Dynamic Postural Balance Research Articles

Does Smart Phone Usage in Young Adults Have an Effect on Static and Dynamic Balance?

Objectives: This study aimed to investigate the effects of talking and note-taking on a smartphone on static and dynamic balance. Materials and Methods: In the study, healthy young adults (n=36) were asked to maintain postural balance while standing on static and dynamic platforms in different tasks: (Task I) without using a smartphone, (Task II) while taking notes on a smartphone, and (Task III) while talking on a smartphone. Center of pressure (CoP) on mediolateral (CoPx) and anteroposterior (CoPy), CoP path length, CoParea, and trunk deviation length were used to measure static and dynamic postural balance. Results: On a static platform, CoPy and CoParea were different between the tasks (p<0.001, p=0.017). Task II and Task III impaired CoPy more than the task I (p<0.001, p=0.004). Task III affected CoParea more negatively than task II (p=0.027). CoP path length was lower in task II and task III (p<0.001). CoP path length was significantly higher in task III compared to task II (p<0.001). On a dynamic platform, there were differences in CoPy between the tasks (p=0.038). There was a difference in CoPy between task II and task III (p=0.005). The CoParea was significantly different between the tasks (p=0.023). CoParea and CoP path length was higher in task II compared to task I (p=0.035, p<0.001). Conclusion: The study showed that smartphone use during specific tasks, including talking and/or note-taking on a smartphone, could increase the risk of falls and accidents by affecting center of pressure and postural sway.

Immediate effect of hip exercises-inducing motor unit recruitment on static and dynamic postural balance in patients with piriformis muscle syndrome

IntroductionA single session of exercises-inducing motor unit recruitment has been reported to immediately improve static and dynamic postural balance in different populations. It remains unclear whether such an effect occurs in patients with piriformis muscle syndrome (PMS). Thus, this study aimed to explore the immediate effect of hip exercises-inducing motor unit recruitment on postural balance in these patients. MethodsIn this pre-post-repeated measure study design, twelve patients with PMS were enrolled. These patients participated in a single session of hip exercises-inducing motor unit recruitment, consisting of two exercises, bilateral bridging to target hip extensors and side lying clams to target hip abductors and external rotators. Static (stabilometric platform) and dynamic (timed up and go test (TUGT) and Functional reach test (FRT)) postural balance, and pain were evaluated before and immediately after the intervention protocol. ResultsPatients with PMS had significant (p<0.001) lower centre of pressure velocity and symmetry index values during the unipedal posture (eyes closed) in post- compared to pre- session. However, no significant effects of hip exercises-inducing motor unit recruitment were found on static bipedal and dynamic postural balance or pain in these patients. ConclusionA single session of hip exercises-inducing motor unit recruitment immediately improved static postural balance (unipedal posture with eyes closed) in patients with PMS. Given that this protocol is simple and easy to implement, it is recommended that patients with PMS consider incorporating these exercises into their daily physical activity.

Physical characteristics inducing Sever's disease in junior gymnasts

ObjectiveThis prospective cohort study aimed to determine characteristics contributing to the development of Sever's disease in junior gymnasts. MethodsThis study included 74 limbs from 37 junior gymnasts. The Baseline demographic data, flexibility measurements, foot alignments, trunk function tests, and functional balancing tests were used for evaluation. The incidence of Sever's disease among this cohort was assessed for six months after the first evaluations. We categorized those diagnosed by medical specialists as having Sever's disease into a Sever's disease group, while those with no foot pain or other diagnosed pathologies were in a no-symptom group. ResultsThe Junior gymnasts with Sever's disease had a lower arch height ratio and lower anterior star excursion balance test values. ConclusionsSever's disease in junior gymnasts may be potentially prevented through using a medial longitudinal arch support and/or undertaking dynamic postural balance training.

Is Achilles tendon structure associated with functional ability and chronic ankle instability in military recruits?

