Center Of Pressure Standard Deviation Research Articles

Four hours of normobaric hypoxia reduces Achilles tendon reflex inhibition.

Acute exposure to hypoxia increases postural sway, but the underlying neurophysiological factors are unclear. Golgi tendon organs (GTOs), located within the musculotendinous junction (MTJ), provide inhibitory signals to plantar flexor muscles that are important for balance control; however, it is uncertain if GTO function is influenced by hypoxia. The aim of this study was to determine how normobaric hypoxia influences lower limb tendon-evoked inhibitory reflexes during upright stance. We hypothesized that tendon-evoked reflex area and duration would decrease during hypoxia, indicating less inhibition of postural muscles compared with normoxia. At baseline (BL; 0.21 fraction of inspired oxygen, FIO2) and at ∼2 (H2) and 4 (H4) h of normobaric hypoxia (0.11 FIO2) in a normobaric hypoxic chamber, 16 healthy participants received electrical musculotendinous stimulation (MTstim) to the MTJ of the left Achilles tendon. The MTstim was delivered as two sets of 50 stimuli while the participant stood on a force plate with their feet together. Tendon-evoked inhibitory reflexes were recorded from the surface electromyogram of the ipsilateral medial gastrocnemius, and center of pressure (CoP) variables were recorded from the force plate. Normobaric hypoxia increased CoP velocity (P ≤ 0.002) but not CoP standard deviation (P ≥ 0.12). Compared with BL, normobaric hypoxia reduced tendon-evoked inhibitory reflex area by 45% at H2 and 53% at H4 (P ≤ 0.002). In contrast, reflex duration was unchanged during hypoxia. The reduced inhibitory feedback from the GTO pathway could likely play a role in the increased postural sway observed during acute exposure to hypoxia.NEW & NOTEWORTHY The Ib pathway arising from the Golgi tendon organ provides inhibitory signals onto motor neuron pools that modifies force and, hence, postural control. Although hypoxia influences standing balance (increases sway), the underlying mechanisms have yet to be unraveled. Our study identified that tendon-evoked inhibition onto a plantar flexor motoneuron pool is reduced by acute exposure to normobaric hypoxia. This reduction of inhibition may contribute to the hypoxia-related increase in postural sway.

Effects of arousal and valence on center of pressure and ankle muscle activity during quiet standing.

Emotion affects postural control during quiet standing. Emotional states can be defined as two-dimensional models comprising valence (pleasant/unpleasant) and arousal (aroused/calm). Most previous studies have investigated the effects of valence on postural control without considering arousal. In addition, studies have focused on the center of pressure (COP) trajectory to examine emotional effects on the quiet standing control; however, the relationship between neuromuscular mechanisms and the emotionally affected quiet standing control is largely unknown. This study aimed to investigate the effects of arousal and valence on the COP trajectory and ankle muscle activity during quiet standing. Twenty-two participants were instructed to stand on a force platform and look at affective pictures for 72 seconds. The tasks were repeated six times, according to the picture conditions composed of arousal (High and Low) and valence (Pleasant, Neutral, and Unpleasant). During the task, the COP, electromyogram (EMG) of the tibialis anterior and soleus muscles, and electrocardiogram (ECG) were recorded. The heart rate calculated from the ECG was significantly affected by valence; the value was lower in Unpleasant than that in Neutral and Pleasant. The 95% confidence ellipse area and standard deviation of COP in the anterior-posterior direction were lower, and the mean power frequency of COP in the anterior-posterior direction was higher in Unpleasant than in Pleasant. Although the mean velocity of the COP in the medio-lateral direction was significantly lower in Unpleasant than in Pleasant, the effect was observed only when arousal was low. Although the EMG variables were not significantly affected by emotional conditions, some EMG variables were significantly correlated with the COP variables that were affected by emotional conditions. Therefore, ankle muscle activity may be partially associated with postural changes triggered by emotional intervention. In conclusion, both valence and arousal affect the COP variables, and ankle muscle activity may be partially associated with these COP changes.

Neuromechanical characterization of the abductor hallucis and its potential role in upright postural control.

