Star excursion balance test scores under different conditions: Effects of arms position and shoe-wear

ObjectivesThe purpose of this study was to investigate the effects of arms position (arms free or hands on the hips) and shoe-wear (with or without athletic shoe) on star excursion balance test (SEBT) scores in healthy physically active individuals.DesignCross-sectional study.MethodsFifty-one participants [Age: 22.74 ± 1.93 years; Body Mass Index: 22.52 ± 2.29 kg/m²] were included in the study. The anterior (ANT), posteromedial (PM) and posterolateral (PL) reach directions of the SEBT were performed under four conditions in a randomized order. Within session reliability analysis was performed for each test condition. The composite (COMP) score was calculated as the average of the normalized scores of anterior, posteromedial and posterolateral reach distances. Repeated measures of ANOVA was used for statistical analysis.ResultsThe ANT and PM reach distances and the composite (COMP) score were found greater with shoes (ANT p = 0.004; PM p < 0.001; COMP p < 0.001). However, the difference in the scores with shoes conditions did not exceed the measurement error. On the other hand, PM and PL reach distances and the COMP score were greater with arms free conditions and the difference in the scores exceeded the measurement error.ConclusionsThe results of the study suggest that the differences in the SEBT procedure should be taken into account when comparing the outcomes of different studies. In addition, measurement error values should be considered while interpreting the change in repeated measures of SEBT scores.     

The effect of a balance training programme on centre of pressure excursion in one-leg stance

Background. Balance training is widely used in the rehabilitation after an ankle sprain and is thought to have a decreasing effect on postural sway. The present study investigated whether a 5.5-week balance training programme leads to a decreased postural sway showing in a reduced range of centre of pressure excursion.

Methods. Thirty university students participated in this study. Twenty-two untrained subjects were randomly assigned to either an intervention group (n = 11) or a control group (n = 11). The remaining eight subjects were participants in an organized volleyball competition and were assigned to an additional volleyball group (n = 8). All subjects of the intervention group and the volleyball group received a 5.5-week balance training programme, while subjects of the control group received no training. Centre of pressure of the ground reaction force was measured as a proxy measure of postural sway, using a force platform. Measurements took place before and after the 5.5-week training programme for standing on one leg (both for right and for left leg) of single leg stance, both for the eyes-open and eyes-closed situation. From these measurements centre of pressure excursion in the anterior–posterior and the medial–lateral direction was calculated. A linear regression analysis was performed to check for differences in centre of pressure excursion between any of the groups over the training period.

Findings. No differences in changes of centre of pressure excursion were found between any of the groups over the 5.5-week training period.

Interpretation. Balance training does not lead to a reduction in centre of pressure excursion in a general population consisting of non-injured and previously injured subjects.     

Kinematic predictors of star excursion balance test performance in individuals with chronic ankle instability

BackgroundThe Star Excursion Balance Test has identified dynamic postural control deficits in individuals with chronic ankle instability. While kinematic predictors of Star Excursion Balance Test performance have been evaluated in healthy individuals, this has not been thoroughly examined in individuals with chronic ankle instability.MethodsFifteen individuals with chronic ankle instability completed the anterior reach direction of the Star Excursion Balance Test and weight-bearing dorsiflexion assessments. Maximum reach distances on the Star Excursion Balance Test were measured in cm and normalized to leg length. Three-dimensional trunk, hip, knee, and ankle motion of the stance limb were recorded during each anterior reach trial using a motion capture system. Sagittal, frontal, and transverse plane displacement observed from trial initiation to the point of maximum reach was calculated for each joint or segment and averaged for analysis. Pearson product–moment correlations were performed to examine the relationships between kinematic variables, maximal reach, and weight-bearing dorsiflexion. A backward multiple linear regression model was developed with maximal reach as the criterion variable and kinematic variables as predictors.FindingsFrontal plane displacement of the trunk, hip, and ankle and sagittal plane knee displacement were entered into the analysis. The final model (p = 0.004) included all three frontal plane variables and explained 81% of the variance in maximal reach. Maximal reach distance and several kinematic variables were significantly related to weight-bearing dorsiflexion.InterpretationIndividuals with chronic ankle instability who demonstrated greater lateral trunk displacement toward the stance limb, hip adduction, and ankle eversion achieved greater maximal reach.     

