Do ankle foot orthoses modify postural control during bipedal quiet standing following a localized fatigue of the ankle muscles?

The purpose of the present experiment was to investigate the effects of wearing ankle foot orthoses (AFO) on postural control during bipedal quiet standing following a localized fatigue of the ankle muscles. To this aim, eight young healthy subjects were asked to stand upright as immobile as possible with and without AFO in two conditions of non-fatigue and fatigue of the ankle muscles. The center of foot pressure displacements (CoP) were recorded using a force platform. Larger CoP displacements in the fatigue than non-fatigue condition were observed without AFO along both the medio-lateral and antero-posterior axes. Interestingly, with AFO, these destabilizing effects were not observed along the medio-lateral axis. Altogether, the present findings suggested that the AFO allowed the subjects to limit the postural perturbation induced by a localized fatigue of the ankle muscles during bipedal quiet standing.     

Evaluation of sitting and standing postural balance in cerebral palsy by center-of-pressure measurement using force plates: comparison with clinical measurements

BackgroundCenter-of-pressure (CoP) measurements have been studied for assessing balance control. While CoP measurements using force plates have been used to assess standing balance in children with cerebral palsy (CP), it has not been assessed in a sitting position, which specifically reflects trunk postural control.Research questionThe purpose of this study was to compare CoP measurements using force plates during both standing and sitting trials with the Pediatric Balance Scale (PBS) in children with spastic CP.MethodsWe recruited 26 children with spastic CP (7.8 ± 3.4 years, 4–13 years) and used the PBS, a validated evaluation tool that measures static and dynamic balance control. We took CoP measurements using force plates during sitting and standing. For both trials, subjects stayed still for 10 s with their eyes open or closed. We calculated the CoP velocity, mediolateral (ML) and anteroposterior (AP) velocity, and ML and AP displacements of CoP.Results and SignificanceDuring standing trials, static PBS standing scores negatively correlated with more AP displacement and velocity than ML displacement and velocity (p < 0.05). During sitting trials, dynamic PBS sitting scores negatively correlated with ML displacement and velocity (p < 0.05). CoP parameters in the ML direction of the sitting position and CoP parameters in the AP direction of the standing position may better reflect the balance control in children with spastic CP.     

Disrupted somatosensory input alters postural control strategies during the Star Excursion Balance Test (SEBT) in healthy people

BackgroundChronic adaptations, including persistent sensorimotor deficits, remain in individuals with a history of ankle instability, resulting in altered postural control strategies during functional tasks such as gait, running, or landing. However, we do not know the contribution of the altered somatosensory input on postural control strategies during a dynamic balance task such as the Star Excursion Balance Test (SEBT).Research questionThe purpose of this study was to characterize postural control strategies with and without disrupted somatosensory input during a dynamic balance task in people without chronic ankle sprain.MethodsThis study was a crossover study design. Twenty healthy young adults (10 men, 10 women; age = 23.9 ± 3.0 years, height = 174.2 ± 7.4 cm, mass = 71.2 ± 16.7 kg) performed the posteromedial reach test during the SEBT while standing on the ground and on foam. We measured the maximum reach distance (MRD); joint angles of the ankle, knee, hip, and trunk in the sagittal, frontal, and transverse planes; and position and displacement of the center of mass (COM) and center of pressure (COP) during the posteromedial reach task.ResultsThe MRD was shorter when standing on the foam than on the ground (p < 0.001). There was a condition by phase interaction for ankle dorsiflexion; tibia internal rotation; and trunk flexion (p < 0.001; p = 0.03; p = 0.01, respectively). The COM and COP were positioned more laterally on the foam (p < 0.001). The COM and COP anterior-posterior displacements were more anterior during the foam condition (p = 0.017).SignificanceBy using a foam pad to disrupt somatosensory information, participants demonstrated altered strategies to control the joint kinematics, COM, and COP, as a function of posteromedial distance. Ankle and trunk movement strategies may influence the posteromedial reach distance. This model may simulate changes that occur with chronic ankle instability.     