There is growing evidence to support a role for the abductor hallucis (AH) in standing balance control; however, functional properties of the muscle that may provide more insight into AH's specific contribution to upright posture have yet to be characterized. This study was conducted to quantify functional neuromechanical properties of the AH and correlate the measures with standing balance variables. We quantified strength and voluntary activation during maximal voluntary isometric contractions of the great toe abductor in nine (3 females and 6 males) healthy, young participants. During electrically evoked twitch and tetanic contractions, we measured great toe abduction peak force and constructed a force-frequency curve. We also evaluated peak abduction force, contraction time (CT), half-relaxation time (HRT), rate of force development (RFD), and relaxation rate (RR) from twitch contractions evoked using doublet stimuli. Strength, VA, CT, HRT, RFD, and RR were correlated to centre of pressure standard deviation (COP SD) and velocity (COP VEL) variables of the traditional COP trace and its rambling and trembling components during single-legged stance. AH twitch properties (e.g., CT: 169.8±32.3ms; HRT: 124.1±29.2ms) and force-frequency curve were similar to other slow contractile muscles. Contractile speed related negatively with COP VEL, suggesting AH may be appropriate for slow, prolonged tasks such as ongoing postural balance control. Correlation coefficient outcomes for all variables were similar between rambling and trembling components. Our results provide further evidence for the importance of AH neuromechanical function for standing balance control, at least during a challenging single-legged posture.

Sport dependent effects on the sensory control of balance during upright posture: a comparison between professional horseback riders, judokas and non-athletes.

Compared to judokas (JU) and non-athletes (NA), horseback riders (HR) may develop specific changes in their sensory control of balance. Thirty-four international-level JU, twenty-seven international-level HR and twenty-one NA participated. Participants stood upright on a plateform (static condition) or on a seesaw device with an instability along the mediolateral (ML) or the anteroposterior (AP) direction (dynamic conditions). These conditions were carried out with eyes opened (EO) or closed (EC), and with (wF) or without a foam (nF). Experimental variables included conventional (linear), non-linear center-of-pressure (COP) parameters, Romberg Quotient (RQ) and Plantar Quotient (PQ). Group effects. COP Surface (COPS) and standard deviation of COP along AP (SDY) were lower in HR than in JU in Static. SD Y was lower in HR than in JU in Dynamic AP. COP velocity (COPV) was lower in both HR and JU than in NA in Static and Dynamic. Sample entropy along AP and ML (SampEnY and SampEnX) were higher in HR than in JU in Static. SampEnY was higher in HR than in JU in Dynamic ML. Sensory effects. In EC, COPV was lower in JU than in NA in Dynamic AP, and lower in JU than in both HR and NA in Dynamic ML. In EO, COPV was lower in both JU and HR than in NA in Dynamic ML. RQ applied to COPS was lower in JU than in both HR and NA in Dynamic AP, and lower in JU than in HR in Dynamic ML. RQ applied to COPV was lower in JU than in both HR and NA in Static and Dynamic. PQ applied to COPS was higher in JU than in both HR and NA in Dynamic ML. Results showed that the effects of sport expertise on postural control could only be revealed with specific COP variables and were directionally oriented and sport-dependant. HR seem to rely more on vision than JU, thus revealing that the contribution of the sensory inputs to balance control is also sport-dependent. Results open up new knowledge on the specificity of sport practice on multisensory balance information during upright posture.

Precision aiming performance with the paretic upper limb is associated with center of pressure patterns in individuals with chronic stroke

BackgroundIndividuals with stroke commonly demonstrate upper-limb sensorimotor impairments. Upper-limb tasks occur against a background level of postural control and thus require a flexible postural control system to facilitate performance. Anterior precision aiming tasks, for example, benefit from lower medial-lateral (ML) center of pressure (COP) fluctuations (where increased fluctuations erode performance) relative to anterior-posterior (AP) fluctuations (where increased fluctuations do not strongly influence performance). After stroke, individuals may compensate for upper-limb impairments by increasing trunk movement which increases overall COP fluctuations and thus may make it more difficult to modulate COP in a task-sensitive manner. Research questionDo upper-limb task demands modulate COP movement patterns after stroke? MethodsIn this cross-sectional study, adults with chronic stroke (n = 23) and unilateral upper-limb impairments were immersed in a virtual environment displaying an anterior target. Participants aimed to maintain the position of a virtual laser pointer (via handheld controller) in the target with each hand. COP was concurrently recorded. Mixed effects models and correlations were used to detect differences in COP patterns between limbs and movement planes and evaluate associations between task performance and COP patterns, respectively. ResultsParticipants showed greater COP standard deviation and regularity in the AP compared to the ML direction. The magnitude of difference between AP and ML COP metrics was greater using the nonparetic limb. Task performance was moderately and positively associated with task-sensitive COP patterns (i.e., higher AP:ML ratios of COP metrics) using the paretic upper limb. Participants consistently demonstrated high levels of task performance and task-sensitive COP movement patterns using the nonparetic limb. SignificanceImpairments in postural control after stroke may be related to the upper limb used. It is important to recognize the role of directional COP variability and regularity in the context of a task goal after stroke.

