Eyes-closed Condition Research Articles

The relationship between concentric and isometric strength of knee flexor and extensor muscles and postural stability in mild stage multiple sclerosis patients

ABSTRACT Background Multiple sclerosis (MS) affects muscle strength and postural stability. However, the relationship between concentric and isometric strength of knee flexors and extensors and postural stability in mild stage MS is not well known. The aim of the study was to examine the relationship between concentric and isometric strength of knee flexors and extensors and postural stability in mild stage MS patients. Materials and Methods The study included 21 mild-stage MS patients with an EDSS score of 4 or less and 21 healthy controls. The concentric and isometric strength of knee flexors and extensors was measured with the Biodex System 4 Dynamometer, and postural stability with the Biodex Balance System under eyes-open and eyes-closed conditions on a rigid surface. Results Mild-stage MS patients had reduced concentric strength of knee extensors and flexors and increased postural sway compared with healthy controls (p < 0.05). Isometric strength of knee extensors and flexors in mild stage MS patients were similar to healthy controls (p > 0.05). There was a moderate positive correlation between concentric strength of knee extensors and flexors and isometric strength of knee flexors and open-eye postural stability indexes in mild stage multiple sclerosis patients (p < 0.05). Conclusions While isometric strength of knee extensors and flexors was preserved, concentric strength of knee extensors and flexors was decreased, and postural stability was adversely affected in mild stage MS patients. The increase in the strength of the knee muscles was associated with an increase in their postural sway in mild stage MS patients.

Resting-State Electroencephalogram Microstate and Correlations with Motor Function and Balance in Chronic Stroke.

Objective: This study aimed to compare electroencephalogram microstates of patients with chronic stroke to healthy subjects and correlated microstates with clinical and functional characteristics in stroke. Methods: This cross-sectional, exploratory and correlational study was performed with chronic stroke patients (n = 27) and healthy subjects (n = 27) matched for age and gender. We recorded electroencephalography microstates using 32 channels during eyes-closed and eyes-open conditions and analyzed the four classic microstates maps (A, B, C, D). Post-stroke participants were assessed using the modified Rankin Scale and the Fugl-Meyer Scale. All participants were assessed for cognitive function, fear of falling, and static balance. Student's t-test was used to compare groups and Pearson's correlation coefficient was used to assess correlations between microstates parameters and stroke-related clinical outcomes. Results: In the eyes-open condition, moderate correlations were observed between the duration of microstate C and functional disability. In the eyes-closed condition, moderate correlations were observed between the coverage of microstate C, the occurrence of microstate C and D, and the duration of microstate B with functional aspects (eg, lower limb motor function, balance, functional disability, and fear of falling). Conclusions: Changes in microstates and correlations between topographies and clinical and functional aspects suggest that electroencephalogram could be used as a biomarker in stroke patients.

Functional connectivity in burnout syndrome: a resting-state EEG study

Chronic occupational stress is associated with a pronounced decline in emotional and cognitive functioning. Studies on neural mechanisms indicate significant changes in brain activity and changed patterns of event-related potentials in burnout subjects. This study presents an analysis of brain functional connectivity in a resting state, thus providing a deeper understanding of the mechanisms accompanying burnout syndrome. The sample consists of 49 burnout employees and 49 controls, matched by age, gender and occupation (Mage = 36.15, SD = 8.10; 59 women, 39 men). Continuous dense-array EEG data were collected from a 256-channel EEG system. The difference in functional connectivity between burnout and control subjects was tested in the eyes-closed (EC) and eyes-open (EO) conditions using the resting-state paradigm. The results indicate significant differences in brain activity between the burnout and the control groups. The resting-state network of the burnout group is characterized by decreased functional connectivity in frontal and midline areas in the alpha3 sub-band (11–13 Hz) in an eyes-open condition. The most significant effect of decreased connectivity was observed in the right frontal brain area. For the first time, these analyses point to distinctive aspects of functional connectivity within the alpha3 sub-band in burnout syndrome. These findings provide insights into the neurobiological underpinnings of burnout syndrome and its associations with changed resting-state networks. The data on neural characteristics in burnout subjects may help to understand the mechanisms of decline in cognitive function and emotion regulation and to search for adequate methods of treatment.

Effect of cannabis on brain activity in males: Quantitative electroencephalography and its relationship with duration, dosage, and age of onset.

