Postural Control In People Research Articles

Effects of visual disruption on static and dynamic postural control in people with and without chronic ankle instability

IntroductionChronic Ankle Instability (CAI) is a chronic syndrome resulting from repeated ankle sprains that lead to persistent dysfunction.the purpose of this study is to determine whether visual disruption could influence static and dynamic postural control in people with and without chronic ankle instability (CAI), with the objective of gaining a comprehensive understanding of the interactions between visual inputs and postural control.MethodsThirty people with CAI (21 males and 9 females, age = 22.0 ± 1.8 years, height = 174.4 ± 10.2 cm, body mass = 72.5 ± 15.4 kg; Cumberland Ankle Instability Tool (CAIT) score = 19.7 ± 1.8) and twenty-nine without CAI (24 males and 5 females, age = 22.9 ± 1.6 years, height = 172.8 ± 8.0 cm, body mass = 69.0 ± 11.3 kg; CAIT score = 29.0 ± 0.7) were recruited. Their static and dynamic postural control was measured in two conditions with or without visual disruption, simulated using stroboscopic glasses. Static postural control was measured during single-limb standing and represented by root mean square (RMS) of the plantar center of pressure (CoP), dynamic postural control was measured during a Y-balance test and represented by the relative reach distance. Two-way mixed ANOVA (between group: CAI vs non-CAI, within group: normal vision vs visual disruption) was used to analyze data.Results and discussionSignificant interactions were detected in the CoP-RMS in the anteroposterior (AP) (p = 0.021, η2p = 0.090) and mediolateral (ML) (p < 0.001, η2p = 0.208) directions, and the relative reach distances in the posteromedial (PM) p = 0.023, η2p = 0.088) and posterolateral (PL) (p = 0.009, η2p = 0.113) directions, from normal vision to visual disruption. The CoP-RMS in the AP and ML directions significantly increased and the relative reach distances in the PM and PL directions significantly decreased in people with CAI while remaining unchanged in those without CAI. People with CAI are susceptible to visual disruption on postural control, highlighting the importance of visual input in maintaining stable posture in this population.

Levodopa-induced dyskinesia alters postural control in people with Parkinson’s disease

While levodopa is the most effective drug for symptom treatment of Parkinson’s Disease (PD), its long-term use often leads to side effects such as uncontrolled involuntary movements known as levodopa-induced dyskinesia (LID). LID has been shown to increase postural sway, but the extent to which these hyperkinetic movements alter postural sway strategies has not been explored. We recruited 25 people with idiopathic PD, of which 13 exhibit clinical signs of LID, and 10 healthy older adults. Participants performed thirty-second standing trials with no added task (single-task) and with performing a cognitive dual-task, known to provoke dyskinesia. Participants with PD were tested in their practical OFF and ON states. The root-means-square (RMS) accelerations were obtained from inertial sensors attached to the lumbar, trunk, and head. Sway ratios (superior-to-inferior segment) were calculated to determine the effect of LID on postural sway strategies. Participants with LID showed greater RMS head sway, compared to those without LID and older adults. The head-to-trunk sway ratio was greater in participants with LID during the ON state or when dual-tasking. In addition, the head-to-lumbar sway ratio was greater in participants with LID in the ON state during both single- and dual-tasking. Our results reveal an altered postural control strategy in PD with LID, presenting increased sway in superior segments of the kinematic chain, leading to head instability. Unlike PD without LID and older adults, PD with LID exhibit multi-link sway in the ON state, which has important implications for measuring postural sway in the presence of dyskinesias.