Posturography measures in specific ballet stance position discriminate ballet dancers with different occurrences of musculoskeletal injuries

BackgroundThis study aimed to identify the postural sway variables that can distinguish between ballet dancers with high and low occurrences of musculoskeletal injuries. MethodsFourteen professional ballet dancers were assigned to a high-occurrence group (N = 5, reports >2 injuries in the previous 6-months) or a low-occurrence group (N = 9, reports ≤1 injury). Center-of-pressure (COP) data were acquired using a force platform during the following tasks: single-leg stance with eyes open, single-leg stance with eyes closed, and demi-pointe stance with eyes open. The COP standard deviation (SD) and range (RA) in both the medial-lateral (ML) and anterior-posterior (AP) directions were estimated. Between-group comparisons were made through Welch's t-tests for unequal sample size along the effect size measure (Cohen's d). Spearman's rho was used to estimate the association between the number of injuries and the COP variables. The statistical threshold was set at 1%. ResultsA between-group effect was found only for the demi-pointe stance, with large effects for SDML (P = 0.006, d = 1.7), RAAP (P = 0.006, d = 1.7), and RAML (P = 0.005, d = 1.7). An inverse relationship was found between the number of injuries and the demi-pointe's COP range in both directions (Spearman's rho from −0.681 to −0.726, P = 0.007). ConclusionsCOP measures taken in ballet-specific positions can distinguish between dancers with a high and low occurrence of musculoskeletal injuries. Suggestions are made to include ballet-specific tasks in the functional assessments of professional dancers.

Micromovements and discomfort associated with flight mission with helmet operation tasks with different levels of cognitive workload

When performing stationary tasks under elevated cognitive workload, individuals must perform continual muscle contractions to maintain stability of the body, resulting in fatigue of the postural muscles. When the muscles perform these contractions in a prolonged manner, the body potentially responds through small changes in body movements—micromovements that may lead to discomfort. The study purpose was to evaluate impact of cognitive load on micromovements. The micromovements were measured during three different cognitive workloads; low, medium, and high. The NASA-TLX score was used to evaluate the perceived mental workload and discomfort was assessed by visual analog scale. In total, 60 subjects (30 males and 30 females) were recruited and performed cognitive tasks that simulated flight operations such as changing the radio frequency based on air traffic control messages, balancing the fuel levels in simulated fuel tanks, and aiming a reticle in a designated moving target using the cyclic control. Cognitive load was defined by the frequency of events. Micromovements were defined by changes in the center of pressure (COP) of the seat pan and COP standard deviation. It was found that the high cognitive workloads had the highest NASA-TLX scores including mental demands, temporal demands, and effort. The neck area had the highest overall levels of discomfort followed by upper back. The highest standard deviation for COP shift and number of micromovements occurred for medium cognitive workloads. While there were some interesting trends, few trends reached a statistical significance due to high variability among subjects for the outcome variables.

축구선수들의 포지션에 따른 균형 능력 비교 분석

The purpose of this study was to comparison of balance ability in male soccer athletes according to the position. In this study, the subject were 31 male high school soccer athletes. The displacement of center of pressure (CoP), standard deviation of CoP, velocity of CoP and trace length of CoP of both feet was evaluated with wireless foot pressure device (Moticon, Germany). And also, one single leg stance was measured. As a result of the study, This study was significantly lower the defender and midfielders than the forwards at the standard deviation of CoP in the non-dominant foot (p<.01). But, there was no statistically significant difference to the position; CoP of anterior-posterior (AP) in the both feet, CoP of medial-lateral (ML) in the both feet, deviation of CoP in the dominant foot, velocity of CoP in the both feet, trace length of CoP of both feet, (p>.05). In conclusion, this study was suggested that the men soccer players were showed differences in standard deviation of CoP of non-dominant foot according to the position.