ObjectiveTo determine the relationship between Achilles tendon (AT) structure, functional ability and chronic ankle instability (CAI) in military recruits. MethodsThree hundred and sixty newly recruited infantry male soldiers recruited in April 2022 were assessed for AT structure by Ultrasound Tissue Characterization (UTC), for functional abilities (included proprioception ability, heel-raise test, dynamic postural balance, and hopping agility ability) and for CAI (recurrent sprains and a positive perceived instability). ResultsSoldiers that were identified with disorganized tendon had significantly lower heel-raise and agility scores compared to those with organized tendon structures (33.6 ± 18.1(n) vs. 49.9 ± 28.9(n), p < 0.001; and 5.39 ± 2.12(n) vs. 6.16 ± 1.90(n), p = 0.002, respectively). The best discriminator between soldiers with organized vs. disorganized structure, was heel-raise test (AUC = 0.741). Moreover, soldiers with disorganized AT structure had a higher prevalence of CAI compared with those with organized tendon structures (p < 0.05). ConclusionRecruits with disorganized tendon structures displayed reduced heel-raise score, agility ability and dynamic postural-balance and greater ankle instability. Inferior tendon quality at the onset of military service is an important physical indicator to consider when seeking to manage future injuries and potential for physical performance. Pre-recruitment screening of the AT structure, CAI, and functional abilities, especially in high-intensity infantry programs, needs to be considered.

Postural Dynamic Balance in clients with Type 2 Diabetes Mellitus - A Study

Postural Dynamic Balance in clients with Type 2 Diabetes Mellitus - A Study

Effectiveness of 12-Week Core Stability Training on Postural Balance in Soccer Players With Groin Pain: A Single-Blind Randomized Controlled Pilot Study.

Core stability training (CST) is effective in improving postural balance, core endurance, and self-reported outcomes in different populations. This study aimed to investigate the effect of CST in soccer players with groin pain (GP). CST would improve postural balance performance, core endurance, and self-reported outcomes in soccer players with GP. Randomized controlled trial. Level 2. Soccer players with GP who met the selection criteria were assigned randomly to a CST (CSTG, n = 10) or a control (CG, n = 10) group. The CG undertook no additional physical activity program besides their usual training. The CSTG performed a 12-week CST comprising 76 ~75 min sessions. Static (force platform) and dynamic (Y-Balance test) postural balance, core endurance (McGill trunk endurance tests), and self-reported outcomes (Copenhagen Hip and Groin Outcome Score [HAGOS]) were assessed before and immediately after the 12-week CST. Significant improvements were seen in dynamic postural balance (P = 0.04 to <0.01), HAGOS scores (P = 0.02 to <0.01), and core endurance measures (P < 0.01) in the CSTG in posttest compared with pretest session and compared with CG. Static bipedal postural balance measures showed significant improvements (eyes open, P = 0.02; eyes closed, P < 0.01) in the CSTG in posttest compared with pretest session. However, no significant differences (P > 0.05) were observed between CSTG and CG after the training period. A 12-week CST improved static (foam surface) and dynamic postural balance, core endurance measures, and HAGOS scores. The beneficial effect of CST on improving postural balance, core endurance, and self-reported outcomes in soccer players with GP suggests that this training would be an important feature of rehabilitation programs for these players. Coaches and clinicians should prioritize CST training when designing rehabilitation programs.

Spinal articulation exercise using an exercise ball enhances dynamic postural control

PurposeWe hypothesized that exercises that selectively utilize local muscles responsible for segmental movements of the spine might promote local muscle activity and dynamic postural balance. In this study, we examined the effects of selective local muscle exercises (spinal articulation exercise) on dynamic postural control in healthy subjects. MethodsThe effects of spinal articulation exercise were examined using a deflated exercise ball for the postural sway in healthy students who were assigned to an exercise or control group. The independent variable was the extent of exposure to selective local muscle exercise, and the dependent variable was dynamic postural control. A stabilometer, which measures dynamic postural control, was used to evaluate the effectiveness of the exercises. In addition, center of gravity movements were assessed using a Gravicorder G-620 stabilometer in which the subject was asked to shift their center of gravity between 2 circles on a computer monitor. Pre- and post-intervention dynamic postural control was statistically evaluated between the exercise group and control group using the Mann-Whitney test. ResultsThe post-intervention average COUNTS were significantly higher in the exercise group than in the control group (p = 0.003, r = 0.78). ENV. AREA was significantly smaller in the exercise group than in the control group (p = 0.036, r = 0.54). Furthermore, LNG/COUNTS were significantly smaller in the exercise group than in the control group (p = 0.024, r = 0.58). ConclusionsSpinal articulation exercise may be used to enhance the dynamic postural balance of healthy young adults.