Brain function changes as a result of cannabis use. This study examined the brain activity of cannabis users compared to a healthy group and nicotine smokers, focusing on the age of onset, duration of use, and dosage. Demographic and quantitative electroencephalography (QEEG) data of 15 healthy individuals, 20 patients with chronic cannabis use, and 15 nicotine smokers were collected and recorded during the eyes-closed and eyes-open conditions in the resting state. The data were analyzed using MATLAB software and the EEGLAB toolbox. In the eyes-closed condition, cannabis users exhibited significantly elevated relative theta band power in widespread brain regions compared to both the healthy group and nicotine smokers. They showed decreased relative power in the beta and gamma bands in the parietal and occipital regions when compared to nicotine smokers. In the eyes-open condition, cannabis users displayed increased relative theta band power in widespread brain regions relative to both groups. Additionally, lower relative power in the beta and gamma bands was observed in cannabis users compared to the healthy group in the frontal region, as well as in various brain regions compared to nicotine smokers. A significant relationship was identified between gamma-band power, age of onset, and dosage of cannabis use. These findings suggest that cannabis use leads to changes in brain wave patterns during the resting state, which may be linked to cognitive impairments affecting functions. Understanding these associations is essential for developing effective intervention programs aimed at mitigating cognitive deficits related to cannabis use.

Age-related changes in the vestibulothalamic pathway: Association with balance ability and subjective visual vertical of vestibular function.

The thalamus regulates various sensory information to each related brain area. The vestibular nucleus transmits information of motor control to the thalamus regulating coordination function. The vestibulothalamic tract (VTT) is a neural pathway between the vestibular nucleus and thalamus that processes vestibular information for postural balance and spatial perception. Therefore, this study analyzed ipsilateral VTT to compare the neural pathway and the differences in vestibular and balance functions according to aging. Eleven elderly and 12 young healthy adults were recruited. This study measured subjective visual vertical (SVV) for vestibular function and body sway during one-leg standing. The ipsilateral VTT were reconstructed to investigate changes of neural pathway between two groups using diffusion tensor imaging. Track volume of left and right VTTs was significantly more in the young healthy adults. In eyes-open (EO) condition during one-leg standing, the body sway demonstrated significant differences between two groups. In the eyes-closed (EC) condition, the degree of hip sway was decreased in the young healthy adults. In the EO condition, the body sway except for antero-posterior direction was significantly correlated with VTT. Meanwhile, in the EC condition, hip sway and all values of body sway were negatively correlated with VTT. In addition, the VTT revealed a negative correlation with SVV. The tract volume of VTT and static balance decreased according to aging. The changes of VTT also affected verticality perception and static balance. Therefore, the study could be helpful in providing the data for patients with thalamus or vestibular injury.

Exploring the role of electrode density in capturing spatiotemporal dynamics of resting-state networks with EEG

Abstract This study investigates the role of electrode density in capturing resting-state brain activity, an area of significant clinical relevance, where electroencephalography (EEG) is favored for its cost-efficiency. We analyze how different electrode configurations affect the precision of cortical current density estimation in EEG recordings. Using exact Low-Resolution Electromagnetic Tomography (eLORETA), we estimated the cortical current density in regions of interest linked to Resting State Networks (RSN). Point process analysis was employed to identify regions of high activity over time, revealing dynamic brain salient activity patterns, or brain maps. We evaluated the impact of electrode density by comparing 64-channel and 20-channel configurations and found that both configurations yielded similar and consistent brain maps. To confirm the robustness of our approach, we assessed the Berger effect in eyes-closed (EC) versus eyes-open (EO) conditions, observing that the functional differences between EC and EO states remained stable regardless of electrode density, aligning with previous research. Conversely, randomization of data or the use of non-homogeneous electrode configurations disrupted the resulting patterns, highlighting the physiological relevance of our methodology. Overall, our results demonstrate that this approach reliably captures the spatiotemporal dynamics of brain activity, even with fewer electrodes, and holds promise for broader clinical applications.

Task activation results in regional 13C-lactate signal increase in the human brain.