Effects of initial foot position on postural responses to lateral standing surface perturbations in younger and older adults.

An age-related decline in standing balance control in the medio-lateral direction is associated with increased risk of falls. A potential approach to improve postural stability is to change initial foot position (IFP). In response to a lateral surface perturbation, how are lower extremity muscle activation levels different and what are the effects of different IFPs on muscle activation patterns and postural stability in younger versus older adults? Ten younger and ten older healthy adults participated in this study. Three IFPs were tested [Reference (REF): feet were placed parallel, shoulder-width apart; Toes-out with heels together (TOHT): heels together with toes pointing outward; Modified Semi-Tandem (M-ST): the heel of the anterior foot was placed by the big toe of the posterior foot]. Unexpected lateral translations of the standing surface were applied. Electromyographic (EMG) activity of the lower extremity muscles, standard deviation (SD) of the body's CoM acceleration (SD of CoMAccel), and center of pressure (CoP) sway area were compared across IFPs and age. Activation levels of the muscles serving the ankle and gluteus medius were greater than for the knee joint muscles and gluteus maximus in the loaded leg across all IFPs in both groups. TOHT showed greater EMG peak amplitude of the soleus and fibularis longus compared to REF, and had smaller SD of CoMAccel and CoP sway area than M-ST. Compared to younger adults, older adults demonstrated lower EMG peak amplitude and delayed peak timing of the fibularis longus and greater SD of CoMAccel and CoP sway area in all IFPs during balance recovery. During standing balance recovery, ankle muscles and gluteus medius are important active responders to unexpected lateral surface perturbations and a toes-out IFP could be a viable option to enhance ankle muscle activation that diminishes with age to improve postural stability.

Age-associated increase in postural variability relate to greater low-frequency center of pressure oscillations

BackgroundPostural control is impaired in older adults, as evidenced from greater variability of the center of pressure (COP) during postural tasks. Although COP variability associates with low-frequency COP oscillations (<1 Hz) in young adults, it remains unknown if the age-associated increase in COP variability relates to greater low-frequency COP oscillations. Research questionDo low-frequency oscillations contribute to greater postural sway (center of pressure (COP) variability) in older adults when attempting to voluntarily maintain posture in a forward leaning position compared to young adults? MethodsSeven young (25.7 ± 4.8) and seven older (71.0 ± 7.0) adults performed a postural lean forward task and attempted to match a COP target in the anterior-posterior direction as steady as possible. We quantified the COP variability as the standard deviation (SD) of COP displacements in the anterior-posterior and medial-lateral directions and quantified the frequency modulation of COP as the power in COP displacement spectra from 0-1 Hz. ResultsWe found that older adults had significantly greater anterior-posterior SD of COP (p = 0.027) and power below 0.5 Hz (p = 0.048) than young adults, but power from 0.5-1 Hz was similar (p = 0.083). In contrast, the medial-lateral SD of COP (p = 0.5) and power from 0-1 Hz (p = 0.228) was similar for the two age groups. For both the anterior-posterior and medial-lateral direction, the SD of COP was related to low frequency oscillations below 0.5 Hz. SignificanceFor the first time, we show that the age-associated increase in postural variability relates to greater COP oscillations below 0.5 Hz.

Relationship between hip abductor strength, rate of torque development scaling factor and medio-lateral stability in older adults