Ankle muscle co-contractions during quiet standing are associated with decreased postural steadiness in the elderly

It has been reported that the elderly use co-contraction of the tibialis anterior (TA) and plantarflexor muscles for longer duration during quiet standing than the young. However, the particular role of ankle muscle co-contractions in the elderly during quiet standing remains unclear. Therefore, the objective of this study was to investigate the association between ankle muscle co-contractions and postural steadiness during standing in the elderly. Twenty-seven young (27.2 ± 4.5 yrs) and twenty-three elderly (66.2 ± 5.0 yrs) subjects were asked to stand quietly on a force plate for five trials. The center of pressure (COP) trajectory and its velocity (COPv) as well as the center of mass (COM) trajectory and its velocity (COMv) and acceleration (ACC) were calculated using the force plate outputs. Electromyograms were obtained from the right TA, soleus (SOL), and medial gastrocnemius (MG) muscles. Periods of TA activity (TAon) and inactivity (TAoff) were determined using an EMG threshold based on TA resting level. Our results indicate that, in the elderly, the COPv, COMv, and ACC variability were significantly larger during TAon periods compared to TAoff periods. However, in the young, no significant association between respective variability and TA activity was found. We conclude that ankle muscle co-contractions in the elderly are not associated with an increase, but a decrease in postural steadiness. Future studies are needed to clarify the causal relationship between (1) ankle muscle co-contractions and (2) joint stiffness and multi-segmental actions during standing as well as their changes with aging.     

Postural control in quiet standing in patients with psychotic disorders

There is evidence that patients with psychotic conditions display greater center of pressure (CoP) displacement during quite standing than healthy subjects, but the underlying impairments in the control mechanisms are uncertain. The aim of this study was to identify the nature of possible impairments in the control of posture by modulation of visual and kinesthetic information during quiet standing. Center of pressure (CoP) data and whole-body kinematics of the center of mass (CoM) were recorded during quite standing on a firm surface with eyes open and with eyes closed, and standing with eyes open on a yielding surface. During all three conditions, patients displayed greater migration of CoM and CoP–CoM, a measure related to ankle joint torque, whereas CoP-frequency (MPF) was similar in patients and healthy subjects. Our results suggested that greater postural sway in patients may depend on disproportionally large ankle joint torque without corresponding increase in frequency. Furthermore, interactions between groups and conditions suggested that the patients made less use of visual information for postural control than the healthy subjects.     

Age-related effects of a memorizing spatial task in the adults and elderly postural control

The aim of this study was to evaluate the age-related changes in postural control during a simple quiet standing task and a dual-task paradigm (applying a memory-spatial task and quiet standing). Thirty-five subjects were divided in two age-related groups: both younger (Y: 20-26 years) and older (O: 60-77 years) groups performed a simple postural task (quiet standing) and a dual-task (a visual memory task combined with quiet standing). Measures of the center of pressure (CoP) were recorded and its two components, the center of gravity (CG) and the differential CoP-CG, were evaluated. An age-related effect was observed in static postural performance during dual-tasking. Postural stability led to improved performance in younger subjects during the dual-task and but not in the elderly. Of the results suggest there is a "cognition first" principle for the younger adults, that is, the mirror image of the "posture first" principle observed in older adults under dual-tasking situations.     