Hyperpolarized-13C magnetic resonance imaging (HP-13C MRI) was used to image changes in 13C-lactate signal during a visual stimulus condition in comparison to an eyes-closed control condition. Whole-brain 13C-pyruvate, 13C-lactate and 13C-bicarbonate production was imaged in healthy volunteers (N = 6, ages 24-33) for the two conditions using two separate hyperpolarized 13C-pyruvate injections. BOLD-fMRI scans were used to delineate regions of functional activation. 13C-metabolite signal was normalized by 13C-metabolite signal from the brainstem and the percentage change in 13C-metabolite signal conditions was calculated. A one-way Wilcoxon signed-rank test showed a significant increase in 13C-lactate in regions of activation when compared to the remainder of the brain (). No significant increase was observed in 13C-pyruvate signal () or 13C-bicarbonate signal (). The results show an increase in 13C-lactate production in activated regions that is measurable with HP-13C MRI.

Eeg Microstates and Balance Parameters for Stroke Discrimination: A Machine Learning Approach.

Electroencephalography microstates (EEG-MS) show promise to be a neurobiological biomarker in stroke. Thus, the aim of the study was to identify biomarkers to discriminate stroke patients from healthy individuals based on EEG-MS and clinical features using a machine learning approach. Fifty-four participants (27 stroke patients and 27 healthy age and sex-matched controls) were recruited. We recorded EEG-MS using 32 channels during eyes-closed and eyes-open conditions and analyzed the four classical EEG-MS maps (A, B, C, D). Clinical information and motor aspects were evaluated. A machine learning method using k-means algorithms to discriminate stroke patients from healthy subjects showed that the most influential parameters in clustering were balance scores and microstate parameters (duration and coverage of microstate A, duration, coverage and occurrence of microstates C and global variance explained). To evaluate the quality of clustering, the Silhouette score was applied and the score was close to 0.20, indicating that the clusters overlap. These results are encouraging and support the usefulness of these methods for classifying stroke patients in order to contribute to the development of therapeutic strategies, improve the clinical management of these patients, and consequently reduce the associated costs.

QEEG Neuromarkers of Complex Childhood Trauma in Adolescents.

Introduction. Complex childhood trauma (CCT) involves prolonged exposure to severe interpersonal stressors, leading to deficits in executive functioning and self-regulation during adolescence, a critical period for neurodevelopment. While qEEG parameters, particularly alpha oscillations, have been proposed as potential biomarkers for trauma, empirical documentation in developmental samples is limited. Aim. This preregistered study investigated whether adolescents with CCT exhibit qEEG patterns similar to those reported for PTSD, such as reduced posterior alpha power, increased individual alpha peak frequency (iAPF), right-lateralized alpha frequencies, and lower total EEG power (RMS) compared to controls. Materials and Methods. EEG data from 26 trauma-exposed adolescents and 28 controls, sourced from an open database, underwent similar preprocessing. qEEG features, including alpha power, iAPF, alpha asymmetry, and RMS, were extracted from eyes-open and eyes-closed conditions and analyzed using mixed ANOVAs. Results. Significant group differences were found in total EEG power, with trauma-exposed adolescents showing lower RMS than controls. No significant differences were found in posterior absolute alpha power, iAPF, or alpha asymmetry. However, we observed that posterior relative alpha power was higher in the trauma group, though the difference was not statistically significant but showing a small to medium effect size. Additionally, a negative correlation between CPTSD severity and EEG power in the EO condition was observed, suggesting trauma-related cortical hypoactivation. Conclusion. Reduced total EEG power and modified alpha dynamics may serve as candidate neuromarkers of CCT. These findings underscore the need for further research to validate qEEG biomarkers for understanding and diagnosing trauma-related disorders in developmental populations.

Evaluating the impact of soft bracing and textile engineering in enhancing postural control and proprioception in adolescent idiopathic scoliosis

Adolescent idiopathic scoliosis (AIS) is often associated with unbalanced posture and proprioceptive deficits and is particularly prone to progression during puberty. However, limited research has addressed early intervention for mild curves (10-20 degrees). This study aims to examine the effects of a soft bracing intervention using the Posture Correction Girdle (PCG) on 3D postural balance and proprioception in adolescents with early-stage scoliosis. Cobb angles were measured with the X-ray Imaging before and after a 2-h wear trial with the girdle to assess immediate curve reduction. Postural angles were visualized using 3D body scanning. Proprioception was assessed using a motion capture system, focusing on trunk, neck, elbow, and knee movements under the eye-open and eye-closed condition. Data were analyzed using descriptive statistics, t-tests, and Pearson’s correlation and partial Mantel tests to examine postural balance and proprioceptive outcomes. Results indicated significant improvements in postural balance in the frontal and sagittal planes, and proprioception in the dominant-side elbow. However, other proprioceptive measures showed limited changes, with responses differing by spinal curvature. Strong correlations emerged between proprioceptive function and postural angles in the thoracic and lumbar regions. These findings suggest that soft bracing can enhance postural control for mild AIS, though individual variability in responses highlights the need for personalized bracing strategies. This study supports soft bracing as a promising therapeutic option, underscoring the importance of individualized assessment to optimize brace design and effectiveness in early-onset scoliosis management.

