Effects of a posture shirt with back active correction keeper on static and dynamic balance in Parkinson's disease

BackgroundPatients with Parkinson's disease (PD) suffer from postural disorders. This study aims at investigating the short- and medium-term effects of a shirt with appropriate tie-rods that allows to correct the posture of the trunk.MethodsThis is a longitudinal clinical study in which a pressure platform was used to assess the static and dynamic baropodometry and the static stabilometry of 20 patients with PD (70.95 ± 8.39 years old; 13 males, time from the onset of symptoms: 6.95 ± 4.04 years, Unified Parkinson's Disease Rating Scale score: UPDRS = 7.25 ± 6.26) without and with a shirt, specifically designed for improving posture, at baseline and after one month of wearing.ResultsThe results showed a significant improvement in symmetry of loads (p = 0.015) and an enlargement of the foot contact surface (p = 0.038). A significant correlation was found between the change in forefoot load and time spent daily in wearing the shirt (R = 0.575, p = 0.008), with an optimal value identified at 8 h per day.ConclusionThe use of a postural shirt in patients with PD symmetrized the postural load and enlarged the foot contact surface improving their balance.     

Relationship between osteopathic manipulative treatment of the temporomandibular joint,molar shim and the orthostatic position: A randomized,controlled and double blinded study

This randomized, controlled, double-blinded study related the effect of osteopathic manipulative treatment (OMT) of the temporomandibular joint (TMJ) and the orthostatic posture using the molar shim (MS) as a postural adjustment factor. Twenty individuals classified with temporomandibular disorder (TMD) were randomly assigned to a treated group (TG, n = 10) and placebo (PG, n = 10). The independent variables were: MS and OMT of the TMJ. The dependent variables were: DC-TMD data; local pressure pain using algometry; and orthostatic posture assessed by the distribution of plantar pressures (baropodometry), in the evaluation periods before and immediately after the interventions. Results: pain did not show a statistically significant difference after the interventions. However, when comparing the Effect Size (ES) between the groups in the post-intervention moment, a moderate relationship was observed for the left trapezius muscle (0.51) and right and left TMJ (0.41 and 0.54 respectively). When correlating the pain and percentage of anteroposterior postural dislocation variables, a significant moderate inverse correlation was observed in the post-intervention moment. The results of the MS pointed to a significant decrease (p ≤ 0.05) of the average peak pressure (Medium P) during the use of the MS (503.4 ± 44.1 kgf/cm2) and after performing the OMT (516.5 ± 49.6 kgf/cm2), both for the TG compared to the pre intervention moment (519.3 ± 42.9 kgf/cm2). There is a correlation between TMJ and orthostatic posture. OMT of the TMJ influences orthostatic posture. The MS can be added to the evaluative context of TMD.     

Immediate and lasting improvements in weight distribution seen in baropodometry following a high-velocity, low-amplitude thrust manipulation of the sacroiliac joint

The biomechanics of the sacroiliac joint makes the pelvic segment responsible for proper weight distribution between lower extremities; however, it is known to be susceptible to altered mobility. The objective of this study was to analyze baropodometric responses following thrust manipulation on subjects with sacroiliac joint restrictions. Twenty asymptomatic subjects were submitted to computerized baropodometric analysis before, after, and seven days following sacroiliac manipulation. The variables peak pressure and contact area were obtained at each of these periods as the average of absolute values of the difference between the right and left foot based on three trials. Data revealed significant reduction only in peak pressure immediately after manipulation and at follow-up when compared to pre-manipulative values (p < 0.05). Strong correlation was found between the dominant foot and the foot with greater contact area (r = 0.978), as well as between the side of joint restriction and the foot with greater contact area (r = 0.884). Weak correlation was observed between the dominant foot and the foot with greater peak pressure (r = 0.501), as well as between the side of joint restriction and the foot with greater peak pressure (r = 0.694). The results suggest that sacroiliac joint manipulation can influence peak pressure distribution between feet, but contact area does not seem to be related to the biomechanical aspects addressed in this study.     

Investigating prismatic adaptation effects in handgrip strength and in plantar pressure in healthy subjects

BackgroundPrismatic Adaptation (PA) is a visuomotor procedure inducing a shift of the visual field that has been shown to modulate activation of a number of brain areas, in posterior (i.e. parietal cortex) and anterior regions (i.e. frontal cortex). This neuromodulation could be useful to study neural mechanisms associated with either postural measures such as the distribution of plantar pressure or to the generation of muscle strength. Indeed, plantar pressure distribution is associated to activation of high-level cognitive mechanisms taking place within the posterior regions of the brain dorsal stream, especially of the right hemisphere. Conversely, hand force mostly rely on sensorimotor mechanisms, fulfilled by anterior regions of the brain and involving both hemispheres.Research questionSince PA effects have been reported to affect both sensorimotor and higher level cognitive processes, is it possible to hypothesize a modulation of both hands strenght and plantar pressure after PA?MethodsForty-six healthy subjects (male = 23; mean age = 25 ± 3 years) were randomly divided into two groups: a leftward prismatic adaptation group (l-PA) and a rightward prismatic adaptation group (r-PA). Hand strength and plantar pressure were assessed, immediately before and after PA, using the handgrip task and baropodometric measurement, respectively.ResultsBoth l-PA and r-PA induced a significant decrease of strength in the hand contralateral to the lenses deviation side. Only r-PA was associated with an increase of the forefoot plantar pressure in both feet. Modulation of interhemispheric inhibitory processes at sensorimotor and higher cognitive level may account for the present results.SignificancePA exerts effects on body posture and hand strength relying on different mechanisms. The PA effects on hand strength are probably related to the modulation of interhemispheric inhibition of sensorimotor processes, involving both hemispheres. The PA effects on body posture are probably related to modulation of body representation, involving mainly the right hemisphere.     