Acute effects of rearfoot manipulation on dynamic standing balance in healthy individuals

Dynamic standing balance is essential to perform functional activities and is included in the treatment of many lower extremity injuries. Physiotherapists utilize many methods to restore standing balance including stability exercises, functional retraining, and manual therapy. The purpose of this study was to investigate the effects of a rearfoot distraction manipulation on dynamic standing balance. Twenty healthy participants (age: 24.4 ± 2.8 years; height: 162.9 ± 37.7 cm; mass: 68.0 ± 4.8 kg; right leg dominant = 20) completed this study. Following familiarization, dynamic standing balance was assessed during: (1) an experimental condition immediately following a rearfoot distraction manipulation, and (2) a control condition. Dominant leg balance was quantified using the Y-balance test which measures lower extremity reach distances. Reach distances were normalized to leg length and measured in the anterior, posteromedial and posterolateral directions. Overall balance was calculated through the summing of all normalized directions. Paired t-tests and Wilcoxon rank tests were used to compare balance scores for parametric and non-parametric data as appropriate. Significance was set at 0.05 a priori. Effect size (ES) was calculated to determine the clinical impact of the manipulation. Increased reach distances (indicating improved balance) were noted following manipulation for overall balance (p = 0.03, ES = 0.26) and in the posteromedial direction (p = 0.01, ES = 0.42). Reach distances did not differ for the anterior (p = 0.11, ES = 0.16) or posterolateral (p = 0.11, ES = 0.25) components. Dynamic standing balance improved after a rearfoot distraction manipulation in healthy participants. It is hypothesized that manual therapy applied to the foot and ankle may be beneficial to augment other therapeutic modalities when working with patients to improve dynamic standing balance.     

A patellar bandage improves mobility but not static balance in elderly female fallers

Background

The deterioration in the somatosensory and motor systems observed with increasing age can cause balance problems. Studies have shown that the use of infrapatellar bandages can enhance proprioception and improve postural balance.

Support for a reduction in the number of trials needed for the star excursion balance test

Robinson RH, Gribble PA. Support for a reduction in the number of trials needed for the Star Excursion Balance Test.

Objective

To determine the number of trials necessary to achieve stability in excursion distance and stance leg angular displacement for the 8 directions of the Star Excursion Balance Test (SEBT).

Design

One-way repeated-measures analysis of variance.

Setting

Athletic training laboratory.

Participants

Twenty participants (10 men, 10 women) without any known musculoskeletal injuries or neurologic deficits that could have negatively affected their dynamic balance volunteered for the study.

Intervention

Participants completed 6 practice and 3 test trials in each of the 8 reach directions of the SEBT.

Main Outcome Measures

Excursion distances of the reaching leg normalized to leg length and angular displacement at the hip and knee of the stance leg in all 3 planes of movement were determined.

Results

There were significant increases in excursion distance, hip flexion, and knee flexion for 7, 4, and 5 of the 8 reach directions, respectively.

Conclusions

For the majority of the reach directions, maximum excursion distances and stance leg angular displacement values achieved stability within the first 4 practice trials, thus justifying a reduction in the recommended number of practice trials from 6 to 4 and supporting the trend toward simplifying SEBT administration.     

Effects of a 12-Week Tai Chi Chuan Program Versus a Balance Training Program on Postural Control and Walking Ability in Older People

Lelard T, Doutrellot P-L, David P, Ahmaidi S. Effects of a 12-week Tai Chi Chuan program versus a balance training program on postural control and walking ability in older people.

Objective

To compare the respective effects of 2 balance training programs: a Tai Chi (TC) program and a balance training program on static postural control and walking ability.

Design

Randomized controlled trial.

Setting

General community.

Participants

Older subjects (N=28) participated in the study.

Interventions

The TC group (n=14; mean age ± SD, 76.8±5.1y) and the balance training group (n=14; 77.0±4.5y) were both trained for 12 weeks.