BackgroundRecently, the rate of torque development scaling factor (RTD-SF) has been proposed as a useful tool that could contribute to a more comprehensive insight into muscular capacity. While lower RTD-SF is associated with ageing and certain neuromuscular diseases, it remains unknown whether this novel measure is associated with the postural control in the older adults. Research questionAre hip abductor muscle strength, RTD and RTD-SF associated with responses to external postural perturbations in medio-lateral direction in older adults? MethodsTwenty healthy older adults (14 females, 6 males) were assessed for hip abductor muscle strength, RTD and RTD-SF, using a custom-built dynamometer. Perturbations were applied at waist level (4 perturbation intensities, 15 repetitions each) using a wire-pull paradigm, with centre-of-pressure (CoP) being recorded with force plates. For each condition (i.e. perturbation intensity), medio-lateral displacement and velocity of the CoP were computed. For both parameters, within-individual variation (representing consistency of the responses), expressed by the standard deviation (SD) of CoP parameters was also considered. Pearson correlation coefficients were computed between parameters of hip muscle capacity and CoP responses and SD values of CoP responses. ResultsRTD-SF was moderately positively related to the consistency of the responses of both CoP displacement and velocity (r = 0.53−0.56; p = 0.011−0.016) at the lowest level of the perturbation magnitude (15 N). No other statistically significant relationships were found (all r < 0.35). SignificanceRTD-SF could play a role in preserving postural balance in older adults when low-intensity perturbations are applied. RTD-SF is a novel outcome measure that could represent an important alternative clinical tool to traditional strength assessments. It could represent a supplementary tool to assess the risk of falls, however, several limitations and ambiguities need to be resolved by future research before it can be utilized in practice.

Effects of core muscle acupuncture on standing balance function of children with spastic cerebral palsy

To investigate the effects of core muscle acupuncture on the standing balance function of children with spastic cerebral palsy. We select 30 cases of spastic cerebral palsy children with standing disequilibrium and divide randomly into two groups. Conventional rehabilitation training was adopted in the rehabilitation group, while core muscle acupuncture combined with the same rehabilitation in the rehabilitation group was adopted in the acupuncture group. In 6 months, the Pro-kin254 equilibrium training detector was utilized to detect the scores of the trunk control ability and those in standing position (region D) among the 88 items in the gross motor function measure (GMFM-88). The center of pressure (COP) in the anterior-posterior and left-right directions, the average speeds of movement in the left-right directions, and the ellipse area formed by the shifting of the center of gravity in the acupuncture group were superior after treatment to those before treatment ( P < 0.05). The standard deviation of COP in the left-right direction, the average speed of movement in the left-right direction, and the swinging path length of the center of gravity n the rehabilitation group were all superior to those before treatment ( P < 0.05). In the rehabilitation group the difference in the average speed of movement in the anterior-posterior direction in the acupuncture group before and after treatment was better than that in the rehabilitation group ( P < 0.05). The GMFM-88 scores in standing position in both groups were better after treatment than those before treatment ( P < 0.05); and the differences in the GMFM-88 scores in standing position of prior and post-treatment were higher in the acupuncture group than in the rehabilitation group ( P < 0.05). Core muscle acupuncture could improve the standing balance function of children with spastic cerebral palsy.

Correlation between movement complexity during static standing and balance function in institutionalized older adults.

PurposeSample entropy (SampEn) is an analysis to evaluate movement complexity of the center of pressure (COP). A lower value of SampEn indicates lower complexity of COP variability, that is, rigidity, and lower degrees of freedom. Previous studies reported the association of increased SampEn with improved standing balance ability in young subjects. However, no studies have examined these relationships among older adults. Thus, we aimed to investigate the relationship between SampEn and standing balance ability in older adults.Subjects and methodsThe subjects were 33 institutionalized older adults (aged 82.2±6.5 years). COP during static standing was measured. The standard deviation (SD) values of COP and SampEn in the sagittal and frontal planes were calculated using time series data. One-leg standing test (OLST), functional reach (FR) test, and lateral reach (LR) test were also measured to evaluate standing balance ability.ResultsOLST, FR, and LR were 6.5±8.3 s, 19.8±5.9 cm, and 18.2±6.4 cm, respectively. Pearson correlation analysis revealed that SampEn in the sagittal plane significantly correlated with OLST (r=−0.35) and FR (r=−0.36). However, SampEn in the frontal plane and SD of COP in both sagittal and frontal planes had no relationship with any of the clinical balance tests.ConclusionLower SampEn implies rigidity for postural control. In the present study, it was found that lower SampEn in the sagittal plane was related to a higher balance function, which suggests that older adults utilized body rigidity to maintain postural stability as a compensative strategy.

Fatigue Effect on Linear Center of Pressure Measures during Gait in People with Flat Feet.

