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Scientific Reports Jul 2023This study investigated the effectiveness of an early aquatic exercise program on trunk muscle function and functional recovery of patients with lumbar fusion.... (Randomized Controlled Trial)
Randomized Controlled Trial
This study investigated the effectiveness of an early aquatic exercise program on trunk muscle function and functional recovery of patients with lumbar fusion. Twenty-eight subjects were divided into two equal groups. Patients in the aquatic group performed two 60-min aquatic exercise sessions and three 60-min home exercise sessions per week for 6 weeks, whereas those in the control group performed five sessions of 60-min home exercises per week for 6 weeks. The primary outcomes were the Numerical Pain Rating Scale (NPRS) and Oswestry Disability Index (ODI), and the secondary outcomes were Timed Up and Go Test (TUGT), trunk flexor and extensor muscle strength, lumbopelvic stability, and lumbar multifidus muscle thickness measured pre- and post-intervention. Compared with participants in the control group, those in the experimental group showed significant improvement in NPRS, ODI, trunk extensor strength, lumbopelvic control, lumbar multifidus muscle thickness, and relative change in multifidus muscle thickness (significant time by group interactions, P < 0.05). Participants in both groups showed significant time effects (P < 0.001) for TUGT and trunk flexor strength outcome. Aquatic exercise combined with home exercise was superior to home exercise alone in reducing pain, disability and improving muscle strength, lumbopelvic stability, and lumbar multifidus muscle thickness.
Topics: Humans; Low Back Pain; Postural Balance; Time and Motion Studies; Lumbosacral Region; Exercise Therapy; Muscle Strength
PubMed: 37400496
DOI: 10.1038/s41598-023-37237-3 -
Scientific Reports Dec 2023Biological sexes (male and female) have been reported to influence postural control and balance due to differences in musculoskeletal structures, hormonal factors, and...
Biological sexes (male and female) have been reported to influence postural control and balance due to differences in musculoskeletal structures, hormonal factors, and neuromuscular control. These factors can contribute to the turning performance, potentially leading to an increased incidence of falls, particularly during turning. Therefore, this study aimed to explore the whole-body coordination and stepping characteristics and during standing turns in healthy adults to determine the effects of biological sex and turn speed. Fifty participants (25 males and 25 females) completed 180° standing turns on level ground. Inertial Measurement Units (XSENS) were used to measure whole-body movement turning kinematics and stepping characteristics. Moreover, clinical outcome of dynamic balance was measured by the Timed Up and Go (TUG). Participants were randomly tasked to turn at three speeds; fast, moderate, or slow to the left and right sides. Mann-Whitney U tests were used to compare the independent variables between male and females, and Friedman tests with Dunn's tests for pairwise comparisons were used to compare between the three turning speeds within the two groups. The results demonstrated that significant differences were seen between males and females during fast turning for the leading foot onset (p = 0.048) and in the slow speed for the total step (p = 0.033), showing that these were greater in female with an increase in turn speed. In addition, significant differences were seen only in the males when comparing different speeds in the trailing foot onset latency (p = 0.035), step size (p = 0.009), and total number of steps (p = 0.002), while in the females a significant difference was found in peak head yaw velocity between fast and slow turn speeds, and moderate and slow turn speeds. Finally, there was no significant difference in TUG between groups. Therefore, these findings show differences between biological sexes in the response to whole-body coordination and step characteristics, indicating that females tend to have more changes in stepping characteristics compared to males due to differences in turning speed. This can affect their balance and stability. However, the differences in biological sex did not impact the dynamic balance and fall risk due to the lack of a significant difference shown by TUG between males and females.
Topics: Humans; Male; Female; Young Adult; Movement; Health Status; Postural Balance; Gait
PubMed: 38092818
DOI: 10.1038/s41598-023-49201-2 -
BMC Musculoskeletal Disorders Oct 2023Dual-task training has been a popular intervention for individuals with balance impairments. However, the effects of dual-task training on chronic ankle instability... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dual-task training has been a popular intervention for individuals with balance impairments. However, the effects of dual-task training on chronic ankle instability (CAI) have not been comprehensively analyzed and reliable clinical evidence is scarce. The purpose of this systematic review and meta-analysis is to evaluate the effectiveness of dual-task training on postural stability and functional ability in individuals with CAI.