Validity and Reliability of Dynamic and Functional Balance Tests in People Aged 19-54: A Systematic Review.

A systematic literature search conducted in August 2019 yielded nine articles meeting predefined selection criteria. Inclusion criteria required studies featuring healthy adult participants aged 19-54, published in English, and focusing on dynamic and functional balance testing. Exclusion criteria excluded studies involving participants with chronic diseases or musculoskeletal disorders, systematic reviews, professional athletes, and those lacking specific participant age information. The quality of the studies was evaluated using a modified PEDro scale. This review analyzed ten distinct postural balance tests. The Star Excursion Balance Test and Y-Balance Test exhibited moderate to high reliability, establishing them as dependable measures of dynamic balance. The Nintendo Wii Balance Board, Clever Balance Board, and Posturomed device also displayed excellent reliability for assessing dynamic postural balance. Comparing one-arm and two-arm functional reach tests, the one-arm reach test emerged as a more suitable option for evaluating dynamic balance among young adults. Moreover, an investigation comparing three dynamic balance tests (one-leg jump landing, Posturomed device, and stimulated forward fall) revealed a low correlation among these tests, indicating a measurement of different balance constructs. In conclusion, the Y-Balance Test stands out as the most practical dynamic balance assessment for clinical use, characterized by a standardized protocol, good repeatability, affordability, and ease of application. The Nintendo Wii Balance Board also presents itself as a cost-effective and reliable tool for dynamic balance evaluation in clinical settings. It is crucial to recognize that these tests appraise discrete postural skills, preventing direct comparisons between test outcomes. This review equips healthcare professionals with valuable insights into optimal balance assessment methods for the healthy, 19 to 54 aged population. Level 3.

Core stability is associated with dynamic postural balance in soccer players experiencing groin pain without time-loss

ObjectivesThe study sought to evaluate possible relationships between dynamic postural balance and pain, core stability, and hip range of motion in soccer players who were experiencing groin pain (GP). Furthermore, the study aimed to compare these measurements in symptomatic and asymptomatic players. MethodsThe study included 42 male soccer players experiencing GP and an equal number of asymptomatic players. Dynamic postural balance, pain, hip range of motion and trunk endurance were measured. ResultsThe GP group revealed reduced dynamic balance performance (p < 0.01–0.001) in injured and non-injured limbs compared to control group. Further, players experiencing GP demonstrated lower hip range of motion in internal (p < 0.05) and total rotations (p < 0.01) in the injured limb, and lower trunk endurance (p < 0.001) compared to their asymptomatic peers. In general, core stability was associated (r = 0.13–0.61, p < 0.05–0.001) with the poor dynamic balance performance in the GP group while standing on injured and non-injured limbs. No significant correlations between dynamic postural balance, pain and hip range of motion were observed. ConclusionPoor core endurance was found to be associated with dynamic balance disorders in soccer players experiencing GP. This information can aid in the development of targeted strategies to enhance dynamic postural balance in these players.

Impact of neuromuscular training including balance, strength and plyometric exercises on static and dynamic balance in high-level male runners with mild intellectual disability.

This study aims to investigate the impact of neuromuscular training (NMT) on static and dynamic postural balance (PB) among high-level male runners with intellectual disability. Twenty-seven runners were randomly assigned to a NMT group and a control group who maintained their conventional training. Static and dynamic PB were assessed using the centre of pressure (CoP) excursions (in bipedal and unipedal stances under open eyes (OE) and closed eyes (CE) conditions) and the star excursion balance test (SEBT), respectively, at pre-training and post-training. The NMT group showed significantly (p < 0.05) decreased CoP values and increased SEBT scores at post-training compared to pre-training. The switch from OE to CE did not affect static PB in the bipedal stance, only in the NMT group. The NMT was effective in improving static and dynamic PB in runners with intellectual disability. The NMT could reduce visual dependency.

