-
The Journal of Sports Medicine and... Jul 2024Interventions on ankle motor control are important to prevent recurrent ankle sprains. Training using whole-body vibration may easily and effectively improve ankle motor... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Interventions on ankle motor control are important to prevent recurrent ankle sprains. Training using whole-body vibration may easily and effectively improve ankle motor control, but the effects have not been investigated. Therefore, this study aimed to clarify the effects of 6 weeks of training with whole-body vibration on ankle motor control in a dynamic movement task among healthy participants.
METHODS
Twenty healthy university students (6 males and 14 females) were randomly allocated to whole-body vibration training and control groups, with 10 participants in each group. The training was performed twice a week for 6 weeks in both groups. Primary outcome was mean ankle angular jerk cost in the star excursion balance test. Secondary outcomes were maximum ankle motion angle and maximum reach distance in the star excursion balance test, ankle proprioception, and range of ankle dorsiflexion motion in the loaded position.
RESULTS
There was a significant group × period (pre- and postintervention) interaction for mean ankle angular jerk cost in the direction of ankle abduction/adduction during posterolateral reaching, which was significantly lower at postintervention than that at preintervention in the whole-body vibration group In the whole-body vibration group, the maximum ankle dorsiflexion motion angle during anterior and posterolateral reaching was significantly higher at postintervention than that at preintervention.
CONCLUSIONS
Training with whole-body vibration improves ankle motor control in dynamic movement tasks, although the direction of reach and plane of motion are limited. Additionally, training with whole-body vibration is also effective in increasing the ankle dorsiflexion angle during dynamic movement tasks.
Topics: Humans; Vibration; Female; Male; Young Adult; Proprioception; Range of Motion, Articular; Ankle Injuries; Postural Balance; Ankle Joint; Adult; Ankle
PubMed: 38916091
DOI: 10.23736/S0022-4707.24.15788-X -
BioRxiv : the Preprint Server For... Jun 2024Spinal cord stimulation (SCS) has emerged as a therapeutic tool for improving motor function following spinal cord injury. While many studies focus on restoring...
Spinal cord stimulation (SCS) has emerged as a therapeutic tool for improving motor function following spinal cord injury. While many studies focus on restoring locomotion, little attention is paid to enabling standing which is a prerequisite of walking. In this study, we fully characterize a new type of response to SCS, a long extension activated post-stimulation (LEAP). LEAP is primarily directed to ankle extensors and hence has great clinical potential to assist postural movements. To characterize this new response, we used the decerebrate cat model to avoid the suppressive effects of anesthesia, and combined EMG and force measurement in the hindlimb with intracellular recordings in the lumbar spinal cord. Stimulation was delivered as five-second trains via bipolar electrodes placed on the cord surface, and multiple combinations of stimulation locations (L4 to S2), amplitudes (50-600 uA), and frequencies (10-40 Hz) were tested. While the optimum stimulation location and frequency differed slightly among animals, the stimulation amplitude was key for controlling LEAP duration and amplitude. To study the mechanism of LEAP, we performed in vivo intracellular recordings of motoneurons. In 70% of motoneurons, LEAP increased at hyperpolarized membrane potentials indicating a synaptic origin. Furthermore, spinal interneurons exhibited changes in firing during LEAP, confirming the circuit origin of this behavior. Finally, to identify the type of afferents involved in generating LEAP, we used shorter stimulation pulses (more selective for proprioceptive afferents), as well as peripheral stimulation of the sural nerve (cutaneous afferents). The data indicates that LEAP primarily relies on proprioceptive afferents and has major differences from pain or withdrawal reflexes mediated by cutaneous afferents. Our study has thus identified and characterized a novel postural motor response to SCS which has the potential to expand the applications of SCS for patients with motor disorders.
PubMed: 38915687
DOI: 10.1101/2024.06.13.598885 -
PeerJ 2024Low energy availability (LEA) causes pathophysiology of the female athlete's body affecting the bone and reproductive health and was observed to have a high prevalence...
BACKGROUND
Low energy availability (LEA) causes pathophysiology of the female athlete's body affecting the bone and reproductive health and was observed to have a high prevalence in recreational female athletes previously. The aim of this study was to analyse the relationship between low energy availability in females questionnaire (LEAF-Q), bone mineral density (BMD), and postural stability in recreational athletes.