METHODS
PubMed, Web of Science, EBSCO, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were researched from inception to November 2022. This study was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers assessed the studies for inclusion and extracted data. The Cochrane Risk of Bias list was used to assess the risk of bias in included studies. Mean differences (MD) with a 95% confidence interval (CI) were calculated with the RevMan 5.3 software.
RESULTS
A total of 7 randomized controlled trials with 192 CAI met the inclusion criteria. The meta-analysis results showed that compared with the control group, dual-task training significantly improved the Y-balance test (MD = 1.60, 95% CI: -0.00 to 3.21, P = 0.050) and reduced COP-area (MD = - 0.94, 95% CI: -1.62 to - 0.26, P = 0.007) in individuals with CAI. However, there is no significant difference between dual-task training and the control group on COP-velocity (MD = - 0.26, 95% CI: -0.70 to 0.17, P = 0.240), hop test (MD = - 0.20, 95% CI: -0.66 to 0.26, P = 0.386) and BESS (MD = - 1.24, 95% CI: -2.95 to 0.48, P = 0.157) in individuals with CAI.
CONCLUSION
This meta-analysis showed that dual-task training may be effective in improving static and dynamic postural stability. However, more high-quality randomized controlled trials are needed to verify the short and long-term effectiveness of dual-task training on CAI.
Topics: Humans; Ankle; Ankle Joint; Physical Therapy Modalities; Joint Instability; Activities of Daily Living; Postural Balance
PubMed: 37833685
DOI: 10.1186/s12891-023-06944-3 -
European Journal of Physical and... Feb 2024Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, degenerative disease of the central nervous system and the second most frequent cause of permanent... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, degenerative disease of the central nervous system and the second most frequent cause of permanent disability in young adults. One of the most common issues concerns the ability to perform postural and gait tasks while simultaneously completing a cognitive task (namely, dual-task DT).
AIM
Assessing cognitive-motor dual-task training effectiveness in patients with Multiple Sclerosis (PwMS) for dynamic gait quality when walking on straight, curved, and blindfolded paths.
DESIGN
Two-arm single-blind randomized controlled trial. Follow-up at 8 weeks.
SETTING
Neurorehabilitation Hospital.
POPULATION
A sample of 42 PwMS aged 28-71, with a score of 4.00±1.52 on the Expanded Disability Status Scale were recruited.
METHODS
Participants were randomized in conventional (CTg) neurorehabilitation and dual-task training (DTg) groups and received 12 sessions, 3 days/week/4 weeks. They were assessed at baseline (T0), after the treatment (T1), and 8 weeks after the end of the treatment (T2) through Mini-BESTest, Tinetti Performance Oriented Mobility Assessment, Modified Barthel Index, and a set of spatiotemporal parameters and gait quality indices related to stability, symmetry, and smoothness of gait extracted from initial measurement units (IMUs) data during the execution of the 10-meter Walk Test (10mWT), the Figure-of-8 Walk Test (Fo8WT) and the Fukuda Stepping Test (FST).
RESULTS
Thirty-one PwMS completed the trial at T2. Significant improvement within subjects was found in Mini-BESTest scores for DTg from T0 to T1. The IMU-based assessment indicated significant differences in stability (P<0.01) and smoothness (P<0.05) measures between CTg and DTg during 10mWT and Fo8WT. Substantial improvements (P<0.017) were also found in the inter-session comparison, primarily for DTg, particularly for stability, symmetry, and smoothness measures.
CONCLUSIONS
This study supports the effectiveness of DT in promoting dynamic motor abilities in PwMS.
CLINICAL REHABILITATION IMPACT
Cognitive-motor DT implemented into the neurorehabilitation conventional program could be a useful strategy for gait and balance rehabilitation.