Effects of a nighttime melatonin ingestion on dynamic postural balance and muscle strength the following morning in people living with multiple sclerosis: A preliminary study

BackgroundDecreased endogenous melatonin concentrations in people with multiple sclerosis (PwMS) are associated with fatigue and pain that impair postural balance and muscle strength. Melatonin ingestion had analgesic and anti-fatigue effects. However, the acute effect of exogenous melatonin on dynamic postural stability and muscle strength has not been studied yet in PwMS. This study aimed to investigate the safety and the efficacy of a nighttime melatonin intake on dynamic postural balance and lower-extremity muscle strength the following morning in PwMS. MethodsFourteen PwMS (28.36 ± 6.81 years) were assessed (8 a.m.) pre- and post-acute intake of melatonin or placebo (6mg, 30 minutes before nocturnal bedtime). Evaluated parameters included dynamic postural balance (force platform), lower-extremity muscle strength [Five-Repetition Sit-To-Stand Test (5-STST)], hand dexterity (Nine-Hole Peg Test), nociceptive pain [Visual Analogue Scale (VAS)], neuropathic pain [Neuropathic Pain 4 Questions (DN4)], sleep quality and fatigue perception [Hooper Index (HI)]. ResultsIn the frontal plane, melatonin reduced the center of pressure (CoP) path length (CoPL), CoPL in the anteroposterior axis (CoPLY) and CoP sway area (CoPAr) compared with placebo by 7.56% (p=0.02, Cohens'd (d)=1.24), 19.27% (p<0.001, d=2.60) and 13.82% (p<0.001, d=2.02), respectively. Melatonin induced a higher decrease in these posturographic parameters compared with placebo in the sagittal plane [CoPL: 9.10% (p=0.005, d=1.02), CoPLY: 4.29% (p=0.025, d=1.07) and CoPAr: 7.45% (p=0.038, d=0.74)]. Melatonin decreased 5-STST duration as well as VAS, DN4, HI-fatigue and HI-sleep scores compared with placebo by 8.19% (p=0.008, d=1.19), 5.74% (p=0.04, d=0.82), 27.30% (p=0.023, d=0.98), 40.15% (p=0.044, d=0.85) and 30.16% (p=0.012, d=1.10), respectively. ConclusionThis preliminary study, among PwMS, showed that acute melatonin ingestion was safe and efficient for improving dynamic postural stability and lower-extremity muscle strength probably through its analgesic and anti-fatigue effects.

Chronic Ankle Instability and Neuromuscular Performance in Prerecruitment Infantry Soldiers.

Ankle instability can describe various impairments, including perceived instability (PI), mechanical instability (MI), and recurrent sprains (RSs), alone or combined. To examine the prevalence of 8 ankle impairment subgroups and their effect on neuromuscular performance in prerecruitment combat soldiers. Cross-sectional study. Military infantry basic training base. A total of 364 infantry male combat soldiers entering basic training (aged 18-21 years). Participants were assessed for PI (via the Cumberland Ankle Instability Tool), MI (using the Anterior Drawer Test and Medial Talar Tilt Test), and RSs (based on history) of their dominant and nondominant legs. Injuries were categorized in 8 subgroups: PI, RSs, PI + RSs, MI, PI + MI, MI + RSs, PI + MI + RSs, and none. Participants were screened for neuromuscular performance (dynamic postural balance, proprioceptive ability, hopping agility, and triceps surae muscle strength) during the first week of military basic training. For the dominant and nondominant legs, RSs were reported by 18.4% (n = 67) and 20.3% (n = 74) of the participants, respectively; PI was reported by 27.1% (n = 99) and 28.5% (n = 104) of the participants, respectively; and MI was seen in 9.9% (n = 36) and 8.5% (n = 31) of the participants, respectively. A 1-way analysis of variance showed differences in the mean proprioceptive ability scores (assessed using the Active Movement Extent Discrimination Apparatus) of all subgroups with impairments in both the dominant and nondominant legs (F = 6.943, η2 = 0.081, P < .001 and F = 7.871, η2 = 0.091, P < .001, respectively). Finally, differences were found in the mean muscle strength of subgroups with impairment in the nondominant leg (F = 4.884, η2 = 0.056, P = .001). A high prevalence of ankle impairments was identified among participants who exhibited reduced abilities in most neuromuscular assessments compared with those who did not have impairments. Moreover, participants with 1 impairment (PI, MI, or RSs) exhibited different neuromuscular performance deficits than those with >1 impairment.