Effects of core strengthening on balance in university judo athletes

BackgroundCore strengthening prepares the body in an integral, safe and efficient way, favoring balance and postural control; physical abilities constantly demanded in sports, especially in body contact modalities, such as Judo. Objective: This study investigated the effects of core strengthening on balance in university judo athletes.MethodsEighteen athletes from the University of Southern Santa Catarina (UNISUL) were randomly allocated into two groups: experimental (n = 9) and control (n = 9). Experimental group athletes were submitted to a core strengthening protocol (30-min sessions, twice a week for 5 consecutive weeks). Evaluations consisted of Stabilometic (center of pressure behavior parameters: total area in mm², laterolateral and anteroposterior width in mm) and baropodometric analysis [peak pressure: obtained during a 30-s acquisition period and expressed by foot area, i.e., (a) forefoot (metatarsal heads and toes); and (b) hindfoot (calcaneus region, distal third of the foot)]. Right/left foot ratios were calculated as relative percentages and used for the analysis. The analyzes were performed at baseline and after 5 weeks of core strengthening. The athletes were evaluated in two situations: eyes-open and eyes-closed.ResultsTotal right/left foot ratio pressure, right/left fore and hindfoot ratio pressure, as well as anteroposterior width measurements were statistically smaller in the experimental group.ConclusionAlthough the results obtained showed that core strengthening presents certain benefits, these data alone are not enough to confirm its effects upon postural oscillation in university judo athletes.     

The effects of unilateral medial arch support stimulation on plantar pressure and center of pressure adjustment in young gymnasts

The purpose of this study was to examine the contribution of tactile afferents from the medial arch of the foot on postural control. The center of pressure (CoP) position and right/left plantar pressure distributions of 13 gymnasts, with and without a medial arch support, were recorded by a force platform coupled with a baropedometry analysis. Stimulation of the subject's plantar sole was accomplished using a 3 mm thick medial arch insert. Right arch stimulation induced an ipsilateral increase of plantar pressure and a contralateral displacement of the CoP to the left. Left arch support also resulted in an ipsilateral increase in plantar pressure and displacement of the CoP to the right. Stimulation of the plantar arch may induce a perception that the body's center of mass has shifted toward the stimulated foot. To maintain stability, individuals may then shift their CoP in the opposite direction. This response may involve compensatory muscle activation strategies to adjust posture. Clinicians may apply these results in their use of foot orthoses to address postural anomalies in patients.     

Baropodometric quantification and implications of muscle coactivation in the lower limbs caused by head movement: A prospective study

BackgroundIn healthy young adults, muscle coactivation can sometimes be induced by remote voluntary contractions when the motor task is forceful, maximal, tiring, or cyclic and brief.ObjectivesTo show that a change in plantar pressure is an unequivocal response to backward movement of the head, and to contribute to a better understanding of physiotherapy methods that involve remote muscle activation.MethodsInvoluntary coactivation was quantified as a percentage of the anteroposterior plantar pressure distribution, using a baropodometric platform in a population of young adults. The baropodometric data were collected from a 1s recording after 30 s in the reference condition, and from 1s recordings during the first second and then during the 120th second in the test condition. The results were analyzed with Bayesian statistics (Markov chains and Monte Carlo integration techniques).Results90 adults participated in the study (age range: 19–26; 38 males and 52 females). The forefoot plantar pressure increased in all cases, by a mean multiplicative factor (on a logit scale) of 1.12 (from 72.24% to 74.45%) when the head was aligned over the trunk.ConclusionsThis 90-participant trial confirmed our initial hypothesis: a increase in forefoot plantar pressure is a systematic response to the motor task (head movement), and suggests greater recruitment of the plantar flexor muscles. A spinal reflex and/or a previously unknown form of motor overflow might be involved in this phenomenon. These results support the development of inductive physiotherapy techniques based on remote muscle activation in the treatment of musculoskeletal disorders.Clinicalstrial.gov identifierNCT02320097.     

The Podoprint® plantar pressure platform: Evaluation of reliability and repeatability,and determination of the normality parameters

IntroductionThe Podoprint® pressure platform system is widely used in routine podiatric clinical practice to measure plantar pressures. It allows non-invasive examination of the patient, and provides fast results with high levels of precision, reliability, and repeatability. Once these conditions have been demonstrated, the clinical and/or research use of baropodometry allows results to be obtained in the field of podology that are far from inconsiderable.The study was designed to evaluate the repeatability and reliability of the platform, and to identify the normal foot pressure parameters.MethodsRecords were collected from 52 random healthy individuals, 10 men and 42 women, in two sessions separated by one week. The study variables were: maximum pressure, mean pressure, support surface areas (heel, midfoot, and forefoot), and contact time. Repeatability and reliability were evaluated by calculating the interclass correlation coefficient (ICC) and the coefficient of variation (CV) in the three tests.ResultsThe ICCs showed moderate to good repeatability for the variables of interest, and the CVs were all less than 18%. The maximum pressure was under the forefoot (mean 2675.4 ± 513.8 g/cm²). The mean contact time of the steps was 0.72 ± 0.07 s.ConclusionsThe Podoprint® system is a reliable tool for evaluating the distribution of plantar pressures in the dynamic study of the barefoot gait of healthy individuals.