Topics: Young Adult; Humans; Multiple Sclerosis; Single-Blind Method; Exercise Therapy; Gait; Cognition; Postural Balance
PubMed: 37997324
DOI: 10.23736/S1973-9087.23.08156-X -
Clinical Interventions in Aging 2023Falls remain the second leading cause of injury-related deaths worldwide; therefore, longstanding practical fall-prevention efforts are needed. Falls can also lead to a...
Falls remain the second leading cause of injury-related deaths worldwide; therefore, longstanding practical fall-prevention efforts are needed. Falls can also lead to a reduction in independence and quality of life among older adults. Fall-prevention research has found that early prevention promotes a prolonged independence. However, it remains unknown which intervention is most beneficial for early prevention and how these interventions should be implemented for long-term effects. In addition, the present and future burden on social and healthcare services contributes to a gap in needs and requires an evidence-based fall prevention. Research suggests that strength, balance, and functional training are effective in reducing falls and fall-related injuries. Such training could greatly impacting independence. Fear of falling and strategies for managing falls are the suggested components to be included when evaluating fall-prevention programs. Thus, the preservation of physical functions is highly relevant for both independence and quality of life. It also contributes to psychological and social well-being, which are important factors for enabling individuals to stay at home for as long as possible. To meet future challenges associated with the expected increase in the older population, older adults should be viewed as a golden resource. With assistance from professionals and researchers, they can learn and gain the ability to institute fall-prevention programs in their own environments. These environments are primarily beyond the responsibilities of the healthcare sector. Therefore, programs comprising current knowledge about fall prevention should be developed, evaluated, and implemented with older adults by using a "train-The-trainer" approach, where a natural collaboration is established between civil society and/or volunteers, healthcare professionals, and researchers. For sustainable and effective fall-prevention programs, a co-design and early collaborative approach should be used in the natural environment, before social and healthcare services are required.
Topics: Humans; Aged; Quality of Life; Fear; Social Behavior; Postural Balance
PubMed: 38149083
DOI: 10.2147/CIA.S430309 -
Medicine Apr 2024Chronic shoulder pain is a common musculoskeletal problem associated with unreleased pain and functional dysfunction that can evolve into central sensitization. Some... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Chronic shoulder pain is a common musculoskeletal problem associated with unreleased pain and functional dysfunction that can evolve into central sensitization. Some forms of manual therapy may exacerbate pain and central sensitization. This study investigated the impact of joint position sense therapy (JPST), a moderate joint proprioception training technique, on central sensitization, shoulder functional dysfunction, and pain in patients with chronic shoulder pain compared with more intense exercises or aggressive manual therapies.
METHODS
We assessed the pressure pain threshold (PPT) in 30 patients with and 30 patients without chronic shoulder pain. The assessment focused on 4 muscle sites: deltoid, upper trapezius, brachioradialis, and tibialis anterior. Thirty patients with chronic shoulder pain were randomly divided into the JPST and control groups. The JPST group underwent additional shoulder joint position-sense training. The efficiency outcomes were the disabilities of the arm, shoulder, and hand questionnaire, visual analog scale (VAS), and PPT, evaluated at baseline and after the intervention.
RESULTS
Significant differences were observed in the PPT values at the brachioradialis (P < .05), deltoid (P < .01), and trapezius (P < .001) among the non-chronic and chronic groups, but not in the tibialis anterior muscle (P > .05). Although both control and JPST interventions effectively improved the disabilities of the arm, shoulder, and hand questionnaire score, pain intensity, and PPT values in the upper limb, the outcomes in the JPST group were significantly different from those in the control group.
CONCLUSIONS
Generalized hyperalgesia changes limited to the upper limbs were observed in patients with chronic shoulder pain. JPST has beneficial effects on pain control and functional dysfunction in patients with chronic shoulder pain.
Topics: Humans; Central Nervous System Sensitization; Shoulder Pain; Upper Extremity; Pain Management; Proprioception
PubMed: 38608097
DOI: 10.1097/MD.0000000000037786 -
Journal of Tissue Viability Nov 2023To investigate the cross-sectional association between deep and superficial diabetic neuropathy, postural impairment assessed by wearable inertial sensors, and the risk...
