Balance Recovery Research Articles

The Effect of Competition Sounds on Balance Performance in Football Players

Abstract Objective This study aimed to investigate the impact of competition environment sounds on the static and dynamic balance of football players. Materials and Methods Thirty-two football players with a mean age of 21.12±2.99 years and a body mass index of 21.98±2.58 kg/m² were included in this study. The initial assessment condition (whether in a quiet environment or with competition sounds) was determined by simple randomization. Forty-eight hours later, at the same time of day, the tests were repeated with the environmental conditions reversed. Balance performance was assessed using the Tecnobody device for both static and dynamic balance. Results In the static balance test, it was found that the surface area covered significantly decreased in the environment where competition sounds were played (p=0.014), while there was no significant change in overall sway (p=0.313), anteroposterior sway (p=0.852), or mediolateral sway (p=0.104). In the dynamic balance test, no significant change was observed in anteroposterior sway (p=0.411), but mediolateral sway (p=0.025) and overall sway (p=0.042) significantly decreased. Additionally, there was a significant improvement in the athletes’ score for reaching the target (p=0.003). The perceived difficulty levels during the tests were found to be significantly lower in both the static (p=0.048) and dynamic (p=0.001) balance tests in the environment where competition sounds were played. Conclusion In conclusion, competition environment sounds were found to positively affect the balance performance of football players and reduce the perceived difficulty level. Incorporating balance training with competition sounds during athlete rehabilitation may contribute to improved balance recovery.

Slow post-fire carbon balance recovery despite increased net uptake rates in Alaskan tundra

Abstract Increasing wildfire occurrence and intensity have immediate effects on northern ecosystems due to combustion of aboveground vegetation and belowground soil organic matter. These immediate impacts have indirect and longer term effects, including deepening of the active layer, changes in soil decomposition rates, and shifts in plant community composition. Despite the increasing fire impacts across the tundra region, the implications of wildfire on ecosystem carbon balance are not well understood. Using paired eddy covariance towers in unburned and burned tundra, we examined the effects of a 2015 wildfire on carbon dioxide and methane fluxes in a wetland tundra ecosystem in the Yukon-Kuskokwim Delta, Alaska, from 2020 to 2022. Wildfire increased the amplitude and variability of carbon uptake and release on seasonal and annual timescales and increased the temperature sensitivity of soil respiration. Seven years post fire, there was annual net uptake in both unburned and burned tundra based on net ecosystem exchange, with the sink strength of burned tundra exceeding that of the unburned tundra by 1.18 to 1.64 times. However, when considering emissions, it would take approximately 86 years to recover the carbon lost from the wildfire itself. Soil moisture was a dominant driver of fluxes and positively associated with higher rates of carbon dioxide uptake and release and methane release. This study underscores the importance of understanding the effects of wildfire-induced shifts on tundra carbon cycling, allowing better predictions of long-term landscape-scale climate feedbacks as the climate continues to warm.

Transcranial Direct Current Stimulation for Improving Balance in Healthy Older Adults and Older Adults with Stroke: A Scoping Review.

Background/Objectives: Age-related decline in balance and postural control is common in healthy elders and is escalated in aging adults with stroke. Transcranial direct current stimulation (tDCS) has emerged as one of the promising brain stimulations adjoining therapeutic exercise to enhance the recovery of balance and motor functions in persons with and without neurological disorders. This review aims to summarize and compare the available evidence of the tDCS on improving balance in the older adults without neurological disorders and the older adults with stroke. Methods: The Ovid (Medline) database was searched from its inception through to 06/15/2024 for randomized controlled trials investigating tDCS for improving balance in older adults with and without stroke. Results: Overall, 20 appropriate studies (including 271 stroke subjects and 259 healthy older adults) were found. The data indicate mixed results of tDCS for improving balance in older adults with and without stroke. Conclusions: Based on current research evidence, we have not found a specific tDCS protocol that is more effective than other tDCS protocols for improving balance and postural control in healthy older adults and older adults with stroke. Further research should explore the ideal tDCS approach, possibly in conjunction with standard interventions, to optimize postural control and balance in healthy older adults and older adults with stroke.