Chronic low back pain and postural instability: interaction effects of pain severity, age, BMI, and disability.

This study aimed to (1) compare postural sway patterns between individuals with chronic low back pain (CLBP) and asymptomatic controls, (2) evaluate correlations between pain severity and postural stability variables, and (3) assess the interaction effects of age, BMI, pain severity, and disability on postural stability under eyes-open and eyes-closed conditions. Postural stability (sway area, sway velocity, CoP displacement) was assessed in 88 CLBP patients and 88 controls using a stabilometric platform. Pain severity (VAS) and disability (ODI) were recorded alongside demographic data. Statistical analyses included t-tests, Pearson's correlations, and ANOVA to explore group differences, correlations, and interaction effects. Chronic low back pain patients exhibited significantly greater postural sway across all conditions, with larger sway area (16.80 ± 6.10 cm2 vs. 11.50 ± 4.10 cm2, p = 0.004) and higher sway velocity (4.10 ± 1.40 cm/s vs. 2.90 ± 1.00 cm/s, p = 0.009) under eyes-closed conditions. Pain severity correlated with sway velocity (r = 0.52, p = 0.003) and CoP displacement (r = 0.57, p = 0.002). Interaction effects indicated greater instability in older, obese individuals with severe pain and high disability. Chronic low back pain is associated with impaired postural stability, influenced by pain severity, BMI, age, and disability. Targeted interventions addressing these factors are essential for improving balance and reducing fall risk.

Abnormal dynamic features of cortical microstates for detecting early-stage Parkinson's disease by resting-state electroencephalography: Systematic analysis of the influence of eye condition.

Resting state electroencephalography (EEG) has proved useful in studying electrophysiological changes in neurodegenerative diseases. In many neuropathologies, microstate analysis of the eyes-closed (EC) scalp EEG is a robust and highly reproducible technique for assessing topological changes with high temporal resolution. However, scalp EEG microstate maps tend to underestimate the non-occipital or non-alpha-band networks, which can also be used to detect neuropathological changes. Recent evidence has shown that the source-space microstates can characterize distinct functional connectivity patterns but its clinical ability to detect neuropathological changes has not been demonstrated so far. It should also be remembered that the eye condition may play an important role in neural activity dynamics. The aim of this study was to systematically characterize the dynamic neuropathological features of sensor-space and source-space EEG microstates in PD patients with no cognitive impairment in both EC and EO conditions with the aim of identifying potential biomarkers that could be used as a complementary clinical screening method for early PD detection. We found that the dynamic features of the source-space microstates were more sensitive in detecting PD than the sensor-space microstates, while EO was able to detect neuropathological changes in PD patients better than EC. In EO, PD disease exhibited significantly higher occurrence and coverage in visual-network related source-space microstates and abnormally high duration in sensorimotor network-related microstates. Our results suggest that the source-space microstate analysis of resting-state EEG could provide robust biomarkers to detect early-stage PD, which would allow the development of patient-oriented strategies to prevent the disease and improve the patients' quality of life.

Effects of Melatonin Supplementation on Muscle Strength, Manual Dexterity, and Postural Balance in Patients Living with Multiple sclerosis - A Randomized Controlled Trial