METHODS
Recreational female athletes ( = 24, age: 23.71 ± 2.94, Tier I) completed LEAF-Q, postural stability measurement during quiet stance (Zebris platform FDM; GmbH) and their BMD was measured using DXA (Hologic QDR Horizon A). Non-parametric statistical tests were used to analyse the relationships between LEAF-Q, BMD, and postural stability and to compare differences between participants divided by the LEAF-Q score and its subscales.
RESULTS
Risk of LEA was observed in 50% of recreational athletes participating in this study. Up to 46% of participants perceived menstrual bleeding changes related to training and 37.50% experienced menstrual dysfunction. Body composition and body weight fluctuations were observed to affect postural stability and BMD. With the risk score for LEA, the BMD and postural stability were not negatively affected in recreational athletes. However, the high number of recreational athletes in the risk score for LEA and menstrual dysfunctions highlights the need for public health programs aimed to increase awareness of LEA and its health consequences and for open communication about the menstrual cycle. Future longitudinal studies observing LEA, BMD, menstrual function, postural stability, and their interrelationship in female athletes are needed to increase the knowledge of this topic.
Topics: Humans; Female; Bone Density; Athletes; Young Adult; Adult; Postural Balance; Surveys and Questionnaires; Athletic Injuries; Relative Energy Deficiency in Sport; Body Composition; Absorptiometry, Photon
PubMed: 38915384
DOI: 10.7717/peerj.17533 -
Journal of Neuroengineering and... Jun 2024Impaired ankle proprioception strongly predicts balance dysfunction in chronic stroke. However, only sparse data on ankle position sense and no systematic data on ankle...
BACKGROUND
Impaired ankle proprioception strongly predicts balance dysfunction in chronic stroke. However, only sparse data on ankle position sense and no systematic data on ankle motion sense dysfunction in stroke are available. Moreover, the lesion sites underlying impaired ankle proprioception have not been comprehensively delineated. Using robotic technology, this study quantified ankle proprioceptive deficits post-stroke and determined the associated brain lesions.
METHODS
Twelve adults with chronic stroke and 13 neurotypical adults participated. A robot passively plantarflexed a participant's ankle to two distinct positions or at two distinct velocities. Participants subsequently indicated which of the two movements was further/faster. Based on the stimulus-response data, psychometric just-noticeable-difference (JND) thresholds and intervals of uncertainty (IU) were derived as measures on proprioceptive bias and precision. To determine group differences, Welch's t-test and the Wilcoxon-Mann-Whitney test were performed for the JND threshold and IU, respectively. Voxel-based lesion subtraction analysis identified the brain lesions associated with observed proprioceptive deficits in adults with stroke.
RESULTS
83% of adults with stroke exhibited abnormalities in either position or motion sense, or both. JND and IU measures were significantly elevated compared to the control group (Position sense: + 77% in JND, + 148% in IU; Motion sense: +153% in JND, + 78% in IU). Adults with stroke with both impaired ankle position and motion sense had lesions in the parietal, frontal, and temporoparietal regions.
CONCLUSIONS
This is the first study to document the magnitude and frequency of ankle position and motion sense impairment in adults with chronic stroke. Proprioceptive dysfunction was characterized by elevated JND thresholds and increased uncertainty in perceiving ankle position/motion. Furthermore, the associated cortical lesions for impairment in both proprioceptive senses were largely overlapping.
Topics: Humans; Male; Robotics; Proprioception; Female; Middle Aged; Stroke; Ankle; Aged; Adult; Chronic Disease; Brain; Stroke Rehabilitation
PubMed: 38915064
DOI: 10.1186/s12984-024-01396-9 -
Nature Communications Jun 2024Neuromuscular control of bionic arms has constantly improved over the past years, however, restoration of sensation remains elusive. Previous approaches to reestablish...
Neuromuscular control of bionic arms has constantly improved over the past years, however, restoration of sensation remains elusive. Previous approaches to reestablish sensory feedback include tactile, electrical, and peripheral nerve stimulation, however, they cannot recreate natural, intuitive sensations. Here, we establish an experimental biological sensorimotor interface and demonstrate its potential use in neuroprosthetics. We transfer a mixed nerve to a skeletal muscle combined with glabrous dermal skin transplantation, thus forming a bi-directional communication unit in a rat model. Morphological analyses indicate reinnervation of the skin, mechanoreceptors, NMJs, and muscle spindles. Furthermore, sequential retrograde labeling reveals specific sensory reinnervation at the level of the dorsal root ganglia. Electrophysiological recordings show reproducible afferent signals upon tactile stimulation and tendon manipulation. The results demonstrate the possibility of surgically creating an interface for both decoding efferent motor control, as well as encoding afferent tactile and proprioceptive feedback, and may indicate the way forward regarding clinical translation of biological communication pathways for neuroprosthetic applications.