Effectiveness Of Visual Feedback Balance Training On Equiboard Versus Traditional Balance Training In Post Stroke Patients- A Comparative Study

Background: A Stroke is classically characterized as a neurological deficit attributed to an acute focal injury of the central nervous system by a vascular cause and is a major cause of disability and death worldwide.(1) Balance problems are thought to be common after stroke and they have been implicated in the poor recovery of activities of daily living and mobility and increased risk of falls.(2) Postural sway for patients with hemiplegia can be twice that of their age matched peers. Many balance training are used but No general physiotherapy approach has proven to be superior for promoting balance recovery from stroke.(3)Novel biofeedback devices based on Virtual reality (VR)technology are now being used for neuromotor rehabilitation. Traditional balance training is based on the automatic repetition of specific movements. These methods can become repetitive and thus reduce the motivation of the patient and adherence to treatment. So the need of my study is to compare the effectiveness of visual feedback balance training on equiboard and traditional balance training in post stroke patients. Aims and objectives-To study and compare the effectiveness of visual feedback balance training on equiboard versus traditional balance training in post stroke patients. Methodology- 30 patients with stroke were equally divided into two groups. patients in group A received the conventional physiotherapy while the patients in group B received visual feedback balance training on equiboard. All the subjects were treated for 1 month, 5 days a week. BBS-Berg Balance Scale and step test was used as the outcome measure at the beginning and end of study. Results-Results showed significant improvement within both the groups for both the outcome measure(p,0.05), while there was no significant difference between two groups in BBS(p>0.5), but there was significant difference in the step test of experimental group(p<0.5) Conclusion-It can be concluded that visual feedback balance training is more effective than the traditional balance training alone in stroke patients.

Impact of whole-body vibration training on ankle joint proprioception and balance in stroke patients: a prospective cohort study

BackgroundAlthough whole-body vibration (WBV) training is acknowledged for its benefits in enhancing motor functions across several neurological disorders, its precise influence on ankle joint proprioception and balance in stroke patients is still not well understood. This research seeks to assess the impact of WBV training on ankle joint proprioception and balance in stroke patients, thereby filling this important research void.MethodsIn this prospective cohort study, thirty-five stroke patients were randomly assigned to either the WBV group (n = 17) or a control group (n = 18) using a random number table method. The control group received daily general rehabilitation for four weeks, while the WBV group received an additional 30 min of WBV training each day with the Trunsan S110 Vibration Training System. Blinded outcome assessments were conducted at baseline and post-treatment, utilizing the Berg balance scale (BBS), Functional reach test (FRT), Romberg test length (RTL) and area (RTA), and completion rates of ankle joint dorsiflexion-plantar flexion (DP) and inversion-eversion (IE) tests. Follow-up assessments were performed after four weeks of intervention, focusing on RTL, RTA, DP, and IE as primary outcomes.ResultsAnalysis of intra-group changes from baseline to post-treatment revealed significant improvements across the BBS, FRT, RTL, RTA, and DP and IE assessments (p < 0.001). Notably, the WBV group showed significant enhancements compared to the control group in DP and IE (p < 0.001 and p < 0.05, respectively), with mean values increasing from 13.556 to 16.765 (23.7%) and from 5.944 to 8.118 (36.6%), respectively. However, WBV did not provide additional benefits over the control treatment for balance recovery parameters such as BBS, FRT, RTL, and RTA (p > 0.05).ConclusionsThis study demonstrates that WBV therapy is equally effective as conventional methods in enhancing proprioception and balance in stroke patients, but it does not provide additional benefits for balance recovery. WBV significantly improves proprioceptive functions, particularly in DP and IE parameters. However, it does not surpass traditional rehabilitation methods in terms of balance recovery. These findings indicate that WBV should be incorporated into stroke rehabilitation primarily to enhance proprioception rather than to optimize balance recovery.Trial registrationThis study was retrospectively registered in the ISRCTN Registry on 29/07/2024 (https://www.isrctn.com/, ISRCTN64602845).