Our previous study revealed the benefits of chronic melatonin intake on dynamic postural imbalance and poor walking capacity induced by multiple sclerosis but its impact on muscle weakness and poor manual dexterity related to this disease has not yet been explored. The objective of the current study was to investigate the effectiveness of 12-week melatonin supplementation on motor skills (i.e., muscle strength, manual dexterity, and static postural balance) and psycho-cognitive status among multiple sclerosis patients. For that, twenty-seven patients were divided into melatonin group (MG, n = 15) and placebo group (PG, n = 12). Melatonin and placebo were each taken at a dose of 3 mg per night, 30 min before bedtime, for 12 weeks. Before and after the intervention, we assessed isokinetic knee muscle strength (dynamometer), manual dexterity (Nine-Hole Peg Test (NHPT)), static postural balance (force platform), mood (Hospital Anxiety and Depression Scale (HADS)), and cognition (Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT), and Trail Making Test (TMT)). The results showed that the peak torques of knee flexors (120°/s: p = 0.015, Hedges’g (g) = 1.84; 180°/s: p = 0.02, g = 2.06) and extensors (120°/s: p = 0.019, g = 1.63; 180°/s: p = 0.03, g = 2.01) increased in MG comparatively with PG. There was also a decrease in the sway area (bipedal stance) and mediolateral amplitude (unipedal stance) of the center of pressure in MG compared with PG in the eyes-open (both: p < 0.001; g = 4.32, g = 1.99, respectively) and eyes-closed (p = 0.0007, g = 1.31; p = 0.003, g = 1.79, respectively) conditions. The MG showed an increase in MoCA (p = 0.0006, g = 1.51) and SDMT (p = 0.02, g = 0.95) scores, as well as a decrease in HADS-Total score (p = 0.012, g = 1.06), TMT (p = 0.03, g = 0.91) and NHPT durations (p < 0.001, g = 2.36) comparatively with PG. Based on this study, the 12-week melatonin supplementation was effective in improving knee muscle strength, manual dexterity, static postural balance, mood, and cognition in multiple sclerosis patients. For clinical trial regsitration, this study was prospectively recorded in the Pan African Clinical Trial Registry (PACTR202007465309582).

The effects of sleep deprivation on the balance system: following normal sleep, 24h of sleep deprivation, and rest under eyes-open and eyes-closed conditions.

This study investigated the effects of sleep deprivation (SD) on balance after normal sleep, 24h of SD, and subsequent rest under eyes-open (EO) and eyes-closed (EC) conditions. Our aim was to ascertain whether the reduced efficiency of balance control following SD is generalized or selective. Nineteen participants (12 females, 7 males) completed the Pittsburgh Sleep Quality Index (PSQI). The mean ages for male participants were 24.14 ± 0.37years, their height was 180.71 ± 5.46cm, and weight of male participants were 81.71 ± 13.42kg. For female participants, the mean ages were 24.41 ± 4.01years, their height was 163.66 ± 2.64cm, and their weight was 59.54 ± 9.18kg. Stance analyses were conducted after normal sleep, 24h of SD, and subsequent rest of both the EO and EC. Participants performed a normal balance test, a second test while holding cubes and counting backwards from 200 by sevens, and a third test after rest under EO and EC. Independent samples t-tests showed significant height and weight differences between sexes (p < 0.05), with females generally smaller. No significant differences were found in age, daytime sleep duration, or PSQI score (p > 0.05). Significant differences in parameters such as length of the minor axis (lomna), angle, and area were observed in EO and EC across the three days, revealing the interplay between visual stimuli, cognitive tasks, and parameter stability. SD has multifaceted impacts on motor and cognitive performance, even when attentional and sensory resources are not strained. Our findings elucidate the nuanced impact of SD on cognitive performance, and suggest the efficacy of external factors in mitigating its effects on postural control.

Single-Leg Balance and Lower Limb Strength: Quantitative Analysis with the Balance Master System.

Objective: This study investigates the relationship between lower limb strength and postural stability in single-leg stance using the Balance Master system. Methods: The research involved 64 participants divided into sedentary and physically active groups based on metabolic equivalents of task (METs) values, normal weight, overweight, and obese according to body composition. Postural control was evaluated using the Sensory Organization Test. Results: The results showed that there were no significant differences in mean and maximum lower limb strength between the groups. Furthermore, postural stability in open and closed eyes conditions did not show significant differences between the groups. However, a significant positive correlation was observed between lower limb strength and stability in single-leg stance with eyes open. Conclusions: These findings suggest that lower limb muscle strength is essential for postural stability, especially when vision is available to aid balance. The study highlights the importance of interventions focused on strengthening muscles to improve physical functionality in adults.

Normative data for instrumented posturography: a systematic review and meta-analysis.

