Postural Control Research Articles

The Impact of Sports Training on the Spinal Cord Injury Individual’s Balance

Spinal cord injury (SCI) causes major challenges to mobility and daily life activities and maintaining balance becomes a crucial issue. Individuals with SCI often need to adopt new strategies to manage balance with minimal discomfort. Sports and physical activities have become one of the most popular rehabilitation methods for people with SCI. The assessment of balance improvement currently relies on subjective evaluation scales, and this study aims to quantitively assess the efficacy of sports on the balance strategies of people with SCI. Twenty-two SCI people remained seated still for 30 s, with their eyes open and closed, and we recorded trunk kinematics with an optoelectronic system before and after a three-months sports program. We also computed trunk total sway length, mean velocity, and sway density curve. Statistical analyses were performed to compare SCI people before and after the rehabilitation program and to investigate any correlations between the trunk balance parameters and the clinical scales. The results demonstrate improvements in static balance, with significant reductions in sway length and mean velocity. In conclusion, our findings confirm the potential of sports to enhance balance in SCI individuals and suggest that integrating structured sports programs into rehabilitation can improve stability and postural control.

Development and validation of a two-dimensional pseudorandom balance perturbation test

IntroductionPseudorandom balance perturbations use unpredictable disturbances of the support surface to quantify reactive postural control. The ability to quantify postural responses to a continuous multidirectional perturbation in two orthogonal dimensions of sway (e.g., AP and ML) has yet to be investigated.MethodsWe developed a balance perturbation paradigm that used two spectrally independent sum of sinusoids signals (SoS1, SoS2), one for each orthogonal dimension of tilt (roll and pitch), to deliver a two-dimensional (2D) balance perturbation. In a group of 10 healthy adults we measured postural sway during 2D perturbations, as well as for each of the two individual 1D perturbation components.ResultsWe found that during 2D perturbations, spectral peaks in the sway response were larger at the perturbed frequencies when compared to (1) the adjacent non-perturbed frequencies and (2) the frequencies contained within the orthogonal, spectrally independent perturbation signal. We also found that for each of the two spectra (SoS1, SoS2), the magnitude and timing of the sway response relative to the platform disturbance was similar when measured during 1D and 2D conditions.DiscussionThese data support that our novel 2D SoS perturbation test was able to evoke ML and AP postural responses that were (1) specific to the roll and pitch perturbations, respectively, and (2) similar to the responses provoked by individual 1D perturbations.

Variability in performance of agility dogs navigating a dynamic obstacle

IntroductionDuring agility performance, dogs complete a preset obstacle course. The teeter, also known as the seesaw, is the only dynamic contact obstacle. Dogs handle dynamic obstacles differently than static obstacles due to the need for increased coordination and postural control. No studies have been performed evaluating dogs’ abilities or biomechanical strategies to navigate the teeter. The goal of this study was to describe and quantify variability in teeter performance across a sample of dogs of differing body mass and breeds.Materials and methodsTwenty dogs of various body masses and breeds were recruited. Handlers were instructed to line their dog up approximately 5 m from the teeter and to handle the obstacle in a way to best reflect the dog’s typical performance. Repetitions were filmed using a GoPro Hero 11 at 240 frames per second. Data were post processed and footfalls were manually tracked using XMALab. Descriptive statistics were used to describe both central tendency and variability.ResultsMean total obstacle completion time (from dog breaking the plane of the teeter until teeter contact with ground) was 1.31 s (sd = 0.38) and mean total footfalls on the teeter was 18.3 (sd = 3.4). Footfall patterns varied across all phases of teeter performance, with particularly noteworthy variation during descent while the teeter was moving. Some dogs were nearly completely stationary while the teeter dropped while others continued to take steps toward the end of the obstacle as the teeter was in motion. Smaller dogs had more total footfalls and longer teeter completion times than larger dogs, and dogs with a stopped contact behavior took longer to fully exit the teeter after it contacted the ground.DiscussionThese data imply that dogs use a variety of biomechanical strategies to perform a dynamic obstacle. Results of this study provide insight into teeter performance and variables that can be utilized for evaluation in future biomechanical studies. This study also provides initial data on biomechanical strategies used by dogs on dynamic surfaces, which may offer insight into dynamic stability and postural control in dogs and how that may influence injury development during sport.