Dampak Penerapan Perubahan Tarif PPN Menurut UU HPP No. 7 Tahun 2021 pada PT. POV

Tax regulations in Indonesia have undergone many changes by harmonizing tax regulations with the hope of increasing stable and balanced economic growth and recovery after covid-19 by increasing the VAT rate to 11% as regulated in the HP law number 7 of 2021.The purpose of this study is to determine the possible impact on PT POV related to the change in Value Added Tax rate. The qualitative method is the method that has been applied to conduct this research, which uses a descriptive approach by explaining a phenomenon that occurs and describing events in the field. Data collection techniques are obtained through interviews and documentation. The results of this study indicate that changes in the amount of VAT rates cause adjustments to the system by KJA in managing VAT at PT POV, namely related to e-invoicing and Microsoft Excel applications. Changes in VAT rates also affect sales made by PT POV which have decreased significantly from the March 2022 tax period before the tax rate has changed to 11%. Researchers provide advice to future researchers to conduct research with a wider object related to the impact of changes in VAT rates.

Mass balance and pharmacokinetic characterization ofzavegepant in healthy male subjects.

Zavegepant, a high-affinity, selective, small-molecule calcitonin gene-related peptide receptor antagonist, is approved as a nasal spray for acute treatment of migraine in adults. This phase I, open-label, single-center, single-period, nonrandomized study in six healthy male subjects assessed mass balance recovery after a single 15-min intravenous (IV) infusion dose of carbon-14 ([14C])-zavegepant. Blood, urine, and fecal samples were collected over 192 h for analysis of zavegepant in plasma and urine; total radioactivity (TR) in plasma, whole blood, urine, and feces; and zavegepant metabolite profiling and structural identification in plasma, urine, and feces. An average of 96.6% of radioactivity administered was recovered in excreta. Most TR (mean 84.9%) was recovered in the feces, indicating that biliary/fecal elimination was the main route. Volume of distribution of zavegepant based on the terminal phase (129 L) was higher than total body water (42 L), indicating substantial distribution into tissue. Total plasma clearance of zavegepant (220 mL/min) is identical to whole blood clearance given the blood/plasma partition ratio of 1, lower than typical hepatic blood flow (1450 mL/min). The observed plasma terminal half-life of zavegepant was 6.8 h. Exposure to zavegepant accounted for ~90% of circulating plasma TR, suggesting that very low levels of uncharacterized circulating metabolites were present. Metabolite profiling did not identify any metabolites representing ≥10% of radioactivity in plasma, urine, or feces. A single IV infusion of 5 mg [14C]-zavegepant was well tolerated in healthy male subjects. Disposition findings of IV [14C]-zavegepant are applicable to the disposition of the approved zavegepant nasal spray.

Effects of 8 weeks aquatic exercises on balance recovery strategies and center of pressure sways in blind women: A randomized controlled trial

Visual impairment presents significant challenges to mobility and daily activities, often resulting in a sedentary lifestyle and decreased physical fitness. This study aimed to investigate the effects of an 8-week aquatic exercise protocol on balance recovery strategies and center of pressure (COP) sways in blind women. A total of 30 participants were randomly assigned to either an experimental group (EX, n = 15) or a control group (CO, n = 15). Balance recovery parameters, including hip sways, ankle sways, and the ratio of hip sways to ankle sways, were assessed using motion analysis, while COP sways were measured using a force platform. The aquatic exercise protocol focused on enhancing the somatosensory system through a variety of targeted exercises. The results revealed a significant improvement in balance recovery strategies among participants in the EX group, characterized by reduced hip sways, increased ankle sways, and a decreased hip sways/ankle sways ratio in both anterior–posterior and posterior–anterior directions. Moreover, COP sways significantly decreased, as indicated by reductions in ellipse area and traveled distance in both directions. These findings suggest that the aquatic exercise protocol facilitated a shift from a hip-dominant to an ankle-based strategy, indicating improved adaptive balance recovery mechanisms. The reduced COP sways further indicate enhanced postural stability. These positive outcomes underscore the effectiveness of targeted aquatic interventions in enhancing physical capabilities and overall balance in blind women. Including such exercises in rehabilitation programs may contribute to reducing fall risks and improving the quality of life for individuals with visual impairments.

Delayed Cortical Responses During Reactive Balance After Stroke Associated With Slower Kinetics and Clinical Balance Dysfunction.