INFOGRAPHIC: Changes in locomotor performance and postural control in people with hemophilia

INFOGRAPHIC: Changes in locomotor performance and postural control in people with hemophilia

A cross-sectional study to assess dual-task interference in postural control in people with lower limb amputation

BackgroundIn people with lower limb amputation (LLA), the loss of limb structures and peripheral motor and sensory systems result in significant mobility challenges, including impaired postural stability. ObjectiveThe primary objective of this study was to evaluate the dual-task interference (DTI) on postural control and dual-task interference on cognition during static and dynamic balance in people with LLA and compare the same with controls. The secondary objective of this study was to compare the DTI on postural control and DTI on cognition between LLA of different etiology. DesignCross-sectional observational study MethodologyFifteen people with unilateral LLA and 15 age and gender-matched controls participated in this study at a tertiary care hospital. The outcome measures used were anterior-posterior stability index (APSI), medial-lateral stability index, and overall stability index (OSI) using Biodex Balance System and a cognitive task parameter, namely correct response rate in serial seven subtraction test. Quantitative variables were compared using a Wilcoxon rank-sum test. Spearman's correlation test was used to establish the correlation between the DTI on cognition and the DTI on postural control. ResultsDTI on postural control during static balance was significantly higher in people with LLA than controls (APSI, OSI). No significant difference was observed in DTI on postural control during dynamic balance. No significant difference was observed in DTI on cognition during static and dynamic balance. A significant negative correlation was observed between DTI on cognition and DTI on postural control (APSI) during static balance people with LLA. SignificanceIn people with unilateral LLA, the addition of a cognitive task results in significant deterioration of sagittal plane postural control during static balance but not during dynamic balance due to the over-allocation of resources to a cognitive task.

Generalization of In-Place Balance Perturbation Training in People With Parkinson Disease.

Reactive balance training improves reactive postural control in people with Parkinson disease (PwPD). However, the extent to which reactive balance training generalizes to a novel, unpracticed reactive balance task is unknown. This study aimed to determine whether reactive training stepping through support surface translations can be generalized to an unpracticed, instrumented tether-release task. Twenty-five PwPD (70.52years±7.15; Hoehn and Yahr range 1-3) completed a multiple baseline, open-label, uncontrolled pre-post intervention study. Stepping was trained through a 2-week (6-session) intervention with repeated support surface translations. Performance on an untrained tether-release task (generalization task) was measured at 2 baseline assessments (B1 and B2, 2 weeks apart), immediately after the intervention (P1), and 2 months after training (P2). The tether-release task outcomes were the anterior-posterior margin of stability (MOS), step length, and step latency during backward and forward steps. After support surface translation practice, tether-release stepping performance improved in MOS, step length, and step latency for both backward and forward steps compared to baseline ( P <0.05). Improvements in MOS and step length during backward and forward steps in the tether-release task, respectively, were related to stepping changes in the practiced task. However, the improvements in the generalization task were not retained for 2 months. These findings support short-term generalization from trained balance tasks to novel, untrained tasks. These findings contribute to our understanding of the effects and generalization of reactive step training in PwPD. for more insights from the authors (see the Video, Supplemental Digital Content available at http://links.lww.com/JNPT/A465 ).

Analysis of the centre of pressure in bipedal stance among individuals with and without intellectual disabilities, individuals with Down syndrome and dancers with Down syndrome.

Individuals with intellectual disabilities (IDs) often present deficiencies in motor, balance and postural control. On the other hand, the practice of physical activity and dance usually reduces these deficiencies. Therefore, in this study, we aimed to compare the control of the centre of pressure (COP) in people with Down syndrome (DS) or other causes of ID in relation to people without disabilities and to observe the influence of vision and the practice of dance. This cross-sectional study analyses the COP in a static standing position with open and closed eyes in four study groups. A total of 273 people were recruited (80 adults without ID, 46adults with DS, 120 adults with other causes of ID and 27 dancers with DS). A greater area of oscillation and path of the COP was observed in the participants with ID compared with the participants without ID, especially in the sway area of the COP. The oscillation speed of the COP was also higher. When analysing the displacement of the COP, anteroposterior and mediolateral components, there were also differences, except when comparing the group of dancers with DS with respect to the group without ID. The visual condition only influenced the group of participants without disabilities. The results of our study show that there is a less efficient static postural control in people with ID, as greater displacements were observed in the COP of the participants with ID. The differences in some specific variables that analyse the displacement of the COP were smaller when comparing the group of dancers with DS and the individuals without ID.