Postural Responses in Trauma-Experienced Individuals

Background: Balance and proprioception are essential elements in postural control and injury prevention. Proprioception, the body’s sense of position and movement, is closely tied to balance, which depends on input from the visual, vestibular, and somatosensory systems. This article explores the link between trauma experiences and proprioceptive dysfunction, emphasizing how heightened muscle tone, dissociation, and altered sensory processing contribute to balance issues and the risk of injury. Method: The study included 48 participants, aged 18–25. Participants completed the Emotional Regulation Scale, Dissociative Experiences Scale II, and Childhood Trauma Questionnaire, after which they had to stand on a BTrackS Balance Plate while being exposed to images that are designed to evoke emotions from the OASIS image set. The balance plate software calculated outcomes of the participants’ postural sway (total sway, sway area, root mean square (RMS) to the mediolateral (ML) and anteroposterior (AP) way, and excursion to ML and AP ways). Results: Dissociative experience shows significant correlation with RMS ML when viewing positive pictures (rτ = 0.207, p = 0.045) and when viewing negative pictures again; scores with RMS ML (rτ = 0.204, p = 0.049) but also with RMS AP (rτ = 0.209, p = 0.042) and with Excursion ML (rτ = 0.200, p = 0.049) were significant. Experiences of physical abuse affected certain indicators of postural sway when viewing positive images compared to participants with no such experience (sway area: U = 374.50, p = 0.027; RMS AP: U = 383.50, p = 0.016; Excursion ML: U = 397.00, p = 0.007). Similarly, physical neglect affected postural sway during viewing of negative images (sway area: U = 366.50, p = 0.003; RMS AP: U = 371.00, p = 0.004; Excursion ML: U = 347.00, p = 0.034; and Excursion AP: U = 353.00, p = 0.010). Conclusions: The study highlights that dissociation disrupts balance in trauma survivors, especially under emotional stress which highlights the potential for motor-based treatments.

The clinical effects of pulsed electromagnetic field therapy for the management of chronic ankle instability: a study protocol for a double-blind randomized controlled trial

BackgroundChronic ankle instability is associated with long-term neuromuscular deficits involving poor postural control and peroneal muscular impairment. Symptoms of chronic ankle instability hinder engagement in physical activity and undermine the patient’s quality of life. Despite the existence of various treatment modalities, none has conclusively provided evidence of clinical effectiveness in counteracting neuromuscular deficits, such as arthrogenic muscle inhibition of the peroneal longus (PL). Pulse electromagnetic field therapy employed as an adjunct biophysical therapy can potentially improve stability by mitigating peroneal muscle weakness and by activating the peroneal muscle. We postulate that by combining standard care (muscle strengthening, balance training, and range of motion exercise) with pulse electromagnetic field therapy, postural control stability and peroneal muscle weakness will significantly improve.MethodsThis is a prospective, randomized, double-blind, placebo-controlled trial. A total of 48 adults with chronic ankle instability will be recruited and randomly allocated into either the intervention or control groups. The intervention group (n = 24) will receive active pulse electromagnetic field therapy and standard exercise training, while the control group (n = 24) will receive sham pulse electromagnetic field therapy and standard exercise training for 8 weeks. Primary and secondary outcomes will be evaluated at baseline, week 4, 8 as well as at 3-, 6-, and 12-month follow-up visits.DiscussionChronic ankle instability is a common debilitating condition without a curative conservative treatment. Investigating different treatment modalities will be essential for improving rehabilitation outcomes in this clinical population. This study will investigate the effectiveness of pulsed electromagnetic field therapy on the functional and clinical outcomes in the chronic ankle instability population. This trial may demonstrate this non-invasive biophysical therapy to be an effective measure to help patients with CAI.Trial registrationClinicalTrials.gov NCT05500885. Registered on August 13, 2022.