Slowed balance and mobility after stroke have been well-characterized. Yet the effects of unilateral cortical lesions on whole-body neuromechanical control is poorly understood, despite increased reliance on cortical resources for balance and mobility with aging. Objective. We tested whether individuals post stroke show impaired cortical responses evoked during reactive balance, and the effect of asymmetrical interlimb contributions to balance recovery and the evoked cortical response. Using electroencephalography, we assessed cortical N1 responses evoked over fronto-midline regions (Cz) during backward support-surface perturbations loading both legs and posterior-lateral directions that preferentially load the paretic or nonparetic leg in individuals' post-stroke and age-matched controls. We tested relationships between cortical responses and clinical balance/mobility function, as well as to center of pressure (CoP) rate of rise (RoR) during balance recovery. Cortical N1 responses were smaller and delayed after stroke (P < .047), regardless of perturbation condition. In contrast to controls, slower cortical response latencies associated with lower clinical function in stroke (Mini Balance Evaluation Systems Test: r = -.61, P = .007; Timed-Up-and-Go: r = .53, P = .024; walking speed: r = -.46, P = .055). Paretic-loaded balance recovery revealed slower CoP RoR (P = .012) that was associated with delayed cortical response latencies (r = -.70, P = .003); these relationships were not present during bilateral and nonparetic-loaded conditions, nor in the older adults control group. Individuals after stroke may be limited in their balance ability by the slowed speed of their cortical responses to destabilization. In particular, paretic leg loading may reveal cortical response impairments that reflect reduced paretic motor capacity.

Lower-limb inter-joint coordination during balance recovery after trips

BackgroundTrips are one of the most common external perturbations that can lead to accidental falls. Knowledge about postural control attributes of balance recovery after trips could help reveal the biomechanical causes for trip-induced falls and provide implications for fall prevention interventions. Research questionThe objective of the present study was to examine coordinated lower-limb movements during balance recovery after trips. MethodsOne hundred and twenty-three volunteers participated in an experimental study. They were tripped unexpectedly by a metal pole when walking on a linear walkway at their self-selected speed. Lower-limb inter-joint coordination quantified by continuous relative phase measures, including the mean of the absolute relative phases (MARP) and the deviation phase (DP), was analyzed during the execution of the first recovery step after unexpected trips. ResultsCompared to unsuccessful balance recovery, smaller MARPknee-ankle and DPknee-ankle of successful recovery were observed with distal inter-joint coordination on the swing side. Inter-joint coordination of the stance limb did not significantly differ between successful and unsuccessful recovery conditions. These findings indicate that the control of the swing limb’s distal joints is crucial for regaining balance after trips. SignificanceAn implication derived from this study is that greater in-phase coordination and smaller coordination variability in distal joints of the swing limb could be considered as potential targets for interventions aimed at preventing trip-induced accidental.

Does proprioceptive reweighting contribute to reactive balance strategies during slip-like perturbations? a proof-of-concept in healthy adults

Falls commonly occur during walking, particularly when struggling to respond to unexpected perturbations. Proprioception plays a significant role in detecting body destabilization even before reactions to perturbations are required. This study investigates the contribution of proprioceptive reweighting strategies to reactive balance during walking. This cross-sectional, proof-of-concept study included fifteen healthy adults (18–40 years). Ankle and back muscle vibrators disrupted proprioceptive input in stance, allowing calculation of the proprioceptive reweighting index. Walk-slip perturbations were then administered on an ActiveStep treadmill. A linear regression model assessed the significance of proprioceptive reweighting in predicting post-slip stability (margin of stability). Participants shifted from an ankle-steered to a central-steered proprioceptive strategy on a foam surface with closed eyes (Difference = 15.70 % (SD=37.87), 95 %CI [0.41, 30.99], p = 0.045). The regression model explained 22.7 % of the variance in pre-touchdown margin of stability, with proprioceptive reweighting on foam significantly contributing to post-perturbation postural control (p < 0.001). Proprioceptive reweighting provides a moderate explanation for the mechanisms of reactive balance, highlighting that the key to effective balance recovery strategies may lie in the person’s ability to both detect and respond to imbalances. Further research should explore if these proprioceptive strategies are a matter of directional control and if responses differ in older adults.

