Postural Control Learning Research Articles

Effectiveness of Customized Exergames to Improve Postural Control in High School Physical Education

This study aimed to determine the effectiveness of customized exergames, with different cognitive loads, on static and dynamic postural control compared with traditional exercises in a group of adolescents. The participants in this study were thirty healthy adolescents, aged 12 to 14 years, divided into three groups. Each group trained during two weeks (2 sessions/week) using traditional physical education exercises, exergames with low cognitive loads, or exergames with high cognitive load. Participants' quiet standing, forward limit of stability and pattern tracking were measured before and after the intervention. Neither traditional exercises nor exergames improved postural control during quiet standing tasks. Interactions with customized exergames, with both high and low cognitive loads, provided increased improvements in the forward limit of stability and improved dynamic weight shifts after the intervention compared with traditional exercises. No differences in the effects were observed between exergames with different cognitive loads. Exergames were more effective than traditional exercises for improving the dynamic aspects of postural control and stability in adolescents. The cognitive requirements for the concurrent cognitive task associated with exergames could not be sufficiently demanding to affect postural control learning.

Single-Session Cerebellar Transcranial Direct Current Stimulation Affects Postural Control Learning and Cerebellar Brain Inhibition in Healthy Individuals.

Cerebellar transcranial direct current stimulation (ctDCS) modulates cerebellar activity and postural control. However, the effects of ctDCS on postural control learning and the mechanisms associated with these effects remain unclear. To examine the effects of single-session ctDCS on postural control learning and cerebellar brain inhibition (CBI) of the primary motor cortex in healthy individuals. In this triple-blind, sham-controlled study, 36 participants were allocated randomly to one of three groups: (1) anodal ctDCS group, (2) cathodal ctDCS group, and (3) sham ctDCS group. ctDCS (2mA) was applied to the cerebellar brain for 20min prior to six blocks of standing postural control training (each block consisted of five trials of a 30-s tracking task). CBI and corticospinal excitability of the tibialis anterior muscle were assessed at baseline, immediately after, 1day after, and 7days after training. Skill acquisition following training was significantly reduced in both the anodal and cathodal ctDCS groups compared with the sham ctDCS group. Changes in performance measured 1day after and 7days after training did not differ among the groups. In the anodal ctDCS group, CBI significantly increased after training, whereas corticospinal excitability decreased. Anodal ctDCS-induced CBI changes were correlated with the learning formation of postural control (r = 0.55, P = 0.04). Single-session anodal and cathodal ctDCS could suppress the skill acquisition of postural control in healthy individuals. The CBI changes induced by anodal ctDCS may affect the learning process of postural control.

Postural control learning dynamics in Parkinson\u2019s disease: early improvement with plateau in stability, and continuous progression in flexibility and mobility

BackgroundBalance training improves postural control in Parkinson’s disease (PD). However, a systematic approach for the development of individualized, optimal training programs is still lacking, as the learning dynamics of the postural control in PD, over a training program, are poorly understood.ObjectivesWe investigated the learning dynamics of the postural control in PD, during a balance-training program, in terms of the clinical, posturographic, and novel model-based measures.MethodsTwenty patients with PD participated in a balance-training program, 3 days a week, for 6 weeks. Clinical tests assessed functional balance and mobility pre-training, mid-training, and post-training. Center-of-pressure (COP) was recorded at four time-points during the training (pre-, week 2, week 4, and post-training). COP was used to calculate the sway measures and to identify the parameters of a patient-specific postural control model, at each time-point. The posturographic and model-based measures constituted the two sets of stability- and flexibility-related measures.ResultsMobility- and flexibility-related measures showed a continuous improvement during the balance-training program. In particular, mobility improved at mid-training and continued to improve to the end of the training, whereas flexibility-related measures reached significance only at the end. The progression in the balance- and stability-related measures was characterized by early improvements over the first 3 to 4 weeks of training, and reached a plateau for the rest of the training.ConclusionsThe progression in balance and postural stability is achieved earlier and susceptible to plateau out, while mobility and flexibility continue to improve during the balance training.

Impact of Visual Biofeedback of Trunk Sway Smoothness on Motor Learning during Unipedal Stance.

The assessment of trunk sway smoothness using an accelerometer sensor embedded in a smartphone could be a biomarker for tracking motor learning. This study aimed to determine the reliability of trunk sway smoothness and the effect of visual biofeedback of sway smoothness on motor learning in healthy people during unipedal stance training using an iPhone 5 measurement system. In the first experiment, trunk sway smoothness in the reliability group (n = 11) was assessed on two days, separated by one week. In the second, the biofeedback group (n = 12) and no-biofeedback group (n = 12) were compared during 7 days of unipedal stance test training and one more day of retention (without biofeedback). The intraclass correlation coefficient score 0.98 (0.93–0.99) showed that this method has excellent test–retest reliability. Based on the power law of practice, the biofeedback group showed greater improvement during training days (p = 0.003). Two-way mixed analysis of variance indicates a significant difference between groups (p < 0.001) and between days (p < 0.001), as well as significant interaction (p < 0.001). Post hoc analysis shows better performance in the biofeedback group from training days 2 and 7, as well as on the retention day (p < 0.001). Motor learning objectification through visual biofeedback of trunk sway smoothness enhances postural control learning and is useful and reliable for assessing motor learning.