The role of cognitive load on interlimb differences in motor coordination in older adults.

While the dominant hand has been shown to have performance advantages over the nondominant hand, these interlimb differences have found to be dependent on task and biomechanical demands. The dynamic dominance hypothesis suggests that the left hemisphere is specialized for the control of intersegmental dynamics while the nondominant right hemisphere is specialized for postural control, in right-handers. In a real-world scenario, however, cognitive challenges might be expected to modulate these specialized behaviors. Therefore, we hypothesized that with increased cognitive load, lateralized motor control processes would become even more asymmetrical. We recruited 16 right-handed older adults (11 females, 5 males; 65.88 years ± 1.99 SEM) to perform 170 trials of a unilateral reaching task with each of their hands on the Kinereach system. In each trial, participants rapidly committed to memory a set of pictorial instructions before identifying and reaching for the correct object on a screen. The complexity of the task increased over the course of the experiment. Our results demonstrated higher reaction times in the right compared to left hand (p = 0.0004). Movements became increasingly curved and erroneous with cognitive load, but interlimb differences in movement quality were absent. We found higher joint cocontraction in the right compared to left arm (p < 0.05), but these differences were unaffected by cognitive load. Hence, with the addition of a cognitive load, we observed asymmetries in reaction time but not in joint coordination or movement quality. This highlights the role of cognitive load in modulating limb/hemisphere specializations for control processes.

Concurrent Cognitive Task Alters Postural Control Performance of Young Adults With Unilateral Cochlear Implants.

The aim of this study was to investigate the balance performances of young adults with unilateral cochlear implants (CIs) in a dual-task condition. Fifteen young adults with unilateral CIs and 15 healthy individuals were included in the study. The balance task was applied using the Sensory Organization Test via Computerized Dynamic Posturography. The Backward Digit Recall task was applied as an additional concurrent cognitive task. In the balance task, participants completed four different conditions, which gradually became more difficult: Condition 1: fixed platform, eyes open; Condition 3: fixed platform, eyes open and visual environment sway; Condition 4: platform sway, eyes open; Condition 6: platform sway, eyes open and visual environment sway. To evaluate the dual-task condition performance, participants were given cognitive and motor tasks simultaneously. Visual (p = .016), vestibular (p < .001), and composite balance scores (p < .001) of CI users were statistically significantly lower than the control group. Condition 3 (p = .003), Condition 4 (p = .007), and Condition 6 (p < .001) balance scores of CI users in the single-task condition were statistically significantly lower than controls. Condition 6 (p < .001) balance scores of CI users in the dual-task condition were statistically significantly lower than the control group. Condition 1 score (p = .002) of the CI users in the dual-task condition showed a statistically significant decrease compared to the balance score in the single-task condition, while the Condition 6 score (p = .011) in the dual-task condition was statistically significantly higher than the balance score in the single-task condition. The balance performance of individuals with CIs in the dual-task condition was worse than typical healthy individuals. It can be suggested that dual-task performances should be included in the vestibular rehabilitation process in CI users in the implantation process in terms of balance abilities in multitasking conditions and risk of falling.

The effects of a four-month skateboarding intervention on motor, cognitive, and symptom levels in children with ADHD