Functional leg performance 2 years after ACL surgery: a comparison between InternalBrace™-augmented repair versus reconstruction versus healthy controls

BackgroundWhile clinical and patient-reported outcomes have been investigated in patients after InternalBrace™-augmented anterior cruciate ligament repair (ACL-IB), less is known regarding restoration of functional performance. We aimed to determine differences in functional performance within and between patients 2 years after ACL-IB, patients 2 years after ACL reconstruction (ACL-R), and healthy controls.Materials and MethodsA total of 29 ACL-IB, 27 ACL-R (hamstring autograft), and 29 controls performed single-leg hop (maximum forward distance hop, SLH; side hop > 40 cm in 30 s, SH), proprioception (knee joint position sense at 30° and 60° flexion), and dynamic postural balance (Y Balance) tests. Differences were calculated within groups (side-to-side difference) and between the involved leg of patients and the non-dominant leg of controls, and were evaluated to predefined statistical (P < 0.05), clinically relevant, and methodological (smallest detectable change) thresholds. The number of exceeded thresholds represented no (0), small (1), moderate (2), or strong (3) differences. In addition, the relative number of participants achieving leg symmetry (≥ 90%) and normal performance (≥ 90% of the average performance of the non-dominant leg of controls) were compared between groups (chi-squared tests, P < 0.05).ResultsWe observed no-to-moderate leg differences within ACL-IB (moderate difference in hops) and within ACL-R (moderate difference in knee proprioception), no leg differences between patient groups, no-to-small leg differences between ACL-IB and controls, and no leg differences between ACL-R and controls in functional performance. However, two patients in ACL-IB and ACL-R, respectively, passed the hop pretest only with their uninvolved leg, and fewer patients after ACL-IB and ACL-R than controls reached a leg symmetry and normal leg performance of controls in SLH (P < 0.001).ConclusionsFunctional performance seems to be comparable 2 years postoperatively between ACL-IB and ACL-R for a specific subgroup of patients (i.e., proximal ACL tears, moderate activity level). However, the presumed advantage of comparable functional outcome with preserved knee structures after augmented ACL repair compared with ACL-R, and the tendency of both patient groups toward leg asymmetry and compromised single-leg hop performance in the involved legs, warrants further investigation.Level of Evidence Level III, case-control study.Trial registration clinicaltrials.gov, NCT04429165 (12/09/2020). Prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04429165.

Influence of the pilates method on postural balance parameters in older women: An exploratory single-arm trial

BackgroundHuman aging is a natural, biological, progressive, dynamic and complex process that involves morphological, physiological and social changes. Alterations such as decreased postural balance increase the risk of falls and exercise has shown benefits. One of the possible exercise modalities for this population is Pilates.Objectives: To investigate the effects of Pilates on parameters of static and dynamic postural balance in older women.Methods: Women aged 60 years or over were evaluated at three time points (pre-training, mid-training, and post-training). Postural balance was assessed using the Short Physical Performance Battery (SPPB), the Timed Up and Go test (TUG), and a force platform. The Pilates exercise protocol consisted of 16 sessions, twice a week, lasting 50 min each. Normality of the data was determined by the Shapiro-Wilk test. Repeated measures ANOVA followed by the Bonferroni post hoc test was used for comparison between assessments. Statistical significance was set at p ≤ 0.05.Results: Fourteen older women were included. Assessment on the force platform revealed no significant differences for most of the variables evaluated. There was a significant difference in SPPB scores and TUG times pre- and post-treatment (p < 0.001).Conclusion: Pilates training significantly improved dynamic postural balance evaluated by the TUG and SPPB but did not significantly improve static balance evaluated by the force platform, although the values have decreased in most assessments.