Postural control is a multisensory adaptive system performing predictive (anticipatory) and/or reactive (compensatory) actions, with varying degrees of accuracy, to maintain balance in a changing environmental context. Common instrumentation to evaluate balance includes static and dynamic force platforms; added sway-referenced perturbations on the dynamic platform constitute its main advantage. Clinical applications notwithstanding, normative data are needed for interpretation in clinical settings. Posturography norms are used to compare a reference group (healthy individuals) and a specific patient population. This work, to the best of our knowledge, represents the first attempt to synthesize the literature on normative data for computerized posturography using a combined mixed method. The search strategy resulted in the retrieval of 1,244 articles from PubMed, Web of Science, and Science Direct. After deduplication, 689 articles were screened based on title and abstract. One hundred and seven articles met the criteria after the first screening. In-depth, full-text screening resulted in the inclusion of 44 studies for the systematic review and 17 studies for the meta-analyses. The main findings of the systematic review are (1) extensive heterogeneity was found in methodological characteristics, (2) there was insufficient risk of bias mitigation, (3) the majority of tasks evaluated less than four components of the systems framework for postural control (SFPC), and (4) studies mostly used distance domain sway parameters and did not report the influence of other variables on postural sway. Based on the multilevel meta-analyses, females appeared to outperform males in eyes closed (EC) conditions significantly. Based on the network meta-analyses, we found that younger children swayed more than those aged between 8 and 14 years both in eyes open (EO) conditions and EC conditions significantly. The results also revealed a significant difference in sway between individuals of age range between 50 and 79 years old and younger individuals, with more instability observed in older participants both in EO conditions and in EC conditions. Thus, future studies need to ensure that enough information about participants is provided. Standardization of experimental conditions and sway parameters harmonization are still needed to ensure high-quality assessment (QA). Finally, evidence-based postural impairment management requires both age- and sex-related normative data. Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023378144, identifier PROSPERO 2023 CRD42023378144.

Effect of Hard- and Soft-Density Insoles on the Postural Control of Adults over 65 Years of Age: A Cross over Clinical Trial.

there is a high risk of falls in older adults. One of the factors contributing to fall episodes is advancing age due to deterioration of the proprioceptive system. Certain clinical procedures improve balance and posture, such as the use of insoles. the objective of this study was to evaluate the impact of hard and soft insoles on static foot balance in healthy older adults compared to barefoot people. a clinical trial was conducted with a sample size of 150 healthy adults (69 male and 81 women) with a mean age of 69.03 ± 3.82 years. Postural control was evaluated in different conditions of barefoot balance with hard and soft insoles. All tests were statistically significant (p < 0.001). The test with soft insoles presented higher stabilometric values and presented worse postural control compared to the barefoot and hard insoles in all eyes-open and eyes-closed conditions. Hard and soft insoles show no improvement in postural control compared to barefoot standing. The findings suggest that soft insoles may result in impaired balance during standing. The density of the materials in the insoles emerges as a significant factor influencing postural control.

The Effects of Ankle and Foot Exercises on Ankle Strength, Balance, and Falls in Older People: A Systematic Review and Meta-Analysis.

Ankle-foot control is essential to maintain balance and gait stability. However, there has been limited evidence on the effect of ankle-foot exercises on balance and falls in older people. This study aimed to summarize the effects of ankle-foot exercises on ankle flexibility and strength, balance, mobility, and falls in older people and to identify determining factors for ankle-foot exercises to improve balance and mobility. Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, and Physiotherapy Evidence Database (PEDro) were searched to identify randomized controlled trials that studied the effects of ankle-foot exercises on ankle control, balance, and falls in older people. The PEDro scale was used to evaluate the methodological quality of the studies. Meta-analyses were done for similar outcomes. The quality of evidence was rated by GRADE. Sixteen papers (n = 651) were included. Meta-analyses showed that ankle-foot exercises significantly improved ankle plantarflexion strength (SMD = 0.35, 95% CI = 0.04 to 0.65, low-quality evidence), ankle flexibility (SMD = 0.48, 95% CI = -0.01 to 0.96, low-quality evidence), and balance in an eyes-open condition (SMD = 0.41, 95% CI = 0.19 to 0.70, low-quality evidence). There was no significant change in ankle dorsiflexion strength (SMD = 0.29, 95% CI = -0.24 to 0.82, very low-quality evidence), balance under eyes-closed condition (SMD = 0.41, 95% CI = -0.1 to 0.92, very low-quality evidence), and gait speed (SMD = 0.36, 95% CI = -0.24 to 0.96, very low-quality evidence). Two studies reported insignificant findings on fear of falling, fall incidence, and risk of falls. Very low- to low-quality evidence showed that ankle-foot exercises effectively improve ankle plantarflexion strength, flexibility, and balance with eyes open, whereas no effect on falls was found. Improvements in balance and gait tend to be associated with improvements in ankle strength and flexibility. Toe-strengthening exercise and training 3 times per week appear to be important for improving balance. This review suggested that ankle-foot exercises might improve balance in older people. Determining factors leading to improvement in balance and mobility were identified. It paves the ground for further research to study the effect of ankle-foot exercises on fall prevention. Ankle and foot exercises appear to be effective in improving ankle plantarflexion strength, flexibility, and balance performance in an eye-open condition. If you are an older adult who wants to improve your balance, your physical therapist may prescribe ankle and foot exercises as a supplemental component in a fall prevention program due to the observed improvements in balance and the safety and ease of the exercise.