Objectives and methodsThis study aimed to investigate whether a four-month skateboarding workshop can positively affect attention-focusing skills and postural control in terms of static and dynamic balance in addition to symptoms of ADHD in school-aged children (N = 58). Kinematic and kinetic movement analysis, attention-focusing tests as well as symptom questionnaires were employed to measure differences caused by the skateboarding intervention. A weekly skateboarding workshop was conducted with children diagnosed with ADHD which intended to encourage children to autonomously engage in physical activity. Group differences were analyzed using a generalized linear mixed model. A partial correlation was used to investigate possible relationships between the variables.ResultsA preceding analysis confirmed that children with ADHD perform statistically significantly inferior in the employed tests of balance and concentration ability than unaffected peers of the same age. The main analysis showed that after the skateboarding intervention, children with ADHD were able to improve cognitive and motor test performances as well as symptom expression significantly. Significant improvements were likewise found in the waitlist control group, these were however less pronounced compared to those of the skateboarding intervention group. The correlation analysis revealed that there is no reciprocal influence between cognitive and motor skills, nor between motor skills and ADHD symptomatology in the present patient group. Possible explanations are discussed.ConclusionSkateboarding as a form of movement intervention can be considered an effective method for children with ADHD to deal with their symptoms and deficits. An intervention period of four months has helped children with ADHD discover and embrace an informal sport like skateboarding, thereby finding enjoyment in movement and practice a skill from intrinsic motivation. To retain the benefits, it is advisable to practice a sport on a long-term basis. Thorough conceptualizations to implement this type of therapy await further research.

Efficacy of Foot Orthoses With Sensorimotor Bars on Gait, Postural Control, and Muscle Activity in Healthy Individuals and Those With Musculoskeletal Disorders: A Systematic Review

Objectives: The foot and ankle complex is crucial in stability, propulsion, and musculoskeletal interactions. Optimizing orthotic interventions in this anatomical region is essential to improve motor outcomes. This systematic review investigates the impact of foot orthoses (FOs) with sensorimotor bars on gait, postural control, and muscle activity in healthy individuals and those with musculoskeletal disorders. Methods: We conducted an electronic search in January 2024 using the PubMed, Web of Science, and Scopus databases. The article identification, screening, and selection followed the PISMA (the preferred reporting items for systematic reviews and meta-analysis) guidelines. We conducted the quality assessment using the PEDro (the physiotherapy evidence database) checklist. Data extraction and synthesis were performed using the Cochrane handbook for systematic review of interventions. Results: FOs with sensorimotor bars can increase foot external rotation, dorsiflexion, and abduction while decreasing foot eversion. Additionally, they can reduce anteroposterior displacement of the hip, shoulder, and head. Furthermore, significant improvements have been observed in spatiotemporal parameters such as walking speed, stride length, stance time, swing time, and kinetic parameters such as plantar pressure. These orthoses can also impact clinical tasks and decrease center-of-pressure movements. Discussion: Sensorimotor bars have demonstrated beneficial effects on gait (kinematic, kinetic, and spatial-temporal measures), balance control (clinical performance and center of pressure displacement measures), and muscle activity recording.

Age-related differences in postural stability and asymmetries among female rhythmic gymnasts: implications for injury prevention and performance enhancement.

The purpose of this study was to determine age group differences in the postural stability of female rhythmic gymnasts, as well as the asymmetries in postural control between them. A total of 126 female rhythmic gymnasts (aged 6-12 years) were tested. The rhythmic gymnasts were grouped based on their age between 6-8 years (N.=45; young pioneers), 9-10 years (N.=36; pioneers), and 11-12 years (N.=45; cadets). Postural stability and asymmetry were evaluated by the Y-Balance Test (YBT) with both legs (right and left) in three directions: anterior, posteromedial, and posterolateral and Balance Error Scoring System (BESS). Postural stability was analyzed between age categories using the Kruskal-Wallis Test and Dunn's post-hoc test, and the differences in asymmetry were determined by univariate analysis of variance (ANOVA). The young pioneers (age 6-8 years) had a greater number of errors in the single-leg foam stance and tandem foam stance than the 9-10-year-old and 11-12-year-old rhythmic gymnasts (P≤0.005). They also had a greater number of errors in BESS Total scores compared to other age categories (young pioneers 18.42±5.63; pioneers 15.08±4.78 and cadets 13.89±5.61; P≤0.005). Results showed significant differences (P≤0.005) between the young pioneers (age 6-8 years) and the cadets (age 11-12 years) in normalized left and right posteromedial reach direction. No significant differences (P≥0.005) in reach asymmetry were observed among age categories. In conclusion, 6-8-year-old rhythmic gymnasts (young pioneers) should have continuum screening during training and completion development.