Evaluation of the Effect of Balance Training on Postural Control in People with Chronic Ankle Instability Against External Disturbances

Objectives: Ankle sprain leads to a decrease in proprioception and awareness of the sense of motion with motor consequences. On the other hand, damage to this joint is an important factor in affecting balance and consequently re-injury. Strengthening the factors that help maintain balance and posture, can be a basic strategy in the treatment of balance and postural problems, as well as injuries.&#x0D; Methods: In this quasi-experimental study, 30 patients with chronic ankle instability were randomly divided into experimental and control groups. Both groups were pre-tested and the experimental group performed core stability exercises against gravity for six weeks. Post-test was taken again from both groups. Data were analyzed using one-way analysis of covariance. Statistical operations were performed at a significant level of α ≤ 0.05.&#x0D; Results: Postural control index in the experimental group was higher in the first position and lower than the other in the sixth position. The mean of the postural control index in the experimental group was significant compared to the control group (α ≤ 0.05).&#x0D; Conclusion: Performing exercises for core stability or training on unstable surfaces deploying sensory receptors is likely to cause the muscles to be more actively involved and the central nervous system to receive more appropriate and effective stimuli from the nerves of different sensory receptors, and thus this exercises improve postural stability.

A non-expensive bidimensional kinematic balance assessment can detect early postural instability in people with Parkinson's disease.

BackgroundPostural instability is a debilitating cardinal symptom of Parkinson’s disease (PD). Its onset marks a pivotal milestone in PD when balance impairment results in disability in many activities of daily living. Early detection of postural instability by non-expensive tools that can be widely used in clinical practice is a key factor in the prevention of falls in widespread population and their negative consequences.ObjectiveThis study aimed to investigate the effectiveness of a two-dimensional balance assessment to identify the decline in postural control associated with PD progression.MethodsThis study recruited 55 people with PD, of which 37 were men. Eleven participants were in stage I, twenty-three in stage II, and twenty-one in stage III. According to the Hoehn and Yahr (H&amp;amp;Y) rating scale, three clinical balance tests (Timed Up and Go test, Balance Evaluation Systems Test, and Push and Release test) were carried out in addition to a static stance test recorded by a two-dimensional movement analysis software. Based on kinematic variables generated by the software, a Postural Instability Index (PII) was created, allowing a comparison between its results and those obtained by clinical tests.ResultsThere were differences between sociodemographic variables directly related to PD evolution. Although all tests were correlated with H&amp;amp;Y stages, only the PII was able to differentiate the first three stages of disease evolution (H&amp;amp;Y I and II: p = 0.03; H&amp;amp;Y I and III: p = 0.00001; H&amp;amp;Y II and III: p = 0.02). Other clinical tests were able to differentiate only people in the moderate PD stage (H&amp;amp;Y III).ConclusionBased on the PII index, it was possible to differentiate the postural control decline among the first three stages of PD evolution. This study offers a promising possibility of a low-cost, early identification of subtle changes in postural control in people with PD in clinical practice.

Investigating the Effects of High-arch and Flat Foot Deformities on Postural Control: A Systematic Review and Meta-analysis

Introduction: High-arch and flat foot deformities can negatively impact an individual’s performance in different situations. They may also balance as well as disturb postural control, which is essential for performing optimal routine and port activities, in addition to preventing injuries. This is a comparative meta-analysis of postural control in people with high-arch and flat foot deformities with normal feet.&#x0D; Materials and Methods: This is a systematic review of articles published from 2004 to 2021 in Medline/PubMed, Embase/Scopus, LILACS, CINAHL, CENTRAL (cochrane central register of controlled trials), Web of Science, PEDro, and Google Scholar databases.&#x0D; Results: The results revealed that the total balance score in people with high-arch and flat foot deformities was lower (P=0.001), compared to normal people. However, no significant difference was observed in the total balance of people with high-arch and flat foot deformities (P&gt;0.05). Additionally, flat-foot people showed a weaker balance in the postural control test on a force plate, when compared to individuals with high-arch feet (P=0.001). Nevertheless, the results of dynamic balance were the same for all groups (P&gt;0.05).&#x0D; Conclusion: Our findings indicate that people with high-arch and flat foot deformities suffer from weaker postural control when compared to their normal peers. Moreover, flat-foot people showed lower scores on postural control tests on force plates, compared to subjects with higharch feet, even though they had no significant differences for static and dynamic tests. There was no difference in the results of dynamic balance among the 3 groups.