Impaired postural control of axial segments in children with cerebral palsy

BackgroundSensorimotor control of axial segments, which develops during childhood and is not mature until adolescence, is essential for the development of balance control during motor activities. Children with cerebral palsy (CP) have deficits in postural control when standing or walking, including less stabilization of the head and trunk which could affect postural control.Research questionIs dynamic stabilization of axial segments during an unstable sitting task deficient in children with CP compared to typically developing children? Is this deficit correlated with the deficit of postural control during standing?MethodSeventeen children with CP (GMFCS I-II) and 17 typically-developing children from 6 to 12 years old were rated on the Trunk Control Measurement Scale (TCMS). In addition, posturography was evaluated in participants while they maintained their balance in stable sitting, unstable sitting, and quiet standing, under “eyes open” and “eyes closed” conditions. In sitting tasks, the participants had to remain stable while being prevented from using the lower and upper limbs (i.e. to ensure the involvement of axial segments alone).ResultsChildren with CP compared to TD children had significantly larger surface area, mean velocity and RMS values of CoP displacements measured during the unstable sitting task and the standing task, under both “eyes open” and “eyes closed” conditions. No significant group effects were observed during the stable sitting task. The TCMS total score was significantly lower, indicating trunk postural deficit, in the CP group than in the TD group and was significantly correlated with postural variables in the sitting and standing tasks.SignificanceChildren with CP indeed have a specific impairment in the postural control of axial segments. Since the postural control of axial segments is important for standing and walking, its impairment should be taken into account in rehabilitation programs for children with CP.     

Effects of age,sex and task on postural sway during quiet stance

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

Postural control in adolescent boys and girls before the age of peak height velocity: Effects of task difficulty

BackgroundAdolescent children experience a critical developmental period marked by rapid biological changes.Research questionTo describe the longitudinal changes in postural control that occur in adolescent boys and girls before the age of peak height velocity (PHV).MethodsHere, to address the gap of knowledge, we compared the postural control and activation strategies of the muscles that control the ankle joint in twenty-three boys (age 12.5 ± 0.29) and twenty-one girls (age 10.5 ± 0.32). They performed easy (two legs) and difficult (two legs-eyes closed; one leg) postural balance tasks at 18 and 9 months before PHV and at PHV. We quantified the center of pressure (COP) displacements in the anterior-posterior (AP) and mediolateral (ML) directions and electromyographic (EMG) activity of tibialis anterior (TA) and medial gastrocnemius (MG) muscles.ResultsBoys exhibited greater AP and ML COP displacement than girls only for the one leg task (difficult task). Although boys and girls had similar postural control 18 months prior to PHV, girls exhibited lesser COP displacement at 9 months before PHV, which related to greater TA-MG coactivation (R² = 0.26; p < 0.01). In contrast, postural control was not different between boys and girls with an easy balance task (two legs) performed with eyes open and closed. Rather, we found that all children improved their COP displacement in the ML direction with maturity and both AP and ML COP was significantly lower with eyes open.ConclusionThese findings provide novel evidence that postural control is superior in early adolescent girls than boys 9 months prior to PHV, likely associated with an earlier maturation of muscle coordination.     

Intrinsic foot muscles act to stabilise the foot when greater fluctuations in centre of pressure movement result from increased postural balance challenge

BackgroundIncreased postural balance challenge is associated with more fluctuations in centre of pressure movement, indicating increased interference from the postural control system. The role of intrinsic foot muscles in balance control is relatively understudied and whether such control system interference occurs at the level of these muscles is unknown.Research QuestionDo fewer fluctuations in intrinsic foot muscle excitation occur in response to increased postural balance challenge?MethodsSurface EMGs were recorded using a grid of 13 × 5 channels from the plantar surface of the foot of 17 participants, who completed three balance tasks: bipedal stance; single leg stance and bipedal tip-toe. Centre of pressure (CoP) movement was calculated from simultaneously recorded force plate signals. Fluctuations in CoP and EMGs for each task were quantified using a sample entropy based metric, Entropy Halflife (EnHL). Longer EnHL indicates fewer signal fluctuations.ResultsThe shortest EMG EnHL, 9.27 ± 3.34 ms (median ± interquartile range), occurred during bipedal stance and the longest during bipedal tip-toe 15.46 ± 11.16 ms, with 18.80 ± 8.00 ms recorded for single leg stance. Differences were statistically significant between bipedal stance and both bipedal tip-toe (p < 0.001) and single leg stance (p < 0.001). CoP EnHL for both anterior-posterior and medial-lateral movements also differed significantly between tasks (p < 0.001, both cases). However, anterior-posterior CoP EnHL was longest for bipedal stance 259.84±230.22 ms and shortest for bipedal tip-toe 146.25±73.35 ms. Medial-lateral CoP EnHL was also longest during bipedal stance 215.73±187.58 ms, but shortest for single leg stance 113.48±83.01 ms.SignificanceFewer fluctuations in intrinsic foot muscle excitation occur in response to increased postural balance challenge. Fluctuations in CoP movement during balance must be predominantly driven by excitation of muscles extrinsic to the foot. Intrinsic foot muscles therefore likely play a greater role in stabilisation of the foot than balance control during the postural tasks studied.     

