Muscle reaction function of individuals with intellectual disabilities may be improved through therapeutic use of a horse

Reaction time and muscle activation deficits might limit the individual's autonomy in activities of daily living and in participating in recreational activities. The aim of the present study was to assess the effects of a 14-week hippotherapy exercise program on movement reaction time and muscle activation in adolescents with intellectual disability (ID). Nineteen adolescents with moderate ID were assigned either to an experimental group (n = 10) or a control group (n = 9). The experimental group attended a hippotherapy exercise program, consisting of two 30-min sessions per week for 14 weeks. Reaction time, time of maximum muscle activity and electromyographic activity (EMG) of rectus femoris and biceps femoris when standing up from a chair under three conditions: in response to audio, visual and audio with closed eyes stimuli were measured. Analysis of variance designs showed that hippotherapy intervention program resulted in significant improvements in reaction time and a reduction in time to maximum muscle activity of the intervention group comparing to the control group in all 3 three conditions that were examined (p < 0.05). The present findings suggest that the muscle reaction function of individuals with ID can be improved through hippotherapy training. Hippotherapy probably creates a changing environment with a variety of stimuli that enhance deep proprioception as well as other sensory inputs. In conclusion, this study provides evidence that hippotherapy can improve functional task performance by enhancing reaction time.     

Effects of aerobic,resistance and balance training in adults with intellectual disabilities

Adults with intellectual disability (ID) have decreased cardiovascular fitness and strength present with lower rates of physical activity (PA), and often have balance and functional impairments. The purpose of this study was to investigate the effect of a combined PA program (CPAP) utilizing aerobic, strength and balance training on cardiovascular fitness, strength, balance and functional measures in a controlled clinical trial. Adults with mild to moderate ID were assigned into either the intervention group (IG; n = 37) or the control group (CG; n = 29). The IG trained 3 day/week, 1 h/day over 14 weeks, while the CG did not participate in any exercise program. Cardiovascular fitness, strength, balance, flexibility and functional ability were assessed pre-post training. The IG increased cardiovascular fitness (26.8 vs. 29.3 ml kg⁻¹ min⁻¹), handgrip strength (19.2 vs. 21.9 kg), leg strength, and balance following the training period (p < .05). Body weight (70.1 vs. 68.1 kg) and body mass index (27.4 vs. 26.6 kg m⁻²) decreased (p < .05) in the IG group. The CG showed no changes in any parameter. These data suggest a combined aerobic, strength and balance exercise training program is beneficial among individuals with ID.     

Does extending the dual-task functional exercises workout improve postural balance in individuals with ID?

Maintaining postural balance, overcoming visual and motor coordination disorders and experiencing problems with low general fitness - typical of intellectually disabled individuals - adversely affect the performance quality of their activities of daily living (ADLs). Physical fitness and postural balance can be improved by taking part in special intervention programs. Our study was designed to test whether extending the dual-task intervention program (combining ADLs with balance exercises on unstable surfaces) from 12 to 24 weeks additionally improved postural balance in individuals with intellectual disability (ID). We also attempted to assess whether the effects of the above intervention program were still noticeable after 8 weeks of holidays, in which participants did not take any rehabilitation exercises. A total of 34 adolescents, aged 14–16 years (15.06 ± 0.9), with moderate ID took part in our study. The experimental group (E) consisted of 17 individuals, who continued the intervention program originated 3 months earlier, and the control group (C) comprised the same number of participants. Postural balance was assessed on a stabilometric platform Alfa. Having extended the workout period by another 12 weeks, we noticed that the path length of the center of pressure (COP) covered by participants on tests with their eyes open and closed significantly shortened. After a lapse of 8 weeks from the completion of the program, the experimental group revealed a statistically significant decrease in the velocity along the medio-lateral (M/L) and anterior–posterior (A/P) axes. The remaining variables stayed at the same level and the control group did not demonstrate any statistically significant changes.Dual-task exercises, in which enhancing functional tasks of daily living is combined with a parallel stimulation of balance reactions, may improve static balance in persons with ID.     