Main Outcome Measures

Static postural control was assessed via measurement of center of pressure sway under eyes open (EO) and eyes closed (EC) conditions. Walking speed over a 10-meter course was also assessed.

Results

After the 12-week training period, there were no significant differences in walking speed or postural parameters in either the EO or EC conditions for the TC and balance training groups. Performance in the EC condition was lower than in the EO condition in pretest and posttest for the balance training and TC groups. The Romberg quotient (EO/EC ratio) was significantly higher after the balance training program than the TC program (P<.05).

Conclusions

We cannot conclude that the balance training program has better effects than the TC program on postural control or walking ability. None of the outcome measures showed significant change posttraining in either the TC or the balance training groups. However, the differences described in the Romberg quotient after the training period between the TC and the balance training groups suggest that TC should be helpful to limit the deleterious effects of eye closure on postural balance.     

星状伸展平衡测试在评估社区老年女性动态平衡功能中的运用

目的:探讨星状伸展平衡测试(SEBT)在评估社区老年女性动态平衡功能中的运用研究,为预防老年人跌倒提供一定的研究依据。方法:通过星状伸展平衡测试和计时起立行走测试方法,测试44名60—74岁认知功能正常、能够独立行走的老年女性的动态平衡能力。根据过去两年内跌倒的情况,将老年人分为跌倒组32人和无跌倒组12人。结果:星状伸展平衡测试结果组内一致性结果为0.940—0.984(P<0.05),其中内侧后方的伸展长度与计时起立行走测试呈中度相关(P<0.05);跌倒组的星状伸展平衡测试结果显著低于无跌倒组(P<0.05),特别是在正后方上的结果有非常显著的差异(P<0.01);"有无跌倒"与正后方向上的伸展长度呈高度相关(P<0.01),与计时起立行走测试无显著相关(P>0.05)。结论:星状伸展平衡测试是一个可靠的社区老年女性动态平衡的测试方法,60—74岁两年内有过跌倒史的社区老年女性,双下肢动态平衡能力均显著差于无跌倒史的老年女性,正前方和正后方方向上的动态平衡能力可能与跌倒风险密切相关。     

Between-limb synchronization for control of standing balance in individuals with stroke

Background

During standing, forces and moments exerted at the feet serve to maintain stability in the face of constant centre-of-mass movement. These actions are temporally synchronized in healthy individuals. Stroke is typically a unilateral injury resulting in increased sensori-motor impairment in the contra-lesional compared with the ipsi-lesional lower-limb, which could lead to reduced between-limb synchronization for control of standing balance. The purpose of this study is to investigate between-limb synchronization of standing balance control in individuals with stroke; a potentially important index of control of upright stability.

Methods

Twenty healthy controls and 33 individuals with unilateral stroke were assessed. Stability was assessed during a 30-second quiet standing trial by measuring data from two force plates (one per foot). Limb-specific centre of pressure was calculated. Between-limb synchronization was defined as the coefficient of the correlation between the left and right foot for both the antero-posterior and medio-lateral centre of pressure time series. Synchronization, weight-bearing symmetry, and root mean square of the total centre of pressure excursion were compared between controls and stroke participants.

Findings

Stroke participants swayed more, were more asymmetric, and had less between-limb synchronization than healthy controls. Among individuals with stroke, reduced between-limb synchronization was related to increased postural sway in the medio-lateral direction and increased weight-bearing asymmetry.

Interpretation

Individuals with stroke have reduced temporal synchronization of centre of pressure fluctuations under the feet when controlling quiet standing. The clinical significance of reduced synchronization remains to be determined, although it appears linked to increased medio-lateral sway and weight-bearing asymmetry.     