Transcranial direct current stimulation suggests not improving postural control during adapted tandem position in people with Parkinson's disease: A pilot study

BackgroundBalance impairments in people with Parkinson's disease (PD) demonstrated mainly in challenging postural tasks, such as increased body oscillation may be attributed to the deficits in the brain structures functionality involved in postural control (e.g., motor cortex, midbrain, and brainstem). Although promising results, the effect of transcranial direct current stimulation (tDCS) on postural control in people with PD is unclear, especially in objective measures such as the center of pressure (CoP) parameters. Thus, we analyzed the effects of a single session of tDCS on the CoP parameters during the adapted tandem position in people with PD. MethodsNineteen people with PD participated in this crossover, randomized, and double-blind study. Anodal tDCS was applied over the primary motor cortex in two conditions of stimulation (2 mA/active and sham) on two different days for 20 min immediately before the postural control evaluation. Participants remained standing in an adapted tandem position for the postural control assessment for 30 s (three trials). CoP parameters were acquired by a force plate. ResultsNo significant differences were demonstrated between stimulation conditions (p-value range = 0.15–0.89). ConclusionsOur results suggested that a single session of tDCS with 2 mA does not improve the postural control of people with PD during adapted tandem.

Effects of Tai Chi on Postural Control in People with Peripheral Neuropathy: A Systematic Review with Meta-Analysis.

Effects of Tai Chi on people with peripheral neuropathy (PN) are not yet apparent. This systematic review was conducted to evaluate the effects of Tai Chi on postural control in people with PN. Literature was screened in seven databases for relevant randomized controlled trials. The reports and methodological quality were evaluated. A meta-analysis was performed using RevMan5.4 software. Ten reports were included, involving a total of 344 subjects. The meta-analysis found that Tai Chi therapy for people with PN resulted in a smaller sway area, in the double-leg stance with eyes closed test (SMD = -2.43, I2 = 0%), than that observed in the control group, greater distance covered in the six-minute walking test (SMD = -0.46, I2 = 49%) and faster performance in the timed-up-and-go test (SMD = 0.68, I2 = 50%), than the baseline. Tai chi effectively enhanced dynamic postural control in people with PN. However, no better effects on postural control from Tai Chi than from other rehabilitation approaches were observed in this study. Further high-quality trials are needed to better understand Tai Chi's effects on individuals with PN.

The feasibility of using an auditory cue to elicit anticipatory postural adjustments for a posterior perturbation

When humans are exposed to a predictable external perturbation, they usually generate anticipatory postural adjustments (APAs), which reduce the effect of potential body disturbance. However, when an external perturbation comes from behind and as such unpredicted, no APAs are generated, which challenges postural control. The aim of this study was to examine whether humans exposed to unpredictable perturbations could generate APAs using an auditory cue. Ten young adults were exposed to external perturbations hitting their shoulders from behind with or without an auditory cue prior to the physical impact. Electromyography (EMG) activities of eight trunk and leg muscles and center-of-pressure (COP) displacements were recorded and analyzed during the anticipatory and compensatory phases of postural control. Outcome measures included the latencies and integrals of muscle activities, COP displacements, and indices of co-contraction and reciprocal activation of muscles. The results showed that young adults were able to rely on an auditory cue to generate APAs prior to external perturbations coming from behind, and they demonstrated stronger APAs with training. Moreover, they utilized co-contraction of ventral and dorsal muscles as their APA response. The outcome provides a foundation for future studies aiming at using auditory cues to facilitate the generation of APAs and improve postural control in people with impaired balance while exposed to perturbations.