Collocation of restorative justice with human rights in Indonesia

Applying restorative justice in Indonesia is beset by obstacles like a lack of knowledge, inadequate infrastructure, and opposition from law enforcement, especially when human rights considerations are incorporated into the process. For this reason, the relationship between these two elements is worth examining. This paper explores and analyses the integration or synthesis of restorative justice with human rights in Indonesia. This paper employs a normative approach with prescriptive analysis based on studies of legislation and cases that integrate the principles of restorative justice with human rights. The findings indicate that collocation helps understand how grammatical structures can reflect and influence the interpretation of restorative justice in human rights, particularly in legal texts and policy reports. In Indonesia, restorative justice can be used in conjunction with the enforcement of human rights laws, particularly when addressing grave human rights breaches, since it emphasizes balanced reconciliation, recovery, and reintegration between offenders, victims, and society. In conclusion, although it has several implementation and legal issues, restorative justice can be an alternate strategy for resolving grave human rights breaches. The recommendations are for a stronger and more comprehensive legal framework to support the implementation of restorative justice in Indonesia's human rights context.

A predictive simulation study to assess the effect of ankle foot orthosis stiffness on balance recovery after tripping

A predictive simulation study to assess the effect of ankle foot orthosis stiffness on balance recovery after tripping

Modelling strategies supplemental to foot placement for frontal-plane stability in walking.

Walking is unstable and requires active control. Foot placement is the primary strategy to maintain frontal-plane balance with contributions from lateral ankle torques, ankle push-off and trunk postural adjustments. Because these strategies interact, their individual contributions are difficult to study. Here, we used computational modelling to understand these individual contributions to frontal-plane walking balance control. A three-dimensional bipedal model was developed based on linear inverted pendulum dynamics. The model included controllers that implement the stabilization strategies seen in human walking. The control parameters were optimized to mimic human gait biomechanics for typical spatio-temporal parameters during steady-state walking and when perturbed by mediolateral ground shifts. Using the optimized model as a starting point, the contributions of each stabilization strategy were explored by progressively removing strategies. The lateral ankle and trunk strategies were more important than ankle push-off, with their removal causing up to 20% worse balance recovery compared with the full model, while removing ankle push-off led to minimal changes. Our results imply a potential benefit of preferentially training these strategies in populations with poor balance. Moreover, the proposed model could be used in future work to investigate how walking stability may be preserved in conditions reflective of injury or disease.

Multi-criteria optimisation of subcritical wet oxidation for sludge treatment

Subcritical wet oxidation (SWO) is an environmentally-friendly solution for sewage sludge volume reduction. However, little study has comprehensively optimised SWO conditions across various aspects. This study developed a multi-objective model using genetic algorithms (GAs) to optimise SWO conditions, considering sludge deconstruction, emissions, energy balance, and resource recovery. The multi-criteria optimisation approach highlights the significant environmental benefits of SWO, including substantial sludge volume reduction and effective pollutant removal. An in-depth analysis of temperature, reaction time, and severity factor revealed their critical roles in enhancing sludge deconstruction and resource recovery efficiency. GAs predicted optimal conditions at 271 ± 2 °C and 51 ± 1 min, with confirmation experiments showing only 12% discrepancy between predicted and actual outcomes. This study provides practical insights for efficient sewage sludge treatment and sustainable wastewater management.

Characteristics of unsuccessful reactive responses to lateral loss of balance in people with stroke

ABSTRACT Purpose The effectiveness of reactive responses to a sudden loss of balance is a critical factor that determines whether a fall will occur. We examined the strategies and kinematics associated with successful and unsuccessful balance recovery following lateral loss of balance in people with stroke (PwS). Methods Eleven PwS were included in the analysis. They were exposed to unannounced right and left horizontal surface translations and demonstrated both successful and unsuccessful balance responses at the same perturbation magnitude. Reactive step strategies and kinematics were investigated comparatively in successful and unsuccessful recovery tests. Results The crossover strategy was used in most of the unsuccessful tests (7/11) while the unloaded-leg side-step in the successful tests (6/11). There were no significant differences in the reactive step initiation time in unsuccessful vs. successful tests. However, the step execution time, step length and center of mass displacement were significantly higher during the first recovery step in unsuccessful tests. Conclusions PwS have difficulties in controlling and decelerating the moving center of mass following a lateral loss of balance. The increased step time and step length of the first reactive step in unsuccessful vs. successful tests suggest the crossover step strategy may be ineffective for PwS.