Modulation of neural networks and symptom correlated in fibromyalgia: A randomized double-blind multi-group explanatory clinical trial of home-based transcranial direct current stimulation.

Transcranial direct current stimulation (tDCS) might modulate neural activity and promote neural plasticity in patients with fibromyalgia (FM). This multi-group randomized clinical trial compared home-based active tDCS (HB-a-tDCS) on the left dorsolateral prefrontal cortex (l-DLPFC) or home-based sham tDCS (HB-s-tDCS), and HB-a-tDCS or HB-s-tDCS on the primary motor cortex (M1) in the connectivity analyses in eight regions of interest (ROIs) across eight resting-state electroencephalography (EEG) frequencies. We included 48 women with FM, aged 30 to 65, randomly assigned to 2:1:2:1 to receive 20 sessions during 20 minutes of HB-a-tDCS 2mA or HB-s-tDCS, over l-DLPFC or M1, respectively. EEG recordings were obtained before and after treatment with eyes open (EO) and eyes closed (EC). In the EC condition, comparing pre to post-treatment, the HB-a-tDCS on l-DLPFC decreased the lagged coherence connectivity in the delta frequency band between the right insula and left anterior cingulate cortex (ACC) (t = -3.542, p = .048). The l-DLPFC HB-a-tDCS compared to HB-s-tDCS decreased the lagged coherence connectivity in the delta frequency band between the right insula and left ACC (t = -4.000, p = .017). In the EO condition, the l-DLPFC HB-a-tDCS compared to M1 HB-s-tDCS increased the lagged coherence connectivity between the l-DLPFC and left ACC in the theta band (t = -4.059, p = .048). Regression analysis demonstrated that the HB-a-tDCS effect on the l-DLPFC was positively correlated with sleep quality. On the other hand, the HB-a-tDCS on l-DLPFC and HB-s-tDCS on M1 were positively correlated with pain catastrophizing. These results show that HB-a-tDCS affects the neural connectivity between parts of the brain that control pain's emotional and attentional aspects, which are most noticeable at lower EEG frequencies in a rest state. This effect on neural oscillations could serve as a neural marker associated with its efficacy in alleviating fibromyalgia symptoms. identifier [NCT03843203].

Quantitative EEG and its relationship with attentional control in patients with anxiety disorders.

Attentional control is crucial in the development and maintenance of anxiety disorders. Understanding the underlying mechanisms of attentional control can help to shed light on the neuropathological processes in anxiety disorders (ANX). Quantitative electroencephalography (QEEG) offers a cost-effective, noninvasive method for examining the neuropathological mechanisms of mental disorders. In this study, 67 patients with ANX and 45 healthy controls (HC) were recruited. EEG recordings were obtained for 5 minutes in an eyes-closed condition. QEEG was employed to evaluate the mechanisms of attentional control in ANX. Neurophysiological measures indicated that anxiety patients exhibited a more frontal topographic pattern of theta/beta ratio (TBR) compared to HC. Additionally, a significant decrease in temporal beta power was observed in the ANX group. Correlation analysis revealed that decreased beta power and increased TBR were significant association between attentional control deficits in ANX. These findings provide electrophysiological evidence of impaired attentional control processing in anxiety patients, characterized by decreased temporal beta power and increased frontal TBR. Temporal beta power and frontal TBR may serve as promising biomarkers for attentional control in ANX.