Motor dual task with eyes closed improves postural control in patients with functional motor disorders: A posturographic study

BackgroundFunctional motor disorders (FMD) are highly disabling neurological conditions in which postural control deficits increase the risk of falls and disability in performing daily living activities. Scattered evidence suggests that such disturbances may depend on abnormal attentional focus and might improve with distraction.Research questionHow do motor and cognitive dual tasks performed under two different sensory conditions shape postural control in patients with FMD.MethodsThis posturographic study involved 30 patients with FMD (age, 45.20 ± 14.57 years) and 30 healthy controls (age, 41.20 ± 16.50 years). Postural parameters were measured with eyes open, and eyes closed in quiet stance (single task) and on a motor dual task (m-DT) and a calculation (cognitive) dual task (c-DT). The dual task effect (DTE, expressed in percentage) on motor and cognitive performance was calculated for sway area, length of Center of Pressure (CoP), and velocity of CoP displacement.ResultsThere was a statistically significant three-way interaction between task, condition, and group for the DTE on sway area (p = 0.03). The mean sway area DTE on the motor task in the eyes-closed condition was increased by 70.4 % in the healthy controls, while it was decreased by 1% in the patient group (p = 0.003). No significant three-way interaction was observed for the DTE on length of CoP and velocity of CoP displacement.SignificanceThis study provides novel preliminary evidence for the benefit of a simple motor dual task in the eyes closed condition as a way to improve postural control in patients with FMD. These findings are relevant for the management of postural control disorders in patients with FMD.     

Differences in postural control between healthy and subjects with chronic ankle instability

IntroductionChronic ankle instability (CAI) is characterized by the occurrence of repetitive inversion mechanism of the ankle, resulting in numerous ankle sprains. CAI occurs in approximately 70% of patients with a history of a lateral ankle sprain. Many causes of functional ankle instability have been postulated and include deficits in proprioception, impaired neuromuscular-firing patterns, disturbed balance and postural control.ObjectiveThe purpose of this study was to compare postural control behaviour in subjects with chronic ankle instability and healthy subjects, using the traditional linear and nonlinear variables for the centre of pressure (CoP) displacement, during one-leg stance on stable and unstable surfaces.Methods16 CAI subjects and 20 healthy subjects were evaluated with the single leg stance on a stable surface and an unstable surface, for 60 s with a force plate. The traditional linear variables like CoP displacement, CoP amplitude and CoP velocity were calculated. Variability of CoP displacement was also submitted to nonlinear analysis and the approximated entropy, sample entropy, correlation dimension and Lyapunov exponent were calculated.ResultsOn the stable surface, no differences between groups for all the traditional variables were found but the correlation dimension of CoP mediolateral displacement had lower values on the CAI group with statistical significance (p < 0.05). On the unstable surface, no differences were found neither with linear variable neither with variability nonlinear analysis.ConclusionCorrelated dimension of CoP displacement during one-leg stance on a stable surface was the only variable that show significant differences between the two groups. The lower values of this variable in the CAI subjects may implicate a balance control system with more difficulties to adapt to the environment and the task demands. More studies are needed to better understand CAI subjects balance control.     

Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability

ObjectiveTo study postural control and muscle activity during the limit of stability test (LOS) in subjects with chronic ankle instability.DesignObservational study.SettingUniversity laboratory.Participants10 healthy subjects were included in the control group and 10 subjects in the CAI group (age between 18 and 30 years, with history of the multiple ankle “giving way” episodes in the last six months and score ≤24 in the Cumberland Ankle Instability Tool).Main outcome measuresA computerized dynamic posturography equipment was used for assessing the LOS. The electromyography activity of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG) and peroneus longus (PL) was registered.ResultsSubjects with CAI had a greater activation in TA to forward (p < .01), forward affected (p = .001), backward affected (p = .007) and backward directions (p < .01); in PL to forward affected (p < .01) and affected directions (p = .001); in MG to forward (p = .023) and affected directions (p < .01) and in SOL to the affected direction (p = .009). We observed restricted excursions and less directional control in subjects with CAI.ConclusionsSubjects with CAI exhibited poorer ability to move their center of gravity within stability limits. In addition, they have an altered ankle muscle activity during LOS test toward the affected ankle joint.     

Can arm movements improve postural stability during challenging standing balance tasks?

BackgroundThere is growing evidence that arm movements make a substantial and functionally relevant contribution to dynamic balance. Additional insight of the important role of arm movements may be gained by quantifying the effects of arm restriction on the performance of commonly recommended static balance tasks of increasing difficulty.Research questionThe purpose of the present study was to determine whether restricting/permitting arm movements influences postural sway during tasks of various levels of difficulty.MethodsA total of 20 healthy and physically active adults (females; n = 10; age, 20.7 ± 1.3 years) randomly completed (a) quiet standing postural control tasks of increasing difficulty (bipedal, tandem, unipedal) on a fixed and foam surface, and (b) a dynamic postural control task (Y balance test), under two different verbally conveyed instructions of arm position; (1) restricted arm movement and (2) free arm movement. Centre of pressure outcomes measured during quiet standing served as a measure of static balance performance.ResultsThe results showed that restricting movements of the arms elicited large magnitude (Cohen’s d = 0.97 – 1.28) increases in mediolateral postural sway (P < 0.05) but not anteroposterior (P > 0.05) sway. These effects were only observed during challenging (tandem and unipedal) standing balance tasks. Restricting arm movements elicited a marked reduction in the Y Balance reach distance (all directions, P < 0.001, d = −0.53 to −1.15).SignificanceThe findings from the present study suggest that the contribution of the arms only become relevant when frontal plane balance is challenged. Moreover, the data indicate that arm movements are vital for the control of mediolateral postural sway.     

Relationship between postural sway on an unstable platform and ankle plantar flexor force steadiness in community-dwelling older women

BackgroundForce steadiness is evaluated as force variability during constant force exertion around a target level. Ankle plantar flexor force steadiness is reported to be related to postural sway on an unstable platform in healthy young adults; however, this relationship in older adults is unclear.Research questionThis study aimed to investigate whether ankle plantar flexor force steadiness was related to postural sway on stable and unstable platforms in older adults.MethodsTwenty-six community-dwelling older women participated in this study (72 ± 6 years). Maximal isometric strength and force steadiness at 5%, 20 %, and 50 % of the maximal strength of ankle plantar flexion were assessed. Postural sway in the anteroposterior direction during bipedal standing was measured on stable and unstable platforms.ResultsThe results showed that force steadiness at any intensity level and maximal isometric strength were not related to postural sway on the stable platform. Force steadiness at 20 % of maximal strength alone was significantly correlated with postural sway on the unstable platform (ρ = 0.441, p < 0.05).SignificanceThese results indicate that the ability to control muscle force could be important for postural stability on an unstable platform in older adults.     