Balance and gait in individuals with diabetic peripheral neuropathy

ABSTRACTBackgroundDiabetic Peripheral Neuropathy (DPN) causes various physical problems such as the increased risk of falling, loss of balance and coordination while standing or walking, susceptibility to injuries due to sensory loss.AimsThe aim of the study was to evaluate and compare the effects of neuropathic pain (NP) in individuals with DPN on balance and gait.MethodsThis prospective controlled study was conducted on 42 adults aged between 40–65 years. The participants were divided into three groups; individuals with DPN and NP (DPN+NP/n = 14), individuals with DPN without NP (DPN-NP/n = 14), and the control group (n = 14), respectively. The Force Plate system and Core Balance System measured static and dynamic postural balance and stability limits. Gait and dynamic plantar pressure distribution analyses were performed with a computerized gait evaluation system.ResultsThe score of LANSS, and VAS during gait were higher in DPN+NP group than in DPN-NP (p < 0.05). No significant difference was observed between the groups in balance parameters (p > 0.05). The right-left heel maximum forces were lower in both groups with DPN compared to the control group (p < 0.05). In terms of spatiotemporal parameters of the gait, there was a difference between the groups only in step width and left single support line parameters (p < 0.05).ConclusionsThe results of this study indicate that the individuals with DPN have an increased step width, their left single support line was shortened, and the maximum force on the heel decreased. The NP did not cause any change in balance and gait parameters.

Effects of multimodal exercise program on postural balance in patients with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial

BackgroundEvidence has shown that patients with chronic obstructive pulmonary disease present significant deficits in the control of postural balance when compared to healthy subjects. In view of this, it is pertinent to investigate the effects of different therapeutic strategies used alone or in association with pulmonary rehabilitation with the potential to improve postural balance and other outcomes with clinical significance in patients with chronic obstructive pulmonary disease. This study will investigate the effects of an 8-week (short-term) multimodal exercise program [inspiratory muscle training (IMT) plus neuromuscular electrical stimulation (NMES)] on postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation program compared to individualized addition of IMT or NMES to pulmonary rehabilitation or standard pulmonary rehabilitation.MethodsThis is a randomized, single-blind, 4-parallel-group trial. Forty patients with chronic obstructive pulmonary disease will be included prospectively to this study during a pulmonary rehabilitation program. Patients will be randomly assigned to one of four groups: multimodal exercise program (IMT + NMES + pulmonary rehabilitation group) or (IMT + pulmonary rehabilitation group) or (NMES + pulmonary rehabilitation group) or standard pulmonary rehabilitation group. Patients will receive two sessions per week for 8 weeks. The primary outcome will be static postural balance and secondary outcomes will include as follows: static and dynamic postural balance, fear of falling, muscle strength and endurance (peripheral and respiratory), functional capacity, health-related quality of life, muscle architecture (quadriceps femoris and diaphragm), and laboratory biomarkers.DiscussionThis randomized clinical trial will investigate the effects of adding of short-term multimodal exercise program, in addition to pulmonary rehabilitation program, in postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation. Furthermore, this randomized control trial will enable important directions regarding the effectiveness of short-term intervention as part of the need to expand the focus of pulmonary rehabilitation to include balance management in chronic obstructive pulmonary disease patients which will be generated.Trial registrationClinicalTrials.gov NCT04387318. Registered on May 13, 2020.

Which is superior for postural stability: contact lens or spectacles?

ABSTRACT Clinical relevance The visual system plays an important role in providing postural balance. Visual input must have good quality to ensure proper balance. Background The aim of this work is to compare the use of soft contact lenses and spectacles in terms of postural stability. Methods Patients who wore both soft spherical or toric contact lenses and spectacles were examined between February and July, 2021. A detailed ophthalmic examination, including contact lens evaluation, was performed. The aim was to fully correct the refractive error and to prescribe the most appropriate spectacle and contact lens correction. After 1 month of use, patients were subjected to the balance test. The balance tests were repeated using the Biodex Balance System (Biodex Inc. Shirley, New York, USA), first with contact lenses and then with spectacles, 15 minutes later. Static and dynamic postural stability indices were compared. Results Thirty patients were included in the study. The mean age of the study group was 31.33 ± 4.54 (26–40) years. All patients had myopic refractive errors (20 patients with myopia and 10 patients with myopia and astigmatism). The mean spherical equivalent was −2.95 ± 1.81 (−4.50–(−0.50)) D. Static stability index score was found to be statistically significantly better in tests with contact lenses (p = 0.004). Among the dynamic postural stability parameters, overall stability index and antero-posterior stability index (APSI) scores with contact lenses were better than with spectacles, but the difference was not statistically significant (p > 0.05 for both). Medio-lateral stability index (MLSI) score was better in tests with contact lenses (p < 0.001). Conclusion Contact lenses may provide better static and dynamic postural balance than spectacles in young patients with myopic refractive errors.