Feasibility and outcomes of the Berg Balance Scale in older adults with intellectual disabilities

High incidence of falls and increased risk of fall-related injuries are seen in individuals with intellectual disabilities (ID). The Berg Balance Scale (BBS) is a reliable instrument for balance assessment in the population of (older) adults with ID. The aims of this study were to assess the balance capacities of a large group of older adults with ID with the BBS and look for gender and age effects, as well as reasons for drop-out on separate items, and to identify feasible subtests for subgroups in which the complete BBS is not feasible. The balance capacities of 1050 older clients with borderline to profound ID of three Dutch care-provider services (mean age 61.6 [sd = 8.0]) were assessed with the BBS. The participants who completed all items of the BBS (n = 508) were the functionally more able part of the study sample. Results showed that even this functionally more able part had poor balance capacities, with a mean BBS score of 47.2, 95% CI [46.3, 48.0], similar to adults in the general population aged around 20 years older. Balance capacities decreased with increasing age and females had poorer balance capacities than males. Difficulties understanding the task and physical limitations were most often the reasons for drop-out. Feasible subtests were identified for the subgroups with very low cognitive levels and wheelchair users. Low balance capacities of older adults with ID show the need for regular screening and the urge for fall prevention programs for individuals with ID.     

Effect of Wii-intervention on balance of children with poor motor performance

The purpose of this study was to investigate the effects of training with the Wii-balance board on balance and balance-related skills of children with poor motor performance. Twenty-nine children (23 boys, 6 girls; aged 7–12 years) participated in this study and were randomly assigned to an experimental and control group. All children scored below the 16th percentile on a standardized test of motor ability and balance skills (Movement Assessment Battery for children (M-ABC-2)). Before and after a six-week Wii-intervention (M = 8 h, 22 min, SD = 53 min), the balance skills of the experimental group and control group were measured with the M-ABC-2 and the Bruininks–Oseretsky test of motor proficiency (BOT-2). Both groups improved on all tests. The M-ABC-2 and the BOT-2 total balance-scores of the experimental group improved significantly from pre to post intervention, whereas those of the control group showed no significant progress. This resulted in significant interaction-effects, favoring the experimental children. No transfer-effects of the intervention on balance-related skills were demonstrated. Our findings showed that the Wii-balance board is an effective intervention for children with poor balance control. Further development and investigation of the intervention could be directed toward the implementation of the newly acquired balance-skills in daily life.     

Vestibulo-ocular response and balance control in children and young adults with mild-to-moderate intellectual and developmental disability: A pilot study

The vestibulo-ocular response (VOR) may not be fully developed in children with an intellectual and developmental disability (IDD). This study aimed to identify the presence of VOR deficit in children and young adults with unspecified mild-to-moderate intellectual and developmental disability and its effect on balance control. Twenty-one children and young adults with IDD ranging in age from 8 to 22 years (mean 17.5 ± 3.9 years) were included in the study. The VOR was evaluated with the Head Impulse Test and the Static and Dynamic Visual Acuity Test (S&D-VAT). Postural stability was measured in an upright standing position by the Clinical Test for Sensory Interaction in Balance (CTSIB), single leg stance (SLS) during eyes open and eyes closed, and Romberg stance under eyes open and eyes closed conditions using a force platform. Reduced vestibulo-ocular responses were found in 13 of 21 (62%) participants who were able to complete testing. In the fifth condition of the CTSIB (standing on foam with eyes closed), those without VOR deficit were able to maintain balance longer than those with VOR deficit (29 s [median 30] vs. 12 s [median 7.3], respectively; p = 0.03). The study demonstrates potential effects of VOR deficit in children and young adults with IDD and some significant differences in balance control between those with and without a VOR deficit. VOR function in children and young adults with IDD should be routinely tested to enable early detection of deficits.     

Clinical measures are feasible and sensitive to assess balance and gait capacities in older persons with mild to moderate Intellectual Disabilities