Evaluation of the effects of different applications of kinesio taping on postural control in healthy women

It has been demonstrated that Kinesio Tape (KT) application has immediate positive effects on balance in healthy individuals, but its mid-term effects have not yet been investigated.ObjectiveEvaluate the effects of KT on postural control in young women, using four strategies.MethodsForty-eight healthy women aged 18–35 years old were randomly assigned to four groups with different elastic bandages (G1: ankle; G2: hamstrings; G3: lumbar; G4: different taping applications) and their postural control was evaluated using stabilographic parameters obtained on a force platform during right and left unipodal (UNP-R and UNP-L) and semi-tamdem tests at pre-intervention (PRE), immediately after (IME), and 24 and 48 h after the application of bandages.ResultsG1 showed a significantly lower velocity in the antero-posterior direction for the PRE compared to the IME period (p = 0.0204) in the UNP-R task, and the same was observed in the medio-lateral velocity when comparing the results for PRE with IME (p = 0.0340 and p = 0.0244) in the UNP-L task. Regarding the frequency, G2 had a significantly lower mean for the PRE, compared to IME (p < 0.001) in the UNP-R in antero-posterior direction, and in medio-lateral direction in the UNP-R (p = 0.003) and in the UNP-L task (p = 0.020).ConclusionsThe use of KT changed postural control, mainly considering the velocity and frequency of COP oscillations, and especially immediately after its application.     

Acute effect of core stability and sensory-motor exercises on postural control during sitting and standing positions in young adults

SummaryCore stability exercises and exercises that stimulate sensory-motor information are recommended for the prevention of injuries and the maintenance and rehabilitation of deficits related to postural control (PC). However, the comparison of results between core stability and sensory-motor exercises in the literature is limited to sitting and standing positions.ObjectiveTo determine the acute effect of core stability and sensory-motor exercises on PC during sitting and standing in young adults.MethodsA total of 39 participants, with a mean age of 23 years, were randomly divided into three groups (1) Core stability exercises; (2) Sensory-motor exercises; (3) Control. Each group performed a sequence of five specific exercises of core stability and sensory-motor exercises (except controls). PC was evaluated before and after exercise in the seated and the one-legged stance conditions using a force platform.ResultsNo significant difference was found for any variables of postural oscillation (P > 0.05) among the three groups studied. The magnitude of the effect of interventions in general was a small to moderate effect (d = 0.02/-0.48).ConclusionThe findings show that acute intervention with core stability and sensory-motor exercises did not produce any significant effects (reduction of postural oscillation) on PC during sitting and standing positions in young adults.     

Unipedal balance test for older adults: a systematic review and meta-analysis of studies providing normative data

Background

The unipedal balance test (UBT) is widely used with older adults, but interpreting performance on the test requires the availability of normative values.

Studying the correlation between balance assessment by Biodex Stability System and Berg Scale in stroke individuals

IntroductionBalance disorders are considered to be a serious clinical manifestation after stroke. Therefore, to assess stroke patients' balance performance, use of a quantitative method appears essential. A fundamental step would be the approval of the efficiency of the measurement instruments. The current study aimed to investigate correlations between balance assessment as examined by Biodex Stability System (BSS) and the clinical Berg Balance Scale (BBS) in post-stroke hemiparesis.MethodsTwenty-five stroke survivors and 25 healthy age-sex matched subjects were recruited. The subjects were assessed using BSS during 3 days, with a 24-h interval. The high interclass correlation coefficient (ICC) values showed that the system was reliable enough to continue the study. The clinical evaluation was performed by the standard BBS.ResultsThere was a significant moderate negative correlation between the Biodex overall indices and BBS scores in the stroke groups (r_avg = ?0.68) and in the healthy cohort (r_avg = -0.55). Also, a significant moderate negative correlation was found between the Biodex antero-posterior stability indices and BBS scores in the stroke groups (r_avg = ?0.67) and in healthy cohort (r_avg = ?0.55). The correlation between the Biodex mediolateral stability indices and BBS scores was moderate to low in the stroke and healthy groups (r_avg = ?0.67 and ?0.39 respectively).Discussion and conclusionModerate negative correlation between the stability indices of the Biodex Stability System and BBS scores indicates that dynamic balance status of the participants partially reflects their functional balance status.     

The effect of post-stroke lower-limb spasticity on the control of standing balance: Inter-limb spatial and temporal synchronisation of centres of pressure

Background

Challenges in stability control are common post-stroke. Although lower-limb spasticity is a common sensorimotor consequence post-stroke, its potential to further complicate stability control among stroke-survivors remains largely unknown. Advancing such understanding can help inform strategies to reduce fall risk and increase independence among these individuals. The purpose of this study was to characterise the extent of limb-specific dyscontrol among individuals with spasticity.