AIMS
To investigate the cross-sectional association between deep and superficial diabetic neuropathy, postural impairment assessed by wearable inertial sensors, and the risk of fall among patients with diabetic foot.
METHODS
Diabetic patients attending a University Podiatric Clinic were evaluated for the presence of deep and superficial peripheral neuropathy in sensory tests. Postural impairment was assessed using a wearable inertial sensor, and the evaluation of balance/gait and risk of fall was determined by the Tinetti Scale and Downton Index, respectively. Glycemic control was measured by glycated haemoglobin concentration and fasting glycaemia. The postural parameters measured were the anteroposterior and medio-lateral sway of the center of mass (CoM) and the sway area (area traveled by the CoM per second). The results were analyzed through a logistic regression model to assess those posture variables mostly significantly associated with neuropathy and risk of fall scales.
RESULTS
A total of 85 patients were evaluated. Spearman's rank correlation coefficients showed a strong and significant relationship (p < 0.05) between deep diabetic neuropathy assessed by Semmes-Weinstein monofilament, diapason and biothensiometer and postural alterations, whereas no significant correlations between superficial (painful sensitivity) neuropathy and the postural parameters. The sway path of the displacement along the anterior-posterior axis recorded during tests performed with eyes open and feet close together were significantly (p < 0.05) correlated with a poor glycemic (glycated haemoglobin concentration) control and each other with all diabetic neuropathy tests, fall risk scales, muscular weakness, ankle joint limitation and history of ulcers.
CONCLUSIONS
The results support the existence of a strong association between alterations of the deep somato-sensitive pathway (although depending on the tool used to measure peripheral neuropathy), glycemic control and balance impairments assessed using a wearable sensors. Wearable-based postural analysis might be part of the clinical assessment that enables the detection of balance impairments and the risk of fall in diabetic patients with diabetic peripheral neuropathy.
Topics: Humans; Diabetic Neuropathies; Diabetic Foot; Cross-Sectional Studies; Glycated Hemoglobin; Postural Balance; Risk Assessment; Wearable Electronic Devices; Diabetes Mellitus
PubMed: 37852919
DOI: 10.1016/j.jtv.2023.10.002 -
Movement Disorders : Official Journal... Feb 2024Transcutaneous vagus nerve stimulation (VNS) showed early evidence of efficacy for the gait treatment of Parkinson's disease (PD). (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Transcutaneous vagus nerve stimulation (VNS) showed early evidence of efficacy for the gait treatment of Parkinson's disease (PD).
OBJECTIVES
Providing data on neurophysiological and clinical effects of transauricular VNS (taVNS).
METHODS
Ten patients with recording deep brain stimulation (DBS) have been enrolled in a within participant design pilot study, double-blind crossover sham-controlled trial of taVNS. Subthalamic local field potentials (β band power), Unified Parkinson's Disease Rating Scales (UPDRS), and a digital timed-up-and-go test (TUG) were measured and compared with real versus sham taVNS during medication-off/DBS-OFF condition.
RESULTS
The left taVNS induced a reduction of the total β power in the contralateral (ie, right) subthalamic nucleus and an improvement of TUG time, speed, and variability. The taVNS-induced β reduction correlated with the improvement of gait speed. No major clinical changes were observed at UPDRS.
CONCLUSIONS
taVNS is a promising strategy for the management of PD gait, deserving prospective trials of chronic neuromodulation. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Topics: Humans; Parkinson Disease; Prospective Studies; Vagus Nerve Stimulation; Pilot Projects; Postural Balance; Deep Brain Stimulation; Time and Motion Studies; Gait; Treatment Outcome
PubMed: 38111224
DOI: 10.1002/mds.29690 -
PeerJ 2023Visual attention is very important in basketball shooting, which is a prerequisite for forming good muscle proprioception and improving the shooting rate. The ability of...