Mobility limitations are common in persons with Intellectual Disabilities (ID). Differences in balance and gait capacities between persons with ID and controls have mainly been demonstrated by instrumented assessments (e.g. posturography and gait analysis), which require sophisticated and expensive equipment such as force plates or a 3D motion analysis system. Most physicians and allied healthcare professionals working with persons with ID do not have such equipment at their disposal, so they must rely on clinical tests to determine whether balance and gait are affected. The aim of this study was to investigate whether existing clinical balance and gait tests are feasible in older persons with mild to moderate ID and to examine whether these tests are able to show limitations in balance and gait capacities in the ID population compared to age-matched peers in the general population. Furthermore, it was aimed to identify the most important determinants of balance and gait disability in persons with the ID. A total of 76 older persons with mild to moderate ID (43 male, mean age 63.1 ± 7.6 years) and 20 healthy controls (14 male, mean age 62.2 ± 5.6 years) participated. Balance and gait abilities were assessed with the Berg Balance Scale (BBS), the Functional Reach test (FR), the Timed Up and Go Test (TUGT), the timed Single Leg Stance (SLS) and the Ten Metre Walking Test (TMWT). Our study showed that it is feasible to conduct standard clinical balance and gait tests in older persons with mild to moderate ID. Balance and gait performance of persons with ID is substantially worse compared to older persons of the general population. Age, number of co-morbidities, Body Mass Index (BMI), body sway and fear of falling are associated with balance and gait performance in persons with ID. These factors might help in the selection of subjects to be monitored on their balance and gait capacities.     

The efficacy of an aquatic program on physical fitness and aquatic skills in children with and without autism spectrum disorders

This study evaluated the efficacy of a 14-week aquatic program on physical fitness and aquatic skills for children with autism spectrum disorders (ASD) and their siblings without a disability. Children with ASD (n = 15) and their siblings (n = 15), between 7 and 12 years (8.55 ± 2.19 years) participated. In the first 14-week phase, 14 children (group A: ASD, n = 7; siblings, n = 7) received the aquatic program while 16 children (group B: ASD, n = 8; siblings, n = 8) did not. The arrangement was reversed in the second phase of another 14 weeks. Both groups continued their regular treatments/activities throughout the study. Improvements were seen in aquatic skills and physical fitness components except subtest body composition for group A and group B subsequent to aquatic program. The results provide evidence that intervention can be developed to promote motor skills and physical fitness components for children with ASD and their siblings.     

The effects of a Special Olympics Unified Sports Soccer training program on anthropometry,physical fitness and skilled performance in Special Olympics soccer athletes and non-disabled partners

The study investigated the effects of a Special Olympics (SO) Unified Sport (UNS) soccer program on anthropometry, physical fitness and soccer skills of male youth athletes with and without intellectual disabilities (ID) who participated in a training group (TRG) and in a comparison group (CG) without specific training.Youth with ID (WID) were randomly selected out of all the students between the ages 12 and 15, with a diagnosis of educable mental retardation and no secondary disabilities, who were attending a special education school. Participants without ID (WoID) were randomly selected from a regular secondary school out of the same age groups of male students. All participants were given permission by their parents or guardians to participate in the study. Participants in the TRG included 23 youth WID and 23 youth WoID. Mean ages were = 14.1 (SD = 1.1) and 13.2 (SD = 0.79) respectively. Fifteen WID, and 15 WoID comprised the CG. Mean ages were 14.51 (SD = 0.81) and 13.78 (SD = 0.49) respectively. Prior to and following the program measurements were conducted, and data were collected on students’ anthropometric and fitness components of the Brockport physical fitness test as well as a soccer skill performance based on the SO soccer skill test. Participants in the TRG trained 8 weeks, 1.5 h per session, three times per week, in an after-school soccer program. CG did not participate in any sports program outside of the school physical education class.Dependent t tests and effect size calculations revealed that SO athletes and non-disabled partners scored significantly higher with regard to physical fitness and football skills in most variables compared with their CG.This Unified Program was successful in increasing fitness and soccer skill performance of youth WID as well as of those WoID.     

The effects of balance training intervention on postural control of children with autism spectrum disorder: Role of sensory information

PurposeThe aim of this study was to investigate the effect of balance training intervention in children with autism spectrum disorder (ASD), and to explore the relative role of the sensory systems in such kids.MethodologyWe recruited 20 school children (IQ > 80) diagnosed with ASD, and categorized them in two groups; a 10-member training group (average age: 7.70 ± 1.05) and a 10-member control group (average age: 7.90 ± 1.10). Thus, following a six-week-long balance training intervention in four conditions of bipedal upright stance [compliant (Foam) vs. non-compliant (Hard) with eyes-open (EO) vs. eyes-closed (EC)], we examined measures such as mean velocity (V), anteroposterior (AP) and mediolateral (ML) axis displacement, and compared the results to those calculated prior to the initiation of the intervention using MANOVA test.ResultsThis study showed that the balance training program efficiently improved the postural control in ASD suffering children, and that removing the visual and plantar proprioceptive information led to increased sway in both groups. The training group performed significantly better than the control group in all conditions.ConclusionIt is thus concludable that children suffering from ASD can benefit from such balance training programs to improve their balance and postural control.     