BackgroundFlat foot, as one of the common foot deformities can affect gait biomechanics and risk of lower extremity injury. Fatigue, as a high load task, can also change biomechanical parameters of locomotion. Studying normal and flat footed individuals under high load tasks such as fatigue can elucidate their differences more easily.ObjectivesIn this study, center of pressure (CoP) changes were studied between individuals with flat and normal feet after fatigue. CoP is one of the important gait measures which can show various biomechanical behaviors of different foot shapes.MethodsSeventeen subjects with normal feet and 17 with flat feet walked across two force plates before and after a functional fatigue protocol. Standard deviation of CoP in mediolateral direction (SD of CoPx) and in anteroposterior direction (SD of CoPy), overall mean velocity of CoP and length of CoP construction line of both groups were analyzed. The values of SD of CoPy and length of CoP construction line were normalized to individual foot lengths prior to statistical analyses.ResultsThere were no significant between-subject effects for all CoP measures. The only significant finding was the within-subject effect for the SD of CoPy (P = 0.008) with a large effect size (partial eta squared = 0.21). Fatigue resulted in lower SD of CoPy in both groups.ConclusionsLower SD of CoPy indicates less fluctuation of CoPy and a probable less center of mass movement which could reduce the risk of injury. Furthermore, the similar fatigue response in both groups of individuals with normal and flat feet indicates a similar biomechanical behavior despite their different foot arch height.

Standing balance post total knee arthroplasty: sensitivity to change analysis from four to twelve weeks in 466 patients

Little is known about how static standing balance changes post total knee arthroplasty (TKA). The primary aim of this study was to examine the sensitivity to change and redundancy of center of pressure (COP) variables post-TKA. The secondary aim was to compare the sensitivity of these measures to standard clinical assessments of one repetition maximum knee extension strength and fast pace gait speed. 466 participants performed instrumented double-limb standing balance tests with eyes open at 4 and 12 weeks post-TKA. Measures of COP standard deviation, amplitude, root mean square (RMS), path length, detrended fluctuation analysis (DFA) and signal frequency content for the medial-lateral (ML) and anterior-posterior (AP) axes were examined. Significant decreases in total path length, ML variables related to sway velocity and AP signal complexity and frequency were observed. Inter-session Cohen's d effect size (ES) revealed the strongest effect was for high velocity ML path length, with a 12% decrease in this rapid sway. This variable, along with AP mean instantaneous frequency and AP DFA, were the only ones significantly different with effect sizes >0.20 and non-redundant (Spearman's rho <0.75). The ES of COP-derived variables (maximum=0.45) were lower than gait speed (1.40) and knee extensor strength (1.54). Increased high velocity ML sway is present at four compared to 12 weeks post-TKA. This augmented rapid sway may provide increased challenges to the postural control system at a time coinciding with reduced strength levels, which could have implications for physical function during activities of daily living.

Children with cerebral palsy effectively modulate postural control to perform a supra-postural task

The purpose of this study was to determine whether signatures of adaptive postural control remain present in children with cerebral palsy (CP) when they performed a supra-postural task (i.e., a task performed above and beyond the control of posture) requiring them to balance a marble inside a tube held in the hands. Measures of center of pressure (COP) dynamics (how regular or predictable were the COP data as quantified by the sample entropy metric) and variability (as quantified by the COP standard deviation) were obtained from a sample of children with CP (n=30) and compared to the same measures taken from typically developing (TD) children. Children with CP demonstrated an apparent inefficiency in postural control (greater irregularity, greater sway variability) relative to TD peers during a quiet-stance (no supra-postural task) condition (p<.05). During supra-postural task performance, those differences were attenuated, though they remained statistically different (p<.05). The findings illustrate flexibility and adaptability in the postural control system, despite the pathological features associated with CP.