뇌성마비인에서 자세조절 증진 중재프로그램의 효과 : 메타분석

This study is to verify the effects of various physical therapies to improve postural control which is necessary for safe and independent daily life in people with cerebral palsy. For this, meta-analysis was completed on related studies published in Korea. A systematic search was performed using 5 electric database to collect articles. Group experiment designs were included. Studies were classified into 4 categories: neurodevelopmental treatment, task oriented approach, therapeutic exercise, and neuromuscular stimulation. Outcomes included dynamic balance, static balance, and motor function. A total of 30 trials was included among initial 380 studies. Neurodevelopmental treatment, task oriented approach, therapeutic exercise, and neuromuscular stimulation significantly improved postural control, but there were no difference between therapies(p>.05). These treatments not only had a positive effect on the improvement of dynamic and static balance, but also had a positive effect on muscle function. The effect size of various physical therapies for postural control in people with cerebral palsy was medium and significant. Based on this meta-analysis, sufficient intervention time can be helpful for more effective postural control intervention.

Efficacy of nGVS to improve postural stability in people with Bilateral Vestibulopathy

Bilateral vestibulopathy occurs when the neural signals from the balance organs (vestibular apparatus) to the brain are weak. This leads to imbalance and blurry vision during head movements (Fujimoto et al., 2019). To date, there are few successful treatment options once damage has occurred (Hain et al., 2018). Noisy galvanic vestibular stimulation (nGVS) is a non-invasive electrical stimulation, delivered at a low level to the vestibular system. When used to boost the weak physiological signal from the vestibular system nGVS has the potential to restore absent vestibular information and improve balance (Dlugaiczyk et al., 2019). This presentation will include the results of my systematic literature review and meta-analysis, examining the evidence for the use of nGVS as a means of improving postural control in people with bilateral vestibulopathy and discussing how these results will inform my research. A comprehensive systematic search of five databases up to July 2022 was performed. The search identified studies applying nGVS to people with bilateral vestibulopathy, with the aim of improving their postural control. Two independent reviewers screened and identified eligible studies, completed a Cochrane risk of bias evaluation, and extracted relevant data. Seven studies met the eligibility criteria with 5 studies being suitable for meta-analysis. The standardized mean difference (SMD) based on Hedges’ g was calculated as a measure of effect size, for the primary outcome measure that best identified postural control, and a forest plot generated. Meta-analysis found that nGVS improved postural control during standing and walking (pooled SMD = 0.47 95% CI, [0.25, 0.7]). nGVS-mediated improvements in postural control were most evident standing on a firm surface with eyes closed, and in measures of lateral stability during gait. Identifying that nGVS is effective in people with bilateral vestibulopathy, and that the efficacy is context-specific, will help inform the development of treatments for people with bilateral vestibulopathy.

Perturbation-based Balance Training to improve postural responses and falls in people with multiple sclerosis: a randomized controlled trial

Purpose To determine the effects of Perturbation-based Balance Training (PBT) on postural responses and falls in people with multiple sclerosis (PwMS) and compare the results with conventional balance training (CBT). Materials and methods Thirty-four PwMS were randomized to receive 4 weeks of PBT or CBT. Latency of postural responses to external perturbations, Timed-Up-and-Go (TUG), 10-meter-walk (10MW), Berg Balance Scale (BBS), and Activities-specific Balance Confidence Scale (ABC) were measured at baseline and post-training. Also, the proportion of fallers and fall rate were assessed at a 3-month follow-up. Results The latency of postural responses significantly decreased in PBT compared to CBT. TUG, 10MW, BBS, and ABC, at post-training, and relative risk of falls and fall rate at 3-month follow-up had no statistically significant between-group differences. Conclusions The results show that PBT is at least as effective as CBT in improving balance and decreasing falls, while it has superiority over CBT whenever the clinicians mainly aim to improve reactive balance strategies. Future studies with a larger sample size are warranted to complement the results of this study. Implication for rehabilitation Perturbation-based Balance Training is at least as effective as conventional balance training (CBT) in improving proactive postural control in people with multiple sclerosis (PwMS). Perturbation-based Balance Training has superiority over CBT in improving reactive postural control in PwMS. Perturbation-based Balance Training has no superiority over CBT in improving fall-related outcomes.