Early motor development of children with a congenital cytomegalovirus infection

BackgroundCongenital cytomegalovirus (cCMV) infection is the most important etiology of non-hereditary childhood hearing loss and an important cause of neurodevelopmental delay. The current study aimed to investigate the early motor development of symptomatic and asymptomatic cCMV infected children with and without sensorineural hearing loss (SNHL).MethodsSixty-four children with a cCMV infection, without cerebral palsy, were compared to a control group of 107 normal hearing children. They were assessed around the ages of 6, 12, and 24 months with the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS), and Ghent Developmental Balance Test (GDBT). The cCMV infected children were subdivided into a symptomatic (n = 26) and asymptomatic cCMV group (n = 38) but also into a cCMV group with SNHL (n = 19) and without SNHL (n = 45).ResultsSymptomatic cCMV infected children and cCMV infected children with SNHL performed significantly weaker for all gross motor outcome measures.ConclusionA congenital CMV infection is a risk factor for a delay in the early motor development. Follow-up will be necessary to gain insight into the exact cause of this motor delay and to define the predictive value of early motor assessment of cCMV infected children.     

The effectiveness of a fundamental motor skill intervention in pre-schoolers with motor problems depends on gender but not environmental context

This study evaluated the effect of a 10-week fundamental motor skill programme in pre-schoolers with motor problems. Alongside the general effect of the intervention, we also explored possible gender differences and the role of the environmental context (living community, socio-economic status, and recreational space inside/outside the house). The intervention group (n = 47; 20 ♂ and 27 ♀) received twenty 60-min motor skill sessions (2 per week) in addition to the regular physical education curriculum for pre-schoolers; the control group (n = 46; 21 ♂ and 25 ♀) did not receive additional practice. General motor competence, and locomotor and object control subscales, were assessed before and after the intervention using the Test of Gross Motor Development 2nd edition (TGMD-2). Data regarding environmental factors were gathered through a questionnaire. A Group × Gender × Time ANOVA revealed that the intervention group benefited significantly from the intervention and scored better than the control group at the post-test for general motor competence and both sub-categories (locomotor and object control skill). Moreover, the intervention programme was found to be effective in helping 49% of the intervention group to achieve an average motor skill level, according to the TGMD-2 norms, while a further decline in motor competence was observed in the control group. Interestingly, the effect appeared to be gender-specific, since object control skill improved only in girls of the intervention group. Considering the environmental context, none of the above-mentioned factors was found to have an influence on the effectiveness of the intervention. The present study highlights the need for an early motor skill programme with a gender-specific approach in order to help low skilled boys and girls master a diverse set of motor skills.     

A randomised controlled trial of a computerised intervention for children with social communication difficulties to support peer collaboration

An intervention aiming to support children with social communication difficulties was tested using a randomised controlled design. Children aged 5–6 years old (n = 32) were tested and selected for participation on the basis of their scores on the Test of Pragmatic Skills (TPS) and were then randomly assigned to the intervention arm or to the delayed intervention control group. Following previous research which suggested that computer technology may be particularly useful for this group of children, the intervention included a collaborative computer game which the children played with an adult. Subsequently, children's performance as they played the game with a classmate was observed. Micro-analytic observational methods were used to analyse the audio-recorded interaction of the children as they played. Pre- and post-intervention measures comprised the Test of Pragmatic Skills, children's performance on the computer game and verbal communication measures that the children used during the game.This evaluation of the intervention shows promise. At post-test, the children who had received the intervention, by comparison to the control group who had not, showed significant gains in their scores on the Test of Pragmatic Skills (p = .009, effect size r = −.42), a significant improvement in their performance on the computer game (p = .03, r = −.32) and significantly greater use of high-quality questioning during collaboration (p < .001, r = −.60). Furthermore, the children who received the intervention made significantly more positive statements about the game and about their partners (p = .02, r = −.34) suggesting that the intervention increased their confidence and enjoyment.     