Topics: Animals; Bionics; Rats; Muscle, Skeletal; Feedback, Sensory; Proprioception; Ganglia, Spinal; Mechanoreceptors; Muscle Spindles; Male; Female; Touch; Skin
PubMed: 38914540
DOI: 10.1038/s41467-024-49580-8 -
Journal of Orthopaedic Surgery (Hong... 2024To observe the activation strategies of the ankle muscles using surface electromyography (sEMG) during single-leg standing (SLS) and both-leg standing (BLS) on flat...
To observe the activation strategies of the ankle muscles using surface electromyography (sEMG) during single-leg standing (SLS) and both-leg standing (BLS) on flat ground (FG), soft mat (SM), and BOSU ball (BB) surfaces. Thirty healthy young adults participated in the study. The muscle activities of the tibialis anterior (TA) and gastrocnemius medial (GM) were measured on the three surfaces during SLS and BLS. Electromyographic evaluations of the TA and GM were recorded during maximum voluntary isometric contractions (MVIC). Muscle activation was evaluated using MVIC%, and muscle co-contraction was evaluated using the co-contraction index (CI). A statistically significant increase was observed in the MVIC% of the TA, GM, and CI on the three surfaces during SLS compared to BLS, except for the comparison of CI on BB between SLS and BLS (t = -1.35, = 0.19). The MVIC% of the TA and GM during SLS and BLS on BB was significantly increased in comparison with FG and SM. The CI during BLS on BB increased compared to FG (t = 3.19, < 0.01) and SM (t = 4.64, < 0.01). The CI during BLS on SM (t = -1.46, = 0.15) decreased when compared to FG but without statistical significance. SLS and unstable surfaces can induce greater muscle activation, and SLS can have a greater influence on ankle muscles.
Topics: Humans; Electromyography; Male; Muscle, Skeletal; Young Adult; Female; Standing Position; Adult; Ankle Joint; Isometric Contraction; Ankle; Postural Balance
PubMed: 38910029
DOI: 10.1177/10225536241258336 -
Current Aging Science 2024The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity,...
BACKGROUND
The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity, disability, and bone fractures, especially hip fractures. This study aimed to investigate balancing ability using a multi-directional reach test (MDRT) in older adults with and without diabetes mellitus.
METHODS
72 older adults with and without diabetes mellitus were recruited, and divided into two groups, including older adults without diabetes mellitus (n = 36) and older adults with diabetes mellitus (n = 36). All subjects completed all directions of the MDRT.
RESULTS
There were no significant differences in MDRT scores in all directions between the two groups (p>0.05). Both groups achieved the highest MDRT scores in the forward direction. In contrast, the two groups had the lowest scores of MDRT in a backward direction. Furthermore, older adults with diabetes mellitus had lower MDRT scores in all directions than older adults without diabetes mellitus.
CONCLUSION
The current study indicated that MDRT could be used to investigate the ability of balance in individuals with diabetes mellitus.
Topics: Humans; Aged; Male; Female; Diabetes Mellitus; Postural Balance; Geriatric Assessment; Accidental Falls; Aged, 80 and over; Age Factors; Aging; Case-Control Studies; Predictive Value of Tests
PubMed: 38904153
DOI: 10.2174/0118746098253144231024052312 -
Cureus May 2024Acute suppurative otitis media can occasionally result in facial paralysis, which calls for prompt diagnosis and treatment. Facial paralysis, a synonym for Bell's palsy,...