Efficacy of nGVS to improve postural stability in people with bilateral vestibulopathy: A systematic review and meta-analysis

ObjectiveNoisy galvanic vestibular stimulation (nGVS) has been used to boost vestibular afferent information to the central nervous system. This has the potential to improve postural control for people for whom vestibular signals are weak, such as in bilateral vestibulopathy (BVP). The aim of this systematic review and meta-analysis is to investigate the evidence for nGVS as a modality to improve postural control in people with BVP.MethodsA comprehensive systematic search was conducted of five databases up to July 2022 to find studies applying nGVS to people with BVP, with the aim of improving postural control. Two independent reviewers screened and identified eligible studies, completed a risk of bias evaluation (Cochrane) and extracted relevant data. The standardized mean difference (SMD) based on Hedges' g was calculated as a measure of effect size for the primary outcome measure that best identified postural control, and a forest plot generated.ResultsSeven studies met the eligibility criteria, with five being suitable for meta-analysis. Meta-analysis revealed a moderate effect in favor of nGVS improving postural control during standing and walking [pooled SMD = 0.47 95% CI (0.25, 0.7)]. nGVS-mediated improvements in postural control were most evident in observations of reduced sway velocity when standing on a firm surface with eyes closed, and in the reduced variability of gait parameters, particularly those measuring lateral stability.ConclusionsCoincident nGVS in people with BVP improves postural control during standing and walking. This improvement appears to be context specific, in that vestibular augmentation is most effective in situations where visual inputs are limited, and where reliable context specific proprioceptive cues are available. Further research is warranted investigating additional circumstances in which nGVS improves postural control, including investigating the residual, and sustained effects of nGVS.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=342147, identifier: 342147.

Resting state functional networks predict different aspects of postural control in Parkinson’s disease

BackgroundParkinson’s disease (PD) is a neurodegenerative disorder causing postural control impairments. Postural control involves multiple domains, such as control of postural sway in stance, automatic postural responses (APRs) and anticipatory postural adjustments (APAs). We hypothesize that impairments in each postural domain is associated with resting-state functional connectivity (rsFC), accounted by predictive modeling and that cortical and cerebellar networks would predict postural control in people with PD (PwPD). ObjectiveTo determine whether rsFC can predict three domains of postural control independently in PwPD and older adults (OA) based on predictive accuracy of models. MethodsThe cohort consisted of 65 PwPD (67.7 +8.1 age) tested in their OFF-state and 42 OA (69.7 +8.2 age). Six body-worn, inertial sensors measured postural sway area while standing on foam, step length of APRs to a backward push-and-release perturbation, and magnitude of lateral APAs prior to voluntary gait initiation. Resting state-fMRI data was reported on 384 regions of interest that were grouped into 13 functional brain networks. Associations between rsFC and postural metrics were characterized using predictive modeling, with an independent training (n = 67) and validation (n = 40) dataset. Models were trained in the training sample and performance of the best model was validated in the independent test dataset. ResultsrsFC of different brain networks predicted each domain of postural control in PD: Frontoparietal and Ventral Attention rsFC for APAs; Cerebellar-Subcortical and Visual rsFC and Auditory and Cerebellar-Subcortical rsFC for APRs; Ventral Attention and Ventral Multimodal rsFC for postural sway. In OA, CinguloOpercular and Somatomotor rsFC predicted APAs. ConclusionsOur findings suggest that cortical networks predict postural control in PD and there is little overlap in brain network connectivities that predict different domains of postural control, given the rsFC methodology used. PwPD use different cortical networks for APAs compared to OA.

Effects on intermittent postural control in people with Parkinson's due to a dual task.