Differences in counter-movement jump between boys with and without intellectual disability

The purpose of this study was to describe the performance and biomechanical parameters of the counter-movement jump for young people with ID, in comparison with age matched individuals without ID. Volunteers with ID (n = 13; age = 15.3 ± 1.6 years; Wisk III intelligence quotient 55.6 ± 11.2) and without ID (n = 13; age = 15.4 ± 1.2 years) performed maximal counter-movement jumps, while knee kinematics, vertical ground reaction forces and electromyographic activity of the vastus lateralis and biceps femoris were captured. Individuals without ID jumped higher than their counterparts with ID and had lower take-off velocity, lower knee joint power and stiffness, lower knee joint extension angle and angular velocity, longer braking and propulsion phase, lower agonist and higher antagonist EMG activity. These results give an insight on possible causes for the performance deficit in CMJ in persons with ID and give the potential for such individuals to improve their ability to jump higher and more efficiently.     

The effect of a combined strength and proprioceptive training on muscle strength and postural balance in boys with intellectual disability: An exploratory study

The aim of our study was to investigate the effect of a combined strength and proprioception training (CSPT) program on muscle strength and postural balance in children with intellectual disability (ID). The maximum voluntary contraction (MVC) and postural parameters (CoP_Vm, CoP_LX, CoP_LY) of 20 children with ID were recorded before and after 8 weeks of a CSPT program. The participants were divided into two groups: an experimental group who attended a CSPT program and a control group who continued with daily activities. In the trained group, the MVC increased significantly (p < 0.001) after the training period and the postural parameters decreased significantly in Double-Leg Stance (DLS) and One-Leg Stance (OLS) during the firm surface condition as well as in the DLS during the foam surface condition; in both eyes open (EO) and eyes closed (EC) conditions. A CSPT program improves postural balance in children with ID could be due to the enhancement in muscle strength and proprioceptive input integration.     

The effects of an exercise training program on hand and wrist strength,and function,and activities of daily living,in adults with severe Cerebral Palsy

The purpose of the current study was to establish measurement reliability in adults with Cerebral Palsy (CP), and to examine the feasibility and outcomes of an upper extremity strength training program (three times per week for 90 min each time). A control group design mixed with a prospective time series design for the intervention group was completed, including a pre-test, a post-test after a 12-week intervention period, and a follow-up in the intervention group after an additional 10-week period. Seventeen adults with CP with severe motor impairment took part in the study (10 in the intervention and seven in the control group). The test battery was comprised of wrist and hand dynamometry; dominant hand upper-extremity function measures (Jebsen Hand Function Test = JHFT, Minnesota Manual Dexterity Test = MMDT, and the Nine Hole Peg Test = NHPT); and activity of daily living with the Barthel Index.The results indicated that in both the control and the intervention groups, the strength tests exhibited good-to-excellent reliability during pre-test and post-test. The group comparison revealed that while in the pre-test no between-group differences existed, in the post-test the strength training group demonstrated significantly higher values in five out of eight strength measures, as well as in the MMDT. Discontinuing the program for eight weeks reversed the effects almost to baseline. In conclusion, the outcomes demonstrated the reliability of the assessments utilized in this study, as well as the feasibility of the strength training program, in adults with severe motor impairment due to CP.     

Acceptance and mindfulness-based stress management for support staff caring for individuals with intellectual disabilities

Support staff working with individuals with intellectual disability (ID) and challenging behaviour experience high levels of work-related stress. Preliminary theoretical and experimental research has highlighted the potential suitability of acceptance and mindfulness approaches for addressing support staff stress. This study examines the effectiveness of an acceptance and mindfulness-based stress management workshop on the levels of psychological distress and well-being of support staff working with individuals with ID and challenging behaviour. Support staff (n = 120) were randomly assigned to a workshop intervention condition (n = 66) or to a waiting list control condition (n = 54). Measurements were completed at three time points (pre-, post and 6 week follow-up) for: psychological distress, well-being, perceived work stressors, thought suppression, and emotional avoidance/psychological inflexibility. Main Findings: The intervention led to significantly greater reductions in distress in the intervention group than in the control group. This was largely maintained at 6 week follow-up. This effect was more pronounced amongst a subsample that had shown higher levels of psychological distress at baseline. Thought suppression was found to reduce significantly in the intervention group between post intervention and follow-up, although no significant change was found in well-being or experiential avoidance/psychological inflexibility. Overall, results demonstrated support for the effectiveness of an acceptance and mindfulness-based intervention in reducing distress.     