Center of mass states render multi-joint torques throughout standing balance recovery.

Reactive balance control requires coordination of neurally-mediated feedforward and feedback pathways to generate stabilizing joint torques at the hip, knee, and ankle. Using a sensorimotor response model, we decomposed reactive joint torques into feedforward and feedback contributions based on delays relative to center of mass kinematics. Responses across joints were driven by the same signals, but contributions from feedforward versus feedback pathways differed, likely due to differences in musculotendon properties between proximal and distal muscles.

Structural housing elements associated with injuries in older adults in the USA

ObjectiveTo quantify the unintentional injuries associated with housing elements among older adults treated in US hospital emergency departments (EDs). To identify modifiable home hazards.MethodsThe National Electronic Injury Surveillance System (NEISS)...

Recovery of balance and walking in people with ataxia after acute cerebral stroke: study protocol for a prospective, monocentric, single-blinded, randomized controlled trial

IntroductionPosterior circulation stroke can lead to ataxia, manifesting in a loss of coordination and balance. Patients experience difficulty in activities of daily living and an increased risk of falling, both profoundly affecting quality of life. In individuals with neurodegenerative diseases, coordination exercises have been shown to lead to a reduction in ataxic symptoms. There is, however, limited evidence on the effect of physical therapy, specifically coordination exercises in patients with stroke-related ataxia. We therefore present a study protocol for a prospective trial.MethodsThe purpose of this trial is to investigate the effects of coordination exercises compared to standard physiotherapy on balance and walking in ataxic stroke patients. Therefore, a prospective, single-blinded randomized controlled trial is currently ongoing at the Clinical Department of Neurology, Medical University of Innsbruck, Austria, in collaboration with two local rehabilitation facilities in Austria, Hochzirl Hospital and the Clinic for Rehabilitation Münster. Balance is the primary outcome of the study as assessed using the Berg Balance Scale. Secondary outcomes are concerned with walking, risk and number of falls, independence in daily life, and quality of life, rated using appropriate scales and scores. Patients are allocated applying a 1:1 ratio and a stratified block randomization. In both groups recruited individuals undergo five 45-min treatment sessions per week, totaling 20 sessions of coordination exercises (IG) or standard physiotherapy (CG) over the course of 4 weeks. Data is collected at the baseline (T0), after the 4-week supervised practice (T1), and after another 8 weeks of independent home-based training (T2).DiscussionThis is the first randomized controlled trial investigating the effects of coordination exercises on balance and walking in people with stroke-related ataxia. As stroke guidelines emphasize the limited evidence of treatment for ataxic symptoms, this study aims to contribute further knowledge regarding tailored interventions for these patients.Clinical Trial RegistrationGerman Clinical Trials Registry (drks.de). Identifier: DRKS00020825.

Enhanced Carbon Flux Response to Atmospheric Aridity and Water Storage Deficit During the 2015–2016 El Niño Compromised Carbon Balance Recovery in Tropical South America

AbstractDuring the 2015–2016 El Niño, the Amazon basin released almost one gigaton of carbon (GtC) into the atmosphere due to extreme temperatures and drought. The link between the drought impact and recovery of the total carbon pools and its biogeochemical drivers is still unknown. With satellite‐constrained net carbon exchange and its component fluxes including gross primary production and fire emissions, we show that the total carbon loss caused by the 2015–2016 El Niño had not recovered by the end of 2018. Forest ecosystems over the Northeastern (NE) Amazon suffered a cumulative total carbon loss of ∼0.6 GtC through December 2018, driven primarily by a suppression of photosynthesis whereas southeastern savannah carbon loss was driven in part by fire. We attribute the slow recovery to the unexpected large carbon loss caused by the severe atmospheric aridity coupled with a water storage deficit during drought. We show the attenuation of carbon uptake is three times higher than expected from the pre‐drought sensitivity to atmospheric aridity and ground water supply. Our study fills an important knowledge gap in our understanding of the unexpectedly enhanced response of carbon fluxes to atmospheric aridity and water storage deficit and its impact on regional post‐drought recovery as a function of the vegetation types and climate perturbations. Our results suggest that the disproportionate impact of water supply and demand could compromise resiliency of the Amazonian carbon balance to future increases in extreme events.