Recurrence dynamics reveals differential control strategies to maintain balance on sloped surfaces

BackgroundStudies on postural control have primarily focused on the maintenance of balance in quiet upright standing on flat horizontal support surfaces that can reveal only a subset of the potential postural stability/instability configurations in everyday contexts.ObjectivesHere we investigated the nature of dynamical properties of postural coordination in an upright standing task as a function of the systematic scaling of seven support surface angles, +20°, +10° dorsiflexion (+), 0 °Flat, −10°, −20°, −30°, −35° plantarflexion (−), mounted on a force plate.MethodsThe center of pressure (CoP) and virtual time-to-contact (VTC) were analyzed to examine the spatial and spatio-temporal aspects of postural coordination dynamics, respectively. Recurrence quantification analysis (RQA) was used to characterize the dynamic postural control strategies as a function of slope surface angle.ResultsThe recurrence findings showed that on a flat surface the postural CoP dynamic are recurrent with a largely deterministic process and higher Shannon entropy compared to elevated slope angles in dorsiflexion and plantarflexion. There were asymmetrical patterns between similar slope angles for dorsiflexion and plantarflexion postures. The recurrence measures revealed that VTC operates on a higher embedding dimension than that of CoP.SignificanceVTC showed an enhanced sensitivity to detection of postural instability in relation to the stability boundary that was magnified on the flat surface but progressively reduced over larger surface angles for both the dorsiflexion and plantarflexion postures.     

Smartphone virtual reality to increase clinical balance assessment responsiveness

ObjectiveTo determine if a low cost smartphone based, clinically applicable virtual reality (VR) modification to the standard Balance Error Scoring System (BESS) can challenge postural stability beyond the traditional BESS.DesignCross-sectional study.SettingUniversity research laboratory.Participants28 adults (mean age 23.36 ± 2.38 years, mean height 1.74 m ± 0.13, mean weight 77.95 kg ± 16.63).Main outcome measuresBESS postural control errors and center of pressure (CoP) velocity were recorded during the BESS test and a VR modified BESS (VR-BESS). The VR-BESS used a headset and phone to display a rollercoaster ride to induce a visual and vestibular challenge to postural stability.ResultsThe VR-BESS significantly increased total errors (20.93 vs. 11.42, p < 0.05) and CoP velocity summed across all stances and surfaces (52.96 cm/s vs. 37.73 cm/s, p < 0.05) beyond the traditional BESS.ConclusionThe VR-BESS provides a standardized, and effective way to increase postural stability challenge in the clinical setting. The VR-BESS can use any smartphone technology to induce postural stability deficits that may otherwise normalize with traditional testing. Thus, providing a unique relatively inexpensive and simple to operate clinical assessment tool and∖or training stimulus.     

Transient characteristics of body sway during single-leg stance in athletes with a history of ankle sprain

BackgroundThe role of the measurements of postural stability in the context of screening for ankle sprain risk is still equivocal. Transient characteristics of body sway have been suggested as an alternative or an improvement to traditional whole-trial analyses.Research questionAre transient characteristics of body sway sensitive to the history of ankle sprain?.MethodsThe assessment of 30-s single-leg body sway was performed on a group of 93 athletes from basketball, soccer, tennis and running who reported at least 1 ankle sprain in the last 12 months, while a group of 244 athletes from the same disciplines served as a control group without an ankle sprain reported for the same time period. We considered the mean center-of-pressure (CoP) velocity, CoP amplitude and CoP frequency. In addition to traditional whole-trial variables, we calculated the relative differences between the 1 st and the 2nd (DIF_21) and 1 st and 3rd (DIF_31) 10-s time intervals within the whole trial.ResultsThe indexes of transient characteristics of body sway (i.e., the DIF_21 and DIF_31) were in trivial or weak correlations with whole-trial variables (all r ≤ 0.29). Athletes with ankle sprain history exhibited smaller CoP ML velocity (p = 0.002) and larger CoP ML frequency (p = 0.001). In the injured group, the injured leg exhibited lower total and medial-lateral (ML) CoP velocity (p = 0.005−0.040), as well as lower CoP ML amplitude (p = 0.002) and higher CoP ML frequency (p = 0.010). The transient characteristics of body sway (DIF_21 and DIF_31) were very similar between the groups and between the injured and uninjured legs.SignificanceTransient characteristics of body sway do not appear to differentiate the athletes with and without a history of ankle sprain. Further research is needed to confirm if the transient characteristics of body sway could be used for detection of risk of falls in older adults or assessment of athletic performance.     