Effects of MISC intervention on cognition,autonomy, and behavioral functioning of adult consumers with severe intellectual disability

This study examined the effects of a yearlong Mediational Intervention for Sensitizing Caregivers (MISC; Klein, 1992) on: (a) the quality of interactions between rehabilitation day center paraprofessional staff (n = 10) and their adult consumers (n = 19) with severe intellectual disability (ID) and (b) the consumers’ cognition, autonomy, and behavioral functioning, versus a consumers’ control group (n = 13). Regarding the staff–consumer interactions, more mediation of meaning (choice-making), expansion, and competence with explanation and less mediation of physical assistance were observed in the intervention group than in the control group following intervention. On a battery of cognitive measures (n = 17), consumers in the MISC group improved their arithmetic skills, temporal concepts, and sequential memory of two digits. Behavioral observations indicated that the MISC group revealed increased positive behaviors, autonomy, and duration of work and decreased verbal and maladaptive behaviors.     

Effects of physical activity on executive function and motor performance in children with ADHD

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often show major deficits in motor and cognitive abilities. Pharmacological treatment is commonly used to reduce ADHD symptoms. However, non-pharmacologic treatment methods would be preferred by parents, children and psychiatrists. Physical activity (PA) has been demonstrated to improve cognitive functioning in healthy populations. It can be hypothesized that there are similar beneficial effects in children with ADHD, however, very little is known about this issue. The purpose of the present study was to determine whether PA improves cognitive performance in children with ADHD.A total of 43 children with ADHD (32 boys and 11 girls) aged between seven and 12 years took part in the study. To investigate whether potential effects on executive functioning depend on the kind of PA, two different 12-week training programs were implemented. The study-design consisted of two experimental groups (EG1, n = 13; EG2, n = 14) and a wait-list control group (CG, n = 16). Participants in EG1 took part in a training which focused on the abilities ball handling, balance and manual dexterity. Participants in EG2 group were trained in sports without a specific focus. The children in the CG group received no intervention. Participants completed assessments of working memory (WM) and motor performance before, immediately after the first training week and one week after the last session. After the 12-week intervention period, several measures of the EG1 and EG2s significantly improved over time. Furthermore, between group comparisons demonstrated significant improvements in both EG1 and EG2 compared to the CG in variables assessing WM performance and motor performance. These findings support the hypothesis that long-term PA has a positive effect on executive functions of children with ADHD, regardless of the specificity of the PA. The outcomes indicated that regular PA can be used as a complementary or alternative non-pharmacologic treatment for ADHD.     

Differential effect of Taekwondo training on knee muscle strength and reactive and static balance control in children with developmental coordination disorder: A randomized controlled trial

This randomized controlled trial aimed to investigate the effect of short-term intensive TKD training on the isokinetic knee muscle strength and reactive and static balance control of children with developmental coordination disorder (DCD). Among the 44 children with DCD (mean age: 7.6 ± 1.3 years) recruited, 21 were randomly assigned to undergo daily TKD training for 1 h over three consecutive months, with the remaining 23 children being assigned to the DCD control group. Eighteen typically developing children (mean age: 7.2 ± 1.0 years) received no training as normal controls. Knee extensor and flexor muscle strength and reactive and static balance control were assessed using an isokinetic machine (with low, moderate and high movement velocities), a motor control test (MCT) and a unilateral stance test (UST), respectively. A repeated measures MANCOVA revealed a significant group through time interaction effect in isokinetic outcomes at 180°/s and in the UST outcome. Post hoc analysis demonstrated that DCD-TKD children's isokinetic knee muscle strength, specifically at 180°/s, was as high as that of the normal control children (p > 0.0083) after TKD training. Moreover, UST body sway velocity was slower in the DCD-TKD group than in the DCD control group (p < 0.001), and was comparable to that of the normal control group (p > 0.05) after TKD training. However, no such improvement in balance was observed in the MCT (p > 0.025). The results show that children with DCD who undergo a 3-month program of intensive TKD training experience improvements in isokinetic knee muscle strength at 180°/s and static single-leg standing balance control, but do not benefit from improved reactive balance control.