Rate of concurrent augmented auditory feedback in postural control learning in adolescents

Introduction: The main objective of this study was to determine the rate of auditory concurrent feedback that best enhanced the learning of a continuous postural task in adolescents. Material and methods: A sample of thirty adolescents (13 to 14-years old) was used, who were assigned to three groups: i) control group (CG); ii) 100% auditory feedback group and iii) 67% auditory feedback group. The subjects performed a pre-test, practice, post-test and a retention (24 hours after the practice). In the postural control task subjects were instructed to remain on a seesaw (unstable in anteroposterior position) and keeping it as level as possible. Results: The results demonstrated that concurrent auditory feedback did not enhance the performance of the continuous postural task, although concurrent auditory feedback (both 100% and 67% rates) caused changes to the postural control strategies. Conclusions: From this it was concluded that 100% and 67% concurrent auditory feedback are more recommendable than no-feedback in adolescents’ postural control learning.

Adolescents’ Postural Control Learning According to the Frequency of Knowledge of Process

Feedback is one of the most influential factors for motor skills learning. Physical Education teachers commonly use verbal cues to provide knowledge of process (KP) when teaching motor skills, but the ideal presentation frequency for KP in adolescents is unclear. The aim of this study was to compare the effectiveness of the frequency of KP (i.e., 100%, 67%, 0%) on dynamic balance. Thirty adolescents, age 14–15 years, participated in the study. Performance on a stabilometer platform was used to assess dynamic balance. Participants received feedback after each trial (100%), in two out of three trials (67%), or no feedback during 12 30-s trials of practice. Adolescents who received feedback (67% or 100%) required lower mean velocity to maintain similar dynamic balance performance (i.e., root mean square). Moreover, adolescents receiving 100% feedback had a higher α-scaling than those who did not received it. During the post-test and the retention, both 67% and 100% KP frequencies were effective at improving postural control, compared to the no feedback control.

Effect of Concurrent Visual Feedback Frequency on Postural Control Learning in Adolescents

ABSTRACTThe purpose was to find better augmented visual feedback frequency (100% or 67%) for learning a balance task in adolescents. Thirty subjects were divided randomly into a control group, and 100% and 67% feedback groups. The three groups performed pretest (3 trials), practice (12 trials), posttest (3 trials) and retention (3 trials, 24 hours later). The reduced feedback group showed lower RMS in the posttest than in the pretest (p = 0.04). The control and reduced feedback groups showed significant lower median frequency in the posttest than in the pretest (p < 0.05). Both feedback groups showed lower values in retention than in the pretest (p < 0.05). Even when the effect of feedback frequency could not be detected in motor learning, 67% of the feedback was recommended for motor adaptation.

Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis

Background. Knowledge on mechanisms of neurophysiological control of trunk movement and posture could help in the development of rehabilitation programs and brace treatment in adolescent idiopathic scoliosis (AIS).Aims. Reviewing up-to-date research on neurophysiology of movement and posture control with the aim of providing basis for new researches in the field of AIS rehabilitation and background understanding for clinicians engaged in management of AIS.Methods. Review of literature.Results. We considered several neurophysiological issues relevant for AIS rehabilitation, namely, the peculiar organization of patterns of trunk muscle recruitment, the structure of the neural hardware subserving axial and arm muscle control, and the relevance of cognitive systems allowing mapping of spatial coordinates and building of body schema.Discussion and conclusion. We made clear the reason why trunk control is generally carried out by means of very fast, feedforward or feedback driven patterns of muscle activation which are deeply rooted in our neural control system and very difficult to modify by training. We hypothesized that augmented sensory feedback and strength exercises could be an important stage in a rehabilitation program aimed at hindering, or possibly reversing, scoliosis progression. In this context we considered bracing not only as a corrective biomechanical device but also as a tool for continuous sensory stimulation that could help awareness of body misalignment. Future research aimed at developing strategies of trunk postural control learning is essential in the rehabilitation of adolescent idiopathic scoliosis.

A "wait and learn" strategy of postural control learning in children?

This study compares the children and adult response to a novel postural challenge. One group of children (n=13, age 7-9) and one adult reference group (n=12 age 15-32) were subjected to vibration induced body sway and posturography with both open and closed eyes for 5 consecutive days. There was a gradual decrease of induced body sway over time in both groups (p< 0.001) between the subsequent trials, but only in the adult group was there a reduction of induced body sway over time within each trial (p< 0.05). The children had on a considerably less level of induced body sway when they started the second trial than they finished the first (p< 0.01). There appears to be a different approach of adaptation to a new postural challenge between children and adults.