Methods

A retrospective analysis of 131 patients assessed for spasticity was performed. Patients selected for inclusion were categorised into two groups, with (n = 19) or without (n = 63) unilateral lower-limb spasticity. Two force platforms were used to determine the individual-limb and net centres of pressure in both anteroposterior and mediolateral directions during 30 s of quiet standing. Limb-specific dyscontrol was assessed by calculating weight-bearing symmetry ratios, cross-correlation coefficients at zero phase-shift (temporal synchrony) and ratios of individual-limb root-mean-square displacements (spatial symmetry). Total body postural control was assessed by examining the root-mean-square of the net centre of pressure displacement.

Findings

The group with spasticity bore less weight on the affected limb and exhibited reduced temporal synchrony of centre of pressure displacements. There were no differences in inter-limb root-mean-square centre of pressure ratios or in the root-mean-square of the net centre of pressure displacement.

Interpretation

Individuals with lower-limb spasticity may have additional challenges with stability control, specifically linked to the ability to modify the location of the centre of pressure beneath the affected limb, in a time-sensitive manner so as to contribute beneficially to the control of whole body stability.     

The effect of quadriceps kinesiotaping on the dynamic balance of young healthy women after fatigue: A randomized controlled trial

BackgroundBalance is a key factor in performing daily activities and the quadriceps muscle plays an important role in regaining balance following imbalance. Quadriceps fatigue may cause disruption in sending proprioception signals to the central nervous system and may, ultimately, lead to motor dysfunction and increased fluctuating dynamic and static balance which is followed by an increased risk of falling. Based on conclusions from previous studies it is proposed that kinesiotaping (KT) might be effective in the reduction of muscle fatigue and eventually balance.ObjectiveTo investigate the effect of quadriceps KT on the dynamic balance of young healthy non-athlete women following local fatigue.DesignA Single-blind parallel randomized clinical trial.Method28 healthy women aged from 18 to 30 years were selected using the convenience sampling method. They were thoroughly evaluated with regard to the inclusion and exclusion criteria and randomly divided into two groups of kinesiotaping (n = 14) and non-tape (n = 14) using coin tossing. Balance measurement was performed on both groups before and after fatigue using the Y balance test. Both groups performed the fatigue protocol, but only the KT group was taped.ResultsResults demonstrated that, the mean of normalized reach distances at anterior (KT: 1.014 ± 0.073, non-tape: 0.964 ± 0.097), posteromedial (KT: 0.816 ± 0.125, non-tape: 0.809 ± 0.076) and posterolateral (KT: 0.794 ± 0.102, non-tape: 0.753 ± 0.093) directions in the Y balance test had no significant difference between both groups after fatigue (p > 0.05).ConclusionOur findings indicated no significant effect of quadriceps KT on the dynamic balance of young healthy women after fatigue.     

健康人群四肢近端肌肉剪切波弹性成像测量的初步研究

目的测量健康人群四肢近端肌肉剪切波速度,分析与其相关的因素。 方法选取2019年1月至2020年12月在四川大学华西医院招募的健康志愿者88例,记录受检者的性别、年龄、体质量指数（BMI）及运动习惯。测量不同肌肉（三角肌、肱二头肌、股直肌、股外侧肌）左右两侧及相同肌肉不同断面、不同位置及不同体位的剪切波速度,并对不同性别、年龄、BMI及运动状态的肌肉剪切波速度进行比较。随机抽取20例受试者,计算三角肌及股直肌剪切波速度测量的观察者间及观察者内一致性。 结果各肌肉纵断面剪切波速度左、右两侧比较,差异无统计学意义（P均＞0.05）。各肌肉剪切波速度纵断面均大于横断面（P均＜0.05）。肱二头肌伸直位纵断面,其剪切波速度肌腹外侧大于肌腹内侧（P均＜0.05）。肱二头肌剪切波速度伸直位均大于屈曲位（P均＜0.05）。三角肌、肱二头肌剪切波速度男性高于女性（P均＜0.05）。股外侧肌剪切波速度18~49岁组高于50~70岁组（P＜0.05）。肱二头肌剪切波速度BMI＜18.5 kg/m²组及18.5 kg/m²≤BMI＜24 kg/m²组均高于BMI≥24 kg/m²组,差异均有统计学意义（P均＜0.05）。三角肌剪切波速度规律运动者高于少运动者,差异有统计学意义（P＜0.05）。三角肌及股直肌的剪切波速度观察者内及观察者间一致性均为良好或优秀（ICC均＞0.88）。 结论剪切波弹性成像（SWE）能够用于定量测量健康人群肌肉的硬度值,肌肉的断面和部位及受检者的体位、性别、年龄、BMI和运动习惯为与其相关的因素,研究结果为特发性炎性肌病的进一步研究提供了依据。     

