization (vTTS) and postural sway were calculated before and after 35 min of an unofficial match. Postural sway was assessed on the basis of center-of-pressure (COP) trajectories. Parameters considered were sway area, COP displacements in the antero-posterior (AP) and medio-lateral (ML) directions and COP path length.ResultsAfter the match, a significant increase in vTTS (p = 0.007) COP path length (p = 0.001) and COP displacements in ML (p < 0.001) was observed. Such effects involve both non-dominant (vTTS, path length) and dominant limb (COP displacements).ConclusionsThe physical effort associated with the match induces significant impairments of players' dynamic balance abilities. On the basis of such findings, coaches might consider integrating training sessions with specific balance exercises as well as performing injury-prevention routines even when players are fatigued, to better adapt them to match conditions.     

Comparison of Kistler 9861A force platform and Chattecx Balance System for measurement of postural sway: correlation and test-retest reliability

Measurement of postural sway has several potential applications in sports medicine. Traditionally, however, rather complicated equipment has been applied. The purpose of the study was to compare two devices based on two different methods of measuring postural sway: (i) a sophisticated Kistler 9861A force platform (KIS)--which all but requires a laboratory setting--and (ii) Chattecx Balance System (CBS)--which is particularly suited for measurement of sway in the dynamic environment of sports. Measurement of sway was performed in 29 subjects twice at baseline and twice at follow-up 2-4 weeks later. One measurement consisted of four 25-second sequences (eyes open, parallel feet; eyes closed, parallel feet; eyes open, tandem Romberg; eyes closed, tandem Romberg). Factor analysis revealed influence of sight and stance on sway, marked interaction between these two factors and a decrease in sway on retest on the same day. Coefficients of variation were--KIS: 0.13-0.23; CBS: 0.11-0.25. Body height was a covariate for all parameters. Kistler 9861A force platform and CBS were correlated (baseline: r(s) = 0.47; follow-up: r(s) = 0.9). These findings suggest that, when the effects of acclimatization and covariance of body height were taken into account, CBS was as reliable and reproducible as KIS in our laboratory.     

Time dependent structure of postural sway in individuals with multiple sclerosis

Non-linear analyses, which examine the time dependent structure of physiological output have been found to be able to detect subtle differences in postural control between pathological groups and healthy controls while traditional linear parameters do not. This investigation examines whether a specific non-linear metric, approximate entropy, may provide a novel biomarker for balance impairment in individuals with multiple sclerosis (MS) who have normal sway. This analysis included a sample of 30 individuals with MS with normal postural sway and 36 controls. Participants stood on a force platform for two trials of 30 s with eyes open. Postural control was indexed by sway area, mean velocity along the antero-posterior (AP) and mediolateral (ML) axis. The time dependent structure of the COP along the AP and ML axes was indexed with approximate entropy (ApEn_AP; ApEn_ML). T-tests and Mann–Whitney U tests were utilized to analyze differences between groups. Per design there were no differences in sway area between the MS and control groups. Additionally, there were no differences in sway velocity. The MS group had lower ApEn_ML values compared to the control group (U = 376, p = .026). The results indicate that individuals with MS who have normal sway area had greater time dependent structure in ML sway. This investigation highlights the utility of non-linear analyses when assessing balance impairment in MS samples that present with minimal sway area.     

Postural sway as a marker of progression in Parkinson's disease: a pilot longitudinal study

Objective measures of postural control that are sensitive to Parkinson's disease (PD) progression would improve patient care and accelerate clinical trials. Although measures of postural sway during quiet stance in untreated PD have been shown to differ from age-matched control subjects, it is not known if sway measures change with disease progression in early PD. In this pilot study, we asked whether accelerometer-based metrics of sway could provide a practical tool for monitoring progression of postural dyscontrol in people with untreated or newly treated PD. We examined 13 subjects with PD and 12 healthy, age-matched control subjects. The PD subjects had been recently diagnosed and had not started any antiparkinsonian medications at the baseline session. All subjects were tested 3-6 months and 12 months after the baseline session. Subjects were asked to stand quietly for two minutes while wearing an inertial sensor on their posterior trunk that measured trunk linear acceleration. Our results suggested that objective sway measures deteriorated over one year despite minimal changes in UPDRS motor scores. Medio-lateral (ML) sway measures were more sensitive than antero-posterior sway measures in detecting progression. The ML JERK was larger in the PD group than the control group across all three testing sessions. The ML sway dispersion and ML sway velocity were also significantly higher in PD compared to control subjects by the 12-month evaluation. It is feasible to measure progression of PD prior to onset of treatment using accelerometer-based measures of quiet standing.