The Effect of Indoor Rock-Climbing Exercises (Based on Traversing and Upward Bouldering) on the Postural Control Indicators of the Elderly Men

The Effect of Indoor Rock-Climbing Exercises (Based on Traversing and Upward Bouldering) on the Postural Control Indicators of the Elderly Men

Altered cervical proprioception and biomechanics in obstructive sleep apnea: a case-control study.

This study aimed to compare cervical proprioception and related biomechanical factors among patients with Obstructive Sleep Apnea (OSA) and asymptomatic controls. In this case-control study, polysomnography scores (apnea-hypopnea index-AHI) were examined to determine the disease severity of the OSA group. Also, we evaluated cervical proprioception by using a laser pointer to detect joint repositioning error sense in cervical rotational movements. Comparison statistics were also conducted for the cervical musculoskeletal variables such as range of motion (ROM) with bubble inclinometer, cranio-cervical (CVA), and thoracic posture (TKA) through photometric analysis, neck flexor muscle endurance test, and pain pressure thresholds of trapezius (PPT). This case-control study included 59 male participants: patients with OSA (n = 29; mean age = 49.10 years; mean BMI = 28.41kg/m2) and asymptomatic controls (n = 30; mean age = 49.73 years; mean BMI = 26.89 ± 3.60kg/m2). The mean AHI score was 26.06 events/hour, categorizing the severity of OSA as mild (31.03%), moderate (31.03%), and severe (37.94%). Patients with OSA demonstrated significantly poorer cervical proprioception compared to controls for both sides of cervical rotation with larger effect sizes (d:1.36-1.45; p < 0.05). Also, cervical ROM, CVA, TKA, neck flexor muscle endurance test, and PPT values were altered in the OSA group compared to the control group (p < 0.05). Impaired cervical proprioception may be a previously unrecognized factor associated with OSA. This finding has implications for understanding the mechanisms underlying cervical musculoskeletal changes in OSA and for developing potential new interventions or exercise designs targeting postural control.

Serious Game-Based Balance Training with Augmented Kinesthetic Feedback Enhances Aspects of Postural Control in Poststroke Patients: A Randomized Clinical Trial.

Background: Poststroke hemiparesis presents with motor asymmetry and decreased postural control leading to functional limitations. Serious games (SG) for balance rehabilitation of people with stroke may improve motor recovery, and the visual and auditory feedback provided by the SGs helps to explain the therapeutic benefits. However, the contribution of SG combined with kinesthetic and verbal cues during balance training has not been investigated. The aim of this study is to compare the effects of two feedback conditions for an SG balance intervention, with or without the addition of kinesthetic and verbal cues, on balance performance of people with stroke. Methods: Thirty people with chronic poststroke hemiparesis and balance impairment participated in this randomized controlled trial and performed 14 individual SG training sessions combined with kinesthetic and verbal cues provided by the physical therapist or with SG's feedback only. Outcomes were assessed before training (pre), 1 week after the end of training (post), and 8 weeks after the end of training, which were adopted as the follow-up period, using the Balance Evaluation Systems Test, Lower Limb Subscale of Fugl-Meyer, six-minute walk test, and Stroke-Specific Quality of Life Scale. Results: The results showed that SG combined with kinesthetic and verbal cues improved outcomes relating to lower limb function and some balance domains (biomechanical constraints and limits of stability outcomes) better than with SG's feedback only. Both groups had similar significant improvement in quality of life and long-distance walking performance. Conclusion: This study is the first to directly compare two feedback conditions for SG-based balance intervention. The addition of kinesthetic and verbal cues during the SG balance improved aspects of postural control better than without this form of feedback.