Effects of initial foot position on postural responses to lateral standing surface perturbations in younger and older adults

BackgroundAn age-related decline in standing balance control in the medio-lateral direction is associated with increased risk of falls. A potential approach to improve postural stability is to change initial foot position (IFP).Research questionsIn response to a lateral surface perturbation, how are lower extremity muscle activation levels different and what are the effects of different IFPs on muscle activation patterns and postural stability in younger versus older adults?MethodsTen younger and ten older healthy adults participated in this study. Three IFPs were tested [Reference (REF): feet were placed parallel, shoulder-width apart; Toes-out with heels together (TOHT): heels together with toes pointing outward; Modified Semi-Tandem (M-ST): the heel of the anterior foot was placed by the big toe of the posterior foot]. Unexpected lateral translations of the standing surface were applied. Electromyographic (EMG) activity of the lower extremity muscles, standard deviation (SD) of the body’s CoM acceleration (SD of CoMAccel), and center of pressure (CoP) sway area were compared across IFPs and age.ResultsActivation levels of the muscles serving the ankle and gluteus medius were greater than for the knee joint muscles and gluteus maximus in the loaded leg across all IFPs in both groups. TOHT showed greater EMG peak amplitude of the soleus and fibularis longus compared to REF, and had smaller SD of CoMAccel and CoP sway area than M-ST. Compared to younger adults, older adults demonstrated lower EMG peak amplitude and delayed peak timing of the fibularis longus and greater SD of CoMAccel and CoP sway area in all IFPs during balance recovery.SignificanceDuring standing balance recovery, ankle muscles and gluteus medius are important active responders to unexpected lateral surface perturbations and a toes-out IFP could be a viable option to enhance ankle muscle activation that diminishes with age to improve postural stability.     

Biomechanical analysis of single-leg stance using a textured balance board compared to a smooth balance board and the floor: A cross-sectional study

BackgroundPrevious research showed that standing on textured surfaces can improve postural control by adapting somatosensory inputs from the plantar foot. The additional stimulation of plantar cutaneous mechanoreceptors by a textured surface during single-leg stance on a balance board may increase afferent information to the central nervous system to accelerate muscular responses and to enhance their accuracy. The additional impact of textured surface during single-leg stance on a balance board on postural control and muscle activity is unknown.Research questionTo investigate the differences of a) postural control during single-leg stance on a textured balance board compared to a smooth balance board and b) activity of lower extremity muscles during single-leg stance on a textured balance board compared to a smooth balance board and the floor.MethodsTwenty-six healthy adults (12 females, 14 males; mean age = 25.4 years) were asked to balance on their randomly assigned left or right leg on a force plate (floor; stable condition), a textured balance board and a smooth balance board (unstable conditions). Center of pressure (CoP) displacements (force plate, Bertec, 1000 Hz) and electromyographic activity (EMG) of eight leg muscles were measured and compared between conditions, respectively.ResultsNeither CoP-displacements, nor EMG activities differed significantly between the textured and the smooth balance board (p > 0.05). Significantly higher muscle activities (p < 0.05) were observed using the balance boards compared to the floor.SignificanceSingle-leg stance using a textured balance board seems not to lead to reduced CoP-displacements compared to a smooth balance board. Muscle activation is significantly increased in both balance board conditions compared to the floor, however, it is not different when both balance board surfaces are compared. It could not be recommended to use a textured balance board for altering muscle activity and improving postural control during single-leg stance in favor of a smooth textured balance board.