Acute suppurative otitis media can occasionally result in facial paralysis, which calls for prompt diagnosis and treatment. Facial paralysis, a synonym for Bell's palsy, is a condition that causes rapid weakening of one side of the face muscles, leading to drooping of the face on that side. A major factor in determining the course of the condition is rehabilitation through physiotherapy. Here, we present a case of a 26-year-old female who felt discomfort in her left ear on February 21, 2024, but chose to ignore it then. She observed an abrupt deviation in her mouth and visited a rural hospital, where she was admitted. Facial asymmetry was observed during the examination, and she was found to have a grade V on the House-Brackmann scale. A near-normal muscle action was initiated by mime therapy, and proprioceptive stimulation was given by facial proprioceptive neuromuscular facilitation along with electrical stimulation. All these approaches benefited the patient in a significant manner.
PubMed: 38903317
DOI: 10.7759/cureus.60795 -
Clinical Nutrition ESPEN Aug 2024Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit an inability to maintain postural balance. However, the contribution of increased...
AIMS
Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit an inability to maintain postural balance. However, the contribution of increased intestinal permeability or leaky gut to the postural imbalance in COPD is not known.
METHODS
We measured plasma zonulin, a marker of leaky gut, with relevance to postural balance in male controls (n = 70) and patients with mild (n = 67), moderate (n = 66), and severe (n = 58) COPD. We employed a short physical performance battery to evaluate postural balance in supine, tandem, and semi-tandem positions. We also measured handgrip strength (HGS), gait speed, plasma c-reactive proteins (CRP), and 8-isoprostanes as potential mechanistic connections between postural imbalance and leaky gut.
RESULTS
COPD patients demonstrated higher plasma zonulin, CRP, and 8-isoprostanes levels and lower balance, HGS, and gait speed than controls (all p < 0.05). These findings were more robust in patients with moderate and severe than mild COPD. In addition, plasma zonulin exhibited significant potential in diagnosing poor balance, low HGS, and gait speed in COPD patients (all p < 0.05). We also found significant correlations of plasma zonulin with CRP and 8-isoprostanes, providing heightened inflammation and oxidative stress as mechanistic connections between leaky gut and postural imbalance.
CONCLUSION
Plasma zonulin may be helpful in evaluating postural imbalance in COPD patients. Repairing intestinal leaks can be a therapeutic target to improve postural control in COPD.
Topics: Humans; Male; Pulmonary Disease, Chronic Obstructive; Postural Balance; Aged; Haptoglobins; Middle Aged; C-Reactive Protein; Biomarkers; Hand Strength; Protein Precursors; Cholera Toxin; Case-Control Studies; Permeability; Dinoprost
PubMed: 38901937
DOI: 10.1016/j.clnesp.2024.05.018 -
Clinical Nutrition ESPEN Aug 2024Skeletal muscles are essential for postural retention and balance function. However, the relationship between trunk muscle mass (TMM) and balance function has not yet... (Observational Study)
Observational Study
BACKGROUND & AIMS
Skeletal muscles are essential for postural retention and balance function. However, the relationship between trunk muscle mass (TMM) and balance function has not yet been clarified. This study aimed to examine the impact of TMM on the change in balance function in patients with stroke from admission to a rehabilitation hospital to discharge.
METHODS
This retrospective observational study included patients aged ≥65 years with cerebral infarction admitted to our rehabilitation hospital from May 2018 to July 2022. The trunk muscle mass index (TMI) was calculated at admission and discharge using bioelectrical impedance analysis. Patients were divided into low and high TMI groups according to the median TMI at admission. The primary outcome was the change in the Berg Balance Scale (BBS) score (BBS score at discharge - BBS score at admission).
RESULTS
A total of 315 patients (mean age, 78.9 ± 8.0 years; 172 men and 143 women) were included. The median TMI was 7.31 kg/m in men and 6.30 kg/m in women. Among male patients, the high TMI group had higher BBS scores at admission (31.2 ± 18.2 vs. 23.4 ± 17.7, P = 0.005) and discharge (43.0 ± 15.3 vs. 33.4 ± 19.0, P < 0.001) than those in the low TMI group. After adjusting for confounding factors, TMI at admission was independently associated with the change in BBS score (β = 0.587, P = 0.002).
CONCLUSIONS
Reduced TMM negatively influences balance function recovery in patients after stroke. A strategy aimed at increasing TMM could have beneficial effects on balance function.
Topics: Humans; Male; Female; Aged; Postural Balance; Retrospective Studies; Muscle, Skeletal; Recovery of Function; Stroke; Stroke Rehabilitation; Aged, 80 and over; Torso
PubMed: 38901932
DOI: 10.1016/j.clnesp.2024.05.004