糖化肌醇磷脂结合蛋白在健康人淋巴细胞及其亚群的表达

目的研究健康人淋巴细胞及其亚群上,糖化肌醇磷脂结合蛋白（GPI锚蛋白）之一CD59的表达,探讨淋巴细胞及其亚群能否做为诊断阵发性睡眠性血红蛋白尿症的指标。方法采用流式细胞术多色分析法,结合多种细胞特异性抗体,分析淋巴细胞及其亚群和中性粒细胞上CD59的表达情况。结果50名健康人中性粒细胞上CD59的表达均为完全阳性,表达率为（98.6±1.5）%。淋巴细胞上CD59的表达率为（90.0±14.9）%,少量呈现阴性和不完全阳性表达。CD3＋T细胞与淋巴细胞类似,但完全阳性细胞少于后者,部分阳性和阴性细胞多于后者。与CD3＋T细胞相比,CD4＋T细胞上CD59的表达率增高,为（92.9±8.1）%,完全阳性细胞增多,但仍有少量阴性细胞存在;CD8＋T细胞表达率明显下降,为（74.6±9.1）%,完全阳性细胞减少,部分阳性和阴性细胞增多;CD45RA＋和CD45RO＋T细胞的表达差异无显著意义（P>0.05）;活化T细胞的表达介于CD3＋和CD8＋T细胞之间。B细胞的表达均为完全阳性,表达率高达（96.3±0.6）%,与中性粒细胞类似。结论健康人淋巴细胞上CD59不完全阳性的表达主要与T细胞、尤其是CD8＋T细胞有关;B细胞表达均一,有望成为诊断阵发性睡眠性血红蛋白尿症的细胞类型。     

The influence of fascial manipulation on function,ankle dorsiflexion range of motion and postural sway in individuals with chronic ankle instability

BackgroundProprioceptive deficits may attribute to functional Chronic ankle instability (CAI) with impairments in balance and postural control. Physical therapy interventions such as taping, bracing, manual therapy, and balance training play an essential role in managing ankle instabilities. Fascial Manipulation (FM) is a manual therapy technique considered to restore function by improving the joint range of motion and proprioception. However, the effects of FM on Ankle dorsiflexion range of motion (ADROM) and postural sway in athletes with chronic ankle instability are unclear.ObjectiveThis study aims to determine the effect of FM on function, ADROM, and Postural sway in athletes with CAI.DesignSingle group, pretest-posttest design.MethodsIndividuals with a history of recurrent ankle sprains with the Cumberland ankle instability tool (CAIT) score of ≤27 were included. FM was applied to the painful and densified center of coordination points on the lower limb myofascial lines based on Stecco's FM method. The outcomes measures include Foot and ankle disability index (FADI), ADROM during the weight-bearing lunge, and postural sway (excursion of the center of pressure during single limb stance).ResultsThere was a significant improvement in the FADI scores (Z = −3.626, p < 0.05), ADROM [F (2)=38.056, p<0.05], ηp ² = 0.69 following FM. However, the center of pressure excursion with both opened and closed eyes showed no differences following FM.ConclusionSince fascial manipulation had shown improvement in the function and ankle dorsiflexion range, it can be used as an adjunct treatment strategy in CAI management.