A head-mounted Tilted Reality Device for the treatment of pusher syndrome: a usability study in healthy young and older adults

Pusher syndrome is a disorder of postural control after stroke. Patients show a mismatch in their perception of (almost preserved) visual and (pathologically tilted) postural verticality. In order to reduce this mismatch, we developed a novel head-mounted Tilted Reality Device (TRD). It presents patients visual footage of their actual surroundings but tilted to one side rather than upright. We investigated its usability and possible limitations in its use for the treatment of pusher patients in two samples of healthy participants with an average age of 26.4 years and 63.9 years respectively. Individuals from both age groups showed similar levels of tolerance to prolonged exposure to the tilted visual environment for an average of 40.4 min while walking around in the hospital. The TRD was found to be comfortable and not frustrating whilst wearing, but somewhat challenging in terms of technical handling, particularly for older participants. At the end of the maximally tolerated exposure time participants of both groups experienced some feelings of discomfort, like dizziness or increased stomach awareness, which disappeared rapidly after terminating TRD exposure. Our TRD appears to be a practical device especially for an older population, like pusher patients. While users must be aware of the possibility of side effects, these should be balanced against the benefits of future use for rehabilitation purposes.

Sex-specific poor physical performance in Korean community-dwelling older adults

BackgroundPoor physical performance appears to be different across age and sex. The aim of this study was to examine changes in physical performance across age groups by sex. MethodsA cross-sectional study was conducted with 292 community-dwelling older adults (144 males, 148 females; age: 74.7 ± 5.2 years, body mass index: 23.8 ± 2.7 kg/m2). Physical performance tests included (i) strength (handgrip, knee extension, ankle dorsiflexion, ankle plantarflexion, and toe grip), (ii) functional mobility (5 sit-to-stand, 4-m gait speed, and 4-m fast gait speed), and (iii) postural control (timed single-leg stance). Physical performance was compared across four different age groups by sex using ANOVA tests, T-score, and linear regression analysis. All statistical analysis was set at 0.05. ResultsANOVA showed a significant age effect (p < 0.05) on physical performance measures with only exception for ankle muscle strength. T-score and linear regression analyses revealed sex-specific trends. In males, postural control showed the most significant poor performance, followed by strength. In females, the most notable poor performance was also observed in postural control, followed by functional mobility. ConclusionsMost main outcome measures in physical performance worsened over time across age groups while poor performance pattern was different between older males (strength) and females (functional mobility). We highlighted the importance of assessing strength, functional mobility, and postural control in older adults. Based on observed poor performance patterns across age groups by sex, sex-specific interventions should be implemented.

Leveraging Sensor Technology to Characterize the Postural Control Spectrum

Leveraging Sensor Technology to Characterize the Postural Control Spectrum

Usefulness of Suture-Tape Augmentation Based on Intraoperative Ankle Stress Radiographs During Anatomical Ligament Repair for Chronic Lateral Ankle Instability.

During the modified Broström procedure for chronic ankle instability, surgeons often experience cases with insufficiently restored mechanical stability even after anatomical ligament repair. In these cases, longer postoperative immobilization and delayed rehabilitation can be required, and a risk for recurrence of instability may persist. This study aimed to evaluate the clinical usefulness of suture-tape augmentation based on intraoperative stress radiographs during anatomical ligament repair for chronic ankle instability. Twenty-four patients who underwent additional suture-tape reinforcement because of residual mechanical instability on intraoperative stress radiographs were followed up ≥3 years. Clinical assessment was performed using the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). Changes in mechanical stability were analyzed through periodic stress radiographs, and postural control ability was evaluated with the modified Romberg test. FAOS and FAAM scores improved significantly from preoperative mean 55.1 and 52.4 points to 92.3 and 90.2 points at final follow-up, respectively (P < .001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean 15.8 degrees and 13.6 mm to 2.9 degrees and 4.2 mm, respectively (P < .001). Balance retention time improved significantly from preoperative mean 3.6 to 6.4 seconds (P < .001). Although 9 patients experienced sprain injury after surgery, no patient showed recurrence of mechanical and subjective instability, and 21 patients (87.5%) were able to return to preinjury level of sports activity. Evaluation of residual mechanical instability through intraoperative stress view and additional suture-tape augmentation showed satisfactory clinical outcomes at midterm follow-up. Suture-tape augmentation based on intraoperative stress radiographs seems to be a useful surgical option for patients with insufficiently restored mechanical stability even after anatomical ligament repair. This combined procedure can provide a reliable mechanical stability that can be performed after recognition of residual instability during the index surgery.