The feasibility of using the Körperkoordinationstest fur Kinder (KTK) in a U.S. elementary physical education setting to assess gross motor skills specific to postural balance.

For the past ten years, falls have been the leading cause of nonfatal injuries for all age groups less than 15 years old. A significant rise in childhood sedentary behavior in schools and limited opportunities to be outside has led to motor coordination deficits which have contributed to fall injuries. A German assessment tool, the Körperkoordinationstest fur Kinder (KTK), which has been used for decades in Western European countries, allows researchers and physical education teachers to evaluate typical and atypical children's motor coordination competencies related to dynamic postural balance successfully. No research has been published on the use of this assessment tool in the United States. If its use were found to be feasible in this country for identifying motor coordination deficits in typical and atypical children, it would close the gap in determining motor coordination. Therefore, this study sought in Phase 1 to determine the feasibility of using the KTK assessment in U.S. children and Phase 2 sought to determine the adaptability of the scoring protocol from use in other countries to the United States. The Phase 1 results revealed the KTK assessment was feasible to administer in U.S. physical education class by addressing three challenges for U.S. schools: 1) KTK implementation, 2) time to assess each skill, and 3) the equipment availability and cost to implement the test in a physical education setting. In Phase 2, the researchers were able to determine the raw scores and motor quotient scores in this population and then were able to show similar scoring trends between U.S. children and Flemish children from a previous study. This assessment tool was deemed feasible and adaptable which is the first step to use the KTK in U.S. physical education elementary school settings.

Perturbation-Based Training on Compliant Surfaces to Improve Balance in Children With Cerebral Palsy: A Feasibility Study

Children with cerebral palsy suffer from balance deficits that may greatly reduce their quality of life. However, recent advancements in robotics allow for balance rehabilitation paradigms that provide greater control of the training environment and more robust measurement techniques. Previous works have shown functional balance improvement using standing surface perturbations and compliant surface balancing. Visual feedback during balance training has also been shown to improve postural balance control. However, the combined effect of these interventions has not been evaluated. This paper presents a robotaided rehabilitation study for children with cerebral palsy on a side-specific performance-adaptive compliant surface with perturbations. Visual feedback of the participants center of pressure and weight distribution were used to evaluate successful balance and trigger perturbations after a period of successful balancing. The platform compliance increased relative to the amount of successful balance during each training interval. Two participants trained for 6 weeks including 10, less than 2 hours long, training sessions. Improvements in functional balance as assessed by the Pediatric Balance Scale, Timed 10 Meter Walk Test, and 5 Times Sit-to-Stand Test were observed for both participants. There was a reduction in fall risk as evidenced by increased Virtual Time to Contact and an increase in dynamic postural balance supported by a faster Time to Perturb, Time to Stabilize, and Percent Stabilized. A mixed improvement in static postural balance was also observed. This paper highlights the feasibility of robot-aided rehabilitation interventions as a method of balance therapy for children with cerebral palsy.

Emergence of Treadmill Running Ability and Quantitative Assessment of Gait Dynamics in Young Ts65Dn Mice: A Mouse Model for Down Syndrome.

Down syndrome (DS), which results from the complete or partial trisomy of chromosome 21 (trisomy-21), is the most common genetically defined cause of intellectual disability. Trisomy-21 also produces, or is associated with, many neurodevelopmental phenotypes and neurological comorbidities, including delays and deficits in fine and gross motor development. The Ts65Dn mouse is the most studied animal model for DS and displays the largest known subset of DS-like phenotypes. To date, however, only a small number of developmental phenotypes have been quantitatively defined in these animals. Here, we used a commercially available high-speed, video-based system to record and analyze the gait of Ts65Dn and euploid control mice. Longitudinal treadmill recordings were performed from p17 to p35. One of the main findings was the detection of genotype- and sex-dependent developmental delays in the emergence of consistent, progressive-intensity gait in Ts65Dn mice when compared to control mice. Gait dynamic analysis showed wider normalized front and hind stances in Ts65Dn mice compared to control mice, which may reflect deficits in dynamic postural balance. Ts65Dn mice also displayed statistically significant differences in the variability in several normalized gait measures, which were indicative of deficits in precise motor control in generating gait.