The aim of the present study was to determine the effects of performing a dual task on the sway density plot parameters in Parkinson's disease and control subjects. A cross-sectional design was used to establish differences in the mean peak, mean time, and mean distance between a group with Parkinson's disease and a control group without Parkinson's disease. The subjects performed, in a unique measurement session, two trials under three different randomized conditions: i. eyes open, ii. eyes closed, and iii. Eyes open with foam base. One trial was performed as a single task (i.e., the subjects completed one of the balance test), while the other trial was performed as a dual task (i.e., the subjects performed a cognitive task at the same time that they maintained the static balance). There was a group x dual task x condition effect in mean peak (F1.5, 51.1=5.21; p=0.015; η2p=0.13) and mean time (F1.4, 47.3=4.43; p=0.03; η2p=0.11) variables. According dual-task cost analysis, there was a main effect of the condition (F6,134=2.44; p=0.05; η2p=0.34) on MD (F2,68=6.90; p<0.01; η2p=0.17). This result indicates differences in the dual task interference in the postural control mechanisms between the Parkinson's disease population and healthy pairs. For easy dual tasks, the Parkinson subjects used anticipatory control responses for longer periods of time, and for more difficult tasks, their control strategy did not change regarding single balance task.

ASSESSMENT OF POSTURAL CONTROL AND GAIT IN LATE POST-STROKE PATIENTS SUBJECTED TO TREADMILL TRAINING WITH CONTROLLED BODY BALANCE PERTURBATIONS. PILOT STUDY

Introduction One of the basic goals of post-stroke rehabilitation is the improvement of postural control and gait quality. Modern post-stroke rehabilitation implements treadmill training with controlled body balance perturbations (PBT). Aim This study aimed to assess the influence of the PBT treadmill training on activities of daily living (ADL), gait quality and postural control in people with chronic stroke. Methods Seventeen patients with stroke hospitalized in a rehabilitation centre were randomly allocated to 3-week PBT training. Functional independence was assessed using Fugl-Meyer Motor Assessment (FMA). ADL were assessed using Barthel Scale. Static and dynamic postural control was assessed using Berg Balance Scale (BBS), Timed Up And Go Test (TUG) and Functional Reach Test (FRT). Static postural control was assessed using stabilometric platform tests (Alfa and Gamma, Ac International East, Poland). The 10-meter walk test was used to evaluate gait. Spatial, temporal gait parameters were also assessed using the MyoMotion (Noraxon, USA). Results A significant improvement was found in the patients’ motor functions (FMA; p = 0.01), independence in daily activities (Barthel Scale; p = 0.01), static and dynamic balance (BBS; p = 0.01). There was no statistically significant improvement in the dynamic balance (TUG; p = 0.15; and FRT; p = 0.19). Conclusions Inclusion of perturbation training during rehabilitation of patients with chronic stroke improved ADL, gait quality and postural control.

Strength, Flexibility and Postural Control of the Trunk and Lower Body in Participants with and without Patellofemoral Pain

Patellofemoral pain (PFP) is a frequent knee condition. The aim of this study was to investigate strength, flexibility and postural control in people with and without PFP. Fifty-five participants between 14 and 54 years of age (PFP = 18, control group = 37) were included. Strength and flexibility for all trunk, hip, knee and ankle muscle groups were measured along with postural control outcomes. Analyses were conducted based on the “affected” and “non-affected” leg within-group and between-groups. Between-groups analysis demonstrated a statistically lower strength of trunk muscles (range: 35.8–29.3%, p &lt; 0.001), knee extensors (20.8%, p = 0.005) and knee flexors (17.4%, p = 0.020) in PFP participants. Within-group analysis proved an 8.7% (p = 0.018) greater hip internal rotation strength and ankle extension flexibility (p = 0.032) of the “affected side” in PFP participants. This was, to our knowledge, the first study to investigate the strength of all trunk muscle groups. The results indicate that participants with PFP exhibit impaired strength of trunk muscle groups, along with knee muscle deficits, which may present a rehabilitation target. Clinicians should consider implementing trunk strengthening exercises into PFP programs along with knee-targeting exercise programs.