Impact of sensory-based therapy on problems with balance and posture in children with cerebral palsy: a systematic review and meta-analysis

ObjectiveThe present systematic review and meta-analysis was intended to evaluate the efficacy of Sensory Integration Therapy (SIT) in ameliorating postural and balance dysfunctions in pediatric populations with cerebral palsy (CP).MethodsAn exhaustive literature search was directed through several well-known systematic databases, including PubMed, Web of Science, Google Scholar, and Scopus, until July 2024. The inclusion criteria targeted studies on sensory integration therapy in children under 18 years diagnosed with CP. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Physiotherapy Evidence Database (PEDro) scale and the Cochrane Risk of Bias-2 (RoB 2.0) were employed to evaluate the methodological rigor and potential bias of the included studies.ResultsSeven randomized controlled trials were selected, encompassing 203 children with CP. The interventions predominantly utilized SIT, focusing on enhancing sensorimotor integration. The findings reveal that sensory-based interventions significantly boost gross motor capabilities and skills, contributing to improved functional mobility and standards of living in CP children. These therapies also facilitate the postural control and active participation in day to day activities.ConclusionSensory-based interventions are efficacious in correcting postural and balance impairments in children with CP. Their integration into comprehensive rehabilitative frameworks is recommended to foster functional autonomy and augment overall developmental outcomes. Future studies should investigate the synergistic effects of these interventions with other therapeutic modalities to maximize rehabilitation efficacy.

The Effects of an 8-Week Cognitive-Motor Training Program on Proprioception and Postural Control Under Single and Dual Task in Older Adults: A Randomized Clinical Trial.

The aim of this study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual task conditions. Design: Randomized clinical trial. Methods: The present study was registered with the ID number NCT04786132. A total of 20 healthy and physically active older adults (73.25 ± 5.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE) and closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants' ability to reposition their dominant knee at 45°. Finally, performance of the cognitive task was measured through a subscale of the Barcelona Test called "categorical evocation in associations". The EG and the CG completed 8-week training programs with two sessions, 30 min per week, of postural control and proprioception exercises. The EG additionally included music in each session. Results: The analysis using a mixed ANOVA model revealed no significant group × time interaction effects (p < 0.05) for any of the assessments. However, a significant main effect for the time factor was observed, with both the control and experimental groups showing improved outcomes in the post-intervention measurements. Specifically, significant results were found for RBOE (F (4,15) = 11.87, p < 0.001, η2p = 0.76), RBCE (F (4,15) = 11.62, p < 0.001, η2p = 0.75), and proprioception (F (1,18) = 11.53, p < 0.003, η2p = 0.39). Conclusions: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music.

Research on the design of posture adjustment structure and control system of carrying robot based on the bionic characteristics of pupae structure

This paper addresses the challenge of incorrect initial positioning of critical patients during lifting and transportation, which can result in secondary injuries due to manual handling. This study proposes a positioning adjustment structure and control strategy for a lifting and transportation robot, inspired by the morphological characteristics of the pupal structure. The positioning adjustment mechanism determines the necessary adjustment values for the patient’s positioning by establishing a human body coordinate system and calculating the difference between the patient’s actual position and the target position. This mechanism achieves optimal positioning by simulating the oscillation of body segments characteristic of the pupal structure. Additionally, this study establishes a dynamic mathematical model for the overall lifting structure and determine its motion parameters. An order for patient body positioning and adjustment is derived based on the twisting amplitude of the human body. A PID controller is designed for the overall transport structure, incorporating optimization through a particle swarm optimization algorithm. This methodology efficiently mitigates excessive overshoot and accelerates convergence towards the target value, significantly minimizing patient discomfort and fluctuation during the positioning procedure.