BACKGROUND
Visual attention is very important in basketball shooting, which is a prerequisite for forming good muscle proprioception and improving the shooting rate. The ability of visual instant searching information in the process of free throw plays an important role in the mobilization of free throw percentage. The aim of this study is to explore the fixation characteristics of athletes at different levels in the process of free throw shooting and to provide scientific basis for improving the free throw training of basketball players.
METHODS
A total of 20 expert basketball players, 20 general basketball players and 20 novice basketball players participated in the experiment. Participants in the three groups wore eye tracker to make free throws, and analyzed the difference of visual attention among the three groups.
RESULTS
The expert group had fewer number of fixations on the front, bottom, top-right, and top-right areas of the basket than the general and novice groups. The expert group also had smaller saccadic amplitudes than the other two groups. In terms of fixation duration, the expert group had longer fixation duration on the front and top areas of the basket than the other two groups, while in the top-right and bottom-right areas, the expert group had shorter fixation durations. The pupil dilation of the expert group was larger than that of the other two groups.
CONCLUSION
During the free throw process, the expert group had a clear attentional focus, concentrated fixation points, efficient information search, and precise processing. Profound basketball knowledge, proficient skills, and accumulated experience are the foundation of visual efficient search and precise processing during free throw attempts, and they are also the prerequisite for ensuring a high free throw shooting percentage.
Topics: Humans; Basketball; Proprioception; Athletes; Saccades
PubMed: 38099305
DOI: 10.7717/peerj.16607 -
PeerJ 2023The effect of foot, especially intrinsic muscles, on postural control and its related mechanisms remain unclear due to the complex structure. Therefore, this study aims...
BACKGROUND
The effect of foot, especially intrinsic muscles, on postural control and its related mechanisms remain unclear due to the complex structure. Therefore, this study aims to investigate the activation of intrinsic foot muscles in the elderly under static and dynamic postural tasks.
METHODS
Twenty-one elderly participants were included to perform different postural tests (sensory organization test (SOT), motor control test (MCT), limit of stability test (LOS), and unilateral stance test) by a NeuroCom Balance Manager System. The participants were instructed to maintain postural stability under conditions with combined different sensory inputs (vision, vestibular, and proprioception) in SOT as well as conditions with translation disturbance in MCT, and to perform an active weight-shifting tasks in LOS. During these tasks, muscle activation were simultaneously acquired from intrinsic foot muscles (abductor halluces (AbH) and flexor digitorum brevis (FDB)) and ankle muscles (anterior tibialis, medial head of gastrocnemius, lateral head of gastrocnemius, and peroneus longus). The root-mean-square amplitude of these muscles in postural tasks was calculated and normalized with the EMG activity in unilateral stance task.
RESULTS
The activation of intrinsic foot muscles significantly differed among different SOT tasks ( < 0.001). tests showed that compared with that under normal condition 1 without sensory interference, EMGs increased significantly under sensory disturbance (conditions 2-6). By contrast, compared with that under the single-sensory disturbed conditions (conditions 2-4; 2 for disturbed vision, 3 for disturbed vestibular sensation, 4 for disturbed proprioception), activation was significantly greater under the dual-sensory disturbed postural tasks (conditions 5 and 6; 5 for disturbed vision and proprioception, 6 for disturbed vestibular sensation and proprioception). In MCT, EMGs of foot muscles increased significantly under different translation speeds ( < 0.001). In LOS, moderate and significant correlations were found between muscle activations and postural stability parameters (AbH, = 0. 355-0.636, < 0.05; FDB, = 0.336-0.622, < 0.05).
CONCLUSION
Intrinsic foot muscles play a complementary role to regulate postural stability when disturbances occur. In addition, the recruitment magnitude of intrinsic foot muscles is positively correlated with the limit of stability, indicating their contribution to increasing the limits of stability in the elderly.
Topics: Humans; Aged; Muscle, Skeletal; Foot; Leg; Lower Extremity; Proprioception
PubMed: 37483972
DOI: 10.7717/peerj.15719