Reliability of Single-leg and Double-leg Balance Tests in Subjects with Anterior Cruciate Ligament Reconstruction and Controls

The purpose of this study was to assess the test–retest reliability of postural balance in patients with anterior cruciate ligament reconstruction (ACL) and controls. Ten healthy subjects and 15 individuals with ACL reconstruction performed single-leg and double-leg balance tests. The center of pressure (COP) was recorded using a pressure platform. For the total COP path, the intraclass correlation coefficient (ICC) ranged from 0.79 to 0.91. For the COP standard deviation, the ICCs ranged from 0.68 to 0.94. For the COP velocity, the ICCs ranged from 0.72 to 0.91. The sway area and ellipse scores displayed ICCs values of 0.67 to 0.95 and 0.53 to 0.92, respectively. The ICCs were higher for double leg tests compared with single-stance ones. These results indicate that 30 s balance tests in double and single-leg stance are reliable tools to assess static balance. The use of such tests to monitor rehabilitation programs following ACL reconstruction is recommended.

Effects of focal ankle joint cooling on unipedal static balance in individuals with and without chronic ankle instability

Application of cryotherapy over an injured joint has been shown to improve muscle function, yet it is unknown how ankle cryotherapy affects postural control. Our purpose was to determine the effects of a 20-min focal ankle joint cooling on unipedal static stance in individuals with and without chronic ankle instability (CAI). Fifteen young subjects with CAI (9 males, 6 females) and 15 healthy gender-matched controls participated. All subjects underwent two intervention sessions on different days in which they had a 1.5L plastic bag filled with either crushed ice (active treatment) or candy corn (sham) applied to the ankle. Unipedal stance with eyes closed for 10s were assessed with a forceplate before and after each intervention. Center of pressure (COP) data were used to compute 10 specific dependent measures including velocity, area, standard deviation (SD), and percent range of COP excursions, and mean and SD of time-to-boundary (TTB) minima in the anterior–posterior (AP) and mediolateral directions. For each measure a three-way (Group–Intervention–Time) repeated ANOVAs found no significant interactions and main effects involving intervention (all Ps>0.05). There were group main effects found for mean velocity (F(1,28)=6.46, P=.017), area (F(1,28)=12.83, P=.001), and mean of TTB minima in the AP direction (F(1,28)=5.19, P=.031) indicating that the CAI group demonstrated greater postural instability compared to the healthy group. Postural control of unipedal stance was not significantly altered following focal ankle joint cooling in groups both with and without CAI. Ankle joint cryotherapy was neither beneficial nor harmful to single leg balance.

Optical Push by Geographical Slant Affects Postural Sway

This study shows that perceived geographical slant affects postural stability. In 2 experimental conditions participants stood on a force platform that measured center of pressure (COP) during quiet stance while looking at a rigid, flat ramp surface of varying geographical slants. Using an otherwise identical procedure, participants in the second condition also provided verbal estimates of the steepness of the surface in degrees. Several measures of postural stability offered converging evidence that COP sway gradually increased as geographical slant decreased to 0 (horizontal ground). Specifically, COP was sensitive to changes in surface slant. Both the range and the standard deviation of COP showed the same trend of increased variability with decreasing geographical slant angles in both conditions. The area of the ellipse covering COP sway (based on a principal components analysis) showed the same tendency: ellipse area got larger for smaller, more horizontal slants. Nonlinear fractal dynamics of COP sway, as measured by the Hurst exponent of COP, pointed in the same direction: more fractal patterns, known to be correlated with increased muscle activity and decline in postural stability, were measured for shallower surface slants. There were no effects of verbal estimates on any of the measures, suggesting that explicit awareness of slant does not bias postural stability above and beyond the effects of visual environment.

Postural sway following cryotherapy in healthy adults

In light of the wide use of cryotherapy and its potential negative effects on postural stability, little is known about how postural sway is affected, particularly when the whole lower limb is immersed. The purpose of this study was to analyze the influence of cryotherapy on postural sway in healthy males. Twenty-six subjects were randomly assigned into two intervention groups: control (tepid water at ∼26°C) or ice (cold water at ∼11°C). Postural sway was measured through the center of pressure (COP) position while they stood on a force plate during bipedal (70s) and unipedal (40s) conditions before and after the subjects were immersed in a water tub up to the umbilical level for 20min. COP standard deviation (SD) and COP velocity were analyzed in the anterior–posterior (AP) and medial–lateral (ML) directions. Statistical analysis showed that in the bipedal condition cryotherapy increased the COP SD and COP velocity in the ML direction. During the unipedal condition, a higher COP velocity in the AP and ML directions was also reported. Our findings indicate that cryotherapy by immersing the whole lower limb should be used with caution before engaging in challenging postural control activities.